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Police Officer Back Health


Abstract and Figures

The purpose of this study was to examine the extent of, and factors related to, lower back pain (LBP) in municipal police officers. Officers (n=30) completed a multi-categorical questionnaire investigating factors associated with LBP, and the Oswestry Disability Questionnaire. Of the 21 officers returning complete data, 86% reported having back pain, with 6% having moderate disability. Fifty-five percent reported occasional back pain, and 10% reported daily pain. Pain was most often associated with muscular strain and ligament sprain (33%), while treatment sought ranged considerably. Officers reported pain to limit prolonged standing (37%), sitting (27%), and sleep quality (53%). Data suggests that police officers are at a high risk of lower back pain, while its frequency and intensity may be related to the physical requirements of the job. Dr. Anderson (PhD) is a professor in Kinesiology and Physical Education. Trained in applied physiology he has an interest in occupational physiology and bona fide occupational requirements in physically demanding occupations.
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Research Article Anderson, Zutz, & Plecas
Copyright 2011 - The Journal of Criminal Justice Research (JCJR) - Volume 2, Number 1 Page 1
The Journal of Criminal Justice Research
Gregory S. Anderson
University of the Fraser Valley
Amber Zutz
University of the Fraser Valley
Darryl B. Plecas
University of the Fraser Valley
The purpose of this study was to examine the extent of, and factors related to, lower
back pain (LBP) in municipal police officers. Officers (n=30) completed a multi-
categorical questionnaire investigating factors associated with LBP, and the Oswestry
Disability Questionnaire. Of the 21 officers returning complete data, 86% reported
having back pain, with 6% having moderate disability. Fifty-five percent reported
occasional back pain, and 10% reported daily pain. Pain was most often associated with
muscular strain and ligament sprain (33%), while treatment sought ranged considerably.
Officers reported pain to limit prolonged standing (37%), sitting (27%), and sleep quality
(53%). Data suggests that police officers are at a high risk of lower back pain, while its
frequency and intensity may be related to the physical requirements of the job.
Keywords: Lower back pain, occupation, disability, prevalence, policing
Dr. Anderson (PhD) is a professor in Kinesiology and Physical Education. Trained in
applied physiology he has an interest in occupational physiology and bona fide
occupational requirements in physically demanding occupations.
Correspondence should be forwarded Gregory S Anderson, PhD. University of the
Fraser Valley, 33844 King Rd., Abbotsford, BC V2S 7M8 CANADA
Research Article Anderson, Zutz, & Plecas
Copyright 2011 - The Journal of Criminal Justice Research (JCJR) - Volume 2, Number 1 Page 2
Ms. Zutz (MSc, CEP) is a faculty instructor in Kinesiology and Physical Education, with
a specialized interest in therapeutic exercise and chronic disease including metabolic
disorders, cardiopulmonary disease, and lower back pain.
Dr. Plecas holds the RCMP Research Chair and is the Director for the Center for
Criminal Justice and Public Safety Research in the School of Criminology and Criminal
Justice at the University of the Fraser Valley.
Lower back pain is a major cause of morbidity in the industrialized world impacting both
work and leisure time pursuits. Back pain was found to be the most frequent cause of
activity limitation in the adult population (Carpenter and Nelson 1999). In industrialized
countries de Girolamo estimates that 5% of the population will be experiencing lower
back pain at any given time (deGirolamoa 1991), with an annual prevalence of 15-45%
(Bonneau et al. 2001, Waxman et al. 2000). It is suggested that 60 - 80% of the
population will experience lower back pain at some point in their lifetime with LBP being
the second leading cause of medical visits (next to cardiovascular problems), while
being ranked third for hospital visits and fifth for surgical procedures (Carpenter and
Nelson 1999). The most frequently documented cause of LBP is muscle strain, with
overexertion and irregular (fast, wrong) movements such as lifting, twisting, turning,
bending, pushing and pulling being typical underlying factors (Bonneau et al. 2001, Ying
et al. 1997).
Acute onset of LBP usually lasts from 2 6 weeks while chronic lower back pain is
reoccurring and lasts a lifetime unless fully rehabilitated and the lower back
strengthened. Of those suffering from lower back pain, 5 - 10% will develop chronic
symptoms, pain and disability (deGirolamoa 1991). For this reason, lower back pain has
a large economic and psychosocial cost. In 1991 the direct and indirect costs
associated with lower back pain were thought to be in the 25 billion dollar range in the
United States (deGirolamoa 1991).
The first onset of lower back pain is most common between the ages of 25 and 55
(deGirolamoa 1991, deZwart 1997). Nohejl et al. found the highest reported initial
incidence of lower back pain in 20 - 30 year olds who were employed in jobs requiring
minimal training, such as general labor (deZwart 1997). de Zwart et al. found the
incidence of back pain to be higher in individuals over the age of 44 who were blue
collar workers exposed to heavy lifting (deZwart 1997), although several others report
high incidence of back pain in those who drive for a significant portion of the day
(Boshuizen et al. 1992, Gyi and Porter 1998, Robb and Mansfield 2007, Okunribido et
al. 2007, Lis et al. 2006). Many sources attribute lower back pain to occupation
(deZwart 1997, Nohejl et al. 1987, Riihimaki et al. 1988, Yu et al. 1984, Robb and
Mansfield 2007).
Understanding the physical requirements of police work and the literature linking driving
and heavy lifting (Anderson et al. 2001, Gyi and Porter 1998), twisting and turning
(Anderson et al. 2001, deGirolamoa 1991, Nohejl et al. 1987, Yu et al. 1984), one could
Research Article Anderson, Zutz, & Plecas
Copyright 2011 - The Journal of Criminal Justice Research (JCJR) - Volume 2, Number 1 Page 3
predict a high incidence of lower back problems in the police force. While Brown et al.
found the one-year prevalence rates of lower back pain in RCMP members to be within
those reported for the general population (25-62%) (Brown et al. 1998), police officers
fall within the upper end of normal with prevalence rates of 44-62%. The purpose of this
study was to develop a method to explore the prevalence of LBP in general duty police
officers, while examining the level of disability associated with the LBP and factors that
the officers attribute to LBP occurrence.
Research ethics were obtained for the study through the institutional Research Ethics
Advisory Committee. The research involved a two part questionnaire that was
distributed to a convenience sample (n= 30) of general duty police officers during their
shift briefing. Respondents were asked to fill out the questionnaire investigating factors
associated with LBP and return it, anonymously, in a sealed envelope to the
researchers following their shift.
The back health questionnaire was a multi-categorical questionnaire collecting
individual demographical data, workplace circumstances, and self-reported lifestyle
behaviors, physical activity and fitness, low back pain and back pain with daily living. In
addition to the questionnaire the Oswestry Disability Questionnaire was included to
assess the level of disability attributed to back pain (Fairbank et al. 1980). The
approximate time required to fill out the questionnaire was 20 minutes.
The Oswestry Scale provides reliable, subjective results that evaluate the individual
disability or level of function (Fairbank et al. 1980, Riihimaki et al. 1988, Gronblad et al.
1994). The questionnaire consists of 10 sections each containing 6 statements that are
related to progressive dysfunction, allowing for the categorization of disability level.
Each section is scored from 0 (no disability) to 5 (significant dysfunction). An
accumulative score is calculated to determine the level of disability the individual is
thought to have.
Descriptive statistics and Pearson two-tailed bivariate correlations were calculated using
SPSS v.12 software. Data were typically expressed as a percent of the total sample,
and where applicable, percent of those reporting LBP. Graphs were generated using
Microsoft Excel for Windows.
Subject’s age ranged from 31-50 years, with 2 female respondents and 19 male
respondents. With a response rate of 71 percent, the data received indicates that most
officers have or had experienced LBP. However, due to a limited sample size and
convenience nature of the sample, statistical analysis were not appropriate. Instead, a
descriptive analysis was performed to identifying factors associated with lower back
pain and help guide further research efforts.
Research Article Anderson, Zutz, & Plecas
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Job Descriptions
Job descriptions of the respondents varied. The majority of police officers were currently
working in either general duty (33%) or investigation (38%). Ninety percent (90%) of the
police officers indicated that they were satisfied with their work and had a good working
relationship with other staff and employer. Forty five percent of the officers currently
worked in a vehicle 4 or more hours of their working day, while 25 percent spent 4 or
more hours of the working day standing or walking; 60% of the officers reported that
their job required this twisting at the trunk on a daily basis.
Reported Lower Back Pain
Eighty six percent of the officers in the present study report having had trouble with their
lower back and associated lower back pain. Of those with back pain 55 percent reported
occasional back pain and 25 percent reported experiencing back pain often. Only 10
percent of the officers reported that the lower back pain bothered them on a daily basis.
The type of back trouble experienced ranged from sciatic pain, acute pain to muscular
strain and ligament sprain in the lower back. The most prevalent problems reported
were muscular strain and ligament sprain (33%). Of those reporting LBP, 76 percent of
the officers did not have back pain prior to entering the police force, although the
majority of officers now report having between 1-7 days (31%) and 8-30 days (27%) of
LBP in the past 12 months. When asked about specifics, 37 percent reported that their
pain limits them from standing for prolonged periods of time, while 27 percent report that
it limits them from prolonged sitting. In addition, 53 percent of the officers claim that their
sleep is affected due to LBP. The length of time they experienced back pain was
positively related to years of service (r=0.53; p < 0.05) but not age (r=0.38; p>0.05). The
relationship between LBP and years of service is reported in Figure 1.
Time off work
The majority of the officers (90%) report that they have used 0-4 days of their sick leave
in the last 12 months to cover days when LBP limited their function. When asked
specifically about sick time due to lower back pain 77 percent reported that their sick
leave total was no greater than 5 working days. However, when asked it they went to
work regardless when they should have taken time off work 63 percent reported that
sick leave was warranted, and in retrospect, think they should have used more sick time
to expedite their recovery.
Treatment and Response to Treatment
Of those officers afflicted with back pain, most responded well to various treatments.
Sixty nine percent (69%) of the officers who suffered lower back pain in the last year
had sought help from a health professional. Many treatment options were sought by the
officers including treatment by a physician (22%), physiotherapy (17%), chiropractic
care (50%) and massage therapy (33%). Along with therapeutic treatment options,
medications were also taken for relief of pain and discomfort. Fifty eight percent (58%)
of the officers answered yes when asked if they had taken medication. As with
treatments, various medications were taken including analgesic medication (26%), anti-
inflammatories (37%) and muscle relaxants (27%). A total of 65% of the officers
reported a good response to medication and previous treatment.
Research Article Anderson, Zutz, & Plecas
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Physical Activity and Fitness
Eighty five percent of the officers reported participating in 3 or more days of moderate to
vigorous physical activity. In addition, most officers (76%) also participated in stretching
and muscular strengthening activities 2 or more days of the week. Ninety percent of the
officers stated they participated in physical activity for associated health benefits,
although many reported themselves as below average for muscular (57%) and cardio
respiratory (38%) fitness. Neither general aerobic or muscular fitness were found to be
correlated to disability (r=0.24 in both cases). The relationship between perceived
fitness and level of disability from LBP is presented in Figure 2.
Duty Belt and Police Car
Sixty one percent (61%) of the police officers within this study attributed their low back
pain to the police belt/vest and the seat in the police car, while 39% attributed sitting or
driving for long periods of time to lower back pain.
Oswestry Questionnaire
Of the 21 officers who participated in the current study, three indicated they have not
experienced back pain, while 1 questionnaire offered incomplete data. Of those
seventeen officers reporting LBP most (94%) fell into the Minimal Disability Category
while 6% reported a Moderate Disability. At the level of Minimal Disability (Fairbank et
al. 1980) it is expected that this group can cope with most living activities. Usually no
treatment is indicated, apart from advice on lifting, sitting posture, physical fitness and
diet. In this group some patients have particular difficulty with sitting, and this may be
important if their occupation is sedentary. At the level of Moderate Disability (Fairbank et
al. 1980) it is expected that this group experienced more pain and problems with sitting,
lifting and standing. Travel and social life are more difficult and they may well be off
work. Personal care, sexual activity and sleeping are not grossly affected, and the back
conditions can usually be managed by conservative means. The Oswestry Disability
Score was significantly related to years of back pain (r=0.62; p<0.05).
In the United States back pain is found to be the most common reason for filing a
workers' compensation claim (Guo et al. 1999). Through the National Health Interview
Survey the prevalence of lost-workdays was estimated to be 4.6%, with 101,800,000
workdays lost to lower back pain in 1998. Guo et al. reported the prevalence of back
pain cases to be 17.6% with 149,100,000 workdays lost to lower back pain in 1988
(Guo et al. 1999). The prevalence was highest in general laborers (construction) in
males (22.6%), and nursing/nursing aides in females (18.8%). The duration of absence
appears to be related to the physical nature of the work, the occupation (e.g. amount of
driving, work posture, whole body vibration), social and economic opportunities of the
employees (Butterfield et al. 1998). Deyo and Tsui-Wu stressed the importance of
socioeconomic factors in disability related to lower back pain (Deyo and Tsui-Wu 1999).
These authors found a direct correlation between level of education and absenteeism
attributable to lower back pain in men, with individuals with higher education having
significantly fewer sick days attributed to lower back pain. Laslett et al. (1991) could not
Research Article Anderson, Zutz, & Plecas
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duplicate these results, however, finding no differences in back pain characteristics
across different social groups and occupational postures.
Studies routinely report 60-85% of the general adult population to have a lifetime
prevalence of LBP. In comparison, the present study found a high incidence of LBP in
the general duty police officers, with 86% of the officers reporting having LBP at some
point in their life. While 76% of the officers did not experience LBP prior to entering the
police force, it would be easy to jump to the conclusion that the physical nature of the
job places police officers at increased risk of LBP; however, police recruits enter the
police force at a younger age (approximately 25 years of age in the municipal police
surveyed) when a lower incidence rate would be expected. Younger aged subjects are
found to report acute LBP (deGirolamoa 1991, deZwart 1997) while increasing age was
linked with greater numbers of chronic lower back pain due to reoccurrence of previous
injury (Waxman et al. 2000). The results indicate that LBP is a mutable problem
throughout life, although the complete healing of the original injury can be related to
reoccurring and chronic LBP (Waxman et al. 2000).
Research in policing, while having identified that lower back pain is a major concern,
has not clearly demonstrated those factors associated with higher incidence of lower
back pain. The high incidence of lower back pain may be associated with many
occupational stressors the physical stress of arresting a suspect, driving, getting in
and out of a vehicle with body armor and gun belts or lifestyle related issues that are
associated with police work shift work, sedentary nature of the job, and lower fitness
with increased years of service. Burton et al. (1998) were able to link the occupational
stress of police work to the first onset of lower back pain, suggesting that body armor,
vehicular exposure and sports participation were all associated with a more rapid onset
of back pain in asymptomatic police officers. Chronic back problems were associated
with length of service and not necessarily length of exposure to stressors.
The National Institute of Occupational Safety and Health in the United States
documented a strong association with LBP and reoccurring back trouble through
comprehensive review of the epidemiological evidence for work related muscular
injuries and LBP (Nygard et al. 1987). Their review supported the contention that
factors within the physical workplace have an effect on the type and frequency of
injuries. Persons most at risk of lower back pain were those performing heavy physical
work, lifting and forceful movements, bending and twisting, exposed to whole body
vibration or required to hold prolonged, static work postures (Ferguson et al. 2000).
Burry and Gravis found 54.7% of all back injuries occurred due to lifting, while 63.6%
had a sudden onset due to muscle strain (Burry and Gravis 1988).
The prevalence of lower back pain appears to be higher for those who spend a
significant portion of their day driving motor vehicles (Gyi and Porter 1998, Robb and
Mansfield 2007, Lis et al. 2006). Brown et al. report the prevalence of lower back pain in
RCMP officers to be between 44 and 62% each year (Brown et al. 1998). Interestingly,
these authors did not find a significant difference between the prevalence of back pain
between those officers who drove for 50% of more of the shift and those that sat/stood
Research Article Anderson, Zutz, & Plecas
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for 50% of the shift. Research out of Britain, however, found self-reported lower back
pain to be positively associated with both distance and hours driven in a motor vehicle
(Gyi and Porter 1998). Thirty nine percent of the officers in the present study attribute
their LBP to prolonged sitting and/or driving.
Prolonged sitting and sustained posture in combination with exposure to whole body
vibration may leave police susceptible to LBP and other musculoskeletal disorders.
Further, after remaining in a static position for a prolonged period (such as sitting while
driving), subsequent reactions and movements are more likely to cause injury (such as
getting in and out of a car) (Gyi and Porter 1998, McIntosh et al. 2000). A recent study
examining 600 members of the British police force supports the relationship between
exposure to driving and reported LBP (Gyi and Porter 1998). Those officers found to be
at risk of LBP appeared to be generally taller, wore bulkier clothing, spent 8+ hours of
their shift driving or sitting in a vehicle, had insufficient posture when driving and were
required to respond to a situation which included strenuous physical activity after
prolonged sitting (Gyi and Porter 1998). The 80 traffic police officers surveyed reported
traveling in the same car all day during their shift for a 3-3.5 year duration with seats
that were never replaced or repaired unless there was obvious damage. Comparing the
LBP reported by traffic police to general duty officers, results indicate that 38% and
29% of officers, respectively, had suffered exposure to LBP for greater than 8 days
within the last 12 months (Gyi and Porter 1998). Absenteeism for police officers who
drove frequently was reported to be high as compared to a general light duty group
(11.2 days and 3.0 days, respectively).
Data from the RCMP suggest that 51% of members regard back pain as a major or
moderate health problem within the force (Laslett et al. 1991). A 1996 LBP survey
revealed that 56% of RCMP members surveyed suffer from acute, chronic or
reoccurring LBP (Laslett et al. 1991). In a random sample of police officers Brown et al.
found increased back pain and rate of injury in those officers who drove a patrol car as
part of their duty (Brown et al. 1998). While 54.9% of the officers sampled report
chronic and/or reoccurring LBP only half of those sought medical interventions by
means of chiropractic care, physical or occupational therapy, massage therapy or other
professional help, comparable to the 64% in the present study. Only 25% reported sick
leave although 60% stated that looking back they should have take days off to recover
faster and not return to work until they were symptom free (Brown et al. 1998). This is
remarkably similar to the present study which reported 63 percent of the officers felt that
in retrospect they should have used more sick time to expedite their recovery.
The high incidence rate of LBP in police officers, with little time taken for recovery from
injury and ineffective use of the health care system, reinforces the need for effective
prevention and treatment methods. While the majority LBP has an etiology in muscular
strain, officers sought chiropractic care and bone-base treatment. Further, without
complete recovery, officers were using a pharmaceutical based treatment that would
leave them drowsy and less capable of making quick and concise decisions. Muller et
al. examined risk indicators for lower back pain in a 15 year follow-up of people who
had previously experienced lower back pain 44. These authors found that previous
Research Article Anderson, Zutz, & Plecas
Copyright 2011 - The Journal of Criminal Justice Research (JCJR) - Volume 2, Number 1 Page 8
absenteeism due to lower back trouble, the use of analgesics to control lower back
pain, and occupation were the most important risk indicators of self-reported work
incapacity. For this reason, LBP education, treatment and prevention should be
undertaken by police agencies.
In a recent study trunk flexion, back extensor endurance, and physical activity
participation were found to be significantly higher in a group of Canadians that reported
no history of back pain, as compared to the group who did report a history of lower back
pain (Payne et al. 2000). Further, those individuals who reported no history of back pain
had significantly lower waist girths. Poor back endurance (Biering-Sorenson 1984) and
high levels of adiposity (Han et al. 1997, Nabeel et al. 2007) have previously been
associated with risk of lower back pain. Carpenter and Nelson in their review of the
literature provided considerable evidence that suggests high levels of hamstring
flexibility and abdominal muscular endurance are likely to reduce lower back problems
(Carpenter and Nelson 1999). While there is no previous support for the link between
physical activity and reduced incidence of lower back pain, Payne et al. found physical
activity participation to be a good discriminator of recurring back pain, while the
relationship between physical activity and general health is well established (Payne et
al. 2000). Recently Nabeel et al. (2007) found police officers who self-reported the
highest fitness levels to be least likely to report lower back pain. Officers who were
more fit were less likely to report incidence of lower back pain over the previous 12
months (OR 0.37, 95% CI 0.10-0.73) or report chronic pain (OR 0.42, 95% CI 0.19-
0.91). Further, these authors found officers reporting a Body Mass Index (BMI) of
greater than 35 to be three times more likely to report lower back pain than those within
a normal BMI range.
Physical activity and back health are extremely interrelated. However, even in heavy
laboring occupations, Nygard did not find the occupational physical stress to be
sufficient to cause superior musculoskeletal fitness, especially in older workers (Nygard
et al. 1987). This suggests that, while there are many risks associated with heavy labor,
the heavy labor itself does not appear to provide a physical conditioning effect that
would help prevent occupational-related injury, and an outside fitness program is
essential. Within this study, 85% of the officers participated in 3 or more days of
physical activity and strengthening exercises. Payne et al. found trunk flexion to be
positively related to back health in both males and females, while extensor endurance
was positively related to back health (Han et al. 1997). Abdominal strength is seen as a
good predictor of future risks for LBP (Han et al. 1997). However, physical
measurements alone could not provide sufficient evidence to accurately assess LBP
and future prognosis. Recent evidence suggests that psychosocial factors such as
attitudes and beliefs, personality and coping strategies towards daily activity and
lifestyle are also associated with LBP (Krause et al. 1999, Papageorgiou et al. 1997,
Pulliam et al. 2001). From a clinical standpoint, LBP is multi-factorial, therefore,
predicting those who may suffer from LBP must incorporate a variety of tests and
measures including physical assessments, lifestyle assessments and psychosocial
assessments (Devereux et al. 1999). The questionnaire developed for the present
analysis therefore asked specific questions in each of these areas.
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The etiology of LBP is no longer specific to physical measures, but has also been linked
to various psychosocial determinants (Devereux et al. 1999, McGorry et al. 1999, Linton
2001). For years researchers have been investigating psychological and emotional
variables that could directly influence LBP in combination with physical work demands
and workloads. These psychosocial determinants include attitudes, beliefs, personality,
stress, mood disorders and related coping strategies (Pulliam et al. 2001, Linton 2001,
Lundberg 1999). While it was difficult to link the psycho-social and lifestyle factors to
LBP in the present study with a small sample size, Brown et al. found strong
correlations between LBP and physical factors such as overexertion, lifting, pushing,
twisting, turning, prolonged sitting, standing, and psychological factors including mental
stress, social support, coping strategies and education level (Fairbank et al. 1980).
Similarly, through descriptive analysis of the present results certain lifestyle factors
appear to have a relation to LBP, including physical inactivity, job requirements and
Devereux et al. examined the combination of physical and psychosocial factors
associated with LBP in 891 workers from various industries (Devereux et al. 1999).
Subjects were asked to complete a questionnaire that examined their occupational
related lifting characteristics, frequency, exposure to whole body vibration, bending,
work positions and psychosocial factors of pressure and workload (time related stress),
job satisfaction, social support and job control. The subjects were then categorized into
four exposure groups: high physical/high psychosocial, low physical/high psychosocial,
high physical/low psychosocial and low physical/low psychosocial. The greater risk
factors were found for those who were lifting > 18 kgs, or 4.3-11.3 kg with a repetition of
25 times per day, whole body vibration and heavy lifting periodically throughout the day
(McGorry et al. 1999). Of the 818 completed questionnaires 39% had recurrent back
pain > 3 times a year for a duration of > 1 week. Half of these subsided within 1-4
weeks, while ¾ remained in mid-moderate discomfort for prolonged periods or
chronically. Further, those exposed to high physical and high psychosocial had greater
risk for LBP. Although having a low response rate (59%) the results were consistent
with other research stating that psychosocial and physical risk factors may affect LBP in
combination or independent of one another (McGorry et al. 1999).
Understanding the physical requirements of police work and the literature linking driving
(Gyi and Porter 1998, Lis et al. 2006, Robb and Mansfield 2007) and heavy lifting,
twisting and turning (deGirolamoa 1991, Nohejl et al. 1987, Yu et al. 1984), one could
predict a high incidence of lower back problems in the police force. The present study
was designed to determine prevalence of low back pain among police officers and to
further identify and outline factors attributed to the onset of LBP. The study confirms
that police officers who reported back pain attribute this injury to job related tasks, and
in particular, perceived the seat of the patrol car and the duty belt as the most
significant contributors to LBP (although little evidence was found to support this). Many
factors previously reviewed such as lifting, twisting, standing, bending, pushing and
pulling, as well as lifestyle factors such as stress, coping, smoking and physical
inactivity, must still be considered when examining LBP.
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This study reinforces the need for a comprehensive LBP prevention and treatment
strategy within police services. The majority of the officers experienced LBP at some
point during their career, with an incidence rate beyond the reported population norm,
indicating the need for targeted research and intervention strategies. However, the
present results are limited by the small convenience sample from one police
detachment, and the fact that the questionnaires were not distributed to police officers
on disability. With a larger sample size and wider questionnaire distribution within police
services further investigation within this specific setting would allow for more significant
Police officers have a high incidence of lower back pain, while its frequency and
intensity may be related to the physical requirements of the job. Prevention programs
should be considered, while research is required investigating vehicle design (eg.
mobile data terminal use), and modification of duties and shifts to avoid prolonged
sitting or walking.
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Figure 1. The relationship between Oswestry Disability Scores and years of service (1
= 0-4 yrs; 2 = 5-9 yrs; 3 = 10-14 yrs; 4 = 15-19 yrs; 5 = 20-25 yrs; 6 = 26+ yrs).
0 5 10 15 20 25 30
Oswestry Disability Score
Years of Service
r = 0.21; p > 0.05
Research Article Anderson, Zutz, & Plecas
Copyright 2011 - The Journal of Criminal Justice Research (JCJR) - Volume 2, Number 1 Page 14
Figure 2. The relationship between perceived fitness (1 = excellent; 2 = above average;
3 = average; 4 = below average; 5 = poor) and level of disability from LBP.
0 5 10 15 20 25 30
Oswestry Disability Score
Muscular Fitness
0 5 10 15 20 25 30
Aerobic Fitness
r = 0.24; p > 0.05
r = 0.24; p > 0.05
Research Article Anderson, Zutz, & Plecas
Copyright 2011 - The Journal of Criminal Justice Research (JCJR) - Volume 2, Number 1 Page 15
The Journal of Criminal Justice Research (JCJR)
Journal Masthead & Editorial Advisory Board
Anthony L. Sciarabba
Editor-in-Chief The Journal of Criminal Justice Research
Clifford Shearing
University of Cape Town, South Africa
Howard Abadinsky
St. John’s University, New York, United States
Rick Sarre
University of South Australia, Adelaide, Australia
Tim Prenzler
Griffith University, Queensland, Australia
Stephen Tong
Canterbury Christ Church University, Kent, United Kingdom
David E. Barlow
Fayetteville State University, North Carolina, United States
Venessa Garcia
Kean University, New Jersey, United States
Robin Bryant
Canterbury Christ Church University, Kent, United Kingdom
Monique Marks
University of KwaZulu-Natal, South Africa
Darryl Plecas
University of the Fraser Valley, British Columbia, Canada
James McCabe
Sacred Heart University, Connecticut, United States
William Sousa
University of Nevada, Las Vegas, Nevada, United States
Jennifer Wood
Temple University, Pennsylvania, United States
Tina G. Patel
University of Salford, Greater Manchester, United Kingdom
Scott W. Phillips
Buffalo State College, New York, United States
S. Caroline Taylor
Edith Cowan University, Joondalup, Western Australia
Branislav Simonvic
University of Kragujevac, The Republic of Serbia
William P. Bloss
East Carolina University, United States
Cliff E. Roberson
Kaplan University, Emeritus Professor of Criminal Justice, Washburn University, Kansas, United States
Joseph E. Pascarella
Violence Institute of New Jersey, University of Medicine and Dentistry of New Jersey, United States
Nadia Gerspacher
US Institute of Peace, Academy for International Conflict Management and Peacebuilding, Washington, D.C., United States
Research Article Anderson, Zutz, & Plecas
Copyright 2011 - The Journal of Criminal Justice Research (JCJR) - Volume 2, Number 1 Page 16
Lorraine Mazerolle
Institute for Social Science Research, ARC Centre of Excellence in Policing and Security, The University of Queensland,
Brent Snook
Memorial University of Newfoundland, Newfoundland, Canada
Timothy G. Nolan
Freeport Police Department, New York, United States
Raymond E. Horton
Freeport Police Department, New York, United States
Michael A. Cretacci
Buffalo State College, New York, United States
Mark Safarik
Forensic Behavioral Services International, Virginia, United States
Ronald van Steden
VU University, Amsterdam, The Netherlands
Sara Charlesworth
The Royal Melbourne Institute of Technology, Melbourne, Australia
Patricia Ferguson
ARC Centre of Excellence in Policing and Security, Institute of Social Science Research, The University of Queensland,
Michael Santaniello
Molloy College, New York, United States
Meritta B. Cullinan
Molloy College, New York, United States
Stephen A. Morreale
Worcester State University, Massachusetts, United States
Mark Ming-Chwang Chen
Central Police University, Taiwan
David Bradley
Victoria Police & Edith Cowan University, Joondalup, Western Australia
Mark Correia
San José State University, California, United States
John C. House
Inspector, Royal Newfoundland Constabulary, Newfoundland, Canada
Brian Nussbaum
Bridgewater State College, Massachusetts, United States
Dawn Anderson
U.S. Marshals Service, Southern District of California, United States
Chris O’Connor
Victoria Police, Melbourne, Victoria, Australia
Benjamin Namanya
UN Department of Peacekeeping Operations, Addis Ababa, Ethiopia, Africa
Debbie Robertson
Victoria Police, Maroondah, Australia
John Burchill
Winnipeg Police Service, Commercial Crime Unit, Winnipeg, Canada
Darren Palmer
Deakin University, Victoria, Australia
Research Article Anderson, Zutz, & Plecas
Copyright 2011 - The Journal of Criminal Justice Research (JCJR) - Volume 2, Number 1 Page 17
Copyright 2011, The Journal of Criminal Justice Research, ISSN 2160-2816. The
Journal of Criminal Justice Research is listed in EBSCO Databases’ Criminal
Justice Abstracts with Full Text™
... Police officers perform a variety of complex physical tasks as part of their law enforcement duties, each with their own unique physical demands [1][2][3][4][5][6][7][8][9][10][11][12][13]. These tasks can range from deskwork to chasing down fleeing suspects on foot [2,6,8,9], and require the maintenance of high levels of physical conditioning and skills to ensure adequate occupational performance. ...
... These tasks can range from deskwork to chasing down fleeing suspects on foot [2,6,8,9], and require the maintenance of high levels of physical conditioning and skills to ensure adequate occupational performance. Performing these routine tasks can expose police officers to an increased risk of musculoskeletal injuries (such as lower back pain) and, over a period of time, chronic conditions such as cardiovascular disease (for example, hypertension and atherosclerosis) [1,[6][7][8]11,[14][15][16][17][18][19][20][21][22][23]. ...
... Research by Anderson et al. [1] found that 86% of Canadian municipal police officers reported intermittent back pain in their careers, with 10% having consistent back pain. The injury incidence within this population was 1.3 injuries per year [1]. ...
Full-text available
Police officers perform a variety of physical tasks that can range from deskwork to chasing down fleeing suspects on foot. If not sufficiently prepared these tasks can lead to an increased risk of injury or task failure. The aim of this study was to profile the routine dispatch tasks performed by the Australian law enforcement officers of a state police force by frequency and duration. Participants for this study (n = 53: male n = 43, age = 33.5 ± 7.7 years, years of service = 7.2 ± 6.4 years: Female n = 10; age = 31.6 ± 9.1 years, years of service = 7.1 ± 6.1 years) were drawn from ten different police stations. Data reporting the tasks attended, their priorities, and their durations were gathered from a computer-aided dispatch system. Data from 77 shifts (3.8 ± 4.0 tasks/shift) captured 292 tasks attended (29.2 ± 17.5 task per station). ‘Check bona fides’ (checking an individual’s identification; 27%) was the most frequently occurring task followed by attending a domestic incident (14%). The longest task was attending an accident (mean = 43.50 ± 78.85 min, range 2–249 min). The results of this study suggest that police tasks are highly varied in terms of type and duration and these may differ between regions. An understanding of the dispatch tasks police officers are required to attend can inform injury mitigation and return-to-work rehabilitation practices.
... LBA is one of the most prevalent musculoskeletal disorders in the working community. A major health problem in our society is that of musculoskeletal disorders 4 . The life time incidence of LBA is up to 85-90%. ...
... The National Institute for Occupational Safety and Health (NIOSH) reported that there is strong evidence of a variety of workplace risk factors associated to LBA 4 . The article provides a study of current workplace health and safety vulnerability issues that police personnel are experiencing either daily or during their training period 4 . ...
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Background: Around 70% to 80% of world’s population has experienced Low Back Ache (LBA) at some point in their lives. Traffic police officers are prone to number of risk factors related to LBA every day. Around 96 various tasks must be completed in a full working day by a police officer. Out of these, 46 tasks require heavy physical work. Other tasks which do not require heavy physical work can be made easier if the police officer is physically good and fit. The traffic police do not know that back pain is caused due to their poor posture. Helpless stance, long walking hours, tedious developments of the body and helpless work community configuration are principle hazard factors for these issues. Objective: The purpose of the study is to determine the prevalence of LBA and functional disability among traffic police in South Bangalore. Material and Method: Nordic musculoskeletal questionnaire is used to record sites of pain among traffic police officers. Modified ODI scale was administered to traffic police officers with Low Back Ache (LBA). Based on the ODI score, the functional disability was evaluated. VAS is used to measure pain in traffic police officers having LBA. Data was analyzed using descriptive statistics. Result: In a total of 246 traffic police personnel who took part in the study, 96 of them reported with LBA i.e, the prevalence percentage was 39.02%. The mean pain intensity according to VAS was 3.95 ± 1.59. Out of the 96 police personnel who reported LBA, 49 personnel (51%) had moderate disability. Minimal disability was observed in 35 personnel (36.5%) and severe disability was noted in 12 personnel (12.5%). Conclusion: The prevalence rate of Low Back Ache among traffic police in south Bangalore is found out to be 39.02%.
... In the present study, the second highest prevalence of WMSDs was the lower back and waist/thigh (34.3%). Many studies have agreed that the lower back was one of the disorders suffered by police officers (Nazmul, 2013;Jennifer, 2006;Anderson et al., 2011;Shea and Poliquin, 2011). Brown (1998) found that a quarter of the respondents reported that their WMSDs caused them to take sick leave of up to five days (Brown, 1998). ...
... Brown (1998) found that a quarter of the respondents reported that their WMSDs caused them to take sick leave of up to five days (Brown, 1998). The majority of the policemen did not experience low back pain before being recruited into the force, which proves that some factors of policing caused the WMSDs among policemen (Anderson et al., 2011). Gyi and Porter (1998) concluded that traffic policemen have a high prevalence of low back pain since they have high exposure to driving, which requires them to spend their shift in the same car all day (Gyi and Porter, 1998). ...
Introduction The occupational safety and health issues for police riders and other professional riders are often related to ergonomic hazards and risks. The purpose of this research was to identify the factors that contribute to the health effects in developing work-related musculoskeletal disorders (WMSDs) among male traffic policemen using high-powered motorcycles. Materials and methods A cross-sectional study was conducted using 137 police riders. A set of questionnaires including the Standardised Nordic Questionnaire (SNQ) and human vibration meter (Svantek 106) was used in this study. Results The prevalence of WMSDs was 67.9%. Multiple logistic regression analysis revealed that the duration of riding a motorcycle (OR = 0.175, 95% CI:0.052, 0.581), years of service (OR = 0.152, 95% CI: 0.040, 0.567), and hand-arm vibration, HAV (OR = 3.053, 95% CI: 1.126, 8.280) were significant risk factors for the prevalence of WMSDs. Discussion The majority of riders reported symptoms of WMSDs within the past 12 months. Riding duration, years of service, and hand-arm vibration (HAV) were found to be the most important risk factors for WMSDs in this rider group. The results highlight that in the context of ergonomic interaction, high-powered motorcycles and the police riders are not a good fit. Hence, further study is needed to improve the safety and health of the police riders.
... Many of the researchers agreed that the level of MSD was high among policemen. [55][56][57][58][59] In their studies, different subjects have different levels of pain in different parts of their bodies because of different body muscles used, different level of severity of body muscle used, and working conditions. [60,61] Lipscomb et al. (2004) found that a quarter of the respondents reported that their MSD caused them to take sick leave of up to 5 days. ...
Background: The traffic police force is one of the occupations that utilize motorcycles as the main mode of transport. The main ergonomic hazard with the constant use of motorcycles is exposure of riders to vibration while riding their motorcycles, which can potentially lead to work‑related musculoskeletal disorders (WMSDs). Objective: This review is meant to provide an overview of the available vibration exposure with WMSDs for traffic police riders and to review the related guidelines. Method: This study involved comprehensive search of database from 1945 to 2015. Published research paper that reported on the vibration exposure, prevalence, and/or risk factors of WMSDs and occupational riders were assessed and reviewed. Result: The review suggests that the main factors involving vibration in motorcycles come from the motorcycles itself, the posture of the hands and arms during the gripping of the handlebars, the surrounding environment, and the period of riding motorcycles. Majority of the studies agreed that police riders had higher percentage of WMSDs especially in lower back, neck, and shoulder. Conclusion: Overall, police riders have a high incidence of WMSDs, which in combination with exposure to vibrations with prolonged sitting and static posture may increase their susceptibility to WMSDs. Further research is required to explore the level of exposure to vibrations and WMSDs among traffic police riders, its potentially consequences, and ways to reduce exposure and risk associated with vibrations and WMSDs.
... Rapid industrialization and urbanization have aggravated the rising levels of ambient air pollution in the cities especially in the developing countries including the Asian countries. The most commonly reported respiratory symptoms associated with traffic pollution in children as well as among occupational groups exposed to traffic pollution include bronchitis, asthma, wheezing, breathlessness, dry cough and cough with phlegm, reduced lung functions and other nasal problems [6,7]. The respiratory diseases due to traffic pollution get increased with time. ...
... Infatti, dalla letteratura internazionale, risulta che gli operatori di polizia, in considerazione delle esigenze fisiche rischiose e le caratteristiche psicosociali del proprio lavoro, sono a rischio per la lombalgia (Beyaz & Ketenci, 2010), mentre la frequenza e l'intensità del dolore sono correlati alle richieste fisiche del lavoro (Anderson, Zutz, & Plecas, 2011). Essi sono a rischio per il dolore al collo, alla schiena e all'anca a causa di uno squilibrio dovuto a un alto impegno ed una bassa ricompensa al lavoro (Von dem Knesebeck et al., 2005). ...
Full-text available
Per garantire le attività investigative, di vigilanza e di ordine pubblico con la massima efficienza e professionalità, gli operatori di Polizia si trovano spesso ad affrontare eventi imprevedibili e fisicamente impegnativi, situazioni che causano un intenso stress lavorativo. Tutto ciò può ripercuotersi, a lungo termine, sulle condizioni di benessere fisico e mentale causando un peggioramento generale della qualità della vita. Diviene fondamentale considerare l’attività fisico-motoria un’occasione formativa per gli operatori di polizia, in un’ottica di apprendimento lungo il corso della vita. A tale scopo, dopo aver presentato i concetti teorici e normativi che sostengono l’educazione e la formazione continua degli adulti come percorso di sviluppo delle competenze professionali, è stata evidenziata la condizione fisica e mentale degli operatori di Polizia nel contesto internazionale. Successivamente, è stata comparata la condizione psicofisica degli operatori della Polizia italiana con un campione rappresentativo della popolazione appartenente a vari ambiti lavorativi ed è risultata evidente la necessità di attuare delle politiche pubbliche per sensibilizzare le istituzioni ad adottare delle strategie di educazione e di formazione continua per promuovere il benessere psicofisico ed incrementare le prestazioni fisiche e lavorative. Infine, sono stati forniti gli strumenti e le procedure necessarie per poter attuare delle strategie didattico-formative con l’obiettivo di migliorare lo stato di benessere, ridurre il rischio di infortuni e patologie croniche e, conseguentemente, di ottimizzare l’efficienza fisica e lavorativa degli operatori di Polizia.
... The incidence of lumbar pains was also reported in other studies with military police officers, being related to factors that are typical of the activity, such as the use of the bulletproof vests (Konitzer et al., 2008;Rocha, 2008;Vasconcelos, 2007) and the sitting posture during motorized patrol (Anderson et al., 2011;Donnelly et al., 2009;Paulo, 2010). ...
Full-text available
Introduction Military police activity individuals performing operational activity remain 12 hours using mandatory safety equipment. This work aimed to verify the electromyographic response in operational military police officers before and after a cycle of two working days. Methods Forty-four male individuals were evaluated, with an average age of 34.59 ± 8.05. The used protocol consisted in the evaluation of paravertebral muscles and rectus abdominis muscles in a maximum isometric voluntary contraction test (MVC) during trunk extension movements, starting from the sitting position. Moreover, the Roland-Morris functional evaluation questionnaire and the Corlett and Manenica diagram for painful areas were used. An electromyograph with 16 pre-set channels was used. Signals were processed in time (EMGME) and spectral (EMGMF) domains, using the MatLab® program. The Shapiro-Wilk test and Wilcoxon Signed Ranks Test were applied. Statistical analyses were performed through the SPSS v21.0 software and Microsoft Office Excel 2010, considering p < 0.05 as significance level. Results Results showed statistical differences in the post-working day for time analysis, an EMGME decrease in the right rectus abdominis muscle (p = 0.016) and in the age-stratified sample, with individuals over 31 years old (p = 0.016); in the spectral analysis, EMGMF reduction in the right iliocostalis (p = 0.027) and right and left side in the stratified sample, in individuals over 31 years old and with more than 10 years of service. Conclusion The used protocol highlighted a decrease in the amplitude of the electromyographic signal, as well as possible muscle fatigue on the right side where officers usually carry their weapons.
... As seen in table 8 , maximum 74 subjects in 35 to 45 degrees of lumbar angle (7) .The minimum lumbar angle being 8.69 degrees, maximum being 84.27 degrees and the mean lumbar angle being 42.62 degrees. 573 ...
Full-text available
Traffic police officers play an immense role in developing countries like ours, where the growth in the number of vehicles is almost in a geometrical progression. The traffic police personnel have long working hours, no active training, unhealthy diet and poor sleeping habits (night duty) which may lead to increased risk of obesity and back problems. Hence, our aim for this study is to assess the prevalence of obesity in Navi Mumbai Traffic Police Department. Back pain is one of the major and the commonest problem for those individuals who suffer from obesity. Thus another objective included is assessment of lumbar curvature angle with flexi curve. Results Obesity assessment of 269 traffic police personnel all around Navi Mumbai was done. Maximum 157 were overweight .Minimum BMI being 18.13, maximum being 34.2 and the mean BMI being 26.18. 212 police personnel have android type of obesity.182 police personnel have high fat percentage .110 traffic police personnel have altered lumbar angle. Thus appropriate preventive measures need to be undertaken for safe guarding the health and occupational well-being of traffic police.
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Introduction: Lumbar pain is a public health problem which carries some kind of functional limitation in the individual affecting the quality of life of police personnel. Objective: Linking lower back pain to anxiety and depression in police officers at a police station in Lima. Methods: It is research with a quantitative, descriptive, transversal analytical and correlal approach, there was the participation of 110 participants, which was obtained through a probabilistic show where all participants had the same opportunity to participate, was conducted at the Monserrat Commissioner, a questionnaire survey was used to measure lower back pain in police personnel "CDLPP" whose reliability was 0.914 alpha crombach and to measure anxiety and depression Zung's test. Results: 75.5% of police officers with lower back pain were shown. A statistically significant relationship between anxiety and lower back pain (p-0.028) was also evident. Similarly, there was no statistically significant association between lower back pain and depression (P > 0.05). Conclusion: Lumbar pain is associated with anxiety in police officers, a police station in Lima. Also a high percentage of police officers suffering from lower back pain, considering that it is a public health problem, which could lead to future some type of disability affecting their quality of life.
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Background: The work environment constitutes an important part of man’s total environment, so health to a large extent is affected by work conditions. These personnel have to undergo physical strain in an environment polluted by fumes, exhaust of vehicles, use of blowing horns, blow of dust in the air by the speeding vehicle, under hot sun, etc. Objective: To assess the health status of the traffic police personnel in Chennai city. Methodology: Cross sectional study was conducted among 139 traffic police personnel in Chennai city. Afterobtaining informed consent,information regarding socio-demographic profile, job experience and physical health profile was collected using a pre-structured proforma. Results: Among the study population, 134 (96.4%) were males and 5 (3.6%) were females. Thirty two (23%) were diabetic, 32 (23%) were hypertensive, 17 (12.2%) had respiratory problems, 26 (18.7%) had skin problems, 70(50.4%) complained of low back pain, 34 (24.5%) reported eye problems, 20 (14.4%) had low PEFR, and 18 (12.9%) were found to have varicose veins by Trendelenberg’s test. Significant association (p<0.05) was found between years of service with diabetes, hypertension, abnormal waist circumference and usage of personal protective equipment (maskand sunglasses). Conclusion: Regularscreening and health education programs need to be implemented. Lifestyle modification, smoking and alcohol control and stress alleviation should be an integral component of these health-related activities.
Full-text available
The aim of this study was to determine the bona fide occupational requirements of general duty police work, and use this information to re-validate a physical abilities test used in the police recruit selection process. A systematic random sample (n = 267) of general duty police officers completed two questionnaires: one concerning “average” duties, and one concerning the most physically demanding critical incident occurring in the 12 months prior. Of those completing the surveys, observational data were collected on every second officer, resulting in observational data collected for 121 officers, involving the recording of all physical activities and movement patterns observed throughout a ten hour shift. Data collected suggest there is a core of bona fide occupational requirements for general duty police work – walking, climbing stairs, manipulating objects, twisting/turning, pulling/pushing, running, bending, squatting and kneeling, and lifting and carrying. Many of these are involved in physical control of suspects, and can be tested using a well designed physical abilities test that simulates getting to the problem, controlling the problem, and removing the problem.
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The purpose of this paper was to review and appraise pertinent articles to gain a better understanding of critical methodological issues necessary to properly design a high-quality back pain prognosis study. The review concentrated on back pain prognosis studies with epidemiologically sound designs focusing on work-disability outcomes and utilizing survival analytic methods. Nine papers were reviewed. There were few well-designed studies that achieved good scientific quality with minimal flaws. The outcomes were well defined in each paper. The age and sex characteristics of the cohorts were described in six papers and an adequate description of the study site occurred in five papers. All papers employed suitable mathematical/statistical techniques, but only one paper discussed accuracy and predictive value. No paper addressed the issue of reproducibility of the predictor variables or the final model. Most papers derived models that were clinically sensible, and the ease of use for clinicians was high. A recommended course of action for use by future patients/therapists in prognostication was rarely documented. To date, prognosis has been an inadequately studied aspect of the continuum from back injury to recovery. Researchers and clinicians interested in prognosis research need to overcome the limitations of past designs and address the methodological guidelines outlined to improve the quality of future prognosis studies.
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To examine changes in musculoskeletal complaints over four years in groups of employees relative to age and work demands. Repeated questionnaire data of male employees in heavy physical work (exposed group, n = 7324) and mental work (control group, n = 4686), stratified for age (20-9, 30-9, 40-9, 50-9), were analysed. For each employee, data on the occurrence of musculoskeletal complaints from two surveys with a mean interval of around four years were available. Changes in prevalences over the follow up interval were analysed. Proportions of new, recovered, and chronic cases as well as those free of complaints at both surveys were studied. For most complaints, there were significantly greater increases in prevalences in the exposed group compared with the control group over the follow up interval particularly within the group aged 40-9 for back, neck, and several sites of the upper and lower limbs. The 20-9 year age group also had significantly greater changes for several musculoskeletal complaints. Within the oldest age group (50-9) exposure to heavy physical work demands only affected changes in prevalences of neck and upper arm complaints. After four years in the cohort free of complaints at the start of the follow up the group aged 40-9 had the highest prevalence of complaints of the back, neck, and the upper and lower limbs. Middle aged and younger employees develop musculoskeletal complaints as a result of exposure to heavy physical work. In the oldest age group health related selection seems to mask the occupational health risks under study. To prevent the expected increase in musculoskeletal disorders and related work disability in our aging workforce, preventive measures should be taken at all stages of a working life.
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The frequency, incidence and severity of low back pain was assessed by a random telephone survey of 314 urban New Zealanders. Relationships between the severity and frequency of low back pain and referred lower extremity pain and other variables such as occupation, recreation, age, sex and predominant working posture was analysed. Point incidence was 17.5%, weekly incidence 33.4%, yearly incidence 63.7% and total incidence 79%. Some 28.3% get frequent minor episodes and 6.4% get frequent severe episodes of low back pain. Nearly 50% suffer the initial episode before the age of 30 years. Of those suffering low back pain within the last seven days, 14.3% experience reference below the knee and the total incidence of below knee pain was 13.7%. Over half (51.6%) have pain that has lasted seven days or less, but a third have had pain for longer than seven weeks. No correlation between the incidence of low back pain and referred pain and occupational posture was found. In conclusion, this telephone survey established that the incidence of low back pain in New Zealand is similar to that reported in overseas studies. The survey could not establish differences in low back pain characteristics across different social groupings, nor could a relationship between occupational posture and low back pain be established.
Physiological and psychological stressors, disease state, and psychosocial factors may influence recall accuracy in low back pain (LBP) reporting. The literature indicates that duration or frequency of the painful episode(s) may exert a greater influence on recall accuracy than pain intensity. The focus of this study is the recall accuracy in self-report of pain by a chronic, nonspecific LBP population. This retrospective study examined recall accuracy of LBP at 1-week, 1-month, and 6-month intervals as compared to self-report using daily pain diaries. Significant differences in recall accuracy were found at the 6-month recall period, but not at the 1-week or 1-month periods. Significant differences in accuracy were found between men and women at the 6-month recall period. Subjects with recurrent LBP were more accurate than subjects with more chronic pain. Pain level or intensity was not shown to effect recall.
Conditions typical of many low-status jobs are known to induce elevated stress. In keeping with this, blue-collar workers show elevated psychophysiological stress levels both during and after work compared with workers in more stimulating and flexible jobs. Health-related behaviors, such as cigarette smoking and drug abuse, that are known to contribute to the social gradient in health, can be seen as ways of coping with a stressful work situation in order to get short-term relief. Negative emotional states associated with low-status jobs, combined with a lack of economic resources, are also likely to reduce the individual's motivation to seek proper medical treatment and, thus, increase the risk that transient symptoms develop into chronic illness. With regard to musculoskeletal disorders, it is well documented that physically monotonous or repetitive work is associated with an increase in neck, shoulder, and low back pain problems. However, recent studies also report an association between psychosocial factors and muscle pain syndromes. Possible mechanisms explaining these findings involve the assumption that psychological stress may induce sustained activation of small, low-threshold motor units that may lead to degenerative processes, damage, and pain. Analysis of short periods of very low muscular electrical activity (EMG gaps) shows that female workers with a high frequency of EMG gaps seem to have less risk of developing myalgia problems than do workers with fewer gaps. Stress induced by psychosocial conditions at work, which is usually more lasting than that resulting from physical demands, may prevent the individual from shutting off their physiological activation and reduces the time for rest and recovery. In the modern work environment, with strong emphasis on a high work pace, competitiveness, and efficiency, it is possible that lack of relaxation is an even more important health problem than is the absolute level of contraction or the frequency of muscular activation.
To study the long-term health effect of whole-body vibration, a questionnaire on symptoms of ill health was mailed to 242 drivers and a reference group of 210 workers from six harbor companies (response 81%). Vehicles driven were fork-lift trucks and freight-container tractors. Vibration level during a representative working period (vector sum of the frequency weighted acceleration in the x-, y-, and z-directions) was 0.8 m/sec2 for the fork-lift trucks and 1.0 m/sec2 for the freight-container tractors. Only the results concerning self-reported symptoms of the back are described. Of the young (less than 35 years), short-term-exposed drivers, 68% reported that they had back pain regularly vs. only 25% of the reference group of comparable age. With increasing age, the difference in the prevalence of self-reported regular back pain between the drivers and the reference group disappeared. Driving during the 5 years preceding the onset of symptoms seemed to increase the risk of back pain, whereas earlier exposure did not.
Low back pain and fibromyalgia represent two of the most common disorders in developed countries. On the whole, up to 75% of the general population has, at some time, suffered from low back pain. A percentage ranging between 5 and 10% of them develops a chronic illness. In most countries, the incidence rate per year of low back pain is 5%. Most low back pain episodes occur between the ages of 25 and 55 years. Most studies have not found any clear influence between genders and frequency of low back pain. There is a relationship between low back pain and occupation, with those who have physically demanding jobs being more at risk. As regards fibromyalgia, the prevalence rates range between 6 and 20%, with a higher frequency among females and between the ages of 25 and 55 years. The direct and indirect costs of low back pain approach $24 billion per year in the U.S. It is in view of its high prevalence among populations of developed countries, of its heavy psychosocial and financial implications, and of the burden imposed on health services, that low back pain represents a severe public health problem.
The frequency of sciatic pain, lumbago, and nonspecific low-back pain (LBP) and factors related to these symptoms were determined among men occupied in machine operating (541 longshoremen and 311 earthmover operators), dynamic physical work (696 carpenters), and sedentary work (674 municipal office workers). Sciatic pain was more common among machine operators and carpenters than among office workers, and also more frequent among machine operators than among carpenters. The occupational differences were considerably smaller with regard to lumbago and nonspecific LBP. In multivariate analysis, occupation, age, reported back accidents, and postural load showed significant independent effects on the occurrence of sciatic pain. Allowing for other risk indicators, the relative risk was 1.3 contrasting machine operators with both office workers and carpenters, but carpenters had no excess risk as compared with office workers.
This study was performed to estimate the discriminatory power of multiple combinations of risk indicators for the occurrence and recurrence of low-back trouble (LBT) in workers. Two categories of LBT provided groups for discrimination; 1) the presence or absence of LBT history, and 2) three patterns of recurrence characterized by the number of episodes (isolated, periodic, chronic). The risk indicators comprised data reflecting occupational and leisure demands on the back, measures of lumbar sagittal mobility, and anamnestic features of the first episode. Discriminant analysis was the statistical procedure used. The results showed that it was possible to find linear combinations of the discriminating variables that successfully allocated around two-thirds of the sample to the correct group. The presence of a history of LBT was predicted by the combined effect of increasing age and adult sports participation, but only in females did a heavier job contribute to such prediction. A reduction in risk was associated with lumbar flexibility and sports participation at school. Chronic LBT was more accurately identified than the two other groups; increasing age, a long initial spell, and an onset early in life were associated with increased likelihood of chronicity, while a report of symptoms being relieved by sitting reduced this risk. It is concluded that the occurrence and recurrence of LBT are related to combinations of risk indicators, and that it is imperative to consider the interactive effect of a multiplicity of factors in epidemiologic studies.