Open Access Highly Accessed Study protocol

Study protocol title: a prospective cohort study of low back pain

Arun Garg1*, Kurt T Hegmann2, J Steven Moore3, Jay Kapellusch1, Matthew S Thiese2, Sruthi Boda1, Parag Bhoyr1, Donald Bloswick2, Andrew Merryweather2, Richard Sesek2, Gwen Deckow-Schaefer1, James Foster1, Eric Wood2, Xiaoming Sheng2, Richard Holubkov2 and The BackWorks Study Team

Author Affiliations

1 Center for Ergonomics, University of Wisconsin-Milwaukee, P.O. Box 784, Milwaukee, WI 53201, USA

2 Rocky Mountain Center for Occupational & Environment Health, Department of Family and Preventive Medicine, University of Utah, 391 Chipeta Way, Suite C, Salt Lake City, UT 84108, USA

3 School of Rural Public Health, Texas A&M University Health Science Center, College Station, TX 77843-1266, USA

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BMC Musculoskeletal Disorders 2013, 14:84  doi:10.1186/1471-2474-14-84

Published: 7 March 2013



Few prospective cohort studies of workplace low back pain (LBP) with quantified job physical exposure have been performed. There are few prospective epidemiological studies for LBP occupational risk factors and reported data generally have few adjustments for many personal and psychosocial factors.


A multi-center prospective cohort study has been incepted to quantify risk factors for LBP and potentially develop improved methods for designing and analyzing jobs. Due to the subjectivity of LBP, six measures of LBP are captured: 1) any LBP, 2) LBP ≥ 5/10 pain rating, 3) LBP with medication use, 4) LBP with healthcare provider visits, 5) LBP necessitating modified work duties and 6) LBP with lost work time. Workers have thus far been enrolled from 30 different employment settings in 4 diverse US states and performed widely varying work. At baseline, workers undergo laptop-administered questionnaires, structured interviews, and two standardized physical examinations to ascertain demographics, medical history, psychosocial factors, hobbies and physical activities, and current musculoskeletal disorders. All workers’ jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of low back pain. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. The lifetime cumulative incidence of low back pain will also include those with a past history of low back pain. Incident cases will exclude prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression.


Data analysis of a prospective cohort study of low back pain is underway and has successfully enrolled over 800 workers to date.

Epidemiology; Ergonomics; Cohort; Low back pain; NIOSH lifting equation