Attachment J-3

Attachment J-3:

OBWC Safety Grants Application Addendum: Volunteer Employee Responsibilities

Volunteer Employee Participation: As part of this special Safety Grants research project, the National Institute for Occupational Safety and Health (NIOSH) will be seeking volunteers among your employees who will be using the Safety Grants-funded intervention to participate by completing questionnaires. Participation of your employees is completely voluntary. If no individual employees wish to answer questionnaires, the company will still be provided the matching funds to put in place the intervention. All employees using the Safety Grant-funded intervention will be recruited to participate using informational flyers placed at each company by NIOSH. Your company will also be asked to provide a contact list for individuals performing delivery operations. NIOSH will also email the recruitment flyer directly to prospective recruits or call recruits if no email address is available. During the phone call, the NIOSH will read from the flyer as a script. NIOSH will also visit a sampling of participating firms to meet prospective recruits in person and explain the nature of the study.

Employee Questionnaires: Employee questionnaires will include background information (Attachment H-4), reported musculoskeletal disorder (MSD) symptoms (Attachments H-1 and H-2), and details about their usage of the Safety Grants-funded intervention and safety incidents (Attachment H-3). These questionnaires will be completed by volunteer employees (who are directly impacted by the Safety Grants-funded intervention) periodically during the two-year course of the study. These questionnaires will be able to be completed online if an internet connection is available. The questionnaires will be administered as private and secure. Each respondent will be assigned a study ID number, and the questionnaire will be identified only with the ID. The list of employee names and ID numbers will be kept separately from the data. Employee answers will be protected to the extent possible under the Privacy Act.

Employee participation in this NIOSH study is completely voluntary and involves minimal risks. Each participant will be fully informed of the potential risks and benefits of participation and will be asked prior to participating to complete an informed consent form. There are not anticipated to be additional risks outside of regular work duties to participants in this study. Potential benefits could involve reduction in risk for musculoskeletal disorders (MSDs) associated with material handling tasks. Companies must give participant employees paid time in their normal work day to complete all questionnaires. It is estimated it will take 170 minutes of total clock time per employee participant to complete questionnaires over the entire two-year study period. Participants will be given a $5 debit card upon completion of each combined questionnaire data collection (a total of $45 for the entire study). In the event that an employee drops out of the study or moves to a task that does not involve the Safety Grant-funded intervention, a replacement volunteer employee will be recruited from the same company. For the employees who leave the study (or employment at the company), a brief voluntary questionnaire will be used to determine whether the reason for leaving was a MSD-related health problem.

Low Back Functional Assessment: A 20% random sample of participating employees from all companies will be asked to take part in a voluntary clinical assessment of their low back function at the start of the study and at the end of the first year. During this 20 minute test (conducted onsite if feasible at the volunteer company) the participating employee will be asked to perform several back motions (e.g. flexion, extension, twisting) to test range-of-motion (ROM). During the tests, the participating employee will also wear a lumbar motion monitor (LMM), which is used to track the velocity and acceleration of the motions. Companies must give participant employees paid time in their normal work day to complete the low back functional assessment. It is estimated it will take 60 minutes of total clock time per employee participant to complete the low back assessment over the entire two-year study period.