OBJECTIVE:The aim of this study was to evaluate relationships between the revised NIOSH lifting equation (RNLE) and risk of low-back pain (LBP).BACKGROUND:The RNLE is commonly used to quantify job physical stressors to the low back from lifting and/or lowering of loads. There is no prospective study on the relationship between RNLE and LBP that includes accounting for relevant covariates.METHOD:A cohort of 258 incident-eligible workers from 30 diverse facilities was followed for up to 4.5 years. Job physical exposures were individually measured. Worker demographics, medical history, psychosocial factors, hobbies, and current LBP were obtained at baseline. The cohort was followed monthly to ascertain development of LBP and quarterly to determine changes in job physical exposure. The relationship between LBP and peak lifting index (PLI) and peak composite lifting index (PCLI) were tested in multivariate models using proportional hazards regression.RESULTS:Point and lifetime prevalences of LBP at baseline were 7.1% and 75.1%, respectively. During follow-up, there were 123 incident LBP cases. Factors predicting development of LBP included job physical exposure (PLI and PCLI), history of LBP, psychosocial factors, and housework. In adjusted models, risk (hazard ratio [HR]) increased per-unit increase in PLI and PCLI (p = .05 and .02; maximum HR = 4.3 and 4.2, respectively). PLI suggested a continuous increase in risk with an increase in PLI, whereas the PCLI showed elevated, but somewhat reduced, risk at higher exposures.CONCLUSION:Job physical stressors are associated with increased risk of LBP. Data suggest that the PLI and PCLI are useful metrics for estimating exposure to job physical stressors.
Objective: The aim of this study was to investigate the relationship between the revised NIOSH lifting equation (RNLE) and risk of seeking care for low-back pain (SC-LBP). Background: The RNLE is commonly used to quantify low-back physical stressors from lifting/lowering of loads in workplaces. There is no prospective study on relationship between RNLE and SC-LBP. Method: A cohort of 258 incident-eligible workers from 30 diverse facilities was followed for up to 4.5 years. Job physical exposures were individually measured. Worker demographics, medical history, psychosocial factors, hobbies, and current low-back pain were obtained at baseline. The cohort was followed monthly to ascertain SC-LBP and quarterly to determine changes in physical exposure. Associations between SC-LBP and both the peak lifting index (PLI) and peak composite lifting index (PCLI) were tested in multivariate models using proportional hazards regression. Results: SC-LBP lifetime prevalence at baseline was 31.9%, and there were 24 incident cases during follow-up. Factors predicting SC-LBP included job physical exposure (PLI and PCLI), history of low-back pain, age, female gender, and lower body mass index. In adjusted models, risk (hazard ratio [HR]) increased per unit increase in PLI and PCLI ( p = .03 and .02, and maximum HR = 23.0 and 21.9, respectively). Whereas PCLI suggested a continuous increase in risk with an increase in PCLI, the PLI showed elevated, though somewhat reduced, risk at higher exposures (HR = 14.9 at PLI = 6). Conclusion: Job physical stressors are associated with increased risk of SC-LBP. Data suggest that both the PLI and PCLI are useful metrics for estimating exposure to job physical stressors.
Few prospective cohort studies of workplace low back pain (LBP) with quantified job physical exposure have been performed. There are few prospective epidemiological studies for LBP occupational risk factors and reported data generally have few adjustments for many personal and psychosocial factors.
This study is based upon data collected for a large scale, multi-site prospective cohort study of work-related low back pain (WLBP). The aim of this study was to validate the Revised NIOSH Lifting Equation (RNLE) and the 3D Static Strength Prediction Model (3D SSPM) to predict the risk of WLBP. Complete baseline and follow up data on job physical exposure and WLBP status were available on 258 workers free of WLBP at baseline. Relationships between job physical factors and incident cases of WLBP were analyzed using the Cox proportional hazards model. There was evidence of association between load moment and the Lifting Index calculated from the RNLE and incidence of WLBP, and no evidence of association with estimated compressive force on L5/S1 disc and percent capable population. It is concluded that the RNLE is predictive of future risk of WLBP.
The aim of this study was to evaluate relationships between the revised NIOSH lifting equation (RNLE) and risk of low-back pain (LBP). Background: The RNLE is commonly used to quantify job physical stressors to the low back from lifting and/or lowering of loads. There is no prospective study on the relationship between RNLE and LBP that includes accounting for relevant covariates. Method: A cohort of 258 incident-eligible workers from 30 diverse facilities was followed for up to 4.5 years. Job physical exposures were individually measured. Worker demo-graphics, medical history, psychosocial factors, hobbies, and current LBP were obtained at baseline. The cohort was followed monthly to ascertain development of LBP and quarterly to determine changes in job physical exposure. The relationship between LBP and peak lifting index (PLI) and peak composite lifting index (PCLI) were tested in multivariate models using proportional hazards regression. Results: Point and lifetime prevalences of LBP at base-line were 7.1% and 75.1%, respectively. During follow-up, there were 123 incident LBP cases. Factors predicting development of LBP included job physical exposure (PLI and PCLI), history of LBP, psychosocial factors, and housework. In adjusted models, risk (hazard ratio [HR]) increased per-unit increase in PLI and PCLI (p = .05 and .02; maximum HR = 4.3 and 4.2, respectively). PLI suggested a continuous increase in risk with an increase in PLI, whereas the PCLI showed elevated, but somewhat reduced, risk at higher exposures. Conclusion: Job physical stressors are associated with increased risk of LBP. Data suggest that the PLI and PCLI are useful metrics for estimating exposure to job physical stressors.