Saskia Baltrusch

9 Chapter 1 increasing lifting height, reducing the lifted load, or introducing lifting robots have shown to be promising in terms of reducing the load on the lower back [13,14]. However, these preventive strategies often require an adaptation of the work environment. In practice, redesigning the workspace is not always feasible and such interventions often face implementation problems. Potential challenges include high costs of the intervention, time-consuming use and the end-user’s lack of trust in an intervention [15]. It therefore remains a challenge to reduce mechanical risk factors at work. In order to illustrate this challenge, I will introduce an example from occupational practice. In the Netherlands, a company that is confronted with high numbers of sick leave due to low-back pain is the Dutch airline company KLM. An employee working at the luggage handling service of KLM has to handle about 300 suitcases per flight for up to 9 flights a day. These suitcases can weigh up to 45 kg. This is associated with 10-20% of all occurrences of sick leave, being due to pain in the low-back, neck or shoulder (Het Parool, April, 2018). KLM has attempted to implement strategies to reduce mechanical risk factors, which have been identified as promising in research, but limitations of these strategies have become apparent. Main tasks of a luggage handler are loading and unloading suitcases from carts and conveyor belts. These conveyor belts used to be built at ankle height, forcing the luggage handlers to bend down, increasing the load on their low-back. Increased lifting height, by redesign of conveyor belts from ankle height to hip height, has been implemented at the company. Nevertheless, old conveyor belts are still in use, indicating the challenge of increasing lifting height in the whole work environment. Reducing the mass that needs to be lifted would reduce mechanical load on the back, but is not feasible in the work of a luggage handler, since there is no strict weight limit for passengers when checking in luggage. As a matter of service, for a given extra fee, they can check in luggage of any weight. Another way the company tries to reduce physical workload and specifically the load on the back, is the implementation of lifting devices, such as a lifting table that can be adjusted in height or a suction device that lifts suitcases with air pressure. However, they often remain unused: “[…] people think: ‘I better leave this thing hanging, because it will be faster if I do it manually’.” (Manager, KLM) 1