title: Combined effect of back pain and stress on work ability.
abstract: BACKGROUND
  Back pain and occupational stress are known risk factors for absenteeism and presenteeism. In addition, the relationship between back pain (BP) and psychosocial stressors has been examined in numerous studies.
  
  
  OBJECTIVE
  To examine the prevalence of BP and perceived stress among employees of different occupational status and to investigate their combined impact on work ability.
  
  
  METHODS
  A comprehensive survey combining questionnaire data and medical examination offered in one division of a major chemical company in Germany. Self-rated health and work ability were assessed using the Work Ability Index (WAI). A synergy index was used to assess a potential interaction between both exposures under an additive model.
  
  
  RESULTS
  Of 867 voluntary participants, 653 returned complete questionnaires on BP and job stress perception. Although occupational stressors were perceived differently, there was no difference in the prevalence of BP between the occupational groups. Back pain and stress perception are correlated with each other and both are negatively associated with work ability. After adjustment for occupational status, demographic and lifestyle factors, we found a synergy effect of BP and stress perception with a modest to strong impact on declining WAI.
  
  
  CONCLUSIONS
  Corporate health promotion interventions to reduce the impact of BP and stress perception on work ability should target both physical and psychological dimensions. Such interventions may be initiated in the context of regular (occupational) medical examinations.
authors: Department of Occupational Medicine and Health Protection, BASF SE, Ludwigshafen 67056, Germany.
authors: C
authors: C
authors: Oberlinner
authors: Department of Occupational Medicine and Health Protection, BASF SE, Ludwigshafen 67056, Germany. mei.yong@basf.com.
authors: M
authors: M
authors: Yong
authors: Department of Occupational Medicine and Health Protection, BASF SE, Ludwigshafen 67056, Germany.
authors: M
authors: M
authors: Nasterlack
authors: Department of Occupational Medicine and Health Protection, BASF SE, Ludwigshafen 67056, Germany.
authors: R-P
authors: RP
authors: Pluto
authors: Department of Occupational Medicine and Health Protection, BASF SE, Ludwigshafen 67056, Germany.
authors: S
authors: S
authors: Lang
mesh_terms: D000041:Absenteeism; D000328:Adult; D001416:Back Pain / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D016272:Occupational Health; D015995:Prevalence; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D014938:Work Capacity Evaluation
keywords: Back pain; Work Ability Index (WAI).; combined effect; corporate health promotion; cross-sectional study; stress perception; synergy index