Work correlates of back problems and activity restriction due to musculoskeletal disorders in the Canadian national population health survey (NPHS) 1994-5 data
D C Colea b, S A Ibrahima, H S Shannona b, F Scottb, J Eylesb
a Institute for Work
and Health, 250 Bloor Street East, Ste 702, Toronto, Ontario, Canada
M4W 1E6, b McMaster University, Hamilton, Canada
Correspondence to: Dr D C Cole dcole{at}iwh.on.ca
Accepted 1 June 2001
OBJECTIVES
To describe
the prevalence of musculoskeletal problems in the Canadian working
population and to determine cross sectional associations between such
problems and work factors, particularly job strain and physical demand variables.
METHODSThe Canadian
1994 national population health survey (NPHS) sampled 4230 working men
and 4043 working women (ages 18-64) who answered an abbreviated
version of the job content questionnaire. Workers were classified into
four strain categories: high, passive, active, and low. Outcomes were
restricted activity due to musculoskeletal disorders and the diagnosis
of a back problem (both yes or no). Survey weights were incorporated to
allow for different probabilities of selection. Logistic regression
analyses were carried out separately for women and men, controlling for
sociodemographic factors.
RESULTSPrevalence of
chronic back problems diagnosed by a health practitioner was 14.5%
among men and 12.5% among women. Men had a 6.6% prevalence of
restricted activity due to musculoskeletal disorders, whereas the
corresponding figure for women was 5.3%. Women, but not men, in high
strain jobs were more likely to report both back problems (odds ratio
(OR) 1.60, 95% confidence interval (95% CI) 1.14 to 2.28) and
restricted activity (OR 1.98, 95% CI 1.16 to 3.48) compared with those
in low strain jobs. High physical exertion was an independent predictor
of back problems in both sexes. For both men and women, low social
support at work and high job insecurity were independent predictors of
restricted activity due to musculoskeletal disorders. Conversely,
chronic back problems contributed to explanation of high job strain
among women (OR 1.76, 95% CI 1.30 to 2.39) and high physical exertion among men (OR 1.39, 95% CI 1.09 to 1.77), whereas restricted activity due to musculoskeletal disorders contributed to explanation of high job
insecurity in both sexes.
CONCLUSIONSAssociations
of interest between work stressors and musculoskeletal problems in this
cross sectional study provide evidence for physical and psychosocial
factors both affecting disability and being affected by disability in a
working population.
Keywords: back pain; cross sectional survey; job strain; Canada
© 2001 by Occupational and Environmental Medicine
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