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Contribution of occupational factors to the incidence and persistence of chronic low back pain among workers: results from the longitudinal VISAT study
  1. Yolande Esquirol1,2,
  2. Michel Niezborala3,
  3. Monique Visentin4,
  4. Anne Leguevel5,
  5. Ignacio Gonzalez6,
  6. Jean-Claude Marquié6
  1. 1UMR 1027 Paul Sabatier University, CHU, Toulouse, France
  2. 2Faculté de médecine, 37 allées jules Guesde 31000 Toulouse, France
  3. 3Occupational Health Department, Toulouse, France
  4. 4Occupational Health Centre, Auch, France
  5. 5Occupational Health Centre, Toulouse, France
  6. 6UMR 5263 CNRS, MDR, University Toulouse II, CLLE (Cognition, Langues, Langage, Ergonomie), Toulouse, France
  1. Correspondence to Dr Yolande Esquirol, UMR 1027 Paul Sabatier University, Toulouse III, CHU-Toulouse, Faculté de médecine, 37 allées jules Guesde, Toulouse 31000, France; esquirol.y{at}


Objective Among the aetiological factors of chronic low back pain (CLBP), occupational factors are often suspected, but their contribution remains to be ascertained. This study aimed to determine the impact of a wide range of occupational factors on the incidence and persistence of CLBP.

Method From the VISAT (VIeillissement SAnté Travail) study, 1560 workers were examined at baseline and 5 years later. CLBP was defined as having low back pain or specific treatment for at least 6 months. Participants newly affected with CLBP and those with persistent CLBP at follow-up were distinguished. In addition to individual factors, a broad panel of occupational factors were analysed, covering employment, physical, organisational and psychosocial factors. Multivariate analyses were used to determine predictive factors of incidence and persistence of CLBP. Receiver operating characteristic (ROC) curves were performed to analyse the contribution of occupational factors.

Results 22.6% of participants without any CLBP initially presented with CLBP 5 years later, while 53.7% of participants with CLBP at baseline had CLBP at the second collection. Carrying heavy loads, the lack of recognition of completed work and productivity-related income predicted a higher risk of incidence of CLBP. However, no significant association between occupational factors and the risk for persistence of CLBP was observed, while the risk was multiplied by two for history of depression and rheumatological events. ROC curves confirmed the significant contribution of occupational factors to incidence of CLBP.

Conclusions Occupational factors played a pivotal role in the incidence of CLBP, while individual factors were the main determinants of persistence of CLBP.

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