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D.P. Manning, MD., MFOM, DIH,
R.G. Mitchell, SRN OHNC, and L.P. Blanch field, SRN
Introduction: In this study (publication date November 1984)
465 factory workers absent or on restricted duty as a result
of back pain were interviewed about its onset. By use of an accident
model researchers were able to divide the injuries between accidental
and non- accidental. A higher percent of the NAI arose at home,
while a larger percentage of the accidents occurred at work.
Significantly more of the NAI than the accidents involved load
handling. Fifty-two percent of the patients able to attribute
a cause to their back pain were not moving loads. The authors
suggest that future attention be directed to contributory factors
such as unsafe floor surfaces, bending and twisting movements
as well as to handling of loads.
Methods: An accident model, developed by the authors,
which plotted and recorded both accidents and details of NAI
on a diagram, was used in interviews with workers at three auto
manufacturing units of a Ford Motor Plant were absent from work
or on restricted duty due to back pain. Back pain was defined
as pain located between the first thoracic vertebra and the tip
of coccyx. An accident in the model, is visualized as an unforseen
event or course of unforseen events causing injury while a non-accident
event is not associated with a preceding accidental event such
as a slip or undexpected load in the back.
Results: During the year studied, 1980, 9,707 full days
were lost due to back pain. Back pain was also was responsible
for 5,893 restricted duty days. One-hundred, twenty-three accidents
were reported and 114 non-accidental injuries were reported for
the year. The most important part of the model used for the purpose
of accident investigation is a description of the first unforseen
event. By definition no accidental first events are evident in
the NAI category. Accidental first events in the study appeared
to be distributed naturally into four main groups:
1) Underfoot accidents 66%
2) Sudden or unexpected load 12%
3) Loss of balance 10%
4) Blow to the back 6%
Eighty-two of the 122 identified "first events 67%"
were apparantely not handling loads manually. Of the 236 patients
sustaining either an accident or NAI 122 apparantely were not
undergoing muscular exertion such as lifting, carrying, pushing,
pulling or straining.
Discussion: Considerable effort was directed toward obtaining
accurate case histories. The authors are confident that the data
collected are reliable. Findings were consistent with a previous
survey and with 20 years experience in the industry by the researchers.
Surprise is expressed that extensive world literature on back
pain gives the impression that manual handling is the only cause
of back injuries. In this survey 78% of first events were shown
to be the result of slips, falls and sudden loading.
Quote: "While manual handling of materials is
important attention should also be directed to other contributory
factors such as floor surfaces, shoe materials, and to body movements
such as bending and twisting of the spine without load"
- "not only at work but around the home".
Published in Spine, Volume 9, November 7, 1984
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