Workplace risk factors and occupational musculoskeletal disorders, Part 1: A review of biomechanical and psychophysical research on risk factors associated with low-back pain.

Injuries and disorders caused by overexertion and repetitive motion are the leading causes of compensable lost-time cases in the United States. Epidemiological and laboratory-based research methods have been used to evaluate the significance of various risk factors associated with overuse injuries and disorders. The National Institute for Occupational Safety and Health performed a comprehensive review of over 600 epidemiological studies in 1997 and concluded that there was evidence of a causal relationship between low-back injuries and disorders and workplace exposures to forceful exertions, awkward posture, and vibration. Although epidemiological studies provide important insights to understanding the causes of work-related overuse disorders, they are sometimes criticized for their inability to measure precisely how people respond to specific risk factors found in the workplace. This article presents a review of recent laboratory studies and biomechanical models of work factors believed to be associated with increased risk of low-back injuries and disorders. Biomechanical models and laboratory studies do not replace epidemiological studies. However, these approaches provide important complementary information that is needed to understand the complex process of how exposures to physical risk factors result in strain that may ultimately lead to injury or disease. These studies also provide important insights as to how people react and respond to specific physical risk factors found in the workplace. Combined with epidemiological research, laboratory studies are an essential element in understanding the causes and prevention of work-related overexertion injuries.

[1]  D B Chaffin,et al.  Postural effects on biomechanical and psychophysical weight-lifting limits. , 1994, Ergonomics.

[2]  Ciriello Vm,et al.  The effects of task duration on psychophysically-determined maximum acceptable weights and forces , 1990 .

[3]  A. Nachemson,et al.  Intravital dynamic pressure measurements in lumber discs , 1970 .

[4]  S H Snook,et al.  Perceived exertion and discomfort versus work height with a pistol-shaped screwdriver. , 1990, American Industrial Hygiene Association journal.

[5]  T P Leskinen,et al.  A dynamic analysis of spinal compression with different lifting techniques. , 1983, Ergonomics.

[6]  W S Marras,et al.  Biomechanical risk factors for occupationally related low back disorders. , 1995, Ergonomics.

[7]  A Luttmann,et al.  Biomechanical analysis and assessment of lumbar stress during load lifting using a dynamic 19-segment human model. , 1989, Ergonomics.

[8]  S H Snook,et al.  A Study of Size, Distance, Height, and Frequency Effects on Manual Handling Tasks , 1983, Human factors.

[9]  S. Snook,et al.  Maximum acceptable weight of lift. , 1967, American Industrial Hygiene Association journal.

[10]  Laura Punnett,et al.  Subjective Worker Assessments of Hand Tools Used in Automobile Assembly , 1989 .

[11]  W S Marras,et al.  A Three-Dimensional Motion Model of Loads on the Lumbar Spine: I. Model Structure , 1991, Human factors.

[12]  Steve Kihlberg,et al.  Discomfort from pneumatic tool torque reaction: Acceptability limits , 1995 .

[13]  T P Leskinen,et al.  Comparison of static and dynamic biomechanical models. , 1985, Ergonomics.

[14]  S H Snook,et al.  Psychophysical studies of repetitive wrist flexion and extension. , 1995, Ergonomics.

[15]  G D Herrin,et al.  Prediction of overexertion injuries using biomechanical and psychophysical models. , 1986, American Industrial Hygiene Association journal.

[16]  B. Bresler,et al.  Role of the Trunk in Stability of the Spine , 1961 .

[17]  A Mital,et al.  Comprehensive maximum acceptable weight of lift database for regular 8-hour work shifts. , 1984, Ergonomics.

[18]  S. Snook,et al.  Maximum weights and work loads acceptable to female workers. , 1974, Occupational health nursing.

[19]  A M Genaidy,et al.  Spinal compression tolerance limits for the design of manual material handling operations in the workplace. , 1993, Ergonomics.

[20]  W Karwowski,et al.  Reliability of the psychophysical approach to manual lifting of liquids by females. , 1986, Ergonomics.

[21]  S Kumar,et al.  Moment arms of spinal musculature determined from CT scans. , 1988, Clinical biomechanics.

[22]  Chapman Ae,et al.  The effect of increased maximal strength on the integrated electrical activity of lumbar erectores spinae. , 1969 .

[23]  M. Okada An electromyographic estimation of the relative muscular load in different human postures. , 1972, Journal of human ergology.

[24]  Arun Garg,et al.  Container Characteristics and Maximum Acceptable Weight of Lift1 , 1980 .

[25]  R. Deyo,et al.  What can the history and physical examination tell us about low back pain? , 1992, JAMA.

[26]  H. Eisler,et al.  Subjective scale of force for a large muscle group. , 1962, Journal of experimental psychology.

[27]  M M Ayoub,et al.  Manual materials handling capabilities in non-standard postures. , 1992, Ergonomics.

[28]  A. Mital The Psychophysical Approach in Manual Lifting---A Verification Study , 1983, Human factors.

[29]  A. E. Chapman,et al.  The effect of increased maximal strength on the integrated electrical activity of lumbar erectores spinae. , 1969, Electromyography.

[30]  S H Snook,et al.  The design of manual handling tasks: revised tables of maximum acceptable weights and forces. , 1991, Ergonomics.

[31]  A. Schultz,et al.  Analysis and Quantitative Myoelectric Measurements of Loads on the Lumbar Spine when Holding Weights in Standing Postures , 1982, Spine.

[32]  A. Garg,et al.  Maximum acceptable weights, heart rates and RPEs for one hour's repetitive asymmetric lifting. , 1988, Ergonomics.

[33]  A. Schultz,et al.  Transmission of moments across the elbow joint and the lumbar spine. , 1979, Journal of biomechanics.

[34]  P. Brinckmann,et al.  Fatigue fracture of human lumbar vertebrae. , 1988, Clinical biomechanics.

[35]  S H Snook,et al.  The effects of task duration on psychophysically-determined maximum acceptable weights and forces. , 1990, Ergonomics.

[36]  E. Heath Borg's Perceived Exertion and Pain Scales , 1998 .

[37]  S. S. Stevens The Psychophysics of Sensory Function. , 1960 .

[38]  W. G. Allread,et al.  The Role of Dynamic Three-Dimensional Trunk Motion in Occupationally-Related Low Back Disorders: The Effects of Workplace Factors, Trunk Position, and Trunk Motion Characteristics on Risk of Injury , 1993, Spine.

[39]  W S Marras,et al.  Trunk kinematics of one-handed lifting, and the effects of asymmetry and load weight. , 1996, Ergonomics.

[40]  Thomas J. Armstrong,et al.  Preferred Tool Shapes for Various Horizontal and Vertical Work Locations , 1992 .

[41]  Don B. Chaffin,et al.  BIOMECHANICAL COMPUTERIZED SIMULATION OF HUMAN STRENGTH. , 1974 .

[42]  L Gordon,et al.  The effect of wearing a flexible wrist splint on carpal tunnel pressure during repetitive hand activity. , 1994, The Journal of hand surgery.

[43]  A. Garg,et al.  Maximum acceptable weights and maximum voluntary isometric strengths for asymmetric lifting. , 1986, Ergonomics.

[44]  T P Andriacchi,et al.  Influence of dynamic factors on the lumbar spine moment in lifting. , 1988, Ergonomics.

[45]  S. Snook,et al.  A study of three preventive approaches to low back injury. , 1978, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[46]  G. Elfström,et al.  Intravital dynamic pressure measurements in lumbar discs. A study of common movements, maneuvers and exercises. , 1970, Scandinavian journal of rehabilitation medicine. Supplement.

[47]  D. Spengler,et al.  A Prospective Study of the Role of Cardiovascular Risk Factors and Fitness in Industrial Back Pain Complaints , 1989, Spine.

[48]  A. Mital Maximum weights of lift acceptable to male and female industrial workers for extended work shifts. , 1984, Ergonomics.

[49]  Don B. Chaffin,et al.  A Biomechanical Model for Analysis of Symmetric Sagittal Plane Lifting , 1970 .

[50]  R. Szabo,et al.  Stress carpal tunnel pressures in patients with carpal tunnel syndrome and normal patients. , 1989, The Journal of hand surgery.

[51]  M. Pope,et al.  The relationship between trunk muscle electromyography and lifting moments in the sagittal and frontal planes. , 1987, Journal of biomechanics.

[52]  W. M. Keyserling,et al.  Isometric strength testing as a means of controlling medical incidents on strenuous jobs. , 1980, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[53]  S Gallagher,et al.  Acceptable weights and physiological costs of performing combined manual handling tasks in restricted postures. , 1991, Ergonomics.

[54]  Albert B. Schultz,et al.  Mechanical Properties of Human Lumbar Spine Motion Segments—Part II: Responses in Compression and Shear; Influence of Gross Morphology , 1979 .

[55]  W M Keyserling,et al.  Workplace risk factors and occupational musculoskeletal disorders, Part 2: A review of biomechanical and psychophysical research on risk factors associated with upper extremity disorders. , 2000, AIHAJ : a journal for the science of occupational and environmental health and safety.

[56]  A Mital,et al.  Psychophysical and physiological responses to lifting symmetrical and asymmetrical loads symmetrically and asymmetrically. , 1986, Ergonomics.

[57]  P Brinckmann,et al.  Prediction of the compressive strength of human lumbar vertebrae. , 1989, Clinical biomechanics.

[58]  L. Haugh,et al.  Trunk Extensor EMG – Torque Relationship , 1987, Spine.

[59]  A Garg,et al.  Revised NIOSH equation for the design and evaluation of manual lifting tasks. , 1993, Ergonomics.

[60]  S. Snook The design of manual handling tasks. , 1978, Ergonomics.

[61]  M K Chung,et al.  Effects of posture, weight and frequency on trunk muscular activity and fatigue during repetitive lifting tasks. , 1995, Ergonomics.

[62]  R W Norman,et al.  Reassessment of the role of intra-abdominal pressure in spinal compression. , 1987, Ergonomics.

[63]  A. Schultz,et al.  Loads on the lumbar spine. Validation of a biomechanical analysis by measurements of intradiscal pressures and myoelectric signals. , 1982, The Journal of bone and joint surgery. American volume.

[64]  W. Marras,et al.  A Three-Dimensional Motion Model of Loads on the Lumbar Spine: II. Model Validation , 1991, Human factors.

[65]  Jeffrey E. Fernandez,et al.  The effects of posture, duration, and force on pinching frequency , 1997 .

[66]  W S Marras,et al.  A Comprehensive Evaluation of Trunk Response to Asymmetric Trunk Motion , 1992, Spine.

[67]  M. M. Ayoub,et al.  Problems and solutions in manual materials handling: the state of the art , 1992 .

[68]  G. Andersson,et al.  Quantitative electromyographic studies of back muscle activity relatated to posture and loading. , 1977, The Orthopedic clinics of North America.

[69]  S H Snook,et al.  Maximum acceptable forces for repetitive ulnar deviation of the wrist. , 1997, American Industrial Hygiene Association journal.

[70]  A. Schultz,et al.  Analysis of Loads on the Lumbar Spine , 1981, Spine.

[71]  R W Norman,et al.  Dynamically and statically determined low back moments during lifting. , 1985, Journal of biomechanics.

[72]  S H Snook,et al.  Maximum weights and work loads acceptable to male industrial workers. A study of lifting, lowering, pushing, pulling, carrying, and walking tasks. , 1970, American Industrial Hygiene Association journal.

[73]  T. Keller,et al.  Mechanical behavior of the human lumbar spine. II. Fatigue strength during dynamic compressive loading , 1987, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[74]  Stover H. Snook,et al.  The Ergonomics Society The Society's Lecture 1978. THE DESIGN OF MANUAL HANDLING TASKS , 1978 .

[75]  D B Chaffin,et al.  A longitudinal study of low-back pain as associated with occupational weight lifting factors. , 1973, American Industrial Hygiene Association journal.

[76]  S H Snook,et al.  Further Studies of Psychophysically Determined Maximum Acceptable Weights and Forces , 1993, Human factors.

[77]  E N Corlett,et al.  A technique for assessing postural discomfort. , 1976, Ergonomics.