Ergonomic interventions among waste collection workers: A systematic review

Waste collection workers are frequently exposed to significant occupational hazards. Even though ergonomic interventions can mitigate these occupational hazards, only a few studies have attempted to study the importance of the interventions. The current review identifies the gaps in ergonomic interventions among waste collection workers. A systematic review and a bibliometric analysis of the literature on the assessment of occupational hazards and ergonomic interventions in different countries were performed to identify the scope of the interventions. A literature search was carried out in Web of Science, PubMed and Scopus for articles published until December 2018. The search yielded seventy articles on the assessment of occupational health and ten articles on ergonomic interventions among waste collection workers. Based on the review, this paper proposes a hierarchical framework for the implementation of ergonomic interventions in waste associated occupations. The problems faced by formal and informal waste collectors are critical, particularly in developing countries and there is a growing need for low-cost interventions. It is suggested that the potential interventions have to be implemented based on the nature of occupational hazard considering social, cultural and economic factors.     

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.     

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.     

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.     

Assessing the effects of positive feedback and reinforcement in the introduction phase of an ergonomic intervention

Resistance to change is common in ergonomic interventions, often resulting in negative consequences when the intervention's effectiveness is studied. A lab-based study assessed the effects of positive reinforcement during the intervention process. On Day 1 all participants performed a simple screw-driving task that placed stress on the cervicobrachial region through static loading. On Day 2 a control group received basic information about ergonomics and then performed the task using an ergonomic intervention that has been shown to reduce loading on these muscle groups. The experimental group received the same basic information but also received positive reinforcement while performing the task with the ergonomic intervention. Subjective task assessment surveys and body-part discomfort surveys were administered, and these, along with speed of performance, were assessed in both groups. The results showed a significantly (p < .05) more positive subjective impression of the intervention for the feedback group than for the control group (29%-57% improvement) with no real changes in either the performance or discomfort levels. Applications of this research include improving workers' acceptance of ergonomic interventions in industrial and other settings. The reinforcement technique evaluated in this paper has yielded consistently positive effects in our ongoing ergonomic intervention research.     

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.     

Effect of Physical Ergonomics on VDT Workers' Health: A Longitudinal Intervention Field Study in a Service Organization

This article examines the effect of physical ergonomic work conditions on occupational health in video display terminal (VDT)-intensive work settings. A longitudinal intervention field study was conducted in a catalog retail service organization in the Midwest to explore the impact of ergonomic interventions. There were 3 levels of ergonomic interventions, each adding incrementally to the previous one. The 1st level was ergonomic training for all VDT users accompanied by workstation ergonomic analysis leading to specific customized adjustments (Group C). The 2nd level added specific workstation accessories supplied by Details, Inc. if the analysis indicated a need for them (Group B). The 3rd level added a Steelcase Criterion(tm) 453 Series chair (Group A). Health data were gathered from 80 volunteer participants by administering a survey before (baseline), 6 months after, and 12 months after interventions were put in place. The findings show that neck, back, and shoulders as well as wrists stand out in terms of self-reported musculoskeletal pain in VDT-intensive work. Reductions in self-reported musculoskeletal discomfort were found for all 3 levels of incremental ergonomic interventions. The number of cases showing improvement in health over time was significant for intervention Groups A and B, but not C.     

Exploring the potential of computer and video games for health and physical education: A literature review

This study aims at critically reviewing recently published scientific literature on the use of computer and video games in Health Education (HE) and Physical Education (PE) with a view: (a) to identifying the potential contribution of the incorporation of electronic games as educational tools into HE and PE programs, (b) to present a synthesis of the available empirical evidence on the educational effectiveness of electronic games in HE and PE, and (c) to define future research perspectives concerning the educational use of electronic games in HE and PE. After systematically searching online bibliographic databases, 34 relevant articles were located and included in the study. Following the categorization scheme proposed by [Dempsey, J., Rasmussen, K., & Lucassen, B. (1996). The instructional gaming literature: Implications and 99 sources. University of South Alabama, College of Education, Technical Report No. 96-1], those articles were grouped into the following four categories: (a) research, (b) development, (c) discussion and (d) theory. The overviewed articles suggest that electronic games present many potential benefits as educational tools for HE and PE, and that those games may improve young people’s knowledge, skills, attitudes and behaviours in relation to health and physical exercise. Furthermore, the newly emerged physically interactive electronic games can potentially enhance young people’s physical fitness, motor skills and motivation for physical exercise. The empirical evidence to support the educational effectiveness of electronic games in HE and PE is still rather limited, but the findings present a positive picture overall. The outcomes of the literature review are discussed in terms of their implications for future research, and can provide useful guidance to educators, practitioners and researchers in the areas of HE and PE, and to electronic game designers.     

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.     

Physical ergonomic hazards in highway tunnel construction: overview from the Construction Occupational Health Program

This report provides an overview of physical ergonomic exposures in highway construction work across trades and major operations. For each operation, the observational method “PATH” (Posture, Activity, Tools and Handling) was used to estimate the percentage of time that workers spent in specific tasks and with exposure to awkward postures and load handling. The observations were carried out on 73 different days, typically for about 4 h per day, covering 120 construction workers in 5 different trades: laborers, carpenters, ironworkers, plasterers, and tilers. Non-neutral trunk postures (forward or sideways flexion or twisting) were frequently observed, representing over 40% of observations for all trades except laborers (28%). Kneeling and squatting were common in all operations, especially tiling and underground utility relocation work. Handling loads was frequent, especially for plasterers and tilers, with a range of load weights but most often under 15 pounds. The results of this study provide quantitative evidence that workers in highway tunnel construction operations are exposed to ergonomic factors known to present significant health hazards. Numerous opportunities exist for the development and implementation of ergonomic interventions to protect the health and safety of construction workers.     

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

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

Negotiating participation: understanding the "how" in an ergonomic change team

In participatory ergonomic (PE) interventions, "how" effective participation by workplace parties can be achieved remains unclear. We conducted a case study of the dynamics of an ergonomic change team (ECT) process in a medium-sized (175 employees) automotive foam manufacturing plant. We present analyses of observer field notes and post-intervention interviews from which key elements on the dynamics of the "how" emerged: (1) impacts of facilitators' involvement and interests; (2) tensions in delimiting the scope of ECT activities; issues around (3) managing meetings and (4) realizing labour and management participation; and (5) workplace ECT members' difficulties in juggling other job commitments and facing production pressures. We highlight the ongoing negotiated nature of responses to these challenges by labour, management and ergonomic facilitator members of the ECT. We argue for greater examination of the social dynamics of PE processes to identify additional ways of fostering participation in ergonomic project implementation.     

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.     

Barriers to the adoption of ergonomic innovations to control musculoskeletal disorders and improve performance

Despite a growing number of published articles describing studies of ergonomic interventions, little is known about the barriers potential adopters face when deciding whether or not to adopt such innovations. To this end, the purpose of this paper is to examine the barriers identified by potential adopters of ergonomic innovations and compare barriers identified by individuals not interested in adopting to those identified by individuals planning to adopt. Eight hundred forty-eight fresh market vegetable farmers were mailed surveys measuring the adoption of and barriers to the adoption of several ergonomic innovations as part of a multi-year intervention study. Barriers such as cost, lack of information, never having seen the innovation used and not being able to try out the innovation were among the barriers identified. The barriers identified were moderated by whether or not the respondents were likely to adopt. Implications for diffusing ergonomic and safety innovations are discussed.     

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.     

Logistical and ergonomic transportation capacity for refuse collection workers: a work physiology field study.

In a work physiology field study, the work flow and the electrocardiogram were recorded throughout whole shifts for six male refuse (garbage) collection workers who transported and emptied 1.1 m3 refuse containers. The work rate (WR), indicated by the number of 1.1 m3 containers emptied per unit of time, and the work pulse rate (WPR) were determined in the data evaluation. The work pulse rate increases with the work rate. The functional relationship can be approximated by a linear regression function (WPR = 20.9 + 35.8.WR). The work pulse rate reaches such high values that it must be assumed that the work cannot be performed continuously throughout the whole working day. Consequently, regular breaks should be provided. When determining the necessary duration of the breaks, it was assumed that an equilibrium between fatigue and recovery should be maintained during the working day. The recovery breaks should be at least long enough for the heart rate to return to the resting level. The necessary duration of the breaks was determined on the basis of the present field study and the laboratory investigations described in the literature. A minimum duration of 10 min per working hour results from the calculations. The breaks should be taken regularly at about hourly intervals. A transportation-capacity model is provided for the planning of the deployment of refuse workers. It permits calculation of the number of 1.1 m3 containers a three-man crew, comprising the refuse collection truck driver and two loaders, can empty during one shift. Both the logistical and ergonomic transportation capacities can be determined using the model. The logistical transportation capacity (TCL) indicates the number of containers which can be emptied per shift by a crew when only criteria such as the optimal utilization of the working time are considered. The ergonomic transportation capacity (TCE) is understood as the number of containers which can be emptied per shift taking into consideration the workers' strain and the recovery breaks they require. TCE amounts to between about 140 and 160 containers per shift depending on the type of city district. TCL is higher by between 20 and 30 containers per shift. In order to meet the demand of protecting workers' health, the number of containers to be emptied per shift by a three-man crew should not exceed the ergonomic transportation capacity.     

Exposure probabilities to ergonomic hazards among miners

The National Occupational Health Survey of Mining (NOHSM) was designed to provide estimates of health and safety hazards, including ergonomic hazards, to which miners are exposed. Nine specially-trained observers documented health hazards for 144 mines that were representative of the metal-nonmetal mining industry. The observers documented 9,121 exposures to 12 different ergonomic hazards. Almost 25% of these exposures were to hazards involving the neck and back. Other major ergonomic hazards included: Movement of the forearms, arms and shoulder; and finger-hand movement. The mining categories (i.e., ‘commodities’) most at risk for ergonomic hazards were (in order of diminishing risk, with the total workforce at risk in parentheses): Trona (N = 749), Leonardite (N = 52), Gold-Lode/Placer (N = 4,290), Gemstones (N = 80), Rare Earths (N = 218), and Aluminium Ore (N = 3,801). These results are discussed in terms of evaluating the effectiveness of various ergonomic interventions, as well as improving the efficacy of current health and safety inspection strategies.     

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.     

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.     

Ergonomics interventions to reduce musculoskeletal risk factors in a truck manufacturing plant

Ergonomic interventions may potentially reduce MSDs, but the context of industries (barriers, ever-changing situations, dialogue processes) might play a significant role in the success of interventions. This study evaluates the effectiveness of ergonomic interventions including engineering/technical and organizational interventions, and the involvement of the stakeholders in reducing musculoskeletal risk factors/symptoms. A pre-post-test experimental study in non-randomized groups was performed over three years in a sector of a truck assembly plant. The mean age of the operators in the sector for the initial and second assessment time was 42.0 (±7.6) years and 39.0 (±8.7), respectively. The mean length of work experience in the current job was 15.2 (±7.2) years and 13.9 (±7.3) for the initial and second assessment times, respectively. Five engineering ergonomic solutions and organizational interventions were implemented after a comprehensive ergonomic analysis. The organizational interventions consisted mostly of transferring and redistributing the tasks, i.e., ergonomically balancing and redesigning of the workstations. Before performing the interventions, the findings of the ergonomic study were presented at several meetings to encourage the involvement of the stakeholders (including managers, engineers, and operators) in the interventions. This study showed that a combination of ergonomic measures—engineering and organizational interventions—could reduce physical workloads. Musculoskeletal symptoms decreased after interventions although the difference was not significant.