Back Belt Use Research Articles

Applying an extended prototype willingness model to predict back seat safety belt use in China

<abstract> <p>The risk of injury and death in traffic accidents for passengers in the back and front seats can be reduced by utilizing safety belts. However, passengers use back seatbelts far less frequently than those in the front. More investigation is therefore required into the psychological constructs that affect individuals' attitudes toward using back seat belts. In this study, four models were used to analyze individual intentions and actual back seat belt use: the standard theory of planned behavior (TPB); the standard prototype willingness model (PWM); a model that integrates the TPB and PWM constructs; and a model that integrates the TPB construct, PWM constructs, descriptive norms and perceived law enforcement. The results showed that the standard PWM has much more explanatory power than the standard TPB in explaining the variance in behavioral intention and behavior. Incorporating perceived behavioral control (PBC) into the standard PWM did not improve the model fit considerably, while incorporating descriptive norms and perceived law enforcement moderately improved the model fit. Attitude greatly impacted behavioral intention and the use of back seat belts, followed by perceived law enforcement and descriptive norms, while subjective norms, prototype favorability, prototype similarity and PBC had no significant effect.</p> </abstract>

ANAMT Technical Guideline (DT 05): prevention of occupational low back pain through back belts, lumbar support or braces.

Low back pain is a considerable global public health problem. Use of back belts in occupational settings arises from the expectation of countless biomechanical benefits, which together would contribute to the prevention of this problem. To orient students, physicians and health institutions on the use of back belts, lumbar support or braces for prevention of low back pain or injury among asymptomatic workers. The present guideline was developed based on a systematic literature review; 809 studies were located in database MEDLINE and 571 in EMBASE and Cochrane CENTRAL. Evaluating back-belt use as preventive intervention against low back pain demands quantifying benefits, harms and difficulties to implementation, as well as the methodological quality of primary studies. Despite the weak benefits reflected in the individual, partial and isolated results of a few studies, there is no consistent evidence for the use of back belts, lumbar supports or braces for primary prevention of low back pain or occupational low back injury among workers. According to the available evidence, back-belt use is not associated with reduction of absenteeism.

Maxillofacial trauma and seat belt: a 10-year retrospective study

Brazil is among the countries with the highest prevalence of people injured by traffic accidents, showing that in 2008, levels reached 18.3 victims for 100,000 habitants were victims of traffic accidents. This retrospective study involved data collected from treated patients' charts at seven different hospitals located in three different cities all in the state of São Paulo, Brazil. Information was obtained through a standardized form, which was designed to investigate the epidemiologic features of maxillofacial traumas, restricted to victims of car accidents. Three hundred ninety-six patients were victims of car crashes with mean age 29.75 years. The age group 18-30 years showed an association with facial trauma in 96 patients, 41.56 % of whom reported using seat belt. Le Fort I, II and III (70 %) and mandible (63.11 %) were more associated with body traumas and seat belt use. The most common soft tissue lesion was laceration with 189 cases (42.3 %). The treatment way was assessed, 93 (23 %) were treated surgically and 303 (77 %) underwent conservative treatment. Classically, it is known front seat belt use was positively correlated with back seat belt use, healthy diet, dental and general health, regular walking, adequate sleep and no smoking. Accidents involving cars occurred more frequently in age group 18-30 years, suffering more general traumas and representing the nonusers group that wore fewer seat belts, caused, perhaps, by bigger access of the youth to cars, driving in high speed and to an inefficient fiscalization of the traffic laws.

Does wearing a non-expanding weight lifting belt change psychophysically determined maximum acceptable weights and forces

The most frequent and expensive cause category of compensable loss is the manual material handling (MMH). Ergonomic redesign of high-risk MMH tasks is the most effective way to minimize these loses. As an alternative to task redesign, back belts have been promoted by management and used by employees to help alleviate the physical demands of, otherwise, unacceptable tasks, despite a lack of the conclusive evidence that back belts will protect against low-back pain or low-back disability. Also, there is a concern that back belts may give the worker a false sense of confidence and encourage them to explore higher work levels. The purpose of this experiment was to investigate the effects of a back belt with maximum resistance to the circumferential expansion on psychophysically determined maximum acceptable weights (MAWs) and forces (MAFs) for a variety of lifting, lowering, pushing, pulling, and carrying tasks. Ten female and eight male industrial workers performed nine MMH tasks with and without a back belt within a larger study of 56 different tasks, which required 17 four-hour days to complete. A psychophysical methodology was used whereby the subjects were asked to select a workload they could sustain for eight hours without “straining themselves or without becoming unusually tired, weakened, overheated or out of breath.” The results revealed that the MAWs and MAFs of all tasks performed by women and all but one MAF of one task performed by men were not significantly affected by the back belt use. Based on these results, the use of a back belt did not change the perception of the subject's physical demands of the task since they chose similar psychophysically acceptable loads. Back belts are still commonly used in the industry despite lack of evidence that they will provide a decrease in low-back disability. This study illustrated that a worker's perception of the task was not altered by the back belt use, thus a worker's preference for the back belt use when job redesign has been limited or ignored should not be discouraged.

A cross-sectional study of back belt use and low back pain amongst forklift drivers

Purpose: To determine the association between back belt usage and back pain amongst forklift drivers exposed to whole-body vibration (WBV). Method: Cross-sectional analytical study design amongst 158 drivers using back belts and 39 controls. Back pain was assessed using a Standardised Nordic Questionnaire for musculoskeletal disorders and WBV was measured on a sample of forklifts as per ISO 2631. Results: Compliance with belt usage was 90%. Eighty-nine percent of drivers reported back pain ever; and back pain after driving was associated with vibration intensity and work area. Belt usage was associated with back pain after driving on multivariate analysis. When restricting analysis to back belt users alone, frequency of usage was associated with increased rates of back pain. Conclusions: In a high WBV-exposed group, back belt usage was not associated with decreased risk of LBP. Users appeared to have increased LBP, although the relationship may be due to selection bias due to non-random assignment of back belt condition. Relevance to industry: back belt use for WBV exposed professional drivers should not be considered as a valid control measure to reduce the prevalence and intensity of LBP.

From the Feds: Research, programs, and products

From the Feds: Research, programs, and products

A prospective study of back belts for prevention of back pain and injury.

Despite scientific uncertainties about effectiveness, wearing back belts in the hopes of preventing costly and disabling low back injury in employees is becoming common in the workplace. To evaluate the effectiveness of using back belts in reducing back injury claims and low back pain. Prospective cohort study. From April 1996 through April 1998, we identified material-handling employees in 160 new retail merchandise stores (89 required back belt use; 71 had voluntary back belt use) in 30 states (from New Hampshire to Michigan in the north and from Florida to Texas in the south); data collection ended December 1998, median follow-up was 6(1/2) months. A referred sample of 13,873 material handling employees provided 9377 baseline interviews and 6311 (67%) follow-up interviews; 206 (1.4%) refused baseline interview. Incidence rate of material-handling back injury workers' compensation claims and 6-month incidence rate of self-reported low back pain. Neither frequent back belt use nor a belt-requirement store policy was significantly associated with back injury claim rates or self-reported back pain. Rate ratios comparing back injury claims of those who reported wearing back belts usually every day and once or twice a week vs those who reported wearing belts never or once or twice a month were 1.22 (95% confidence interval [CI], 0.87-1.70) and 0.95 (95% CI, 0.56-1.59), respectively. The respective odds ratios for low back pain incidence were 0.97 (95% CI, 0.83-1.13) and 0.92 (95% CI, 0.73-1.16). In the largest prospective cohort study of back belt use, adjusted for multiple individual risk factors, neither frequent back belt use nor a store policy that required belt use was associated with reduced incidence of back injury claims or low back pain. JAMA. 2000;284:2727-2732.

Back Pain, Intra-Abdominal Pressure, and Belt Use

Back Pain, Intra-Abdominal Pressure, and Belt Use

The effect of industrial back belts and breathing technique on trunk and pelvic coordination during a lifting task.

Relative phase angle was used to study segmental motion patterns during a lifting and lowering task. To investigate the effect of back belts, breathing technique, and their interaction on lumbar and pelvic motion patterns. Trunk and pelvic coordination has been investigated in healthy and low back pain populations. Back belts have been shown to alter range of motion and intra-abdominal pressure. Little has been reported about belts and coordination during lifting and lowering. Phase angle has been used for quantifying segmental coordination. Six individuals performed lifting/lowering tasks with a 23-kg load under elastic, rigid, and no belt conditions. During a second session, individuals were trained in Valsalva's maneuver and repeated the protocol. Cinematography was used to track trunk and pelvis displacements. Segmental coordination during lowering generally was found to be the inverse of lifting. Significant differences in the relation between lumbar and pelvis phase angles were found during the initial stage of lifting because of the interaction of belt use and breathing. Lumbar range of motion decreased significantly with belt use during lifting and lowering. No significant change in pelvis range of motion was observed. Back belt use and breathing technique interacted during the initial stage of lifting to significantly alter the lumbar and pelvis phase angles. The change in segmental kinematics was similar to that previously reported for patients with a history of low back pain. Lumbar range of motion significantly decreased with belt use during both lifting and lowering.

Do workplace interventions prevent low-back disorders? If so, why?: a methodologic commentary

The demand for workplace interventions to prevent low-back disorders has increased in recent years. At the same time, a crisis in the literature has become apparent: there are conflicting reports on whether or not these interventions work. With the aim of understanding the reason for the dissension in the literature, six studies were selected for close examination. These were studies of interventions based on differing principles, i.e. a change in organizational ethos to promote back safety, back belt use, the introduction of ergonomic devices, and back-strengthening exercises. If the studies are taken at face value, any of the interventions, regardless of type, has a tremendous effect. Methodological problems inherent in these studies may provide a clue to why essentially different interventions were found to be consistently successful. Study design quality has long been noted to exert a particular influence on the evaluation of outcomes: the quality of the study design is often inversely related to reported outcomes. Of the six studies selected for examination, four did not include a contemporaneous control group, five did not randomly assign subjects to test and control groups, and none included a placebo group. Given these research designs, variables other than those tested by the studies may have produced the reported results. These variables include ‘beliefs of the intervention providers’ and ‘coalescence of the work group ’, both of which are discussed. Two approaches, the pragmatic and the explanatory, may be used to study workplace interventions to prevent low-back disorders. Most of the examined studies are pragmatically oriented. Having dealt with study design problems expeditiously, these studies may be characterized as more immediately responsive to the demand to evaluate workplace interventions than explanatory studies. On the other hand, explantory studies, most notably associated with randomized clinical trials in medicine, are more rigorous. Enough pragmatically oriented studies have been conducted to suggest that workplace interventions may have an effect on low-back disorders. More conclusive explanatory studies may now be conducted.

Occupational Back Belt Use

1. Back belts are thought to act by decreasing spinal loading, decreasing vertebral compression, and increasing intra-abdominal pressure by limiting twisting and upper body gross motions. 2. They appear to have little effect on most back injury risk factors, but may have a limited effect on improving muscle strength and supporting the back during lifting and twisting activities. 3. The use of back belts as a psychological support requires further investigation. 4. Based on insufficient objective scientific data, NIOSH recommended against back belt use by healthy people.