title: Predictors of low back pain in nursing home workers after implementation of a safe resident handling programme.
abstract: Healthcare workers have high rates of low back pain (LBP) related to handling patients. A large chain of nursing homes experienced reduced biomechanical load, compensation claims and costs following implementation of a safe resident handling programme (SRHP). The aim of this study was to examine whether LBP similarly declined and whether it was associated with relevant self-reported occupational exposures or personal health factors.
  
  
  
  Worker surveys were conducted on multiple occasions beginning with the week of first SRHP introduction (baseline). In each survey, the outcome was LBP during the prior 3 months with at least mild severity during the past week. Robust Poisson multivariable regression models were constructed to examine correlates of LBP cross-sectionally at 2 years (F3) and longitudinally at 5-6 years (F5) post-SRHP implementation among workers also in at least one prior survey.
  
  
  
  LBP prevalence declined minimally between baseline and F3. The prevalence was 37% at F3 and cumulative incidence to F5 was 22%. LBP prevalence at F3 was positively associated with combined physical exposures, psychological job demands and prior back injury, while frequent lift device usage and 'intense' aerobic exercise frequency were protective. At F5, the multivariable model included frequent lift usage at F3 (relative risk (RR) 0.39 (0.18 to 0.84)) and F5 work-family imbalance (RR=1.82 (1.12 to 2.98)).
  
  
  
  In this observational study, resident lifting device usage predicted reduced LBP in nursing home workers. Other physical and psychosocial demands of nursing home work also contributed, while frequent intense aerobic exercise appeared to reduce LBP risk.
authors.affiliation: Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden.
authors.forename: Judith E
authors.initials: JE
authors.lastname: Gold
authors.affiliation: Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Punnett
authors.affiliation: Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Gore
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D055805:Moving and Lifting Patients / Q000379:methods; D015999:Multivariate Analysis; D009735:Nursing Homes; D009740:Nursing Staff / Q000523:psychology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D017751:Safety Management / Q000379:methods*; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: aerobic exercise; healthcare workers; intervention, moving and lifting patients; protective devices