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Mathiassen SE, Waleh Åström A, Strömberg A, Heiden M. Cost and statistical efficiency of posture assessment by inclinometry and observation, exemplified by paper mill work. PLoS One 2023; 18:e0292261. [PMID: 37788296 PMCID: PMC10547196 DOI: 10.1371/journal.pone.0292261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/16/2023] [Indexed: 10/05/2023] Open
Abstract
Postures at work are paramount in ergonomics. They can be determined using observation and inclinometry in a variety of measurement scenarios that may differ both in costs associated with collecting and processing data, and in efficiency, i.e. the precision of the eventual outcome. The trade-off between cost and efficiency has rarely been addressed in research despite the obvious interest of obtaining precise data at low costs. Median trunk and upper arm inclination were determined for full shifts in 28 paper mill workers using both observation and inclinometry. Costs were estimated using comprehensive cost equations; and efficiency, i.e. the inverted standard deviation of the group mean, was assessed on basis of exposure variance components. Cost and efficiency were estimated in simulations of six sampling scenarios: two for inclinometry (sampling from one or three shifts) and four for observation (one or three observers rating one or three shifts). Each of the six scenarios was evaluated for 1 through 50 workers. Cost-efficiency relationships between the scenarios were intricate. As an example, inclinometry was always more cost-efficient than observation for trunk inclination, except for observation strategies involving only few workers; while for arm inclination, observation by three observers of one shift per worker outperformed inclinometry on three shifts up to a budget of €20000, after which inclinometry prevailed. At a budget of €10000, the best sampling scenario for arm inclination was 2.5 times more efficient than the worst. Arm inclination could be determined with better cost-efficiency than trunk inclination. Our study illustrates that the cost-efficiency of different posture measurement strategies can be assessed and compared using easily accessible diagrams. While the numeric examples in our study are specific to the investigated occupation, exposure variables, and sampling logistics, we believe that inclinometry will, in general, outperform observation. In any specific case, we recommend a thorough analysis, using the comparison procedure proposed in the present study, of feasible strategies for obtaining data, in order to arrive at an informed decision support.
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Affiliation(s)
- Svend Erik Mathiassen
- Centre for Musculoskeletal Research, Department of Occupational Health Science and Psychology, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Amanda Waleh Åström
- Centre for Musculoskeletal Research, Department of Occupational Health Science and Psychology, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Annika Strömberg
- Department of Business and Economic Studies, Faculty of Education and Business Studies, University of Gävle, Gävle, Sweden
| | - Marina Heiden
- Centre for Musculoskeletal Research, Department of Occupational Health Science and Psychology, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
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Graben PR, Schall MC, Gallagher S, Sesek R, Acosta-Sojo Y. Reliability Analysis of Observation-Based Exposure Assessment Tools for the Upper Extremities: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710595. [PMID: 36078310 PMCID: PMC9518117 DOI: 10.3390/ijerph191710595] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 05/13/2023]
Abstract
(1) Background: The objectives of this systematic review were to (i) summarize the results of studies evaluating the reliability of observational ergonomics exposure assessment tools addressing exposure to physical risk factors associated with upper extremity musculoskeletal disorders (MSDs), and (ii) identify best practices for assessing the reliability of new observational exposure assessment tools. (2) Methods: A broad search was conducted in March 2020 of four academic databases: PubMed, Science Direct, Ergonomic Abstracts, and Web of Science. Articles were systematically excluded by removing redundant articles, examining titles and abstracts, assessing relevance to physical ergonomics and the upper extremities, and article type. (3) Results: Eleven articles were included in the review. The results indicated no singular best practice; instead, there were multiple methodological approaches researchers chose to use. Some of the significant variations in methodologies include the selection of reliability coefficients, rater and participant selection, and direct vs. digital observation. (4) Conclusion: The findings serve as a resource summarizing the reliability of existing observational risk assessment tools and identify common methods for assessing the reliability of new observational risk assessment tools. Limitations of this review include the number of databases searched, the removal of truncation symbols, and the selection of keywords used for the initial search.
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Affiliation(s)
| | - Mark C. Schall
- Correspondence: (P.R.G.); (M.C.S.J.); Tel.: +1-(708)-539-8957 (M.C.S.J.)
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Abarca-Reyes YM, Toalongo-Rojas LM, Bueno-Palomeque FL. Optimization of the Static Posture Evaluation Process Through Digital Processing of Photographic Images. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:1801-1805. [PMID: 34891636 DOI: 10.1109/embc46164.2021.9630704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Traditional methods of posture evaluation carried out by physical therapists manually measure or test the alignments of body segments, investing a long time for its development and adding an error percentage related to the level of professional expertise. The present study uses a system of two dimensions photogrammetry to investigate its applicability on measurement of posture parameters and the variation of the measurements using different photographic cameras locate at different distances from the subject. The "marker automatic measurement" system (LAM) filters and segments body markers on photographic images. Data were collected using a semi-professional, a mid-range cellphone and a sports camera. Tests were recorded by placing the camera at 2.50, 2.00 and 1.80 meters from the subject, and the lens at a height of 1.10, 1.00 and 0.97 meters with an illuminance of 29.92 lux. Subsequently, 30 volunteers participated in the postural tests. The Measurements were made on frontal, anterior and posterior planes as well as sagittal plane. The maximum absolute error on the measuring of distances was 0.64 cm. On angles related to the horizontal was 0.70 degrees and for angles concerning the vertical was 0.76 degrees.Clinical Relevance-By utilizing LAM system all three views were evaluated in less than a minute without counting the time for putting on the markers. The results obtained suggest that the system presents trustworthy results, which reduce considerably the time of carrying out posture evaluations where results are measurable, repeatable and away from the evaluator's subjectivity.
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Lins C, Fudickar S, Hein A. OWAS inter-rater reliability. APPLIED ERGONOMICS 2021; 93:103357. [PMID: 33524664 DOI: 10.1016/j.apergo.2021.103357] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/01/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
The Ovako Working posture Assessment System (OWAS) is a commonly used observational assessment method for determining the risk of work-related musculoskeletal disorders. OWAS claims to be suitable in the application for untrained persons but there is not enough evidence for this assumption. In this paper, inter-rater (inter-observer) reliability (agreement) is examined down to the level of individual postures and categories. For this purpose, the postures of 20 volunteers have been observed by 3 varying human raters in a laboratory setting and the inter-rater agreement against reference values was determined. A high agreement of over 98%(κ=0.98) was found for the postures of the arms but lower agreements were found for posture classification of the legs (66-97%,κ=0.85) and the upper body (80-96%,κ=0.85). No significant difference was found between raters with and without intense prior training in physical therapy. Consequently, the results confirm the general reliability of the OWAS method especially for raters with non-specialized background but suggests weaknesses in the reliable detection of a few particular postures.
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Affiliation(s)
- Christian Lins
- Fraunhofer Institute for Digital Media Technology IDMT, Division Hearing, Speech and Audio Technology, Marie-Curie-Straße 2, 26129, Oldenburg, Germany; Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 140, 26129, Oldenburg, Germany.
| | - Sebastian Fudickar
- Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 140, 26129, Oldenburg, Germany.
| | - Andreas Hein
- OFFIS - Institute for Information Technology, Escherweg 2, 26121, Oldenburg, Germany; Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 140, 26129, Oldenburg, Germany.
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An Evaluation of Posture Recognition Based on Intelligent Rapid Entire Body Assessment System for Determining Musculoskeletal Disorders. SENSORS 2020; 20:s20164414. [PMID: 32784732 PMCID: PMC7472503 DOI: 10.3390/s20164414] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/30/2020] [Accepted: 08/06/2020] [Indexed: 12/11/2022]
Abstract
Determining the potential risks of musculoskeletal disorders through working postures in a workplace is expensive and time-consuming. A novel intelligent rapid entire body assessment (REBA) system based on convolutional pose machines (CPM), entitled the Quick Capture system, was applied to determine the risk levels. The aim of the study was to validate the feasibility and reliability of the CPM-based REBA system through a simulation experiment. The reliability was calculated from the differences of motion angles between the CPM-based REBA and a motion capture system. Results show the data collected by the Quick Capture system were consistent with those of the motion capture system; the average of root mean squared error (RMSE) was 4.77 and the average of Spearman’s rho (ρ) correlation coefficient in the different 12 postures was 0.915. For feasibility evaluation, the linear weighted Cohen’s kappa between the REBA score obtained by the Quick Capture system and those from the three experts were used. The result shows good agreement, with an average proportion agreement index (P0) of 0.952 and kappa of 0.738. The Quick Capture system does not only accurately analyze working posture, but also accurately determines risk level of musculoskeletal disorders. This study suggested that the Quick Capture system could be applied for a rapid and real-time on-site assessment.
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Robert-Lachaine X, Larue C, Denis D, Delisle A, Mecheri H, Corbeil P, Plamondon A. Feasibility of quantifying the physical exposure of materials handlers in the workplace with magnetic and inertial measurement units. ERGONOMICS 2020; 63:283-292. [PMID: 31043140 DOI: 10.1080/00140139.2019.1612941] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 04/03/2019] [Accepted: 04/23/2019] [Indexed: 05/27/2023]
Abstract
Handling tasks can expose workers to risk factors. The objective was to describe the feasibility of using magnetic and inertial measurement units (MIMUs) to quantify the physical exposure of materials handlers in the workplace. Full-body kinematics were obtained with MIMUs on 10 handlers gathering products ordered by retailers with a pallet truck. An observer classified the visual difference (VD) of segment orientation between a MIMUs avatar and video recordings in three categories (none, minor and major) for each product transfer. The feet, arms, shoulders and head were considered similar for ≥97% of observations. The trunk segment obtained the most differences with 9% of minor VD and 5% of major VD, which were related to the duration of the magnetic disturbances of the MIMUs. Estimating parameters of the physical exposure of handlers in the workplace is feasible with kinematics and an order list, but visual verification remains important for scientific rigour.Practitioner Summary: The feasibility of measuring physical exposure with magnetic and inertial measurement units was evaluated on materials handlers in the workplace. Visual observation of the postures indicated that most of the data is considered acceptable. Magnetic disturbances can increase the measurement error, so data must be verified to ensure validity.
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Affiliation(s)
- Xavier Robert-Lachaine
- Institut de Recherche Robert Sauvé en Santé et en Sécurité du Travail (IRSST), Montréal, Canada
- Département de Kinésiologie, Groupe de Recherche en Analyse du Mouvement et Ergonomie, Université Laval, Québec City, Canada
| | - Christian Larue
- Institut de Recherche Robert Sauvé en Santé et en Sécurité du Travail (IRSST), Montréal, Canada
| | - Denys Denis
- Institut de Recherche Robert Sauvé en Santé et en Sécurité du Travail (IRSST), Montréal, Canada
| | - Alain Delisle
- Faculté d'Éducation Physique et Sportive, Université de Sherbrooke, Sherbrooke, Canada
| | - Hakim Mecheri
- Institut de Recherche Robert Sauvé en Santé et en Sécurité du Travail (IRSST), Montréal, Canada
| | - Philippe Corbeil
- Département de Kinésiologie, Groupe de Recherche en Analyse du Mouvement et Ergonomie, Université Laval, Québec City, Canada
| | - André Plamondon
- Institut de Recherche Robert Sauvé en Santé et en Sécurité du Travail (IRSST), Montréal, Canada
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Boudet G, Chausse P, Thivel D, Rousset S, Mermillod M, Baker JS, Parreira LM, Esquirol Y, Duclos M, Dutheil F. How to Measure Sedentary Behavior at Work? Front Public Health 2019; 7:167. [PMID: 31355172 PMCID: PMC6633074 DOI: 10.3389/fpubh.2019.00167] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 06/05/2019] [Indexed: 12/23/2022] Open
Abstract
Background: Prolonged sedentary behavior (SB) is associated with increased risk for chronic conditions. A growing number of the workforce is employed in office setting with high occupational exposure to SB. There is a new focus in assessing, understanding and reducing SB in the workplace. There are many subjective (questionnaires) and objective methods (monitoring with wearable devices) available to determine SB. Therefore, we aimed to provide a global understanding on methods currently used for SB assessment at work. Methods: We carried out a systematic review on methods to measure SB at work. Pubmed, Cochrane, Embase, and Web of Science were searched for peer-reviewed English-language articles published between 1st January 2000 and 17th March 2019. Results: We included 154 articles: 89 were cross-sectional and 65 were longitudinal studies, for a total of 474,091 participants. SB was assessed by self-reported questionnaires in 91 studies, by wearables devices in also 91 studies, and simultaneously by a questionnaire and wearables devices in 30 studies. Among the 91 studies using wearable devices, 73 studies used only one device, 15 studies used several devices, and three studies used complex physiological systems. Studies exploring SB on a large sample used significantly more only questionnaires and/or one wearable device. Conclusions: Available questionnaires are the most accessible method for studies on large population with a limited budget. For smaller groups, SB at work can be objectively measured with wearable devices (accelerometers, heart-rate monitors, pressure meters, goniometers, electromyography meters, gas-meters) and the results can be associated and compared with a subjective measure (questionnaire). The number of devices worn can increase the accuracy but make the analysis more complex and time consuming.
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Affiliation(s)
- Gil Boudet
- Faculté de Médecine, Institut de Médecine du Travail, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Pierre Chausse
- Cellule d'Accompagnement Technologique-Department of Technological Accompaniment, CNRS, LaPSCo, Université Clermont Auvergne, Clermont-Ferrand, France
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P EA 3533), Université Clermont Auvergne, Clermont-Ferrand, France.,Institut Universitaire de France, Paris, France
| | - Sylvie Rousset
- Unité de Nutrition Humaine, INRA, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Martial Mermillod
- Institut Universitaire de France, Paris, France.,LPNC, CNRS, Université Grenoble Alpes, Université Savoie Mont Blanc, Grenoble, France
| | - Julien S Baker
- School of Science and Sport, Institute of Clinical Exercise and Health Sciences, University of the West of Scotland, Hamilton, United Kingdom
| | - Lenise M Parreira
- Faculté de Médecine, Institut de Médecine du Travail, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Yolande Esquirol
- Occupational and Preventive Medicine, INSERM UMR-1027, Université Paul Sabatier Toulouse 3, CHU Toulouse, Toulouse, France
| | - Martine Duclos
- Sport Medicine and Functional Explorations, CRNH, INRA UMR-1019, University Hospital of Clermont-Ferrand, Université Clermont Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Frédéric Dutheil
- LaPSCo, Physiological and Psychosocial Stress, Preventive and Occupational Medicine, CNRS, University Hospital of Clermont-Ferrand, Université Clermont Auvergne, CHU Clermont-Ferrand, WittyFit, Clermont-Ferrand, France.,Faculty of Health, School of Exercise Science, Australian Catholic University, Melbourne, VIC, Australia
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Heiden M, Zetterberg C, Mathiassen SE. Trunk and upper arm postures in paper mill work. APPLIED ERGONOMICS 2019; 76:90-96. [PMID: 30642529 DOI: 10.1016/j.apergo.2018.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 10/01/2018] [Accepted: 12/08/2018] [Indexed: 06/09/2023]
Abstract
The aim of this study was to assess postures and movements of the trunk and upper arm during paper mill work, and to determine the extent to which they differ depending on method of assessment. For each of 28 paper mill workers, postures and movements were assessed during three full shifts using inclinometer registration and observation from video. Summary metrics for each shift, e.g., 10th, 50th, and 90th posture percentile, were averaged across shifts and across workers. In addition, the standard deviation between workers, and the standard deviation between shifts within worker were computed. The results showed that trunk and arm postures during paper mill work were similar to other occupations involving manual materials handling, but the velocities of arm movements were lower. While postures determined by inclinometry and observation were similar on a group level, substantial differences were found between results obtained by the two methods for individual workers, particularly for extreme postures. Thus, measurements by either method on individuals or small groups should be interpreted with caution.
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Affiliation(s)
- Marina Heiden
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, SE-801 76, Gävle, Sweden.
| | - Camilla Zetterberg
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, SE-801 76, Gävle, Sweden.
| | - Svend Erik Mathiassen
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, SE-801 76, Gävle, Sweden.
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Rodrigues MS, Sonne M, Andrews DM, Tomazini LF, Sato TDO, Chaves TC. Rapid office strain assessment (ROSA): Cross cultural validity, reliability and structural validity of the Brazilian-Portuguese version. APPLIED ERGONOMICS 2019; 75:143-154. [PMID: 30509519 DOI: 10.1016/j.apergo.2018.09.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 06/09/2023]
Abstract
Forty-three occupational health professionals (observers) and 90 workers were enrolled in this study to perform the cross-cultural adaptation of the Rapid Office Strain Assessment into Brazilian Portuguese (ROSA-Br) and evaluate its psychometric properties. After cross-cultural adaptation, the measurement properties were checked in three stages: study 1: pre-testing (27 observers rated 15 office worker videos), study 2: intra- and inter-observer reliability (26 observers rated 15 office worker videos), and study 3: validity and accuracy of ROSA-Br final scores (90 office workers). For the ROSA scores, acceptable intraclass correlation coefficients were found for 75% and 86% of the intra-observer reliability comparisons for non-trained and trained observers, respectively, and for 100% of the inter-observer reliability comparisons (0.43-0.86). For construct validity, moderate correlations were observed for 70% of the comparisons between ROSA final scores and other ergonomic instruments. Moderate accuracy was observed for a ROSA-Br final score of 6 (AUC [area under the curve] = 0.72, 0.89). Taken together, these results support the use of the ROSA-Br for ergonomic field assessments and research.
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Affiliation(s)
- Mirela Sant'Ana Rodrigues
- Post-graduation Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo - USP, Brazil
| | - Michael Sonne
- Occupational Health Clinics for Ontario Workers Inc, Hamilton, Ontario, Canada
| | - David M Andrews
- Department of Kinesiology, University of Windsor, Windsor, ON, Canada
| | | | | | - Thaís Cristina Chaves
- Post-graduation Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo - USP, Brazil; Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo - USP, Brazil.
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10
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Holtermann A, Schellewald V, Mathiassen SE, Gupta N, Pinder A, Punakallio A, Veiersted KB, Weber B, Takala EP, Draicchio F, Enquist H, Desbrosses K, García Sanz MP, Malińska M, Villar M, Wichtl M, Strebl M, Forsman M, Lusa S, Tokarski T, Hendriksen P, Ellegast R. A practical guidance for assessments of sedentary behavior at work: A PEROSH initiative. APPLIED ERGONOMICS 2017; 63:41-52. [PMID: 28502405 DOI: 10.1016/j.apergo.2017.03.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 03/23/2017] [Accepted: 03/24/2017] [Indexed: 06/07/2023]
Abstract
Sedentary behavior is defined as sitting or lying with low energy expenditure. Humans in industrialized societies spend an increasing amount of time in sedentary behaviors every day. This has been associated with detrimental health outcomes. Despite a growing interest in the health effects of sedentary behavior at work, associations remain unclear, plausibly due to poor and diverse methods for assessing sedentary behavior. Thus, good practice guidance for researchers and practitioners on how to assess occupational sedentary behavior are needed. The aim of this paper is to provide a practical guidance for practitioners and researchers on how to assess occupational sedentary behavior. Ambulatory systems for use in field applications (wearables) are a promising approach for sedentary behavior assessment. Many different small-size consumer wearables, with long battery life and high data storage capacity are commercially available today. However, no stand-alone commercial system is able to assess sedentary behavior in accordance with its definition. The present paper offers decision support for practitioners and researchers in selecting wearables and data collection strategies for their purpose of study on sedentary behavior. Valid and reliable assessment of occupational sedentary behavior is currently not easy. Several aspects need to be considered in the decision process on how to assess sedentary behavior. There is a need for development of a cheap and easily useable wearable for assessment of occupational sedentary behavior by researchers and practitioners.
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Affiliation(s)
- Andreas Holtermann
- National Research Centre for the Working Environment (NRCWE), Copenhagen, Denmark.
| | - Vera Schellewald
- German Sport University Cologne (DSHS), Köln, Germany; Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA), Sankt Augustin, Germany
| | | | - Nidhi Gupta
- National Research Centre for the Working Environment (NRCWE), Copenhagen, Denmark
| | - Andrew Pinder
- HSE's Health & Safety Laboratory (HSL), Buxton, Derbyshire, United Kingdom
| | - Anne Punakallio
- Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
| | | | - Britta Weber
- Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA), Sankt Augustin, Germany
| | - Esa-Pekka Takala
- Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
| | - Francesco Draicchio
- National Institute for Insurance Against Accidents at Work (INAIL), Rome, Italy
| | - Henrik Enquist
- Lund University, Skane Medical Services, Department of Laboratory Medicine, Occupational and Environmental Medicine, Lund, Sweden
| | - Kevin Desbrosses
- French National Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), Vandoeuvre Les Nancy, France
| | | | - Marzena Malińska
- Central Institute for Labour Protection - National Research Institute (CIOP-PIB), Warszawa, Poland
| | - María Villar
- Spanish National Institute for Safety and Hygiene at Work (INSHT), Madrid, Spain
| | - Michael Wichtl
- Austrian Workers' Compensation Board (AUVA), Wien, Austria
| | | | | | - Sirpa Lusa
- Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
| | - Tomasz Tokarski
- Central Institute for Labour Protection - National Research Institute (CIOP-PIB), Warszawa, Poland
| | - Peter Hendriksen
- National Research Centre for the Working Environment (NRCWE), Copenhagen, Denmark
| | - Rolf Ellegast
- Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA), Sankt Augustin, Germany
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