PROSPECTIVE COHORT STUDY OF PREDICTORS OF INCIDENT LOW-BACK-PAIN IN NURSES

Objective: To assess the impact of handling patients and indicators of individual susceptibility on risk of low back pain in nurses. Design: Prospective cohort study with follow up by repeated self administered questionnaires every three months over two years. Setting: NHS univer sity hospitals trust. Subjects: 961 female nurses who had been free fr om low back pain for at least one month at the time of completing a ba seline questionnaire. Main outcome measures: Incidence of new low back pain during follow up and of pain leading to absence from work. Resul ts: Of 838 women who provided data suitable for analysis, 322 (38%) de veloped low back pain during follow up (mean 18.6 months), including 9 3 (11%) whose pain led to absence from work. The strongest predictor o f new low back pain was earlier history of the symptom, and risk was p articularly high if previous pain had lasted for over a month in total and had occurred within the 12 months before entry to the study (inci dence during follow up 66%). Frequent low mood at baseline was strongl y associated with subsequent absence from work for back pain (odds rat io 3.4; 95% confidence interval 1.4 to 8.2). After adjustment for earl ier history of back pain and other potential confounders, risk was hig her in nurses who reported frequent manual transfer of patients betwee n bed and chair, manual repositioning of patients on the bed, and lift ing patients in or out of the bath with a hoist. Conclusions: Of the i ndicators of individual susceptibility that were examined, only histor y of back trouble was sufficiently predictive to justify selective exc lusion of some applicants for nursing posts. The main route to prevent ion of back disorders among nurses is likely to lie in improved ergono mics.