Skip to main content
Article thumbnail
Location of Repository

Low back pain and sickness absence among sedentary workers: the influence of lumbar sagittal movement characteristics and psychosocial factors

By Jamie Bell


Introduction:\ud Low back pain remains a burden for society, since it can lead to sickness absence and\ud work disability. Physical occupational risk factors can contribute to the development of back\ud pain, yet little is known about any risks in sedentary jobs posed by sitting. The influence of\ud psychosocial factors on back pain and sickness absence amongst sedentary workers is\ud also unclear. The aim of this study was to measure work activities, lumbar movement\ud characteristics, symptoms and psychosocial factors in order to determine associations with\ud low back pain and sickness absence.\ud \ud \ud Methods:\ud Phase 1: involved validation of a fibre-optic goniometer system that attaches to the lumbar\ud spine and hip to continuously measure: (1) activities (sitting, standing, walking); and (2)\ud lumbar movement characteristics (notably sitting postures and kinematics). New\ud questionnaires were also validated to measure aspects of low back discomfort.\ud Phase 2: consisted of a cross-sectional survey of call centre workers (n=600) to collect data\ud on: demographics, clinical and occupational psychosocial factors, and symptoms. An\ud experimental sample (n=140) wore the goniometer system during work.\ud Phase 3: involved a 6-month follow-up survey to collect back pain and sickness absence\ud data (n=367). Logistic regression was used to determine associations (P<0.05) between data.\ud \ud \ud Results:\ud Workers spent 83% of work-time sitting, 26% of which was spent adopting a lordotic lumbar\ud posture. Current back pain (>24hrs: yes/no) was associated with a kyphotic sitting posture\ud (time spent with a lumbar curve ≥180°) (R2 0.05), although future back pain was not. Using\ud multivariable models: limited variety of lumbar movement whilst sitting was associated with\ud future (persistent) LBP, dominating other variables (R2 0.11); yet high levels of reported\ud back discomfort, physical aggravating factors and psychological demand at work were\ud stronger predictors of sickness absence, and dominated other variables (R2 0.24).\ud \ud \ud Interpretation:\ud Workers do not follow the advice from employers to maintain a lumbar lordosis whilst\ud sitting, as recommended by statutory bodies. Furthermore, sitting with a kyphotic posture\ud did not increase the risk of back pain, although a relative lack of lumbar movement did.\ud Thus, ergonomic advice encouraging lumbar movement-in-sitting appears to be justified.\ud Predictors of sickness absence were multi-factorial, and consideration of work-relevant\ud biomedical and psychosocial factors would be more useful than adopting more narrow\ud screening approaches

Topics: R1, RZ
OAI identifier:

Suggested articles


  1. (1990). A comparison of the effects of two sitting postures on back and referred pain.
  2. (2001). A Critical Review of Psychosocial Hazard Measures.
  3. (1989). A digital videofluoroscopic technique for spine kinematics.
  4. (1993). A Fear Avoidance Beliefs Questionnaire (FABQ) and the role of fear avoidance beliefs in chronic low back pain and disability.
  5. (2002). A female ghetto? Women's careers in call centres
  6. (1987). A new clinical model for the treatment of low back pain.
  7. (1983). A prospective study of low back pain in a general population. Occurrence, recurrence and aetiology.
  8. (1983). A prospective study of low back pain in a general population. Part 2: location, character, aggravating and relieving factors.
  9. (1991). A prospective study of work perceptions and psychosocial factors affecting reports of back injury.
  10. (2002). A review of functional status measures for workers with upper extremity disorders.
  11. (2000). A review of psychological risk factors in back and neck pain.
  12. (2002). A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain.
  13. (1999). Accuracy of recall of usual pain intensity in back pain patients.
  14. (2001). Achieving Excellence in Call Centres. The Fourth Annual Benchmarking Report.
  15. (2003). Acute low back pain: systematic review of it's prognosis.
  16. (2006). Advice Regarding Call Centre Working Practices. Local Authority Circular, Health and Safety Executive, Local Authorities Enforcement Liasions Committee:
  17. (1998). Ambulatory monitoring of physical activity in working situations: a validation study.
  18. (1986). An electronic inclinometer technique for measuring lumbar curvature.
  19. (1975). An epidemiological study of the relationship between occupations and acute herniated lumbar intervertebral discs.
  20. (1988). An image processing method for spine kinematics - preliminary studies.
  21. (1992). An Improved Method of Stature Measurement for Quantitative Determination of Spinal Loading. Application to Sitting Postures and Whole Body Vibration.
  22. (2006). An objective spinal motion imaging assessment (OSMIA): reliability, accuracy and exposure data.
  23. (1987). Application of Karasek's Demand/Control Model in a Canadian occupational setting including shift workers during a period of reorganisation and downsizing. Emotional Health:
  24. (2007). Are causal beliefs about sedentary work associated with low back pain? International Society for the Study of the Lumbar Spine: poster presentation, 12th June. Hong Kong,
  25. (2002). Assessment of activities of daily living with an ambulatory monitoring system: A comparative study in patients with chronic low back pain and nonsymptomatic controls.
  26. (1981). Assessment of patients with low back pain by biplanar radiographic measurement of intervertebral motion.
  27. (2000). Assessment: A Mental Health Portfolio, Global Measures of Distress.
  28. (2007). Association between sitting and occupational LBP.
  29. (1995). Attitudes, beliefs and associated absence: impact of a psychosocial back pain pamphlet in an industrial setting.
  30. (1993). Attributions (beliefs) and job satisfaction associated with back pain in an industrial setting.
  31. (2002). Attributions, stress, and workrelated low back pain.
  32. (2000). Back pain in Britain: A comparison of two prevalence surveys at an interval of 10 years.
  33. (1987). Back surface curvature and measurement of lumbar spinal motion.
  34. (1986). Biomechanical properties of human intervertebral discs subjected to axial dynamic compression - influence of age and degeneration.
  35. (2000). Biopsychosocial determinants of chronic disability and low back pain: a review.
  36. (1999). Can quantified lumbar spine postures and trunk muscle activation levels predict discomfort during prolonged sitting.
  37. (1998). Can we screen for problematic back pain? A screening questionnaire for predicting outcome in acute and subacute back pain.
  38. (2000). Chronic pain explained.
  39. (1985). Chronicity and the General Health Questionnaire.
  40. (1994). Classification of chronic pain syndromes and definition of pain terms.
  41. (1999). Clinical Guidelines for the Management of Acute Low Back Pain. Royal College of General Practitioners,
  42. (2000). Clinical research: issues in data collection.
  43. (1951). Coefficient alpha and the internal structure of tests.
  44. (1987). Commonly adopted postures and thier effect on the lumbar spine.
  45. (1998). Comparison between two devices for measuring hip joint motions.
  46. (1993). Comparison of spinal health indicators in predicting spinal status in a 1 year longitudinal study.
  47. (2008). Comparisons of self-reported and register data on sickness absence among public employees in Sweden.
  48. (2001). Computer terminal work and the benefit of microbreaks.
  49. (2004). Concepts of rehabilitation for the management of common health problems. Department for Work and Pensions.
  50. (2006). Continuous dynamic spinal motion analysis.
  51. (1994). Continuous measurement of lumbar posture using flexible electrogoniometers.
  52. (1994). Continuous passive motion in seating: a new strategy against low back pain.
  53. (1983). Correlation between radiographic and clinical measurement of lumbar spine movement.
  54. (1987). Descriptive epidemiology of low back pain and its related medical care in the United States.
  55. (2001). Determinants of chronic disability related to low back pain: towards an integrative biopsychosocial model. Disability and Rehabilitation
  56. (2002). Determinants of occupational disability following low back injury: a critical review of the literature.
  57. (1981). Developing criteria for establishing interrater reliability: applications to assessment of adaptive behavior.
  58. (2002). Development and validation of a new technique for assessing lumbar spine motion.
  59. (2006). Development and validation of the low back discomfort scale for use in sedentary work environments. Society for Back Pain Research: poster presentation, 4th November.
  60. (2006). Development and validation of the sitting and symptom modifying factors questionnaire. Society for Back Pain Research: poster presentation, 4th November.
  61. (2007). Development of a fibre-optic goniometer system to measure lumbar and hip movement to identify activities and their lumbar postures.
  62. (2000). Development, Evaluation and Use of an Optical Fibre Goniometer to Continuously Monitor Lumbar Sagittal Curves. PhD Thesis. The University of Leeds,
  63. (2004). Differences in measurements of lumbar curvature related to gender and low back pain.
  64. (2000). Differences in repositioning error among patients with low back pain compared with control subjects.
  65. (2006). Differences in sitting postures are associated with nonspecific chronic low back pain disorders when patients are subclassified.
  66. (1983). Discomfort and pain from loaded passive joint structures.
  67. (1996). Do attitudes and beliefs influence work loss due to low back trouble.
  68. (1997). Do resources bolster coping and does coping buffer stress? An organisational study with longitudinal aspect and control for negative affectivity.
  69. (2000). Does long term compressive loading on the interveretbral disc cause degeneration.
  70. (2004). Does questionnaire design affect data quality? A randomised study of outcome measures in back pain.
  71. (1994). Does stress at work cause back pain? A prospective study of 10,308 office workers. Society for Back Pain Research
  72. (1999). Duration of work disability after low back injury: a comparison of administrative and self-reported outcomes.
  73. (2005). Early disability risk factors for low back pain assessed at outpatient occupational health clinics.
  74. (1997). Early predictors of delayed return to work in patients with low back pain.
  75. (2000). Economic and occupational influences on pain and disability. Pain Managament: an interdisciplinary approach.
  76. (2001). Edwards revisited: Technical control and call centres.
  77. (1996). Effect of sustained loading on the water content of intervertebral discs: Implications for disc metabolism.
  78. (2007). Effectiveness of a lumbar support continuous passive motion device in the prevention of low back pain during prolonged sitting.
  79. Effects of hydrostatic pressure on matrix synthesis and matrix metalloproteinase production in the human lumbar intervertebral disc.
  80. (1996). Effects of hydrostatic pressure on matrix synthesis in different regions of the intervertebral disc.
  81. (2005). Effects of prolonged sitting on the passive flexion stiffness of the in-vivo lumbar spine.
  82. (1999). Epidemiological features of chronic low back pain.
  83. (1980). Epidemiology and the impact of low back pain.
  84. (2002). Episodes of back pain. A proposal for uniform definitions to be used in research. Institute for research in extramural medicine.,
  85. (2004). European Guidelines for Prevention in Low Back Pain.
  86. (2003). Evaluation of driver discomfort during long duration car driving.
  87. (1982). Evaluation of seating discomfort.
  88. (1996). Evaluation of symptom surveys for occupational musculosketal disorders.
  89. (2006). Evaluation of the flexion relaxation phenomenon of the trunk muscles in sitting.
  90. (2002). Examination of the flexion relaxation phenomenon in erector spinae muscles during short duration slumped sitting.
  91. (2000). Exercise therapy for low back pain. A systematic review within the framework of the Cochrane Collaboration Back Review Group.
  92. (2005). Expert forecast on emerging physical risks related to occupational safety and health. European Agency for Safety and Health at Work: Risk Observatory: 1-68. Luxembourg, Office for Official Publications of the European Communities.
  93. Exploration of physicians' recommendations for activities in chronic low back pain.
  94. (1990). Extension-flexion radiographs for motion studies of the lumbar spine: A comparison.
  95. (2006). Fear avoidance and prognosis in back pain: a systematic review and synthesis of current evidence.
  96. (1999). Fear of movement (re)injury and pain disability in chronic low back pain patients.
  97. (2004). Fear-avoidance beliefs and distress in relation to disability in acute and chronic low back pain.
  98. (1997). Field studies of comfort and discomfort in sitting.
  99. (1986). Flexibility and velocity of the normal and impaired lumbar spine.
  100. (1989). Flexible goniometer computer system for the assessment of hip function.
  101. (2000). Flexion and rotation of the trunk and lifting at work are risk factors for low back pain.
  102. (2001). Four-year follow up of patients with low back pain -outcomes and predictors.
  103. (2002). Gate control theory of pain stands the test of time.
  104. (2005). Gender and regional differences in perceived job stress across Europe.
  105. (2002). Guide to Assessing Psychosocial Yellow Flags in Acute Low Back Pain: Risk Factors for Long Term Disability and Work Loss.
  106. (2002). Guidelines for constructing a survey.
  107. (2002). High physical work load and low job satisfaction increase the risk of sickness absence due to low back pain: Results of a prospective cohort study.
  108. (2003). How to assess epidemiological studies.
  109. (1998). How to measure sickness absence? Literature review and suggestion of five basic measures.
  110. (2002). Human resource management in call centres.
  111. (2005). Improved early pain management for musculoskeletal disorders. Norwich, Health and Safety Executive:
  112. (2000). In-chair movements: validity, reliability and implications for measuring sitting discomfort.
  113. (2002). Influence of daily life activities on pain in patients with low back pain.
  114. (1995). Influence of physical, psychological and behavioural factors on consultations for back pain.
  115. (1999). Interactions between physical and psychosocial risk factors at work increase the risk of back disorders: An epidemiological approach.
  116. (1999). International Encyclopedia of Behavioural Sciences.
  117. (2001). Interrelations of risk factors and low back pain in scaffolders.
  118. (1970). Intravital dynamic pressure measurements in lumbar discs.
  119. (1995). Introduction to research in the health sciences.
  120. (1975). Investigation of the relation between low back pain and occupation.
  121. (1997). Is ergonomic intervention alone sufficient to limit musculoskeletal problems in nurses?
  122. (2000). Is sitting while at work associated with low back pain? A systematic, critical literature review.
  123. (1979). Job decision latitude, job demands, and mental strain: Implications of job redesign.
  124. (2008). Kyphosed seated postures: extending concepts of postural health beyond the office.
  125. (2002). Low back disorders: evidence-based prevention and rehabilitation. United States, Human Kinetics: Chapter 4.
  126. (2001). Low Back Joint Loading and Kinematics During Standing and Unsupported Sitting.
  127. (1989). Low back pain and occupation. A cross-sectional questionnaire study of men in machine operating, dynamic physical work, and sedentary work.
  128. (2003). Low back pain and widespread pain predicts sickness absence among industrial workers.
  129. (1996). Low back pain in children and adolescents: To treat or not?
  130. (1992). Low back pain in eight areas of Britain.
  131. (1982). Low back pain in forty to fortyseven year old men. Frequency of occurence and impact on medical services.
  132. (1997). Low back pain.
  133. (1999). Low Back Pain. Epidemiology of
  134. (1996). Low back pain. Prevention and management.
  135. (1974). Lumbar disc pressure and myoelectric back muscle activity during sitting. Studies on an experimental chair.
  136. (2000). Lumbar erector spinae oxygenation during prolonged contractions: implications for prolonged work.
  137. (1997). Lumbar lordosis: Effects of sitting and standing.
  138. (2003). Lumbar lordosis: Study of patients with and without low back pain.
  139. (1996). Lumbar range of motion: Reliability and validity of the inclinometer technique in the clinical measurement of trunk flexibility.
  140. (2003). Lumbar repositioning deficit in a specific low back pain population.
  141. (2000). Lumbar spine curvature during office chair sitting.
  142. (2002). Lumbofemoral rhythm during hip flexion in young adults and children.
  143. (2000). Management of health and safety at work regulations - approved code of practice and guidance (L21). Health and Safety Executive. Norwich, Her Majesty's Stationary Office.
  144. (1969). Measurement of back movement.
  145. (1987). Measurement of lumbar sagittal mobility: A comparison of methods.
  146. (2002). Measurement of movements of the lumbar spine.
  147. (1986). Measurement of thoracolumbar posture and mobility with a Myrin inclinometer.
  148. (1987). Measuring health: A guide to rating scales and questionnaires.
  149. (2002). Measuring sick leave: a comparison of self-reported data on sick leave and data from company records.
  150. (2000). Mechanical effects of continuous passive motion on the lumbar spine in seating.
  151. (1997). Mechanical response of the lumbar spine to seated postural loads.
  152. (1998). Medically certified work loss, recurrence and costs of wage compensation for back pain: a follow-up study of the working population of Jersey.
  153. (2004). Methodological aspects in sickness absence research.
  154. (1986). Modern Epidemiology.
  155. (1995). Motion characteristics of normal subjects and people with low back pain.
  156. (1995). Motion characteristics of the lumbar spine in the normal population. Spine
  157. (1991). Motion of the lumbar spine: reliability of two measurement techniques.
  158. (2000). Multiple applications of the GHQ-12 in a general population sample: an investigation of long term effects. Social Psychiatry and Psychiatric Epidemiology
  159. (2005). Muscular activation patterns of healthy persons and low back pain patients performing an evaluation test.
  160. (2002). Musculoskeletal Disorders 7(1): doi:
  161. (2002). Musculoskeletal symptoms and duration of computer and mouse use.
  162. (1998). Natural history of low back pain: A longitudinal study in nurses.
  163. (1999). New invivo measurements of pressures in the intervertebral disc in daily life.
  164. (1991). Noninvasive measurement of lumbar sagittal mobility. An assessment of the flexicurve technique.
  165. (1999). Nonspecific low back pain in adolescents: risk factors.
  166. (1971). Normal range of spinal mobility: An objective clinical study.
  167. (2005). Obstacles to recovery from musculoskeletal disorders in industry,
  168. (1995). Occupational back pain - an unhelpful polemic.
  169. (1998). Occupational factors affecting sick leave attributed to low back pain.
  170. (2000). Occupational health guidelines for the management of low back pain at work - principal recommendations. London, Faculty of Occupational Medicine.
  171. (2001). Occupational health guidelines for the management of low back pain at work: evidence review.
  172. (2000). Occupational low back disorder causation and control.
  173. (2001). Occupational psychological factors increase the risk for back pain: A systematic review.
  174. (1993). Occupational risk factors for low back pain among sedentary workers.
  175. (1996). Occupational risk factors for the first onset of low back trouble: A study of serving police officers.
  176. (1998). Outcome measures for low back pain research: A proposal for standardised use.
  177. (1998). Outcome of low back pain in general practice: A prospective study.
  178. (2000). Outcomes in work-related upper extremity and low back injuries: results of a retrospective study.
  179. (2001). Pain and the neuromatrix in the brain.
  180. (2000). Pain Management. An interdisciplinary approach.
  181. (2008). Pain Management. Practical applications of the biopsychosocial perspective in clinical and occupational settings.
  182. (1999). Pain measurement in persons in pain. Textbook of pain.
  183. (1965). Pain mechanisms: a new theory.
  184. (1999). Pain related fear is more disabling than pain Itself: Evidence on the role of pain-related fear in chronic back pain disability.
  185. (1986). Pain terms.
  186. (2007). Passive rotatory dynamic sitting at the workplace by office workers with lumbar pain: a randomised multi-centre study.
  187. (1987). Patterns of Lumbar Sagittal Mobility and Their Value in the Natural History of Back and Sciatic Pain. PhD Thesis. Huddersfield Polytechnic.
  188. (2001). Pay and conditions in call centres. Income Data Services.
  189. (1996). Perception of fault in patients with chronic pain.
  190. (1999). Personal risk factors for first time low back pain.
  191. (2004). Physical activities and low back pain: A community based study.
  192. (2001). Physical activity in daily life in patients with chronic low back pain.
  193. (1996). Physical exercise and low back pain.
  194. (1996). Physical loading and performance as predictors of back pain in healthy adults: A 5 year prospective study.
  195. (1997). Positive and Negative Evidence of Risk Factors for Back Disorders.
  196. (1994). Posture and the compressive strength of the lumbar spine.
  197. (2000). Posture discomfort and performance in a VDT task.
  198. (1998). Practical research methods for physiotherapists.
  199. (2000). Precision and accuracy of in measuring absence from work as a basis for calculating productivity costs in The Netherlands.
  200. (1999). Predicting who develops chronic low back pain in primary care: A prospective study.
  201. (2007). Prediction of absence among sedentary workers using beliefs and symptom modifying factors. Society for Back Pain Research: poster presentation, 28th June.
  202. (1989). Prediction of low back trouble frequency in a working population.
  203. (2006). Prediction of sickness absence in patients with chronic low back pain: a systematic review.
  204. (2007). Prevalence of low back pain in Greek office workers.
  205. (1996). Prevalence of low back pain in the community: Implication for service provision in Bradford, United Kingdom.
  206. (2001). Preventive interventions for back and neck problems: what is the evidence.
  207. (2004). Principal component and factor analysis; Analytic strategies to increase content validity of questionnaire factors. Joint Programme in Survey Methodology.
  208. (2005). Prognostic factors for duration of sick leave due to low back pain in Dutch health care professionals.
  209. (2004). Prognostic factors related to recurrent low back pain and sickness absence.
  210. Prospective evidence from the South Manchester back pain study.
  211. (1996). Psychological distress and low back pain. Spine
  212. (1996). Psychological factors in disabling low back pain: Causes or consequences? Disability and Rehabilitation
  213. (1996). Psychological Questionnaires: Do abnormal scores precede or follow first time low back pain.
  214. (1996). Psychological tests and scales.
  215. (1998). Psychosocial and physical risk factors associated with low back pain: a 24 year follow-up among women and men in a broad range of occupations.
  216. (1996). Psychosocial and physical risk factors for musculoskeletal disorders of the neck, shoulders, and lower back in salespeople.
  217. (1999). Psychosocial correlates of long term sick leave among patients with musculoskeletal pain.
  218. (1993). Psychosocial factors at work and musculoskeletal disease.
  219. (1995). Psychosocial factors at work in relation to back and limb disorders.
  220. (2004). Psychosocial factors at work in relation to low back pain and consequences of low back pain; a systematic, critical review of prospective cohort studies.
  221. (2003). Psychosocial factors at work, musculoskeletal disorders, and the implementation of guidelines principles.
  222. (1997). Psychosocial factors in the workplace: Do they predict new episodes of low back pain.
  223. (2003). Psychosocial risk factors in call centres: An evaluation of work design and well being. Sheffield, Health and Safety Laboratory:
  224. (1998). Quantification of physical activities by means of ambulatory accelerometry: A validation study.
  225. (1997). Quantitative assessment of the motion of the lumbar spine in the low back pain population and the effect of different spinal pathologies on this motion.
  226. (1984). Quantitative description of two sitting postures.
  227. (1987). Quebec Task Force Report: Spinal Disorders.
  228. (1992). Questionnaire development: An examination of the Nordic Musculoskeletal Questionnaire.
  229. (1994). Questionnaire for the identification of back pain for epidemiological purposes.
  230. (2002). Real World Research - Second Edition.
  231. (1995). Recent advances in lumbar spinal mechanics and their clinical significance.
  232. (2001). Recent advances in lumbar spinal mechanics and their significance for modelling.
  233. (1988). Reference values for 'normal' regional lumbar sagittal mobility.
  234. (2002). Relationship between comfort and back posture and mobility in sitting-postures.
  235. (2002). Relationship between pain and vertebral motion in chronic low-back pain subjects.
  236. (1998). Reliability and validity of the French version of the 18-item Karasek Job Content Questionnaire. Work and Stress
  237. (2001). Reliability in rehabilitation measurement.
  238. (1996). Reliability of a questionnaire on sickness absence with specific attention to absence due to back pain and respiratory complaints.
  239. (2002). Reliability of safe maximum lifting: determinations of a functional capacity evaluation.
  240. (1993). Reliability of the modified-modified Schober and double inclinometer methods for measuring lumbar flexion and extension.
  241. (1997). Reliability of three lumbar sagittal motion measurement methods: surface inclinometers.
  242. (1992). Reliability problems associated with the modified schober technique for true lumbar flexion measurement.
  243. (1994). Report of a Clinical Standards Advisory Group on Back Pain. London, Clinical Standards Advisory Group.
  244. (2000). Research on Work Related Low Back Disorders -
  245. (2000). Results: activity detection 89-8.11. Summary of
  246. (2004). Risk factors for low back pain among office workers in Ibadan, Southwest Nigeria.
  247. (2005). Risk factors for musculoskeletal symptoms and ensuing health care use sick leave.
  248. (1991). Risk factors for neck and back pain in a working population
  249. (2002). Risk factors for sick leave due to low back pain: A prospective study.
  250. (1995). Schober test measurements
  251. (2003). Screening to identify people at risk of long term incapacity for work: A conceptual and scientific review. Department for Work and Pensions.
  252. (1997). Seating at work. Health and Safety Executive. Norwich, Her Majesty's Stationery Office.
  253. (2001). Seeking the optimal posture of the seated lumbar spine. Physiotherapy Theory and Practice
  254. (2003). Self reported work related illness in 2001/2002: Results from a household survey.
  255. (1993). Self reported work-related illness. Results from a trailer questionnaire on the 1990 Labour Force Survey in England and Wales. London, Health and Safety Executive.
  256. (2005). Self-report measure of low back-related biomechanical exposures: clinical validation.
  257. (1997). Sensitivity, specificity and predictive value. In: The adult spine: principles and practice.
  258. (2007). Shared and independent associations of psychosocial factors on work status among men with subacute low back pain.
  259. (1999). Short term physical risk factors for new episodes of low back pain.
  260. (2004). Sickness absence due to back and neck disorders.
  261. (1997). Sickness absence from back pain, psychosocial work characteristics and employment grade among office workers.
  262. (2003). Sickness absence with musculoskeletal diagnoses.
  263. (1999). Sitting biomechanics part 1: review of the literature.
  264. (2003). Sitting comfort and discomfort and the relationships with objective measures.
  265. (1993). Sitting posture in a waiting room environment.
  266. (2006). Sitting posture of subjects with postural backache.
  267. (1999). Social Observation Table of Call Centres:
  268. (2000). Spinal load changes during rotatory dynamic sitting.
  269. (1997). Spinal range of motion. Accuracy and sources of error with inclinometric measurement.
  270. (1989). Spine kinematics: a digital videofluoroscopic technique.
  271. (1997). Spine update, back injury and work loss: Biomechanical and psychosocial Influences.
  272. (1987). Standardised nordic questionnaires for the analysis of musculoskeletal symptoms.
  273. (1986). Statistical Methods for Assessing Agreement Between Two Methods of Clinical Measurement.
  274. (1996). Statistics notes: Measurement error and correlation coefficients.
  275. (1995). Stress, coping and social support processes: Where are we? What next?
  276. (2004). Structural, psychological, and genetic influences on low back and neck pain: a study of adult female twins.
  277. (1999). Survey Research.
  278. (1996). Sustained loading generates stress concentrations in lumbar intervertebral discs.
  279. (2000). Systematic review of psychosocial factors at work and private life as risk factors for back pain.
  280. (1997). Systematic reviews of bed rest and advice to stay active for acute low back pain.
  281. (1990). Techniques in mental workload assessment. Ergonomics Task Analysis:
  282. (2003). Technology use and psychosocial factors in the self-reporting of musculoskeletal disorder symptoms in call center workers.
  283. (1947). Test 'reliability': Its meaning and determination.
  284. (2000). The ability of background factors, work practices, and psychosocial variables to predict the severity of musculoskeletal discomfort.
  285. (2003). The association between the meaning of working and musculoskeletal discomfort.
  286. (1999). The Back Pain Revolution.
  287. (2002). The Biomechanics of Back Pain.
  288. (1995). The classification of anatomic and symptom based low back disorders using motion measure models. Spine
  289. (1998). The contribution of job satisfaction to the Transition from acute to chronic low back pain.
  290. (1986). The effect of posture on diffusion into lumbar intervertebral discs.
  291. (1997). The epidemiology of spinal disorders. The adult spine: principles and practice.
  292. (1996). The essence of measurement.
  293. (1989). The General Health Questionnaire: reliability and validity in Australian youth.
  294. (2001). The Influence of Work Related Psychosocial Factors and Psychological Distress on Regional Musculoskeletal Pain: A Study of Newly Employed Workers.
  295. (1998). The Job Content Questionnaire (JCQ): An instrument for internationally comparative assessments of psychosocial job characteristics.
  296. (1975). The McGill pain questionnaire: major properties and scoring methods.
  297. (1986). The measurement of clinical pain intensity: a comparison of six methods.
  298. (1985). The Nuprin pain report.
  299. (2000). The odds ratio.
  300. (1999). The prevalence of back pain
  301. (1993). The prevalence of back pain in Britain. London, Her Majesty's Stationary Office.
  302. (1994). The prevalence of back pain in Great Britain. London, Office of Population Censuses and Surveys Social Survey Division.
  303. (1999). The prevalence of low back pain in adults: A methodological review of the literature.
  304. (1995). The prevalence of low back pain in the literature. A structured review of 26 Nordic studies from 1954-1993. Spine
  305. (2000). The prevalence of low back pain: A systematic review of the literature from 1966-1998.
  306. (2005). The prevention of musculoskeletal disorders within the telecommunication sectors. A systematic review of the scientific literature. The University of Birmingham.
  307. (1999). The quantification of low back disorders using motion measures. Methodlogy and validation.
  308. (2000). The relationship between leisure time, physical activities and musculoskeletal symptoms and disability in worker populations.
  309. (2000). The relationship between psychosocial work characteristics and low back pain: underlying methodological issues.
  310. (1984). The relationship between work history, work environment and low back pain in men.
  311. (1997). The role of demographic and psychosocial factors in the transition from acute to chronic pain. In:
  312. (1993). The role of dynamic three dimensional trunk motion in occupationally related low back disorders.
  313. (1987). The short-form McGill pain questionnaire.
  314. (1991). The tissue origin of low back pain and sciatica: A report of pain response to tissue stimulation during operation using local anaesthesia.
  315. (2004). The transition from acute to subacute and chronic pain: a study based on determinants of quality of life and prediction of chronic disability.
  316. (1996). The use of multiple-item scales for pain intensity measurements in chronic pain patients.
  317. (1997). The visual analogue pain intensity scale: what is moderate pain in millimetres.
  318. (1984). Three dimensional X-ray analysis of normal movement in the lumbar spine.
  319. (2001). Trunk posture: reliability, accuracy and risk estimates for low back pain from a video based assessment method.
  320. (1992). Two key factors that belong in a macro economic analysis of electronic monitoring: employee perceptions of fairness and the climate of organisational trust or distrust.
  321. (2004). UK call centre environment report.
  322. (2004). United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: cost effectivness of physical treatments for back pain in primary care.
  323. (1996). Uses and abuses of coefficient alpha.
  324. (1998). Validity and reliability of self-reported retrospectivley collected data on
  325. (1996). Validity and reliability of the modified Schober's test in measuring flexion and extension in normal subjects.
  326. (1996). Validity of self-reported physical work load in epidemiologic studies on musculoskeletal disorders.
  327. (1995). Variance in the measurement of sagittal lumbar spine range of motion among examiners, subjects, and instruments. Spine
  328. (1990). VDT work duration and musculoskeletal discomfort.
  329. (2000). Video display terminal workstation improvement programme: 1. Baseline associations betweem musculoskeletal discomfort and ergonomic features of workstations.
  330. (1990). Volvo award in clinical sciences. Lumbar spinal pathology in cadaveric material in relation to history of back pain, occupation, and physical loading.
  331. Water diffusion pathway, swelling pressure, and biomechanical properties of the intervertebral disc during compression load.
  332. (1991). What is a cause and how do we know one? A grammar for pragmatic epidemiology.
  333. (1998). When can odds ratios mislead?
  334. (1987). Work organisation and low back pain in nursing personnel.
  335. (2004). Working conditions and health among female and male employees at a call centre in Sweden.
  336. (2006). Working with VDUs. Health and Safety Executive. Norwich, Her Majesty's Stationary Office.

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.