Gender differences in work-related risk factors associated with low back symptoms

A Cross-Sectional Descriptive Study of Musculoskeletal Disorders (MSDs) of Male Shipbuilding Workers and Factors Associated the Neck, Shoulder, Elbow, Low Back, or Knee MSDs

This study investigates the cross-sectional descriptive characteristics of male shipbuilding workers’ musculoskeletal disorders (MSDs) and factors associated with MSDs in the neck, shoulders, elbows, low back, or knees. From the national compensation data confirmed as MSDs during three years between 2015 and 2017, 985 male workers were analyzed in terms of age, work experience, occupations, company size, and MSD type according to each body region. In the analysis of frequency and severity according to ‘occupation–body region–MSD type’, ‘Electrician/plumber–low back–herniated disc’ (6.9%) was the form of MSDs with the highest frequency among total MSDs, and ‘Crane–neck–herniated disc’ (500.5 days) was the highest mean of sick leave days. The low back MSDs (28.9%) were the highest frequency, followed by shoulders (27.7%) and knees (16.2%). The herniated disc was frequent in the neck and lumbar region, and the mean of sick leave days of the neck herniated disc (402.2 days) was greater than that of the low back herniated disc (321.1 days). While a rupture was frequent in the shoulder or knee region, the mean of sick leave days for shoulder rupture (335.1 days) was greater than that of the knee rupture (318.8 days). In the binary logistic regression analysis, age was positively associated with MSDs in the neck, shoulder, or elbow regions, while the low back MSDs category was not positively associated with age. Large companies with >1000 employees were highly associated with neck MSDs, while small companies with <30 employees were related to the low back MSDs. This study derives the characteristics for frequency and sick leave days of MSDs in the neck, shoulders, elbows, low back, or knees to prioritize MSD prevention information. The results of this study can be used as primary data for establishing MSD prevention policy.

Chronic back pain among Brazilian adults: data from the 2019 National Health Survey

ABSTRACT Objective: To estimate the prevalence of chronic back pain (CBP) and its associated factors. Methods: This cross-sectional study analyzed the 2019 National Health Survey, with 88,531 adults, using logistic regression to identify associated factors. Results: CBP was reported by 21.6% of adults and was more likely to occur among women (odds ratio — OR=1.27; 95% confidence interval — 95%CI 1.19–1.35), increased with age: 25–34 years (OR=1.30; 95%CI 1.11–1.51), 35–44 (OR=1.78; 95%CI 1.54–2.07), 45–54 years (OR=2.23; 95%CI 1.91–2.59), 55–64 years (OR=2.47; 95%CI 2.12–2.88), and 65 years or older (OR=2.17; 95%CI 1.85–2.54); among smokers (OR=1.24; 95%CI 1.13–1.35); ex-smokers (OR=1.30; 95%CI 1.21–1.39); those who mentioned heavy housework (OR=1.41; 95%CI 1.31–1.53); obesity (OR=1.12; 95%CI 1.03–1.21); hypertension (OR=1.21; 95%CI 1.11–1.32); high cholesterol (OR=1.53; 95%CI 1.42–1.65); with self-rated health — with a very good reference — in the gradients: good (OR=1.38; 95%CI 1.23–1.55), regular (OR=2.64; 95%CI 2.34–2.98), poor (OR=4.24; 95%CI 3.64–4.94), and very poor (OR=5.24; 95%CI 4.13–6.65); its likelihood was lower in adults with complete elementary school/incomplete high school (OR=0.82; 95%CI 0.75–0.90) and complete high school/incomplete higher education (OR=0.87; 95%CI 0.81–0.95). Conclusion: Back pain has a high prevalence and shows associations with demographic and socioeconomic factors, lifestyle, chronic diseases, and self-rated health.

Dor crônica na coluna entre adultos brasileiros: dados da Pesquisa Nacional de Saúde 2019

RESUMO Objetivo: Estimar a prevalência da dor crônica na coluna (DCC) e os fatores associados à sua ocorrência. Métodos: Estudo transversal analisando a Pesquisa Nacional de Saúde 2019, com 88.531 adultos, usando regressão logística para identificar fatores associados. Resultados: A DCC foi apontada por 21,6% dos adultos, mostrou maior chance em mulheres (odds ratio — OR=1,27; intervalo de confiança de 95% — IC95% 1,19–1,35), aumentou com a idade de 25–34 anos (OR=1,30; IC95% 1,11–1,51), 35–44 (OR=1,78; IC95% 1,54–2,07), 45–54 anos (OR=2,23; IC95% 1,91–2,59), 55–64 anos (OR=2,47; IC95% 2,12–2,88) e 65 anos ou mais (OR=2,17; IC95% 1,85–2,54); fumantes (OR=1,24; IC95% 1,13–1,35); ex-fumantes (OR=1,30; IC95% 1,21–1,39); que citaram atividade física doméstica pesada (OR=1,41; IC95% 1,31–1,53); obesidade (OR=1,12; IC95% 1,03–1,21); hipertensos (OR=1,21; IC95% 1,11–1,32); colesterol aumentado (OR=1,53; IC95% 1,42–1,65); autoavaliação, cuja referência era muito boa, mostrou gradiente boa (OR=1,38; IC95% 1,23–1,55); regular (OR=2,64; IC95% 2,34–2,98), ruim (OR=4,24; IC95% 3,64–4,94), e muito ruim (OR=5,24; IC95% 4,13–6,65); e menor chance em adultos com ensino fundamental completo/ensino médio incompleto (OR=0,82; IC95% 0,75–0,90) e médio completo/superior incompleto (OR=0,87; IC95% 0,81–0,95). Conclusão: A dor na coluna tem elevada prevalência e mostra associação com fatores demográficos, socioeconômicos, estilo de vida, doenças crônicas e autoavaliação de saúde.

A kinematic posture analysis of neurological assistants in their daily working practice-a pilot study

Background

The aim of this pilot study was to analyze postures during the work of neurologists with respect to their occupational activities.

Methods

A total data material of 64.8 h (3885.74 min) of nine (three m/six f) neurologists (assistant physicians) was collected. Kinematic data were collected using the CUELA system (electro-goniometry). In addition, the occupational tasks performed on-site were subject to a detailed objective activity analysis. All activities were assigned to the categories “Office activities” (I), “Measures on patients” (II) and “Other activities” (III). The angle values of each body region (evaluation parameters) were evaluated according to ergonomic ISO standards.

Results

Only 3.4% of the working hours were spent with (II), while 50.8% of time was spent with (I) and 45.8% with (III). All tasks of category (II) revealed an increased ergonomic risk to the head, neck, trunk and back areas. During category (I) especially neck and back movements in the sagittal plane showed higher ergonomic risk levels.

Conclusion

Despite frequently performed awkward body positions in (II), the ergonomic risk is considered as rather low, since the percentage time share totaled only 3.4%. As a result, “Office activities” have been detected as high predictor to cause stress load on the musculoskeletal system in the daily work of neurologists.

Persistent pain associated with socioeconomic and personal factors in a Sami and Non-Sami population in Norway: an analysis of SAMINOR 2 survey data

In international studies, higher prevalence of persistent pain has been reported in indigenous populations compared to majority populations. The present study aimed to determine the prevalence of persistent pain within a Sami and a non-Sami population in northern Norway, with adjustment for the confounding factors of age, sex, marital status, education, income, mental health, smoking status and ethnic background. Using SAMINOR 2 survey data including Sami and non-Sami populations, we analysed 5,546 responses, from individuals aged 40-79 years, to questions concerning persistent pain (≥ 3 months). In total, 2,426 (43.7%) participants reported persistent pain with differences between Sami women and non-Sami women (44.1% versus 51.1%, respectively), but none between Sami men and non-Sami men (38.7% versus 38.2%, respectively). Elderly Sami women were less likely to report persistent pain than were elderly non-Sami women. In men, no ethnic differences in pain were observed according to age-group. Marital status, education levels, household income, psychological distress, and smoking status did not influence the association between ethnicity and pain. Pain severity and location did not differ between Sami and non-Sami participants. In this study, we found only minor ethnic differences in persistent pain. Similar living conditions and cultural features may explain these findings.

The role of perceived organisational justice in the experience of pain among male and female employees

This study examined the association of organisational justice with pain among employees of a large organisation. Employees (n = 1829) completed measures of pain, fair pay, organisational justice, job satisfaction and stress. Logistic regression analyses found that organisational justice was unrelated to pain among women, but men with higher perceptions of fair pay were more likely to report chronic pain as were men with lower perceptions of distributive justice. This is the first study indicating that fair pay and distributive justice are both unique predictors of chronic pain in men. The findings have implications for supporting employees with chronic pain.

Design and evaluation of an ergonomic chair for near-ground welding based on muscle activity and usability

BACKGROUND

Work-related musculoskeletal disorders (WMSDs) are one of the major problems in industrial societies. Awkward postures in theworkplace are considered as a main reasons for these disorders. Therefore, the study and investigation of postures to improve them (in the workplace) have a significant role in appropriate intervention.

OBJECTIVE

This study aimed to design an ergonomic chair for near-ground welding operations and evaluate its impact on the electromyography (EMG) activity of a select group of lower limb muscles.

METHODS

The EMG activity of lower limb muscles was measured in eight postures consisting of three postures identified via observing welders at work, and five on-chair postures suggested for chair use during welding. The usability of the designed chair was evaluated through the use of the System Usability Scale (SUS).

RESULTS

The results showed that the suggested on-chair postures had significantly lower mean muscle activity compared with the identified postures (p < 0.001). Among the identified postures, kneeling posture had the lowest mean muscle activity (p < 0.01), still significantly higher than the mean activity of the on-chair postures (p < 0.001). Applying a 15° slope to the seat pad led to a decrease in muscle activity and an increase in usability score. The usability score of the chair was acceptable in all postures except KCC-90 posture.

CONCLUSIONS

Using a suitable chair or support for different work postures can prevent detrimental muscle activities during work and the development of musculoskeletal disorders caused by intense muscle activity due to awkward postures.

Prediction model of the effect of postural interactions on muscular activity and perceived exertion

Musculoskeletal disorders are a prevalent disease in many Western countries. While a large number of ergonomic analyses and assessment methods are nowadays available, most current methods that assess exposure calculate overall risk scores of individual body segments without considering interaction effects of exposure variables. Therefore, a study was conducted that aimed at investigating and quantifying interaction effects of trunk inclination and arm lifting on ratings of perceived exertion (RPE) and muscle activity. A multiple regression model to predict musculoskeletal load under consideration of interaction effects was derived. The study revealed that there is a significant interaction effect of trunk inclination and arm lifting. Furthermore, final regression models explained variance in exposure variables in a range of R² = 0.68 to R² = 0.147 with a subset of two to three inputs. The predicative equations support the computer-based post-processing of sensor data. Practitioner summary: This article elaborates on the importance of interaction effects of working postures on assessment results of load. In practise, easy to-use-methods for an assessment of working postures are needed. Therefore, a regression model is derived, which facilitates the quantification of work load under consideration of interaction effects. The use of this regression model for the assessment of posture data gathered by range sensors is recommended. Abbreviations: RPE: rating of perceived exertion; MSD: musculoskeletal disorder; OWAS: ovako working posture analysing system; RULA: rapid upper limb assessment; LUBA: postural loading on the upper body assessment; REBA: rapid entire body assessment; OCRA: occupational repetitive action;S D: standard deviation; EMG: surface electromyography; LUT: left upper trapezius pars descendens; RUT: right upper trapezius pars descendens; LLT: left trapezius pars ascendens; RLT: right trapezius pars ascendens; LAD: left anterior deltoideus; RAD: right anterior deltoideus; LES: left erector spinae longissimus; RES: right erector spinae longissimus; SENIAM: surface electroMyoGraphy for the non-invasive assessment of muscles; MVC: maximum voluntary contraction; MANOVA: multivariate analysis of variance; ANOVA: analysis of variance; OLS: ordinary least squares; MANCOVA: multivariate analysis of covariance.

Sex-specific effects of sitting vs standing on upper body muscle activity during text typing

Standing computer work is increasingly popular. However, despite the higher rates of computer work-related disorders in women, no studies have compared how standing work affects men and women. Twelve males and 12 females completed 90-min typing tasks in each posture while electromyography (EMG) data was recorded from eight muscles of the upper body. Results show that females had significantly higher EMG root-mean-squared (RMS) values in the anterior deltoid than males when seated, but higher EMG RMS in the medial trapezius than males when standing (SBC ≤ 0.05). In standing, they also had lower values than males in the erector spinae. Overall, standing elicited less activity in the upper trapezius, wrist extensors and erector spinae than sitting. Results suggest that the standing posture is generally less muscularly demanding than the seated one, although men and women's neck/shoulder musculature responds differently to the same task performed while seated or standing.

How do we assess musicians' musculoskeletal symptoms?: a review of outcomes and tools used

Recent reviews of musicians' musculoskeletal symptoms (MSS) have reported heterogeneity in the outcomes reported and data collection tools used, making it difficult to compare and synthesise findings. The purpose of this present review was to improve the consistency of future research, by documenting the outcomes reported in recent studies of musicians' MSS and the data collection tools used. All English language, peer-reviewed studies, published 2007-2016 that reported musicians' self-reported MSS outcomes were identified. Details of the types of outcomes reported and the tools used were extracted, and synthesised descriptively. A range of MSS outcomes were reported, including MSS with a temporal relationship to activities performed, and the consequences of symptoms. Only 24% of studies used standardised questionnaires, with the Nordic Musculoskeletal Questionnaire (NMQ) being the most commonly used. To improve the homogeneity of outcomes and data collection tools when investigating musicians' MSS, we recommend using the NMQ, where appropriate. Recall periods of 12-months and 7-d are the most appropriate for prevalence, and 7-d recall periods for ratings. Importantly, outcomes and the tools used to collect data should be reported in sufficient detail to ensure that the study can be replicated, critiqued, and accurately interpreted.

Investigation of observational methods assessing workload of static working postures based on surface electromyography

BACKGROUND:

A large number of different methods are available to identify and assess working postures. Although observation-based methods are most commonly used in practise, investigations showed different results regarding validity of such methods.

OBJECTIVE:

To investigate validity of one of the most commonly used observation-based assessment method in ergonomics, the Ovako Working Posture Analysing System (OWAS) and the European standard EN 1005-4 for evaluation of working postures, an experimental laboratory study was conducted.

METHODS:

Muscle activity was measured under combinations of static working postures of trunk inclination and shoulder flexion to compare these measurements and observation-based assessments according to OWAS and EN 1005-4. In order to investigate the magnitude of correspondence between muscle activity and observation-based assessments, Spearman rank correlation coefficients (r_s) were calculated.

RESULTS:

Significant correlations were found between OWAS and muscle activity (range from r_s² = 0.17 r_s² = 0.55). Significant correlations were found between EN 1005-4 and muscle activity (range from r_s² = 0.34 to r_s² = 0.74).

CONCLUSIONS:

Results emphasise a need for further developments of observation-based methods, since the two investigated methods showed a variance of validity ranging from small to large. Such improvements may also form a better basis for the ergonomic improvement of working conditions in practise, which is highly necessary due to a constantly high prevalence of MSDs in the last decades.

Low back pain and some associated factors: is there any difference between genders?

OBJECTIVE

To compare men and women with low back pain and identify the prevalence and some of its associated factors in a population-based sample of adults aged 20 and over a seven day period.

METHODS

Cross-sectional study based on a population survey. 600 individuals were interviewed on the following: (1) characteristics of the participants (i.e. demographic, socioeconomic, and labor aspects); (2) physical activity level (IPAQ); (3) musculoskeletal symptoms (Nordic Questionnaire). Descriptive, bivariate, and Poisson regression analyses were performed.

RESULTS

Overall prevalence of LBP was 28.8%, being 39.0% in men and 60.9% in women. The measured associated factors in men were age between 36 and 59 years (PR=3.00 [1.31-6.88]) and over 60 (PR=4.52 [2.02-10.12]), smoking (PR=2.47 [1.20-5.11]), fewer years of formal education (0-4 years) (PR=6.37 [2.15-18.62]), and hypertension (PR=2.27 [1.15-4.50]). For women, the associated factors were occupational activities that involved heavy lifting (PR=1.80 [1.03-3.16]), standing posture leaning forward (PR=2.04 [1.20-3.44]), sitting posture leaning forward (PR=2.17 [1.24-3.82]), and sitting at the computer three or more days per week (PR=4.00 [1.44-11.11]). Widowed or divorced participants were more likely to report LBP, in both men (PR=3.06 [1.40-6.66]) and women (PR=2.11 [1.15-3.88]).

CONCLUSION

This study reveals high prevalence of low back pain in a seven day period. Older age, low education, hypertension, and smoking were associated with LBP in men. Occupational and ergonomic factors were associated with LBP in women. Marital status was associated with LBP in both genders.

Work-related musculoskeletal injuries in prosthetists and orthotists in Australia

Objective. This study aims to determine the prevalence of work-related musculoskeletal disorders in prosthetists/orthotists working in Australia. Secondary to this, the relationship between work-related hazards and work-related musculoskeletal disorders will be examined. Methods. In 2012, a self-report survey was conducted with the prosthetist/orthotist workforce in Australia (N = 139, 56% response rate). Data on workplace physical and psychosocial hazards, job satisfaction, work-life balance and musculoskeletal discomfort were collected. Predictors of work-related musculoskeletal disorders were assessed using logistic regression analysis. Results. Prevalence of work-related musculoskeletal disorders was 80%. Gender (β = 1.31, p = 0.030), total weekly hours (β = 0.9, p < 0.010) and physical (β = 1.91, p < 0.010) and psychosocial (β = 1.28, p < 0.010) hazards were all associated with reporting of work-related musculoskeletal disorders. Females reported higher levels of work-related musculoskeletal disorder discomfort than males in all body areas. Conclusions. Work-related musculoskeletal disorders prevalence is high in prosthetists/orthotists. This suggests that focus on workplace injury prevention is required. Targeted prevention requires systematic identification and then control of all relevant workplace hazards.

Is an insecure job better for health than having no job at all? A systematic review of studies investigating the health-related risks of both job insecurity and unemployment

Background

Though previous research repeatedly found that being employed is better for health than having no job at all, evidence suggests that employment is not always beneficial for health. With especially job insecurity reflecting a contemporary health risk for the employed, a systematic review was performed to assess if insecure employment can be as detrimental for health as unemployment, and to determine whether these associations vary according to different health measures and among men and women.

Methods

The literature search was conducted in the databases Medline, Embase and PsychInfo. In order to allow a more accurate comparison between the two risk factors, studies were included if the data for job insecurity and unemployment was ascertained from the same sample, and contained a quantitative analysis for both exposures towards one (or more) health outcome(s).

Results

Out of 375 articles, in total, 13 studies were included in the systematic review. In 24 analyses contrasting the health-related associations between job insecurity and unemployment, 16 statistically significant associations were found for each exposure. According to the different health outcomes used, job insecurity and unemployment were strongly related to mental health, whereas job insecurity was more strongly associated with somatic symptoms. Unemployment showed stronger relations with worse general health and mortality. In 4 out of 16 gender-stratified analyses, significant associations between job insecurity/unemployment and health were found for men but not for women. Beyond that, associations were significant or insignificant in both gender groups.

Conclusions

Though there were moderate differences across the health outcomes, overall, it was found that job insecurity can pose a comparable threat to health than unemployment. Policy interventions should therefore not only consider health risks posed by unemployment, but should also aim at the reduction of insecure employment.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-2313-1) contains supplementary material, which is available to authorized users.

Is sitting worse than static standing? How a gender analysis can move us toward understanding determinants and effects of occupational standing and walking

The Yant Award was established in 1964 to honor the contributions of William P. Yant, the first president of the American Industrial Hygiene Association. It is presented annually for outstanding contributions in industrial hygiene or allied fields to an individual residing outside the United States. The 2014 award recipient is Dr. Karen Messing, Professor emeritus, Department of Biological Sciences, Université du Québec à Montréal and Researcher, CINBIOSE Research Centre. Gender (socially determined) differences in occupations, employment, and working conditions, task assignments, and work methods that affect exposure to health risks are increasingly documented. Interactions of (biologically influenced) sex differences with workplace parameters may also influence exposure levels. During field studies, ergonomists learn a lot about gender and sex that can be important when generating and testing hypotheses about the mechanisms that link workplace exposures to health outcomes. Prolonged standing is common in North America; almost half (45%) of Québec workers spend more than three-quarters of their working time on their feet and 40% of these cannot sit at will. This posture has been linked to chronic back pain and musculoskeletal disorders (MSDs) in the lower limbs, but many health professionals suggest workers should stand rather than sit at work. We ask: (1) Given the fact that roughly the same proportion of men and women stand at work, what does a gender-sensitive analysis add to our ability to detect and thus prevent work-related MSDs?; (2) How does ergonomics research inform gender-sensitive analysis of occupational health data?; and (3) What do researchers need to know to orient interventions to improve general working postures? We have sought answers to these questions through collaborative research with specialists in epidemiology, occupational medicine, biomechanics, and physiology, carried out in partnership with public health organisations, community groups, and unions. We conclude that failure to characterize prolonged static standing and to apply gender-sensitive analysis can confuse assessment of musculoskeletal and circulatory effects of working postures. We suggest that prolonged static sitting and standing postures can and should be avoided by changes to workplace organization and environments. Research is needed to define optimal walking speeds and arrive at optimal ratios of sitting, standing, and walking in the workplace.

Interaction between physical and psychosocial work risk factors for low back symptoms and its consequences amongst Indonesian coal mining workers

This study assessed the interaction between physical and psychosocial factors for low back symptoms (LBS) and its consequences (reduced activities and absenteeism) in a developing country. A sample of 1294 Indonesian coal mining workers reported occupational exposures, LBS and its consequences using a self-administered questionnaire. Respondents were placed into one of four combination exposure groups: high physical and high psychosocial (HPhyHPsy); high physical and low psychosocial (HPhyLPsy); low physical and high psychosocial (LPhyHPsy), and; low physical and low psychosocial (LPhyLPsy). The attributable proportion due to interaction between physical and psychosocial factors was examined. Individuals in the HPhyHPsy group were most likely to report LBS (OR 5.42, 95% CI 3.30-8.89), reduced activities (OR 4.89, 95% CI 3.09-7.74), and absenteeism (OR 4.96, 95% CI 3.05-8.06). Interactions between physical and psychosocial factors were present for LBS, reduced activities, and absenteeism; although for LBS and absenteeism the interactions were not significant. Current smokers were more likely to report LBS consequences. Permanent employment and night shift work increased the odds of LBS and its consequences. We conclude that interventions aimed at reducing LBS and its consequences should address both physical and psychosocial factors, with a focus on smokers, permanent employment and night shift work.

The combined effect of physical, psychosocial/organisational and/or environmental risk factors on the presence of work-related musculoskeletal symptoms and its consequences

This study assessed the combined effect of physical and psychosocial/organisational and/or environmental factors on the presence of musculoskeletal symptoms (MSS) and its consequences (reduced activities and absenteeism due to MSS) in a random sample of 3003 workers in New Zealand. By telephone interview, participants reported their current workplace exposures and MSS (neck/shoulder, arm/elbow, wrist and low back) and its consequences. Data were analysed using multivariable logistic regression. Combined exposure to physical and psychosocial/organisational and/or environmental factors increased the odds of MSS in the neck/shoulder (OR 3.14, 95% CI 1.79-5.52), arms/elbow regions (OR 4.14, 95% CI 2.21-7.76) and low back (OR 1.74, 95% CI 1.28-2.37) and its consequences, i.e. reduced activities due to neck/shoulder symptoms (OR 5.45, 95% CI 2.28-13.00), absenteeism due to neck/shoulder symptoms (OR 5.19, 95% CI 2.24-12.01) and absenteeism due to low back symptoms (OR 4.37, 95% CI 2.92-6.53). In contrast, favourable psychosocial/organisational work conditions reduced the odds of wrist symptoms due to poor physical work conditions (OR 2.19, 95% CI 1.44-3.34). We conclude that to reduce MSS and its consequences, employers need to adopt a multifaceted approach: concentrate on improving physical conditions as well as the psychosocial/organisational and environmental aspects of the working environment.

Prevalence and work-related risk factors for reduced activities and absenteeism due to low back symptoms

Although quite a lot is known about the risk factors for low back symptoms (LBS), less is known about the risk factors for the consequences of LBS. A sample of 3003 men and women randomly selected from the New Zealand Electoral Roll, were interviewed by telephone about self reported physical, psychosocial, organizational, environmental factors and the consequences of LBS (i.e. self-reported reduced activities and absenteeism). The 12-month period prevalence of reduced activities and absenteeism were 18% and 9%, respectively. Lifting (OR 1.79 95% CI 1.16-2.77) increased the risk of reduced activities. Working in awkward/tiring positions (OR 2.11 95% CI 1.20-3.70) and in a cold/damp environment (OR 2.18 95% CI 1.11-4.28) increased the risk of absenteeism. Among those with LBS, reduced activities increased with working in a hot/warm environment (OR 2.14 95% CI 1.22-3.76) and absenteeism was increased with work in awkward/tiring positions (OR 2.06 95% CI 1.13-3.77), tight deadlines (OR 1.89 95% CI 1.02-3.50), and a hot/warm environment (OR 3.35 95% CI 1.68-6.68). Interventions to reduce the consequences of LBS should aim to reduce awkward/tiring positions, lifting and work in a cold/damp environment. For individuals with LBS, additional focus should be to reduce tight deadlines, and work in hot/warm environments.