Quality, productivity, and economic implications of exoskeletons for occupational use: A systematic review.

The objective of this systematic review was to synthesize the current state of knowledge on the quality and productivity of workers and their work while wearing exoskeletons, as well as the economic implications of exoskeletons for occupational use. Following the PRISMA guidelines, six databases were systematically searched for relevant journal articles, written in English, and published since January 2000. Articles meeting the inclusion criteria had their quality assessed using JBI's Checklist for Quasi-Experimental Studies (Non-Randomized Experimental Studies). A total of 6,722 articles were identified and 15 articles focusing on the impact of exoskeletons on quality and productivity of exoskeleton users while performing occupational tasks were included in this study. None of the included articles evaluated the economic implications of exoskeletons for occupational use. This study revealed several quality and productivity measures (e.g., endurance time, task completion time, number of errors, number of task cycles completed) used to evaluate the impact of exoskeletons. The current state of the literature suggests that quality and productivity impacts of exoskeleton use are dependent on task characteristics that should be considered when adopting exoskeletons. Future studies should evaluate the impact of exoskeleton use in the field and on a diverse pool of workers, as well as its economic implications to better support decision-making in the adoption of exoskeletons within organizations.

Evaluating the Effectiveness of Return-to-Work Interventions for Individuals with Work-Related Mental Health Conditions: A Systematic Review and Meta-Analysis.

The workplace is a vital setting to support positive mental health. Mental health conditions in the workforce contribute to decreased work engagement and participation. There is existing literature on return-to-work (RTW) interventions for individuals with work-related mental health conditions, however, there lacks consensus on their effectiveness. Therefore, the primary aim of this systematic review was to synthesize the literature and evaluate the effectiveness of return-to-work interventions on return-to-work rates, quality of life, and psychological wellbeing for individuals with work-related mental health conditions. Selected articles were organized and identified using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and the Population/Intervention/Comparison/Outcome (PICO) framework. Quality assessment of the included studies was completed using the Critical Appraisal Skills Programme randomized controlled trials checklist and the Joanna Briggs Institute quasi-experimental studies checklist. A random effects meta-analysis model was performed using DerSimonian-Laird weighting to calculate standard mean difference and risk ratios to assess the impact of RTW interventions on return-to-work rates, absenteeism, stress symptoms, depression symptoms, and quality of life. A total of 28 out of 26,153 articles met the inclusion criteria. Diagnoses for participants in the studies ranged from work-related stress to work-related PTSD following exposure to a psychologically traumatizing event in the workplace. No significant differences were found for the meta-analyses examining return-to-work rates, absenteeism, depression, stress, and quality of life. The most effective interventions were found to be a multi-domain intervention (67% of participants RTW full time) and a health-focused intervention (85% RTW rate). Future research may consider establishing effective interventions to develop programs or policies supporting the RTW of employees and promote mental well-being among employees experiencing work-related mental health conditions.

Is there a u-shaped relationship between load levels and fatigue and recovery? An examination of possible mechanisms.

In a previous study, an unexpected u-shaped relationship was observed between load level and fatigue/recovery responses. Moderate load levels resulted in lower perceived discomfort, pain, and fatigue, and shorter recovery times compared to either low or high load levels. This phenomenon has been reported in other studies, but no article has examined the possible mechanisms that might explain this u-shaped relationship. In this paper, we re-examined the previously published data and found that the phenomenon does not appear to be due to the experimental artefact; the u-shape may be due to unexpectedly lower fatigue effects at moderate loads, and higher fatigue effects at lower loads. We then conducted a literature review and identified several possible physiological, perceptual, and biomechanical explanatory mechanisms. No single mechanism explains the entirety of the phenomenon. Further research is needed on the relationship between work exposures, fatigue, and recovery, and the mechanisms related to the u-shaped relationship.Practitioner summary: We examine a previously observed u-shaped relationship between load level and fatigue/recovery, where moderate force resulted in lower perceived fatigue and shorter recovery times. A u-shaped fatigue response suggests that simply minimising load levels might not be an optimal approach to reduce the risk of workplace injuries.

Synthesis of Evidence to Support EMS Personnel's Mental Health During Disease Outbreaks: A Scoping Review.

Emergency medical services (EMS) personnel are at high risk for adverse mental health outcomes during disease outbreaks. To support the development of evidence-informed mitigation strategies, we conducted a scoping review to identify the extent of research pertaining to EMS personnel's mental health during disease outbreaks and summarized key factors associated with mental health outcomes. We systematically searched three databases for articles containing keywords within three concepts: EMS personnel, disease outbreaks, and mental health. We screened and retained original peer-reviewed articles that discussed, in English, EMS personnel's mental health during disease outbreaks. Where inferential statistics were reported, the associations between individual and work-related factors and mental health outcomes were synthesized. Twenty-five articles were eligible for data extraction. Our findings suggest that many of the contributing factors for adverse mental health outcomes are related to inadequacies in fulfilling EMS personnel's basic safety and informational needs. In preparation for future disease outbreaks, resources should be prioritized toward ensuring adequate provisions of personal protective equipment and infection prevention and control training. This scoping review serves as a launching pad for further research and intervention development.

Mental and physical health and well-being of canadian employees who were working from home during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has drastically changed various aspects of our lives, including how we work. Since the start of the pandemic, numerous organizations in Canada have mandated their employees to work from home (WFH) on a full-time basis. The rapid rise in the number of remote workers and the possibility for WFH continuing in the future signifies the importance of understanding the health and well-being of employees working from home over the course of the pandemic in Canada. We present the findings of two surveys (initial and 6-month follow-up) to examine the health and well-being of WFH employees during the COVID-19 pandemic in Canada. We analyzed the changes in mental and physical health and well-being of employees who were working from home between two time points during the pandemic. METHODS: Initial survey was completed between October 2020 and December 2020 (n = 1617); follow-up survey was completed between May 2021 and June 2021 (n = 382). We calculated the frequencies for survey questions involving demographics, WFH preferences, workstation setup training, employment situation, provision of hardware technologies, provision and usage of software technologies, and organization's return to work plan. We conducted Wilcoxon signed-rank tests to analyze the within-individual changes in mental and physical health and well-being of the 382 respondents who completed both the initial and follow-up surveys. RESULTS: Our analyses showed significant changes in various aspects of employee mental and physical health and well-being. Burnout, stress, general mental health, and job insecurity levels significantly decreased between the two time periods. Work-related sedentary behaviour reduced over time; however, the average proportion of time spent sitting during work hours was more than 80% in both surveys. Employees received more help and feedback from their colleagues and experienced a better sense of community with their co-workers over time. CONCLUSION: The findings can inform workers and organizations on the changes in mental and physical health and well-being of employees working from home during the pandemic. By understanding the changes in worker health and well-being, employers can develop effective strategies and implement policies that help protect employees' health and well-being.

Working in the digital economy: A systematic review of the impact of work from home arrangements on personal and organizational performance and productivity.

Work-from-home has become an increasingly adopted practice globally. Given the emergence of the COVID-19 pandemic, such arrangements have risen substantially in a short timeframe. Work-from-home has been associated with several physical and mental health outcomes. This relationship has been supported by previous research; however, these health and safety issues often receive little resources and attention from business perspectives compared to organizational and worker performance and productivity. Therefore, aligning work-from-home practices with business goals may help catalyze awareness from decision makers and serve to effectively implement work-from-home policies. We conducted a review to synthesize current knowledge on the impact of work-from-home arrangements on personal and organizational performance and productivity. Four large databases including Scopus, PubMed, PsychInfo, and Business Source Complete were systematically searched. Through a two-step screening process, we selected and extracted data from 37 relevant articles. Key search terms surrounded two core concepts: work-from-home and productivity/performance. Of the articles published prior to the COVID-19 pandemic, 79% (n = 19) demonstrated that work-from-home increased productivity and performance whereas 21% (n = 5) showed mixed or no effects. Of the articles published during the pandemic, 23% (n = 3) showed positive effects, 38% (n = 5) revealed mixed results, and 38% (n = 5) showed negative effects. Findings suggest that non-mandatory work-from-home arrangements can have positive impacts on productivity and performance. When work-from-home becomes mandatory and full-time, or external factors (i.e., COVID-19 pandemic) are at play, the overall impacts are less positive and can be detrimental to productivity and performance. Results will help foster an understanding of the impact of work-from-home on productivity and performance and inform the development of organizational strategies to create an effective, resilient, and inclusive work-from-home workplace by helping to effectively implement work-from-home policies that are aligned with business goals.

Organizational strategies to address posttraumatic stress injuries among Canadian paramedics.

BACKGROUND: Paramedics are a high-risk occupational group for posttraumatic stress injuries (PTSI), and increasingly, evidence suggests that organizational factors play a significant role. While several resources for paramedic services to address PTSI exist, there is limited knowledge as to which PTSI-related programs and practices are implemented and how they are perceived in the workplace. OBJECTIVES: This research aimed to explore key informants' perspectives on existing and desired organizational-wide initiatives for, as well as the challenges and potential solutions to, the primary prevention, early detection and intervention, and disability management of PTSI in Canadian paramedic services. METHODS: Semi-structured interviews were conducted with 12 key informants from jurisdictions across Canada who have over five years of work experience in prehospital care. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. RESULTS: Eight recurrent organizational elements (themes) for addressing PTSI emerged: psychologically safe and healthy work culture; consistent supervisor support, mental health training and awareness, opportunities for recovery and maintaining resiliency, recognition of PTSI and its diverse risk factors, access to a variety of support initiatives for PTSI, communication during medical leave, and meaningful work accommodations. CONCLUSIONS: While organizational-wide initiatives were in place for the primary prevention, early detection and intervention, and disability management of PTSI, systemic challenges with coordination, resource allocation, and worker engagement were also identified. These challenges prevented paramedic services from optimally addressing PTSI in their workplace. Integrating considerations from the eight organizational elements to address PTSI into broader existing management systems may have merit in overcoming the systemic challenges.

Factors Associated with Job Satisfaction in Medical Laboratory Professionals during the COVID-19 Pandemic: An Exploratory Study in Ontario, Canada.

Job satisfaction has been widely studied across several healthcare disciplines and is correlated with important outcomes such as job performance and employee mental health. However, there is limited research on job satisfaction among medical laboratory professionals (MLPs), a key healthcare group that aids in diagnosis, treatment, and patient care. The objective of this study is to examine the demographic and psychosocial factors associated with job satisfaction for MLPs in Ontario, Canada during the COVID-19 pandemic. A survey was administered to medical laboratory technologists (MLTs) and medical laboratory technicians/assistants (MLT/As) in Ontario, Canada. The survey included demographic questions and items from the Copenhagen Psychosocial Questionnaire, third edition. Binary logistic regressions were used to examine the association between job satisfaction and demographic variables and psychosocial work factors. There were 688 MLPs included in the analytic sample (72.12% response rate). Having a higher sense of community at work was correlated with higher job satisfaction in both MLT (OR = 2.22, 95% CI: 1.07-4.77) and MLT/A (OR = 3.85, 95% CI: 1.12-14.06). In addition, having higher stress was correlated with lower job satisfaction in both MLT (OR = 0.32, 95% CI: 0.18-0.57) and MLT/A (OR = 0.26, 95% CI: 0.10-0.66). This study provides preliminary evidence on factors associated with job satisfaction in MLT and MLT/A. The findings can be used to support organizational practices and policies to improve psychosocial work factors.

Musculoskeletal health in the workplace.

Musculoskeletal (MSK) problems remain the most frequent reason why individuals are absent from work, including those with work-related musculoskeletal disorders (WRMSDs or MSDs) and those with chronic MSK problems. This paper aims to examine changes in work and the workforce since 2000; how work impacts on chronic MSK conditions and how we can help people with these conditions to stay at work. While our knowledge of the causes of WRMSDs has increased since 2000, there has been limited workplace action in reducing exposure to hazards. A life course approach is needed as individuals of all ages are reporting MSK problems. How people work has also changed and informalisation of work contracts has increased with a perceived concurrent reduction in occupational safety and health (OSH) protection. Retaining people at work with MSK problems requires compliance with relevant safety, health and diversity legislation and a risk management approach. Good and open communication within the workplace and identification of other sources of support is also necessary. Considerations must be made at the individual level (internal motivation), organisational level (a supportive manager) and self-management of symptoms. Simple case examples are provided in the paper of what works in practice as well as a proposed research agenda. Increased awareness at all levels of society of MSK health is essential.

Exploring the need for and application of human factors and ergonomics in ambulance design: Overcoming the barriers with technical standards.

Ergonomic risk factors, such as excessive physical effort, awkward postures or repetitive movements, were the leading causes of injuries amongst EMS workers in the United States, of which 90% were attributed to lifting, carrying, or transferring a patient and/or equipment. Although the essential tasks of patient handling, transport, and care cannot be eliminated, the design of ambulances and associated equipment is modifiable. Our aims were to identify the extent of Human Factors and Ergonomic (HFE) considerations in existing ambulance design standards/regulations, and describe how HFE and the standards/regulations were applied in the EMS system. Through an extensive environmental scan of jurisdictionally relevant standards/regulations and key informant interviews, our findings demonstrated that existing standards/regulations had limited considerations for HFE. As a result, HFE principles continue to be considered reactively through retrofit rather than proactively in upstream design. We recommend that performance-based HFE requirements be integrated directly into ambulance design standards.

Impact of a Caregiver-Friendly Workplace Policies Intervention: A Prospective Economic Evaluation.

OBJECTIVE: We estimate the potential cost-benefit of a caregiver-friendly workplace policies (CFWPs) educational intervention to facilitate uptake of supports for carer-employees (CEs) at a post-secondary institution. METHODS: We identified CEs through a voluntary survey and estimated the economic burden of caregiving activities from the CEs' and employer's perspective. The latter is used as the baseline of comparison for evaluating the cost-benefit of the intervention. RESULTS: The economic cost of caregiving-related activities for the "no intervention" scenario was estimated at $33,841,789 ($32,922 per-case) and $8,916,342 ($8,674 per-case) from the CEs' and employer's perspectives, respectively. We find the educational intervention is a cost-beneficial program with the net benefit ranging from $48,010 to $676,657, based on six scenarios of effectiveness. CONCLUSION: This study provides practical information for human resources and operations management decision-making in terms of a CFWPs educational intervention.

Existing Science on Human Factors and Ergonomics in the Design of Ambulances and EMS Equipment.

Background: Emergency medical services (EMS) personnel face a disproportionally high risk for fatality and injury due to the nature of their work; and current ambulance and EMS equipment design standards do not adequately safeguard EMS personnel from sacrificing personal safety for patient care, a known human factors and ergonomic (HFE) design challenge. Despite the desire to include HFE interventions or considerations into a standard, the effectiveness of existing HFE interventions for EMS is unclear. Objective: Therefore, this study aimed to synthesize the peer-reviewed literature on the design features of patient compartments and EMS equipment that affect EMS personnel's performance or well-being. Methods: A scoping review methodology was applied to systematically search and screen for relevant articles, and extract data. Three databases (EmBase, Scopus, and PubMed) were searched, and search results were screened for articles that pertained to the performance or well-being of EMS personnel when interacting with the patient compartment or its associated equipment. Results and Discussion: Of the 4,125 search results, 48 relevant articles were retained, and then sorted into one of 3 categories: general design, patient handling, and patient transport. It was concluded that, although research has progressed over the past 15 years, more research, development, and resources are needed. Newer generations of ambulances have not been shown to be safer during collisions and there is a knowledge gap in how occupants and contents of a patient compartment behave during a collision. Crash-tests have been performed with restrained occupants and supplies; however, that scenario is unrealistic in the field. While the existing literature provided initial ideas and innovations for improving the HFE of patient handling and patient transport, it is important for future research to convey findings in a manner that can be used to inform design standards.

Barriers for implementation of successful change to prevent musculoskeletal disorders and how to systematically address them.

This scoping review identified common barriers and facilitators encountered during the implementation of changes to prevent musculoskeletal disorders (MSD) and examined their relationship with those encountered in general Occupational Health and Safety (OHS) efforts. Thematic analysis of the literature identified 11 barriers: (i) Lack of time; (ii) Lack of resources; (iii) Lack of communication; (iv) Lack of management support, commitment, and participation; (v) Lack of knowledge and training; (vi) Resistance to change; (vii) Changing work environment; (viii) Scope of activities; (ix) Lack of trust, fear of job loss, or loss of authority; (x) Process deficiencies; and (xi) Difficulty of implementing controls. Three facilitators identified were: (i) Training, knowledge and ergonomists' support; (ii) Communication, participation and support; and (iii) An effective implementation process. The barriers and facilitators identified were similar to those in general OHS processes. The integration of MSD prevention into a general management system approach may overcome these barriers.

Evaluation of caregiver-friendly workplace policy (CFWPs) interventions on the health of full-time caregiver employees (CEs): implementation and cost-benefit analysis.

BACKGROUND: Current Canadian evidence illustrating the health benefits and cost-effectiveness of caregiver-friendly workplace policies is needed if Canadian employers are to adopt and integrate caregiver-friendly workplace policies into their employment practices. The goal of this three-year, three study research project is to provide such evidence for the auto manufacturing and educational services sectors. The research questions being addressed are: What are the impacts for employers (economic) and workers (health) of caregiver-friendly workplace policy intervention(s) for full-time caregiver-employees? What are the impacts for employers, workers and society of the caregiver-friendly workplace policy intervention(s) in each participating workplace? What contextual factors impact the successful implementation of caregiver-friendly workplace policy intervention(s)? METHODS: Using a pre-post-test comparative case study design, Study A will determine the effectiveness of newly implemented caregiver-friendly workplace policy intervention(s) across two workplaces to determine impacts on caregiver-employee health. A quasi-experimental pre-post design will allow the caregiver-friendly workplace policy intervention(s) to be tested with respect to potential impacts on health, and specifically on caregiver employee mental, psychosocial, and physical health. Framed within a comparative case study design, Study B will utilize cost-benefit and cost-effectiveness analysis approaches to evaluate the economic impacts of the caregiver-friendly workplace policy intervention(s) for each of the two participating workplaces. Framed within a comparative case study design, Study C will undertake an implementation analysis of the caregiver-friendly workplace policy intervention(s) in each participating workplace in order to determine: the degree of support for the intervention(s) (reflected in the workplace culture); how sex and gender are implicated; co-workers' responses to the chosen intervention(s), and; other nuances at play. It is hypothesized that the benefits of the caregiver-friendly workplace policy intervention(s) will include improvements in caregiver-employees' mental, psychosocial and physical health, as well as evidence of cost-benefit and cost-effectiveness for the employer. DISCUSSION: The expected project results will provide the research evidence for extensive knowledge translation work, to be carried out in collaboration with our knowledge transition partners, to the employer/human resources and occupational health/safety target populations. TRIAL REGISTRATION: ISRCTN16187974 Registered August 25, 2016.

Workplace accommodations for persons with physical disabilities: evidence synthesis of the peer-reviewed literature.

PURPOSE: To identify and synthesize research evidence on workplace accommodations used by employers to recruit, hire, retain, and promote persons with physical disabilities. METHOD: A structured search of six electronic journal databases was undertaken to identify peer-reviewed literature on the topic published from January 1990 to March 2016. Articles describing or evaluating workplace disability accommodation policies and practices were given a full-text review. Topic experts were contacted to identify additional studies. RESULTS: Details on specific accommodations described in 117 articles were synthesized and organized into three groups comprised of a total of 12 categories. The majority of studies did not rigorously evaluate effectiveness or cost-effectiveness of the accommodations under study. CONCLUSIONS: This evidence synthesis provides an overview of the peer-reviewed literature of value to occupational rehabilitation professionals and employers seeking guidance on workplace accommodation policies and practices for persons with physical disabilities. A wide range of accommodation options is available for addressing physical, social, and attitudinal barriers to successful employment. Besides physical/technological modifications, accommodations to enhance workplace flexibility and worker autonomy and strategies to promote workplace inclusion and integration are important. More comprehensive reporting and evaluations of the effectiveness of accommodations in research literature are needed to develop best practices for accommodating persons with disabilities. Implications for rehabilitation There is a substantial peer-reviewed literature that provides insights into the barriers for persons with physical disabilities and the workplace accommodation practices to address them, though rigorous evaluations of effectiveness and cost-effectiveness are uncommon. Attitudinal and social barriers stemming from stereotypes, ignorance and lack of knowledge are as important as physical barriers to employment for persons with physical disabilities. In addition to physical/technological modifications, accommodations to enhance workplace flexibility and autonomy of a worker, as well as strategies to promote workplace inclusion and integration may facilitate successful employment of persons with physical disabilities.

Prevention of musculoskeletal disorders within management systems: A scoping review of practices, approaches, and techniques.

The purpose of this study was to identify and summarize the current research evidence on approaches to preventing musculoskeletal disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS). Databases in business, engineering, and health and safety were searched and 718 potentially relevant publications were identified and examined for their relevance. Twenty-one papers met the selection criteria and were subjected to thematic analysis. There was very little literature describing the integration of MSD risk assessment and prevention into management systems. This lack of information may isolate MSD prevention, leading to difficulties in preventing these disorders at an organizational level. The findings of this review argue for further research to integrate MSD prevention into management systems and to evaluate the effectiveness of the approach.

How compatible are participatory ergonomics programs with occupational health and safety management systems?

OBJECTIVES: Musculoskeletal disorders (MSD) are a major cause of pain, disability, and costs. Prevention of MSD at work is frequently described in terms of implementing an ergonomics program, often a participatory ergonomics (PE) program. Most other workplace injury prevention activities take place under the umbrella of a formal or informal occupational health and safety management system (OHSMS). This study assesses the similarities and differences between OHSMS and PE as such knowledge could help improve MSD prevention activities. Methods Using the internationally recognized Occupational Health and Safety Assessment Series (OHSAS 18001), 21 OHSMS elements were extracted. In order to define PE operationally, we identified the 20 most frequently cited papers on PE and extracted content relevant to each of the OHSAS 18001 elements. RESULTS: The PE literature provided a substantial amount of detail on five elements: (i) hazard identification, risk assessment and determining controls; (ii) resources, roles, responsibility, accountability, and authority; (iii) competence, training and awareness; (iv) participation and consultation; and (v) performance measurement and monitoring. However, of the 21 OHSAS elements, the PE literature was silent on 8 and provided few details on 8 others. CONCLUSIONS: The PE literature did not speak to many elements described in OHSMS and even when it did, the language used was often different. This may negatively affect the effectiveness and sustainability of PE initiatives within organizations. It is expected that paying attention to the approaches and language used in management system frameworks could make prevention of MSD activities more effective and sustainable.

Prevention of MSD within OHSMS/IMS: a systematic review of risk assessment strategies.

The purpose of this systematic review was to identify and summarize the research evidence on prevention of Musculoskeletal Disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS) and Integrated Management Systems (IMS). Databases in business, management, engineering and health and safety were systematically searched and relevant publications were synthesized. The number of papers that could address the research questions was small. However, the review revealed that many of the techniques to address MSD hazards require substantial background knowledge and training. This may limit employees' involvement in the technical aspects of the risk assessment process. Also these techniques did not usually fit into techniques used by companies to address other risk factors within their management systems. This could result in MSD prevention becoming a separate issue that cannot be managed with company-wide tools. In addition, this review also suggested that there is a research gap concerning the MSD prevention within companies' management systems.