title: Occupational driving as a risk factor for low back pain in active-duty military service members.
abstract: BACKGROUND
  Although occupational driving has been associated with low back pain, little has been reported on the incidence rates for this disorder.
  
  
  OBJECTIVE
  To determine the incidence rate and demographic risk factors of low back pain in an ethnically diverse and physically active population of US military vehicle operators.
  
  
  METHODS
  Retrospective database analysis.
  
  
  METHODS
  All active-duty military service members between 1998 and 2006.
  
  
  METHODS
  Low back pain requiring visit to a health-care provider.
  
  
  METHODS
  A query was performed using the US Defense Medical Epidemiology Database for the International Classification of Diseases, Ninth Revision, Clinical Modification code for low back pain (724.20). Multivariate Poisson regression analysis was used to estimate the rate of low back pain among military vehicle operators and control subjects per 1,000 person-years, while controlling for sex, race, rank, service, age, and marital status.
  
  
  RESULTS
  A total of 8,447,167 person-years of data were investigated. The overall unadjusted low back pain incidence rate for military members whose occupation is vehicle operator was 54.2 per 1,000 person-years. Compared with service members with other occupations, motor vehicle operators had a significantly increased adjusted incidence rate ratio (IRR) for low back pain of 1.15 (95% confidence interval [CI] 1.13-1.17). Female motor vehicle operators, compared with males, had a significantly increased adjusted IRR for low back pain of 1.45 (95% CI 1.39-1.52). With senior enlisted as the referent category, the junior enlisted rank group of motor vehicle operators had a significantly increased adjusted IRR for low back pain: 1.60 (95% CI 1.52-1.70). Compared with Marine service members, those motor vehicle operators in both the Army, 2.74 (95% CI 2.60-2.89), and the Air Force, 1.98 (95% CI 1.84-2.14), had a significantly increased adjusted IRR for low back pain. The adjusted IRRs for the less than 20-year and more than 40-year age groups, compared with the 30- to 39-year age group, were 1.24 (1.15-1.36) and 1.23 (1.10-1.38), respectively.
  
  
  CONCLUSIONS
  Motor vehicle operators have a small but statistically significantly increased rate of low back pain compared with matched control population.
authors.affiliation: Orthopaedic Surgery Service, Department of Surgery, Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI 96859, USA. Electronic address: jeffrey.bruce.knox@us.army.mil.
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Knox
authors.affiliation: Orthopaedic Surgery Service, Department of Surgery, Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI 96859, USA.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Orchowski
authors.affiliation: Orthopaedic Surgery Service, Department of Surgery, William Beaumont Army Medical Center, 5005 N. Piedras St, El Paso, TX 79920, USA.
authors.forename: Danielle L
authors.initials: DL
authors.lastname: Scher
authors.affiliation: Department of Orthopaedic Surgery, Keller Army Hospital, 900 Washington Rd, West Point, NY 10996, USA.
authors.forename: Brett D
authors.initials: BD
authors.lastname: Owens
authors.affiliation: Graduate School of Operational and Information Sciences, Naval Postgraduate School, 1411 Cunningham Rd, Monterey, CA 93940, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Burks
authors.affiliation: Orthopaedic Surgery Service, Department of Surgery, William Beaumont Army Medical Center, 5005 N. Piedras St, El Paso, TX 79920, USA.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Belmont
mesh_terms: D000328:Adult; D001334:Automobile Driving; D016208:Databases, Factual; D005006:Ethnicity; D005260:Female; D006801:Humans; D015994:Incidence; D017116:Low Back Pain / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D009784:Occupational Diseases / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Epidemiology; Low back pain; Motor vehicle operator