coronel institute ergonomics in the construction sector henk van der molen, judith sluiter, monique...
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Coronel Institute
Ergonomics in the construction sector
Henk van der Molen, Judith Sluiter, Monique Frings-Dresen
email: [email protected] [email protected]@amc.uva.nl
Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, The Netherlands
Arbouw, Health & Safety Institute in the Construction Industry, Amsterdam, The Netherlands
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Coronel Institute of Occupational Health
• Department of the Academic Medical Center (AMC)• Samuel Coronel (Sr) (1827-1892):
– one of the first to relate living conditions on health
• Coronel Institute:– Largest university-based center on occupational
health in the Netherlands (± 80 colleagues) – Netherlands Center for Occupational Diseases – Research Center for Insurance Medicine– Out-patient Clinic People and Work
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Arbouw
• Knowledge & Service institute for Dutch industry sector • Working circumstances & disability for work • Board of employers & employee organisations• Collectively financed
• Organisation:• Research & Development• Contract with Occupational Health & Safety services• Facilitative towards sector, e.g. instruments
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What works!? (examples of studies)
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What works!? (1)_ Cochrane review
• Effectiveness of interventions to prevent occupational injuries among workers at construction sites
• Systematic literature review • 7522 references• N = 5 studies with time series• Meta analysis
(van der Molen et al 2007, Lehtola et al. accepted 2008 )
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• No evidence that legislation alone is effective for reducing injuries
• Additional strategies necessary to increase compliance employers and workers to measures prescribed by legislation
• Multifaceted and continuing interventions seem effective for reducing injuries (like safety campaign and drug-free workplace program)
• Influencing safety culture and enforcement / feedback important elements of these interventions
Implications on basis of systematic review
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What works!? (2) _ technical devices
• Effect of adjusting working height materials & mechanisation of transport on work demands
• Controlled field study; real time observations• N = 10 bricklayers, 10 assistants
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Results with respect to day exposures:
bricklayers:• frequency trunk flexion > 60º : 79% (920 times)• duration trunk flexion > 60º : 52% (42
minutes)
assistants:• frequency trunk flexion > 60º : 94% (474 times)• duration trunk flexion > 60º : 92% (25
minutes)• mmh objects > 4 kg : 86% (1326
times)
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What works!? (3)_lower weight
Effect block weight on: Compression force on low back?
Conditions 6, 11, 14 (2 types) en 16 kg N=9 blocklayers Most demanding activities
(based on field study)
Measurements Direct measurement Biomechanical modelling
(Faber et al. 2007 & Kuijer et al. 2007)
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Maximale piek compressiekracht op lage rug
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
2 handen 1hand 2 handen 1 hand 2 handen 1 hand 2 handen 1 hand 2 handen 1 hand 2 handen
oppakken vanaf 10 cmhoogte
oppakken vanaf 90 cmhoogte
oppakken vanaf steiger neerzetten in muurgrondhoogte
neerzetten in muurheuphoogte
neerzetten in muurschouderhoogte
Kra
cht
(N)
blok 6 kgblok 11 kgblok 14 kg zonder gatenblok 14 kg met gatenblok 16 kg
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What works!? (4) _ paver’s trolley
• Effect of paver’s trolley on productivity, task demands, discomfort
• Controlled field study; observations and questionnaires• N = 10 paviours
(Kunst et al. 2007)
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RESULTS
With paver's trolley Working on knees (rolling) : 141 min.Without paver's trolleyWorking on knees (crowling) : 146 min.
• No differences in:– productivity– energetic workload– local discomfort
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What works!? (5) _ergonomic measures
• Effect of use of ergonomic measures on musculoskeletal complaints
• Cohort study: 4.5 years• Questionnaires: 2 times (pre-post) • N= 1,114 carpenters, bricklayers and pavers
(van der Molen, Sluiter & Frings-Dresen 2007;
in press
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6 ergonomic measures
Mechanical transport
Liftingaids
Bricks on elevation
Mechanical transport
Mechanical paving
Mechanical kerbs placing
carpenters bricklayers pavers
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Results: primary prevention
Over a 4.5 years period:
• 17.3% incidence of low back complaints
• Frequent use of ergonomic measures is associated with a non-significant 15% reduction of the risk on reported regularly or sustained low back complaints
• ´Number needed to treat´: 38 construction workers who are regularly using ergonomic measures to prevent 1 construction worker with low back complaints
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Low back complaints
N RR (95% CI)
Materials on elevation (31 cm) 143 0,63
(0,44-0,92)
More use of elevated tubs is related to reduced low back complaints over time
Results: secondary prevention
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What works!? (5a)_Actor analysis
• Assocation between behavioural change and use of ergonomic measures
• Cross sectional study• Structered interviews • N=42;
– Employers as behavior environmental agents– Workers as behavior individual agents
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Tresle know understand want decide able
E W E W E W E W E W
A
B
C
D
E
F
G
H
IE = employers; W = workers; A-I: companies
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example Odds Ratio’s (95% CI)
Employers Bricklayers
Elevation of materials
2,4 (1,1 - 5,1) 7,2 (1,5 - 35,1)
Results
Overall:- Strength of associations between use of ergonomic measures and
behavioral change phases differs between ergonomic measures actor groups of employers and workers
- Significant positive associations between use of ergonomic measures and behavioral change phases
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- Wrist
- Underarm
- Elbow
- Shoulder
Design and development of new tools
Awkard postures and high forces when working with traditional trowel of:
What works!? (6)_Product development
(Kuyt-Evers 2006)
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Position of handle determines load on body regions
TRADITIONAL SMART ERGO
Results
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Developing effective solutions is often a long
and winding road….,
• Evaluate ergonomic measures before implementation on:• Workload / Energy• Complaints / Injuries
• Feasibility of measures for stakeholders• Employer• Worker• but also at architects, manufacturers, et cetera
Take home messages
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Exchange of knowledge (research)
• Fifth IEA symposium in Beijing 2009 • Increase of peered reviewed articles• Special issues about construction ergonomics
– Scandinavian Journal of Work, Environment & Health 2005– Applied Ergonomics 2005– American Journal of Industrial Medicine (in preparation)
• Scientific committees– IEA – ICOH
• International projects (e.g. Cochrane review safety interventions)