Background and Objective: Population aging is a major driver of the ergonomic low back pain(LBP) burden, but its impact may vary across regions with different development levels. This study aimed to quantify and compare these differences. Methods: Using data from the Global Burden of Disease Study 2021 (GBD 2021), we conducted a decomposition analysis to assess the independent contributions and attributable fractions of population aging and epidemiological rate changes to the disability-adjusted life years(DALYs) of ergonomic LBP from 1990 to 2021. Differences were compared across Socio-demographic Index(SDI) regions and by sex. Results: From 1990 to 2021, population aging contributed to an increase of 958,564.25 DALYs globally (attributable fraction: 24.74%). The highest attributable fraction was observed in high-middle SDI regions (127.9%). Globally, reductions in DALY rates fully offset the effects of aging (R < – 1), with the largest relative impact seen in low-SDI regions (R = 14.64). The contribution of aging was higher in men (29.36%) than in women (21.70%) across all regions. Conclusion: The impact of aging on the burden of ergonomic LBP is not uniform and follows a non-linear pattern across SDI levels. Public health efforts can mitigate this burden. Targeted strategies focusing on high-middle SDI regions and male workers are needed to support healthy aging and reduce disparities in global occupational health protection. Keywords: population aging, low back pain, LBP, ergonomic risk factors, disability-adjusted life years, DALYs, socio-demographic index, SDI
Yang et al. (2026) studied this question.