The National Institute for Occupational Safety and Health (NIOSH) found no evidence that back belts reduce back injury or back pain for retail workers who lift or move merchandise, according to results published in the Dec. 6 issue of the Journal of the American Medical Association (JAMA).
Back belts, also called back supports or abdominal belts, resemble corsets.
In recent years, they have been widely used in numerous industries to prevent worker injury during lifting.
The results of this study are consistent with NIOSH''s previous finding, reported in 1994, that there is insufficient evidence that wearing back belts protects workers from the risk of job-related back injury.
The study, conducted over a two-year period, found no statistically significant difference between the incidence rate of workers'' compensation claims for job-related back injuries among employees who reported using back belts usually every day, and the incidence rate of such claims among employees who reported never using back belts or using them no more than once or twice a month.
Similarly, no statistically significant difference was found in comparing the incidence of self-reported back pain among workers who reported using back belts every day, with the incidence among workers who reported never using back belts or using them no more than once or twice a month, said NIOSH.
Neither did the study find a significant difference between the rate of back injury claims among employees in stores that required the use of back belts, and the rate of such claims in stores where back belt use was voluntary.
"Work-related musculoskeletal disorders cost the economy an estimated $13 billion every year, and a substantial proportion of these are back injuries," said CDC Director Dr. Jeffrey Koplan. "By taking action to reduce exposures, employers can go a long way toward keeping workers safe and reducing the costs of work-related back injury."
The study was the largest prospective study ever conducted on use of back belts.
From April 1996 to April 1998, NIOSH interviewed 9,377 employees at 160 newly opened stores owned by a national retail chain.
The employees were identified by store management as involved in materials handling tasks.
The study also examined workers'' compensation claims for back injuries among employees at the stores over the two-year period.
NIOSH concluded from the study that after adjusting for individual risk factors, "neither frequent back belt use nor a store policy that required belt use was associated with reduced incidence of back injury claims or low back pain."
Focus on ''Psychosocial Factors'' of Back Pain
It''s time to consider back belts ordinary clothing, not useful safety devices, say two University of North Carolina at Chapel Hill experts who specialize in back pain and related ailments.
Although such apparel was long thought to reduce back pain and workers'' compensation claims, a recent NIOSH study provides further evidence that they don''t work.
"Moreover, it is time to focus on psychosocial elements of life, on and off the job, that render too much of back pain so intolerable that it is memorable and even incapacitating," said Drs. Nortin Hadler and Timothy Carey. "Therein lie potentially effective remedies to one of the most pressing public health issues facing industrialized countries."
NIOSH''s new research supports previous studies, especially one published in JAMA two years ago, that showed no benefit to airline baggage handlers wearing back belts, said Hadler and Carey.
It also tested the effectiveness of the belts among workers who chose, rather than were required, to wear them.
"Any recommendation to wear back belts when exposed to tasks with this range of physical demands should be met with skepticism," said Hadler. "The burden of proof should be on those who might still advocate them."
Back injuries are the leading cause of disability in the United States among people under age 45 and are the most expensive healthcare problem for patients aged 30 to 50.
According to the Bureau of Labor Statistics, 279,507 back injuries due to over-exertion and resulting in lost workdays occurred in 1998.
In 1995, approximately 4 million back belts were sold to industry.
by Virginia Sutcliffe