Processes, barriers, and outcomes described by ergonomics consultants in preventing work-related musculoskeletal disorders

Despite the importance of reducing work-related musculoskeletal disorders, there appears to have been little evaluation of routine ergonomics consultancy interventions aimed at reducing risks leading to these conditions. In many instances, the effectiveness of advice depends on organisations accepting and implementing measures recommended, involving changes of both individual and collective behaviour. Behaviour change theory, developed elsewhere, suggests that if change is to take place, recipients need to hold positive attitudes and beliefs relating to the desirable behaviour. To investigate the extent to which this is accommodated by current ergonomics consultancy practices, 14 ergonomics consultants were interviewed to explore the consultancy process from which recommendations are developed, exploring the factors that are assessed by consultants, perceived barriers to promoting change, and the extent to which evaluation of outcomes takes place. Consultants' recommendations generally focused on physical aspects of the work environment and did not take explicit account of employees' knowledge or attitudes. Little evaluation of outcomes was conducted by the consultants interviewed. Implications of these findings for improving the efficacy of interventions to reduce work-related musculoskeletal disorders within organisations are discussed.     

Ergonomic evaluation of masons laying concrete masonry units and autoclaved aerated concrete

Masons working with concrete masonry unit block have high rates of work-related musculoskeletal disorders to the low back and shoulders associated with repetitively lifting and buttering heavy block. A new material, autoclaved aerated concrete, may reduce the risk of shoulder and back injury but, ergonomic evaluation is needed. This study evaluated shoulder exposure parameters, low back stress, and worker perceptions in two groups of journey level masons, one using CMU and the other using AAC block. Results indicate that for the left arm AAC masons spent significantly more time than CMU masons in static (38.2% versus 31.1%, respectively), and less time in slow motions (48.2% versus 52.2%, respectively) and faster motions (13.6% versus 16.7%, respectively) (p < 0.05). CMU masons had significantly greater shoulder and low back pain (p = 0.009) and they held block significantly longer than AAC masons (p < 0.001). Low back compressive forces were high for both materials. Masons handling AAC demonstrated less left upper extremity stress but both materials were estimated to be hazardous to the low back.     

Intervention practices in musculoskeletal disorder prevention: a critical literature review

Musculoskeletal disorders (MSDs) affect much of the workforce and remain a major form of occupational ill health. With a view to improving the efficacy of interventions, this review examined preventative actions relating to these disorders. A detailed analysis grid was used to classify the information contained in the 47 reviewed articles whose common aspect was to report actions carried out in the workplace that led to the implementation of changes to prevent MSDs. The analysis identified and characterized three major categories of intervention processes in MSD prevention: the complete type (n=17), the shortened type (n=16), and the turnkey type (n=14). These three groups of intervention processes were differentiated by their approaches and their contexts of application. The result was important differences in the changes implemented. Because of the variability in intervention processes and possible impacts on MSD prevention, a proposal to "delimit" these processes so as to improve their effectiveness is presented.     

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 development of the Quick Exposure Check (QEC) for assessing exposure to risk factors for work-related musculoskeletal disorders

This paper describes the development and evaluation of the Quick Exposure Check (QEC), which is an observational tool developed for Occupational Safety and Health (OSH) practitioners to assess exposure to risks for work-related musculoskeletal disorders and provide a basis for ergonomic interventions. The tool is based on epidemiological evidence and investigations of OSH practitioners' aptitudes for undertaking assessments. It has been tested, modified and validated using simulated and workplace tasks, in two phases of development, with participation of 206 practitioners. The QEC allows the four main body areas to be assessed and involves practitioners and workers in the assessment. Trials have determined its usability, intra- and inter-observer reliability, and validity which show it is applicable to a wide range of working activities. The tool focuses primarily on physical workplace factors, but also includes the evaluation of psychosocial factors. Tasks can normally be assessed within 10min. It has a scoring system, and exposure levels have been proposed to guide priorities for intervention. Subsequently it should be used to evaluate the effectiveness of any interventions made. The QEC can contribute to a holistic assessment of all the elements of a work system.     

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.     

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.     

Assessing exposure to risk factors for work-related musculoskeletal disorders using Quick Exposure Check (QEC) in taxi drivers

Work-related musculoskeletal disorders (WMSDs) are a common health problem throughout the world. This study aimed to examine the risk factors that are involved in the development of WMSDs in taxi drivers. In total 382 taxi drivers were observed using Quick Exposure Check (QEC) observational tool, which allows practitioners and workers to assess four key areas of the body. Results of the QEC scores were found to be very high for the shoulder/arm, wrist/hand and neck, whereas the scores for the back were found to be high for static use and moderate for moving. The results also showed that the occupational risk factors for WMSDs were associated with restricted postures, repetitive movements, vibration, work related stress. Essential ergonomic interventions are needed to eliminate risk of exposures to WMSDs in taxi drivers.Relevance to industryThe study results have relevance for ergonomists, health and safety practitioners as well as the drivers themselves, and helpful for estimating the main physical risk factors for WMDSs before choosing a method prior to an ergonomic intervention in industry.     

Prevention of musculoskeletal disorders at work: Validation and reliability in a multicenter intervention study

During the years 1986–1989 The Finnish Work Environment Fund initiated a multicenter, intervention study (programme) to prevent musculoskeletal disorders at work. The programme consisted of four different projects comprising methodological, epidemiological, and interventive themes. The main results were as follows: (1) More than half of the occupational physiotherapists and physicians involved in the project felt that they did not have adequate training for testing the performance capacity of the musculoskeletal system. Several of the most commonly used musculoskeletal tests had either poor validity in predicting future musculoskeletal troubles or had poor reliability. (2) A controlled intervention study showed that active training of neck-shoulder muscles can prevent musculoskeletal troubles, even more than ergonomic actions. (3) It is possible to reduce sick-leave due to low-back disorders by intervention measures directed toward both the work (environment, tools) and the workers (working methods, positive attitude to work, preparedness to keep fit). (4) The identification of ergonomic hazards with the help of teamwork proved to be feasible. The practical improvements, however, were difficult to implement in the prevailing conditions. Some of the improvements increased the work load and the stress of the workers. This aspect needs further consideration.     

Vibration of portable orbital sanders and its impact on the development of work-related musculoskeletal disorders in the furniture industry

The wood furniture industry has a strong presence in Canada, where it employs over 100,000 workers. Because of the extensive number of manual tasks required in this industry, several studies have been undertaken to characterize the health and safety risk factors to which these workers are exposed, such as awkward postures, repetitive movements and the application of undue force. However, very little research has been done on workers’ exposure to vibration from portable orbital sanders, one of the most common tools used in this industry. Vibration is responsible for a specific occupational disease called vibration syndrome, but is also recognized as a risk factor that increases the prevalence of more common work-related musculoskeletal disorders (WMSDs). This study proposed to determine the level of vibration to which sanders of furniture parts are exposed, and to analyze its impact on the risk of WMSDs. The results show that the level of vibration to which the workers are exposed is well above acceptable levels defined by recognized standards and directives and that this vibration is combined with many other risk factors, thus representing a risk for the development of WMSDs.     

Upper Bound limit analysis model for FRP-reinforced masonry curved structures. Part I: Unreinforced masonry failure surfaces

A two-steps approach for the FE limit analysis of FRP reinforced curved masonry structures is presented in this paper. In step I, discussed extensively in the present Part I, a simplified kinematic procedure is proposed at a cell level to obtain macroscopic masonry behavior in the case of unreinforced masonry curved structures. In step II, discussed in the companying paper (Part II) strips are applied at a structural level on the already homogeneous material.Unreinforced masonry strength domain is obtained by means of a compatible approach in which each brick is supposed to interact with its six neighbors by means of rigid-plastic interfaces with frictional behavior representing mortar joints. A sub-class of possible elementary deformations is a-priori chosen to describe joints cracking under in- and out-of-plane loads. Suitable internal macroscopic actions are applied on the boundary of the representative element of volume, in analogy to the flat case. The limit analysis problem at a cell level is finally solved adopting an upper bound approach and discretizing the seven bricks by means of six-noded rigid infinitely resistant wedge elements. In this way, internal power dissipation is possible only at the interfaces between wedge adjoining elements (brick–brick interfaces and mortar joints with zero thickness).Several examples consisting of single and double curvature elementary cells are analyzed. For each representative element of volume, in- and out-of-plane failure surfaces are provided. Macroscopic strength domains so recovered will be utilized in Part II for the limit analysis of entire vaults FRP reinforced.     

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.     

Assessing attitudes, beliefs and readiness for musculoskeletal injury prevention in the construction industry

The objectives are to determine attitudes and beliefs among construction workers and supervisors related to taking action to reduce musculoskeletal injuries (MSIs). “Action” stage of change was confirmed if workers in the last 6 months are continuing to take steps to reduce MSIs. Surveys (520 workers; 35% and 171 supervisors; 67%) revealed that more workers are concerned about MSIs (p < 0.05) and are taking action to reduce MSIs (p < 0.05) than supervisors. Workers taking action tended to be younger and less experienced than other workers (p = 0.00). The final multivariate model showed those workers taking action were more likely to be mechanics and general laborers, to have experienced pain within the last week, to be involved in health and safety, to feel that changes aimed at reducing MSIs would be effective, and that injuries are due to adverse work conditions rather than with characteristics of individual workers. This information can be used to target ergonomics interventions in this industry.     

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.     

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).     

Identification of ergonomics interventions used to reduce musculoskeletal loading for building installation tasks

Skilled workers in the mechanical and electrical installation (M/EI) building and construction trades experience high rates of disabling work-related musculoskeletal disorders (WMSDs). The M/EI trades involve installing piping; heating, ventilation and air conditioning (HVAC), and electrical systems in residential, commercial, and industrial buildings. In the absence of an ergonomics standard in the United States, some building and construction contractors, including M/EI sector contractors, have implemented various ergonomics interventions on their worksites on a voluntary basis. However, no data were available to determine the type of voluntary control measures being implemented, the task-specific hazards for which control measures needed to be developed or refined, and perceived barriers to improving hazard control. As part of a larger effort to obtain this data, the National Institute for Occupational Safety and Health (NIOSH) organized a stakeholder meeting to gather information regarding ergonomics interventions or "best practices" by M/EI contractors and tradespeople. The attendees included 39 industry representatives, 17 construction ergonomics researchers from government and academia, and four ergonomics consultants with experience in the construction industry. Participants spent more than 50% of time meeting in small trade-specific breakout sessions. According to the participants, tasks common to the three trades included (1) drill holes and shoot fasteners; (2) place and install systems, and (3) lift and carry materials and equipment. Engineering interventions described in the stakeholder meeting included tools, equipment, and engineered building materials; administrative controls largely consisted of training and education programs and modifications of work and management practice. Most participants believed that there were significant limits to the impact individual contractors and tradespeople could have in leading ergonomics improvement in the building and construction industry.     

Upper bound limit analysis model for FRP–reinforced masonry curved structures. Part II: Structural analyses

A homogenized full 3D limit analysis model for the evaluation of collapse loads of FRP–reinforced masonry vaults is presented. Six-noded rigid infinitely resistant wedges are used to model masonry. Three-noded rigid infinitely resistant triangles are used to model FRP strips. Plastic dissipation is allowed only at the interfaces between adjoining elements. Unreinforced masonry homogenized failure surfaces obtained in Part I of the present paper are used to evaluate plastic dissipation at the interfaces between masonry/masonry elements. A possible dissipation at the interfaces between FRP triangles and masonry wedges is also considered in order to take into account, in an approximate but effective way, the possible delamination of the strips from the supports. Italian code CNR DT 200 [CNR-DT 200, 2006. Guide for the design and construction of externally bonded FRP systems for strengthening existing structures. C.N.R., National Research Council, Italy; 2006.] formulas are used to evaluate peak interface tangential strength. While the delamination from the support can be modelled only in an approximate way within limit analysis, the aim of the paper is to accurately reproduce the change in the failure mechanism observed in experimentations due to the introduction of strengthening elements.A 3D approach to model masonry is used in order to take into account the presence of FRP strips either at the extrados or at the intrados of the vaults.Several numerical examples are analyzed, consisting of two different typologies of masonry arches (a parabolic vault and an arch in a so-called “skew” disposition), a ribbed cross vault, a hemispherical dome and a cloister vault. For all the examples presented, both the unreinforced and FRP-reinforced case are discussed. Additional non-linear FE analyses are performed, modeling masonry through an equivalent macroscopic material with orthotropic behavior at failure and possible softening, in order to assess limit analysis results. Comparisons with experimental evidences, where available, are finally reported.Reliable predictions of collapse loads and failure mechanisms are obtained with the model proposed for all the cases analyzed, meaning that the approach proposed may be used by practitioners for a fast and reliable evaluation of the effectiveness of a strengthening intervention.     

Best practices in code inspection for safety-critical software

One of the most important issues in analyzing safety-critical systems is code verification through an inspection checklist, whose items must be applied to the source code. The attention given to this list will help ensure obedience to good coding rules and represents an important factor in the design of safety-critical systems. This list also helps in the development of non-safety-critical systems, improving their quality and correctness.