Early Intervention

Study Targets Lower Back Injury

Early identification of workers at risk for developing low back pain can reduce injuries as well as comp costs.
By: | April 24, 2014

Identifying at-risk workers for low back pain ahead of time may reduce injuries and lower workers’ comp costs, suggest researchers. Their report indicates the value of an appropriately administered post-hire intervention.

While much attention has been focused on improving safety for commercial drivers, less has been targeted on preventing low back pain. The researchers looked at the use of a functional capacity evaluation during post-hire evaluation of truck drivers for their fitness for duty and the outcomes related to it. Their results were published in the Journal of Occupational and Environmental Medicine.


“There was a 54 percent reduction in low back injury incidence rate with an associated 45 percent reduction in workers’ comp costs on average between the pre-intervention period and the post-intervention period,” the study says. “The workers’ comp costs of low back injuries per injured driver increased over the pre-intervention period then decreased thereafter over the post-intervention period.”

Low back pain accounts for 15-25 percent of all workers’ comp injuries, but 30-40 percent of the costs, according to the Bureau of Labor Statistics. Commercial truck drivers are especially at risk due to the long hours of driving and additional tasks such as unloading freight, cranking dollies, sliding tandems, pulling fifth wheel pins, securing loads, applying tire chains in inclement weather, applying tarps on loads, and performing pre- and post-trip inspections.

More than 5 million commercial drivers were employed in the U.S. in 2012, according to the study. The back continues to be the body part most affected by work incidence.

“Recognizing that musculoskeletal injury is common among commercial truck drivers, some employers and insurers are employing an FCE as a tool to assist in decision making regarding appropriate job placement of these commercial truck drivers as well as regarding return to work duty after an injury,” the study says. “The assumption is that if the testing results are employed to appropriately fit the worker to the job, there will be a reduction in injury and subsequent workers’ comp costs. This research focuses on the institution of such program and on determining the outcomes of said interventions.”

For the study, a nationwide trucking company incorporated a standardized fitness-for-duty evaluation of drivers in 2003, the main element of which included the addition of an FCE to the already established and traditional Department of Transportation physical examination. Called the RoadReady Evaluation, the FCE was used in conjunction with the DOT exam, and the results evaluated to guide worker placement on low back injury incidence and costs.

Trained physical therapists asked the post-hire employees a series of questions focusing on the neck and back. They also conducted various assessments to determine potential risk factors.

After the evaluation, approximately 3 percent of the drivers were found to not meet the standards. They were given the opportunity for placement elsewhere within the company.


The researchers looked at the incidence rates and workers’ comp costs of drivers with low back injuries from 1999 to 2003, three years before the FCE and from 2003-06, three years after the intervention. They pointed out that overall in the transportation industry there was a reduction of low back injuries between 1999 and 2006.

“Nevertheless, the reduction in workers’ comp costs associated with low back injury since the introduction of the program in 2003 may have been due to the intervention, where individuals assessed as having a higher risk of low back injury may have been placed elsewhere,” the report says. “The upper back, not targeted in this intervention, served as a comparison group where the number of injuries and associated workers’ comp costs remained flat.”

Nancy Grover is the president of NMG Consulting and the Editor of Workers' Compensation Report, a publication of our parent company, LRP Publications. She can be reached at [email protected]

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The R&I Editorial Team can be reached at [email protected]