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Back Injury Trajectories in Heavy Industries: Defining Outcomes for Epidemiological Research

Koehoorn, Mieke PhD; Xu, Fan MSc; Village, Judy MSc; Trask, Catherine PhD; Teschke, Kay PhD

Journal of Occupational and Environmental Medicine: September 2010 - Volume 52 - Issue 9 - p 908-912
doi: 10.1097/JOM.0b013e3181f02806
Original Articles

Objective: To propose an incidence definition of back injury for epidemiologic studies using health care contacts.

Methods: Medical services, hospitalizations, and workers' compensation data were linked for a longitudinal database of health care contacts among a cohort of heavy-industry workers for trajectory, group-based analysis.

Results: During follow-up, 25.8% of workers had no health care contacts for back injury. Among workers with at least one contact, four trajectories were identified: one with a high probability of back injury during follow-up and three with episodic trajectories of increasing and decreasing probability of back injury.

Conclusions: Workers with no back injury history could be followed for incidence in cohort studies or as controls in case-control designs. Episodic groups could be followed for new episodes, providing they were free of health care contacts for back injury for at least 3 years.

From the School of Population and Public Health (Dr Koehoorn, Dr Teschke); School of Environmental Health, College for Interdisciplinary Studies (Dr Koehoorn, Ms Village, Dr Trask, Dr Teschke); and Centre for Health Services and Policy Research, Faculty of Medicine (Dr Koehoorn, Mr Xu), University of British Columbia, Vancouver, British Columbia, Canada.

This project was governed by a Data Access Agreement between the Researchers and the Ministry of Health-Government of British Columbia and WorkSafeBC (03–032). The project was approved by the Behavioural Research Ethics Board, University of British Columbia (B03-0644).

Address correspondence to: Mieke Koehoorn, School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada V6T 1Z3; E-mail:

©2010The American College of Occupational and Environmental Medicine