Exposure assessment within the so-called German Spine Study - EPILIFT

Status:

completed 09/2006

Aims:

An epidemiological study was commissioned by the Federation of Institutions for Statutory Accident Insurance and Prevention (HVBG) the results of which were to permit conclusions on the dose-response relationship of occupational disease No. 2108. Similar studies conducted in the past were criticized for the fact that the exposure assessment interviews were conducted by inexperienced personnel. This made a plausibility check of the data (load weights, intervals) impossible, even retrospectively. The objective of the study was now to conduct exposure assessment in as much detail as a retrospective study permits. For this purpose, exposure assessment was performed by intensive interviews conducted by staff of the technical inspectorates of the statutory accident insurance and prevention institutions. Where justified, these personnel were also to launch retrospective assessments including on-site studies of existing workplaces. The task of training the interviewers, work on generation of a suitable instrument for exposure assessment, and co-ordination of these assessments by the technical inspectorates fell to the BG Institute for Occupational Safety and Health.

Activities/Methods:

Under the overall control of the BGIA, a research support group was formed comprising experts from the technical inspectorates of the statutory accident insurance institutions. Among the functions of the BGIA within this group of experts was to support in the development of an initial-interview questionnaire. Assistance was also required in the development of a survey instrument (including development of an interview guide) to be used subsequently by the technical inspectorate staff for intensive exposure assessment. The staff received intensive advance training by the BGIA. Finally, the deployment of these interviewers at the various study centres were co-ordinated from the BGIA, where the data records were gathered and relayed to the Institute for Occupational Physiology at the University of Dortmund (IfADo) for further assessment and calculation of the spinal stresses.

Results:

A modular questionnaire was employed during intensive investigation of exposure by interviewers from the TAD (the technical inspectorate of the statutory accident insurance system). Those questioned were to complete the questionnaire either in writing or electronically. The semi-standardized TAD interview encompassed four different stress categories: high-stress body postures (including bending of the trunk to different degrees, leg posture, performance of work overhead), manual handling of loads (including lifting, holding, carrying, pulling, pushing of loads and persons), exertion of force (leveraging and assembly tasks), and exposure to whole-body vibration (for example during the driving of certain vehicles).
The exposure assessment covered the full course of occupational life, including training, of each test subject, structured chronologically according to the discrete phases of employment and the shifts typically worked. Of the 1816 test subjects participating in the study, 1373 were found in the standardized initial interview to have experienced relevant exposure. A TAD interview was therefore arranged for these subjects by the BGIA. Following cancellation of the interview by 171 test subjects, 1202 test subjects were ultimately interviewed by a total of 42 TAD interviewers. The data records were passed to the BGIA, where they were checked for completeness and plausibility. Finally, the data were forwarded to the IfADo for biomechanical analysis.
The next step planned involves a follow-on project in which the data collected will be suitably processed, evaluated, and interpreted with regard to OH&S and occupational medical aspects.

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