Sociodemographic differences in low back pain: which subgroups of workers are most vulnerable?
Humans
Low Back Pain
/ epidemiology
Male
Female
Adult
Middle Aged
Prevalence
Occupational Diseases
/ epidemiology
Young Adult
Sex Factors
Age Factors
Vulnerable Populations
/ statistics & numerical data
Brazil
/ epidemiology
Adolescent
Risk Factors
Sociodemographic Factors
Occupations
/ statistics & numerical data
Cross-Sectional Studies
Socioeconomic Factors
Back pain
SES
Social inequality
Socioeconomic status
Vulnerable groups
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
26 Oct 2024
26 Oct 2024
Historique:
received:
19
07
2024
accepted:
16
10
2024
medline:
27
10
2024
pubmed:
27
10
2024
entrez:
27
10
2024
Statut:
epublish
Résumé
Low back pain (LBP) is a common health problem in workers that contributes to work disability and reduces quality of life. However, studies examining vulnerable groups in relation to sociodemographic differences in LBP remain scarce. Therefore, the current study investigates which sociodemographic groups of workers are most affected by LBP. Data from the 2018 BIBB/BAuA employment survey were used (N = 16252). Age, education, occupational group, income, working hours, atypical working time, relationship status, and having children were used as sociodemographic predictors. Gender-stratified logistic regression analyses and intersectional classification tree analyses were conducted. A higher prevalence of LBP was observed for women compared to men. Significant differences in LBP emerged for age, working hours, atypical working time, occupational group and education, with some gender differences in the importance of predictors: Age was a significant predictor mostly in men as compared to women, atypical working hours had a slightly greater effect in women, whereas differences in LBP according to the occupational group were more pronounced for men. Vulnerable groups were found to be women who work in occupations other than professionals or managers, work atypical hours and have an intermediate or low educational level as well as men who work as skilled agricultural workers, craft workers, machine operators, or elementary occupations and are between 35 and 64 years old. Thus, workers with certain occupations and lower levels of education, middle-aged men and women with unfavourable working time characteristics are most affected by low back pain. These groups should be focused on to potentially increase healthy working life and prevent work disability.
Sections du résumé
BACKGROUND
BACKGROUND
Low back pain (LBP) is a common health problem in workers that contributes to work disability and reduces quality of life. However, studies examining vulnerable groups in relation to sociodemographic differences in LBP remain scarce. Therefore, the current study investigates which sociodemographic groups of workers are most affected by LBP.
METHODS
METHODS
Data from the 2018 BIBB/BAuA employment survey were used (N = 16252). Age, education, occupational group, income, working hours, atypical working time, relationship status, and having children were used as sociodemographic predictors. Gender-stratified logistic regression analyses and intersectional classification tree analyses were conducted.
RESULTS
RESULTS
A higher prevalence of LBP was observed for women compared to men. Significant differences in LBP emerged for age, working hours, atypical working time, occupational group and education, with some gender differences in the importance of predictors: Age was a significant predictor mostly in men as compared to women, atypical working hours had a slightly greater effect in women, whereas differences in LBP according to the occupational group were more pronounced for men. Vulnerable groups were found to be women who work in occupations other than professionals or managers, work atypical hours and have an intermediate or low educational level as well as men who work as skilled agricultural workers, craft workers, machine operators, or elementary occupations and are between 35 and 64 years old.
CONCLUSIONS
CONCLUSIONS
Thus, workers with certain occupations and lower levels of education, middle-aged men and women with unfavourable working time characteristics are most affected by low back pain. These groups should be focused on to potentially increase healthy working life and prevent work disability.
Identifiants
pubmed: 39462332
doi: 10.1186/s12891-024-07970-5
pii: 10.1186/s12891-024-07970-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
852Informations de copyright
© 2024. The Author(s).
Références
Buchbinder R, van Tulder M, Öberg B, Costa LM, Woolf A, Schoene M, et al. Low back pain: a call for action. Lancet. 2018;391:2384–8.
pubmed: 29573871
doi: 10.1016/S0140-6736(18)30488-4
Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391:2356–67.
pubmed: 29573870
doi: 10.1016/S0140-6736(18)30480-X
Jelsma J, Mielke J, Powell G, De Weerdt W, De Cock P. Disability in an urban black community in Zimbabwe. Disabil Rehabil. 2002;24:851–9.
pubmed: 12450461
doi: 10.1080/09638280210129766
Chen S, Chen M, Wu X, Lin S, Tao C, Cao H, et al. Global, regional and national burden of low back pain 1990–2019: a systematic analysis of the Global Burden of Disease study 2019. J Orthop Translation. 2022;32:49–58.
doi: 10.1016/j.jot.2021.07.005
Grabovac I, Dorner TE. Association between low back pain and various everyday performances: activities of daily living, ability to work and sexual function. Wien Klin Wochenschr. 2019;131:541–9.
pubmed: 31493101
pmcid: 6851039
doi: 10.1007/s00508-019-01542-7
Beller J, Luy M, Giarelli G, Regidor E, Lostao L, Tetzlaff J, et al. Trends in Activity limitations from an International Perspective: Differential Changes between Age groups across 30 countries. J Aging Health. 2022. 089826432211411.
Beller J, Epping J, Sperlich S, Tetzlaff J. Changes in disability over time among older working-age adults: which global and specific limitations are increasing in Germany using the SHARE-data from 2004 to 2015? SAGE Open Med. 2023;11:20503121231184012.
pubmed: 37435099
pmcid: 10331346
doi: 10.1177/20503121231184012
Freedman VA, Spillman BC, Andreski PM, Cornman JC, Crimmins EM, Kramarow E, et al. Trends in Late-Life Activity limitations in the United States: an Update from five national surveys. Demography. 2013;50:661–71.
pubmed: 23104207
doi: 10.1007/s13524-012-0167-z
Sperlich S, Beller J, Epping J, Safieddine B, Tetzlaff J, Geyer S. Are disability rates among people with diabetes increasing in Germany? A decomposition analysis of temporal change between 2004 and 2015. J Aging Health. 2020. 089826432097032.
Elfering A, Käser A, Melloh M. Relationship between depressive symptoms and acute low back pain at first medical consultation, three and six weeks of primary care. Psychol Health Med. 2014;19:235–46.
pubmed: 23514323
doi: 10.1080/13548506.2013.780131
Amiri S, Behnezhad S, Azad E. Back pain and depressive symptoms: a systematic review and meta-analysis. Int J Psychiatry Med. 2020;:91217420913001.
Bartys S, Frederiksen P, Bendix T, Burton K. System influences on work disability due to low back pain: an international evidence synthesis. Health Policy. 2017;121:903–12.
pubmed: 28595897
doi: 10.1016/j.healthpol.2017.05.011
Fatoye F, Gebrye T, Mbada CE, Useh U. Clinical and economic burden of low back pain in low- and middle-income countries: a systematic review. BMJ Open. 2023;13:e064119.
pubmed: 37185180
pmcid: 10151982
doi: 10.1136/bmjopen-2022-064119
Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The global burden of low back pain: estimates from the global burden of Disease 2010 study. Ann Rheum Dis. 2014;73:968–74.
pubmed: 24665116
doi: 10.1136/annrheumdis-2013-204428
Liebers F, Brendler C, Latza U. Alters- und berufsgruppenabhängige Unterschiede in Der Arbeitsunfähigkeit durch häufige Muskel-Skelett-Erkrankungen: Rückenschmerzen Und Gonarthrose. Bundesgesundheitsbl. 2013;56:367–80.
doi: 10.1007/s00103-012-1619-8
Bucher T, Volken T, Pfeiffer F, Schaffert R. Musculoskeletal pain in health professionals at the end of their studies and 1 year after entry into the profession: a multi-center longitudinal questionnaire study from Switzerland. BMC Musculoskelet Disord. 2023;24:518.
pubmed: 37353764
pmcid: 10290399
doi: 10.1186/s12891-023-06635-z
Parto DN, Wong AY, Macedo L. Prevalence of musculoskeletal disorders and associated risk factors in Canadian university students. BMC Musculoskelet Disord. 2023;24:501.
pubmed: 37337246
pmcid: 10278339
doi: 10.1186/s12891-023-06630-4
Geyer S. Education, income, and occupational class cannot be used interchangeably in social epidemiology. Empirical evidence against a common practice. J Epidemiol Community Health. 2006;60:804–10.
pubmed: 16905727
pmcid: 2566032
doi: 10.1136/jech.2005.041319
Mackenbach JP. Health inequalities: Persistence and change in modern welfare states. 1st edition. Oxford University Press; 2019.
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.
pubmed: 19753591
doi: 10.1002/ajim.20750
Sauter M, Barthelme J, Müller C, Liebers F. Manual handling of heavy loads and low back pain among different occupational groups: results of the 2018 BIBB/BAuA employment survey. BMC Musculoskelet Disord. 2021;22:956.
pubmed: 34781946
pmcid: 8594139
doi: 10.1186/s12891-021-04819-z
Stranjalis G, Tsamandouraki K, Sakas DE, Alamanos Y. Low back Pain in a Representative Sample of Greek Population: analysis according to Personal and socioeconomic characteristics. Spine. 2004;29:1355.
pubmed: 15187638
doi: 10.1097/01.BRS.0000127181.59012.1C
Gorce P, Jacquier-Bret J. Global prevalence of musculoskeletal disorders among physiotherapists: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2023;24:265.
pubmed: 37016332
pmcid: 10071744
doi: 10.1186/s12891-023-06345-6
Dionne CE, Korff MV, Koepsell TD, Deyo RA, Barlow WE, Checkoway H. Formal education and back pain: a review. J Epidemiol Community Health. 2001;55:455–68.
pubmed: 11413174
pmcid: 1731944
doi: 10.1136/jech.55.7.455
Dupeyron A, Ribinik P, Gélis A, Genty M, Claus D, Hérisson C, et al. Education in the management of low back pain. Literature review and recall of key recommendations for practice. Annals Phys Rehabilitation Med. 2011;54:319–35.
doi: 10.1016/j.rehab.2011.06.001
Ikeda T, Sugiyama K, Aida J, Tsuboya T, Watabiki N, Kondo K, et al. Socioeconomic inequalities in low back pain among older people: the JAGES cross-sectional study. Int J Equity Health. 2019;18:15.
pubmed: 30665404
pmcid: 6341699
doi: 10.1186/s12939-019-0918-1
Guo H. Working hours spent on repeated activities and prevalence of back pain. Occup Environ Med. 2002;59:680–8.
pubmed: 12356929
pmcid: 1740219
doi: 10.1136/oem.59.10.680
Zhao I, Bogossian F, Turner C. The effects of Shift Work and Interaction between Shift Work and Overweight/Obesity on low back Pain in nurses: results from a longitudinal study. J Occup Environ Med. 2012;54:820–5.
pubmed: 22796926
doi: 10.1097/JOM.0b013e3182572e6a
Bahk J, Khang Y-H, Lim S. The unequal burden of self-reported Musculoskeletal pains among South Korean and European employees based on age, gender, and employment status. Saf Health Work. 2021;12:57–65.
pubmed: 33732530
doi: 10.1016/j.shaw.2020.10.007
Kiadaliri A, Merlo J, Englund M. Complex sociodemographic inequalities in consultations for low back pain: lessons from multilevel intersectional analysis. Pain. 2021;162:1135–43.
pubmed: 32947540
doi: 10.1097/j.pain.0000000000002081
Kuntz B, Hoebel J, Fuchs J, Neuhauser H, Lampert T. Soziale Ungleichheit und chronische Rückenschmerzen Bei Erwachsenen in Deutschland. Bundesgesundheitsbl. 2017;60:783–91.
doi: 10.1007/s00103-017-2568-z
Şc FFMB. H, E V. Is lumbosacral transitional vertebra associated with lumbar disc herniation in patients with low back pain? European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European section of the cervical. Spine Res Soc. 2022;31.
Hu H-Y, Chen L, Wu C-Y, Chou Y-J, Chen R-C, Huang N. Associations among low back pain, income, and body mass index in Taiwan. Spine J. 2013;13:1521–6.
pubmed: 23978625
doi: 10.1016/j.spinee.2013.06.049
Hall A, Hünefeld L, Rohrbach-Schmidt D, BIBB/BAuA-Employment. Survey 2018BIBB/BAuA-Erwerbstätigenbefragung 2018 - Arbeit und Beruf im Wandel. Erwerb und Verwertung beruflicher Qualifikationen. 2020.
Austin PC. Using the standardized difference to compare the prevalence of a Binary Variable between two groups in Observational Research. Commun Stat - Simul Comput. 2009;38:1228–34.
doi: 10.1080/03610910902859574
Austin PC. A Tutorial and Case Study in Propensity score analysis: an application to estimating the Effect of In-Hospital Smoking Cessation Counseling on Mortality. Multivar Behav Res. 2011;46:119–51.
doi: 10.1080/00273171.2011.540480
Strobl C, Malley J, Tutz G. An introduction to recursive partitioning: Rationale, application, and characteristics of classification and regression trees, bagging, and random forests. Psychol Methods. 2009;14:323–48.
pubmed: 19968396
pmcid: 2927982
doi: 10.1037/a0016973
Shiri R, Falah-Hassani K, Heliövaara M, Solovieva S, Amiri S, Lallukka T, et al. Risk factors for low back Pain: a Population-based longitudinal study. Arthritis Care Res (Hoboken). 2019;71:290–9.
pubmed: 30044543
doi: 10.1002/acr.23710
Harari L, Lee C. Intersectionality in quantitative health disparities research: a systematic review of challenges and limitations in empirical studies. Soc Sci Med. 2021;277:113876.
pubmed: 33866085
pmcid: 8119321
doi: 10.1016/j.socscimed.2021.113876
Shmagel A, Foley R, Ibrahim H. Epidemiology of chronic low back Pain in US adults: data from the 2009–2010 National Health and Nutrition Examination Survey. Arthritis Care Res (Hoboken). 2016;68:1688–94.
pubmed: 26991822
doi: 10.1002/acr.22890
Bowleg L. Evolving Intersectionality within Public Health: from analysis to action. Am J Public Health. 2021;111:88–90.
pubmed: 33326269
pmcid: 7750585
doi: 10.2105/AJPH.2020.306031
Hankivsky O. Women’s health, men’s health, and gender and health: implications of intersectionality. Soc Sci Med. 2012;74:1712–20.
pubmed: 22361090
doi: 10.1016/j.socscimed.2011.11.029
Garg A, Pathak H, Churyukanov MV, Uppin RB, Slobodin TM. Low back pain: critical assessment of various scales. Eur Spine J. 2020;29:503–18.
pubmed: 31916001
doi: 10.1007/s00586-019-06279-5
Magnusson Hanson LL, Madsen IE, Rugulies R, Peristera P, Westerlund H, Descatha A. Temporal relationships between job strain and low-back pain. Scand J Work Environ Health. 2017;43:396–404.
pubmed: 28636724
doi: 10.5271/sjweh.3654
Damrongsak M, Prapanjaroensin A, Brown KC. Predictors of Back Pain in firefighters. Workplace Health Saf. 2018;66:61–9.
pubmed: 28750579
doi: 10.1177/2165079917709020
Mohseni Bandpei MA, Ehsani F, Behtash H, Ghanipour M. Occupational Low Back Pain in Primary and High School teachers: Prevalence and Associated factors. J Manip Physiol Ther. 2014;37:702–8.
doi: 10.1016/j.jmpt.2014.09.006
Zhang T-T, Liu Z, Liu Y-L, Zhao J-J, Liu D-W, Tian Q-B. Obesity as a risk factor for low back Pain: a Meta-analysis. Clin Spine Surg. 2018;31:22.
pubmed: 27875413
doi: 10.1097/BSD.0000000000000468
Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49:1373–9.
pubmed: 8970487
doi: 10.1016/S0895-4356(96)00236-3
Beller J, Graßhoff J, Safieddine B. Differential trends in prolonged sitting time in Europe: a multilevel analysis of European Eurobarometer data from 2013 to 2022. J Public Health (Berl). 2023. https://doi.org/10.1007/s10389-023-02090-1 .
doi: 10.1007/s10389-023-02090-1
Beller J, Graßhoff J, Safieddine B. Physical working conditions over time: a repeated cross-sectional study in German employees. J Occup Med Toxicol. 2024;19:24.
pubmed: 38858744
pmcid: 11165766
doi: 10.1186/s12995-024-00423-8