Evaluating the effectiveness of a participatory ergonomics approach in reducing the risk and severity of injuries from manual handling

Manual handling is the greatest contributor to non-fatal injury and disease in the workplace, commonly accounting for one-third of national injury counts. Interventional strategies that have focused on selecting or modifying the worker have been ineffective in reducing injury risk. In recent times, participatory ergonomics has been widely adopted as a process to reduce the risk of injury from manual handling but it is not well validated as an intervention. This study evaluated the effectiveness of a participatory ergonomics risk assessment approach in reducing the rate and severity of injuries from manual and non-manual handling sustained by a cohort of 137 cleaners within a hospital setting. The date of injury and the workers' compensation claim cost and hours lost from work were obtained for each injury incurred during the 4-year pre-intervention and 3-year intervention period. The age, gender and hours worked were ascertained for every cleaner whether injured or not. Using generalized linear mixed modelling analysis, reductions of rate of injury by two-thirds, workers' compensation claim costs by 62% and hours lost by 35% for manual handling injuries were found to be associated with the intervention period. Although the cleaners experienced a significant intervention period reduction in non-manual handling injury rate, the corresponding changes in severity of injury were not significant. The success of the intervention supports the adoption of a participatory ergonomics approach in reducing the rate and consequence of injuries in the workplace.     

Implementation of a participatory ergonomics program in the rehabilitation of workers suffering from subacute back pain

This paper describes a participatory ergonomics program aimed at early return to regular work of workers suffering from subacute occupational back pain and assesses the perceptions of the participants on the implementation of ergonomic solutions in the workplace. The participatory ergonomics program was used in the rehabilitation of workers suffering from subacute back pain for more than 6 weeks, a program that was associated with an increased rate of return to work. The perceptions of the participatory ergonomics participants were assessed 6 months after completion of the ergonomic intervention through a questionnaire sent to employer representatives, union representatives and injured workers of participating workplaces. About half of the ergonomic solutions were implemented according to the perception of the participants, with a substantial agreement between respondents.     

ErgoVSM: A Tool for Integrating Value Stream Mapping and Ergonomics in Manufacturing

Value stream mapping (VSM) is a lean tool aiming at waste reduction. Previous research suggests that the use of VSM may result in work intensification and thus an increased risk for the workers of developing work‐related musculoskeletal disorders (MSD). In the current study, VSM was developed to also consider physical exposure in the analyzed production system (ErgoVSM). As the VSM, ErgoVSM is based on a participatory approach. ErgoVSM was tested in a Swedish manufacturing company. The results suggest that ErgoVSM catalyzes change processes to include intervention proposals emphasizing ergonomics in addition to waste reduction. Thus, ErgoVSM appeared useful for the investigated target group of production engineers and experienced operators. The performance improvements suggested when using the ordinary VSM seemed not to be hampered by adding the ergonomics complement. However, the use of ErgoVSM was somewhat more time consuming than the use of VSM. In conclusion, ErgoVSM is suggested as a feasible tool to be used by production engineers and experienced operators for including ergonomics considerations in the rationalization process.     

Contextual factors affecting task distribution in two participatory ergonomic interventions: a qualitative study

This article provides an analysis of the evolution of the division of labour in participatory ergonomics (PE) programmes in two worksites. The analysis is based on interviews and field observations in the worksites. In both settings there was meaningful participation by both worker and management members of ergonomic change teams (ECTs) in the hazard assessment and solution identification stages, but as the teams moved to the implementation stage, worker representatives were marginalised and the participatory nature of the programmes was severely curtailed. The removal of workers from the process was the outcome of the interplay among the type of activities pursued in the implementation stage, the skills and knowledge required to carry out those activities, and workers' limited influence in the organisational hierarchies. Findings highlight the salience of the social context in which participatory programmes are located and the importance of examining participatory programmes as they evolve over time. STATEMENT OF RELEVANCE: This article contributes to a growing literature on the process and implementation of PE programmes. The article's focus on social and organisational factors that affect the division of labour and attention to the evolution of involvement over time extend current understandings of participation in ergonomics programmes.     

Limited economic evaluation to assess the effectiveness of a university-wide office ergonomics program

The objective of this research was to evaluate the effectiveness and provide a limited economic evaluation of an office ergonomics program at a major university from 1995 to 2007. The relationship between office-related recordable injuries, reported lost time, severity of these injuries, and the Workers' Compensation (WC) paid was analyzed and the corresponding incident cost was calculated. Two major datasets analyzed were OSHA 200/300 logs (1991-2007) and WC claims paid (1999-2007). Since the beginning of the office ergonomics program in 1995 and through 2007 (13-year period), the number of office cumulative trauma disorder (CTD) cases decreased by 53%. Since the official start (in 1999) of a 50-50 cost share agreement for office equipment purchases between the university's Safety and Health Department (SHD) and the university departments evaluated, it was observed that the incident rate decreased by 63%, Total Days Away/restrict or Transfer (DART) rate decreased by 41%, Lost Time Case (LTC) rate decreased by 71% and office-related carpal tunnel syndrome decreased by almost 50%. The long-term goal of this research is to demonstrate the self-sustainability of an office ergonomics program by showing that equipment costs are eventually offset by a decrease in WC claims paid and lost time from office-related injuries and illnesses. While limited, this research helps in cost-justifying the implementation of future office ergonomics programs for large organizations.     

A multilayered ergonomic intervention program on reducing musculoskeletal disorders in an industrial complex: A dynamic participatory approach

Work-related musculoskeletal disorders (WMSDs) are closely identified with common complaints in different workplaces. This study aimed to implement an intervention program through which ergonomic measures were dynamically localized in industry. An interventional study, including three basic layers, namely, training workshops, participatory ergonomics (PE), and workstation redesign was fulfilled in an Iranian steel manufacturing complex from 2017 to 2020. A steering committee (SC) was formed following several meetings held for clarification of the project to the management team. The SC members then attended four organized workshops managed by an ergonomics specialist. Afterwards, the basics of ergonomics were transferred to action groups. After developing ergonomic assessment tools, the ergonomic problems were prioritized and numerous positive changes were made by the action groups. The findings of the tailored checklists revealed a load of WMSDs risk factors. All the three layers of the program were implemented as initiated. Ergonomics training workshops were then held and significant differences were observed between the participants' pre/posttest mean scores in all workshops (p < 0.001). Moreover, PE measures were exercised at all levels of the organization inducing enthusiastic motivation of the workforce to consider ergonomic requirements in the workplace. Consequently, the workers' innovative ideas and the managerial support yielded diverse workstation redesigns due to a growth in either the workers' ergonomics awareness or participatory culture grounding. A multilayered ergonomic intervention was implemented in this study. In conclusion, a multifaceted long-term follow-up intervention program could be applied to enhance workers’ health status and to raise system productivity.     

Evaluation of the effects of two alternative participatory ergonomics intervention strategies for construction companies

To improve the use of ergonomics tools by construction workers, the effect of two guidance strategies – a face-to-face strategy (F2F) and an e-guidance strategy (EG) – of a participatory ergonomics intervention was studied. Twelve construction companies were randomly assigned to the F2F group or the EG group. The primary outcome measure, the percentage of workers using ergonomics tools, and secondary outcome measures – work ability, physical functioning and limitations due to physical problems – were assessed using surveys at baseline and after 6 months. Additionally, a cost-benefit analysis was performed on company level. No differences in primary and secondary outcomes were found with the exception of the use of ergonomics tools to adjust working height (F2F +1%; EG +10%; p?=?.001). Newly-implemented tools were used by 23% (F2F) and 42% (EG) of the workers (p?=?.271). Costs were mainly determined by guidance costs (F2F group) or purchase costs (EG group).

Practitioner Summary: Participatory strategies aim to stimulate behavioural change of stakeholders to increase the use of ergonomics tools. Two guidance strategies – face-to-face or e-mail interventions – among construction companies were studied. Both guidance strategies led to an increase in the use of new ergonomics tools.     

Evaluation of an ergonomics intervention programme in VDT workplaces

This paper focuses on an intervention programme based on the concept of participatory ergonomics. The study was designed within the framework of a multidisciplinary project concerned with identifying the work conditions and problems necessary to improve the working life of VDT operators with routine data-entry and data-dialogue tasks. The intervention programme was evaluated in two follow-up studies. The evaluation criteria covered the proposals for improvement emerging from (1) the intervention programme's final joint decisions (of experts and employees) on measures needed, and (2) workers' views of the effectiveness of the programme itself. As the implementation period was marked by increasing turbulence caused by recession in many branches of the Swedish economy, attention was paid to the impact of the restructuring and rationalization effected by company management in the workplaces under study. To obtain a better understanding of the outcome of the intervention programme, the follow-up was extended systematically to explore the disturbing organizational factors operating during the implementation period. The results of the evaluation offer increased knowledge of organizational barriers to the implementation of ergonomics measures decided upon within the framework of intervention research.     

A comparative analysis of participatory ergonomics programs in U.S. and Japan manufacturing plants

The use of a participative approach to ergonomics is growing in countries throughout the world. This paper compares and contrasts Participatory Ergonomics programs in two U.S. and two Japanese manufacturing plants. All four programs focused on the redesign of repetitive manufacturing jobs to reduce physical stress on workers. In all four cases, this traditional ergonomics concern was addressed in a non-traditional way-involving broad participation of many manufacturing functions who worked together as an ergonomics team and direct input from operators whose jobs were redesigned.

The participatory ergonomics programs were successful in making significant numbers of job changes in both countries. A comparison of the ergonomics programs across countries revealed some significant differences in structure and process. An overarching difference was in how participation was managed. In the Japan cases, participation was a carefully controlled process by which upper management and staff specialists worked through first-line supervisors to get input from workers meeting in quality (or safety) circles. In the U.S., multi-functional and multi-level task forces (including union and worker representatives) were formed and operators were invited to meetings to give input. The U.S. plants gave the task force a great deal of autonomy and virtually all decisions were group decisions. The differences suggest that effective participatory ergonomics programs can take many forms. The best program for any particular plants in differing countries depends on their own unique history, structure, and culture.     

Theory and practice for the implementation of ‘in-house’, continuous improvement participatory ergonomic programs

This paper presents a case study of an implementation of a participatory ergonomics program in a public service agency. The objective of the study was to develop a theoretical model and related design principles for the implementation of ‘in-house’, continuous improvement participatory programs. The proposed model is based on the behavioral cybernetic theory of learning (Smith and Smith, 1966, Cybernetic Principles of Learning and Educational Design held, Rhinehart and Winsten, New York) and emphasizes the concepts of action, feedback, feedback control, and individual learning as essential for a progression from external regulation (by outside experts) to internal regulation (by organizational members) of participatory programs. Results support the proposed model, but do suggest an expansion of the model to include macro-level organizational variables as additional factors necessary for developing internally regulated participatory programs. Results have led to the specification of several design principles for implementing ‘in-house’, continuous improvement participatory programs.     

Ergonomics--costs and benefits revisited

An earlier review reported a dozen cases where ergonomics applications had resulted in cost savings. A large number of publications which refer to the topics of the cost-effectiveness and cost-benefits of ergonomics can now be found. However, data showing the value of ergonomics applications remain scarce. Cost-benefit and cost-effectiveness studies are difficult to conduct for a number of reasons. While it is unlikely that the general case for the value of ergonomics can be proven, ergonomists must be in a position to discuss the potential costs and benefits of their work with clients. The Business case model is suggested as one way to structure an analysis of where a potential ergonomics application might reduce the risks to costs or the possibility of lost benefits.     

Empirical evaluation of training and a work analysis tool for participatory ergonomics

A controlled laboratory experiment was performed to test the effects of ergonomics training and the NIOSH lifting equation on the participatory redesign of a simulated manual material handling job. Before performing the job, 16 subjects were given ergonomics training and 16 were instructed on how to use the NIOSH lifting equation for manual lifting tasks. Compared to a control group, subjects who received the ergonomics instruction identified and eliminated more risk factors in the simulated job. While subjects who used the NIOSH lifting equation also identified more risk factors, they did not eliminate any more risk factors than the control group. No additive benefit was found using both the training and the lifting equation over either method alone. Ergonomics training led to better improvements than use of the lifting equation in terms of risk factors identified and eliminated. Implications for use of training and tools in participatory ergonomics approaches are discussed.

Relevance to industry

This study supports that ergonomics training should be a requisite for any participatory ergonomics approach. Given a fundamental level of ergonomics training, subjects demonstrated that they were better capable of identifying and eliminating risk factors in the job.     

Effectiveness of participatory ergonomic interventions on health outcomes: a systematic review

The objective of this study was to conduct a systematic review of the literature on the effectiveness of participatory ergonomic (PE) interventions for improving workers' health. The search strategy targeted six electronic databases and identified 442 potential articles. Each article was examined by pairs of reviewers for relevance (assessed a participative ergonomic workplace intervention, with at least one health outcome, published in English in peer reviewed literature). Twenty-three articles met relevance criteria and were then appraised for methodological strength. Using a best evidence synthesis approach, 12 studies that were rated as 'medium' or higher provided partial to moderate evidence that PE interventions have a positive impact on: musculoskeletal symptoms, reducing injuries and workers' compensation claims, and a reduction in lost days from work or sickness absence. However, the magnitude of the effect requires more precise definition.     

Effectiveness of a participatory ergonomics intervention in improving communication and psychosocial exposures

A participatory ergonomics programme was implemented in an automotive parts manufacturing factory in which an ergonomics change team was formed, composed of members from management, the organized labour union and the research team. It was hypothesized that the participatory nature of this change process would result in enhanced worker perceptions of workplace communication dynamics, decision latitude and influence, which in conjunction with anticipated mechanical exposure reductions would lead to reduced worker pain severity. Utilizing a sister plant in the corporation as a referent group, a quasi-experimental design was employed with a longitudinal, repeat questionnaire approach to document pre-post intervention changes. Nine participatory activities (psychosocial interventions) were implemented as part of the process. Communication dynamics regarding ergonomics were significantly enhanced at the intervention plant compared to the referent plant. However, there were no significantly different changes in worker perceptions of decision latitude or influence between the two plants, nor did pain severity change. Possible explanations for these results include limited intervention intensity, context and co-intervention differences between the two plants, high plant turnover reducing the statistical power of the study and lack of sensitivity and specificity in the psychosocial measures used. Further research should include the development of psychosocial tools more specific to participatory ergonomic interventions and the assessment of the extent of change in psychosocial factors that might be associated with improvements in pain.     

Effectiveness of a participatory ergonomics intervention in improving communication and psychosocial exposures

A participatory ergonomics programme was implemented in an automotive parts manufacturing factory in which an ergonomics change team was formed, composed of members from management, the organized labour union and the research team. It was hypothesized that the participatory nature of this change process would result in enhanced worker perceptions of workplace communication dynamics, decision latitude and influence, which in conjunction with anticipated mechanical exposure reductions would lead to reduced worker pain severity. Utilizing a sister plant in the corporation as a referent group, a quasi-experimental design was employed with a longitudinal, repeat questionnaire approach to document pre-post intervention changes. Nine participatory activities (psychosocial interventions) were implemented as part of the process. Communication dynamics regarding ergonomics were significantly enhanced at the intervention plant compared to the referent plant. However, there were no significantly different changes in worker perceptions of decision latitude or influence between the two plants, nor did pain severity change. Possible explanations for these results include limited intervention intensity, context and co-intervention differences between the two plants, high plant turnover reducing the statistical power of the study and lack of sensitivity and specificity in the psychosocial measures used. Further research should include the development of psychosocial tools more specific to participatory ergonomic interventions and the assessment of the extent of change in psychosocial factors that might be associated with improvements in pain.     

Medium- and long-term reproducibility of self-reported exposure to physical ergonomics factors at work

INTRODUCTION: The literature is sparse on reproducibility of self-reported exposure to physical ergonomics risk factors for musculoskeletal disorders (MSDs). Aims of this study were to evaluate, in a cohort of workers interviewed up to three times: 1-year test-retest reliability; and 5- and 6-year recall of physical exposures. We also examined whether reproducibility was influenced by the presence of UE MSD or by technological changes introduced between the last two surveys. METHODS: A cohort of automobile manufacturing employees was interviewed at baseline, one and six years later about work history, physical and psychosocial exposures at work, upper limb symptoms, injury and medical history, and demographics. Agreement between interviews was evaluated by intraclass correlation and Spearman coefficients. Differences in exposure between 1- and 6-year follow-up were analyzed by Wilcoxon matched-pairs signed-ranks test. RESULTS: Large and significant decreases in work pace and physical effort were observed from baseline, although an upper extremity composite index was quite stable in the total population. One-year test-retest reliability was fair to good for the composite exposure index (ICC=0.58), whole-body vibration, handling parts, and tool use, but poor for the other variables considered. Long-term reproducibility, from baseline or 1-year follow-up to 6-year follow-up, was poor for the composite index and almost all single items. UE MSD case status influenced 1-year test-retest reliability, with subjects who changed case status from baseline displaying higher reliability, but not reproducibility of recalled exposures. A strong regression to the mean effect was observed on exposures reported at follow-up surveys. CONCLUSIONS: Recalled ergonomics exposures could be employed in retrospective cohort studies as a somewhat reliable and unbiased estimate of the self-reported exposures that would have been obtained up to one year earlier, but not over a longer period (5-6 years). These longer-term results may have been limited by difficulty in matching jobs between interviews; also the regression to the mean effect likely contributed to reduce agreement. Changes in production technology and work organization produced a decrease in physical workload intensity and job pace, but did not have a substantial impact on an exposure index for the upper limb.