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To the Editor: Dr Wassell and colleagues¹ found that neither voluntary nor mandatory back belt use reduced incidence of back injury claims or low back pain. In their accompanying editorial, Drs Hadler and Carey² implied that there was nothing to be done prior to the onset of back pain among workers and only physical and psychological treatment afterward.

It is not yet known whether back belts give any mechanical external support. Weight lifters do use such belts, but whether they get any true support or just psychological benefit has not been determined. My observations of workers suggest that the belts are often loosely worn, like vests, and never properly buckled to give any mechanical support. Rarely are workers given any instruction about the reasons for the back belt or how to use it properly. There is also the psychological factor of looking like a weakling and undergoing teasing by fellow . . . [Full Text of this Article]