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      Response to “Ergonomic Intervention For Musculoskeletal Disorders in Construction Workers”

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          Abstract

          In Reply, We'd like to respond to the comments on our recently published article “Use of Ergonomic Measures Related to Musculoskeletal Complaints among Construction Workers: A 2-year Follow-up Study” [1] and share our opinion on the topics mentioned. The methodological quality of the study is discussed and questions are raised regarding selection criteria, the reliability of the data gathered, and possible confounding factors that might have influenced the study results. Furthermore, we're asked how we monitored the workers and ensured that all workers used the ergonomic measures correctly. Finally, we're asked why we did not use qualitative methods to gain insight into barriers and facilitators for using ergonomic measures among the construction workers. Based on the comments, we've got the impression that the commenters confused our implementation evaluation with an effectiveness evaluation of ergonomic measures for construction workers. We'd like to point out that the Dutch sectors' Health and Safety Institute implemented the national campaign “LighterWork(s)”, whose goal was to inform both workers and employers about ergonomic measures and to increase awareness about the use of those measures to decrease musculoskeletal disorders (MSDs) (see Introduction of the original article). Monitoring workers and intervening on the correct use of ergonomic measures was not the goal of the campaign. Other research projects have shed light on this approach [2]. The sectors' implementation allowed for an evaluation; we didn't design it as a randomized controlled trial as in other studies [3]. With respect to the comments about the methodological limitations of the study, we feel that we've covered the important topics in our discussion. We mentioned several sources of bias, confounding, and the limitations of our study design. Of course, we agree that the proposed development of reliable and valid instruments to gather job-specific information on the use of ergonomic measures would be valuable for both research and practice. However, the development of new instruments is not always feasible, and thus by adequately and transparently describing the questions, as we did, other researchers are provided with insight into how and what data was gathered. We'd like to point out that all occupations were asked about the same types of ergonomic measures (horizontal and vertical transport, and the positioning and installing of materials), but in a job-specific way in order to increase the relevancy for the workers. Overall, we think that the commenters were confused and misinterpreted our implementation evaluation with an effectiveness trial. We think both study designs are very distinct and serve different necessary (research) purposes [4]. Of course, the commenters are welcome to share other or remaining questions by sending a direct message. Conflicts of interest All contributing authors declare no conflicts of interest.

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          Developing and evaluating complex interventions: the new Medical Research Council guidance

          Evaluating complex interventions is complicated. The Medical Research Council's evaluation framework (2000) brought welcome clarity to the task. Now the council has updated its guidance
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            Guidance strategies for a participatory ergonomic intervention to increase the use of ergonomic measures of workers in construction companies: a study design of a randomised trial

            Background More than seven out of 10 Dutch construction workers describe their work as physically demanding. Ergonomic measures can be used to reduce these physically demanding work tasks. To increase the use of ergonomic measures, employers and workers have to get used to other working methods and to maintaining them. To facilitate this behavioural change, participatory ergonomics (PE) interventions could be useful. For this study a protocol of a PE intervention is adapted in such a way that the intervention can be performed by an ergonomics consultant through face-to-face contacts or email contacts. The objective of this study is to evaluate the effectiveness of the face-to-face guidance strategy and the e-guidance strategy on the primary outcome measure: use of ergonomic measures by individual construction workers, and on the secondary outcome measures: the work ability, physical functioning and limitations due to physical problems of individual workers. Methods/Design The present study is a randomised intervention trial of six months in 12 companies to establish the effects of a PE intervention guided by four face-to-face contacts (N = 6) or guided by 13 email contacts (N = 6) on the primary and secondary outcome measures at baseline and after six months. Construction companies are randomly assigned to one of the guidance strategies with the help of a computer generated randomisation table. In addition, a process evaluation for both strategies will be performed to determine reach, dose delivered, dose received, precision, competence, satisfaction and behavioural change to find possible barriers and facilitators for both strategies. A cost-benefit analysis will be performed to establish the financial consequences of both strategies. The present study is in accordance with the CONSORT statement. Discussion The outcome of this study will help to 1) evaluate the effect of both guidance strategies, and 2) find barriers to and facilitators of both guidance strategies. When these strategies are effective, implementation within occupational health services can take place to guide construction companies (and others) with the implementation of ergonomic measures. Trail registration Trailnumber: ISRCTN73075751, Date of registration: 30 July 2013.
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              Strategies to reduce safety violations for working from heights in construction companies: study protocol for a randomized controlled trial

              Background Safety measures should be applied to reduce work-related fatal and non-fatal fall injuries. However, according to the labor inspectorate, more than 80% of Dutch construction sites violate safety regulations for working from heights. To increase compliance with safety regulations, employers and workers have to select, implement and monitor safety measures. To facilitate this behavioral change, stimulating knowledge awareness and personalized feedback are frequently advocated behavior change techniques. For this study, two behavior change strategies have been developed in addition to the announcement of safety inspections by the labor inspectorate. These strategies consist of 1) face-to-face contacts with safety consultants and 2) direct mail with access to internet facilities. The objective of this study is to evaluate the effectiveness of these two strategies on the safety violations for working from heights, the process and the cost measures. Methods/Design This study is a block randomized intervention trial in 27 cities to establish the effects of the face-to-face guidance strategy (N = 9), a direct mailing strategy (N = 9) and a control condition of no guidance (N = 9) on safety violations to record by labor inspectors after three months. A process evaluation for both strategies will be performed to determine program implementation (reach, dose delivered and dose received), satisfaction, knowledge and perceived safety behavior. A cost analysis will be performed to establish the financial costs for both strategies. The present study is in accordance with the CONSORT statement. Discussion This study increases insight into performing practice-based randomized controlled trials. The outcome will help to evaluate the effect of two guidance strategies on safety violations. If these strategies are effective, implementation of these strategies through the national institute of safety and health or labor inspectorate can take place to guide construction companies in complying with safety regulations. Trial registration NTR 4298 on 29-nov-2013.
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                Author and article information

                Contributors
                Journal
                Saf Health Work
                Saf Health Work
                Safety and Health at Work
                Occupational Safety and Health Research Institute
                2093-7911
                2093-7997
                18 December 2015
                September 2016
                18 December 2015
                : 7
                : 3
                : 256
                S2093-7911(15)00112-2
                10.1016/j.shaw.2015.12.001
                5011090
                Copyright © 2016, Occupational Safety and Health Research Institute. Published by Elsevier.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                Categories
                Letter to the Editor

                Occupational & Environmental medicine

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