Video display terminal workstation improvement program: I. Baseline associations between musculoskeletal discomfort and ergonomic features of workstations

Associations between selected sites of musculoskeletal discomfort and ergonomic characteristics of the video display terminal (VDT) workstation were assessed in analyses controlling for demographic, psychosocial stress, and VDT use factors in 273 VDT users from a large administrative department. Significant associations with wrist/hand discomfort were seen for female gender; working 7+ hours at a VDT; low job satisfaction; poor keyboard position; use of new, adjustable furniture; and layout of the workstation. Significantly increased odds ratios for neck/shoulder discomfort were observed for 7+ hours at a VDT, less than complete job control, older age (40 to 49 years), and never/infrequent breaks. Lower back discomfort was related marginally to working 7+ hours at a VDT. These results demonstrate that some characteristics of VDT workstations, after accounting for psychosocial stress, can be correlated with musculoskeletal discomfort.     

Effects of ergonomic intervention in work with video display units

OBJECTIVES: This study evaluated the effect of an intensive ergonomic approach and education on workstation changes and musculoskeletal disorders among workers who used a video display unit (VDU). METHODS: A randomized controlled design was used. The subjects (N=124) were allocated into three groups (intensive ergonomics, ergonomic education, reference) using stratified random sampling. The evaluation involved questionnaires, a diary of discomfort, measurements of workload, and an ergonomic rating of the workstations. The assessments were made 2 weeks before the intervention and after 2 and 10 months of follow-up. RESULTS: The intensive and training groups showed less musculoskeletal discomfort than the reference group after 2 months of follow-up. Positive effects on discomfort were seen primarily for the shoulder, neck, and upper back areas. No significant differences were found for the strain levels or prevalence of pain. After the intervention the ergonomic level was distinctly higher in the intensive ergonomic group than in the education or reference group. CONCLUSIONS: Both the intensive ergonomics approach and education in ergonomics help reduce discomfort in VDU work. In attempts to improve the physical ergonomics of VDU workstations, the best result will be achieved with cooperative planning in which both workers and practitioners are actively involved.     

Physical discomfort among visual display terminal users in a semiconductor manufacturing company: a study of prevalence and relation to psychosocial and physical/ergonomic factors

The associations among several alleged psychosocial and physical/ergonomics risk factors and the visual and musculoskeletal discomforts were assessed in a cross-sectional study of 119 video display terminal (VDT) users in a semiconductor manufacturing company. Cases of discomfort were identified using self-reported discomfort symptoms through questionnaire surveys. Data on individual, physical/ergonomic, and psychosocial aspects were obtained. Multivariate logistic regression models were developed to predict physical discomforts of 11 body areas. The prevalence of upper extremity discomfort found in this semiconductor manufacturing company was 42%, which is similar to the prevalence among VDT users in telecommunication companies and the newspaper industry. Full-time VDT users (data-entry personnel, programming engineers, and CAD engineers) had significantly higher rates of physical discomfort (66%) than part-time VDT users (fabrication engineers) (41%). Physical/ergonomic variables were found more dominant than psychosocial factors for visual and upper extremity discomforts. However, psychosocial variables were the dominant for back and lower extremity discomfort, when compared with the subjectively characterized physical/ergonomic factors. Because both physical/ergonomics variables and psychosocial factors and some of their interactions were associated with visual and musculoskeletal discomfort, integrating psychosocial prevention with physical/ergonomic design improvements is an effective approach to reducing the prevalence of discomfort.     

Effect of an ergonomic intervention involving workstation adjustments on musculoskeletal pain in office workers—a randomized controlled clinical trial

Office workers remain in a awkward position for long periods, which can lead to musculoskeletal symptoms. Ergonomic guidelines are recommended to avoid such problems. Evidence of the long-term effectiveness of ergonomic interventions is scarce. The aim of this randomised controlled trial was to compare pain intensity among office workers who received an ergonomic intervention and a control group before as well as 12, 24, and 36 wk after the intervention. Workers were randomly allocated to a control group (CG) and experimental group (EG). The EG received an ergonomic workstation intervention. Furniture measurements were related to individual anthropometric measurements to identify mismatches. The outcome was pain intensity, which was determined using a numerical pain scale and the Nordic Musculoskeletal Questionnaire. A linear mixed model was created with pain intensity as the dependent variable. Group and time were the independent variables. No significant interactions were found between group and time. Significant differences between groups were found for the pain intensity in the neck, shoulder, upper back, and wrist/hand (p<0.05), with lower intensity in the EG. The intervention reduced pain intensity in the neck, shoulder, upper back, and wrist/hand. However, no reduction in pain intensity was found for the lower back or elbow.     

A randomised controlled trial of postural interventions for prevention of musculoskeletal symptoms among computer users

Aims: To examine the effect of two workstation and postural interventions on the incidence of musculoskeletal symptoms among computer users.

Methods: Randomised controlled trial of two distinct workstation and postural interventions (an alternate intervention and a conventional intervention) among 376 persons using computer keyboards for more than 15 hours per week. The incidence of neck/shoulder symptoms and hand/arm symptoms during six months of follow up among individuals in the intervention groups was compared to the incidence in computer users who did not receive an intervention (comparison group). For individuals in the intervention groups, study staff adjusted workstations, where possible, and trained individuals to assume the intervention postures. Individuals reported musculoskeletal symptoms in a weekly diary. Participants who reported discomfort intensity of 6 or greater on a 0–10 visual analogue scale or who reported musculoskeletal symptoms requiring use of analgesic medication were considered symptomatic.

Results: There were no significant differences in the incidence of musculoskeletal symptoms among the three intervention groups. Twenty two (18.5%) participants in the alternate intervention group, 25 (20.2%) in the conventional intervention group, and 25 (21.7%) in the comparison group developed incident arm or hand symptoms. Thirty eight (33.3%) participants in the alternate intervention group, 36 (31.0%) in the conventional intervention group, and 33 (30.3%) in the comparison group developed incident neck or shoulder symptoms. Compliance with all components of the intervention was attained for only 25–38% of individuals, due mainly to the inflexibility of workstation configurations.

Conclusions: This study provides evidence that two specific workplace postural interventions are unlikely to reduce the risk of upper extremity musculoskeletal symptoms among computer users.

     

Effects of ergonomic intervention on work-related upper extremity musculoskeletal disorders among computer workers: a randomized controlled trial

Purpose

The aim of the study was to determine effects of ergonomic intervention on work-related upper extremity musculoskeletal disorders (WUEMSDs) among computer workers.

Methods

Four hundred computer workers answered a questionnaire on work-related upper extremity musculoskeletal symptoms (WUEMSS). Ninety-four subjects with WUEMSS using computers at least 3 h a day participated in a prospective, randomized controlled 6-month intervention. Body posture and workstation layouts were assessed by the Ergonomic Questionnaire. We used the Visual Analogue Scale to assess the intensity of WUEMSS. The Upper Extremity Function Scale was used to evaluate functional limitations at the neck and upper extremities. Health-related quality of life was assessed with the Short Form-36. After baseline assessment, those in the intervention group participated in a multicomponent ergonomic intervention program including a comprehensive ergonomic training consisting of two interactive sessions, an ergonomic training brochure, and workplace visits with workstation adjustments. Follow-up assessment was conducted after 6 months.

Results

In the intervention group, body posture (p < 0.001) and workstation layout (p = 0.002) improved over 6 months; furthermore, intensity (p < 0.001), duration (p < 0.001), and frequency (p = 0.009) of WUEMSS decreased significantly in the intervention group compared with the control group. Additionally, the functional status (p = 0.001), and physical (p < 0.001), and mental (p = 0.035) health-related quality of life improved significantly compared with the controls. There was no improvement of work day loss due to WUEMSS (p > 0.05).

Conclusions

Ergonomic intervention programs may be effective in reducing ergonomic risk factors among computer workers and consequently in the secondary prevention of WUEMSDs.     

Changes in Cognitive-Behavioral Factors and Muscle Activation Patterns after Interventions for Work-Related Neck-Shoulder Complaints: Relations with Discomfort and Disability

Objectives Knowledge regarding the working mechanism of an intervention is essential for obtaining a better understanding of the intervention and contributes to optimize its outcome. This study aimed at investigating whether changes in cognitive-behavioral factors and muscle activation patterns after myofeedback training and ergonomic counseling were associated with outcome, in subjects with work-related musculoskeletal neck-shoulder complaints. Methods Seventy-nine symptomatic subjects received either myofeedback with ergonomic counseling (Mfb/EC) or ergonomic counseling alone (EC). Outcome measures discomfort and disability, and process factors catastrophizing, pain control, fear-avoidance beliefs, and muscle activation patterns were assessed at baseline, after the interventions (T0), and at 3 months follow-up (T3). Mixed modeling techniques were used for analysis. Results Outcome in terms of discomfort and disability was generally comparable between both interventions. Catastrophizing was significantly reduced and fear-avoidance beliefs about work slightly increased after the interventions, but no consistent changes in muscle activation patterns were observed. Changes in discomfort were especially associated with changes in catastrophizing at T0 and T3, but R² was low (<0.14). Reduced catastrophizing at T0 and T3, and also reduced fear-avoidance beliefs about work at T3, were related to reduced disability (R² between 0.30 and 0.40). No differences between the two intervention groups were observed. Conclusions Intervention effects were generally non-specific and findings suggested that cognitive-behavioral factors underlie the outcome of these interventions rather than changes in muscle activation patterns. Emphasizing these factors during therapy may increase the beneficial outcome of occupational interventions.     

Evaluation of a Physical Ergonomic Intervention for Milking Parlor Operatives – A Case Study

Musculoskeletal pain and disorders frequently occur among milking parlor operatives on dairy farms, irrespective of the farm size and despite that the work is carried out in an upright position. The objective of this case study was to assess the effect of a new milking system, a physical ergonomic intervention, to reduce the prevalence of musculoskeletal pain and disorders among milking parlor operatives. The new milking system has a reduced cluster weight and single tube guidance and, consequently, abandons the positioning of the cluster underneath the udder, thus reducing the postural load. In a pre/post treatment study the parlor operatives of five farms were questioned, and parlor specifics were measured. The gap between visits was at least one year. There was no significant reduction in pain, but three-quarters of the workers experienced a workload reduction and would recommend the new system. The isolation of the effect of the ergonomic intervention was not possible, because all but one farm completely rebuilt their milking parlors, and several things were changed including work organizational aspects. The expected reduction in pain in the musculoskeletal system was noticed, but not statistically significant. Worker satisfaction and participation in decision making could be improved on the farms and might increase the effect of the intervention, especially because work satisfaction is correlated with the occurrence of pain in the musculoskeletal system.     

Expert assessment of physical ergonomics at video-display unit workstations: repeatability,validity and responsiveness to changes

Aims Inter-observer repeatability, validity and responsiveness to change were determined for an expert assessment method for video-display unit (VDU) workstation ergonomics. The aim was to determine to what extent the expert assessment of ergonomics is related to the technical measurements, tidiness and space, work chair ergonomics and responds to changes in these characteristics.Methods Technical measurements and video-recordings before and 2 months after an ergonomic intervention were made for 109 VDU office workstations. Two experts in ergonomics analysed and rated the ergonomics of the workstations. A researcher analysed tidiness and available space. A physiotherapist classified the work chairs used according to their ergonomic properties.Results The intra-class correlation coefficient between the workstation ergonomic ratings of the two experts was 0.74 at the baseline and 0.81 at the follow-up. Workstation tidiness and space, and work chair ergonomics, had a strong effect on the assessments of both experts. For both experts a change in the locations of the mouse, the screen and the keyboard and values of tidiness and space and work chair ergonomics during the intervention showed a significant association with the ratings.Conclusion The assessment method studied can be utilized by an expert in a repeatable manner both in cross-sectional and in longitudinal settings.     

Laboratory evaluation of belt usage with apple buckets

BACKGROUND: Migrant and seasonal orchard harvest workers experience musculoskeletal strain caused by carrying heavy loads and holding awkward postures. An ergonomic hip belt designed to redistribute weight from the upper back, neck, and shoulders to the hips was evaluated. METHODS: A comparison of muscle exertion (using electromyography [EMG]) of four key back and shoulder muscles and shoulder surface pressure (using a surface pressure sensor [PS]) was made among 10 laboratory volunteers under intervention and control conditions, in two postures (standing erect [0 degrees ]) and flexed [45 degrees ]). RESULTS: All but one measure showed a significant reduction in the flexed posture with the intervention. Two of eight measures showed a significant reduction in the erect posture. Correlations with shoulder discomfort were found for deep shoulder EMG (r=0.71, P=0.021) and shoulder surface pressure (r=0.58, P=0.082). CONCLUSIONS: The hip belt intervention produces significant reductions in muscle activity while in a posture commonly assumed during orchard work.     

Prevalence of upper extremity symptoms and possible risk factors in workers handling paper currency

The prevalence of upper extremity symptoms in the workforceis high, particularly in industries characterized by forceful,repetitive or awkward movements. A study was undertaken to assessthe prevalence of upper extremity symptoms in bank workers ina paper currency processing operation and to examine the roleof possible risk factors for these complaints. Thirty-nine workersof a total workforce of 47 were assessed with a questionnaireand physical examination. The questionnaire collected informationabout demographics, health status, symptom reporting, psychosocialwork stressors and other work exposure characteristics. Overall,59% of the workers reported having significant work-relatedupper extremity musculoskeletal symptoms in the preceding year,including 49% with neck and shoulder symptoms and 49% with armand wrist symptoms. In this study the key predictive factorfor upper extremity musculoskeletal symptoms was psychologicaljob demands. The workers had similar ergonomic stressors (withlittle gradient of exposure) and therefore our results do notcontradict the importance of ergonomic factors in the developmentof upper extremity symptoms. However, the results do suggestthat within a group exposed to similar ergonomic stressors,psychological job demands may be an important factor associatedwith musculoskeletal symptoms.     

Ergonomic guidelines for using notebook personal computers. Technical Committee on Human-Computer Interaction, International Ergonomics Association

In the 1980's, the visual display terminal (VDT) was introduced in workplaces of many countries. Soon thereafter, an upsurge in reported cases of related health problems, such as musculoskeletal disorders and eyestrain, was seen. Recently, the flat panel display or notebook personal computer (PC) became the most remarkable feature in modern workplaces with VDTs and even in homes. A proactive approach must be taken to avert foreseeable ergonomic and occupational health problems from the use of this new technology. Because of its distinct physical and optical characteristics, the ergonomic requirements for notebook PCs in terms of machine layout, workstation design, lighting conditions, among others, should be different from the CRT-based computers. The Japan Ergonomics Society (JES) technical committee came up with a set of guidelines for notebook PC use following exploratory discussions that dwelt on its ergonomic aspects. To keep in stride with this development, the Technical Committee on Human-Computer Interaction under the auspices of the International Ergonomics Association worked towards the international issuance of the guidelines. This paper unveils the result of this collaborative effort.     

Effectiveness of measures and implementation strategies in reducing physical work demands due to manual handling at work

This review aimed at producing insight into the effectiveness of interventions to reduce the physical work demands associated with manual (materials) handling in the work situation and musculoskeletal symptoms in the longer-term. A systematic electronic literature search between 1990 and February 2003 was performed in the following databases: Embase, Medline, HSE-line, Nioshtic, and Nioshtic-2. Three inclusion criteria were applied, and altogether 44 studies were included for review. The interventions were divided into two categories, (ergonomic) measures and implementation strategies. One randomized controlled field study was found that established a causal effect for a combination of implementation strategies in reducing the physical work demands associated with manual handling and reducing acute musculoskeletal symptoms. All four of the controlled field studies showed a significant reduction in the physical work demands when lifting devices were part of the intervention. Two of these studies measured a significant reduction in low-back disorders in the longer term. Several uncontrolled pre-post studies showed effects in the same direction. Of the 26 implementation strategies, 21 that measured an improvement in the process variables (eg, aimed behavioral variables) used a participatory ergonomics approach, an education (or training) program or both with the direct involvement of workers. It was concluded that significant reductions in physical work demands and musculoskeletal symptoms were found when (mechanical) lifting devices were part of the intervention. The higher quality studies that showed improvement in behavior indicate the importance of using facilitating and educational strategies in the implementation of ergonomic measures.     

Identifying Work Organization Targets for a Work-Related Musculoskeletal Symptom Prevention Program

While research linking work organization factors to work-related musculoskeletal disorders has been increasing, there is still a need to delineate specific dimensions to be targeted by intervention programs. The present cross-sectional investigation identified work organization risk factors for low back (LB) and upper extremity (UE) symptoms and determined the magnitudes of such associations. Questionnaires containing items on ergonomic, individual psychosocial, and occupational psychosocial factors were administered to a sample of workers (n = 248 U.S. Marines) in previously identified high-risk job categories for musculoskeletal disorders. Study participants were categorized into groups of either having LB symptoms only, UE symptoms only, concurrent LB and UE symptoms, or being asymptomatic on the basis of self-report. Additionally, measures of pain intensity, physical function, and mental health were obtained. Linear regression analyses adjusting for demographics, ergonomic factors, and individual psychosocial factors indicated that decision authority and experienced responsibility for work were significant correlates for pain intensity during the week. Logistic regression analyses indicated that ergonomic stressors were a risk factor for all symptomatic groups (OR = 1.02 per point increase; 95% CI: 1.0-1.1). Time pressure (OR = 1.2 per point increase; 95% CI: 1.0-1.4) was also a significant risk factor for all symptomatic groups, while cognitive processing placed workers at higher risks for concurrent LB and UE symptoms (OR = 1.2; 95% CI: 1.0-1.4). Interpersonal demands placed individuals at a lower risk for LB symptoms (OR = 0.8; 95% CI: 0.5-1.0). Findings highlight the importance of intervention approaches that address time pressure, cognitive processing factors, and interpersonal demands at work. In light of past biobehavioral studies, these results also suggest that job redesign and interventions that address a worker's workstyle when faced with increased work demands may help reduce the likelihood of musculoskeletal symptoms and/or their intensity.     

Prevalence of musculoskeletal disorders,ergonomics risk assessment and implementation of participatory ergonomics program for pistachio farm workers

Background and objectives: Pistachio farmers are exposed to a variety of risk factors for musculoskeletal disorders (MSDs). However, no study has been conducted to investigate MSDs in pistachio workers. Therefore, in the present study, besides investigating the prevalence of MSDs and their ergonomic risk factors, the participatory ergonomics (PE) method is used to provide an intervention program to reduce MSDs in this population in harvesting and processing pistachio. Methods: The present study was conducted in two phases. In the first phase 138 workers participated. The prevalence of MSDs was assessed with Nordic Musculoskeletal Questionnaire and the ergonomic risk factors was identified with ManTRA method. In the second phase PE was used to perform ergonomic interventions for reducing MSDs and the effect of the intervention was investigated. Sixty-four workers participated in the second phase (32 in the case group and 32 in the control group). Results: The highest prevalence of MSDs was in shoulders (63.7%), followed by the lower back (63%) and wrists/hands (52.1%). The comparison showed that after implementing the PE intervention program, the prevalence of MSDs in the intervention group was not significantly different from that in the control group. However, in the reassessment by the ManTRA method for five tasks that were identified as high risk in the first phase, a decrease in ManTRA final score was observed for all the five tasks. Conclusions: MSDs were prevalent in all body regions of workers. After implementing PE interventions exposure to ergonomic risk factors decreased. Key words: Agriculture, musculoskeletal disorders, participatory ergonomics, working posture, pistachio, farmer     

A new bricklayers' method for use in the construction industry

OBJECTIVES: The aim of this study was to investigate the effect of raised bricklaying on physical workload, reported musculoskeletal disorders, sickness absence, and job satisfaction. METHODS: A controlled intervention study with a follow-up period of 10 months was performed among 202 bricklayers from 25 construction companies. RESULTS: The introduction of devices for raised bricklaying decreased the physical load on the lower back and, to a less extent, on the shoulders and upper extremities. Although raised bricklaying had no effect on the number of lifts, decreases in trunk bending lowered the biomechanical moment. The results showed no decrease in reported musculoskeletal symptoms as a result of the adoption of raised bricklaying. Irrespective of the reason(s), the percentage of bricklayers in the intervention group reporting sickness absence was significantly lower than the same percentage in the control group. The results also showed that, in general, the bricklayers in this study were very satisfied with the use of devices for raised bricklaying. CONCLUSIONS: Controlled intervention studies on ergonomic improvements are rare. This study shows that the introduction of an ergonomic improvement in the construction industry may reduce physical load and the incidence of sickness absence.     

Musculoskeletal disorders and visual strain in intensive data processing workers

BACKGROUND: This study was conducted for a UK Trade Union in response to increasing numbers of health complaints among intensive computer workers in a data processing environment. AIM: To estimate prevalence of musculoskeletal pain/discomfort and visual strain symptoms among data processing workers and to explore associations with work factors. METHODS: A self-report questionnaire was distributed to data processors (n = 175) and a control group (n = 129) in the same organization. RESULTS: Eighty-six per cent of data processors reported musculoskeletal pain/discomfort in the previous year, with the highest prevalence rate found for the neck (58%). The 12 month reported prevalence for visual strain symptoms was 47%, tired eyes (41%) was the most commonly reported symptom. In the last week, 56% reported pain/discomfort and 25% visual strain symptoms. Data processors reporting pain in the previous year were more likely to be dissatisfied with their jobs (P < 0.01), to report a lack of choice in deciding what they did at work (P < 0.02), to have insufficient time to complete work (P < 0.05) or to receive help from others when time was limited (P < 0.03). CONCLUSION: The prevalence of self-reported musculoskeletal pain/discomfort and visual strain symptoms was high among data processors. A systematic approach to risk reduction addressing organizational, psychosocial and physical work factors is required. This study has implications for reorganization of this and other intensive computer work, given the increasing requirement for intensive computing work in many industrial sectors. More research is needed to investigate interactions between job demands and support systems for these workers.     

clinical ergonomic job analysis and consultation: Facilitating work reentry in a case with upper extremity cumulative trauma-related disability

The management of work-related recurrent and chronic upper extremity cumulative trauma disorders (UECTDs) represents a challenge particularly when return to work is a treatment goal. Many of these work-related UECTDs may be the consequence of exposure to such physical stressors as repetition, excessive force, awkward and sustained posture in addition to psychosocial stressors in the workplace. Pain and associated disability can be exacerbated by these ergonomic and psychosocial stressors. The application of ergonomic principles and techniques in the context of clinical management of UECTDs may assist in efforts to return the injured worker to work and reduce the likelihood of increased symptoms, discomfort, and disability. This paper presents a case of a 43-year-old dental hygientist unable to work for a period of 2 months due to recurrent episodes of pain in the neck, right shoulder, and arm radiating to the right thumb experienced episodically over a 10-year duration. The case is presented to illustrate the application of ergonomic principles and techniques in the clinical management of a chronic episodic UECTD. The implementation of an ergonomic job analysis and subsequent ergonomic interventions at the workplace that occurred in conjunction with rehabilitation was associated with anecdotal improvements in pain, function, and comfort levels upon returning to work. While the case highlights the potential utility of ergonomics in the management of an occupational musculoskeletal upper extremity disorder, the need for reliable, valid, cost effective, and time efficient methods to assess ergonomic exposure within a clinical context remain to be developed.     

Workstyle Risk Factors for Work Related Musculoskeletal Symptoms Among Computer Professionals in India

Introduction Work-related musculoskeletal disorders are common in computer professionals. Workstyle may be one of the risk factors in the development of musculoskeletal discomfort. The objective of this retrospective study was to examine the prevalence of adverse workstyle in computer professionals from India and to evaluate if workstyle factors were predictors of pain and loss of productivity. Methods Office workers from various information technology (IT) companies in India responded to the short-form workstyle questionnaire and pain questionnaire. Correlation analyses were conducted to examine the associations between different variables followed by a multivariate logistic regression to understand the unique predictors of pain and loss of productivity. Results 4,500 participants responded to the workstyle and pain questionnaire. 22% of participants were reported to have a high risk of an adverse workstyle. 63% of participants reported pain symptoms. Social reactivity, lack of breaks, and deadlines/pressure subscales of workstyle questionnaire were significantly correlated with pain and loss of productivity. Regression analyses revealed that workstyle factors and duration of computer use per day were significant predictors of pain. Conclusion Workstyle seems to be a mediating factor for musculoskeletal pain, discomfort, and loss of productivity. Based on the study findings, it is recommended that intervention efforts directed towards prevention of musculoskeletal disorders should focus on psychosocial work factors such adverse workstyle in addition to biomechanical risk factors.     

The effect of ergonomic interventions in healthcare facilities on musculoskeletal disorders

BACKGROUND: The high incidence of musculoskeletal disorders (MSDs) among healthcare workers suggests that the introduction of ergonomic interventions could be beneficial. While laboratory studies have clearly documented the efficacy of ergonomic devices, few studies have examined their effectiveness in the healthcare workplace. METHODS: This study evaluated a statewide program that provided ergonomic consultation and financial support for purchasing ergonomic devices, which aid in patient handling and lifting. Changes in MSD rates between baseline (1 year pre-intervention) and post-intervention (up to 2 years) periods were examined in 100 work units in 86 healthcare facilities. RESULTS: The median MSD rate decreased from 12.32 to 6.64 per 200,000 employee-hours, a decrease greater than the secular trend for the study period (1999-2003). CONCLUSIONS: This study suggests that ergonomic consultation and financial support for purchasing ergonomic equipment can be an effective intervention to reduce MSDs among healthcare workers.