Manual rolling load and low back pain among workers in Japan: a cross-sectional study.

OBJECTIVES: Manual rolling of heavy objects remains in the workplace. The Health and Safety Executive (HSE) in the United Kingdom recommends load weights of <400 kg in the rolling task. However, the association of rolling weights <400 kg with work-related low back pain (LBP) has not been sufficiently investigated. This study examined the effect of rolling loads weighing <400 kg on LBP among Japanese workers. METHODS: A web-based survey gathered information from 15 158 workers in 2022. Among them, 15 035 did not handle loads, whereas 123 handled rolling weights <400 kg. Load weight was categorized into 4 groups: no-handling (0 kg) and rolling weights of ≤20, 20-40, and >40 kg. Multiple logistic regression analysis examined the association between the subdivided rolling weight and LBP. RESULTS: No significant differences in odds ratio (OR) of LBP were found for workers handling ≤40 kg rolling weights compared with that for no-handling workers. However, workers handling >40 kg rolling weights had a significantly greater OR of LBP than those not handling loads. CONCLUSIONS: Rolling weights between 40 and 400 kg could place a high stress on the lower back. Implementation in Japan of the HSE recommendations regarding rolling load should be carefully considered.

Validity and reliability of Japanese version of the MAPO index for assessing manual patient handling in nursing homes.

OBJECTIVES: Low back pain (LBP) among caregivers in Japanese nursing homes has long been considered an occupational health issue. This study aimed to verify the reliability and validity of our developed Japanese version of the Movement and Assistance for Hospitalized Patients (J-MAPO) index, a risk assessment tool for LBP, in nursing homes. METHODS: Two inspectors assessed 15 nursing homes using J-MAPO, and deduced 3 LBP risk levels as follows: low, moderate, and high risk. Caregivers in nursing homes responded to a self-administered questionnaire on LBP over the past 12 months. Data from 296 caregivers with no missing data were used. We further used logistic regression models to analyze the association between LBP as a dependent variable, and J-MAPO risk level as an independent variable. We used Cohen kappa coefficient to assess interrater reliability to further assess the agreement between the 2 inspectors. RESULTS: The multivariate logistic regression analysis showed that the adjusted odds ratio and 95% CIs for LBP increased progressively with J-MAPO risk level (Low-risk: 1.00; Moderate-risk: 1.70 [0.74-3.91]; High-risk: 2.67 [1.28-5.56]). Furthermore, the J-MAPO risk levels assessed by the 2 inspectors were in perfect agreement (κ = 1) observed for interrater reliability using Cohen kappa coefficient. CONCLUSIONS: There was high interrater reliability, and J-MAPO risk levels were associated with LBP. Therefore, our results suggest that the J-MAPO is a useful risk assessment tool for LBP in Japanese nursing homes.

Effect of occupational pushing and pulling combined with improper working posture on low back pain among workers.

This study aimed to investigate the impact of occupational pushing and pulling combined with improper working posture on work-related low back pain (LBP) among workers. A web-based survey was conducted in 2022 to collect data from 15,623 workers, who were categorized into proper and improper working posture groups. Multiple logistic regression analysis was used to analyze the association between pushing and pulling loads and LBP in each group. In the proper working posture group, the odds ratios (ORs) of LBP for workers who pushed and pulled were not significantly different compared with those of no-handling workers. However, in the improper working posture group, the ORs of LBP were significantly greater among workers who pushed and pulled compared with those of no-handling workers, and this association became stronger with increasing weights. Therefore, improper working posture combined with pushing and pulling were strongly associated with LBP among workers, particularly with heavier weights.

Effect of relative weight limit set as a body weight percentage on work-related low back pain among workers.

INTRODUCTION: A quarter of work-related low back pain (LBP) cases result from handling heavy loads in Japan. The maximum weight male/female workers can handle is 40%/24% of their body weight but has set a constant load weight in ISO 11228-1 and NIOSH lifting equation. The preventive effect of the relative weight limit on LBP has not been clarified. This study aimed to identify the effect of relative weight limits set as body weight percentages on LBP prevalence. METHODS: Data from 21924 workers were collected via a web-based survey in 2022. The workers were categorized into three groups: group A, "no handling," group B, "handling loads up to 40%/24% or less of body weight," and group C, "handling loads over 40%/24% of body weight." Moreover, they were categorized into eight groups: no handling, 1-5 kg, 5-10 kg, 10-15 kg, 15-20 kg, 20-25 kg, 25-30 kg, and ≥30 kg. Multiple logistic regression analysis was used to identify the effects of the limits set to body weight percentages and constant load weights on LBP. RESULTS: In groups A, B, and C, 25.5%, 39.2%, and 47.3% of males or 16.9%, 26.4%, and 38.0% of females had LBP, respectively. The odds ratio (OR) of LBP was significantly greater in group B than in group A and even greater in group C. The OR of LBP among workers handling loads under 10 kg was not significantly different compared to no-handling workers. CONCLUSIONS: LBP prevalence was greater in group B than in group A but lesser than in group C. Weight limits based on body weight percentages could not eliminate the factor of handling loads. However, handling loads under 10 kg suppressed LBP. Relative weight limits set as body weight percentages were inappropriate and ineffective for preventing LBP.

Organization factors influencing quality of work life among seniors' care workers with severe low back pain.

OBJECTIVES: The prevalence of work-related low back pain (LBP) is high among care workers and can negatively affect quality of work life (QWL). To improve workplace satisfaction, this study aimed to identify factors influencing QWL among seniors' care workers with severe LBP. METHODS: A questionnaire survey including items on demographics, qualifications, basic job responsibilities, job stressors, LBP severity, QWL, and job satisfaction was conducted in 2018. In total, 1000 senior care facilities were selected via random sampling and eight care workers per institution were asked to complete the survey. Multiple logistic regression analysis was used to identify independent factors influencing QWL of care workers with and without severe LBP. RESULTS: Data from 1247 care workers with severe LBP and 2009 with nonsevere LBP were included in the analysis. Overall QWL was lower in the severe LBP group than in the nonsevere LBP group. In both groups, human relationships, workplace support, discretionary responsibility level, and working hours or time off were identified as common factors influencing QWL. In the severe LBP group, the salary was also a significant influence on QWL, while in the nonsevere LBP group, the number of workers, promotion or official position, and caregiving technique were identified as significant QWL factors. CONCLUSIONS: The QWL of care workers with severe LBP was strongly influenced by salary. Since care workers suffering from severe LBP are working for a salary while enduring the pain and do not have found a worth doing, they need to prevent LBP and get job satisfaction and self-progress.

Computer and Furniture Affecting Musculoskeletal Problems and Work Performance in Work From Home During COVID-19 Pandemic.

OBJECTIVES: We surveyed how home-working conditions, specifically furniture and computer use, affected self-reported musculoskeletal problems and work performance. METHODS: Questionnaires from 4112 homeworkers were analyzed. The relationship between subjective musculoskeletal problems or work performance and working conditions were determined by logistic regression analyses. RESULTS: More than half the homeworkers used a work desk, work chair, and laptop computer. However, approximately 20% of homeworkers used a low table, floor chair/floor cushion, or other furniture that was different from the office setup. Using a table of disproportionate size and height, sofa, floor cushion, and floor chair were associated with neck/shoulder pain or low back pain. Disproportionate table and chair, floor cushion, and tablet computer were associated with poor work performance. CONCLUSIONS: Disproportionate desk and chair, floor cushion/chair, and computer with small screen may affect musculoskeletal problems and home-working performance.

Relationship between using tables, chairs, and computers and improper postures when doing VDT work in work from home.

This study focused on everyday furniture and computers used in work from home and aimed to investigate how improper postures increase the risk of musculoskeletal disorders using different combinations of tables, chairs, and computers. Twenty-one healthy participants were asked to perform a visual display terminal task for 30 minutes in a laboratory modeled on the work from home concept. Seven experimental conditions were set up according to the different combinations of desks, chairs, and computers. Three-dimensional body posture was measured using a magnetic tracking device. The results showed that when using a low table, floor chair, and laptop computer, the body posture above the hip was similar to that when using a dining table, chair, and desktop computer. When using a sofa, and tablet computers, or laptop computer, severe neck flexion, which is stressful to the neck, was observed. Moreover, excessive low back flexion was observed when using a floor cushion and laptop computer. We suggest that computer work while sitting on a sofa or floor cushion without a backrest is harmful to the neck and low back.

[Occupational low back pain in reports of workers' casualties between 2018 and 2019].

OBJECTIVES: Reports of workers' casualties include occupational low back pain (LBP), accounting for approximately 60% of compensable occupational disease. While LBP has become an important safety and health problem, the occurrence of occupational LBP has not been analyzed recently. This study aimed to evaluate the occurrence of occupational LBP in reports of workers' casualties between 2018 and 2019. METHODS: The study included 10,208 cases of occupational LBP (2018, n = 5,043; 2019, n = 5,165). Data on the location and date of industrial accidents, as well as type and size of business, age, sex, and leave period of the victims were tabulated. RESULTS: The number of occupational LBP cases was the highest in the health and hygiene industry (31.3%), followed by the commercial, manufacturing, and transportation industries. In the health and hygiene industry, social welfare facilities were listed in 24.3% of the total cases, and many caregivers suffered from LBP. Occupational LBP cases were less in cold regions and few during the cold period between November and January. Several occupational LBP cases occurred on Mondays following a holiday, and approximately 40% occurred between 9 a.m. and 12 a.m. Occupational LBP was frequently reported in workplaces with a volume of 10-49 workers, such as social welfare facilities in terms of business type. In terms of work-related accident victims per 100,000 workers, women were slightly more prone to LBP than men, and most of them were in their 20s and 30s. Approximately 60% of the leave period taken by victims was 2 weeks maximum. CONCLUSIONS: Occupational LBP was experienced by most workers in workplaces with at least 10-49 workers, such as social welfare facilities, between 2018 and 2019. In addition, LBP was more common in women than in men. Most workers with LBP take a leave period of 2 weeks. Suitable measures should be taken to prevent occurrences of occupational LBP.

[Factors affecting quality of working life among caregivers in care facilities for the elderly].

OBJECTIVE: Theshortage of caregivers in care facilities has become a problem in Japan. Building a comfortable workplace and improving the quality of working life (QWL) of caregivers are essential. However, the factors of QWL that should be prioritized remain unclear. The purpose of this study was to identify the major factors currently affecting the QWL of caregivers in care facilities for the elderly and recognize the priorities that should be addressed. METHODS: A questionnaire survey targeting administrators and caregivers working in care facilities for the elderly was conducted from October to December in 2018. In total, 1,000 care facilities located throughout Japan were selected via random sampling. Eight caregivers who differed by sex, age, and years of experience were selected from each facility (a total of 8,000 caregivers). A logistic regression analysis was used to analyze the association between QWL and the factors affecting it. RESULTS: Ultimately, data from 504 facilities and 3,478 caregivers were included in the analysis. Human relationships (OR: 3.92, 95% CI: 3.09-4.97) had the highest odds ratio in terms of caregivers' QWL, followed by the number of workers (OR: 3.69, 95% CI: 2.56-5.32), communication (OR: 3.42, 95% CI: 2.66-4.40), support from the facility (OR: 3.37, 95% CI: 2.69-4.23), working hours or time off (OR: 3.20, 95% CI: 2.53-4.04), and discretion of responsibility level (OR: 3.09, 95% CI: 2.46-3.88). In contrast, salary (OR: 2.81, 95% CI: 2.19-3.61) was associated with QWL but the association was lower than that of human relationships and the other factors. Lower back pain among caregivers was also associated with QWL. CONCLUSIONS: Findings of this study show that improvement in human relationships is the primary factor for improved QWL among caregivers in care facilities. Thus, it should be prioritized. Secondary factors that affect QWL are the number of workers, communication, support from the facility, working hours or time off, and discretion of responsibility level. Considering the reasons for caregivers' dissatisfaction, improving their QWL requires promoting the exchange of information with superiors and colleagues. It also involves consulting with persons in charge about working hours, time off, and mental health. Salary is related to QWL but is less important than the aforementioned factors. The prevention of lower back pain, however, contributes to improving QWL.

Changes in risk factors for severe low-back pain among caregivers in care facilities in Japan from 2014 to 2018.

In Japan, the practice of the no-lift policy, which states that care recipients should be lifted with care equipment rather than by human power, has been increasing since around 2014. The purpose of this study was to examine whether severe low back pain (LBP) risk factors in caregivers changed between 2014 and 2018. A questionnaire survey targeting administrators and caregivers working in care facilities for the elderly was conducted in 2014 and 2018. A total of 612 facilities and 2,712 caregivers responded to the questionnaires in 2014, and 504 facilities and 3,478 caregivers completed the questionnaires in 2018. The percentage of caregivers who experienced severe LBP did not differ significantly between 2014 (37.3%) and 2018 (38.3%). However, the number of facilities that introduced care equipment for transfer increased in 2018. Moreover, the number of participants who received training on care methods and using care equipment increased. Lifting a facility resident using human power and taking an unsuitable posture were associated with severe LBP in 2014, but only taking an unsuitable posture was associated with severe LBP in 2018. As taking an unsuitable posture remains to be a primary risk factor for severe LBP, it needs to be addressed in care facilities.

[Current status of annual health check-ups for part-time employees in Japan].

OBJECTIVES: The number of part-time staff is increasing every year, and they are becoming very essential in completing the workforce. Healthcare and assurance for part-timers will be an important issue in the future. The purpose of our study was to collect recent data and examine the status of health management for part-time employees in workplaces. METHODS: We administered a questionnaire to part-time staff at 14,000 workplaces that were randomly selected from a nationwide list of workplaces. Of the 4,718 respondents, 4,652 valid cases were analyzed. Part-timers were classified as those working more than 3/4 (Category 1), more than 1/2 and less than 3/4 (Category 2), and less than 1/2 (Category 3) of the routine working hours of full-time employees. RESULTS: A total of 97.2% of workplaces conducted regular medical health check-ups (medical check-ups) for full-time employees. The percentage of workplaces conducting medical check-ups for part-timers was lower as their working hours were fewer; only 32.2% of workplaces conducted medical check-ups for Category 3 part-timers. The percentages were lower for smaller workplaces, and workplaces with 29 or fewer employees had the lowest percentage for Category 3 part-timers (27.9%). The percentage of employers bearing the full cost of medical check-ups was lower for Category 1 (90.5%), 2 (87.7%), and 3 (85.0%) part-timers than that for full-time employees (93.7%). CONCLUSIONS: The rate of regular medical check-ups in workplaces was lower for part-timers, as their working hours were shorter, and workplaces were smaller. Expanding health management in workplaces may be necessary owing to the diversity in working styles.

Impact of health literacy on health practices in the working life of young Japanese nurses and care workers.

To continue to work healthily, health practices are necessary. This study assessed the impact of health literacy (HL) on health practices in the working life of young Japanese nurses and care workers, occupations with heavy physical and psychological burdens. A web-based survey was conducted with 500 women (330 nurses and 170 care workers) under the age of 30 in 2019. Data regarding their demographic characteristics, HL and health practices in their working life were collected. A significant association was found between high HL and better health practices, such as being likely to rest when tired, working at their own pace maintaining a good work-life balance and regularly performing self-check-ups, which were common to nurses and care workers. In addition, sub-analysis among the high-HL group revealed that the attendance of lectures regarding working life and health for new employees was effective for taking rest when needed, working when not overtired and a good work-life balance. The results of this study suggest that high HL relates to healthy practices in the working life of young Japanese nurses and care workers. Increasing HL or fundamentally enhancing attitudes towards their own health or both may, therefore, have some benefits for healthy working practices.

Priority approaches of occupational safety and health activities for preventing low back pain among caregivers.

OBJECTIVES: The incidence of occupational low back pain (LBP) is high among caregivers. The use of care equipment and training about care methods could prevent LBP among caregivers. However, in care facilities in Japan, these measures are not adequately employed. Moreover, the care facilities have faced issues regarding poor staffing in recent years. The present study investigated the relationship between LBP and occupational safety and health activities (OSHAs) for preventing LBP among caregivers and aimed to validate the priority approaches of OSHA. METHODS: This cross-sectional study was conducted in care facilities for the elderly in Japan. Questionnaires for administrators and caregivers were distributed to 1,000 facilities and 5,000 caregivers, respectively. Questionnaires completed by 612 facilities and 2,712 caregivers were analyzed. RESULTS: No direct association was observed between severe LBP and OSHA, but indirect association was done. A significant relationship was noted between severe LBP and the care methods. Direct factors causing severe LBP were lifting a resident using human power and taking an unsuitable posture. These care methods were associated with the following OSHAs: promoting the use of care equipment, training about care methods, and consultation regarding the use of care equipment and employing an appropriate care method with the person in charge. CONCLUSIONS: These OSHAs decreased lifting a resident using human power and taking an unsuitable posture, which are the primary risk factors of LBP. Therefore, these OSHAs should be implemented as priority approaches to prevent LBP among caregivers in care facilities for the elderly.

Effectiveness of re-education based on appropriate care methods using welfare equipment on the prevention of low back pain among care workers: a 1.5†year follow-up study.

Many care workers at elderly care facilities in Japan suffer occupational low back pain (LBP) despite the utilization of welfare equipment. When introducing welfare equipment such as hoists and sliding boards, education on appropriate care methods using welfare equipment is usually conducted, but the effect of education diminishes with time. This intervention study aimed to examine the effect of re-education on appropriate care methods using welfare equipment on the prevention of care workers' LBP at an elderly care facility. At the intervention facility, 49 care workers were enrolled in ergonomic education program for 1.5 yr in order to improve care methods using welfare equipment. At the non-intervention facility, 33 care workers were not enrolled in the program. Rates of severe LBP were not significantly different between the facilities. However, during the study period, the rate of severe LBP among care workers did not increase at the intervention facility, while it doubled among care workers at the non-intervention facility. The care workers at the intervention facility showed improvement in care methods using welfare equipment during the study period. Hence, we think that re-education regarding appropriate care methods using welfare equipment has the potential to prevent exacerbation of LBP.

White-collar workers' hemodynamic responses during working hours.

In the present study, two investigations were conducted at a communication center, to examine white-collar workers' hemodynamic responses during working hours. In investigation I, hemodynamic responses were measured on a working day; and in investigation II, cardiovascular responses were verified on both working and non-working days. In investigation I, blood pressure, cardiac output, heart rate, stroke volume, and total peripheral resistance were measured in 15 workers during working hours (from 9:00 am to 18:00 pm) on one working day. Another 40 workers from the same workplace participated in investigation II, in which blood pressure and heart rate were measured between the time workers arose in the morning until they went to bed on 5 working days and 2 non-working days. The results showed that blood pressure increased and remained at the same level during working hours. The underlying hemodynamics of maintaining blood pressure, however, changed between the morning and the afternoon on working days. Cardiac responses increased in the afternoon, suggesting that cardiac burdens increase in the afternoon on working days. The present study suggested that taking underlying hemodynamic response into consideration is important for managing the work-related cardiovascular burden of white-collar workers.

Effects of intervention program for systematic use of transfer equipment on care workers' low back pain in elderly care facilities.

OBJECTIVE: The purpose of this study was to investigate the effects of an intervention program to prevent care workers' low back pain by the systematic use of transfer equipment at elderly care facilities. METHODS: Questionnaire surveys were administered to administrators and care workers before (baseline), 1 year after, and 2.5 year after starting the program at two elderly care facilities. Care workers at the intervention facility were requested to ensure the use of a transfer's hoist, sliding board, and sliding sheet when assisting in the transfer of residents who were judged as appropriate to use the equipment (27.5% of residents living the intervention facility). Care workers at the control facility received no instructions on the use of transfer equipment. RESULTS: The average response rate of administrators and care workers was 100% and 90.3%, respectively. The number of care workers who responded during all three survey periods was 29 at the intervention facility and 23 at the control facility, and they were subjected to the current analysis. At baseline, transfer equipment was already introduced in both facilities, but it was found that the care workers did not regularly use it for assisting transfer. At 2.5-year follow-up, 31.0% of the intervention group and 4.3% of the control group always used the transfer's hoist. Similarly, 27.6% of the intervention group and 4.3% of the control group always used the sliding board and sliding sheet. Further, 60%-70% of the care workers at both facilities reported of having low back pain, but no statistically significant difference was found between the facilities or over the measurement periods. Among the intervention group, however, the care workers who reported an active use of the transfer's hoist, sliding board, and sliding sheet showed an improvement in low back pain. In the control group, no significant association was found between the active use of transfer equipment and low back pain. CONCLUSION: These results indicated that the prevention of care workers' low back pain requires the introduction of transfer equipment in facilities and its regular use under the implementation program. If the number of residents requiring transfer equipment increases, its systematic use is expected to improve low back pain in care workers. This improvement can translate into safer and healthier workplaces for elderly care.

Positive emotion inducement modulates cardiovascular responses caused by mental work.

BACKGROUND: Positive emotion is considered as an important factor related to health-relevant biological processes, including cardiovascular responses. To explore the possibility of using positive emotion as a tool to manage cardiovascular response of white-collar workers, we examined the influence on cardiovascular response of positive emotion inducement before a mental work. METHOD: Seventeen healthy males participated and performed a 10-min, PC-based Stroop color word task as their mental work. Before the task, 60 pleasant pictures chosen from the International Affective Picture System were presented in a random order under a positive emotion inducement condition while a gray screen was presented under a control condition. A 30-min relaxation period after completing the task was provided to examine the aftereffects of positive emotion inducement. Throughout these periods, systolic and diastolic blood pressure, mean arterial blood pressure, heart rate, stroke volume, cardiac output, and total peripheral resistance were measured continuously. RESULTS: Blood pressure and total peripheral resistance were lower during the picture presentation period under the positive emotion inducement period compared to the control condition. All indices did not differ during the color word task period. During the relaxation period after the task, however, blood pressure and total peripheral resistance were lower under the positive emotion inducement condition compared to the control condition. CONCLUSION: Positive emotion inducement before a mental work beneficially modulates cardiovascular responses, suggesting that positive emotion inducement may be a useful tool to manage the cardiovascular response to mental work.

Low back pain among workers in care facilities for the elderly after introducing welfare equipment.

OBJECTIVE: The purpose of this study was to clarify the causes of low back pain among workers in care facilities for the elderly after the introduction of welfare equipment. METHODS: We conducted anonymous questionnaire surveys among administrators and care workers in eight elderly care facilities. The questionnaires were designed to investigate the status of both the care workers and facility. In reference to the care facility, the questionnaires were comprised items for investigating basic information, occupational safety, and health activities. For care workers, in addition to basic information, occupational safety, and health activities, the questionnaires also comprised items for investigating resident transfer and bathing methods, low back pain, and occupational stress. RESULTS: Completed questionnaires were returned by eight care facility administrators (response rate: 100%) and 373 care workers (response rate: 92.3%), among which 367 were used for analyses. Many care workers participated in a variety of occupational safety and health activities that were conducted in the facilities. Various types of welfare equipment were introduced into the care facilities and subsequently used by many care workers during resident transfer and bathing. As a result, 89.9% of the care workers reported having only slight or no low back pain. The remaining 10.1% reported having serious low back pain that interfered with their work. On the basis of logistic regression analysis, low back pain was associated with the following variables: failure to provide the appropriate method of care to each resident, failure of colleagues to discuss methods for improving care, lack of instructions regarding the use of welfare equipment, and inappropriate job rotation. An association was also found between low back pain and poor posture, poor resident-lifting technique, insufficient time to complete work, and a shortage of workers to assist with resident transfer or bathing. CONCLUSION: Although care workers received instructions on the health and safety activities extracted from the surveys, an association was still found between these activities and low back pain. This was thought to result from some care workers not establishing the appropriate method of care for each resident, not discussing methods for improving care with other colleagues, not using the welfare equipment, and failing to practice appropriate job rotation. These results suggest that low back pain among care workers in the facilities for the elderly that have introduced welfare equipment is caused by a failure to sufficiently conduct appropriate care methods.

Biomechanical analysis of low back load when sneezing.

BACKGROUND: Although sneezing is known to induce low back pain, there is no objective data of the load generated when sneezing. Moreover, the approaches often recommended for reducing low back pain, such as leaning with both hands against a wall, are not supported by objective evidence. METHODS: Participants were 12 healthy young men (mean age 23.25 ± 1.54 years) with no history of spinal column pain or low back pain. Measurements were taken using a three-dimensional motion capture system and surface electromyograms in three experimental conditions: normal for sneezing, characterized by forward trunk inclination; stand, in which the body was deliberately maintained in an upright posture when sneezing; and table, in which the participants leaned with both hands on a table when sneezing. We analyzed and compared the intervertebral disk compressive force, low back moment, ground reaction force, trunk inclination angle, and co-contraction of the rectus abdominis and erector spinae muscles in the three conditions. FINDINGS: The intervertebral disk compressive force and ground reaction force were significantly lower in the stand and table conditions than in the normal condition. The co-contraction index value was significantly higher in the stand condition than in the normal and table conditions. INTERPRETATION: When sneezing, body posture in the stand or table condition can reduce load on the low back compared with body posture in the normal sneezing condition. Thus, placing both hands on a table or otherwise maintaining an upright body posture appears to be beneficial for reducing low back load when sneezing.