SEPTEMBER 1978 P H Y S I O T H E R A P Y 9

INDUSTRIAL/OCCUPATIONAL PHYSIOTHERAPY: 

A NEW CHALLENGE
B. M . IA H O L K O W S K I, M .C .S .P .*

"S.A. lost 29 m illio n  w o rk in g  d a y s . . . le c t u r e r ” .
This h e a d in g  a p p e a r e d  in  a  C a p e  T o w n  n e w s p a p e r in 

September 1977. T h e  s p e a k e r w as a d d re s s in g  d e le g a te s 
to the I n s titu te  o f  P u b lic  H e a lth  C o n g re ss in C a p e  
Town. H e  s ta te d  th a t in d u s tr ia l sa fe ty  in S o u th  A fric a , 
where 2 0 0 0  w o rk e rs  d ie  a n n u a lly , le ft “ m u c h  to be 
desired”.

The lec tu re r, D r. M . B a rry , o f th e  D e p a r tm e n t of 
Public H e a lth  a t W itw a te r s r a n d  U n iv e r s ity , s ta te d  th a t 
335 000 w o rk e rs  w e re  in ju re d  a n n u a lly ; o f th e s e  31 000 
suffered p e rm a n e n t d is a b le m e n t. H e  sa id  th e re  h a d  
been a d ro p  in th e  d e a th  ra te  f r o m  4 in e v e ry  1 000 

'•vorkers in  1913 to 1,29 p e r th o u s a n d  in  1975. E v e r y  
•4'ear the R e p u b lic  lo st 29 m illio n  w o rk in g  d a y s, a n d  
the W o rk m e n ’s C o m p e n s a tio n  F u n d  p a id  o u t a p p r o x i­
mately R 25 m illio n  in  c o m p e n s a tio n , r e h a b ilit a ti o n  a n d  
medical e xpenses. F u r th e r m o r e , D r. N . S tu tte rh e im , 
President o f  th e  A s s o c ia tio n  o f  S c ie n tific  a n d  T e c h n ic a l 
Studies, sp e a k in g  to  o v e r 500 d e le g a te s a t th e  N a tio n a l 
O ccupational S a fe ty  A s s o c ia tio n  (N O S A ) c o n v e n tio n  in 
Johannesburg in A p ril, 1978, sta te d  th a t it is e s tim a te d  
that in th e  c u r re n t y e a r o v e r 250 000 p e o p le  w ill b e 
victims o f  “o n  th e  j o b ” a c c id e n ts  s e rio u s  e n o u g h  to  
keep th em  off w o r k  f o r  a t lea st o n e  day. D r. S tu tte rh e im  
also said th a t a lth o u g h  th e r e  is a d o w n w a rd  tr e n d  in 
disabling in ju rie s  in  S o u th  A fric a  (a d r o p  f r o m  4 %  in 
the 1960’s to  2,3%  in  1977, w h ic h  is lo w e r th a n  th e  
present A m e ric a n  fig u re  o f  2 ,6 % ) th e re  is n o  ro o m  fo r  
complacency. H e  sa id  w e s h o u ld  m a k e  d e te rm in e d  e ffo rts 
to e lim in a te  c a u s e s o f a c c id e n ts. A t th e  sa m e  c o n v e n ­
tion the G e n e r a l M a n a g e r o f  N O S A  r e p o rte d  th a t 
110 000 h a n d s, 50 000 fe et, a n d  40 000 eyes w o u ld  be 
badly in ju re d ; 32 000 m e n  a n d  w o m e n  p e rm a n e n tly  
maimed, se v e ra l th o u s a n d  so b a d ly  h u r t  t h a t  th e y  c o u ld  
never re tu rn  to  th e i r  jo b s a n d  m o re  th a n  2 0 0 0  w o rk e rs  
would be kille d .

In th e  U n ite d  K in g d o m  13 m illio n  w o rk in g  d a y s 
are lost a n n u a lly  d u e  to in d u s tria l a c c id e n ts  (H a y n e , 
1977). T h e r e  a re  9 0 -  100 p h y s io th e r a p is ts  w o rk in g  in 

^industry in th e  B ritis h  Isles, o f  w h o m  81 b e lo n g  to  th e  
Association o f  C h a r te r e d  P h y s io th e r a p is ts  in I n d u s tr y  

.<ACPI). T h e s e  A C P I m e m b e rs  c a n  b e  fo u n d  in  m o st 
of the m a jo r  in d u s tria l c o n c e rn s in B r ita in  a n d  a t  such 
varied lo c a tio n s  as H e a t h r o w  A i r p o r t , S hell C e n tre , 
M arks a n d  S p e n c e rs in  L o n d o n , A to m ic  E n e rg y  R e ­
search E s ta b lis h m e n t, steel p la n ts , c h e m ic a l in d u s trie s , 
and m a n y  o th e rs  (H a y n e , 1976). I n  a d d itio n , H a y n e  
states in  h is P h y s io th e r a p y  F e llo w s h ip  T h e s is , 1976, 
“there a re  th r e e  m a in  f u n c tio n s  o f th e  p h y s io th e r a p is t 
in in d u stry : to p ro v id e  a fu lly  c o m p re h e n s iv e  tr e a tm e n t 
service fo r  th e  e m p lo y e e s, r e a s o n a b ly  lo c a te d  in r e ­
lation to th e ir  p la c e  o f  w o rk ; to p r e v e n t d ise a s e  a n d  
injury, e sp e c ia lly  o f o c c u p a tio n a l o rig in ; to p ro v id e  
e d u cation a n d  a d v ic e  as n e c e ssa ry , re la te d  to h e a lth , 
safety a n d  w e lfa re  o f  th e  e m p lo y e es. T h is  c a n  b e st be 
achieved b y  w o rk in g  in c o m b in a tio n  w ith  th e  o th e r  
m em bers o f  th e  h e a lth  a n d  sa fe ty  g r o u p ” .

In o r d e r  to p la c e  th e  B ritis h  in d u s tria l p h y s io th e r a p is t 
in w o rld -w id e  c o n te x t a s u rv e y  o f m e m b e r c o u n trie s

* C linical S u p e rv is o r, D e p a r tm e n t o f  P h y s io th e ra p y , 
U n iversity o f C a p e  T o w n . A s so c ia te  M e m b e r A .C .P .I. 

(GB)

o f  th e  W .C .P .T . w as u n d e r ta k e n  b y  H a y n e  (1 9 7 3 - 1976). 
In  th is  s u rv e y  h e  e s ta b lis h e d  t h a t  S w ed e n , N o rw a y  a n d  
D e n m a rk  h a v e  th e  la rg e s t n u m b e r  o f  in d u s tr ia l p h y s io ­
th e ra p is ts , fo llo w e d  b y  H o lla n d , F r a n c e  a n d  G e rm a n y . 
It is in te re s tin g  to  n o te  th a t in th is  s u rv e y  in th e  
B ritis h  Isles m a s sa g e  te c h n iq u e s  a r e  u se d  as p a r t  o f th e  
n o r m a l t r e a tm e n t sc h e d u le s o f  73%  o f  a ll in d u s tria l 
p h y s io th e ra p is ts .

I n  th e  D e c e m b e r 1977 issue o f  th e  I n d u s tr ia l P h y s io ­
th era p ist, th e  n e w sp a p e r o f  th e  A .C .P .I. in  B rita in , th e  
e d ito r  a n n o u n c e s  th a t “ th e  S w e d ish  P h y s io th e r a p y  E r g o ­
n o m ic s  G r o u p  (P .E .G .) h a s  a g re e d  to a  o n e - y e a r  tr ia l 
p e rio d  o f m e m b e rs h ip  w ith  th e  A .C .P .I. T h is  is th e  first 
im p o r ta n t ste p  to w a rd s  t h e  c r e a tio n  o f  a n  i n te r n a tio n a l 
In d u s tr i a l a n d  E rg o n o m ic  P h y s io th e r a p y , G r o u p . T h e  
e d ito r  a lso  s ta te s th a t “ th e  S w ed ish  P .E .G - h a s  a lr e a d y  
c re a te d  lin k s w ith  th e ir  c o lle a g u e s in N o r w a y , D e n m a r k  
a n d  F in la n d , a n d  in th e  s a m e  w a y  th e  A .C .P .I. h a s  
A m e ric a n , A u s tra lia n , a n d  S o u th  A f r ic a n  A s s o c ia te  
m e m b e rs  w h o  w ill h o p e fu lly  c re a te  t h e ir  o w n  g ro u p s  
in th e  fu tu re . T h e  f o u n d a tio n s  a r e  la id . N o w  le t us all 
s ta rt b u ild in g .”

S W E D E N

T h e  S w e d ish  P h y s io th e ra p is ts  E rg o n o m ic s  G r o u p  w as 
fo u n d e d  in  1973, b e g in n in g  w ith  35 m e m b e rs  w o rk in g  
in , v a r io u s  in d u s trie s  a n d  c o m p a n ie s  as p a r t o f  th e  
O c c u p a tio n a l H e a lth  T e a m . T h e  m e m b e rs h ip  n o w  s ta n d s  
a t 259; 30%  a r e  e m p lo y e d  by  lo ca l a u th o r it ie s , 50%  
a r e  in  p r iv a te  in d u s trie s  a n d  2 0 % a r e  p r iv a t e  p r a c t i ­
tio n e r s  w ith  in d u s tria l clinics.

T h e  S w ed ish  in d u s tria l p h y s io th e r a p is t w o r k s  a s a 
m e m b e r o f  a  te a m  c o n sistin g  o f  a d o c to r , n u rs e , e n g in e e r, 
a n d  se c re ta ry . T h e  m a jo r ity  o f  p h y s io th e r a p is ts  d e v o te  
h a lf  th e i r  tim e  to r o u tin e  tr e a tm e n ts  a n d  th e  o th e r  
h a lf  to sh o p -flo o r e rg o n o m ic s a n d  e d u c a tio n  o f  th e  
e m p lo y e es.

A s th e  n o rm a l e d u c a tio n  sy ste m  f o r  p h y s io th e r a p is ts  
in S w ed e n  d o e s n o t d eal w ith  th e  su b je c t o f  e rg o n o m ic s  
a n d  o c c u p a tio n a l h e a lth  in a n y  d e ta il, t h e  S w ed ish  
P h y s io th e r a p y  A s s o c ia tio n  in c o n ju n c tio n  w ith  th e  
S w ed ish  E m p lo y e rs  F e d e r a t io n  h a s  o rg a n iz e d  th re e  
c o u rse s in th ese  su b je cts. T h e  c o u rse s n o w  r u n  f o r  
f o u r  w e ek s s p re a d  o v e r six  m o n th s . E v e r y  c o u rs e  has 
b e en  o v e r-s u b s c rib e d  (C a rd e ll 1977).

D E N M A R K

In  1972 a  g ro u p  o f  D a n is h  p h y s i o th e r a p is ts  e s ta ­
b lis h e d  t h e i r  e q u iv a le n t o f  a S p e c ific  I n te r e s t  G r o u p  o f  
th e  C h a rte re d  S o c ie ty  o f P h y s io th e r a p y . T h e r e  a r e  50 
m e m b e rs  w o rk in g  fu ll-tim e  in in d u s tr y  as c o n s u lta n ts  
a n d  tr a in in g  w o rk e rs  in th e  p r in c ip le s  o f  e rg o n o m ic s . 
T r a in i n g  c o u rse s a re  a v a ila b le  a t th e  T e c h n ic a l U n i ­
v e rs ity  o f  D e n m a rk .

C A N A D A

“ P h y s io th e r a p is ts  h a v e  a  v a lu a b le  r o le  to  p la y  in th e  
c o m m u n ity , b e y o n d  th e  tr e a tm e n t c e n tre  o r  h o s p ita l,
i.e. a n  o n -g o in g  p h y s ic a l m a in te n a n c e  o r  fitn ess p r o ­
g r a m m e ” (S e n z ile t, 1977).

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10 F I S I O T E R A P I E SEPTEMBER 1978

S h a w  (1977) in  a n  a rtic le  “ B a ck  in ju r y  p re v e n tio n  in a 
h o s p ita l a c c id e n t p r e v e n tio n  d e p a r tm e n t” re c o m m e n d s 
a  sta ff e d u c a tio n  p ro g ra m m e  in  h o s p ita ls , a d v is in g  
m a n a g e m e n t o n  liftin g  e q u ip m e n t a n d  se rv in g  as c o n ­
s u lta n t p h y s io th e ra p is ts  to  h o sp ita ls.

F I N L A N D  /A U S T R A L IA

M c P h e e  (1978), a n  o c c u p a tio n a l p h y s io th e r a p is t in 
th e  O c c u p a tio n a l E n v ir o n m e n ta l H e a lth  s e c tio n  o f  th e  
U n iv e rs ity  o f S y d n e y  w h o  is in v o lv e d  in  re se a rc h , 
te a c h in g  a n d  c o n su lta n c y , sta te s th a t m u c h  is g o in g  o n  
in  F in la n d  in  o c c u p a tio n a l h e a lth  a n d  in p a r tic u la r  
o c c u p a tio n a l p h y s io th e ra p y , a n d  th a t  th e  c h a rg e  
p h y s io th e r a p is t a t th e  In s titu te  o f O c c u p a tio n a l H e a lth  
in H e lsin k i!- is in v o lv e d  in re s e a rc h  a n d  te a c h in g , 
to g e th e r w ith  c o n s u lta tio n  w o rk .

M c P h e e  h a s  re c e n tly  re tu rn e d  f r o m  a  th re e -m o n th  
T ra v e llin g  F e llo w s h ip  g ra n te d  b y  th e  A u s tra lia n  
g o v e rn m e n t to  U .S .A ., C a n a d a , B rita in , S c a n d in a v ia  
a n d  E u r o p e  a n d  e x p resses s u rp r is e  a t th e  la c k  o f 
in itia tiv e  ta k e n  b y  p h y s io th e ra p is ts  in  th e  field o f 
o c c u p a tio n a l h e a lth  a n d  e rg o n o m ic s , b u t feels t h a t the 
s itu a tio n  in  A u s tra lia  is r ip e  fo r  th e  d e v e lo p m e n t o f' 
th e  o c c u p a tio n a l h e a lth  p h y s io th e ra p is t. “W e h a v e ”, she 
w rite s , “ a n  u p g ra d in g  in  th e  s ta n d a rd  o f  u n d e r g ra d u a te  
t r a in in g  w h ic h  is m a k in g  o u r  th e ra p is ts  m o re  sc ien tific  
in  t h e i r  a p p r o a c h , a n d  h o p e fu lly  m o re  q u e s tio n in g  of 
th e  system . W ith  th is  q u e s tio n in g  o f  c o u rse , co m es 
c h an g e , a n d  such w ell tra in e d  g ra d u a te s  a re  id e a l to 
w o rk  in  p re v e n tio n  te a m s a n d  in th e  re se a rc h  th a t is so 
b a d ly  n e e d e d ” .

S h a w  (1977), a  le c tu re r o n  sa fe ty  a n d  o c c u p a tio n a l 
h e a lth  in  A u s tr a lia , w rite s  o n  th e  ro le  o f th e  p h y s io ­
th e r a p is t in  a c c id e n t p re v e n tio n , “w h e re  th e  fu n d a m e n ta l 
a im s o f  p re v e n tiv e  p h y s io th e r a p y  a re  to d e v e lo p  g o o d  
p o s tu ra l h a b its ; to  la y  d o w n  g u id e lin e s  to a v o id  sk e letal 
a n d  lig a m e n to u s  s tra in s ; to d e v e lo p  g o o d  b re a th in g  
c o n tro l; to te a c h  h a b its  o f  g e n e ra l r e la x a ti o n ” . She 
e m p h a siz e s th e  i m p o rta n c e  o f the ro le  p h y s io th e ra p is ts  
can  p la y  in  o c c u p a tio n a l h e a lth .

E R G O N O M I C S  I N  B R I T A I N

E rg o n o m ic s  is th e  sc ien tific  stu d y  o f  m a n  in r e la tio n  
to h is  w o rk , a n d  th e r e  a re  n o w  six  p h y s io th e ra p is ts  in 
B r ita in  w h o  a r e  p ra c tis in g  as g ra d u a te  e rg o n o m ists. 
B irm in g h a m  U n iv e rs ity  r a n  a  c o u rse  o n  e rg o n o m ic s  in 
J a n u a ry  1976, a tte n d e d  b y  n in e  in d u s tria l p h y s io th e ra p is ts  
f r o m  th e  U n ite d  K in g d o m  a n d  o n e  f r o m 1'N o r w a y . T h e  
c o u rs e  in c lu d e d  a m o n g s t o th e rs , such su b je c ts as th e  
p rin c ip le s  o f  lif tin g  a n d  h a n d lin g , th e  p ro b le m s  o f 
w o rk in g  p o s tu re s , d isc u ssio n  o f e q u ip m e n t d esign 
stu d ie s , th e  p h y s io lo g ic a l te c h n iq u e s  u se d  in  e rg o n o m ic s 
fo r  th e  m e a s u re m e n t o f  s tr a in  d u rin g  p h y s ic a l w o rk  
a n d  a  case h is to r y  a s a n  e x a m p le  o f  th e  in tr o d u c tio n  
o f  e rg o n o m ic s  by a p h y s io th e r a p y  u n it in  a  m a n u f a c ­
tu r in g  c o m p a n y  p re s e n te d  by  H a y n e  (1976).

I n  B rita in , in d u s tria l e rg o n o m ic s is p ra c tis e d  a t th re e  
le v e ls ;

U n iv e rs ity  re s e a rc h  d e p a rtm e n t 
In d u s tria l e rg o n o m ic s  d e p a rtm e n t 
E rg o n o m ic s  te a m  c o m p o s e d  o f  n o n - g r a d u a te  m em bers 

o f th e  H e a lth  a n d  S a fe ty  G r o u p  in c lu d in g  physio- 
th e ra p is ts  (H a y n e  1976).'

I n  c o n c lu sio n , as M c P h e e  (1978) says “ th e  situ atio n  
in  A u s tr a lia  is r ip e  f o r  th e  d e v e lo p m e n t o f th e  occu­
p a tio n a l p h y s io th e r a p is t” . C a n n o t th e  sa m e  b e  sa id  
a b o u t  th e  s it u a tio n  in  S o u th  A fric a ?

C A N  P H Y S I O T H E R A P Y  P L A Y  A  R O L E  I N  O C C U . 
P A T I O N A L  H E A L T H  I N  S.A .?

T h e  f u tu r e  is fu ll o f  p o s s ib ilitie s  a n d  ch allen g e s. T he 
in v o lv e m e n t o f  th e  S o u th  A fric a n  p h y s io th e r a p is t in in­
d u s try , in th e  o c c u p a tio n a l h e a lth  te a m , in co m m u n ity  
m ed ic in e , in th e  D e p a rtm e n t o f E d u c a tio n , in th e  D e­
p a r tm e n t o f  L a b o u r, in a p re v e n tiv e  ro le , in a  c onsul­
ta n t ro le, a r e  all th e re  f o r  th e  ta k in g ; b u t it is u p  to 
th e  in d iv id u a l. W e  m u st ta k e  th e  in itia tiv e . W e  m ust 
m a k e  th e  e ffo rt by:

fo rm in g  a  sp e c ia l in te re s t g ro u p ; 
o rg a n iz in g  w o rk s h o p s; 
c o m m u n ic a tin g  w ith  o u r  c o lle ag u e s; 
s h a rin g  k n o w le d g e  a n d  in fo rm a tio n ; 
in fo rm in g  th e  a u th o r itie s  o f  o u r  p o te n tia l; 
in te re s tin g  th e  le c tu re rs ’ g ro u p  in u n d e r- a n d /o r  p o st­

g ra d u a te  tr a in in g  in c o m m u n ity  m e d ic in e , o c c u p a ­
tio n a l h e a lth , p re v e n tiv e  p h y s io th e r a p y  in  general, 
a n d  e rg o n o m ic s  in p a r tic u la r .

I f  w e can  a c h ie v e  a ll th e s e  th in g s  w e  m a y  w ell be in 
a  b e tte r  p o s itio n  to o b ta in  th e  fu ll re c o g n itio n  o f  o u r 
p r o fe s s io n  a n d  c o m m e n s u ra te  fin a n c ia l im p ro v e m e n t 
th a t w e h a v e  b e en  s triv in g  f o r  f o r  so long.

W o u ld  a n y  m e m b e r in te re s te d  in  th e  a b o v e , o r e m ­
p lo y e d  in  in d u stry , c o m m e rc e  o r  o c c u p a tio n a l health, 
p le a se  c o n ta c t th e  w r ite r  w ith  a v iew  to  “ s ta rtin g  the 
b a ll ro llin g ” .

R e fe re n c e s

C a rd e ll, H . (1977): P re s id e n t S w ed ish  P h y s io th e ra p y  
E rg o n o m ic s  G ro u p . T h e  In d u stria l P h ysio th e ra p ist,
2, N o . 3, 2.

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