Effects of training to implement new working methods to reduce knee strain in floor layers. A two-year follow-up

Abstract

Objectives: Follow-up study after two years to measure the effects of an implementation strategy consisting of information, education and training in the use of new tools and working-methods for the purpose of reducing knee strain and knee complaints in floor layers. Methods: Training of floor layers (n = 292) in using new working methods was evaluated by questionnaires during the courses. Two years later, this follow-up included questionnaires for the course participants (n = 216) and a control group of floor layers (not trained on courses) (n = 454). Results: Two years after training, 38% used the new working methods weekly or daily compared to 37% three months after the courses, and 10% before. Among controls, only 16% had used the new working methods weekly or daily. The risk of knee complaints .30 days (OR 2.46, 95% CI 1.03 to 5.83) or locking of the knees (OR 2.89, 95% CI 1.11 to 7.5) was more than double among floor layers who had used the new workingmethods for less than one year compared to those who had used them more. The results were adjusted for age, body mass index, and stress. The reduction in more severe knee complaints was greatest if floor layers started to use the new working methods before they developed knee problems. Other musculoskeletal complaints did not increase. Conclusion: This indicates that, within a two-year perspective, the implementation strategy to introduce new working methods in the floor laying trade has been effective; the number of floor layers using the new working-methods has increased, and severe knee problems have reduced.Earlier studies have shown that floor layers spend more than half their working day in knee-straining working positions [1][2][3][4] and have an increased frequency of knee disorders compared with other trades in the construction industry. [2][3][4][5][6] In Denmark, around 900 floor layers are members of the trade union, which is about 90% of all floor layers in Denmark. Floor and carpet layers (collectively referred to as floor layers in this paper) install linoleum, carpet and vinyl floorings. Their work tasks include priming, grinding, filling, gluing and welding. Nearly all floor layers in Denmark use knee pads (98%) and this frequency of use was equal before and after the courses. During recent years, new tools have been introduced which make it possible to carry out some of the job tasks, such as gluing and welding, from a standing position. In spite of campaigns and the development of the new tools, a study from 2000 showed that only 13% of floor layers used the new working methods during the previous 12 months. 7 The floor layers reported that the reason for the lack of change was that the new methods required instruction and that educational training was necessary. In general, the floor layers would only take suggestions from people who were experienced in their trade. These results agree with the findings of other studies. [8][9][10] From 2002-3, 292 floor layers were therefore trained in using new working methods. The effects were ...

Workplace intervention and musculoskeletal disorders: the need to develop research on implementation strategy

“…Multidimensional ergonomic interventions, including a participatory approach and individual, technical and organisational measures, seem to be an appropriate strategy for reducing the physical demands and the symptoms of MSDs,1 2 but evidence of their efficacy is still limited 3. Nevertheless, the scientific understanding of the aetiology of MSDs and their work-relatedness is sufficient to implement effective preventive interventions,1 2 4 as demonstrated by the study of Jensen and Friche5 published in this issue ( see page ). The study provides interesting insights into the prevention of musculoskeletal (knee) disorders and the strategy to implement interventions in a specific trade—that is, floor and carpet fitters (floor layers)—in daily practice.…”

“…Their intervention consisted of providing new working tools to allow performance of tasks in an upright posture to reduce the time spent in a kneeling position,6 which they hypothesised would reduce knee disorders. The implementation strategy followed a complex process including scientific research, information for employees, employers and trade unions, training, and participatory ergonomics with direct involvement of workers to develop and implement new working methods for floor layers 5 6. The results showed a positive effect of training to introduce new working methods and change workers’ behaviour during floor laying.…”

The effectiveness of participatory ergonomics to prevent low-back and neck pain – results of a cluster randomized controlled trial

“…However, many of the studies included in the review suffered from methodological shortcomings (ie, lack of a proper randomization procedure or a lack of a control group), making their findings at risk for bias. Several randomized controlled trials (RCT) have been conducted to evaluate the effectiveness of PE as a strategy to prevent MSD and/or to reduce MSD-related pain (16)(17)(18)(19). However, no RCT on PE has specifically focused on LBP and NP prevention.…”

Participatory ergonomics to reduce exposure to psychosocial and physical risk factors for low back pain and neck pain: results of a cluster randomised controlled trial

“…Probably because of the low implementation rate of the prioritised ergonomic measures, the ergocoaches played a less effective role than expected. However, Jensen and Friche showed that a participatory ergonomics programme in combination with an implementation strategy (ie, information about ergonomics and training in ergonomic skills) resulted in sustainable reductions in severe knee problems among Danish floor layers 40. Based on the findings of our process evaluation in which participatory ergonomics appeared to be a successful method to prioritise risk factors and develop and prioritise ergonomic measures,21 and the promising findings of Jensen and Friche, we still believe that participatory ergonomics has the potential to reduce workers′ exposure to occupational risk factors.…”