A1870 The contribution of occupational factors to the global burden of low back pain

Tuesday, March 20, 2012
Ground Floor (Cancun Center)
Tim Driscoll, Sydney School of Public Health, University of Sydney, Sydney, Australia
Gemma Jacklyn, Sydney School of Public Health, University of Sydney, Sydney, Australia
Jess Orchard, Sydney School of Public Health, University of Sydney, Sydney, Australia
Erin Passmore, University of Sydney, Sydney School of Public Health, Sydney, Australia
Introduction
The new Global Burden of Disease project provides information on a range of disorders and risk factors for many of these disorders. It also seeks to compare burden between 1990 and 2005. One of the occupational risk factors examined in the study was occupational exposures leading to low back pain.

Methods
A population attributable fraction (PAF) approach was used. Exposure data were based on occupation. The occupation information was obtained primarily from International Labour Organization (ILO) Labour Force data, adjusted by information on the Economically Active Population obtained from the same ILO sources. Relative risk (RR) estimates for major occupation categories were meta-analytic estimates developed from a systematic review of relevant literature. The same RR estimates were used for both years (1990 and 2005), but the employment information was specific to the two years.

Results
The meta-analytic RRs (95% confidence interval) were: Professional, technical and related workers 1.17 (1.06-1.28); Administrative and managerial workers 1.20 (0.96-1.50); Sales workers 1.21 (1.01-1.44); Service workers 1.47 (1.38-1.57); Agriculture, animal husbandry and forestry workers, fishermen and hunters 3.73 (2.61-5.33) and Production and related workers, transport equipment operators and labourers 1.54 (1.41-1.68). Clerical and related workers were the reference group. Estimated PAFs were higher in developing countries compared to developed countries; in younger and middle ages compared to older ages; in males compared to females; and in 1990 compared to 2005.

Discussion
This analysis confirms that work is a very important contributor to the burden of back pain in communities worldwide, and suggests that this burden has decreased moderately between 1990 and 2005 due to a shift in occupation distribution to lower risk occupations. Shortcomings of the analytic approach include limited occupation information in some regions and no useable information on different interventions in place in different regions.

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