An epidemiologic study of lifting and twisting on the job and risk for acute prolapsed lumbar intervertebral disc

Kelsey, Jennifer L.; Githens, Penny B.; White, III, Augustus A.; Holford, Theodore R.; Walter, Stephen D.; O'Connor, Theresa; Ostfeld, Adrian M.; Weil, Ulrich; Southwick, Wayne O.; Calogero, John A.

Affiliations

¹Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut

²Division of Epidemiology, Columbia University School of Public Health, New York, New York

³Department of Orthopaedic Surgery, Beth Israel Hospital and Harvard Medical School, Boston, Massachusetts

⁴Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario

⁵Section of Orthopaedic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut

⁶Department of Neurological Surgery, St. Francis Hospital, Hartford, Connecticut

Abstract and keywords

An epidemiologic case-control study undertaken in Connecticut during 1979–1981 indicated that persons with jobs requiring lifting objects of more than 11.3 kg (25 lb) an average of more than 25 times per day had over three times the risk for acute prolapsed lumbar intervertebral disc as people whose jobs did not involve lifting objects of this weight. If the body was usually twisted while the lifting was done, this elevation in risk was apparent with less frequent lifting. An especially high risk for prolapsed lumbar disc was associated with jobs involving lifting objects of more than 11.3 kg with the body usually twisted and the knees not bent while the lifting was done. Neither lifting objects of less than 11.3 kg nor twisting without lifting was associated with an increase in risk.

Keywords: Epidemiology; Prolapsed intervertebral disc; Occupations; Twisting; Lifting

Links

DOI: 10.1002/jor.1100020110

PubMed: 6491800

Cited Works (3)

Year	Entry
1981	Adams MA, Hutton WC. The relevance of torsion to the mechanical derangement of the lumbar spine. Spine. May–June 1981;6(3):241-248.
1982	Adams MA, Hutton WC. Prolapsed intervertebral disc: a hyperflexion injury. Spine. May 1982;7(3):184-191.
1980	Hickey DS, Hukins DWL. Relation between the structure of the annulus fibrosus and the function and failure of the intervertebral disc. Spine. March–April 1980;5(2):106-116.

Cited By (26)

Year	Entry
1990	Boshuizen HC, Hulshof CTJ, Bongers PM. Long-term sick leave and disability pensioning due to back disorders of tractor drivers exposed to whole-body vibration. Int Arch Occup Environ Health. February 1990;62(2):117-122.
1991	Adams MA, Dolan P. A technique for quantifying the bending moment acting on the lumbar spine in vivo. J Biomech. 1991;24(2):117-126.
1994	Shirazi-Adl A. Nonlinear stress analysis of the whole lumbar spine in torsion: mechanics of facet articulation. J Biomech. March 1994;27(3):289-299.
1992	Panjabi MM. The stabilizing system of the spine, I: function, dysfunction, adaptation, and enhancement. J Spinal Disord. December 1992;5(4):383-389.
1988	Miller JAA, Schmatz C, Schultz AB. Lumbar disc degeneration: correlation with age, sex, and spine level in 600 autopsy specimens. Spine. February 1988;13(2):173-178.
1994	Shirazi-Adl A. Biomechanics of the lumbar spine in sagittal/lateral moments. Spine. November 1, 1994;19(21):2407-2414.
2000	Adams MA, Freeman BJC, Morrison HP, Nelson IW, Dolan P. Mechanical initiation of intervertebral disc degeneration. Spine. July 1, 2000;25(13):1625-1636.
2006	Adams MA, Roughley PJ. What is intervertebral disc degeneration, and what causes it? Spine. August 15, 2006;31(18):2151-2161.
1996	Iatridis JC. Biomechanics of the Anulus Fibrosus and Nucleus Pulposus of the Human Lumbar Intervertebral Disc and the Effects of Degeneration [PhD thesis]. Columbia University; 1996.
2002	Cheung T-mJ. A Finite Element Study of the Effects of Mechanical Loading on the Fluid Flow and Biomechanical Response of the Intervertebral Disc [Master's thesis]. Hong Kong Polytechnic University; September 2002.
2002	Budihardjo I. Studies of Compressive Forces on L5/S1 During Dynamic Manual Lifting [PhD thesis]. Iowa State University; 2002.
2015	Craig TD. Investigating Occupational Factors Linked to Back Pain: Repetitive Lifting Strategies and a Method for Examining Effects of Vibration [PhD thesis]. Lawrence, KS: University of Kansas; 2015.
2006	Arjmand N. Computational Biomechanics of the Human Spine in Static Lifting Tasks [PhD thesis]. École polytechnique de Montréal; October 2006.
2007	Bazrgari B. Biodynamic of the Human Spine [PhD thesis]. École polytechnique de Montréal; February 2007.
1998	Eger TR. Load Transfer Hand Forces During a Two-Dimensional Sagittal Plane Box Lift [Master's thesis]. Queen's University; September 1998.
1999	Albert WJ. Analysis of the Freestyle Technique Used by Experienced Lifters [PhD thesis]. Queen's University; September 1999.
2006	Abdoli-Eramaki M. Design and Instrumentation of a Mechanical Personal Lift Augmentation Device (PLAD) for Manual Lifting Tasks [PhD thesis]. Queen's University; January 2006.
1994	Nussbaum MA. Artificial Neural Network Models for Analysis of Lumbar Muscle Recruitment During Moderate Static Exertions [PhD thesis]. University of Michigan; 1994.
1996	Andrews DM. Biomechanical Methods for Low Back Physical Demands Assessment [PhD thesis]. University of Waterloo; 1996.
2000	Mientjes MIV. On a 55/5 Second Minute of Light Assembly Work by Women: Effects of Work/recovery Ratios on Discomfort and Loading on the Low Back [PhD thesis]. University of Waterloo; 2000.
2007	Scannell JP. In Vitro and in Vivo Biomechanical Investigation of the Clinical Practice of Disc Prolapse Prevention and Rehabilitation [PhD thesis]. University of Waterloo; 2007.
2008	Drake JDM. Axial Twist Loading of the Spine: Modulators of Injury Mechanisms and the Potential for Pain Generation [PhD thesis]. University of Waterloo; 2008.
2008	Parkinson RJ. Refining the Relationship Between the Mechanical Demands on the Spine and Injury Mechanisms Through Improved Estimates of Load Exposure and Tissue Tolerance [PhD thesis]. University of Waterloo; 2008.
2013	Noguchi M. Examining Changes in Intradiscal Pressure During Intervertebral Disc Herniation [Master's thesis]. University of Waterloo; 2013.
2017	McKinnon CD. Axial Twist of the Lumbar Spine: Mechanical Responses to Twisted Postures and Potential Factors for Workplace Injury [PhD thesis]. University of Waterloo; 2017.
2008	Slota GP. Effects of Seated Whole-Body Vibration on Spinal Stability Control [PhD thesis]. Virginia Polytechnic Institute and State University; 2008.