Objectives: A twelve-year follow-up study was carried out in middle-aged farmers, both men and women, to evaluate the risk factors of neck pain. Methods: Five hundred and thirty-seven farmers, 45-54 years of age, reported in a 1979 postal questionnaire that they had experienced no neck or low-back pain during the previous year. In a 1992 follow-up study, 366 [68%] of these farmers were interviewed by telephone. The outcome of new neck or prolonged radiating neck pain during the past year was recorded. Results: The incidence of neck pain and prolonged radiating neck pain were 46.2% and 13.4%, respectively. Smoking, mental stress, height and body mass index did not correlate to neck pain. In logistic regression modeling, the adjusted odds ratios of neck pain for men with hip pain during the past year was 4.36 [95% CI 1.17-16.2] and of prolonged radiating neck pain for women with hip pain during the past year was 3.39 [95% CI 1.01-11.3]. In both sexes, owning a tractor was associated negatively, and in men, ...