Addressing Musculoskeletal Pain, Occupational Stress, and Health Status Among Manufacturing Workers

This proMarionMixersWelding2 copyject is a non-randomized intervention trial to examine the effects of an integrated health protection and health promotion intervention among manufacturing workers. Study activities are ongoing in two manufacturing facilities operated by the same company, one in central Iowa (the intervention facility) and the other in central Ohio (the referent facility). The study facilities produce identical vinyl-framed window and door assemblies for residential construction using similar manufacturing processes and workstation configurations, and are located in regions with similar socio-demographic characteristics.


Description of the Intervention

Consistent with the goals and intent of the National Institute for Occupational Safety and Health (NIOSH) Total Worker Health® program during the 2011-2016 funding cycle, the intervention was designed to integrate traditionally disparate occupational safety and health protection activities with workplace health promotion and chronic disease prevention activities. Intervention activities have included the formation of two distinct entities under the direction of company personnel but trained and advised by the research team.

First, an intervention “strategic planning committee” was convened that included representation from corporate executive management; corporate risk management; corporate health benefits management; facility-level general, production, human resources, and safety management; production employees; and the research team.

Second, workplace health promotion was integrated into an existing safety committee at the intervention facility. The integrated committee was subsequently renamed the “safety and wellness” committee, and included representation from facility-level general, production, human resources, and safety management; production employees; fabrication and maintenance personnel; and the research team.

With respect to occupational health protection, the research team supports the safety and wellness committee through ergonomics activities intended to improve the musculoskeletal health status of employees.

With respect to workplace health promotion, the research team supports the safety and wellness committee through activities intended to create a culture of wellness and increase employee engagement. A component of the intervention includes on-site access to a certified health and wellness coach who had received specialized training in motivational interviewing.



Specific Aims

Aim 1: Examine intervention effects on (a) occupational exposures to ergonomic hazards, (b) musculoskeletal symptoms, and (c) OSHA-recordable events consistent with musculoskeletal disorders.

(a) Occupational exposure to ergonomic hazards (i.e., physical risk factors: force, posture, repetition) is estimated at the facility-level through video-based exposure assessment using standard observation-based methods. Video recordings are made of 60 production tasks at six-month intervals.

(b) Individual study participants at each facility report musculoskeletal symptom status at six-month intervals.

(c) The company provides the research team with monthly data on work-related injuries/illness and production hours for each facility.

Aim 2: Examine the effects of the intervention on (a) participation in employer-sponsored disease management programs and (b) indicators of modifiable health risks.

(a) The company provides facility-level data concerning participation in employer-sponsored chronic disease management programs.

(b) Study participants at each facility have authorized the research team to access individual responses to an annual health risk appraisal and biometric screen conducted by third-party vendors.

Aim 3: Estimate the economic impact of the intervention.

The company provides facility-level data concerning workers’ compensation expenses, health insurance expenses, absenteeism, and turnover.

Project Activities

Ergonomics activities during the intervention included:

training to improve employees’ recognition of physical risk factors associated with musculoskeletal health outcomes
• review of existing administrative controls (e.g., the timing of training received by new employees)
• development of new administrative controls (e.g., design of job rotation strategies for areas of the facility)
• review of existing exposure assessment methods
• walk-throughs of production areas to identify targets for immediate workstation redesign.

In addition, we used digital human modeling software to explore workstation design alternatives during the development and implementation of controls. The software allowed us to analyze biomechanical hazards in situations for which traditional exposure assessment techniques are problematic, and also allowed us to consider personal factors (e.g., gender and body mass index) when developing task design criteria.

Health promotion activities during the intervention included:

• review of facility needs related to creating and sustaining a culture of wellness (e.g., prioritized areas of need/interest by surveying employees)
• creation of environmental supports (e.g., evaluation and improvement of healthy vending options)
• review and development of a comprehensive communication plan (e.g., monthly wellness newsletter distributed to employees)
• promotion of facility-wide wellness activities.

In addition, our health and wellness coach conducted nearly 400 30-minute sessions with individual study participants at the intervention facility, with promising preliminary results.

Data collection and intervention activities were completed in December 2015, and we are are currently finalizing data sets for statistical analyses.