A prospective study of back belts for prevention of back pain and injury

JAMA. 2000 Dec 6;284(21):2727-32. doi: 10.1001/jama.284.21.2727.


Context: Despite scientific uncertainties about effectiveness, wearing back belts in the hopes of preventing costly and disabling low back injury in employees is becoming common in the workplace.

Objective: To evaluate the effectiveness of using back belts in reducing back injury claims and low back pain.

Design and setting: Prospective cohort study. From April 1996 through April 1998, we identified material-handling employees in 160 new retail merchandise stores (89 required back belt use; 71 had voluntary back belt use) in 30 states (from New Hampshire to Michigan in the north and from Florida to Texas in the south); data collection ended December 1998, median follow-up was 6(1/2) months.

Participants: A referred sample of 13,873 material handling employees provided 9377 baseline interviews and 6311 (67%) follow-up interviews; 206 (1.4%) refused baseline interview.

Main outcome measures: Incidence rate of material-handling back injury workers' compensation claims and 6-month incidence rate of self-reported low back pain.

Results: Neither frequent back belt use nor a belt-requirement store policy was significantly associated with back injury claim rates or self-reported back pain. Rate ratios comparing back injury claims of those who reported wearing back belts usually every day and once or twice a week vs those who reported wearing belts never or once or twice a month were 1.22 (95% confidence interval [CI], 0.87-1.70) and 0.95 (95% CI, 0.56-1.59), respectively. The respective odds ratios for low back pain incidence were 0.97 (95% CI, 0.83-1.13) and 0.92 (95% CI, 0.73-1.16).

Conclusions: In the largest prospective cohort study of back belt use, adjusted for multiple individual risk factors, neither frequent back belt use nor a store policy that required belt use was associated with reduced incidence of back injury claims or low back pain. JAMA. 2000;284:2727-2732.

MeSH terms

  • Adult
  • Back Injuries / epidemiology
  • Back Injuries / prevention & control*
  • Back Pain / epidemiology
  • Back Pain / prevention & control*
  • Female
  • Humans
  • Male
  • Occupational Diseases / epidemiology
  • Occupational Diseases / prevention & control*
  • Prospective Studies
  • Protective Clothing* / statistics & numerical data
  • Regression Analysis
  • United States
  • Workers' Compensation
  • Workplace / standards*
  • Workplace / statistics & numerical data