Associations of psychosocial and individual factors with three different categories of back disorder among nursing staff

Although back disorders are a major occupational problem for nursing staff, few studies distinguish different types. By means of a structured questionnaire, we performed a cross-sectional study on the prevalence of diagnosed lumbar disc hernia, chronic low-back pain (LBP) (at least 90 d in the preceding 12 months) and acute LBP (intense pain for at least 1 d) with respect to physical, individual and psychosocial factors among female nurses (n=587), nursing aides (n=228) and head-nurses (n=43) working in a university hospital (95% of the female workforce). Almost all respondents reported known high-risk occupational activities. Overall prevalence of reported back disorders was 44% (acute LBP 19%, chronic LBP 17%, lumbar hernia 8%). On multinomial logistic regression analysis, scoliosis and commonly stress-related psychosomatic symptoms were associated with all three types of back disorder; trauma/ fractures of the spine, pelvis and/or legs and a global work-environment/job-satisfaction score with acute LBP; increasing age with lumbar disc hernia. While confirming the relevance of considering different definitions of back disorder, our data indicate items for investigation in cohort studies. These include: identification of specific risk factors for lumbar hernia; avoidance of possible work-environment risk factors such as hurried execution of different tasks at the same time; and influence on job suitability of underlying spinal pathologies such as scoliosis.