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Study: Back belts don't prevent back injury
(CNN) -- Back belts -- the kind you see workers wear when they lift heavy loads -- don't help avoid injury, according to a recent study by the National Institute for Occupational Safety and Health and the Centers for Disease Control and Prevention.
Back belts have been controversial for many years, with some studies showing they work and others showing they don't. It's an important question because back injuries account for nearly 20 percent of all injuries and illnesses in the workplace and cost the nation an estimated $20- to $50-billion per year, according to NIOSH.
In this recent study, workers at 160 Wal-Mart stores were assigned to two groups: one requiring participants to wear back belts, the other allowing participants to wear the belts if they chose to do so.
During two-years of follow-up, researchers found no difference in reports of back pain between workers who wore belts every day compared to those who never used them or used them no more than once or twice a month. The study is being published in this week's edition of The Journal of the American Medical Association.
The study supports recommendations already in place by the Occupational Safety & Health Administration. According to OSHA's Web site: "back belts are not recognized by OSHA as effective engineering controls to prevent back injury."
And this from NIOSH's Web site: "Although back belts are being bought and sold under the premise that they reduce the risk of back injury, there is insufficient scientific evidence that they actually deliver what is promised."
Why require employees to wear the belts?
Yet many companies, including Wal-Mart, still require back belts for some employees.
Some experts have argued that back belts are effective for several reasons. They say a belt supports the back as a worker lifts a heavy load, and that simply having the belt on reminds workers not to bend at the waist when picking up a load (instead, bend at the knees).
In fact, a study done by UCLA of employees at Home Depot in 1996, found a significant decrease in back-related injuries when workers used belts and were provided with body mechanics training.
A spokesman for Wal-Mart, where the most recent study was conducted, said many Wal-Mart stores require employees who do heavy lifting to use back belts, even though OSHA and NIOSH say back belts are ineffective. "A number of our folks who were using them said they really helped," said Tom Williams, a spokesman for Wal-Mart. But, he added that other employees have said the belts don't help, and the company is reviewing their policy in light of the new study.
Although back belts might not help prevent injuries, they can help people recover from a recent back injury or back surgery, according to some experts, including Bill Boissonnault, president of the Orthopedic Section of the American Physical Therapy Association. In fact, NIOSH says their statement that back belts don't work does not apply to people who used them as part of rehabilitation following an injury.
Job satisfaction a factor
If not a back brace -- then what?
NIOSH and OSHA both recommend that instead of focusing on back braces, companies should make workplaces safer. "NIOSH has recommended that employers put in a comprehensive program for lifting," said Douglas Landsittel, a NIOSH scientist and co-author of the recent study. "One simple example would be having the store set up a procedure so individuals won't have to lift [loads] from the ground but lift from a higher place." And the Wal-Mart study points out that perhaps lifting isn't the only reason for back pain.
In the study, employees with poor job satisfaction tended to have more back pain.
"Psycho-social conditions determine if people say they hurt their back at work," said Dr. Norton Hadler, a rheumatologist at the University of North Carolina -- Chapel Hill School of Medicine and co-author of an editorial in JAMA. "If you don't like your work and you have back pain, then it hurts more." In fact, a new study by Ohio State University shows that emotional stress effects the back. In the study, researchers criticized participants who were lifting boxes off the floor. When stressed, some subjects began using muscles in their abdomen and sides -- muscles not necessary for lifting. "We found that psychological stress seems to amplify the physical demands of lifting for certain personality types," said Catherine Heaney, one of the researchers, who published the study in the journal Spine.
Study finds ways to reduce cost of treating back pain
The Journal of the American Medical Association
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