WORK: A Journal of Prevention,Assessment & Rehabilitation

Cumulative trauma disorders (CTDs) are a major problem facing industry and workers today. A successful ergonomics program can be designed by the occupational therapist (OT) to meet the unique needs of a company. It can help manage costs and control CTDs. The successful implementation of an ergonomics program requires a team effort and must include management, engineers, line supervisors, workers and the health care provider with a knowledge of ergonomic principles. A well designed ergonomics program should include surveillance activities, worksite job analysis and education and training of all employees. Solutions to identified problems can be developed through administrative and engineering controls and modification of work practices. This article reviews the role of the OT in the implementation and management of an on-site ergonomics program.

In order to identify the relevant challenges in occupational health in the next century, changes in demographic profile and work activity must first be considered. Only then can the challenges be identified, and appropriate strategies be formulated to respond to these challenges. In a newly industrializing country such as Singapore, improved work conditions; the advent of new technology; a redistribution of work activity (with a reduction of factory workers and an increase in service sector workers); and an ageing workforce can be expected. These changes, together with a possible increase of some types of work related disorders (such as cumulative trauma disorders, and disorders resulting from psychosocial hazards); will determine the relevant occupational health challenges to be faced. Added to this would be society's higher expectations for health care, a humane and compassionate health care, and an improved quality of life. As a result, what is needed in Singapore might be (1) a shift in the focus of current health care activities to pay sufficient attention to new hazards at work, and newly emerging work related diseases, (2) improved training and development of health professionals to better prepare them to face these changes, and (3) a responsive and appropriate legislation to protect the health of all workers.

This study examines the age-related risk of overexertion injuries among Swedish nursing auxiliaries. Overexertion ratios (ORs) and injury severity were measured over time, for males and females separately, all injuries aggregated and for three injury patterns, employing five age categories and three time periods. OR values varied by time period, age and gender. The number of injuries by overexertion-injury pattern varied over time, and the ORs of particular age groups were related to pattern. Female auxiliaries aged 16–24 and 45–54, and also male auxiliaries aged 25–34 consistently showed ORs greater than 1.0. Injuries of all types tended to be more severe with increasing age. These findings provide grounds for reconsidering auxiliaries' occupational tasks and work aids, and methods for safety promotion. They suggest that preventive programs should be targeted so as to address several different overexertion-injury patterns, depending on age group and gender.

Objectives: Work assessment and work hardening were components of a comprehensive interdisciplinary program to prevent and manage back injury in nurses in a large tertiary care hospital. The effect of work hardening on morbidity and work status is described.

Study Design: Nurses injured on ‘target’ wards who had time loss exceeding four working days received a work assessment. Results determined work placement: work hardening. modified work or return to regular work. Pain, disability and lifting tolerance were monitored during work hardening and modified work; pain, disability, work endurance and work status were compared between initial and follow-up assessments.

Results: Seven nurses received work hardening. All had increased lifting capacity; pain and disability scores decreased and, by 6 months follow-up, all were working full shifts at their regular jobs.

Conclusion: Results support the concept of maintaining individuals with back injury in the workplace by providing early, on-site intervention that includes work hardening and modified work.

This study investigated the combined use of three measurement techniques to monitor fatigue in forearm muscles during pressure glove work. Pressurized gloves are a component of the spacesuit used by shuttle astronauts during extravehicular activities (EVA). The study was conducted to specifically evaluate and compare the effects of pressure and non-pressure components of the glove on work and fatigue. Ten healthy male subjects were recruited to perform a constrained task of repetitively squeezing a custom hand-grip dynamometer adjusted for constant resistance. Surface electromyographic (EMG) signals from two muscles of the forearm (m. extensor carpi ulnaris (ECU) and m. flexor digitorum superficialis (FDS)) were recorded concurrently with mechanical work and subjective fatigue. Measurements were made before, during, and after the repetitive gripping task. Each subject performed the test under three conditions: (1) bare hand, (2) gloved-hand without a pressure differential, and (3) gloved-hand with a pressure differential equal to the normal operating pressure of the shuttle glove. The results demonstrated that the three measurement procedures provided complementary information about the interrelationship between glove characteristics, muscle function, and work productivity. The EMG results from the FDS muscle indicated that the resistance offered by the glove materials provided a component of fatigue that was compounded by the presence of differential pressure. Although not muscle specific, measurements of work output and subjective fatigue supported this finding. In contrast to the FDS, the EMG results from the ECU muscle indicated that this muscle was less fatigued overall and less sensitive to the test conditions. Although high inter-subject variability precluded a statistically significant effect of test condition on the EMG results from the ECU muscle, 8 of the 10 subjects had higher EMG manifestations of fatigue for bare hand work than for either gloved-hand condition. We interpret these findings as evidence that the stiffness of the glove may have provided support to the wrist, thereby reducing the amount of fatigue present in this muscle during the work task. The study findings demonstrate the feasibility of using this multidimensional approach to fatigue measurement when evaluating other work-related tasks.

Objectives: the research was designed to evaluate the success of a Project set up to find employment or training in ordinary firms or organisations for people with disabilities.

Methods: three main sources of data were used: the Project's data-base, which included information on client ‘outcomes’; postal questionnaires and interviews with Project clients; postal questionnaire and interviews with referrers to the Project.

Results: the rate of referral to the Project vastly exceeded expectations. According to the Project's ‘outcome’ categories, 66% of the clients were successfully placed, and clients' accounts verified this. The expectations of referrers of people with learning disabilities for their clients exceeded ‘outcomes’ but referrers of people with physical disabilities under-estimated them. Clients' views were generally favourable but they would have liked more choice and aspired to improving their work placements.

Conclusions: The evidence indicated that the Project had a role in the area not filled by other agencies.

The workplace often requires the use of critical thinking which, in turn, may stimulate certain aspects of adult development. This article proposes several characteristics of critical thinking that may contribute to adult development as it occurs in the workplace. The concepts considered apply to managers and workers in a variety of situations.

High unemployment rates for people with multiple sclerosis are frequently attributed to decreases in self-efficacy and outcome expectations with respect to job seeking and retaining tasks. Hence, return-to-work interventions must enable people with MS to develop positive expectations. They must believe (a) that they possess the abilities needed to respond effectively in the job interview and request reasonable job accommodations (self-efficacy) and (b) that they will secure employment as a result of their efforts (outcome expectations). Based on social cognitive strategies, the Accommodations Planning Team (APT) Seminar offers the skill training required for increasing employment-related efficacy and outcome expectations.

UK banks have traditionally employed blind and partially sighted people as telephonists. The introduction of new technology and organisational restructuring has lead to a decrease in the need for clerical staff. Banks are faced with the dilemma of what to do with blind and partially sighted telephonists. Many are considering the options and preferring to deal with individual cases at a local level as they become pressing rather than take a co-ordinated approach. This paper describes how one Bank decided to tackle this challenge at a corporate level through a company wide redeployment project, assisted by the Royal National Institute for the Blind (RNIB). Data collection, assessments, job analysis and technical investigations are described. The central role of training both for project participants and personnel staff is discussed and the responsibilities of project Case Managers are reported. So far over 100 members of staff have been relocated, supplied with new equipment, had their current job expanded or been placed in a new job. Some other wide ranging results such as changes to Bank policy are discussed. The conclusion highlights some of the challenges encountered and suggests how the lessons learned through the project might be applied to other situations.

The Occupational Safety and Health Administration has developed a draft Ergonomic Protection Standard. The goal of having such a standard is to prevent work-related musculoskeletal disorders or reduce the severity of such injuries. The guidelines address identification of problem jobs, control of risk factor exposures, ergonomic design, training and documentation. How businesses and employees will be affected if the draft becomes a guideline is addressed in this paper. Also addressed is the possible role that occupational therapists may play in ergonomics if such a guideline is implemented.