Three Dutch tools for online risk assessment of physical workload Marjolein Douwes, Heleen de Kraker

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Marcus Fisher
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1 Three Dutch tools for online risk assessment of physical workload Marjolein Douwes, Heleen de Kraker

Factsheet physical workload in the Netherlands (self-reported) Prevalence of physically demanding work Percentage of workers: 42% physically heavy work 35% repetitive movements 19% manual handling

2 Factsheet physical workload in the Netherlands (self-reported) Prevalence of physically demanding work Percentage of workers: 42% physically heavy work 35% repetitive movements 19% manual handling 10% awkward postures Sectors with rel. high exposure agricultural transportation Retail/wholesale Hotel/catering Construction Health care (Ass) Industry plications for health Occupational diseases: Disability pensions % workers with symptoms last year: Of all sick leave days: MSDs (total) Costs Arm neck shld Back Lower extremities 800 million / year Costs from extra sickleave days because of MSDs 38% MSD 30% heavy work 66% of self reported occupational diseases are MSDs 21% of new disability pension are MSDs

3 How to sustain physically demanding jobs? Risk management starts with risk assessment Need for valid but simple risk assessment tools, which can: identify hazardous work tasks assess the appropriate kind of solutions test and evaluate the effect of solutions

4 Development of three tools Government policy: provide self-help tools for companies Objective: create insight in risks and causes Target group: OSH consultants, human factors specialists, HRM Main criteria: Generally applicable Simple and quick, no training required (observations) Distinguish high from low risk tasks Indicate risk factors and type of solutions Complement to general Risk Assessment (OiRA), not replace it

5 Assessment process 22 October2015 Physical Load Checklist Level I Aspects in checklist: lifting and carrying pushing and pulling hand arm tasks working postures computer work vibrations (hand, arm, whole body) energetic over load energetic under load existing health complaints Level II Next step tools: NIOSH (lifting) and KIM (carrying) KIM pushing/pulling HARM WRAP Checklist computer work Vibration exposure calculator No tool, but recommendations No tool, but recommendations No tool, but recommendations Three tools: 1. Physical Load Checklist for a quick first assessment (level I) 2. Hand Arm Risk assessment Method (HARM) for hand arm tasks (level II) 3. Working Posture Risk Assessment tool (WRAP) (level II) Publically available on:

Development process Define criteria on usability and quality Study (epidemiological) literature Pairwise comparisons to weigh the risk factors (HARM) Expert meeting to reach consensus on health

6 Development process Define criteria on usability and quality Study (epidemiological) literature Pairwise comparisons to weigh the risk factors (HARM) Expert meeting to reach consensus on health limits Development of a prototype Test phase: feasibility, reliability, validity Finalize and launch Implementation: publications, presentations, workshops Manage, maintain and update website and tools Tools are available at:

7 Checklist physical load Covers 9 aspects Addresses the potential risk factors Simplification of level II method to which it refers Characteristics Yes-no answers Output: green-red traffic light per aspect of physical load (no amber) Threshold between green and red: chosen in expert group

8 yes/no questions 15 kg is is about the the weight weight of a beer of a crate beer crate

9 Checklist: Example of the results rating Red : reference to level II instrument + insight in risk factors

Hand Arm Risk Assessment Method (HARM) Risk assessment of hand arm tasks > 1 hour, < 6 kg Based on the KIM MHO, epidemiological literature and expert opinions Includes task duration, force exertions,

10 Hand Arm Risk Assessment Method (HARM) Risk assessment of hand arm tasks > 1 hour, < 6 kg Based on the KIM MHO, epidemiological literature and expert opinions Includes task duration, force exertions, working postures, hand-arm vibration from using powered tools, other risk factors (e.g. cold) Risk evaluation uses a traffic light model Field tested and tested on inter tester reliability and concurrent validity Validated

11 Results of logistic regression analysis For the 3 HARM evaluation categories Upper limb symptoms at baseline (n=88) crude OR (95% CI) adjusted OR (95% CI) HARM score <25 Reference Reference HARM 25 & < ( ) 2.90 ( ) HARM ( ) ( ) Upper limb symptoms during 3 year follow-up (n=66) crude OR (95% CI) adjusted OR (95% CI) HARM score <25 Reference Reference HARM 25 & < ( ) 0.32 ( ) HARM ( ) 2.21 ( ) For 2 HARM evaluation categories Upper limb symptoms at baseline (n=88) crude OR (95% CI) adjusted OR (95% CI) HARM <50 Reference Reference HARM ( ) 5.38 ( ) Upper limb symptoms during 3 year follow-up (n=66) crude OR (95% CI) adjusted OR (95% CI) HARM <50 Reference Reference HARM ( ) 4.57 ( ) OR = Odds ratio, 95%CI = 95% confidence interval. Significant results are printed in bold Adjusted = for age, sex, height, weight and years in the job

12 Sensitivity and specificity of HARM scores 50.9 The highest summed sensitivity and specificity was found for HARM-score = 50.9 at baseline and 44.1 at follow-up. 44.1

cut off point of 50 is supported by the cross sectional results, but

13 Conclusions validation study HARM can be used to distinguish high from low risk hand arm tasks (risk of neck or upper limb symptoms) A cut off point of 50 is supported by the cross sectional results, but may be a little high considering the longitudinal results 22 October2015

WRAP (Working Posture Risk Assessment) Assess hazardous working postures (< 1kg) 6 steps All postures described and illustrated by photographs Simple and quickly (observations)

14 WRAP (Working Posture Risk Assessment) Assess hazardous working postures (< 1kg) 6 steps All postures described and illustrated by photographs Simple and quickly (observations) Output: traffic light per working posture Recommendations on preventive measures and examples Currently: PhD study on variation between static and dynamic arm elevation tasks Validation study

Other tools: Guide: from physically heavy to sustainable jobs Wegwijzer Fysieke belasting How to evaluate the interventions and improve them if needed, how to last effectivity How to start: support

16 Other tools: Guide: from physically heavy to sustainable jobs Wegwijzer Fysieke belasting How to evaluate the interventions and improve them if needed, how to last effectivity How to start: support from the management, set up a working group, inform stakeholders etc How to implement measures, get support and change workers behaviour Perform a risk assessment; Define priorities How to find solutions and select the best and most appropriate measures

18 Network activities Annual day Sustainable heavy jobs : 5 november! Pay It Forward Network -> companies show their prevention policy and risk management strategy to other companies

19 Current activities and plans Further implementation of the tools in NL Development of a tool for pushing-pulling Develop up to date tool for risk assessment of computer work Release Work posture tool (WRAP 2.0) Explore the need and criteria for an employee tool (increase awareness, knowledge, own influence) Explore interest in other (EU) countries (Swedish Inspectorate uses HARM already)

20 Thank you for your attention! Tools (Dutch and English) available on:

Overview of Dutch working conditions 2014. Summary

Overview of Dutch working conditions 2014 Summary Overview of Dutch working conditions 2014 Summary Authors Marjolein Douwes Anita Venema Seth van den Bossche Publisher TNO, Leiden, 2015 Commissioned by