title: Physical and psychosocial ergonomic risk factors for low back pain in automobile manufacturing workers.
abstract: OBJECTIVE
  To examine the association between ergonomic physical and psychosocial exposures and the risk of prevalent and incident low back pain (LBP) in a longitudinal cohort of automobile manufacturing workers.
  
  
  METHODS
  Ergonomic exposure intensity and LBP presence were determined through questionnaires at baseline (n=1181) and to workers in the same job 1 year later (n=505). Models were constructed using log-binomial regression with special attention to interactions between ergonomic exposures.
  
  
  RESULTS
  Awkward back posture (prevalence ratio (PR) 1.12, 95% CI 1.07 to 1.17), hand force (PR 1.06, 95% CI 1.02 to 1.10), physical effort (PR 1.10, 95% CI 1.04 to 1.16) and whole body vibration (PR 1.04, 95% CI 1.01 to 1.08) were each associated cross-sectionally with LBP. Awkward back posture (RR 1.13, 95% CI 0.98 to 1.31) and hand force (RR 1.07, 95% CI 0.93 to 1.22) also predicted incident LBP, although estimates were statistically less precise. Neither job control, psychological demands, nor job strain was independently related to risk of incident LBP. Among participants reporting high physical ergonomic exposures and moderate to high job control, increasing job demands was associated with a reduced LBP risk (RR 0.72, 95% CI 0.52 to 1.00). Among participants reporting high physical exposures and low job control, psychological demands was associated with an increased LBP risk (RR 1.30, 95% CI 1.02 to 1.66).
  
  
  CONCLUSIONS
  Psychosocial workplace interventions for LBP should prioritise jobs in which there are high physical ergonomic exposures. Future studies of LBP should examine the interactions between physical ergonomic risk factors.
authors.affiliation: Department of Public Health, Temple University, Philadelphia, Pennsylvania, USA. vandergrift@nccn.org
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Vandergrift
authors.forename: Judith E
authors.initials: JE
authors.lastname: Gold
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hanlon
authors.forename: Laura
authors.initials: L
authors.lastname: Punnett
mesh_terms: D000328:Adult; D000368:Aged; D001336:Automobiles; D003430:Cross-Sectional Studies; D004812:Epidemiologic Methods; D006804:Ergonomics; D005260:Female; D006801:Humans; D007221:Industry; D007389:Internal-External Control; D017116:Low Back Pain / Q000453:epidemiology* / Q000523:psychology*; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000523:psychology*; D015995:Prevalence; D012307:Risk Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D055815:Young Adult