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NIOSH Publication No. 97-141:

Musculoskeletal Disorders and Workplace Factors

July 1997
 

A Critical Review of Epidemiologic Evidence for Work-Related Musculoskeletal Disorders of the Neck, Upper Extremity, and
Low Back


Chapter 6. Low-Back Musculoskeletal Disorders: Evidence for Work-Relatedness - Tables and Figures

Epidemiologic criteria used to examine studies of:
6.1 Low back MSDs associated with heavy physical work/Risk indicator
6.2 Low back MSDs associated with lifting and forceful movements/Risk indicator
6.3 Low back MSDs associated with bending, twisting, or awkward postures/Risk indicator
6.4 Low back MSDs associated with whole-body vibration /Risk indicator
6.5 Low back MSDs associated with static work postures /Risk indicator
6.6 Epidemiologic studies evaluating back musculoskeletal disorders
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6.1 Low back MSDs associated with heavy physical work/Risk indicator

Epidemiologic criteria used to examine studies of low back MSDs associated with heavy physical work

Study (first author and year) Risk indicator (OR, PRR, IR or p-value)*,† Participation rate >70% Physical examination Investigator blinded to case and/or exposure status Basis for assessing back exposure to heavy physical work
Met at least one criterion:
Åstrand 1987 2.3† Yes Yes No Job titles or self-reports
Bigos 1991b No association No No NR† Observation or measurements
Burdorf 1991 No risk estimate Yes No No Observation or measurements
Clemmer 1991 2.2†, 4.3† Yes No NR Job titles or self-reports
Heliövaara 1991 1.9, 2.5† Yes Yes No Job titles or self-reports
Hildebrandt 1995 1.2† Yes No No Job titles or self-reports
Hildebrandt 1996 No association Yes No No Job titles or self-reports
Johansson 1994 No association Yes No NR Job titles or self-reports
Leigh 1989 1.5† Yes No NR Job titles or self-reports
Masset 1994 No association Yes No NR Job titles or self-reports
Partridge 1968 1.2 Yes Yes No Job titles or self-reports
Riihimäki 1989b 1.0 Yes No NR Job titles or self-reports
Ryden 1989 2.2† Yes No NR Job titles or self-reports
Svensson 1989 No association Yes No NR Job titles or self-reports
Videman 1984 1.1 Yes No NR Job titles or self-reports
Videman 1990 2.8, 12.1† NR Yes NR Job titles or self-reports
Met none of the criteria:
Bergenudd 1988 1.8† No No NR Job titles or self-reports
Burdorf 1990 4.0 No No NR Job titles or self-reports

*Odds ratio (OR), prevalence rate ratio (PRR), or incidence ratio (IR).

†Indicates statistical significance.

‡Not reported.

Significant associations found in univariate but not multivariate results.

Figure 6.1 Chart

6.2 Low back MSDs associated with lifting and forceful movements/Risk indicator

Epidemiologic criteria used to examine studies of Low back MSDs associated with lifting and forceful movements

Study (first author and year) Risk indicator (OR, PRR, IR or p-value)*,† Participation rate >70% Physical examination Investigator blinded to case and/or exposure status Basis for assessing back exposure to lifting and forceful movements
Met all four criteria:
Punnett 1991 2.2† Yes Yes Yes Observation or measurements
Met at least one criterion:
Burdorf 1991 No association Yes No No Observation or measurements
Chaffin 1973 Approx. 5† NR No NR Observation or measurements
Holmström 1992 1.3 ** Yes Yes Yes Job titles or self-reports
Huang 1988 No risk estimate Yes No NR Observation or measurements
Johansson 1994 No association Yes No NR Job titles or self-reports
Kelsey 1975b 0.94 Yes Yes NR Job titles or self-reports
Kelsey 1984 3.8 Yes Yes NR Job titles or self-reports
Knibbe 1996 1.3 Yes No No Job titles or self-reports
Liles 1984 4.5† NR No No Observation or measurements
Magora 1972 No association, 1.7† NR No NR Observation or measurements
Marras 1995 10.7† NR No NR Observation or measurements
Svensson 1989 1.2 ** Yes No NR Job titles or self-reports
Toroptsova 1995 1.4† Yes Yes NR Job titles or self-reports
Undeutsch 1982 No risk estimate NR Yes NR Job titles or self-reports
Videman 1984 No association Yes No NR Job titles or self-reports
Walsh 1989 1.5†, 2.0† Yes No NR Job titles or self-reports
Met none of the criteria:
Burdorf 1990 0.70,
5.2†		 No No NR‡ Job titles or self-reports

*Odds ratio (OR), prevalence rate ratio (PRR), or incidence ratio (IR).

†Indicates statistical significance.

‡Not reported.

**Significant associations found in univariate but not multivariate results.

Figure 6.2 Chart

6.3 Low back MSDs associated with bending, twisting, or awkward postures/Risk indicator

Epidemiologic criteria used to examine studies of Low back MSDs associated with bending, twisting, or awkward postures

Study (first author and year) Risk indicator (OR, PRR, IR or p-value)*,† Participation rate >70% Physical examination Investigator blinded to case and/or exposure status Basis for assessing back exposure to bending, twisting, or awkward postures
Met back criteria:
Punnett 1991 8.09† Yes Yes Yes Observation or measurements
Met at least one criterion:
Burdorf 1991 1.2† Yes No No Observation or measurements
Holmström 1992 2.6†, 3.5† Yes Yes Yes Job titles or self-reports
Johansson 1994 NR†,‡ Yes No NR Job titles or self-reports
Kelsey 1984 3 Yes Yes NR Job titles or self-reports
Magora 1972, 1973 No association NR No NR Observation or measurements
Marras 1993, 1995 10.7† NR No NR Observation or measurements
Masset 1994 No association ** Yes No NR Job titles or self-reports
Riihimäki 1989b 1.5† Yes No NR Job titles or self-reports
Riihimäki 1994 No association ** Yes No NR Job titles or self-reports
Svensson 1989 No association ** Yes No NR Job titles or self-reports
Toroptsova 1995 1.7† Yes Yes NR Job titles or self-reports

*Odds ratio (OR), prevalence rate ratio (PRR), or incidence ratio (IR).

†Indicates statistical significance. If reported with NR, a significant association was reported without a numerical value.

‡Not reported.

**Significant associations found in univariate but not multivariate results.

Figure 6.3 Chart

6.4 Low back MSDs associated with whole-body vibration/Risk indicator

Epidemiologic criteria used to examine studies of low back MSDs associated with whole-body vibration

Study (first author and year) Risk indicator (OR, PRR, IR or p-value)*,† Participation rate >70% Physical examination Investigator blinded to case and/or exposure status Basis for assessing back exposure to lifting and whole-body vibration
Met at least one criterion:
Bongers 1988 2.0†–5.7 Yes Yes NR‡ Job titles or self-reports
Bongers 1990 3.3–39.5† Yes No NR Observation or measurements
Boshuizen 1990a, 1990b 1.5–3.6† Yes No NR Observation or measurements
Boshuizen 1992 0.99 Yes No NR Observation or measurements
Bovenzi 1992 2.6† Yes No NR Observation or measurements
Bovenzi 1994 2.4–4.6† Yes No NR Observation or measurements
Burdorf 1991 3.1† Yes No No Job titles or self-reports
Burdorf 1993 2.5–3.3† Yes No NR Observation or measurements
Kelsey 1975b 2.8†, 4.7† Yes Yes NR Job titles or self-reports
Magnusson 1996 1.8† NR No NR Observation or measurements
Magora 1972 1.2 NR No NR Observation or measurements
Masset 1994 1.2† Yes No NR Job titles or self-reports
Riihimäki 1989a 1.3† Yes No NR Job titles or self-reports
Riihimäki 1994 No association Yes No NR Job titles or self-reports
Toroptsova 1995 No association Yes Yes NR Job titles or self-reports
Walsh 1989 1.7† Yes No NR Job titles or self-reports
Met none of the criteria:
Burdorf 1990 0.66 No No NR Job titles or self-reports
Johanning 1991 3.9† No No NR Job titles or self-reports
Skov 1996 2.8† No No NR Job titles or self-reports

*Odds ratio (OR), prevalence rate ratio (PRR), or incidence ratio (IR).

†Indicates statistical significance.

‡Not reported.

Figure 6.4 Chart

6.5 Low Back MSDs Associated with Static Work Postures/Risk indicator

Epidemiologic criteria used to examine studies of low back MSDs associated with static work postures

Study (first author and year) Risk indicator (OR, PRR, IR or p-value)*,† Participation rate >70% Physical examination Investigator blinded to case and/or exposure status Basis for assessing back exposure to static work postures
Met at least one criterion:
Holmström 1992 No association Yes Yes Yes Job titles or self-reports
Kelsey 1975b 0.81, 2.4† Yes Yes NR Job titles or self-reports
Magora 1972, 1973 No association NR No NR Observation or measurements
Masset 1994 1.5 Yes No NR Job titles or self-reports
Svensson 1989 1.3 ** Yes No NR Job titles or self-reports
Toroptsova 1995 No association Yes Yes NR Job titles or self-reports
Videman 1990 24.6† NR Yes NR Job titles or self-reports
Walsh 1989 1.7†
(females)		 Yes No NR Job titles or self-reports
Met none of the criteria:
Burdorf 1990 0.49 No No NR Job titles or self-reports
Skov 1996 2.45† No No NR Job titles or self-reports

*Odds ratio (OR), prevalence rate ratio (PRR), or incidence ratio (IR).

†Indicates statistical significance.

‡Not reported.

**Significant associations found in univariate but not multivariate results.

Figure 6.5 Chart

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