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Special Issue "Injury Prevention and Safety Promotion: A Physical and Cognitive Ergonomic Approach"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Occupational Safety and Health".

Deadline for manuscript submissions: closed (31 December 2020).

Special Issue Editors

Dr. Harish Chander
E-Mail Website
Guest Editor
Neuromechanics Laboratory, Department of Kinesiology, Mississippi State University, Mississippi State, MS 39762, USA
Interests: human factors; ergonomics; biomechanics; motor control; fall prevention; slip, trips, and falls; postural control; balance
Special Issues, Collections and Topics in MDPI journals
Dr. Reuben Burch
E-Mail Website
Guest Editor
Human Factors & Athlete Engineering Department, Center for Advanced Vehicular Systems (CAVS); Department of Industrial & Systems Engineering; National Strategic Planning & Analysis Research Center (NSPARC), Mississippi State University
Interests: human factors and ergonomics; human interaction with industrially rugged mobile and wearable tools, robotics and autonomy, and athletic technology; cognitive engineering

Special Issue Information

Dear Colleagues,

The United States Bureau of Labor Statistics reported a total of 2.8 million non-fatal injuries and 5250 fatal work injuries in 2018. Globally, the International Labor Organization estimates that there are around 340 million occupational accidents and 160 million work-related diseases each year. Moreover, hazardous occupations such as construction, manufacturing, transportation, warehousing, mining, quarrying, and healthcare services, as well as emergency responders such as firefighters, law enforcement, and military, are predisposed greater risk for occupational injuries due to their inherent danger. The constant increase in injury, illness, and accident rates in the workplace warrants the successful implementation of safety practices that are evidence-based and warrants the need for new innovating and emerging research to minimize workplace accidents.

The scientific discipline of human factors and ergonomics and their domains of physical and cognitive ergonomics provide specialized approaches in preventing injuries and promoting safety. According to the International Ergonomics Association, physical ergonomics are concerned with human anatomical, physiological, and biomechanical characteristics while cognitive ergonomics is concerned with human, higher mental processing, motor response, and interactions with other elements of a system. Research and clinical approaches in physical ergonomics have included topics on working postures, balance, gait, slips, trips, falls, material handling, acute and repetitive work-related musculoskeletal disorders, fatigue, overexertion, and exhaustion. Research and clinical approaches in cognitive ergonomics have included topics on mental workload, situation awareness, vigilance, attention, memory, cognitive fatigue, memory, reasoning, decision-making, and human–computer interaction.

With recent advancements in human biomechanical, physiological, psychological, and cognitive research, this Special Issue will focus on the application of physical and cognitive ergonomics in workplace injury prevention and safety promotion. A wide range of topics addressing injury prevention and safety promotion in various hazardous occupations will be covered. Contributions including empirical research, review articles, case reports, etc. on injury prevention and safety promotion in ergonomics are encouraged.

Dr. Harish Chander
Dr. Reuben Burch
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Human factors
  • Occupational injuries
  • Occupational safety
  • Physical ergonomics
  • Cognitive ergonomics
  • Cognitive engineering
  • Occupational biomechanics
  • Occupational physiology

Published Papers (13 papers)

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Research

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Article
Impact of Prolonged Exposure to a Slippery Surface on Postural Stability
Int. J. Environ. Res. Public Health 2021, 18(5), 2214; https://doi.org/10.3390/ijerph18052214 - 24 Feb 2021
Cited by 1 | Viewed by 876
Abstract
Falls are extremely common in occupational settings. Intrinsic factors such as overexertion and extrinsic factors such as the supporting surface are causative factors of falls. The impact of prolonged exposure to a slippery surface on postural stability has not been previously studied. The [...] Read more.
Falls are extremely common in occupational settings. Intrinsic factors such as overexertion and extrinsic factors such as the supporting surface are causative factors of falls. The impact of prolonged exposure to a slippery surface on postural stability has not been previously studied. The purpose of the study was to analyze the effect of extended exposure to a dry and a slippery surface on postural stability. Eighteen males (age: 21.17 ± 3.38 years; height: 1.77 ± 0.08 m; mass: 89.81 ± 14.23 kg) were recruited and subjected to one-hour walking on a dry surface and a slippery surface on two different days. Participants’ balance was assessed using a force platform in stable and unstable conditions at 0, 30, and 60 min. Postural sway variables were analyzed using a 2 (surface) × 3 (time) repeated-measures ANOVA. Significant time main effects were observed in the stable condition with greater balance decrements at 30 and 60 min. Greater balance decrements were observed on the slippery surface compared to the dry surface in the unstable condition. The balance decrements can be attributed to overexertion due to the physiological workload of prolonged walking and to the potential gait modifications due to walking on the slippery surface. Full article
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Article
Company Representatives’ Experiences of Occupational Health Surveillance for Workers Exposed to Hand-Intensive Work: A Qualitative Study
Int. J. Environ. Res. Public Health 2021, 18(4), 2018; https://doi.org/10.3390/ijerph18042018 - 19 Feb 2021
Viewed by 839
Abstract
Exposure assessment seldom precedes the medical health checks in occupational health surveillance. In order to emphasize the interconnection between exposure assessment and medical health checks, a process model was developed. The process model aimed to guide employers and Occupational Health Service providers through [...] Read more.
Exposure assessment seldom precedes the medical health checks in occupational health surveillance. In order to emphasize the interconnection between exposure assessment and medical health checks, a process model was developed. The process model aimed to guide employers and Occupational Health Service providers through the execution of occupational health surveillance. The objective of this qualitative study is to explore company representatives’ experiences of the process model, in terms of feasibility and values, and to identify factors that facilitate or impede the process. Thirty-three company representatives from ten companies were interviewed. Interviews were analyzed using content analysis. The company representatives experienced that the model contributed to increased risk awareness and understanding of the exposure effects on workers’ health. They valued the exposure assessments performed by an ergonomics expert, which led to the discovery of previously unidentified risks. The feasibility was facilitated by: a joint start-up meeting in which the process was planned, clear communication between the involved parties, and clarity regarding the process ownership. The findings reveal that a guiding process model is valuable for the execution of occupational health surveillance. However, the model should not only define the components included; a practical guide concerning how the process can be executed is also needed. Full article
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Article
Lower Extremity Muscle Activation in Alternative Footwear during Stance Phase of Slip Events
Int. J. Environ. Res. Public Health 2021, 18(4), 1533; https://doi.org/10.3390/ijerph18041533 - 05 Feb 2021
Viewed by 886
Abstract
Muscle activity from the slipping leg have been previously used to analyze slip induced falls. However, the impact of casual alternative footwear on slipping leg muscle activity when exposed to slippery environments is still unknown. The purpose of the study was to analyze [...] Read more.
Muscle activity from the slipping leg have been previously used to analyze slip induced falls. However, the impact of casual alternative footwear on slipping leg muscle activity when exposed to slippery environments is still unknown. The purpose of the study was to analyze the impact of alternative footwear (crocs (CC) and flip-flops (FF)) compared to slip-resistant footwear (LT) on lower extremity muscle activity when exposed to dry gait (NG), unexpected (US), alert (AS), and expected slips (ES). Eighteen healthy males (age: 22.3 ± 2.2 years; height: 177.7 ± 6.9 cm; weight: 79.3 ± 7.6 kg) completed the study in a repeated measures design in three footwear sessions separated by 48 h. Electromyography (EMG) muscle activity from four muscles of the lead/slipping leg was measured during the stance phase of the gait-slip trials. A 3 (footwear) × 4 (gait-slip trials) repeated measures analysis of variance was used to analyze EMG dependent variables mean, peak, and percent of maximal voluntary contraction. Greater lower extremity muscle activation during the stance phase was seen in US and AS conditions compared to NG and ES. In addition, footwear differences were seen for the alternative footwear (CC and FF) during US and AS, while the low top slip resistant shoe had no differences across all gait trials, suggesting it as the most efficient footwear of choice, especially when maneuvering slippery flooring conditions, either with or without the knowledge of an impending slip. Full article
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Article
Factors Affecting Material-Cart Handling in the Roofing Industry: Evidence for Administrative Controls
Int. J. Environ. Res. Public Health 2021, 18(4), 1510; https://doi.org/10.3390/ijerph18041510 - 05 Feb 2021
Cited by 2 | Viewed by 884
Abstract
Material-cart handling can be strenuous and lead to overexertion injuries. The aim of this study is to produce a thorough understanding of how the cart condition, tire type, physical environment-related factors, and load interact to influence the ergonomics and productivity of cart handling. [...] Read more.
Material-cart handling can be strenuous and lead to overexertion injuries. The aim of this study is to produce a thorough understanding of how the cart condition, tire type, physical environment-related factors, and load interact to influence the ergonomics and productivity of cart handling. Eighteen roofing carts with different conditions, tires, and loads were tested by one subject on three laboratory tracks: one L-shaped, one with ramps within constrained spaces, and one with obstacles within constrained spaces. A multiple linear regression analysis was performed to quantify the main and interaction effects of the factors of interest on the cart operations. The research findings confirm that using aged carts increases the injury risk by as much as 30.5% and decreases productivity by 35.4%. Our study also highlights the necessity of keeping an open space for cart operation; the travel distance from a cart to a ramp/obstacle should be greater than 61 cm. Finally, the results suggest the at-risk thresholds for different ramp slopes and obstacle heights, and the safe load capacities for the various working circumstances that are common on construction sites. The evidence created in this study can be translated into administrative controls for cart handling to reduce overexertion injuries and enhance performance. Full article
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Article
Can We Use Grip Strength to Predict Other Types of Hand Exertions? An Example of Manufacturing Industry Workers
Int. J. Environ. Res. Public Health 2021, 18(3), 856; https://doi.org/10.3390/ijerph18030856 - 20 Jan 2021
Viewed by 816
Abstract
Background: There are different types of hand motions in people’s daily lives and working environments. However, testing duration increases as the types of hand motions increase to build a normative database. Long testing duration decreases the motivation of study participants. The purpose of [...] Read more.
Background: There are different types of hand motions in people’s daily lives and working environments. However, testing duration increases as the types of hand motions increase to build a normative database. Long testing duration decreases the motivation of study participants. The purpose of this study is to propose models to predict pinch and press strength using grip strength. Methods: One hundred ninety-eight healthy volunteers were recruited from the manufacturing industries in Central Taiwan. The five types of hand motions were grip, lateral pinch, palmar pinch, thumb press, and ball of thumb press. Stepwise multiple linear regression was used to explore the relationship between force type, gender, height, weight, age, and muscle strength. Results: The prediction models developed according to the variable of the strength of the opposite hand are good for explaining variance (76.9–93.1%). Gender is the key demographic variable in the predicting models. Grip strength is not a good predictor of palmar pinch (adjusted-R2: 0.572–0.609), nor of thumb press and ball of thumb (adjusted-R2: 0.279–0.443). Conclusions: We recommend measuring the palmar pinch and ball of thumb strength and using them to predict the other two hand motions for convenience and time saving. Full article
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Article
Normative Hand Strength of Healthcare Industry Workers in Central Taiwan
Int. J. Environ. Res. Public Health 2021, 18(1), 187; https://doi.org/10.3390/ijerph18010187 - 29 Dec 2020
Cited by 1 | Viewed by 586
Abstract
Objectives: The purpose of this study is to establish the norms of hand grip strength in the healthcare industry in Taiwan and propose models to predict the strength of hand movement by regression with demographic and anthropometric factors. Methods: This is [...] Read more.
Objectives: The purpose of this study is to establish the norms of hand grip strength in the healthcare industry in Taiwan and propose models to predict the strength of hand movement by regression with demographic and anthropometric factors. Methods: This is a cross-sectional study with a stratified convenience sample of workers in healthcare service industries in central Taiwan. Three hundred twenty-nine healthy subjects were recruited. Strength of different hand movement were tested three times in both hands and rests were given between tests. Results: Female strength of these hand movement was 59.1% to 73.0% that in males (p < 0.001). In general, the hand strength of male workers in the healthcare industry was less than that of male workers in the manufacturing industry (p < 0.001). In the prediction model, sex and weight played important roles in predicting hand strength. Conclusions: The norms of different types of hand strength was investigated the first time in workers in the healthcare industry in Taiwan. The tasks performed by healthcare personnel vary widely, and this variable should be considered in a future prediction model. Full article
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Article
Effect of Using an 8-Figure Shoulder Brace on Posture and Muscle Activities during the Performance of Dental Hygiene Procedures
Int. J. Environ. Res. Public Health 2020, 17(22), 8494; https://doi.org/10.3390/ijerph17228494 - 16 Nov 2020
Viewed by 876
Abstract
The incidence of work-related musculoskeletal disorders (MSDs) among dental workers has been increasing. Many ergonomic devices and accessories have been introduced. The aim of this study was to investigate the effects of an 8-figure shoulder brace on posture-related muscle activities in dental hygiene [...] Read more.
The incidence of work-related musculoskeletal disorders (MSDs) among dental workers has been increasing. Many ergonomic devices and accessories have been introduced. The aim of this study was to investigate the effects of an 8-figure shoulder brace on posture-related muscle activities in dental hygiene practitioners during scaling procedures. In this study, 33 participants (age: 21.9 ± 2.1 years, height: 162.0 ± 6.0 cm, weight: 55.8 ± 9.0 kg, body mass index: 21.2 ± 2.4 kg/m2) performed the scaling procedure with and without the 8-figure shoulder brace in a randomized order. The normalized electromyography activity in the amplitude probability distribution function and joint angles (cervical, thoracic, lumbar, and shoulder joints) were simultaneously recorded during scaling. A paired t test was used to compare the differences in muscle kinematics, with the alpha level set at 0.05. The dental hygienists who wore the 8-figure shoulder brace during scaling showed thoracic and lumbar extension, improved sitting postures, and reduced shoulder joint abduction. However, we also observed an unintended increase in internal rotation. Use of the 8-figure shoulder brace could prevent work-related MSDs in lumbar and thoracic regions by reducing the effort exerted by the upper trapezius and deltoid muscles, despite the increased muscular effort of the cervical erector spinae. Full article
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Article
Firefighter Overexertion: A Continuing Problem Found in an Analysis of Non-Fatal Injury Among Career Firefighters
Int. J. Environ. Res. Public Health 2020, 17(21), 7906; https://doi.org/10.3390/ijerph17217906 - 28 Oct 2020
Cited by 4 | Viewed by 1124
Abstract
Traditionally, safety-related research on firefighting has focused on fires and fireground smoke as the primary source of non-fatal firefighter injury. However, recent research has found that overexertion and musculoskeletal disorders may be the primary source of firefighter injury. This study aimed to provide [...] Read more.
Traditionally, safety-related research on firefighting has focused on fires and fireground smoke as the primary source of non-fatal firefighter injury. However, recent research has found that overexertion and musculoskeletal disorders may be the primary source of firefighter injury. This study aimed to provide an update on injury occurrence among career firefighters. Injury data were collected over a two-year period from two large metropolitan fire departments in the U.S. Injury data were categorized based on the Bureau of Labor Statistics’ Occupational Injury and Illness Classification System. Cross-tabulations and Chi-square tests were used to determine the primary causes of injury, as well as the injury region. Between the two fire departments, there were 914 firefighters included in the analysis. The median age was 40.7 years old with those aged 40–49 as the largest age group for injury cases (38.3%). The most frequently reported cause of injury was ‘overexertion and bodily reaction’ (n = 494; 54.1%). The most reported injury region was in ‘multiple body parts’ (n = 331; 36.3%). To prevent subsequent musculoskeletal disorders that may arise due to overexertion, initiatives that promote enhanced fitness and ergonomics based on an analysis of the physical demands of firefighting are suggested. Full article
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Article
Effects of Carrying Police Equipment on Spatiotemporal and Kinetic Gait Parameters in First Year Police Officers
Int. J. Environ. Res. Public Health 2020, 17(16), 5750; https://doi.org/10.3390/ijerph17165750 - 09 Aug 2020
Cited by 1 | Viewed by 937
Abstract
The main purpose of the study was to explore the effects of carrying police equipment on spatiotemporal and kinetic gait parameters. Two-hundred and seventy-five healthy men and women attending police academy (32% women) were randomly recruited. Gait analysis without and with a police [...] Read more.
The main purpose of the study was to explore the effects of carrying police equipment on spatiotemporal and kinetic gait parameters. Two-hundred and seventy-five healthy men and women attending police academy (32% women) were randomly recruited. Gait analysis without and with a police equipment load (≈3.5 kg) was analyzed using the Zebris pressure platform. Differences and effect sizes were calculated using a Student t-test and Wilcoxon test for dependent samples and Cohen’s D statistics. In both men and women, carrying police equipment significantly increased the foot rotation (effect size 0.13–0.25), step width (0.13–0.33), step time (0.25), stride time (0.13–0.25) and peak plantar pressure beneath the forefoot (0.16–0.30), midfoot (0.15–0.32) and hindfoot (0.13–0.25) region of the foot. Significant reductions in the step length (0.12–0.25), stride length (0.14–0.23), cadence (0.15–0.28) and walking speed (0.20–0.22) were observed in both sexes. Although significant, the effect sizes were mostly trivial in men and small in women. Our study shows significant changes in the spatiotemporal and kinetic gait parameters when carrying police equipment for both men and women. Although the effect sizes are trivial to small, carrying police equipment of ≈3.5 kg may have a negative impact on gait characteristics in first-year police officers. Full article
Article
Active Shooter Training Drill Increases Blood and Salivary Markers of Stress
Int. J. Environ. Res. Public Health 2020, 17(14), 5042; https://doi.org/10.3390/ijerph17145042 - 13 Jul 2020
Cited by 2 | Viewed by 1200
Abstract
Police officers are frequently engaged in a variety of high-stress scenarios, such as high-speed chases and other suspect conflicts, that cause significant increases in a variety of physiological and psychological stress markers. The purpose of this study was to investigate salivary and blood [...] Read more.
Police officers are frequently engaged in a variety of high-stress scenarios, such as high-speed chases and other suspect conflicts, that cause significant increases in a variety of physiological and psychological stress markers. The purpose of this study was to investigate salivary and blood markers of stress in response to an active shooter training drill (ASD). Thirty-one participants (n = 31; males = 15, females = 16; Age: 21 ± 3.5 years) participated in an ASD involving professional actors playing the role of one active gunman, as well as four victims. The ASD lasted approximately 50 s. Blood samples were collected 15 min prior as well as after the ASD and analyzed for epinephrine (EPI) and norepinephrine (NE) levels. Saliva samples were collected 30 and 5 min prior to the ASD and 5 and 30 min after the ASD, were analyzed for cortisol, α-amylase, and secretory immunoglobulin-A (SigA). The ASD resulted in significant (p < 0.05) increases in EPI, α-amylase, and SigA levels. The increase in NE from pre to post ASD approached significance (p = 0.06). These results demonstrate that a short duration (~50 s) ASD results in significant increases in both blood and salivary markers of stress. These data may provide meaningful implications for those engaged in high-stress tactical occupations, especially law enforcement and military personnel, as chronic exposure to such occupational stressors can contribute to cardiometabolic disease. Full article
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Review

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Review
The Cardiometabolic Health Benefits of Sauna Exposure in Individuals with High-Stress Occupations. A Mechanistic Review
Int. J. Environ. Res. Public Health 2021, 18(3), 1105; https://doi.org/10.3390/ijerph18031105 - 27 Jan 2021
Cited by 1 | Viewed by 3155
Abstract
Components of the metabolic syndrome (i.e., hypertension, insulin resistance, obesity, atherosclerosis) are a leading cause of death in the United States and result in low-grade chronic inflammation, excessive oxidative stress, and the eventual development of cardiometabolic diseases (CMD). High-stress occupations (HSO: firefighters, police, [...] Read more.
Components of the metabolic syndrome (i.e., hypertension, insulin resistance, obesity, atherosclerosis) are a leading cause of death in the United States and result in low-grade chronic inflammation, excessive oxidative stress, and the eventual development of cardiometabolic diseases (CMD). High-stress occupations (HSO: firefighters, police, military personnel, first responders, etc.) increase the risk of developing CMD because they expose individuals to chronic and multiple stressors (i.e., sleep deprivation, poor nutrition habits, lack of physical activity, psychological stress). Interestingly, heat exposure and, more specifically, sauna bathing have been shown to improve multiple markers of CMD, potentially acting as hormetic stressors, at the cellular level and in the whole organism. Therefore, sauna bathing might be a practical and alternative intervention for disease prevention for individuals with HSO. The purpose of this review is to detail the mechanisms and pathways involved in the response to both acute and chronic sauna bathing and collectively present sauna bathing as a potential treatment, in addition to current standard of care, for mitigating CMD to both clinicians and individuals serving in HSO. Full article
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Review
Wearable Stretch Sensors for Human Movement Monitoring and Fall Detection in Ergonomics
Int. J. Environ. Res. Public Health 2020, 17(10), 3554; https://doi.org/10.3390/ijerph17103554 - 19 May 2020
Cited by 16 | Viewed by 2714
Abstract
Wearable sensors are beneficial for continuous health monitoring, movement analysis, rehabilitation, evaluation of human performance, and for fall detection. Wearable stretch sensors are increasingly being used for human movement monitoring. Additionally, falls are one of the leading causes of both fatal and nonfatal [...] Read more.
Wearable sensors are beneficial for continuous health monitoring, movement analysis, rehabilitation, evaluation of human performance, and for fall detection. Wearable stretch sensors are increasingly being used for human movement monitoring. Additionally, falls are one of the leading causes of both fatal and nonfatal injuries in the workplace. The use of wearable technology in the workplace could be a successful solution for human movement monitoring and fall detection, especially for high fall-risk occupations. This paper provides an in-depth review of different wearable stretch sensors and summarizes the need for wearable technology in the field of ergonomics and the current wearable devices used for fall detection. Additionally, the paper proposes the use of soft-robotic-stretch (SRS) sensors for human movement monitoring and fall detection. This paper also recapitulates the findings of a series of five published manuscripts from ongoing research that are published as Parts I to V of “Closing the Wearable Gap” journal articles that discuss the design and development of a foot and ankle wearable device using SRS sensors that can be used for fall detection. The use of SRS sensors in fall detection, its current limitations, and challenges for adoption in human factors and ergonomics are also discussed. Full article
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Other

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Protocol
Study Protocol for a Qualitative Research Project Exploring an Occupational Health Surveillance Model for Workers Exposed to Hand-Intensive Work
Int. J. Environ. Res. Public Health 2020, 17(17), 6400; https://doi.org/10.3390/ijerph17176400 - 02 Sep 2020
Cited by 3 | Viewed by 974
Abstract
The objective of this study protocol is to describe the development of a process model for occupational health surveillance for workers exposed to hand-intensive work (the HIW-model), and to describe the studies that will explore the model. The studies are designed to: (1) [...] Read more.
The objective of this study protocol is to describe the development of a process model for occupational health surveillance for workers exposed to hand-intensive work (the HIW-model), and to describe the studies that will explore the model. The studies are designed to: (1) explore stakeholders’ experiences of the model, and (2) explore if, and how, the model affects actions for reduction of exposure to hand-intensive work. The study protocol presents a research project that is described as two studies. The first study will explore company representatives’ and ergonomists’ experiences of the execution of the HIW-model and its various components concerning feasibility and values. Semi-structured interviews will constitute the data source. The second study will explore whether the execution of the HIW-model leads to work environmental changes, such as actions for reduction of exposure to hand-intensive work, and whether these potential actions are based on the ergonomist’s feedback of the exposure assessment and the medical health checks. A mixed method approach will be applied, in which the data sources will be comprised of semi-structured interviews, questionnaires, and documents. The project is expected to generate knowledge regarding the values of the HIW-model. The project is anticipated to shed light on factors that facilitate or impede execution of the model from the different stakeholders’ perspectives; the employer’s as having the legal responsibility for the work environment, and the occupational health service consultants’, being the work environment experts supporting the employers. Full article
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