Is hard physical work in the early working life associated with back pain later in life? A cross-sectional study among 5700 older workers

Rúni Bláfoss, Sebastian Venge Skovlund, Rubén López-Bueno, Joaquin Calatayud, Emil Sundstrup, Lars L Andersen, Rúni Bláfoss, Sebastian Venge Skovlund, Rubén López-Bueno, Joaquin Calatayud, Emil Sundstrup, Lars L Andersen

Abstract

Objectives: Physically demanding work increases the risk of developing musculoskeletal disorders during working life, with low back pain (LBP) as the most prevalent and debilitating musculoskeletal disorder worldwide. However, a lack of knowledge exists about the role of early working years on musculoskeletal health later in life. This study investigated whether an exposure-response association exists between physical demands in early working life and risk of LBP in later working life.

Design: Cross-sectional study.

Setting, participants and outcome measure: In the SeniorWorkingLife study, 5909 wage earners aged ≥50 years with currently sedentary work replied to a questionnaire survey in 2018 about physical work demands during their first working years (exposure) and current LBP (outcome). Associations between physical work demands in the early working years and current LBP were modelled using general linear models controlling for various confounders, combined with model-assisted weights based on national registers.

Results: Hard physical work during early working life was associated with more intense LBP later in life among senior workers with currently sedentary jobs. In the fully adjusted model, workers with 'standing/walking work with lifting/carrying' and 'heavy or fast work that is physically strenuous' during the first years of working life reported higher LBP intensity than those with sedentary work during their first working years (0.2 (95% CI, 0.0 to 0.4) and 0.6 (95% CI, 0.4 to 0.9), respectively).

Conclusion: Work involving lifting/carrying or work that is physically strenuous in early life is associated with higher intensity of LBP among older workers with currently sedentary employment. These findings suggest that early working life may have an impact on later working years and underscore the necessity for careful introduction and instruction to the working environment for retaining musculoskeletal health and prolonging working life.

Trial registration number: NCT03634410.

Keywords: back pain; musculoskeletal disorders; occupational & industrial medicine; public health.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

References

    1. Danish agency for labour market and recruitment (StAR) Folkepensionsalderen nu OG fremover. Available: [Accessed 4 Feb 2020].
    1. Lauretani F, Russo CR, Bandinelli S, et al. . Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol 2003;95:1851–60. 10.1152/japplphysiol.00246.2003
    1. Anton SD, Woods AJ, Ashizawa T, et al. . Successful aging: advancing the science of physical independence in older adults. Ageing Res Rev 2015;24:304–27. 10.1016/j.arr.2015.09.005
    1. Liguori I, Russo G, Aran L, et al. . Sarcopenia: assessment of disease burden and strategies to improve outcomes. Clin Interv Aging 2018;13:913–27. 10.2147/CIA.S149232
    1. Aversa Z, Zhang X, Fielding RA, et al. . The clinical impact and biological mechanisms of skeletal muscle aging. Bone 2019;127:26–36. 10.1016/j.bone.2019.05.021
    1. Kenny GP, Yardley JE, Martineau L, et al. . Physical work capacity in older adults: implications for the aging worker. Am J Ind Med 2008;51:610–25. 10.1002/ajim.20600
    1. European Agency for Safety and Health at Work Work-related musculoskeletal disorders: prevalence, costs and demographics in the EU - European risk observatory report. European Agency for Safety and Health at Work, 2019.
    1. Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ 2003;81:646–56.
    1. Hoy D, Bain C, Williams G, et al. . A systematic review of the global prevalence of low back pain. Arthritis Rheum 2012;64:2028–37. 10.1002/art.34347
    1. Weinstein SL. The burden of musculoskeletal conditions. J Bone Joint Surg Am 2016;98:1331. 10.2106/JBJS.16.00595
    1. GBD 2015 Disease and Injury Incidence and Prevalence Collaborators Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the global burden of disease study 2015. Lancet 2016;388:1545–602. 10.1016/S0140-6736(16)31678-6
    1. Hartvigsen J, Hancock MJ, Kongsted A, et al. . What low back pain is and why we need to pay attention. Lancet 2018;391:2356–67. 10.1016/S0140-6736(18)30480-X
    1. Kuiper JI, Burdorf A, Verbeek JHAM, et al. . Epidemiologic evidence on manual materials handling as a risk factor for back disorders:a systematic review. Int J Ind Ergon 1999;24:389–404. 10.1016/S0169-8141(99)00006-2
    1. da Costa BR, Vieira ER. Risk factors for work-related musculoskeletal disorders: a systematic review of recent longitudinal studies. Am J Ind Med 2010;53:285–323. 10.1002/ajim.20750
    1. Coenen P, Gouttebarge V, van der Burght ASAM, et al. . The effect of lifting during work on low back pain: a health impact assessment based on a meta-analysis. Occup Environ Med 2014;71:871–7. 10.1136/oemed-2014-102346
    1. Lallukka T, Viikari-Juntura E, Viikari J, et al. . Early work-related physical exposures and low back pain in midlife: the cardiovascular risk in young Finns study. Occup Environ Med 2017;74:163–8. 10.1136/oemed-2016-103727
    1. Heuch I, Heuch I, Hagen K, et al. . Physical activity level at work and risk of chronic low back pain: a follow-up in the Nord-Trøndelag health study. PLoS One 2017;12:e0175086. 10.1371/journal.pone.0175086
    1. National Research Centre for the Working Environment (NRCWE) Work environment & health in Denmark, 2018. Available: [Accessed 03 Dec 2020].
    1. Merkus SL, Lunde L-K, Koch M, et al. . Physical capacity, occupational physical demands, and relative physical strain of older employees in construction and healthcare. Int Arch Occup Environ Health 2019;92:295–307. 10.1007/s00420-018-1377-5
    1. Oakman J, Clays E, Jørgensen MB, et al. . Are occupational physical activities tailored to the age of cleaners and manufacturing workers? Int Arch Occup Environ Health 2019;92:185–93. 10.1007/s00420-018-1364-x
    1. European Agency for Safety and Health at Work OSH in figures: work-related musculoskeletal disorders in the EU - Facts and figures. Luxembourg: Office for Official Publ. of the Europ. Communities, 2010.
    1. Sundstrup E, Hansen Åse Marie, Mortensen EL, et al. . Cumulative occupational mechanical exposures during working life and risk of sickness absence and disability pension: prospective cohort study. Scand J Work Environ Health 2017;43:415–25. 10.5271/sjweh.3663
    1. Sundstrup E, Hansen Åse Marie, Mortensen EL, et al. . Retrospectively assessed physical work environment during working life and risk of sickness absence and labour market exit among older workers. Occup Environ Med 2018;75:114–23. 10.1136/oemed-2016-104279
    1. Pedersen J, Schultz BB, Madsen IEH, et al. . High physical work demands and working life expectancy in Denmark. Occup Environ Med 2020;77:576–82. 10.1136/oemed-2019-106359
    1. Andersen LL, Sundstrup E. Study protocol for SeniorWorkingLife - push and stay mechanisms for labour market participation among older workers. BMC Public Health 2019;19:133. 10.1186/s12889-019-6461-6
    1. Andersen LL, Jensen PH, Meng A, et al. . Strong labour market inequality of opportunities at the workplace for supporting a long and healthy work-life: the SeniorWorkingLife study. Int J Environ Res Public Health 2019;1610.3390/ijerph16183264
    1. von Elm E, Altman DG, Egger M, et al. . The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 2008;61:344–9. 10.1016/j.jclinepi.2007.11.008
    1. Bláfoss R, Micheletti JK, Sundstrup E, et al. . Is fatigue after work a barrier for leisure-time physical activity? cross-sectional study among 10,000 adults from the general working population. Scand J Public Health 2019;47:383–91. 10.1177/1403494818765894
    1. Bláfoss R, Sundstrup E, Jakobsen MD, et al. . Are insomnia type sleep problems associated with a less physically active lifestyle? A cross-sectional study among 7,700 adults from the general working population. Front Public Health 2019;7:117. 10.3389/fpubh.2019.00117
    1. Alghadir AH, Anwer S, Iqbal A, et al. . Test-retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. J Pain Res 2018;11:851–6. 10.2147/JPR.S158847
    1. Shiri R, Karppinen J, Leino-Arjas P, et al. . The association between smoking and low back pain: a meta-analysis. Am J Med 2010;123:87.e7–35. 10.1016/j.amjmed.2009.05.028
    1. Hoy D, Brooks P, Blyth F, et al. . The epidemiology of low back pain. Best Pract Res Clin Rheumatol 2010;24:769–81. 10.1016/j.berh.2010.10.002
    1. Clausen T, Andersen LL, Holtermann A, et al. . Do self-reported psychosocial working conditions predict low back pain after adjustment for both physical work load and depressive symptoms? A prospective study among female eldercare workers. Occup Environ Med 2013;70:538–44. 10.1136/oemed-2012-101281
    1. Shiri R, Falah-Hassani K. Does leisure time physical activity protect against low back pain? systematic review and meta-analysis of 36 prospective cohort studies. Br J Sports Med 2017;51:1410–8. 10.1136/bjsports-2016-097352
    1. Pejtersen JH, Kristensen TS, Borg V, et al. . The second version of the Copenhagen psychosocial questionnaire. Scand J Public Health 2010;38:8–24. 10.1177/1403494809349858
    1. Pincus T, Bergman M, Sokka T, et al. . Visual analog scales in formats other than a 10 centimeter horizontal line to assess pain and other clinical data. J Rheumatol 2008;35:1550–8.
    1. Salaffi F, Stancati A, Silvestri CA, et al. . Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale. Eur J Pain 2004;8:283–91. 10.1016/j.ejpain.2003.09.004
    1. Haefeli M, Elfering A. Pain assessment. Eur Spine J 2006;15:S17–24. 10.1007/s00586-005-1044-x
    1. Øverås CK, Villumsen M, Axén I, et al. . Association between objectively measured physical behaviour and neck- and/or low back pain: a systematic review. Eur J Pain.
    1. Andersen LL, Clausen T, Burr H, et al. . Threshold of musculoskeletal pain intensity for increased risk of long-term sickness absence among female healthcare workers in eldercare. PLoS One 2012;7:e41287. 10.1371/journal.pone.0041287
    1. Aagaard P, Suetta C, Caserotti P, et al. . Role of the nervous system in sarcopenia and muscle atrophy with aging: strength training as a countermeasure. Scand J Med Sci Sports 2010;20:49–64. 10.1111/j.1600-0838.2009.01084.x
    1. Podsakoff PM, MacKenzie SB, Lee J-Y, et al. . Common method biases in behavioral research: a critical review of the literature and recommended remedies. J Appl Psychol 2003;88:879–903. 10.1037/0021-9010.88.5.879

Source: PubMed

3
購読する