Methodological issues in evaluating workplace interventions to reduce work-related musculoskeletal disorders through mechanical exposure reduction

Abstract

Researchers of work-related musculoskeletal disorders are increasingly asked about the evidentiary base for mechanical exposure reductions. Mixed messages can arise from the different disciplinary cultures of evidence, and these mixed messages make different sets of findings incommensurate. Interventions also operate at different levels within workplaces and result in different intensities of mechanical exposure reduction. Heterogeneity in reporting intervention processes and in measuring relevant outcomes makes the synthesis of research reports difficult. As a means of synthesizing the current understanding of measures, this paper describes a set of intervention and observation nodes for which relevant workplace indicators prior to, during, and after mechanical exposure reduction can provide useful information. On the basis of this path of impacts from exposure reduction, an approach to the evaluation of multilevel ergonomic interventions is described that can assist fellow researchers in producing evidence relevant to the challenges faced by workplace parties and policy makers.Key terms arm pain, back pain, ergonomics, human factors, occupational injury, repetitive strain injury, cumulative trauma disorders.

Opening the black box: Presenting a model for evaluating organizational-level interventions

“…For example, it has been found that different stakeholders have conflicting mental models about what constitutes success (Cole et al, 2003;Shannon & Cole, 2004). Detecting these different perspectives may help to explain how different motivations drive differences in key stakeholders' behaviours during the intervention process.…”

The ability of limited exposure sampling to detect effects of interventions that reduce the occurrence of pronounced trunk inclination

“…While ergonomics interventions are usually aimed to reduce the risk of MSD, intervention effects on biomechanical exposure are often used as proxies of health effects, assuming that exposure is predictive of risk (Westgaard and Winkel, 1997;Lö tters and Burdorf, 2002;Cole et al, 2003). One major reason is that the exposure effects of an intervention have a much shorter latency (if any) than health outcomes, making them more readily accessible, in particular to practitioners.…”

“…Westgaard and Winkel, 1997;Silverstein and Clark, 2004;van der Molen et al, 2005;Brewer et al, 2006;Boocock et al, 2007;Denis et al, 2008). While the ultimate goal of the intervention is to reduce the risk of contracting or maintaining WMSD, changes in biomechanical exposure accompanying the intervention are often used as a proxy for its eventual effect on health (Westgaard and Winkel, 1997;Lö tters and Burdorf, 2002;Cole et al, 2003). Due to constraints on time and resources, safety and ergonomics practitioners are particularly compelled to judging intervention effects by how they affect exposure.…”

Untitled

“…We live in an age of evidence-based practice in the healthcare sector; yet, as pointed out by Shamian and El-Jardali, despite the sheer volume of these reports, there has been very little high-quality research evidence available upon which to base effective interventions. But the scope of the challenges faced when conducting rigorous workplace intervention research should not be underestimated (Cole et al 2003).…”