Musculoskeletal pain, obesity, and smoking are among the factors associated with an increased risk of work disability due to low back disorders, reports a study in the May Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).

Using data from a large study of Finnish twins, the researchers looked for factors associated with a higher or lower risk of going on disability pension for low back disorders. The senior author was Annina Ropponen, PhD, of the University of Eastern Finland, Kuopio.

The factor most strongly related to disability was pain in the neck, shoulder, or back — more than a twofold increase in risk. Other risk factors were frequent use of analgesic drugs (pain relievers), being a former or current smoker, having some type of chronic disease, and being a manual worker.

Increased education and higher income were associated with a lower risk of back-related disability. Being overweight increased disability risk in men, but not in women. The use of twin data avoided potential confounding due to genetic factors and childhood environment.

Low back disorders are a major public health problem, and a leading cause of lost productivity and work disability. The new study helps to clarify the factors that may increase the risk of back-related disability.

These include some potentially modifiable factors — for example, musculoskeletal pain, smoking, and overweight — that could be addressed in younger workers to help reduce their lifelong risk of disability related to low back disorders. “Health interventions early in work-life may be of importance both to improve workability and prolong working careers, particularly in occupations including physical loading,” Dr. Ropponen and co-authors conclude.