Prevention of occupational musculo-skeletal injuries. Labour Inspectorate investigation.Scand J Rehabil Med Suppl. 1996; 35:1-34.SJ
The present study was undertaken to investigate the effect on ergonomic conditions by Labour Inspectorate intervention at the work place and to follow health and employment among occupationally injured. 195 reports on occupational musculo-skeletal injury (accidents and diseases) from men and women with different occupations were collected consecutively at three Labour Inspectorate offices. Fifteen Labour Inspectors volunteered to investigate half of the reports by work place visits within three months. The other half was kept for control. The inspectors were trained in ergonomics and also got complementary training in ergonomic work place assessment. A check-list was designed for the purpose and tested for validity and reliability. Eighteen months after the time of the injury reports, all work places were visited by ergonomists to evaluate possible improvements in ergonomic conditions. Due to turnover and prolonged sick-leaves, evaluations were performed for only 92 of the injured. At 160 work places other employees had performed similar tasks as the injured at the time of the injury report. Evaluations of possible improvements in ergonomic conditions were performed also for these employees. As regards changes at the work place there were no differences between the injured in the study and control groups. The inspectors had delivered 11 inspection notices to the employers demanding improvements for the injured and 14 notices regarding the conditions of work-mates. For this latter group there was a significant association between delivered notices and improved ergonomic conditions eighteen months after the reports. Three years after the time of the reports a postal questionnaire on health, psychological well-being and employment was distributed to the injured. The response rate was 93%. Questionnaire answers were compared to results from other studies, where identical questions were used. There was a significantly higher prevalence of musculo-skeletal and psychological symptoms in the study group compared to data from population groups. Activities in daily life were more restricted in the study group. 109 persons were in active employment. The association between the two effect measures improved ergonomic conditions and active employment, and both individual and work-related characteristics was analysed. The odds for improved working conditions were increased where the employer had given an informative injury description in the injury report, probably indicating that an understanding of the mechanisms of injury is a prerequisite for effective prevention. Sick-leaves for more than 6 months during the year following the report had a significant negative association with active employment, whereas male sex and higher education, respectively, had a positive association. The studied musculo-skeletal injuries were associated with a high prevalence of physical and psychological symptoms. Identification and investigation of ergonomic hazards, as appearing in informative reports on the origin of injuries and in inspection notices, seemed to have a positive influence on the process of prevention.