PRIM (Project on Research and Intervention in Monotonous Work)

This material was written by Torsten Skov, and submitted by: National Institute of Occupational Health Arbejdsmiljoinstituttet
Lerso Parkalle 105
DK-2100 Copenhagen O
Denmark
Telefon (+45) 39 29 97 11
Telefax (+45) 39 27 01 07
E-mail amilpost@uts.uni-c.dk

PRIM is a multidisciplinary study undertaken by the National Institute of Occupational Health; the Departments of Occupational Medicine at Glostrup Hospital, Herning Hospital, Arhus Hospital; Centre for Alternative Social Analysis (CASA); Department of Working Environment, Technical University of Denmark (DWE/TU); and the Danish Institute of Physical Education.

The main objectives of the project are:

To study the musculoskeletal and psychosocial effects of the physical and psychosocial risk factors which occur in monotonous and repetitive work, with special emphasis in the joint and interacting effects of these factors.

To develop knowledge about organizational methods which can lead to viable changes in the companies that introduce more variation in the work, and to evaluate the health effects of such interventions.

To study the effects of dynamic and static muscle training on the perception of musculoskeletal pain among workers with monotonous repetitive work.

The project consists of 6 integrated substudies.

Substudies 1 and 5 are mainly concerned with the musculoskeletal and psychosocial effects of monotonous repetitive work. Substudies 2, 3, and 4 carry out and evaluate interventions in the companies, the aim of which are to introduce more variation in the work. Substudy 6 intervenes against the effect of monotonous repetitive work by subjecting the exposed workers to dynamic and static muscle training.

The projects are closely integrated. Firstly, the persons and companies from substudies 2-6 are also included in substudy 1. Thus, the health effects of the interventions will be closely monitored. Secondly, a number of different scientific methods and fields are involved in the data collection. Since data is collected for individuals, it can be analyzed jointly and thus can give an integrated understanding of the studied phenomena.

Substudy 1

A study group of 3500 persons will be identified in around 20 companies with various types of monotonous repetitive work (meat cutting, sewing, assembly work, packaging, keyboard operation, supermarket cashiers). Around half of the study group will be an internal comparison group with varied work. The data collection will include the physical and psychosocial exposures at work and in leisure time, former jobs with relevant exposures, and outcome measures with emphasis on muskuloskeletal complaints and diseases from the neck, shoulders, and upper limb, and psychosocial effects. The data collection will take place by a combination of self administered questionnaires, work observation, and clinical examination. The cohort will be followed for 5 years with repeated exposure and outcome assessments. The substudy is done by the Departments of Occupational Medicine at Glostrup Hospital, Herning Hospital, and Arhus Hospital and the Department of Work Physiology and the Department of Occupational Medicine at the National Institute of Occupational Health.

Substudies 2 & 3

Substudies 2 and 3 will be carried out in 5 companies manufacturing bread, packaging materials and garments. Substudy 2 will assist the companies in planning and carrying out interventions against monotonous repetitive work. Substudy 3, which is done by a different research team from the one that assisted with the interventions, will evaluate the interventions with special emphasis on the potentials and barriers to the implementation of interventions in the companies, and the technical changes and the viability of the changes in the companies. The substudy is done by the Centre for Alternative Social Analysis (CASA) and the Department of Working Environment, Technical University of Denmark (DWE/TU).

Substudy 4

Substudy 4 is an intervention study in 3 garment sewing plants with 200 seamstresses and 2 control plants with 200 seamstresses, which will include physical, medical, and psychological measurements on the study persons during the transformation towards varied work. Also the phases in the process of change will be studied as in substudy 3. The substudy is done by the Department of Occupational Medicine, Herning in collaboration with CASA and DWE/TU.

Substudy 5

Substudy 5 is related to substudy 4 in that biological samples will be collected before and after the intervention, and will be analyzed for number of biomarkers of stress, e.g. adrenaline, noradreniline, cortisol, IgA, HbAIC. Heart rate, blood pressure, and self reported activity and stress level will be recorded simultaneously. The substudy is done by the Department of Chemistry and Biochemistry at the National Institute of Occupational Health in collaboration with the Department of Occupational Medicine, Herning.

Substudy 6

Substudy 6 will be undertaken among supermarket cashiers. There will be 2 training groups of 25 persons each and 2 comparison groups of 25 persons each. The training groups will have intensive dynamic and static training for 40 minutes twice a week. The muscle strength and endurance will be tested before and after the training period. The training will be done by the Danish Institute of Physical Education. The follow up for health effects will be undertaken by substudy 1.

The project is coordinated by the Department of Occupational Medicine at the National Institute of Occupational Health. The project group includes physicians, physiologists, psychologists, sociologists, and a pharmacologist.

The study was initiated by a request from the Danish Work environment Fund and the Danish Medical Research Council for research on the effects of and interventions against monotonous repetitive work. These funds have granted 15 million Dkr to the project. The Danish Humanistic Research Council has indicated that it will provide the additional funding.

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