Changing concepts in approaches to occupational low back pain

A retrospective analysis of back pain claim data from two sources, a workers' compensation provider and Washington State Department of Labor and Industries. The Workers' Compensation Provider claim data were examined over a 9-year period, 1987-1995, and the Washington claim data were examined over a 5-year period, 1991-1995. In addition, a third source of data, reports of back pain from the the Bureau of Labor Statistics, was examined over a 4-year period, 1992-1995. To characterize occupational low back pain trends in the United States. More specifically, trends in back pain rates and costs as well as back injury rates from the Bureau of Labor Statistics were discerned. The literature often refers to a recent rise in occupational low back pain. However, the question is: Do empirical data support this notion? Retrospective analysis of workers' compensation provider, Washington State, and Bureau of Labor Statistics data. The U.S. estimate of the annual low back pain claim rate decreased 34% between 1987 and 1995, although the trend was not monotonic. There was a sharper decrease in the U.S. estimate of the annual low back pain claim costs during this time (58%). In 1995, however, occupational low back pain remained a major problem in the U.S.: an estimated $8.8 billion was spent on low back pain claims, and the rate of filing low back pain claims was 1.8 per 100 workers. Evidence of a rise in occupational low back pain was not discerned for the 8-year period studied. Data from three sources support this finding. However, occupational back pain remains a major problem in the U.S.

Objective To investigate the health status of clinical nurses and nurses with occupational low back pain (OLBP) and its influencing factors. Methods Using convenience sampling method, 1 279 clinical nurses from 7 ClassⅢ Grade A hospitals in 6 cities of China were investigated by using Chinese Version of Roland-Morris Disability Questionnaire (CRMDQ) , the MOS Item Short Form Health Survey (SF-36) and Visual Assimilation Scale (VAS) from April to October 2016 to understand the health status of nurses with OLBP and the related influencing factors. By comparing with the domestic norms, the health status of nurses with OLBP and the influence of different demographic characteristics on the health status of nurses with OLBP were analyzed, and the correlation between the functional disorders and health status of nurses with OLBP was analyzed. Results The incidence of low back pain in clinical nurses was 91.0% (1 164/1 279) , and the scores of each dimensions of health status were lower than the national norm (n=8 448) . Nine factors, such as sex, age, marital status, fertility status, working life, department, night shift frequency, pain degree and pain frequency, can affect the health status of nurses with low back pain in varying degrees. The nurses with low back pain got the total score of (41.60±5.72) from the CRMDQ and the scores of the 8 dimensions in SF-36 were all lower than the national norm, with statistical differences (P<0.01) . The results of correlation analysis showed that nurses' lumbar vertebral dysfunction was negatively correlated with all dimensions of health status (P < 0.01) . Conclusions The factors influencing the health status of nurses with low back pain include many aspects. It is suggested to improve the occupational environment, strengthen occupational protection, prevent and alleviate the OLBP of nurses, so as to improve the health status of clinical nurses. Key words: Nurse; Investigation; Occupational low back pain; Health status

Details on the association between heavy lifting and low back pain

Occupational low back pain not only poses a serious threat to the physical and mental health of clinical nurses, but also affects the quality of nursing care and patient safety. Based on the epidemiological status of nurses' occupational low back pain, this paper reviews the research trends of symptom assessment tools and preventive interventions for nurses' occupational low back pain, aiming to promote subjective and objective assessment tools for nurses' occupational low back pain and propose psychosomatic intervention measures. Key words: Review; Nurse; Occupational low back pain; Symptom assessment; Current status; Prevention; Intervention; Progress

Causal assessment of occupational carrying and low back pain: results of a systematic review

To explore the prevalence of occupational low back pain (OLBP) and assess work-related risk factors in ICU nurses. Forty hundred seventy-seven ICU nurses of study group and nurses working in other wards (control group) of the same comprehensive hospital were investigated using OLBP Investigation Questionnaire for nurses. Working postures and related work activities were evaluated by using the Win OWAS software and the compressive force (Fc) of the disc between L5 and S1 was calculated by using the Bless Pro software and sampling was taken by digital camera in ICU ward of one hospital. The prevalence of OLBP (87%), frequency of OLBP (48%=1 per month) and OLBP related work-absence (7%) of the ICU nurses were significantly higher than the control group (64%, 32% and 2%, respectively). The frequency of harmful postures occurred during working tasks of observing drainage, lifting and transferring patients in bed, injection, suctioning and adjusting drip were 99%, 90%, 75%, 75% and 6%, respectively. The ratios of Fc of adjusting drip rate (taken as 100), suctioning, injection, observing drainage and lifting and transferring patients in bed were 100:155:199:301:418. Prevalence of OLBP in ICU nurses is high. High frequency of bending and twisting, transferring patients in bed are the main causes of OLBP in ICU nurses.

Objective To understand the present situation of occupational low back pain of clinical nurses, and analyze its influence factors. Methods A questionnaire survey was conducted among 1 300 clinical nurses from 7 Class Ⅲ Grade A general hospitals in 5 provincial capital cities, in the region of north China, central China, southern China, southwest and northwest, from April to December 2016. The survey tools included general demographic characteristics questionnaire, Visual Analogue Scale (VAS) and Chinese version of Fear-Avoidance Belief Questionnaire (FABQ-CHI) . A total of 1 300 questionnaires were distributed, and 1 279 valid were collected. SPSS 21.0 was applied for statistical analysis. Results In the 1 279 nurses, 115 (8.99%) had no low back pain, and 1 164 (91.01%) was positive. The majority of nurses suffered with mild pain, account for 64.69%. The average score of FABQ-CHI in negative nurses was (50.11±17.5) , and that in positive nurses was (55.24±8.2) , the difference was statistically significant (t=14.56, P<0.001) . Univariate analysis showed that there were significant differences in VAS scores among nurses of different ages, marital status, fertility status, professional titles, working years, and whether or not they participated in training (P<0.01) . Multivariate analysis showed that age (OR=1.40) and professional title (OR=1.84) were the influencing factors of low back pain. Conclusions The incidence of occupational low back pain in nurses is high, and it is related to individual factors, work related factors and psychological factors. It is suggested that great attention should be paid to the popularization of knowledge on prevention and treatment of low back pain and the training of occupational protection skills for clinical nurses. Especially, we should pay attention to the correlation between psychological factors and nurses' occupational low back pain, gradually improve the working environment and bad living habits of nurses, reduce the occurrence of low back pain, and improve the job satisfaction of clinical nurses. Key words: Nurses; Low back pain; Fear avoidance beliefs; Multi-center survey; Influencing factors

BackgroundEarly magnetic resonance imaging (eMRI) for nonspecific low back pain (LBP) not adherent to clinical guidelines is linked with prolonged work disability. Although the prevalence of eMRI for occupational LBP varies substantially among states, it is unknown whether the risk of prolonged disability associated with eMRI varies according to individual and area-level characteristics. The aim was to explore whether the known risk of increased length of disability (LOD) associated with eMRI scanning not adherent to guidelines for occupational LBP varies according to patient and area-level characteristics, and the potential reasons for any observed variations.MethodsA retrospective cohort of 59,360 LBP cases from 49 states, filed between 2002 and 2008, and examined LOD as the outcome. LBP cases with at least 1 day of work disability were identified by reviewing indemnity service records and medical bills using a comprehensive list of codes from the International Classification of Diseases, Ninth Edition (ICD-9) indicating LBP or nonspecific back pain, excluding medically complicated cases.ResultsWe found significant between-state variations in the negative impact of eMRI on LOD ranging from 3.4 days in Tennessee to 14.8 days in New Hampshire. Higher negative impact of eMRI on LOD was mainly associated with female gender, state workers’ compensation (WC) policy not limiting initial treating provider choice, higher state orthopedic surgeon density, and lower state MRI facility density.ConclusionState WC policies regulating selection of healthcare provider and structural factors affecting quality of medical care modify the impact of eMRI not adherent to guidelines. Targeted healthcare and work disability prevention interventions may improve work disability outcomes in patients with occupational LBP.

Objective To explore the nurses' real feelings in Class Ⅲ hospital with occupational low back pain (OLBP) so as to provide reference in the improvement of nurses' occupational protection. Methods In August 2018, 12 nurses with OLBP in a Class Ⅲ hospital were interviewed in depth by using phenomenological method of qualitative research, and data were analyzed by content analysis method. Results Two themes were concluded which were: nurses' perception on the risk factors of OLBP and nurses' psychological feeling on the severity of OLBP. Conclusions Nurses' perception on the risk factors of OLBP is mainly related to their occupational characteristics. The psychological experience of its severity has negative impact on their body and mind; the nurses themselves and the nursing managers should pay enough attention to it and take a number of occupational protective measures to actively prevent the occurrence of OLBP in nurses. Key words: Nurse; Occupational low back pain; Occupational safety; Psychological experience; Qualitative research

Experts estimate that anywhere from 24% to 90% of women experience low back or pelvic-region pain when they are pregnant. Many women find that this pain goes away when the baby is born. However, more than a third of women still have pain 1 year after giving birth. Physical therapy during and after pregnancy can help decrease low back and pelvic pain. A study published in the July 2014 issue of JOSPT reviewed the best published research to better understand the benefits of physical therapy in treating women with back and pelvic pain during and after pregnancy. J Orthop Sports Phys Ther 2014;44(7):474. doi:10.2519/jospt.2014.0505

Reports of workers' casualties include occupational low back pain (LBP), accounting for approximately 60% of compensable occupational disease. While LBP has become an important safety and health problem, the occurrence of occupational LBP has not been analyzed recently. This study aimed to evaluate the occurrence of occupational LBP in reports of workers' casualties between 2018 and 2019. The study included 10,208 cases of occupational LBP (2018, n = 5,043; 2019, n = 5,165). Data on the location and date of industrial accidents, as well as type and size of business, age, sex, and leave period of the victims were tabulated. The number of occupational LBP cases was the highest in the health and hygiene industry (31.3%), followed by the commercial, manufacturing, and transportation industries. In the health and hygiene industry, social welfare facilities were listed in 24.3% of the total cases, and many caregivers suffered from LBP. Occupational LBP cases were less in cold regions and few during the cold period between November and January. Several occupational LBP cases occurred on Mondays following a holiday, and approximately 40% occurred between 9 a.m. and 12 a.m. Occupational LBP was frequently reported in workplaces with a volume of 10-49 workers, such as social welfare facilities in terms of business type. In terms of work-related accident victims per 100,000 workers, women were slightly more prone to LBP than men, and most of them were in their 20s and 30s. Approximately 60% of the leave period taken by victims was 2 weeks maximum. Occupational LBP was experienced by most workers in workplaces with at least 10-49 workers, such as social welfare facilities, between 2018 and 2019. In addition, LBP was more common in women than in men. Most workers with LBP take a leave period of 2 weeks. Suitable measures should be taken to prevent occurrences of occupational LBP.

Causal assessment of awkward occupational postures and low back pain: results of a systematic review

3) Objectives: Occupational low back pain is a major cause of morbidity and the increases of medical and industrial costs. Efforts to control occupational low back pain have been largely unsuccessful, and further understanding of the risks including the psychological factors is needed. This retrospective study was designed to identify the effect of job stress on occupational low back pain among shipyard workers. Methods: The study group consisted of 976 male workers who were working at a Korean shipyard. A structured self-reported questionnaire was used to assess the participants' physical work factors, job stress and general characteristics. Job stress was measured using Karasek's JCQ(Job Content Questionnaire). Occupational low back pain was identified according to the NIOSH symptom survey criteria. Physical work factors were assessed using the Quick Exposure Check. Since the work duration can affect the rela - tionship of physical work factors and job stress to occupational low back pain, we analyzed this associa - tion by dividing workers into two groups by work duration: 1) all workers, and 2) less than 5 years. Cox's proportional hazard model was used to elucidate the relationship of job stress with occupational low back pain in these two groups. Data were analysed with SAS 8.1. Results: In the all workers group, job demand, bending or twisting of the back, and carrying heavy materials were associated with an increased the risk of occupational low back pain. In the workers with less than 5 years work experience, people with high job demand were more likely to experience occupa - tional low back pain than those with low job demand. Conclusions: These results suggest that job stress as well as physical work factors can raise the risk of occupational low back pain. Especially, in the workers with less than 5 years work duration, job stress played a more crucial effect on the occurrence of occupational low back pain than physical work factors did.

The global epidemic of low back pain.

Causal assessment of occupational sitting and low back pain: results of a systematic review