Objective This study aimed to investigate the association between perceived stress and risk of low-back pain (LBP), in a population of Danish hospital workers. Methods Utilizing a prospective cohort design with 1-year follow-up, a total of 1,944 healthcare workers from 389 departments at 19 hospitals responded to questionnaires containing items related to lifestyle, health and working environment. Using Cohen´s Perceived Stress Scale, associations between baseline stress levels and LBP intensity (0-10 scale) at follow-up were modelled using cumulative logistic regression accounting for clustering at the department level and adjusting for age, sex, baseline intensity of LBP, education, seniority, number of daily patient transfers, psychosocial work environment (recognition and influence at work), and lifestyle (BMI, smoking, leisure physical activity). Results Moderate and high stress (reference: low stress) at baseline increased the risk for LBP at 1-year follow-up with OR’s of 1.44 (95% CI 1.12-1.86) and 2.30 (95% CI 1.61-3.29), respectively. Sensitivity analyses in smaller subgroups showed similar results, although only statistically significant for high stress (i.e. OR 3.17, 95% CI 1.88-5.37 and OR 3.13, 95% CI 1.28-7.70 for female nurses and female nurses pain-free at baseline, respectively). Conclusions Perceived stress increases the risk of LBP among healthcare workers in a dose-response manner. Identifying and diminishing psychosocial stressors should be included in strategies for preventing LBP in this population.
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