CUELA analysis of employees in inclusive workplaces: Investigation of the current situation and evaluation of preventive measures

Status:

completed

Aims:

Inclusive companies are companies with a social mandate to offer opportunities for training and regular employment (i.e. jobs where social insurance premiums are payable) for persons with disabilities who face particular obstacles to accessing working life. They are governed by Volume 9 of the German Social Code (SGB IX), Sections 215-218. The universal principle that occupational safety and health should be assured for all workers also applies in inclusive companies. The GAIN project, which is funded by the DGUV and promotes healthy working in inclusive companies, addresses the occupational safety and health of workers with and without disabilities in such companies. Within this framework, its overarching goal is to produce information for the development of measures to safeguard health. The purpose of the IFA sub-project was to assess risks associated with the physical workload and to identify and evaluate preventive measures for reducing musculoskeletal workload at workplaces in a range of sectors. The findings were to be used to formulate specific recommendations for the shaping of work in inclusive companies and also in regular companies seeking to increase the proportion of persons with disabilities within their workforce.

Activities/Methods:

An exploratory study was conducted to identify physical and mental stress factors and health impairments in a total of 127 workers, both with and without disabilities, in inclusive companies belonging to the Main-Kinzig network of sheltered employment companies. The IFA played a leading role in determining and assessing musculoskeletal workload in two inclusive companies (a laundry and a scanning service provider) and in one regular company (a battery factory) serving as a control. Exposure analyses were carried out with use of the CUELA system on 44 people with and without disabilities (laundry: n = 14, scanning service provider: n = 9, battery factory: n = 21). The CUELA method employs sensors worn on the body to perform a detailed analysis of stresses on the neck, back, shoulders, elbows, hands, hips and knees. Relevant biomechanical stress parameters, such as unfavourable joint angles, static postures, repetitive movements, joint moments or disc compression forces, are evaluated for their possible health risks. The CUELA analysis was used to analyse the current situation. From the results, intervention requirements were determined and specific preventive measures formulated. A CUELA analysis was also used to evaluate the measures following implementation. Recommendations for action are to be developed based on the results.

Results:

The CUELA analysis identified increased workloads in the laundry activities, caused by repetitive movements of the upper extremities, unfavourable head posture and work with elevated arms. Activities in the scanning company were characterized in particular by a lack of movement, non-neutral positions of the forearms (rotated inwards) and postures with a bent back and neck. The consistently low flexion angles of the hip and knee joints were notable. This suggests suboptimal adjustment of the seating, which in turn appears to be the cause of the unfavourable back and neck postures. In neither of the inclusive companies were differences in exposure to these issues noted between people with and without disabilities. Nor were differences noted between the two groups in their subjective perception of musculoskeletal complaints. Furthermore, the CUELA analysis revealed no notable differences in the severity of the workload in the inclusive laundry compared to that in the battery factory (non-inclusive control company). Activities in these two companies are characterized by a high proportion of repetitive manual work processes performed in a standing position. Workers in the two companies reported comparable musculoskeletal complaints.

Potential intervention measures were identified based on the exposure data and interviews with workers and managers at the companies. Within the time frame of the project and the available budget, two of these measures were tested and evaluated quantitatively. To reduce unfavourable head postures, two work tables with electric height adjustment were introduced in the laundry’s folding area. These allow the working height to be adjusted ergonomically to the worker’s anthrpometry. In addition, workers were offered brief fitness breaks (strength and mobility training) tailored to the specific workload at their respective workstations. The effectiveness of these breaks was demonstrated by reference to functional diagnostics and indications of complaints. Before-and-after comparative measurements were carried out for the table intervention. However, the CUELA analysis of the workers at this workstation (n = 4) revealed no change in body posture resulting from use of the height-adjustable tables. With only one exception, the workers did not use the height adjustment function optimally or at all, even after repeated instruction. The project results show that effective prevention of musculoskeletal workload in inclusive companies cannot be assured by technical or ergonomic measures alone, but depends significantly on accessible communication and the active involvement of workers with communication difficulties. The challenges that already exist in occupational safety and health in regular companies are even more apparent in contexts of inclusive work, and show clearly that inclusion can be achieved only through directed communication and participation strategies with sensitivity for inclusion.

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