title: Reducing musculoskeletal burden through ergonomic program implementation in a large newspaper.
abstract: OBJECTIVE
  To assess the impact of a workplace ergonomic program to reduce musculoskeletal burden among newspaper employees and to understand relationships among participation, risk factor changes and health status within an employee cohort.
  
  
  METHODS
  We conducted repeat cross-sectional surveys, with 1,003 employees from all major departments in 1996 and 813 in 2001, generating a cohort of 433 participants in both surveys. Elements of the ergonomic program included employee RSI (repetitive strain injury) training, pro-active assessment of workstations and workstation modifications, and encouragement of early treatment through on-site physiotherapy. Potential risk factors included biomechanical and work organizational aspects of office work. Health status measures included pain intensity and the Work-Disability of the Arm, Shoulder, and Hand (DASH). Repeat cross-sectional analyses incorporated modifications for shared variance. For the cohort, a theory of change informed path analyses using MPLUS.
  
  
  RESULTS
  Among respondents in 2001, 69% reported participation in RSI training and 56% had workstation assessments. Among those with pain, 57% had consulted a health practitioner, including the on-site physiotherapist. In repeat cross-sectional analyses, the proportion reporting moderate pain or worse, at least once per month or for longer than 1 week, declined from 20 to 16% (p=0.01). Among the cohort, pain intensity and work disability in 1996 were the strongest predictors of 2001 health status (both p<0.001). Stable or increased supervisor awareness and concern about RSI was associated with decreased pain in 2001(p<0.01). Participation in RSI training was associated with increases in decision latitude (p<0.05), which themselves were associated with decreased work disability in 2001 (p<0.05). Increased time mousing was associated with increases in work disability (p<0.05).
  
  
  CONCLUSIONS
  Implementation of a worksite ergonomics program was associated with a reduction in frequent and severe pain in the workforce. Changes in work disability were affected by multiple factors.
authors.affiliation: Institute for Work and Health, 481 University Avenue, Suite 800, M5G 2E9, Toronto, ON, Canada. dcole@iwh.on.ca
authors.forename: Donald C
authors.initials: DC
authors.lastname: Cole
authors.forename: Sheilah
authors.initials: S
authors.lastname: Hogg-Johnson
authors.forename: Michael
authors.initials: M
authors.lastname: Manno
authors.forename: Selahadin
authors.initials: S
authors.lastname: Ibrahim
authors.forename: Richard P
authors.initials: RP
authors.lastname: Wells
authors.forename: Sue E
authors.initials: SE
authors.lastname: Ferrier
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D012090:Cumulative Trauma Disorders / Q000453:epidemiology / Q000517:prevention & control*; D004867:Equipment Design / Q000592:standards; D006804:Ergonomics / Q000379:methods*; D005260:Female; D006801:Humans; D007318:Inservice Training; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000517:prevention & control*; D009524:Newspapers as Topic; D009784:Occupational Diseases / Q000453:epidemiology / Q000517:prevention & control*; D009786:Occupational Health Services / Q000379:methods; D010147:Pain Measurement; D015397:Program Evaluation; D012307:Risk Factors