Back injuries are the leading cause of disability in the United States for people younger than 45 years of age and have been the most expensive health care problem for the 30-50 year old age group [Bureau of Labor Statistics. Lost work time injuries and illnesses: Characteristics and resulting time away from work. U.S. Department of Labor, Washington, D.C., 1998.].

There is evidence that low back belts are helpful in protecting the worker from low back injury. However, there is a pervasive feeling that wearing these belts confers absolute protection. That is not the case. Workers need to be instructed in proper lifting techniques. The back belts need to be part of a comprehensive program of back care stressing proper ergonomics, correcting potential back overload situations, and educating workers on injury avoidance.

At the same time workers need to be screened for cardiovascular risk. Mounting data indicates these back belts are responsible for significant increases in blood pressure and heart rate. Obviously, this poses a hazard for patients who already have other risk factors for cardiovascular disease.

Finally, the worker should be told not to wear the belt for extended periods of time In addition, workers should be instructed in proper core strengthening techniques along with general overall fitness.

"Back school" education and assessment of the job site for proper ergonomics is also recommended.

Summary tips:

? Maintain ideal weight ? Exercise regularly ? Maintain proper body mechanics and core strengthening ? Learn proper lifting techniques and make sure the work area is ergonomically "friendly" ? Use back belts judiciously ? Get your heart and blood pressure checked out.