BACK BELTS

In the largest study of its kind ever conducted, the Centers for Disease Control and Prevention’s (CDC’s) National Institute for Occupational Safety and Health (NIOSH) found no evidence that back belts reduce back injury or back pain for retail workers who lift or move merchandise, according to results published in the December 6, 2000 issue of the Journal of the American Medical Association (JAMA).

The study found no statistically significant difference between the incidence rate of workers’ compensation claims for job-related back injuries among employees who reported using back belts usually every day, and the incidence rate of such claims among employees who reported never using back belts or using them no more than once or twice a month.

Similarly, no statistically significant difference was found in comparing the incidence of self-reported back pain among workers who reported using back belts every day, with the incidence among workers who reported using them no more than once or twice a month. Neither did the study find a statistically significant difference between the rate of back injury claims among employees in stores that required the use of back belts, and the rate of such claims in stores where back belt use was voluntary.

Back belts, also called back supports or abdominal belts, resemble corsets. In recent years, they have been widely used in numerous industries to prevent worker injury during lifting. There are more than 70 types of industrial back belts, including the lightweight, stretchable nylon style used by workers in this study. Approximately four million back belts were purchased for workplace use in 1995, the most recent year for which data were available. The results of the new study are consistent with NIOSH’s previous finding, reported in 1994, that there is insufficient scientific evidence that wearing back belts protects workers from the risk of job-related back injury.

This study was the largest prospective study ever conducted on use of back belts. From April 1996 to April 1998, NIOSH interviewed 9,377 employees at 160 newly opened stores owned by a national retail chain. The employees were identified by store management as involved in materials handling tasks (lifting or moving merchandise). Through interviews, data were gathered on detailed information on workers’ back-belt wearing habits, work history, lifestyle habits, job activities, demographic characteristics, and job satisfaction. The study also examined workers’ compensation claims for back injuries among employees at the stores over the two-year period.

In a prospective study, researchers identify a cohort or group of workers for evaluation, and then collect current information on that group as the study progresses. In this study, NIOSH determined workers’ habits in wearing back belts in advance of any injuries, and collected data as workers filed back injury claims.

Findings from this study included:

• There was no statistically significant difference comparing the back injury rate among workers who wore back belts every day (3.38 cases per 100 full time equivalent workers or FTEs) and the back injury rate among workers who wore them no more than once or twice a month (2.76 cases per 100 FTEs).
• There was no statistically significant difference between the incidence of self-reported back pain among workers who wore back belts usually every day (17.1 percent) and the incidence of self- reported back pain among workers who wore them no more than once or twice a month (17.5 percent).
• There was no statistically significant difference between the rate of back injury claims in stores requiring the use of back belts (2.98 cases per every 100 FTEs) and the rate in stores where back belt use was voluntary (3.08 cases per 100 FTEs).
• A history of back injury was the strongest risk factor for predicting either a back-injury claim or reported back pain among employees, regardless of back-belt use. The rate of back injury among those with a previous history of back pain (5.14 cases per 100 FTEs) was nearly twice the rate of workers without a previous history of back pain (2.68 per 100 FTEs).
• Even for employees in the most strenuous types of jobs, comparisons of back injury claims and self-reported back pain failed to show any differences associated with back belt use.

NIOSH recommends that employers and workers minimize their risk of back injury by developing and implementing a comprehensive ergonomics program. A program of this nature would focus on prevention and:

1. include an assessment of all work activities to ensure that tasks can be accomplished without exceeding the physical capabilities of the worker;
2. incorporate on-going, comprehensive training for all workers on lifting mechanics and techniques;
3. provide a surveillance program to identify potential work-related musculoskeletal problems; and
4. include a medical management program

A copy of the JAMA study is available on the NIOSH Web site (http://www.cdc.gov/niosh). Information about NIOSH’s previous research on back belts is contained in two NIOSH publications: Workplace Use of Backbelts, Review and Recommendations (DHHS [NIOSH] Publication No. 94-122) and Back Belts - Do They Prevent Injury? (DHHS [NIOSH] Publication No. 94-127). Information on establishing a workplace ergonomics program is provided in the NIOSH publication Elements of Ergonomics Programs - A Primer Based on Workplace Evaluations of Musculoskeletal Disorders (DHHS [NIOSH] Publication No. 97-117). All three publications are also available on the NIOSH Web site.

telephone 1-800-35-NIOSH (1-800-356-4674)
fax 513-533-8573
e-mail pubstaft@cdc.gov

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Document #705004

Febuary, 2001