Effectiveness of Work Injury Prevention Education and Safety Training by an Occupational Therapist

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Introduction

Injuries that occur in the workplace are a serious matter for both the injured employee and the employer. The US Department of Labor's Bureau of Labor Statistics reported that 4,257,300 nonfatal injuries occurred in private industry during 2004. Over a million of these injuries required the employee to spend days away from work. Overall, musculoskeletal disorders accounted for 32% of injuries (US Department of Labor 2006).

Financially, these injuries affect the cost of care, loss of employee productivity and lost wages. Kinn et al (2000) reported that 52.6% of the injured workers in their study had not received job-site safety orientation before the injury occurred and 57.9% did not receive safety education and training. The cost for employee education to prevent employee injury can be far less than that of medical care, loss in productivity and lost wages. In a study that utilised data from the Occupational Safety and Health Administration (OSHA) log, which is used to report injuries and the hospital's workers' compensation insurance records, from 1 January 1996 to 31 December 1997, Evanoff et al (1999) evaluated the effectiveness of a participatory ergonomics programme. They found that the rate of injuries and lost days fell dramatically among orderlies following implementation of the intervention (Evanoff et al 1999). Also reported was a drop in workers' compensation insurance costs from a total cost of $58,650 in the 3 years preceding the study to $22,758 throughout the 2-year study period, while the overall cost of the safety and ergonomics programme implementation was reported to be less than $5,000. Effective methods for educating employees that present safety information and increase employee understanding and awareness of how to perform their jobs safely are needed.

There is a need in the workplace for determining what can be done to help to prevent work-related musculoskeletal disorders (WRMSDs) and workers' compensation costs. For example, a survey to measure the knowledge and application of proper body mechanics was given to 100 workers at DeRoyal Orthopedic Group who were considered 'at risk' for back injury (Neal 1997, p67). The survey results showed that the participants chose the best answer to the questions only 53.4% of the time, with a trend towards knowing more about proper lifting techniques than the actual application of safe techniques, indicating the need for increased education on proper body mechanics.

Purpose of the study

The purpose of the study presented was to evaluate the changes in supervisor and employee perceptions of their knowledge regarding work injury after prevention education was provided by an occupational therapist. The purpose was addressed by answering the following research questions:

1. After injury prevention education, was the perception of supervisors regarding the prevention of WRMSDs improved?

2. After injury prevention education, was the perception of employees regarding the prevention of WRMSDs improved?

It was suspected that injury prevention education provided by an occupational therapist to supervisors and employees would result in an increased knowledge about WRMSDs, which could result in a decrease in the number of injuries at work. However, this would need to be the subject of future research.

Literature review

A musculoskeletal disorder (MSD) is an injury or disorder of the muscles, nerves, tendons, joints, cartilage or spinal discs (US Department of Labor 2006). In 2004, 525,390 cases were reported involving sprains, strains and tears while 282,240 involved a back-related injury. Overall, MSDs accounted for 32% of injuries with days away from work (US Department of Labor 2006). These statistics suggest that there is a significant need to reduce work-related musculoskeletal injuries.

Although there are some studies that implement and analyse the effectiveness of injury prevention programmes, most do so by evaluating the overall reduction in the number of injuries and subsequent monetary gains rather than evaluating the workers' perceptions of their ability to understand job safety. Some studies that report a reduction in the number of injuries do not delineate if this drop is due to an overall general emphasis on safety or workers' perceptions of their understanding of new techniques that prevent injury. The following studies provided supportive evidence that work injury prevention education and safety training from an occupational therapist could result in improved employee perception of how to complete their jobs with increased safety, while also demonstrating the need for further research.

Lieber et al (2000) stated that the effects of lower back pain account for a significant portion of workers' compensation losses and work-related injuries. In recent years, many companies have strived to counteract this problem by developing and implementing programmes to educate and train employees about safe lifting habits and procedures. In order to provide evidence-based substantiation for these, a study to ascertain the effectiveness of body mechanics instruction in patients with low back pain was investigated by Lieber et al (2000). The findings showed that major increases in static lifting strength, lifting endurance and number of lifts were attained after the instruction. A motion analysis also showed that positive changes were made regarding starting posture and lifting speed for three out of the four participants.

Kinn et al (2000) investigated the efficacy of a safety orientation programme among construction workers, specifically plumbing and pipefitting workers. These investigators reported that the average direct cost that an injured construction worker incurred in 1997 was between $781 and $935 and that indirect costs varied between twice and 20 times that amount. With 84,000 injuries in that job classification alone during 1996 -1998, 'total losses in the plumbing and pipefitting industry were estimated to range between 216 million and 1.51 billion dollars' (p1143). To that end, many safety education or injury prevention programmes were implemented in these fields in an effort to reduce these costs. Six large employers from northwestern Ohio were included in the study. Injuries were collected from the OSHA 200 log between those years. Information regarding the time, type of injury, injured person, the employee's regular duties, time lost and resulting fatalities (if any), as well as how the injury occurred, materials involved in the occurrence and the affected body parts were obtained …