An analytical cross-sectional epidemiological study carried out among 109 manganese plant workers aimed to examine the prevalence and association between lower back problems (LBP) and occupational risk factors. Outcome was defined using a guided questionnaire and a functional rating index. Exposure to occupational risk factors was determined using self-reported questionnaires and workstation analyses. Multivariate logistic regression analyses indicated significant adjusted odds ratios (OR) for prolonged 90 degrees trunk flexion (OR 2.16; CI 1.15-4.05); manual handling (1.89; 1.17-3.08); load carriage (1.54; 1.08-2.19); and lifting (4.61; 1.37-15.47). The findings illustrate regional and occupational specifics of risk for LBP, and indicate that self-selection or adaptation to task-specific demands could possibly lead to observations of ergonomically relevant risk factors, which do not necessarily yield statistically significant associations with LBP. The findings further support multi-modal preventative approaches.