March 30 , 2001
A Primer on Occupational Back Injuries and Safety Guidelines to Avoid Injury
Peter P. Greaney , MD
Board-Certified Occupational Physician
President, WorkCare
According to the National Institute for Occupational Safety and Health (NIOSH), the most common type of non-fatal occupational health injuries involving lost-work days are sprains, strains and tears. This category of injury resulted in 799,000 cases in 1997 (latest available data). Of those incidents, half of the cases (385,000) were back injuries, accounting for about 80% of all traumatic back injuries and disorders.
Overexertion is the most common cause of sprains, strains and tears, accounting for over 50% of all cases. It is also the most costly type of injury. The price tag for injuries caused by overexertion cost employers $9.8 billion in wage replacement and medical payments in 1998, according to a recently published report by Liberty Mutual. This amount represents about 25.57% of the total estimated workers' compensation costs nationwide.
In addition, 50% of the workforce experience some type of back pain each year, from mild to severe. Those employees who miss work due to more serious back injuries are away from work for an average of three months.
Given these statistics, an increasing number of occupational health and safety managers are placing greater emphasis on back injury prevention programs. Following is a general guideline for avoiding back injuries in the workplace.
Overexertion-The Leading Cause of Back Injuries
Overexertion injuries are the result of excessive lifting, pushing, pulling, holding, carrying or throwing an object. These injuries, which involve the nerve, tendons, muscles and supporting structures of the body are considered musculoskeletal disorders ( MSDs ).
Risk Factors
NIOSH conducted a critical epidemiologic review of evidence to examine the relationship between selected MSDs of the upper extremity and low back, and exposure to physical factors at work.
The review established strong evidence that low-back disorders are associated with work-related lifting and forceful movements. The review also cited strong evidence of a causal relationship between low-back disorder and whole body vibration (WBV), which occurs when mechanical energy oscillations are transferred to the body as a whole. Typical exposures for WBV include driving automobiles, trucks and operating industrial vehicles. Other physical workplace factors found to have an association with back disorders include awkward posture and heavy physical work, although these risk estimates are more moderate than lifting and forceful movements. MSDs risk factors include intensity, frequency and duration of the physical exposure. MSDs are also affected by individual factors, such as age, physical condition, sociocultural and psychosocial variables.
Injuries Segmented by Occupation and Industries
Almost a third of non-fatal, occupational MSDs injuries that involve lost workdays, occur in the service sector, with the manufacturing industry falling closing behind at 21%. Most of these injuries were experienced by operators, fabricators and laborers, comprising 42% of all cases in 1997.
Type of Injuries
Back strain occurs when the muscle, ligaments and/or tendons in the back are damaged due to overstretching or overuse of the muscles in the back. These injuries result in strains, sprains and tears. Herniated disks are also a type of back injury found in workplace situations.
The most common causes of low-back pain are:
- Improper and/or excessive methods of lifting, pulling, pushing, carrying, holding, carrying or throwing an object (overexertion)
- Lowering, Bending or twisting
- Cumulative trauma-multiple micro-injuries sustained over a period of time
Components for Designing an Effective Back Safety Program
To avoid workplace back injury, NIOSH recommends the implementation of an ergonomics program that focuses on redesign of the work environment and work tasks to reduce the hazards of lifting.
There are a number of proven ergonomic program components that can minimize back injuries on the job. These components include:
- Training in proper lifting techniques
- Physical conditioning and stretching
- Reduction in size of objects or material being moved
- Adjusting the height at which the object or materials are retrieved or deposited
- Implementing mechanical aids, such as hoists or adjusted lift tables to reduce the need to bend, reach and twist
- Evaluation of production, storage and display workflows to remove excessive reaching, bending, pushing, pulling, lifting loading and unloading
For complete guidelines to effective back injury prevention techniques, see the link below.
http://www.cdc.gov/niosh/nasd/docs/as04100.html
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