Cumulative spinal loading exposure methods for manual material handling tasks. Part 2: methodological issues and applicability for use in epidemiological studies

Objective: The goal of this paper is to review and discuss methodological issues related to cumulative spinal loading exposure assessment methods. Background: Research has indicated that there likely is an association between integrated spinal loading and lower back pain. A number of studies have been conducted to evaluate cumulative load; however, comparisons between studies is difficult due to the use of different methods for the assessment of cumulative spinal loading. Methods: A comprehensive electronic search was conducted to locate articles dealing with methods of cumulative spinal loading estimation. The articles were evaluated with respect to methods for obtaining postural data, methods for estimating spinal loads, methods for integrating loads over time and spinal load parameters to be measured. Results: Thirteen articles were located. A summary of the methods used to estimate cumulative spinal load is described and evaluated. Conclusions: There is a pressing need for integrated spinal loading methods that are reliable, valid and practical for use in large occupational epidemiological studies. A number of research needs were outlined aimed at improving the ability to use cumulative load to predict risk of low back disorders due to manual material handling.

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