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Epidemiology of lower back problems in two South African industrial settings and the development of a concise back screening instrument (CBSI)

Monday, 14 November, 2005 - 18:00
Campus: Brussels Humanities, Sciences & Engineering campus
Faculty: Physical Education and Physiotherapy
Bernard Van Vuuren
phd defence

Lower back problems (LBP) affect more workers
and result in higher costs to industry than any
other musculoskeletal disorder. Although
literature on the epidemiology of LBP is
accumulating, for the most part studies are
restricted to high-income countries, which
comprise less than 15% of the world's
population. The importance of regional and
industrial specific studies, particularly in
developing, middle and low-income countries, is
apparent in the further understanding of
industrial LBP.

Early and initial screening for disability risk
factors may further be helpful to recognize those
workers at greatest risk for delayed recovery
from occupational LBP. There is thus a need for
screening instruments, based on relevant risk
factors to assess and manage work-related LBP.
The purpose of the present research undertaking
was to determine the prevalence and aetiology of
LBP among workers in two South African
industries. Variables that were studied included
occupational factors, work and family support
systems, and fear-avoidance and pain coping
strategies. In addition the study comprised the
initial development of a concise back screening
instrument (CBSI) to recognize functional
impairment due to LBP among industrial

The findings of this study support the current
view of a multi-dimensional aetiological
approach to LBP. Accordingly the following
recommendations are made for practice with the
purpose of preventing and managing LBP in
Multiple intervention and prevention strategies
are needed to counter exposure to high-risk
occupational tasks.

Supervisors are encouraged to develop
appropriate work, family and organizational
support systems, which could be an inexpensive,
but potentially beneficial, means of reducing
worker stress and LBP.

Procedures are further needed to identify workers
with fear-avoidance behaviour and negative
coping strategies. The timely implementation of
intervention, prevention and treatment strategies
is recommended to counter such behaviour
among workers.

The CBSI, employed as a screening instrument,
should be utilized to recognize notable cases for
further assessment in the risk management of
staff. Screening to recognize workers at risk for
developing a chronic problem would allow
allocation of resources to those workers most in
need and most likely to benefit from further
evaluation and intervention. Early identification
of such cases could additionally prevent adverse
outcomes such as injuries, absenteeism, and
decreased productivity through appropriate