This study aimed to estimate the global burden of LBP in terms of YLDs attributable to smoking, occupational risks, and high BMI from 1990 to 2021. By examining these modifiable risk factors based on sex, age, and the social-demographic index (SDI), the study seeks to identify trends and inform global health strategies to reduce the impact of LBP.
As part of the Global Burden of Diseases, Injuries, and Risk Factors Study, we analyzed data from 204 countries and territories from 1990 to 2021. YLDs attributable to smoking, occupation, and high BMI-induced LBP were estimated using a direct estimation approach. We stratified the data by sex, age, and SDI, allowing for a detailed assessment of how each risk factor contributed to the LBP burden across various population groups. The analysis also included age-standardized YLD rates (YLDs_ASR) to examine long-term trends in the impact of these risk factors.
In 2021, smoking accounted for 12.6% (95% UI: 16.7-8.4) of LBP-related YLDs, occupational risks for 22.1% (95% UI: 23.7-20.3), and high BMI for 11.9% (95% UI: 23.2-1.2). Both smoking and occupational risks showed an increase, peak, and subsequent decline with age, while high BMI-related LBP surged particularly among males aged 50-54, and remained stable among females. YLDs attributable to smoking peaked at age 50-54 in males and 55-59 in females, whereas the impact of occupational risks increased with age for both genders. Over the last three decades, the age-standardized YLD rates for smoking and occupational hazards decreased, while those for high BMI rose significantly.
Smoking, occupational risks, and high BMI are significant contributors to the global burden of LBP, with clear trends across different demographic groups. Smoking and occupational hazards have seen reductions in their age-standardized YLD rates, but high BMI remains a growing concern. Despite these improvements, the overall prevalence of LBP remains high, particularly as populations age.
These findings underscore the need for targeted interventions to address modifiable risk factors for LBP, particularly in reducing the burden of high BMI. Public health strategies should focus on raising awareness of LBP and its risk factors among both the public and policymakers, emphasizing smoking cessation, workplace ergonomics, and weight management. Further research is needed to explore the mechanisms through which smoking influences LBP and to develop effective prevention strategies.
Modifiable risk factors
Years lived with disability
