Carrying out participatory ergonomics

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Sarah Copsey, Ioannis Anyfantis, European Agency for Safety and Health at Work, Peter Buckle, Imperial College, London, UK

Introduction

This article provides some basic guidance on how to carry out participatory ergonomics in the workplace, in particular for preventing musculoskeletal disorders (MSDs). It draws on a longer article on participatory ergonomics[1].

Informing and consulting workers on occupational health and safety is a legal requirement[2][3] and worker involvement, to take account of their experiences and knowledge of their work and associated hazards, is vital for effective risk assessment and prevention. As well as improving worker acceptance of the workplace changes they have contributed to, it has the potential to improve communication between workers and management[4] and enhance organisational performance[5][6].

What is participatory ergonomics?

Participatory ergonomics is a way to involve an organisation’s workers, supervisors and other workplace parties in jointly identifying and removing the hazards or risk factors in their workplace, including musculoskeletal disorder risk factors.

It has been defined as “the involvement of people in planning and controlling a significant amount of their own work activities, with sufficient knowledge and power to influence both processes and outcomes in order to achieve desirable goals.”[7] This is just one of various definitions. According to Koningsveld and de Loozesources “the participatory approach to ergonomics relies on actively involving workers in implementing ergonomic knowledge, procedures and changes with the intention of improving working conditions, safety, productivity, quality, morale and/or comfort.”

Value of an inclusive, participatory process

There is a significant literature regarding those members of the workforce who might be disadvantaged or overlooked and might therefore benefit most when included as part of a participatory initiative. Gender issues in the design and performance of work have been addressed in a number of reports including the European Trade Union Institute publication entitled Integrating Gender in Ergonomic Analysis[8] and a special edition of the journal Ergonomics[9].

The need to understand work ‘as done’ and not work as imagined or as prescribed has led ergonomists to recognise the importance and value of working with those that actually undertake the work itself. This enables a fuller and wider understanding of how work tasks are achieved, how they vary between individual workers and how tasks may change according to other system requirements and demands. Importantly, it also facilitates the identification of ideas that individual workers may have to improve the performance of the system.

Setting up a Participatory Ergonomics project

Framework

Participatory ergonomics projects can take many forms from a small re-design issue to a substantive workforce re-deployment or product/process change. The size and nature of the project will influence the level of engagement required. Box 1 provides a framework for optimising participation and implementation[10].

Box 1: A framework for participatory ergonomics
Extent/level of the planned intervention

Organisational or work system or a specific workplace or product

Purpose

For example the method of work organisation or a design exercise or the implementation of a change

Continuity

Continuous or discrete (e.g. one-off) intervention

Involvement

Direct or through a worker representative

Formality

Formal (e.g. teams and committees) or informal

Requirement

Voluntary (the most common format) or compulsory

Decision-making

Workers decide or consensus or consultation

Coupling

Direct (views and recommendations applied directly) or remote (participants views filtered)

Key steps

Tips for carrying out the process include the following[11][12]:

  • Set up a PE team with appropriate members (see ‘Who to involve’).
  • Define team members’ responsibilities (including for problem identification, solution development, implementing changes).
  • Decide the remit of the intervention (i.e. whether it is process development, problem. identification, solution generation, solution evaluation, implementation or process maintenance.
  • Provide training covering general ergonomic concepts and organisational processes (such as equipment purchase, obtaining the services of maintenance staff). Let the whole team make decisions about which problems to focus on and solutions using group consultation. Management can become involved to approve the decisions when financial resource are required.
  • Your intervention process will and should be unique to your workers and workplace.

Who to involve[13]

PE is carried out by setting up a PE team which should include workers and supervisors directly affected by the intervention. Including more senior management provides commitment and will help to ensure that the necessary resources are available and that decisions taken. It is also beneficial to include someone with ergonomics expertise. It is important to have a clear team leader or champion who is interested and enthusiastic about the intervention to steer the process.

Participants usually include:

  • workers;
  • supervisors;
  • advisors (human resources, OHS personnel, ergonomists);
  • technical specialists (maintenance personnel, engineers, skilled tradespeople).

In addition to the core team, others from management, purchasing and maintenance and workers from other departments may provide information about their work and their perspective. Senior management commitment for the whole process is crucial. If there are trade unions in the organisation, these should be represented.

As mentioned, it is beneficial to have involve someone with ergonomics expertise and training in participatory methods. Professional ergonomists and human factors experts may be found through national and international professional groups. The International Ergonomics Association[14] (IEA) is an international federation of human factors/ergonomics societies and networks across the globe. (Note: This website lists all the EU Ergonomics/Human Factors affiliated societies.) In addition, the Federation of the European Ergonomics Societies[15] (FEES) enhances the recognition of ergonomics to economic development, quality of life, health and safety at work, and to social progress in European Countries.

Challenges of a real-world intervention

Issues identified as most often being either facilitators or barriers in PE interventions are[16] :

  • Having support for the PE programme from the organisation (management, co-workers and union).
  • Having resource commitment from the organisation. (Resources include time and money.)
  • Having open communication about the PE programme.

Methods often used within participatory ergonomics approaches to address musculoskeletal disorders

This section provides resources to support the PE approach in workplace interventions that aim to prevent MSDs. The links provided are for guidance only, as many other options exist for each method. This section should be read in conjunction with the OSHwiki article on assessment of physical loads to prevent work-related musculoskeletal disorders.

Some commonly used methods and examples are listed in Table 1. This is not an exhaustive list and textbooks describing these and other methods are included in the further reading list at the end of this article.

Table 1. Commonly used methods in participatory ergonomics approaches for MSDs (with some suggested links)
Method Further information
Stakeholder identification and engagement This article discusses the importance of consulting stakeholders when the work comprises new technologies and when risk perceptions may affect workers.
Task analysis This article provides a basic introduction to the principles of task analysis[17]
Risk assessments This article shows specific assessments for disorders affecting back, arm, neck and their associated workplace risks.
Assessing exposure to known MSD risks and risk evaluations To prevent work-related MSDs, performing a risk assessment of physical workload is an important part of risk management. This article deals predominantly with physical risk factors.

This article considers psychosocial factors that are known to be associated with an increased risk of MSDs.

Interviews and questionnaires These articles detail the broad range of methods that are available to collect relevant information from and with the workforce, including interviews and questionnaire techniques.
Checklists There are many available checklists, for example the Dutch WEBA checklist on well-being at work[18]
Body and hazard mapping Body and hazard mapping techniques[19] are interactive and are used to gather evidence from groups of workers about the effects of work on their bodies, such as musculoskeletal aches and pains.
Techniques for ideas generation There is a long history of such methods, arising from action research. Clemensen et. al., (2017) provide a practical case study with methodology[20]
Focus groups There is a vast literature. This site lists the pros and cons of this approach[21]

An example of a PE methodology – ErgoPar[22]

ErgoPar is a 3-step participatory approach designed to:

  • identify MSD-related hazards and exposures and determine causes;
  • develop preventive measures that either eliminate or at least reduce risk situations;
  • implement and monitor solutions to ensure continuous improvement.

Workers participate in every phase of the approach.

Preliminary phase: Start with a formal meeting to present the aim and create commitment that includes all relevant potential stakeholders. Create an Ergo Team comprising an equal number of management representatives with decision-making power and worker representatives with knowledge of the workplace and relevant tasks. Also consider involving health and safety professionals. The team is responsible for coordinating and communicating. Members should receive training on the method, and ideally training in ergonomics and working conditions.

Intervention phase: Participative risk assessments, such as individual questionnaires or check lists are used to identify hazards. Then the Ergo Team and the organisation’s health and safety committee define, plan, and implement preventive measures. They monitor the measures, assess their efficiency and outline results in a follow-up report.

Assessment and continuity phase: Based on the follow-up report, the Ergo Team formulates a continuity strategy to ensure a systematic and iterative process and to sustain results and further improvements.

Some examples of successful participatory ergonomic interventions

ErgoKita - an ergonomic intervention in nursery day-care[23]

The ErgoKita study utilised PE to engage with nursery school-teachers in an ergonomics intervention study aimed at reducing musculoskeletal demands through improving equipment and enhancing behaviour to reduce risk of disorders. The study covered multiple nurseries. The investigation included site inspections and task analysis. The participatory methods used included surveys and workshops to investigate the problems and involving a team of workers in discussion and decisions on measures taken, such as furniture and equipment. Workers were also involved in workshops to evaluate the success of the intervention.

Participatory ergonomic intervention in kitchen work[24]

This study involved municipal kitchens in four large cities in Finland. Kitchens with at least three full-time employees working at least 6 hours per day were included. Kitchens were randomized to intervention and control groups. Workers developed their working conditions over an 11–14-month intervention period. This was achieved through active group work during which problems were identified. They then generated and evaluated solutions for the identified problems technical staff. An ergonomist initiated and then guided the process and also trained the participants. The ergonomist was also available for consultation. A local steering group was set up for improving the exchange of information between the research group and food service management in two cities. Evaluative data were collected using research diaries, questionnaires and focus group interviews and 402 workplace changes were implemented.

The changes in ergonomics were perceived to decrease physical load and improve musculoskeletal health. Lack of time and motivation and insufficient financial resources were mentioned as limitations in the process and the workers expressed a wish for more support from the management, technical staff and ergonomists.

Participatory ergonomics applied in installation work[25]

All 7,000 employees in an installation company were informed of the objective to improve efficiency by reducing sick leave caused by musculoskeletal workload during maintenance or construction operations. This required identifying major loading tasks and then creating and prioritising solutions in group sessions. Promising solutions were then tested during real operations. Implementation and the sharing of knowledge through the company took place and further solutions were sought. Health and safety specialists completed a questionnaire and asked workers about the effects of the workplace changes, to evaluate both the effect of the intervention and the participatory process. Users reported a reduction in musculoskeletal loading and were satisfied. The project was cost-effective within 1 year. However, adding organisational measures or system solutions and more direct participation might have improved the impact of the intervention. Limiting factors for adoption of the solutions were their perceived applicability and workforce acceptance.

Participatory ergonomics intervention in a vehicle foam parts manufacturer[26]

A PE intervention was carried out in a 175-employee company that manufactures foam parts for vehicle interiors, following the steps outlined in a PE guide[27]. An ergonomics change team was set up to implement the programme at the worksite. The team included worker representatives from all shifts, a trade union and a corporate health and safety representative, a mechanical engineer, the production manager, the tooling supervisor, human resources representatives and a person from the external research team. The team identified and prioritised potential ergonomic changes based on departmental injury rates, worker suggestions, worker pain reports and production and quality issues. The team introduced 10 physical changes to the plant. These included five easier-to-implement ‘fast track’ changes, such as installing anti-fatigue matting to reduce leg and back fatigue, and changing a tool to reduce wrist flexion by fabricating a 45-degree angle on the tool. They also included five more substantial projects, such as installing platforms to reduce low-back stressors and changing a packing protocol to reduce above-shoulder work.

Participatory ergonomics in a textile plant[28]

A PE intervention was carried out in a clothing manufacturer with 295 workers. A worksite ergonomics change team was set up, which included management and trade union representatives from the plant, as well as two external ergonomics experts. Team members were trained to use PE principles to identify jobs for improvement, assess the ergonomic risk factors of the identified jobs and come up with solutions. The team identified many changes across different jobs. These ranged from equipment and workstation adjustments to process changes. Almost all were low-cost and low-tech changes that were made by the plant’s mechanics and maintenance staff (e.g. adjusting workstation heights).

Participatory ergonomics in a vineyard

There was concern about MSDs among workers from pruning grapevines. A PE intervention combined video analysis of workers performing their tasks by consultants with worker participation. Initially, a meeting was held with all workers to explain the aim and process of the intervention and important aspects, such as the confidentiality of data collected. Next, a working group of workers was set up and trained about MSDs. The consultants then analysed the work (types of postures, time spent in the posture, other aggravating factors, etc.), including through the use of the video techniques. The work situation was studied in favourable conditions and poorer ones, and they attempted to capture all aspects which could impact on how the workers worked. Following this, the working group was used to verify the consultants’ analysis of the videos and scoring of postures, to take into account the workers’ individual experiences of performing the same work. Then, using the videos, the working group identified the technical, organisational and social factors applicable in the given work situation. The working group was then involved in researching and the testing solutions. The working group and the manager collaborated on how the agreed solution would be tested and implemented. This ensured that workers checked how the solution worked in practice before it was fully implemented. The chosen solution was the introduction of a seat to help eliminate poor postures. (Source: EU-OSHA, unpublished).

Success factors and limitations of participatory ergonomics

The Institute of Work and Health (IWC) in Canada, emphasises that ensuring support prior to commencing an intervention is vital to the success of a project[29]. It has identified 3 key barriers to successful PE interventions, which are supported by others[30][31], and underlines the importance of keeping them in mind[32]:

  • Not having support for the PE programme from the organisation (management, co-workers and trade union).
  • Not having resource commitment (time and money) from the organisation.
  • Not having open communication about the PE programme.

Based on a review of interventions that have achieved the greatest success, IWC also recommends the following[33]:

  • Participatory ergonomics approaches should be formally documented and should describe the participants, the nature of ergonomic changes, and the intensity of the ergonomic intervention process (level of participation, extent of involvement).
  • The evaluation of these interventions should include comparison groups whenever possible.
  • Study design should consider the possibility of randomisation when many sites or organisations are involved.
  • Those who design, carry out and evaluate such interventions in the workplace should consider the presence of co-interventions and potential confounders.
  • They should also continue to measure important risk factors for musculoskeletal symptoms.

The success of the PE approach has largely been demonstrated through small interventions in a variety of workplaces. Authoritative reviews that have considered the efficacy of participatory ergonomics interventions aimed at preventing musculoskeletal disorders[34][35][36] have found mixed evidence. However, there are significant methodological challenges in designing and undertaking rigorous intervention studies of this nature. Many studies have recognised limitations resulting from study design, resources available to fully implement any changes identified as required and follow-up issues relating to outcome variables (e.g. health, sickness absence, injury). A consensus across reviews is similarly difficult to establish and summarise regarding the effectiveness and the impact of participatory ergonomics on musculoskeletal disorders. Evidence for the effectiveness of PE is discussed further in Buckle (2021)[37], where more information on the advantages and limitations of study designs is also given.

Further reading and resources


References

  1. Buckle, P., EU-OSHA, 2021. Participatory ergonomics and preventing MSDs in the workplace, EU-OSHA. Available at: https://osha.europa.eu/en/publications/participatory-ergonomics-and-preventing-musculoskeletal-disorders-workplace/view
  2. Biagi, M., Consultation and information on health and safety, In: Encyclopaedia of occupational health and safety, ILO, 1998, Chapter 21.25
  3. Framework Directive 89/391/eec https://osha.europa.eu/en/legislation/directives/the-osh-framework-directive/the-osh-framework-directive-introduction
  4. EU-OSHA – European Agency for Safety and Health at Work, Quality of the working environment and productivity, 2004. Available at: http://osha.europa.eu/en/publications/reports/211
  5. EUROFOUND, ‘Employment through flexibility: Squaring the circle’, 2001. Available at: https://www.eurofound.europa.eu/sites/default/files/ef_files/pubdocs/2001/53/en/1/ef0153en.pdf
  6. Sisson, K., ‘Direct Participation and the Modernisation of Work Organisation’, EUROFOUND, 2000. Available at: https://www.eurofound.europa.eu/sites/default/files/ef_files/pubdocs/2000/29/en/1/ef0029en.pdf
  7. Wilson, J.R., 1995. Ergonomics and participation. In: Wilson, J.R., Corlett, E.N. (Eds.), Evaluation of Human Work, second ed. Taylor and Francis, London.
  8. Messing, K. 1999. Integrating gender in ergonomic analysis. ETUC. https://www.etui.org/publications/books/integrating-gender-in-ergonomic-analysis
  9. Habib, R. R. and Messing, K. (2012) ‘Gender, women’s work and ergonomics’, Ergonomics, 55(2), pp. 129–132. doi: 10.1080/00140139.2011.646322. https://www.tandfonline.com/doi/abs/10.1080/00140139.2011.646322?scroll=top&needAccess=true&journalCode=terg20
  10. Haines, H.M., Wilson, J.R., 1998. Development of a Framework for Participatory Ergonomics. Health and Safety Executive, HSE Books, Sudbury, Suffolk. https://www.hse.gov.uk/research/crr_pdf/1998/crr98174.pdf
  11. IWC – Institute of Work and Health, 2009. MSD hazards in the workplace: A guide to successful participatory ergonomics programs. https://www.iwh.on.ca/sites/iwh/files/iwh/tools/pe_guide_2009b.pdf
  12. Hignett, S., Wilson, J.R., Morris, W., 2005. Finding ergonomic solutions - participatory approaches. Occup. Med. 55, 200–207. DOI: 10.1093/occmed/kqi084
  13. IWC – Institute of Work and Health, 2009. MSD hazards in the workplace: A guide to successful participatory ergonomics programs. https://www.iwh.on.ca/sites/iwh/files/iwh/tools/pe_guide_2009b.pdf
  14. https://iea.cc/
  15. https://www.ergonomics-fees.eu/
  16. Cole et al (2010) Process and implementation of participatory ergonomic interventions: a systematic review, Ergonomics, 53:10, 1153-1166, DOI: 10.1080/00140139.2010.513452
  17. https://en.wikipedia.org/wiki/Task_analysis
  18. PRIMA – Psychosocial Risk Management Framework, Healthy working for health - using the WEBA method, http://www.prima-ef.org/healthy-working-for-health---using-the-weba-method.html
  19. Body and hazard mapping in the prevention of musculoskeletal disorders (MSDs), EU-OSHA, 2020 https://osha.europa.eu/en/publications/body-and-hazard-mapping-prevention-musculoskeletal-disorders-msds/view
  20. Clemensen J, Rothmann MJ, Smith AC, Caffery LJ, Danbjorg DB. Participatory design methods in telemedicine research. J Telemed Telecare. 2017 Oct;23(9):780-785. doi: 10.1177/1357633X16686747
  21. https://www.gov.uk/guidance/focus-group-study-qualitative-studies
  22. ISTAS, Summary of the ErgoPar method. http://ergopar.istas.net/ficheros/documentos/Summary_ERGOPAR_2.0_%28English%29.pdf
  23. ErgoKita: an example of an ergonomic intervention in the education sector https://osha.europa.eu/en/publications/ergokita-example-ergonomic-intervention-education-sector/view
  24. Pehkonen I, Takala E‐P, Ketola R, et al. (2009) Evaluation of a participatory ergonomic intervention process in kitchen work. Appl Ergon. 40:115‐123. https://doi.org/10.1016/j.apergo.2008.01.006
  25. de Jong, A.M., Vink, P (2002) Participatory ergonomics applied in installation work. Appl. Ergon. 33, 439–448. https://doi.org/10.1016/S0003-6870(02)00033-9
  26. IWC – Institute of Work and Health, 2009. Ergonomics case study: Car parts manufacturer realizes benefits of PE program. At Work, Issue 57, Summer 2009: Institute for Work and Health, Toronto https://www.iwh.on.ca/newsletters/at-work/57
  27. IWC – Institute of Work and Health, 2003. Participative Ergonomic Blueprint. https://www.iwh.on.ca/tools-and-guides/participatory-ergonomic-blueprint
  28. IWC – Institute of Work and Health, 2013. Manufacturer learns participatory ergonomics worth the investment. At Work, Issue 72, Spring 2013: Institute for Work & Health, Toronto. https://www.iwh.on.ca/newsletters/at-work/72/manufacturer-learns-participatory-ergonomics-worth-investment
  29. Cole, D., et al., ‘Effectiveness of Participatory Ergonomics Interventions: A Systematic Review’, Institute for Work and Health - IWC, 2005. Available at: https://www.iwh.on.ca/sites/iwh/files/iwh/reports/iwh_best_evidence_pe_effectiveness_2005.pdf
  30. Haines, H.M., Wilson, J.R., 1998. Development of a Framework for Participatory Ergonomics. Health and Safety Executive, HSE Books, Sudbury, Suffolk.
  31. Burgess-Limerick R (2018) Participatory ergonomics: Evidence and implementation lessons Appl Erg 68, 289-293 https://doi.org/10.1016/j.apergo.2017.12.009
  32. IWC – Institute of Work and Health, 2009. MSD hazards in the workplace: A guide to successful participatory ergonomics programs. https://www.iwh.on.ca/sites/iwh/files/iwh/tools/pe_guide_2009b.pdf
  33. https://www.iwh.on.ca/summaries/sharing-best-evidence/effectiveness-of-participatory-ergonomics)
  34. Kennedy, C.A., Amick III, B.C., Dennerlein, J.T. et al. Systematic Review of the Role of Occupational Health and Safety Interventions in the Prevention of Upper Extremity Musculoskeletal Symptoms, Signs, Disorders, Injuries, Claims and Lost Time (2010). J Occup Rehabil 20, 127–162 https://doi.org/10.1007/s10926-009-9211-2
  35. Palmer K , Harris E , Linaker C , Barker M , Lawrence, W Cooper C , Coggon D (2012) Effectiveness of community- and workplace-based interventions to manage musculoskeletal-related sickness absence and job loss: a systematic review, Rheumatology, 51, 230–242, https://doi.org/10.1093/rheumatology/ker086
  36. Burgess-Limerick R (2018) Participatory ergonomics: Evidence and implementation lessons Appl Erg 68, 289-293 https://doi.org/10.1016/j.apergo.2017.12.009
  37. Buckle, P., EU-OSHA, 2021. Participatory ergonomics and preventing MSDs in the workplace, EU-OSHA. Available at: https://osha.europa.eu/en/publications/participatory-ergonomics-and-preventing-musculoskeletal-disorders-workplace/view

Contributors

Palmer