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Predictors of low back pain in nursing home workers after implementation of a safe resident handling programme
  1. Judith E Gold1,
  2. Laura Punnett2,
  3. Rebecca J Gore2,
  4. ProCare Research Team2
  1. 1Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
  2. 2Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA
  1. Correspondence to Dr Judith E Gold, Gold Standard Research Consulting, Bryn Mawr, PA 19010, USA; JudithEGold{at}


Objectives Healthcare workers have high rates of low back pain (LBP) related to handling patients. A large chain of nursing homes experienced reduced biomechanical load, compensation claims and costs following implementation of a safe resident handling programme (SRHP). The aim of this study was to examine whether LBP similarly declined and whether it was associated with relevant self-reported occupational exposures or personal health factors.

Methods Worker surveys were conducted on multiple occasions beginning with the week of first SRHP introduction (baseline). In each survey, the outcome was LBP during the prior 3 months with at least mild severity during the past week. Robust Poisson multivariable regression models were constructed to examine correlates of LBP cross-sectionally at 2 years (F3) and longitudinally at 5–6 years (F5) post-SRHP implementation among workers also in at least one prior survey.

Results LBP prevalence declined minimally between baseline and F3. The prevalence was 37% at F3 and cumulative incidence to F5 was 22%. LBP prevalence at F3 was positively associated with combined physical exposures, psychological job demands and prior back injury, while frequent lift device usage and ‘intense’ aerobic exercise frequency were protective. At F5, the multivariable model included frequent lift usage at F3 (relative risk (RR) 0.39 (0.18 to 0.84)) and F5 work–family imbalance (RR=1.82 (1.12 to 2.98)).

Conclusions In this observational study, resident lifting device usage predicted reduced LBP in nursing home workers. Other physical and psychosocial demands of nursing home work also contributed, while frequent intense aerobic exercise appeared to reduce LBP risk.

  • intervention, moving and lifting patients
  • healthcare workers
  • protective devices
  • aerobic exercise

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  • Contributors JEG analysed the data, participated in data interpretation and drafted the manuscript. LP designed the study and the survey instrument, oversaw data collection, and participated in data interpretation and drafting of the manuscript. RJG supervised data entry and quality control and provided critical statistical consulting support. All authors critically read and approved the final manuscript.

  • Funding This work was supported by the US National Institute for Occupational Safety and Health (NIOSH/CDC) (grant number U19-OH008857).

  • Disclaimer The contents are solely the responsibility of the authors and do not necessarily represent the official views of NIOSH.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval University of Massachusetts Lowell Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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