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Occupational risk factors for symptomatic lumbar disc herniation; a case-control study
A Seidler1, U Bolm-Audorff, T Siol
1Institute of Occupational Medicine, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany. A.Seidler@em.uni-frankfurt.de
Occupational and Environmental Medicine
|October 24, 2003
Summary
Physical and psychosocial workloads are linked to lumbar disc herniation. Extreme forward bending is a risk factor for disc herniation, with or without spinal degeneration. Weight lifting is associated with herniation in degenerated discs.
Area of Science:
- Occupational Health
- Orthopedics
- Epidemiology
Background:
- Previous studies often combined disc herniation with and without spinal degeneration (osteochondrosis/spondylosis).
- This lack of differentiation may explain varied risk patterns observed in prior research.
Purpose of the Study:
- To investigate the etiological relevance of physical and psychosocial workload factors.
- To differentiate risks for lumbar disc herniation with and without concomitant osteochondrosis/spondylosis.
Main Methods:
- A case-control study involving 267 patients with acute lumbar disc herniation and 197 controls.
- Data collected via structured interviews; logistic regression used for analysis, controlling for confounding factors.
- Risk factors analyzed separately for herniation with (n=131) and without (n=94) radiographic osteochondrosis/spondylosis.
Main Results:
- Extreme forward bending showed a significant association with lumbar disc herniation, irrespective of osteochondrosis/spondylosis.
- Cumulative exposure to heavy lifting/carrying correlated with herniation in cases with, but not without, concomitant osteochondrosis/spondylosis.
- Cases reported higher rates of work-related time pressure and psychic strain from client contact.
Conclusions:
- Further research with larger cohorts is necessary.
- The study suggests potentially distinct etiologies for disc herniation in younger individuals with healthy discs versus older individuals with pre-existing disc damage.