Predictors of occupational low back disability: Implications for secondaryprevention

Over the past decade, studies have identified a combination of demographic, physical/medical, ergonomic, and psychosocial factors in the development o f work disability related to occupational low back pain. Using such data on disability risk factors, investigators have begun to develop risk identifi cation and disability prevention programs. As part of an ongoing effort to develop a secondary prevention program, the present case-control study iden tified the relative contribution of demo-graphic, physical demand, physical fitness, as well as occupational and individual psychosocial variables to back-related work disability in the US Army. Soldiers (n = 174) diagnosed w ith a lumbosacral strain and medically discharged from the Army were compar ed with non-disabled controls (n = 173), Dependent measures Were obtained f rom the US Army Health Risk Appraisal (HRA). Far cases, these data pre-date d disability determination by 1 to 3 years. For controls, the HRA was compl eted during the same time period. Significantly predictors of low back disa bility were: age (odds ratio [OR] = 1.13 per year), lower rank (E2/E3) (OR = 4.08/OR = 3.02), infrequent aerobic exercise (OR = 2.2), higher work stre ss (OR = 2.71), worries (OR = 2.17), and lower social support (OR = 5.07). The model correctly classified 73.13% of all subjects. These results highli ght the importance of considering age, status level in the organisation, fr equency of aerobic exercise, occupational stress, general worries, and soci al support for the early detection of soldiers at increased risk for back-r elated disability. Additionally, the findings support past research indicat ing thp multivariate nature of work disability, and emphasis the importance of co considering such factors in future secondary prevention efforts.