Are Work Organization Interventions Effective in Preventing or Reducing Work-Related Musculoskeletal Disorders? A Systematic Review of the Literature

The authors sought to determine whether interventions that target work organization or the psychosocial work environment are effective in preventing or reducing work-related musculoskeletal disorders (WMSD) compared with usual work by systematically reviewing the 2000–2015 English- and French-language scientific literature, including studies evaluating the effectiveness of an organizational or psychosocial work intervention on incidence, prevalence or intensity of work-related musculoskeletal pain or disorders in the neck, shoulders, upper limbs, or back or of work absence because of such problems, among nonsick-listed workers.

Rehabilitation and individual-level behavioral interventions and studies with >50% attrition were excluded. Medium- and high-quality studies were analyzed and the evidence was synthesized using the grading of recommendations assessment, development, and evaluation (GRADE) approach. An analysis of key workplace intervention elements supplemented the interpretation of results.

The study identified 884 articles; 28 met selection criteria, yielding two high-quality, 10 medium-quality, and 16 low-quality studies. There was moderate evidence that supplementary breaks, compared to conventional break schedules, are effective in reducing symptom intensity in various body regions. Evidence was low to very low quality for other interventions, primarily because of the risk of bias related to study design, high attrition rates, cointerventions, and insensitive indicators. Most interventions lacked key intervention elements, such as work activity analysis and ergonomist guidance during implementation, but the relation of these elements to intervention effectiveness or ineffectiveness remains to be demonstrated.

Targeting work/rest cycles may reduce WMSD. Better quality studies are needed to allow definitive conclusions to be drawn on the effectiveness of other work organizational or psychosocial interventions to prevent or reduce WMSD.

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