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Development and evaluation of an affordable lift device to reduce musculoskeletal injuries among home support workers
RS2000/01-007
Final Report Date: September 2004
| Principal Investigator: | Nancy Paris, British Columbia Institute of Technology |
| Co-investigators: | Helen Heacock; James Watzke, British Columbia Institute of Technology |
For more information about this study please contact Nancy Paris.
Issue
Home support workers (HSWs) are at increased risk for developing back injuries. Between 1994 and 1998, nearly 40 percent of accepted WCB claims from HSWs were for over-exertion injuries involving persons. These claims amounted to 4.5 million dollars and more than 65,000 days lost.
Devices used to lift and transfer persons have been shown to reduce injuries to the worker, but many are designed for institutional use and are too bulky for home use. Most lifts designed for home use retail for over $4,000, which may be unaffordable to many home care clients.
Key findings
- A manual lift mechanism has been designed and a prototype built that can be retailed for about half the cost of an automated lift device.
- User trials found the BCIT-designed lift to be comparable to a commercially available automated lift in terms of perceived exertion on the back, suggesting that the new lift is effective at eliminating/minimizing force on the spine when lifting and transferring a client.
- The manual lift has been further improved based on feedback given by HSWs and clients during the study, and the new prototype is being evaluated in home settings, through a WCB-funded community intervention study.
Objectives
- To design an affordable and safe manual lift mechanism, which is compatible with commercially available slings and ceiling tracks, and that is suitable for home use by HSWs.
- To evaluate the lift device with home support workers and clients in a simulation of a typical bathroom setting.
Method
The development and evaluation of a lift device for use in the home followed the system of Design Controls developed by the Food and Drug Administration (FDA) to ensure the safety and effectiveness of medical device development (FDA 1997). To contain costs, a manually operated lift design was chosen.
Design inputs were identified, including:
- reduced biomechanical loading for HSWs when lifting clients
- affordable retail cost
- portability
- compatibility with commercially available slings and track devices
- operational force of not more than 9 kg required to lift a maximum safe working load of 182 kg
- acceptable noise levels
- understandable instructions for use
- comfort of drive "chain" or "rope"
- ability to withstand typical bathroom conditions, and
- compliance with relevant sections of: ISO 10533: 1998 Hoists for the transfer of disabled persons - requirements and test methods, and WCB 2001. Preventing musculo-skeletal injury (MSI): a guide for employers and joint committees.
An initial prototype was developed based on a mechanical hoist system. The prototype lift device was tested against design requirements in an independent design review by a professional engineer at BCIT, and was found to meet and/or exceeded all performance requirements.
The BCIT device was then evaluated in a study conducted in the Dr. Tong Louie Living Laboratory in Vancouver, British Columbia, with a model bathroom, typical of that encountered by HSWs.
Thirty-eight HSWs transferred a senior citizen using the BCIT manual lift, a commercially available automated lift, and the manual method of transfer and lift. Perceived exertion, safety and ease of use were evaluated, and feedback on the device design was provided by the study participants.
Results
Results indicated that the BCIT lift was an improvement over the manual method of lifting and transferring, and was comparable to the more expensive, automated lift in terms of perceived exertion, ease of use and safety. The majority (87%) of HSWs in the study said they were "moderately" to "extremely" likely to use the BCIT lift device.
Participants identified noise and smoothness of ride and chain as needing improvement. This feedback has been incorporated into a new design that is considerably quieter, has a chain that is more aesthetically pleasing and easier to pull, thereby making the ride smoother.
Conclusions
The study results suggest that the BCIT lift device is safe and effective, while being approximately half the price of commercially available lifts. The device is ready for testing with home clients and HSWs in home settings.
Future directions
With a second grant from the WCB, the BCIT research team is conducting a study to evaluate the lift device in home settings in the community, in partnership with the Occupational Health and Safety Agency for Health Care Workers in BC (OHSAH).
Publications and conference presentations
Peer-reviewed paper:
Heacock H, Paris-Seeley N, Tokuno C, Frederking S, Keane B, Mattie J,
Kanigan R, and Watzke J: Development and evaluation of an affordable lift
device to reduce musculo-skeletal injuries among home support workers.
Applied Ergonomics, July 2004.
Conference proceedings:
Paris-Seeley NJ, Keane BJ, Kanigan R, Heacock HJ, Tokuno CD, Frederking
S, Watzke J, Janzen E: Development and Commercialization of Lift Devices
for Home Care Workers. 11th conference: Occupational Hazards to Health
Care Workers, Vancouver, Canada, May 2004.
Paris-Seeley NJ, Keane BJ, Kanigan R, Heacock HJ, Tokuno CD, Frederking S, Watzke J: Lift Devices to Reduce Musculo-skeletal Injuries Among Home Support Workers in British Columbia. Paper presented at the 27th International Congress on Occupational Health, Igaussu Falls, Brazil, February 2003.
Heacock HJ, Tokuno CD, Frederking S, Paris-Seeley NJ, Keane BJ, Kanigan R, Watzke JR, Mattie JL: Lift Devices to Reduce Musculo-Skeletal Injuries Among Home Support Workers in British Columbia. Paper presented at the ACE conference, Banff, Alberta, Canada, November 2002.
Patents:
United States Patent Application No. 60/448,564, February 17, 2004: Patient
Raising and Lowering Device and Equipment Therefor. Inventors: Brian Keane,
Thom Bellaire, Ernie Janzen, Ryan Kanigan, Johanne Mattie, Nancy Paris-Seeley,
Colin Wilson. Letter of Intent developed with Waverley Glen Systems Ltd.
to commercialize the technology.