A Health-Impact Assessment of an Ergonomic Measure to Reduce the Risk of Work-Related Lower Back Pain, Lumbosacral Radicular Syndrome and Knee Osteoarthritis among Floor Layers in The Netherlands

Abstract

Sand–cement-bound screed floor layers are at risk of work-related lower back pain, lumbosacral radicular syndrome and knee osteoarthritis, given their working technique of levelling screed with their trunk bent while mainly supported by their hands and knees. To reduce the physical demands of bending of the trunk and kneeling, a manually movable screed-levelling machine was developed for floor layers in the Netherlands. The aim of this paper is to estimate the potential health gains of working with a manually movable screed-levelling machine on the risk of lower back pain (LBP), lumbosacral radicular syndrome (LRS) and knee osteoarthritis (KOA) compared to traditional working techniques. This potential health gain was assessed using the epidemiological population estimates of the Population Attributable Fraction (PAF) and the Potential Impact Fraction (PIF), combined with work-related risk estimates for these three disorders from systematic reviews. The percentage of workers exceeding these risk estimates was based on worksite observations among 28 floor layers. For LBP, 16/18 workers were at risk when using traditional working techniques, with a PAF = 38%, and for those using a manually movable screed-levelling machine, this was 6/10 with a PIF = 13%. For LRS, these data were 16/18 with a PAF = 55% and 14/18 with a PIF = 18%, and for KOA, 8/10 with a PAF = 35% and 2/10 with a PIF = 26%. A manually movable screed-levelling machine might have a significant impact on the prevention of LBP, LRS and KOA among floor layers in the Netherlands, and health-impact assessments are a feasible approach for assessing health gains in an efficient way.

What have we learned about risk assessment and interventions to prevent work-related musculoskeletal disorders and support work participation?

“…Also the individual worker might benefit from these sensors given the advantages for workplace risk assessments, worker health surveillance, occupational disease assessments, and evaluating the effectiveness of a preventive measure. For instance, when sensors incorporate algorithms as used in health impact assessment, workers can get real-time feedback on whether their work puts them at risk for specific MSD like low-back pain ( 27 – 29 ) or knee osteoarthritis ( 28 ).…”

The causal effect of two occupational factors on osteoarthritis and rheumatoid arthritis: a Mendelian randomization study

“…The absence of adequate rest intervals during continuous exertion may impede the proper repair and reconstruction of tissues, which can negatively affect the health of joint structures, increasing their susceptibility to degeneration and OA. Fifth, the risk of OA in heavy physically demanding occupations can be significantly influenced by ergonomic factors ( 32 , 33 ). Improper joint alignment, excessive joint loading, and unnatural movement patterns can result from poorly designed workstations or equipment ( 32 , 33 ).…”

“…Fifth, the risk of OA in heavy physically demanding occupations can be significantly influenced by ergonomic factors ( 32 , 33 ). Improper joint alignment, excessive joint loading, and unnatural movement patterns can result from poorly designed workstations or equipment ( 32 , 33 ). These factors may contribute to joint misalignment and heighten the likelihood of cartilage wear and tear, thus promoting the development of OA.…”