Study Design:​ This study analyzed the role of exposure to driving and other covariates in reports of back, neck, and shoulder pain and resultant disability. Cohorts in Sweden and the United States were compared.

Objectives:​ To establish the effect of mechanical and psychosocial factors in reporting back, neck, and shoulder pain and work loss.

Summary of Background Data:​ There are numerous reports of a positive relationship between back pain and driving. However, exposure data are minimal. The influence of job satisfaction has not been assessed.

Methods:​ The physical factors affecting reports of back, neck, and shoulder pain were investigated in a two-country cohort study of bus and truck drivers and sedentary workers. Vibration exposure was obtained by directly measuring the vibration imposed on the driver during a typical work day. Lifting exposure was attained by questionnaire. Cumulative exposure was computed based on work history. Musculoskeletal health information was based on a modified nordic questionnaire, and other questionnaires recorded the physical and psychosocial aspects of the work environment.

Results:​ Of the sample, 50% reported low back pain, with no difference between countries. The highest risk factors (odds ratios) for back and neck pain were long-term vibration exposure, heavy lifting, and frequent lifting. A combination of long-term vibration exposure and frequent lifting carried the highest risk of low back pain. Work loss from low back pain was influenced by perceived job stress.

Conclusions:​ Vibration (resulting from driving) and lifting cause back, neck, and shoulder pain, whereas inability to work seems affected by stress at work.