Paper: Health perception in workers exposed to hand-arm vibration: prerequisite for putting in place an effective preventive program in the workplace

Author(s) and Affiliation(s):
Alice Turcot, Institut national de santé publique du Québec
Barbara Tessier, Direction de santé publique de Chaudière-Appalaches
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Objectives:

Knowledge of risks from exposure to hand-arm vibration is usually presented by clinicians and researchers from a medical and engineering point of view. There is a strong need to develop innovative health promotion programs for exposed workers. Risk perceptions by vibration exposed workers and HAVS( hand-arm vibration syndrome)affected workers are less well known.Risk awareness on the part of exposed workers and their employers, as well as knowledge and acceptance of available preventive solutions are necessary steps before, installing adequate preventive measures whether organizational, behavioral or environemental.1 Our research objectives are:
1) to document knowledge, beliefs, perception and attitudes with regards to risk exposure and health effects
2) to document knowledge, beliefs, perception and attitudes with regards to preventive strategies including barriers and facilitating factors towards these measures
3) To document the latter form the standpoint of employers and public health physicians involved in the promotion of worplace safety.

Methods:

A descriptive exploratory study with workers exposed to hand-arm vibrations has been used. It uses qualitative methods that include focus group discussions with workers exposed to hand-arm vibrations, as well as individual interviews with other key informants( health care professionals and employers). An open-ended questionnaire was developped to collect qualitative date on perceived risks and solutions to prevent or reduce HAVS. Based on integrated theoretical framework related to known determinants of behaviour change, the analysis will focus on the following 2: 1) knowledge of health effects, safety, well-being and/or quality of life 2) related beliefs about individually susceptibility and severity of consequences 3) attitude and values related to hand-arm vibration exposure 4) knowledge and attitudes towards exposure reduction, as well as perceptions of barriers and facilitating factors for the measures, in the workplace environment or otherwise Interviews were transcribed. We proceeded to the content analysis using N'Vivo and a thematic approach.

Results:

Several obstacles exist that need to be addressed, when putting in place preventive measures in the workplace. Problem identification by workers and employers is an important stage for empowering employees and employers to control the design of their workplace. Risk perception of vibration is quite low form the standpoint of workers, employers and health physicians. For workers, vibration exposure is an inevitable risk, it is part of the job. Knowledge of health effects from the vibration exposure as well as preventive strategies is low among workers, employers and health physicians.

Conclusions:

This study highlights the importance of taking into account determinants of behavioral change within a theoretical frmaework while respecting the workers' and employers' perspective, when setting up HAVS preventive programs.There is a lot of work to be done. An individual approach is not beneficial, rather a broader approach from a macroscopic point of view such as the putting in place of standards and putting close attention to more efficient knowledge transfer models. " Health profesionals must consult the people who are the intended target of health programs to determine their needs, problems and aspirations concerning quality of life. If professionals do not take this vital step, health policies will remain sterile technocratic solutions to problems that may not exist or that hold a low priority in the minds of the people." 3

References:

1. Nicholson PJ,(2000), Communicating occupational and environmental issues, Occup Med, 50, 226-230.
2. Committee on Communication for Behaviour change in the 21 th century: Improving the Heealth od Diverse Populations (2002), Board on Neuroscience and Beahaviour Health, The National Academic Press, Washington, DC.
3. Green Lawerence, Kreuter Marshall, ( 1991), Health promotion planning, An educational and environmental approach.