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PubMed1990

Australian workers with back injury: a statistical overview.

This paper reviews international and Australian data concerning the occurrence of back injuries amongst the labour force. Analyses of Australian Bureau of Statistics data for the period 1977 to 1986 revealed substantial differences between Australian states in their rates of back injury claims for work injuries, with a decline in rates over the ten years surveyed. Analyses of WorkCare data from the State of Victoria in Australia revealed that claimants with back injury claims of greater than 12 months standing were very costly. A total of 8,633 claimants accounted for 68.7% of all payments for back injury ($362 million out of a total of $527 million) when these claimants represented only 10.7% of all back injury claimants for the period September 1985 to May 1989. Substantial variations were found in claim rates across occupations and age levels. An almost linear (r = 0.98) association was found between age and proportion of long term claimants at each age level. It is suggested that these data could be used to identify 'at risk' groupings with a view to the implementation of preventive measures.

Adolescent↗
PubMed1987

Personal and job-related factors as determinants of incidence of back injuries among nursing personnel.

The purpose of this multicenter prospective cohort study was to assess personal and job-related factors as determinants of incidence of reported back injuries among nurses. The study population included 5,649 nurses who were surveyed by questionnaire and then observed for a 12-month study period. An annual injury rate of 4.9% was observed. Four factors were found to be significant (P less than .01) predictors of back injury. All four factors--service area, lifting, job category, and previously reported back injury--maintain significance when a forward stepping model of logistic regression is applied. The adjusted odds ratios observed are 4.26 for service areas where lifting occurs most as compared with areas where lifting occurs least; 2.19 for daily lifters v light, occasional, and nonlifters; 1.77 for nursing aides v registered nurses and supervisory personnel; and 1.73 for individuals who have previously reported back injury v those who have not reported previous injury. These findings strongly suggest that job-related rather than personal characteristics are the major predictors of back injury in nurses.

Accidents, Occupational↗
PubMed1986

Neck and low back injuries in wrestling.

Drs. Wroble and Albright review the neck and low back injuries of the University of Iowa wrestling teams over the last 8 years with respect to diagnosis, mechanism of injury, time lost from wrestling, and recurrence. They describe examination of the low back and treatment of low back injuries. Examination of the neck is reviewed in detail and common neck injuries are discussed. Emergency management of acute neck injuries is outlined. Various aspects of prevention of neck injuries are presented.

Adult↗
PubMed1989

The effects of compensation on recovery from low-back injury.

The influence of compensation on recovery from low-back pain was assessed in a retrospective controlled cohort study. One hundred fifty compensable and 150 noncompensable back injury patients were invited for review between 1 and 5 years from presentation. A 91.3% follow-up was achieved, and there was no difference in the median age, follow-up, and initial injury score between the two groups. The incidence of reported pain, disability, psychological disturbance, unemployment, and length of time off work was greater in the compensation group (P less than 0.001). Settlement of the claim did not result in any reduction in morbidity, even up to 5 years later. These results demonstrate that the payment of compensation delays recovery from low-back injury.

Adult↗
PubMed1991

Low-back injuries in a heavy industry. I. Worker and workplace factors.

The costs and circumstances of low-back strains, low-back impact injuries, and non-low-back injuries among field employees of an offshore petroleum drilling company, 1979-1985, were compared. The objectives were to identify worker and workplace factors associated with low-back injuries, to identify factors differentially associated with lost-time injuries, and to formulate recommendations for the control of low-back injuries. Low-back-impact injuries resulted largely from falls. Efforts to prevent falls would have a potential to reduce other serious consequences as well as back injuries. Workers performing the heaviest physical labor were at highest risk of low-back strains. Based on activities precipitating the injury, modifications of work site, equipment, and procedures to help reduce low-back strains are recommended. Only job was a predictor of whether a low-back strain was likely to be associated with lost time. Even this association was lacking for low-back impact injuries. Cost control by preventing the small proportion of high cost injuries may not be feasible. Rather, subsets of low-back injuries defined, for example, by work site or activity can suggest options for intervention.

Accidental Falls↗
PubMed1990

Results of a multicenter trial using an intensive active exercise program for the treatment of acute soft tissue and back injuries.

Dissatisfaction with current nonsurgical treatment of acute soft tissue and back injuries initiated a search for more effective treatment. A multicenter trial, involving 12 clinics, treated 1,072 patients. Treatment consisted of intensive, time-limited exercises emphasizing mobility, muscle strengthening, work conditioning, sequence training, and appropriate education sessions. Return to full-time work was proof that the patient had recovered fully. Time off work and compensation costs were parameters used to evaluate results. A detailed study of 703 patients treated at five clinics, operational for more than 12 months, showed superior results when compared with the comparison group of 2,172 matched control subjects. The treatment group returned to work earlier and realized substantial cost savings. This treatment program has proved to be superior to the miscellaneous variety of treatment modalities used for acute soft tissue and back injuries provided to the comparison group.

Back Injuries↗
PubMed1992

MMPI scale 3 as a predictor of back injury report: what does it tell us?

Items and selected subscales of Scale 3 (Hysteria) of the MMPI were examined to pinpoint personality or emotional factors predictive of back injury reports in an industrial setting. Data were derived from a previous prospective-design study of back pain in volunteer hourly wage employees of an aircraft manufacturing company. After physical examination and completion of questionnaires pertaining to demographic, psychosocial (including the MMPI), and workplace factors, workers were followed for an average of 3 years. Those who subsequently reported back injury were compared with those who did not. In that study three variables predicted report of back injury, one of which was Scale 3 of the MMPI. Individual items, Ornduff et al. subscales of Psychological Denial and Body Concern, and the five Harris-Lingoes (1955) subscales of Scale 3 were analyzed. Three Harris-Lingoes subscales showed significant relationships to the criterion. Hy-3: Lassitude/Malaise; Hy-1: Denial of Social Anxiety; and, marginally, Hy-2: Need for Affection, significantly contributed to prediction effectiveness. Results and implications for the understanding of factors predicting back injury reports and for the medical evaluation of pain and the concept of pain are discussed.

Back Injuries↗
PubMed1989

Occupational low-back injury in a hospital employee population: an epidemiologic analysis of multiple risk factors of a high-risk occupational group.

A case-control study was carried out using 84 cases of employee back injuries and 168 controls (matched triplets) at Children's Hospital and Health Center, San Diego. The objective was to examine the impact of multiple individual and work-related risk factors for low-back injury from hospital employee health records. Hospital workers include occupational groups historically regarded as being at high risk, particularly nurses and others involved in patient care. In terms of traditional risk factors, significant associations were found for history of low-back pain or "slipped disc" by self-report and for history of previous back injury. Working the day shift also was significant (odds ratio [OR] = 2.23, P less than 0.005). Marital status (single) approached significance (OR = 1.65, confidence interval [CI] = 0.091, 2.99), as did low body weight (OR = 1.47, Cl 0.70, 3.10). No significant association was found between cigarette smoking and low-back injury. Possible work site health promotion interventions to lower the risk of low-back injury in this population are suggested.

Adult↗
PubMed1976

Tenderness at motor points. A diagnostic and prognostic aid for low-back injury.

In patients with low-back injury the motor points of some muscles may be tender. Of fifty patients with low-back "strain", twenty-six had tender motor points and twenty-four did not, while forty-nine of fifty patients with radicular signs and symptoms suggesting disc involvement had tender motor points, and the one without such tender points had a hamstring contusion which limited straight leg raising. Of fifty controls with no back disability, only seven had mild tender points after strenuous activity, while forty-six of another fifty controls with occasional back discomfort had mild motor-point tenderness. In all instances the tender motor points were located in the myotomes corresponding to the probable segmental levels of spinal injury and of root involvement, when present. Patients with low-back strain and no tender motor points were disabled for an average of 6.9 weeks, while those with the same diagnosis but tender motor points were disabled for an average of 19.7 weeks, or almost as long as the patients with signs of radicular involvement, who were disabled for an average of 25.7 weeks. Tender motor points may therefore be of diagnostic and prognostic value, serving as sensitive localizers of radicular involvement and differentiating a simple mechanical low-back strain from one with neural involvement.

Adult↗
PubMed1987

Disabling back injuries among nursing personnel: research needs and justification.

The need for more research on the problem of work-related back injuries among nursing personnel is documented by two comparisons based on the ratio of back injury workers' compensation claims to eligible employees. The first analysis of occupations across industries indicated that nursing aides, licensed practical nurses, and registered nurses all had high back injury ratios compared to other occupations. The second analysis of occupations within four parts of the health care industry indicated that aides in nursing and personal care facilities had the greatest problem with disabling back disorders. The article concludes with a list of research needs and suggested research methodologies.

Back Injuries↗
PubMed1988

Back injury.

Explore the source record for details and available documents.

Back Injuries↗
PubMed1979

Strength and fitness and subsequent back injuries in firefighters.

This prospective investigation was done to evaluate five strength and fitness measurements and the subsequent occurrence of back injuries in 1652 firefighters for the years 1971 to 1974. The prospective measurements included flexibility, isometric lifting strength, bicycle ergometer exercise measurements of two-minute recovery heart rate, diastolic blood pressure at a heart rate of 160 beats per minute and watts of effort required to sustain heart rate at 160. Three fitness and conditioning groups were established by multivariate ranking and regression techniques (259 high, 266 low, and 1127 middle) and the subsequent back injuries were tabulated for the three groups. The results showed a graded and statistically significant protective effect for added levels of fitness and conditioning (least fit, 7.1% injured; middle fit, 3.2% jured; and most fit, 0.8% injured). It was concluded that physical fitness and conditioning of firefighters are preventive of back injuries and that further investigations are warranted to study other injuries and physical fitness in this physically active occupational group.

Adult↗
PubMed1987

Occupational lower-back injuries in a primary medical care setting: a five-year follow-up study.

A cohort study with follow-up that describes the clinical characteristics and outcome five years later of patients with new occupational lower-back injuries, who were seen at a primary-care occupational health clinic in 1979, is presented. Follow-up data were obtained for 119 cases, 63% of all eligible cases. Occupational lower-back injuries constituted 9.5% of new occupational injuries that were seen at the clinic. Men aged less than 50 years accounted for 82% of all cases, and lifting was the most common method of injury. Forty-three per cent of patients were able to return to alternative duties without any absence from work and the majority (82%) of patients had returned to work in fewer than five days. Between 1979 and 1984, 48% of those studied had experienced recurrences of occupational lower-back injury that required medical treatment; half these recurrences occurred on more than three occasions. At five-year follow-up, 93% of patients were in work, although 70% of respondents stated they were still suffering back pain. Fewer than one-third of patients were receiving medical or other treatment at the time of follow-up. Only 2% of patients had undergone surgery and only 8% of patients were engaged in legal action in pursuit of a workers' compensation claim. This primary medical-care study challenges a number of popular stereotypes concerning occupational back injuries.

Absenteeism↗
PubMed1990

Risk for occupational low-back injury after lumbar laminectomy for degenerative disc disease.

Thirty-two Postal Service applicants who had undergone laminectomies were classified as low risk for back injury after preplacement examinations and were subsequently hired for employment. Each was compared with six control subjects, who were matched by age, gender, date of hire, and job classification. The odds ratios for occupational back injury with 95% confidence intervals were 5.9 (1.9-18.8) overall and 9.1 (1.5-73.8) for letter carriers. Of subjects, 25% were injured, compared with 6% of controls. The median elapsed time between surgery and hire was 5.9 years for injured subjects and 6.8 years for uninjured subjects. A rank sum test comparing the elapsed times of the two groups was not significant (P = 0.30). Postal workers are at increased risk for back injury after laminectomy. The risk does not appear to decrease with increased time since surgery.

Adult↗
PubMed1989

Low back injury in industry: the value of a recovery program.

Low back pain is the most frequent chronic disabling condition in the United States in patients younger than 45 years, and it is the second largest cause of employee absenteeism. In this retrospective study involving extreme working conditions at an industrial plant, we found that 20% of all employees incurred a back injury (occupational and nonoccupational) during the 12-month study period, costing more than 5,000 days of work lost, and approximately $920,000. Based on these findings a three-phased program of education/prevention, physical therapy, and an on-site rehabilitation workshop was implemented. After the first operational year, the net saving to the corporation was $255,000, and all employees who participated in the program returned to work within 60 days. We conclude that good job design, employee education on back injury prevention, and immediate on-site rehabilitation for injuries incurred can reduce employee disability and lost work time thus benefiting the employer and employee alike.

Absenteeism↗
PubMed1991

Low-back injuries in a heavy industry. II. Labor market forces.

Trends in rates of low-back strains, low-back impact injuries, and non-low-back injuries among field employees of a petroleum drilling company, 1979-1985, were examined to investigate the relationship between economic factors and the incidence of low-back and other injuries. Economic indicators included the rate of resignations, a surrogate for turnover, and the rate of layoffs. Only lost-time low-back strain rates increased during times of worker layoffs. Non-low-back injury rates were highest during periods of high turnover and no layoffs. Although the increasing age of the work force and the anxiety generated by an industry-wide depression may have played a role, it is likely that the increase in lost-time low-back strain injuries was a worker response to possible layoff.

Accidental Falls↗
PubMed1991

A prospective study of work perceptions and psychosocial factors affecting the report of back injury.

A longitudinal, prospective study was conducted on 3,020 aircraft employees to identify risk factors for reporting acute back pain at work. The premorbid data included individual physical, psychosocial, and workplace factors. During slightly more than 4 years of follow-up, 279 subjects reported back problems. Other than a history of current or recent back problems, the factors found to be most predictive of subsequent reports in a multivariate model were work perceptions and certain psychosocial responses identified on the Minnesota Multiphasic Personality Inventory (MMPI). Subjects who stated that they "hardly ever" enjoyed their job tasks were 2.5 times more likely to report a back injury (P = 0.0001) than subjects who "almost always" enjoyed their job tasks. The quintile of subjects scoring highest on Scale-3 (Hy) of the MMPI were 2.0 times more likely to report a back injury (P = 0.0001) than subjects with the lowest scores. The multivariate model, including job task enjoyment, MMPI Scale-3, and history of back treatment, revealed that subjects in the highest risk group had 3.3 times the number of reports in the lowest risk group. These findings emphasize the importance of adopting a broader approach to the multifaceted problem of back complaints in industry and help explain why past prevention efforts focusing on purely physical factors have been unsuccessful.

Adult↗