Ergonomic interventions are not working the way employers think, review finds

Under provincial and federal occupational health legislation, employers across Canada are required to manage and prevent musculoskeletal disorders (MSDs) through ergonomics — however, a new review suggests those interventions may not be working the way employers or HR think. 

The review analyzed 20 randomized controlled trials involving 2,478 workers with complaints of the arm, neck, or shoulder — a cluster of conditions known as Complaints of the Arm, Neck and Shoulder (CANS) — and found that ergonomic adaptations had no benefit over time for reducing pain, recovery, or quality of life, according to a review publsihed in the Cochrane Database of Systematic Reviews. 

 Those interventions included adjustments to workstation height and layout, computer equipment and operator chairs, as well as biomechanical education and workstyle changes 

For HR leaders managing health hazards, experts say the findings point to a gap in how employers are applying ergonomic interventions — focusing on narrow fixes rather than addressing how work is designed and how MSDs develop in the first place. 

What is CANS? 

CANS is part of the broader category of MSDs that can affect the upper body. It normally develops through repetitive movements and awkward postures and can result in fewer hours of working and long-term sick leave, the report finds. Ontario refers to these conditions as repetitive strain injuries (RSI). 

The disorder can include carpal tunnel syndrome from frequent mouse clicking, a shoulder injury from repeated lifting, and general pain from the limbs and arms. 

Across three measures, the Cochrane review found ergonomic interventions offered little to no benefit: 

• 386 participants showed little to no difference in recovery compared to no treatment 

• 68 participants showed little to no difference in quality of life 

• 692 participants showed no difference in pain compared to no treatment 

Patrick Neumann, a professor in the Department of Mechanical, Industrial and Mechatronics Engineering at Toronto Metropolitan University, studies like this miss the point of what ergonomics is. 

The review looks at interventions like furniture and training — but for Neumann, ergonomics go much further than that . It is about how work is designed in the first place. “Ergonomics is a discipline and a scientific practice — it is about the design of systems that optimize the interaction with humans,” he says. 

The studies took place in Europe, North America, Asia, and the Middle East and looked at workers who worked in office spaces, factories. slaughterhouses and sewing machine operations.The study was led by researcher from University of  Sydney Australia with researchers in Netherlands, Denmark and the United Kingdome.Authors of the review note high-quality, well-designed trials are still needed to establish the role of ergonomic interventions in managing CANS.  

What workplaces are getting wrong with ergonomics  

What workplaces get wrong, Neumann says, is designing jobs without keeping the worker at the centre — that means looking at the mental demands of the job, the psychosocial factors, and the overall work environment. 

“What you need to do is really look at what are the goals that you’re trying to achieve. And how can designing a better workplace — be it physical or mental or psychosocial — how can we do that in a way that helps people get the job done quicker, easier, more reliably, and more comfortably?” he says. 

He points to warehouse workers as an example. 

“If you want to improve the situation for them, you need to look at how your racking is designed. What postures do they have to get into to reach those boxes? How far do they have to lift and carry the boxes? How frequently are you asking them to do it? So, it comes down to the actual design of the work — and that’s not what this paper is looking at,” he says. 

Neumann also says workplaces get caught up with what he calls “phantom profits” — thinking that innovation or signing off on small workplace improvements will make things better, while forgetting the humans in the system. 

“The work that’s left is what makes things worse for the employee. Because people automate the easy stuff,” he says. 

Need a prevention plan, not just treatment 

Past research has found that musculoskeletal disorders (MSDs) can cost the Canadian economy almost $15 billion in productivity losses, according to a 2020 study conducted by an international research team including the Canadian Institute for Safety, Wellness, and Performance at Conestoga College.   Quebec’s National Institute of Public Health reported in 2022 that 2.5 million days per year are lost from non-traumatic work-related MSDs. 

Kim Meszaros, ergonomics research coordinator at the University of Waterloo in Ontario, says workplace data shows MSD claims have remained consistent as a share of all workplace injury claims over the past decade. 

These hazards, she says, can range from forceful exertions and awkward postures to repetitive work — but the picture is broader than that. 

“There are influencing factors as well — organizational factors and psychosocial factors in the workplace that can also contribute to MSD risk,” she says. 

Ergonomics vs. MSD prevention 

For MSD prevention to work alongside ergonomic interventions, Meszaros says it must happen in a systematic way and is about the bigger picture — using science-based systems in the workplace. Ergonomics is part of that science, but workplaces need to think about how to make it work as a program. 

Most workplaces, she says, only think about the ergonomics part and miss the program part entirely. 

“It’s applying the process of taking the tools that we have to assess ergonomics risk and MSD risk factors and applying them in a systematic way. If we don’t have processes in place to systematically collect this information, assess it, and then come up with controls and prioritize how we fix these problems, that’s where it usually falls flat,” she says. 

Why one-time initiatives do not work 

The program, Meszaros says must be ongoing — especially when it comes to ergonomic interventions. If workplaces treat it as a one-time initiative, it becomes unsustainable. 

Work changes constantly — new tasks, new equipment, new people. That is why,  a real prevention program cannot be static, she says. 

“If you don’t have a program in place to systematically make sure you’re identifying the hazards proactively, assessing the MSD risk associated with those hazards, and developing controls on a continuous basis — it’s really having that sustainable approach that helps with preventing these types of injuries,” 

Getting workers involved 

A key part of making that work, Meszaros says, is having workers engaged in identifying hazards and maintaining open communication with joint health and safety committees. 

Having the people in the workforce actively identify hazards — rather than just being told about them — is what makes a prevention program work. 

“When we’re looking at identifying these hazards in the workplace, we want to make sure that we have open communication and good involvement with our joint health and safety committees and health and safety representatives to talk about these types of hazards,” she says. 

Building it in from the start 

Meszaros points to Ontario Power Generation as an example. The organization spent a full year on awareness alone — getting workers, supervisors, and managers up to speed on MSD risk factors — before moving to hazard identification. From there, they built tools to help workers document hazards, prioritize where to invest, and shared fixes across all their Ontario plants. 

“It’s really taking the concepts and emerging technologies in ergonomics and applying it to how they design work up front,” she says. “If you have the opportunity to evaluate for MSD hazards when you’re designing work, that is the most efficient way to try and fix the problems — because when the work is already designed, it’s very hard sometimes to make changes.” 

Meszaros says a good place for all workplaces to start is by looking at the MSD Prevention Guideline for Ontario and how it can be embedded into existing health and safety programs. 

Where HR fits — and where it should not 

However, ergonomic interventions and MSD prevention should not be left solely to HR, Neumann says. 

While HR can help with gathering information and data — tracking whether interventions and programs are working and what ergonomic hazards workers are facing — HR should not be put in charge of the design. 

“Responsibility for the workplace needs to lie with those people that are making core decisions about the work and the work design. And so, by taking on ergonomics as their thing, human resources is disabling the organization,” he says. 

Where HR can make a real difference, Neumann says, is in making sure the people hired into key roles have the knowledge to act on it. His research found that fewer than two per cent of undergraduate engineering courses in Canada include any mention of human factors or ergonomics — meaning most engineers entering the workforce have no exposure to it at all. 

“HR needs to make sure that the people they hire to those roles have some knowledge,” he says. “You need to understand how the human in the system affects our performance — and how the well-being of those people will secure the organization’s future.