Objectives This study investigated the influence of manual stone and brick handling and psychosocial work factors on the risk of chronic low-back pain and describes the impact in terms of risk advancement period.

Methods The Hamburg Construction Worker Study included a longitudinal study among 488 male construction workers. Adjusted prevalence ratios (PR) of chronic low-back pain (>3 months during the last 12 months) according to self-reported worktasks in the baseline survey were estimated with the Cox proportional hazards model.

Results The 1-year prevalence of chronic low-back pain was 15.4%. Workers with chronic low-back pain in the baseline survey had a higher risk of such pain during the follow-up (PR 4.07, 95% CI 2.18-7.59). The prevalence in association with laying large lime sandstones for >2 hours per shift (PR 1.80, 95% CI 1.04-3.14) further increased after adjustment for job category (PR 2.69, 95% CI 1.25-5.78), and it advanced the risk by a risk advancement period of 18 years (95% CI 4-39). Workers with low satisfaction with their work achievements had a higher prevalence of chronic low-back pain (PR 2.07, 95% CI 1.10-3.88). Similar risk estimates were observed in the subgroup without chronic low-back pain in the baseline survey. A strong effect of time pressure was only present for these workers (high: PR 6.30, 95% CI 1.41-28.21).

Conclusions The results suggest that repetitive work involving bent positions and the manual manipulation of heavy stones increases the risk of future chronic low-back pain. For risk communication, the notion that a 40-year-old construction worker laying large sandstones has the same risk as an unexposed 58-year-old construction worker may be more informative.

Key terms accelerated failure time; bricklayer; chronic low-back pain; cohort study; construction worker; musculoskeletal disease; occupational disease; prevalence; psychosocial work factor; repetitive manual materials handling; risk and rate advancement period; risk factor