Evaluation of the effects of two alternative participatory ergonomics intervention strategies for construction companies.

To improve the use of ergonomics tools by construction workers, the effect of two guidance strategies - a face-to-face strategy (F2F) and an e-guidance strategy (EG) - of a participatory ergonomics intervention was studied. Twelve construction companies were randomly assigned to the F2F group or the EG group. The primary outcome measure, the percentage of workers using ergonomics tools, and secondary outcome measures - work ability, physical functioning and limitations due to physical problems - were assessed using surveys at baseline and after 6 months. Additionally, a cost-benefit analysis was performed on company level. No differences in primary and secondary outcomes were found with the exception of the use of ergonomics tools to adjust working height (F2F +1%; EG +10%; p = .001). Newly-implemented tools were used by 23% (F2F) and 42% (EG) of the workers (p = .271). Costs were mainly determined by guidance costs (F2F group) or purchase costs (EG group). Practitioner Summary: Participatory strategies aim to stimulate behavioural change of stakeholders to increase the use of ergonomics tools. Two guidance strategies - face-to-face or e-mail interventions - among construction companies were studied. Both guidance strategies led to an increase in the use of new ergonomics tools.

Uncertainty in monetary cost estimates for assessing working postures using inclinometry, observation or self-report.

OBJECTIVE: To assess uncertainty in cost estimates for collecting posture data by inclinometry, observations and self-report. METHOD: In a study addressing physical workloads at a paper mill, costs were calculated for measuring postures of twenty-eight workers during three shifts. Uncertainty in costs was assessed for all three methods as the range between an assumed best case (lowest cost) and worst case (highest cost) using scenario analysis. RESULTS: The cost for observation was larger, but also more uncertain (€16506 and €89552 in the best and worst case, respectively) than that of inclinometry (€7613 - €45896). Self-report costs were both lower and less uncertain (€3743 - €23368). CONCLUSIONS: The extent of uncertainty in cost estimates implies that observation could be less expensive than inclinometry, e.g., in a scenario where experienced observers could use existing software, while inclinometers would have to be purchased. We propose adding uncertainty assessments to cost estimates when selecting a method for measuring working postures, and offer guidance in how to proceed in a specific setting.

Economic evaluations of ergonomic interventions preventing work-related musculoskeletal disorders: a systematic review of organizational-level interventions.

BACKGROUND: Work-related musculoskeletal disorders (WMSD) represent a major public health problem and economic burden to employers, workers and health insurance systems. This systematic review had two objectives: (1) to analyze the cost-benefit results of organizational-level ergonomic workplace-based interventions aimed at preventing WMSD, (2) to explore factors related to the implementation process of these interventions (obstacles and facilitating factors) in order to identify whether economic results may be due to a successful or unsuccessful implementation. METHODS: Systematic review. Studies were searched in eight electronic databases and in reference lists of included studies. Companion papers were identified through backward and forward citation tracking. A quality assessment tool was developed following guidelines available in the literature. An integration of quantitative economic results and qualitative implementation data was conducted following an explanatory sequential design. RESULTS: Out of 189 records, nine studies met selection criteria and were included in our review. Out of nine included studies, grouped into four types of interventions, seven yielded positive economic results, one produced a negative result and one mixed results (negative cost-effectiveness and positive net benefit). However, the level of evidence was limited for the four types of interventions given the quality and the limited number of studies identified. Our review shows that among the nine included studies, negative and mixed economic results were observed when the dose delivered and received by participants was low, when the support from top and/or middle management was limited either due to limited participation of supervisors in training sessions or a lack of financial resources and when adequacy of intervention to workers' needs was low. In studies where economic results were positive, implementation data showed strong support from supervisors and a high rate of employee participation. CONCLUSION: Studies investigating the determinants of financial outcomes of prevention related to implementation process are very seldom. We recommend that in future research economic evaluation should include information on the implementation process in order to permit the interpretation of economic results and enhance the generalizability of results. This is also necessary for knowledge transfer and utilization of research results for prevention-oriented decision-making in occupational health and safety.

Key Recommendations from the MedtecHTA Project.

There are particular characteristics of Medical Devices, such as the device-user interaction, the incremental nature of innovation and the broader organizational impact that lead to additional challenges for health technology assessment (HTA). The project explored key aspects of the conduct and methods of HTA for MDs. Systematic reviews and original research studies were conducted to determine improvements in processes and methods that could enhance the potential for HTA and optimize the diffusion of MDs. Regulatory processes for MDs should be more closely aligned, the HTA evaluative framework should be harmonized and processes for conditional coverage and evidence development should be used. The methods for HTA should consider MDs as complex interventions, require the establishment of high quality registries, consider an iterative approach to the evaluation over time, recognize and allow for the particular characteristics of devices and use appropriate approaches for confounder adjustment in comparative effectiveness studies. To optimize the diffusion, a common classification should be developed across countries in order to facilitate international comparisons, factors driving diffusion should be explored in HTA reports and physicians' personal goals and motivation should be better understood. The key recommendations of the MedtecHTA project should improve the conduct and use of HTA for MDs. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd.

The stage of change approach for implementing ergonomics advice - Translating research into practice.

The Stage of Change (SOC) approach has been proposed as a method to improve the implementation of ergonomics advice. However, despite evidence for its efficacy there is little evidence to suggest it has been adopted by ergonomics consultants. This paper investigates barriers and facilitators to the implementation, monitoring and effectiveness of ergonomics advice and the adoption of the SOC approach in a series of focus groups and a subsequent survey of members of the Human Factors Societies of Australia and New Zealand. A proposed SOC assessment tool developed for use by ergonomics practitioners is presented. Findings from this study suggest the limited application of a SOC based approach to work-related musculoskeletal injury prevention by ergonomics practitioners is due to the absence of a suitable tool in the ergonomists' repertoire, the need for training in this approach, and their limited access to relevant research findings. The final translation of the SOC assessment tool into professional ergonomics practice will require accessible demonstration of its real-world usability to practitioners and the training of ergonomics practitioners in its application.

Integrating ergonomics knowledge into business-driven design projects: The shaping of resource constraints in engineering consultancy.

BACKGROUND: The integration of ergonomics knowledge into engineering projects leads to both healthier and more efficient workplaces. There is a lack of knowledge about integrating ergonomic knowledge into the design practice in engineering consultancies. OBJECTIVES: This study explores how organizational resources can pose constraints for the integration of ergonomics knowledge into engineering design projects in a business-driven setting, and how ergonomists cope with these resource constraints. PARTICIPANTS: An exploratory case study in an engineering consultancy was conducted. A total of 27 participants were interviewed. METHODS: Data were collected applying semi-structured interviews, observations, and documentary studies. Interviews were transcribed, coded, and categorized into themes. RESULTS: From the analysis five overall themes emerged as major constituents of resource constraints: 1) maximizing project revenue, 2) payment for ergonomics services, 3) value of ergonomic services, 4) role of the client, and 5) coping strategies to overcome resource constraints. CONCLUSION: We hypothesize that resource constraints were shaped due to sub-optimization of costs in design projects. The economical contribution of ergonomics measures was not evaluated in the entire life cycle of a designed workplace. Coping strategies included teaming up with engineering designers in the sales process or creating an alliance with ergonomists in the client organization.

Home safety assessment and modification to reduce injurious falls in community-dwelling older adults: cost-utility and equity analysis.

BACKGROUND: This study aimed to improve on previous modelling work to determine the health gain, cost-utility and health equity impacts from home safety assessment and modification (HSAM) for reducing injurious falls in older people. METHODS: The model was a Markov macrosimulation one that estimated quality-adjusted life-years (QALYs) gained. The setting was a country with detailed epidemiological and cost data (New Zealand (NZ)) for 2011. A health system perspective was taken and a discount rate of 3% was used (for both health gain and costs). Intervention effectiveness estimates came from a Cochrane systematic review and NZ-specific intervention costs were from a randomised controlled trial. RESULTS: In the 65 years and above age group, the HSAM programme cost a total of US$98 million (95% uncertainty interval (UI) US$65 to US$139 million) to implement nationally and the accrued net health system costs were US$74 million (95% UI: cost saving to US$132 million). Health gains were 34 000 QALYs (95% UI: 5000 to 65 000). The incremental cost-effectiveness ratio (ICER) was US$6000 (95% UI: cost saving to US$13 000), suggesting that HSAM is highly cost-effective. Targeting HSAM only to older people with previous injurious falls and to older people aged 75 years and above were also cost-effective (ICERs=US$1000 and US$11 000, respectively). There was no evidence for differential cost-effectiveness by gender or by ethnicity (Indigenous New Zealanders: Maori vs non-Maori). CONCLUSIONS: As per other studies, this modelling study indicates that the provision of an HSAM intervention produces considerable health gain and is highly cost-effective among older people. Targeting this intervention to older people with previous injurious falls is a promising initial approach before any scale up. TRIAL REGISTRATION NUMBER: ACTRN12609000779279.

Effects of two ergonomic improvements in brazing coils of air-handler units.

The research aims to address the physically loading task and quality and productivity problems in the brazing of coils of air-handler units. Eight operators participated in two intervention studies conducted in a factory in Malaysia to compare the status quo brazing with (1) the use of a new twin-brazing torch that replaced the single-brazing gun and (2) brazing in a sitting position. The outcome measures are related to quality, productivity, monetary costs, body postures and symptoms. After baseline, Interventions I and II were applied for 3 months respectively. The results show a 58.9% quality improvement, 140% productivity increase and 113 times ROI. There was also a reduction in poor work postures e.g. in the raising of the arms and shoulders; bending, twisting and extending of the neck; and bending of left and right wrists, and the back. This research can be replicated in other factories that share similar processes.

The Minimally Invasive Manipulator: an ergonomic and economic non-robotic alternative for endoscopy?

INTRODUCTION: Since the da Vinci robotic system was introduced, it has been reported to have ergonomic advantages over conventional laparoscopy (COV). High investments associated with this system challenged us to design a more economical, mechanical alternative for improvement of laparoscopic ergonomics: the Minimally Invasive Manipulator (MIM). MATERIAL AND METHODS: An earlier reported MIM prototype was investigated. Its shortcomings were input for the establishment of design criteria for a new prototype. RESULTS: A new prototype was developed, aiming at improved intuitiveness and ergonomics. The handle and instrument tip were redesigned and the parallelogram mechanism was converted from linear moving parts to mainly rotating parts. DISCUSSION: The new prototype was tested by a panel of experts and novices during an indicative ergonomic experiment. A major advantage of the MIM seems to be the possibility to perform laparoscopic surgery in a sitting position, in line with the working axis, instead of standing at the side of the patient. At an estimated cost level of 10% of the da Vinci system, the MIM can be an economical alternative for the enhancement of laparoscopy ergonomics. However, further development for clinical feasibility is necessary.

Guidance strategies for a participatory ergonomic intervention to increase the use of ergonomic measures of workers in construction companies: a study design of a randomised trial.

BACKGROUND: More than seven out of 10 Dutch construction workers describe their work as physically demanding. Ergonomic measures can be used to reduce these physically demanding work tasks. To increase the use of ergonomic measures, employers and workers have to get used to other working methods and to maintaining them. To facilitate this behavioural change, participatory ergonomics (PE) interventions could be useful. For this study a protocol of a PE intervention is adapted in such a way that the intervention can be performed by an ergonomics consultant through face-to-face contacts or email contacts. The objective of this study is to evaluate the effectiveness of the face-to-face guidance strategy and the e-guidance strategy on the primary outcome measure: use of ergonomic measures by individual construction workers, and on the secondary outcome measures: the work ability, physical functioning and limitations due to physical problems of individual workers. METHODS/DESIGN: The present study is a randomised intervention trial of six months in 12 companies to establish the effects of a PE intervention guided by four face-to-face contacts (N = 6) or guided by 13 email contacts (N = 6) on the primary and secondary outcome measures at baseline and after six months. Construction companies are randomly assigned to one of the guidance strategies with the help of a computer generated randomisation table. In addition, a process evaluation for both strategies will be performed to determine reach, dose delivered, dose received, precision, competence, satisfaction and behavioural change to find possible barriers and facilitators for both strategies. A cost-benefit analysis will be performed to establish the financial consequences of both strategies. The present study is in accordance with the CONSORT statement. DISCUSSION: The outcome of this study will help to 1) evaluate the effect of both guidance strategies, and 2) find barriers to and facilitators of both guidance strategies. When these strategies are effective, implementation within occupational health services can take place to guide construction companies (and others) with the implementation of ergonomic measures. TRIAL REGISTRATION: [corrected] Trailnumber: ISRCTN73075751, Date of registration: 30 July 2013.

Designing sustainable work systems: the need for a systems approach.

There is a growing discussion concerning sustainability. While this discussion was at first mainly focused on a society level--and sometimes regarding especially environmental problems, one can now see that this topic is of increasing relevance for companies worldwide and even the social dimension of this three pillar approach is gaining more and more importance. This leads to some questions: Is sustainability already a part of human factors thinking or do we have to further develop our discipline? How can we define sustainable work systems? What are the topics we have to consider? Do we need a new systems ergonomics perspective regarding whole value creation chains and a life-cycle perspective concerning products (and work systems)? How can we deal with potential contradictions about social, ecological, and economic goals?

A newly designed portable ergonomic laparoscopic skills Ergo-Lap simulator.

OBJECTIVE: The cost of laparoscopic simulators restricts the wide use of simulation for training of basic psychomotor skills. This paper describes the scientifically-based development of an inexpensive and portable Ergonomic Laparoscopic Skills (Ergo-Lap) simulator with multiple tasks. MATERIAL AND METHODS: The design of this Ergo-Lap simulator and related training task panel was based on scientific research regarding the representative skills and the ergonomic guidelines for laparoscopic surgery. A user-centred design approach was followed. Fifty-three surgical participants with variable laparoscopic experience (14 medical students, 27 surgeons in training, and 12 experienced laparoscopic surgeons) performed several tasks on the prototype and gave their feedback by filling out a 5-point scale Likert scale questionnaire. RESULTS: The results of the usability evaluation showed that the participants regarded the Ergo-Lap simulator as a useful device to practice the basic and advanced skills effectively. Forty-three of the 53 participants indicated they would like to purchase this simulator since it is easy to use and challenges their laparoscopic skills. CONCLUSIONS: For laparoscopic skills training, this inexpensive Ergo-Lap simulator with diverse task choices offers a simple training opportunity for trainees who want to practice laparoscopic skills at home or at the office.

Cost-efficient measurement strategies for posture observations based on video recordings.

Assessment of working postures by observation is a common practice in ergonomics. The present study investigated whether monetary resources invested in a video-based posture observation study should preferably be spent in collecting many video recordings of the work and have them observed once by one observer, or in having multiple observers rate postures repeatedly from fewer videos. The study addressed this question from a practitioner's perspective by focusing two plausible scenarios: documenting the mean exposure of one individual, and of a specific occupational group. Using a data set of observed working postures among hairdressers, empirical values of posture variability, observer variability, and costs for recording and observing one video were entered into equations expressing the total cost of data collection and the information (defined as 1/SD) provided by the resulting estimates of two variables: percentage time with the arm elevated <15° and >90°. Sixteen measurement strategies involving 1-4 observers repeating their posture ratings 1-4 times were examined for budgets up to €2000. For both posture variables and in both the individual and group scenario, the most cost-efficient strategy at any specific budget was to engage 3-4 observers and/or having observer(s) rate postures multiple times each. Between 17% and 34% less information was produced when using the commonly practiced approach of having one observer rate a number of video recordings one time each. We therefore recommend observational posture assessment to be based on video recordings of work, since this allows for multiple observations; and to allocate monetary resources to repeated observations rather than many video recordings.

Inovações tecnológicas e organizacionais em escritórios e os impactos na qualidade de vida no trabalho / Technological and organizational innovations in offices and the impacts on the quality of work life

Este estudo buscou identificar as novas exigências do trabalho em escritórios, no atual cenário produtivo, motivadas pelas inovações tecnológicas e organizacionais e sua repercussão na qualidade de vida no trabalho. O referencial teórico fundamentou-se nos pressupostos da Ergonomia da Atividade, e o método baseou-se na Análise Ergonômica do Trabalho (AET). A pesquisa, de abordagem qualitativa, utilizou entrevistas semiestruturadas individuais, com a participação de trinta profissionais de uma instituição financeira brasileira de grande porte, e os dados foram analisados com o uso do programa Alceste. Os resultados apontaram que os entrevistados reconhecem a importância das inovações tecnológicas na realização de suas atividades, mas associam a elas o advento de novas exigências, decorrentes principalmente da intensificação e da maior complexidade e controle do trabalho, que resultam no aumento do custo humano do trabalho.

This study aimed to identify the new requirements of work in offices, in the current production scenario, driven by technological and organizational innovations, and their impact on the quality of work life. The theoretical framework was based on the assumptions of Ergonomics of Activity, and the method was based on Ergonomic Work Analysis (EWA). The research, which has a qualitative approach, used individual semi-structured interviews, with the participation of thirty professionals from a large Brazilian financial institution, and the data were analyzed using the software Alceste. The results indicated that respondents recognize the importance of technological innovations to carry out their activities, but they associate to them the advent of new requirements, mainly due to the intensification and greater complexity and control of work, resulting in an increased human cost of work.

Is there enough information to calculate the financial benefits of ergonomics projects?

Many authors studied work situations and, mainly, ergonomics projects concerning the financial benefit point of view. At the same time seems to be little information available concerning these financial benefits in manufacturing companies' processes. The aim of this article is to identify if there enough information available within a company to quantify the financial benefits of an ergonomic project. The study was applied on two manufacturing companies, one in Brazil and other in Portugal. A literature review based checklist and a manager interview was applied on each company in order to identify if the information was available and how were been used. The two companies have revealed a good quantity of available information regarding ergonomics benefit calculation. The interviews showed that managers are not aware of the financial savings possibility with investments in ergonomics projects.

The charge of ergonomics--a model according to the influence of ergonomic workplace design for economical and efficient indicators of the automotive industry.

The importance of ergonomic workplace design has been rising incredibly. The knowledge of the interaction with a view to many indicators (e.g. operators' health, quality, productivity etc.) in the automotive assembly shop pushed into another thinking of ergonomics and an increasing awareness of economic possibilities relating to benefits and cost savings aligned with ergonomics. The paper discusses exemplary the various indicators and factors which could be influenced by ergonomic workplace design. These factors are linked each other and support the statement of ergonomic efficiency. Thus, the aim of this paper is to present a model which describes that investments in ergonomic work placement acts with preventive measurements, minimization of losses (refinishing operations, compensation money etc.) and extensive economies on the whole company.

The businesscase for ergonomic changes in health care: calculating and predicting financial outcome for ergonomic changes and innovations in health care: interactive businesscase modelling.

Research can point to new opportunities and assist in the development of valid business cases to help nurse managers plan change and allocate their budgets to the most promising interventions. These business cases and their results will, in turn, pave the way for more in depth and more fundamental research into implementation processes. It will add to the body of knowledge of intervention research and ultimately hopefully also add to our understanding of why ergonomic interventions in the workplace will or will not be effective and what the impact of financial constraints is. It is difficult to develop and design a valid businesscase. This poster will present one of the possible strategies to develop one.

Development of an ergonomics device for maintenance of hydraulic generators of Tucuruí hydropower plant.

This paper aims to present an ergonomic device to assist in the maintenance of the units of Tucuruí Hydropower Plant. The development of this ergonomic device made possible to reduce maintenance time, reduce losses caused by billing, improve performance and reduce the physical strain for labors during the execution of services.