Ergo-Kita - Prevention of musculo-skeletal disorders among nursery school teachers in day-care centers

Status:

completed 12/2013

Aims:

The project aimed at developing approaches to improve the vocational and health situation of the pedagogical staff in pre-schools and evaluating the effects of the prevention measures, particularly those aimed at reducing physical stress and workload.

The study and its results shall improve the working conditions of nursery school teachers in day-care centers but shall also affect the work of accident insurance companies responsible for this personnel and the work of the owners of these day care units.

Activities/Methods:

• Participate of day-care centers in several different German federal states
• Contribution of new ideas and interventional activities for the prevention of musculo-skeletal disorders; implementation and evaluation of preventive activities in the participating day-care centers with respect to efficiency and practicability

Results:

The project "ErgoKita - prevention of musculoskeletal disorders in pre-school teachers in child care centers (pre-schools)" was carried out in the period between June 2011 and December 2013 from the project partners IAD (Institute of Ergonomics, TU Darmstadt), ASU (Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main) and IFA (Institute for Occupational Safety and Health of the German Social Accident Insurance, St. Augustin).

Based on the results from questionnaires (conditions, stresses) used in 256 facilities in Hessen, Rheinland-Pfalz and Nordrhein-Westfalen and in 24 selected facilities (257 participating employees), in-depth investigations with workshops and workplace inspections, as well as the findings from the objective workplace assessments (CUELA) and the task descriptions in 9 facilities (2 teachers/organization), fundamental shortcomings or stresses from essential activities such as playing, eating, nursing and sleeping, which occur in varying degrees in many institutions, were identified. These primarily included:

• Adverse postures with loading of the lower spine, shoulder, neck area and the knee (especially unfavorable knee angles >90°) through unfavorable heights in sitting and standing postures by non-adult-oriented or missing furniture
• Handling of loads as a result of double occupancy of rooms or unsuitable load transporting equipment
• Discrepancies between educational understanding and heath appropriate behavior, resulting in unfavorable postures and unnecessary lifting and carrying
• Lack of activity/stress variation and unfavorable work process organization
• Time pressure, noise (these aspects were not addressed in the intervention)

Under consideration of the current pedagogical approach, different approaches to stress reduction were derived:

• Enabling work at different heights to become a "standard":
• Children sitting at the height of the educator, educators sitting on the level of children using appropriate furniture, "standing workstations" for children or teachers (e.g. documentation)
• Anthropometric design: customized dimensions for beds, washing facilities, changing tables
• Child-appropriate furniture which allows the children to be more independent (e.g. changing table with steps, step stool elements)
• Reduction of the weight of furniture (e.g. beds)
• Assistive equipment
• Organizational measures to promote a change in the task-related physical load ("job rotation")
• Ergonomic Behavior-Orientated Training (e.g. "healthy lifting and carrying techniques")

These approaches were, among others, included in a basic catalog which contained exemplary solution proposals for the activities mentioned above. Additionally, based on the research findings, behavior-oriented training was implemented on a pilot basis in six day care centers. The effectiveness of the solutions and their acceptance were assessed by two means, once with the identical objective methodology used prior to the intervention and secondly through questionnaires and workshops.

The project findings confirm the view from the DGUV that there is a definite need for preventive measures in order to maintain the health of education staff with particular focus on preventing musculoskeletal disorders. Within the framework of the project, various intervention approaches were developed and evaluated, all of which can be applied for the ergonomic work design in child care centers. Based on these results, a qualitative improvement in the work situation can be expected, which may be associated with a reduction in musculoskeletal complaints and disorders.

The results of the project may have the following future practical applications:

• Incorporating the findings in the education curriculum of training pre-school teachers
• Assist in providing training materials with regards to behavior-orientated ergonomics (Target group: Teachers)
• Development of a checklist for risk assessment (target group: KiTa carrier)
• Optimal transformation of individual pre-schools to model daycare centers, which can be used for demonstration purposes for training of pedagogical staff
• Creating a practical guide for health-oriented daycare center design

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