Of all types of injuries resulting from manual handling, back injuries have been reported consistently as being the most common and the most costly.
A Problem on a Global Scale
The literature abounds with reports of high back injury occurrence frequencies around the world. Compensation data from many industrialised countries showed manual handling injuries generally, and manual handling related back injuries specifically, as their most prevalent workplace injury problem. While it is difficult to accurately compare data from one country to another due to different approaches the various governments have to workers compensation, such as different minimum thresholds of injury severity to qualify for
compensation, different reporting criteria, different injury classification
methods and the many varied methods used for reporting accident frequency, the consistent theme of high back injury occurrence rates within the various jurisdictions suggested the problem remained an unchecked worldwide industrial epidemic.
In 1981, the USA National Institute for Occupational Safety and Health (NIOSH) reported that 35% of workers compensation claims in USA were related to back injuries (NIOSH (1981)). In 1987 back injuries accounted for 27% of all lost time compensation claims in Ontario Canada (WCB (1988)) and in 1989, the US Occupational Safety and Health Agency (OSHA) reported that a quarter of all compensation indemnity claims in USA involved back injuries costing billions of dollars in addition to the pain and suffering borne by the employees. OSHA indicated that more than one million workers in the USA suffered back injuries each year, that back injuries accounted for one in every five workplace injuries or illnesses and that three out of four workplace back injuries occurred while the employees were involved in lifting tasks (OSHA (1989)).
Damlund et al (1982) in a Danish study of 157 workers, who had retired early, found that 40% of the retirees reported low back pain as one of their reasons
for early retirement. Stubbs (1986) in a report of a study of the nursing profession in England, and, Saraste (1993), in a study of Swedish male workers with back ailments, both suggested that 80% of workers experienced lower back ailments during their working life.
In 1994, Jensen reported that 31 million Americans have low back pain at any given time with the medical care cost exceeding $US 8 billion every year (Jensen et al (1994)). Bernard (Ed) (1997) reported that 60% of lost time injuries due to manual handling in the United States in 1994, were back injuries which, according to NIOSH (1994)1, cost over $US 20 Billion and accounted for 20% of all injuries and illnesses in USA workplaces that year.
In Hong Kong, Yu T. et al (1984) found that 60% of workers, in a 12 year study of Chinese workers, suffered from low back pain at work.
In New Zealand in 1993-94, 14,644 of 120,893 claims were back claims costing nearly NZ$ 34 million (ACC (1998)). In 1994-95, the number of new back injury claims in New Zealand rose to 17,720 costing nearly $NZ 43 million and in 1995-96 there were 17,216 new back claims costing $NZ41.6 million. The ACC also reported that in the same three years, the additional number and costs of ongoing back injury claims were: 1993/94: 6199 claims costing $NZ 37 million, 1994/95: 8268 claims costing $NZ60 million, and 1995/96: 21,710 claims costing $NZ170 million. In New Zealand these back claims represented the largest single cost to the social insurer and the number of claims and their associated costs were still steadily increasing. Half of all the back injury claims and the costs were work-related, according to the ACC.
In Australia, the situation seems to have been similar to elsewhere in the world. In 1994, Wissenden and Condon (1994) reported that back injuries accounted for more than 25% of work related injuries and cost over $1 billion per year in Victoria, and while many people recovered quite quickly, some became severely disabled and never returned to work. Foley (1996) elevated these figures slightly by suggesting that in Australia in 1993-94, 31% of
compensated work-related injury and disease cases were the result of manual lifting, carrying and/or handling objects and that sprains and strains to the
joints and muscles of the back accounted for 49.5% of those manual handling injuries.
Similar figures were reported by the Victorian Health and Safety Organisation in 1995. They reported that back injuries were the most serious injury type suffered by the claimants in 25% of workers compensation claims lodged in Victoria in the period 1992 to 1994 (Health and Safety Organisation (1995)). Also, back injuries were reported to be 30% of all New South Wales workplace injuries in the period 1993 to 1995 (Workcover New South Wales (1996).
More recently, the Australian Bureau of Statistics (ABS) reported in 2002 that back injuries accounted for 25% of non-fatal compensated injuries across Australia in the year 1999-2000 that resulted in 10 or more days off work (ABS (2002)). This percentage remained relatively constant the following year since, in 2003, NOHSC confirmed that in the period July 2001 to June 2003, 24.9 % of the 138,810 new workers compensation claims in Australia were back injuries and that 17% of all the new claims were injuries to the lower back (NOHSC (2003)).
A Problem for Companies
Occupational back injuries have clearly been an ongoing problem for national economies globally. They have also been a problem for corporations having a substantial impact on their profitability. In addition to the direct costs such as insurance premiums and medical fees, back injury cases have cost
companies significantly under common law litigation. For example, CCH (1995) reported that two back injury cases heard in the Supreme Court of Queensland, where the employers had been found negligent for requiring their respective employees to lift weights beyond the reasonable capacity of an ordinary male, found in favour of the injured employees and awarded damages in the order of $399,000 and $450,000, respectively.
A Problem for Workers
Manual handling injuries also have a significant cost to the persons injured. The injuries have a substantial negative impact on quality of life and often shorten the persons’ working lives. Wissenden & Conden (1994) suggested:
"Some people recover quite quickly and are still able to return to their work. However, others become so severely disabled with back pain that they are never able to return to work again". This was supported by Davies et al (2003) who found that a fifth of people who suffered manual handling injuries required more than a month's absence from work and that around one in sixty people who suffered a manual handling injury, permanently left the workforce.
ACC (1998) also reported that those people in the more physically demanding jobs in New Zealand were less able to continue working after a back injury and may also have had to leave their employment. OSHA (1999) agreed with this and suggested that manual handling of heavy objects exposed employees to high forces that usually had the greatest impact on the back resulting in the most severe injuries.
In 2001, the leading USA medical technology company Medtronic Inc.
(Medtronic (2001)), suggested that chronic pain seriously affected the quality of life, was unrelenting and demoralizing, and that people with chronic pain often could not work and their families and social lives deteriorated to the point where their total preoccupation with the pain caused irritability and depression. Medtronic further accounted that the psychosocial effects of chronic pain included the loss of employment income, depression, fear, anxiety, sleep disorders, marital dysfunction and feelings of personal isolation.
More recently in 2006, Professor Alan Hedge of Cornell University suggested in a literature review paper that “low back pain was second only to upper respiratory tract infections as a cause of absence from work” and the total
annual cost of back pain in the USA had risen to US$56 billion, (Hedge (2006)).
The evidence is clear that worldwide, back injuries due to manual handling have for a significant period been an area of consistently poor industry
performance. The injury rates continue unabated. There is little doubt there is a need to rethink the back injury prevention strategies applied in the past. In the face of the evidence, those strategies have not been effective in stemming the back injury tide.