Back injury and low back pain.
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Back Pain↗
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Back injuries in dancers.
Back injuries may occur at any age or level of skill and are slightly more prevalent in male dancers. The risk factors that may be involved in a given injury include training errors, musculotendinous imbalance, anatomic malalignment of the lower extremity, shoe wear, and floor surface. Assessment of these risk factors provides guides for management and prevention.
Adolescent↗
Decreased rate of back injuries through a wellness program for offshore petroleum employees.
High rates of injury, particularly those for back injuries, at an offshore petroleum unit were addressed through an intensive wellness program initiated in 1991. The number of all types of injuries, including back injuries, decreased between 1991 and 1995. The number of back injuries decreased from nine in 1987 to four in 1992 and was zero in 1993. Although there are inadequate data to provide power for a significant result, other criteria suggest a causal relationship. The results are consistent with the few published studies that suggest a decrease in the number of injuries in association with exercise and perhaps with modification of psychosocial risk factors. Calculations suggest a cost savings of over $800,000 and a return on investment of $2.51, as well as avoidance of pain and injury.
Back Injuries↗
A study of three preventive approaches to low back injury.
The prevention of low back injuries in industry has traditionally been attempted by (1) careful selection of workers, (2) good training in safe lifting, and (3) designing the job to fit the worker (ergonomics). One hundred ninety-one low back injuries were analyzed to determine the effectiveness of each preventive approach. The results indicate that the common selection techniques, as they are being used today, are not an effective control for low back injuries. Similarly, training on safe lifting procedures, as it is being administered today, is not an effective control for low back injuries. It was determined that a worker is three times more susceptible to low back injury if exposed to excessive manual handling tasks. The ergonomic redesign of these tasks to reduce the manual handling exposure represents a partial control for low back injuries.
Back Injuries↗
Back injuries in industry: a retrospective study. I. Overview and cost analysis.
To evaluate the impact off back injury on industry, the authors conducted a retrospective analysis of injuries among hourly employees of a large industrial manufacturer in western Washington. The Boeing Company provided injury information on 31,200 employees for a 15-month period from July 1, 1979 to September 30, 1980. Of the 4,645 injuries reported, 900 were back injuries. Claims related to back injuries constituted 19% of all workers' compensation claims but were responsible for 41% of the total injury costs, or approximately $1,800,000. The 90 most expensive back injury claims (10% of all back injury claims) were responsible for 79% of the total back injury costs. The percentage of back injury claimants with claims having a total incurred cost exceeding $10,000 (6.5%) was significantly higher than the corresponding percentage of claimants (1.5%) with claims for other than back injuries (P = 0.000). A similar significant difference was found concerning the tendency of back injury claimants to have multiple claims compared with the non-back injury claimants. This retrospective study reaffirms the significant economic impact of back injuries on industry, and specifically high-cost back injuries. In addition, it provides insight into factors associated with back injury and points to positive measures that may be taken to reduce back pain and economic loss. Characteristics of the back injury and employee-related factors associated with back injury are presented in two subsequent articles.
Back Injuries↗
A cost-benefit analysis of a California county's back injury prevention program.
Back-related injuries have become a major health problem in the workplace, affecting as many as 35 percent of the work force and accounting for about 25 percent of all compensation claims. This study evaluates a back injury prevention program among employees in a northern California county in 1989-90. Six divisions of the county government were selected for the study because they had the highest prevalence of back pain experienced and the most back-related injuries in recent years. Four of the six divisions were randomly selected as the intervention group and the remaining two, the control group. Overall, 77 percent or 205 of the targeted employees in the intervention group participated in the study. The intervention group was given an identical health risk assessment (HRA) before and after the 1-year back injury prevention program that offered employees a combination of education, training, physical fitness activities, and ergonomic improvement. The control group was neither given the HRA nor offered the program. The back injury and cost data of both the control and intervention groups were collected before and after the 1-year intervention. The results showed a modest overall decline in back pain prevalence rates, but significant improvement in satisfaction and reduction in risky behaviors. Cost-benefit analysis showed the net benefit of introducing back injury prevention program was $161,108, and the return on investment is 179 percent. Therefore, the study offers suggestive evidence for the initial benefits of a back injury prevention program and lends support to the widely held belief that health promotion in the workplace can reduce employee health risks, increase healthful behaviors and attitudes, and improve attitudes toward the employer organization.Whether such intervention will continue to reap benefits in future years depends, to a large extent,on a favorable work environment and the maintenance and continuation of positive behavioral changes.
Adult↗
The Back Injury Prevention Project pilot study. Assessing the effectiveness of back attack, an injury prevention program among nurses, aides, and orderlies.
The Back Injury Prevention Project was a pilot study of "Back Attack," an educational program designed to prevent back injuries among nurses, nurses' aides, and orderlies. The pilot tested program feasibility, developed and tested instruments, and generated preliminary data measuring program effectiveness. Fifty-five nurses, aides, and orderlies on two medical/surgical units at two Kaiser Permanente medical centers in Portland, Oregon participated in the study. Intervention group scores on the composite back pain and composite fatigue scales decreased relative to the control group, but this did not reach statistical significance. A 19% improvement in scores for quality of patient transfer was observed for the intervention group (P < .0003), while the control group did not show any significant improvement during the same time period. Results of the pilot suggest that the Back Attack program changes behavior at least in the short term. Further study will be necessary to determine if the behavior change persists and back pain and injury rates are subsequently reduced.
Accidents, Occupational↗
Compensated back injury in New Zealand.
Back injury is one of the commonest claims for accident compensation. A survey carried out over three months in 1984 identified 420 claimants having details of their accidents. Labourers, freezing workers, coal miners and railway workers were at high risk. Over half (54.7%) developed back pain whilst lifting and for almost two-thirds (63.6%) there was a sudden strain. Half had a previous history of back pain and the incidence rose to 70% for those aged 40-59 years. Eighty-two percent returned to work within four weeks. Most were treated by a general practitioner and physiotherapy was increasingly used as the period of disability lengthened. Rest and pain killers were assessed as the most popular forms of treatment. There was a need for education of the workforce in the ergonomics of lifting.
Accidents, Occupational↗
Personal characteristics and back injury among hospital nursing personnel.
Since back injury is the largest workman's compensation claim in most industries, the relationship between selected personal characteristics and back injury in hospital nursing personnel were studied. The sample included 64 female nursing personnel, half back injured and half not. Demographic: Workers were more likely to be back injured if they were older, worked longer on nursing units requiring frequent lifting, had family members with back problems, and had family members whose back problems began at an early age. Physical: The back injured had less muscle flexibility, less keen proprioception, and greater unequal leg length. Life style: Back injured were more vulnerable to frustration and stress overload (overstimulation), smoked more cigarettes, spent fewer hours exercising, and rated their physical condition lower. The variables with the greatest discriminatory power to predict back injury were a sense of overload, muscle flexibility, proprioception, family history of back problems, difference in leg length, years of risk in nursing practice, and smoking.
Adult↗
Back injury in municipal workers: a case-control study.
OBJECTIVES: The purpose of this study was to identify factors associated with acute low back injury among municipal employees of a large city. METHODS: For each of 200 injured case patients, 2 coworker controls were randomly selected, the first matched on gender, job, and department and the second matched on gender and job classification. In-person interviews were conducted to collect data on demographics, work history, work characteristics, work injuries, back pain, psychosocial and work organization, health behaviors, and anthropometric and ergonomic factors related to the job. Psychosocial work organization variables were examined with factor analysis techniques; an aggregate value for job strain was entered into the final model. Risk factors were examined via multivariate logistic regression techniques. RESULTS: High job strain was the most important factor affecting back injury (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.28, 3.52), and it showed a significant dose-response effect. Body mass index (OR = 1.54, 95% CI = 1.08, 2.18) and a work movement index (twisting, extended reaching, and stooping) (OR = 1.42, 95% CI = 0.97, 2.08) were also significant factors. CONCLUSIONS: Results suggest that increasing workers' control over their jobs reduces levels of job strain. Ergonomic strategies and worksite health promotion may help reduce other risk factors.
Accidents, Occupational↗
Back injuries in industry: a retrospective study. II. Injury factors.
To evaluate the impact of back injury on industry, the authors conducted an extensive retrospective analysis of injuries among hourly employees of The Boeing Company, the largest industrial manufacturer in western Washington. The Boeing Company provided injury information on 31,200 employees for a 15-month period from July 1, 1979 to September 30, 1980. From this information, we analyzed 4,645 injury claims filed as of February 28, 1981 by 3,958 different employees. There were 900 back injuries in this group. Claims were categorized according to total incurred cost (TIC), made up of the medical costs and indemnity costs. High-cost claims were defined as those with a TIC greater than $10,000, and low-cost claims were those with a TIC less than $10,000. Among 857 claimants with 900 back injuries, lifting or material handling was much more commonly considered the cause of injury than accidents such as slips or falls. Accidents, however, had a much greater tendency to result in an expensive claim. The authors could not make reliable conclusions regarding injuries and 32 job skill classifications. The rate of injury did not vary according to day of the week or month, but a significantly higher rate of high-cost back injuries was noted on the day shift than on the evening or night shifts.
Absenteeism↗
Back injuries in industry: a retrospective study. III. Employee-related factors.
To evaluate the impact of back injuries on industry, the authors conducted a retrospective analysis of injuries occurring among a group of 31,200 employees of The Boeing Company, a large industrial manufacturer in Western Washington. They analyzed 4,645 injury claims (including 900 back injuries) made by 3,958 different employees. Two previous articles give an overview of the study, provide a detailed analysis of the costs associated with these back injuries, and analyze the characteristics of the injury. This article focuses on employee-related factors associated with back injuries. Claims were categorized according to severity, as indicated by total incurred cost (TIC), the sum of the medical costs, and indemnity costs. High-cost claims were defined as those with a TIC greater than $10,000 and low-cost claims as those with a TIC less than $10,000. Employees younger than 25 years of age had a statistically significant increased risk of back injury, although their claims tended to be low-cost ones. This finding tends to discredit the premise that back problems are related to aging of the lumbar spine. While older employees had a lower injury rate, they did have a significantly increased risk of incurring high-cost back injury claims. The 31-40-year age group was the most susceptible to high-cost back injuries. Newer employees tended to have a significantly increased risk of back injury. The data show that women had fewer injuries than men but a statistically significant increased risk of becoming a high-cost injury claim.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Back injuries in college athletes.
Frequency and types of back injuries sustained by intercollegiate athletes were determined by examining medical records of 4,790 athletes that competed in 17 varsity sports over a 10-year period. These athletes sustained 333 back injuries, an injury rate of 7 per 100 participants. Injury rates were significantly higher in football and gymnastics, and 80% of the injuries occurred in practice, 6% in competition, and 14% during preseason conditioning. Muscle strains occurred with much greater frequency than other types of injuries, and acute back injuries were much more prevalent (59%) than overuse injuries (12%) or injuries associated with pre-existing conditions (29%).
Athletic Injuries↗
Fitness and lifestyle parameters fail to predict back injuries in nurses.
Performance on fitness and back related isometric strength tests, as well as the response to a lifestyle questionnaire, were related to the subsequent occurrence of back injuries in 119 nurses. In all, 22% of subjects sustained injuries during the 18-month study. Injured nurses were more likely to be from high-risk wards and to have received worker's compensation pay for past back injuries. Fitness and lifestyle characteristics did not differ significantly between injured and not-injured groups. Using backward stepwise logistic regression, a model was developed that accounted for 41% of the variability between groups and predicted 67% of those injured. Prior compensation pay, smoking status, and job satisfaction were the most useful discriminators. It was concluded, however, that the fitness and lifestyle parameters measured did not effectively predict back injury in nurses.
Adult↗
The psychosocial implications of back injury at work.
The majority of studies on back injury have been quantitative in nature, focusing on ergonomic or financial implications of back injury problems for trusts and the profession. The psychological and social effects upon the individual suffering the injury have largely been ignored. This qualitative study sought to redress the balance by examining why injuries were occurring. It focuses on the personal cost of back injury to nurses and its effect on their lives and careers. Questionnaires were sent to members of the Work Injured Nurses' Group (WING) which is funded by the Royal College of Nursing. The findings revealed that a large proportion of accidents were preventable. Nurses who sustained a back injury suffered both physically and psychologically, and generally felt unsupported and isolated. This, together with a lack of redeployment opportunities, seemed to affect adversely their ability to adapt to their injury and remain in the profession.
Accidents, Occupational↗
Prioritizing back injury risk in hospital employees: application and comparison of different injury rates.
To identify high risk areas for back injury in a large teaching hospital, we calculated standard injury rates and newly developed composite statistics for nursing and non-nursing work groups. Data were extracted from the hospital's workers' compensation database. The hospital-wide total injury rate was 4.6 reports per 100 full-time equivalents (FTE); Compensation Case Rate, 1.4 cases per 100 FTE; Compensation Severity Rate, 76 days lost per 100 FTE; and the Cost Rate, $3742 per 100 FTE. The Total Injury Reports Rate for nursing varied from 14.2 per 100 FTE for Intensive Care Unit (ICU) Nursing to 3.8 per 100 FTE for Pediatric Nursing. Non-nursing areas also demonstrated increased rates for back injury. Individual statistical rates ranked areas differently in risk, whereas composite statistical measures consistently ranked ICU Nursing, Buildings and Grounds, and Orthopedics/Neurological Nursing as the top three. Patient handling was the precipitating event in the majority of nursing back injuries, indicating the need for ergonomic intervention. The use of combined statistical measures provided a more integrative measure for describing and following back injury risk over time.
Absenteeism↗
Back injuries in competitive squash players.
BACKGROUND: The aim of this investigation was to examine the prevalence of back injuries in competitive squash players. METHODS EXPERIMENTAL DESIGN: a retrospective analysis was made using a cross-section of current competitive squash players (survivor population). SETTING/PARTICIPANTS: an attempt was made to distribute a questionnaire on back injuries to all competitive squash players registered in the Otago provincial area, New Zealand, (n = 1047), of which 495 questionnaires were returned (47.3% compliance). INTERVENTIONS: variables were cross-tabulated and analysed via descriptive statistics, paired t-tests, chi-analyses of trend and chi 2 tests of significance. MEASURES: the questionnaire obtained information on demographics, the level of play (ability), overall volume of play (average frequency and duration of all exposures), plus the occurrence and severity of back injury. RESULTS: Nearly 52% of the sample reported they had suffered back injury. Of these, 33.5% claimed squash initiated their injury, 20.6% claimed squash exacerbated a previous back injury and the remaining 45.9% felt that squash had no detrimental effect on their back injury. Significantly higher frequencies of back injury were observed in males (56.5% compared to 46.4% in females, p = 0.033), in players of higher grade (p = 0.006),and with increased frequency (p = 0.01), but not duration of play (p = 1.0). CONCLUSIONS: These results suggest that the greater activity and possible over-reaching for the ball associated with higher levels of play may increase the risk of back injury and provides tentative support for the notion that back injuries in squash players might be related to periods of relative over-use.
Adult↗
Back injuries to fast bowlers in cricket: a prospective study.
Eighty-two high performance young male fast bowlers (mean age 16.8 years) were tested immediately prior to the season for selected kinanthropometric and physiological data. Subjects were also filmed both laterally (200 Hz) and from above (100 Hz) while bowling so that their front foot impacted a force platform during the delivery stride. The players then completed a log book over the ensuing season that detailed their training and playing programmes. All cricket related injuries over this season were assessed by a sports physician who used computerized tomography to assist in the diagnosis of spinal injuries. At the completion of this season the players were grouped according to their injury status (Group 1--bony injury to a vertebra; Group 2--soft tissue injury to the back that caused the player to miss at least one game, and Group 3--no injuries). A one-way analysis of variance was used to identify if any variables were significantly (P less than 0.05) different between the three groups, and a Scheffe post hoc comparison was used to determine which groups were significantly different. Eleven per cent of the players sustained a stress fracture to a vertebra(e) (L4 to S1), while 27 per cent sustained a soft tissue injury to the back. Bowlers with a low longitudinal foot arch were more likely to develop a stress fracture than those with a high arch. Shoulder depression and horizontal flexion strength for the preferred limb and quadriceps power in the non-preferred limb were also significantly related to back injuries. Results suggest that bowlers with the above physical characteristics, who bowl with these biomechanical techniques for extended periods, are predisposed to back injuries.
Adolescent↗