National Research Centre for the Working Environment, Copenhagen, Denmark.
BMC Public Health. 2010 Mar 9;10:120. doi: 10.1186/1471-2458-10-120.
A mismatch between individual physical capacities and physical work demands enhance the risk for musculoskeletal disorders, poor work ability and sickness absence, termed physical deterioration. However, effective intervention strategies for preventing physical deterioration in job groups with high physical demands remains to be established. This paper describes the background, design and conceptual model of the FINALE programme, a framework for health promoting interventions at 4 Danish job groups (i.e. cleaners, health-care workers, construction workers and industrial workers) characterized by high physical work demands, musculoskeletal disorders, poor work ability and sickness absence.
METHODS/DESIGN: A novel approach of the FINALE programme is that the interventions, i.e. 3 randomized controlled trials (RCT) and 1 exploratory case-control study are tailored to the physical work demands, physical capacities and health profile of workers in each job-group. The RCT among cleaners, characterized by repetitive work tasks and musculoskeletal disorders, aims at making the cleaners less susceptible to musculoskeletal disorders by physical coordination training or cognitive behavioral theory based training (CBTr). Because health-care workers are reported to have high prevalence of overweight and heavy lifts, the aim of the RCT is long-term weight-loss by combined physical exercise training, CBTr and diet. Construction work, characterized by heavy lifting, pushing and pulling, the RCT aims at improving physical capacity and promoting musculoskeletal and cardiovascular health. At the industrial work-place characterized by repetitive work tasks, the intervention aims at reducing physical exertion and musculoskeletal disorders by combined physical exercise training, CBTr and participatory ergonomics. The overall aim of the FINALE programme is to improve the safety margin between individual resources (i.e. physical capacities, and cognitive and behavioral skills) and physical work demands, and thereby reduce the physical deterioration in a long term perspective by interventions tailored for each respective job-group.
The FINALE programme has the potential to provide evidence-based knowledge of significant importance for public health policy and health promotion strategies for employees at high risk for physical deterioration.
ISRCTN96241850, NCT01015716 and NCT01007669.
个人身体能力与体力工作要求不匹配会增加肌肉骨骼疾病、工作能力下降和病假的风险,这种不匹配被称为身体恶化。然而,对于体力要求高的工作群体,预防身体恶化的有效干预策略仍有待建立。本文介绍了 FINALE 计划的背景、设计和概念模型,该计划是一个针对丹麦 4 个工作群体(清洁工、医护人员、建筑工人和工业工人)的健康促进干预框架,这些工作群体的特点是体力工作要求高、肌肉骨骼疾病、工作能力下降和病假。
方法/设计:FINALE 计划的一个新方法是,干预措施,即 3 项随机对照试验(RCT)和 1 项探索性病例对照研究,根据每个工作群体的体力工作要求、身体能力和健康状况进行定制。清洁工组的 RCT 以重复性工作任务和肌肉骨骼疾病为特征,旨在通过身体协调训练或基于认知行为理论的训练(CBTr)使清洁工减少肌肉骨骼疾病的易感性。由于医护人员超重和重负荷的比例较高,RCT 的目的是通过结合体育锻炼训练、CBTr 和饮食来实现长期减肥。建筑工作以举重、推和拉为特点,RCT 的目的是提高身体能力,促进肌肉骨骼和心血管健康。在以重复性工作任务为特点的工业工作场所,干预措施旨在通过结合体育锻炼训练、CBTr 和参与性人体工程学来减少体力消耗和肌肉骨骼疾病。FINALE 计划的总体目标是改善个体资源(即身体能力、认知和行为技能)与体力工作要求之间的安全裕度,从而通过针对每个特定工作群体的干预措施,从长远来看减少身体恶化。
FINALE 计划有可能为公共卫生政策和针对身体恶化高风险员工的健康促进策略提供具有重要意义的循证知识。
ISRCTN96241850、NCT01015716 和 NCT01007669。