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«FICHA TÉCNICA Título Segurança e Higiene Ocupacionais - SHO 2012 - Livro de Resumos Autores/Editores Arezes, P., Baptista, J.S., Barroso, M.P., ...»

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Single interventions have revealed very low efficacy in fighting MSDs multidimensional problem, and over the last decades multidisciplinary/interdisciplinary approaches and participatory interventions have been indicated as the most effective on their prevention, treatment and control (Bergman, 2007a, 2007b; Bremander & Bergman, 2008; Evanoff, Bohr & Wolf, 1999; Finestone, Alfeeli & Fisher, 2008; Hanada, 2003; Hignett, Wilson & Morris, 2005; Keefe et al., 1996; Laitinen, Saari, Kivisto & Rasa, 1998; Noonan & Wagner, 2010; Rivilis et al., 2008; St-Vincent, Bellemare, Toulouse & Tellier, 2006; Vink, Urlings & van der Molen, 1997). On the other hand, biomedical model has been proved not able to fully explain MSDs symptoms and consequences and, since 1977, the biopsychosocial model of health and disease, which beyond the biological aspects also integrate social and psychological factors, has been presented as the best medical model available by some authors (see e.g. Berquin, 2010). The latest approaches to prevention, treatment and management of MSDs are mainly based on the perspective of human being as a whole system as well as on the multifactorial nature of health and disease.

4. CONCLUSIONS Psychosocial and lifestyle aspects are now recognised as important risk factors for MSDs. Due to the current economic crisis, renewed attention must also be paid to socioeconomic risk factors. Evidences have been found supporting the effectiveness of participatory ergonomics interventions in the prevention of MSDs and associated outcomes, as well as the efficacy of biopsychosocial approaches on their treatment and control, despite some contradictory positions. Key stakeholders (e.g. workers, managers and educators) are considered to play an essential role in the success of the design and implementation of prevention strategies (participatory ergonomics interventions). Conversely, the multidisciplinary biopsychosocial model is still considered the best medical model available for the treatment and management of MSDs.

These most recent approaches on MSDs problem highlight the participation of all people at risk or suffering from the disease on their prevention or treatment and management, respectively, what led to the increased importance of education, training and global awareness as the most effective way of changing attitudes and behaviours. Meanwhile, the difficult economic situation lived in large regions of the world may hamper the implementation of policies and strategies adopted during the last decade in order to reverse the concerning trend of MSDs. Since most of MSDs outcomes are associated to low socioeconomic status, and socioeconomic factors have crossed effects on both psychosocial and lifestyle factors we may be in front of an uncontrolled increase of MSDs problem with all the associated negative consequences on individuals’ health and well-being, as well as on society. Particularly the costs to society may represent the failure of the welfare state adopted in the EU countries, unless new solutions are found and implemented.

5. REFERENCES Adler, N. E., & Ostrove, J. M. (1999). Socioeconomic Status and Health: What We Know and What We Don't. Annals of the New York Academy of Sciences, 896(1), 3-15.

APA. (2007). Report of the APA Task Force on Socioeconomic Status. Washington, DC: American Psychological Association.

Bauer, R., & Steiner, M. (2009). Injuries in the European Union: Statistics Summary 2005 – 2007. Vienna: European Commission, Health and Consumers Directorate-General (DG Sanco).

Bergman, S. (2007a). Management of musculoskeletal pain. Best Practice & Research in Clinical Rheumatology, 21(1), 153-166.

Bergman, S. (2007b). Public health perspective - how to improve the musculoskeletal health of the population. Best Practice & Research Clinical Rheumatology, 21(1), 191-204.

Berquin, A. (2010). The biopsychosocial model: much more than additional empathy. Rev Med Suisse, 6(258), 1511-1513.

Bjorklund, L. (1998). The Bone and Joint Decade 2000-2010. Inaugural meeting 17 and 18 April 1998, Lund, Sweden. Acta Orthop Scand Suppl, 281, 67-80.

Bongers, P. M., Ijmker, S., van den Heuvel, S., & Blatter, B. M. (2006). Epidemiology of work related neck and upper limb problems:

psychosocial and personal risk factors (part I) and effective interventions from a bio behavioural perspective (part II). J Occup Rehabil, 16(3), 279-302.

Brekke, M., Hjortdahl, P., & Kvien, T. K. (2002). Severity of musculoskeletal pain: relations to socioeconomic inequality. Social Science & Medicine, 54(2), 221-228.

Bremander, A., & Bergman, S. (2008). Non-pharmacological management of musculoskeletal disease in primary care. Best Practice & Research Clinical Rheumatology, 22(3), 563-577.

Browner, B. D. (1999). The Bone and Joint Decade, 2000-2010. J Bone Joint Surg Am, 81(7), 903-904.

Burton, A. K., Kendall, N. A. S., Pearce, B. G., Birrell, L. N., & Bainbridge, L. C. (2008). Management of upper limb disorders and the biopsychosocial model: Health and Safety Executive European League Against Rheumatism. (2010). Rheumatic and Musculoskeletal Diseases: Improving the quality of life for more than 100 million EU citizens. Retrieved November 29, 2010, from http://www.eular.org/myUploadData/files/EU_Presidency_Poster.pdf Evanoff, B. A., Bohr, P. C., & Wolf, L. D. (1999). Effects of a participatory ergonomics team among hospital orderlies. American Journal of Industrial Medicine, 35(4), 358-365.





Finestone, H. M., Alfeeli, A., & Fisher, W. A. (2008). Stress-induced physiologic changes as a basis for the biopsychosocial model of chronic musculoskeletal pain: a new theory? Clin J Pain, 24(9), 767-775.

Occupational Safety and HygieneInternational Symposium on

Gillen, M., Yen, I. H., Trupin, L., Swig, L., Rugulies, R., Mullen, K., et al. (2007). The association of socioeconomic status and psychosocial and physical workplace factors with musculoskeletal injury in hospital workers. American Journal of Industrial Medicine, 50(4), 245-260.

Gjesdal, S., Bratberg, E., & Maeland, J. (2009). Musculoskeletal impairments in the Norwegian working population: the prognostic role of diagnoses and socioeconomic status: a prospective study of sickness absence and transition to disability pension. Spine, 34, 1519-1525.

Hagen, K., Zwart, J.-A., Svebak, S., Bovim, G., & Stovner, L. J. (2005). Low socioeconomic status is associated with chronic musculoskeletal complaints among 46,901 adults in Norway. Scand J Public Health, 33(4), 268-275.

Hanada, E. Y. (2003). Efficacy of rehabilitative therapy in regional musculoskeletal conditions. Best Practice & Research Clinical Rheumatology, 17(1), 151-166.

Hignett, S., Wilson, J. R., & Morris, W. (2005). Finding ergonomic solutions - participatory approaches. Occupational MedicineOxford, 55(3), 200-207.

Hootman, J. M. (2007). ‘‘These Old Bones’’ - A Growing Public Health Problem. Journal of Athletic Training, 42(3), 325-326.

Janwantanakul, P., Pensri, P., Jiamjarasrangsi, W., & Sinsongsook, T. (2009a). Associations between prevalence of self-reported musculoskeletal symptoms of the spine and biopsychosocial factors among office workers. J Occup Health, 51(2), 114-122.

Janwantanakul, P., Pensri, P., Jiamjarasrangsi, W., & Sinsongsook, T. (2009b). Biopsychosocial Factors Are Associated with High Prevalence of Self-reported Musculoskeletal Symptoms in the Lower Extremities Among Office Workers. Archives of Medical Research, 40(3), 216-222.

Keefe, F. J., KashikarZuck, S., Opiteck, J., Hage, E., Dalrymple, L., & Blumenthal, J. A. (1996). Pain in arthritis and musculoskeletal disorders: The role of coping skills training and exercise interventions. Journal of Orthopaedic & Sports Physical Therapy, 24(4), 279Krokstad, S., Johnsen, R., & Westin, S. (2002). Social determinants of disability pension: a 10-year follow-up of 62 000 people in a Norwegian county population. International Journal of Epidemiology, 31(6), 1183-1191.

Laitinen, H., Saari, J., Kivisto, M., & Rasa, P. L. (1998). Improving physical and psychosocial working conditions through a participatory ergonomic process - A before-after study at an engineering workshop. International Journal of Industrial Ergonomics, 21(1), 35-45.

Lidgren, L. (2003). The Bone and Joint Decade and the global economic and healthcare burden of musculoskeletal disease. The Journal of Rheumatology, 67, 4-5.

Macfarlane, G. J., Norrie, G., Atherton, K., Power, C., & Jones, G. T. (2009). The influence of socioeconomic status on the reporting of regional and widespread musculoskeletal pain: results from the 1958 British Birth Cohort Study. Ann Rheum Dis, 68(10), 1591Månsson, N.-O., Råstam, L., Eriksson, K.-F., & Israelsson, B. (1998). Socioeconomic inequalities and disability pension in middleaged men. International Journal of Epidemiology, 27(6), 1019-1025.

Noonan, J., & Wagner, S. L. (2010). A Biopsychosocial Perspective on the Management of Work-Related Musculoskeletal Disorders.

Aaohn Journal, 58(3), 105-114.

Rivilis, I., Van Eerd, D., Cullen, K., Cole, D. C., Irvin, E., Tyson, J., et al. (2008). Effectiveness of participatory ergonomic interventions on health outcomes: A systematic review. Applied Ergonomics, 39(3), 342-358.

Schneider, E., Irastorza, X., & European Agency for Safety and Health at Work. (2010). OSH in figures: Work-related musculoskeletal disorders in the EU — Facts and figures. Luxembourg: Publications Office of the European Union.

St-Vincent, M., Bellemare, M., Toulouse, G., & Tellier, C. (2006). Participatory ergonomic processes to reduce musculoskeletal disorders: summary of a Quebec experience. Work (Reading, Mass.), 27(2), 123-135.

The Bone and Joint Decade. (2010). Momentum: Looking back at a Decade of Action in Musculoskeletal Health, and moving forward:

Report 2000-2010: The Bone and Joint Decade.

The Work Foundation. (2009). Musculoskeletal Disorders in the European Workforce. Retrieved May 2, 2011, from http://www.fitforworkeurope.eu/Default.aspx.LocID-0afnew009.RefLocID-0af002.Lang-EN.htm United States Bone and Joint Decade. (2008). The Burden of Musculoskeletal Diseases in the United States. Rosemont: American Academy of Orthopaedic Surgeons (AAOS).

Vink, P., Urlings, I. J. M., & van der Molen, H. (1997). A participatory ergonomics approach to redesign work of scaffolders. Safety Science, 26(1-2), 75-85.

Qualitative Occupational Risk Assessment model – an overview Pinto, Abel a, Ribeiro, Rita A., b Nunes, Isabel L.c a Universidade Nova Lisboa, Faculdade de Ciências e Tecnologia, Departamento de Engenharia Mecânica e Industrial, Campus de Caparica, 2829-516 Caparica, Portugal, abel.fnpinto@gmail.com; b Centro de Tecnologia e Sistemas, UNINOVA, Campus de Caparica, 2829-516 Caparica, Portugal, rar@uninova.pt; c Universidade Nova Lisboa, Faculdade de Ciências e Tecnologia, Departamento de Engenharia Mecânica e Industrial and Centro de Tecnologia e Sistemas, UNINOVA, Campus de Caparica, 2829-516 Caparica, Portugal, imn@fct.unl.pt

1. INTRODUCTION Occupational Risk Analysis and Occupational Risk Assessment (ORA) is the core of any safety practices in any industry.

ORA are a complex process that entails the consideration of many parameters, which are, more often than not, difficult to quantify.

The specifics of the work on construction industry (Tam et al., 2004) ensure that uncertainties are inherent in every condition. Construction industry is an aggregate of many specialized groups working together to build, maintain, repair, renovate, or demolish buildings, highways, dams, bridges, viaducts and any other number of structures. Labor nature ranges from difficult physical tasks to fully mechanized operations. It is often performed under extreme conditions and in isolated or, conversely, heavily congested areas.

When conducting ORA at construction sites, there is often inadequate data or imprecise information available and safety practices encountered at construction sites are as variable as the sites themselves. Therefore, the use of quantitative occupational risk assessment models based on probabilistic techniques, using data collected at different construction sites and in various types of construction projects, seems that can lead to distorted results and do not reflect the reality of the site under analysis. On construction, the problem of ORA is more acute (comparing with other industries) because the occupational safety knowledge basis, that is a base of accumulated knowledge and experience, is not available.

Several authors (Faber and Stewart, 2003; Kentel and Aral, 2004; Pinto et al., 2011) have discussed the limitations of traditional (probabilistic) methods for ORA and stated that the kinds of uncertainties include scarce or incomplete data, measurement error, data obtained from expert judgment, or subjective interpretation of available information cannot be treated solely by traditional statistical or probabilistic methods. By this, probabilistic ORA methods are not objective: it simply fails to acknowledge its subjectivity.

By other hand, man is capable of abstracting, thinking and reasoning, thus, can assess the risks without having necessarily to experience their consequences. Hollnagel (2008) stated that Safety cannot genuinely be improved only by looking to the past and taking precautions against the accidents that have happened, it must also look to the future.



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