title: Low back pain among professional bus drivers: ergonomic and occupational-psychosocial risk factors.
abstract: BACKGROUND
  Professional drivers have been found to be at high risk for developing low back pain. However, the exact reasons are poorly understood.
  
  
  OBJECTIVE
  To assess the prevalence of LBP among Israeli professional urban bus drivers, and evaluate the association between LBP in drivers and work-related psychosocial and ergonomic risk factors.
  
  
  METHODS
  A total of 384 male full-time urban bus drivers were consecutively enrolled to this cross-sectional study. Information on regular physical activity and work-related ergonomic and psychosocial stressing factors was collected during face-to-face interviews. The prevalence of LBP was assessed using the Standardized Nordic Questionnaire.
  
  
  RESULTS
  From the total cohort, 164 bus drivers (45.4%) reported experiencing LBP in the previous 12 months. Ergonomic factors associated with LBP were uncomfortable seat (odds ratio 2.6, 95% confidence interval 1.4-5.0) and an uncomfortable back support (OR 2.5, 95% CI 1.4-4.5). In the group of drivers with LBP, 48.5% reported participation in regular physical activities vs. 67.3% in the group without LBP (P<0.01). The following psychosocial stressing factors showed significant association with LBP: "limited rest period during a working day" (1.6, 1.0-2.6), "traffic congestion on the bus route" (1.8, 1.2-2.7), "lack of accessibility to the bus stop for the descending and ascending of passengers" (1.5, 1.0-1.5), and "passengers' hostility" (1.8, 1.1-2.9).
  
  
  CONCLUSIONS
  Work-related ergonomic and psychosocial factors showed a significant association with LBP in Israeli professional urban bus drivers. Prevention of work-related stress, organizational changes targeted to reduce stressful situations, improvement in seat comfort, and encouraging regular sports activity need to be evaluated as prevention strategies for LBP in professional bus drivers.
authors.affiliation: Department of Physical Therapy, Steyer School of Health Professions, Tel Aviv University, Ramat Aviv, Israel. deboraha@post.tau.ac.il
authors.forename: Deborah
authors.initials: D
authors.lastname: Alperovitch-Najenson
authors.forename: Yoav
authors.initials: Y
authors.lastname: Santo
authors.forename: Youssef
authors.initials: Y
authors.lastname: Masharawi
authors.forename: Michal
authors.initials: M
authors.lastname: Katz-Leurer
authors.forename: Diana
authors.initials: D
authors.lastname: Ushvaev
authors.forename: Leonid
authors.initials: L
authors.lastname: Kalichman
mesh_terms: D000328:Adult; D001334:Automobile Driving / Q000523:psychology*; D003430:Cross-Sectional Studies; D006804:Ergonomics; D006801:Humans; D007557:Israel; D017116:Low Back Pain / Q000453:epidemiology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles; D009784:Occupational Diseases / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications*; D014504:Urban Health