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Risk factors for new-onset low back disability among Japanese workers: results from the Cultural and Psychosocial Influences on Disability (CUPID) study

Objectives We investigated physical and psychosocial risk factors for incident low back pain (LBP) with disability (LBD) among Japanese workers who were initially pain-free. Methods As a part of the international CUPID study, we followed up 955 workers (651 men; mean age 37.0 years), who at baseline had been free from LBP for ≥1 year. At baseline, information was collected about demographic variables, musculoskeletal pain at different anatomical sites, occupational physical activities, and psychosocial risk factors. Subsequent occurrence of LBP and associated disability was ascertained by a follow-up questionnaire after 1 year. LBD was defined as LBP interfering with work or leading to sick-leave. Associations between risk factors and incident LBD were assessed by logistic regression. Results 6.1% of the workers developed LBD during the follow-up period. History of LBP, occupational physical activities (eg, climbing up or down more than 30 flights of stairs per day, bending and twisting for ≥4 h per day), frequent and severe neck or shoulder discomfort, inadequate breaks at work, and ≥60 h of work per week were statistically significant risk factors of new-onset LBD. Conclusions The observed associations with long working hours and frequent and severe neck or shoulder discomfort (which is a common somatising symptom in the Japanese) indicate a role of psychosocial as well as physical risk factors in the development of LBD.