Biomechanical risk factors for occupationally related low back disorders

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Abstract
A continuing challenge for ergonomists has been to determine quantitatively the types of trunk motion and how much trunk motion contributes to the risk of occupationally-related low back disorder (LBD). It has been difficult to include this motion information in workplace assessments since the speed at which trunk motion becomes dangerous has not been determined. An in vivo study was performed to assess the contribution of three-dimensional dynamic trunk motions to the risk of LBD during occupational lifting in industry. Over 400 industrial lifting jobs were studied in 48 varied industries. The medical records in these industries were examined so that specific jobs historically categorized as either low, medium, or high risk for occupationally-related LBD could be identified. A tri-axial electrogoniometer was worn by workers and documented the three-dimensional angular position, velocity, and acceleration characteristics of the lumbar spine while workers worked at these low, medium, or high risk jobs. Workplace and individual characteristics were also documented for each of the repetitive lifting tasks. A multiple logistic regression model indicated that a combination of five trunk motion and workplace factors predicted well both medium risk and high risk occupational-related LBD. These factors included lifting frequency, load moment, trunk lateral velocity, trunk twisting velocity, and trunk sagittal angle. Increases in the magnitude of these factors significantly increased the risk of LBD. The analyses have enabled us to determine the LBD risk associated with combined changes in the magnitudes of the five factors. The results indicate that by suitably varying these five factors observed during the lift collectively, the odds of high risk group membership may decrease by over ten times. These results were related to the biomechanical, ergonomic, and epidemiologic literature. The five trunk motion and workplace factors could be used as quantitative, objective measures to redesign the workplace so that the risk of occupationally-related LBD is minimized.