The Working Back: A Systems View

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Format: eBook
Pub. Date: 2008-02-01
Publisher(s): Wiley-Interscience
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Summary

A systems approach to understanding and minimizing the causes of low back pain in the workplace Low back pain affects 800f the population at some point during their lifetime; it is responsiblefor over 400f the compensation costs for work-related injuries. This book provides an understanding of the mechanisms influencing low back pain in the workplace and indicates how low back pain might be prevented, saving employers extraordinary amounts in medical costs and protecting workers from the most common on-the-job injury. With a unique, multidisciplinary perspective that shows how various influences or risk factors can be considered collectively, The Working Back: A Systems View: Explains basic concepts in anatomy and physiology that are essential to understanding and preventing low back pain Provides a systems perspective on the occupational causes of back pain, not only addressing factors such as spine loading, but also considering the potential impact of psychosocial and organizational interactions, genetics, and physiology Discusses implementing preventive engineering and administrative controls and integrating risk interventions into the workplace Offers an expert analysis of current medical research on low back pain in one comprehensive, accessible reference This book gives readers the knowledge to assess a work environment and prescribe effective interventions. It is a hands-on reference for ergonomists, manufacturing engineers, process engineers, industrial engineers and managers, safety engineers, nurses, therapists, chiropractors, physicians, and workers with back pain. It is also an excellent resource for graduate or undergraduate students of kinesiology, physiology, ergonomics, physical therapy, nursing, industrial design, engineering, and general medicine.

Table of Contents

Introduction
Audience for the Book
Apolitical Causality Assessment
A Systems View of Low Back Pain Causality
The Reality of Work
How Might the Different Aspects of Work Be Associated with Back Pain
Organization of the Book
References
Back Pain Magnitude and Potential Risk Factors
What is back pain?
How common is back pain?
Back Pain at Work
Epidemiology of Work Risk Factors
Epidemiology of Physical Risk Factors
Epidemiology of Individual (Personal) Risk Factors
Age
Gender
Anthropometry
Fitness/Strength
Alcohol
Smoking
Heredity/Genetics
Social Class and Psychological Factors
Epidemiology of Work-Related Psychosocial/Organizational Factors
Potential Interaction of Physical and Psychosocial Factors
Key Points
References
Function, Structure, and Support of the Back
Body Coordinates
Bony Structures of the Spine
The Disc
Functional Spinal Unit
Spine Support
Ligaments
Muscles
Fascia
Nerves
Blood Vessels
End Plates and Nutrition
Facets
The System
Key Points
References
The Process of Pain
What is Pain?
Origins of Pain
Pain Transmission
The Pain Process
The Inflammatory Process (Cytokines
Peripheral Nervous System Sensitization
Neuropathic Pain: The Cytokine Cascade and Nerve Sensitization
Pain Mechanisms of the Central Nervous System
Role of the Environment in Central Sensitization
Implications for Low Back Pain
Nerves at Risk of Sensitization
Tissues at Risk of Sensitization
Disc and Nerve Roots
Facet Joints
Muscular based Pain
Lumbar Nerve Roots
Relationship between Tissue Loading and Pain
Conclusions
Key Points
References
Potential Pathways to Back Pain
Views of Back Pain Causality
A Unifying Model of Low Back Pain Pathways
The Support Structure Disruption Pathways
Support Structure Tolerance
Disc Tolerance Summary
Pain Tolerance
The Muscle Function Disruption Pathway
The Role of Individual Differences in the Pain Pathways
System Feedback
Summary
Key Points
References
The Assessment of Biomechanical Forces Acting on the Low Back
Biomechanical Concepts Applicable to the Back
Load - Toleranc
Moments and Levers
External vs. Internal Loading
How can we Modify Internal Spine Loads?
Biomechanical Arrangement of the Musculoskeletal Lever System
Length-Strength Relationship
The Impact of Velocity on Muscle Force
Temporal Relationships
Incorporating Spine Load Reductions into the Work System
Loading of the Lumbar Spine
Spine Load Assessments
Models of Spine Load
Biologically-Driven Modeling of Spine Loading
Stability-Driven Spine Loading Models
Predictions of Muscle (Motor) Control within Torso
What Drives Motor Control- - The Mental Model
Summary
Key Points
References
The Influence of Physical Work Factors on Muscle Activities and Spine Loads
Introduction
Industrial Quantitative Surveillance of Physical Exposure
Strength Capacity Assessments of Work Load
Static Analyses of Work Load
Dynamic Analyses of Work Load
Surveillance Conclusions
Spine Loading and Task Performance
Spine Loading and Primary Physical Workplace Factors
Moment Exposure
Role of Trunk Muscle Cocontraction in Spine Loading
Trunk Motion
Non-Sagittal Plane Loading
Lateral Motion
Twisting Motion
Task Asymmetry
Lift Height
One-Handed vs. Two-Handed Lifting
Lifting vs. Lowering
Cumulative Exposure
Duration of Exposure to Lifting Tasks
Worker Experience, Task Frequency, and Moment Exposure
Spine Loading associated with Modification of Physical Workplace Factors
Handles
Lifting While Supporting the Body
Team Lifting
Pushing and Pulling
Seated and Constrained Work Postures
Physical Work Factor Summary
Relationship between Spine Loading and Observed Risk of Low Back Pain
Summary
Key Points
References
Psychosocial and Organizational Factor Influence on Spine Loading
Introduction
Psychosocial and Organizational Interactions
Biomechanical Responses to Psychosocial Environment
Biomechanical Responses to Mental Stress at Work
Expectation
Conclusions
Key Points
References
Individual Factors Role in Spine Loading
Introduction
Gender
Personality
Experience
Conclusions
Key Points
References
Physical, Individual, and Psychosocial/Organizational Risk Factor Interactions
When Risk Factors Collide
The Magnitude of Influence of the Three Risk Factor Categories
Can Risk Factor Interactions be Predicted?
Conclusions
Key Points
References
Engineering Controls to Mediate Back Pain at Work: Tools for the Assessment of Physical Factor Impact on Spine Loads and Intervention
Effectiveness
Introduction
Static Strength Prediction Programs
Psychophysical Tolerance Limits
Job Demand Index
NIOSH Lifting Guide and Revised Equation
The 1981 Lifting Guide
The 1993 Revised Equation
Video-based biomechanical models
Lumbar Motion Monitor Risk Assessment
Lifting Threshold Limit Values (TLVs
Workplace Assessment Comparisons
Conclusions
Key Points
References
Administrative Controls for the Workplace: Psychosocial and Organizational Interventions
Implementing Psychosocial and Organizational Change
Elements of the Process
Traditional Administrative Controls
Worker Selection
Worker Rotation
Training
Stretching Programs
Back Belts
Summary
Key Points
References
Integrating Risk Interventions into the Workplace
Introduction
Systems Intervention
Examples of Intervention Effectiveness
Patient Handling Interventions
Types of Physical Interventions
Implementing both Physical and Psychosocial Interventions
Distribution Center Interventions
Summary
Key Points
References
Understanding Recurrent Low Back Pain and Implications for Return to Work
Introduction
The Natural History of Low Back Pain Recovery
How can one Quantify the Extent of Low Back Pain?
Impairment Assessment
Effort Sincerity
Spine Loading of those Experiencing Low Back Pain
Can Kinematic Impairment Assessments Predict Changes in Spine Loading?
Lifting Exposure Limits for Workers with LBP
Recurrence of LBP and Work
A Return-to Work Strategy
Conclusions
Key Points
References
Conclusions
Summary
References
Table of Contents provided by Publisher. All Rights Reserved.

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