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Musculoskeletal disorders (MSDs) result in lost-time injury claims and lost productivity worldwide, placing a substantial burden on workers and workplaces. Participatory ergonomics (PE) is a popular approach to reducing MSDs; however, there are challenges to implementing PE programmes. Using evidence to overcome challenges may be helpful but the impacts of doing so are unknown. We sought to disseminate an evidence-based PE tool and to describe its use. An easy-to-use, evidence-based PE Guide was disseminated to workplace parties, who were surveyed about using the tool. The greatest barrier to using the tool was a lack of time. Reported tool use included for training purposes, sharing and integrating the tool into existing programmes. New actions related to tool use included training, defining team responsibilities and suggesting programme implementation steps. Evidence-based tools could help ergonomists overcome some challenges involved in implementing injury reduction programmes such as PE. Practitioner Summary Practitioners experience challenges implementing programmes to reduce the burden of MSDs in workplaces. Implementing participatory interventions requires multiple workplace parties to be 'on-board'. Disseminating and using evidence-based guides may help to overcome these challenges. Using evidence-based tools may help ergonomics practitioners implement PE programmes.

Work related musculoskeletal disorders have been associated with office work yet exposure quantification is challenging and not measured consistently. Our objective was to examine associations within and across exposure measurements guided by a conceptual model of three measurement locations: external to the body, at the interface, and internal to the body. Forty-one office workers (71% female), mean age 41 years (SD=9.6), mean height 168cm (SD=10.3), and mean weight 74kg (SD=19), were recruited from a large urban newspaper. Four methods of quantifying mechanical exposure were used linked to locations: equipment dimensions (external), relative fit and postures (interface), and EMG (internal). We explored: (1) a within-location analysis of relationships among methods; and (2) a cross-location analysis of relationships among methods. Exposure method comparisons showed mostly weak correlations among equipment variables, moderate correlations among posture variables, and strong or moderate correlations among EMG variables. For the majority of pair-wise comparisons between exposure measures across locations, the correlations were weak or moderate. Comparisons of relative fit revealed some differences in dimensions, postures, and EMG measures. Few strong associations between various exposure measures were found, although worker-reported relative fit holds promise. Future work might link exposure methods (specific measures) with locations for particular purposes., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Evaluations of participative ergonomics (PE) interventions have reported mixed results, potentially due to both program and theory deficits. In a multiple case study of four worksites in different companies using a quasi-experimental approach, we examined process, implementation, and effects. The process evaluation was based upon fieldwork and interviews with approximately 90 persons. Implemented changes were documented by PE teams and intensity judged by the research team. The effect evaluation was performed using questionnaire-based measures (physical effort, influence, pain and potential confounders) among cohorts present both before and after the changes (N=258). Ergonomic change teams (ECTs) faced challenges securing employees' time, varying management commitment and significant production pressures. Nevertheless they actively introduced between 10 and 21 changes over 10-20 months of activity. Limited intensity of exposure reduction was observed, resulting in no discernible effects on physical effort or pain among the employees. Potential reasons that may account for limited effects and lessons for workplace parties, practitioners, and intervention researchers are discussed.

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.

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.

Objectives: To assess the impact of a workplace ergonomic program to reduce musculoskeletal burden among newspaper employees and to understand relationships among participation, risk factor changes and health status within an employee cohort., Methods: We conducted repeat cross-sectional surveys, with 1,003 employees from all major departments in 1996 and 813 in 2001, generating a cohort of 433 participants in both surveys. Elements of the ergonomic program included employee RSI (repetitive strain injury) training, pro-active assessment of workstations and workstation modifications, and encouragement of early treatment through on-site physiotherapy. Potential risk factors included biomechanical and work organizational aspects of office work. Health status measures included pain intensity and the Work-Disability of the Arm, Shoulder, and Hand (DASH). Repeat cross-sectional analyses incorporated modifications for shared variance. For the cohort, a theory of change informed path analyses using MPLUS., Results: Among respondents in 2001, 69% reported participation in RSI training and 56% had workstation assessments. Among those with pain, 57% had consulted a health practitioner, including the on-site physiotherapist. In repeat cross-sectional analyses, the proportion reporting moderate pain or worse, at least once per month or for longer than 1 week, declined from 20 to 16% (p=0.01). Among the cohort, pain intensity and work disability in 1996 were the strongest predictors of 2001 health status (both p<0.001). Stable or increased supervisor awareness and concern about RSI was associated with decreased pain in 2001(p<0.01). Participation in RSI training was associated with increases in decision latitude (p<0.05), which themselves were associated with decreased work disability in 2001 (p<0.05). Increased time mousing was associated with increases in work disability (p<0.05)., Conclusions: Implementation of a worksite ergonomics program was associated with a reduction in frequent and severe pain in the workforce. Changes in work disability were affected by multiple factors.

Background: Participatory ergonomic (PE) interventions have been increasingly utilized to deal with work-related musculoskeletal disorders (WMSD)., Methods: Using a longitudinal quasi-experimental design, a PE process was launched at one depot of a large courier company, with a nearby depot serving as a control. Evaluations focused on 122 employees across the two depots who participated in both pre- and post-questionnaires. An evaluation framework assessed the process of implementation, changes in risk factors, and changes in musculoskeletal health outcomes. Partial and multiple regressions explored the relationships in the evaluation framework., Results: Changes in work organizational factors had a consistent impact upon changes in health outcomes. Greater participation in the process was associated with increased levels of job influence and communication (P = 0.0059 and P = 0.0940 respectively). Improvements in communication levels were associated with reduced pain intensity and improved work role function (WRF) (P = 0.0077 and P = 0.0248 respectively). Lower levels of pain post-intervention were related to greater WRF (P = 0.0493)., Conclusions: A PE approach can improve risk factors related to WMSD, and meaningful worker participation in the process is an important aspect for the success of such interventions.

Background: When applied to workplace interventions, integrative may be seen in various ways, requiring elucidation., Methods: Identification of primary studies through systematic reviews, limited bibliographic literature searches, the Cochrane Occupational Health Field database on intervention studies, and authors' files. Focus was 2000 on. Categorization according to the Cochrane classes and lenses on integrative. Synthesis as narrative review., Results: Examples of each lens on integrative were uncovered: biomechanical and psychosocial, multiple component, primary and secondary prevention, organizational, and system. Each contributed different understanding to the potential impacts on different knowledge, exposure, behavior, health and administrative outcomes., Conclusions: Considerable opportunities exist to expand the range of integrative interventions, particularly at the organizational and system levels, and incorporate a combination of knowledge transfer and exchange with intervention evaluation.

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.

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.