title: The role of past and current strenuous physical work in the association between professional car driving and chronic low-back syndromes: a population-based study.
abstract: METHODS
  Population-based cross-sectional study of clinically assessed low back syndromes.
  
  
  OBJECTIVE
  To investigate whether exposure to professional car driving, either alone or in combination with strenuous physical work is associated with clinically defined sciatica or other clinically diagnosed chronic low back syndromes.
  
  
  BACKGROUND
  Several studies have found an association between professional driving and back disorders, but drivers' histories of heavy physical work tasks has rarely been taken into account.
  
  
  METHODS
  The nationally representative sample comprised of 2323 men aged 30 to 64 (the Health 2000 Survey). The diagnoses of sciatica and chronic low back syndromes were based on a standardized clinical examination by specially trained physicians. Life-long exposure to professional car driving and to physically demanding work was assessed retrospectively via interviews. Logistic regression was used to estimate the risk of clinical chronic low back syndromes related to these exposures, and the risks were presented with odds ratios (OR) with 95% confidence intervals (95% CI).
  
  
  RESULTS
  The prevalence of physician-diagnosed sciatica was 5.4% and that of other chronic low back syndromes 4.0%. Professional car driving in general was associated with sciatica at an OR of 1.42 (95% CI 0.92-2.18) and with other chronic low back syndromes at an OR of 1.31 (0.80-2.16), after adjustment of covariates and strenuous physical work. Exposure to driving without exposure to physical work was not associated with the outcomes, whereas driving in combination with strenuous physical work increased the risk for sciatica threefold (3.22; 1.86-5.59), and that of low back syndromes twofold (2.08; 1.12-3.87).
  
  
  CONCLUSIONS
  The increased risk of low back disorders related to professional car driving is more likely due to strenuous work tasks rather than to driving itself.
authors.affiliation: Finnish Institute of Occupational Health, Helsinki, Finland. leena.kaila-kangas@ttl.fi
authors.forename: Leena
authors.initials: L
authors.lastname: Kaila-Kangas
authors.forename: Helena
authors.initials: H
authors.lastname: Miranda
authors.forename: Esa-Pekka
authors.initials: EP
authors.lastname: Takala
authors.forename: Päivi
authors.initials: P
authors.lastname: Leino-Arjas
authors.forename: Jaro
authors.initials: J
authors.lastname: Karppinen
authors.forename: Eira
authors.initials: E
authors.lastname: Viikari-Juntura
authors.forename: Ritva
authors.initials: R
authors.lastname: Luukkonen
authors.forename: Markku
authors.initials: M
authors.lastname: Heliövaara
mesh_terms: D000328:Adult; D001334:Automobile Driving; D002908:Chronic Disease; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009784:Occupational Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D012189:Retrospective Studies; D012585:Sciatica / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology