Most studies on the occupational hazards associated with forklift operation have examined risks of fatalities and traumatic injuries. Few studies have examined the magnitude of risk of lower back pain. This research deals with an evidence-based approach designed to examine if there is a relationship between whole-body vibration and driver postures with lower back pain among forklift operators and to offer some recommendations to minimize the risk of lower back pain. To accomplish the study goal, an evidence-based approach was adopted from evidence-based medicine. The basic steps of this evidence-based approach were: (1) formulation of a clear research question from a worker-occupational problem; (2) search of the literature for the best evidence with which to answer the question; (3) critically appraise the evidence; and (4) implement useful findings in occupational health and safety practices. In addition, the metarelative risk was calculated and the biological plausibility between whole body vibration (WBV) and operator posture with lower back pain was investigated. Six observational articles satisfied the inclusion criteria adopted in this research. The methodological qualities of the published studies ranged from marginal to average. The metarelative risk was 2.1, indicating that operators exposed to driving forklifts are greater than twice the risk of those not exposed to driving forklifts to experience lower back pain. There are biological mechanisms by which WBV and operator postures could develop lower back pain. Some aspects of the work environment that influenced vibration are seat, speed, track, and tires. Awkward postures and static postures are affected by cab design, seat, time spent seated, and the task performed. It appears that there is a causal relationship between forklift operation and lower back pain. The evidence examined shows a strong association and consistency between all studies and this relationship is biologically plausible. It is recommended that intervention studies be conducted to determine the effectiveness of ergonomic controls. © 2008 Wiley Periodicals, Inc.