Authors' objectives: To determine whether there is any evidence on the (causal) association between a tower crane operator, potentially exposed to whole body vibration, and the development of low back pain and/or sciatica.

Authors' results and conclusions: There was 20 published studies identified in our literature searches. Upon examination of the titles and abstracts of these 20 studies, two studies were thought to be relevant and were retrieved in full for further appraisal. Further, one study was identified from manual searches. It should be noted that one published study was submitted with the claim and was appraised below. Overall, there are four published studies appraised in this systematic review. One of the study, was a large (743 all male crane operators and 662 all male floor workers as controls), retrospective cohort study (level of evidence 3) investigating the occurrence of a spell of sickness absence due to lumbar disorders (defined as ICD-9 coding of spondyloarthrosis, discopathy with or without complications, herniated disc and other unspecified back disorders) lasting ? 28 days, among steel workers. The authors of this large retrospective cohort hypothesized that exposure to whole-body vibration caused adverse health effects, in the form of excessive absenteeism due to lumbar disorders. It should be noted that although the authors stated a hypothesis, this statement was not followed by the necessary sample size calculation. The authors reported that the incidence density ratio for all back disorders was 0.98 (95% confidence interval (CI): 0.77-1.25) and found that there was no significant difference in the occurrence of at least one spell of long-term absence due to lumbar spine disorders between the index group and the control group (adjusted for age). The same results were found when the incidence density ratios were simultaneously adjusted for age and one of the other potential confounders (it should be noted that potential confounders considered in this study were age, shiftwork, nationality, and calendar year). Another study was a small (33 cases with 30 controls) case-control study (level of evidence 3) investigating the risk of low back pain among operators on overhead travelling cranes in a steel factory. In this study, the authors demonstrated that the higher risk for LBP among crane operators compared to controls may have been influenced by occupational exposures in the past including the fact that more crane operators had previous jobs with heavy physical demands and frequent lifting compared to the control group. It should be noted that there was no hypothesis with relevant sample size calculation reported while multiple comparisons and only limited role of confounders explored (age, height and weight) in this study. We conclude that, at present, there are some low-quality mid-level of evidence that working as a crane operators was associated with back pain. However, the results of these studies need to be interpreted with caution since bias, chance and confounding effect may affect the reported outcomes. It should be noted that the association reported was not necessarily causative in nature since criteria for assessing causation, as outlined in the Bradford Hill criteria were not fulfilled.

Authors' methods: A comprehensive and systematic literature search was conducted on January 14, 2025. The literature search was done on commercial and non-commercial medical and occupational health and safety (OHS) related literature databases employing a combination of key words. No limitation, such as on the language and date of publication, was implemented in any of these searches. A manual search was also done on the references of the articles retrieved in full.

Project Status: Completed

URL for project: https://www.worksafebc.com/en/about-us/research-services/evidence-based-medicine-and-systematic-reviews

Year Published: 2025

URL for published report: https://www.worksafebc.com/en/resources/health-care-providers/guides/tower-crane-operators-and-low-back-pain?lang=en&origin=s&returnurl=https%3A%2F%2Fwww.worksafebc.com%2Fen%2Fforms-resources%23sort%3DDate%26q%3DTower%2520Crane%2520Operators%2520and%2520Low%2520Back%2520Pain%26f%3Alanguage-facet%3D%5BEnglish%5D%26tags%3DGuide%7C2d7eb4b30f6a4a319e0d40565c9abbab%2CHealth%2520Care%2520Provider%7C13468b0b3f074f6bade3f57ac3cdfb8e%2CSystematic%2520Review%7Cf78c29d570c14ec3b5a394385905df70&highlight=Tower%20Crane%20Operators%20and%20Low%20Back%20Pain

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Canada

Organisation Name: WorkSafeBC

Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698

Contact Name: ebpg@worksafebc.com

Contact Email: ebpg@worksafebc.com

Copyright: WorkSafe BC