Rassegna bibliografica

Journal of Occupational and Environmetal Medicine. Vol. 65, Iss. 2, March 2015

Combined effect of back pain and stress on work ability


Background Back pain and occupational stress are known risk factors for absenteeism and presenteeism. In addition, the relationship between back pain (BP) and psychosocial stressors has been examined in numerous studies.

Aims To examine the prevalence of BP and perceived stress among employees of different occupational status and to investigate their combined impact on work ability.

Methods A comprehensive survey combining questionnaire data and medical examination offered in one division of a major chemical company in Germany. Self-rated health and work ability were assessed using the Work Ability Index (WAI). A synergy index was used to assess a potential interaction between both exposures under an additive model.

Results Of 867 voluntary participants, 653 returned complete questionnaires on BP and job stress perception. Although occupational stressors were perceived differently, there was no difference in the prevalence of BP between the occupational groups. Back pain and stress perception are correlated with each other and both are negatively associated with work ability. After adjustment for occupational status, demographic and lifestyle factors, we found a synergy effect of BP and stress perception with a modest to strong impact on declining WAI.

Conclusions Corporate health promotion interventions to reduce the impact of BP and stress perception on work ability should target both physical and psychological dimensions. Such interventions may be initiated in the context of regular (occupational) medical examinations.


Back pain, combined effect, corporate health promotion, Cross-sectional study, stress perception, synergy index, Work Ability Index (WAI).

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