Childhood and Early Adult Predictors of Risk of Incident Back Pain: Ontario Child Health Study 2001 Follow-up

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Abstract
Musculoskeletal disorders of the back and spine are a leading cause of disability in working-age populations. There is limited information on the potential consequences of childhood socioeconomic and health status on the risk of incident back pain in early adulthood. The authors describe factors associated with having had a first episode of back pain during the past year in the Ontario Child Health Study, a prospective cohort study of children who were aged 4–16 years at the time of enrollment in 1983 and were resurveyed in 2001. Respondents reporting a first episode of back pain (n = 143) were compared with respondents who had never experienced back pain (n = 896). The annual incidence of a first episode of back pain in this sample of young adults was 74.7/1,000. Following adjustment for age, sex, childhood conditions, childhood health status, and measures of early adult health, behavior, socioeconomic status, and work environment, the risk of incident back pain was associated with both low (odds ratio (OR) = 1.86, 95% confidence interval (CI): 1.14, 3.03) and moderate/high (OR = 1.85, 95% CI: 1.07, 3.02) levels of psychological distress, current heavy smoking (OR = 1.85, 95% CI: 1.10, 3.10), lower levels of parental education in childhood (OR = 1.72, 95% CI: 1.06, 2.80), and emotional or behavioral disorders in childhood (OR = 1.87, 95% CI: 1.02, 3.41). The associations of low childhood socioeconomic status and childhood emotional and behavioral disorders with risk of incident back pain in early adulthood are important findings with implications for better understanding the etiology of soft-tissue disorders.