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Occupational Medicine 1999;49:155-160
© 1999 Society of Occupational Medicine

research-article

Smoking, heavy physical work and low back pain: A four-year prospective study

W. Eriksen, B. Natvig and D. Bruusgaard

Institute of General Practice and Community Medicine, University of Oslo PO Box 1130 Blindern, 0317 Oslo, Norway

Data from a community-based four-year prospective study were used to test the hypothesis that heavy physical work is a stronger predictor of low back pain in smokers than in non-smokers. Of 708 working responders without low back pain during the entire year prior to 1990, 562 (79%) completed a questionnaire four years later in 1994. A job involving heavy lifting and much standing in 1990 was a strong predictor of low back pain in smokers four years later [odd ratio (OR)=5.53, 95% confidence interval (Cl)=1.93–15.84, p<0.01) after having adjusted for other job characteristics, demographic factors, emotional symptoms, physical exercise and musculoskeletal pain elsewhere. In non-smokers, having a job with heavy lifting and much standing was not associated with low back pain. One explanation may be that smoking leads to reduced perfusion and malnutrition of tissues in or around the spine and causes these tissues to respond inefficiently to mechanical stress.

Keywords      Aetiology; job characteristics; low back pain; risk factors; smoking

Received       10 August 1998
Accepted        8 October 1998

Correspondence and reprint requests to: W. Eriksen, Institute of General Practice and Community Medicine, University of Oslo, PO Box 1130 Blindern, 0317 Oslo, Norway. Tel: (+47)22 850605; Fax: (+47)22 850610; email: w.b.eriksen{at}samfunnsmed.uio.no


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