Objectives To determine the prevalence and incidence of LBP in Costa Rica and Nicaragua, middle-income countries, and Spain, a high income economy.
Methods A secondary analysis of office workers from baseline (Costa Rica: n = 224, 91%; Nicaragua: n = 285, 100%; Spain: n = 438, 98%) and a 12-month follow-up (92%, 89% and 90%, respectively) data collected as part of the Cultural and Psychosocial Influences in Disability (CUPID) study from the three participating Spanish-speaking countries. We examined three outcomes measures at baseline: (1) prevalence of LBP in last 12 months, (2) prevalence of LBP in past month, and (3) prevalence of disabling LBP; and three at follow-up: (4) incidence of LBP in past month, (5) incidence of disabling LBP, and (6) persistence of LBP. We used logistic regression to estimate the association, odd ratios (OR) and their corresponding 95% confidence intervals (95% CI), between country and these outcome measures. Models were adjusted for socio-demographic, job and health variables.
Results After adjusting for covariates, the prevalence of LBP in Costa Rica and Nicaragua was always higher than in Spain, but only the prevalence of disabling LBP was simultaneously, and statistically significant, higher both in Costa Rica (27%) and Nicaragua (28%) than in Spain (15%). Compared to Spain, and after adjustment, the incidence of LBP was statistically significantly higher only in Nicaragua: LBP in the last month (OR = 2.38; 95% CI: 1.33–3.92), disabling pain (OR = 2.53; 95% CI: 1.38–4.62), persistence of pain (OR = 2.51; 95% CI: 1.36–4.66).
Conclusion LBP was common among office workers in all three countries, but with a higher prevalence in Costa Rica and Nicaragua than Spain. Incidence was higher only in Nicaragua. These differences persisted despite adjustments for sociodemographic, organisational, physical demands, and health-related factors. Future studies are needed to examine whether or not other working conditions (e.g., workplace ergonomics) and/or cultural determinants explain the remaining differences.
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