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Dahlqvist C, Arvidsson I, Löfqvist L, Gremark Simonsen J. Consistency between the ACGIH TLV for hand activity and proposed action levels for wrist velocity and forearm muscular load based on objective measurements: an example from the assembly industry. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2024; 30:927-935. [PMID: 38961651 DOI: 10.1080/10803548.2024.2367367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
Objectives. This study aimed to investigate the consistency between results of the American Conference for Governmental Occupational Hygienists (ACGIH) threshold limit value (TLV) for hand activity and proposed action levels of objective measurements in risk assessments of work-related musculoskeletal disorders. Methods. Wrist velocities and forearm muscular load were measured for 11 assemblers during one working day. Simultaneously, each assembler's hand activity level (HAL) during three sub-cycles was rated twice on two separate occasions by two experts, using a HAL scale. Arm/hand exertion was also rated by the assemblers themselves using a Borg scale. In total, 66 sub-cycles were assessed and assigned to three exposure categories: A) below ACGIH action limit (AL) (green); B) between AL and TLV (yellow); and C) above TLV (red). The median wrist velocity and the 90th percentile of forearm muscular load obtained from the objective measurements corresponding to the sub-cycles were calculated and assigned to two exposure categories: A) below or C) above the proposed action level. Results. The agreement between ACGIH TLV for hand activity and the proposed action level for wrist velocity was 87%. Conclusions. The proposed action level for wrist velocity is highly consistent with the TLV. Additional studies are needed to confirm the results.
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Affiliation(s)
- Camilla Dahlqvist
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Department of Occupational and Environmental Medicine, Region Skåne, Lund, Sweden
| | - Inger Arvidsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Department of Occupational and Environmental Medicine, Region Skåne, Lund, Sweden
| | - Lotta Löfqvist
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Department of Occupational and Environmental Medicine, Region Skåne, Lund, Sweden
| | - Jenny Gremark Simonsen
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Department of Occupational and Environmental Medicine, Region Skåne, Lund, Sweden
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Lind CM, Abtahi F, Forsman M. Wearable Motion Capture Devices for the Prevention of Work-Related Musculoskeletal Disorders in Ergonomics-An Overview of Current Applications, Challenges, and Future Opportunities. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23094259. [PMID: 37177463 PMCID: PMC10181376 DOI: 10.3390/s23094259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/14/2023] [Accepted: 04/22/2023] [Indexed: 05/15/2023]
Abstract
Work-related musculoskeletal disorders (WMSDs) are a major contributor to disability worldwide and substantial societal costs. The use of wearable motion capture instruments has a role in preventing WMSDs by contributing to improvements in exposure and risk assessment and potentially improved effectiveness in work technique training. Given the versatile potential for wearables, this article aims to provide an overview of their application related to the prevention of WMSDs of the trunk and upper limbs and discusses challenges for the technology to support prevention measures and future opportunities, including future research needs. The relevant literature was identified from a screening of recent systematic literature reviews and overviews, and more recent studies were identified by a literature search using the Web of Science platform. Wearable technology enables continuous measurements of multiple body segments of superior accuracy and precision compared to observational tools. The technology also enables real-time visualization of exposures, automatic analyses, and real-time feedback to the user. While miniaturization and improved usability and wearability can expand the use also to more occupational settings and increase use among occupational safety and health practitioners, several fundamental challenges remain to be resolved. The future opportunities of increased usage of wearable motion capture devices for the prevention of work-related musculoskeletal disorders may require more international collaborations for creating common standards for measurements, analyses, and exposure metrics, which can be related to epidemiologically based risk categories for work-related musculoskeletal disorders.
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Affiliation(s)
- Carl Mikael Lind
- IMM Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Farhad Abtahi
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, 141 57 Huddinge, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Clinical Physiology, Karolinska University Hospital, 141 86 Huddinge, Sweden
| | - Mikael Forsman
- IMM Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, 141 57 Huddinge, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, 113 65 Stockholm, Sweden
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Lovén K, Gudmundsson A, Assarsson E, Kåredal M, Wierzbicka A, Dahlqvist C, Nordander C, Xu Y, Isaxon C. Effects of cleaning spray use on eyes, airways, and ergonomic load. BMC Public Health 2023; 23:99. [PMID: 36639638 PMCID: PMC9840290 DOI: 10.1186/s12889-022-14954-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 12/27/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Cleaning workers are exposed to chemicals and high physical workload, commonly resulting in airway problems and pain. In this study the response in the upper airways and the physical workload following airborne and ergonomic exposure of cleaning spray was investigated. METHODS A survey was answered by professional cleaning workers to investigate their use of cleaning sprays and the perceived effects on eyes, airways and musculoskeletal pain. A human chamber exposure study was then conducted with 11 professional cleaning workers and 8 non-professional cleaning workers to investigate the airborne exposure, acute effects on eyes and airways, and physical load during cleaning with sprays, foam application and microfiber cloths premoistened with water. All cleaning products used were bleach, chlorine, and ammonia free. The medical assessment included eye and airway parameters, inflammatory markers in blood and nasal lavage, as well as technical recordings of the physical workload. RESULTS A high frequency of spray use (77%) was found among the 225 professional cleaning workers that answered the survey. Based on the survey, there was an eight times higher risk (p < 0.001) of self-experienced symptoms (including symptoms in the nose, eyes and throat, coughing or difficulty breathing) when they used sprays compared to when they cleaned with other methods. During the chamber study, when switching from spray to foam, the airborne particle and volatile organic compound (VOC) concentrations showed a decrease by 7 and 2.5 times, respectively. For the whole group, the peak nasal inspiratory flow decreased (-10.9 L/min, p = 0.01) during spray use compared to using only water-premoistened microfiber cloths. These effects were lower during foam use (-4.7 L/min, p = 0.19). The technical recordings showed a high physical workload regardless of cleaning with spray or with water. CONCLUSION Switching from a spraying to a foaming nozzle decreases the exposure of both airborne particles and VOCs, and thereby reduces eye and airway effects, and does not increase the ergonomic load. If the use of cleaning products tested in this study, i.e. bleach, chlorine, and ammonia free, cannot be avoided, foam application is preferable to spray application to improve the occupational environment.
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Affiliation(s)
- Karin Lovén
- grid.4514.40000 0001 0930 2361Ergonomics and Aerosol Technology, Lund University, Lund, Sweden
| | - Anders Gudmundsson
- grid.4514.40000 0001 0930 2361Ergonomics and Aerosol Technology, Lund University, Lund, Sweden
| | - Eva Assarsson
- grid.4514.40000 0001 0930 2361Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Monica Kåredal
- grid.4514.40000 0001 0930 2361Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Aneta Wierzbicka
- grid.4514.40000 0001 0930 2361Ergonomics and Aerosol Technology, Lund University, Lund, Sweden
| | - Camilla Dahlqvist
- grid.4514.40000 0001 0930 2361Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Catarina Nordander
- grid.4514.40000 0001 0930 2361Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Yiyi Xu
- grid.8761.80000 0000 9919 9582Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Christina Isaxon
- grid.4514.40000 0001 0930 2361Ergonomics and Aerosol Technology, Lund University, Lund, Sweden
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AlMubarek NA, Al-Otaibi ST, Herzallah HK. Musculoskeletal disorders among sonographers in secondary care hospitals in the city of Al-Ahsa, Saudi Arabia. Work 2022; 71:1105-1111. [DOI: 10.3233/wor-205145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Work-related musculoskeletal disorders (WMSDs) among sonographers have raised significant concerns in recent years. OBJECTIVES: This study aimed to estimate the prevalence of WMSDs and identify risk factors for WMSDs among sonographers. To date, there is little research on WMSDs among sonographers in Saudi Arabia. Therefore, this study aimed to contribute to the Saudi literature by filling this gap. METHODS: A cross-sectional study was conducted among sonographers (n = 98) working in four major governmental hospitals in the city of Al-Ahsa, Saudi Arabia. The participants completed a validated, self-administered questionnaire that focused on the analysis of musculoskeletal symptoms among sonographers. RESULTS: The mean age of the respondents was 35.5±9 years. The majority of the participants were female (71.4%), non-Saudi (51%), and working as technicians (49%). The prevalence rates of shoulder and neck disorders among the participants were 65.3% and 57.1%, respectively. Gender (female), job title (sonography technicians), and years of experience (seasoned sonographers) were identified as risk factors for WMSDs. CONCLUSIONS: Among the studied sonographers, WMSDs were a significant, common problem. Being female, being a sonography technician, and being a seasoned sonographer were identified as risk factors for these disorders. Preventive measures should be implemented to reduce the risk of WMSDs in this occupational setting.
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Affiliation(s)
| | - Sultan T. Al-Otaibi
- Department of Public Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Hatem K. Herzallah
- Department of Public Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
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Kliewer M, Walker T, Bagley AR. Toward Ergonomic Design in Ultrasound Scanning: Strategies to Mitigate Injurious Forces. Ultrasound Q 2022; 38:65-71. [PMID: 35239630 DOI: 10.1097/ruq.0000000000000564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Sonographers experience stress-related musculoskeletal injuries at alarming rates. The magnitude of the problem has resulted in substantial economic and human costs. Early efforts, such as the transposition of office ergonomic models to the ultrasound suite, have been only marginally successful because of the vast difference between clerical and sonography work demands. In addition, although the issue has attracted the attention of professional sonographer societies, equipment manufacturers, and governmental agencies, such as the OSHA (Occupational Safety and Health), the causative mechanisms by which sonographers are injured remain inadequately addressed. A definitive ergonomic solution has been elusive.With the help of occupational therapists and biomechanical engineers, we have developed a number of possible ergonomic modifications of ultrasound equipment. We explain the rationale behind these approaches to transducer design and assess the strengths and deficiencies of each.
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Affiliation(s)
- Mark Kliewer
- Department of Radiology, University of Wisconsin School of Medicine, Madison, WI
| | - Tim Walker
- Department of Radiology, University of Wisconsin School of Medicine, Madison, WI
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Gremark Simonsen J, Axmon A, Nordander C, Arvidsson I. Neck and upper extremity pain in sonographers - a longitudinal study. BMC Musculoskelet Disord 2020; 21:156. [PMID: 32164619 PMCID: PMC7069173 DOI: 10.1186/s12891-020-3096-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 01/27/2020] [Indexed: 11/25/2022] Open
Abstract
Background Sonographers have reported a high occurrence of musculoskeletal pain for more than 25 years. Assessments of occupational risk factors have previously been based on cross-sectional surveys. The aim of this longitudinal study was to determine which factors at baseline that were associated with neck/shoulder and elbow/hand pain at follow-up. Methods A questionnaire was answered by 248 female sonographers at baseline and follow-up (85% of the original cohort). 208 were included in the analyses. Physical, visual, and psychosocial work-related conditions were assessed at baseline. Pain in two body regions (neck/shoulders and elbows/hands) was assessed at both baseline and follow up. Results Pain at baseline showed the strongest association with pain at follow-up in both body regions [prevalence ratio (PR) 2.04; 95% confidence interval (CI) 1.50–2.76], for neck/shoulders and (PR 3.45; CI 2.29–5.22) for elbows/hands. Neck/shoulder pain at follow-up was associated with inability of ergonomic adjustments at the ultrasound device (PR 1.25; CI 1.05–1.49), a high mechanical exposure index (PR 1.66; CI 1.09–2.52), and adverse visual conditions (PR 1.24; CI 1.00–1.54) at baseline. Moreover, among participants with no neck/shoulder pain at baseline, high job demands (PR 1.78; CI 1.01–3.12), and a high mechanical exposure index (PR 2.0; CI 0.98–4.14) predicted pain at follow-up. Pain in the elbows/hands at follow-up was associated with high sensory demands at baseline (PR 1.63; CI 1.08–2.45), and among participants without pain at baseline high sensory demands predicted elbow/hand pain at follow-up (PR 3.34; CI 1.53–7.31). Conclusion Pain at baseline was the strongest predictor for pain at follow-up in both body regions. We also found several occupational factors at baseline that were associated with pain at follow-up: inability to adjust equipment, adverse visual conditions, a high MEI, high job demands and high sensory demands. These results point at a possibility to influence pain with better ergonomics.
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Affiliation(s)
- Jenny Gremark Simonsen
- Division of Occupational and Environmental Medicine, Lund University, SE-223 81, Lund, Sweden.
| | - Anna Axmon
- Division of Occupational and Environmental Medicine, EPI@LUND (Epidemiology, Population studies, and Infrastructures at Lund University), Lund University, SE-223 81, Lund, Sweden
| | - Catarina Nordander
- Division of Occupational and Environmental Medicine, EPI@LUND (Epidemiology, Population studies, and Infrastructures at Lund University), Lund University, SE-223 81, Lund, Sweden
| | - Inger Arvidsson
- Division of Occupational and Environmental Medicine, EPI@LUND (Epidemiology, Population studies, and Infrastructures at Lund University), Lund University, SE-223 81, Lund, Sweden
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Dahlqvist C, Nordander C, Forsman M, Enquist H. Self-recordings of upper arm elevation during cleaning - comparison between analyses using a simplified reference posture and a standard reference posture. BMC Musculoskelet Disord 2018; 19:402. [PMID: 30442141 PMCID: PMC6238373 DOI: 10.1186/s12891-018-2328-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 10/29/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To reduce ergonomic risk factors in terms of awkward and constrained postures and high velocities, it is important to perform adequate risk assessments. Technical methods provide objective measures of physical workload. These methods have so far mainly been used by researchers. However, if written instructions how to apply the sensors and how to adopt the reference posture are provided, together with triaxial accelerometers, it may be possible for employees to record their own physical workload. The exposure in terms of e.g. upper arm elevations could then easily be assessed for all workers in a workplace. The main aims of this study were: 1) to compare analyses for self-recording of upper arm elevation during work using a simplified reference posture versus using a standard reference posture, and 2) to compare the two reference postures. METHODS Twenty-eight cleaners attached an accelerometer to their dominant upper arm and adopted a simplified reference according to a written instruction. They were thereafter instructed by a researcher to adopt a standard reference. Upper arm elevations were recorded for 2 or 3 days. Each recording was analysed twice; relative to the simplified reference posture and relative to the standard reference posture. The group means of the differences in recorded upper arm elevations between simplified and standard reference analyses were assessed using Wilcoxon signed ranks test. Furthermore, we calculated the group mean of the differences between the simplified reference posture and the standard reference posture. RESULTS For arm elevation during work (50th percentile), the group mean of the differences between the two analyses was 0.2° (range -7 - 10°). The group mean of the differences between the two references was 9° (range 1 - 21°). The subjects were able to follow the instructions in the protocol and performed self-recording of upper arm elevation and velocity. CONCLUSIONS The small difference between the two analyses indicates that recordings performed by employees themselves are comparable, on a group level, with those performed by researchers. Self-recordings in combination with action levels would provide employers with a method for risk assessment as a solid basis for prevention of work-related musculoskeletal disorders.
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Affiliation(s)
- Camilla Dahlqvist
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Catarina Nordander
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Mikael Forsman
- Division of Ergonomics, KTH Royal Institute of Technology, SE-141 57 Huddinge, Sweden
| | - Henrik Enquist
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
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