Design and implementation of a participatory ergonomics program for machine sewing tasks

A participatory ergonomics program was designed and implemented to control and reduce workers' compensation costs within an automobile products manufacturing company. Pareto analysis identified a substantial number of musculoskeletal disorders (MSD) associated with manual, machine sewing of canvas automobile accessory products. This case study will discuss the elements of the participatory ergonomics program, describe its implementation, highlight intervention measures, and present program results. Specifically, during the period of 1993 to 1996, the participatory ergonomics program played a significant part in reducing the number of MSD claims by approximately 85%, and contributed to an overall reduction in workers' compensation incurred loss costs by approximately 42%.     

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.     

Evaluation of a participatory ergonomic intervention process in kitchen work

We evaluated a participatory ergonomic intervention process applied in 59 municipal kitchens. In groups of three to five kitchens, the workers participated in eight workshops, and generated and evaluated solutions to optimize musculoskeletal load in their work. An ergonomist initiated and supported the process. By the end, 402 changes were implemented. Evaluative data were collected using research diaries, questionnaires, and focus group interviews. The intervention model proved feasible and the participatory approach was mostly experienced as motivating. The workers’ knowledge and awareness of ergonomics increased, which improved their ability to tackle ergonomic problems by themselves. The changes in ergonomics were perceived to decrease physical load and improve musculoskeletal health. As hindering factors for implementation, lack of time and motivation, and insufficient financial resources were mentioned. In addition, the workers expressed a wish for more support from the management, technical staff, and ergonomists.     

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.     

Paddling upstream: a contextual analysis of implementation of a workplace ergonomic policy at a large newspaper

Efforts to implement workplace ergonomic programs aimed at reducing the burden of work-related musculoskeletal disorders (WMSD) have to address multiple physical and psychosocial aspects of work environments yet often contextual factors limit their success. We describe the processes involved in an ergonomic program to reduce neck and upper limb WMSDs at a large Canadian newspaper. Using qualitative data collection and analysis methods, we illustrate the impact of key contextual characteristics of: (1) the program (management commitment, union involvement, experience and skill of program leaders, and researcher involvement); (2) the organization (drive for productivity, management control, organizational culture); and (3) the broader social context (economic climate, nature of newspaper work, technology and nature of WMSD). We argue for increased attention to identification and response to the contextual factors affecting program implementation in order to more successfully address upstream determinants of WMSD.     

Study of the effectiveness of a participatory ergonomics intervention in reducing worker pain severity through physical exposure pathways

A participatory ergonomics programme was implemented in an automotive parts manufacturing factory. An ergonomics change team was formed composed of members from management and the organized labour union. It was hypothesized that the physical change projects implemented as part of this process would result in decreased worker exposures to peak and cumulative physical demands and reduced worker perceptions of physical effort and pain severity. A quasi-experimental design was employed, utilizing a sister plant in the corporation as a referent group. A longitudinal questionnaire approach was used to document pre-post changes in worker perceptions. In general, the physical change projects were rated as improvements by workers and were successful at reducing peak and/or cumulative mechanical exposures. However, there were few systematic changes in perceived effort or pain severity levels. Explanations include the confounding effects of differential production rate and staffing changes at the intervention and referent plants and/or insufficient overall intervention intensity due to a relatively short intervention period, plant and team ambivalence towards the process and the low overall impact on exposure of the particular changes implemented.     

Time trends in ergonomic intervention research for improved musculoskeletal health and comfort in Latin America

Studies on ergonomic intervention research aiming at improved musculoskeletal health published in Latin America in the past 20 years were reviewed. The tendencies observed over time in these studies show that interventions carried out are trying to deal with the changes occurring in the production processes in this period. Thus, more participative approaches have been used, involving different parts interested in the process. The previous transversal projects, more focused on the physical aspects of the work, are now substituted by studies including organizational and longitudinal designs. Despite this, some negative or unchanged outcomes have been obtained. Therefore, good quality intervention studies are needed to provide more generalizable data and improve our understanding on planning, implementing and sustaining effective measures for controlling work-related musculoskeletal disorders.     

Bernardino Ramazzini's early observations of the link between musculoskeletal disorders and ergonomic factors

Bernardino Ramazzini (1633-1714) systematically studied the relationship between work and diseases. He realized that it was not possible to ascribe all workers' diseases to chemicals or physical agents and foresaw that other factors were involved. He observed that common diseases could originate following the maintenance either of prolonged stationary postures or of unnatural postures (e.g. bakers, workers who stand, sedentary worker, scribes, weavers) or following activities requiring heavy muscular performance (e.g. porters and woodworkers). Furthermore, Ramazzini recognized the need to undertake measures to prevent disorders from repetitive motions and manual lifting and anticipated the now accepted advice of moderation and recommendations of reduction of work duration for a number of hard jobs requiring a standing position or severe muscular effort. From his early writings therefore it is evident that Ramazzini realized the importance of assessing the ergonomic factors associated with the occurrence of work-related musculoskeletal disorders.     

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

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

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.     

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

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

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

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

Participatory ergonomics in design processes: the role of boundary objects

The aim of this paper is to introduce the concept of boundary objects in order to better understand the role of objects in participatory ergonomics (PE) design processes. The research question is: What characterizes boundary objects in PE processes? Based on two case studies, we identify eight characteristics of boundary objects and their use, which make them particularly useful in PE design processes. These characteristics go beyond the object itself and extend into the context of their use. We argue that the selection of boundary objects in PE processes is of great importance, since different objects enable workers’ participation and collaborative design in different ways. The framework developed may serve to provide criteria to guide practitioners and intervention researchers in the selection of objects to facilitate a PE process. The paper concludes with a list of recommendations for ergonomic practitioners that are based on the framework.     

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.     

Task exposures in an office environment: a comparison of methods

Task-related factors such as frequency and duration are associated with musculoskeletal disorders in office settings. The primary objective was to compare various task recording methods as measures of exposure in an office workplace. A total of 41 workers from different jobs were recruited from a large urban newspaper (71% female, mean age 41 years SD 9.6). Questionnaire, task diaries, direct observation and video methods were used to record tasks. A common set of task codes was used across methods. Different estimates of task duration, number of tasks and task transitions arose from the different methods. Self-report methods did not consistently result in longer task duration estimates. Methodological issues could explain some of the differences in estimates seen between methods observed. It was concluded that different task recording methods result in different estimates of exposure likely due to different exposure constructs. This work addresses issues of exposure measurement in office environments. It is of relevance to ergonomists/researchers interested in how to best assess the risk of injury among office workers. The paper discusses the trade-offs between precision, accuracy and burden in the collection of computer task-based exposure measures and different underlying constructs captures in each method.     

Comparison of concepts in easy-to-use methods for MSD risk assessment

This article presents a comparative analysis of easy-to-use methods for assessing musculoskeletal load and the risk for developing musculoskeletal disorders. In all such methods, assessment of load consists in defining input data, the procedure and the system of assessment. This article shows what assessment steps the methods have in common; it also shows how those methods differ in each step. In addition, the methods are grouped according to their characteristic features. The conclusion is that the concepts of assessing risk in different methods can be used to develop solutions leading to a comprehensive method appropriate for all work tasks and all parts of the body. However, studies are necessary to verify the accepted premises and to introduce some standardization that would make consolidation possible.     

The predictive validity of the RSI QuickScan questionnaire with respect to arm,shoulder and neck symptoms in computer workers

The aim of this study was to determine whether results from the RSI QuickScan questionnaire on risk factors for arm, shoulder and neck symptoms can predict future arm, neck and shoulder symptoms in a population of computer workers. For this prospective cohort study, with a follow-up of 24 months, 3383 workers who regularly worked with a computer were approached. Generalised estimating equations (GEE) with 6, 12, 18 and 24 months time lags were used to determine whether high exposure was related to symptoms at follow-up. The results showed that high scores on 9 out of 13 scales, including previous symptoms, were significantly related to arm, shoulder and neck symptoms at follow-up. These results provide support for the predictive validity of the RSI QuickScan questionnaire.

Practitioner Summary: The results showed that high scores on 9 out of 13 scales, including previous symptoms, were significantly related to arm, shoulder and neck symptoms at follow-up. The RSI QuickScan questionnaire may be recommended as a tool in the identification of computer workers who should be targeted with interventions aimed at prevention of future symptoms.