Resource:Back Injury Risk Factors and Risk Reduction Tips

Approximately one million people lose time from work each year due to back injuries.[i] Musculoskeletal disorders of the low back and upper extremities are not only an important national health problem; these disorders also impose a substantial economic burden in compensation costs, lost wages and productivity. Conservative cost estimates vary, but a reasonable figure is about $50 billion annually in work-related costs.[ii] 

While back injuries may seem to be caused by one single event, they are often caused by a combination of factors, such as years of straining, awkward posture, lifting, twisting, and the weakening of back and stomach muscles. These small injuries can cause muscle aches, spasms and limited flexibility; and, over time, can lead to more serious back injuries. 

Back Injury Risk Factors

The risk of back injury is increased when risk factors occur in combination. To reduce the work-related risks of back injury, consider the following factors when designing, planning and organizing work tasks:

  • Body posture
  • Weight of load (maximum of 51pounds) [i]
  • Location of load (above/below 30inches)
  • Frequency of lift (50 or more times per hour)
  • Reaching distance
  • Carrying distance
  • Twisting
  • Sudden, jerky lifting
  • Type of grip
  • Availability of handles, dollies, carts, etc. 
  • Push/pulls requiring large force to start rolling
  • Temperature extremes
  • Slippery floors/shoes
  • Cramped work areas

Some additional factors that may increase the potential for back injuries are listed below. Reducing these stressors may also reduce the risk of back injury. [i]

  • Whole body vibration
  • Static postures
  • Prolonged sitting
  • Direct trauma to the back

Risk Reduction Tips

Employees and employers have an opportunity to reduce the risk of back injury before, during and after a lifting task. Consider the following:

Before the lift:

  • Evaluate the weight and determine if assistance from a co-worker is needed.
  • Determine if the object can be lifted with a mechanical assist.
  • If possible, divide the load for safer transport.
  • Move other items out of the way to get as close to the item as possible.
  • Organize work areas so items are not stored on the floor.
  • Arrange storage areas so items are not stored above shoulder level.
  • Store materials at waist level to avoid bending to lift.
  • Change the work height so the item can be handled with the back in a neutral position.

During the lift:

  • Use material handling devices, such as dollies, carts, skid-loaders and lift trucks.
  • Secure a stance and put one foot beside the item if possible.
  • Bend the knees, not the back, to lift.
  • Move feet, instead of twisting, to move items.
  • Push items rather than lifting them.

After and in between lifts:

  • Alternate tasks and postures that use different motions and muscle groups.
  • Break standing tasks with seated tasks.
  • Take time to stretch during scheduled breaks.

Understanding the primary work-related risk factors that increase the chance of a back injury is the first step in evaluating work tasks. Applying the lifting task risk reduction tips to the work task design may help reduce these stressors on the lower back. Educating employees in these back injury risk reduction principles will possibly help them to assess and alter their daily tasks to further reduce the potential for work-related back injuries. 

[1] University of Maryland – Department of Environmental Safety, Sustainability and Risk (2005) Back Injuries. [Online] Retrieved from:

[1] The Center for Construction Research and Training (2007) Back Injuries and Illnesses in Construction and Other Industries. [Online] Retrieved from:

[1] National Institute of Occupational Safety and Health (1996). Revised NIOSH Lifting Equation. [Online] Retrieved from

[1] National Institute of Occupational Safety and Health (1996). Applications Manual for the Revised NIOSH Lifting Equation. [Pdf] Retrieved from