Physical load in daily life and low back problems in the general population - The MORGEN study

Background. We studied the contribution of physical load in daily activities, including activities in work, housekeeping, and leisure time, to the burden of low back problems (LBP) in the population. Methods. Logistic regression models were used to calculate the association between physical load and several LBP parameters as assessed by questionnaire in a cross-sectional study on 22,415 randomly selected men and women in The Netherlands, controlling for well-known LBP determinants. The population attributable risk (PAR) percentage was estimated with the elimination method using the logistic model. Results. Half of the population reported LBP during the past year and 19% chronic LBP. Activities characterized by an awkward posture, by the same posture for a long time, or by often bending and rotating the trunk increased the risk for LBP, with ORs between 1.1 and 1.6. More than 13% of the I-year prevalence of LBP could be contributed to these activities. This PAR was higher for those belonging to the working population, for women, and for the more severe LBP parameters. Conclusion. Because LBP present such a large public health problem, the estimated potential impact of eliminating (the unhealthy effect of) physical load is substantial. To assess the real health gain, more insight is necessary into the causality of the relationship and into effective preventive measures, (C) 2000 American Health Foundation and Academic Press.