Raising awareness of psychosocial factors in the occurrence of low back symptoms in developing countries Baiduri Widanarko a,d, , Stephen Legg a , Jason Devereux b , Mark Stevenson c a Centre for Ergonomics, Occupational Safety and Health, School of Management, College of Business, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand b Business Psychology Unit, Department of Psychology, University College London, UK c EpiCentre, Institute of Veterinary, Animal and Biological Sciences, College of Sciences, Massey University, Palmerston North, New Zealand d Department of Occupational Health and Safety, Faculty of Public Health, Universitas Indonesia, Depok 16424, Indonesia Abstract. Although there is strong evidence that single physical, psychosocial and organisational risk factors are each inde- pendent predictors of low back symptoms (LBS), little is known about their combination/interaction, particularly in those working in developing countries. A total of 1294 Indonesian coal mining industry workers reported information about physi- cal, psychosocial, and organisational factors using self-reported questionnaires and were placed into one of four combination exposure groups: 1) high physical (working with bent trunk; whole body vibration exposure; lifting) and high psychosocial (high effort; low reward; work stress), 2) high physical and low psychosocial, 3) low physical and high psychosocial, and 4) low physical and low psychosocial (as the reference group). The odds of LBS in the high physical and high psychosocial group was 5.15 times (95% confidence interval 2.69-9.86) that of the reference group. Psychosocial factors played a more important role than physical factors in increasing the likelihood of reporting LBS. Permanent and night shift workers were more likely to report LBS. These findings imply that efforts to reduce LBS in this workplace should address both psychoso- cial and physical factors but psychosocial factors should be the priority, with a special focus on permanent and night shift workers. Keywords: musculoskeletal disorders; discomfort; back pain; blue-collar workers; coal mining  Corresponding author. Email: baiduri@ui.ac.id or B.Widanarko@massey.ac.nz Work 41 (2012) 5734-5736 DOI: 10.3233/WOR-2012-0934-5734 IOS Press 1051-9815/12/$27.50 © 2012 – IOS Press and the authors. All rights reserved 5734