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    No Support in Study for Back Belts as Injury Preventers


    Those corporate policies are backed by the results of a study conducted by Jess F. Kraus, MPH, PhD and colleagues at the Southern California Injury Prevention Research Center at UCLA. They had the good fortune to approach Home Depot about doing a study of back-injury just when the company had made an 180 degree switch from a corporate policy prohibiting back-belt use by employees to a policy requiring their use. Because the policy change happened one store at a time on different schedules, the researchers were able to do a before-and-after study of the effects of belt use on back injury.

    They found that the rate of acute low-back injuries fell by about a third after implementation of the policy. This effect was seen in both men and women, in younger workers and those aged 55 and older, and among employees whose jobs included either light- or heavy-duty lifting, says co-author David L. McArthur, PhD, MPH.

    "The results were far more than we expected, and at one point the group of us that were sitting around analyzing it said 'these numbers can't be right, let's go back and do it again just to make sure that we haven't slipped a digit somewhere,' and in fact we did go all the way back and reconfirm every step just so that we knew for a fact that the degree of difference was so large," McArthur tells WebMD.

    But in an editorial accompanying the Wal-Mart study in JAMA, Nortin M. Hadler, PhD and Timothy S. Carey, MD, MPH from the department of medicine at the University of North Carolina at Chapel Hill, write that "The findings suggest back belts should be viewed as no more than an option in apparel. Furthermore, any recommendation to wear back belts when exposed to tasks with this range of physical demand should be met with skepticism; the burden of proof should be on those who might still advocate them."

    They contend that recalled back pain and back-injury claims may be related as much to individual perceptions of pain as they are to actual physical injury or degree of incapacitation, and that work-safety and worker's compensation regulations give incentive to employees to report back-related disability as being related to a workplace accident.

    "It is no wonder that in addition to the lack of benefit from back belts, [the researchers] could show that job dissatisfaction and prior workers' compensation claims were associated with memorable and compensable," they write. "The challenge is to fashion employment that is comfortable when workers are well and accommodating when they are ill of incapacitated, including those with regional back pain."

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