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Risk Factors for Hospitalization Due to Lumbar Disc Disease

Wahlström, Jens PhD; Burström, Lage PhD; Nilsson, Tohr MD, PhD; Järvholm, Bengt MD, PhD

doi: 10.1097/BRS.0b013e31824b5464
Occupational Health/Ergonomics

Study Design. Prospective cohort study.

Objective. To study biomechanical factors in relation to symptomatic lumbar disc disease.

Summary of Background Data. The importance of biomechanical factors in lumbar disc disease has been questioned in the past decade and knowledge from large prospective studies is lacking.

Methods. The study basis is a cohort of 263,529 Swedish construction workers who participated in a national occupational health surveillance program from 1971 until 1992. The workers' job title, smoking habits, body weight, height, and age were registered at the examinations. The occurrence of hospitalization due to lumbar disc disease from January 1, 1987, until December 31, 2003, was collected from a linkage with the Swedish Hospital Discharge Register.

Results. There was an increased risk for hospitalization due to lumbar disc disease for several occupational groups compared with white-collar workers and foremen. Occupational groups with high biomechanical loads had the highest risks, for example, the relative risk for concrete workers was 1.55 (95% confidence interval [CI], 1.29–1.87). A taller stature was consistently associated with an increased risk. The relative risk for a man of 190- to 199-cm height was 1.55 (95% CI, 1.30–1.86) compared with a man being 170- to 179-cm height. Body weight and smoking were also risk factors, but weaker than height. Workers in the age span of 30 to 39 years had the highest relative risk (RR = 1.87; 95% CI, 1.58–2.23) compared with those aged 20 to 29 years, whereas men aged 60 to 65 years had a lower risk (RR = 0.86; 95% CI, 0.68–1.09).

Conclusion. This study indicates that factors increasing the load on the lumbar spine are associated with hospitalization for lumbar disc disease. Occupational biomechanical factors seem to be important, and a taller stature was consistently associated with an increased risk.

We investigated determinants for symptomatic lumbar disc disease in a large prospective cohort of men in the construction industry. There was an increased risk for symptomatic lumbar disc disease for several occupational groups compared with white-collar workers and foremen as well as for persons with a taller stature.

From the Department of Public Health & Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.

Address correspondence and reprint requests to Jens Wahlström, PhD, Occupational and Environmental Medicine, Umeå University Hospital, SE-901 85, Umeå, Sweden; E-mail: jens.wahlstrom@envmed.umu.se

Acknowledgment date: July 21, 2011. First revision date: October 17, 2011. Second revision date: December 8, 2011. Acceptance date: December 13, 2011.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Foundation funds were received to support this work.

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

© 2012 Lippincott Williams & Wilkins, Inc.