Musculoskeletal problems in bricklayers as a function of length of employment: The role of secondary selection by low-back pain

Low-back problems that are caused by heavy physical work should increase with the length of employment. In a cross-sectional study 195 bricklayers were interviewed and subjected to a medical examination concerned with complaints and functional impairments of the musculoskeletal systems of different body regions (neck/shoulder, arms/hands, back, hip/legs/feet). Summary variables for complaints and impairments indicated an increase with increasing age. Contrary to expectation, in pairs of bricklayers of the same age, but different length of employment, a general decline of complaints and impairments with longer employment was observed. This finding suggested a healthy worker effect. In a follow-up the turnover rate among 190 of the 195 bricklayers of the original study was determined. Bricklayers who had quit the job had a higher incidence of low-back troubles before leaving than bricklayers who had stayed in the job; the relation between turnover and low-back problems was limited to bricklayers older than about 40 years.