Outcomes for facilitators of workplace environment improvement applying a participatory approach.

OBJECTIVES: The purpose of this study was to determine changes in awareness, behavior, and relationships among facilitators who were involved in facilitating the conduct of the participatory workplace improvement program and to examine the facilitators' outcomes as a result of their active involvement in the program. The outcome components were also examined in relationship to their associations with various factors. METHODS: An anonymous self-administered questionnaire survey was conducted for 83 facilitators. Exploratory factor analysis was applied to determine the facilitators' outcomes. The relationship between those elements which influenced the outcomes was taken into account by means of hierarchal multiple regression analysis. RESULTS: The outcomes for facilitators consisted of four sub-concepts: "knowing practical ways and strategies to ensure full participation," "building confidence and self-development," "improving safety and health-risk sensitivity," and "gaining better-than-expected results based on developing relationships with workers." According to the results of hierarchal multiple regression analysis, facilitators' outcomes were significantly associated with the realization of creativity, sense of solution for safety and health issues, and facilitators' involvement. CONCLUSIONS: It is suggested that the role of a facilitator dynamically changes through a participatory workplace improvement program as a key person in the workplace. Supporting acting facilitators' initiatives in the process of workplace improvement programs, as well as promoting the active involvement of workers and managers were considered useful for effective implementation of workplace improvement programs.

Association of socioeconomic and lifestyle-related risk factors with mental health conditions: a cross-sectional study.

BACKGROUND: There is rising public concern over the widening health inequalities in many countries. The aim of this study was to clarify the associations of socioeconomic status (SES)-related variables, such as levels of household disposable income and employment status, and lifestyle factors with mental health conditions among Japanese adults aged 40 to 69. METHODS: A cross-sectional study of 3085 participants (1527 males and 1558 females) was undertaken by using a self-administered questionnaire that included the Japanese version of the 12-item General Health Questionnaire (GHQ-12) and questions related to socioeconomic and lifestyle factors. RESULTS: The prevalence of poor mental health conditions, represented by a GHQ-12 score of 4 or more, was 33.4% among males and 40.4% among females. Males whose annual household disposable income was less than 2 million yen had significantly higher GHQ-12 scores than those with an annual household disposable income above 2 million yen. As per binary logistic regression analyses, short sleep duration and the absence of physical exercise were significantly related to poor mental health conditions among both males and females. Among females, a household disposable income of less than 2 million yen could be a risk factor for poor mental health conditions. Age and habitual drinking were inversely associated with poor mental health conditions. CONCLUSIONS: Low levels of household disposable income and unhealthy lifestyle factors were significantly associated with mental health conditions. These results suggest the importance of improving unhealthy lifestyle behaviours and developing effective health promotion programmes. In addition, there is a need for social security systems for people from different socioeconomic backgrounds.

Findings of the Work Improvement on Board (WIB) programme by the Fishery Agency in Japan.

BACKGROUND: Concerns are growing about the safety and health of seamen exposed to high risks while working on vessels. Their accident rate in 2013 was 9.9 per 1000 workers, 5 times higher than that in industry. In order to mitigate the risks of seamen, we developed the Work Improvement on Board (WIB) programme by applying participatory action-oriented training (PAOT) methods that have proven effective for reducing work-related risks in small enterprises, construction sites, and agriculture. MATERIALS AND METHODS: We analysed which features of the WIB programme would be most effective for facilitating the planning and implementation of practical improvements on vessels. We examined action -oriented tools used, including a WIB action checklist and good examples, and practical improvements proposed by the participants in 1-day or half-day WIB workshops. To study the effectiveness of the WIB programme, we analysed 1121 replies of a questionnaire distributed to 1459 participants of the programme. We compared the types of improvements achieved and the improvement costs in the WIB programme with those in other PAOT programmes. The impact of the WIB programme on promoting primary prevention by seamen and fishermen was discussed. RESULTS: The action checklist listing practical improvements on board and good example photos apparently facilitated the planning and implementation of improvements feasible on board. The participating crews could propose readily applicable improvements of their vessels within short time. In the case of workshops held in 10 harbours between August and October 2014, participants coming from 110 vessels presented 228 improvement proposals which were mostly feasible at low cost. Among the 1121 questionnaire replies from participants of the WIB programme, over 75% evaluated the programme as necessary, practical and easy-to-understand. These positive results led to the adoption of the WIB programme for training fishermen and seamen on commercial vessels by the Fishery Agency and the Ministry of Land, Infrastructure, Transport and Tourism. The Fishery Agency adopted plans to improve the working environment on fishing vessels by training 500 fishermen per year in the WIB programme from 2013 to 2018. CONCLUSIONS: The participatory work improvement programme can work in vessels when it utilises in a flexible manner local good practices and low-cost improvements as guides. The use of action-oriented tools such as a WIB action checklist and good examples seems important. We recommend the wide use of WIB methods in occupational safety and health management systems on board vessels in Japan and other countries.

Utility of action checklists as a consensus building tool.

The present study's objective was to determine the mechanisms for enhancing the utility of action checklists applied in participatory approach programs for workplace improvements, to identify the benefits of building consensus and to compare their applicability in Asian countries to find the most appropriate configuration for action checklists. Data were collected from eight trainees and 43 trainers with experience in Participatory Action-Oriented Training. Statistical analysis was performed in SPSS using the package PASW, version 19.0. The difference in the mean score for the degree of the utility of action checklists between countries was analyzed using ANOVA methods. Factor analysis was performed to validate the action checklists' utility. Pearson Correlation Coefficients were then calculated to determine the direction and strength of the relationship between these factors. Using responses obtained from trainees' in-depth interviews, we identified 33 key statements that were then classified into 11 thematic clusters. Five factors were extracted, namely "ease of application", "practical solutions", "group interaction", "multifaceted perspective" and "active involvement". The action checklist was useful for facilitating a participatory process among trainees and trainers for improving working conditions. Action checklists showed similar patterns of utility in various Asian countries; particularly when adjusted to local conditions.

Practical ways to facilitate ergonomics improvements in occupational health practice.

OBJECTIVE: Recent advances in participatory programs for improving workplace conditions are discussed to examine practical ways to facilitate ergonomics improvements. BACKGROUND: Participatory training programs are gaining importance, particularly in promoting occupational health and safety in small-scale workplaces. These programs have led to many improvements that can reduce work-related risks in varied situations. MATERIALS: Recent experiences in participatory action-oriented training programs in small workplaces and agriculture are reviewed.The emphasis of the review is on training steps, types of improvements achieved, and the use of action tools by trainers and training participants. RESULTS: Immediate improvements in multiple technical areas are targeted, including materials handling,workstation design, physical environment, welfare facilities, and work organization. In facilitating ergonomics improvements in each local situation, it is important to focus on (a) building on local good practices; (b) applying practical, simple improvements that apply the basic principles of ergonomics; and (c) developing action-oriented toolkits for direct use by workers and managers. This facilitation process is effective when locally designed action toolkits are used by trainers, including local good examples, action checklists, and illustrated how-to guides. Intervention studies demonstrate the effectiveness of participatory steps that use these toolkits in promoting good practices and reducing work-related risks. CONCLUSION: In facilitating ergonomics improvements in small-scale workplaces, it is important to focus on practical, low-cost improvements that build on local good practices. The use of action-oriented toolkits reflecting basic ergonomics principles is helpful.The promotion of the intercountry networking of positive experiences in participatory training is suggested.

Roles of Participatory Action-oriented Programs in Promoting Safety and Health at Work

Reflecting the current international trends toward proactive risk assessment and control at work with practical procedures, participatory action-oriented approaches are gaining importance in various sectors. The roles of these approaches in promoting the safety and health at work are discussed based on their recent experiences in preventing work-related risks and improving the quality of work life, particularly in small-scale workplaces. The emphasis placed on the primary prevention at the initiative of workers and managers is commonly notable. Participatory steps, built on local good practices, can lead to many workplace improvements when the focus is on locally feasible low-cost options in multiple aspects. The design and use of locally adjusted action toolkits play a key role in facilitating these improvements in each local situation. The effectiveness of participatory approaches relying on these toolkits is demonstrated by their spread to many sectors and by various intervention studies. In the local context, networks of trainers are essential in sustaining the improvement activities. With the adequate support of networks of trainers trained in the use of these toolkits, participatory approaches will continue to be the key factor for proactive risk management in various work settings.

Prevalence of self-reported finger deformations and occupational risk factors among professional cooks: a cross-sectional study.

BACKGROUND: Previous studies have pointed out that the school lunch workers in Japan are suffering from work-related disorders including finger deformations. The purpose of this study was to investigate the prevalence of self-reported finger deformations and the association with job-related risk factors. METHODS: A cross-sectional questionnaire study of 5,719 subjects (response rate: 81%, 982 men and 4,737 women) was undertaken during September 2003 to February 2004. RESULTS: Finger deformations were found among 11.7% of the men and 35.6% of the women studied, with significant differences among sex, age and sex-age groups. For both men and women the pattern of finger deformations across the hand was similar for the right and the left hand. For women, the deformations were found in about 10% of the distal interphalangeal joints of all fingers. Based on multiple logistic regression analyses, the factors female sex, age, the number of cooked lunches per cook and cooking activities were independently associated with the prevalence of finger deformations. High prevalence odds ratios were found for those frequently carrying or using tools by hands such as delivering containers, distributing meals, preparing dishes, washing equipment, cutting and stirring foods. CONCLUSIONS: Among the school lunch workers studied, women had a higher prevalence of finger deformations on all joints of both hands. Various cooking tasks were associated with the prevalence of finger deformations. The results suggest that improvements in working conditions are important for preventing work-related disorders such as finger deformations.

Considerations of circadian impact for defining 'shift work' in cancer studies: IARC Working Group Report.

Based on the idea that electric light at night might account for a portion of the high and rising risk of breast cancer worldwide, it was predicted long ago that women working a non-day shift would be at higher risk compared with day-working women. This hypothesis has been extended more recently to prostate cancer. On the basis of limited human evidence and sufficient evidence in experimental animals, in 2007 the International Agency for Research on Cancer (IARC) classified 'shift work that involves circadian disruption' as a probable human carcinogen, group 2A. A limitation of the epidemiological studies carried out to date is in the definition of 'shift work.' IARC convened a workshop in April 2009 to consider how 'shift work' should be assessed and what domains of occupational history need to be quantified for more valid studies of shift work and cancer in the future. The working group identified several major domains of non-day shifts and shift schedules that should be captured in future studies: (1) shift system (start time of shift, number of hours per day, rotating or permanent, speed and direction of a rotating system, regular or irregular); (2) years on a particular non-day shift schedule (and cumulative exposure to the shift system over the subject's working life); and (3) shift intensity (time off between successive work days on the shift schedule). The group also recognised that for further domains to be identified, more research needs to be conducted on the impact of various shift schedules and routines on physiological and circadian rhythms of workers in real-world environments.

Participatory intervention for workplace improvements on mental health and job performance among blue-collar workers: a cluster randomized controlled trial.

OBJECTIVE: To explore the effect of participatory intervention for workplace improvement on mental health and job performance. METHODS: Eleven assembly lines were randomly allocated to six intervention and five control lines (47 and 50 workers, respectively). The primary outcome was defined as the improvement in the following measures during the intervention period: General Health Questionnaire and WHO Health and Work Performance Questionnaire. RESULTS: General Health Questionnaire scores significantly deteriorated in the control lines, whereas the score remained at the same level in the intervention lines. Health and Work Performance Questionnaire scores increased in the intervention lines, but decreased in the control lines, yielding a significant intervention effect (P = 0.048). CONCLUSION: It is suggested that the participatory intervention for workplace improvement is effective against deterioration in mental health and for improving job performance.

Participatory support to farmers in improving safety and health at work: building WIND farmer volunteer networks in Viet Nam.

The government of Viet Nam places a high priority on upgrading the quality of farmers' lives. Providing adequate occupational safety and health (OSH) protection for all farmers is an important challenge. The Ministry of Labour, Invalids and Social Affairs (MOLISA) of Viet Nam trained WIND (Work Improvement in Neighbourhood Development) farmer volunteers. From 2004-2007, MOLISA in cooperation with ministries of health and agriculture trained 480 WIND farmer volunteers in selected 14 provinces. Trained farmer volunteers trained their neighbouring farmers and expanded their networks. The WIND training programme produced in Cantho, Viet Nam in 1996, was used as the core training methodology. The WIND action-checklist, good example photo-sheets, and other participatory training materials were designed for WIND farmer volunteers as practical training tools. The volunteers trained 7,922 farmers. The trained farmers implemented 28,508 improvements in materials handling, work posture, machine and electrical safety, working environments and control of hazardous chemicals, and welfare facilities. The provincial support committees organized follow-up workshops and strengthen the WIND farmer volunteer networks. The system of WIND farmer volunteers proved effective in extending practical OSH protection measures to farmers at grassroots level. The system of WIND farmer volunteers was adopted in the First National Programme on Labour Protection and OSH of Viet Nam as a practical means in OSH and is now further expanding within the framework of the National Programme.

Facilitating participatory steps for planning and implementing low-cost improvements in small workplaces.

In this paper, practical means of facilitating participatory steps taken in workplace improvement programs in small workplaces were reviewed. The reviewed programs included those organized by partners of our Asian inter-country network for small enterprises, construction sites, home workplaces and agricultural farms. Trainers who commonly acted as facilitators were found to play multiple roles in helping managers, workers and farmers take initiative and achieve immediate improvements. The participatory steps were more successfully facilitated when the trainers supported (a) building on local good practice, (b) focusing on a range of basic ergonomics principles, and (c) stepwise progress through feedback of achievements. The use of action-oriented toolkits comprising low-cost action checklists and group work guides was commonly helpful. The locally adjusted nature of the toolkits seemed essential. Trainers could thus help people build local initiative, plan and implement low-cost ideas through serial group work steps and confirm benefits in a stepwise manner. The review of the results suggested that a local network of trainers trained in the use of locally adjusted toolkits was vital for facilitating effective improvements in different small workplaces.

Development of a mental health action checklist for improving workplace environment as means of job stress prevention.

An action checklist for improving the workplace environment by means of enhancing mental health of workers (Mental Health Action Check List: MHACL) was developed. The use of the checklist for primary prevention was examined. MHACL was developed through three steps: (1) Review of related references and collection of improvement examples for designing a draft MHACL; (2) pilot application of the draft at industrial workplaces and trials at workshops of occupational health staff; and (3) proposing a new MHACL for general use in industry. Workplace improvement actions related to mental health were listed in eight technical areas. From 84 workplaces in Japan, 201 such actions were collected. Typical improvement action phrases were extracted based on these examples, and a draft MHACL containing 40 generally applicable actions were prepared. This draft was applied to selected workplaces for its use as a tool for group discussion. Then, the utility of the checklist was discussed by 105 occupational health staff working in public service offices. The workshop suggested modifications of the draft MHACL including improved check items and usage procedures and the need to use easy-to-understand actions. The final version of the MHACL comprised 30 items in six technical areas: A) sharing work planning, B) work time and organization, C) ergonomic work methods, D) workplace environment, E) mutual support in the workplace, and F) preparedness and care. A new action checklist was proposed for use as a means of changing existing workplace environments and proposing practical actions for improving it. The checklist was confirmed to be useful for organizing workplace-level discussion for identifying immediate improvements at the workplace. The checklist is expected to be widely applied for promoting primary prevention measures in terms of better mental health.

Action-oriented use of ergonomic checkpoints for healthy work design in different settings.

Recent experiences in the action-oriented use of ergonomic checkpoints in different work settings are reviewed. The purpose is to know what features are useful for healthy work design adjusted to each local situation. Based on the review results, common features of ergonomic checkpoints used in participatory training programs for improving workplace conditions in small enterprises, construction sites, home work and agriculture in industrially developing countries in Asia are discussed. These checkpoints generally compile practical improvement options in a broad range of technical areas, such as materials handling, workstation design, physical environment and work organization. Usually, "action checklists" comprising the tiles of the checkpoints are used together. A clear focus is placed on readily applicable low-cost options. Three common features of these various checkpoints appear to be important. First, the checkpoints represent typical good practices in multiple areas. Second, each how-to section of these checkpoints presents simple improvements reflecting basic ergonomic principles. Examples of these principles include easy reach, fewer and faster transport, elbow-level work, coded displays, isolated or screened hazards and shared teamwork. Third, the illustrated checkpoints accompanied by corresponding checklists are used as group work tools in short-term training courses. Many practical improvements achieved are displayed in websites for inter-country work improvement networks. It is suggested to promote the use of locally adjusted checkpoints in various forms of participatory action-oriented training in small-scale workplaces and in agriculture particularly in industrially developing countries.

Participatory methods effective for ergonomic workplace improvement.

Recent experiences in using participatory methods for ergonomic workplace improvement are reviewed to know how these methods can be effective in different settings. The review covered participatory programmes for managers and workers in small enterprises, home workers, construction workers and farmers in Asian countries. To meet diversifying ergonomic needs, participatory steps reviewed are found to usually follow a good-practice approach easily adjustable according to local needs. These steps are found to usually focus on low-cost improvements. They can thus lead to concrete results particularly by addressing multiple technical areas together. Typical areas include materials handling, workstation design, physical environment and work organization. Further, the review confirms that the participatory methods are always modified according to each local situation. This is done by developing a group-work toolkit comprising action checklists and illustrated manuals and by building a support network of trained trainers. It is suggested that participatory methods taking a good-practice approach by multi-area low-cost improvements through the group use of locally adjusted toolkits are effective for improving small-scale workplaces including those in developing countries.