Employers and employees can work together to help prevent injuries that are costing between $50 billion and $100 billion each year, and estimated to affect half of working-age adults annually.

The American College of Occupational and Environmental Medicine (ACOEM) this week is highlighting the growing problem of low-back injuries, issuing a "Labor Day CheckList" with some simple suggestions on how to avoid low-back injuries in the workplace.

These suggestions include addressing such areas as lifting or heavy physical work, awkward postures, whole-body vibrations and the work environment. For example, employers should conduct ergonomics reviews of workstation design and equipment to ensure that each employee is sitting and moving in the safest positions; teach and reinforce good habits and safety techniques to employee drivers; provide ongoing programs to help employees learn how to reduce stress levels; and regularly review accident/injury records to identify problem areas and eliminate hazards.

Many preventive strategies are quite simple and inexpensive to implement, according to Dr. Edward J. Bernacki, director of the division of occupational medicine at Johns Hopkins University School of Medicine, Baltimore.

"It's so easy to adjust workplace design and teach people how to modify their habits so as to reduce the stress on their bodies," he said. "Many times it just takes something as uncomplicated as placing a table in a worker's area to let that person avoid repetitive bending. It's the simple things you can do that eliminate most of the risks."

Employer focus on such areas as fitness, diet, smoking and sleep also can contribute to preventing low-back injuries in the workplace. For example, ACOEM suggests:

Provide time and/or facilities for employee exercise and create incentive programs that encourage employee fitness.

Offer healthy food options in on-site dining facilities.

Supply water coolers/fountains in the workplace.

Sponsor smoking cessation programs and discourage smoking in the workplace. (Smoking reduces blood/fluid flow to the spine.)

Use accepted guidelines for safe shift-work practices.

Educate your work force on the importance of adequate sleep for optimum functioning and accident prevention.

You need to be relentless in your pursuit of safety and education, Bernacki said, noting that the payoff of prevention always greatly outweighs the cost.

"It's much cheaper to fix these problems up front than to treat injuries and deal with lost work time," he said.

"[Preventive measures] can certainly minimize the frequency and recurrence, and often prevent, injuries," added Dr. Donald T. Statuto, CEO of Occupational and Industrial Health in Peterborough, N.H., who guides companies through a process designed to eliminate problems that could cause injury, using regular plant walk-throughs to identify and eliminate possible hazards. The process used to treat those who are injured also plays a part.

"We set up a medical clinic and examine and treat every person who sustains an injury to determine whether it's work-related. Then, if it is work-related, we go to the worksite to determine how it occurred and prevent it from happening again," Statuto explained.

"The assessment and adjustments to the job or working conditions are made with the involvement of both the employee and the supervisor, because everyone has to agree on a workable solution to make sure it's implemented successfully," he said, adding that immediate treatment and conducting of the assessment process minimize the chances of additional injury.

One of the reasons you may be seeing such a high incidence in back injuries today, says Dr. Stanley H. Miller, medical director at Saturn, is the general deconditioning and increased obesity in the U.S. population.

"If someone has weak abdominal muscles, for example, they've lost a very important component of the back structure, because these muscles help support the back," explained Miller. "Extra weight in the front of the body increases the curvature of the lower back, which creates additional stress to the region."

The aging work force also plays a role in the frequency of back injuries, since older workers are usually less physically capable of tolerating activities that might cause injury, said Bernacki. And, the proliferation of new industry — and the lack of control rapid growth brings — are contributing factors, he said.

You can receive a complementary copy of the checklist — which highlights more than 40 measures for preventing low-back injuries — by sending a stamped, self-addressed, business-sized envelope to: Labor Day CheckList, ACOEM, 55 W. Seegers Road, Arlington Heights, IL 6005-3919; visiting the ACOEM Web site at www.acoem.org; or using its fax-on-demand service, (800) 226-3626.

Copyright 1999 Health Resources Publishing