A socio-cognitive strategy to address farmers' tolerance of high risk work: Disrupting the effects of apprenticeship of observation

IntroductionWhy do generations of farmers tolerate the high-risk work of agricultural work and resist safe farm practices? This study presents an analysis inspired by empirical data from studies conducted from 1993 to 2012 on the differing effects of farm safety interventions between participants who live or work on farms and those who don't, when both were learning to be farm safety advocates. Both groups show statistically significant gains in knowledge and behavioral change proxy measures. However, non-farm participants' gains consistently outstripped their live/work farm counterparts.MethodDrawing on socio-cultural perspectives, a grounded theory qualitative analysis focused on identifying useful constructs to understand the farmers' resistance to adopt safety practices.FindingsUnderstanding apprenticeships of observation and its relation to experiential learning over time can expose sources of deeply anchored beliefs and how they operate insidiously to promote familiar, albeit unsafe farming practices. The challenge for intervention-prevention programs becomes how to disrupt what has been learned during these apprenticeships of observation and to address what has been obscured during this powerful socialization process.Practical applicationsImplications focus on the design and implementation of farm safety prevention and education programs. First, farm safety advocates and prevention researchers need to attend to demographics and explicitly explore the prior experiences and background of safety program participants. Second, farm youth in particular need to explore, explicitly, their own apprenticeships of observations, preferably through the use of new social media and or digital forms of expression, resulting in a story repair process. Third, careful study of the organization of work and farm experiences and practices need to provide the foundations for intervention programs. Finally, it is crucial that farm safety programs understand apprenticeships of observation are generational and ongoing over time, and interventions prevention programs need to be ‘in it’ for the long haul.     

Enhancing safety competencies of young adults: A randomized field trial (RCT)

IntroductionYoung workers are exposed to various occupational hazards, often with limited experience and skills. In this study, we investigated the effects of the Attitude to Work Program on the safety competencies of young workers. Based on the social cognitive theory, the intervention was developed to help young people adopt an active role in preventing occupational hazards and overcoming barriers to safe work.MethodThe program was implemented in eight upper secondary-level vocational schools in Finland during 2015. A total of 464 students participated in the cluster randomized field trial. Those in the intervention group (n = 229) participated in the Attitude to Work Program. During the program, students identified and practiced behavioral strategies to prevent occupational hazards. Students in the control condition (n = 235) received written material about the same safety-related topics.ResultsThe short-term follow-up showed that the intervention significantly increased safety preparedness and the internal safety locus of control among the students in the intervention condition in comparison to those in the control condition. Students in the intervention condition also showed reduced risk-taking attitudes relative to those in the control condition. Furthermore, those who benefited most from the program were high conscientiousness students. The sensation-seeking level or vocational track did not moderate any of the intervention effects.ConclusionThe results demonstrated that safety competencies can be modified by intervention techniques based on a social-cognitive framework.Practical implicationsThis study provides tools for school-based safety training and future intervention development. Further research is needed to study the relationships between cognitive factors, safety behavior, and accidents.     

The Ergonomic Program Implementation Continuum (EPIC): Integration of health and safety - A process evaluation in the healthcare sector

IntroductionThis article presents a health and safety intervention model and the use of process evaluation to assess a participatory ergonomic intervention.MethodThe effectiveness of the Ergonomic Program Implementation Continuum (EPIC) was assessed at six healthcare pilot sites in Ontario, Canada. The model provided a framework to demonstrate evaluation findings.ResultsParticipants reported that EPIC was thorough and identified improvements related to its use. Participants believed the program contributed to advancing an organizational culture of safety (COS). Main barriers to program uptake included resistance to change and need for adequate funding and resources. The dedication of organizational leaders and consultant coaches was identified as essential to the program's success.Impact on IndustryIn terms of impact on industry, findings contribute to the evidence-based knowledge of health and safety interventions and support use of the framework for creating a robust infrastructure to advance organizational COS and link staff safety and wellness with patient safety in healthcare.     

A systematic review of interventions to promote work participation in older workers

PurposeThe objective of this systematic review was to synthesize evidence on the effectiveness of interventions aimed at promoting work participation in older workers.MethodsWe followed a systematic review process developed by the Institute for Work & Health and a best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient.ResultsSeven electronic databases were searched from inception to March 2014. Evidence from 14 studies were synthesized in 4 different intervention categories: multi-component, exercise, medication and other interventions. There was moderate evidence that work participation was improved by multi-component interventions encompassing at least two of three components (health service delivery, coordination of services, and work modifications). There was not enough evidence to recommend the other interventions.ConclusionsAlthough there is a vast body of research on work participation of older workers, there are only a few high quality intervention studies aimed at improving work participation in this population. We recommend that multi-component interventions could be considered for implementation by practitioners to help improve work participation in older workers.Practical applicationsWith a moderate level of evidence, multi-component interventions could be considered for use in practice if practitioners deem it suitable for their setting. There is not enough evidence to recommend exercise interventions, pharmaceutical interventions, different types of surgeries, patient education or work accommodation alone to improve work participation. However, the lack of evidence should not be considered, as absence of effect and practitioners should continue to be creative in developing solutions.     

Participants' appraisals of process issues and the effects of stress management interventions

It has been argued that traditional quasi‐experimental approaches to evaluation do not adequately measure, or take account of, perceptual processes that could contribute to the effectiveness of organizational‐level interventions. Using longitudinal data with added process measures at time 2 gathered from 11 intervention projects in Denmark, this paper used structural equation modelling (n = 462) to explore the impact of employees' direct appraisals of the intervention itself on intervention outcomes. Perceived influence on the content of interventions was directly linked to voluntary participation in these interventions. Participants' appraisals of the activities within an intervention were found to fully mediate the relationships between exposure to interventions and outcome measures (changes in working conditions, behavioural stress and job satisfaction). The results of the study indicate that employees' appraisal of the intervention itself can play an important role in determining the success or failure of a variety of organizational‐level interventions. Copyright © 2007 John Wiley & Sons, Ltd.     

Influence of Exercise-Focused Group Activities on the Physical Activity,Functional Capacity,and Work Ability of Female Farmers—A Three-Year Follow-Up

Abstract

The objective of this randomised study was to evaluate the influence of exercise-focused group activities on female farmers’ physical activity, functional capacity, and work ability over a period of 3 years. Physical activity increased more in the intervention group (n = 62) than in the control group (n = 64) during the first year. By the third year physical activity had almost returned to the pre-intervention level. In the 3-year follow-up examination muscular endurance and cardio-respiratory fitness had improved in the intervention group, and musculoskeletal symptoms had decreased more often in the intervention group than in the control group. The index used to measure perceived work ability showed no changes over the 3-year period. It can be concluded that group activities focused on leisure-time physical activity and work habits can be recommended as health promotion measures for farmers’ occupational health services.     

Teen drivers' awareness of vehicle instrumentation in naturalistic research

IntroductionNaturalistic driving methods require the installation of instruments and cameras in vehicles to record driving behavior. A critical, yet unexamined issue in naturalistic driving research is the extent to which the vehicle instruments and cameras used for naturalistic methods change human behavior. We sought to describe the degree to which teenage participants' self-reported awareness of vehicle instrumentation changes over time, and whether that awareness was associated with driving behaviors.MethodForty-two newly-licensed teenage drivers participated in an 18-month naturalistic driving study. Data on driving behaviors including crash/near-crashes and elevated gravitational force (g-force) events rates were collected over the study period. At the end of the study, participants were asked to rate the extent to which they were aware of instruments in the vehicle at four time points. They were also asked to describe their own and their passengers' perceptions of the instrumentation in the vehicle during an in-depth interview. The number of critical event button presses was used as a secondary measure of camera awareness. The association between self-reported awareness of the instrumentation and objectively measured driving behaviors was tested using correlations and linear mixed models.ResultsMost participants' reported that their awareness of vehicle instrumentation declined across the duration of the 18-month study. Their awareness increased in response to their passengers' concerns about the cameras or if they were involved in a crash. The number of the critical event button presses was initially high and declined rapidly. There was no correlation between driver's awareness of instrumentation and their crash and near-crash rate or elevated g-force events rate.ConclusionAwareness was not associated with crash and near-crash rates or elevated g-force event rates, consistent with having no effect on this measure of driving performance.Practical applicationsNaturalistic driving studies are likely to yield valid measurements of driving behavior.     

Youth on racial minority operated U.S. farms, 2008: Demographics and injuries

IntroductionTo obtain injury surveillance data for youth on racial minority operated farms, the National Institute for Occupational Safety and Health developed the Minority Farm Operator Childhood Agricultural Injury Survey (M-CAIS) in collaboration with the U.S. Department of Agriculture.MethodsUsing a regionally stratified telephone survey of U.S. minority operated farm households, M-CAIS data were collected for youth less than 20 years of age.ResultsThere were an estimated 37,443 youth living on racial minority operated U.S. farms in 2008, almost half (46%) of these youth worked on the farm. Racial minority farm operators hired 6,443 youth, and reported an estimated 775,991 youth relative and other visitors on the farm. These youth suffered an estimated 516 injuries (5.9 injuries/1000 farms).ConclusionsHousehold youth had an injury rate of 7.8 injuries/1000 household youth and a work-related injury rate of 6.9 injuries/1000 working household youth.Practical applicationsThe research enables agricultural safety and health researchers, practitioners, and educators to identify priorities and design trainings and interventions to minimize the risk of farm hazards to youth on racial minority farm operations in the United States.     

Evaluating an intervention to improve belt fit for adult occupants

IntroductionPrevious laboratory studies have demonstrated that some drivers position their seat belts suboptimally. Specifically, the lap portion of the belt may be higher and farther forward relative to the pelvis than best practice, and the shoulder portion of the belt may be outboard or inboard of mid-shoulder. This study evaluated the performance of a video-based intervention for improving the belt fit obtained by drivers.MethodTwenty-nine adult drivers participated in this study. Belt fit was measured before and after the intervention in participants’ vehicles and in a laboratory mockup.ResultsData from both the in-vehicle and laboratory belt measures found that 95% of participants sampled improved some aspect of lap belt fit. For the in-vehicle test conditions, participants who lowered the lap belt location (Z) after the intervention showed an improvement of 26 mm on average. Among those participants who shifted the horizontal lap belt location rearward (closer to the pelvis), an average improvement of 36 mm was observed. No significant differences were observed between baseline and post-intervention shoulder belt fit.ConclusionsThe results provide preliminary evidence that an intervention improves driver belt fit. More research is needed to establish what aspects of this intervention affected behavior and how effective such an intervention is in the context of public health.Practical applicationsThese findings can help better inform intervention initiatives to improve occupant belt fit.     

Occupational injury rates among Norwegian farmers: A sociotechnical perspective

Introduction: This study addressed relative injury risk among Norwegian farmers, who are mostly self-employed and run small farm enterprises. The aim was to explore the relative importance of individual, enterprise, and work environment risks for occupational injury and to discuss the latent conditions for injuries using sociotechnical system theory. Method: Injury report and risk factors were collected through a survey among Norwegian farm owners in November 2012. The response rate was 40% (n = 2,967). Annual work hours were used to calculate injury rates within groups. Poisson regression using the log of hours worked as the offset variable allowed for the modeling of adjusted rate ratios for variables predictive of injury risk. Finally, safety climate measures were introduced to assess potential moderating effects on risk. Results: Results showed that the most important risk factors for injuries were the design of the workplace, type of production, and off-farm work hours. The main results remained unchanged when adding safety climate measures, but the measures moderated the injury risk for categories of predominant production and increased the risk for farmers working with family members and/or employees. An overall finding is how the risk factors were interrelated. Conclusions: The study identified large structural diversities within and between groups of farmers. The study drew attention to operating conditions rather than individual characteristics. The farmer’s role (managerial responsibility) versus regulation and safety climate is important for discussions of injury risk. Practical Applications: We need to study sub-groups to understand how regulation and structural changes affect work conditions and management within different work systems, conditioned by production. It is important to encourage actors in the political-economic system to become involved in issues that were found to affect the safety of farmers.     

Measuring determinants of occupational health related behavior in Flemish farmers: an application of the Theory of Planned Behavior

PROBLEM: Preventive interventions to reduce occupational injuries and health problems in farmers require the identification of factors that contribute to unsafe and health damaging behavior. This paper describes the development and validation of a self-report questionnaire, which measures the determinants of occupational health-related behaviors in farmers. METHOD: A representative sample of 283 Flemish farmers completed a provisional 135 item questionnaire based on the Theory of Planned Behavior, measuring four behaviors related to occupational health (machinery use, animal handling, preventing falls, and pesticide use), as well as the intentions, attitudes, perceived social norms, and self-efficacy for each of these behaviors. RESULTS: The fit indices of the Confirmatory Factor Analysis turned out not to be sufficient to reproduce the dimensions of the TPB. Therefore exploratory factor analysis was use to determine the underlying dimensions. Principal Component Analyses (PCA) on the behavioral items yielded single component solutions explaining a considerable proportion of the variance for each behavior and for behavioral intentions. Principal component analyses toward an a priori three-component structure reflecting the TPB dimensions did not produce sufficient congruence for the determinants of the four behaviors. Subsequent Varimax rotations and discarding of redundant items resulted in three component solutions explaining 50% to 69% of the variance in the determinants of each behavior, corresponding with the dimensions of the TPB. Internal consistencies ranged from .25 to .89. Scale scores accounted for a significant proportion of the variance in intention and self-reported behavior. IMPACT: The study demonstrates the validity of the TPB in predicting behavior related to occupational safety and health in farmers, and provides a valid and reliable questionnaire to measure the cognitive concepts featured in this model. IMPACT ON INDUSTRY: Both authors share the same view on this study's impact on industry. In recent years, efforts have been made to create awareness among farmers about occupational hazards, and to encourage farmers to perform safer and healthier behavior. However, only a limited number of these interventions have proven to be successful. A possible reason for this relative lack of success is that interventions typically focus on risk analysis and raising awareness, whereas the literature on preventive health behavior change indicates that knowledge and awareness with regard to possible health risks are neither necessary nor sufficient to change behavior. To raise the effectiveness of prevention programs, other relevant determinants of behavior need to be addressed as well, such as: attitudes, perceived social norms, self efficacy, and elements of the physical environment that elicit or reinforce behavior. These determinants play a key role in psychological models of health related behavior, such as the Theory of Planned Behavior. Thus far, the use of these models within agricultural settings is fairly limited. This study demonstrates the validity of the Theory of Planned Behavior in predicting behavior related to occupational safety and health in farmers, and provides a valid and reliable questionnaire to measure the cognitive concepts featured in this model.     

Examining motorcyclists' postcrash impressions: A qualitative study

Objective: Motorcycle-related crashes and injuries continue to be of great concern in Iran. This study seeks to explore how motorcyclists' perspectives and impressions of a crash are shaped and influence their future riding behaviors.

Methods: This was a qualitative study conducted in 3 major cities in Iran between March 2011 and February 2012. Participants included 31 male motorcyclists, of whom 22 participated in 4 focus groups and 9 in in-depth interviews. Findings were derived through the thematic method of analysis.

Results: Six delineated themes suggest different factors that influence riders' postcrash impressions. These include (1) opposing reactions from family and peers postcrash; (2) the motorcyclist's perception of his or her ability to handle risky road situations; (3) risk-taking attributes; (4) perceived responsibility in meeting family needs; (5) the severity of the crash-related injury; and (6) elapsed time from the crash experience.

Conclusions: Riders' postcrash impressions were formed by the opposing reactions of their family and peers to the crash experience (i.e., the index crash); the personality of riders, including being overconfident and a risk taker; familial obligations; feeling traumatized by the crash; and passage of time. These formed their perceptions, feelings, attitudes, and thoughts about the index crash.

These findings are an important step in understanding how perception and attitudes of motorcyclists are shaped and how these influence their future riding behavior. The needs for interventional studies to assess the effectiveness of road safety risk reduction programs aligned with the riders' degree of postcrash impressions are discussed.     

The effects of co-presence on risk perception and intention to engage in risky behaviors

IntroductionThis study investigated the relation between co-presence and bicyclists' riding behavior. We assumed that the presence of peer riders would either facilitate or inhibit risky behaviors depending on bicyclists' perceptions of three traffic contexts conducive to risk taking (i.e., red-light, go straight, and turn to left).MethodYoung bicyclists (N = 207) were randomly assigned to two experimental conditions (alone vs. with peers). They filled in a scenario-based questionnaire about their intentions to adopt risky behaviors in three specific traffic situations as well as their risk perception of these situations and their general self-perceived efficacy as a bicyclist. We hypothesized that the presence of peer riders engaged in a risky behavior will facilitate the intention to adopt risky behaviors in situations where group risk is evaluated as lower than individual risk. In opposition, the presence of peer riders engaged in a risky behavior will inhibit the intention to adopt risky behaviors in situations where group risk is evaluated as higher than individual risk.ResultsThe results confirmed the hypotheses.Practical ApplicationsThe findings offer insights for developing new effective education and intervention programs in order to reduce the frequency of dangerous behavior among bicyclists.     

Implementing risk management to reduce injuries in the U.S. Fire Service

IntroductionRisk management, a proactive process to identify and mitigate potential injury risks and implement control strategies, was used to reduce the risk of occupational injury in a fire department. The objective of this research was to study the implementation of the risk management process for future replication. A second objective was to document changes in fire personnel's knowledge, attitudes, and behaviors related to the selected control strategies that were implemented as part of the risk management process.MethodA number of control strategies identified through the risk management process were implemented over a 2-year period beginning in January 2011. Approximately 450 fire personnel completed each of the three cross-sectional surveys that were administered throughout the implementation periods. Fire personnel were asked about their awareness, knowledge, and use of the control strategies.ResultsFire personnel were generally aware of the control strategies that were implemented. Visual reminders (e.g., signage) were noted as effective by fire personnel who noticed them. Barriers to use of specific control strategies such as new procedures on the fireground or new lifting equipment for patient transfer included lack of knowledge of the new protocols, lack of awareness/access to/availability of the new equipment, and limited training on its use. Implementation challenges were noted, which limited self-reported adherence to the control strategies.ConclusionsFire personnel generally recognized the potential for various control strategies to manage risk and improve their health and safety; however, implementation challenges limited the effectiveness of certain control strategies. The study findings support the importance of effective implementation to achieve the desired impacts of control strategies for improving health and safety.Practical applicationsEmployees must be aware of, have knowledge about, and receive training in safety and health interventions in order to adopt desired behaviors.     

The transtheoretical model of change in adolescents: implications for injury prevention

INTRODUCTION: Many injury prevention interventions require changes in human behavior to reduce self-risk or risk to others. Promising injury prevention interventions may be discarded if they lack power to create a significant difference in outcomes when judging their ability to "move a person from nonaction or negative action to positive action (safety)." The transtheoretical model of change (TMC) allows greater sensitivity in detecting along the change process where an intervention may be effective. The stages of change consist of precontemplation, contemplation, preparation, action, maintenance, and termination. Change is not viewed as an "all or none phenomenon." METHOD: Use of the TMC was examined using a quasiexperimental, cross-over design involving high school agriculture students enrolled in 21 schools in Kentucky (n=9), Iowa (n=7), and Mississippi (n=5). A series of physical and narrative simulations (safety training exercises) were developed with a focus on preventing amputation, spinal cord injury, hypersensitivity pneumonitis, and noise-induced hearing loss. Contemplation and action, as part of the TMC, were measured using a 10-item, Likert-type, stages of change (SOC) instrument comprised of two subscales (reliability coefficients were.88 and.81, respectively). The final sample consisted of 790 students (373 treatment and 417 control). RESULTS: There was a significant group effect for both contemplation, F(1,732)=197.4; p<.0001, and action, F(1,730)=106.1; p<.0001. A convenience sample of 29 of the participating students was selected for follow-up farm visits 1 year postparticipation. Of these students, 25 (86%) had made safety behavior changes in their farm work. IMPACT ON INDUSTRY: The use of the TMC model can provide researchers with greater precision in examining intervention effectiveness in promoting change.     

Evaluating an intervention to improve belt fit for adult occupants: Promoting positive beliefs

IntroductionSeat belt use provides significant public health benefit, however, most public awareness campaigns have generally focused on seat belt use rather than encouraging adults to improve seat belt fit with belt placement. This study provides an evaluation of a video-based intervention to improve adult belt fit assessing whether a video-based intervention can target beliefs and knowledge of seat belt placement and be perceived as relevant by the target audience.MethodAn intervention group of 29 adults (15 women and 14 men) and a comparison group of 99 adults (41 women and 47 men) participated.ResultsThe intervention group had significantly more favorable beliefs around belt fit than the comparison group related to Health Belief Model constructs of higher self-efficacy, greater benefits, and fewer barriers. The intervention group was also significantly better at accurately drawing belt fit than the comparison group. The video intervention was described as relevant, interesting, and the intervention group favored the provision of a diverse sample of models in the intervention.ConclusionsOverall, the study provides insight into relevant target beliefs for an intervention focused on belt fit and suggests that a brief video-based intervention in the style of a public service announcement may be effective in promoting positive beliefs and knowledge around belt fit. Future efforts should confirm these findings with a larger sample size spanning multiple geographic and demographic areas.Practical applicationsThese findings can help better inform intervention initiatives to improve occupant belt fit.     

Evaluation of a responsible beverage service and enforcement program: Effects on bar patron intoxication and potential impaired driving by young adults

Objective: Studies of alcohol-related harm (violence, injury, illness) suggest that the most significant risk factors are the amount of alcohol consumed and whether obviously intoxicated patrons continue to be served. This study's objective was to investigate the effects of a responsible beverage service (RBS)/enhanced alcohol enforcement intervention on bars, bar patrons, and impaired driving.

Method: Two communities—Monroe County, New York, and Cleveland, Ohio—participated in a demonstration program and evaluation. The intervention applied RBS training, targeted enforcement, and corrective actions by law enforcement to a random sample of 10 identified problem bars in each community compared to 10 matched nonintervention problem bars. Data were collected over 3 waves on bar serving practices, bar patron intoxication, drinking and driving, and other alcohol-related harm from intervention and control bars and treatment and comparison communities.

Results: In Monroe County, New York, of the 14 outcome measures analyzed, 7 measures showed statistically significant differences from pre- to postintervention. Six of those measures indicated changes in the desired or positive direction and 2 measures were in the undesired or negative direction. Of note in the positive direction, the percentage of intervention bar patrons who were intoxicated decreased from 44 to 27% and the average blood alcohol concentration of patrons decreased from 0.097 to 0.059 g/dL pre- to postintervention. In Cleveland, Ohio, 6 of the 14 measures showed statistically significant changes pre- to postintervention with 6 in the positive direction and 4 in the negative direction. Of note, the percentage of pseudo-intoxicated patrons denied service in intervention bars increased from 6 to 29%.

Conclusions: Of the 14 outcome measures that were analyzed in each community, most indicated positive changes associated with the intervention, but others showed negative associations. About half of the measures showed no significance, the sample sizes were too small, or the data were unavailable. Therefore, at best, the results of these demonstration programs were mixed. There were, however, some positive indications from the intervention. It appears that when bar managers and owners are aware of the program and its enforcement and when servers are properly trained in RBS, fewer patrons may become intoxicated and greater efforts may be made to deny service to obviously intoxicated patrons. Given that about half of arrested impaired drivers had their last drink at a licensed establishment, widespread implementation of this strategy has the potential to help reduce impaired driving.     

Teens' distracted driving behavior: Prevalence and predictors

IntroductionTeen drivers' over-involvement in crashes has been attributed to a variety of factors, including distracted driving. With the rapid development of in-vehicle systems and portable electronic devices, the burden associated with distracted driving is expected to increase. The current study identifies predictors of secondary task engagement among teenage drivers and provides basis for interventions to reduce distracted driving behavior. We described the prevalence of secondary tasks by type and driving conditions and evaluated the associations between the prevalence of secondary task engagement, driving conditions, and selected psychosocial factors.MethodsThe private vehicles of 83 newly-licensed teenage drivers were equipped with Data Acquisition Systems (DAS), which documented driving performance measures, including secondary task engagement and driving environment characteristics. Surveys administered at licensure provided psychosocial measures.ResultsOverall, teens engaged in a potentially distracting secondary task in 58% of sampled road clips. The most prevalent types of secondary tasks were interaction with a passenger, talking/singing (no passenger), external distraction, and texting/dialing the cell phone. Secondary task engagement was more prevalent among those with primary vehicle access and when driving alone. Social norms, friends' risky driving behaviors, and parental limitations were significantly associated with secondary task prevalence. In contrast, environmental attributes, including lighting and road surface conditions, were not associated with teens' engagement in secondary tasks.ConclusionsOur findings indicated that teens engaged in secondary tasks frequently and poorly regulate their driving behavior relative to environmental conditions. Practical applications: Peer and parent influences on secondary task engagement provide valuable objectives for countermeasures to reduce distracted driving among teenage drivers.     

Occupational interventions for the prevention of back pain: Overview of systematic reviews

IntroductionWe conducted an overview of systematic reviews of interventions for the prevention of low back pain (LBP) that can be conducted in a workplace setting.MethodsAn electronic literature search was performed in Medline, EMBASE, and the Cochrane Library. Published peer-reviewed systematic reviews and meta-analyses, which described interventions for the primary or secondary prevention of LBP applicable to a workplace setting, were eligible for inclusion. The methodological quality of the included systematic reviews was assessed with the AMSTAR tool. The primary outcome of interest was the incidence of LBP; secondary outcomes were LBP-associated absenteeism, activity interference, and costs related to LBP.ResultsTwenty-eight eligible articles published between 1994 and 2016 were included in a qualitative synthesis following our screening of abstracts and full-text articles. The AMSTAR rating revealed 14 reviews of high, 10 of moderate, and 4 of low methodological quality. The identified interventions included workplace modifications (6 reviews, 10 studies, 6,751 subjects); shoe insoles (4 reviews, 6 studies, 2,356 subjects); and lumbar supports and other assistive devices (15 reviews, 18 studies, 60,678 subjects). Educational interventions investigated were back schools (10 reviews, 30 studies, 9,973 subjects); manual material handling techniques/advice (6 reviews, 24 studies, 10,505 subjects); and other forms of instruction including pamphlets, booklets, and other media (four reviews, 14 studies, 11,991 subjects). Exercise interventions, investigated in 12 reviews (35 studies, 19,330 subjects), showed moderate quality evidence of effectiveness for exercise interventions alone or in conjunction with educational interventions; no other type of intervention was consistently effective in the prevention of LBP or LBP-associated outcomes of interest.ConclusionsOur overview provides evidence of effectiveness for exercise with or without educational interventions in the prevention of LBP.Practical applicationsExercise interventions with or without educational interventions that can be applied in the workplace have the potential to prevent LBP.     

Simulator study of young driver's instinctive response of lower extremity to a collision

Objective: A driver's instinctive response of the lower extremity in braking movement consists of two parts, including reaction time and braking reaction behavior. It is critical to consider these two components when conducting studies concerning driver's brake movement intention and injury analysis. The purposes of this study were to investigate the driver reaction time to an oncoming collision and muscle activation of lower extremity muscles at the collision moment. The ultimate goal is to provide data that aid in both the optimization of intervention time of an active safety system and the improvement of precise protection performance of a passive safety system.

Method: A simulated collision scene was constructed in a driving simulator, and 40 young volunteers (20 male and 20 female) were recruited for tests. Vehicle control parameters and electromyography characteristics of eight muscles of the lower extremity were recorded. The driver reaction time was divided into pre-motor time (PMT) and muscle activation time (MAT). Muscle activation level (A_COL) at the collision moment was calculated and analysed.

Results: PMT was shortest for the tibialis anterior (TA) muscle (243～317 ms for male and 278～438 ms for female). Average MAT of the TA ranged from 28-55 ms. A_COL was large (5～31% for male and 5～23% for female) at 50 km/h, but small (<12%) at 100 km/h. A_COL of the gluteus maximus was smallest (<3%) in the 25 and 100 km/h tests. A_COL of RF of men was significantly smaller than that of women at different speeds.

Conclusions: Ankle dorsiflexion is firstly activated at the beginning of the emergency brake motion. Males showed stronger reaction ability than females, as suggested by male's shorter PMT. The detection of driver's brake intention is upwards of 55ms sooner after introducing the electromyography. Muscle activation of the lower extremity is an important factor for 50 km/h collision injury analysis. For higher speed collisions, this might not be a major factor. The activations of certain muscles may be ignored for crash injury analysis at certain speeds, such as gluteus maximus at 25 or 100 km/h. Furthermore, the activation of certain muscles should be differentiated between males and females during injury analysis.