Occupational driving and lumbar disc degeneration: a casecontrol study

Background Back problems are reported more by occupational drivers than by any other occupational group. One explanation is that whole-body vibration caused by the vehicle leads to accelerated disc degeneration, herniation, and associated symptoms. We aimed to investigate the effects of lifetime driving exposure on lumbar disc degeneration in monozygotic twins with very different histories of occupational driving during their life. Methods We assessed 45 male monozygotic twin pairs from the population-based Finnish Twin Cohort who had greatly different patterns of occupational driving during their life. Data were obtained for driving exposures and potential confounding factors through an extensive, structured interview. We assessed disc degeneration with lumbar MRI. Findings Disc degeneration did not differ between occupational drivers and their twin brothers. We also did not identify any overall tendency for greater degeneration or pathology in occupational drivers than their twin brothers. Interpretation Although driving may exacerbate symptoms of back problems, it does not damage the disc. Our inability to identify structural damage should be encouraging to those employed in occupations involving motorised vehicles and operation of heavy equipment. Published online Oct 15, 2002 http://image.thelancet.com/extras/01art9329web.pdf