An Evidence-Based Multidisciplinary Practice Guideline to Reduce the Workload due to Lifting for Preventing Work-Related Low Back Pain

Annals of Occupational and Environmental Medicine

P Paul FM Kuijer⁴  Jos HAM Verbeek¹  Bart Visser³  Leo AM Elders⁷  Nico Van Roden⁶  Marion ER Van den Wittenboer²  Marian Lebbink⁷  Alex Burdorf⁵  Carel TJ Hulshof⁷ 

[1] Finnish Institute of Occupational Health, Kuopio, Finland

[2] Professional Association of Work and Organizational Experts, Eindhoven, the Netherlands

[3] Amsterdam School of Health Professions, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands

[4] Netherlands Center for Occupational Diseases, Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands

[5] Department of Public Health, Erasmus MC, Rotterdam, the Netherlands

[6] Dutch Society of Safety Science, Eindhoven, the Netherlands

[7] Centre of Excellence, the Netherlands Society of Occupational Medicine (NVAB), Utrecht, the Netherlands

关键词: Lifting;    Practice guideline;    Surveillance;    Prevention;    Occupational health care;    Interventions;    Back pain;   

Others  :  790411
DOI  :  10.1186/2052-4374-26-16

 received in 2014-05-07, accepted in 2014-06-12,  发布年份 2014

【 摘 要 】

We developed an evidence-based practice guideline to support occupational safety and health (OSH) professionals in assessing the risk due to lifting and in selecting effective preventive measures for low back pain (LBP) in the Netherlands. The guideline was developed at the request of the Dutch government by a project team of experts and OSH professionals in lifting and work-related LBP. The recommendations for risk assessment were based on the quality of instruments to assess the risk on LBP due to lifting. Recommendations for interventions were based on a systematic review of the effects of worker- and work directed interventions to reduce back load due to lifting. The quality of the evidence was rated as strong (A), moderate (B), limited (C) or based on consensus (D). Finally, eight experts and twenty-four OSH professionals commented on and evaluated the content and the feasibility of the preliminary guideline. For risk assessment we recommend loads heavier than 25 kg always to be considered a risk for LBP while loads less than 3 kg do not pose a risk. For loads between 3–25 kg, risk assessment shall be performed using the Manual handling Assessment Charts (MAC)-Tool or National Institute for Occupational Safety and Health (NIOSH) lifting equation. Effective work oriented interventions are patient lifting devices (Level A) and lifting devices for goods (Level C), optimizing working height (Level A) and reducing load mass (Level C). Ineffective work oriented preventive measures are regulations to ban lifting without proper alternatives (Level D). We do not recommend worker-oriented interventions but consider personal lift assist devices as promising (Level C). Ineffective worker-oriented preventive measures are training in lifting technique (Level A), use of back-belts (Level A) and pre-employment medical examinations (Level A). This multidisciplinary evidence-based practice guideline gives clear criteria whether an employee is at risk for LBP while lifting and provides an easy-reference for (in)effective risk reduction measures based on scientific evidence, experience, and consensus among OSH experts and practitioners.

【 授权许可】

   
2014 Kuijer et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]European Foundation for the Improvement of Living and Working Conditions: Work and Health: a Difficult Relationship?. Eurofound; 2011. http://www.eurofound.europa.eu/pubdocs/2011/17/en/1/EF1117EN.pdf
• [2]Hooftman W, Klein Hesselink J, Van Genabeek J, Wiezer N, Willems D: Working Conditions Overview 2010: Quality of Labour, Consequences and Measures Taken in the Netherlands. In Dutch: Arbobalans 2010: Kwaliteit van de Arbeid, Effecten en Maatregelen in Nederland. Hoofddorp (The Netherlands): TNO Innovation for Life; 2011. 978-90-5986-381-1
• [3]Lötters F, Burdorf A, Kuiper J, Miedema H: Model for the work-relatedness of low-back pain. Scand J Work Environ Health 2003, 29(6):431-440.
• [4]Bakker EW, Verhagen AP, van Trijffel E, Lucas C, Koes BW: Spinal mechanical load as a risk factor for low back pain: a systematic review of prospective cohort studies. Spine 2009, 34:E281-E293.
• [5]Wai EK, Roffey DM, Bishop P, Kwon BK, Dagenais S: Causal assessment of occupational lifting and low back pain: results of a systematic review. Spine J 2010, 10:554-566.
• [6]Kwon BK, Roffey DM, Bishop PB, Dagenais S, Wai EK: Systematic review: occupational physical activity and low back pain. Occup Med 2011, 61:541-548.
• [7]Da Costa BR, Vieira ER: Risk factors for work-related musculoskeletal disorders: a systematic review of recent longitudinal studies. Am J Ind Med 2010, 53:285-323.
• [8]Griffith LE, Shannon HS, Wells RP, Walter SD, Cole DC, Côté P, Frank J, Hogg-Johnson S, Langlois LE: Individual participant data meta-analysis of mechanical workplace risk factors and low back pain. Am J Public Health 2012, 102(2):309-318.
• [9]Takala EP: Lack of “statistically significant” association does not exclude causality. Spine J 2010, 10:944.
• [10]Olsen O: Letter to the Editor: Re: Bakker EW, Verhagen AP, van Trijffel E, et al. Spinal mechanical load as a risk factor for low back pain: a systematic review of prospective cohort studies. Spine 2010, 35:E576.
• [11]Takala EP, Andersen JH, Burdorf A, Fallentin N, Hartvigsen J, Leclerc A, Veiersted KB: Letter to the Editor: Re: Bakker EW, Verhagen AP, van Trijffel E, et al. Spinal mechanical load as a risk factor for low back pain: a systematic review of prospective cohort studies. Spine 2010, 35(20):E1011-E1012.
• [12]Kuijer PP, Frings-Dresen MH, Gouttebarge V, Van Dieën JH, Van der Beek AJ, Burdorf A: Low back pain: we cannot afford ignoring work. Spine J 2011, 11:164-168.
• [13]Kuijer PP, Takala EP, Burdorf A, Gouttebarge V, Van Dieën JH, Van der Beek AJ, Frings-Dresen MH: Low back pain: doesn’t work matter at all? Occup Med 2012, 62:152-154.
• [14]Van Dieën JH, Kuijer PP, Burdorf A, Marras WS, Adams MA: Non-specific low back pain. Lancet 2012, 379(19):1874.
• [15]Health Council of the Netherlands: Manual Lifting During Work. The Hague (The Netherlands): Health Council of the Netherlands; 2012. publication no. 2012/36E. http://www.gezondheidsraad.nl/sites/default/files/2136E_Manual_Lifting_during_work.pdf
• [16]TNO Innovation for Life: Ziekteverzuim in Nederland in 2010. Dutch: Sick Leave in the Netherlands in 2010http://www.tno.nl/downloads/pb_2012_11_ziekteverzuim_in_nl_2010.pdf
• [17]Kuiper JI, Burdorf A, Frings-Dresen MH, Kuijer PP, Spreeuwers D, Lötters F, Miedema HS: Assessing the work-relatedness of non-specific low-back pain. Scand J Work Environ Health 2005, 31(3):237-243.
• [18]Van der Molen HF, Kuijer PP, Smits PB, Schop A, Moeijes F, Spreeuwers D, Frings-Dresen MH: Annual incidence of occupational diseases in economic sectors in The Netherlands. Occup Environ Med 2012, 69:519-521.
• [19]Miedema HS, Van der Molen HF, Kuijer PP, Koes BW, Burdorf A: Incidence of low back pain related occupational diseases. Eur J Paindoi:10.1002/j.1532-2149.2013.00430.x. [Epub ahead of print]
• [20]Kim KH, Kim KS, Kim DS, Jang SJ, Hong KH, Yoo SW: Characteristics of work-related musculoskeletal disorders in Korea and their work-relatedness evaluation. J Korean Med Sci 2010, 25(Suppl):S77-S86.
• [21]Hussey L, Turner S, Thorley K, McNamee R, Agius R: Comparison of work-related ill health reporting by occupational physicians and general practitioners. Occup Med 2010, 60(4):294-300.
• [22]Punnett L, Prüss-Utün A, Nelson DI, Fingerhut MA, Leigh J, Tak S, Phillips S: Estimating the global burden of low back pain attributable to combined occupational exposures. Am J Ind Med 2005, 48(6):459-469.
• [23]Wells R: Why have we not solved the MSD problem? Work 2009, 34(1):117-121.
• [24]Institute of Medicine of the national academies: Clinical Practice Guidelines We Can Trust. 2011. http://www.iom.edu/Reports/2011/Clinical-Practice-Guidelines-We-Can-Trust.aspx
• [25]Qaseem A, Forland F, Macbeth F, Ollenschläger G, Phillips S, van der Wees P, Board of Trustees of the Guidelines International Network: Guidelines international network: toward international standards for clinical practice guidelines. Ann Intern Med 2012, 156:525-531.
• [26]Dutch Institute for Healthcare Improvement CBO: Evidence-Based Richtlijnontwikkeling: Handleiding Voor Werkgroepleden. In Dutch: Evidence-Based Development of Guidelines: a Manual for Team Members. Utrecht (The Netherlands): Dutch Institute for Healthcare Improvement CBO; 2007.
• [27]Van der Beek AJ, Frings-Dresen MH: Assessment of mechanical exposure in ergonomic epidemiology. Occup Environ Med 1998, 55(5):291-299.
• [28]Takala E-P, Pehkonen I, Forsman M, Hansson G-A, Mathiassen SE, Neumann WP, Sjøgaard G, Veiersted KB, Westgaard RH, Winkel J: Systematic evaluation of observational methods assessing biomechanical exposures at work. Scand J Work Environ Health 2010, 36(1):3-24.
• [29]Verbeek J, Kuijer PP: Does KIM what she promises to do? Work 2012, 43(2):249-250.
• [30]Waters TR, Putz-Anderson V, Garg A, Fine LJ: Revised NIOSH equation for the design and evaluation of manual lifting tasks. Ergonomics 1993, 36(7):749-776.
• [31]The MAC-tool - manual handling assessment charts https://osha.europa.eu/en/topics/msds/slic/handlingloads/20.htm
• [32]Kuijer PP, Van der Molen HF, Frings-Dresen MH: Evidence-based exposure criteria for work-related musculoskeletal disorders as a tool to assess physical job demands. Work 2012, 41(Suppl 1):3795-3797.
• [33]Burdorf A, Koppelaar E, Evanoff B: Assessment of the impact of lifting device use on low back pain and musculoskeletal injury claims among nurses. Occup Environ Med 2013, 70(7):491-497.
• [34]Van Dieën JH, Hoozemans MJ, Toussaint HM: Stoop or squat: a review of biomechanical studies on lifting technique. Clin Biomech 1999, 14(10):685-696.
• [35]Lavender SA, Lorenz EP, Andersson GBJ: Can a new behaviorally oriented training process to improve lifting technique prevent occupationally related back injuries due to lifting? Spine 2007, 32(4):487-494.
• [36]Daltroy LH, Iversen MD, Larson MG, Ryan J, Zwerling C, Fossel AH, Liang MH: Teaching and social support: effects on knowledge, attitudes, and behaviors to prevent low back injuries in industry. Health Educ Q 1993, 20(1):43-62.
• [37]Martimo KP, Verbeek J, Karppinen J, Furlan AD, Kuijer PPFM, Viikari-Juntura E, Takala EP, Jauhiainen M, Martimo KP, Verbeek J, Karppinen J, Furlan AD, Kuijer PPFM, Viikari-Juntura E, Takala EP, Jauhiainen M: Manual material handling advice and assistive devices for preventing and treating back pain in workers. Cochrane Database Syst Rev 2007, 3:CD005958. DOI: 10.1002/14651858.CD005958.pub2
• [38]Martimo KP, Verbeek J, Karppinen J, Furlan AD, Takala EP, Kuijer PPFM, Jauhiainen M, Viikari-Juntura E: Effect of training and lifting equipment for preventing low back pain in lifting and handling: systematic review. BMJ 2008, 336(7641):429-431. 23;336(7641):429–31
• [39]Verbeek JH, Martimo KP, Karppinen J, Kuijer PP, Viikari-Juntura E, Takala EP: Manual material handling advice and assistive devices for preventing and treating back pain in workers. Cochrane Database Syst Rev 2011., 6CD005958
• [40]Mahmud N, Schonstein E, Schaafsma F, Lehtola MM, Fassier JB, Reneman MF, Lehtola MM, Fassier JB, Reneman MF, Verbeek JH: Pre-employment examinations for preventing occupational injury and disease in workers. Cochrane Database Syst Rev 2010., 12CD008881
• [41]Van Duijvenbode IC, Jellema P, van Poppel MN, van Tulder MW: Lumbar supports for prevention and treatment of low back pain. Cochrane Database Syst Rev 2008., 2CD001823
• [42]Graham RB, Agnew MJ, Stevenson JM: Effectiveness of an on-body lifting aid at reducing low back physical demands during an automotive assembly task: assessment of EMG response and user acceptability. Appl Ergon 2009, 40(5):936-942.
• [43]Santaguida PL, Pierrynowski M, Goldsmith C, Fernie G: Comparison of cumulative low back loads of caregivers when transferring patients using overhead and floor mechanical lifting devices. Clin Biomech 2005, 20(9):906-916.
• [44]Daynard D, Yassi A, Cooper JE, Tate R, Norman R, Wells R: Biomechanical analysis of peak and cumulative spinal loads during simulated patient-handling activities: a substudy of a randomized controlled trial to prevent lift and transfer injury of health care workers. Appl Ergon 2001, 32(3):199-214.
• [45]Miller A, Engst C, Tate RB, Yassi A: Evaluation of the effectiveness of portable ceiling lifts in a new long-term care facility. Appl Ergon 2006, 37(3):377-385.
• [46]Koppelaar E, Knibbe HJ, Miedema HS, Burdorf A: The influence of ergonomic devices on mechanical load during patient handling activities in nursing homes. Ann Occup Hyg 2012, 56(6):708-718.
• [47]Zadvinskis IM, Salsbury SL: Effects of a multifaceted minimal-lift environment for nursing staff: pilot results. West J Nurs Res 2010, 32(1):47-63.
• [48]Vink P, Urlings IJM, Van der Molen HF: A participatory ergonomics approach to redesign work of scaffolders. Safety Sci 1997, 26:75-85.
• [49]Knezovich M, McGlothlin JD: The development and field testing of an ergonomic intervention for the preparation of footers in postframe building construction. J Occup Environ Hyg 2007, 4(2):D10-D14.
• [50]Mirka GA, Monroe M, Nay T, Lipscomb H, Kelaher D: Ergonomic interventions for the reduction of low back stress in framing carpenters in the home building industry. Int J Ind Ergon 2003, 31(6):397-409.
• [51]Burdorf A, Windhorst J, van der Beek AJ, Van der Molen HF, Swuste PHJJ: The effects of mechanised equipment on physical load among road workers and floor layers in the construction industry. Int J Ind Ergon 2007, 37:133-143.
• [52]Hermans V, Hautekiet M, Spaepen A, Cobbaut L, De CJ: Influence of material handling devices on the physical load during the end assembly of cars. Int J Ind Ergon 1999, 24(6):657-664.
• [53]Southard SA, Freeman JH, Drum JE, Mirka GA: Ergonomic interventions for the reduction of back and shoulder biomechanical loading when weighing calves. Int J Ind Ergon 2007, 37(2):103-107.
• [54]Mirka GA, Shin G, Kucera K, Loomis D: Use of the CABS methodology to assess biomechanical stress in commercial crab fishermen. Appl Ergon 2005, 36(1):61-70.
• [55]de Looze MP, Stassen AR, Markslag AM, Borst MJ, Wooning MM, Toussaint HM: Mechanical loading on the low back in three methods of refuse collecting. Ergonomics 1995, 38(10):1993-2006.
• [56]Van der Molen HF, Grouwstra R, Kuijer PP, Sluiter JK, Frings-Dresen MH: Efficacy of adjusting working height and mechanizing of transport on physical work demands and local discomfort in construction work. Ergonomics 2004, 47(7):772-783.
• [57]Hignett S: Systematic review of patient handling activities starting in lying, sitting and standing positions. J Adv Nurs 2003, 41(6):545-552.
• [58]Verschoof S, Kuijer PP, Frings-Dresen MH: Does a rolling floor reduce the physical work demands and workload, and increase the productivity of truck drivers handling packed goods? Appl Ergon 2005, 36(5):595-600.
• [59]Haiduven D: Lifting teams in health care facilities: a literature review. AAOHN J 2003, 51(5):210-218.
• [60]Guthrie PF, Westphal L, Dahlman B, Berg M, Behnam K, Ferrell D: A patient lifting intervention for preventing the work-related injuries of nurses. Work 2004, 22(2):79-88.
• [61]Springer PJ, Lind BK, Kratt J, Baker E, Clavelle JT: Preventing employee injury: implementation of a lift team. AAOHN J 2009, 57(4):143-148.
• [62]Kutash M, Short M, Shea J, Martinez M: The lift team’s importance to a successful safe patient handling program. J Nurs Adm 2009, 39(4):170-175.
• [63]Faber G, Visser S, Van der Molen HF, Kuijer PP, Hoozemans MJ, van Dieen JH, Frings-Dresen MH: Does team lifting increase the variability in peak lumbar compression in ironworkers. Work 2012, 41(Suppl 1):4171-4173.
• [64]Van der Molen HF, Visser S, Kuijer PP, Faber G, Hoozemans MJ, van Dieen JH, Frings-Dresen MH: The evaluation of team lifting on physical work demands and work load in ironworkers. Work 2012, 41(Suppl 1):3771-3773.