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- General. Back disorders can develop gradually as a result of microtrauma brought about by repetitive activity over time or can be the product of a single traumatic event. Because of the slow and progressive onset of this internal injury, the condition is often ignored until the symptoms become acute, often resulting in disabling injury. Acute back injuries can be the immediate result of improper lifting techniques and/or lifting loads that are too heavy for the back to support. While the acute injury may seem to be caused by a single well-defined incident, the real cause is often a combined interaction of the observed stressor coupled with years of weakening of the musculoskeletal support mechanism by repetitive micro-trauma. Injuries can arise in muscle, ligament, vertebrae, and discs, either singly or in combination.
- Incidence. Although back injuries account for no work-related deaths, they do account for a significant amount of human suffering, loss of productivity, and economic burden on compensation systems. Back disorders are one of the leading causes of disability for people in their working years and afflict over 600,000 employees each year with a cost of about $50 billion annually in 1991 according to NIOSH. The frequency and economic impact of back injuries and disorders on the work force are expected to increase over the next several decades as the average age of the work force increases and medical costs go up.
II. Back Disorders
- Factors Associated With Back Disorders. Back disorders result from exceeding the capability of the muscles, tendons, discs, or the cumulative effect of several contributors:
- Reaching while lifting.
- Poor posture--how one sits or stands.
- Stressful living and working activities--staying in one position for too long.
- Bad body mechanics--how one lifts, pushes, pulls, or carries objects.
- Poor physical condition-losing the strength and endurance to perform physical tasks without strain.
- Poor design of job or work station.
- Repetitive lifting of awkward items, equipment, or (in health-care facilities) patients.
- Twisting while lifting.
- Bending while lifting.
- Maintaining bent postures.
- Heavy lifting.
- Poor footing such as slippery floors, or constrained posture.
- Lifting with forceful movement.
- Vibration, such as with lift truck drivers, delivery drivers, etc.
- Signs and Symptoms. Signs and symptoms include pain when attempting to assume normal posture, decreased mobility, and pain when standing or rising from a seated position.
III. Reports of Back Injuries
- Contributing Factors. These factors usually account for very few work-related back injuries.
- Congenital defects of the spine.
- Increase in static standing or sitting tasks.
- An aging work force.
- Decreases in physical conditioning and exercise.
- Increased awareness of workplace hazards.
- Job dissatisfaction.
- Manual Materials Handling. Manual materials handling is the principal source of compensable injuries in the American work force, and four out of five of these injuries will affect the lower back.