The effects of occupational interventions on reduction of musculoskeletal symptoms in the nursing profession

The objective of the review was to gain more insight into the effects of occupational interventions for primary prevention of musculoskeletal symptoms in healthcare workers. The Cochrane Collaboration methodological guidelines for systematic reviews functioned as a starting point. Thirteen studies meeting the inclusion criteria were analysed for methodological quality and effects. Eight outcome effect areas were established and defined as areas in which an effect had been determined in at least two studies. A method based on levels of scientific evidence was then used to synthesize the information available. Strong scientific evidence for the beneficial effect of occupational interventions was found for the outcome effect areas physical discomfort, technical performance of transfers and frequency of manual lifting. Insufficient evidence was found for the effect areas absenteeism due to musculoskeletal problems, musculoskeletal symptoms, fatigue, perceived physical load and knowledge of risk factors at work and ergonomic principles. Training and education combined with an ergonomic intervention were found to be effective.     

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.     

Benefits of nanotechnology for occupational ergonomic design: A positive step toward more protection of workers' health

Nowadays, the combination of “Nanotechnology” and “Ergonomics” has been known as “Nano-ergonomics.” Nano-ergonomics can help to develop more comfortable conditions in workplaces. So, the aim of this study is to reveal benefits of nanotechnology for occupational health and safety design, especially ergonomic design. The search strategy was provided based on cochrane guidelines with main search terms of “Nanotechnology,” “Nanomaterial,” and “Nanoparticle” combined with “Ergonomics” and “Human Factors.” PubMed, Scopus, Web of Sciences and Google Scholar Databases were researched for relevant articles. Also, Google search engine was used to find nano-ergonomic commercial products and to complete the research with identifying additional information. A total of 32 articles were first achieved. By providing Synthesis Without Meta-analysis reporting guideline, finally, four studies were regarded as appropriate. The results showed that nanotechnology has developed in three major areas of ergonomics such as physical, environmental, and cognitive ergonomics, which is a positive step toward more protection of workers' health. Although, there are not any original article related to nanotechnology for ergonomic product design, they are offered as the commercial products by the largest companies such as Amazon. Also, workers at the nanotechnology-related industries have the challenges of exposure to toxic nanomaterials. So, before the application of nanomaterials, we should have proper knowledge of nanomaterials-caused toxic hazards and how to handle them.     

Associations of ergonomic and psychosocial work hazards with musculoskeletal disorders of specific body parts: A study of general employees in Taiwan

Background and aimsMusculoskeletal disorders (MSDs) are major occupational health concerns. This study examined the associations of ergonomic and psychosocial work hazards with the risks of MSDs of specific body parts and their distribution across a wide range of occupational groups.MethodsStudy participants comprised 8,937 male and 7,052 female employees aged 20–65 years from a nationwide survey in 2016. A self-report questionnaire was administered to obtain information regarding demographic characteristics, work conditions, ergonomic and psychosocial work hazards, and MSDs of different body parts in 12 months. Multivariate logistic regression models were used to estimate prevalence ratios of MSDs in relation to ergonomic and psychosocial work hazards.ResultsIn professionals and skilled workers, MSDs of the neck and shoulders were more prevalent, whereas in manual workers, MSDs of the hands, wrists, and lower back were more prevalent. Psychosocial work hazards, including high psychological demand and low workplace justice, were major work-related risk factors for shoulder and neck disorders, whereas ergonomic hazards were major work-related risk factors for lower back and wrist or hand disorders.ConclusionDifferent workplace hazards contribute to the risks of different MSDs. To prevent the development of MSDs, occupational health professionals should evaluate both ergonomic and psychosocial work hazards and develop health prevention programs tailored to the risk profiles of working populations.     

Occupational musculoskeletal and mental health: Significance of rationalization and opportunities to create sustainable production systems – A systematic review

This literature review aims to identify occupational musculoskeletal and mental health effects of production system rationalization as well as organizational-level measures that may improve health outcome (“modifiers” in this review). A short review of the effect of ergonomic interventions is included as background and rationalization is discussed as a theoretical concept. Indicator variables for occupational musculoskeletal and mental health and related risk factors are presented. Variables with a generalized format were allowed in the literature searches (e.g., job satisfaction and absenteeism were accepted as risk factor and health indicator, respectively), suitable for the research fields of work sociology, organization science, human resource management (HRM) and economics research.One hundred and sixty-two studies of rationalization effects on health and risk factors and 72 organization-level modifier results were accepted into the final database. Entries were sorted by rationalization strategy and work life sector, and trends in outcome (positive, mixed, no effect, or negative effect on health and risk factors) were determined.Rationalizations have a dominant negative effect on health and risk factors (57% negative, 19% positive); the most negative effects were found for downsizing and restructuring rationalizations in general (71 studies negative, 13 positive) and for the health care sector in particular (36 studies negative, 2 positive). The rationalization strategy High Performance Work System (HPWS) was associated with the highest fraction positive outcome studies (6 of 10 studies). Other rationalization strategies (lean practices, parallel vs. serial production and mechanization level) reported intermediate results, in part dependent on work life sector, but also on the year when studies were carried out. Worker participation, resonant management style, information, support, group autonomy and procedural justice were modifiers with favourable influence on outcome.It is concluded that production system rationalization represents a pervasive work life intervention without a primary occupational health focus. It has considerable and mostly negative influence on worker health, but this can be reduced by attention to modifiers. The results create a basis for new priorities in ergonomic intervention research.     

Ergonomic intervention research for improved musculoskeletal health: A critical review

This literature review of ergonomic intervention studies aims to identify effective ergonomic interventions for improved musculoskeletal health in the workplace and to make recommendations for quality criteria in ergonomic intervention research. To avoid ambiguity in terminology a list of definitions of the ergonomic terms used in this paper is provided in an appendix. Models were developed for use in the classification of ergonomic intervention research and to illustrate the problems in interpreting ergonomic intervention data. The relevant literature was identified by a two-step process. First the relevant literature was identified by inclusion criteria, then, quality criteria were applied to identify studies of good quality for effective intervention. These appear to be firstly “organizational culture” and secondly modifier interventions, the former using multiple interventions with high stakeholder commitment to reduce identified risk factors, and the latter especially focusing workers at risk and using measures which actively involve the individual. A list of recommendations is provided.     

The effects of occupational interventions on reduction of musculoskeletal symptoms in the nursing profession

The objective of the review was to gain more insight into the effects of occupational interventions for primary prevention of musculoskeletal symptoms in healthcare workers. The Cochrane Collaboration methodological guidelines for systematic reviews functioned as a starting point. Thirteen studies meeting the inclusion criteria were analysed for methodological quality and effects. Eight outcome effect areas were established and defined as areas in which an effect had been determined in at least two studies. A method based on levels of scientific evidence was then used to synthesize the information available. Strong scientific evidence for the beneficial effect of occupational interventions was found for the outcome effect areas physical discomfort, technical performance of transfers and frequency of manual lifting. Insufficient evidence was found for the effect areas absenteeism due to musculoskeletal problems, musculoskeletal symptoms, fatigue, perceived physical load and knowledge of risk factors at work and ergonomic principles. Training and education combined with an ergonomic intervention were found to be effective.     

Injuries and the 'poor' worker

It is commonly assumed that occupational injuries are less of a problem in developing countries because there is less industrialization. Spot studies reveal, however, that injuries are a serious problem among miners, agricultural workers, and industrial workers in most countries

Each nation differs greatly in its level of industrialization, laws, working conditions, and range of products. Those with lower per capita incomes and lower levels of industrialization are likely to have more decentralized production which is less likely to be controlled effectively. Workers in developing countries are more likely to be injured; injuries are more likely to be disabling; and rehabilitation services more likely to be unavailable. Workers' transiency makes it more difficult for them to appreciate hazards which operate over long periods. Finally, workers' social status and level of organization in many cases greatly reduces their power to promote change

In this paper, an attempt is made to understand which experiences of the rich industrialized nations are valid for other nations and what new research needs to be done.     

Ergonomics and occupational safety and health: An ILO perspective

The ILO has a mandate to protect workers against sickness, diseases and injuries due to workplace hazards and risks including ergonomic and work organization risk factors. One of the main functions for the ILO is to develop international standards related to labour and work. ILO standards have exerted considerable influence on the laws and regulations of member States. The ILO standards take the form of international Conventions and Recommendations. ILO Conventions and Recommendations relevant to protection of workers against ergonomic risk factors at the workplace include Convention No. 127 and Recommendation No.128 which specify the international requirements concerning the manual transport of a load. To help member States in applying the ILO standards, the ILO produces practical guides and training manuals on ergonomics at work and collects and analyses national practices and laws on ergonomics at the workplace. The ILO also conducts technical cooperation activities in many countries on ergonomics to support and strengthen the capacities of its tripartite constituents in dealing with workplace ergonomic and work organization risks. The ILO’s technical cooperation activities give priorities on the promotion of voluntary, participatory and action-oriented actions to improve working conditions and work organizations of the small and medium sized enterprises. This paper reviews ILO’s policies and activities on ergonomics in relation to occupational safety and health and prescribes ILO’s considerations for its future work on ergonomics.     

Study protocol and baseline results for a quasi-randomized control trial: An investigation on the effects of ergonomic interventions on work-related musculoskeletal disorders,quality of work-life and productivity in knowledge-based companies

IntroductionWork-related musculoskeletal disorders (WMSDs) are the major causes of lost workdays, increased costs, and occupational diseases in all countries. The prevalence of WMSDs among the workers in small and medium-sized enterprises in Iran was reported as 73%. This paper aimed to describe the design of an interventional study to investigate the effects of ergonomic interventions on work-related musculoskeletal disorders, quality of work-life, and productivity among office workers of knowledge-based companies and introduce the results obtained from the baseline survey.Methods/designIt was a quasi-randomized control trial study on 313 participants with four parallel groups including ergonomic training intervention; management training and work changes intervention; ergonomic training, management training and work changes intervention; and non-interventional control group. The primary outcome was WMSDs, and the secondary outcomes were occupational stress factors, quality of work-life, and productivity. All primary and secondary outcomes were measured before the interventions, one, three, and six months after the interventions.ResultsAt this phase of study only baseline results were reported. 328 participants, with a mean age of 31.97 years (SD = 5.39), completed the baseline survey and entered the study. The highest prevalence of musculoskeletal disorders was found in neck (52.13%), right shoulder (41.16%) and right forearm (37.2%), respectively.ConclusionErgonomic interventions were conducted based on baseline data of the participants at individual and management levels. The focus of training program interventions was to reduce musculoskeletal disorders in upper limbs; in management training and work changes program, the focus was to increase social support.Trial registrationIRCT registration number: IRCT20181204041840N1 (date of registration: 2019-02-05).     

Process and implementation of participatory ergonomic interventions: a systematic review

Participatory ergonomic (PE) interventions may vary in implementation. A systematic review was done to determine the evidence regarding context, barriers and facilitators to the implementation of participatory ergonomic interventions in workplaces. In total, 17 electronic databases were searched. Data on PE process and implementation were extracted from documents meeting content and quality criteria and synthesised. The search yielded 2151 references. Of these, 190 documents were relevant and 52 met content and quality criteria. Different ergonomic teams were described in the documents as were the type, duration and content of ergonomic training. PE interventions tended to focus on physical and work process changes and report positive impacts. Resources, programme support, ergonomic training, organisational training and communication were the most often noted facilitators or barriers. Successful PE interventions require the right people to be involved, appropriate ergonomic training and clear responsibilities. Addressing key facilitators and barriers such as programme support, resources, and communication is paramount.

Statement of Relevance: A recent systematic review has suggested that PE has some effect on reducing symptoms, lost days of work and claims. Systematic reviews of effectiveness provide practitioners with the desire to implement but do not provide clear information about how. This article reviews the literature on process and implementation of PE.     

Whole-body vibration-related health disorders in occupational medicine – an international comparison

Workers with whole-body vibration (WBV) exposure are likely to report non-specific health complaints. Health and safety providers may not recognise such occupational injuries and may be unfamiliar with appropriate exposure assessment and prevention. This is a review of clinical studies, medical evidence, differential diagnostic evaluation protocols, surveillance programmes, national and international standards, and interventions recommendations utilising PubMed and other online resources. In summary, several studies show a clear trend: with increasing duration and intensity of occupational WBV exposure, primarily musculoskeletal or neurological disorders of the spine occur. Other organ damage has also been reported. In some European Union countries, spinal injury caused by WBV is recognised as an occupational disease and may be compensable. The WBV-related injury diagnosis includes a review of the work history, exposure assessment and differential diagnostic evaluation. WBV health surveillance should assess health status of WBV-exposed workers and address preventive measures.     

Cardiovascular load assessment in the workplace: A systematic review

Cardiovascular disease (CVD) is the leading cause of death worldwide. Health and safety hazards and risk factors in the workplace are associated with occupational CVD, though inconsistent evidence of causal associations represents a knowledge gap. The assessment of physical load on the cardiovascular system in relation to work different risk factors and occupational groups is necessary, if preventative measures for occupational CVD are to be better tailored to workers’ needs.The pertinent literature reports the use of different objective and subjective metrics to evaluate the cardiovascular load (CVL). We aimed to identify how cardiovascular stress is assessed in the workplace and to bring together related evidence-based recommendations for preventative measures. Hence, we systematically searched the Google Scholar database for corresponding publications to a) gather metrics used to assess CVL, b) summarize the related risk factors investigated, c) report the occupational groups and activities targeted in these studies, and d) compile recommendations resulting from these studies.The majority of studies reported objective measures, mostly Relative Heart Rate. The identified risk factors included work environment factors, general job features (such as the number of working hours), task-related factors and individual characteristics of the worker. Most studies focused on the industrial sector, namely, the manufacturing industry and construction were the two most frequent occupational groups, due to high exposure to risk factors. Few evidence-based recommendations were identified, though guidelines to promote safety and productivity were proposed. Our results encourage further research on CVL, occupational risk and CVD.     

Stakeholder perspectives on managing the occupational health of UK business drivers: a qualitative approach

Musculoskeletal disorders are one of leading causes of work related ill health and sickness absence. Those drive as part of their job may be at particular risk, with evidence suggesting that prolonged exposure to driving is associated with increased absence from work due to low back pain. Business drivers often work away from a traditional office environment. Such mobile working may pose greater risks to occupational health due to increased ergonomic risks, for example working from the car, longer working hours and a lack of concern amongst drivers about health and safety. It has been suggested that occupational health practices have not adapted to meet the needs of peripatetic workers. The current study explored how occupational health services are delivered to business drivers. Semi-structured interviews were carried out with a sample of 31 stakeholders in 4 organisations. Respondents included, health and safety professionals, occupational health nurses, fleet managers and high mileage business drivers. The interviews were transcribed and analysed using ‘Template Analysis’. The data revealed that, within these organisations, the provision of occupational health services was often fragmented and drivers and other key stakeholders were often unaware of the existing systems within their organisations. The peripatetic nature of business drivers meant that they were difficult for occupational health teams to reach. The paper concludes by presenting recommendations for occupational health professionals and researchers engaged with improving the health of peripatetic workers, namely that occupational health policies should be integrated in company strategy and widely disseminated to drivers and those with responsibility for managing their occupational health provision.     

A systematic review of comparative studies on ergonomic assessment techniques

This review provides a systematic overview of the comparison of ergonomic assessment techniques’ output in variety of industrial sectors.The relevant publications have been classified into broad categories such as comparison of applied industry sector, trend analysis, ergonomic assessment techniques been compared, comparative studies between two ergonomic assessment techniques, frequently compared techniques, levels of Action categories used. The summary of extracted data from included papers is provided.Authors have compared the results based on observational techniques which are easy to understand and apply. Available publications related to such comparison is limited. Authors have compared and analysed the correlation between the outputs of techniques but only few researchers pointed out the exact reason of variation in outputs applied in the same task. Hence, establishing applicability of each technique required. To identify the causes of variation, the sensitivity study of exposure factor-Task-posture assessment techniques is highly required. There are few techniques which are not yet compared for checking agreement or correlation, serving as a research gap.Authors have studied and published literature review specific to one technique of ergonomic assessment. Few authors have compared the outputs from various ergonomic assessment techniques in particular sector and investigated the correlation between them. No study has been carried out till date to review available literature on comparative study of comparisons made. In this paper, two research gaps have also been identified.     

Evaluation of musculoskeletal health outcomes in the context of job rotation and multifunctional jobs

Higher physical demands at work are associated with health outcomes such as discomfort, disorders and sick leave. Variations in work exposure patterns, introduced by multifunctional jobs and ergonomic interventions, bring confounders into the complex relation between occupational risks and musculoskeletal disorders. This study compared whole-body rating of perceived exertion (RPE), discomfort, ergonomic workplace analysis (EWA) and sick leave due to musculoskeletal disorders, among workers exposed to diversified work. The results showed that EWA performed by the observer differed from workers' ratings. There were no differences between groups of workers taking or not taking sick leave regarding RPE and discomfort at their current workstations. Workers significantly discriminated between progressive workload levels, and RPE scores for specific tasks were nonlinear during shifts. These differences might be associated with exposure variability. Thus, in the context of diversified work, the RPE scale seems more appropriate for evaluating acute effects of work variability.     

Ergonomic evaluation of work table for waste sorting tasks using digital human modelling

Waste sorting facilities rely heavily on plentiful human labour, and the lack of adequately designed work systems leads to musculoskeletal disorders among the workers. The present research explores the ergonomic design aspects of a cost-effective intervention, a work table for waste sorting in developing countries. This study evaluates the appropriate range of work height for the sorting tasks and proper location of hoppers to drop the sorted items. The ergonomic assessment was conducted by simulating postures involved in sorting tasks in a virtual environment and performing a biomechanical evaluation of the static postures by digital human modelling. Thirty male subjects from Indian population simulated the postures of sorting tasks. The compressive force at L4/L5 intervertebral disc, shoulder flexion moment, shoulder abduction moment, and elbow flexion moment were taken as the indicative parameters of the subject's physical workload. The appropriate table height was marginally lower than the elbow height of the subject and within 4 cm. The preferred hopper position was on the floor adjacent to the worker compared with the hopper on the top of the table.     

Ergonomic Criteria Necessary to Epidemiological Studies in Industrial Medicine and Public Health

Abstract

While protective measures in industrialized countries mention ergonomic factors as possible means to improve health, safely and well-being at the work place, more and more ergonomic variables are introduced in recent epidemiological studies concerning the relationship between work hazards and health effects. After a short review of this literature, the author attempts to list relevant ergonomic criteria for further researches in industrial medicine and public health.

Critères Ergonomiques Nécessaires aux Études Épidémiologiques en Médecine du Travail et en Santé Publique

Notwendige Ergonomische Kriterien für Epidemiologische Studien in der Arbeitsmedizin und im Öffentlichen Gesundheitswesen     

Design of assembly lines with the concurrent consideration of productivity and upper extremity musculoskeletal disorders using linear models

Work-related musculoskeletal disorders (WMSDs) are common occupational diseases among assembly workers due to repetitive motions or heavy workloads. The conventional approaches to decreasing WMSDs in assembly workers usually focus on individual assembly work at the station level. These approaches, however, do not pay enough attention to work allocation at the whole assembly line level such as balancing ergonomic burdens among workers by proper work assignment. This paper presents a methodology that can be used to integrate ergonomic measures of upper extremities into assembly line design problems. Linear models are developed to link work-worker assignment to the upper extremity ergonomic measures based on a guideline from American Conference of Governmental Industrial Hygienists. These linear models allow ergonomic and productivity measures to be integrated as a mixed-integer programming model. The case studies of this paper show the new model can effectively balance and control exposure levels in the upper extremity while not significantly decreasing line efficiency. This research shows the potential to reduce the need of numerous task adjustments for ergonomic improvement after initial assembly line design in conventional trial-and-error based assembly task adjustment. Furthermore, these linearization methods can be generalized in order to incorporate other ergonomic measures in tabulated forms into assembly line design problems.     

Compensation for occupational injuries and diseases: its effect upon prevention at the workplace

Abstract

In Switzerland, as in many other industrialized countries, the nature and extent of prevention at the workplace is determined, at least partially, by known cases of compensated occupational injuries and diseases. At both the national and international levels ∥ILO conventions) injuries and diseases that fit appropriate lists and definitions are eligible for compensation. It has been found, based upon an investigation of a representative sample (965 subjects) of the working population in the French-speaking region of Switzerland, that this restrictive view does not take into account the fact that a large proportion of injuries and diseases are claimed by the victims to be caused by their job. These injuries and diseases, responsible for at least one month's absence from work, are not considered to be eligible for compensation but must be covered by the patient's own insurance. Moreover, the survey showed that workers considered the ill effects on health and safety to be a consequence less of the physical working environment than of the work organization, and that this category of risks was not recognized. Thus, in addition to the reduction of hazards by the application of industrial hygiene, an informed improvement of the workplace and the work organization was required. Consequently, laws and regulations on occupational injuries and diseases should be changed in order to emphasize the role of more appropriate preventive tools, which includes ergonomics.