title: Engaging workers in WRMSD prevention: Two interdisciplinary case studies in an activity clinic.
abstract: BACKGROUND
  This paper reports on two case studies conducted by the Activity Clinic team to support the prevention of Work-Related Musculoskeletal Disorders (WRMSDs) in the workplace. Research so far qualifies WRMSDs as multifactorial and organizational pathologies. It has also demonstrated that in situ clinical analysis of the work activity improves the understanding of WRMSDs and their long-term prevention.
  
  
  OBJECTIVE
  In the two cases reported here (one in the car industry and the other among gravediggers in a large French city), the interventionist framework combined ergonomic observations, biomechanical monitoring, and a developmental methodology called Cross Self-Confrontation (CSC). The goal was to help workers and managers reflect on their work constraints, the impact of those constraints on health, and the possibility of transforming the work.
  
  
  METHODS
  Volunteers among the workers were prompted to engage in collective re-thinking of their work based on video-recordings and monitoring of their physical activity. In the CSC dialogues, biomechanical or ergonomic quantitative representations of the work activity were transformed by the researchers and the workers into argumentation and analysis tools for understanding and prevention of WRMSDs. CSC interviews were recorded and analyzed to track the dynamics of collective elaboration--both conceptual and practical--on WRMSDs prevention.
  
  
  RESULTS
  CSC discussions helped workers and managers transform their views on health, activity, and work constraints, and experiment with alternatives for health protection. The dialogical framework and quantitative representations were instrumental in the process of collective re-conceptualization of conflicts in the work activity and of resources for its transformation.
  
  
  CONCLUSIONS
  This research demonstrates how the integration of biomechanical and ergonomic mediations in the CSC framework promotes WRMSDs prevention in the workplace. This integration supports discussions within work teams and across organizational levels on work dimensions, which may lead to alternatives supporting health.
authors.affiliation: Equipe Psychologie du Travail et Clinique de l'Activité, CNAM Paris, Paris, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Kloetzer
authors.affiliation: Equipe Psychologie du Travail et Clinique de l'Activité, CNAM Paris, Paris, France.|Working Life Department, Management, Organization for Health and Safety at Work Laboratory, Vandoeuvre-Les-Nancy, France.
authors.forename: Edwige
authors.initials: E
authors.lastname: Quillerou-Grivot
authors.affiliation: Equipe Psychologie du Travail et Clinique de l'Activité, CNAM Paris, Paris, France.|Aix Marseille University, ENS Lyon, Marseille, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Simonet
mesh_terms: D001336:Automobiles; D001696:Biomechanical Phenomena; D006804:Ergonomics; D006801:Humans; D033183:Interdisciplinary Communication; D009027:Mortuary Practice; D009140:Musculoskeletal Diseases / Q000517:prevention & control*; D009784:Occupational Diseases / Q000517:prevention & control*; D016272:Occupational Health; D019982:Organizational Case Studies; D012307:Risk Factors; D013647:Task Performance and Analysis; D017132:Workplace
keywords: Power to act; cross self-confrontations; developmental methodology; dialogue; intervention