Outil d'analyse multifactorielle pour la prévention des lésions au dos

The purpose of this research is to review, rigorously, the problem and fundaments of back pain. To do so, we examined the multi-disciplinary and fundamental knowledge on which the lesional mechanisms rest on. This is necessary for a causal analysis, therefore we will present this notion and its frontiers.

In a methodological manner, current knowledge has been reviewed according to epistemology, physiology and to the evaluation methods suited to the different aspects of the problem.

Precisely, the principal aim of this research is to identify the risks of back injuries, which are scientifically grounded. To reach this objective, we have to identify the lesional mechanisms and their determinants.

The immediate cause of back pain is the effort. The problem rests on the effort generating mechanisms, the foregoing the lesional mechanisms. Therefore, the problem has a probabilistic aspect (the effort generating mechanisms) and a deterministic aspect (the lesional mechanisms).

The risks identified were classified as a hierarchical network and computerized on a database management system, ACCESS. This permits the user to scan the hierarchical network and enter this network by any constitutive factor. In addition, each element can be consulted on its justification, genealogy and characteristics. Therefore the initial aim of a listing became a structured network.

The research has to be useful for any intervening party or anyone interested in the problem. Therefore, we have studied the field-work management of the tool developed. Among other things, we have examined and outlined solutions complying with the requirements of reality (legislative aspects and other executive organisms).

As foreseen, the first level validation, in three categories of companies, with different organizations, operations and work management, was a success. We studied: (1) a cardboard mass production plant involving manual material handling in a stable environment; (2) a car dealer where each workstation involves altering operations, effort requirements and positions with a relatively stable environment; (3) a furniture remover company where the effort requirements and positions are extreme and where the environment and manpower is unstable.

In every case, the tool was powerful to identify the risks, to plan a prevention program and to construct incitements to encourage a synergy of efforts between the different intervening parties. Some problems have already been solved with this tool in the furniture removing industry.

We suggest to extend the research to the establishment of a priority of risks: (1) to be able to propose realistic prevention measures; (2) to make easier the justification of the prevention projects. We also suggest, to permit the generalization of the results of this study to continue the validation of this model in other firms.