Out on a limb: Applying the Person-Environment-Occupation-Performance model to examine injury-linked factors among light rail drivers

Work-related injuries and musculoskeletal disorders are a workplace problem within and across organisations, particularly in rail, where they tend to be treated as non-significant and localised health issues. While physical ergonomics and interface-design issues invariably contribute to the incidence of such injuries, contemporary socio-technical systems theories suggest that wider system factors and complex interrelationships between them may also play a role. The Person-Environment-Occupation-Performance (PEOP) model was applied to identify, map and examine injury-linked factors in light rail vehicle (i.e. tram) drivers. Two connected studies were undertaken in a mixed methods research design involving direct (e.g. interviews, observations) and indirect (e.g. cross-sectional surveys) methods of data capture within an Australian light rail organisation. Analysis of data and triangulation of findings revealed that impacts to work-related musculoskeletal disorders are not only local and physical, but psychosocial and distal, such as in driving behaviours engendered by knowledge and levels of interpersonal support received. Application of the PEOP model enabled determination of the complexity around the systems factors contributing to driver injury in the context of rail driving and identification of specific strategies and implications for policy, education and practice. This paper presents the first use of the PEOP model to examine and better understand work-related injuries and musculoskeletal disorders in the rail industry and provides an adaptation of the model as a template for future use in rail and to assist in the understanding of complex injury scenarios within a socio-technical systems approach. © 2020 The Authors