Cost-Effectiveness and Return-on-Investment of a Participatory Ergonomics Intervention Among Childcare Workers: An Economic Evaluation in a Randomized Controlled Trial

Nidhi Gupta, Johanna M. van Dongen, Andreas Holtermann, Allard J. van der Beek, Matthew Leigh Stevens, Charlotte Diana Nørregaard Rasmussen

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Objectives To evaluate the cost-effectiveness and return-on-investment (ROI) of 20-week ergonomic intervention to reduce physical exertion at work compared with usual-practice among childcare workers. Methods One hundred ninety workers from 16 institutions were cluster-(institute)-randomized to intervention (n = 96) and usual-practice (n = 94) group. The intervention group participated in three workshops to develop/implement action plans improving ergonomic conditions. The rating of physical exertion (RPE) was measured at baseline and 20-weeks. Employer-perspective-based costs of intervention, absenteeism, and presenteeism were estimated. Results Although statistically non-significant, one-unit reduction in RPE was associated with saving of 592 EUR/worker. Per-EUR invested by the employer was associated with 1.6 EUR (95% CI: -3.1; 6.5) return in the intervention compared with usual practice. Conclusion The intervention tended to gain monetary benefit for the employer. The results should be replicated in larger populations for improved precision of economic evaluation estimates.

Original languageEnglish
Pages (from-to)533-539
Number of pages7
JournalJournal of occupational and environmental medicine / American College of Occupational and Environmental Medicine
Issue number6
Early online date9 Feb 2022
Publication statusPublished - 1 Jun 2022


  • childcare
  • economic evaluation
  • pain
  • perceived exertion

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