Improving the risk assessment capability of the revised NIOSH lifting equation by incorporating personal characteristics.

The impact of manual material handling such as lifting, lowering, pushing, pulling and awkward postures have been studied, and models using these external demands to assess risk of injury have been developed and employed by safety and health professionals. However, ergonomic models incorporating personal characteristics into a comprehensive model are lacking. This study explores the utility of adding personal characteristics such as the estimated L5/S1 Intervertebral Disc (IVD) cross-sectional area, age, gender and Body Mass Index to the Revised NIOSH Lifting Equation (RNLE) with the goal to improve risk assessment. A dataset with known RNLE Cumulative Lifting Indices (CLIs) and related health outcomes was used to evaluate the impact of personal characteristics on RNLE performance. The dataset included 29 cases and 101 controls selected from a cohort of 1022 subjects performing 667 jobs. RNLE risk assessment was improved by incorporation of personal characteristics. Adding gender and intervertebral disc size multipliers to the RNLE raised the odds ratio for a CLI of 3.0 from 6.71 (CI: 2.2-20.9) to 24.75 (CI: 2.8-215.4). Similarly, performance was either unchanged or improved when some existing multipliers were removed. The most promising RNLE change involved incorporation of a multiplier based on the estimated IVD cross-sectional area (CSA). Results are promising, but confidence intervals are broad and additional, prospective research is warranted to validate findings.

Finnish discourses of the stakeholders on development of the implementation of EU legislation concerned with occupational safety and health in computer work.

The overall research objective was to empirically develop the ideas around a system of occupational safety and health (OSH) practices in visual display unit (VDU) work, to describe their relationship with the OSH legislation and to explore how these best practices work to achieve positive results. The aim of the present study was to explore qualitative perceptions of the stakeholders (Finnish Employers' Associations, Employees Organizations and OSH Governmental Inspectorates) concerning the way that the OSH legislation on VDU work is being applied at work. Many stakeholders claim that technological advances require that in OSH the VDU legislation should be updated, especially that it should be clarified, e.g., when does the VDU worker have the right to obtain special eyeglasses needed for VDU work. Many stakeholders believe that additional guidelines concerning practical ergonomic arrangements in VDU work environment and eyeglasses of the VDU workers are needed. In VDU ergonomics, the co-operation between workplace and occupational health care professionals needs to be developed.

A legacy of struggle: the OSHA ergonomics standard and beyond, Part I.

In November 2000, the Occupational Safety and Health Administration (OSHA) issued an ergonomics standard to prevent debilitating work-related musculoskeletal disorders (WMSDs). It was rescinded by Congress within four months. We explore how this story unfolded over two decades of collaboration and conflict. Part I provides an overview of the historical context of the struggle for a standard, followed by interviews with key players from labor, academia and government. They provide a snapshot of the standard; discuss the prevalence of WMSDs in the context of changing work organization; give insight into the role of unions and of scientific debate within the context of rulemaking; and uncover the basis for the groundbreaking OSHA citations that laid the foundation for a standard. Part II interviews further explore the anti-regulatory political landscape of the 1990s that led to repeal of the standard, discuss the impact of the struggle beyond the standard, and describe creative approaches for the future.

A legacy of struggle: the OSHA ergonomics standard and beyond, Part II.

The OSHA ergonomics standard issued in 2000 was repealed within four months through a Congressional resolution that limits future ergonomics rulemaking. This section continues the conversation initiated in Part I, documenting a legacy of struggle for an ergonomics standard through the voices of eight labor, academic, and government key informants. Part I summarized important components of the standard; described the convergence of labor activism, research, and government action that laid the foundation for a standard; and highlighted the debates that characterized the rulemaking process. Part II explores the anti-regulatory political landscape of the 1990s, as well as the key opponents, power dynamics, and legal maneuvers that led to repeal of the standard. This section also describes the impact of the ergonomics struggle beyond the standard itself and ends with a discussion of creative state-level policy initiatives and coalition approaches to prevent work-related musculoskeletal disorders (WMSDs) in today's sociopolitical context.

Application of a screening method in assessing occupational safety and health of computer workstations.

Employers and workers need concrete guidance to plan and implement changes in the ergonomics of computer workstations. The Näppärä method is a screening tool for identifying problems requiring further assessment and corrective actions. The aim of this study was to assess the work of occupational safety and health (OSH) government inspectors who used Näppärä as part of their OSH enforcement inspections (430 assessments) related to computer work. The modifications in workstation ergonomics involved mainly adjustments to the screen, mouse, keyboard, forearm supports, and chair. One output of the assessment is an index indicating the percentage of compliance items. This method can be considered as exposure assessment and ergonomics intervention used as a benchmark for the level of ergonomics. Future research can examine whether the effectiveness of participatory ergonomics interventions should be investigated with Näppärä.

Factores de riesgo ergonómico y su relación con dolor musculoesquelético de columna vertebral: basado en la primera encuesta nacional de condiciones de empleo, equidad, trabajo, salud y calidad de vida de los trabajadores y trabajadoras en Chile (ENETS) 2009-2010 / Ergonomic risk factors and their relationship to spinal musculoskeletal pain: based on the first national survey of conditions of employment equity, labour, health and quality of life of the workers in Chile (ENETS) 2009-2010

El dolor de columna constituye un importante problema de salud en la población trabajadora, atribuido a factores individuales y condiciones laborales. Este estudio buscó determinar la influencia de la exposición a factores de riesgo ergonómico durante la jornada laboral sobre la presencia de dolor musculoesquelético en la columna vertebral. Los datos de este estudio se originaron a partir de los resultados que obtuvo la ENETS dirigida a la población laboral chilena. Se pudo concluir que los factores de riesgo ergonómicos que más explican el riesgo de padecer dolor de columna fueron "movimiento repetitivo" (OR: 1.34; CI: 1.08-1.65) seguido de "vibración corporal" (OR: 1.28; CI: 1.04-1.58). En relación al resultado del estudio, es recomendable revisar las políticas públicas en relación a la seguridad y salud laboral así como la legislación vigente relacionada con los problemas musculoesquelético. Estas deben orientarse a la acomodación ergonómica del puesto de trabajo con el propósito de reducir el impacto generado por la exposición reiterada a factores tales como, el manejo de cargas, posturas forzadas y movimientos corporales repetitivos y el efecto acumulativo por trabajos anteriores (AU)

Spinal pain is a major health problem in the working population, attributed to individual factors and conditions factors. This study sought to determine the influence of exposure to ergonomic risk factors during working hours on the presence of musculoskeletal pain in the spine. The data in this study originated from the results obtained ENETS aimed at Chilean workforce. We concluded that ergonomic risk factors that best explain the risk of spinal pain were "repetitive motion" (OR 1.34, CI: 1.08-1.65) followed by "body vibration" (OR: 1.28, CI: 1.04-1.58). Regarding the outcome of the study, you should review the policies in relation to occupational health and safety and current legislation related to musculoskeletal problems. These should focus on the accommodation ergonomic workstation in order to reduce the impact caused by repeated exposure to factors such as load handling, awkward postures and repetitive body movements and the cumulative effect from previous work (AU)

The application of human engineering interventions reduces ventilator-associated pneumonia in trauma patients.

BACKGROUND: Ventilator-associated pneumonia (VAP) increases mortality and length of stay and escalates the cost of care. Our institution embarked on a project to eradicate VAP. METHODS: We compared the outcome of trauma patients admitted in period 1 (P1) (January 2005 to December 2006) and period 2 (P2) (January 2006 to December 2009). Team building, culture change, and the ventilator bundle were introduced and modified during P1 and were fully implemented in P2. Outcome data were calculated for both periods. The Center for Disease Control VAP definition was used. The VAP rate was calculated as VAP/1,000 ventilator days. Chi-square and t test statistics were used as appropriate. Data were considered statistically significant if p ≤ 0.05. RESULTS: In total, 299 trauma patients were admitted in P1 and 655 in P2. The two groups were identical in age, Injury Severity Score, mortality, and non-VAP. There was a trend toward a shorter length of stay in P2 (p = 0.06). The days on ventilator was significantly shorter in P2 compared with P1 (p = 0.05). The VAP rate dropped significantly from 7.9/1,000 in P1 to 1.0/1,000 in P2 (p = 0.04). The Appropriate Care Measure score increased from 45% in early P1 to 91% in late P2 (p = 0.0001). CONCLUSION: The application of the VAP bundle, a checklist, and the multidisciplinary team approach resulted in significant improvement of VAP in all trauma patients admitted to the shock trauma unit and to the decrease in days on ventilator in the trauma patients. This intervention did not affect mortality or the rate of non-VAP in the trauma patients. LEVEL OF EVIDENCE: Therapeutic study, level IV.

Visual ergonomics and computer work--is it all about computer glasses?

The Swedish Provisions on Work with Display Screen Equipment and the EU Directive on the minimum safety and health requirements for work with display screen equipment cover several important visual ergonomics aspects. But a review of cases and questions to the Swedish Work Environment Authority clearly shows that most attention is given to the demands for eyesight tests and special computer glasses. Other important visual ergonomics factors are at risk of being neglected. Today computers are used everywhere, both at work and at home. Computers can be laptops, PDA's, tablet computers, smart phones, etc. The demands on eyesight tests and computer glasses still apply but the visual demands and the visual ergonomics conditions are quite different compared to the use of a stationary computer. Based on this review, we raise the question if the demand on the employer to provide the employees with computer glasses is outdated.

Rediseño de la sala de control de tráfico del ferrocarril de Antofagasta-Bolivia: diseño acústico y mobiliario / Redesign of the traffic control room of the Antofagasta -Bolivia railroad company: acoustic and furniture design

El Departamento de Tráfico del Ferrocarril de Antofagasta a Bolivia se encarga de las comunicaciones de todo el sistema de la red ferroviaria.El cálculo predictivo de los elementos acústicos permite valorar cuál es el mejor material para la sala de control en su fase de diseño, permitiendo aquello ahorrar importantes costos. El mobiliario en este tipo de trabajo es clave dado que es en la sala de control donde se desarrollan las operaciones. El presente artículo propone la implementación de nuevos elementos que generen un impacto directo en la baja de los costos por concepto de ausentismo, seguridad laboral y calidad de vida de las personas.

The Traffic Department of the Antofagasta-Bolivia Railroad Company deals with communications among all the railroad network system. Predictive calculations of acoustic elements allow us to assess the best material for the control room in the design phase, and thus making costs saving easier. The furniture in this kind of job is crucial because all operations are carried out in the control room. This article suggests the implementation of new elements that create a direct impact on costs related to absenteeism, occupational safety and quality of life.

[Ergonomic risk assessment: aspects applicable in the light of current standards]. / La valutazione dei rischi ergonomici: aspetti applicativi alla luce dell'attuale normativa.

The Italian decree law 81/2008 mentions the application of ergonomic principles as a basic tool for the prevention. In this regulation we can not find the definition either of Ergonomics nor of the competences required for its correct application. The Authors consider that occupational physicians have a suitable competence and knowledge on the matter, thanks to their highly specialized training. Actually, the ergonomic doctrine shows up in the daily practice of occupational physicians, who regularly base their activity on the evaluation of the binomial "worker-task": in the management of fitness to work judgements they try to combine operating conditions with worker's psychophysical state, not confining themselves to a simple expression ofa medico-legal certificate. However, the legislative references to specific regulations raise difficulties to occupational physicians in dealing with aspects such as gender, age, reference values and methodological choices. The Authors debate these difficulties in the application of rules.

Ergonomics and regulatory politics: the Washington State case.

BACKGROUND: Every year in the State of Washington more than 50,000 workers experience a work related musculoskeletal disorder (WMSD), making up more than 30% of all worker compensation cases. In 2000, the Washington State Department of Labor and Industries (L&I) adopted a workplace ergonomics rule requiring employers to reduce worker exposure to hazards that cause or contribute to WMSDs. In 2003, the ergonomics rule was repealed by a margin of 53.5-46.5 in a statewide voter initiative. METHODS: The official rulemaking record of approximately 100,000 pages, along with supplementary published and unpublished material, was reviewed. The relationship between scientific deliberation and the public policy process in adopting and repealing the ergonomics rule was assessed and described. The deliberative features of the regulatory, judicial, legislative, and ballot processes were compared. RESULTS AND CONCLUSIONS: The ergonomics rule was successful in the regulatory and legal arenas where the process was most transparent and open to public involvement, differing views could be presented fully, and decision makers were expected to explain their decisions in light of the record. The rule fared most poorly in the legislature and at the ballot box when these features were lost and where considered deliberation was replaced by unconstrained political conflict. Additional checks and balances are needed.

Ergonomics policy in Indonesia.

Workers' conditions in accordance with their place of work are different from one area to another, especially in this reformation era where there are immense alterations in politics shown from the centralized government shifting to decentralization and district autonomy. Ergonomics problems in Indonesia are reviewed. In home industries, workers have to adjust themselves to their jobs, and ergonomic improvement may face significant impediments especially in small-scale industries. It is necessary to create or identify the most plausible model to be implemented in accordance with the conditions of districts, including low awareness about the relation between ergonomics and workers' productivity in producing goods and services and working processes scattered often at their own houses. As conditions conducive to ergonomics programs, district-level willingness to improve and increase the wealth of their society, recognition by businesses about the impacts of ergonomics on productivity and reduction of medical treatment costs may be mentioned. Labor unions support ergonomic improvements at production processes, and professionals and academicians are ready to assist, whereas national banks and foreign investment may encourage new technologies including ergonomics aspects. It is important to strengthen ergonomic improvement efforts in Indonesia through establishing district ergonomics improvement networks and ergonomics peer leaders with the support of continual training starting from the training of core leaders at the province level and extending to peer leaders at district level. This training should be made as simple as possible in order to facilitate innovations toward changes. Finally assistance is needed by the mentor teams in order to periodically monitor the improvements undertaken.

Labor's critical role in workplace health and safety in California and beyond--as labor shifts priorities, where will health and safety sit?

Organized labor has been largely responsible for the health and safety protections many U.S. workers take for granted. This article provides a brief history of labor's influence on California's health and safety policies--sometimes with ripple effects beyond its borders. Six cases where various successful strategies were used are examined. These gains were achieved with strong support from international health and safety staff, and, on some issues, support from the state labor federation. But in most cases local union staff involvement was key. Now that labor mobilizes to build its shrinking membership--with only 1 out of 12 workers in the private sector organized--resources are being re-directed toward organizing. Understandably, health and safety advocates have expressed concern that worker protections may suffer. Time will tell, but there is evidence that health and safety demands are front and center in a number of current and upcoming organizing campaigns. Now more than ever, it is in health and safety professionals' interest to tie their research and clinical work into these emerging campaigns.

Ergonomics in Latin America: background, trends and challenges.

This paper offers an introduction to ergonomics in Latin America through a brief overview of ergonomics practice in Argentina, Brazil, Chile, Colombia, Mexico, and Peru. It provides a short description of the history of ergonomics in each country, ergonomics teaching, its organisation through the ergonomics associations, and some highlights of the areas of interest, and examples of ergonomics practice.

The relation between OSH and ergonomics: a 'mother-daughter' or 'sister-sister' relation?

Despite the growing importance of ergonomics and ergonomists worldwide, the position of ergonomics in companies is often not clear. Today, in many countries ergonomics is mainly (or even only) associated with the reduction of risks of work-related musculoskeletal disorders (WMSDs). Therefore, many companies consider ergonomics a part of occupational safety and health (OSH) that focuses mainly on the reduction of risks. This paper aims to analyse the links between occupational ergonomics and OSH. The position of occupational ergonomics in legislation, the presence of ergonomics in OSH networks, and the position of ergonomics in OSH company services are discussed. In addition, the added value of ergonomics to companies is examined. From these discussions, it becomes clear that ergonomics should be part of the OSH policy of companies, and should be integrated into today's company strategies to improve labour conditions. If ergonomics is considered as a discipline in its own right, a clear legislative context should be developed that goes beyond voluntary guidelines and the goodwill of employers, and necessitates the presence of ergonomics professionals in companies.