Effectiveness of an ergonomic intervention on work-related posture and low back pain in video display terminal operators: A 3 year cross-over trial

This study investigated the effectiveness of a workstation ergonomic intervention for work-related posture and low back pain (LBP) in Video Display Terminal (VDT) workers. 100 VDT workers were selected to receive the ergonomic intervention, whereas 100 were assigned to a control group. The two groups were then crossed-over after 30 months from baseline. Follow-ups were repeated at 5, 12, and 30 months from baseline and then at 6 months following crossover. Outcomes: Work-related posture and LBP point-prevalence using the Rapid Entire Body Assessment method and a Pain Drawing, respectively. The ergonomic intervention at the workstation improved work-related posture and was effective in reducing LBP point-prevalence both in the first study period and after crossover, and these effects persisted for at least 30 months. In conclusion, our findings contribute to the evidence that individualized ergonomic interventions may be able to improve work-related posture and reduce LBP for VDT workers.     

Work posture, workstation design, and musculoskeletal discomfort in a VDT data entry task

Self-report data on musculoskeletal discomfort were collected from several hundred VDT users in two agencies of a state government. Aspects of worker posture and workstation design were objectively assessed for 40 of the VDT users. Multiple regression analyses were used to examine the relationship between these ergonomic variables and musculoskeletal discomfort. Effects of ergonomic factors on musculoskeletal discomfort were clearly evident in the analyses. Regression models explained up to 38% of the variance in discomfort at different body sites. Of special interest was that leg discomfort increased with low, soft seat pans, suggesting that postural constraint is more important than thigh compression as a risk factor for leg discomfort in VDT work. In addition, arm discomfort increased with increases in keyboard height above elbow level, supporting arguments for low placement of the keyboard. Finally, high levels of neck and shoulder girdle discomfort observed in the study population suggest the need for further attention to the control of cervicobrachial pain syndromes in VDT work.     

Do ergonomics improvements increase computer workers' productivity?: an intervention study in a call centre

This paper examines whether improving physical ergonomics working conditions affects worker productivity in a call centre with computer-intensive work. A field study was conducted at a catalogue retail service organization to explore the impact of ergonomics improvements on worker production. There were three levels of ergonomics interventions, each adding incrementally to the previous one. The first level was ergonomics training for all computer users accompanied by workstation ergonomics analysis leading to specific customized adjustments to better fit each worker (Group C). The second level added specific workstation accessories to improve the worker fit if the ergonomics analysis indicated a need for them (Group B). The third level met Group B requirements plus an improved chair (Group A). Productivity data was gathered from 72 volunteer participants who received ergonomics improvements to their workstations and 370 control subjects working in the same departments. Daily company records of production outputs for each worker were taken before ergonomics intervention (baseline) and 12 months after ergonomics intervention. Productivity improvement from baseline to 12 months post-intervention was examined across all ergonomics conditions combined, and also compared to the control group. The findings showed that worker performance increased for 50% of the ergonomics improvement participants and decreased for 50%. Overall, there was a 4.87% output increase for the ergonomics improvement group as compared to a 3.46% output decrease for the control group. The level of productivity increase varied by the type of the ergonomics improvements with Group C showing the best improvement (9.43%). Even though the average production improved, caution must be used in interpreting the findings since the ergonomics interventions were not successful for one-half of the participants.     

Trends in approaches to night and shiftwork and new international standards

This paper examines whether improving physical ergonomics working conditions affects worker productivity in a call centre with computer-intensive work. A field study was conducted at a catalogue retail service organization to explore the impact of ergonomics improvements on worker production. There were three levels of ergonomics interventions, each adding incrementally to the previous one. The first level was ergonomics training for all computer users accompanied by workstation ergonomics analysis leading to specific customized adjustments to better fit each worker (Group C). The second level added specific workstation accessories to improve the worker fit if the ergonomics analysis indicated a need for them (Group B). The third level met Group B requirements plus an improved chair (Group A). Productivity data was gathered from 72 volunteer participants who received ergonomics improvements to their workstations and 370 control subjects working in the same departments. Daily company records of production outputs for each worker were taken before ergonomics intervention (baseline) and 12 months after ergonomics intervention. Productivity improvement from baseline to 12 months post-intervention was examined across all ergonomics conditions combined, and also compared to the control group. The findings showed that worker performance increased for 50% of the ergonomics improvement participants and decreased for 50%. Overall, there was a 4.87% output increase for the ergonomics improvement group as compared to a 3.46% output decrease for the control group. The level of productivity increase varied by the type of the ergonomics improvements with Group C showing the best improvement (9.43%). Even though the average production improved, caution must be used in interpreting the findings since the ergonomics interventions were not successful for one-half of the participants.     

Ergonomic analysis of musculoskeletal discomforts among conversational VDT operators

VDT tasks are rapidly increasing as the office automation prevails. Despite its numerous benefits, occupational hazards such as visual fatigue, eye strain, radiation and musculoskeletal stresses have emerged as an important issue. This study was designed to investigate the effects of work postures and anthropometric differences upon the musculoskeletal stresses experience by operators involved in conversational VDT tasks. Evaluation of the level of muscoloskeletal discomfort was performed for 297 VDT operators from three divisions of telecommunication company in Korea. The ergonomic variables of the VDT tasks and the operators' anthropometric variables were evaluated for 70 out of the 297 VDT operators. Factor analysis is used for identifying underlying pattern of discomfort and multiple regression analysis were performed to examine the relationship between the measured ergonomic variables and the musculoskeletal discomfort. This study indicates that the ergonomic variables have influences on the musculoskeletal discomfort. It is important to provide the workers with fully adjustable workstations so that they can maintain their work postures most suitable for the sustained VDT work. Furthermore, in order to achieve the best working conditions, VDT operators should be given a proper training for the adjustment of their workstations.     

Occupational stress factors in visual display terminal (VDT) operation: a review of empirical research

A review of the literature involving empirical research (experimental and field investigations) on stressful aspects of visual display terminal (VDT) operation is presented. Studies reviewed included assessment of visual fatigue and/or performance, musculoskeletal symptoms and operator attitudes towards job demands and quality of working life. In addition, some investigation included discussions and evaluations of the physical attributes of VDT workplaces; including ergonomic factors (task lighting, glare conditions, anthropometric configuration of VDT and accompanying furniture), environmental factors (temperature, humidity, radiation) and psychosocial factors (job demand, work content, work-rest schedules).

The literature reveals that levels of visual and musculoskeletal complaints among VDT operators are high. Moreover, ergonomic field assessment of VDT workplaces indicate that the majority of those examined were suboptimal with respect to existing recommendations regarding lighting, glare control and anthropometric dimensions of screen, keyboard, desk and chair. Nevertheless, evidence of causal linkages between specific ergonomic attributes of the workplace and specific patterns of symptomatology are lacking.

Finally, work demand and task structure attributes to the VDT operation were demonstrated to have strong effects on incidences of reports of visual and postural symptoms as well as on psychosocial attitudinal indicators. Hence, it is argued that approaches toward stress reduction must include job content as well as ergonomic factors.     

Relationship between trapezius load and the incidence of musculoskeletal illness in the neck and shoulder

A relationship between m. trapezius load measured by electromyography (EMG) and the incidence of musculoskeletal illness in the neck and shoulder regions, was investigated both for assembly workers and VDT operators. For assembly workers, the static trapezius load (probability 0.1 of the amplitude probability distribution function, APDF) was significantly reduced from 4.3% MVC (Maximum Voluntary Contraction) to 1.4% MVC as a group median value after an ergonomic adaptation of their work places. Musculoskeletal sickleave was significantly reduced from 22.9 days to 1.8 days as a medium duration per-man-labour year for the same group.

Three groups of VDT operators were examined in terms of trapezius load and pain intensity and duration before and after an ergonomic intervention. All groups reported significant less intensity or duration of pain either in the neck or in the shoulder regions after the intervention. The trapezius load was reduced for all groups post vs. prior intervention. This reduction was measured in terms of a decrease in the static level of APDF and an increase in the number of periods per minute and total duration of muscle activity below 1% MVC. The results from this study indicate that the trapezius load may be a predictor for development of musculoskeletal illness in the neck and shoulder regions.     

Musculoskeletal disorders among visual display terminal workers: individual,ergonomic, and work organizational factors

A number of individual, ergonomic, and organizational factors of presumed importance for the occurrence of musculoskeletal disorders were investigated in a group of 260 visual display terminal (VDT) workers. The cross-sectional study utilized medical and workplace investigations as well as questionnaires. The results were subjected to a multivariate analysis in order to find the major factors associated with various upper-body muscular problems. Several such factors were identified for each investigated type of musculoskeletal problem. Some were related to the individual: age, gender, woman with children at home, use of spectacles, smoking, stomach-related stress reactions, and negative affectivity. Organizational variables of importance were opportunities for flexible rest breaks, extreme peer contacts, task flexibility, and overtime. Identified ergonomic variables were static work posture, hand position, use of lower arm support, repeated work movements, and keyboard or VDT vertical position.     

The effects of an office ergonomics training and chair intervention on worker knowledge, behavior and musculoskeletal risk

A large-scale field intervention study was undertaken to examine the effects of office ergonomics training coupled with a highly adjustable chair on office workers’ knowledge and musculoskeletal risks. Office workers were assigned to one of three study groups: a group receiving the training and adjustable chair (n=96), a training-only group (n=63), and a control group (n=57). The office ergonomics training program was created using an instructional systems design model. A pre/post-training knowledge test was administered to all those who attended the training. Body postures and workstation set-ups were observed before and after the intervention. Perceived control over the physical work environment was higher for both intervention groups as compared to workers in the control group. A significant increase in overall ergonomic knowledge was observed for the intervention groups. Both intervention groups exhibited higher level behavioral translation and had lower musculoskeletal risk than the control group.     

Effectiveness of ergonomic training to reduce physical demands and musculoskeletal symptoms - An overview of systematic reviews

Work-related musculoskeletal disorders are associated with awkward postures, excessive force, manual material handling and repetitive movements. This risk factors can be minimized through interventions such as ergonomic training. The literature covers several studies involving the use of this type of intervention, but there is no consensus about the effectiveness of ergonomic training. The aim of this study was to identify the available evidence about the effectiveness of ergonomic training to reduce physical work demand and musculoskeletal symptoms through an overview of systematic reviews. The searches were carried out in Pubmed/Medline, Web of Science, CINAHL, Embase and Cochrane Library. The START (State of the Art through Systematic Review, v.1.06.2) platform aided the selection and evaluation of studies. The studies were evaluated for methodological quality through the AMSTAR (Assessing the Methodological Quality of Systematic Reviews) criteria and the implications for practice. This overview identified a large number of studies with a low to moderate level of evidence, indicating the ineffectiveness of ergonomic training alone or associated with another type of intervention in reducing physical demand and musculoskeletal symptoms in workers. The findings may have occurred due to four main factors: superficial identification of the ergonomic risk factors; lack of scientific evidence about the appropriate configurations of the types of ergonomic training; ambiguous results in the application of ergonomic training; and the difficulty in the effectiveness of the intervention. The study identified an inconsistency in the level of evidence of ergonomic training to reduce physical demand and musculoskeletal symptoms among workers.     

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.     

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.     

Job stress management and ergonomic intervention for work-related upper extremity symptoms

In practice the secondary prevention of work-related upper extremity (WRUE) symptoms generally targets biomechanical risk factors. Psychosocial risk factors have also been shown to play an important role in the development of WRUE symptom severity and future disability. The addition of a stress management component to biomechanically focused interventions may result in greater improvements in WRUE symptoms and functional limitations than intervening in the biomechanical risk factors alone. Seventy office workers with WRUE symptoms were randomly assigned to an ergonomics intervention group (assessment and modification of work station and stretching exercises) or a combined ergonomic and job stress intervention group (ergonomic intervention plus two 1-h workshops on the identification and management of workplace stress). Baseline, 3- and 12-month follow-up measures of observed ergonomic risks and self-reported ergonomic risks, job stress, pain, symptoms, functional limitation, and general physical and mental health were obtained from all participants. While both groups experienced significant decreases in pain, symptoms, and functional limitation from baseline to three months with improvements continuing to 12 months post baseline, no significant differences between groups were observed for any outcome measures. Findings indicate that the additional two-session job stress management component did not significantly enhance the short- or long-term improvements brought about by the ergonomic intervention alone.     

Flexible workspace design and ergonomics training: impacts on the psychosocial work environment, musculoskeletal health, and work effectiveness among knowledge workers

A macroergonomics intervention consisting of flexible workspace design and ergonomics training was conducted to examine the effects on psychosocial work environment, musculoskeletal health, and work effectiveness in a computer-based office setting. Knowledge workers were assigned to one of four conditions: flexible workspace (n=121), ergonomics training (n=92), flexible workspace+ergonomics training (n=31), and a no-intervention control (n=45). Outcome measures were collected 2 months prior to the intervention and 3 and 6 months post-intervention. Overall, the study results indicated positive, significant effects on the outcome variables for the two intervention groups compared to the control group, including work-related musculoskeletal discomfort, job control, environmental satisfaction, sense of community, ergonomic climate, communication and collaboration, and business process efficiency (time and costs). However, attrition of workers in the ergonomics training condition precluded an evaluation of the effects of this intervention. This study suggests that a macroergonomics intervention is effective among knowledge workers in office settings.     

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.     

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.     

A review of physical exercises recommended for VDT operators

This paper presents an evaluation of exercises that have been recommended for the prevention of musculoskeletal discomfort among VDT/office workers. 127 individual exercises were analysed for their suitability for performance in VDT workplaces. Additionally, each exercise was judged in terms of its safety and its compliance with principles of physiotherapy. Results showed that, in the majority of cases, the prepared instructions for the exercises were satisfactory and the exercises could be readily performed at the workstation. However, over a third of the exercises were conspicuous and potentially embarrassing to perform, and half would significantly disrupt the work routine. Additionally, a number of the exercises posed potential safety hazards, exacerbated biomechanical stresses common to VDT work, or were contraindicated for persons with certain health problems. These findings suggest a need for greater attention to both the practical and the therapeutic aspects of exercises promoted for VDT users.     

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).     

Best practices for preventing musculoskeletal disorders in masonry: stakeholder perspectives

Brick masons and mason tenders report a high prevalence of work-related musculoskeletal disorders (WMSDs), many of which can be prevented with changes in materials, work equipment or work practices. To explore the use of "best practices" in the masonry industry, NIOSH organized a 2-day meeting of masonry stakeholders. Attendees included 30 industry representatives, 5 health and safety researchers, 4 health/safety specialists, 2 ergonomic consultants, and 2 representatives of state workers' compensation programs. Small groups discussed ergonomic interventions currently utilized in the masonry industry, including factors affecting intervention implementation and ways to promote diffusion of interventions. Meeting participants also identified various barriers to intervention implementation, including business considerations, quality concerns, design issues, supply problems, jobsite conditions and management practices that can slow or limit intervention diffusion. To be successful, future diffusion efforts must not only raise awareness of available solutions but also address these practical concerns.