Plenary 3: Strategies to prevent back injuries, a priority problem in the automotive industry Best Practices in Ergonomics in the Automotive Industry Richard

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.


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


large loads

• Lifting/pushing/pulling moderate loads in disadvantageous postures



F

Interventions for Low Back Pain at Work I


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



• 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



• 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



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



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



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



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



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

[email protected]

Documents

Plenary 3: Strategies to prevent back injuries, a priority problem in the automotive industry Best Practices in Ergonomics in the Automotive Industry Richard