A LITERATURE-REVIEW OF LOW-BACK DISORDER SURVEILLANCE MEASURES AND RISK-FACTORS

Objective. The goal of this literature review was to gain insight into low back disorder risk factors via a critical examination of the surv eillance measures and analysis techniques employed in existing literat ure. Design. Fifty-seven original articles were evaluated and categori zed as a function of their surveillance measures. Background. There ha ve been a plethora of articles concerning the causes of tow back disor der, yet no specific risk factors are consistently associated with the development of these disorders. It was hypothesized that different lo w back surveillance measures and variations in risk factor (dependent variable) measurements have led to the inconsistencies in the literatu re. Methods. Five low back disorder surveillance measures a nd five ri sk factor categories were defined for this review. Each article was cl assified an several criteria including: surveillance measures, risk fa ctors, statistical methods, population and type of study. Summary stat istics were calculated for the percentage of positive findings as a fu nction of surveillance measure and risk factor category. Results. The most consistently defined surveillance measure was incidence of low ba ck disorder, with 82% of those investigating it as claims from medical records or Occupational Safety and Health Administration records. The combination of surveillance measures and risk factor influenced the o utcome of investigations. Ninety-one percent of the direct or video me thods of measuring exposure risk factor influenced outcome. Psychosoci al measures had positive findings in 70% of the studies examining lost time. Finally, statistical methodology was critical in the outcome of these investigations. Conclusions. The surveillance measure of incide nce had more positive findings, with exposure risk factors and the sur veillance measures indicating more advanced stages of low back disorde r such as lost time had more positive findings with psychosocial risk factors. Thus, as low back disorders progress to disability, the psych osocial risk factors play a more prominent role. Relevance In order to prevent low back disorders we must first understand the plethora of e pidemiological literature. This literature review provides new insight on the critical issues that have contributed to the results of previo us research. (C) 1997 Elsevier Science Ltd.