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WORK: A Journal of Prevention, Assessment & Rehabilitation is an interdisciplinary, international journal which publishes high quality peer-reviewed manuscripts covering the entire scope of the occupation of work. The journal's subtitle has been deliberately laid out: The first goal is the prevention of illness, injury, and disability. When this goal is not achievable, the attention focuses on assessment to design client-centered intervention, rehabilitation, treatment, or controls that use scientific evidence to support best practice.
WORK occasionally publishes thematic issues, but in general, issues cover a wide range of topics such as ergonomic considerations with children, youth and students, the challenges facing an aging workforce, workplace violence, injury management, performing artists, ergonomic product evaluations, and the awareness of the political, cultural, and environmental determinants of health related to work.
Dr. Karen Jacobs, the founding editor, and her editorial board especially encourage the publication of research studies, clinical practice, case study reports, as well as personal narratives and critical reflections of lived work experiences (autoethnographic/autobiographic scholarship),
Sounding Board commentaries and
Speaking of Research articles which provide the foundation for better understanding research to facilitate knowledge dissemination.
Narrative Reflections on Occupational Transitions, a new column, is for persons who have successfully transitioned into, between, or out of occupations to tell their stories in a narrative form. With an internationally renowned editorial board,
WORK maintains high standards in the evaluation and publication of manuscripts. All manuscripts are reviewed expeditiously and published in a timely manner.
WORK prides itself on being an author-friendly journal.
WORK celebrates its 25th anniversary in 2015.
*WORK is affiliated with the Canadian Association of Occupational Therapists (CAOT)* *WORK is endorsed by the International Ergonomics Association (IEA)* *WORK gives out the yearly Cheryl Bennett Best Paper Award*
Abstract: BACKGROUND: Efforts have been paid to lower the health risks associated with use of computers at the workplace. Computerized risk assessment systems are available in the market for adoption by companies. OBJECTIVES: The Display Screen Equipment Risk Assessment and Management System was designed for conducting risk assessment and providing intelligent-driven solutions for DSE-related occupational health problems. This report summarizes two consecutive research work conducted on evaluating its effect in reducing body discomfort and mental…fatigue, and enhancing sedentary workers' occupational health. METHODS: Convenience sampling was adopted to recruit participants (111 participants for Study 1 and 75 participants for Study 2 who were randomly assigned to an immediate or a delayed intervention group. The intervention was using DSE RAM System to perform a risk assessment followed by an immediate modification of participant's workstation based on the recommendations generated by the System. Face to face interview was conducted and participants completed three sets of questionnaires right before the assessment and two weeks after the intervention. RESULTS: The results of Study 1 revealed that the DSE RAM System was effective for alleviating the discomfort and fatigue levels by rectifying the workstation-worker match. These mismatches were identified to be the heights of monitor, keyboard and chair with the workers. The results of Study 2 indicate that the System was specific for promoting participants to take more frequent rest breaks (OR: 3.65) and pay more attention to occupational safety and health information (OR: 3.90). In particular, the take frequent rest breaks behavior was found to predict decrease in discomfort in the eyes and mental fatigue (lack of energy). Nevertheless, there was no strong evidence on the use of the System can lead to immediate attitudinal changes towards occupational health and safety. CONCLUSION: The findings support the notion that workers' participation and integration of ergonomics into the management are important for successful implementation of occupational health programs. Together with educational and skill training sessions on occupational health at the workplace, the DSE RAM System offers a venue for implementing participatory ergonomics at the workplace.
Abstract: BACKGROUND: All around the world, there is a rising trend of computer use among young children especially at home; yet the computer furniture is usually not designed specifically for children's use. In Hong Kong, this creates an even greater problem as most people live in very small apartments in high-rise buildings. Most of the past research literature is focused on computer use in children in the school environment and not about the home setting.…OBJECTIVE: The present pilot study aimed to examine ergonomic issues in children's use of computers at home in Hong Kong, which has some unique home environmental issues. PARTICIPANTS: Fifteen children (six male, nine female) aged 8–11 years and their parents were recruited by convenience sampling. METHODS: Participants were asked to provide information on their computer use habits and related musculoskeletal symptoms. Participants were photographed when sitting at the computer workstation in their usual postures and joint angles were measured. RESULTS: The participants used computers frequently for less than two hours daily and the majority shared their workstations with other family members. Computer furniture was designed more for adult use and a mismatch of furniture and body size was found. Ergonomic issues included inappropriate positioning of the display screen, keyboard, and mouse, as well as lack of forearm support and suitable backrest. These led to awkward or constrained postures while some postural problems may be habitual. Three participants reported neck and shoulder discomfort in the past 12 months and 4 reported computer-related discomfort. CONCLUSIONS: Inappropriate computer workstation settings may have adverse effects on children's postures. More research on workstation setup at home, where children may use their computers the most, is needed.
Abstract: BACKGROUD: An effective office ergonomics program can predict positive results in reducing musculoskeletal injury rates, enhancing productivity, and improving staff well-being and job satisfaction. OBJECTIVE: Its objective is to provide a systematic solution to manage the potential risk of musculoskeletal disorders among computer users in an office setting. A FITS Model office ergonomics program is developed. METHODS: The FITS Model Office Ergonomics Program has been developed which draws on the legislative requirements for promoting the health and safety…of workers using computers for extended periods as well as previous research findings. The Model is developed according to the practical industrial knowledge in ergonomics, occupational health and safety management, and human resources management in Hong Kong and overseas. RESULTS: This paper proposes a comprehensive office ergonomics program, the FITS Model, which considers (1) Furniture Evaluation and Selection; (2) Individual Workstation Assessment; (3) Training and Education; (4) Stretching Exercises and Rest Break as elements of an effective program. CONCLUSION: An experienced ergonomics practitioner should be included in the program design and implementation. Through the FITS Model Office Ergonomics Program, the risk of musculoskeletal disorders among computer users can be eliminated or minimized, and workplace health and safety and employees' wellness enhanced.
Abstract: BACKGROUND: Work-related musculoskeletal disorders (WMSDs) are a major public health concern. There has been a strong demand from occupational safety and health agencies and operators to develop simple tools for risk assessment and management of WMSDs. The Quick Exposure Check (QEC) was designed to assess exposure to WMSDs risk factors affecting the back, shoulder/upper arm, wrist/hand, and the neck. It is a valuable observational ergonomic assessment tool, suitable for field-based assessment. OBJECTIVE: This study…set out to translate, culturally adapt, and validate a Chinese version of the Quick Exposure Check (CQEC), an observational tool used to assess exposure to physical and psychosocial workplace risk factors for the development of WMSDs in different body sites. METHODS: The CQEC was translated from its original English version using a forward- and back-translation approach. Content validity was examined by an expert panel and expert committee using item- and scale-level content validity indices. The intra-class correlation coefficient (ICC) was used to analyze the inter-rater reliability of the observer's assessment, with kappa statistics and percentage agreements used to estimate the test-retest reliability of the worker's assessment of individual items. RESULTS: The CQEC demonstrated an excellent scale-level content validity index (S-CVI > 0.90). The ICC lay between 0.71 and 0.97, indicating good inter-rater reliability. Test-retest reliability showed substantial agreement between the two measurement occasions for most of the items (kappa=0.68 to 1, percentage agreement=76 to 100%) capturing exposure to risk factors. CONCLUSIONS: The CQEC is a valid and reliable tool that can be used to calculate levels of exposure to risk factors for WMSDs.
Keywords: Work-related musculoskeletal disorders, Chinese Quick Exposure Check, validation
Abstract: BACKGROUND: Work-related musculoskeletal disorders (WRMDs) are recognized as a major source of significant pain and disability in the healthcare sector. However, they are preventable if appropriate surveillance and intervention programs are implemented. OBJECTIVE: The purpose of this paper is to describe the holistic ergonomic approach that was used to address the multifactorial problems encountered by healthcare workers in their daily work. METHODS: Using participatory ergonomics, healthcare workers in this study teamed up with…management and staff with expertise in ergonomic analysis, design, and implementation of remedies. Selected participatory ergonomic intervention programs targeted at an organizational level are elaborated. Interventions included pre-work stretching, workplace surveillance at a psychiatric department, on-site ergonomic teaching for community nurses, and display screen equipment consultancy. DISCUSSIONS: Changes in workplace design, equipment re-arrangement, awareness of proper posture, and adoption of good work practices all play important roles in reducing musculoskeletal disorders among healthcare workers. Prompt occupational medicine and rehabilitation services were also provided to complement the work disability prevention process. The impact of the various intervention programs on staff health, costs and productivity of the organization are simultaneously discussed.
Abstract: BACKGROUND: Orthographically similar drug names create confusion errorsand pose a potential threat to medication safety. Enhancing the differing letters in similar drug names is one possible way to address the problem. OBJECTIVE: This study investigated the effects oftext enhancement methods(tall man, boldface, larger lowercase, and red lettering withlowercase as the comparison group) and orthographic similarity (referred to the extent to which the letters that made up the two names in a pair were similar to each…other) on the differentiation performance of look-alike drug names. METHODS: Sixty individualsfroma university and its affiliatedhospitalparticipated in the differentiation test in which theydetermined whether the two drug names in each of the120 confusable name pairs were the same or different. Outcome measures were response time and proportion of correct responses. RESULTS: Using larger lowercase and red letteringresulted in significantly shorter response times. Drug names that were more similar to each other led to significantly longer response times. Text enhancement and orthographic similarity did not have impact on proportion of correct responses. CONCLUSIONS: Our study provides additional support for the use of text enhancement to emphasize the differences between medicines with names that look alike.
Keywords: Human factors, drug safety, orthographically similar drug name, textual format, drug name differentiation
Abstract: BACKGROUND: Use of electronic medical records (EMR) has the potential to offer quality and safety benefits, but without the adoption of the technology, the benefits will not be realized. OBJECTIVE: This study aimed to identify the factors perceived as relevant by private physicians when considering EMR adoption. METHODS: A qualitative pre-implementation study was conducted using semi-structured, face to face interviews to explore the perspectives of physicians (n=16) operating in private clinics on the factors affecting their…adoption of EMR. A multilevel, work system approach and the immersion/crystallization data analysis technique guided the researchers in examining the data, identifying patterns and key themes, and extracting representative quotes to illustrate these themes. RESULTS: The major factors associated with EMR adoption, which relate to the five categories of a work system, were system usefulness; user interface design; technical support; cost; system reliability; the privacy, confidentiality, and security of patient information; physical space in the clinic; data migration process; adverse work-related factors; and the computer and systems skills of physicians. CONCLUSIONS: Pre-implementation identification of factors important to adoption can allow system developers to focus proactively on these factors when developing the system and its implementation strategies, to maximize the likelihood of successful introduction.
Keywords: Health IT adoption, physician, primary care, work system approach
Abstract: This article is a case presentation of an onsite ergonomic assessment of the risk factors for work-related musculoskeletal disorders (WMSDs) among three cooks working at a medium-sized Chinese restaurant in Hong Kong. The weight of workload was measured during the onsite assessment and the Ovako Working Posture Analysis System (OWAS), Rapid Upper Limb Assessment (RULA), and National Institute of Occupational Safety and Health (NIOSH) lifting equation used to assess the risk of WMSDs. The results showed…that these cooks usually had to hold utensils for extended periods of time, toss woks, and barbecue meat, all of which demanded a lot of repetitive movements of the upper limbs. Future research is needed on the implementation of effective prevention measures, including administrative and ergonomic controls, to reduce the problems within this industry associated with such high-risk tasks.
Keywords: Ovako Working Posture Analysis, Rapid Upper Limb Assessment, National Institute of Occupational Safety and Health lifting
equation, Chinese restaurant
Abstract: Upper limb musculoskeletal complaints are common among certain health professionals. We report two cases, both involving technicians working in a diagnostic tuberculosis laboratory in Hong Kong. A work process evaluation suggest that the need to repeatedly open and close small bottles, as well as to work for prolonged periods of time in confined areas, could be related to the workers' clinical presentation. The cases are also compatible with the diagnosis of repetitive strain injury (RSI) of…the upper limb, but this term is not commonly used nowadays because of various definitional issues. A review of the various diagnostic issues in RSI is presented.
Keywords: Case study, upper limb musculoskeletal complaints, laboratory technicians
Abstract: BACKGROUND: There is little health specific literature on returning nurses with injuries to work despite the high incidence of injuries and the workforce shortages of these professionals. OBJECTIVE: To identify enabling factors and barriers to return-to-work for nurses with injuries from the perspective of return-to-work coordinators. PARTICIPANTS: Workplace return-to-workcoordinators employed in a health or disability facility who had worked on a rehabilitation case with a nurse with injuries in the past 12…months in New South Wales (NSW), Australia. METHOD: Five focus groups were conducted with 25 return-to-work coordinators from 14 different organisations, representing different health sectors (aged, disability, public and private hospital and community health) in metropolitan and rural areas of NSW, Australia. RESULTS: This study reports findings specifically relating to the provision of suitable duties for nurses with injuries. Four key themes were identified: suitable duties; supernumerary positions; nurse specialisation and tailoring of return-to-work plans. CONCLUSIONS: This study identified that return-to-work coordinators were resourceful and innovative in their approach to the provision of suitable duties for nurses with injuries and highlighted the importance of including clinical duties in any return-to-work program and of tailoring the return-to-work to the nurses' work and personal circumstances.
Keywords: Suitable duties, workplace based return-to-work, health sector, qualitative
Abstract: BACKGROUND: Early graduate occupational therapists (OTs) and physiotherapists (PTs) are routinely employed in work injury management and prevention in Australia. However, our understanding is limited about employer requirements for early graduates entering the field, and how commencing practitioners manage transition to practice. In addition, employers have expressed concerns anecdotally about the preparedness of early graduates for work injury management and prevention. However, evidence is limited about early gradutate preparedness for the field.…OBJECTIVES: The study aimed to develop a detailed qualitative account of the perceptions of employers and early graduates on the attributes required of early graduates in work injury management and prevention, and processes for effective transition to practice in this field. METHOD: A purposive sample of 12 employers and 12 early graduates in work injury management and prevention participated in semi-structured interviews. Questions to employers focused on recruitment, supervision and readiness for practice. Questions to early graduates focused on challenges in transition and effective learning methods. Transcripts were analysed by Leximancer™ and supported by manual coding and synthesis. RESULTS: Four themes with findings were, 1) 'Job and workplace requirements'; skills required by employers and support needed for early graduates, 2) 'Learning for work injury management and prevention'; options for early graduate development and learning methods early graduates found effective, 3) 'Employer expectations of early graduates in transition to work injury management and prevention', responses to transition; and 4) 'Early graduate perceptions on transition to work injury management and prevention'; early graduates responses to transition. CONCLUSION: Findings for employers and early graduates were similar to those expected in other areas of practice for OTs and PTs. Work injury management and prevention skills were not expected of early graduates by employers. Employers and early graduates shared similar views that clinical education in work injury management and prevention was useful to early graduates entering this field. Physiotherapy employers considered PT early graduates not yet ready for work injury management and prevention.
Keywords: Work injury management and prevention, early graduates, occupational therapy, physiotherapy, occupational health
Abstract: BACKGROUND: Workplace absenteeism is still a curse for developed countries, and more systematic practices need to be adopted to address this issue. OBJECTIVE: To review the literature on best practices for managing work absences related to musculoskeletal or common mental disorders. METHODS: A review was conducted by performing a search in bibliographic databases and on work-disability research institute websites. Recommendations regarding work-absence management and return-to-work practices were extracted from all the retained…documents and organized within a chronological framework. RESULTS: In total, 17 documents were analyzed, leading to identification of common work-absence management and return-to-work practices, the importance of a worker support approach, and recommended roles and responsibilities for stakeholders. These practices were then integrated into a six-step process: (1) time off and recovery period; (2) initial contact with the worker; (3) evaluation of the worker and his job tasks; (4) development of a return-to-work plan with accommodations; (5) work resumption, and (6) follow-up of the return-to-work process. CONCLUSIONS: Based on this review, we constructed a comprehensive work-absence management and return-to-work process designed to assist organizations. Our results indicate that such a process must be included within a broader policy of health promotion and job retention. Adaptations will be required for implementation in the workplace.
Keywords: Absenteeism, mental illness, pain, organizational policy, work disability
Abstract: BACKGROUND: It is well established that environmental factors can have impact upon an injured person's recovery and return-to-work outcomes. To date, there has been no cohesive model to provide theoretical understanding of the way in which these divergent factors combine to create disability behaviours. OBJECT: Development of a conceptual model for understanding the development of disability behavior. METHODS: Interpolation from existing neuroplasticity theory to observed behaviors and studies of behavior in the…workers' compensation environment, including existing research concerning predictors for disability. RESULTS: The paper describes a conceptual model for understanding instances of disability that are not necessarily attributable to physical harm. Preliminary testing provides support for the model. CONCLUSIONS: Factors that contribute to the formation of a neural network supporting the behavior of learned disability are described. From that description, intervention methods to prevent or resolve so-called "needless disability" are discussed.
Keywords: Neuroplasticity, disability management, return to work