Shawn Buchanan is a strong proponent of wearing back belts to prevent injuries when doing heavy lifting on the job.
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It’s his responsibility, in fact, to help make sure that hundreds of workers have taken the time to strap the protective devices around their midsections at the Wal-Mart Super Center store where he is an assistant manager.
“All of our sales associates are supposed to wear them so that we can cut down on back injuries,” he said at the Dallas store. “You never know when a customer is going to ask you to pick up a television or something.”
So it comes as a surprise, perhaps, that a recent national study involving Wal-Mart employees has found that wearing a back belt does not reduce the overall number of complaints about lower back pain or the number of back injuries.
The results were published in the Journal of the American Medical Association.
“Neither frequent back belt use nor a store policy that required belt use was associated with reduced incidence of back injury claims or low back pain,” concluded researchers for the National Institute for Occupational Safety and Health.
But Wal-Mart has not figured out what to do about back belts, which are mandatory in some stores and optional in others.
“We haven’t changed our policy,” regarding use of the belts, says Wal-Mart spokesman Tom Williams.
“But we really want to probe the study data with them, especially because it was data that was collected at Wal-Mart.”
While various studies have come down on both sides of the debate, the latest research is considered the most comprehensive so far.
It included interviews with 6,311 employees in 160 Wal-Mart stores in 30 states. It compared back injuries and complaints between those who used a company-issued belt with those who did not.
The belt was constructed of stretchable nylon material with Velcro ends and mesh in the back. All employees were given a short training session on how to tighten the belt and when to use it.
Among the workers who took part in the study and completed a follow-up interview, there were 1,088 cases of back pain.
Those with a history of previous back injury were the ones most likely to report further pain or injury, the study found.
“Back pain was not different between those who reported wearing a belt every day compared with those who reported never wearing a belt,” the report states, “and the back injury claim was not different for these groups.”
The study is significant because back injuries account for nearly 20 percent of all on-the-job injuries and illness in U.S. workplaces, according to the institute, which placed the cost of such injuries between $20 billion and $50 billion each year in medical costs and absenteeism.
While the debate has raged, back belts, also known as back supports or abdominal belts, remain standard equipment for millions of grocery store clerks, airline baggage handlers and warehouse workers.
There are about 70 styles of back belts on the market. In 1995, more than 4 million were sold.
Previous studies indicated that using a back belt might be helpful in preventing lower back pain and back injuries.
The broadest study, a six-year look at employees of Home Depot stores in California, was released in 1996.
It suggested that the belts reduced the rate of back injuries for employees who used them and who were provided training in body mechanics.
The theory is that back belts help hold the numerous ligaments, tendons and other soft tissues that surround the back.
A belt, supposedly, decreases the movement between the segments of the spine, therefore decreasing the likelihood of damage to the discs in the lower back.
But this idea has not been proven, researchers say.
Dr. Michael Perkins, who has a worker’s comp practice in Austin, Texas, says his 1995 review of all back belt studies found no proof that the devices worked as promised.
“We were not able to find any convincing scientific literature that supported the contention that they prevent back injury,” he recalls of the study he conducted with others at the University of California at Irvine.
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Another element of the debate is a growing concern that back belts can elevate a worker’s blood pressure and pelvic pressure. Employees have complained that the belt increases sweating and causes heat rash, particularly in warm environments. Worse yet, the National Institute for Occupational Safety and Health says the belts may give employees a false sense of security, encouraging them to lift heavier loads than may be safe.
Wal-Mart, the nation’s largest employer, decided to join the debate by giving researchers access to its employees between 1996 and 1998, Williams said. Like other employers across the nation, Wal-Mart had adopted the safety device over the past decade, requiring their use in certain departments where employees routinely lift objects that are 20 pounds or heavier.
“In the early ’90s, we had a number of questions from associates in the stores when they saw our vendors wearing back belts,” Williams recalls.
“We supplied belts to people who requested them until the mid-’90s, when they became mandatory in shipping and receiving areas of the stores and voluntary in other areas.”
More recently, Wal-Mart also has been redesigning its checkout counters to try to reduce back stress among employees who stand for long periods of time and lift merchandise, he says. “We wanted to allow the employees to put a foot up on a shelf behind the counter or to stand closer to the customer by having their feet in a space under the counter.”
The AMA offers some alternatives to back belts. They include getting regular exercise and stretching to strengthen back muscles and make them more flexible.
Heavy lifters should avoid standing in one position too long and should lose weight if they need to.
Federal safety experts also recommend implementing an ergonomics program that focuses on redesigning the work environment and work tasks to reduce the hazards of lifting.
Any change in Wal-Mart’s use of the belts will take some educating of its workforce, however, because some managers are sold on the idea that they work.
“I still think they help,” Buchanan says after being informed of the recent back belt study. “It gives you more support and it helps you bend properly when you’re trying to pick something up. When you take it off, your whole gut falls out. So it must be doing something.”