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International Journal of Industrial Ergonomics 44 (2014) 24e31

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International Journal of Industrial Ergonomics

journal homepage: www.elsevier .com/locate/ergon

Work training and MSDs prevention: Contribution of ergonomics

Sylvie Ouellet*, Nicole VézinaUniversité du Québec à Montréal, Case postale 8888, succursale Centre-ville, Montreal, Quebec, Canada H3C 3P8

a r t i c l e i n f o

Article history:Received 15 May 2012Received in revised form13 June 2013Accepted 30 August 2013Available online 16 November 2013

Keywords:Work trainingMSDs preventionErgonomic researchinterventionMeat processingLearning conditions

* Corresponding author. Tel.: þ1 514 987 3000x172E-mail address: ouellet.sylvie@uqam.ca (S. Ouellet

0169-8141/$ e see front matter � 2013 Elsevier B.V.http://dx.doi.org/10.1016/j.ergon.2013.08.008

a b s t r a c t

In ergonomics, the intervention can be an integral part of the research. The presented study was carriedout in the meat-processing sector with the dual objective of generating new knowledge about jobtraining for musculoskeletal disorders prevention and of responding to the request of a company thatwanted training content as well as guidance in the organization of its training. The developed meth-odology combines the production of knowledge in cooperation with the stakeholders and concrete ac-tion proposals. There were two phases to our approach: 1) description of the knowledge and know-howof six experienced workers; and 2) daily follow-up, with audio recordings and interviews, of the traininggiven to three groups of apprentices. Each follow-up led to the analysis of training organization, learningconditions and the evolution of the apprentices’ symptoms and difficulties. After monitoring the training,recommendations were made about how the training should be organized and what learning conditionsneeded to be implemented following each group’s training. The instructors and apprentices helped todevelop these recommendations. Analysis of the experienced workers’ activity allowed the potentiallytransmissible knowledge to be put into words. A range of learning condition factors were associated withthe occurrence of pain in the trainees, such as the cutting quality of the knife and the state of the meat.The results likewise indicated that, with regard to MSD prevention, training itself did not suffice and thatit was important to identify conditions requiring improvement. This paper shows how ergonomicresearch intervention facilitated the development of training content and recommendations on learningconditions, whose goal was to prevent musculoskeletal disorders. The results are of interest for thetraining of ergonomists interested in this field of intervention.Relevance to industry: This study shows the importance for any company to consider the expertise oftheir experienced employees to develop training content. It also highlights that injury prevention re-quires the creation of favorable conditions when learning the craft. Finally, the results show thecontribution of ergonomics to support companies in the design of training and prevention of muscu-loskeletal disorders.

� 2013 Elsevier B.V. All rights reserved.

1. Introduction

Quebec’s RSPSAT organism (Réseau de Santé Publique en Santéau Travail e organization for public and worker’s health) definesmusculoskeletal disorders (MSD) as a set of inflammatory ordegenerative symptoms that affect such parts as the neck, back,arms or legs (INSPQ, 2010). These musculoskeletal disordersrepresent an important problem in Quebec as well as in many othercountries. According to a work health study from Quebec’s INSPQ(Institut National de Sante Publique du Quebec), there was onaverage, between 1998 and 2007, 46,400 new TMS cases declaredand verified each year in Quebec, which represents an average of

2.).

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35% of the total number of declared and verified worker injuries, ormore than one out of three for the whole period (INSPQ, 2010).European countries are not spared. For instance, Aptel and St-Vincent (2008) underline the worrying amplitude of the MSDepidemic by noting among others that in 2006, the direct cost ofMSD cases recognized as work-related (spine, upper and lowerlimbs) and indemnified by the CNAMTS (Caisse Nationale d’Assur-ance Maladie des Travailleurs Salariés) in France, including lum-balgias, exceeds 710 million euros. Besides which, among thosepublic sectors affected by MSD cases, agribusiness presents unen-viable statistics. For instance, according to the “Prevention Index”as described by Silverstein et al. (2002) and Bonauto et al. (2006),the top spot on the list of the 20 sub-sectors most susceptible toMSD cases is occupied by the livestock slaughtering and meat-processing business (Stock et al., 2008). Other studies also notethe high prevalence of MSD in this economic sector (Tappin et al.,

S. Ouellet, N. Vézina / International Journal of Industrial Ergonomics 44 (2014) 24e31 25

2006; Isolani et al., 2002). Several risk factors are present in thissector such as repetitive movements, contraigning postures, coldand effort (Tappin et al., 2006). Concerning this last factor, authorshave demonstrated the impact of knife quality on the amount ofeffort exerted while cutting meat (Claudon and Marsot, 2006;Richard et al., 2001).

Moreover, even while different methods can be proposed asmeans of MSD prevention, several studies led in this field andaiming at MSD prevention have described the superior skills ofexperienced workers and underlined the importance of havingthese skills transmitted via workplace training (Chatigny andVézina, 1994; Richard, 2000; Toulouse et al., 1995; Vézina et al.,1999).

In addition, positive changes have been noted in the way thisproblem is being approached by managers in meat industry, whoare showing a growing interest in better organizing the training ofnew employees. In Québec, some companies are now calling onergonomists to develop training programs intended to preventMSDs. One such example of this was the ergonomics researchintervention presented below, which was carried out in the agri-food sector with pork ham deboners. Several questions come tomindwhen the issue of workplace training is raised. First of all, whoare the instructors? In the company that participated in this study,as in many others (Bélanger and Robitaille, 2008), task training isgenerally given by experienced workers who are known for theiroccupational knowledge and know-how. These instructors becomethe standard and pass on their own personally developed methods.This leads to the question of which content should be passed on toapprentices. Does this situation properly ensure that the trainingcontent is safe and well adapted to each apprentice? If the collec-tive know-how of a group of experienced workers was broughttogether, could it enrich training content so as to make it safer andbetter adapted? In addition to these content-related questions,there are also those concerning the organizational, physical, tech-nical, and social conditions in which apprentices learn tasks. Towhat extent can the characteristics of a given training session havean impact on the health of workers as they learn their tasks? Do thelearning conditions help apprentices to stay healthy during theirtraining? Though previous studies have already shown theimportance of considering learning conditions in injury prevention(Chatigny, 2001; Guy, 1997), the present research makes an originalcontribution by assiduously documenting learning conditions andtheir relationship toworkers’ physical sensations over a long periodof time.

In French-speaking ergonomics (Daniellou and Rabardel, 2005),the intervention can be an integral part of the research (Teiger,2007). The methodological aspects of intervention research arelinked since they provide data that allow the generation of newknowledge and a response to a request from a workplace. More-over, the contribution and effectiveness of ergonomic interventionsin improving work conditions is a main concern of researchers andconsultants in the discipline (Coutarel et al., 2007; Cole et al., 2005).When we look at the development of training to prevent MDSsother questions come to mind: what contribution can the ergo-nomic intervention make, and what must ergonomists do to ensurethat the fruit of their analysis helps workers to remain healthy andeffective. This article reports results to answer these questions.

So, this intervention research had two goals: to contribute newknowledge to the issue of company training, and to proposechanges to a company concerning training content, training orga-nization and the learning conditions of apprentices so as to moresuccessfully prevent MSDs. This paper relates more particularly tomethods and results that meet the following objectives: 1) identifythe knowledge and skills of a group of expert workers and developa consensus on training content, 2) conduct a follow-up on

apprenticeship training to document the learning conditions andthe links with their problems and musculoskeletal symptoms. Therecommendations of this intervention research are also presented.

2. Method

2.1. Setting

The study was carried out in a company with a total of 350production employees. Of these, 25 male, right-handed workersremoved the fat and bones from the pork hams. The average age ofthese 25 workers was 41.8 � 7.3 years old. The work was organizedsuch that the workers carried out defatting and deboning insequence on a conveyor belt, alternating from one workstation tothe other. All the workers had to therefore learn to do both tasks.Training lasted eight weeks: six weeks for deboning and twoweeksfor defatting. Theworkers had to learn all the steps in bone removaland trimming on the first day of training. Our study only looked atthe deboning task. That being said, some of the results apply to bothfat and bone removal, in particular with regard to pain-relatedfactors, since the apprentices had to learn both tasks and werethus exposed to factors associated with both.

2.2. Instruments and data collection

There were two main phases to the present study: the firstconsisted in analyzing the work activity of a group of experienceddeboners, including the two deboning instructors (Ouellet andVézina, 2008a); the second consisted in conducting a follow-upof the training given by these two butcher-instructors to threegroups of apprentices (N ¼ 7) (Ouellet and Vézina, 2009).

The ergonomic approach adopted in the study drew its inspi-ration from the work activity analysis approach (St-Vincent et al.,2011; Guérin et al., 2006) whose contribution in describing thevarious strategies used by workers and putting their knowledgeinto words has already been demonstrated in several studies (Deniset al., 2007; Chassaing, 2006; Cloutier et al., 2002; Chatigny, 2001;Vézina et al., 1999; Garrigou et al., 1998; Gaudart, 1996).

2.3. Phase 1: work activity analysis of experienced deboners

2.3.1. SubjectsAt the start of the project, six experienced workers were

selected. Two of them were also deboning trainers. Because allworkers were right-handed men, the main selection criteria werethe recognition of skills by their peers and the diversity of workingmethods. Workstation observations by the ergonomisteresearcherand discussions with the supervisor of the group of workers led tothe selection of participants. All selected workers agreed toparticipate in the study. The six experienced deboners were44 � 7.9 years old on average (34e54), and had 11 � 7.7 years ofexperience (5e25 years) in the company. Note that four of theworkers have held the same type of position for over 10 years inother companies in the food industry.

2.3.2. ProcedureDuring the initial phase, six workers were met individually in a

semi-controlled interview lasting 60 min. The purpose of the in-terviews was to: 1) determine their career path; 2) understandtheir work; and 3) determine the difficulties and physical problems.A consent form outlining the study objectives and stages wassigned by all the workers who took part in the study. The six par-ticipants were allowed to withdraw from the study at any time.

The method has 4 steps: 1) two days of workstation observa-tions to become familiar with the organization of the work, the

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steps in the task, and the different factors that could influence thevarious work methods; 2) detailed description and analysis of themovements and work methods carried out at each step of the task;3) analysis of the workers’ strategies with an individual self-analysis and clarification interview lasting 2.5 h in length perworker to validate the observation results and to identify eachmethod’s determining elements. During the meeting (which wasrecorded), each worker was first asked to observe himself on avideotape and make comments. One of the six workers was un-available because hewas on extended sick leave. This interviewalsomade it possible to document the cognitive component of themovements (Bourgeois and Hubault, 2005) by identifying thesensorimotor information being processed by the workers; 4) twodays of group meetings that were recorded and videotaped for atotal of 14.5 h. Five deboners attended the first day, while four ofthem participated in the second. Workers who have not partici-pated in themeetings were absent when theywere held. One of thediscussions dealt with work methods and reference points used tocarry out a task. This discussion endedwith a series of example cutsin the processing room so as to verify certain work methods anddetermine their advantages and disadvantages in terms of healthand product quality. These discussions thus made it possible toreach a consensus about the determinants of differentmethods andabout how know-how could be safely adapted to the variouscharacteristics of apprentices. Because the goal of this study was toprevent MSDs, the relationships between some factors wereexamined, such as posture, physical effort, and the repetitiveness ofmovements on the one hand (Aptel et al., 2011) and, on the other,the work methods and strategies developed by experiencedworkers to preserve their health.

2.3.3. Data analysisBefore doing a systematic analysis of the work practices, the

videotaped sequences were viewed in order to characterize theworkers’ operating methods and identify the variables that wereused for the systematic analysis. Next, the Actogram softwareprogram was used to observe the work being done and to obtaindata logs (Kerguelen, 2003); the software is designed to processchronological observations using digital video sequences that canbe analyzed in slow motion. For the in-depth analysis of themovements, based on the video recordings, we chose 10 consecu-tive incident-free cycles that allowed to obtain five cycles with theright piece of meat, and five cycles with the left piece. The followingwas considered in the analysis: 1 e temporal organization of thetask (duration: cycle, inter-cycle, deboning/finishing, waiting,communication, knife sharpening, other); 2 e the order in whichthe steps were followed; 3 e the frequency of certain actions thatappeared to determine the effort being exerted and the cycle time(positions the piece, puts back the piece, moves the piece); 4 e theposition of the piece of meat in relation to the worker (distancefrom the piece and position of the parts in relation to theworker); 5e types of grips on the knife based on the step (full-hand grip, indexfinger on the back of the blade, thumb on the back of the blade andlow grip) and; 6 e the amount of time during which each grip wasused. As for the motions that were done, our analysis involveddifferent observable elements such as: 1e direction, angle, numberand length of knife strokes; 2 e the articular range of certainmovements of the shoulder, elbow and wrist, assessed qualita-tively, and; 3 e the parts of the bone (zones) where the knifethrusts are found. It is important to mention that even though theincident-free cycles were not considered for the motion analysis,the incidents were logged and discussed at meetings aimed atidentifying the work method influencing factors. In addition, onesection is found in the training curriculum to explain the impact ofthe incidents (e.g. variability of the raw materials and associated

consequences) and the ways used to deal with them. The discus-sions on these incidents also led to recommendations in somecases.

2.4. Phase 2: monitoring training

2.4.1. SubjectA total of seven apprentices followed training in the deboning

and defatting of pork hams, with three in the first group, two in thesecond, and two in the third group. Six of the seven apprenticeswere right-handed and one was left-handed. Their average age was39.7 � 6.7 years and they had on average 9.6 � 1.3 years of expe-rience in the company. So these areworkers who had other avenuesof work in the company and wanted to serve as butcher.

2.4.2. ProcedureEach group of apprentices was followed, successively, for a

period of six months, on a daily basis for the eight weeks oftraining; on a weekly basis for the next four weeks; and once everytwo weeks for the last three months. The total number of days offollow-up per apprentice varied from 45 to 56 days, depending onthe apprentice. This variation in the number of days of follow-up isexplained by the variable duration of the training from one group toanother and by the days of absence of some apprentices. One of theseven apprentices (group 2) withdrew from training after 34 days.During all of the days of training, there was audio and videorecording of the training. An individual interview with each ap-prentice was conducted before the training to learn about theircareer path and determine existing physical symptoms. Thefollowing data-collection activities were conducted with each ap-prentice every day: 1) a meeting with the apprentice at thebeginning of his shift to collect information about physical symp-toms (questionnaire). The degree of discomfort was graded on ascale of 1e5, 5 corresponding to “extreme discomfort” (Vézinaet al., 1998); 2) an assessment of the knife cutting quality by theinstructor and apprentice using a grid designed for this purpose(adapted from Vézina and Ouellet, 2002); 3) a description of thetraining’s organization and the learning conditions (productionrate, learning on or off the production line, workspace, equipment,etc.); 4) meeting with the apprentice at the end of the work shift togo over the same data as at the beginning of the shift, with an addedquestions about the level of general fatigue and difficultiesencountered, and the factors which they associated with the painand difficulties; 5) formal and informal comments from theinstructor on how the apprentices were evolving and on the diffi-culties he had encountered that day. After a group was trained,recommendations were made to the company concerning theimprovement of learning conditions for the following group. Theinstructors and apprentices helped to develop these recommen-dations. The way in which these recommendations were imple-mented after group 1 e without any assistance from theergonomist e was observed by the latter during the training ofgroups 2 and 3.

2.4.3. Data analysisDuring follow-up of training activities, an analysis of the results

was performed by considering the following variables: 1 e theorganization of training (training time, task being learned), e 2production rate and its variation during the day, and 3 e the fre-quency and duration of follow-up on knife steeling and sharpening;4 e the evaluation results of the quality of apprentices’ deboning, 5e the daily layout of the learning station; 6 e the evaluation resultsof the cutting quality of the knife; 7 e the frequency of knifesharpening, and 8 e all events that occurred during training days(unforeseen events, incidents, feedback from workers, etc.). All

S. Ouellet, N. Vézina / International Journal of Industrial Ergonomics 44 (2014) 24e31 27

these data were used to make the diagnosis of the learning situa-tion and highlight the links between learning conditions and painexperienced by deboners. Recommendations made to the companyoriginated mainly from the results of this analysis.

3. Results

The results focus on the temporal organization of the task seenin the different work methods of experienced deboners, on thechanges noted by apprentices in their physical symptoms duringand after training and on the factors associated with these changes.

3.1. Movement strategies of experienced deboners: reconciling time,quality, and health

The deboner carried out the defatting and deboning of porkhams in rotation. Their work respectively consisted in: removingthe fat from a piece of meat using a tool called the “whizard” (anelectric knife with a rotating, circular blade); and removing thebones using a knife. These tasks are carried out on a conveyor belt.The bones are put on another conveyor, and the deboner must thentrim them. The deboning of the femur was chosen for analysisbecause it was considered to be the most difficult to master.

Tables 1 and 2 show the relationship between the average timetaken to “remove the bone from the piece of meat,” the averagenumber of knife strokes used to remove the bone, and the averagenumber of times the piece of meat is moved. The term “moving themeat” mean “a change in position made on the conveyor withoutlifting the piece.” The first observation is that the average time usedto remove the bone from the piece of meat ranged from 21.6 � 2.7to 24.9� 1.8 s for the right piece and 17.0� 1.8 s to 25.6� 1.6 for theleft piece. Note that it is not the cycle time but the time taken toremove the bone from the piece. The data show that the two de-boners who had the lower average bone removal time were thosewho made the least cuts, that is 12 and 13 cuts on the right and leftsides respectively. These two deboners recorded an averageremoval time of 21.6 � 2.7 (#2) and 23.1 � 1.6 s (#3) for the rightpiece and of 20 � 0.8 and 17 � 1.8 s, respectively, for the left piece.The deboner with the longest average removal time (#1), with24.9 � 1.8 s (right) and 25.6 � 1.6 s (left), is also the one who usedthe most knife strokes, with an average of 16.8 (right) and 17.4strokes (left). This likewise meant that this deboner had a shorterand less frequent waiting period between two pieces of meat. Thefactors that the workers identified as possibly being linked to thenumber of knife cuts were: the cutting quality of the knife, certainwork method elements (e.g., the spot where knife cuts were made,the length of the knife cut), and the search for precision. Duringgroup meetings, the deboners mentioned that it was important tolimit the number of knife cuts so as to reduce lost time and work-load. After giving demonstrations at theworkstations, the debonersreached a consensus of 12e14 knife cuts to remove the femur.

An analysis of the experienced deboners’ strategies highlightedtheir differences and points in common. It is possible to draw outparameters such as how the piece of meat was handled, the posi-tion of the meat with respect to the butcher, the different ways the

Table 1Relationship between the average bone removal time (s), average number of knife strokespiece of meat (Ouellet and Vézina, 2008a).

No. of experienced workers

No. 1 No. 2

Average number of knife strokes 16.8 � 1.8 12.0 � 0Average number of positioning of the piece 2.0 � 0.0 3.4 � 0.5Average deboning time (s) 24.9 � 1.8 21.6 � 2.7

knife was held, and the direction of the cut. For example, debonerscutting along the bone brought the knife toward the body. Eventhough some experienced deboners did these movements whenthe bone was pointed directly toward them, there was consensusthat it was preferable to place the bone on a slight diagonal so thatthe knife movement ended toward the side of the body. Thisallowed the deboners to be more at ease, to reduce postural con-straints in the wrists and shoulders, and to eliminate the risk ofstriking their body with their knife, even though theywerewearinga protective steel apron.

This task required movements e influenced by the knife posi-tion ewhere the armwas moved away from the body. Fig. 1 showsthe flexion and abduction of a deboner’s shoulder as he moves theblade away from the body while cutting. All the experienced de-boners agreed that it was important to supervise these types ofpostures in apprentices.

As can be seen, the experienced deboners’work methods variedsomewhat. In order to develop training content that was safe andwell adapted to the apprentices’ characteristics, it was necessarythat the group of experienced deboners reach a consensus aboutwhich elements to show to the apprentices and which not to show.To reach a consensus however, it was necessary to understand whythere were differences and what their determinants were. Forexample, the information obtained during the clarification in-terviews helped to highlight that the determinants of the numberof knife cuts were: 1) the knife cutting quality; 2) the quality of thefinished product; and 3) the series of elements that made up thelearned or chosen work method. Furthermore, the data show thateven experienced deboners sometimes used work methods inwhich certain elements could increase the risk of injury. If theseworkers become instructors, they might perpetuate these morerisky elements. It was therefore important to build up trainingcontent that was based on the know-how of a group of experienceddeboners and to reach a consensus about what should be shown.Moreover, the workers agreed that it was important to showdifferent work techniques so that apprentices could choose themethods that best suited them. Discussions and demonstrationsduring the meetings led to a consensus about: 1) choosing differenttechniques that were safe and that facilitated MSD prevention; 2)choosing effective techniques that attained the expected level ofquality; 3) ensuring that the apprentices’ knives cut well; 4)ensuring that the apprentices fully understood the instructions; 5)paying attention to the apprentices’ postures and movements.

However, one aspect of thework has generatedmuch discussionand it was impossible to get a consensus, particularly because of thelack of scientific data on this subject at the time of the study. Thisaspect concerns the type of grips to adopt on the knife handle.Indeed, there is considerable variability in the ways the knifehandle is gripped and in the types of grips that are used. The ob-servations in fact show that the workers will change the grip basedon the steps and direction of the movement. The decision of placingthe “index on the back of the blade” has generatedmuch discussion.Two deboners frequently use this type of grip, while another fromthe group said that he did not use this type of grip because thetrainer who trained him some 20 years ago told him not to, saying

and average number of times the piece was moved during bone removal in the right

No. 3 No. 4 No. 5 No. 6

12.0 � 0 16.6 � 1.8 15.8 � 0.4 14.4 � 1.12.2 � 0.4 2.0 � 0.7 4.0 � 0.0 4.6 � 0.5

23.1 � 1.6 24.8 � 1.1 23.8 � 1.8 22.5 � 3.6

Table 2Relationship between the average bone removal time (s), average number of knife strokes, and average number of times the piece wasmoved during the removal of the bone inthe left piece of meat (Ouellet and Vézina, 2008a).

No. of experienced workers

No. 1 No. 2 No. 3 No. 4 No. 5 No. 6

Average number of knife strokes 17.4 � 1.1 13.0 � 0.7 12.0 � 0 14.8 � 0.8 16.2 � 0.8 14.8 � 1.3Average number of positioning of the piece 1.0 � 0.0 2.2 � 1.6 1.2 � 0.4 1.0 � 0.0 2.0 � 0.0 2.0 � 0.7Average deboning time (s) 25.6 � 1.6 20.0 � 0.8 17.0 � 1.8 24.1 � 0.9 25.2 � 1.0 22.4 � 1.9

S. Ouellet, N. Vézina / International Journal of Industrial Ergonomics 44 (2014) 24e3128

that this type of grip caused wrist pain. However, in this study, itwas impossible to gather biomechanical data from video sequencesdue to the space constraints between the workers (assembly line)and the lack of equipment suitable for use in this type of environ-ment. This type of data would have allowed us to expand on certainaspects with the workers, which may perhaps have made it easierto obtain a consensus.

As mentioned in the introduction, content did not constitute thesole component of the training. It was important to consider theorganizational, physical, technical, and social conditions in whichapprentices had to learn their tasks if MSD prevention was to befostered. Theway inwhich pain evolved during the training and thevarious associated factors will be discussed in the next twosections.

3.2. The evolution of pain: inter- and intra-individual variability

A total of seven male apprentices were observed. Six were right-handed and one left-handed. Their average age was 39.7 � 6.7years. These workers had several years of seniority but had neverworked at the deboning and defatting workstations before thetraining sessions. The analyses focused on the upper limbs giventhe predominance of pain there. The information obtained duringthe individual interviews held with the apprentices before thetraining and during the daily meetings showed us that, of the sevenapprentices, three already felt pain before the training started, butthat all of them felt new symptoms at certain moments during andafter the training. The frequency and intensity of these symptomsvaried from one person to another. For the apprentices who hadsymptoms before the training began, the intensity either: 1)remained stable, or 2) increased during the training and thendiminished toward the end of the monitoring period (6 months)without disappearing completely. For example, Fig. 2 shows

Fig. 1. Flexion and abduction of a deboner’s shoulder.

changes observed in symptoms in the left elbow of an apprenticefrom the first group over the 53 days of monitoring. The scaleemployed ranges from1 to 5, 5 representing extreme discomfort. Atthe beginning of the training sessions, this apprentice had pain inthe left elbow that he rated as 2; after a few days of training hemarked the degree of pain as 4. The difficulties that the apprenticesencountered in learning their tasks and in their work conditionshave been identified so as to make recommendations to the com-pany. In the following section, a few factors that were associatedwith pain are presented.

3.3. Evolution in pain: a wide range of factors

At the end of every day, the apprentices had to fill out a ques-tionnaire on pain and general fatigue, difficulties encountered, andthe factors which they associated with the pain and difficulties, ourgoal being to establish relationships between pain and risk factorsin learning situations. For instance, the following question wasasked to identify the factors: do you associate this pain with anevent or incident that occurred today? If so, which one? Difficultsituations were likewise observed by the ergonomist during dailymonitoring. All told,12 factors were identified. Somewere reportedby the apprentices and others observed by the ergonomist. The datain Table 3 shows, for example, that the adjustment and/or cuttingquality of the tool (whizard or knife) were the factors most oftenidentified by the 7 apprentices: 1. thewhizardwas cited for 38.6% ofthe whole days at the defatting station (N ¼ 44) and 16.5% of thedays at the defatting and deboning stations (N ¼ 85); 2. for theknife, 23.4% of the whole days at the deboning station (N ¼ 201)and 22.4% of the days at the defatting and deboning stations(N ¼ 85).

The dailymonitoring of symptoms brought out different profileswith regard to these factors. Three types of symptom situationswere recorded: 1. appearance or increase of symptoms themorningafter a day when these factors were present; 2. appearance or in-crease of symptoms on the day when these factors were present(end of shift); 3. continuation of these symptoms on the day whenthese factors were present. Table 4 shows the number of days forwhich the recording of the most important factors coincided with achange in symptoms (types 1 and 2). All the apprentices andmonitoring days were considered.

For example, for the 31 days for which a problem in theadjustment or the cutting quality of the whizard was reported,there were 23 days (74%) when the symptoms appeared orincreased, either during the day when the factor was present (endof shift) or the morning after. It is worth noting that a poorlyadjusted whizard has two negative impacts. First of all, theincreased tool vibration leads to greater MSD risks in the dominantupper limb; and second, the blade can no longer be correctly honed(or steeled), which leads to poor cutting quality. The blade edge issteeled by running it along a long, thin file rod called, appropriately,a steel (Vézina et al., 1999). The data in Table 2 concerning the knifecutting quality shows that, for the 66 days for which the poorcutting quality of the knife was reported, therewere 21 (31.8%) days

1

2

3

4

5

1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52

# Days of monitoring

Scal

e le

vel o

f di

scom

fort

Morning P.M.

Vac

atio

n

Abs

ent

Abs

ent

Abs

ent

Abs

ent

Fig. 2. Changes in symptoms felt in the left shoulder by an apprentice in group 1 over 53 days of monitoring (Ouellet and Vézina, 2006).

S. Ouellet, N. Vézina / International Journal of Industrial Ergonomics 44 (2014) 24e31 29

where the symptoms appeared or increased during the day thisfactor was present (end of shift) or the morning after. It is knownthat poor cutting quality increases the cutting force required andthe number of knife cuts.

Recommendations were made to the company concerning theseconditions. The company was free to implement them in whole orin part. In this regard, the daily monitoring of training situationsrealized in the study revealed that despite the fact that the majorityof these recommendations were accepted by the leaders of thecompany, they needed the intervention of the ergonomisteresearcher thereafter to promote their implementation. Thisintervention is not the subject of this article but is described inOuellet and Vézina (2008b).

4. Discussion and conclusion

4.1. Understanding the wealth of knowledge implemented by agroup of workers

The ergonomic approach employed in this study led to a muchbetter understanding of the work activity, a detailed description ofthe deboners’ work methods and movements, a verbalization oftheir occupational knowledge, and theworkers’ participation in thedevelopment of training content for deboning. Previous studieshave shown the benefits of the ergonomic analysis of the skills ofexperienced workers for the development of training content(Chassaing, 2006; Chatigny and Vézina, 1994; Denis et al., 2007.

Table 3Factors most often associated with pain and difficulties (Ouellet and Vézina, 2006).

Most often reportedor observed factors

Whole daysat the defattingstation(N ¼ 44)

Whole daysat the deboningstation(N ¼ 201)

Days at boththe defattingand deboningstations(N ¼ 85)

Adjustment and cuttingquality of the whizard

38.6% N.A. 16.5%

Adjustment and cuttingquality of the knife

N.A. 23.4% 22.4%

Vézina et al., 1999). The uniqueness of this study lies in the detaileddescription of the work gestures performed within the activityanalysis that led to the formulation of a series of questions specif-ically built to search for sensorimotor information considered byworkers in the completion of the task. The individual and collectivemeetings allowed us to validate information, discuss different workmethods, and put into words the diverse tricks of the trade thatfacilitated the work. The series of example cuts during the collec-tive meetings were very useful in reaching a consensus aboutwhich safety principles needed to be integrated into the trainingcontent and adapted to the workers’ characteristics. The resultsobtained in this step show that, despite the very repetitive nature ofthe task, there was considerable variability in the different workmethods and, furthermore, that certainworkmethods could lead togreater MSD risk. The potential for developing safe training contentadapted to the apprentices’ characteristics involves determiningwhat can be shown to apprentices (Ouellet and Vézina, 2005). Itthus became important to determine the nature of this variabilityso as to better ensure that the training content offers severalworking methods to meet the various apprentices’ characteristicswhile avoiding aspects that may increase the risk of MSDs. Theresults also highlight the contribution that ergonomists could havein the development of training content aimed at learning a trade(Ouellet, 2013).

Is such an approach focusing on the detailed analysis of thework gestures to describe the skills of workers only necessary anduseful in the case of manual labor? From our point of view,regardless of the job, there will always be a need to describe andunderstand all the components of the acts of trade in a broad senseif we want to, first, get training content representative of the actualwork and, second, promote the development of expertise in thetransmission of job know-how.

4.2. Training activity analysis and transformation of learningconditions

This study was able to show that symptoms appeared for all theworkers during and/or after the training. The long-termmonitoring(6 months) of these symptoms went well beyond the normaladaptation period of a few days inwhich symptoms are usually felt.

Table 4Percentage of days when the presence of a factor coincided with the appearance or increase of a symptom (Ouellet and Vézina, 2006).

State of the whizard(adjustment/cut) (N ¼ 31 days)a

State of the knife (cut)(N ¼ 66 days)

Rate (N ¼ 13 days) Equipment (N ¼ 7 days) State of the meat(N ¼ 11 days)

Tight grip on the handle(N ¼ 8 days)

23 days (74%) 21 days (31.8%) 6 days (46.2%) 4 days (57.1%) 6 days (54.5%) 8 days (100%)

a N ¼ the number of days this factor was present.

S. Ouellet, N. Vézina / International Journal of Industrial Ergonomics 44 (2014) 24e3130

It is not enough to provide training in order to prevent MSD.Learning conditions should also be considered to prevent thedevelopment of symptoms of musculoskeletal pain. In addition,daily monitoring of training situations has shown that it is notenough for recommendations to be accepted by a company forthese changes to be made. It highlighted the limits that the deliveryof recommendations to a company might entail without being ableto follow-up the implementation of these recommendations. Thisknowledge can be useful to train future ergonomists interested inthis field of intervention.

4.3. Limitation and recommendations for future research

Even though this study shows the contribution of ergonomicanalysis in describing the occupational activity and movements,this approach cannot answer all questions concerning the effec-tiveness of experienced workers’ movements. This approach islimited to a qualitative analysis of movements. Though it providesextremely useful information, it does not produce quantitative dataabout muscular stress, the precise angles of moving limb segments,or the speed of movements. Some equipment used in the field ofbiomechanics are sometimes difficult to use in the workplace butstill, it is important to consider the integration of biomechanicalmeasurements in studies to develop training content for manuallabor. The integration of these measures would provide an oppor-tunity to refine the description of the actions and to answerquestions about the level of risk presented by certain actions, forexample how to hold the knife. Interdisciplinarity would be ofsome interest in this type of study since qualitative analysisdescribing the variability in occupational movements leads tocertain questions that could be at least partially answered by aquantitative analysis (Richard, 2002; Vézina, 2001). However, itwould be important to actively involve workers and put the data inrelation to the results from ergonomic analyses in order to preservethe sense of the process initiated for the development of training.

Moreover, even if the approach and methods have allowed theidentification of several skills and the putting into words of muchknowledge of experienced workers, we cannot claim to have suc-ceeded in identifying all the knowledge held by these workers.Some knowledge incorporated is neither observable nor verbal-izable. However, the collection of quantitative data as mentionedabove would likely facilitate the verbalization of a large amount ofknowledge. According to workers, the meetings held during thestudy led them to reflect on their practices. This observation sug-gests that it is important to develop, in the company, a dynamic thatwould promote the improvement of the learning content by inte-grating other practical knowledge derived from ongoing reflectionof worker-trainers.

4.4. Research perspectives

More and more studies are designed to analyze the conditionsfor learning and transmitting knowledge. To our knowledge, veryfew studies, if any, have been designed to closely analyze thestrategies used by apprentices in a real learning situation at work.Although there is knowledge of the motor learning of a task, it

derives in part from sport-related studies.With a view to improvingtraining in the workplace in order to promote the acquisition ofmotor skills and health protection, it is important to understandhow workers are doing to learn a task by checking the contributionof knowledge on motor learning. Knowledge on this issue couldguide the organization of training. It would also be interesting tosee how a detailed analysis of the biomechanical movements couldallow a better understanding of the know-how of experiencedworkers.

Moreover, considering the changing world of work and themobility that individuals may have in their careers, knowledge isneeded about the possibility of mobilizing knowledge developed ina trade for the performance of tasks belonging to related trades.

Acknowledgments

We would like to thank the Institut de recherche Robert-Sauvéen santé et en sécurité du travail (IRSST) and Institut Santé etSociété for Doctoral scholarship given to the principal author forthis project as part of the doctoral program at the University ofQuebec at Montreal.

We also thank the company, the union and the workers whomade possible the realization of this intervention research.

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