Prior to this study, virtually no studies had been conducted into the exposure of childcare professionals in children's daycare facilities to musculoskeletal workloads. Nor was it known what effect the underlying structural conditions (such as the number of children in the institutions' care and the distribution of their ages, the ratio of staff to children, and the equipment) had upon the stress situation. In view of the rising number of under-threes in daycare facilities, it was however assumed that physical workloads levels had changed, for example as a result of more frequent lifting and carrying. Existing strategies for reducing workloads, such as special desks, or special chairs for the childcare professionals, had also not yet been studied with regard to their effectiveness.
In order for a suitable intervention study to be planned, the Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA) formed the "ErgoKita" group of experts comprising representatives of the German Social Accident Insurance Institutions for the public sector in North Rhine-Westphalia, Rhineland-Palatinate and Hesse, the German Social Accident Insurance Institution for the health and welfare services (BGW), the German Social Accident Insurance (DGUV), the Institute of Ergonomics of Darmstadt University of Technology (IAD), and the Institute of Occupational, Social and Environmental Medicine of the Goethe University in Frankfurt (ASU). Preparation for the study formed the subject of IFA Project 4179, "Prevention of musculoskeletal diseases in teachers and care staff in nursery schools and children's day-care centres." The present project had the purpose of implementing the intervention study.
Within the project, the IFA had the task of conducting physiological measurements in children's daycare facilities before and after ergonomic intervention measures, and of reviewing the effectiveness of suitable intervention measures.
In the first phase, surveys were conducted in 250 children's daycare facilities in North Rhine-Westphalia (NRW), Rhineland-Palatinate (RP) and Hesse concerning the facilities' equipment and the musculoskeletal workloads that may be anticipated. 24 representative facilities (eight each in NRW, RP and Hesse) were selected from among these 250 facilities. The selected facilities were then closely inspected and detailed surveys conducted of the physical work situations. An analysis was conducted of musculoskeletal workloads exposures currently experienced by two childcare professionals in each of nine facilities (three each with a low, moderate and high need for intervention). The CUELA measurement system was employed for the analysis. The stress measurements were conducted during two shifts worked by each childcare professional.
Based upon the results of the analysis of the current situation, the following task-specific prevention measures were identified: ergonomic furniture/equipment, work organization measures, and advice on personal behaviour. In six of the nine daycare facilities subject to intervention, the measures were implemented in conjunction with the childcare professionals, together with training in behaviour and ergonomics. Following a period of acclimatization, CUELA measurements were repeated for review of the measures' efficacy.
Altogether, 36 shift recordings were performed for analysis of the current situation, and the associated musculoskeletal workloads quantified in detail. Significant stress factors were identified for work performed at low working heights with the trunk bent (mean proportion of time spent with the trunk bent: between 16% and 35% of the working shift). The proportion of time spent caring for under-threes had an influence upon load handling (up to 4% of the shift was spent handling loads greater than 10 kg). The relatively high proportion of time spent in a kneeling posture was also notable (on average, up to 16% of the working shift).
Following implementation of the prevention measures in the children's daycare facilities and training of the personnel in the facilities, the measurements were repeated. They revealed reductions in the musculoskeletal workloads. The use of ergonomic furniture and optimization of personal behaviour resulted in statistically significant reductions particularly in the proportion of time spent with the trunk strongly inclined and in kneeling postures.
public serviceType of hazard:
work-related health hazardsCatchwords:
musculoskeletal disorders (except cancer), ergonomics, workplace designDescription, key words:
childcare professionals, ergonomic design, children's day-care facilities, nursery schools, musculoskeletal workloads, work organization, materials, CUELA, under-threes care, lifting and carrying, work design measures, quality of education