ArticleBMC musculoskeletal disorders2009
Cumulative occupational lumbar load and lumbar disc disease--results of a German multi-center case-control study (EPILIFT).
Article in BMC musculoskeletal disorders, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 8 of them syntheses that pooled it.
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Who cites it
47 citing papers in PubMed, 8 syntheses or guidelines pooled it, 124 citations in OpenAlex.
- Global prevalence and associated risk factors of work-related musculoskeletal disorders among steelworkers: a systematic review and meta-analysis.Frontiers in public health · 2026Pooled it
- Incidence of and risk factors for lumbar disc herniation with radiculopathy in adults: a systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Pooled it
- Occupational mechanical exposures as risk factor for chronic low-back pain: a systematic review and meta-analysis.Scandinavian journal of work, environment & health · 2023Pooled it
- The association between occupational loading and spine degeneration on imaging - a systematic review and meta-analysis.BMC musculoskeletal disorders · 2019Pooled it
- Work-relatedness of lumbosacral radiculopathy syndrome: Review and dose-response meta-analysis.Neurology · 2018Pooled it
- Dose-response relationship between cumulative physical workload and osteoarthritis of the hip - a meta-analysis applying an external reference population for exposure assignment.BMC musculoskeletal disorders · 2018Pooled it
- Do Technical Aids for Patient Handling Prevent Musculoskeletal Complaints in Health Care Workers?-A Systematic Review of Intervention Studies.International journal of environmental research and public health · 2018Pooled it
- Does the use of small aids during patient handling activities lead to a decreased occurrence of musculoskeletal complaints and diseases? A systematic review.International archives of occupational and environmental health · 2016Pooled it
- Age-Related Transitions in Low Back Pain Pathology: A Life-Course Narrative Review.Pain and therapy · 2026Review
- Impact of nursing shift patterns on work-related musculoskeletal disorders: a systematic review and meta-analysis.BMC nursing · 2026Article
- Reliability of Ultrasonography to Assess Spinal Compression During Heavy Load Carriage.JOR spine · 2026Article
- Development and validation of a prognostic prediction model for lumbar-disc herniation based on machine learning and fusion of clinical text data and radiomic features.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Lumbar Disc Herniation Resorption: When and How Does It Occur?Neurospine · 2026Review
- Occupational risk factors for surgically treated lumbar disc herniation - a 33-year follow-up.Scandinavian journal of work, environment & health · 2025Article
- Article
- Biomechanical Study of Symmetric Bending and Lifting Behavior in Weightlifter with Lumbar L4-L5 Disc Herniation and Physiological Straightening Using Finite Element Simulation.Bioengineering (Basel, Switzerland) · 2024Article
- Understanding the etiopathogenesis of lumbar intervertebral disc herniation: From clinical evidence to basic scientific research.JOR spine · 2024Review
- Long-term whole-body vibration induces degeneration of intervertebral disc and facet joint in a bipedal mouse model.Frontiers in bioengineering and biotechnology · 2023Article
- Influence of physically demanding occupations on the development of osteoarthritis of the hip: a systematic review.Journal of occupational medicine and toxicology (London, England) · 2022Review
- Application of a nomogram to radiomics labels in the treatment prediction scheme for lumbar disc herniation.BMC medical imaging · 2022Article
Corrections and comments
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Authors and funding
15 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe to date evidence for a dose-response relationship between physical workload and the development of lumbar disc diseases is limited. We therefore investigated the possible etiologic relevance of cumulative occupational lumbar load to lumbar disc diseases in a multi-center case-control study.
methodsIn four study regions in Germany (Frankfurt/Main, Freiburg, Halle/Saale, Regensburg), patients seeking medical care for pain associated with clinically and radiologically verified lumbar disc herniation (286 males, 278 females) or symptomatic lumbar disc narrowing (145 males, 206 females) were prospectively recruited. Population control subjects (453 males and 448 females) were drawn from the regional population registers. Cases and control subjects were between 25 and 70 years of age. In a structured personal interview, a complete occupational history was elicited to identify subjects with certain minimum workloads. On the basis of job task-specific supplementary surveys performed by technical experts, the situational lumbar load represented by the compressive force at the lumbosacral disc was determined via biomechanical model calculations for any working situation with object handling and load-intensive postures during the total working life. For this analysis, all manual handling of objects of about 5 kilograms or more and postures with trunk inclination of 20 degrees or more are included in the calculation of cumulative lumbar load. Confounder selection was based on biologic plausibility and on the change-in-estimate criterion. Odds ratios (OR) and 95% confidence intervals (CI) were calculated separately for men and women using unconditional logistic regression analysis, adjusted for age, region, and unemployment as major life event (in males) or psychosocial strain at work (in females), respectively. To further elucidate the contribution of past physical workload to the development of lumbar disc diseases, we performed lag-time analyses.
resultsWe found a positive dose-response relationship between cumulative occupational lumbar load and lumbar disc herniation as well as lumbar disc narrowing among men and women. Even past lumbar load seems to contribute to the risk of lumbar disc disease.
conclusionAccording to our study, cumulative physical workload is related to lumbar disc diseases among men and women.
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