title: The NIOSH lifting equation and low-back pain, Part 2: Association with seeking care in the backworks prospective cohort study.
abstract: OBJECTIVE
  The aim of this study was to investigate the relationship between the revised NIOSH lifting equation (RNLE) and risk of seeking care for low-back pain (SC-LBP).
  
  
  BACKGROUND
  The RNLE is commonly used to quantify low-back physical stressors from lifting/lowering of loads in workplaces. There is no prospective study on relationship between RNLE and SC-LBP.
  
  
  METHODS
  A cohort of 258 incident-eligible workers from 30 diverse facilities was followed for up to 4.5 years. Job physical exposures were individually measured. Worker demographics, medical history, psychosocial factors, hobbies, and current low-back pain were obtained at baseline. The cohort was followed monthly to ascertain SC-LBP and quarterly to determine changes in physical exposure. Associations between SC-LBP and both the peak lifting index (PLI) and peak composite lifting index (PCLI) were tested in multivariate models using proportional hazards regression.
  
  
  RESULTS
  SC-LBP lifetime prevalence at baseline was 31.9%, and there were 24 incident cases during follow-up. Factors predicting SC-LBP included job physical exposure (PLI and PCLI), history of low-back pain, age, female gender, and lower body mass index. In adjusted models, risk (hazard ratio [HR]) increased per unit increase in PLI and PCLI (p = .03 and .02, and maximum HR = 23.0 and 21.9, respectively). Whereas PCLI suggested a continuous increase in risk with an increase in PCLI, the PLI showed elevated, though somewhat reduced, risk at higher exposures (HR = 14.9 at PLI = 6).
  
  
  CONCLUSIONS
  Job physical stressors are associated with increased risk of SC-LBP. Data suggest that both the PLI and PCLI are useful metrics for estimating exposure to job physical stressors.
authors.forename: Arun
authors.initials: A
authors.lastname: Garg
authors.forename: Jay M
authors.initials: JM
authors.lastname: Kapellusch
authors.forename: Kurt T
authors.initials: KT
authors.lastname: Hegmann
authors.forename: J Steven
authors.initials: JS
authors.lastname: Moore
authors.forename: Sruthi
authors.initials: S
authors.lastname: Boda
authors.forename: Parag
authors.initials: P
authors.lastname: Bhoyar
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Thiese
authors.forename: Andrew
authors.initials: A
authors.lastname: Merryweather
authors.forename: Gwen
authors.initials: G
authors.lastname: Deckow-Schaefer
authors.forename: Donald
authors.initials: D
authors.lastname: Bloswick
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Malloy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007899:Leisure Activities; D017770:Lifting / Q000009:adverse effects*; D017116:Low Back Pain / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009314:National Institute for Occupational Safety and Health, U.S.; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology / Q000628:therapy*; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology