Back injury: back to basics.
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Back Injuries↗
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Patient-handling skill, back injuries, and back pain. An intervention study in nursing.
The aim of this intervention was to evaluate the effect of training on patient-handling skills and prospectively to assess the effect of skill on subsequent back pain and back injuries in nursing. Of a total of 255 nurses, 199 were assessed for their skill in patient-handling. One-half (control group) received traditional training in patient-handling, and the other half (trained group) received a curriculum of instruction totaling 40 hours. The skills of both groups were assessed on graduation. The control group was rated as less competent in patient-handling. Nurses in both groups were questioned about the prevalence of back pain and incidence of back injuries in the first year after graduation. In multiple regression analysis, the major risk indicators for back injuries were poor patient-handling skill, low numbers of repetitions in the sit-up test, and high work-load scores. High score on the hysteria scale of Middlesex Hospital Questionnaire was a risk indicator for all kinds of back pain. Though back pain was independent of patient-handling skill, those rated as "bad" or "poor" had more back injuries (24%) than those who had been rated as "good" or "excellent" (2%) (P less than 0.001), but the difference between the trained and control groups was not statistically significant. It was concluded that back injuries may be prevented by the teaching of patient-handling skills.
Back Injuries↗
The role of exercise and posture in preventing low back injury.
Low back injury is a serious problem for U.S. industries, accounting for as much as one third of all workers' compensation payments. The number of low back injuries can be reduced effectively through the stressing of proper posture and the use of back care exercises. Body posture that maintains the spine's three natural curves decreases intradiscal stress. Back care exercises decrease the likelihood of low back injury by strengthening and adding flexibility to the spine's supportive structures.
Back Pain↗
The value of preemployment roentgenographs for predicting acute back injury claims and chronic back pain disability.
Preemployment roentgenographs have long been used in industry to screen job applicants. Roentgenographs have had little effect, however, in curbing the cost of back problems in industry. This study evaluates the capabilities of preemployment roentgenographs for predicting acute back injury claims within the longshoring industry and for predicting back problems that lead to back disability of more than six months. The data indicate that lumbosacral roentgenographs are not helpful in predicting who is more likely to make a back injury claim, or those few who make up the vast majority of the costs for industrial back pain by becoming disabled for more than six months. Lumbosacral roentgenographs have little link to back disorders and may be viewed as discriminatory. The radiation exposure is not justified by their predictive value as a preemployment screening tool.
Acute Disease↗
Restoration of function in industrial low back injury.
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Back Injuries↗
Back injury prevention program on a spinal cord injury unit.
A back injury prevention program was developed for the Spinal Cord Injury (SCI) nursing staff at the San Diego Veterans Affairs Medical Center (SDVAMC). This preventive program has the following components: 1. All nursing staff are sent to a one hour "back school" in order to learn and practice proper body mechanics. This program is held in the therapy clinic and conducted by a kinesiotherapist. In addition, each nurse must be certified in transfer techniques by our clinical nurse specialist, before performing transfers on patients. 2. All nursing staff participate in 5-10 minutes of stretching, warm-up exercises at the beginning of their shift. These exercises are helpful as injuries are less likely to occur when muscles have been warmed up prior to lifting and moving patients. 3. All nursing staff wear a lumbar sacral back support while on duty. This device will offer physical support to the lower back as well as provide a mental reminder to use proper body mechanics when transferring patients. This back injury prevention program has been in effect since the opening of the SCI unit in March 1989. The rate of low-back injuries on the SCI unit from October 1989 to September 1990 was compared to the rate of low-back injuries on the other hospital units. As a result of this program, there were only four low-back injuries with six lost work days on the SCI unit. This rate compares favorably with the incidence of low-back injuries in other patient care areas.
Back Pain↗
Back injury and low back pain.
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Back Pain↗
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↗
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↗
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↗
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↗
Design and evaluation of a back injury prevention program within a geriatric hospital.
Two phases of a back injury prevention program were studied using 2035 accident reports filed between 1979 and 1984. Phase 1, Personnel Program, was designed to decrease the duration of wage-loss claims by increasing the effectiveness of the existing procedures used to process these claims. This program significantly lowered the proportion of high-hour claims (P less than .05) and significantly reversed a trend of increasing accident rates (P less than .05). Phase 2, Back Program, was designed to lower the incidence of back injuries through a feedback-oriented educational program. The Back Program itself could not demonstrate a significant reduction in back injuries primarily due to the powerful and confounding effect of the Personnel Program. The combination of the Personnel Program and the Back Program significantly lowered back injuries for nurses when compared with a similar group of injuries that occurred at geriatric hospitals (P less than .001). The large effect of the Personnel Program and the small effect of the Back Program have design implications for any injury prevention program.
Aged↗
Low back injury in sport.
Low back injuries are shown to present a serious hazard to sportsmen and women, and may lead to long-term disability in relation to their sport. Training methods, particularly weight training, led to many of the injuries and it is recommended that personnel involved in training become more aware of these dangers. Spondylolysis was found in 18% of cases and it is suggested that the full investigation of low back pain in a sportsman is incomplete until this lesion has been excluded.
Adolescent↗
[Back injuries and the work site].
Payments through obligatory accident insurance for back injuries as a result of an accident in the legal sense are common. In contrast, the acceptance of back injuries as an occupational illness is associated with such strict legal prerequisites that, considering the early appearance and frequency of degenerative back diseases in the general population, the condition whereby a back injury must have been caused exclusively or predominantly, i.e. at least three quarters, by the occupational activity is satisfied only in rare cases. Epidemiological studies show that back conditions occur more frequently in certain types of exposed occupation. The high degree of causality required by the legislature is, however, not demonstrated so that back injuries could therefore be recognized as occupational illnesses only in rare cases. Because of this, prevention at the place of work is all the more important.
Accidents, Occupational↗
A case-control study of risk factors for industrial low back injury: implications for primary and secondary prevention programs.
Data were collected on 228 consecutive back injuries in Boston's General Mail Facility and 228 non-injured controls drawn randomly from each case's work unit, matching on craft (clerk, mailhandler, maintenance), shift, and general supervisor. Data were collected on age, gender, duration of employment, 3 year history of injury claims, overtime work in the past 2 weeks, job change in the past 60 days, and machine vs. manual job. Risk factors for back injury were examined simultaneously in a conditional logistic regression for matched pairs. Risk factors included history of back injury claim (OR = 16.5, p less than 0.0001), younger age (OR = 3.0, p = 0.0001), shorter duration of employment (OR = 2.6, p = 0.0007), recent job change (OR = 2.5, p = 0.06), and history of non-back injury claim (OR = 2.0, p = 0.08). Among heavy lifters (vs. clerks) overtime and being female increased the risk of injury. In this setting, higher risk workers who may benefit from preventive education programs can be identified.
Accidents, Occupational↗