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K. Dunleavy1, A. Kane2, A. Coffman1, J. Reidy1, M. Bishop1
1University of Florida, Physical Therapy, Gainesville, United States, 2University of Florida, Occupational and Environmental Health, Gainesville, United States
Background: Participatory ergonomics engages workers in the development of strategies to reduce to workplace-related pain, offering flexible and practical options to create individualized context-specific interventions. There is limited information on management of low back pain (LBP) in physically demanding occupations such as agricultural and seafood workers who continue to work despite pain. Condensed and time-dependent production cycles, job uncertainty and limited medical care contribute to workers ignoring pain and not seeking care, with potential for lower productivity and long-term disability. Developing targeted strategies for workers in these industries in rural areas provides a unique challenge.
Purpose: The aim of this study was to examine the effectiveness of self-management work strategies introduced using participatory ergonomic approaches for seafood workers with chronic low back pain.
Methods: A within-subject pragmatic approach was used with repeated baseline and post-intervention assessments, and 8wk intervention. After refinement of a list of Individual and team-based strategies developed from prior surveillance research and stakeholder interviews in a rapid prototyping phase, workers selected 3 strategies to use for 8 weeks. Strategies were introduced in the workplace using video clips and demonstrations by a research assistant with previous experience in the industry. Work teams were videotaped and provided feedback during the review of tapes. Workers received weekly text reminders to use the strategies. Primary outcomes were pain-related disability, task difficulty, pain during workers’ most problematic tasks, and pain related-fear, self-efficacy, and coping strategies.
Results: Nineteen participants completed the study. Participants chose both team and individual strategies, with most using strategies 5 days a week >50% of the time. Strategies were rated as easy to use and most workers (74%) recommended use of strategies for others. Significant improvements for pain-related disability (ODI), pain during specific tasks, pain-related anxiety (PASS), and coping were seen after 8wks of implementing strategies. No changes occurred in task difficulty (PSFS), fear, self-efficacy or average resting pain. Of the 19 participants 74% reported improvements in at least 1 work task or related pain, 37% reported both less difficulty and less pain , while 47% reported improvements in average pain exceeding published MDC95. The proportion of participants exceeding their personalized MDC95 was 56% for moving baskets or boxes and 64% for ‘moving bags.
Conclusion(s): The approach was effective for improving pain-related disability, and pain with work tasks, as well as pain anxiety and coping ability and control. Participatory processes, and selection of self-management options provides viable options to introduce work-related changes in occupations with time restrictions and variable workloads. Larger studies with additional objective performance and productivity measures and long term follow up are needed.
Implications: Participatory methods provide feasible opportunities to introduce, support and build worker capacity for self-management and team buy-in. Introduction of self-management strategies in the workplace is valuable for rural communities and small work teams with time constraints. Sector-specific videos and strategies and feedback using video and demonstrations are important. The high variability in workload should be considered for future research studies.
Funding, acknowledgements: CDC, NIOSH Southeastern Coastal Center for Agricultural Health and Safety under grant# 3U54OH011230-02S1
Keywords: Low back pain, Participatory ergonomics, Seafood harvesters
Topic: Musculoskeletal: spine
Did this work require ethics approval? Yes
Institution: University of Florida
Committee: Institutional Review Board
Ethics number: University of Florida IRB201702245, Registered as a Clinical Trial NCT03524378
All authors, affiliations and abstracts have been published as submitted.
