Back injury in municipal workers: a case-control study

• Published in: American journal of public health (1971) Vol. 89; no. 7; pp. 1036 - 1041
• Main Authors: Myers, A H, Baker, S P, Li, G, Smith, G S, Wiker, S, Liang, K Y, Johnson, J V
• Format: Journal Article
• Language: English
• Published: Washington, DC Am Public Health Assoc 01.07.1999; American Public Health Association
• Subjects: Accidents, Occupational - statistics & numerical data; Adult; Anthropometry; Back Injuries - epidemiology; Back Injuries - etiology; Baltimore - epidemiology; Biological and medical sciences; Case controlled studies; Case-Control Studies; Employees; Ergonomics. Workplace layout; Ergonomics. Workplace layout. Occupational psychology; Female; Humans; Incidence; Injuries of the limb. Injuries of the spine; Logistic Models; Low back pain; Male; Medical sciences; Municipal government; Occupational medicine; Public health. Hygiene-occupational medicine; Risk Factors; Surveys and Questionnaires; Traumas. Diseases due to physical agents; USA; United States; North America; America; Baltimore; Human; Health promotion; Spine; Diseases of the osteoarticular system; Spine disease; Case control study; Epidemiology; Trauma; Recommendation; Occupational environment; Ergonomics; Risk factor; Lumbar; Occupational medicine; Public health
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.89.7.1036

The purpose of this study was to identify factors associated with acute low back injury among municipal employees of a large city. For each of 200 injured case patients, 2 coworker controls were randomly selected, the first matched on gender, job, and department and the second matched on gender and job classification. In-person interviews were conducted to collect data on demographics, work history, work characteristics, work injuries, back pain, psychosocial and work organization, health behaviors, and anthropometric and ergonomic factors related to the job. Psychosocial work organization variables were examined with factor analysis techniques; an aggregate value for job strain was entered into the final model. Risk factors were examined via multivariate logistic regression techniques. High job strain was the most important factor affecting back injury (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.28, 3.52), and it showed a significant dose-response effect. Body mass index (OR = 1.54, 95% CI = 1.08, 2.18) and a work movement index (twisting, extended reaching, and stooping) (OR = 1.42, 95% CI = 0.97, 2.08) were also significant factors. Results suggest that increasing workers' control over their jobs reduces levels of job strain. Ergonomic strategies and worksite health promotion may help reduce other risk factors.