Applied Ergonomics 68 (2018) 289–293

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Applied Ergonomics
journal homepage: www.elsevier.com/locate/apergo

Review article

Participatory ergonomics: Evidence and implementation lessons T

Robin Burgess-Limerick
Sustainable Minerals Institute, The University of Queensland, 4072, Australia

A R T I C L E I N F O A B S T R A C T

Keywords: Participatory ergonomics programs have been proposed as the most effective means of eliminating, or re-
Participatory ergonomics designing, manual tasks with the aim of reducing the incidence of occupational musculoskeletal disorders. This
Manual tasks review assesses the evidentiary basis for this claim; describes the range of approaches which have been taken
Musculoskeletal disorders under the banner of participatory ergonomics in diverse industries; and collates the lessons learned about the
implementation of such programs.

1. Introduction
Participatory ergonomics means actively involving workers in de-
veloping and implementing workplace changes which will improve
productivity and reduce risks to safety and health - or as Wilson (1995)
put it, the “involvement of people in planning and controlling a sig-
nificant amount of their own work activities, with sufficient knowledge
and power to influence both processes and outcomes to achieve desir-
able goals”. The underpinning assumptions are that: workers are the
experts; and, given appropriate knowledge, skills, tools, facilitation,
resources and encouragement, they are best placed to identify and
analyse problems, and to develop and implement solutions which will
be both effective in reducing injury risks and improving productivity
and be acceptable to those effected (Brown, 2005). There are many
types of participation, including consultative or representative partici-
pation where users or elected representatives respectively express ideas
or opinions, and management makes decisions (Wilson, 1991). Here,
however, we are more concerned with direct participation (Vink et al.,
2006) in which workers have some degree of influence over the deci-
sions regarding workplace changes.
According to Noro (1999), the term “participatory ergonomics” was
coined in 1984, however it's antecedents are found in the management
practices of quality circles and industrial democracy (Brown, 1993;
Liker et al., 1989; Nagamachi, 1995; Noro, 1991). A participatory er-
gonomics program typically employs one or more teams assembled for
the purpose of improving the design of work, and the common element
is to ensure utilisation of the expert knowledge that workers have of
their own tasks by involving the workers, and others potentially af-
fected by proposed changes. Although such programs have typically
been primarily focussed on reducing musculoskeletal injuries, partici-
patory ergonomics programs have also explicitly aimed to create more
human-centered work (Imada, 2000), to improve organisational
climate (Maciel, 1998), or been used as a framework for health pro-
motion (Punnett et al., 2013). Participatory ergonomics may be con-
sidered to be a method of work system design and thus, fundamentally,
a macroergonomics technique (Brown, 2002; Hendrick, 2002; Kleiner,
2006).
Participatory ergonomics programs have been implemented across a
large range of industries and organisations (eg., Hignett et al., 2005),
including mining (Burgess-Limerick et al., 2007; Torma-Krajewski
et al., 2007), domestic and civil construction (Dale et al., 2016; de Jong
and Vink, 2000; de Jong and Vink, 2002; Dennis and Burgess-Limerick,
2009; Jaegers et al., 2014; Vink et al., 1997), and office environments
(Haims and Carayon, 1998; Polanyi et al., 2005; Vink et al., 1995) as
well as diverse small businesses (Straker et al., 2004); newspapers
(Rosecrance and Cook, 2000), health care institutions (Bohr et al.,
1997; Carrivick et al., 2005; Evanoff et al., 1999; Rasmussen et al.,
2015) and numerous manufacturing sites (Cantley et al., 2014;
Guimaraes et al., 2015; St-Vincent et al., 1998, 2001; Nagamachi, 1995;
Halpern and Dawson, 1997; Laing et al., 2005; Liker et al., 1989;
Motamedzade et al., 2003; Moore and Garg, 1997; Gjessing et al.,
1994).
Perhaps as a consequence of the diverse settings in which programs
have been implemented and the need for programs to “fit” each orga-
nisation or situation (Brown, 2005) there are many variations in the
program characteristics, such as the degree and nature of participation
(Jensen,1997; Liker et al., 1989), extent of expert facilitation and as-
sistance provided, the nature and extent of training provided to teams
(in ergonomics methods and team work), and the tools employed to
assist teams identify issues and develop solutions (Kuorinka, 1997;
Reynolds et al., 1994; Nagamachi, 1995).
A conceptual framework for defining the range of variations found
in participatory ergonomics programs has been proposed by Haines
et al. (2002). The dimensions defined (in order of importance,

E-mail address: r.burgesslimerick@uq.edu.au.

https://doi.org/10.1016/j.apergo.2017.12.009
Received 16 August 2017; Received in revised form 5 December 2017; Accepted 16 December 2017
Available online 20 December 2017
0003-6870/ © 2017 The Author. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/BY/4.0/).
R. Burgess-Limerick
according to Hignett et al., 2005) are:
(i) location of decision making power - whether retained by man-
agement and informed by consultation with individual workers or
groups, or delegated to the workers;
(ii) mix of participants formed for the interventions - front-line staff
only, or including technical staff, middle management and/or
senior management;
(iii) remit - that is, the extent of the participants' involvement in set-
ting up and monitoring of the participatory ergonomics process,
the identification of problems to be addressed, and the genera-
tion, evaluation and implementation of solutions;
(iv) role of ‘ergonomics specialist/s’ - acknowledged as potentially
changing and evolving over time, ranging from being a facilitator
or leader, trainer, expert team member, or available for con-
sultation as required (or not involved);
(v) nature of worker involvement - varying from direct face-to-face
involvement of all affected workers to representative participa-
tion of selected workers;
(vi) focus - whether aimed at the level of design of tasks undertaken
by individuals or teams, or broader work organisation issues or
policies;
(vii) level of influence - variations in the level of the organisation at
which the intervention takes place, whether at the level of the
work team or department, through to the entire organisation, or
indeed, across an industry (eg., Tappin et al., 2016);
(viii) requirement - that is, whether the participation is undertaken by
volunteers, or an expected part of a job role, noting that this may
vary across group members;
(ix) permanence of the intervention - ranging from a temporary pro-
gram introduced as means of solving a particular problem, to
programs intended to be permanently integrated into the ongoing
continuous improvement activities of the organisation.;
Haines et al. (2002) also noted that participatory ergonomics pro-
grams may differ in terms of the complexity of the structures in which
the activities are embedded. While a single layer structure involving
work group/s only might be involved, more complex structures in-
cluding, for example, a second layer of “steering committee” might well
oversee the activities of multiple working groups; and more layers are
also possible in large multi-site organisations.
The effectiveness of a participatory ergonomics intervention may
well vary as a function of different combinations of these dimensions.
The characteristics and level of commitment of the organisations in
which such programs are implemented also varies considerably, and
these factors are also very likely to influence the outcomes of such
programs.
2. Effectiveness of participatory ergonomics programs
Participative ergonomics is reported to have a range of benefits in
addition to reduction in musculoskeletal injury risks, such as improved
flow of useful information within an organisation, an improvement in
the meaningfulness of work, more rapid technological and organisa-
tional change, and enhanced performance (Haines and Wilson, 1998;
Brown, 1993; Haims and Carayon, 1998). As well as developing more
effective solutions, the use of participative ergonomics techniques to
derive solutions is believed to result in greater “ownership” by those
affected, leading to greater commitment to the changes being im-
plemented (Brown, 2005; Burgess-Limerick et al., 2007; Nagamachi,
1995).
Psychosocial characteristics of work-places such as the workplace
culture; high workloads; lack of control; high levels of interpersonal
conflict; and poor change management (Gerr et al., 2014; Devereux
et al., 2004) both impact on the potential success of a participatory
ergonomics intervention (Polanyi et al., 2005; Rivilis et al., 2006) and
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Applied Ergonomics 68 (2018) 289–293
may be influenced by such an intervention (Macdonald and Oakman,
2015; Vink et al., 1995). A workplace with an existing culture of dis-
trust and adversarial industrial relations, and without any history of
worker involvement in decision making, is unlikely to be a fertile
ground for participatory approaches to flourish without first addressing
these issues (eg., Dixon et al., 2009; Jensen, 1997; Polanyi et al., 2005).
However, in absence of such a adverse context, the impact of a parti-
cipatory ergonomics program in which management and workers work
together to improve workplace conditions has potential to further im-
prove the organisational culture and other aspects of the psychosocial
work environment (Cole et al., 2005; Laitinen et al., 1998; Maciel,
1998).
The economic impact of workplace ergonomic interventions (re-
gardless of the process by which such interventions were devised) has
been the subject of a review (Tompa et al., 2010) which found the
strength of the evidence to vary from strong in the manufacturing and
warehousing sector, moderate in the administrative and support ser-
vices sector, and health care sectors, and limited in the transportation
industry. The implementation of a participatory ergonomics program at
a Brazilian furniture manufacturer was report to lead to a 46% pro-
ductivity increase attributable to a combination of reducing un-
necessary load handling, waiting and transportation; and reduction in
manufacturing time (Guimaraes et al., 2015). Nagamachi (1995) re-
ported similarly large productivity improvements in manufacturing
case studies while Motamedzade et al. (2003) reported more modest
productivity improvements (5% waste reduction, 8% reduction in re-
work) in a manufacturing context as consequence of introducing a
participatory ergonomics program. Reynolds et al. (1994) reported a
17% increase in hourly earnings associated with changes made to a
work-station at an apparel manufacturer.
While some research has demonstrated significant effects of im-
plementing a participatory ergonomics program on physical risk factors
associated with manual tasks (eg., Straker et al., 2004) most evaluations
have focussed on direct health effects. The effect of participatory er-
gonomics programs on musculoskeletal health have been the subject of
three systematic reviews. The outcomes of individual evaluations are
mixed. Silverstein and Clark (2004) noted this variability, concluding
that participatory ergonomics programs were “often, but not always
successful”. Cole et al. (2005) reviewed 10 evaluations of the health
effects of participatory ergonomics programs, concluding that the stu-
dies provided limited evidence that participatory ergonomics programs
can have a positive impact on musculoskeletal injury symptoms and
compensation costs. More encouragingly, Rivilis et al. (2008) con-
cluded that the “12 studies that were rated as 'medium' or higher pro-
vided partial to moderate evidence that PE interventions have a positive
impact on: musculoskeletal symptoms, reducing injuries and workers'
compensation claims, and a reduction in lost days from work or sickness
absence.”
More recent evaluations not included in these reviews have also
demonstrated mixed results. For example, Haukka et al. (2008) found
no systematic effects of a participative ergonomics program involving
six 3 h workshops at 119 Finnish kitchens, despite reporting the im-
plementation of 402 ergonomic changes. Cole et al. (2009) reported a
multiple case study involving programs of varying details across four
production contexts. Production pressures were encountered as a bar-
rier at each site and management commitment varied. Although
changes were introduced at each site, no statistically significant effect
on health outcomes could be detected. Driessen et al. (2011) reported
that an intervention involving a single six hour meeting with 19
working groups in randomly assigned departments across four Dutch
companies in diverse industries did not result in subsequently reduced
low-back or neck discomfort compared to a control group of 18 de-
partments, although a significant effect on recovery from back pain was
noted. Dale et al. (2016) evaluated the implementation of a participa-
tory ergonomics program consisting of six 10 min tool box talks in small
construction firms. Issues with commitment to the program were
R. Burgess-Limerick
encountered and while worker knowledge improved and changes to
work practices and tools occurred, no changes in musculoskeletal
symptoms were observed.
However, Rivilis et al. (2006) reported positive health effects of
implementing a “ergonomic change team” including worker and man-
agement representatives, and an ergonomics facilitator, at one courier
company depot compared with a referent depot. The team received
four, 6 h training sessions covering ergonomics principles and tools
required to develop and evaluate solutions. The team met weekly for
seven months, and twice per month for the following seven months.
Fourteen changes at the intervention depot were made during this
period including new tools, workstation modifications and reduced
conveyor speeds, while no changes were made at the referent depot.
Cantley et al. (2014) similarly reported positive outcomes from a 6
year evaluation of a large scale participatory ergonomics process at a
multi-site aluminium manufacturer. Control measure implementation
targets were set by senior management and the evaluation noted 204
control measures implemented across 123 jobs at 17 study sites, ef-
fecting the work of 14,540 workers. Jobs in which control measures
were introduced were associated with significantly lower musculoske-
letal injury risk and the authors concluded that the study “provides
evidence that a systematic approach to ergonomic hazard identifica-
tion, quantification and control implementation, in conjunction with
requirements to establish an ergonomic process at each manufacturing
plant, may be effective in reducing risk of MSD and acute injury out-
comes among workers in targeted jobs”.
The mixed nature of health effect evaluations is perhaps un-
surprising given the diversity of program designs and the variety of
organisational characteristics and contexts in which program im-
plementation has been attempted. It is reasonable to conclude that,
while participatory ergonomics programs have potential to reduce the
incidence of musculoskeletal disorders, there are many potential bar-
riers and success has not always been achieved. An examination of
these potential barriers, and the lessons learned during the im-
plementation of such programs, yields insights of value for the im-
plementation of future programs.
3. Implementation of participatory ergonomics programs
Van Eerd et al. (2008, 2010) have provided an excellent review of
the structure of participatory ergonomics programs. Fifty-two papers
were identified which met content and quality criteria and the char-
acteristics of the programs described were categorised, as far as pos-
sible, according to the nine dimensions identified by Haines et al.
(2002) relating to intervention permanence; nature of worker in-
volvement, influence and decision making power; group composition;
focus and remit; and the role of ergonomists in the process. The teams
in which participatory activity was undertaken varied, including de-
partment or work group teams, as well as inter-departmental teams,
and steering committees. The frequency and duration of team meetings
varied greatly. Ergonomics training was typically provided, most often
by an ergonomist, although the duration of training provided varied
greatly (from 2 h to 100 h). In addition to ergonomics and risk man-
agement information, some programs included training on working as a
team.
Participants in participatory ergonomics teams included workers,
supervisors, external advisors, internal specialists and management.
Union representation occurred relatively infrequently. Participation
was typically voluntary. Decision making was typically “group con-
sultation” in which the teams were responsible for problem and solu-
tion identification followed by management approval of resources re-
quired for implementation, while implementation was the
responsibility of the ergonomics teams. External ergonomists were ty-
pically active in initiating and guiding the process, and took on roles of
consultant and trainer at varying times throughout the program life.
The programs most frequently aimed to change tools, equipment,
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Applied Ergonomics 68 (2018) 289–293
workplaces or processes, rather than organisational factors, and the
level of influence was on a workplace or department. The goal was most
often to integrate the participatory ergonomics program as part of on-
going continuous improvement processes. Drawing on the dimensions
identified by Haines et al. (2002) this combination of program char-
acteristics may be considered to be a consensus view of the design of a
workplace based participatory ergonomics program. More complex
designs may be required for interventions which span larger, multi-site
organisations (eg., Cantley et al., 2014; Dennis et al., 2015) or multiple
organisations across an industry (eg., Tappin et al., 2016).
A number of potential facilitators and barriers exist to the successful
implementation of participatory ergonomics programs. Organisations
are likely to differ in their ability to benefit from such a program.
Organisations which are less hierarchical, have good labour relations, a
tradition of consultatory processes in other areas, good communication
channels and job design which emphasise personal control are likely to
most easily adopt and benefit from a participatory ergonomics program
(Haines and Wilson, 1998).
The commitment of management, at all levels, to the program is the
most important factor contributing to the probability of success (Brown,
2005; Dixon et al., 2009; Liker et al., 1991). Senior management
commitment is essential to ensure adequate resources are available,
including provision of time for team members to participate in training
and intervention activities, and approval of the expenditure required to
implement workplace changes (Haines and Wilson, 1998). Constraint
on the availability of such resources (both time and money) have been
noted as providing significant barriers to success in some studies (Bohr
et al., 1997; Brown, 2005; Cole et al., 2005; Rasmussen et al., 2017;
Dale et al., 2016; Halpern and Dawson, 1997; Laitinen et al., 1998;
Moore and Garg, 1997; Torma-Krajewski et al., 2007; Jensen, 1997;
Rosecrance and Cook, 2000).
It is also important to ensure that middle managers within the or-
ganisation maintain commitment in the face of inevitable production
pressures. The challenge of achieving this is well described by Dixon
et al. (2009) who investigated the implementation of three participa-
tory ergonomics programs
“While senior management in all sites was supportive at the outset
of the process, it was middle management and supervisors who, for
the most part, had to deal with the pragmatic issues around main-
taining production once the intervention program was in progress.
Given the pressures they faced, it is not surprising that securing their
support was an ongoing challenge. Additionally, there were varia-
tions across the sites in the degree to which senior management's
initial commitment was sustained throughout the course of the er-
gonomics program, and importantly, backed up by active interven-
tion when the program encountered resistance” (p. 67)
Programs are likely to be most successful when senior management
dictate implementation targets for control measures across the organi-
sation (eg., Cantley et al., 2014; Dennis et al., 2015; Pazell et al., 2016).
Ensuring genuine participation by team members is the next hurdle
which some workplaces encounter, depending on the history of re-
lationships between management and workers (Cole et al., 2005). As
well as management being committed, workers need to believe this to
be the case (Haines and Wilson, 1998). The role of the facilitator of the
ergonomics program may sometimes need to extend to facilitating
communication between management and workers (Burgess-Limerick
et al., 2007; Rosecrance and Cook, 2000). The presence of a site
champion to drive the process has been considered important (Burgess-
Limerick et al., 2007; Laing et al., 2005; Wells et al., 2003; Wilson,
1995; Wilson et al., 2005) and staff turnover which disrupts the site
champions’ ongoing contributions is a threat to program sustainability,
as is general instability within the workplace or industry generally
(Cole et al., 2005).
One method of promoting participation from skeptical team mem-
bers is to carefully choose the initial target issue. The initial target issue
R. Burgess-Limerick
should be one with good probability of prompt success and one which
can be solved for modest cost, but at the same time not a task with an
extremely obvious fix (Reynolds et al., 1994; Liker et al., 1991; Gjessing
et al., 1994; Wells et al., 2003). Allocation of a pre-approved budget to
participatory ergonomics teams is another means of overcoming skep-
ticism (Haines and Wilson, 1998). The careful choice of team members
is also an important issue here. Starting small, with a “pilot project” and
allowing the initial success to prepare the way for more substantial
implementation is sensible. It also allows opportunity for the program
progress to be evaluated, and the program design revised to suit the
organisation if required (Haines and Wilson, 1998; Wells et al., 2003).
There appears to be wide variety across programs in the provision of
tools to assist workplace teams identify hazardous tasks, analyse the
characteristics of the task which contribute to injury risks, and evaluate
the degree of risk associated with the tasks. For example, Carrivick et al.
(2005) described the use of a “simple MH checklist” to assess the injury
risks associated with tasks performed by hospital cleaners. The checklist
included consideration of “body actions and postures required, the
duration and frequency of MH and the load” as well as “workplace
factors”. This data was combined with injury and exposure data to rank
tasks according to injury risk likelihood and severity. Cantley et al.
(2014) reported that a variety of tools were used such as the NIOSH
Lifting Equation, Liberty Mutual Psychophysical tables, Rapid Upper-
Limb Assessment or the Quick Exposure Check, in combination with
injury, exposure and expected intervention costs and a “specified al-
gorithm with a pre-determined hazard threshold to determine whether
the specified job task constituted an ergonomic hazard”. Laing et al.,
2005 similarly provided training in these and other tools, including the
Watbak biomechanical modeling software.
However, as Haines and Wilson (1998) noted, the use of overly
complex analytical tools may be counter-productive to the long-term
viability of a participatory ergonomics program. A variety of simpler
analysis tools have been provided (Burgess-Limerick, 2004; Burgess-
Limerick et al., 2007; Dennis and Burgess-Limerick, 2009; Torma-
Krajewski et al., 2007) and formed part of the evolution of the risk
analysis, evaluation and communication tool subsequently described by
Dennis and Burgess-Limerick (2010).
Although the tools employed to analyse and evaluate tasks should
be kept as simple as possible, workers and management require some
understanding of relevant ergonomics concepts and techniques. Again,
however, this training should be restricted to the essential aspects to
minimise costs and long-term program sustainability (Burgess-Limerick,
2004; Haines and Wilson, 1998). Use of workplace-specific video is
useful to engage workers, and on-line delivery of training can reduce
costs. Training in team-work skills and provision of team facilitation
may also assist in ensuring participation (Gjessing et al., 1994). Train
the trainer approaches in which an ergonomist trains team facilitators,
who in turn lead the ergonomics project teams, is likely to be a efficient
method of efficiently expanding the program beyond the pilot stage.
It is important to ensure that worker participation continues
throughout the development and revision of control measures, as well
as the initial hazard identification, analysis and solution ideation stages
(Burgess-Limerick et al., 2007; Dixon & Theberge, 2011). It is important
to ensure that internal experts (eg., engineers) are included in the
process when appropriate, as well as those potentially effected by
proposed changes (eg., maintenance staff).
In some large organisations, administrative structures may act as
impediments to the timely implementation of controls (Bohr et al.,
1997). Such delays may cause frustration which, in turn, decrease team
enthusiasm and participation. When delays in implementation of con-
trol measure inevitably occur, for whatever reason, it is important that
communication with the team members involved in a project is main-
tained. Even if there is no progress to report it is critical that partici-
pants understand the reasons for delays and that the process was still
underway (Burgess-Limerick et al., 2007).
A process to efficiently analyse risks, and to develop and implement
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Applied Ergonomics 68 (2018) 289–293
suggested controls appear to be important components of successful
participative ergonomics interventions (Haims and Carayon, 1998;
Laing et al., 2005) and the use of task-specific video footage appears to
be a useful part of this process (Burgess-Limerick et al., 2007; St-
Vincent et al., 2001). Documenting both successes and failures is an
important step, but one which has not typically been undertaken. Ide-
ally, the risk analysis and control information should be readily ac-
cessible across the organisation, particularly where similar work is
undertaken at geographically distributed locations.
4. Conclusion
Performance of manual tasks which involve high exertion, long
duration, awkward or static postures, or repeated similar movements,
and especially combinations of these characteristics, increases the risk
of musculoskeletal disorders at the body regions involved. Eliminating
the hazardous manual task or redesign of the task to reduce exposure to
these task characteristics is likely to reduce this risk. Harnessing the
expertise of the workers who undertake the tasks through a participa-
tory ergonomics process has potential to both ensure that the solutions
proposed are optimal, and will be accepted by workers. Successful
implementation of such a program requires ongoing management
commitment at all levels and genuine participation from workers, in-
ternal specialists, and other people effected by proposed changes.
Training in ergonomics principles, team work and problem solving is
likely to be required; as well as tools for the efficient analysis of manual
tasks risks and for the development and documentation of proposed and
implemented changes.
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