Halonen JI, et al. - Through a prospective longitudinal cohort study, experts ascertained the correlations for workload and health-related factors with incident and recurrent low back pain (LBP), and to discover the mediating role of health-related factors in relationships between physical workload factors and incident LBP. All risk factors at baseline but smoking and physical activity were related to incident LBP following adjustment for confounders. For working in twisted positions and occupational lifting, the strongest relationships were noted. These correlations were not mediated by health-related factors. The studied factors did not have significant impacts on recurrent LBP. Hence, workload and health-related factors have powerful impacts on the development than on the recurrence or progression of LBP, and that health-related factors do not mediate relationships between workload factors and incident LBP.