Plenary 3: Strategies to prevent back injuries, a priority problem in the automotive industry
Best Practices in Ergonomics in the Automotive Industry
Richard Wells, Jack Callaghan and Mardy Frazer
Department of Kinesiology University of Waterloo, Canada and CCentre of entre of RResearch esearch EExpertisexpertisefor thefor the PrePrevention of Work-Relatedvention of Work-Related MusMusculoskeletal culoskeletal Disorders and Disability (CRE-PREMUS)Disorders and Disability (CRE-PREMUS)
Outline
• Strategies to address root causes of low back pain at work
• Root causes of low back pain at work and intervention examples
• Strategies revisited
Approaches to Prevention of Low Back Pain in the Automobile Industry
• Many approaches are talked about…
Back belts? Product redesign?
Job enlargement? Rebalancing?
Exercise programs? Back school? Platforms?
Stretching programs?
Job rotation?
Hoists? Health promotion?
Teams?
Eliminate/ Substitute
Engineering Controls
Administrative Controls
Personal Protective Equipment
Training
Increase workers’ capacity
Redesign (Product)
Platforms, Hoists, Rebalancing (Process) Job enlargement, Job rotation, Teams, etc
Back belts, etc
Back school, etc
Health Promotion, Exercise programs, Stretching programs, etc
Strategies to prevent back injuriesExampleGeneral Strategy
Root Causes of Low Back Pain at Work
An epidemiological study of low back pain in a large Canadian auto assembly plant revealed these mechanical risk factors:
• High peak loads on the low back• High cumulative loads on the low back• Large degree of trunk motionThese complement the more common approach of
thinking about force, posture and repetition but better inform interventions
Norman, R., Wells, R., Neumann, P, Frank, J., Shannon, H. and Kerr, M. A Comparison of Peak vs Cumulative Physical Loading Factors for Reported Low Back Pain in the Automobile Industry, Clinical Biomechanics, 13(8): 561-573, 1998.
Kerr, M.S., Frank, S.W., Shannon, H.S., Norman, R.W., Wells, R.P., Neumann, W.P., and Bombardier, C. and the OUBPS group. Biomechanical and psychosocial risk factors for low-back pain at work. American Journal of Public Health, 91:1069-1075, 2001.
Root Causes of Low Back Pain at Work I
• High peak loads on the low back
• Lifting/pushing/pulling large loads
• Lifting/pushing/pulling loads in disadvantageous postures
This is the factor most people recognize
Norman, R., Wells, R., Neumann, P*., Frank, J., Shannon, H. and Kerr, M. A Comparison of Peak vs Cumulative Physical Loading Factors for Reported Low Back Pain in the Automobile Industry, Clinical Biomechanics, 13(8): 561-573, 1998.
Kerr, M.S., Frank, S.W., Shannon, H.S., Norman, R.W., Wells, R.P., Neumann, W.P., and Bombardier, C. and the OUBPS group. Biomechanical and psychosocial risk factors for low-back pain at work. American Journal of Public Health, 91:1069-1075, 2001.
23+ kg
Interventions for Low Back Pain at Work I
• High peak loads on the low back• Lifting/pushing/pulling
large loads
Interventions• Force/ insertion Limits and
Weight Limits e.g. 40lb (~18kg) PRODUCT+PROCESS
• Hoist and lift assists PROCESS
Lifting/pushing/pulling large loads
Manual With lift assist
Root Causes of Low Back Pain at Work I
• High peak loads on the low back• Lifting/pushing/pulling
large loads
• Lifting/pushing/pulling moderate loads in disadvantageous postures
Norman, R., Wells, R., Neumann, P*., Frank, J., Shannon, H. and Kerr, M. A Comparison of Peak vs Cumulative Physical Loading Factors for Reported Low Back Pain in the Automobile Industry, Clinical Biomechanics, 13(8): 561-573, 1998.
Kerr, M.S., Frank, S.W., Shannon, H.S., Norman, R.W., Wells, R.P., Neumann, W.P., and Bombardier, C. and the OUBPS group. Biomechanical and psychosocial risk factors for low-back pain at work. American Journal of Public Health, 91:1069-1075, 2001.
F
Interventions for Low Back Pain at Work I
• High peak loads on the low back• Lifting/pushing/pulling
moderate loads in disadvantageous postures
Interventions• Position of load/force application
PRODUCT+PROCESS
• Force magnitude PRODUCT
• Hoist and lift assists PROCESS
F
Root Causes of Low Back Pain at Work II
• High cumulative loads on the low back• Lifting/pushing/pulling light to
moderate loads for long duration
• Lifting/pushing/pulling of light to moderate loads many times per shift
• Holding non-upright trunk postures for long duration
• Long shiftsNorman, R., Wells, R., Neumann, P*., Frank, J., Shannon, H. and Kerr, M. A Comparison of Peak vs Cumulative Physical Loading Factors for Reported Low
Back Pain in the Automobile Industry, Clinical Biomechanics, 13(8): 561-573, 1998.Kerr, M.S., Frank, S.W., Shannon, H.S., Norman, R.W., Wells, R.P., Neumann, W.P., and Bombardier, C. and the OUBPS group. Biomechanical and
psychosocial risk factors for low-back pain at work. American Journal of Public Health, 91:1069-1075, 2001.
x 500+
Interventions for Low Back Pain at Work II
• High cumulative loads on the low back• Lifting/pushing/pulling light to
moderate loads for long duration
• Interventions• Position of load/force PRODUCT-
PROCESS
• Reduce forces PRODUCT -PROCESS
• Reduce proportion of cycle loaded or total time loaded PRODUCT-PROCESS-ADMIN
• Reduce number of movements PRODUCT-PROCESS-ADMIN x 500+
Root Causes of Low Back Pain at Work II
• High cumulative loads on the low back• Lifting/pushing/pulling light to
moderate loads for long duration
• Lifting/pushing/pulling of light to moderate loads many times per shift
• Holding non-upright trunk postures for long duration
• Long shiftsNorman, R., Wells, R., Neumann, P*., Frank, J., Shannon, H. and Kerr, M. A Comparison of Peak vs Cumulative Physical Loading Factors for Reported Low
Back Pain in the Automobile Industry, Clinical Biomechanics, 13(8): 561-573, 1998.Kerr, M.S., Frank, S.W., Shannon, H.S., Norman, R.W., Wells, R.P., Neumann, W.P., and Bombardier, C. and the OUBPS group. Biomechanical and
psychosocial risk factors for low-back pain at work. American Journal of Public Health, 91:1069-1075, 2001.
Interventions for Low Back Pain at Work II
• High cumulative loads on the low back• Holding non-upright trunk
postures for long duration
• Interventions• Position of load/force
PRODUCT -PROCESS
• Reduce force PRODUCT –PROCESS
• Reduce time loaded PRODUCT-PROCESS-ADMIN
If force small, limited benefit to reducing force as trunk so heavy
Holding non-upright trunk postures for long duration
Old New
Root Causes of Low Back Pain at Work III
• Large degree of trunk motion• Many trunk motions• Large trunk motions
Norman, R., Wells, R., Neumann, P*., Frank, J., Shannon, H. and Kerr, M. A Comparison of Peak vs Cumulative Physical Loading Factors for Reported Low Back Pain in the Automobile Industry, Clinical Biomechanics, 13(8): 561-573, 1998.
Kerr, M.S., Frank, S.W., Shannon, H.S., Norman, R.W., Wells, R.P., Neumann, W.P., and Bombardier, C. and the OUBPS group. Biomechanical and psychosocial risk factors for low-back pain at work. American Journal of Public Health, 91:1069-1075, 2001.
many
Interventions for Low Back Pain at Work III
• Large degree of trunk motion• Many trunk motions
• Interventions• # Parts handled PRODUCT- PROCESS-
ADMIN
• Position of part/load/force PRODUCT-PROCESS
x 500+
Root Causes of Low Back Pain at Work III
• Large degree of trunk motion• Many trunk
flexion/extension motions
• Large trunk motions
Norman, R., Wells, R., Neumann, P*., Frank, J., Shannon, H. and Kerr, M. A Comparison of Peak vs Cumulative Physical Loading Factors for Reported Low Back Pain in the Automobile Industry, Clinical Biomechanics, 13(8): 561-573, 1998.
Kerr, M.S., Frank, S.W., Shannon, H.S., Norman, R.W., Wells, R.P., Neumann, W.P., and Bombardier, C. and the OUBPS group. Biomechanical and psychosocial risk factors for low-back pain at work. American Journal of Public Health, 91:1069-1075, 2001.
Interventions for Low Back Pain at Work III
• Large degree of trunk motion
• Large trunk motions
Interventions• Position of
part/load/force PRODUCT-PROCESS
Eliminate/ Substitute
Engineering Controls
Administrative Controls
Personal Protective Equipment
Training
Increase workers’ capacity
Redesign (Product)
Platforms, Hoists, Rebalancing (Process) Job enlargement, Job rotation, Teams, etc
Back belts, etc
Back school, etc
Health Promotion, Exercise programs, Stretching programs, etc
Strategies to prevent back injuriesExampleGeneral Strategy
Research Based Approaches to Interventions
More Basic More Applied
Knowledge Generation and Synthesis
Outreach and Application: Getting the Knowledge Out
Evaluation: What Works and Why (not)
Human Human Characteristics Characteristics and Capabilities and Capabilities Related to the Related to the Development of Development of WMSDWMSD
Outcome, Outcome, Exposure, Exposure, Hazard and Risk Hazard and Risk Assessment for Assessment for the Development the Development of of WMSDWMSD
Development of Development of Appropriate Appropriate Interventions to Interventions to Prevent WMSDPrevent WMSD
Processes to Processes to Make Make Workplace Workplace Changes to Changes to Prevent WMSDPrevent WMSD
Evaluation Evaluation of WMSD of WMSD Prevention Prevention ProgramsPrograms
Laboratory studies show belts have little effect on spinal loading
Epidemiological studies show belts have little or no effect on low back pain
Back BeltsBack Belts
Eliminate/ SubstituteEliminate/ Substitute
Engineering ControlsEngineering Controls
Administrative ControlsAdministrative Controls
Personal Protective Personal Protective EquipmentEquipment
TrainingTraining
Increase worker capacityIncrease worker capacity
Design (Product)Design (Product)
Platforms, Hoists, Rebalancing, (Process) Job enlargement, Job rotation, Teams, etc
Back belts, etc
Back school, lift training etc
Health Promotion, Exercise programs, Stretching programs, etc
Strategies to prevent back injuriesExampleGeneral Strategy
Implement &Implement &DisseminateDisseminate
Generate Generate K nowledgeK nowledge
EvaluateEvaluate?
Develop Develop InterventionsInterventions
?
CRE-PREMUS
MusMusculoskeletal Disorders and Disabilityculoskeletal Disorders and Disability
CCentre of entre of RResearch esearch EExpertisexpertise
for thefor the PrePrevention of Workvention of Work--RelatedRelated
The Centre of Research Expertise for theCentre of Research Expertise for the Prevention of WorkPrevention of Work--Related Musculoskeletal Disorders and Disability receives substaRelated Musculoskeletal Disorders and Disability receives substantial funding through a grant provided by the Workplace Safety antial funding through a grant provided by the Workplace Safety and Insurance Boardnd Insurance Board
Implement &Implement &DisseminateDisseminate
Implement &Implement &DisseminateDisseminate
Generate Generate K nowledgeK nowledgeGenerate Generate K nowledgeK nowledge
EvaluateEvaluate?
EvaluateEvaluate?
Develop Develop InterventionsInterventions
Develop Develop
InterventionsInterventions
?
CRE-PREMUS
MusMusculoskeletal Disorders and Disabilityculoskeletal Disorders and Disability
CCentre of entre of RResearch esearch EExpertisexpertise
for thefor the PrePrevention of Workvention of Work--RelatedRelated
The Centre of Research Expertise for theCentre of Research Expertise for the Prevention of WorkPrevention of Work--Related Musculoskeletal Disorders and Disability receives substaRelated Musculoskeletal Disorders and Disability receives substantial funding through a grant provided by the Workplace Safety antial funding through a grant provided by the Workplace Safety and Insurance Boardnd Insurance Board
The Centre of Research Expertise for theCentre of Research Expertise for the Prevention of Work-Related Prevention of Work-Related Musculoskeletal Disorders and Disability Musculoskeletal Disorders and Disability receives substantial funding through a receives substantial funding through a grant provided by the Workplace Safety grant provided by the Workplace Safety and Insurance Boardand Insurance Board