Low back pain

O5.1 CARDIOVASCULAR RISK FACTORS, STRENUOUSNESS OF WORK, AND LOW BACK PAIN: A 28 YEAR FOLLOW UP OF INDUSTRIAL EMPLOYEES

P. Leino-Arjas¹, S. Solovieva¹, J. Kirjonen, A. Reunanen², H. Riihimäki¹.¹Department of Epidemiology and Biostatistics, Finnish Institute of Occupational Health; ²University of Jyväskylä, Finland; ³National Public Health Institute, Helsinki

Introduction: It has been proposed that atherosclerosis of the lumbar vessels may lead to low back pain (LBP). We studied whether classic risk factors of cardiovascular disease were predictive of increased LBP among a cohort of industrial employees, when physical workload was taken into account.

Methods: A sample (n = 902) stratified by sex, age, and occupational class was drawn from among employees in an engineering company in 1973, and examined for serum total cholesterol (S-Chol) and triglyceride (S-Trigl) concentrations, blood pressure, body mass index (BMI), smoking, leisure time physical activity, self-reported cardiac diseases, physical workload, and LBP (frequency of local and radiating pain). A composite score was constructed as the sum of tertiles of the seven cardiovascular risk factors. As of November 2000, 232 subjects had died, 108 for cardiovascular causes. In 2000, 546 (81% of the survivors) responded to a follow up questionnaire on for example, LBP.

Results: Self-reported cardiac diseases were associated with LBP. In men free of cardiac disease at baseline, an increased LBP score during the 28 year follow up was predicted by smoking (stopped v never: OR 2.04; 95% CI 1.13 to 3.69 and current v never: 2.05; 1.13 to 3.72), BMI (high tertile v low: 2.95; 1.57 to 5.55), S-Chol (1.96; 1.06 to 3.60), S-Trigl (2.33; 1.30 to 4.19), and systolic (2.91; 1.57 to 5.41) and diastolic (1.95; 1.05 to 3.61) blood pressure, when adjusted for age and occupational class. In a total model, the effects of smoking, BMI, SBP, and work strenuousness remained statistically significant. The composite score showed a graded association pattern (middle …