Developing a Work Accommodation Operating Model for Workplaces and Work Ability Support Services.

PURPOSE: Workplace accommodation can help employees with disabilities remain employed or access employment rather than leave the labor force. However, the workplace accommodation process is still poorly understood and documented. AIM: The aim of this study was to develop a national operating model to make workplace accommodation interactive and procedural for workplaces and work ability support services and lower the threshold to making accommodations. METHODS: The collaborative development process was carried out by a multiprofessional expert team with eleven workplaces in the private and public sectors in Finland. The design of this study was conceptual and developmental. The development process of the operating model consisted of four phases: the orientation phase, the joint planning phase, the implementation advancement phase, and the instilling phase. RESULTS: The operating model has six stages: 1) identifying needs, 2) gathering knowledge, 3) exploring alternatives, 4) selecting solutions, 5) implementing solutions, and 6) monitoring and evaluating. The model defines the actions, roles, and responsibilities for each phase. To help implement the model, we published an information package, a guide, a planning formula, and a video animation in Finnish and Swedish. CONCLUSION: The operating model is a tool that workplaces and work ability support services can use to help working-aged people remain employed or access employment. Future studies should determine the workplace-specific functionality of this model using implementation research.

'Return to Work' Coordinator Model and Work Participation of Employees: A Natural Intervention Study in Finland.

Purpose Employers increasingly use 'return to work' (RTW) coordinators to support work ability and extend working careers, particularly among employees with reduced work ability. We examined whether applying this model was associated with changes in employee sickness absence and disability retirements. Methods We used data from the Finnish Public Sector study from 2009 until 2015. Employees where the model was introduced in 2012 constituted the cases (n = 4120, one municipality) and employees where the model was not in use during the follow-up, represented the controls (n = 5600, two municipalities). We analysed risk of disability retirement in 2013-2015 and risk of sickness absence after (2013-2015) vs. before (2009-2011) intervention by case-control status. Results The incidence of disability retirement after the intervention was lower in cases compared to controls both in the total population (hazard ratio HR = 0.49, 95% CI 0.30-0.79) and in the subgroup of participants with reduced work ability (HR = 0.34, 95% CI 0.12-0.99). The risk of sickness absence increased from pre-intervention to post-intervention period both among cases and controls although the relative increase was greater among cases (RRpost- vs. pre-intervention = 1.26, 95% CI 1.14-1.40) than controls (RRpost- vs. pre-intervention = 1.03, 95% CI 0.97-1.08). In the group of employees with reduced work ability, no difference in sickness absence trends between cases and controls was observed. Conclusions These findings suggest that RTW-coordinator model may increase employee sickness absence, but decrease the risk of disability retirement, i.e., permanent exclusion from the labour market.

Validity of long-term and short-term recall of occupational sitting time in Finnish and Chinese office workers.

BACKGROUND: As sedentary behavior is a global health issue, there is a need for methods of self-reported sitting assessment. The accuracy and reliability of these methods should also be tested in various populations and different cultural contexts. This study examined the validity of long-term and short-term recall of occupational sitting time in Finnish and Chinese subgroups. METHODS: Two cohort groups of office-based workers (58.6% female, age range 22-67 years) participated: a Finnish group (FIN, n = 34) and a Chinese group (CHI, n = 36). Long-term (past 3-month sitting) and short-term (daily sitting assessed on 5 consecutive days) single-item measures were used to assess self-reported occupational sitting time. Values from each participant were compared to objectively measured occupational sitting time assessed via thigh-mounted accelerometers, with Spearman's rho (ρ) used to assess validity and the Bland-Altman method used to evaluate agreement. Coefficients of variation depicted day-to-day variability of time spent on sitting at work. RESULTS: In the total study sample, the results showed that both long-term and short-term recall correlated with accelerometer-derived sitting time (ρ = 0.532, 95% confidence intervals (CI): 0.336-0.684, p< 0.001; ρ = 0.533, 95%CI: 0.449-0.607, p< 0.001, respectively). Compared to objectively measured sitting time, self-reported occupational sitting time was 2.4% (95%CI: -0.5% to 5.3%, p = 0.091) and 2.2% (95%CI: 0.7%-3.6%, p = 0.005) greater for long-term and short-term recall, respectively. The agreement level was within the range -21.2% to 25.9% for long-term recall, and -24.2% to 28.5% for short-term recall. During a 5-day work week, day-to-day variation of sitting time was 9.4% ± 11.4% according to short-term recall and 10.4% ± 8.4% according to accelerometry-derived occupational sitting time. CONCLUSION: Overall, both long-term and short-term self-reported instruments provide acceptable measures of occupational sitting time in an office-based workplace, but their utility at the individual level is limited due to large variability.

The Effectiveness of Rehabilitation Interventions on the Employment and Functioning of People with Intellectual Disabilities: A Systematic Review.

Purpose This systematic review analyzed the effectiveness of rehabilitation interventions on the employment and functioning of people with intellectual disabilities (ID), as well as barriers and facilitators of employment. Methods This was a systematic review of quantitative, qualitative, and mixed methods studies. The outcomes were employment, transition to the open labor market and functioning. The review included qualitative studies of employment barriers and facilitators. The population comprised people with ID aged 16-68 years. Peer-reviewed articles published in English between January 1990 and February 2019 were obtained from the databases Cinahl, the Cochrane Library, Embase, Eric, Medic, Medline, OTseeker, Pedro, PsycInfo, PubMed, Socindex, and the Web of Science. We also searched Google Scholar and Base. The modified selection instrument (PIOS: participants, intervention, outcome, and study design) used in the selection of the articles depended on the selection criteria. Results Ten quantitative (one randomized controlled, one concurrently controlled, and eight cohort studies), six qualitative studies, one multimethod study, and 21 case studies met the inclusion criteria. The quantitative studies showed that secondary education increases employment among people with ID when it includes work experience and personal support services. Supported employment also increased employment in the open labor market, which sheltered work did not. The barriers to employment were the use of sheltered work, discrimination in vocational experience, the use of class teaching, and deficient work experience while still at school. The facilitators of employment were one's own activity, the support of one's family, job coaching, a well-designed work environment, appreciation of one's work, support form one's employer and work organization, knowledge and experience of employment during secondary education, and for entrepreneurs, the use of a support person. Conclusions The employment of people with ID can be improved through secondary education including proper teaching methods and personal support services, the use of supported work, workplace accommodations and support from one's family and employer. These results can be utilized in the development of rehabilitation, education, and the employment of people with ID, to allow them the opportunity to work in the open labor market and participate in society.

Dilemmatic group memberships of hard-of-hearing employees during the process of acquiring and adapting to the use of hearing aids.

We describe how hard-of-hearing (HOH) employees renegotiate both their existing and new group memberships when they acquire and begin to use hearing aids (HAs). Our research setting was longitudinal and we carried out a theory-informed qualitative analysis of multiple qualitative data. When an individual discovers that they have a hearing problem and acquire a HA, their group memberships undergo change. First, HOH employees need to start negotiating their relationship with the HOH group. Second, they need to consider whether they see themselves as members of the disabled or the nondisabled employee group. This negotiation tends to be context-bound, situational, and nonlinear as a process, involving a back-and-forth movement in the way in which HOH employees value different group memberships. The dilemmatic negotiation of new group memberships and the other social aspects involved in HA rehabilitation tend to remain invisible to rehabilitation professionals, occupational healthcare, and employers.

Effects of environmental intervention on sedentary time, musculoskeletal comfort and work ability in office workers.

Sit-stand workstations offer a potential strategy to reduce prolonged occupational sitting. This controlled intervention study examined the effects of an environmental intervention on occupational sedentary time, musculoskeletal comfort and work ability, and the usability of sit-stand workstations in office work via a self-reported questionnaire. The intervention group (n = 24) used sit-stand workstations during the 6-month intervention period, and the control group (n = 21) used traditional sitting workstations. The results showed that working at sit-stand workstations can reduce sitting time significantly compared to control workstations (-6.7% vs. 5.0%, p = .019), which is reallocated mostly to standing (r = -0.719, p < .001). Sit-stand workstations improved perceived musculoskeletal comfort in the neck and shoulders (p = .028), as well as work ability (p = .022). The majority of intervention subjects rated sit-stand workstation adjustability as good (83.3%), and 75.0% were satisfied with the workstation. About 41.7% of the intervention participants, who were exclusively female, used the sit-stand function on a daily basis. While the environmental change alone was effective, it is likely that promoting the daily use of sit-stand workstations with counselling would lead to even more substantial positive effects.

User-oriented evaluation of mechanical single-channel axial pipettes.

Hand tools should be designed so that they are comfortable to use, fit the hand and are user-oriented. Six different manual, single-channel axial pipettes were evaluated for such objective outcomes as muscular activity, wrist postures and efficiency, as well as for subjective outcomes concerning self-assessed features of pipette usability and musculoskeletal strain. Ten experienced laboratory employees volunteered for the study. The results showed that light and short pipettes with better tool comfort resulted in reduced muscular activity and perceived musculoskeletal strain when they were compared with a long and heavy pipette. There were no differences in the efficiency between the different pipettes. Combining both the objective and subjective measures enabled a broader evaluation of product usability. The results of this study can be used both in product development and as information on which to base the purchase of new pipettes for laboratory work.

Effects of vocationally oriented medical rehabilitation for aircraft maintenance personnel--a preliminary study of long-term effects with 5-year follow-up.

Changes in the physical capacity, musculoskeletal symptoms, and perceived work ability of Finnish Air Force maintenance personnel were studied after vocationally oriented medical rehabilitation (VOMR). Twenty persons with chronic musculoskeletal symptoms in their back or neck took part in VOMR courses. The measurements were carried out at the beginning of the rehabilitation course and after two follow-up periods (0.5 and 5 years). The subjects worked most of the time in a bent position and often with their backs twisted and their arms above their shoulders. The severity of low-back pain and the number of days of sick leave decreased significantly (p < 0.05-0.01) during the 5-years follow-up. Also the exercise breaks at work increased (p < 0.01). After half a year of medical rehabilitation the measured range of the cervical spine and the dynamic and endurance strength of the upper and lower extremities was greater (p < 0.05-0.001) than at the beginning of the rehabilitation. There were no statistically significant differences in the use of physical therapy, experienced work strain, physical exercise or maximal oxygen consumption during the follow-up. This is a preliminary follow-up study lasting 5 years showed some significant changes in physical capacity, musculoskeletal symptoms and work ability. However, controlled studies are needed to evaluate these preliminary findings of this kind of rehabilitation model.

Reducing the physical work load and strain of personal helpers through clothing redesign.

This study assessed the effects of redesigning clients' clothing on the physical work load and strain of personal helpers. Five women, aged 18-54 years, who helped persons with physical disabilities were measured at their worksites before and after development of the clothes worn by clients. The physical work load and strain of the helpers' dressing/undressing of clients were determined from their hand and back movements, work time, muscular activity, heart rate (HR), percentage of heart rate range (%HRR), and rating of perceived exertion (RPE). The muscular activity of the right (p=0.05) and left (p=0.02) trapezius muscles, HR (p=0.03), and %HRR (p=0.03) of the helpers were lower when the new outerwear was used in place of traditional outerwear. Four helpers reported lower perceived exertion, and three had shorter work time with the new outerwear. This study showed that redesigning clients' clothing can help reduce the physical work load and strain of personal helpers.