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Background: The industrial production of upholstered furniture exposes workers to significant risk of occupational disorders due to ergonomics-related problems, such as repetitive strain and movements of the upper limb, manual load lifting, prolonged static postures., Objective: This paper describes the main measures taken by the biggest company in the "sofa sector" in southern Italy in order to solve such problems in the years 1996-2004., Methods: the classic instruments of ergonomics were used such as risk assessment, medical surveillance, training and information programmes, technological reorganization of the manufacturing process and of single working tasks., Results: The accident rate (number of accidents per million working hours) which showed an increasing trend in the previous years, rose from a value of 31 in 1996 to 51 in the years 1999-2000 (with a percentage of accidents related to load lifting in the range 25-35%). At the same time the incidence rate of work-related upper limb musculoskeletal disorders (UL-WMSDs) in the population of workers (which had increased in the meantime from 2500 to 3500 employees) reached nearly 5% in 2001, with peaks of 8-9% in the work tasks with higher exposure. Accident rates progressively fell in the following three years until a value of 20 was reached in 2004 and 2005, while the mean incidence rate of WMSDs reached a value of nearly 1%. The data need to be compared with the trends in the other companies of the sector in the same period, with an average incidence rate of WMSDs around 2% and a generally increasing trend., Conclusions: Ergonomic interventions not only concur in the management and control of negative events for workers health but also in achieving advantages in terms of lower costs and greater productivity.

Background: The paper considers a database of old (already published) and new data concerning 23 groups of workers (Total number of subjects examined=5373) with different levels of exposure to repetitive movements of the upper limbs: for all these groups data were available regarding exposure indexes (OCRA index and Checklist "OCRA" score) and clinically determined UL-WMSD outcomes (PA=Prevalence of workers Affected by one or more UL- WMSDs; PC=Prevalence of single diagnosed Cases of an UL- WMSDs)., Objectives: Using these data, the paper aimed at presenting and discussing the results obtained in order to estimate: new critical values of OCRA index for discriminating different exposure levels (green, yellow, red areas); new prediction models of expected PA and PC in exposed populations based on exposure indexes., Methods: New critical values of the OCRA index (and, consequently, of the checklist score) were estimated by an original approach in which data of the effect variable PA in a reference population not exposed to the specific risks were combined with the regression function between OCRA and PA, as resulting from the 23 available groups., Results: The resulting critical values and the consequent classification system of the OCRA index and of the checklist score are synthetically reported in the following table: [table: see text]. The best simple regression functions between exposure indexes (OCRA; checklist) and health outcome variables (PA; PC) were then sought, in order to obtain prediction models of effects starting from exposure. The following were the main prediction models derived from the available set of data (standard error of b in brackets): [formula: see text]. Finally, a multiple regression model was computed for estimating PA (Y) based on OCRA index and gender structure of the group (SEXRATIO=n. females x 100/n. total) with its 5 degrees and 95 degrees percentiles (in brackets); the resulting model was. Y = 2.02 (1.72-2.32) x OCRA + 0.075 (0.035-0.115) x SEXRATIO. This model showed a very high association between the two independent variables and the effect variable (PA) (R2=0.96)., Discussion: Discussion of the results obtained considers their intrinsic limits, as they are based on prevalence studies, and also suggests due recommendations and caution in the use of the proposed classification system and prediction models when the OCRA methods are applied for the evaluation of occupational risk associated with repetitive movements of the upper limbs.

This paper reviews the impact of ageing on physical work capacity in the elderly worker and the benefits of exercise programmes designed for the prevention of musculo-skeletal complaints. Physical work capacity generally declines significantly after 50 years of age as a consequence of a reduction in aerobic capacity and muscle strength. The latter is accompanied by a decline in the fatigue threshold. This, in combination with a reduced recovery capacity after exercise, may lead to chronic overload of muscles and tendons in the elderly worker. Thus, it has been proposed that physical exercise programmes may prevent the onset of musculo-skeletal disorders. The effectiveness of different physical exercise programmes proposed in the literature for the prevention of musculo-skeletal disorders is reviewed here. The adoption of an active life-style and the rational use of ergonomic interventions, such as automatization of certain work processes, also appear to be crucial in minimizing the impact of ageing on work ability and capacity in the elderly worker.

In the light of the experiences and guidelines developed by other countries and of Italian legislative and operational conditions, the authors outline a strategy for a health surveillance programme for work-related musculo-skeletal disorders of the upper limbs. In particular, the paper defines the various aims of the health surveillance programme and identifies significant relevant criteria for its implementation (i.e. existence of risks or effects). A screening schedule is presented based on successive investigations (1st and 2nd level surveillance); the authors discuss the principal methods used for processing the results of the health surveillance programme, in collective (i.e. statistical comparisons; planning of periodical investigations) and individual terms (job fitness judgements; reporting of suspected occupational diseases.