A trial of a job-specific workers' health surveillance program for construction workers: study protocol

<p>Abstract</p> <p>Background</p> <p>Dutch construction workers are offered periodic health examinations. This care can be improved by tailoring this workers health surveillance (WHS) to the demands of the job and adjust the preventive actions to the specific health risks of a worker in a particular job. To improve the quality of the WHS for construction workers and stimulate relevant job-specific preventive actions by the occupational physician, we have developed a job-specific WHS. The job-specific WHS consists of modules assessing both physical and psychological requirements. The selected measurement instruments chosen, are based on their appropriateness to measure the workers' capacity and health requirements. They include a questionnaire and biometrical tests, and physical performance tests that measure physical functional capabilities. Furthermore, our job-specific WHS provides occupational physicians with a protocol to increase the worker-behavioural effectiveness of their counselling and to stimulate job-specific preventive actions. The objective of this paper is to describe and clarify our study to evaluate the behavioural effects of this job-specific WHS on workers and occupational physicians.</p> <p>Methods/Design</p> <p>The ongoing study of bricklayers and supervisors is a nonrandomised trial to compare the outcome of an intervention (job-specific WHS) group (n = 206) with that of a control (WHS) group (n = 206). The study includes a three-month follow-up. The primary outcome measure is the proportion of participants who have undertaken one or more of the preventive actions advised by their occupational physician in the three months after attending the WHS. A process evaluation will be carried out to determine context, reach, dose delivered, dose received, fidelity, and satisfaction. The present study is in accordance with the TREND Statement.</p> <p>Discussion</p> <p>This study will allow an evaluation of the behaviour of both the workers and occupational physician regarding the preventive actions undertaken by them within the scope of a job-specific WHS.</p> <p>Trial registration</p> <p><a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3012">NTR3012</a></p

Use of Ergonomic Measures Related to Musculoskeletal Complaints among Construction Workers: A 2-year Follow-up Study

Background: The physical work demands of construction work can be reduced using ergonomic measures. The aim of this study was to evaluate the use of ergonomic measures related to musculoskeletal disorders (MSDs) among construction workers. Methods: A questionnaire was sent at baseline and 2 years later to 1,130 construction workers. We established (1) the proportion of workers reporting an increase in their use of ergonomic measures, (2) the proportion of workers reporting a decrease in MSDs, (3) the relative risk for an increase in the use of ergonomic measures and a decrease in MSDs, and (4) workers' knowledge and opinions about the use of ergonomic measures. Results: At follow-up, response rate was 63% (713/1,130). The proportion of workers using ergonomic measures for vertical transport increased (34%, 144/419, p < 0.01); for measures regarding horizontal transport and the positioning of materials, no change was reported. The proportion of workers reporting shoulder complaints decreased (28%, 176/638, p = 0.02). A relationship between the use of ergonomic measures and MSDs was not found; 83% (581/704) of the workers indicated having sufficient knowledge about ergonomic measures. Lightening the physical load was reported to be the main reason for using them. Conclusion: Only the use of ergonomic measures for vertical transport increased over a 2-year period. No relationship between the use of ergonomic measures and MSDs was found. Strategies aimed at improving the availability of ergonomic equipment complemented with individualized advice and training in using them might be the required next steps to increase the use of ergonomic measures

Response rate of bricklayers and supervisors on an internet or a paper-and-pencil questionnaire

It is unclear whether or not internet surveys yield response rates comparable to paper-and-pencil surveys for specific occupational groups, such as construction workers. The objective of this study was to examine the differences in response rates between a paper-and-pencil questionnaire and an internet questionnaire for two construction-related occupations: bricklayers and supervisors. In total 600 participants were randomly assigned to the internet questionnaire survey or to the conventional paper-and-pencil questionnaire survey. Undeliverable postal was excluded from the response rate. A total of 237/590 subjects responded, leading to a response rate of 40% across both arms of the study. Total response rate in the paper-and-pencil questionnaire group (45%, 1311293) was significantly higher (Chi-Square = 4.99, p = 0.025) than in the internet questionnaire arm (36%, 106/297). Among bricklayers, the response rate on the paper-and-pencil questionnaire (44%, 64/147) was significantly higher (Chi-Square 7.36, p = 0.007) than on the internet questionnaire (28%, 42/148). For construction supervisors response rates were not different for both arms of the study, 46% (67/146) on the paper-and-pencil questionnaire and 43% (64/149) on the internet questionnaire. Overall, a paper-and-pencil questionnaire is more effective in terms of response rate than an internet questionnaire in a random sample of two construction professions. Relevance to industry: Questionnaire surveys play an important role in gathering information on interventions aimed at reducing occupational risks and health effects for construction workers. The most effective survey mode should be explored before a large scale survey is carried out. (C) 2011 Elsevier B.V. All rights reserve

When is job rotation perceived useful and easy to use to prevent work-related musculoskeletal complaints?

Job rotation is often recommended to optimize physical work demands and prevent work-related musculoskeletal complaints, but little is known about possible facilitators and barriers to its usefulness and ease of use. Following a qualitative research design, semi-structured interviews with employers (n = 12) and workers (n = 11) from the construction industry were conducted. Organizational climate, job autonomy, job characteristics and work processes were mentioned as either facilitators or barriers on an organizational level. Worker characteristics, work behavior and attitude were mentioned as either facilitators or barriers on an individual level. Following a structured approach to assess usefulness of job rotation to optimize physical work exposures and identifying barriers to usefulness and ease of use in relevant stakeholder groups is necessary in order to select or develop strategies to overcome these barriers, or to reject job rotation as a useful or easy to use intervention in the given contex

Musculoskeletal disorders among construction workers: a one-year follow-up study

Background: Work-related musculoskeletal disorders (MSDs) are an important cause of functional impairments and disability among construction workers. An improved understanding of MSDs in different construction occupations is likely to be of value for selecting preventive measures. This study aimed to survey the prevalence of symptoms of MSDs, the work-relatedness of the symptoms and the problems experienced during work among two construction occupations: bricklayers and supervisors. Methods: We randomly selected 750 bricklayers and 750 supervisors resident in the Netherlands in December 2009. This sample was surveyed by means of a baseline questionnaire and a follow-up questionnaire one year later. The participants were asked about complaints of the musculoskeletal system during the last six months, the perceived work-relatedness of the symptoms, the problems that occurred during work and the occupational tasks that were perceived as causes or aggravating factors of the MSD. Results: Baseline response rate was 37%, follow-up response was 80%. The prevalence of MSDs among 267 bricklayers and 232 supervisors was 67% and 57%, respectively. Complaints of the back, knee and shoulder/upper arm were the most prevalent among both occupations. Irrespective of the body region, most of the bricklayers and supervisors reported that their complaints were work-related. Complaints of the back and elbow were the most often reported among the bricklayers during work, whereas lower arm/wrist and upper leg complaints were the most often reported among the supervisors. In both occupations, a majority of the participants perceived several occupational physical tasks and activities as causes or aggravating factors for their MSD. Recurrent complaints at follow-up were reported by both bricklayers (47% of the complaints) and supervisors (31% of the complaints). Participants in both occupations report that mainly back and knee complaints result in additional problems during work, at the time of follow-up. Conclusions: A substantial number of the bricklayers and the supervisors report musculoskeletal disorders, mainly back, knee and shoulder/upper arm complaints. The majority of the bricklayers and half of the supervisors believe that their complaints are work-related. Irrespective of occupation, participants with MSDs report substantial problems during work. Workplace intervention measures aimed at occupational physical tasks and activities seem justified for both occupation

Occupational Demands and Health Effects for Bricklayers and Construction Supervisors: A Systematic Review

Background Knowledge was gathered on occupational demands and health effects of two occupations in the construction industry, bricklayers and supervisors, in order to design a job-specific workers' health surveillance (WHS) for construction workers. Methods We systematically searched MEDLINE, EMBASE, PsycINFO, HSELINE, NIOSHTIC-2, and Picarta up to December 2008. Results A total of 60 articles were included. Evidence was found for the following demands for bricklayers: energetic load (exceeding 25% heart rate reserve), load on the lower back (exceeding the NIOSH-threshold value of 3.4 kN), repetitive force exertions of the upper extremities, frequent bending with trunk flexion exceeding 60 degrees and working with the arms more than 608 elevated. Environmental demands include: dust and quartz exposure (exceeding the limit values of 3.0 and 0.05 mg/m(3), respectively), vibration and noise (exceeding the limit value of 80 dBA). Bricklayers are at increased risk of lung cancer, low back pain, complaints of arms and legs and getting injuries. Among construction supervisors are walking and standing common physically demanding activities. Psychosocial demands with evidence for supervisors were mental demands, workload, time pressure, working long hours, and social-organizational factors. Supervisors are at increased risk of lung cancer and injuries. Conclusions For bricklayers evidence was found for physical demands and risk on low back pain and complaints of arms and legs, for construction supervisors on psychosocial demands. Both occupations are at increased risk of lung cancer and injuries. Job-specific demands and health effects should be incorporated in WHS for construction workers. Am. J. Ind. Med. 54: 55-77, 2011. (C) 2010 Wiley-Liss, In

Improving occupational health care for construction workers: a process evaluation

To evaluate the process of a job-specific workers' health surveillance (WHS) in improving occupational health care for construction workers. From January to July 2012 were 899 bricklayers and supervisors invited for the job-specific WHS at three locations of one occupational health service throughout the Netherlands. The intervention aimed at detecting signs of work-related health problems, reduced work capacity and/or reduced work functioning. Measurements were obtained using a recruitment record and questionnaires at baseline and follow-up. The process evaluation included the following: reach (attendance rate), intervention dose delivered (provision of written recommendations and follow-up appointments), intervention dose received (intention to follow-up on advice directly after WHS and remembrance of advice three months later), and fidelity (protocol adherence). The workers scored their increase in knowledge from 0-10 with regard to health status and work ability, their satisfaction with the intervention and the perceived (future) effect of such an intervention. Program implementation was defined as the mean score of reach, fidelity, and intervention dose delivered and received. Reach was 9% (77 workers participated), fidelity was 67%, the intervention dose delivered was 92 and 63%, and the intervention dose received was 68 and 49%. The total programme implementation was 58%. The increases in knowledge regarding the health status and work ability of the workers after the WHS were graded as 7.0 and 5.9, respectively. The satisfaction of the workers with the entire intervention was graded as 7.5. The perceived (future) effects on health status were graded as 6.3, and the effects on work ability were graded with a 5.2. The economic recession affected the workers as well as the occupational health service that enacted the implementation. Programme implementation was acceptable. Low reach, limited protocol adherence and modest engagement of the workers with respect to the intervention were the most prominent aspects that influenced the intervention process. The increase in the workers' knowledge about their health status and work ability was substantial, and the workers' satisfaction with the intervention was good. The perceived effect of the advised preventive actions on health status was sufficient. Netherlands Trial Register: http://NTR301