Introduction Work-related low back pain (WRLBP) is a complex phenomenon accounting for a high proportion of occupational costs. Growing evidence links organizational risk factors to WRLBP.

Objective To examine the impact of work organization on WRLBP and mental health of Tunisian craftsmen.

Methods A cross-sectional study was conducted among the registered craftsmen of the governorate of Monastir (Tunisia) (n=8526). The research was implemented on a representative sample, stratified by gender and craft activity. The survey included items related to health status, work organization, in addition to the Nordic Musculoskeletal and the Job Content Questionnaires.

Results The sample consisted of 368 craftsmen with a mean age of 42.7±8.5 years and a sex-ratio of 0.88. Work schedules were fixed with a mean duration of 8±2 hours. Craftsmen had at least one break per day with a mean duration of 60±12 minutes. Freedom in item design was found in 39% of cases. Room for manoeuvre was acceptable in 53% of cases. Mutual help was possible in 40% of cases. Relationships with colleagues and superiors were ‘good’ in more than 80% of cases. According to the Karazek model, 13.6% were in a Job Strain situation. WRLBP during the week preceding the survey were reported by 0.8% of the workers and 14.9% of them reported WRLBP during the last 12 months. Statistical analysis showed that WRLBP were less frequently reported by craftsmen with fewer hours of work (p<10^-3), those who had more than one break per day (p<10^-3) and the freedom of item design with non-monotonous production (p<10^-3). WRLBP was also less reported by workers non-constrained by an accelerated pace of work (p<10^-3), by a strict monitoring of work (p=0.008), or by an increased sense of responsibility (p<10^-3).

Conclusion The risk factors for WRLBP are complex. Our research suggests that the role of organizational and psychosocial factors need to be better examined.