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PubMed2004

Physical demands and low-back injury risk among children and adolescents working on farms.

Little information currently exists regarding the risk of low-back disorders among youth who perform physically demanding farm activities. Thus, afield study was conducted in which children and adolescents who engage in farm work were recruited, fitted with a lumbar motion monitoring system, and then observed performing their usual chores. The lumbar motion monitor was used to record the trunk movements required while youth were performing routine manual material handling tasks on a farm. Workplace factors and motions from both males and females were recorded on over 40 farm tasks, such as feeding animals, lifting bales of hay and straw, and other miscellaneous farm chores. Although the sample size and number of observations in this study were small, the results showed that the magnitude of several work-related factors, such as weight and horizontal moment arm, and trunk motions for many farm activities were equal to or greater than those associated with high injury risk jobs previously assessed in industrial workplaces. In this study, we quantified the physical demands of tasks performed by children and adolescents on farms. In addition, the specific farm chores more likely to load the spines of youth and thereby contribute to musculoskeletal injury were identified.

Adolescent↗
PubMed2003

Back injuries in young fast bowlers--a radiological investigation of the healing of spondylolysis and pedicle sclerosis.

OBJECTIVE: To demonstrate the efficacy of various radiological diagnostic modalities in assessing lower back pain in young fast bowlers. METHODS: Ten cricketers who presented to either a physiotherapist or a doctor with suspected spondylolysis underwent an X-ray, a single photon emission computed tomography (SPECT) bone scan and a computed tomography (CT) scan to assess the severity of the injury. Three and 12 months after the initial CT scan, second and third CT scans were performed in order to assess whether healing had taken place. After the initial radiological investigation the subjects diagnosed with spondylolysis or pedicle sclerosis underwent prescribed intervention and rehabilitation which included physiotherapy modalities, postural correction, and specific individually graded flexibility, stabilisation, strengthening and cardiovascular programmes. RESULTS: Radiographs were normal in 8 subjects, while 2 had evidence of sclerosis. The isotope scan showed increased uptake in all of the subjects. The CT scans showed no fracture (N = 3), partial fractures (N = 3), complete fractures (N = 2) and old fractures bilaterally (N = 2). When the follow-up CT scan was carried out at 3 months, 1 of the subjects had developed a partial fracture of the left pars interarticularis on the inferior border, which showed complete union when CT scanned at 12 months. At 3 months the partial and complete fractures showed progressive healing in 2 subjects, with complete healing in all the other cases. Complete healing was achieved in all subjects at 12 months, with the exception of 1 subject who showed near-complete union, with a small area of fibrous union on the inferior border and 2 old bilateral fractures that remained un-united. RESULTS: From the results it is evident that when a young fast bowler presents with backache after bowling, it would be appropriate to do an X-ray, a bone scan and a CT scan to make the diagnosis. Discontinuing the fast bowling and following an active rehabilitation programme should result in spontaneous resolution and healing of the fractures. If it is not detected early a fibrous or non-union fracture could result.

Adolescent↗
PubMed1987

A prospective two-year study of functional restoration in industrial low back injury. An objective assessment procedure.

One hundred sixteen consecutive patients entered a functional restoration treatment program for chronic low back pain and were compared with 72 patients not treated. A two-year follow-up survey reached more than 85% of both groups; its findings were compared with earlier results of a five-month and one-year follow-up. Analysis demonstrated that 87% of the treatment group was actively working after two years, as compared with only 41% of the nontreatment comparison group. Moreover, about twice as many of the comparison group patients had additional spine surgery relative to the treatment group. The comparison group continued with an approximately five times higher rate of patient visits to health professionals in the second year as the treatment group. Also, treatment group reinjury rates were no higher than those expected in the general population, while nontreatment subjects had a higher incidence of reinjury. Finally, a small treatment "dropout" group did poorest of all, with results in almost all areas even worse than those of the comparison group patients.

Adult↗
PubMedDate not supplied

Ergonomic standards, guidelines, and strategies for prevention of back injury.

Now is the time for ergonomics to be taken seriously. OSHA and other regulatory agencies are concentrating on ergonomic issues, directing greater efforts in developing ergonomic guidelines and standards. Employers are being required to develop multifaceted programs to include prevention, education, and treatment. Ergonomics will become one of the direct responsibilities of ergonomists, safety professionals, and health care providers. Progress in preventing musculoskeletal injuries and illness will depend on the cooperation and availability of trained safety and health professionals who are knowledgeable about ergonomics and the extent of musculoskeletal problems in the workplace. These trained personnel must be able to educate workers and employers about risk factors and to assist them in implementing effective control procedures for prevention. Those responsible for the program will need to keep up-to-date with current engineering and medical trends in the field and be required to keep abreast of the latest legislation and regulations. The challenge is great but the rewards are even greater. Employers implementing ergonomic programs have not only reduced recordable injuries, saved hundreds of thousands of dollars in labor and materials, and reduced turnover, but have experienced increases in production and quality. The reduction in human suffering alone is reason enough to develop an effective proactive ergonomic management program.

Back Pain↗
PubMed1993

The development of guideline factors for the evaluation of disability in neck and back injuries. Division of Industrial Accidents, State of California.

This is the second article documenting the development of guideline factors for the evaluation of spine injuries by a committee supported by the Division of Industrial Accidents (DIA) in the State of California. The committee was asked to develop guidelines that incorporated cervical and thoracic spine injuries into the original guidelines developed for lumbar spine injuries (Clark et al, Spine 1988; 13:332). Multiple Independent Medical Examiners (IMEs) were requested to rate disability on 42 case reports submitted to the DIA. A tremendous variation existed in the disability rating recommended by physicians given the same set of facts. One hundred eighty-five IMEs then were asked to evaluate a series of potential factors influencing disability. Each factor was listed according to its perceived importance in determining disability. These factors then were subjected to an intensive search of the medical and scientific literature to determine their validity. A final list of 28 factors for the cervical and thoracic spine were developed and combined with the previously published factors for the lumbar spine. This led to the development of 37 factors or guidelines for the evaluation of spine disability. Testing of this schedule was performed by reviewing 159 submitted disability consultation reports. This review showed that there were no factors in the reports that were not included in the schedule. An average of 3.1 subjective factors and 2.3 objective factors were noted in the reports, with a very poor relationship between the number of factors and the level of disability given by the assessing physician. It is thought that the incorporation of the proposed guideline factors into the current disability rating system would allow for a more reproducible evaluation of disability and allow Workers' Compensation judges and administrators to make disability decisions based on documentable and reliable facts.

Back Pain↗
PubMed1992

An evaluation of a weightlifting belt and back injury prevention training class for airline baggage handlers.

This study evaluated the efficacy of a commercially available weightlifting belt in relation to reduction of lumbar injury incident rate and severity of injuries over an 8-month period. The study used 642 baggage handlers working for a major airline company as participants. Four treatment groups were randomly selected: a group receiving the belt only, a group receiving a 1 h training class only, a group receiving both a belt and a 1 h training class, and a control group receiving nothing. Two treatment groups were added which contained participants who discontinued use of the belt prior to the end of an 8-month study period. Results indicated that there were no significant differences for total lumbar injury incident rate, restricted workday case injury incident rate, lost workdays and restricted workdays rate, and worker's compensation rates. There was, however, a marginal significant difference for lost workday case injury incident rate. Groups with participants who wore the belt for a while then discontinued its use had a higher lost day case injury incident rate than did either the group receiving training only or the control group. Compliance was an overriding factor as the belt questionnaire response indicated that 58% of participants in the belt groups discontinued use of the belt before the end of 8 months. Comments made on the survey forms indicated that the belt was too hot. Similarly, comments suggested that the belt rubbed, pinched, and bruised ribs. Based on these results, the weightlifting belt used for this study cannot be recommended for use in aid of lifting during daily work activities of baggage handlers. Results indicate that use of the belts may, in fact, increase the risk of injury when not wearing a belt following a period of wearing a belt. As industries are experimenting with the use of belts, it is recommended that great care be taken in any further evaluation and close attention directed towards injuries which occur when not wearing the belt following a period of wearing the belt (ie, off-the-job injuries).

Journal Article↗