Individual Participant Data Meta-Analysis of Mechanical Workplace Risk Factors and Low Back Pain

• Published in: American journal of public health (1971) Vol. 102; no. 2; pp. 309 - 318
• Main Authors: GRIFFITH, Lauren E, SHANNON, Harry S, WELLS, Richard P, WALTER, Stephen D, COLE, Donald C, COTE, Pierre, FRANK, John, HOGG-JOHNSON, Sheilah, LANGLOIS, Lacey E
• Format: Journal Article
• Language: English
• Published: Washington, DC American Public Health Association 01.02.2012
• Subjects: Age Factors; Back pain; Biological and medical sciences; Biomechanics; Cross-sectional studies; Datasets; Diseases of the osteoarticular system; Diseases of the spine; General aspects; Humans; Job titles; Lifting - adverse effects; Low Back Pain - epidemiology; Low Back Pain - etiology; Mechanical Phenomena; Medical sciences; Mens health; Meta-analysis; Methods; Miscellaneous; Occupational Diseases - epidemiology; Occupational Diseases - etiology; Occupational Health; Occupational medicine; Occupations; Odds Ratio; Pathology; Posture - physiology; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Research and Practice; Risk Factors; Sex Factors; Studies; Systematic review; Womens health; Workplace - statistics & numerical data; Human; Participation; Data analysis; Work place; Lumbar spine; Low back pain; Diseases of the osteoarticular system; Evidence-based practice; Spine disease; Evidence-based medicine; Metaanalysis; Pain; Risk factor; Rachialgia; Occupational medicine; Public health
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/ajph.2011.300343

We used individual participant data from multiple studies to conduct a comprehensive meta-analysis of mechanical exposures in the workplace and low back pain. We conducted a systematic literature search and contacted an author of each study to request their individual participant data. Because outcome definitions and exposure measures were not uniform across studies, we conducted 2 substudies: (1) to identify sets of outcome definitions that could be combined in a meta-analysis and (2) to develop methods to translate mechanical exposure onto a common metric. We used generalized estimating equation regression to analyze the data. The odds ratios (ORs) for posture exposures ranged from 1.1 to 2.0. Force exposure ORs ranged from 1.4 to 2.1. The magnitudes of the ORs differed according to the definition of low back pain, and heterogeneity was associated with both study-level and individual-level characteristics. We found small to moderate ORs for the association of mechanical exposures and low back pain, although the relationships were complex. The presence of individual-level OR modifiers in such an area can be best understood by conducting a meta-analysis of individual participant data.