Occupational psychosocial exposures and chronic low-back pain: a systematic review and meta-analysis

Abstract

OBJECTIVE: This study aimed to explore the association between occupational psychosocial exposures and chronic low-back pain (LBP) by conducting a systematic review and meta-analysis. METHODS: The research protocol was registered in PROSPERO. A systematic literature search was performed in six databases, identifying articles complying with predefined inclusion criteria. In our PECOS, we defined outcome as chronic LBP ≥3 months, exposures as occupational psychosocial exposures, and restricted study design to case–control and cohort studies. Two authors independently excluded articles, extracted data, assessed risk of bias, and graded evidence levels. Meta-analyses were performed using random-effects models. RESULTS: The 20 included articles encompassed six different occupational psychosocial exposures (job control, demand, strain, support, stress, and satisfaction), only 1 had low risk of bias. For all occupational psychosocial exposures, odds ratios ranged from 0.8 to 1.1. Sensitivity analyses based on risk of bias was conducted for two outcomes ie, job control and job demand, finding no differences between high and low-to-moderate risk of bias studies. Using GRADE, we found a very low level of evidence of the association for all occupational psychosocial exposures. CONCLUSION: In this study, we found no association between occupational psychosocial exposures and chronic LBP. However, it is important to underline that the level of evidence was very low. High quality studies are highly warranted.

Keywords

• etiology
• stress
• low-back pain
• meta-analysis
• work
• job demand
• pain
• systematic review
• spine
• psychosocial exposure