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The NIOSH Lifting Equation and Low-Back Pain, Part 2

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. Method: 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). Conclusion: 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.