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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