Prospective cohort study of predictors of incident low back pain in nurses.
OBJECTIVE
To assess the impact of handling patients and indicators of individual susceptibility on risk of low back pain in nurses.


METHODS
Prospective cohort study with follow up by repeated self administered every three months over two years.


METHODS
NHS university hospital trust.


METHODS
961 female nurses who had been free from low back pain for at least one month at the time of completing a baseline questionnaire.


METHODS
Incidence of new low back pain during follow up and of pain leading to absence from work.


RESULTS
Of 838 women who provided data suitable for analysis, 322 (38%) developed low back pain during follow up (mean 18.6 months), including 93 (11%) whose pain led to absence from work. The strongest predictor of new low back pain was earlier history of the symptom, and risk was particularly high if previous pain had lasted for over a month in total and had occurred within the 12 months before entry to the study (incidence during follow up 66%). Frequent low mood at baseline was strongly associated with subsequent absence from work for back pain (odds ratio 3.4; 95% confidence interval 1.4 to 8.2). After adjustment for earlier history of back pain and other potential confounders, risk was higher in nurses who reported frequent manual transfer of patients between bed and chair, manual repositioning of patients on the bed, and lifting patients in or out of the bath with a hoist.


CONCLUSIONS
Of the indicators of individual susceptibility that were examined, only history of back trouble was sufficiently predictive to justify selective exclusion of some applicants for nursing posts. The main route to prevention of back disorders among nurses is likely to lie in improved ergonomics.
Smedley
J
J
MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital.
Egger
P
P
Cooper
C
C
Coggon
D
D
D000041:Absenteeism; D000328:Adult; D015331:Cohort Studies; D004198:Disease Susceptibility; D005260:Female; D005500:Follow-Up Studies; D006779:Hospitals, Public; D006785:Hospitals, University; D006801:Humans; D017770:Lifting / Q000009:adverse effects; D017116:Low Back Pain / Q000453:epidemiology* / Q000209:etiology*; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data*; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D014187:Transportation of Patients; D006113:United Kingdom / Q000453:epidemiology