title: The cost-effectiveness of a back education program for firefighters: a case study.
abstract: BACKGROUND
  Low Back Pain (LBP) is one of the most common causes of disability in the working population, and its impact on industry is enormous. The high financial costs of LBP and its apparent relationship with working conditions have led to efforts to prevent this condition. Several reviews have suggested that there is considerable potential for multimodal preventive interventions to cost-effectively reduce the overall burden of illness.
  
  
  OBJECTIVE
  The objectives of this study were to assess the feasibility of implementing a multi-faceted back injury prevention program in the community, and to assess the effectiveness of this program.
  
  
  METHODS
  A case study involving 92 firefighters from a suburb north of Toronto, Ontario, Canada.
  
  
  METHODS
  A back education program, called the Back Informed Program, was conducted on-site by a trained chiropractor. It offered employees job-specific education, ergonomic advice, exercises and pain management, as well as hands-on practice sessions. Data on absenteeism due to back injury, and cost of lost work days due to back injury were collected between January 1995 and December 1996. Data were compared to a municipality that received no such program during the same time period. Secondary outcomes, including information attained among the workers were qualitatively assessed. Absenteeism and financial data were used to demonstrate the potential efficacy of such a program.
  
  
  RESULTS
  The results showed a significant decrease in the number of days lost due to back injuries in the year following implementation of the program. Upon implementation of the Back Informed program, there was a reduction of 72.4% in days lost reported over the two year period of program implementation. The rate of days lost per worker was 0.64 prior to program implementation and dropped to 0.13 two years later. This resulted in substantial cost-savings in both direct and indirect costs to the municipality.
  
  
  CONCLUSIONS
  This study suggests that a multi-faceted, occupation-specific back education program may help reduce back injuries and reduce injury-related costs.
authors.affiliation: Canadian Memorial Chiropractic College, Toronto, Ontario, Canada. pkim@cmcc.ca
authors.forename: Peter
authors.initials: P
authors.lastname: Kim
authors.forename: Jill A
authors.initials: JA
authors.lastname: Hayden
authors.forename: Silvano A
authors.initials: SA
authors.lastname: Mior