A prospective cohort study of risk factors for disability retirement because of back pain in the general working population

Study Design. A 7-year prospective cohort study of 34,754 employed men and women was conducted. Objective. To determine the relative contribution of occupational risk factors, lifestyle factors, comorbidity, and psychological and social factors to the incidence of disability retirement bacause of back pain in the general working population. Summary of Background Data. Permanent occupational disability is a serious consequence of a disabling process. Although this condition is a great burden to the individual and extremely costly for society, few population-based studies exist on the risk factors for obtaining disability persion because of back pain. Methods. Patients granted back pain disability pension were asvertained from the national disability register. The exposure variables were taken from a health screening of all the inhabitants in one country Norway. The participation rate was 72% to 90%. Results. During the follow-up period, 715 induviduals (2.1%) were granted a back pain disability pension. In the final combined multivariate model, the strongest predictors for future back pain disability were the occupational risk factor "physically demanding work" (odds ration [OR], 4.1; 95% confidence interval [CI], 2.7-6.4) and the comorbidity factor "poor general gealth" (OR, 3.7; 95% CI, 2.4-5.8). "Feeling of being worn out" (OR, 1.7, 95% CI, 1.1-2.4), current smoking (OR, 1.4; CI, 1.2-1.7), and body mass index in the upper percentile (OR, 1.6; 95% CI, 1.2-2) also predicted back pain disability pension. Conclusions. In a broad public health perspective within a European welfare system, subjects at high risk for future back pain disability persion perceived their work as constantly phisically demanding, had health complaints other than back pain, and most felt generally tired and worn out. The results indicate that interventions directed toward the painful back alone may be unsuccessful in preventing disability pernsions.