Objectives: To investigate the relevance of established risk factors for low back pain (LBP) and their interactions as well as the influence of prior LBP using data from the recent BASF back pain project. Methods: Longitudinal questionnaire data were collected at two points in time. Using the data from the first collection date (n = 435) a logistic regression model for the retrospective explanation of LBP occurrence during the 12 preceding months was developed. The resulting model was validated in a prospective analysis with a second sample of employees (n = 216). As an additional predictor the risk of recurrence of LBP was included. Results: The retrospective study revealed four risk factors or interactions: age, high physical work load (e. g. heavy work, working in an unfavourable posture) combined with perceived work overload and stress, unfavourable work environment (e. g. heat, noise) combined with low levels of social support and with engagement in private house-construction during the previous five years. The prospective analysis identified a history of LBP and high physical work load combined with perceived work overload and stress to have the highest predictive power for the development of low back pain. Conclusions: Our data show the importance of both physical and psychosocial factors at the workplace for the development of low back pain. Leisure time activities with a high strain for the vertebral column (e. g. engagement in private house-construction) must be considered as well. To prevent low back pain, integrative efforts are necessary including individual as well as technical and organisational measures at the workplace.
