The effectiveness of participatory ergonomics approaches - CafeErgo

As I work through some of my doctoral thesis, I?ve been writing a little about the effectiveness of participatory ergonomics (PE). Clearly, there is support for the approach but traditional academic evaluations of success seem to discount the effectiveness. While searching through literature and compiling this section of my thesis, I thought I could share some of these perspectives with you.

Review:

PE has been applied and demonstrated reported improvements to the workplace and employee health in many sectors, including health care, office work, food processing and manufacturing. However, most PE projects rely on a case-study approach and the time frame of the intervention research does not always allow for collection of quantitative data regarding indicators of health, or changes in reported health outcomes. This lack of conclusive, quantitative, evidence has led to questions regarding the trues effectiveness of PE approaches (Carrivick, Lee, & Yau, 2002; Carrivick, Lee, Yau, & Stevenson, 2005).

A systematic review of the effectiveness of PE approaches in 2008 did show evidence that PE approaches led to positive changes within enterprises (Rivilis et al., 2008). Still, there are those in the health science community that believe evidence of PE effectiveness can only be judged through a randomized control trial design. In a review of PE randomized control trials there was limited evidence to support the benefits of PE in reducing musculoskeletal complaints at work, and providing health care and sick leave economic benefits (M. Driessen et al., 2012; M. T. Driessen et al., 2010). However, they authors caution that, given the limited number of studies that met criteria for inclusion in the reviews, the results should be interpreted carefully. It is also worth noting that randomized control trials, by their nature, are not an appropriate design for judging the effectiveness of participatory interventions. For example, randomized control trials must assume that, outside of the experimental treatment, all other factors are assumed equal. This is impossible with a PE program; no two workplaces have exactly matched work tasks, work forces, work organization and design of the work space. Furthermore, cultural or learning and apply knowledge, and political/managerial structures differ between organizations, and these factors impact on delivery and implementation of a PE program. It is also important to note that changes in health outcomes and injuries diagnosed by medical professionals can have a significant latency period, often on the scale of years (Lotters & Burdof, 2002). Intervention projects rarely have a long enough partnership between researchers/practitioners and the workplace to see the changes in health outcomes become evident.

Based on this, it is important to evaluate a PE program from an interdisciplinary perspective, and not just on reduction in reported injury claims. For example, evaluating a PE intervention might involve evaluating the process of the implementation (Dale, Jaegers, Buchholz, Welch, & Evanoff, 2012). This evaluation identifies aspects that facilitated or impeding program delivery, training and implementation of the changes so that it can be improved in future interventions. There are also value in developing capacity and knowledge of a community of stakeholder so they can continue to work towards safeguarding their health and well being. In participatory research, evaluating capacity development is noted as one of the main indicators of a successful project (Crisp, Swerissen, & Duckett, 2000; Hawe, Noort, King, & Jordens, 1997). In fact, Hawe et al. (1997) note that projects that focus on building capacity may result in initially poor levels of traditional health outcome detection, but provide long term sustainability and action within the community that lower physical health risks in the future.

CafeErgo Comments:

To me, this research supports the need to better share knowledge between quantitative and PE studies. Quantitative physical studies could be completed to demonstrate scientific validity of approaches, but it should be recognized that the results require transfer and adaptation to fit the needs of the workplace. Meanwhile, PE approaches often lack to ability to demonstrate quantitative changes in injury rates and health outcomes, but can be used harness and develop the knowledge and capacity of the stakeholders to ensure the adaptation and application of underlying scientific principles.

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REFERENCES:

Carrivick, P. J. W., Lee, A. H., & Yau, K. K. W. (2002). Effectiveness of a participatory workplace risk assessment team in reducing the risk and severity of musculoskeletal injury. [Article]. Journal of Occupational Health, 44(4), 221-225.

Carrivick, P. J. W., Lee, A. H., Yau, K. K. W., & Stevenson, M. R. (2005). Evaluating the effectiveness of a participatory ergonomics approach in reducing the risk and severity of injuries from manual handling. [Article]. Ergonomics, 48(8), 907-914. doi: 10.1080/0014013042000327698

Crisp, B. R., Swerissen, H., & Duckett, S. J. (2000). Four approaches to capacity building in health: consequences for measurement and accountability. Health Promot. Int., 15(2), 99-107. doi: 10.1093/heapro/15.2.99

Dale, A. M., Jaegers, L., Buchholz, B., Welch, L., & Evanoff, B. A. (2012). Using process evaluation to determine effectiveness of participatory ergonomics training interventions in construction. Work (Reading, Mass.), 41(0), 3824-3826.

Driessen, M., Bosmans, J., Proper, K., Anema, J., Bongers, P., & Van der Beek, A. (2012). The economic evaluation of a Participatory Ergonomics programme to prevent low back and neck pain. Work (Reading, Mass.), 41(0), 2315-2320.

Driessen, M. T., Proper, K. I., van Tulder, M. W., Anema, J. R., Bongers, P. M., & van der Beek, A. J. (2010). The effectiveness of physical and organisational ergonomic interventions on low back pain and neck pain: a systematic review. Occupational and Environmental Medicine, 67(4), 277-285. doi: 10.1136/oem.2009.047548

Hawe, P., Noort, M., King, L., & Jordens, C. (1997). Multiplying Health Gains: The critical role of capacity-building within health promotion programs. Health Policy, 39(1), 29-42.

Lotters, F., & Burdof, A. (2002). Are changes in mechanical exposure and musculoskeletal health good performance indicators for primary interventions? International Archives of Occupational and Environmental Health, 75(8), 549-561. doi: 10.1007/s00420-002-0368-7

Rivilis, I., Van Eerd, D., Cullen, K., Cole, D. C., Irvin, E., Tyson, J., & Mahood, Q. (2008). Effectiveness of participatory ergonomic interventions on health outcomes: A systematic review. [Article]. Applied Ergonomics, 39(3), 342-358. doi: 10.1016/j.apergo.2007.08.006

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