Cumulative occupational lumbar load and lumbar disc disease – results of a German multi-center case-control study (EPILIFT)
Andreas Seidler*1, Annekatrin Bergmann2, Matthias Jäger3, Rolf Ellegast4, Dirk Ditchen4, Gine Elsner5, Joachim Grifka6, Johannes Haerting2, Friedrich Hofmann7, Oliver Linhardt6, AlwinLuttmann3, Martina Michaelis7, Gabriela Petereit-Haack8, Barbara Schumann1,2 and Ulrich Bolm-Audorff8
Address: 1Federal Institute for Occupational Safety and Health, Nöldnerstraße 40–42, 10317 Berlin, Germany, 2Institute for Medical Epidemiology, Biostatistics, and Informatics, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06097 Halle/Saale, Germany, 3Institute for OccupationalPhysiology at the University of Dortmund, Ardeystraße 67, 44139 Dortmund, Germany, 4Institute for Occupational Safety and Health, BGIA, German Statutory Accident Insurance, Alte Heerstraße 111, 53757 Sankt Augustin, Germany, 5Institute of Occupational Medicine, Frankfurt University, Johann Wolfgang Goethe-Universität, Theodor Stern-Kai 7, 60590 Frankfurt am Main, Germany, 6Orthopaedic Clinic, Universityof Regensburg, Kaiser Karl V Allee 3, 93077 Bad Abbach, Germany, 7Research Center for Occupational and Social Medicine Freiburg, Bertoldstraße 27, 79098 Freiburg, Germany and 8Labor inspection, Occupational Health Division, Regional Government of South Hesse, Simone Veil Straße 5, 65197 Wiesbaden, Germany Email: Andreas Seidler* - email@example.com; Annekatrin Bergmann -firstname.lastname@example.org; Matthias Jäger - email@example.com; Rolf Ellegast - firstname.lastname@example.org; Dirk Ditchen - email@example.com; Gine Elsner - firstname.lastname@example.org; Joachim Grifka - email@example.com; Johannes Haerting - firstname.lastname@example.org; Friedrich Hofmann - email@example.com; Oliver Linhardt - firstname.lastname@example.org;Alwin Luttmann - email@example.com; Martina Michaelis - firstname.lastname@example.org; Gabriela Petereit-Haack - email@example.com; Barbara Schumann - firstname.lastname@example.org; Ulrich Bolm-Audorff - email@example.com * Corresponding author
Published: 7 May 2009 BMC Musculoskeletal Disorders 2009, 10:48 doi:10.1186/1471-2474-10-48
Received: 11 September 2008 Accepted:7 May 2009
This article is available from: http://www.biomedcentral.com/1471-2474/10/48 © 2009 Seidler et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work isproperly cited.
Background: The 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. Methods: In 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 subjectswere 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...