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.

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 It was rescinded by Congress within four months.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.

[Ergonomic risk assessment: aspects applicable in the light of current standards]

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 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.

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.

Musculoskeletal disorders (Msds) and dental practice. part 1. General information-terminology, aetiology, work-relatedness, magnitude of the problem, and prevention

Occupational health hazards are common in many sectors and are on the increase. Musculoskeletal disorders (MSDs), which are problems of musculoskeletal system, are significant and costly workplace problems affecting occupational health, productivity and the careers of the working population. Although there is a lack of uniform medical information and a clear understanding of the nature of MSDs, and significant difficulties in diagnosis which generate an ongoing debate regarding many aspects of these conditions, various risk factors are identified and preventive measures are available. As safety and health at work is a realistic target and prevention is clearly the best approach, the preventive philosophy deserves particular attention. This review aims to provide background information on general features of MSDs, identified risk factors and the basic philosophy of prevention.

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.

Ergonomic considerations in work-related upper extremity disorders

Correctly applied, an ergonomics approach can reduce the likelihood of work-induced disorders and can assist in accommodating individuals who have work-related disorders, but it cannot eliminate disorders that have been mistakenly attributed to work by social processes. A contextual model of work-related upper extremity disorders is proposed that explicitly acknowledges that factors extrinsic to work can shape perceptions of upper extremity disorders and influence the process of somatic interpretation and health outcomes. Experiences in the United Kingdom of ergonomic regulations associated with computer use and the media coverage of work-related upper extremity disorders are used to illustrate this model.

Research on human embryos and cloning: difficulties of legislating in a changing environment and model approaches to regulation

It is difficult to regulate rapidly changing fields of science. New technologies are not anticipated and legislation becomes inadequate. Legislative definitions are also problematic. This article begins with consideration of such difficulties in the context of research on human embryos and cloning. It considers problems with past legislative definitions in Australia, the new regulatory regime, and whether that regime now sets clear boundaries. It is found that problems still exist--some terms are not adequately defined and boundaries for research prove unclear. Three regulatory approaches are therefore discussed. Legislation based on strict definitions is compared to a legislative model that leaves terms undefined. The third model--which combines framework legislation with the oversight of a regulatory authority--is seen as most suitable. However, problems with this model are recognised and suggestions made regarding how to ensure the "framework" remains workable and effective.

Reproductive and therapeutic cloning, germline therapy, and purchase of gametes and embryos: comments on Canadian legislation governing reproduction technologies

In Canada, the Assisted Human Reproduction Act received royal assent on 29 March 2004. The approach proposed by the federal government responds to Canadians' strong desire for an enforceable legislative framework in the field of reproduction technologies through criminal law. As a result of the widening gap between the rapid pace of technological change and governing legislation, a distinct need was perceived to create a regulatory framework to guide decisions regarding reproductive technologies. In this article the three main topics covered in the new legislation are commented on: cloning, germline therapy, and purchase of gametes and embryos. Some important issues also covered in the new legislation, such as privacy and access to information, data protection, identity of donors, and inspection, will not be addressed.

Ergonomics and the dental office: an overview and consideration of regulatory influences

Nearly 2 million workers suffer from musculoskeletal disorders each year. These problems are caused by repetitive, awkward, or stressful motions. Dental health care workers are susceptible to these types of injuries. This article will discuss state and federal programs to control job-related injuries and relate the regulations to dental practice.

Integrated ergonomics approach toward designing night and shift work in developing countries based on experiences in Bali, Indonesia

Recently, the effort in carrying out an integrated ergonomics approach known as "SHIP" (systemic, holistic, interdisciplinary and participatory) approach has been intensively undertaken in Bali with the aim of sustaining improvements being done. The People's Consultative Assembly of the Republic of Indonesia issued for the 1999-2004 period a "SHIP" Act on the Macro Guidelines of Tourism Development in which ergonomics and other factors must be considered comprehensively to attain sustainable development in tourism. Therefore the night and shift work that is recently increasingly applied in the tourism industry must also be designed and organized through this approach. In fact, however, economic factors have still been the predominant reason for workers to accept any type of night and shift work decided by the management, without taking into account possible impacts and consequences. For example, rapid forward rotation schemes seem more adapted to the hotel industry instead of traditional 6-6-6 rotation. Further, inter-city bus drivers are approved to work a 24-hour shift followed by one day off. These drivers often work an additional risky night shift after two consecutive night shifts so as to meet needed expenses for the family. Cultural or religious activities still presented constraints for workers as they carried out subsequently the night work. Therefore, proactive steps should be taken in a timely manner through the integrated SHIP approach in designing night and shift work so as to achieve work schedules compatible with both social life of shiftworkers and business concerns.

Beneficial effects on employment and preventive health care: the concept and results of counselling processes from a German project

Since December 1998 a project of working time counselling named "Design of Modern Working Times" is supported by the federal state of North Rhine-Westphalia in Germany and the European Union; AWiS-consult is entrusted to carry out this project. The service offered to all companies, institutions, work committees, and employees interested covers information, assessment of existing working time schedules, development of alternative or new working time schedules, and accompanying implementation processes. Up to June 2001 nearly 300 inquiries were worked on, most of them from industry, service companies, and from the field of care and hospitals. Working time design in this project aims not only at work safety and health care but also at beneficial effects on employment. In a special campaign from May 2000 to May 2001, 61 companies were supported by AWiS-consult, with the result of more than 400 new employees and 16 companies with employment secured, so the combination of preventive health care and beneficial effects on employment by working time design can be assessed as successful.

Occupational health and safety in physiotherapy: guidelines for practice

Most physiotherapists (91%) experience work related musculoskeletal disorders (WMSDs) at some time, and one in six makes a career change as a consequence. Many of these disorders are attributed to manual handling of patients. This paper proposes guidelines to reduce the risk of WMSDs based on Australian legislative requirements, the results of a survey of Australian physiotherapists and the literature surrounding injury prevention. These guidelines address the areas of environmental and job design, and the personal physical capabilities of physiotherapists, within the context of law. The paper concludes by calling for further research to explore and develop this area of injury prevention in the physiotherapy profession.

Fulfilling the bargain: how the science of ergonomics can inform the laws of workers' compensation

In the last decade, cumulative trauma disorders have become a significant percentage of reported workplace injuries and litigated workers' compensation claims. Arising from the accumulated impact of daily work activities on the body, these injuries do not fall neatly within either the "accident" or "disease" categories which comprise workers' compensation laws. As a result, courts and legislatures have struggled to properly evaluate workers' compensation claims for these injuries. This Note looks at the legal treatment of cumulative trauma injuries in light of the "original bargain" of workers' compensation, where workers give up a tort remedy against their employers in exchange for guaranteed, but limited, compensation for work-related injuries. In doing so, this Note undertakes a comprehensive comparison of litigated cumulative trauma cases in the tort and workers' compensation systems. Ultimately, this Note argues that judges must use the original bargain as an interpretive less when deciding cumulative trauma cases, and points to ergonomics--the science of the workplace--as a significant new tool for determining whether such injuries are work-related.

OSHA sets final ergonomics rule

After years of advocating for an ergonomic regulation through the Occupational Safety and Health Administration (OSHA), at last on November 14, 2000, the final standards were issued. The OSHA Ergonomic Standards are designed to prevent musculoskeletal injury by matching workplace conditions to job demands. This rule will provide long awaited relief to nurses in direct care who have worked for years without benefit, in most cases, of technology that could have prevented ergonomic injury.

OSHA 2000: a review of compliance issues

The California Occupational Safety and Health Administration is responsible for enforcing worker safety regulations in the state of California. The infection control regulation, while the best known to dentists, is only one of many that affect every dental practice. The past two years have brought significant changes to Cal/OSHA rules. This paper reviews some of the current regulations that apply to dental offices.