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between potential occupational risk factors.
Table 1.1 Work related risk factors for development of LBP (adapted from
Op de Beek and Hermans, 2000).
Category of risk factor
Risk factor
Manual material handling (lifting loads ≥ 3 kg)
Awkward postures
Heavy manual labour (incl. lifting heavy loads)
Slipping and falling
Static work
Social support
Job dissatisfaction
Job content
Job control
Work/time pressure
Medical history
Socio-economic status
Physical activity
Physical factors
Psychosocial factors
Individual factors
Strong evidence of work-relatedness
Sufficient evidence
Insufficient evidence
Manual Material Lifting and Lowering Tasks
For industrial workers who perform manual lifting or lowering tasks a high risk exist for suffering
LBD (EU-OSHA, 2000; Mathers, Stevens, and Mascarenhas, 2009; NIOSH, 1981; Op de Beek
and Hermans, 2000; Podniece et al., 2008). The ISO 11228-1 (2003) standard, defines manual
material lifting and lowering task as the action to move an object with a moderate mass of 3
kg or more (included people or animals) from its initial position upwards/downwards without
mechanical assistance. Workers who perform lifting tasks constitute a high risk group for suffering
WRLBD resulting to LBP (EU-OSHA, 2000; Mathers, Stevens, and Mascarenhas, 2009; NIOSH,
1981; Op de Beek and Hermans, 2000; Podniece et al., 2008). As early as 1911, Middleton and
Teacher (1911) (cited by Lancet, 1911) postulated, that possible intervertebral disk injury during
lifting heavy loads is due to the high muscular effort, and may be fatal.
Although epidemiological studies have be used to identify occupational risk factors leading to
the development of WRLBD, an inherent problem is that it is difficult to determine the level or
magnitude at which the presence of a risk factor becomes problematic (Marras, 2000; Marras
et al., 1993). Marras et al. (1993), performed a cross-sectional study in order to understand the
relationship between risk factors for WRLBD and biomechanical variables. The study reported
that the most significant variables associated with WRLBD in repetitive lifting tasks are (I) lifting
frequency, (II) maximum load moment, (III) maximum trunk lateral velocity, (IV) mean trunk