Occupational Exposures and Back Disorders

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Since 2011 SBU has had a mandate from the Swedish government to systematically assess the evidence associating occupational exposures to health issues. The objective of this review was to assess the scientific basis describing the influence of occupational exposures on back disorders.


  • People in the following groups develop more back trouble over time than those who are not subjected to the specified exposure at work:
    • Those who work with manual handling (e.g. lift) or in a posture where the back is bent or rotated
    • Those who work in a kneeling or squatting posture, or have physically demanding work tasks
    • Those exposed to whole body vibration
    • Those who experience work as mentally stressful; or those who find their work demanding, but lack decision latitude (personal control of their own working situation); or those who have insufficient opportunities for personal development
    • Those who work outside standard office hours.
  • In some work environments, people have less back trouble. Those who experience high influence over work-related decisions, those who get social support at work and those with high job satisfaction develop less back trouble than others.
  • Women and men with similar occupational exposures develop back troubles to the same extent.
  • Those who work in forward bent postures or are exposed to whole body vibration in their work develop more symptoms of sciatica than others, while those with high job satisfaction develop less such symptoms. Those whose work entails manual handling develop more intervertebral disc changes than others.
  • This systematic literature review has uncovered a substantial body of knowledge concerning occupational exposures and back disorders. Future research should include intervention studies, i.e. studies that scientifically test the effect of well defined interventions on back disorders over extended periods of time in authentic work situations.

How to cite this report: SBU. Occupational exposures and back disorders. Stockholm: Swedish Council on Health Technology Assessment (SBU); 2014. SBU report no 227 (in Swedish).

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SBU Assessment presents a comprehensive, systematic assessment of available scientific evidence. The certainty of the evidence for each finding is systematically reviewed and graded. Full assessments include economic, social, and ethical impact analyses.

SBU assessments are performed by a team of leading professional practitioners and academics, patient/user representatives and SBU staff. Prior to approval and publication, assessments are reviewed by independent experts, SBU’s Scientific Advisory Committees and Board of Directors.

Published: 10/8/2014
Contact SBU: registrator@sbu.se
Report no: 227