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Biomechanical risk factors for low back pain in North Carolina crab pot and gill net commercial fishermen.
Kucera KL; Loomis D; Lipscomb HJ; Marshall SW; Mirka G; Daniels J
Sixth International Scientific Conference on Prevention of Work-Related Musculoskeletal Disorders (PREMUS 2007), August 27-30, 2007 Boston, Massachusetts. Rome, Italy: International Commission on Occupational Health (ICOH), 2007 Aug; :233
Aims: Low back pain (LBP) is common among commercial fishermen. The objective of this research was to determine the association between LBP that limited or interrupted fishing work and biomechanical low back stress measured by 1) self-reported task, and 2) two ergonomic assessment methods of low back stress. Methods: Eligible participants were from a cohort of North Carolina commercial fishermen followed for LBP in regular clinic visits from 1999 to 2001 (n=204). Work history, including crab pot and gill net fishing task frequency, was evaluated in a telephone questionnaire. Ergonomic exposures were measured in previous study of 25 fishermen using two methods: Posture, Activity, Tools, and Handling (PATH) and Continuous Assessment of Back Stress (CABS). These measures were applied to work histories of the fishermen to estimate the percent of time exposed to low back stress. The occurrence rate of LBP that limited or interrupted fishing work since last visit (severe LBP) was evaluated in a generalized Poisson regression model. Results: The rate of severe LBP for fishermen who responded to the telephone questionnaire (n=105) was 0.69 per 1000 person-days (95% CI: 0.47-0.90). Predictors of severe LBP included fishing with crew members (2.4, 95% CI 0.9-6.2) and a previous history of severe LBP (6.1, 95% CI 3.1-12.1). Fishing for other catch types (shrimp, oyster, clam, or other) was associated with a decrease rate of LBP (0.6, 95% CI 0.3-1.1). Among crab pot and gill net fishermen (n=89), running pullers or net reels (RR 2.5, 95% CI 1.2-5.5), sorting catch (RR 1.9, 95% CI 0.8-4.3), and unloading catch with a dolly or lift (RR 2.5, 95% CI 1.1-5.6) were associated with an increased rate of LBP. Driving the boat, loading bait, working with fishing gear, cleaning the boat, and maintenance work were not associated with LBP. Percent of time in forces >20 lbs while in non-neutral trunk posture (1.31, 95% CI 0.75-2.29), spine compression >3400 Newtons (1.23, 95% CI 0.89-1.70), and National Institute of Occupational Safety and Health lifting indices >3.0 (1.19, 95% CI 0.90-1.57) were associated with LBP. Conclusions: Tasks characterized by higher biomechanical low back stress in this study (unloading boat and sorting catch) were associated with the occurrence of severe LBP. Tasks characterized by lower back stress (running puller or net reel and use of a dolly or lift for unloading) were also associated with LBP in this population. Our results demonstrated that neither fishing task frequency nor ergonomic stress alone consistently predict LBP. History of LBP, addition of crew members, and self-selection out of tasks were likely important contributors to the patterns of low back stress and outcomes we observed.
Back-injuries; Fishing-industry; Stress; Ergonomics; Questionnaires; Exposure-levels; Posture; Tools
Sixth International Scientific Conference on Prevention of Work-Related Musculoskeletal Disorders (PREMUS 2007), August 27-30, 2007 Boston, Massachusetts
Iowa State University