title: Psycho-behavioural risks of low back pain in railway workers.
abstract: BACKGROUND
  Low back pain (LBP) is the most costly ailment in the work force. Risky work behaviour and psychological stress are established risk factors.
  
  
  OBJECTIVE
  To explore the associations between workplace risk factors, psychological stress and LBP among Malaysian railway workers.
  
  
  METHODS
  A cross-sectional study was carried out on railway workers in Malaysia. Socio-demographics, workplace risk factors for LBP, perceived psychological stress and history of LBP over the previous month were obtained by direct interviews using a structured closed-ended questionnaire. Descriptive, bivariate and logistic regression analyses were conducted.
  
  
  RESULTS
  There were 513 study participants (70% response rate). The prevalence of LBP in the previous month was 69%. Multivariate analysis yielded four significant predictors of LBP: employment of ≥ 10 years, lifting and lowering heavy loads, prolonged standing posture and psychological stress.
  
  
  CONCLUSIONS
  The high prevalence of LBP and its significant associations with physical and psychological stress factors in railway workers points to an urgent need for preventive measures, particularly among workers in high-risk occupations.
authors.affiliation: International Medical School, Management and Science University (MSU), 40100 Shah Alam, Selangor, Malaysia, medkuru@yahoo.com.
authors.forename: K
authors.initials: K
authors.lastname: Ganasegeran
authors.affiliation: Medical Department, Tengku Ampuan Rahimah Hospital (HTAR), 41200 Klang, Selangor, Malaysia.
authors.forename: W
authors.initials: W
authors.lastname: Perianayagam
authors.affiliation: Department of Orthopaedics, M.S. Ramaiah Medical College (MSRMC), Bangalore 560054, India.
authors.forename: P
authors.initials: P
authors.lastname: Nagaraj
authors.affiliation: Department of Community Medicine, International Medical University (IMU), 57000 Kuala Lumpur, Malaysia.
authors.forename: S A R
authors.initials: SA
authors.lastname: Al-Dubai
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D006801:Humans; D017770:Lifting; D017116:Low Back Pain / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D016273:Occupational Exposure / Q000009:adverse effects*; D009790:Occupations; D011187:Posture; D015995:Prevalence; D011890:Railroads; D012307:Risk Factors; D013314:Stress, Mechanical; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires; D014937:Work; D055815:Young Adult
keywords: Epidemiology; low back pain; musculoskeletal; psychological stress; railway workers; workplace risk factors.