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Physical workload and risk of low back pain in adolescence
  1. Paula Mikkonen1,
  2. Eira Viikari-Juntura2,
  3. Jouko Remes2,
  4. Tuomo Pienimäki3,
  5. Svetlana Solovieva2,
  6. Simo Taimela4,
  7. Paavo Zitting5,
  8. Markku Koiranen5,
  9. Päivi Leino-Arjas2,
  10. Jaro Karppinen1,2
  1. 1Institute of Clinical Sciences, Department of Physical and Rehabilitation Medicine, University of Oulu, Oulu, Finland
  2. 2Finnish Institute of Occupational Health, Oulu and Helsinki, Finland
  3. 3Social Insurance Institution, Oulu, Finland
  4. 4Department of Public Health, University of Helsinki, Helsinki, Finland
  5. 5Institute of Health Sciences, University of Oulu, Oulu, Finland
  1. Correspondence to Dr Paula Mikkonen, Department of Physical and Rehabilitation Medicine, University of Oulu, Oulu University Hospital, Box 21, Oulu 90029, Finland; paula.mikkonen{at}


Objectives To evaluate the role of physical workload in low back pain (LBP) among adolescents.

Methods Working history and physical workload factors at 18 years were assessed for 1984 members of the Northern Finland Birth Cohort 1986. The associations between work characteristics and LBP were analysed by multinomial logistic regression. Those with and without LBP at 18 years of age were compared in two subsamples. The incidence of LBP was studied among the 986 subjects without LBP at 16 years of age. Persistence of LBP was studied among the 728 subjects with LBP at 16 years of age. Latent class analysis (LCA) was used to form natural clusters of workload factors and their associations with LBP were investigated using log-binomial regression.

Results 753 (75%) subjects without LBP at 16 years of age had been working during the 2-year follow-up period. The average duration of work was 6.2 months. In adolescent girls, working regularly or irregularly and duration of work exposure were associated with incident LBP. Of specific physical workload factors, only awkward trunk postures were associated with incident LBP in both genders (RR 1.2 in girls and 1.7 in boys). The work exposure patterns in adolescent girls and boys were different. In the LCA, subjects in a cluster with high exposure to awkward trunk postures or an overall physically demanding job had a higher likelihood of incident LBP in both genders (RR 1.3–1.9). None of the specific workload factors or clusters was associated with persistent LBP.

Conclusions Physical workload factors constitute a risk for LBP even in adolescents.

  • Low back pain
  • workload
  • adolescent
  • workload
  • epidemiology
  • back disorders
  • musculoskeletal
  • back disorders
  • statistics
  • public health
  • polymorphisms
  • mathematical models
  • genetic susceptibility
  • osteoarthritis
  • physiology
  • sickness absence
  • rehabilitation
  • organisation of work
  • longitudinal studies
  • genetic susceptibility
  • fitness for work
  • smoking
  • physical work
  • stress
  • disability

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  • Funding The Academy of Finland, grant numbers 200868 and 129504.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Institutional ethics committee of Oulu University Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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