The association between low back pain and occupational work loads, lifestyle factors and socio-demographic factors was examined in 469 steelplant workers (436 men, 33 women), aged 40±12 years (mean±$$$). Fifty-one per cent had experienced low back pain during the preceding year. The strongest associations were found between recent low back pain and domestic recreational activities (≥3h/weekvs. 0–2h/week), and between recent low back pain and work pace (too fastvs. adequate), with odds ratios (95%confidence limits) of 3.0 (1.5–5.8) and 2.3 (1.2–4.2), respectively. We considered a subject to have a particularly severe history of low back pain if, due to low back trouble, he (i) had ever been admitted to a hospital, (ii) had ever had to change work, or (iii) had had more than one week's accumulated sick leave during the preceding year. There was a strong association between a severe low back pain history and lifetime occupational exposure to heavy and frequent lifting at work. Forty-seven per cent of severe low back pain events could be ascribed to heavy and frequent lifting, assuming the associations were causal. We conclude that domestic recreational activities may be an important potential confounder in studies on occupational risk factors for low back pain, and that, based on the results of this and of other studies, a case for prevention still seems to exist regarding lifting of heavy burdens in the work en
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