Working with low back pain: workplace and individual psychosocial determinants of limited duty and lost time.
BACKGROUND
Few studies have identified the risk factors associated with lost time in employees working with occupational low back pain (OLBP) despite the presence of pain. Such data could assist in the development of evidenced-based secondary prevention programs.


METHODS
The present investigation was a case-control study (n = 421) of demographic, health behavior, ergonomic, workplace and individual psychosocial factors hypothesized to be associated with lost time in young, full-time employees (i.e., soldiers) with OLBP. Analyses of the burden of OLBP in terms of the number of days on limited duty and lost time status were also computed.


RESULTS
Logistic regression analysis indicated that female gender, education beyond HS/GED, longer time working in military, higher levels of daily life worries, no support from others, higher levels of ergonomic exposure, stressful work, increased peer cohesion, and greater perceived effort at work placed a worker at a greater likelihood for OLBP-related lost work time. Lower levels of innovation, involvement, and supervisor support were also associated with lost time. Linear regression indicated that the number of days of lost time and limited duty was associated with lower levels of physical health and higher levels of symptom severity.


CONCLUSIONS
The results support the potential utility of interventions targeting ergonomic, workplace and individual psychosocial risk factors in secondary prevention.
Feuerstein
M
M
Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA. mfeuerstein@usuhs.mil
Berkowitz
S M
SM
Haufler
A J
AJ
Lopez
M S
MS
Huang
G D
GD
D000041:Absenteeism; D000328:Adult; D016022:Case-Control Studies; D002908:Chronic Disease; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D006801:Humans; D016015:Logistic Models; D017116:Low Back Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D008297:Male; D008889:Military Personnel; D009784:Occupational Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D011584:Psychology; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012803:Sick Role; D016526:Workload / Q000523:psychology / Q000592:standards*; D017132:Workplace