Back Belts Don’t Work

NIOSH Studies Back Belts for Prevention of Back Pain and Injury

The Journal of the American Medical Association reported a massive NIOSH study showing the lack of effect of back belts in preventing back injuries in people doing material handling. From April 1996 through April 1998, NIOSH identified material-handling employees in 160 new or substantially expanded retail merchandise stores in 30 states; data collection ended December 1998, median follow-up was 61/2 months. A referred sample of 13,873 material handling employees provided 9377 baseline interviews and 6311 (67%) follow-up interviews. The investigators compared the incidence rate of material-handling back injury workers’ compensation claims and 6-month incidence rate of self-reported low back pain.

RESULTS: Neither frequent back belt use nor a belt-requirement store policy significantly changed with back injury claim rates or self-reported back pain. Workers compensation back injury claims were about 2.75 per 100 fulltime equivalent employees. Back injury claims among those who reported wearing back belts usually every day and once or twice a week were slightly higher than among those who reported wearing belts never or once or twice a month. The incidence of reports of greater than four incidents of back pain was about 17%, and was essentially the same among all groups. Workers lifting more than 20 lbs on the job reported significantly more back pain but not workers compensation claims. Workers with previous back injuries reported substantially more incidents of back pain and workers compensation claims. There was a slight, non-significant reduction in complaints with age, and women and smokers reported more problems.

CONCLUSIONS: The investigators concluded that in the largest prospective cohort study of back belt use, adjusted for multiple individual risk factors, neither frequent back belt use nor a store policy that required belt use was associated with reduced incidence of back injury claims or low back pain.

1 Wassell JT, Gardner LI, Landsittel DP, Johnston JJ, Johnston JM, JAMA. 2000;284:2727-2732

UAW Commentary On the Study of Back Belts The remarkable strength of this study was finding a large group of employees newly assigned to lifting tasks. The most striking finding was unrelated to back belts. Remarkably, 17% of this group of store employees suffered repeated incidence of back pain, and a nearly 3 per 100 incidence of workers compensation back claims was observed. Older workers were not at greater risk than younger workers. Since biomechanical calculations show that backbelts will have no direct physical protective effect against stress on the back, therefore, any benefits of back belts arise from reminding workers to keep a certain posture, or from a psychosocial benefit. In this study, wearers of back belts had a slightly worse result than those who did not, possibly because back belts encouraged more lifting risks. Increased risks among smokers may arise from a correlation of job stress of repetitive lifting, and pain, with a propensity to smoke. The failure of back belts to protect gives greater impetus to job redesign in preventing back injuries.