Back Injury Control Measures For Manual Lifting And Seat Design (713e5a18-b501-4cad-ba17-ce99f61f5c68)

Introduction The mining industry has long been associated with a high incidence of low back disorders and pain (Klein et al. 1984, Leigh and Sheetz 1989, Brinckmann et al. 1998). It is believed that the higher incidence of these injuries among miners is the result of high exposures to postural demands, heavy manual work, and exposure to whole-body vibration (WBV). Recent work has indicated that miners involved with heavy lifting (especially in restricted spaces or on uneven ground) or who have been exposed to whole-body vibration in undamped seats experience noticeable changes in their spines that are consistent with degeneration of the intervetebral discs of the spine (Brinckmann et al. 1998). As will be described shortly, there is mounting evidence that disc degeneration plays a large role in the development of low back pain, particularly chronic back pain. Until fairly recently, medical doctors generally assumed that back pain was the result of muscle strain, ligament pain, or so-called “trigger points” (Bogduk, 1997). However, research supporting these mechanisms of pain has been very scant. When subjected to scientific scrutiny, none of these mechanisms has been shown to relate to back pain in a convincing manner. On the other hand, there are three mechanisms that have been shown to be highly associated with back pain in controlled scientific studies: sacroiliac pain (present in 13% of back pain sufferers) (Maigne et al. 1996), facet joint pain (present in 15 % of back pain sufferers) (Schwarzer et al 1994), and disc disruption and degeneration (present in 39% of chronic back pain sufferers) (Moneta et al. 1994). The latter mechanism, which bears the highest relationship to back pain that has been objectively demonstrated, will be the focus of this section. Scientists now believe they have a good idea how back pain may develop in cases involving disc disruption and degeneration (Bogduk 1997). As the spine experiences loading during lifting tasks or whole body vibration, the first structure to fail is called the vertebral endplate, which is a structure that attaches the disc of the spine to the vertebral body (Figure 1). The endplate typically experiences a fracture, which the body will attempt to heal by means of scar tissue. Unfortunately, this scar tissue impedes the flow of nutrition to the disc itself (discs are dependent on nutrition from the vertebral bones), and if the supply is reduced sufficiently, the disc will start to degenerate. As this degeneration process proceeds, fissures or tears in the fibers of the disc start to develop. If any of these tears is a grade 3 fissure (Figure 2), an inflammatory response occurs in the disc, which will lead to the well-known sensation of low back pain (Peng 2006).