Participatory Ergonomic Interventions Save $$ for Childcare Employers, Study Hints

Nancy Grover

Sarasota, FL ( – Employers seeking a cost-effective way to reduce musculoskeletal pain among their employees may want to consider participatory ergonomic interventions. A new study suggests organizations might save money through programs designed to engage both workers and managers to effect meaningful changes in work risks.

Researchers in Denmark conducted a study of workers who care for children between 0 and 3 years of age to determine if they could reduce the incidence of physical exertion and musculoskeletal pain-related absenteeism with a demonstrated return-on -investment. While the study was small, the results indicate positive outcomes.

“Overall, we found tendencies for the participatory ergonomics intervention for reducing physical exertion among childcare workers to be cost-effective and cost-beneficial from an employer’s perspective, compared to usual practice,” the researchers wrote, in the Journal of Occupational Environmental Medicine. “We found that although our results were non-significant, the intervention tended to be cost effective and has potential, with moderate probability, for employers to approximately double their investment.”

Childcare Workers

There are an estimated 488,000 childcare workers in the U.S., according to the American Community Survey. These workers are especially prone to a variety of health problems.

“A recent study based on accelerometer and observational methods among childcare workers has indicated that excessive ergonomic demands, such as forward bending of the back and knee straining postures, could impose risks for musculoskeletal pain and sickness absence,” the study said. “Thus, effective workplace interventions are needed to improve ergonomic conditions among childcare workers.”

Participatory ergonomic interventions have been shown to be somewhat effective in reducing physical problems among workers in manufacturing, healthcare, and clerical, among other industries. However, there has been little, if any, exploration of the economic value of these programs.

The Study

The researchers conducted a trial of childcare workers between August 2017 and July 2018. They divided the 190 employees into either an intervention or usual-practice control group. The rating of physical exertion (RPE) was measured at the beginning of the trial and 20 weeks later.

Those in the intervention group participated in three workshops aimed at developing/implementing action plans to improve ergonomic conditions. The first workshop was conducted in week 2 and lasted for 3 hours. The remaining two each lasted 1.5 hours, and occurred in weeks 8 and 12. Also, each workplace was offered one visit by an ergonomic consultant.

The participatory ergonomics followed 6 steps:

  1. Identification of risk factors
  2. Analysis of risk factors
  3. Solution building
  4. Prototype implementation
  5. Prototype evaluation
  6. Solution adoption

The implementation of the intervention was integrated within the workers’ existing work tasks.

Self-reported physical exertion at work was measured with answers to the question, ‘How physically demanding do you usually perceive your current job?’ with responses on a scale of 0 to 10.

Cost effectiveness was determined by measuring costs related to the intervention activities and expenses associated with health-related productivity loss.

Intervention costs included such things as staff participation – of workers and supervisors; ergonomists’ time; materials used, along with refreshments; and overhead, such as use of meeting rooms, phone bills, and the like. The average intervention cost approximately $233.

Health-related productivity loss costs were measured in terms of absenteeism due to sickness and presenteeism, or reduced productivity due to health problems. These were measured every four weeks via questionnaire to the participants.


The study was admittedly small and should be replicated using larger populations, the authors said. Nevertheless, the promising results were represented as Euros.

“Although statistically non-significant, one-unit reduction in RPE was associated with saving of 592 EUR/worker [approximately $676],” according to the study. “Per-EUR invested by the employer was associated with 1.6 EUR return in the intervention than usual practice.”

Though small and statistically non-significant, there was a difference in physical exertion between the intervention and control group, with an average decrease of 0.24 from follow-up compared to the control group. Workers in the intervention group had a mean incremental total cost that was 143 Euros (about $162) lower than the control group. That included the cost of the intervention, presenteeism and absence.

The ROI results were also not statistically significant. However, the total benefit for the intervention group was 336 Eur (approx. $381) compared to the control group.

“The cost-benefit ratio was 1.63, suggesting that each EUR invested in the intervention compared to usual practice resulted in cost savings of 1.63 EUR per worker,” the researchers wrote. “The ROI was 63%, indicating a return of 63% of investment per worker in the intervention compared to control group. The estimated maximal probability of return was 0.67, indicating 67% probability for the employer to expect a positive return on investment from the intervention.”