Ergonomic recommendations and their impact on child care workers' health

The purpose of this study was to determine the impact ergonomics has had on the occurrence of musculoskeletal symptoms and injuries among child care workers in Wisconsin using a Classroom and Work Methods Survey developed for this investigation. Information on perceived need for and knowledge of ergonomic interventions, the extent to which ergonomic interventions had been introduced to child care settings, and barriers to implementation of ergonomic recommendations was gathered. Two hundred and fifty-eight respondents completed the survey. The majority of respondents was aware of most (18 of 20) of the recommended ergonomic interventions for child care centers and did not perceive a need to make ergonomic changes. Although the majority of respondents had implemented 15 out of the 20 recommendations, they were currently experiencing musculoskeletal pain while performing their jobs. The results of this study highlight the need for further analysis of specific child care tasks and identification of more effective methods to reduce the risk for musculoskeletal pain and injuries.     

Mitigation of musculoskeletal problems and body discomfort of agricultural workers through educational intervention

Farming is a physically arduous occupation that places farm workers' at potential risk of musculoskeletal disorders, which has been observed to impose a greater impact on their health. Each activity in agriculture brings about certain stress and strain on bones and muscles leading to work-related musculoskeletal disorders which can lead to several permanent diseases and disabilities. The purpose of analyzing musculoskeletal problems among male and female workers engaged in agriculture was to know about the risk factors dangerous to health so that interventions can be planned for mitigating them thereby increasing the efficiency of work. Educational intervention included audio-visual aids as well as printed literature. It was hoped that awareness of these factors through dissemination of information would contribute at preventing hazards amongst farmers and their families. The results revealed that the workers reported very severe to severe pain in low back while performing agricultural activities. Weeding was the most strenuous activity for females and threshing crop for males. Training and education on MSDs through educational intervention proved that the knowledge of the farm workers could be enhanced and can help reduce risk of many musculoskeletal problems. It can be help in empowering the community and mitigate MSDs in agriculture.     

Prevention of musculoskeletal disorders (MSDs) in office work: a case study

Twelve recently built office work stations, where jobs imply continued use of information and communication technologies, were analyzed for ergonomic risk factors. Based on a literature review of ergonomic recommendations for computer and general office work, a checklist was devised for assistance in identifying inadequate ergonomic situations, a process that was informed by pain complaints information. RULA (Rapid Upper Limb Assessment) was selected to estimate the risk of MSDs, considering the criteria of applicability and appropriateness to the case studied. This method was applied by an occupational health and safety technician to the most critical job observed in the workplace. Criticality was estimated through observations aided by the systematic use of a checklist tailored to the specific office scenario. Recommendations for change were provided for implementation in all workplaces in the office, in order to improve work conditions, and guide the setup of a MSD prevention training program.     

Study of musculoskeletal risks of the office-based surgeries

Due to the cost and time benefits associated with patients and physicians, outpatient surgeries continue to become more and more popular over time. With the increase in the number of office-based surgical procedures, the prevalence of work-related musculoskeletal disorders (WMSDs) associated with office-based surgeries has been reported. The purpose of this pilot study is to ergonomically evaluate the risk of work-related musculoskeletal disorders of physicians/surgeons performing office-based surgery (OBS). Ergonomic assessment tools included Questionnaire, the BodyMap and the Rapid Upper Limb Assessment for measuring potential ergonomic concerns. The findings have shown that the ergonomic issues of greatest concerns were the discomforts in the neck, shoulders, arms/wrists, and back. Some additional comments were provided by the participants regarding the duration of discomfort or clarification on the frequency of their body discomfort. This study suggests that there is a considerable risk of musculoskeletal injuries of physicians/surgeons performing the OBS tasks. By properly using the ergonomic assessment techniques, valuable information on ergonomic OBS workplace design and selection could assist in the early interventions of WMSD prevention.     

A collaborative effort to apply ergonomics to electric utility workers at generating stations

As part of a collaborative approach involving electric utility companies, university researchers, individual contractors and a not-for-profit research institute, two ergonomics teams consisting of skilled utility workers and trained ergonomists, were assembled. These teams were to identify tasks with risk factors for musculoskeletal disorders (MSDs) among workers in fossil-fueled generating stations and and to propose ergonomic interventions for these tasks. One team focused on tasks of electricians and the other focused on tasks of plant operators and mechanics. Several of the tasks were tested in an ergonomics laboratory and at one of the utility's generating stations. We present a sample of the recommended interventions in this paper. An anthropometric analysis of electrical box height recommended the appropriate height for electrical boxes. The results of a field experiment showed that low rolling resistance wheels decreased the forces to initiate and sustain pushing a cart. The same experiment also demonstrated that the forces required to turn a cart with six wheels were lower than the forces equired to turn a cart with four wheels. A collaborative approach to ergonomics proved to be an effective method to identify and assess tasks that are problematic for workers and to develop best practices for these tasks in the electric power industry. This method could be used by other industries in their attempt to decrease the incidence, cost and severity of workplace MSDs.     

A controlled case study of supervisor training to optimize response to injury in the food processing industry

The role of supervisors to aid injured workers, access health care, and provide reasonable accommodation may prevent prolonged disability among workers reporting musculoskeletal pain. Although supervisor training has been a common element of broad-based ergonomic interventions to prevent injuries, the impact of supervisor training alone to improve injury response has not been studied. In a controlled design, 11 supervisors in an intervention group and 12 supervisors in a delayed intervention control group from the same plant were provided a 4-hour training workshop. The workshop emphasized communication skills and ergonomic accommodation for workers reporting injuries or health concerns. Workers' compensation claims data in the 7 months before and after the workshop showed a 47% reduction in new claims and an 18% reduction in active lost-time claims versus 27% and 7%, respectively, in the control group. Improving the response of frontline supervisors to employees' work-related health and safety concerns may produce sustainable reductions in injury claims and disability costs.     

Associations between psychosocial risk factors and musculoskeletal disorders: application to the IT profession in India

The exponential growth of the information technology (IT) industry in India has been accompanied with a substantial increase in the reporting of work-related musculoskeletal disorders (WMSDs). The purpose of the current study was to identify and assess the contributions of prevalent psychosocial factors on perceived WMSD outcomes among IT professionals from India. About 77 IT professionals from India completed a survey set consisting of 26 question items from the Job Content Questionnaire and 3 separate question items pertaining to WMSD outcomes (pain/discomfort and psychological stress scores). The findings suggest prevalence of existing pain (shoulder/neck and low back) in more than one-fourth of the respondents. Additionally two-thirds of the respondents had never had any ergonomics awareness training. Co-worker support and psychological work demands were found to be the strongest contributors of psychosocial risk factors towards pain/discomfort and psychological stress outcomes. Findings from this study highlight the influence of certain psychosocial traits of the Indian IT workplace on perceived WMSD outcomes. There is a need to develop and implement intervention strategies to address these factors that may help lower the risk of work-related musculoskeletal pain.     

Intervention of gender friendly land preparation technologies for drudgery reduction of hill farm women

Inventory of all agricultural tasks depicted land preparation by women farmers as one of the most drudgery prone task with high energy cost, thereby, making it amenable to ergonomic interventions in terms of improved technologies (clod breaker, improved plough/'danella') to relieve women from high energy demands, time spent and associated drudgery. The study was conducted in two hill states of India viz. Himachal Pradesh (35 villages and 900 representative samples) and Uttrakhand (10 villages and 900 representative samples). Experimental data were conducted on representative sub sample of 60 hill farm women of both the states to assess physiological workload and musculo-skeletal problems both while working with traditional tools along with improved tools by employing selected parameters viz. physical fitness level, physiological parameters etc. The results showed that heart rate values were more than acceptable limits for task performed with the traditional tools as compared with improved tools. Significant reduction in the heart rate was observed while working with improved tools. Analysis of MSDs showed that the postural stress and severity of pain in various body parts was reduced by adopting new technology. Hence, the use of improved land preparation tools is recommended over the existing ones for drudgery reduction.     

Biomechanical modelling and evaluation of construction jobs for performance improvement

Occupational risk factors, such as awkward posture, repetition, lack of rest, insufficient illumination and heavy workload related to construction-related MMH activities may cause musculoskeletal disorders and poor performance of the workers, ergonomic design of construction worksystems was a critical need for improving their health and safety wherein a dynamic biomechanical models were required to be empirically developed and tested at a construction site of Tata Steel, the largest steel making company of India in private sector. In this study, a comprehensive framework is proposed for biomechanical evaluation of shovelling and grinding under diverse work environments. The benefit of such an analysis lies in its usefulness in setting guidelines for designing such jobs with minimization of risks of musculoskeletal disorders (MSDs) and enhancing correct methods of carrying out the jobs leading to reduced fatigue and physical stress. Data based on direct observations and videography were collected for the shovellers and grinders over a number of workcycles. Compressive forces and moments for a number of segments and joints are computed with respect to joint flexion and extension. The results indicate that moments and compressive forces at L5/S1 link are significant for shovellers while moments at elbow and wrist are significant for grinders.     

Ergonomic design of crane cabins: a case study from a steel plant in India

The study, carried out at the Batch Annealing Furnace (BAF) shop of Cold Rolling Mill (CRM) at an integrated steel plant of India, concerns ergonomic evaluation and redesign of a manually-operated Electrical Overhead Travelling (EOT) crane cabin. The crane cabin is a complex worksystem consisting of the crane operator and twelve specific machine components embedded in a closed workspace. A crane operator has to perform various activities, such as loading and unloading of coils, setting and removal of convector plates, and routine maintenance work. Initially, an operator had to work in standing posture with bent back most of the time. Ergonomically poor design of the chair and the controls, awkward work postures, and insufficient vision angle resulting in musculoskeletal disorders (MSDs) are some of the critical problems observed.. The study, conceived as an industry-academia joint initiative, was undertaken by a design team, the members of which were drawn from both the company concerned and the institute. With the project executed successfully, a number of lessons, such as how to minimize the anthropometric mismatch, how to improve the layout of the components and controls within enclosed workspace, and how to improve work posture minimizing risk of MSDs have been learned.     

Participatory ergonomics among female cashiers from a department store

The objective of this paper was to control ergonomic risks among female cashiers working in a department store belonging to the retail market. This study was conducted between May and November 2010. Participatory ergonomics was applied through knowing and understanding how the company works, establishing the work team (Ergo group), training the team in ergonomics-related topics, and making decisions and interventions. The sample was composed of 71 participants--mostly female cashiers--, and all of them have a musculoskeletal compromise, declaring pain or discomfort mainly in the neck, lower back, right wrist and shoulders. Among others, following problems were found: postural overload, repetitive work, manual load handling, mental fatigue, environmental discomfort, variable work schedules, extended working days, and absence of breaks. In the intervention, the main implemented changes were the redesign of workstation, complete change of chairs and keyboards, and the implementation of a rotation system, as well breaks for compensatory exercises. After that, an evident improvement of found problems was observed, therefore it can be concluded that participatory ergonomics is an attractive methodology, appropriate and efficient for solving and controlling ergonomic risks and problems.     

Target groups for prevention of neck/shoulder and low back disorders: an exploratory cluster analysis of working and living conditions

Musculoskeletal disorders (MSDs) have a multifactorial etiology. Therefore, a holistic approach to identifying target groups for primary/secondary prevention is essential. In this study, an exploratory person-oriented approach was applied, using cluster analysis of variables related to physical and psychosocial work conditions, and conditions in the private sphere, on a data set of 1,341 Swedish women and men who had not sought care for MSDs the 6 months preceding enrollment in the study. Three groups at risk and five "healthy" groups regarding MSDs were identified. Two of the risk groups had a strained situation regarding psychosocial work conditions or domestic/family conditions, respectively. The majority of individuals in these groups were women. The third risk group had a strained situation regarding both physical and psychosocial work conditions. This group consisted largely of men working in male-dominated jobs. The five healthy groups had low/moderate metabolic demands at work, and all of them having high proportions of subjects with moderate to high education, and fairly even distributions of men and women. In conclusion, the results indicate that gender-specific working and living conditions are associated with an increased risk for MSDs. The identification of these subgroups in the population may facilitate a selective prevention approach.     

Yoga for stress reduction and injury prevention at work

At work employees face numerous psychological stressors that can undermine their work performance. These stressors, stemming from a variety of possible causes, have enormous health and financial impacts on employees as well as employers. Stress has been shown to be one of the factors leading to musculo-skeletal disorders (MSDs) such as: include back pain, carpal tunnel syndrome, shoulder or neck tension, eye strain, or headaches. Yoga is an ancient form of exercise that can reduce stress and relieve muscular tension or pain. Practicing yoga at the workplace teaches employees to use relaxation techniques to reduce stress and risks of injury on the job. Yoga at the workplace is a convenient and practical outlet that improves work performance by relieving tension and job stress.     

The etiology of low back pain in military helicopter aviators: prevention and treatment

Low back pain (LPB) is a major health problem among military rotary-wing aircrews worldwide. In order to define the etiology and propose remedies to LBP in helicopter aviators a review and critique of the literature was conducted. In-flight sitting posture and vibration generated by the aircraft were identified as high risk factors for LBP. Consequently, researchers recommended ergonomic modifications to the crew stations. The efficacy of these technical interventions has not been proven. As well, these design changes are not financially practical. Following an in depth kinesiological analysis of the physical demands of this type of flying, and preliminary experimentation, an alternative aeromedical approach focusing on the aircrew rather than the craft is presented. The authors propose a set of flight-specific exercises that might effectively deal with this problem. A thorough testing of this approach is envisioned.     

Evidence-based exposure criteria for work-related musculoskeletal disorders as a tool to assess physical job demands

Despite worldwide attention, musculoskeletal disorders (MSDs) remain a substantial concern at work. To support ergonomists to assess the work-related risk factors for MSDs, several instruments are available. Unfortunately, many of these instruments are not supported by evidence-based exposure criteria for particular MSDs. For effective prevention of MSDs, it is important to know to what extent work-related risk factors are present in the work situation. The Netherlands Center for Occupational Diseases (NCOD) develops evidence-based criteria documents for the assessment of work-related MSDs. The exposure criteria of these documents can be used on a group level to support ergonomists in their assessment of the physical job demands that are associated with work-related MSDs. At the moment the NCOD has exposure criteria for the assessment of 22 work-related MSDs, for instance on the work-relatedness of upper extremity disorders, non-specific low back pain or patellar tendinopathy. The use of these exposure criteria enables ergonomist to better assess the work-related risks of MSDs as a starting point for effective prevention.     

Multi dimensional system for evaluating preventive program for upper extremity disorders among computer operators

Typing is associated with musculoskeletal complaints (MSCs), caused by multiple risk factors. Although a wide variety of ergonomic intervention programs were conducted to reduce risk factors and MSC's, only few of them were found evidence based. This study aimed to test the efficacy of a workplace intervention in reducing MSC's among computer workers. 66 computer workers were assigned randomly to one of three intervention programs: ergonomic intervention including biofeedback, intervention without biofeedback and control group without intervention. The efficacy was tested by advanced assessment including; pain location and severity, posture at work, upper extremity 3D kinematics, muscle activity and psychosocial status. Working hypothesis; significant score differences will be found between the study groups which underwent ergonomic intervention and the control group on the following measures: pain complaints, upper extremity kinematics, muscle activity and psychosocial status. Significant differences were found between pre and post intervention and between research groups and the control group in pain, posture and motion. The ergonomic intervention with biofeedback had no unique contribution in comparison to other interventions. In conclusion; the proposed intervention program was found efficient for reducing pain among computer workers.     

A single-subject design of ergonomic intervention effectiveness for university employees in a new facility

As clinicians are searching for evidence to support their practice interventions, it is sometimes hard to find the "real-world" studies that incorporate the complexities of actual practice. Following calls in the public health, nursing and medical literature for clinicians to participate in practice-based evidence, this pilot study explores the effectiveness of a single-subject design for practice-based evidence. Twenty-five "well" university employees participated in an ergonomic intervention over the course of one academic semester that consisted of a 15 min ergonomic intake session, a 45 min group hands-on ergonomic educational session and a 15 min individual ergonomic consult in their offices. Participants were sent postural comfort surveys weekly and their subjective ratings were analyzed to determine the effectiveness of the intervention to decrease their perceived postural discomfort at a computer work station. Twenty-one of the twenty-five participants reported an improvement in postural comfort over the course of the study. This pilot study suggests that further investigation needs to be conducted to determine the effectiveness of hands-on ergonomic education and consultation for well populations working at computer workstations.     

Consulting in industry: Moving beyond traditional interventions

Despite increased efforts to address musculoskeletal disorders (MSDs) in the work place, these injuries continue significantly impact the bottom line financial performance of companies, not to mention the health and safety of their most important resource - their workers. As MSD costs continue to rise, rehabilitation professionals must approach effective injury management and prevention processes from an onsite perspective. A paradigm shift is in order. Successful practitioners need to transform themselves from a clinical specialist to an onsite consultant. This article introduces various elements that are critical to the successful transformation of an onsite consultant. Effective onsite injury management and prevention concepts are discussed. Case studies are also presented to further illustrate the value of the onsite consultant approach.     

The gap between exposure and implementation of computer workstation ergonomics in the workplace

The population of people using computers is increasing in home, school and work environments [20,21]. Research suggests that more computer usage may lead to increased incidence of upper extremity cumulative trauma disorder (UECTD) and other work related musculoskeletal injuries [8]. Yet, proper computer workstation ergonomics training is not readily available. This pilot study attempts to better understand the gap between ergonomic interventions and the initiation of work-practice change. The pilot study used self-report through an anonymous Internet survey to explore university faculty and staff training in computer workstation ergonomics, assess UECTD and other computer-use related symptoms, and learn about the respondents' success implementing their knowledge of computer workstation ergonomics. The 55 respondents ranged in age from 21 to 65, and spent an average of 5.3 hours at the computer during a typical workday. Over 70% of respondents experienced symptoms associated with excessive computer use. Although 60% of respondents had exposure to computer workstation ergonomics information, less than 10% reported implementing their knowledge of computer workstation ergonomics in their tasks. This paper looks at organizational and individual issues preventing the implementation of computer workstation ergonomics in the workplace. The Transtheoretical Model for Health Behavior Change [25,27] is used to further evaluate effectiveness of ergonomic interventions. Recommendations for interventions and future evaluations are presented.     

Client Disclosure of Lesbianism:

Three hundred lesbian women were recruited through a snowball design survey. Discriminant analysis was used to differntiate those who disclosed their sexual orientation to their health care provider from those who did not. Disclosers had a greater number of friends to whom they disclosed, were less likely to currently drink alcoholic beverages, were more likely to have obtained a physical examination in Alaska in the previous five years, were older, and had seen more mental health counselors than nondisclosers. The model accounted for 20.91 percent of the variance in disclosure to health care providers. A majority of the respondents who disclosed (65.32%#37;) reported no perceived difference in health care provided following disclosure of sexual orientation.