Cut-points to prevent low back injury due to force exertion at work

Force exertion is related to low back injuries (LBI). This paper critically reviews the literature concerning cut-points for back force exertion, presents available guidelines in a concise manner, and identifies areas that need further research. The studies reviewed were grouped according to the criteria used to set the cut-point values. Most often cut-points differ than concur. The approach considering physiological, psychophysical, epidemiological, and biomechanical aspects of back force exertion meets the most known criteria and presents the lowest common denominator of instantaneous load for lifting tasks. Further experimental and epidemiological studies in peak load and cumulative exposure are necessary. Compound indices should also be developed for pushing, pulling, and carrying. Future indices should consider electromyographically determined fatigue, differential viscoelastic properties of tissues, aging, and the cross sectional area of back muscles. We hope that this paper contributes to a more systematic appraisal of back force exertion at work.