Abstract
This paper will try to examine the evidence which is associated with pre-employment screening in the automotive industry, the use of pre-employment screening in the automotive industry is often driven more by cultural practices than evidence. There is a lack of evidence in trying to justify the effectiveness in preventing work-related injuries in the automotive industry. A worker in the automotive industry can be screened if he/she is suffering from Musculoskeletal Injuries, but there is no standardized procedure which to determine the level of fitness of a worker in these industries. Ther is an inherent problem when screening for Musculoskeletal Injuries (MSD) because of racial bias and other negative effects which are usually associated with the pre-employment examination. Health assessment on workers in the automotive industry should only be taken when it is appropriate, “but health professionals should advise against the inappropriate application of physical or mental standards that are not necessary for the fulfilling the job that an employee is being screened” (Jackson, 1994).
Work-related injuries are costly to the automotive industry in terms of time an employee will spend away from work nursing his injuries and the cost of treatment the employee will undergo. According to the Center for Disease Control: musculoskeletal injuries (MSD) also known as cumulative/repetitive injuries, MSDs will occur when the body experiences strenuous movement or motion, for example during; bending, climbing, crawling, and twisting of an extremity. MSD’s injuries are caused when the body muscles experience strain or sprain, “and as a result of this can cause; back sprains, back pain, hernia, carpal tunnel syndrome, bursitis, and tendonitis. Most of these injuries will affect the musculoskeletal system and the body tissues” (Jackson, 1994).
A study was conducted by National Health Interview Survey (NHIS) and its findings were that 20.1 million people in the United State suffered a musculoskeletal injury, it was estimated the annual medical cost for musculoskeletal injuries was approximately $127.4 billion according to the Medical Expenditures Panel Survey (MEPS) each person suffering from musculoskeletal injuries will use an average of $5,160 in the cost for treatment. With the rise in healthcare treatment and the profit margin in the motor automotive industry shrinking due to the recession experienced in the United State. These industries nowadays are employing individuals who are fit to perform work without being a risk to themselves or other workers. Management in the motor automotive industry seeks to increase efficiency, eliminate waste and minimize the cost of production. Many industries in the automotive industry are seeking workers who are physically fit and who can perform in the job description in which they are being employed. As a result of these factors most industries in the Manufacturing industries, It mandatory for a new employee to undergo pre-employment testing to identify if a worker is suffering from musculoskeletal injuries because such workers will not perform to their highest ability in the automotive industry.
Pre-employment testing is one way in which the automotive industry is looking to improve the process of hiring healthy and physically able workers in their industries. There are Laws in the United State-Disabilities Act of 1990 (ADA) – which guide the process of pre-employment screening, “and every automotive industry is required to follow these conditions under the Law. Special attention is paid to bias, misuse of tests, color, race, and religion of the new employee” (Harley, 2004).
If the validity of the pre-test analysis is met and is consistent with business necessity, the information collected from the pre-employment screening will be considered in the selection process, which ensures the appropriate individual is employed. Furthermore, employers in the automotive industry will use their internal criteria to improve new employee selection. They will ensure a clear and meaningful understanding of job duties and performance expectations for the positions of the workers is being hired for. “Companies will use trained testers and evaluators utilize validity evidence accurately, that statistical analyses for disparate impact are engaged” (Harbin, & Olson, 2005).
Some pre-employment testing areas are used for employee selection, and this will involve; aptitude, psychomotor, job knowledge, proficiency, interest, psychological, polygraph and drug use, and other physical or medical testing. For example in some automobile industries require certain psychomotor skills and an appropriate candidate in these positions requires an employee to be physically fit. Since the terror attacks that occurred on September 11, 2001, security concerns have led to an increase in frequency and type of applicant testing. Meanwhile, issues concerning potential violence in the workplace, as well as safety and liability issues, have raised the specter of lawsuits against employers. “Also charges of discrimination have risen steadily throughout the last decade, and in 2007, 304 charges were brought forward against employers for using background information, obtaining candidate credit reports, and employing other exclusory qualifying procedures” (Graham, 2008).
In May of 2007, a public meeting was held by the Equal Employment Opportunity Commission (EEOC) on employment testing and screening in which witnesses addressed employee testing and selection procedures and emerging legal cases accused automotive industry employers of discrimination. “The resulting legal ramifications have created an environment of sensitivity to all types of potential discrimination through pre-employment testing procedures” (Gibson, 2002).
The ADA (Act) of 2008 became effective at the beginning of 2009; a significant change in the way ‘disability’ is defined is incorporated in the language of the Act. Because of this, the EEOC is preparing to evaluate the impact of how the language affects the ADA and how the Act is enforced. Pre-employment, even though conducted for ethical reasons and meaningful outcomes could ultimately be affected.
Although historically, employers could utilize job applications and could conduct interviews in which information was requested concerning an applicant’s mental and physical condition, seeking such information has created legal repercussions against employers, largely because the information was found to be used to discriminate against, and even exclude, applicants with disabilities. “Today this kind of information seeking is illegal. A medical exam or drug test may also not be administered until after a conditional job offer is provided to, and accepted by the applicant” (Borofsky, & Smith, 1993).
Pre-employment testing of applicants’ physical abilities and skills may indicate that work-related injuries may be reduced through the careful selection of employees.
Given the issues of high injury rates, high legal and medical costs decreased productivity, poor quality of product outcomes, the automotive company used in this project decided this type of pre-employment testing may cost savings and benefits to their bottom line of doing business. However, it is not known whether the test would be beneficial with identifying those that may or may not be physically capable of performing the requirement of the job demand of the production line, “and whether a good physical fit and the capable worker would be less likely to be injured on the job compared to operators which are in less good physical shape” (Alexander, Maida, & Walker, 1975).
Methods
In 2004, a major automotive industry company contacted BTE Technologies to develop a reliable and non-discriminatory method to screen candidates who are physically fit to perform the duties in the job descriptions in the automotive company. The Company identified six manufacturing plants to develop the Physical Assessment Test (PAT).” Those plants which pre-employment testing was employed was in the Midwest United States in both urban and suburban areas” (Franzblau, 2004).
In 2006 a new Automotive Manufacturing Plant (AMP) was built and this AMC (automobile manufacturing company) was to hire new workers for the new plant in the Midwest of the USA. Approximately 3169 potential new employees were tested with the PAT between 2003 and 2006 was the control group consisted of 113 transferred employees that had already worked for the company before-let call them D-; plant D subjects did not receive the PAT pre-employment testing. Plant D subjects were given a physician-administered history and physical and a six-panel urine drug testing with a brochure and literature of correct lifting and operation hazards with incorrect postures on the job also a 2-week work hardening and work simulation program on-site at the new plant. The age of the workers in that new company was between 18 years and 70 years.
Workers were scheduled to take a medical questionnaire at the new company upon arrival, an Informed Consent document was signed after a valid form of identification. A plant physician-administered history and a basic physical before the physical testing which included blood tests, hypertension, and blood pressure tests, and urinalysis tests (drug tests). These tests were performed to pre-determine if the worker is capable to perform the work as per the contract between the two parties. In addition, to rule out any previous medical condition the worker has suffered in the past. Some workers were excluded from the physical test due to medical considerations including post-surgical and a history of significant heart disease. The test was carried out and approximately 10.5% and 8.4% of the women in this study failed to meet the criteria necessary for a safe administration of the test.
Before the test the Human Resource Departments in the automotive company which had the information for those works transferred in this new plant: supplied injury statistics, departmental job titles, and descriptions of jobs and workstations in the plant. An independent contractor of a national rehabilitation company which included trained physical therapists, athletic trainers, occupational therapists, certified occupational therapists performed plant-wide workplace assessments to determine the essential job tasks and job demands of each workstation in several of these automobile plants before testing. This information was collected and manually entered into a database of the testing equipment which was the BTE (Baltimore Therapeutic Equipment).
The auto manufacturer decided the testing protocol be automatically constructed with tests utilizing the BTE program. This included 17 different physical demand requirements which encompassed several areas specifically related to the job tasks of the automobile workers. The testing assessed every worker to determine the individual capability to perform the job demands with reasonable equivalence. Secondly, the testing goal ensured that the potential employee could perform the job duties for which they are being employed. Several tests included areas that copy both fine motor and gross motor assembly-type jobs. A specific order was given for each test component; to allow consistency between the tasks.
All tests were conducted using the Baltimore Therapeutic Evaluation and Rehabilitation System Tests (BTE):
- Seven tests required the application of force for three seconds and were repeated three times.
- Hand Grip- position 2- using the Jamar dynamometer of the BTE the wrist in a neutral position
- Hand Grip- position 2- Jamar with the hand position is in a supinated position
- Hand Grip- Position 2-Jamar with hand position –Jamar in a pronated position.
- Hand Grip-Position 3-Jamar IN Neutral position
- Key Pinch Grip
- Tip Pinch
- One Thumb Press
- Two thumb press
- Push Strength- Hands Neutral
- Push strength –Hands Pronated 90 degrees
- Pull Strength-Hands Neutral
- Pull Strength-Hands Pronated 90 degrees
- Static Knuckle Height Lift
- Dynamic Lift 1 – Up to 40 lbs. with 3 repetitions
- Dynamic Lift 2- Up to 75 lbs. with 1 repetition
- From Upper-Level Reach (time-motion based positional Tolerance )
- From Stoop with 36-inch Horizontal Displacement Reach (Time –motion-based positional tolerance).
Lift Assessments
Dynamic lift assessments included a rest period of 15 seconds between each weight interval. Dynamic lifts i.e. lift #2 required one lift of each weight interval, commencing with a weight of fifty pounds and incremental of five pounds until a final weight reached seventy-five pounds was achieved for the lift.
Tests such as #16 and #17 items were included with the utilization of the Functional Range of motion (FROM) test. The test is a sub-component of the BTE testing equipment. This assessment puts the worker through a series and motions which are similar to activities that are replicated by their job. A portion of the Upper-Level Reach test includes an anthropometric component modification which appears to have a similar carryover to actual jobs on the assembly line. Job cycle timings which copy cycle time as seen with productivity is taken into consideration with this test and the subject is rated with these Method –Time- Measurements (MTM)
Throughout the test, the workers wear a “Polar Heart Rate Monitor” strap which allows the evaluator to monitor the subject’s heart rate. The strength portion of the testing includes a loading format which is performed closer to the end of testing to determine the endurance of the worker when performing repetitive activities.
Standardization for Testing
All workers tested were provided instructions for each test component. Instructions for each test component were taken from the BTE-ER system and protocol booklet. Instructions were given verbally and a verbal acknowledgment by the worker understood the instructions. The worker is shown the correct postures before the test component with a demonstration by the evaluator. However, body postures are not corrected during the testing. Self-selecting postures may influence testing results.
There were special procedures for isometric testing which allowed retrials on test components. Retrials were given to the worker if they perform an error, such as losing grip on the handles of the BTE, the worker starts before being told to do so.
Each individual was screened for resting heart rate and blood pressure. The highest was identified at 149/94 which resulted in 15 workers being eliminated from the testing procedure.
Hand Grip Testing
Strength testing of the wrist and hand was obtained by the Jamar Grip Dynamometer. The Jamar dynamometer was set at position 2 (second rung from the smallest handgrip position) with the cord and transducer from the BTE upright. The test was conducted with the working in a standing position with wrists in a neutral posture. Three repetitions were performed bilaterally. Workers squeezed the Jamar dynamometer for three seconds and a rest break was given of 5 seconds between each repetition. The second handgrip test was using the Jamar dynamometer using the same setting, however, the test was conducted with the worker standing and holding the Jamar dynamometer with their wrist pronated. Three repetitions were performed bilaterally with 5 seconds between each repetition. Position three for Jamar Dynamometer grip testing used position 3 rungs from the smallest handgrip position. The same instructions were given to the worker as the two previous tests.
Pinch Test
Utilizing the Pinch Grip Jamar Dynamometer the worker was tested in the standing position, wrist neutral holding the dynamometer using the key pinch grip also known as the lateral pinch. Three repetitions were given bilaterally with the 5-second break between repetitions. The test continued with testing the worker’s pinch grip using the pinch tip test. The operator held the dynamometer standing with wrist neutral. Three repetitions were given with 5-second rest breaks.
Tip pinch testing was conducted with the worker standing with the wrist in a neutral position, holding the dynamometer using a tip pinch grip. Three repetitions were performed with the left hand and then repeated on the right upper extremity. The test is performed by holding the pinch dynamometer and pressing it between the pad of the tip of the thumb and the pad of the tip of the index finger. Testing is performed for three seconds on each extremity with five-second breaks between each repetition.
A thumb strength test was performed using an n algometric device. This test measured thumb press force and was conducted with the worker standing with their feet
Reference List
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Borofsky, G. L., & Smith, M. (1993). Reductions in turnover, accidents, and absenteeism: The contribution of a pre-employment screening inventory. Journal of Clinical Psychology, 49(1), 109-116.
Franzblau, A. (2004). Preplacement Nerve Testing for Carpal Tunnel Syndrome. Journal of Occupational and Environmental Medicine, 46, 714-719.
Gibson, L. a. J. S. (2002). Expert review of an approach to functional capacity evaluation. Work, 19, 231-242.
Graham, B. (2008). The value added by electrodiagnostic testing in the diagnosis of Carpal tunnel syndrome. Bone Joint Surgery Am, 12(90), 2587-2593.
Harbin, G., MD & Olson, J. (2005). Post-offer, pre-placement testing in the industry. American Journal of Industrial Medicine, 47, 296-307.
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