Occupational driving and lumbar disc degeneration: a casecontrol study

BACKGROUND Back problems are reported more by occupational drivers than by any other occupational group. One explanation is that whole-body vibration caused by the vehicle leads to accelerated disc degeneration, herniation, and associated symptoms. We aimed to investigate the effects of lifetime driving exposure on lumbar disc degeneration in monozygotic twins with very different histories of occupational driving during their life. METHODS We assessed 45 male monozygotic twin pairs from the population-based Finnish Twin Cohort who had greatly different patterns of occupational driving during their life. Data were obtained for driving exposures and potential confounding factors through an extensive, structured interview. We assessed disc degeneration with lumbar MRI. FINDINGS Disc degeneration did not differ between occupational drivers and their twin brothers. We also did not identify any overall tendency for greater degeneration or pathology in occupational drivers than their twin brothers. INTERPRETATIONS Although driving may exacerbate symptoms of back problems, it does not damage the disc. Our inability to identify structural damage should be encouraging to those employed in occupations involving motorised vehicles and operation of heavy equipment.

[1]  J. Ott,et al.  An allele of COL9A2 associated with intervertebral disc disease. , 1999, Science.

[2]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[3]  H. Dupuis.  Medical and occupational preconditions for vibration-induced spinal disorders: occupational disease no. 2110 in Germany , 1994, International archives of occupational and environmental health.

[4]  M. Battié,et al.  Determinants of Lumbar Disc Degeneration: A Study Relating Lifetime Exposures and Magnetic Resonance Imaging Findings in Identical Twins , 1995, Spine.

[5]  R P Wells,et al.  Disability resulting from occupational low back pain. Part I: What do we know about primary prevention? A review of the scientific evidence on prevention before disability begins. , 1996, Spine.

[6]  M. Heliövaara,et al.  Occupation and risk of herniated lumbar intervertebral disc or sciatica leading to hospitalization. , 1987, Journal of chronic diseases.

[7]  C. Boesch,et al.  Quantitative MR imaging of lumbar intervertebral disks and vertebral bodies: influence of diurnal water content variations. , 1993, Radiology.

[8]  A. Hofman,et al.  Heritabilities of radiologic osteoarthritis in peripheral joints and of disc degeneration of the spine. , 1999, Arthritis and rheumatism.

[9]  D Mohan,et al.  Effect of whole-body vibration on the low back. A study of tractor-driving farmers in north India. , 1999, Spine.

[10]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[11]  J. Eisman,et al.  Allelic variation in the vitamin D receptor, lifestyle factors and lumbar spinal degenerative disease , 1998, Annals of the rheumatic diseases.

[12]  A. Rissanen,et al.  Relation between Plasma Leptin Levels and Measures of Body Fat in Identical Twins Discordant for Obesity , 1997, Annals of Internal Medicine.

[13]  C. Leboeuf‐Yde,et al.  Whole-body vibration and low back pain: a systematic, critical review of the epidemiological literature 1992–1999 , 2000, International archives of occupational and environmental health.

[14]  J N Weinstein,et al.  Effects of Whole Body Vibration on: Dorsal Root Ganglion Neurons Changes in Neuronal Nuclei , 1994, Spine.

[15]  T Videman,et al.  The long-term effects of rally driving on spinal pathology. , 2000, Clinical biomechanics.

[16]  J. Kaprio,et al.  1991 Volvo Award in Clinical Sciences: Smoking and Lumbar Intervertebral Disc Degeneration: An MRI Study of Identical Twins , 1991, Spine.

[17]  W. E. Hoogendoorn,et al.  Physical load during work and leisure time as risk factors for back pain. , 1999, Scandinavian journal of work, environment & health.

[18]  Professor Dr. Heinrich Dupuis,et al.  The Effects of Whole-Body Vibration , 1986, Springer Berlin Heidelberg.

[19]  P Brinckmann,et al.  Fatigue fracture of human lumbar vertebrae. , 1987, Clinical biomechanics.

[20]  J. Kelsey,et al.  Driving of motor vehicles as a risk factor for acute herniated lumbar intervertebral disc. , 1975, American journal of epidemiology.

[21]  D M Spengler,et al.  In vivo creep behavior of the normal and degenerated porcine intervertebral disk: a preliminary report. , 1988, Journal of spinal disorders.

[22]  H. Broman,et al.  Back muscle fatigue and seated whole body vibrations: an experimental study in man. , 1991, Clinical biomechanics.

[23]  L. Peltonen,et al.  1998 Volvo Award Winner in Basic Science Studies: Intragenic Polymorphisms of the Vitamin D Receptor Gene Associated With Intervertebral Disc Degeneration , 1998, Spine.

[24]  Massimo Bovenzi,et al.  An Updated Review of Epidemiologic Studies on the Relationship Between Exposure to Whole-Body Vibration and Low Back Pain , 1998 .

[25]  E. Viikari-Juntura,et al.  Lumbar disc degeneration in relation to occupation. , 1998, Scandinavian journal of work, environment & health.

[26]  Carel Hulshof,et al.  Whole-body vibration and low-back pain , 1987, International archives of occupational and environmental health.

[27]  W. Frobin,et al.  Quantification of overload injuries to thoracolumbar vertebrae and discs in persons exposed to heavy physical exertions or vibration at the workplace Part II Occurrence and magnitude of overload injury in exposed cohorts. , 1998, Clinical biomechanics.

[28]  A. Kjellberg,et al.  Injuries and other adverse effects of occupational exposure to whole-body vibration. A review for criteria documentation , 1994 .

[29]  M. V. Jensen,et al.  Prolapsed Cervical Intervertebral Disc in Male Professional Drivers in Denmark, 1981‐1990: A Longitudinal Study of Hospitalizations , 1996, Spine.