Document Detail

Causal assessment of occupational pushing or pulling and low back pain: results of a systematic review.
MedLine Citation:
PMID:  20494815     Owner:  NLM     Status:  MEDLINE    
BACKGROUND CONTEXT: Low back pain (LBP) is a prevalent and expensive musculoskeletal condition that predominantly occurs in working-age individuals of industrialized nations. Although numerous occupational physical activities have been implicated in its etiology, determining the causation of occupational LBP still remains a challenge.
PURPOSE: To conduct a systematic review evaluating the causal relationship between occupational pushing or pulling and LBP.
STUDY DESIGN: Systematic review of the literature.
SAMPLE: Studies reporting an association between occupational pushing or pulling and LBP.
OUTCOME MEASURES: Numerical association between exposure to pushing or pulling and the presence of LBP.
METHODS: A systematic review was performed to identify, evaluate, and summarize the literature related to establishing a causal relationship, according to Bradford-Hill criteria for causation for occupational pushing or pulling and LBP. A search was conducted using Medline, EMBASE, CINAHL, Cochrane Library, and OSH-ROM, gray literature, hand-searching occupational health journals, reference lists of included studies, and expert knowledge. Methodological quality was assessed using a modified Newcastle-Ottawa Scale.
RESULTS: This search yielded 2,766 citations. Thirteen studies met the inclusion criteria. Eight were high-quality studies and five were low-quality studies. There was conflicting evidence with one high-quality study demonstrating a positive association between occupational pushing or pulling and LBP and five studies showing no relationship. One study reported a nonstatistically significant dose-response trend, four studies discussed temporality of which one indicated a positive finding, two studies discussed the biological plausibility of a causal link between occupational pushing or pulling and LBP, and no evidence was uncovered to assess the experiment criterion.
CONCLUSIONS: A qualitative summary of existing studies was not able to find any high-quality studies that fully satisfied any of the Bradford-Hill causation criteria for occupational pushing or pulling and LBP. Based on the evidence reviewed, it is unlikely that occupational pushing or pulling is independently causative of LBP in the populations of workers studied.
Darren M Roffey; Eugene K Wai; Paul Bishop; Brian K Kwon; Simon Dagenais
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  The spine journal : official journal of the North American Spine Society     Volume:  10     ISSN:  1878-1632     ISO Abbreviation:  Spine J     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-24     Completed Date:  2010-08-20     Revised Date:  2011-09-20    
Medline Journal Info:
Nlm Unique ID:  101130732     Medline TA:  Spine J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  544-53     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
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MeSH Terms
Low Back Pain / etiology*
Occupational Diseases / etiology*
Stress, Mechanical
Comment In:
Spine J. 2011 Jul;11(7):690-1; author reply 691-2   [PMID:  21821202 ]

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