title: Prevalence and influencing factors of chronic back pain among staff at special schools with multiple and severely handicapped children in Germany: results of a cross-sectional study.
abstract: BACKGROUND
  In Germany, about 70,000 teachers and educational staff were teaching at more than 3,000 special schools during the school year 2010/2011. Nursing services like lifting pupils form a substantial part of the work content of the staff at special schools. Since nursing care often involves carrying and lifting pupils, there is a reason to assume an adverse effect on the musculoskeletal health of teachers and other professionals. With the present study we aimed to describe the prevalence and risk factors of chronic back pain among employees at this type of school.
  
  
  METHODS
  The cross-sectional survey was carried out between August 2010 and August 2012 at 13 special schools focusing on motoric and/or holistic development of handicapped children in Rhineland-Palatinate (Germany). Teachers and educational staff were interviewed using a questionnaire. We applied multivariable logistic regression analyses to identify influencing factors of chronic back pain.
  
  
  RESULTS
  Altogether 395 persons (response rate: 59.7%) participated in our study. Respondents were mostly female (86.8%) with a mean age of 45 years. The prevalence of chronic back pain was 38.7%. More than 40% reported frequently carrying and lifting heavy loads (>20 kg). Age [adjusted OR = 1.03 (95%-CI 1.00-1.05) for 1-year increase in age], current smoking [adjusted OR = 2.31 (95%-CI 1.27-4.23)], depression/depressive mood [adjusted OR = 1.85 (95%-CI 1.12-3.06)], frequently carrying and lifting heavy loads [adjusted OR = 2.69 (95%-CI 1.53-4.75)], and frequent exposure to environmental impacts [adjusted OR = 2.18 (95%-CI 1.26-3.76)] were influencing factors of chronic back pain in the final multivariable regression model.
  
  
  CONCLUSIONS
  A large proportion of teachers and educational staff suffered from chronic back pain in our study, indicating a high need for treatment in this professional group. Increasing age, current smoking, a diagnosed depression/depressive mood, carrying and lifting heavy loads, and exposure to environmental impacts were associated with chronic back pain. Due to the sparse literature on the topic, further studies using a longitudinal design are necessary for a better understanding of the risk factors of chronic back pain.
authors.affiliation: Institute for Teachers´ Health at the University Medical Center of the Johannes Gutenberg University of Mainz, Kupferbergterrasse 17-19, 55116 Mainz, Germany. matthias.claus@unimedizin-mainz.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Claus
authors.forename: Renate
authors.initials: R
authors.lastname: Kimbel
authors.forename: Daniel
authors.initials: D
authors.lastname: Spahn
authors.forename: Sarah
authors.initials: S
authors.lastname: Dudenhöffer
authors.forename: Dirk-Matthias
authors.initials: DM
authors.lastname: Rose
authors.forename: Stephan
authors.initials: S
authors.lastname: Letzel
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D001416:Back Pain / Q000453:epidemiology*; D015992:Body Mass Index; D017028:Caregivers / Q000706:statistics & numerical data; D002648:Child; D059350:Chronic Pain / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D019988:Children with Disabilities; D004519:Education, Special; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D055805:Moving and Lifting Patients / Q000009:adverse effects*; D009140:Musculoskeletal Diseases / Q000453:epidemiology*; D009784:Occupational Diseases / Q000453:epidemiology*; D012307:Risk Factors; D012574:Schools; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D013663:Teaching; D017132:Workplace