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A randomised controlled trial on whether a participatory ergonomics intervention could prevent musculoskeletal disorders

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Journal Occupational and environmental medicine
Year 2008
Links Pubmed DOI

This article is included in 2 Systematic reviews Systematic reviews (2 references) 1 Broad synthesis Broad syntheses (1 reference)

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Objectives: To examine the efficacy of a participatory ergonomics intervention in preventing musculoskeletal disorders among kitchen workers. Participatory ergonomics is commonly recommended to reduce musculoskeletal disorders, but evidence for its effectiveness is sparse. Methods: A cluster randomised controlled trial among the 504 workers of 119 kitchens in Finland was conducted during 2002-2005. Kitchens were randomised to an intervention (n = 59) and control (n = 60) group. The duration of the intervention that guided the workers to identify strenuous work tasks and to seek solutions for decreasing physical and mental workload, was 11 to 14 months. In total, 402 ergonomic changes were implemented. The main outcome measures were the occurrence of and trouble caused by musculoskeletal pain in seven anatomical sites, local fatigue after work, and sick leave due to musculoskeletal disorders. Individual level data were collected by a questionnaire at baseline and every 3 months during the intervention and 1-year follow-up period. All response rates exceeded 92%. Results: No systematic differences in any outcome variable were found between the intervention and control groups during the intervention or during the 1-year follow-up. Conclusions: The intervention did not reduce perceived physical work load and no evidence was found for the efficacy of the intervention in preventing musculoskeletal disorders among kitchen workers. It may be that a more comprehensive redesign of work organisation and processes is needed, taking more account of workers' physical and mental resources.

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Effects of ambulant myofeedback training and ergonomic counselling in female computer workers with work-related neck-shoulder complaints: a randomized controlled trial.

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Journal Journal of occupational rehabilitation
Year 2007
Links Pubmed DOI PubMed Central

This article is included in 3 Systematic reviews Systematic reviews (3 references) 1 Broad synthesis Broad syntheses (1 reference)

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OBJECTIVE: To investigate the effects of ambulant myofeedback training including ergonomic counselling (Mfb) and ergonomic counselling alone (EC), on work-related neck-shoulder pain and disability. METHODS: Seventy-nine female computer workers reporting neck-shoulder complaints were randomly assigned to Mfb or EC and received four weeks of intervention. Pain intensity in neck, shoulders, and upper back, and pain disability, were measured at baseline, immediately after intervention, and at three and six months follow-up. RESULTS: Pain intensity and disability had significantly decreased immediately after four weeks Mfb or EC, and the effects remained at follow up. No differences were observed between the Mfb and EC group for outcome and subjects in both intervention groups showed comparable chances for improvement in pain intensity and disability. CONCLUSIONS: Pain intensity and disability significantly reduced after both interventions and this effect remained at follow-up. No differences were observed between the two intervention groups.

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The effectiveness of a work style intervention and a lifestyle physical activity intervention on the recovery from neck and upper limb symptoms in computer workers.

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Journal Pain
Year 2007
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This article is included in 3 Systematic reviews Systematic reviews (3 references) 1 Broad synthesis Broad syntheses (1 reference)

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This study assessed the effectiveness of a single intervention targeting work style and a combined intervention targeting work style and physical activity on the recovery from neck and upper limb symptoms. Computer workers with frequent or long-term neck and upper limb symptoms were randomised into the work style group (WS, n=152), work style and physical activity group (WSPA, n=156), or usual care group (n=158). The WS and WSPA group attended six group meetings. All meetings focused on behavioural change with regard to body posture, workplace adjustment, breaks and coping with high work demands (WS and WSPA group) and physical activity (WSPA group). Pain, disability at work, days with symptoms and months without symptoms were measured at baseline and after 6 (T1) and 12 months (T2). Self-reported recovery was assessed at T1/T2. Both interventions were ineffective in improving recovery. The work style intervention but not the combined intervention was effective in reducing all pain measures. These effects were present in the neck/shoulder, not in the arm/wrist/hand. For the neck/shoulder, the work style intervention group also showed an increased recovery-rate. Total physical activity increased in all study groups but no differences between groups were observed. To conclude, a group-based work style intervention focused on behavioural change was effective in improving recovery from neck/shoulder symptoms and reducing pain on the long-term. The combined intervention was ineffective in increasing total physical activity. Therefore we cannot draw conclusions on the effect of increasing physical activity on the recovery from neck and upper limb symptoms.

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Effects of Participation in Decision Making on Performance and Employee Attitudes: A Quality Circles Meta-analysis

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Authors Pereira, GM , Osburn, HG
Journal Journal of Business and Psychology
Year 2007
Links DOI

This article is included in 1 Broad synthesis Broad syntheses (1 reference)

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This study explores the effects of a participative technique, quality circles (QCs), on several employee attitudes and performance. The sample included 36 studies with 42 independent samples. Mean effect sizes were small for employee attitudes and moderate for job performance suggesting QCs affected job performance to a greater degree than employee attitudes. For organizations involved in quality management these results seem to suggest that quality interventions have a stronger impact on job performance than on employee attitudes. The study conclusions provide a positive outlook on the effects of total quality management interventions on productivity.

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Economic evaluation of a multi-stage return to work program for workers on sick-leave due to low back pain.

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Journal Journal of occupational rehabilitation
Year 2006
Links Pubmed Health Technology Assessment (HTA) DOI crd.york.ac.uk

This article is included in 2 Systematic reviews Systematic reviews (2 references)

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OBJECTIVE: To evaluate the cost-effectiveness and cost-utility of a return to work (RTW) program for workers on sick-leave due to low back pain (LBP), comparing a workplace intervention implemented between 2 to 8 weeks of sick-leave with usual care, and a clinical intervention after 8 weeks of sick-leave with usual care. DESIGN: Economic evaluation alongside a randomised controlled trial (RCT). STUDY POPULATION: Workers sick-listed for a period of 2 to 6 weeks due to LBP. INTERVENTIONS: 1. workplace assessment, work modifications and case management). 2. physiotherapy based on operant behavioural principles. 3. usual care: provided by an occupational physician. OUTCOMES: The primary outcome was return to work (RTW). Other outcomes were pain intensity, functional status, quality of life and general health. The economic evaluation was conducted from a societal perspective. Outcomes were assessed at baseline (after 2-6 weeks on sick-leave), and 12 weeks, 26 weeks, and 52 weeks after the first day of sick-leave. RESULTS: The workplace intervention group returned to work 30.0 days (95% CI=[3.1, 51.3]) earlier on average than the usual care group at slightly higher direct costs (ratio of 1 day: 19 euro). Workers in the clinical intervention group that had received usual care in the first 8 weeks returned to work 21.3 days (95% CI= [-74.1, 29.2]) later on average. The group that had received the workplace intervention in the first 8 weeks and the clinical intervention after 8 weeks returned to work 50.9 days (95% CI=[-89.4, -2.7]) later on average. A workplace intervention was more effective than usual care in RTW at slightly higher costs and was equally effective as usual care at equal costs on other outcomes. A clinical intervention was less effective than usual care and associated with higher costs. CONCLUSION: The workplace intervention results in a safe and faster RTW than usual care at reasonable costs for workers on sick-leave for two to six weeks due to LBP.

Primary study

Unclassified

Work with visual display units: Long-term health effects of high and downward line-of-sight in ordinary office environments

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Journal International Journal of Industrial Ergonomics
Year 2006
Links http://www.sciencedirect.com/ Google Scholar

This article is included in 1 Systematic review Systematic reviews (1 reference) 1 Broad synthesis Broad syntheses (1 reference)

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ABSTRACT : This study investigated the long-term effects of vertical monitor placement in 150 ordinary offices workers. Random assignment was used in creating a high line-of-sight (HLS) group (n=75) and a downward line-of-sight (DLS) (n=75) group. The line-of-sight to the midpoint of the screen was 15° below horizontal for the HLS-group and 30° for the DLS-group. Measurements were taken at set-up and again 12 months later. Significant differences, favouring the DLS-group compared to HLS-group, were found for subjective symptoms, oculomotor capacity, and self-reported sick leave. The DLS-group exhibited flexion of both the neck and back about 5° more than the HLS-group. No differences were found for work-related diagnoses, traditional clinical measures, or electromyographic activity. The results correspond with previous laboratory findings and give additional empirical support from natural work environments to the beneficial effect of DLS in visual display unit (VDU) work. RELEVANCE FOR INDUSTRY VDUs are widely used in industry. Vertical monitor placement is an important factor in the discussion about negative health effects associated with VDUs. Knowledge about health effects of different line-of-sight in ordinary offices and the concordance of results between field and experimental settings has importance for future guidelines.

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Mini-intervention for subacute low back pain: a randomized controlled trial.

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Journal Spine
Year 2003
Links Pubmed DOI

This article is included in 3 Systematic reviews Systematic reviews (3 references)

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STUDY DESIGN: Randomized controlled trial. OBJECTIVES: To investigate the effectiveness and costs of a mini-intervention, provided in addition to the usual care, and the incremental effect of a work site visit for patients with subacute disabling low back pain. SUMMARY OF BACKGROUND DATA: There is lack of data on cost-effectiveness of brief interventions for patients with prolonged low back pain. METHODS: A total of 164 patients with subacute low back pain were randomized to a mini-intervention group (A), a work site visit group (B), or a usual care group (C). Groups A (n = 56) and B (n = 51) underwent one assessment by a physician plus a physiotherapist. Group B received a work site visit in addition. Group C served as controls (n = 57) and was treated in municipal primary health care. All patients received a leaflet on back pain. Pain, disability, specific and generic health-related quality of life, satisfaction with care, days on sick leave, and use and costs of health care consumption were measured at 3-, 6-, and 12-month follow-ups. RESULTS: During follow-up, fewer subjects had daily pain in Groups A and B than in Group C (Group A Group C, = 0.002; Group B Group C, = 0.030). In Group A, pain was less bothersome (Group A Group C, = 0.032) and interfered less with daily life (Group A Group C, = 0.040) than among controls. Average days on sick leave were 19 in Group A, 28 in Group B, and 41 in Group C (Group A Group C, = 0.019). Treatment satisfaction was better in the intervention groups than among the controls, and costs were lowest in the mini-intervention group. CONCLUSIONS: Mini-intervention reduced daily back pain symptoms and sickness absence, improved adaptation to pain and patient satisfaction among patients with subacute low back pain, without increasing health care costs. A work site visit did not increase effectiveness.

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Ten years' experience using an integrated workers' compensation management system to control workers' compensation costs.

Authors Bernacki EJ , Tsai SP
Journal Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine
Year 2003
Links Pubmed

This article is included in 3 Systematic reviews Systematic reviews (3 references)

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This work presents 10 years of experience using an Integrated Workers' Compensation Claims Management System that allows safety professionals, adjusters, and selected medical and nursing providers to collaborate in a process of preventing accidents and expeditiously assessing, treating, and returning individuals to productive work. The hallmarks of the program involve patient advocacy and customer service, steerage of injured employees to a small network of physicians, close follow-up, and the continuous dialogue between parties regarding claims management. The integrated claims management system was instituted in fiscal year 1992 servicing a population of approximately 21,000 individuals. The system was periodically refined and by the 2002 fiscal year, 39,000 individuals were managed under this paradigm. The frequency of lost-time and medical claims rate decreased 73% (from 22 per 1000 employees to 6) and 61% (from 155 per 1000 employees to 61), respectively, between fiscal year 1992 and fiscal year 2002. The number of temporary/total days paid per 100 insureds decreased from 163 in fiscal year 1992 to 37 in fiscal year 2002, or 77%. Total workers' compensation expenses including all medical, indemnity and administrative, decreased from $0.81 per $100 of payroll in fiscal year 1992 to $0.37 per $100 of payroll in fiscal year 2002, a 54% decrease. More specifically, medical costs per $100 of payroll decreased 44% (from $0.27 to $0.15), temporary/total, 61% (from $0.18 to $0.07), permanent/partial, 63% (from $0.19 to $0.07) and administrative costs, 48% ($0.16 to $0.09). These data suggests that workers' compensation costs can be reduced over a multi-year period by using a small network of clinically skilled health care providers who address an individual workers' psychological, as well as physical needs and where communication between all parties (e.g., medical care providers, supervisors, and injured employees) is constantly maintained. Furthermore, these results can be obtained in an environment in which the employer pays the full cost of medical care and the claimant has free choice of medical provider at all times.

Primary study

Unclassified

Early prognostic factors for duration on temporary total benefits in the first year among workers with compensated occupational soft tissue injuries.

Authors Hogg-Johnson S , Cole DC
Journal Occupational and environmental medicine
Year 2003
Links Pubmed

This article is included in 2 Systematic reviews Systematic reviews (2 references)

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AIMS: To develop a model of prognosis for time receiving workers' compensation wage replacement benefits in the first year. METHODS: A prospective cohort of 907 injured workers off work because of soft tissue injuries was followed for one year through structured telephone interviews and administrative data sources. Workers were recruited at workers' compensation claim registration. Only those still off work at four weeks post-registration were included in the analysis. Data from several domains (demographics, clinical factors, workplace factors, recovery expectations) were collected at approximately two weeks and a subset again at four weeks. Outcome was duration on total temporary wage replacement benefits. Variable selection was carried out in two steps using content experts and backward elimination with the Cox model. RESULTS: Body region specific functional status, change in pain, workplace offers of arrangements for return to work, and recovery expectations were independently predictive of time on benefits. Change in pain and workplace offers interacted, so the largest mutual association occurred for those whose pain was getting worse-that is, reduction in median duration from 112.5 to 32.5 days. Across observed values, widely different recovery profiles of groups of workers resulted; for example, at four months, only one third of the highest risk group had gone off benefits while over 95% of the lowest risk group had done so. CONCLUSIONS: Focus on a relatively small set of prognostic factors should enable occupational health practitioners to triage injured workers within the first month and concentrate on those requiring additional assistance to return to work.

Primary study

Unclassified

Early workplace intervention for employees with musculoskeletal-related absenteeism: a prospective controlled intervention study.

Journal Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine
Year 2003
Links Pubmed DOI

This article is included in 2 Systematic reviews Systematic reviews (2 references)

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Sickness absenteeism caused by musculoskeletal disorders (MSDs) is a persistent and costly occupational health challenge. In a prospective controlled trial, we compared the effects on sickness absenteeism of a more proactive role for insurance case managers as well as workplace ergonomic interventions with that of traditional case management. Patients with physician-diagnosed MSDs were randomized either to the intervention group or the reference group offered the traditional case management routines. Participants filled out a comprehensive questionnaire at the initiation of the study and after 6 months. In addition, administrative data were collected at 0.6, and 12 months after the initiation of the project. For the entire 12-month period, the total mean number of sick days for the intervention group was 144.9 (SEM 11.8) days/person as compared to 197.9 (14.0) days in the reference group (P < 0.01). Compared with the reference group, employees in the intervention group significantly more often received a complete rehabilitation investigation (84% versus 27%). The time for doing this was reduced by half (59.4 (5.2) days versus 126.8 (19.2), P < .01). The odds ratio for returning to work in the intervention group was 2.5 (95% confidence interval 1.2-5.1) as compared with the reference group. The direct cost savings were USD 1195 per case, yielding a direct benefit-to-cost ratio of 6.8. It is suggested that the management of MSDs should to a greater degree focus on early return to work and building on functional capacity and employee ability. Allowing the case managers a more active role as well as involving an ergonomist in workplace adaptation meetings might also be beneficial.