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337 Determinants of back-pain in the European Countries. A cross-sectional analysis of data from the fifth European Working Conditions Survey
  1. A F Farioli1,
  2. Quaglieri1,
  3. Curti1,
  4. Mattioli1,
  5. Violante1,
  6. Palmer2,
  7. Coggon2
  1. 1University of Bologna, Bologna, Italy
  2. 2MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom


Objectives Prevalence of back-pain in European countries has been reported to vary considerably. We used data from the fifth European Working Conditions Survey (EWCS) to explore the role of personal, occupational, and country socioeconomic characteristics in determining the national prevalence of back-pain.

Methods The EWCS was conducted in 34 countries during 2010. 43,816 subjects were interviewed using a standardised questionnaire. We analysed the prevalence of back-pain over the last year. Occupational and personal exposures investigated include: age, gender, biomechanical risk factors (carrying or moving loads; lifting or moving people; standing; tiring or painful positions; vibrations); job-demand control model; educational level; socio-economic status; housework or gardening; caring for children or elderly/disabled; performing housework or gardening; doing sporting, cultural or leisure activity outside home; somatisation tendency. We also studied the role of country socioeconomic characteristics. Analyses were performed with logistic or Poisson regression models incorporating sampling weights and with standard error clustered on NUTS regions. Multilevel models were fitted to study country socioeconomic characteristics.

Results 30,066 workers entered the main analysis. With the exception of gender, all personal and occupational characteristics were associated with back-pain in multivariate analysis; somatising tendency was the strongest predictor of the symptoms. Country socioeconomic characteristics were associated with back-pain in univariate analysis. However, no association was found after adjustment by subject-level characteristics. National prevalence of back-pain ranged between 22.1% (Ireland) and 64.2% (Portugal). Neighbouring countries frequently had similar prevalences. Adjustment for personal and occupational risk factors did not explain all of the variation in prevalence of back-pain among European countries.

Conclusions The high variability in prevalence of back-pain among European countries was not explained by subject-level characteristics. The inclusion of current country socioeconomic characteristics did not improve the fit of multivariate statistical models. Group-level characteristics and cultural factors should be investigated.

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