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STUDY PROTOCOL Open Access The effectiveness of job
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Comper and Padula BMC Musculoskeletal Disorders 2014 15 170 Page 2 of 6. http www biomedcentral com 1471 2474 15 170, Thus the job rotation has been adopted in repetitive rotation program that has specific criteria to reduce the. static or monotonous activities aiming to relieve the cumulative and average biomechanical exposure and then. effects of muscle and cognitive overload monotony ab to evaluate the effect of this newly developed job rotation. senteeism and stress 5 6 program in the prevention of musculoskeletal disorders in. Regarding the assessment of the effectiveness of the industrial textile workers. job rotation and the prevention of musculoskeletal com. plaints strategy studies show conflicting results Hinnen Methods. et al evaluated supermarket workers by a cross sectional Study design approval and registration. study and found a 40 reduction in complaints of neck This is a randomized cluster controlled trial prospectively. pain and a 20 reduction in complaints of pain in the registered and with blinded assessment will be used to in. shoulder for those who carried out labor 7 Another vestigate the effectiveness of job rotation to prevent muscu. study compared groups who performed or did not per loskeletal disorders in industrial workers The procedures. form job rotation and also found significant reductions and consent form were approved by the Research Ethics. in physical burden on workers of a garbage collection Committee of Cidade de S o Paulo University protocol no. department who underwent rotation between the driving 18170313 5 0000 0064 and were prospectively registered at. task and collecting trash 8 However while performing ClinicalTrials gov NCT01979731 The study is being. in a longitudinal study it was observed that in the long funded by the National Counsel of Technological and. run the job rotation increased overload on other body Scientific Development CNPq Brazil 473651 2013 0. regions and workers began to report more back pain. especially in the group who had just completed the driv. ing task 9 Probably it is because the groups continued Study population and setting. exposure to the same risk factors even when switching Study participants will be production line workers re. the task Similar results were obtained by Frazer et al cruited from the textile industry of a large company in. 10 who evaluated two tasks of material handling with Bahia Brazil The productive sectors of this industry will. low and high overhead level The risk of lower back pain be classified according to the level of exposure to risk. increased as a greater amount of time was used to per factors for musculoskeletal pain and disorders The sec. form the task with higher overhead due to the cumula tors to be included should have production lines that. tive and peak force 10 allow switching between tasks with different biomecha. The different study methods and criteria used for de nical demands and levels of risk for musculoskeletal pain. ployment of job rotation may partly explain the hete and disorders and further that the work is carried out. rogeneity of results This plus the absence of clinical in cell production Sectors whose production lines are. controlled randomized studies evaluating the effective automated or semi automated possessing the pace of. ness of the job rotation and the prevention of mus work determined by machinery where work stoppage is. culoskeletal complaints strategy complicates the clinical not possible will be excluded All workers in selected. decision making of professionals in the health and safety sectors will be invited to participate in the study. of the worker, Importantly positive results for the worker s health Sample size calculation. will only be achieved if the planning of the job rotation The number of working hours lost due to sick leave by. meets some important criteria such as number of musculoskeletal injuries M Group International Clas. workers and tasks involved exposure level requested sification of Diseases ICD 10 was used to estimate the. body region frequency of movements duration of ex sample size The average time lost during the last three. posure and duration of rest break among others 11 months in companies that the study observed was ap. To assist in this planning some methods and algorithms proximately 1 100 hours The authors assume that inter. have been developed using the variables mentioned be ventions will enable a reduction of this number by 10. fore 11 14 however the proposed rotation as reported that is the groups will have a difference of 100 lost wor. in the literature has not been evaluated in controlled king hours with a standard deviation of 250 hours A. clinical studies or randomized and the effect of reducing statistical power of 80 an alpha of 5 and a possible. absenteeism caused by musculoskeletal disorders in the sample loss of up to 15 is considered Therefore 116. workplace is not yet proven participants are needed per group or 232 in total But in. All these limitations point to the need for implementing this study the calculation of sample size was made by clus. a well design job rotation program along with a well ters and considered the number of production sectors in. designed intervention study in order to fully and robustly cluded The clusters number was four sectors n 957. evaluate the theory of job rotation and its application The intervention group has 504 workers selected from. Hence we aimed to develop such a well designed job Finishing Socks and Finishing Underwear departments. Comper and Padula BMC Musculoskeletal Disorders 2014 15 170 Page 3 of 6. http www biomedcentral com 1471 2474 15 170, and the control group is 453selected from Sewing Socks test blinding after assessment of outcomes the worker s. and Sewing Underwear departments Figure 1 assessment researcher will note his opinion as to the. type of intervention received by workers Moreover all. Randomization workers in both groups will receive ergonomic guide. Randomization was performed at the group level depart lines used as a placebo intervention. ments productive sectors in order to avoid contamin. ation from workers allocated in the intervention to those. Study groups, in the control group The productive sectors included in. Control group, the study were pre stratified by the level of exposure to.
Workers allocated in the control group will be invited to. risk factors for musculoskeletal pain and disorders Sectors. attend training with ergonomic guidelines taught by a. with similar demands were grouped and randomly divi. physiotherapist ergonomist The training will be held on. ded between intervention and control groups Using a. a single day over 4 hours with lectures on ergonomic. computer generated randomization www randomizer org. risk factors and their influence on the development of. with random numbers to define groups the randomization. musculoskeletal symptoms improvements and adapta, was performed by an independent researcher who was not. tions for workstations work postures and preventive. involved in recruitment and assessment Sealed envelopes. exercise 15 Participants in the intervention group will. will be used The randomization was performed before. receive the same information,baseline measurements. Blinding Intervention group, Obviously the nature of the intervention used in this Workers allocated in intervention sectors will receive. study made it impossible to blind workers and ergono the same ergonomic guidelines as the control group In. mists However the workers interview researcher will be addition they will realize job rotation as described. blind to the study design and the group assignment To below. Assessment to determine,productive sectors,departments elegibility. n 1 897 workers,n 10 departments,excluded for not meeting the eligibility.
n 940 workers,n 6 departments,n 957 workers,n 4 departments. Randomization by Cluster,departments and Shifts,Control Group Intervention Group. Ergonomic Guidelines Job Rotation Ergonomic Guidelines. Cluster Allocation,n 2 departments n 2 departments. n 453 workers n 504 workers, Informed consent Application of Informed consent Application of. baseline questionnaires baseline questionnaires, Absence from work due to sick leave Absence from work due to sick leave.
Musculoskeletal symptoms Musculoskeletal symptoms,3 6 9 e 12 months follow up. Psychosocial factors and fatigue Psychosocial factors and fatigue. General Health Productivity General Health Productivity. Figure 1 Study flow diagram, Comper and Padula BMC Musculoskeletal Disorders 2014 15 170 Page 4 of 6. http www biomedcentral com 1471 2474 15 170,Intervention Assessment instruments and outcomes. Job rotation Although the intervention is applied to the production. The job rotation is proposed in order to modify expos sectors the outcomes are on an individual level since. ure so that workers will perform tasks alternating be they reflect aspects of the health of workers Data re. tween low moderate and high risk for musculoskeletal garding outcome measures will be assessed at baseline. pain and disorders and exposure to risk for injury to dif and after 3 6 and 12 months except for information re. ferent body regions Therefore an ergonomic analysis lating to removal for sick leave which will be recorded. will indicate based on the main posture adopted to carry daily After a period of 12 months the sector that had. out the task the body regions of higher overload level received only ergonomic guidelines will receive job rota. and intensity of exposure The autonomy of the work tion considering the hypothesis of this study in relation. techniques and work rate and the use of machines and to its effectiveness Both groups of workers will be moni. tools will also be evaluated The level of exposure to risk tored in a longitudinal study in subsequent months and. of musculoskeletal pain and disorders will be assessed by compared to other workers identified within the criteria. Quick Exposure Check QEC 16 17 and Rapid Entire for risk analysis for 24 months. Body Assessment REBA 18 These methods enable, the characterization of worker exposure to the task be Socio demographic. cause they assess the main risk factors for musculoskel At baseline socio demographics age sex level of edu. etal disorders frequency of movements and postures cation length of service in the company and the current. performed by spine and upper limbs amount of weight role working days per week and hours of work per. handled time to perform the task manual force visual week among others will be assessed using a question. demands of the activity presence of vibration work naire developed by the researchers of this study. pace and stress 16 17, The structure of the job rotation will be proposed Primary outcome measure.
from the results obtained by ergonomic assessment ac Absence from work due to sick leave. cording to the following priority criteria 1 level of ex In this study we will use the sick leave for sick leave due. posure intensity low moderate high or very high 2 to illness of the musculoskeletal system and connective. posture predominantly adopted for conducting task sit tissue as a primary outcome measure This outcome will. ting kneeling standing walking 3 the main physical be measured by the number of working hours lost due. demand material handling repetition of movements to the removal of a symptom or disease of the musculo. static posture and 4 body regions of higher overhead skeletal system and connective tissue These data will be. shoulders elbows wrists hands spine Table 1 Tasks obtained from records of medical certificates validated. that have similarity of these criteria will be grouped to by the Human Resources department HR of each in. then be alternated so that 1 tasks with exposure level dustry Information regarding the clinical diagnosis and. will be low or moderate risk tasks alternated with high body region will also be collected using the specific. and very high 2 tasks that require a predominantly codes of the International Classification of Diseases. standing posture will alternate with tasks that require a 10th revision ICD 10. sitting posture 3 handling tasks will be alternated. with tasks requiring repetition of movements and 4 Secondary outcome measure. the tasks alternate body regions of higher overhead Musculoskeletal symptoms. Figure 2 The completion of the rotation will take place The occurrence of musculoskeletal symptoms pain tin. at intervals of 2 hours It is estimated that this time is gling or numbness will be assessed using the Nordic Mus. compatible with a lower lactic acid 19 culoskeletal Questionnaire QNSO 20 The respondents. Table 1 Summarized description of the job rotation definition. Step Definition Description, Evaluate the main demand of work posture adopted in the task movements per body region. 1 Ergonomic work analysis, amplitude and frequency autonomy work rate percentage of occupation in work cycles. Ergonomic exposure risk Classify the activity exposure level ergonomic low moderate high and very high by two observational. level assessment protocols Quick Exposure Check QEC and Rapid Entire Body Assessment REBA. 3 Job rotation definition Propose the structure of job rotation in accordance with the following priority criteria 1 the level of. exposure intensity low moderate high or very high 2 predominantly stance taken by the completion. task sitting kneeling standing walking 3 the main physical demand material handling repetition of. movements static posture 4 body regions of higher overhead shoulders elbows wrists hands spine. 5 production s specificities, Comper and Padula BMC Musculoskeletal Disorders 2014 15 170 Page 5 of 6. http www biomedcentral com 1471 2474 15 170,answers of numbers up to 4 0 never 1 sometimes. 2 often and 3 always The answer always indicates, an unfavorable situation and receives 3 scores with the.
exception of item 4 which features reverse scoring The. total score is obtained by summing the final transformed. by rule of three direct on a scale of 0 minimum to 100. maximum In this case the higher the score the greater. the amount of higher symptoms and need of recovery. General health, The WHOQOL BREF will be used to assess the overall. health status and quality of life of workers This ins. trument contains 26 questions divided into four areas. social psychological physical and environment Each. domain consists of questions whose answer scores range. between 1 and 5 26, Figure 2 Job rotation design Group A operate Alome machine. Firsan shaping socks separation of product s color and size stamping Productivity. Tecma machine packaging silicon preparing Group B Alome choice Besides this information other single issues related to. of pair of socks operate Satellite machine operate Sealing machine fix productivity at work will be answered by the workers dur. fast pin automatic packaging Group C Firsan choice of pair of socks. Satellite packing socks Alome socks review manual packaging. ing the follow ups Productivity is measured by a single. operate Autotex machine application of silicon seamless products item WHO General Health Questionnaire and Perfor. review mance at Work 27 In this participants should assign a. score 0 10 for their labor productivity over the past. three months, will answer simple questions yes or no in relation to. musculoskeletal symptoms they have experienced in the Cost effectiveness. past 12 months and or in the past seven days as well as The cost effectiveness of interventions will be calculated. regarding the occurrence of disability and demand for according to the cost effectiveness incremental 28 29. health aid professionals in the last 12 months due to these For this we considered the cost required to conduct. symptoms The intensity of the pain will be assessed by ergonomic guidelines and cost guidelines in conjunction. the Verbal Numerical Pain Scale 21 It is an 11 point with job rotation These values are divided by the time. scale where 0 means no pain and 10 means worst pos lost from work. sible pain,Statistical analysis, Risk factors for musculoskeletal pain and disorders Descriptive statistics frequencies means standard de. Some studies show that ergonomic interventions reduce viation standard error confidence interval will be used. the occurrence of removal for medical leave due to lower in the analysis of socio demographic characteristics of. levels of exposure to risk factors 22 23 This study ad the population The Kolmogorov Smirnov test is used to. dresses the perception of workers against risk factors assess the normality of the data The chi square test is. that may contribute to the development of musculoske used to evaluate the blinding of the assessor by com. letal complaints through the Job Factors Questionnaire paring the randomization codes and the evaluator The. This instrument presents a descriptive list of 15 risk difference between the groups and their respective confi. factors that should be classified on a scale of zero to ten dence intervals are calculated using linear mixed models. indicating how much each factor contributed to the 30 The significance level is 5 The statistical program. emergence of work related musculoskeletal symptoms SPSS will be used for all analyses which will be held fol. with zero meaning no problem and ten indicating the lowing the principles of intention to treat. largest possible problem 24,Discussion, Psychosocial factors and fatigue This study design was developed to investigate the effec.
Data on the perception of workers against psychosocial tiveness of job rotation to prevent musculoskeletal disor. factors and stress resulting in fatigue induced by work ders in industrial workers Despite being a topic of great. will be obtained through the Scale of Need for Recovery relevance due to the difficulty of completely reducing the. 25 This Likert type scale has 11 questions and possible risk factors of the work environment few studies have. Comper and Padula BMC Musculoskeletal Disorders 2014 15 170 Page 6 of 6. http www biomedcentral com 1471 2474 15 170, evaluated the effect of job rotation in reducing absentee 13 Azisi N Zolfaghari S Liang M Modeling job rotation in manufacturing. ism caused by musculoskeletal disorders It is expected systems The study of employee s boredom and skill variations Int J Prod. Econ 2010 123 1 69 85, that interventions to reduce the occurrence of mus 14 Aptel M Cail F Gerling A Louis O Proposal of parameters to implement a. culoskeletal disorders and the consequent removal of the workstation rotation system to protect against MSDs Int J Ind Ergon 2008. workers for sick leave 100 hours of lost work It is also 38 11 12 900 909. 15 Mahmud N Kenny DT Md Zein R Hassan SN Ergonomic training reduces. hoped that the results obtained in this study may contri musculoskeletal disorders among office workers results from the. bute to setting standards in the field of Occupational 6 month follow up Malays J Med Sci 2011 18 2 16 26. Health as well as for decision making of professionals 16 Comper MLC Costa LOP Padula RS Quick Exposure Check QEC. a cross cultural adaptation into Brazilian Portuguese Work 2012. working in this area 41 supl 2056 2059, 17 Comper ML Costa LO Padula RS Clinimetric properties of the Brazilian. Competing interests Portuguese version of the Quick Exposure Check QEC Braz J Phys Ther. The authors declare that they have no competing interests 2012 16 6 487 494. 18 Lamar o AM Costa LCM Comper MLC Padula RS Translation cross. cultural adaptation to Brazilian Portuguese and reproducibility analysis. Authors contributions of the method rapid entire body assessment reba Braz J Phys Ther 2014. MLCC and RSP were responsible for designing the study RSP procured in press. funding All authors have contributed to the manuscript All authors read 19 Filus R Okimoto ML O efeito do tempo de rod zios entre postos de trabalho nos. and approved the final manuscript indicadores de fadiga muscular o cido l tico Curitiba PR 14 Congresso. Brasileiro de Ergonomia 2006, Acknowledgements 20 Barros EN Alexandre NM Cross cultural adaptation of the Nordic. The authors thank Dr Jack Dennerlein Professor of Ergonomic and Safety at musculoskeletal questionnaire Int Nurs Rev 2003 50 2 101 108. the Bouv College of Health Sciences at Northeastern University and Harvard 21 Farrar JT Young JP Jr LaMoreaux L Werth JL Poole RM Clinical. School of Public Health in Boston MA USA for his support of this study and importance of changes in chronic pain intensity measured on an. his friendly review of the manuscript In addition this study is supported by 11 point numerical pain rating scale Pain 2001 94 2 149 158. the National Counsel of Technological and Scientific Development CNPq 22 Shiri R Martimo KP Miranda H Ketola R Kaila Kangas L Liira H Karppinen J. Brazil 473651 2013 0 Viikari Juntura E The effect of workplace intervention on pain and. sickness absence caused by upper extremity musculoskeletal disorders. Received 6 March 2014 Accepted 16 May 2014 Scand J Work Environ Health 2011 37 2 120 128. Published 22 May 2014 23 van Oostrom SH Driessen MT de Vet HC Franche RL Schonstein E Loisel P. Van Mechelen W Anema JR Workplace interventions for preventing work. disability Cochrane Database Syst Rev 2009 2 CD006955. References 24 Coluci M Alexandre N Rosecrance J Reliability and validity of an. 1 Ekl f M Hagberg M Are simple feedback interventions involving ergonomics related Job Factors Questionnaire Int J Ind Ergon 2009. workplace data associated with better working environment and health 39 6 995 1001. A cluster randomized controlled study among Swedish VDU workers 25 Moriguchi CS Alem MER Veldhoven MV Coury HJCG Cultural adaptation. Appl Ergon 2006 37 2 201 210 and psychometric properties of Brazilian need for recovery scale Rev. 2 Mathiassen SE Diversity and variation in biomechanical exposure what is Saude Publica 2010 44 1 131 139. it and why would we like to know Appl Ergon 2006 37 4 419 427 26 Fleck MP Louzada S Xavier M Chachamovich E Vieira G Santos L Pinzon. 3 Sato Tde O Coury HJ Evaluation of musculoskeletal health outcomes in V Aplica o da vers o em portugu s do instrumento abreviado de. the context of job rotation and multifunctional jobs Appl Ergon 2009 avalia o da qualidade de vida WHOQOL bref Rev Saude Publica 2000. 40 4 707 712 34 2 178 183, 4 Keir PJ Sanei K Holmes MWR Task rotation effects on upper extremity 27 Kessler RC Barber C Beck A Berglund P Cleary PD McKenas D Pronk N.
and back muscle activity Appl Ergon 2011 42 6 814 819 Simon G Stang P st n TU Wang P The world health organization. 5 Rissen D Melin B Sandsjo L Dohns I Lundberg U Psychophysiological health and work performance questionnaire HPQ J Occup Environ Med. stress reactions trapezius muscle activity and neck and shoulder pain 2003 45 2 156 174. among female cashiers before and after introduction of job rotation 28 Lahiri S Markkanen P Levenstein C The cost effectiveness of occupational. Work Stress 2002 16 2 127 137 health interventions preventing occupational back pain Am J Ind Med. 6 Ho WH Chang CS Shih YL Liang RD Effects of job rotation and role 2005 48 6 515 529. stress among nurses on job satisfaction and organizational commitment 29 Drummond MF Richardson WS O Brien BJ Levine M Heyland D Users. BMC Health Serv Res 2009 9 8 guides to the medical literature XIII How to use an article on economic. 7 Hinnen U Laubli T Guggenbuhl U Krueger H Design of check out analysis of clinical practice A Are the results of the study valid. systems including laser scanners for sitting work posture Scand J Work Evidence based medicine working group JAMA 1997 277 19 1552 1557. Environ Health 1992 18 3 186 194 30 Twisk JW Longitudinal data analysis A comparison between generalized. 8 Kuijer PP Visser B Kemper HC Job rotation as a factor in reducing estimating equations and random coefficient analysis Eur J Epidemiol. physical workload at a refuse collecting department Ergonomics 1999 2004 19 8 769 773. 42 9 1167 1178, 9 Kuijer PP van der Beek AJ Van Dieen JH Visser B Frings Dresen MH Effect. doi 10 1186 1471 2474 15 170, of job rotation on need for recovery musculoskeletal complaints and. Cite this article as Comper and Padula The effectiveness of job rotation. sick leave due to musculoskeletal complaints a prospective study to prevent work related musculoskeletal disorders protocol of a cluster. among refuse collectors Am J Ind Med 2005 47 5 394 402 randomized clinical trial BMC Musculoskeletal Disorders 2014 15 170. 10 Frazer MB Norman RW Wells RP Neumann PW The effects of job rotation. on the risk of reporting low back pain Ergonomics 2003 46 9 904 919. 11 Asensio Cuesta S Diego Mas JA Cremades Oliver LV Gonz lez Cruz MC. A method to design job rotation schedules to prevent work related. musculoskeletal disorders in repetitive work Int J Prod Res 2012. 50 25 7467 7478, 12 Michalos G Makris S Rentzos L Chyssolouris G Dynamic job rotation for. workload balancing in human based assembly systems CIRP J Mfg Sci.

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