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The NIOSH lifting equation and low-back pain, part 1: association with low-back pain in the Backworks prospective cohort study.

Garg A; Boda S; Hegmann KT; Moore JS; Kapellusch JM; Bhoyar P; Thiese M; Merryweather A; Deckow-Schaefer G; Bloswick D; Malloy EJ
Hum Factors 2014 Feb; 56(1):6-28
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.
Etiology; Risk-factors; Humans; Men; Women; Back-injuries; Musculoskeletal-system; Musculoskeletal-system-disorders; Physical-stress; Physical-reactions; Physiology; Physiological-effects; Physiological-factors; Physiological-stress; Workers; Work-capacity; Demographic-characteristics; Sociological-factors; Exposure-levels; Analytical-processes; Statistical-analysis; Author Keywords: epidemiology; ergonomics; occupational cohort; job analysis; risk assessment
Arun Garg, Industrial and Manufacturing Engineering, University of Wisconsin-Milwaukee, P.O. Box 784, Milwaukee, WI 53201
Publication Date
Document Type
Journal Article
Email Address
Funding Type
Cooperative Agreement; Grant
Fiscal Year
Identifying No.
Cooperative-Agreement-Number-U01-OH-008083; Grant-Number-T42-CCT-810426; B20130805
Issue of Publication
Source Name
Human Factors
Performing Organization
University of Wisconsin Milwaukee
Page last reviewed: April 1, 2022
Content source: National Institute for Occupational Safety and Health Education and Information Division