The use of actor-based immersive health and safety inductions: Lessons from the Thames Tideway Tunnel megaproject.

Health and safety inductions are ubiquitous in construction but tend to be poorly designed and suffer low levels of worker engagement. In this paper we report on the evaluation of an innovative, full day, actor-based health and safety induction called EPIC, currently being used on London's Thames Tideway Tunnel megaproject. As of March 2019, more than 14,000 individuals had attended EPIC. This evaluation examines the impact of EPIC from the perspective of participants and other stakeholders, and considers the utility of actor-based immersive health and safety inductions for use more widely, in both construction and other sectors. Using a mixed-method, longitudinal approach to data collection, EPIC is evaluated against Kirkpatrick's (1959) 'four levels' framework of reactions, learning, behaviour change and results. This paper discusses factors which support and hinder actor-based inductions, and the challenges involved in assessing the impact of inductions on subsequent behaviour and health and safety outcomes.

Exploring differences in pain beliefs within and between a large nonclinical (workplace) population and a clinical (chronic low back pain) population using the pain beliefs questionnaire.

BACKGROUND: Beliefs, cognitions, and behaviors relating to pain can be associated with a range of negative outcomes. In patients, certain beliefs are associated with increased levels of pain and related disability. There are few data, however, showing the extent to which beliefs of patients differ from those of the general population. OBJECTIVE: This study explored pain beliefs in a large nonclinical population and a chronic low back pain (CLBP) sample using the Pain Beliefs Questionnaire (PBQ) to identify differences in scores and factor structures between and within the samples. DESIGN: This was a cross-sectional study. METHODS: The samples comprised patients attending a rehabilitation program and respondents to a workplace survey. Pain beliefs were assessed using the PBQ, which incorporates 2 scales: organic and psychological. Exploratory factor analysis was used to explore variations in factor structure within and between samples. The relationship between the 2 scales also was examined. RESULTS: Patients reported higher organic scores and lower psychological scores than the nonclinical sample. Within the nonclinical sample, those who reported frequent pain scored higher on the organic scale than those who did not. Factor analysis showed variations in relation to the presence of pain. The relationship between scales was stronger in those not reporting frequent pain. LIMITATIONS: This was a cross-sectional study; therefore, no causal inferences can be made. CONCLUSIONS: Patients experiencing CLBP adopt a more biomedical perspective on pain than nonpatients. The presence of pain is also associated with increased biomedical thinking in a nonclinical sample. However, the impact is not only on the strength of beliefs, but also on the relationship between elements of belief and the underlying belief structure.

Planning crowd events to achieve high participant satisfaction.

A case study investigation within a large UK university involving semi-structured stakeholder interviews, examined the organisation, coordination, and security within crowd events of various descriptions. Similarities in approaches and priorities emerged with crowd event organisation, primarily attention to safety requirements, in protecting crowd members, venue reputation, and legal obligations. Conversely, attention to and attitudes and beliefs surrounding user experience, crowd comfort and satisfaction, were often based on personal judgment, and appeared to be influenced by budget considerations. The findings suggest a lack of knowledge and usable evidence based guidance for planning crowd events in relation to important aspects affecting participant satisfaction.

The effect of load distribution within military load carriage systems on the kinetics of human gait.

Military personnel carry their equipment in load carriage systems (LCS) which consists of webbing and a Bergen (aka backpack). In scientific terms it is most efficient to carry load as close to the body's centre of mass (CoM) as possible, this has been shown extensively with physiological studies. However, less is known regarding the kinetic effects of load distribution. Twelve experienced load carriers carried four different loads (8, 16, 24 and 32 kg) in three LCS (backpack, standard and AirMesh). The three LCS represented a gradual shift to a more even load distribution around the CoM. Results from the study suggest that shifting the CoM posteriorly by carrying load solely in a backpack significantly reduced the force produced at toe-off, whilst also decreasing stance time at the heavier loads. Conversely, distributing load evenly on the trunk significantly decreased the maximum braking force by 10%. No other interactions between LCS and kinetic parameters were observed. Despite this important findings were established, in particular the effect of heavy load carriage on maximum braking force. Although the total load carried is the major cause of changes to gait patterns, the scientific testing of, and development of, future LCS can modify these risks.

What constitutes effective manual handling training? A systematic review.

BACKGROUND: Injuries caused by manual handling are a major burden to society. Manual handling training programmes have been designed to reduce the likelihood of injury among the workforce; however, concerns have been raised over the efficacy of current manual handling training methods. AIMS: To undertake a systematic review of the literature examining the effectiveness of different approaches to training in manual handling. METHODS: Peer-reviewed publications along with published conference proceedings published in English, between 1980 and 2009, on the topic of manual handling training comprised the search criteria. A published checklist for reviewing papers was selected, which formed the basis for assessing the quality of the papers reviewed. RESULTS: A total of 1827 papers were located. Following elimination of duplicates, 221 papers were collected and reviewed. Of these, 53 papers were intervention studies with the primary aim of investigating the effectiveness of manual handling training. The review identified little evidence supporting the effectiveness of both technique- and educational-based manual handling training. In addition, there was considerable evidence supporting the idea that the principles learnt during training are not applied in the working environment. Strength and flexibility training shows promise; however, further research is needed to ascertain whether such an intervention is sustainable over the long term. CONCLUSIONS: The evidence collected indicates that manual handling training is largely ineffective in reducing back pain and back injury. High priority should be given to developing and evaluating multidimensional interventions, incorporating exercise training to promote strength and flexibility, which are tailored to the industrial sector.

The effect of military load carriage on 3-D lower limb kinematics and spatiotemporal parameters.

The 3-D gait analysis of military load carriage is not well represented, if at all, within the available literature. This study collected 3-D lower limb kinematics and spatiotemporal parameters in order to assess the subsequent impact of carrying loads in a backpack of up to 32 kg. Results showed the addition of load significantly decreased the range of motion of flexion/extension of the knee and pelvic rotation. Also seen were increases in adduction/abduction and rotation of the hip and pelvis tilt. No changes to ankle kinematics were observed. Alterations to the spatiotemporal parameters of gait were also of considerable interest, namely, an increase in double support and a decrease in preferred stride length as carried load increased. Analysing kinematics during military or recreational load carriage broadens the knowledge regarding the development of exercise-related injuries, while helping to inform the human-centred design process for future load carrying systems. The importance of this study is that limited available research has investigated 3-D lower limb joint kinematics when carrying loads.

Subjective skeletal discomfort measured using a comfort questionnaire following a load carriage exercise.

OBJECTIVE: Limited research has been conducted into the effect of load carriage on discomfort and injuries. This study aimed to determine the skeletal discomfort for part-time soldiers who completed a 1-hour field march carrying 24 kg. METHODS: A postmarch comfort questionnaire was completed by 127 participants, with exercise withdrawals and postmarch injuries also recorded. RESULTS: The foot was subjectively rated as the most uncomfortable skeletal region. Females reported hip discomfort to be significantly greater than males. The military experience of participants had no difference on the mean perceived comfort ratings of any of the measured regions. Finally, only one participant withdrew from the exercise, with no participants reporting a load carriage injury in the 2 to 3 days proceeding the exercise CONCLUSIONS: This study concludes that although a 1-hour period of load carriage causes noteworthy discomfort it is not sufficient to result in noncompletion of a military exercise or cause injury.

The Cochran-Weiss-Shanteau performance index as an indicator of upper limb risk assessment expertise.

Ergonomists and many other professionals apply ergonomics principles to musculoskeletal health problems. This study examines whether there are differences when it comes to judgement expertise concerning upper limb disorders (ULDs) between ergonomists and those with less ergonomics training. The Cochran-Weiss-Shanteau (CWS) performance index combines judgement consistency with discrimination into one CWS index. Fifty-eight professionals working in the musculoskeletal health area, from four different professions, judged the likelihood of staff complaining of ULDs in a number of written work scenarios containing ULD risk factors. A student group (n = 148) taking an introductory ergonomics module was used as a reference. The ergonomists scored higher on the CWS index than all of the other groups, performing significantly better than all but the occupational health advisors. Performance improved with increased training level but not with experience. This study suggests that ergonomists are quantifiably different from other ergonomics advisors in their judgement performance in this context. Given the global cost of musculoskeletal disorders, assessing the expertise of those giving ergonomics advice for the management of musculoskeletal health is of great significance. This study presents a method for assessing judgement performance in ULD risk assessment, an important part of musculoskeletal health management.

The effectiveness of interventions for preventing injuries in the construction industry: a systematic review.

BACKGROUND: Occupational injury rates among construction workers are the highest among the major industries. A number of injury-prevention interventions have been proposed, yet the effectiveness of these is uncertain. Thus a systematic review evaluating the effectiveness of interventions for preventing occupational injuries among construction workers was conducted. METHODS: Seven databases were searched, from the earliest available dates through June 2006, for published findings of injury prevention in construction studies. Acceptable study designs included RCTs; controlled before-after studies; and interrupted time series (ITS). Effect sizes of similar interventions were pooled into a meta-analysis in January 2007. RESULTS: Of 7522 titles found, four ITS studies and one controlled ITS study met the inclusion criteria. The overall methodologic quality was low. No indications of publication bias were found. Findings from a safety-campaign study and a drug-free-workplace study indicated that both interventions significantly reduced the level and the trend of injuries. Three studies that evaluated legislation did not decrease the level (ES 0.69; 95% CI=-1.70, 3.09) and made the downward trend (ES 0.28; 95% CI=0.05, 0.51) of injuries less favorable. CONCLUSIONS: Limited evidence was found for the effectiveness of a multifaceted safety campaign and a multifaceted drug program, but no evidence was found that legislation is effective to prevent nonfatal or fatal injuries in the construction industry.

The effect of military load carriage on ground reaction forces.

Load carriage is an inevitable part of military life both during training and operations. Loads carried are frequently as high as 60% bodyweight, and this increases injury risk. In the military, load is carried in a backpack (also referred to as a Bergen) and webbing, these combined form a load carriage system (LCS). A substantial body of literature exists recording the physiological effects of load carriage; less is available regarding the biomechanics. Previous biomechanical studies have generally been restricted to loads of 20% and 40% of bodyweight, usually carried in the backpack alone. The effect of rifle carriage on gait has also received little or no attention in the published literature. This is despite military personnel almost always carrying a rifle during load carriage. In this study, 15 male participants completed 8 conditions: military boot, rifle, webbing 8 and 16 kg, backpack 16 kg and LCS 24, 32 and 40 kg. Results showed that load added in 8 kg increments elicited a proportional increase in vertical and anteroposterior ground reaction force (GRF) parameters. Rifle carriage significantly increased the impact peak and mediolateral impulse compared to the boot condition. These effects may be the result of changes to the vertical and horizontal position of the body's centre of mass, caused by the restriction of natural arm swing patterns. Increased GRFs, particularly in the vertical axis, have been positively linked to overuse injuries. Therefore, the biomechanical analysis of load carriage is important in aiding our understanding of injuries associated with military load carriage.