Accessible Workplace Method (AWM) for workplace adaptation among employees with physical disabilities

Nevala, Nina

Finnish Institute of Occupational Health / Topeliuksenkatu 41 a A

/ FIN-00250 Helsinki, Finland / Nina.Nevala@ttl.fi Juhola, Tiina

Finnish Institute of Occupational Health / Topeliuksenkatu 41 a A

/ FIN-00250 Helsinki, Finland Alaranta, Hannu

Käpylä Rehabilitation Centre, National Association of the Disabled

in Finland / Nordensköldinkatu 18 B / FI-00251 Helsinki, Finland

ABSTRACT                                                                                                                                

ABSTRACT                                                                                                                                

The aim of this study was to investigate the intra-observer reliability and usability of the Accessible Workplace Method (AWM) among workers with physical disabilities. The electrical checklist includes background factors and 31 items with assessing criteria. The method considers the employees' opinions about the problems related to the work and the means to solve them. The intra-rater reliability of the method was calculated as the percentage of agreement between two assessments made by 37 disabled workers. The accessible workplace method can be used as a part of the occupational health care services or rehabilitation process when design or redesign measures of workplaces are planned or work ability is assessed for employees with physical disabilities.

Keywords

Accessibility, disability, ergonomics, rehabilitation, design for all.

INTRODUCTION

Integration and reintegration of disabled people into ordinary employment is one of the main objectives of the rehabilitation [13]. Persons with permanent physical disabilities should have possibilities to continue working by means of ergonomic redesign measures and the use of aids [2,11,16]. However, only few redesign measures have been carried out at work of physically disabled employees in Finland [12].

Every fifth of the physically disabled workers (n=249) reported that they regularly need help of other persons at work [12]. This help was needed especially for materials handling, performing tasks requiring fine motor movements or force of the upper limbs, ”running affairs”, taking materials from high levels, and performing tasks requiring climbing. The study showed that the employees themselves recognize what kind of redesign measures they will need to increase their work ability. There are several possibilities to adjust the workstation e.g., in computerized work [8].

There is a need for a simple and reliable method for making ergonomic and accessibility assessments of work environments. To be interpretable, the method must be reliable. Wiktorin et al. [19] and Barriera-Viruet et al. [1] reported that the reliability of the self-report approach is too low in relation to the needs for ergonomic intervention. Accordingly, posture observation methods are often used for this purpose [3,5,6]. If the aim of the intervention is to optimise the physical work load and, at the same time, implement possible changes at workplaces, a more comprehensive method for ergonomic analyses is needed.

The Accessible Workplace Method (AWM) is an electrical checklist for evaluating accessibility and ergonomics of workplaces for employees with permanent physical disabilities. The AWM is based on a telephone interview [12], which was led to the development of the checklist [10]. The internal validity of the method was established through the collaboration of experts and users of the method. The AWM is available on the Internet. The AWM is a general checklist with criteria for accessibility evaluation. It is used to specify working conditions that need development or improvement and to help find optimal solutions to any problems. The AWM also applies the participatory approach [15,18], which has been successfully used in several studies to reduce physical work demands and improve ergonomics at workplaces [4,14].

There are few methods for evaluating ergonomics of workplaces for employees with permanent physical disabilities and no results are available concerning the reliability of the AWM. The aim of this study was to investigate the intra-observer reliability and usability of the AWM among workers with physical disabilities in openlabour market.

MATERIALS AND METHODS

Accessible Workplace Method

The AWM includes background factors and 31 accessibility items with special criteria: journey to work, parking the car, enclosure, the entrance to the building, use of doors, moving on passages, use of lifts, use of stairs, rescue facilities, kitchen/coffee room facilities, accessible toilet facilities, meeting rooms, space, design of the workstation, use of computer, use of work tools and machines, lighting, noise, temperature, safety, work posture, fine motor movements, reaching, manual materials handling, work tasks, amount of work and work pace, flexibility of work time, use of personal helper, equality, getting help of others, accessibility of occupational health care services.

Each item is assessed according to a three-level scale (Table 1). In addition, the employees' opinions about the problems related to the item and the means to solve them can be written. An electrical report of workplace accessibility will be printed after fulfilling the checklist. The report tells the items which are in order, partly in order and not in order and the most important redesign measures that are needed.

Table 1. Meaning of the three level scale of the Accessible Workplace Method

Subjects

The selection criteria for this study were that the person be employed, use some mobility aid (a lower limb prosthesis, cane, crutches, walking frame, wheelchair) due to a physical disability, be 18 - 65 years old, and be volunteer for this study (Figure 1). Twenty-four men and 13 women with the mean age of 44 years participated. Several different diagnoses were represented among the subjects (Table 2).

Figure 1. Also wheelchair users assessed the reliability and usability of the Accessible Workplace Method.

Table 2. The disabilities of the subjects (n=37) who assessed the reliability and usability of the Accessible Workplace Method (AWM)

Assessment of the reliability and usability

The reliability and usability of the AWM were assessed from the intra-observer reliability, and the observers’ experience with the usability of the method. The interval between the two assessments was two weeks. After the two weeks, the assessment of the workplace was repeated in the same way as earlier.

The intra-observer consistency of the assessments was determined as the percentages of agreement using the Intra-class correlation coefficient, ICC and the Kappa coefficient. The Kappa coefficient was classified according to criteria presented by Landis and Koch [7]: < 0.20 slight, 0.21–0.40 fair, 0.41–0.60 moderate, 0.61–0.80 substantial, and 0.81–1.00 almost perfect.

The usability of the AWM was analysed on the basis of the time used for the assessment, the structure of the method, and clearness of the criteria [9].

RESULTS

The intra-rater reliability according to the Kappa coefficient was very good (k= 0.81-1.00) in eight items, good (k= 0.61-0.80) in 12 items, moderate (k= 0.41-0.60) in four items, moderate (k= 0.21-0.40) in five items, and poor (k< 0.20) in one item (Table 3).

The mean time used for the AWM was 32±17 minutes (range 5-75 minutes). Most subjects (97%) considered the length of the checklist to be good. Most subjects (83%) said that the criteria of the items were clear. However 17% of the subjects considered the criteria to be unclear. According to the subjects the structure of the AWM was either good (70%) or moderate (30%). The most important items of the AWM were parking facilities, entrance, rescue facilities and accessible toilet facilities.

Table 3. The intra-rater reliability according to the Kappa coefficient in two assessments when the Accessible Workplace Method (AWM) was used among physically disabled workers (n=37)

Landis and Koch [7]: < 0.20 slight, 0.21–0.40 fair, 0.41–0.60 moderate, 0.61–0.80 substantial,and 0.81–1.00 almost perfect.

DISCUSSION

The AWM is a simple electrical checklist for accessibility assessments and redesign measures among workers with physical disabilities. We found the intra- observer reliability of the AWM to be good for most items. This finding is in line with results of previous studies analysing other ergonomic methods [14].

Accessibility at work increases work ability and equality between the workers in various tasks. The employees themselves recognize what kind of redesign measures they will need to increase their work ability. They are not only the best experts concerning their disability, but also concerning their work. A simple electrical method was needed for the assessment of work conditions among disabled workers. The traditional methods, developed for able-bodied workers, take not into account the specific needs of disabled [3,5,6].

Improving the planning process for workplace adaptations may result in more successful rehabilitation. The work ability of disabled persons should be better taken into account in the tertiary preventive actions implemented in occupational health services and in occupational rehabilitation. Ergonomic measures at work can also be protective factors that prevent physical disability from turning into a social handicap. The method can be used as a part of the occupational health services or rehabilitation process when design or redesign measures of workplaces are planned or work ability is assessed for employees with physical disabilities.

According to our results, the AWM is suitable for assessing the accessibility of workplaces among physically disabled workers. However, the method should be developed also for workers with visually or hearing impairments. Different occupational groups can use the method after receiving training and basic knowledge in accessibility.

The authors thank the subjects who made this work possible. Financial support was provided by the Finnish Work Environment Fund.

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