Authors: Hussam A. Alzahrani , Elaf S. Althobaiti , Renad A. Altuwaiher , Manal I. Alrefaee , Abdulelah M. Alsakti , Faisal S. Alhafi , Duaa A. Qulasrar , Maram A. Almarhabi , Naif A. Alzahrani

Abstract

Background: To assess low back pain (LBP) attributable to high body mass index (BMI), occupational ergonomic factors, and smoking in Gulf Cooperation Council (GCC) countries from 1990 to 2023, with exploratory forecasting to 2050.

Methodology: Global Burden of Disease data were extracted for Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. DALYs and age-standardized rates were analyzed by country, sex, age group, and risk factor. Trends were assessed using estimated annual percentage change, and exploratory ARIMA and ETS models described future trajectories.

Results: DALYs attributable to selected LBP risk factors increased by 447.4%, from 46,635 in 1990 to 255,288 in 2023. High BMI showed the largest increase, from 16,157 to 111,138 DALYs (+587.7%), followed by occupational ergonomic factors, from 18,824 to 89,123 (+373.5%), and smoking, from 11,655 to 55,028 (+372.3%). Age-standardized rates for high BMI and occupational ergonomic factors increased in all GCC countries, while smoking-attributable rates declined in most countries except Saudi Arabia. Females had a higher BMI-related burden, whereas males had a higher smoking-related burden.

Conclusion: LBP burden attributable to modifiable risk factors increased substantially across GCC countries, with high BMI and occupational ergonomic factors identified as major contributors within the GBD framework. Exploratory forecasts should be interpreted cautiously. These findings support obesity prevention, workplace ergonomic interventions, tobacco control, and strengthened clinical management.

Keywords: Low back pain, Gulf Cooperation Council, disability-adjusted life years, body mass index, occupational health, obesity.