The impact of ergonomics intervention on psychosocial factors and musculoskeletal symptoms among office workers

Musculoskeletal disorders have a multi factorial etiology that includes not only physical risk factors but also psychosocial factors. This study aimed to investigate psychosocial risk factors and musculoskeletal symptoms among office workers of an Iranian oil refinery and also to examine the subsequent effects of ergonomics intervention on musculoskeletal discomfort and psychosocial risk factors.In this study, 73 office workers as a case group and 61 office workers as a control group from an Iranian oil refinery plant were randomly selected and examined. The Nordic Musculoskeletal Disorders Questionnaire and the Persian version of the Job Content Questionnaire (P-JCQ) were used as collecting data tools before and after the interventional program.Low back problem (28.8%) was found to be the most common problem among the office workers. Significant differences found between prevalence rates of reported musculoskeletal in upper back, lower back and feet/ankle regions before and after intervention. Our findings showed that psychosocial variables were not affected by the intervention. The only variables on the P-JCQ that were significantly different pre/post intervention are the physical variables: physical job demands, physical exertion and physical isometric load. None of the other psychosocial variables were found to be significant. With the top management support, improvements in all office workstation components were made successfully.

Relevance to industry

Recently, changes in the nature of work draw increased attention to the relation between psychosocial factors and musculoskeletal disorders. The results of the current study indicate that a well conducted implementation of an interventional program can lead to a decrease in musculoskeletal symptoms and to some extent in the psychosocial factors at work.     

Evaluation of a prototype multi-posture office chair

Office chairs have often been designed to promote a single ‘correct’ rather rigid and upright posture, yet it is acknowledged that allowing changes in posture is good ergonomics practice. The present study investigated office worker's preferences for a standard shaped typist's chair (ST) and a prototype multi-posture (PMP) office chair designed to allow its users a variety of sitting positions. Forty-two (22 male and 20 female) telesales personnel (12), clerical staff (12) and researchers (18) used ST or PMP in their workplace for the first week of a 2-week study (with an even number in each work area). The PMP chair was introduced to participants with a brief lecture on how to use it and with an information booklet. Following this, each participant completed a chair comfort questionnaire. In the second week, participants swapped chairs and again completed the chair comfort questionnaire. At the end of the second week participants were also asked to complete a separate questionnaire about the usability of the information booklet that accompanied the PMP chair. Statistically significant differences in subject's rating of the two chairs were observed in 7 out of 19 questions. On a 100 mm scale, the ST chair was rated as having a greater mean overall acceptability, desirability and suitability for body build than the PMP chair. Participants also claimed to achieve better posture in the ST chair, that they tipped forward less and were more satisfied with its width. Although the participants generally preferred the ST chair, the PMP chair received more favourable ratings among the researchers who were quite mobile in their work, and in whom there was a trend for less neck, shoulder and upper back discomfort. More participants reported an overall preference for the PMP chair. The findings suggest that a more aesthetically acceptable PMP chair should be developed, peoples' reasons for preferring a more traditionally designed chair should be explored, and that the effect of postural stability education on personal preconceptions should be examined to obtain an optimal combination of healthy sitting habits, comfort and aesthetic qualities in an office chair.     

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).     

Neck pain prevalence and associated occupational factors in Portuguese office workers

ObjectiveThis study aimed to assess the prevalence of neck pain and to identify associated occupational factors in Portuguese office workers.BackgroundThere is still necessary to quantify the association of the use of new technologies with neck pain in office workers.MethodsSix hundred-and-one office workers completed online questionnaires with questions related to anthropometric parameters, work-related variables, workstation setup, and musculoskeletal pain from the Portuguese version of the Standardized Nordic Musculoskeletal Questionnaire.ResultsThe prevalence of neck pain was 56.1%. An average of 35.6% of the office workers with neck pain reported pain in more than three body segments. The significantly risk factors were “age between 50 and 65” [OR: 1.92 (1.26–2.91) P = 0.002], “working without break for 2 h” [OR: 1.82 (1.00–3.31) P = 0.05], “more than 3 h” [OR: 2.41 (1.35–4.10) P = 0.003], screen localization not centered” [OR: 2.01 (1.01–4.00) P = 0.045], and “use of computer mouse more than 50% of the worktime” [OR: 2.05 (1.14–3.71) P = 0.017].ConclusionThere was a high prevalence of neck pain and a considerable number of painful body segments in office workers. Age, working without break, screen localization and the use of computer mouse where the significant risk factors associated with the development of neck pain.Relevance to industryA high prevalence of neck pain and number of areas with pain in office workers require a detailed pain mechanism assessment. There were associated occupational risk factors for the development of neck pain. Call for concerted actions to explore optimal and efficient management plans.     

Physical risks of work-related musculoskeletal complaints among quarry workers in East of Iran

Quarry workers are at high risk of developing musculoskeletal complaints. The aim of this study was to evaluate the working postures and prevalence of musculoskeletal problems among quarry workers. In this cross-sectional study 78 male quarry workers were assessed using the method of Rapid Entire Body Assessment (REBA), and musculoskeletal complaints data were obtained by the Standardized Nordic Musculoskeletal questionnaire (NMQs). Results of the prevalence of musculoskeletal problems in body parts of stonemasonry workers was higher found than in the stonecutting workers. The highest prevalence rate of musculoskeletal problems in both stonemasonry and stonecutting workers was 65.7% and 54.8% respectively related to waist. The stonemasons with 62% had high level of risk and stone cutting workers with 47.6% had moderate risk level. Significant correlation was found among age, work experience, BMI, and prevalence of musculoskeletal problems. There was also a significant relationship between the wrist and lower back pain with the risk level of REBA score. The study results showed that musculoskeletal problems of workers had high prevalence and accordingly most of the work conditions and postures needed to be improved, so prioritizing the necessity of corrective actions and intervention are to be gained.     

Aviation deicing workers,global risk assessment of musculoskeletal injuries

Deicing technicians working from open baskets are exposed to ergonomic risks and fatigue. This study aims to assess the global risk of musculoskeletal injuries (MSIs) for this type of activity. An ergonomic study was conducted with the workers of a Canadian airport deicing operator during the winter of 2016–2017. Video recordings made it possible to observe the activities during the most intensive work shifts, as well as characterise and quantify (frequency and duration) the movements/postures of twelve human subjects. The resulting risk assessment identified the body structures submitted to exertion, analysed the efforts involved and globally assessed the forces exerted on the spine and upper limbs. This global risk assessment leads to the conclusion that the risks to the upper limbs are preoccupying and must be examined further.     

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.     

Effect of a novel teat preparation system on upper extremity muscle activity among U.S. large-herd dairy parlor workers

BackgroundDairy production in the U.S. is moving towards large-herd milking operations resulting in an increase in task specialization and work demands. Large-herd dairy parlor workers experience a high prevalence of musculoskeletal symptoms in the upper extremity. The purpose of this study is to evaluate the effects of an alternative teat scrubber (TS) cow preparation method on upper extremity muscle activity among large-herd parlor workers, as well compare to muscle activity associated with conventional manual milking tasks.MethodsUpper extremity muscle activity was recorded among U.S. large-herd parlor workers (n = 15) using surface electromyography. Participants performed multiple task cycles, using both conventional and TS methods. Muscle activity levels were then compared across conventional manual and TS milking tasks.ResultsConventional manual milking tasks of dip, strip and wipe were associated higher muscle activity levels of the upper trapezius and anterior deltoid. Biceps muscle activity was greatest during teat dip and wipe. Forearm flexor and extensor muscle activity was greatest during teat wipe and dip. The TS system resulted in more desirable anterior deltoid EMG profiles, and less desirable biceps, forearm flexor and extensor profiles.ConclusionsResults suggest that the TS system is effective in reducing anterior deltoid muscle activation levels. The TS system also appears to result in increased biceps, forearm flexor and extensor muscle activation levels. Increases in muscle activation levels could be offset by reduced repetitiveness resulting from three conventional manual milking tasks being replaced with one TS task.Relevance to industryIf parlor production requirements (e.g., quality and onsistency) are maintained while simultaneously reducing cumulative muscle loading and worker fatigue, then TS use should be considered in milking parlor operations.     

Computer-telephone interactive tasks: predictors of musculoskeletal disorders according to work analysis and workers' perception

Sixty-two workers engaged in computer-telephone interactive tasks in an active telemarketing center and a telephone call center of an international bank subsidiary in S?o Paulo. Brazil, were assessed by means of a work analysis and a self-administered questionnaire aiming to determine the statistical relationship of ergonomic, organizational and psychosocial characteristics of their jobs with the report of symptoms in neck-shoulder and hand-wrist for more than 7 consecutive days and any time away from work during the current job due to musculoskeletal disorders (MSD). According to chi-square univariate tests and multiple logistic regression models, active telemarketing operations, duration in the job and the low level of satisfaction with the physical arrangement of the workstation emerged as the factors most related to neck-shoulder and hand-wrist MSD and MSD-induced time away from work. This study emphasizes the role of psychosocial factors and duration in the job in MSD occurrence and induced absenteeism among workers engaged in computer-telephone interactive tasks.     

The prevalence of musculoskeletal symptoms among British Columbia sonographers

A survey (n = 211, 92% response rate) was carried out to determine baseline prevalence of musculoskeletal symptoms and identify related biomechanical, psychosocial, work organization and demographic factors among the population of sonographers in British Columbia, Canada. Ninety-one percent of respondents reported musculoskeletal pain or discomfort that they associated with the work tasks of scanning. Almost half reported frequent and severe symptoms. The neck, shoulder, and upper back were the main symptomatic body sites. A very small minority were absent from work due to the symptoms, with more than two thirds of respondents reporting working in pain. Bivariate analyses found significant associations between scanning time, static postures, psychosocial factors, and degree of musculoskeletal symptoms.     

Prevalence of work-related musculoskeletal symptoms among grocery workers

Work-related musculoskeletal disorders (WMSDs) affect all sectors of the working population, and grocery workers have especially high rates. Although the incidence of WMSDs among any worker population can be estimated from workers' compensation claims, musculoskeletal symptom surveys can be used as a proxy estimate of WMSDs. The purposes of this cross-sectional study were to describe the prevalence of work-related musculoskeletal symptoms in grocery store employees from many different departments, and to determine the association between exposure to physical risk factors and presence of symptoms. Study participants (N = 254) were grocery store workers from five different stores in a medium sized grocery chain. Participants completed a self-administered survey consisting of demographic information and job history; the modified Nordic Questionnaire (MNQ); and physical component (PCS) and mental component (MCS) summary measures of the SF-36v2^®. Rodgers Muscle Fatigue Analysis (Rodgers) was used to assess exposure to physical risk factors in the most difficult tasks in certain store departments. Prevalence of musculoskeletal symptoms was estimated for each body region and for various subgroups, and multivariable logistic regression analysis was used to identify independent predictors of presence of musculoskeletal symptoms. Approximately 78% of grocery store workers reported work-related musculoskeletal symptoms in at least one body region, with most workers complaining of low back and feet symptoms. The high prevalence of foot symptoms has not been previously reported for this population. Approximately 11% of employees missed work because of symptoms and 25% sought medical care for symptoms. There were no differences among Rodgers rating groups for proportions reporting symptoms. SF-36v2^® scores were inconsequential predictors for musculoskeletal symptoms. Gender and age were both significant predictors of symptoms, and age predicted healthcare utilization. These findings are relevant to the grocery industry in order to target WMSD preventive interventions to specific body regions for high-risk activities within a grocery store position.     

A computerized method for assessment of musculoskeletal discomfort in the workforce: a tool for surveillance

A musculoskeletal discomfort survey was conducted to assess musculoskeletal discomforts among rural mail carriers in two post offices. Perceived musculoskeletal discomfort was collected directly from the workforce by means of a computerized discomfort assessment system (DAS). This investigation aimed at: (1)assessing the rural mail carrier's perception of DAS; and (2) assessing the rural mail carrier's musculoskeletal discomforts resulting from work. Most participants in the study found the computer tool easy to learn and easy to use. The information collected by DAS was used: (1) to determine the number of participating employees who were experiencing some kind of musculoskeletal problem; (2)to determine subtasks associated with discomfort; (3) to determine the body areas most affected by different subtasks; and (4) to investigate the patterns of discomfort that occurred with time.     

Risk of slaughterhouse workers developing work-related musculoskeletal disorders in different organizational working conditions

Job rotation is defined as workers rotating between tasks with different exposure levels and occupational demands. The aim of the present study was to analyze the risk factors for the development of upper-limb work-related musculoskeletal disorders (UL-WMSDs) in poultry slaughterhouse workers as well as compare the score of the OCRA Checklist in different organizational working conditions. In this cross-sectional study, 118 workers were involved, 68 women (32.3 ± 10.7 years) and 50 men (29.5 ± 10.5 years). Three organizational configurations (“without job rotation”, “with job rotation – tasks >1h” and “with job rotation - tasks <1h”) were evaluated using the OCRA Checklist method, totaling 36 tasks and 28 job rotation schemes composed of 2–3 tasks. The OCRA score of the right upper limbs (17.8 ± 3.2) was significantly higher (p = 0.046) relative to the left upper limbs (16.4 ± 3.6). The median score was significantly lower in the “with job rotation - tasks <1h” condition (18.6) when compared to the “job rotation – tasks >1h” (19.4) (p < 0.001) and the “without job rotation” (19.0) (p = 0.038) conditions. However, there was no significant difference between the condition “with job rotation - tasks >1h” and “without job rotation” (p = 0.155). Thus, job rotations with intervals <1h reduced the risk of developing UL-WMSDs. Job rotations with <1 h intervals in poultry slaughterhouses are recommended along with further studies to verify the effectiveness of rotations with more than two tasks, involving mild or non-repetitive tasks.     

DASH questionnaire for the analysis of musculoskeletal symptoms in industry workers: a validity and reliability study

Purpose

The disabilities of the arm, shoulder and hand (DASH) questionnaire is a self-administered region-specific outcome instrument developed as a measure of self-rated upper-extremity disability and symptoms. The aim of this study was to evaluate the reliability and the construct validity of the DASH questionnaire by establishing its correlation to the Medical Outcomes Study Short Form-36 (SF-36) in industry workers. Also we aimed to investigate whether the DASH can be used as a standardized questionnaire to evaluate the work-related musculoskeletal disorders (WMSDs) in upper extremity in industrial settings and epidemiological studies.

Material and methods

The Turkish version's reliability and construct validity were evaluated in 240 industry workers with upper-extremity musculoskeletal complaints. Workers were asked to complete a packet that included the DASH and the SF-36. Test-retest reliability was assessed in all workers who filled in the DASH questionnaire 15 days later. Construct validity was evaluated by comparing the overall and work component DASH scores with SF-36 summary and subscales.

Results

The mean DASH score for the textile workers whose duties were confection, dyeing, sewing, quality control and packaging was calculated as 65, 55, 68, 54 and 67, respectively. As a result of this study, pain intensity in shoulder, wrist and hand was significantly associated with the DASH score (p<0.05). Internal consistency of the DASH was high (Cronbach alpha 0.91). Test-retest reliability was excellent for the overall DASH (intraclass correlation coefficient (ICC) 0.92). Moderate correlations (p<0.05) were found between the overall and work component DASH and the SF-36 summary scales. Pearson correlation coefficients of the overall and work component DASH to the SF-36 subscales ranged from −0.33 to −0.82.

Conclusion

These results support that DASH is a reliable and valid instrument to measure functional disability and investigate the ergonomic risk factors in textile workers with upper-extremity musculoskeletal complaints.     

Examining the relationship between job design and worker strain over time in a sample of office workers

This study examines relationships between job design variables and worker strain. Office workers from a public service organization participated in a three-year study. Once during each of the three years, the same questionnaire was handed out to the subjects to examine job design and worker strain. The results indicate that the bivariate relationships between job design and worker strain change over time. At round 1, quantitative workload, work pressure and supervisor social support were the most important predictors of the worker strain variables. At round 2, task clarity, supervisor social support, and job future ambiguity were the most important predictors of worker strain. At round 3, task clarity, attention, and job future ambiguity were the most consistent predictors of worker strain. The results of the canonical correlation analysis were relatively similar for rounds 1 and 3, but not for round 2. There appears to be some consistency in the overall underlying structure of the relationships between job design and worker strain, but there is also some inconsistency in terms of which specific job design factors are related to specific measures of worker strain.     

Quantitative and qualitative assessment of musculoskeletal disorders and socioeconomic issues of workers of brick industry in Pakistan

Brick industry, in Pakistan, is prominent and provides job to 3.1 million people only in one province. The industry hires different percentage of workers for different stages of brick formation and these stages trigger musculoskeletal disorders (MSDs) in workers. This study identifies relation between 5 work stages and MSDs in 9 body parts and also finds socioeconomic sufferings inflicted by the industry and removal of research gap at national level. We conducted both qualitative and quantitative research. 105 men and 45 women from 15 brick kilns were selected as subject. Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA) sheets, Standard Nordic MSDs Questionnaire along with general questionnaire, still photography and video recording were used to carry out the study. About 96% workers involved in mixing & molding complained tiredness at end of day. Similarly, 90% male and 83% female staff performing spreading task suffered tiredness after their duty hours. Workers engaged in different tasks reported varying levels of pain in observed body parts. Digging and carrying jobs caused significant pain in body parts including neck, upper back, shoulders, lower back and hips. Mixing and molding emerged most dangerous activities for most of the body parts and exhibited 7 score on RULA. Furthermore, mixing and molding demonstrated high to very high risk level by showing 9 and 13 higher score on REBA, respectively. The current study divulged that all observed work tasks during manufacturing and transportation of bricks are equally dangerous for pain generation in lower back. Many socioeconomic issues like residency of workers in muddy house (83%) low monthly income (<90.3 $) of 83% workers, higher tendency of alcoholism and smoking in men, lack of health facilities and higher illiteracy rate were also identified. The enhanced musculoskeletal disorders during brick making process render the brick industry unhealthy for work. This dismal picture requires an improvement in quality of life and occupational environment of workers of the industry. Well organized duty timings, modified working posture, job rotation and preliminary training perhaps manage these miseries and the output of the brick industry may increase many fold.     

The investigation of work-related musculoskeletal disorders among female workers in a hazelnut factory: Prevalence,working posture,work-related and psychosocial factors

BackgroundWork-related musculoskeletal disorders (WMSDs) are the most common occupational health problems in the industrialized world. The identification of WMSDs specific to occupation is essential to plan and implement preventative programs. This study investigated the prevalence of WMSDs and determined the factors related to the severity of the most common disorders among female workers in a hazelnut factory.MethodsA total of 114 female workers were examined in this cross-sectional study using the Nordic Musculoskeletal Questionnaire, the Dutch Musculoskeletal Questionnaire, and an author-developed questionnaire (for socio-demographic characteristics and psychosocial factors). Working posture, craniovertebral angle, thoracic kyphosis angle (TKA), and lumbar lordosis angle were evaluated based on a photogrammetry method using the ImageJ program.ResultsThe prevalence of WMSDs in at least one body part during the last 12 months was 92.1%. The highest prevalence of WMSDs was in the lower back (61.4%), neck (57.9%), shoulder (53.6%), and upper back (45.6%). The least affected part was the elbow. Lower back, shoulder, and neck disorders were the most common causes of activity limitation. The severity of lower back pain was associated with stress in the workplace and work-related factors. The neck pain severity was related to craniovertebral angle and work-related factors. The shoulder pain severity increased with TKA and employment duration. TKA was related to upper back pain severity.ConclusionsWMSDs are common among female workers in a hazelnut factory. Reorganizing of working posture, work-related factors, and stress at work may be beneficial to decrease the prevalence of WMSDs and pain severity.Relevance to Industry; The female workers in the hazelnut factory are vulnerable to the work-related musculoskeletal disorders, particularly in the spinal region. The employers should endeavor to improve the health of the workers by the adjustment of the working posture and environmental factors.     

Perceived competence in computer use as a moderator of musculoskeletal strain in VDU work: An ergonomics intervention case

Musculoskeletal strain and other symptoms are common in visual display unit (VDU) work. Psychosocial factors are closely related to the outcome and experience of musculoskeletal strain. The user – computer relationship from the viewpoint of the quality of perceived competence in computer use was assessed as a psychosocial stress indicator. It was assumed that the perceived competence in computer use moderates the experience of musculoskeletal strain and the success of the ergonomics intervention. The participants (n = 124, female 58%, male 42%) worked with VDU for more than 4 h per week. They took part in an ergonomics intervention and were allocated into three groups: intensive; education; and reference group. Musculoskeletal strain, the level of ergonomics of the workstation assessed by the experts in ergonomics and amount of VDU work were estimated at the baseline and at the 10-month follow-up. Age, gender and the perceived competence in computer use were assessed at the baseline. The perceived competence in computer use predicted strain in the upper and the lower part of the body at the follow-up. The interaction effect shows that the intensive ergonomics intervention procedure was the most effective among participants with high perceived competence. The interpretation of the results was that an anxiety-provoking and stressful user – computer relationship prevented the participants from being motivated and from learning in the ergonomics intervention. In the intervention it is important to increase the computer competence along with the improvements of physical workstation and work organization.     

Structural equation modeling of office environment quality,sick building syndrome,and musculoskeletal complaints on aggregate satisfaction of office workers

This study aims to analyze the effects of office environment quality (OEQ), sick building syndrome (SBS), and musculoskeletal complaints on aggregate office satisfaction level using the structural equation. A questionnaire survey targeting 483 office workers of 18 public agencies was conducted and surveyed on workers’ characteristics (gender, age, work experience, work hours, and computer time of day), OEQ satisfaction level (temperature and humidity, lighting, noise, and air quality), SBS frequency (eye, noise, throat, skin, and headache), musculoskeletal complaints intensity (neck, shoulder, arm, wrist, waist, and leg), and aggregate office satisfaction level. As a result of the model using the structural equation, the level of OEQ on temperature and humidity, noise, and air quality directly affect the level of SBS frequency. Also, the OEQ level indirectly affects both musculoskeletal complaints’ intensity and aggregate office satisfaction level via the level of SBS frequency. Thus, providing pleasant office environments can be an effective measure to enhance office workers’ satisfaction, because workers’ levels for musculoskeletal complaints and aggregate office satisfaction depend on OEQ and SBS levels.     

Work-related musculoskeletal complaints: some ergonomics challenges upon the start of a new century

Three themes likely to be important within health-related ergonomics in the coming years are discussed. The first two themes concern methods for risk analysis of low-level biomechanical and psychosocial exposures. The third theme is approaches to successful implementation of ergonomics interventions. Evidence on the assessment of low-level biomechanical and psychosocial exposures by instrumented measurements is discussed. It is concluded that, despite recent advances in our understanding of exposure-effect associations under these exposure conditions, we must at present rely on more subjective methods, employed in a collaboration between expert and worker. This approach to risk analysis identifies in most cases critical exposures in a work situation. The focus should then be on the successful implementation of measures against those exposures, as identification alone does not solve problems. The aim of improved health for the workers further requires that the full complement of risk factors be considered, including work, leisure time and person-based risk factors. Finally, the need to put ergonomics intervention initiatives in an organisational context is emphasised, and examples of approaches used by Norwegian companies are presented.