Ergonomics for occupational hygienists in developing countries with examples from Sri Lanka.

Occupational health problems in developing countries, especially those situated in the tropical zone, are difficult to define. The conditions are more adverse in unorganized small-scale industries. The application of ergonomic principles in the practice of occupational health in developing countries must be subject to all aspects of community health and impact of industrialization as well. Ergonomics offers a broad concept to health scientists in developing countries. "Systems ergonomics" is not applicable. On the contrary, the fact that ergonomics conveys a different meaning to those in developing countries is highlighted by a few examples from Sri Lanka. The author presents his view for consideration in the development of international instruments to prescribe the sale of guarded machinery to developing countries and the limitation of incentive schemes for performing arduous tasks leading to occupational illnesses.     

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.     

Flexible work hours, health and well-being in the European Union: preliminary data from a SALTSA project

Demand for flexible work hours (FWH) is increasing in Europe aimed at increasing the number of production hours on one hand, and, on the other, reducing individual working hours and/or increasing autonomy and control on them. In view of the lack of knowledge of the effects of FWH on health and safety, we started a pilot project, funded by the Joint Programme for Working Life Research in Europe (SALTSA), aimed at: a) comparing the most relevant national legislation and how the EU Directive 93/104 "concerning certain aspects of working time" has been implemented in the member States; b) reporting prevalence and trend of FWH in Europe according to the three EU Surveys on Working Conditions carried out in the last decade; c) collecting practical examples of innovative FWH; d) evaluating their impact on health and safety in relation to work sectors, job demands, social life, aging and gender. Consequent actions are going to include information and consultancy for pertinent authorities and social parties involved, as well as training programmes for Union officials and similar groups concerning the organisation of FWH according to ergonomic principles.     

Anthropometric evaluation of the Creches children furniture in Turkey

The dimensions of the living and working space and buildings, the types of material and different riggings should be designed to conform to the users' anthropometric measures. The first requirement to design on ergonomic system is to measure the human being who will work and live in that system. Because of this, anthropometric measures are the most frequently used ergonomic data during the design process. In this research paper, we attempt to organize a new data base of anthropometric data to use in the design of children's equipment and furniture used in crèches. A starting point for research on the proper dimensions of creche furniture is to investigate how the dimensions of furniture reflect the body dimensions and the functional needs of the children using furniture. The anthropometric data of 3, 4 and 5 year-old-children in crèches was used. We report the results of the measurements of 18 anthropometric characteristics of children which constitute a set of basic data for the design of functional spaces and furniture.     

Work-related musculoskeletal disorders: the epidemiologic evidence and the debate.

The debate about work-relatedness of musculoskeletal disorders (MSDs) reflects both confusion about epidemiologic principles and gaps in the scientific literature. The physical ergonomic features of work frequently cited as risk factors for MSDs include rapid work pace and repetitive motion, forceful exertions, non-neutral body postures, and vibration. However, some still dispute the importance of these factors, especially relative to non-occupational causes. This paper addresses the controversy with reference to a major report recently commissioned by the US Congress from the National Research Council (NRC) and Institute of Medicine (IOM) (2001). The available epidemiologic evidence is substantial, but will benefit from more longitudinal data to better evaluate gaps in knowledge concerning latency of effect, natural history, prognosis, and potential for selection bias in the form of the healthy worker effect. While objective measures may be especially useful in establishing a more secure diagnosis, subjective measures better capture patient impact. Examination techniques still do not exist that can serve as a "gold standard" for many of the symptoms that are commonly reported in workplace studies. Finally, exposure assessment has too often been limited to crude indicators, such as job title. Worker self-report, investigator observation, and direct measurement each add to understanding but the lack of standardized exposure metrics limits ability to compare findings among studies. Despite these challenges, the epidemiologic literature on work-related MSDs-in combination with extensive laboratory evidence of pathomechanisms related to work stressors-is convincing to most. The NRC/IOM report concluded, and other reviewers internationally have concurred, that the etiologic importance of occupational ergonomic stressors for the occurrence of MSDs of the low back and upper extremities has been demonstrated.     

Ergonomic workplace evaluation of an Asian garment-factory

A large number of establishments in the garment industries of the world are situated in the southeastern part of Asia where labor is plentiful and cheap. Recent reports and observational studies suggest that employees in this industry often work under difficult conditions that are unacceptable in industrialized countries. This paper reports the results of an ergonomic study in an export garment manufacturing plant in South East Asia to evaluate the working conditions of the plant from an ergonomics/human factors perspective and to suggest possible solutions to management for implementation. The investigation was done by a questionnaire survey and by observations and measurements in the workplace. The results indicated that the plant conditions were stressful, involving long work hours with poor safety and labor relations, and that work equipment and the physical workplace design were acceptable ergonomic practices. A low-cost solution, presented to management by the investigators, was implemented and, over a period of six months, seemed to be the dominant reason for significant improvements in throughput (14.6%), reduction in absenteeism (65%), job satisfaction (40%), decrease in employee turnover (75%), and reduction in health complaints (50%).     

The role of academic health sciences centres in international health.

For many years, Canadian academic health science centres have been active in international health. This brief review describes the activities of the Canadian Society for International Health, the Canadian University Consortium for Health in Development, and McGill, McMaster and Ottawa universities. Three principles are derived from these examples. Health must be placed in the broader context of development, and international health initiatives must be intersectoral. Canadian universities can make a distinctive and important contribution to health and development internationally, but this requires a clear commitment to scientific excellence and social responsibility. Finally, Canadian institutions, as representatives of the North, have much to learn through collaboration and partnerships with institutions in the South.     

The handaxe reconsidered

The Acheulean handaxe is one of the longest‐known and longest‐surviving artifacts of the Palaeolithic and, despite its experimentally tested functionality, is often regarded as puzzling. It is unnecessary to invoke a unique‐for‐mammals genetic mechanism to explain the handaxe phenomenon. Instead, we propose that two nongenetic processes are sufficient. The first is a set of ergonomic design principles linked to the production of sturdy, hand‐held cutting tools in the context of a knapped‐stone technology that lacked hafting. The second is an esthetic preference for regular forms with gradual curves and pleasing proportions. Neither process is a cultural meme but, operating together in a cultural context, they can account for all of the supposedly puzzling time‐space patterns presented by handaxes.     

Healthy shiftwork, healthy shiftworks

Reflecting diversifying shift systems, extensive effort is put into managing shiftwork and reducing safety and health risks. It is accepted that shiftworkers are exposed to particular risks inherent in their irregular work schedules. This raises the question of how and to what extent we can ensure healthy work life for shiftworkers. In answering the question, we need to identify effective measures to improve both shiftworking conditions and the health of shiftworkers. Based on recent experiences in managing shiftwork, we note three directions of such measures: (a) comprehensive action to avoid risk-enhancing conditions based on general guidelines, (b) risk control as to workload, worksite ergonomics and risk reduction, and (c) support for flexible and restful working life. International standards are obviously relevant to these three aspects. Our own experiences in applying a set of ergonomic checkpoints to plant maintenance shiftwork demonstrate the usefulness of focusing on flexible work schedules and on multiple job-related factors such as night workload, ergonomic environment, resting conditions and training. There is a strong need for participatory planning and implementation of multi-area improvements as well as for relying on flexible schedules and autonomic teamwork. We may conclude that healthy shiftwork and healthy shiftworkers are compatible with each other only when certain conditions are met. In achieving this end, we need to combine (a) comprehensive measures to improve work schedules and job life, (b) strict risk management and (c) locally adjusted participatory steps for continual improvement.     

Disease risks and overabundance of game species

Different studies have evidenced the relationship between host abundance and health status of wildlife populations. Diseases that benefit from wildlife overabundance can affect not only the fitness and trophy quality of game species, but also public health, livestock health, and the conservation of endangered species. This paper reviews a number of European examples to highlight the relationship between overabundance and disease in game species, and discusses the possibilities of limiting the associated risks. Management tools to estimate overabundance are needed for legislative purposes and for the monitoring of wildlife populations, but artificial feeding interferes in the objective measurement of overabundance. Therefore, we propose a multidisciplinary approach to diagnose if a given wildlife population is overabundant. This includes not only signs such as adverse effects on the soil, vegetation or fauna (first group), poor body condition scores, low trophy scores or low reproductive performance (second group), or increased parasite burdens (third group), but also the measurement of infectious disease prevalences (the fourth group of overabundance signs). This combined assessment of overabundance ideally requires the cooperation of wildlife managers, botanists, and veterinarians. Once a given wildlife population is defined as overabundant, it is difficult to establish palliative management actions. These can consist in banning certain management tools (e.g. feeding) or increasing the hunting harvest, but both of them are difficult to implement in practice. A close monitoring of both wildlife densities and wildlife diseases, the establishment of reference values for all signs of overabundance, and the mapping of the disease and density hotspots will be needed to design adequate risk-control measures for each particular situation.     

Unique design for fixed ventilated changing station

The Jackson Laboratory animal colonies present a unique challenge for the design and operation of an animal changing station that maximizes protection of animal health and welfare while also protecting the health and safety of the animal caretaker. The authors describe the modification of a fixed ventilated changing station for improved animal health, reduced ergonomic strain, and decreased allergen exposure.     

浅谈麻醉机的外形设计中人性化考虑

本文就国内市场上进口和国产品牌麻醉机的外形和显示方面作了比较,探讨在这方面的人性化设计思路对用户使用的影响,也让用户,生产厂家看到到国内产品和进口品牌的外形差距,建立产品设计生产符合医疗使用流程和安全的意识。     

Evaluating the Cost-Effectiveness of Lifestyle Modification versus Metformin Therapy for the Prevention of Diabetes in Singapore

BackgroundIn Singapore, as diabetes is an increasingly important public health issue, the cost-effectiveness of pursuing lifestyle modification programs and/or alternative prevention strategies is of critical importance for policymakers. While the US Diabetes Prevention Program (DPP) compared weight loss through lifestyle modification with oral treatment of diabetes drug metformin to prevent/delay the onset of type 2 diabetes in pre-diabetic subjects, no data on either the actual or potential cost effectiveness of such a program is available for East or South-east Asian populations. This study estimates the 3-year cost-effectiveness of lifestyle modification and metformin among pre-diabetic subjects from a Singapore health system and societal perspective.MethodologyCost effectiveness was analysed from 2010–2012 using a decision-based model to estimate the rates of getting diabetes, healthcare costs and health-related quality of life. Cost per quality-adjusted life year (QALY) was estimated using costs relevant to the time horizon of the study from Singapore. All costs are expressed in 2012 US dollars.ConclusionBased on adaptation of the DPP data to local conditions, both lifestyle modification and metformin intervention are likely to be cost-effective and worth implementing in Singapore to prevent or delay the onset of type 2 diabetes. However, the cost of lifestyle modification from the societal perspective would have to be reduced in order to match the cost-effectiveness of metformin intervention.     

A reversal of fertility trends in Singapore

Free access to contraception and effective legislation measures, have resulted in a decline in fertility in Singapore. A new population policy of 'three children or more if you can afford it' was therefore introduced in 1986. This paper discusses the new population policies and measures their effect on fertility in Singapore.     

Combined physiological and anthropometrical databases as ergonomic tools

The purpose of this study was to establish an ergonomic basis for the integration of female personnel at military workplaces. The results of anthropometrical and physiological measurements of 1337 male and female subjects (aged 18-25 years) are presented. The empirical design included classical and functional body measures of high ergonomic relevance. Additionally, the isometric forearm-flexor and knee-extensor forces of the subjects were tested as representative variables for their physiological suitability. With regard to biometric and strength parameters, the present results clearly show only small overlaps between the sexes. Rating the 5th percentile of the male subjects as an exclusion value, the anthropometrical variables (sitting and standing body height measures, shoulder breadth, hand length and breadth etc.) show that 29% up to 72% of the women do not match this criterion. The situation becomes even worse when strength parameters are taken into consideration: Only 26% (knee extensors) respectively 3% (forearm flexors) of the females generate higher forces than the corresponding 5th percentiles of their male counterparts. The application of the database established in this survey aims at the integration of female personnel at all kinds of military workplaces; our data account for a combination of anthropometrical and physiological variables. In contrast to former systems based on isolated percentile tables, the results of our investigation make multivariate queries possible in optimization processes. This type of combined database is to be considered a useful tool for the evaluation of workplaces and personal equipment, for general ergonomic considerations and for personnel planning purposes to prevent applicants from occupational harm.     

Designing safer (soft) drugs by avoiding the formation of toxic and oxidative metabolites

Integration metabolic considerations into the drug-design process can allow safer pharmaceuticals to be designed. "Soft" drugs are designed to be deactivated in a predictable and controllable way after achieving their therapeutic role. They are designed to be metabolized rapidly and by avoiding oxidative pathways into inactive and nontoxic species. Successful application of such design principles has already resulted in a number of marketed drugs. The present article illustrates advantages inherent in avoiding the formation of oxidative metabolites, with examples that include soft bufuralol analogs and soft insecticides such as chlorobenzilate and malathion. Design principles for various soft drug classes are briefly summarized together with computerized tools intended to make the application of these principles more quantitative and more accessible.     

Sensitivity of the Welfare Quality® broiler chicken protocol to differences between intensively reared indoor flocks: which factors explain overall classification?

There is a large demand for holistic welfare assessment systems that result in a singular balanced summary of welfare. The Welfare Quality® (WQ) broiler protocol summarizes 18 welfare measures into four principles (‘good feeding’, ‘good housing’, ‘good health’ and ‘appropriate behaviour’), which are then integrated into one overall category (‘excellent’, ‘enhanced’, ‘acceptable’ or ‘not classified’). But the protocol is time consuming which hampers implementation. Furthermore, WQ’s aim to assess animal welfare in a wide range of husbandry systems may decrease its ability to discriminate between flocks from the same system. We applied the protocol in the context of intensive indoor rearing to assess whether it discriminated sufficiently between flocks, could be shortened without losing essential information, and provided a balanced summary of welfare. The vast majority of the flocks (88%) received the same overall classification (acceptable) whilst all other flocks received an adjacent classification (enhanced), suggesting poor discriminative capacity. For 95% of the flocks overall classification was explained by two measures only (‘drinker space’ and ‘stocking density’). A system based on these two measures would reduce assessment time from 3.5 h to a few minutes. However, both measures’ validity can be questioned as they are risk factors for poor welfare rather than animal-based outcome measures and they suffer from methodological weaknesses. Furthermore, the possibility for such an extreme simplification raises doubts on whether the overall classification reflects a balanced summary of different welfare aspects. In line with this, overall classification was not affected by replacing single measures within the ‘good health’ and ‘appropriate behaviour’ principles with realistically attainable minima or maxima for intensively reared flocks. Even replacing either of these two principles entirely with their realistically obtainable minimum or maximum did not affect classification. Such insensitivity to change may discourage attempts to improve the welfare of intensively reared flocks when assessments are made based on the overall classification. This calls for an adjustment of the classification system, which is currently being developed by the Welfare Quality Network.     

Designed and real working situations in machine systems operation.

New work situations designed at the stage when new machine systems are introduced are realized on the assumption that the new systems can maintain their designed functions consistently, generally eliminating previous work habits and without sufficient knowledge about real working processes and skills. This may produce differences between designed and real working situations. Some examples are presented from observations on influence of modern design of cargo ships on their crews. It was difficult for crews to maintain stable working conditions, especially when machine systems deviated from their designed functions. Often the crew had to work in off-duty hours giving up private freetime activities. Among various factors contributing to the discrepancies between designed and real work, lack of availability of the new systems is the most important factor. Also important is lack of back-up systems which would function either when the machine systems are out of order or when previous working skills and habits must be applied. A need for developing methods of evaluation of these two factors from ergonomic points of view is pointed out.     

Anthropological research in reference to ergonomics

Ergonomic anthropology is a complex synthesis of studies which was formed at the borderline of anthropology, physiology and psychology. The subject of the studies is the psychosomatic status of working men interacting with techniques by means of technical tools. This status has a dual display: first, through somatometric features, known as ergonomic dimensions; second, through the subjective feelings (proprioreceptive) of a working person on the level of comfort or discomfort of the soma. The ergonomic dimensions of the body serve as a basis for calculations of the parameters of working places and reflect posture and movement activity. Three groups of methodological tasks are tested. 1. Adaptation of the anthropometric method and discovery of its specificity for ergonomics tasks. 2. Elaboration of principles and rules of applying ergonomics measurements of the body for constructing techniques. 3. The choice of objective and subjective methods of somatic comfort evaluations.