Introduction

The use of abdominal belts (back belts) in the workplace has increased remarkably over the last few years. Grocery clerks, delivery drivers, hotel staff and a variety of personnel in both service and manufacturing operations, use abdominal belts. With the rapid proliferation of belt use, several questions have been raised: Are abdominal belts effective in preventing back injuries? Who should wear and use abdominal belts? Does their use increase productivity? Does belt wearing reduce muscular fatigue?

Review of Studies

In the clinical trials, the first trial evaluated 81 male warehouse workers. The study reviewed three groups (a control group, a group which received ½ hour training on lifting, and a group that received 1 hour training and lumbar supports). From the study there appeared to be some increased benefit to workers who had a previous low-back injury.

The second trials evaluated belt use among baggage handlers that worked for a major airline. There were four groups that received: no belts, belts (no training), belts and training, and a one-hour back training session (no belt). The overall conclusion found no significant differences between the groups when total lumbar injury incident rates, lost workdays or workers' compensation rates were compared.

In the biomechanical studies, evidence supporting and not supporting the benefits of abdominal belts was contrasted. Both studies used the hypothesis that intra-abdominal pressure during belt use was a useful indicator to determine the effectiveness of abdominal belts. The pro-belt study concluded that intra-abdominal pressure indicated an increase in lower back support while the opposite view concluded no effect or actually increased load on the spine came from belt use.

The physiological studies found blood pressure and heart rate to increase while study participants wore belts and performed varied exercises. One author concluded that individuals with cardiovascular problems may be at a greater risk while performing exercise and wearing back supports.

In the psychophysical studies, participants were able to select weights to lift repeatedly based upon their own subjective perceptions of physical exertions. It was noted that subjects that wore belts were willing to increase load lifts by almost 20%.

Summary

A review of the available data regarding abdominal belt use is inconclusive to strongly support or discourage belt use. The following items are suggested as points of reference and information to consider for a new or existing abdominal belt program:

• Abdominal belts should not be distributed until a comprehensive ergonomic evaluation of an individual's job tasks has been performed.
• Personnel with high blood pressure and other cardiovascular problems should be evaluated by medical personnel before being issued an abdominal belt.
• All belt wearers should receive training in lifting mechanics.
• Belts should not be considered for long term use.
• A monitoring program should be initiated to document any increased injury.
• Providing belts to all employees is not an effective method to reduce injuries and potential claims. There may be no additional benefit to uninjured workers from belt use.
• Supervisor involvement to assure correct belt usage is highly recommended.

If a decision to use or try abdominal belts is reached, the belts should be given the same consideration as safety or personal protective equipment. This involves a belt program coordinator, careful selection (one size may not fit all) fitting, education and training, and periodic evaluation.