The First Step towards a Salutogenic Workplace: The Experience of Umbra Group

Background: One of the leading risk factor for absenteeism and loss of working capability is represented by work related musculoskeletal disorders (WMSD). Lifting heavy objects, working with the neck in a flexed position, are just some of the risk factors that can lead to WMSD, which can develop into chronic lumbar pain, hernias or other neck, shoulder, elbow, hand, wrist and back diseases. In regards to the Italian situation, in the last decade there has been a double increase in WMSD cases between 2005 and 2009 (7926 cases in 2005, 16593 in 2009). Evidence today, underlines the necessity to create and effective and sustainable health and safety organization to think global (all risks – work and individual, all fonts – organizational or individual) and act on a single or max two activities each year.

Objective: Introduce a new strategy in promoting health and safety in the workplace starting with a border line risk. Describe, the experience of the Italian Umbra Group in introducing WHP philosophy and all the steps and outcomes aimed to avoid, prevent and treat musculoskeletal disorders (WMSD).

Methods: Re-organized and created the WHP group. Recruited 52 voluntary among workers reporting to be affected by low back pain and/or neck pain and/or Skeletal Muscle Disorders (DMS). Four validated questionnaires were used: anamnestic questionnaire, Neck Pain Questionnaire, Oswestry Low Back Pain Questionnaire, and Numeric Pain Intensity Scale. Based on the results the participated where divided in five small heterogeneous groups. Two checkups and face to face counseling. For each participate was prepared a specific protocol of therapeutic exercises. Included a phase of direct observation, with the aim of identify incorrect behaviors, and an educational program aimed to modify or remove them. A second direct observation period was organized 6 months after to evaluate the effective change in habits.

Results: The main results for NRS back in T0 is 6.1± 3.2, in T1 it is 3.88 ± 2.9. The Oswestry Low Back Pain in T0 24.4 ± 17.8,in T1 it is 16.1 ± 7.2.Postural analysis using the Posture Score Sheet 57.3 ± 10.7 in T0 and in T1 of 63.7 ± 9.8.

Conclusions: The first experience by the WHP group was completed with success. From the decision making, to the therapeutic protocol as a result of the multidisciplinary table for health for a recognized "border" risk: WMSD was completed with satisfaction by the management and workers. The planning process had two main outcomes: Demonstrated that it is more convenient to program, then repair; that a participatory procedure guarantees participation, and gives the management the power to take the next step: free internal resources: introduce an internal gym and free courses for correct posture. The idea is to replay the same participatory process for other issues, in order to become, step by step, a Salutogenic workplace.