Flexion and rotation of the trunk and lifting at work are risk factors for low back pain: results of a prospective cohort study (original) (raw)
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Flexion and Rotation of the Trunk and Lifting at Work Are Risk Factors for Low Back Pain
Spine, 2000
Study Design. A 3-year prospective cohort study among workers of 34 companies in the Netherlands. Objectives. To investigate the relation between flexion and rotation of the trunk and lifting at work and the occurrence of low back pain. Summary of Background Data. Previous studies on work-related physical risk factors for low back pain either lacked quantification of the physical load or did not take confounding by individual and psychosocial factors into account. Methods. The study population consisted of 861 workers with no low back pain at baseline and complete data on the occurrence of low back pain during the 3-year follow-up period. Physical load at work was assessed by means of analyses of video-recordings. Information on other risk factors and the occurrence of low back pain was obtained by means of self-administered questionnaires. Results. An increased risk of low back pain was observed for workers who worked with the trunk in a minimum of 60°of flexion for more than 5% of the working time (RR 1.5, 95% CI 1.0-2.1), for workers who worked with the trunk in a minimum of 30°of rotation for more than 10% of the working time (RR 1.3, 95% CI 0.9-1.9), and for workers who lifted a load of at least 25 kg more than 15 times per working day (RR 1.6, 95% CI 1.1-2.3). Conclusions. Flexion and rotation of the trunk and lifting at work are moderate risk factors for low back pain, especially at greater levels of exposure.
Prevalence and Risk Factors for Low Back Pain in Industrial Workers
Folia Medica, 2011
The aim of the present study was to determine the prevalence of low back pain (LBP) in industrial workers, check for possible LBP related risk factors and investigate the associations between physical activity and severity of low back pain. METHODS: We conducted a cross-sectional study among 430 workers of an industrial company over the previous 12 months. The industrial workers were given questionnaires and assigned to two groups: (1) with low back pain, (2) without low back pain. Group 1 was then divided into three subgroups according to the answer to question (a) LBP without irradiation, called mild cases, (b) LBP with irradiation above the knee, called moderate cases, LBP with the irradiation below the knee, called severe cases. RESULTS: LBP was found in 61.6% of workers. The prevalence of LBP was signifi cantly associated with physical activity (p = 0.03). There was a signifi cant difference between frequent physical activity and severity of LBP (p = 0.01). Work-related physical factors showed strong associations with LBP. The main risk factors for low back pain among production workers were extreme trunk fl exion (OR = 3.5, 95% CI 1.7-7.3), as well as lifting of loads (OR = 3.5, 95% CI 1.9-6.2), pushing or pulling heavy loads (OR = 3.5, 95% CI 1.9-6.2) and exposure to whole body vibration (OR = 1.7, 95% CI 1.0-3.0). CONCLUSION: Daily life conditions, job-related factors are associated with the occurrence of low back pain. These results suggest that individuals with LBP should avoid nonspecifi c physical activities to reduce pain and improve psychological health.
Biomechanical and psychosocial risk factors for low back pain at work
American Journal of Public Health, 2001
Objectives. This study determined whether the physical and psychosocial demands of work are associated with low back pain. Methods. A case-control approach was used. Case subjects (n = 137) reported a new episode of low back pain to their employer, a large automobile manufacturing complex. Control subjects were randomly selected from the study base as cases accrued (n = 179) or were matched to cases by exact job (n = 65). Individual, clinical, and psychosocial variables were assessed by interview. Physical demands were assessed with direct workplace measurements of subjects at their usual jobs. The analysis used multiple logistic regression adjusted for individual characteristics. Results. Self-reported risk factors included a physically demanding job, a poor workplace social environment, inconsistency between job and education level, better job satisfaction, and better coworker support. Low job control showed a borderline association. Physical-measure risk factors included peak lumbar shear force, peak load handled, and cumulative lumbar disc compression. Low body mass index and prior low back pain compensation claims were the only significant individual characteristics. Conclusions. This study identified specific physical and psychosocial demands of work as independent risk factors for low back pain.
Low back pain and lifting: A review of epidemiology and aetiology
Work, 2003
The incidence of low back pain has continued to increase in modern society, despite the considerable amount of scientific research that has aimed to isolate its exact aetiology. Although low back pain is still largely idiopathic, research has identified over one hundred risk factors for the condition. Of these risk factors, manual material handling tasks are perhaps the most widely explored within the biomechanical literature, as these tasks have been associated with high mechanical stresses on the lower back. Numerous technique-related variables have been addressed by researchers, whilst the influence of intra-abdominal pressure has also been considered. In addition to this, the implications of variations in the size and structural composition of the load have also been assessed. However, low back pain continues to pose a significant threat to the financial stability and happiness of millions of people worldwide. In addition, a number of functional work capacity assessment tests use lifting as a method for assessment of return to work condition. Many of these tests are not standardised and do not consider the implications of low back loading. Therefore new research attempts in this area are justified and should aim to identify the extent of the association that exists between the known risk factors and the incidence of low back pain.
The aim of this study was to evaluate relationships between the revised NIOSH lifting equation (RNLE) and risk of low-back pain (LBP). Background: The RNLE is commonly used to quantify job physical stressors to the low back from lifting and/or lowering of loads. There is no prospective study on the relationship between RNLE and LBP that includes accounting for relevant covariates. Method: A cohort of 258 incident-eligible workers from 30 diverse facilities was followed for up to 4.5 years. Job physical exposures were individually measured. Worker demo-graphics, medical history, psychosocial factors, hobbies, and current LBP were obtained at baseline. The cohort was followed monthly to ascertain development of LBP and quarterly to determine changes in job physical exposure. The relationship between LBP and peak lifting index (PLI) and peak composite lifting index (PCLI) were tested in multivariate models using proportional hazards regression. Results: Point and lifetime prevalences o...
Elders LA, Burdorf A. Interrelations of risk factors and low back pain in scaffolders
Occupational and Environmental Medicine
Objectives-To assess with a cross sectional study the interrelations between physical, psychosocial, and individual risk factors and diVerent end points of low back pain. Methods-In total, 229 scaVolders and 59 supervisors completed a questionnaire about manual handling of materials, awkward back posture, strenuous arm position, perceived exertion, psychosocial load, need for recovery, and general health. Physical load at the worksite was also measured with many frequent observations. Interrelations between risk factors and their relation with four end points of low back pain were investigated.
Objectives: To assess the evidence for a dose-response relationship between ROM, duration, and frequency of trunk flexion, and risk of occupational LBP. Methods: An electronic systematic search was conducted using Medline, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Scopus databases focusing on cohort and case-control studies. Studies were included if they focused on non-specific LBP and postural exposure, considering ROM, duration, or frequency of trunk flexion as independent variables. No language restriction was imposed. Included studies were assessed for risk of bias using the Newcastle-Ottawa Scale for observational studies and a summary of evidence is presented. Results: Eight studies were included and all were methodologically rated as high quality. The included studies yielded a total of 7023 subjects who were considered for risk analysis. Different outcome measures for postural exposure were adopted making meta-analysis difficult to perform. Conclusions: We could not find a clear dose-response relationship for work posture exposures and LBP. Limited evidence was found for ROM and duration of sustained flexed posture as risk factor for LBP. We found no evidence for frequency of trunk flexion as a risk factor for LBP.