Sustainable MSD prevention: management for continuous improvement between prevention and production. Ergonomic intervention in two assembly line companies

What is meant by case management for the return-to-work of workers with musculoskeletal disorders? A scoping review

BACKGROUND

Case management interventions have shown to be effective to prevent musculoskeletal pain and disability, but a single definition has not been achieved, nor an agreed profile for case managers.

OBJECTIVE

To describe the elements that define case management and case managers tasks for return-to-work of workers with musculoskeletal disorders (MSDs).

METHODS

A comprehensive computerized search of articles published in English until February 16, 2021 was carried out in several bibliographic databases. Grey literature was obtained through a search of 13 key websites. A peer-review screening of titles and abstracts was carried out. Full text in-depth analysis of the selected articles was performed for data extraction and synthesis of results.

RESULTS

We identified 2,422 documents. After full-text screening 31 documents were included for analysis. These were mostly European and North American and had an experimental design. Fifteen documents were published between 2010 to 2021 and of these 7 studies were published from 2015. Fifteen elements were identified being the commonest "return-to-work programme" (44.4%) and "multidisciplinary assessment/interdisciplinary intervention" (44.4%). Of 18 tasks found, the most frequent was "establishing goals and planning return-to-work rehabilitation" (57.7%). Eighteen referral services were identified.

CONCLUSIONS

Despite there were several elements frequently reported, some elements with scientific evidence of their importance to deal with MSDs (e.g. early return-to-work) were almost not mentioned. This study proposes key points for the description of case management and case managers tasks.

A thorough investigation on pushing activities in industry: The impact of the variation in the speed of motion and load conditions on initial and sustained forces

Pushing and pulling wheeled objects represent a significant part of manual material handling activities in industry. Medical investigations and epidemiological studies proved the correlation between such activities and the occurrence of lumbago, low back pain and adverse effects on the shoulders. The ISO 11228-2:2007 provides the recommended limits for pushing and pulling. Such values are the results of psychophysical studies realized under prescribed speed conditions referring to a slow walk. However, observation of real industrial and service sector environments reveals that workers are required to perform pushing activities at higher speed of motion. The aim of this study was to investigate the impact of the variation in the speed of motion and load conditions on push forces. 96 subjects performed a total of 2592 trials consisting of pushing an industrial trolley for warehouse applications, at different speed values and load conditions. Results confirm the presence of correlation between the increasing speed of motion and push forces. The findings have practical value for researchers, occupational physicians and ergonomics practitioners.

International Occupational Health and Safety Management-Systems Standards as a Frame for the Sustainability: Mapping the Territory

A significant part of literature has shown that the adoption of Sustainability and Health-Safety management systems from organizations bears some substantial benefits since such systems (i) create a suitable frame for the sustainable development, implementation and review of the plans and/or processes, necessary to manage occupational health-safety (OHS) in their workplaces and (ii) imply innovative thinking and practices in fields of economics, policy-making, legislation, health and education. To this context, the paper targets at analysing current sustainability and OHSMSs in order to make these issues more comprehend, clear and functional for scholars and practitioners. Therefore, a literature survey has been conducted to map the territory by focusing on two interrelated tasks. The first one includes the presentation of the main International Management Systems (IMS) with focus on Sustainability and OHS (S_OHSMS) topics and the second task depicts a statistical analysis of the literature-review findings (for the years 2006–2017). In particular, the main purposes of the literature research were: (i) the description of key points of OHSMS and sustainability standards, (ii) the comparative analysis of their characteristics, taking into account several settled evaluation-criteria and (iii) the statistical analysis of the survey’s findings, while our study’s primary aim is the reinforcement of OHMSs’ application in any organization. The results evince, that the field of industry (with 28%) and also of the constructions (with 16%), concentrate the highest percentage of OHSMS use. In general, there were only few publications including OHSMSs (referred to various occupational fields) available in the scientific literature (during 2006–2017) but on the other hand, there was a gradually increasing scientific interest for these standards (especially during 2009–2012).

Forms of work organization and associations with shoulder disorders: Results from a French working population

The aim of this study was to identify forms of work organization in a French region and to study associations with the occurrence of symptomatic and clinically diagnosed shoulder disorders in workers. Workers were randomly included in this cross-sectional study from 2002 to 2005. Sixteen organizational variables were assessed by a self-administered questionnaire: i.e. shift work, job rotation, repetitiveness of tasks, paced work/automatic rate, work pace dependent on quantified targets, permanent controls or surveillance, colleagues' work and customer demand, and eight variables measuring decision latitude. Five forms of work organization were identified using hierarchical cluster analysis (HCA) of variables and HCA of workers: low decision latitude with pace constraints, medium decision latitude with pace constraints, low decision latitude with low pace constraints, high decision latitude with pace constraints and high decision latitude with low pace constraints. There were significant associations between forms of work organization and symptomatic and clinically-diagnosed shoulder disorders.

Promoting a Shared Representation of Workers' Activities to Improve Integrated Prevention of Work-Related Musculoskeletal Disorders

Effective and sustainable prevention of work-related musculoskeletal disorders (WR-MSDs) remains a challenge for preventers and policy makers. Coordination of stakeholders involved in the prevention of WR-MSDs is a key factor that requires greater reflection on common knowledge and shared representation of workers' activities among stakeholders. Information on workers' strategies and operational leeway should be the core of common representations, because it places workers at the center of the "work situation system" considered by the intervention models. Participatory ergonomics permitting debates among stakeholders about workers' activity and strategies to cope with the work constraints in practice could help them to share representations of the "work situation system" and cooperate. Sharing representation therefore represents a useful tool for prevention, and preventers should provide sufficient space and time for dialogue and discussion of workers' activities among stakeholders during the conception, implementation, and management of integrated prevention programs.

Prevention of musculoskeletal disorders within management systems: A scoping review of practices, approaches, and techniques

The purpose of this study was to identify and summarize the current research evidence on approaches to preventing musculoskeletal disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS). Databases in business, engineering, and health and safety were searched and 718 potentially relevant publications were identified and examined for their relevance. Twenty-one papers met the selection criteria and were subjected to thematic analysis. There was very little literature describing the integration of MSD risk assessment and prevention into management systems. This lack of information may isolate MSD prevention, leading to difficulties in preventing these disorders at an organizational level. The findings of this review argue for further research to integrate MSD prevention into management systems and to evaluate the effectiveness of the approach.

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.

Corporate Ergonomics

Corporations have been implementing ergonomics programs for more than 30 years. Initially, the purpose of these programs was improving operational efficiency by applying knowledge of human capabilities and limitations to the design of work. In recent years, corporate programs in the United States have increasingly focused on reducing the impact of work-related musculoskeletal disorders on both business and employee well-being. This article provides a brief summary of both types of ergonomics program strategies and describes my experiences leading two corporate ergonomics programs.

Design and development of EMR supporting medical process management

Current EMR system benefits physicians by facilitating order entry and reducing errors. It can improve the safety and effectiveness of medical services, but cannot manage the whole medical process and the quality of medical services. In addition to physicians, EMR should be designed for all medical professionals because medical services cannot be accomplished by physicians alone, but also requires the involvement of other medical professionals. Therefore, we applied PDCA, the famous quality management cycle to design a comprehensive and coherent EMR system which can be used throughout the entire treatment process. EMR with the PDCA Cycle can record every order state and every treatment procedure in order to monitor the whole medical process. This extends the safety from planning the treatment to fulfilling it. By analyzing the records, doctors and hospital managers can perfect the medical process and improve healthcare quality. The EMR we designed with the PDCA Cycle provides a record entry interface for physicians and a worksheet interface for nurses and other professionals. Every treatment procedure and every change of orders or tasks will be fed back to medical professionals. So information generated from the beginning to the end of treatment will link with each other to avoid any information islands. Furthermore, the EMR can display the additional information intuitively and real-timely without increasing the burden of medical professionals' work.