Review Article

Risk Factors of Low Back Pain in Iranian Workers during 2000-2015: a systematic review


Previous studies confirm direct and indirect costs of low back pain in occupational settings. However, there is no systematic study of the risk factors for low back pain in different occupations; while planning and allocating resources requires comprehensive knowledge at the national and regional levels in order to control and manage low back pain. Therefore, the aim of this study was to identify risk factors of low back pain in Iranian workers during the years 2000 to 2015. Published journal papers, articles presented at the congresses and student thesis reports were systematically reviewed. Abstracts were extracted using appropriate keywords and authentic English-language (Google Scholar, Scopus, and PubMed) and Farsi (Magiran, SID, IranMedex, and Irandoc) databases. Following quality assessment of the selected publications, the full texts of the related ones were reviewed.  In 150 eligible studies, the mean prevalence of low back pain in the last 12 months was 48.77. Nordic questionnaire was the most commonly used technique for assessing back pain, and RULA and REBA were the most commonly used method for determining risk factors. All risk factors were categorized into nine groups: biomechanical, workplace design, tools and equipment, environmental, temporal aspects of job design, job content, organizational aspects, personal characteristics, and training. According to the findings, about half of the workers in Iran experienced low back pain. Considering the widespread risk factors and the high prevalence of low back pain among various occupational groups, it is suggested that appropriate measures be taken based on the findings of this study.

1. Liddle SD, Baxter GD, Gracey JH. Exercise and chronic low back pain: what works? Pain. 2004;107(1-2):176-90.
2. Kinkade S. Evaluation and treatment of acute low back pain. American family physician. 2007;75(8):1181-8.
3. Whitfield BH, Costigan PA, Stevenson JM, Smallman CL. Effect of an on-body ergonomic aid on oxygen consumption during a repetitive lifting task. International Journal of Industrial Ergonomics. 2014;44(1):39-44.
4. Spyropoulos P, Papathanasiou G, Georgoudis G, Chronopoulos E, Koutis H, Koumoutsou F. Prevalence of low back pain in Greek public office workers. Pain physician. 2007;10(5):651.
5. Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R. Lost productive time and cost due to common pain conditions in the US workforce. Jama. 2003;290(18):2443-54.
6. Chou R, Qaseem A, Snow V, Casey D, Cross JT, Shekelle P, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of internal medicine. 2007;147(7):478-91.
7. Nasl Saraji J, Ghaffari M, Shahtaheri S. Survey of correlation between two evaluation method of work related musculoskeletal disorders risk factors REBA& RULA. Iran Occupational Health. 2006;3(2):5-0.
8. Bidassie B, Zhang L, Gao Y, Duffy V. A Predictive Model of Occupational and Lifestyle Risk Factors and Pain Management Strategies for Participants in a Wellness Program Diagnosed with Chronic Low Back Pain. J Ergonomics S. 2014;4:2.
9. Punnett L, Prüss‐Ütün A, Nelson DI, Fingerhut MA, Leigh J, Tak S, et al. Estimating the global burden of low back pain attributable to combined occupational exposures. American journal of industrial medicine. 2005;48(6):459-69.
10. Şimşek Ş, Yağcı N, Şenol H. Prevalence and risk factors of low back pain among health-care workers in Denizli. Ağrı-The Journal of The Turkish Society of Algology. 2017;29(2):71-8.
11. Antwi-Afari MF, Li H, Edwards DJ, Pärn EA, Owusu-Manu D-G, Seo J, et al. Identification of potential biomechanical risk factors for low back disorders during repetitive rebar lifting. Construction Innovation. 2018.
12. Miyamoto M, Konno S, Gembun Y, Liu X, Minami K, Ito H. Epidemiological study of low back pain and occupational risk factors among taxi drivers. Industrial health. 2008;46(2):112-7.
13. Ogunbode AM, Adebusoye LA, Alonge TO. Prevalence of low back pain and associated risk factors amongst adult patients presenting to a Nigerian family practice clinic, a hospital-based study. African journal of primary health care & family medicine. 2013;5(1).
14. Assadi SN. Chronic Low Back Pain Frequency and its Risk Factors in Clinical and Office Staff of Hospitals. Middle East Journal of Rehabilitation and Health. 2015;2(3).
15. (ILO) ILO. International Standard Classification of Occupations 2008 (ISCO-08): structure, group definitions and correspondence tables: International Labour Office; 2012.
16. Coste J, Delecoeuillerie G, De Lara AC, LeParc J, Paolaggi J. Clinical course and prognostic factors in acute low back pain: an inception cohort study in primary care practice. Bmj. 1994;308(6928):577-80.
17. Guo H-R, Tanaka S, Halperin WE, Cameron LL. Back pain prevalence in US industry and estimates of lost workdays. American journal of public health. 1999;89(7):1029-35.
18. Williams D, Feuerstein M, Durbin D, Pezzullo J. Health care and indemnity costs across the natural history of disability in occupational low back pain. Occupational Health and Industrial Medicine. 1999;2(40):104.
19. Ozguler A, Leclerc A, Landre M-F, Pietri-Taleb F, Niedhammer I. Individual and occupational determinants of low back pain according to various definitions of low back pain. Journal of Epidemiology & Community Health. 2000;54(3):215-20.
20. Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al. A systematic review of the global prevalence of low back pain. Arthritis & Rheumatism. 2012;64(6):2028-37.
21. Tveito TH, Hysing M, Eriksen HR. Low back pain interventions at the workplace: a systematic literature review. Occupational medicine. 2004;54(1):3-13.
22. Guo HR, Tanaka S, Cameron LL, Seligman PJ, Behrens VJ, Ger J, et al. Back pain among workers in the United States: national estimates and workers at high risk. American journal of industrial medicine. 1995;28(5):591-602.
23. Xiang H, Stallones L, Keefe TJ. Back pain and agricultural work among farmers: an analysis of the Colorado Farm Family Health and Hazard Surveillance Survey. American journal of industrial medicine. 1999;35(3):310-6.
24. Soroush A, Shamsi M, Izadi N, Heydarpour B, Samadzadeh S, Shahmohammadi A. Musculoskeletal disorders as common problems among iranian nurses: a systematic review and meta-analysis study. International journal of preventive medicine. 2018;9.
25. Pandya M, Desai D. Systematic Review on Various Risk Assessment Techniques of Musculoskeletal Disorder. Industrial Engineering Journal. 2019;12(6).
26. Hita-Gutiérrez M, Gómez-Galán M, Díaz-Pérez M, Callejón-Ferre Á-J. An overview of reba method applications in the world. International Journal of Environmental Research and Public Health. 2020;17(8):2635.
27. Frymoyer JW, Pope MH, Costanza MC, Rosen JC, Goggin JE, Wilder DG. Epidemiologic studies of low-back pain. Spine. 1980;5(5):419-23.
28. Burdorf A, Naaktgeboren B. Occupational risk factors for low back pain among sedentary workers. Journal of occupational medicine: official publication of the Industrial Medical Association. 1993;35(12):1213-20.
29. Hartvigsen J, Leboeuf-Yde C, Lings S, Corder EH. Is sitting-while-at-work associated with low back pain? A systematic, critical literature review. Scandinavian journal of public health. 2000;28(3):230-9.
30. Chen S-M, Liu M-F, Cook J, Bass S, Lo SK. Sedentary lifestyle as a risk factor for low back pain: a systematic review. International archives of occupational and environmental health. 2009;82(7):797-806.
31. Corlett E. Background to sitting at work: research-based requirements for the design of work seats. Ergonomics. 2006;49(14):1538-46.
32. Lim Y, AR NA, Minhat H. Contributing factors toward social problems among adolescents in governmental rehabilitation center in kuala lumpur. International Journal of Public Health and Clinical Sciences. 2014;1(1):70-9.
IssueVol 12 No 3 (2020) QRcode
SectionReview Article(s)
Prevalence Low back pain Systematic review Iranian workers

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How to Cite
Mazloumi A, Kazemi Z, Mehrdad R, Vahedi Z, Hajizadeh L. Risk Factors of Low Back Pain in Iranian Workers during 2000-2015: a systematic review. Int J Occup Hyg. 12(3):239-255.