Abstract
Objective
To evaluate the effectiveness of an ergonomic intervention program based on the PRECEDE–PROCEED model in terms of improving exposure risks and work-related health problems in emergency medical dispatchers.
Methods
This quasi-experimental study used an interrupted time series design. Participants were 55 employees working in an Emergency Medical Communications Center in Iran. The intervention program was based on the PRECEDE–PROCEED model and included five face-to-face training sessions and installing auxiliary equipment according to best ergonomic principles. Direct observations of the emergency medical dispatchers’ working postures using the Rapid Office Strain Assessment and a survey which included a modified Nordic Questionnaire, Work Ability Score, Visual Fatigue Questionnaire, and a Behavioral Factors Questionnaire were used at three time points: baseline, 1 month post-intervention, and 3 months post-intervention.
Results
The modified Nordic Questionnaire showed significant reductions in pain intensity scores for neck, lower back, knee and ankle after the ergonomic intervention program. In addition, there were considerable post-training improvements in behavioral factors (knowledge and enabling factors) and working postures. No significant changes were observed in Work Ability Scores, or visual symptoms.
Conclusions
An ergonomic intervention program based on a systematic framework such as the PRECEDE–PROCEED model and on-site interventions can be effective in improving and enhancing the working conditions of emergency medical dispatchers. Therefore, it is suggested that ergonomic interventions be implemented based on standard and valid behavioral change models such as PRECEDE–PROCEED model in other work environments in which musculoskeletal pain and digital eye strain are common.
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References
Aarås A, Horgen G, Ro O, Løken E, Mathiasen G, Bjørset H-H, Larsen S, Thoresen M (2005) The effect of an ergonomie intervention on musculoskeletal, psychosocial and visual strain of VDT data entry work: the Norwegian part of the international study. Int J Occup Saf Ergon 11:25–47. https://doi.org/10.1080/10803548.2005.11076627
Albin TJ (2015) Computer ergonomics: the state of the art. Work 52:215–216. https://doi.org/10.3233/work-152169
Ali M, Ahsan GU, Hossain A (2020) Prevalence and associated occupational factors of low back pain among the bank employees in Dhaka City. J Occup Health 62:e12131. https://doi.org/10.1002/1348-9585.12131
Baumann A, Holness DL, Norman P, Idriss-Wheeler D, Boucher P (2012) The Ergonomic Program Implementation Continuum (EPIC): integration of health and safety-A process evaluation in the healthcare sector. J Saf Res 43:205–213. https://doi.org/10.1016/j.jsr.2012.07.003
Berezutsky VI (2018) Computer mouse, keyboard and carpal tunnel syndrome. Med Perspekt 23:23–33. https://doi.org/10.26641/2307-0404.2018.2(part1).142330
Blagojević L, Petrović B, Blagojević J (2012) Risk factors for health disorders in computer operators in telecom Serbia. Int J Occup Saf Ergon 18:321–327. https://doi.org/10.1080/10803548.2012.11076935
Boadi-Kusi SB, Adueming POW, Hammond FA, Antiri EO (2021) Computer vision syndrome and its associated ergonomic factors among bank workers. Int J Occup Saf Ergon. https://doi.org/10.1080/10803548.2021.1897260
Castrén M, Karlsten R, Lippert F, Christensen EF, Bovim E, Kvam A, Robertson-Steel I, Overton J, Kraft T, Engerstrom L, Garcia-Castrill Riego L (2008) Recommended guidelines for reporting on emergency medical dispatch when conducting research in emergency medicine: the Utstein style. Resuscitation 79:193–197. https://doi.org/10.1016/j.resuscitation.2008.07.007
Chen HM, Leung CT (2007) The effect on forearm and shoulder muscle activity in using different slanted computer mice. Clin Biomech 22:518–523. https://doi.org/10.1016/j.clinbiomech.2007.01.006
Choobineh A, Motamedzade M, Kazemi M, Moghimbeigi A, Pahlavian AH (2011) The impact of ergonomics intervention on psychosocial factors and musculoskeletal symptoms among office workers. Int J Industrial Ergon 41:671–676. https://doi.org/10.1016/j.ergon.2011.08.007
Derbew H, Nega A, Tefera W, Zafu T, Tsehaye K, Haile K, Temesgen B (2021) Assessment of computer vision syndrome and personal risk factors among employees of Commercial Bank of Ethiopia in Addis Ababa, Ethiopia. J Environ Pub Health. https://doi.org/10.1155/2012/6636907
Dunford JV (2002) Emergency medical dispatch. emergency Med. Clinics 20:859–875. https://doi.org/10.1016/S0733-8627(02)00032-9
Gielen AC, McDonald EM, Gary TL, Bone LR (2008) Using the precede-proceed model to apply health behavior theories. In: Glanz K, Rimer BK, Viswanath K (eds) Health behavior and health education: theory, research, and practice, 4th edn. Jossey-Bass, CA, pp 407–433
Golding SE, Horsfield C, Davies A, Egan B, Jones M, Raleigh M, Schofield P, Squires A, Start K, Quinn T, Cropley M (2017) Exploring the psychological health of emergency dispatch centre operatives: a systematic review and narrative synthesis. PeerJ 5:e3735
Green LW, Kreuter MW (2005) Health program planning: an educational and environmental approach, 4th edn. McGraw-Hill, New York (IBSN 0072556838)
Gustafsson E, Hagberg M (2003) Computer mouse use in two different hand positions: exposure, comfort, exertion and productivity. Appl Ergon 34:107–113. https://doi.org/10.1016/s0003-6870(03)00005-x
Habibi E, Pourabadian S, Rajabi H, Deghan H, Maracy MR (2011) Development and validation of a visual fatigue questionnaire for video display terminal users. Health System Res 7:492–503 https://sid.ir/en/journal/ViewPaper.aspx?id=2630701
Heidarimoghadam R, Mohammadfam I, Babamiri M, Soltanian AR, Khotanlou H, Sohrabi MS (2020) Study protocol and baseline results for a quasi-randomized control trial: an investigation on the effects of ergonomic interventions on work-related musculoskeletal disorders, quality of work-life and productivity in knowledge-based companies. Int J Industrial Ergon 80:103030. https://doi.org/10.1016/j.ergon.2020.103030
Janwantanakul P, Pensri P, Jiamjarasrangsri V, Sinsongsook T (2008) Prevalence of self-reported musculoskeletal symptoms among office workers. Occup Med 58:436–438. https://doi.org/10.1093/occmed/kqn072
Jomoah IM (2014) Work-related health disorders among Saudi computer users. Sci World J. https://doi.org/10.1155/2014/723280
Jovanović S, Šimunič B (2021) Effect of ergonomic Armrest® forearm support on wrist posture related to carpal tunnel pressure during computer mouse work. Int J Industr Ergon 66:103220. https://doi.org/10.1016/j.ergon.2021.103220
Khattak SA (2019) Role of ergonomics in re-designing job design in call centres. Int J Occup Saf Ergon 27:748–793. https://doi.org/10.1080/10803548.2019.1630111
Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sørensen F, Andersson G, Jørgensen K (1987) Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon 18:233–237. https://doi.org/10.1016/0003-6870(87)90010-X
Mokarami H, Cousins R, Kalteh HO (2021) Comparison of the work ability index and the work ability score for predicting health-related quality of life. Int Arch Occup Environ Health. https://doi.org/10.1007/s00420-021-01740-9
Moshki M, Alami A, Fallahi M, Sarvari Khah H (2020) Applying the PRECEDE-PROCEED model to promote preventive behaviors of musculoskeletal disorders in computer users. Iran Occup Health 17:71
Namnik N, Negahban H, Salehi R, Shafizadeh R, Tabib MS (2016) Validity and reliability of Persian version of the Specific Nordic questionnaire in Iranian industrial workers. Work 54:35–41. https://doi.org/10.3233/WOR-162268
Nazari M, Beigi R, Salesi M, Cousins R, Mokarami H (2020) Development and validation of the tool for the evaluation of the behavioral factors affecting the prevalence of musculoskeletal disorders in Iranian students. BMC Pediatr 20:551. https://doi.org/10.1186/s12887-020-02452-8
Ranasinghe P, Wathurapatha W, Perera Y, Lamabadusuriya D, Kulatunga S, Jayawardana N, Katulanda P (2016) Computer vision syndrome among computer office workers in a developing country: an evaluation of prevalence and risk factors. BMC Res Notes 9:150. https://doi.org/10.1186/s13104-016431962-1
Robertson M, Amick BC III, DeRango K, Rooney T, Bazzani L, Harrist R, Moore A (2009) The effects of an office ergonomics training and chair intervention on worker knowledge, behavior and musculoskeletal risk. Appl Ergon 40:124–135. https://doi.org/10.1016/j.apergo.2007.12.009
Salvendy G (2012) Handbook of human factors and ergonomics, 4th edn. Wiley, New York (IBSN 9781118131350)
Sanaeinasab H, Saffari M, Valipour F, Alipour HR, Sepandi M, Al Zaben F, Koenig HG (2018) The effectiveness of a model-based health education intervention to improve ergonomic posture in office computer workers: a randomized controlled trial. Int Arch Occup Environ Health 91:951–962. https://doi.org/10.1007/s00420-018-1336-1
Schmidt AB, Kubler PA, Johnston V, Coppieters MW (2015) A vertical mouse and ergonomic mouse pads alter writst position but do not reduce carpal tunnel pressure in patients with carpal tunnel syndrome. Appl Ergon 47:151–156. https://doi.org/10.1016/j.apergo.2014.08.020
Sezgin D, Esin MN (2018) Effects of a PRECEDE-PROCEED model based ergonomic risk management programme to reduce musculoskeletal symptoms of ICU nurses. Intensive Critical Care Nurs 47:89–97. https://doi.org/10.1016/j.iccn.2018.02.007
Shariat A, Cleland JA, Danaee M, Kargarfard M, Sangelaji B, Tamrin SBM (2018) Effects of stretching exercise training and ergonomic modifications on musculoskeletal discomforts of office workers: a randomized controlled trial. Brazil J Phys Therapy 22:144–153. https://doi.org/10.1016/j.bjpt.2017.09.003
Skřehot P, Marek J, Houser F (2017) Ergonomic aspects in control rooms. Theoret Issues Ergon Sci 18:46–58. https://doi.org/10.1080/1463922X.2016.1159356
Sohrabi MS, Babamiri M (2021) Effectiveness of an ergonomics training program on musculoskeletal disorders, job stress, quality of work-life and productivity in office workers: a quasi-randomized control trial study. Int J Occup Saf Ergon. https://doi.org/10.1080/10803548.2021.1918930
Sonne M, Villalta DL, Andrews DM (2012) Development and evaluation of an office ergonomic risk checklist: ROSA–Rapid office strain assessment. Appl Ergon 43:98–108. https://doi.org/10.1016/j.apergo.2011.03.008
Sprigg CA, Stride CB, Wall TD, Holmann DJ, Smith PR (2007) Work characteristics, musculoskeletal disorders, and the mediating role of psychological strain: a study of call center employees. J App Psychol 92:1456–1466. https://doi.org/10.1037/0021-9010.92.5.1456
Torlén K, Kurland L, Castrén M, Olanders K, Bohm K (2017) A comparison of two emergency medical dispatch protocols with respect to accuracy. Scand J Trauma Resusc Emerg Med 25:122. https://doi.org/10.1186/s13049-017-0464-z
Trillos-Chacón M-C, Castillo-M JA, Tolosa-Guzma IT, Medina APS, Ballesteros SM (2021) Strategies for the prevention of carpal tunnel syndrome in the workplace: a systematic review. Appl Ergon 93:103353. https://doi.org/10.1016/j.apergo.2020.103353
Visser S, van der Molen HF, Sluiter JK, Frings-Dresen MH (2019) Evaluation of the effects of two alternative participatory ergonomics intervention strategies for construction companies. Ergon 62:41–51. https://doi.org/10.1080/00140139.2018.1516806
Woo EHC, White P, Lai CWK (2016) Ergonomics standards and guidelines for computer workstation design and the impact on users’ health–a review. Ergon 59:464–475. https://doi.org/10.1080/00140139.2015.1076528
Acknowledgements
This study is part of the first author’s MSc thesis and was conducted with financial support from Shiraz University of Medical Sciences (Grant number: 98-01-04-21376.). The authors would like to thank the EMD employees for participating in the project.
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Barkhordarzadeh, S., Choobineh, A., Razeghi, M. et al. Effects of an ergonomic intervention program based on the PRECEDE–PROCEED model for reducing work-related health problems and exposure risks among emergency medical dispatchers. Int Arch Occup Environ Health 95, 1389–1399 (2022). https://doi.org/10.1007/s00420-022-01846-8
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DOI: https://doi.org/10.1007/s00420-022-01846-8