In the next three years we will be holding a series of workshops with potential topics including; “Research to Practice: How to get the best evidence into the hands of workplace parties” which would be aimed a general audience, “Threshold Limit Values for Mechanical Exposures; Evidence and Utility” for a more technically oriented audience such as ergonomists and health and safety professionals, and “Communication between ergonomists, workers, workplaces and return to work specialists: tools and procedures" for those involved with return to work activities. As usual we will be drawing on expertise from our researcher network, our research partners and experts nationally and internationally.
The Six Question Initiative (6QI): Stakeholder Workshops
This year, CRE-MSD launched its 6Q1, an innovative approach to establish research and collaborative priorities for tackling the seemingly intractable issue of: Why have we have not solved the MSD problem?” The 6Q1 is based on six cascading questions, each of which, if it is not being approached correctly, may be the key to why we have not solved the MSD problem.
To make sure that we are on track, in June and July 2009, we held a number of stakeholder workshops to get feedback from the multiple groups that have an invested interest in our research on the relevance and usefulness of the questions we are asking. We held groups with health and safety consultants, organized labour, employer representatives, and managers and directors from the Workplace Safety and Insurance Board (WSIB).
We focused on the three questions that make up CRE-MSD’s focused research agenda:
1. How effective and informative are current workplace MSD assessment approaches?
2. How effective are the recommended interventions in actually reducing MSDs in the workplace?
3. How intensely and widely implemented are workplace interventions to prevent MSD?
The common themes that emerged from the workshops were:
- There is limited awareness of MSDs. Training on MSDs is inadequate.
- Everyone, including researchers, is doing a reasonable job on identifying the immediate physical changes that are needed.
- Workplace organization and work culture are critical to the frequency and duration of disabilities from MSDs and are rarely if ever dealt with.
- There are no good metrics for measuring the success of interventions.
Here are some of the highlights from the workshops:
WSIB Directors and Managers
Health and Safety Professionals
WSIB Directors and Managers
The workshop with WSIB managers and directors was organized by Susan Fuciarelli, Director, Disability Prevention Branch, WSIB. Represented at this table was Program Delivery, the Innovation Group from the Prevention Division, the Workwell Prevention Division, the Disability Prevention Branch from the Prevention Division, and the Kitchener, Hamilton and Toronto Delivery Divisions.
When asked whether the assessment approaches that are available are effective, the group was not very positive. They thought that new tools were needed, that would help identify leading indicators instead of relying on lagging indicators like claims.
When asked whether they thought interventions were reducing MSDs, the group came up with some success stories, but they were few and far between. They said that although many employers have modified their work ghettos (areas that have high MSD injuries), they have not solved the root cause of the problems. MSDs are not on the table for most workplaces and are not being considered at the design stage. They also noted that there is no structural follow-up to find out if an intervention was effective, so there is no way for them to actually know.
When asked whether workplace interventions to prevent MSD are intensely and widely implemented, the group thought that although health and safety was on the radar of some companies, very little primary prevention is taking place. Medium and large companies were more likely doing something, but smaller companies are less likely to be doing anything because they don’t have either the resources or education. So far, WSIB incentive programmes have not been very successful.
When asked what they thought were the major barriers to solving the MSD problem, the major issue they identified was lack of awareness: “MSDs are invisible and we need to make them visible.” Workplace culture was identified as a major barrier, and employers have to be held accountable. It is important to embed MSDs in the management system; MSDs are part of an integrated H&S process and should be treated that way. It is dangerous to consider the issue of the physical environment alone – without regard to the psychosocial or cultural factors. Psychosocial factors include the workers relationships with their supervisors; the safety culture; the individual attitudes and behavior; their job satisfaction; leadership and communication. Yet, if you include psychosocial factors in a report, they are ignored or definitely resisted. It is necessary to consider job satisfaction and employer/employee relationships. Education and awareness are critical and to this end, you should include unions in the training. Back to top
The organized labour workshop was organized by Keith McMillan, National Representative, Health & Safety Ontario Region, Communications, Energy and Papersworkers Union of Canada (CEP). At the table were also representatives from the United Steelworkers, Ontario Public Employees Union (OPSEU), the Canadian Union of Public Employees (CUPE), the Ontario Nurses Association (ONA), the Occupational Health Clinic for Ontario Workers (OHCOW), and RSI Canada’s injured worker group.
Their opinion on current MSD risk/assessment tools was that they thought there was a significant absence of proper tools, measures and processes to assess hazards; that the ones that exist are difficult and not very effective because no one knows how to use them, and that there is a real need for sector-specific tools. They said that the technological changes were important, but they need to be twinned with training, practice and policy to make them work and be effective. They did think that check-lists would be helpful if they came with more training about MSDs.
When asked whether workplace interventions to prevent MSD are intensely and widely implemented, they said they believed that very few workplaces were making changes; that they could actually list the ones that were.
When asked what they thought the major barrier was to solving the MSD problem, the group identified the lack of awareness of MSDs as the major issue. They said that Health and Safety should not be an add-on but imbedded in design and planning activities; that finding the root cause of the problem is critical. They noted that if the change affected the work process there was usually resistance on the part of employer. Work-organizational issues will usually involve workplace power relationships, and these relationships will determine the possibilities or limits to change. Most workers will not speak up (especially if they are part time or temporary workers) about MSDs because they are afraid of being fired or losing their jobs; the workers need the money too much. They also thought that regulations and enforcement are critical; that JHSC need to be empowered to address problems; and that interventions will fail if there is no supportive training.
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The employer workshop was organized by Michelle Morrissey-O’Ryan, Vice President, Construction, at Hydro One, and Roland Hosein, Vice President, Environment Health and Safety, GE Canada. At the table were also representatives from Toronto Hydro, Hydro One, Canadian Vehicle Manufacturers, IBM, CAMCO, REA, Dofasco, and Ontario Power Generation.
Their opinion on the effectiveness of hazard assessment tools was that there were problems with many of the ergonomic recommendations; that they rested on slim evidence and hence should not be treated as “gospel”. There is too strong an emphasis on physical hazards, and that focus is inadequate. MSD assessments also need to be part of a larger process, and part of the larger health and safety picture.
When asked whether workplace interventions to prevent MSD are intensely and widely implemented, they though that the implementation was restricted to a select group of large employers that have the resources. More information is needed at every level to give guidance. They wanted to know what the risk factors are in individual sectors and subsectors.
Their opinion as to the major barriers to solving the MSD problem was that the distinction between work and non-work is artificial, and workers bring their problems from home into the workplace. They thought the literacy on ergonomics was sorely lacking and awareness was a major issue. The leadership and workplace culture needed to change. They wanted to know about the relationship between MSDs and psychosocial factors. An idea that gained a lot of support was that the word, “disability”, needs to be reframed as “MSD health”.
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Health and Safety Professionals
The OHS group was made up of ergonomists from the WSIB, the Ministry of Labour and the Institute for Work & Health, and consultants from the health and safety associations including: Health Care, Construction, Industrial Accident Prevention Association, and Electrical & Utilities.
Their opinion on the effectiveness of hazard assessment tools was: The ability to identify physical risks is good and there is now sufficient knowledge on how to reduce physical risks. But there is a need for more training about MSDs and the assessment tools – especially for members of JHSCs. Another major issues is that a reduction in MSDs is only a lagging indicator which are hard to attribute to any specific practice, and there is a lack of good tools to assess organizational risks, together with a lack of good measures of success.
Their opinion as to the major barrier to solving the MSD problem was that there is a real problem with awareness, because MSD injuries are not immediately obvious and develop over time. There is also an excessive focus on changes to the physical nature of work – to the exclusion of psychosocial factors. They thought that many of the problems are not restricted to MSDs, and that reducing MSDs requires planning for physical, psychosocial and cultural change. You need to encourage a safety culture that is appropriate for all hazards.
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