Validity of fixed-interval observations for postural assessment in construction work

Two Complementary Approaches toward Geodetic Monitoring of a Historic Wooden Church to Inspect Its Static and Dynamic Behavior

To support the conservation efforts regarding a wooden church in Domachowo, extensive research and design work was required to strengthen its weakened structure. A variety of data and analyses are necessary to make an accurate assessment, including obtaining a dimensional model, monitoring the behavior of the structure and its response to external forces, and also performing strength analyses and verifying them with measurement data. For accurate geometric evaluation, static and dynamic measurements were required. A mathematical model and a flowchart of the necessary tasks were developed, along with the selection and installation of measuring devices. For this particular structure, static measurements were made using an automatic total station, and dynamic measurements using tilt sensors. The purpose of the analysis was to correlate the inertia measurements with the absolute tachymetric observations related to reference points fixed outside the object in order to accurately assess the behavior of the object. Another important issue was to model the column element under study in such a way that its horizontal displacements could be determined from the measured inclinations. The obtained results indicated the need to strengthen the joints of the two main parts of the structure in order to minimize the impact of dynamic weather conditions. The paper describes the measurement process, the method of calculating displacements, and the correlation of both types of data. Selected results confirming the conclusions are also presented.

Quality and usability of clinical assessments of static standing and sitting posture: A systematic review

BACKGROUND

A validated method to assess sitting and standing posture in a clinical setting is needed to guide diagnosis, treatment and evaluation of these postures. At present, no systematic overview of assessment methods, their clinimetric properties, and usability is available.

OBJECTIVE

The objective of this study was to provide such an overview and to interpret the results for clinical practice.

METHODS

A systematic literature review was performed according to international guidelines. Two independent reviewers assessed risk of bias, clinimetric values of the assessment methods, and their usability. Quality of evidence and strength of recommendations were determined according to the Grading of Recommendations Assessment, Development and Evaluation working group (GRADE).

RESULTS

Out of 27,680 records, 41 eligible studies were included. Thirty-two assessment instruments were identified, clustered into five categories. The methodological quality of 27 (66%) of the articles was moderate to good. Reliability was most frequently studied. Little information was found about validity and none about responsiveness.

CONCLUSIONS

Based on a moderate level of evidence, a tentative recommendation can be made to use a direct visual observation method with global posture recorded by a trained observer applying a rating scale.

Effects of Sensor Types and Angular Velocity Computational Methods in Field Measurements of Occupational Upper Arm and Trunk Postures and Movements

Accelerometer-based inclinometers have dominated kinematic measurements in previous field studies, while the use of inertial measurement units that additionally include gyroscopes is rapidly increasing. Recent laboratory studies suggest that these two sensor types and the two commonly used angular velocity computational methods may produce substantially different results. The aim of this study was, therefore, to evaluate the effects of sensor types and angular velocity computational methods on the measures of work postures and movements in a real occupational setting. Half-workday recordings of arm and trunk postures, and movements from 38 warehouse workers were compared using two sensor types: accelerometers versus accelerometers with gyroscopes-and using two angular velocity computational methods, i.e., inclination velocity versus generalized velocity. The results showed an overall small difference (<2° and value independent) for posture percentiles between the two sensor types, but substantial differences in movement percentiles both between the sensor types and between the angular computational methods. For example, the group mean of the 50th percentiles were for accelerometers: 71°/s (generalized velocity) and 33°/s (inclination velocity)-and for accelerometers with gyroscopes: 31°/s (generalized velocity) and 16°/s (inclination velocity). The significant effects of sensor types and angular computational methods on angular velocity measures in field work are important in inter-study comparisons and in comparisons to recommended threshold limit values.

Web-based KAP Intervention on Office Ergonomics: A Unique Technique for Prevention of Musculoskeletal Discomfort in Global Corporate Offices

Aims:

The purpose of this study was to evaluate web-based Knowledge, Attitude and Practice (KAP) intervention on office ergonomics – a unique method for prevention of musculoskeletal discomfort (MSD) – in corporate offices that influences behavior modification.

Background:

With the increasing use of computers, laptops and hand-held communication devices globally among office employees, creating awareness on office ergonomics has become a top priority. Emphasis needs to be given on maintaining ideal work postures, ergonomic arrangement of workstations, optimizing chair functions, as well as performing desk stretches to reduce MSD arising from the use of these equipment, thereby promoting safe work practices at offices and home, as in the current scenario many employees work from home with flexible work hours. Hence, this justifies the importance of our study.

Objective:

To promote safe working by exploring cost-effective communication methods to achieve behavior change at distant sites when an on-site visit may not be feasible.

Materials and Methods:

An invitation was sent by the Medical and Occupational Health Team of a multinational corporation to all employees at their offices in Sri Lanka, Singapore, and Malaysia to take up an online Nordic questionnaire, a screening tool for musculoskeletal symptoms, shared in local languages on two occasions – baseline evaluation (n = 240) and a follow-up evaluation after 3 months (n = 203). After completing the baseline questionnaire, employees were immediately trained on correct postures and office ergonomics with animation graphics. The same questionnaire was sent again after a 12-week gap only to those employees who responded to the baseline questionnaire on initial assessment.

Statistical Analysis Used:

Data collected were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.0 software and variables were compared using odds ratio as well as Chi-square test.

Results:

Of the 203 employees who responded, 47.35% had some musculoskeletal symptoms. Among them 58.7% had lower back pain, 46.9% had upper back pain, 44.1% had wrist pain, 39.5% had shoulder pain, and 37% had knee pain. The percentages are high as some participants had multiple complaints i.e. 2 or 3 complaints. However, only 40% of these employees had ongoing symptoms at the time of evaluation (past 7 days). A subsequent 3-month evaluation after web-based intervention showed a significant 41–50% decline in ongoing symptoms.

Conclusions:

We conclude that newer technology using web-based animation graphics is a highly efficient technique to create office ergonomics awareness and has the potential to become a best practice in countries where language is a communication barrier and an on-site visit may not be feasible due to meagre resources.

An evaluation of wearable sensors and their placements for analyzing construction worker's trunk posture in laboratory conditions

This study investigates the effect of sensor placement on the analysis of trunk posture for construction activities using two off-the-shelf systems. Experiments were performed using a single-parameter monitoring wearable sensor (SPMWS), the ActiGraph GT9X Link, which was worn at six locations on the body, and a multi-parameter monitoring wearable sensor (MPMWS), the Zephyr BioHarness™3, which was worn at two body positions. One healthy male was recruited and conducted 10 experiment sessions to repeat measurements of trunk posture within our study. Measurements of upper-body thoracic bending posture during the lifting and lowering of raised deck materials in a laboratory setting were compared against video-captured observations of posture. The measurements from the two sensors were found to be in agreement during slow-motion symmetric bending activities with a target bending of ≤45°. However, for asymmetric bending tasks, when the SPMWS was placed on the chest, its readings were substantially different from those of the MPMWS worn on the chest or under the armpit.

Estimation of Muscle Contraction Forces and Joint Reaction Forces at the Low Back and Shoulder during Drywall Installation

Construction workers performing drywall installation are exposed to a variety of ergonomic hazards, including heavy material handling, repetitive motions and awkward postures. The rates of musculoskeletal injuries and disorders among drywall installers are very high, especially at the low back and shoulder. The unique characteristics of the work environment in the construction industry do not allow for applying objective ergonomic assessment instruments. Thus, biomechanical models and computer simulations were combined for a more comprehensive evaluation of ergonomic hazards. Utilizing Monte-Carlo simulation to generate the input for biomechanical models based on information from PATH (Posture, Activity, Tools, and Handling), a work-sampling based approach, the present study estimated the required muscle contraction forces and joint reaction forces at the low back and shoulder during a simulated 8-hour drywall installation workday. The results of this study also provided a database for future evaluations of ergonomic interventions on drywall installation work.

Body-fixed Orientation Sensors for Trunk Motion Sensing

Awkward trunk postures and dynamic trunk movements are associated with increased risk of low back disorders (LBDs). Recent advancements in computing and micro-electromechanical systems (MEMS) technology have resulted in high precision, compact, and relatively inexpensive commercial orientation sensors that address the workplace usage limitations of the most common kinematics measurement methods (video analysis, magnetic field sensors, and electrogoniometers). The purpose of this study is to review the available body-fixed orientation sensing technology for its use in ergonomics research and practice. A laboratory study of a custom MEMS accelerometer-based inclinometer highlights issues of axial orientation, vibration, and non-gravitational acceleration that affect orientation results from basic inclinometers. Techniques are presented for correcting for such issues in advanced sensors using computational methods and combinations of MEMS accelerometers, gyroscopes, and/or magnetometers. Body-fixed orientation sensors provide enhanced opportunities to identify and reduce harmful work postures that may reduce the prevalence and severity of work-related musculoskeletal disorders (WMSDs).

Toward Unobtrusive Patient Handling Activity Recognition for Injury Reduction Among At-Risk Caregivers

Nurses regularly perform patient handling activities. These activities with awkward postures expose healthcare providers to a high risk of overexertion injury. The recognition of patient handling activities is the first step to reduce injury risk for caregivers. The current practice on workplace activity recognition is based on human observational approach, which is neither accurate nor projectable to a large population. In this paper, we aim at addressing these challenges. Our solution comprises a smart wearable device and a novel spatio-temporal warping (STW) pattern recognition framework. The wearable device, named Smart Insole 2.0, is equipped with a rich set of sensors and can provide an unobtrusive way to automatically capture the information of patient handling activities. The STW pattern recognition framework fully exploits the spatial and temporal characteristics of plantar pressure by calculating a novel warped spatio-temporal distance, to quantify the similarity for the purpose of activity recognition. To validate the effectiveness of our framework, we perform a pilot study with eight subjects, including eight common activities in a nursing room. The experimental results show the overall classification accuracy achieves 91.7%. Meanwhile, the qualitative profile and load level can also be classified with accuracies of 98.3% and 92.5%, respectively.

Accuracy and repeatability of an inertial measurement unit system for field-based occupational studies

The accuracy and repeatability of an inertial measurement unit (IMU) system for directly measuring trunk angular displacement and upper arm elevation were evaluated over eight hours (i) in comparison to a gold standard, optical motion capture (OMC) system in a laboratory setting, and (ii) during a field-based assessment of dairy parlour work. Sample-to-sample root mean square differences between the IMU and OMC system ranged from 4.1° to 6.6° for the trunk and 7.2°-12.1° for the upper arm depending on the processing method. Estimates of mean angular displacement and angular displacement variation (difference between the 90th and 10th percentiles of angular displacement) were observed to change <4.5° on average in the laboratory and <1.5° on average in the field per eight hours of data collection. Results suggest the IMU system may serve as an acceptable instrument for directly measuring trunk and upper arm postures in field-based occupational exposure assessment studies with long sampling durations. Practitioner Summary: Few studies have evaluated inertial measurement unit (IMU) systems in the field or over long sampling durations. Results of this study indicate that the IMU system evaluated has reasonably good accuracy and repeatability for use in a field setting over a long sampling duration.

An integrated biomechanical modeling approach to the ergonomic evaluation of drywall installation

Three different methodologies: work sampling, computer simulation and biomechanical modeling, were integrated to study the physical demands of drywall installation. PATH (Posture, Activity, Tools, and Handling), a work-sampling based method, was used to quantify the percent of time that the drywall installers were conducting different activities with different body segment (trunk, arm, and leg) postures. Utilizing Monte-Carlo simulation to convert the categorical PATH data into continuous variables as inputs for the biomechanical models, the required muscle contraction forces and joint reaction forces at the low back (L4/L5) and shoulder (glenohumeral and sternoclavicular joints) were estimated for a typical eight-hour workday. To demonstrate the robustness of this modeling approach, a sensitivity analysis was conducted to examine the impact of some quantitative assumptions that have been made to facilitate the modeling approach. The results indicated that the modeling approach seemed to be the most sensitive to both the distribution of work cycles for a typical eight-hour workday and the distribution and values of Euler angles that are used to determine the "shoulder rhythm." Other assumptions including the distribution of trunk postures did not appear to have a significant impact on the model outputs. It was concluded that the integrated approach might provide an applicable examination of physical loads during the non-routine construction work, especially for those operations/tasks that have certain patterns/sequences for the workers to follow.

A comparison of instrumentation methods to estimate thoracolumbar motion in field-based occupational studies

The performance of an inertial measurement unit (IMU) system for directly measuring thoracolumbar trunk motion was compared to that of the Lumbar Motion Monitor (LMM). Thirty-six male participants completed a simulated material handling task with both systems deployed simultaneously. Estimates of thoracolumbar trunk motion obtained with the IMU system were processed using five common methods for estimating trunk motion characteristics. Results of measurements obtained from IMUs secured to the sternum and pelvis had smaller root-mean-square differences and mean bias estimates in comparison to results obtained with the LMM than results of measurements obtained solely from a sternum mounted IMU. Fusion of IMU accelerometer measurements with IMU gyroscope and/or magnetometer measurements was observed to increase comparability to the LMM. Results suggest investigators should consider computing thoracolumbar trunk motion as a function of estimates from multiple IMUs using fusion algorithms rather than using a single accelerometer secured to the sternum in field-based studies.

Using Kinect™ sensor in observational methods for assessing postures at work

This paper examines the potential use of Kinect™ range sensor in observational methods for assessing postural loads. Range sensors can detect the position of the joints at high sampling rates without attaching sensors or markers directly to the subject under study. First, a computerized OWAS ergonomic assessment system was implemented to permit the data acquisition from Kinect™ and data processing in order to identify the risk level of each recorded postures. Output data were compared with the results provided by human observers, and were used to determine the influence of the sensor view angle relative to the worker. The tests show high inter-method agreement in the classification of risk categories (Proportion agreement index = 0.89 κ = 0.83) when the tracked subject is facing the sensor. The camera's point of view relative to the position of the tracked subject significantly affects the correct classification of the postures. Although the results are promising, some aspects involved in the use of low-cost range sensors should be further studied for their use in real environments.

A physical workload index to evaluate a safe resident handling program for nursing home personnel

OBJECTIVE

The aim of this study was to obtain a comprehensive analysis of the physical workload of clinical staff in long-term care facilities, before and after a safe resident handling program (SRHP).

BACKGROUND

Ergonomic exposures of health care workers include manual handling of patients and many non-neutral postures. A comprehensive assessment requires the integration of loads from these varied exposures into a single metric.

METHOD

The Postures, Activities, Tools, and Handling observational protocol, customized for health care, was used for direct observations of ergonomic exposures in clinical jobs at 12 nursing homes before the SRHP and 3, 12, 24, and 36 months afterward. Average compressive forces on the spine were estimated for observed combinations of body postures and manual handling and then weighted by frequencies of observed time for the combination. These values were summed to obtain a biomechanical index for nursing assistants and nurses across observation periods.

RESULTS

The physical workload index (PWI) was much higher for nursing assistants than for nurses and decreased more after 3 years (-24% versus -2.5%). Specifically during resident handling, the PWI for nursing assistants decreased by 41% of baseline value.

CONCLUSION

Spinal loading was higher for nursing assistants than for nurses in long-term care centers. Both job groups experienced reductions in physical loading from the SRHP, especially the nursing assistants and especially while resident handling.

APPLICATION

The PWI facilitates a comprehensive investigation of physical loading from both manual handling and non-neutral postures. It can be used in any work setting to identify high-risk tasks and determine whether reductions in one exposure are offset by increases in another.

Statistical performance of observational work sampling for assessment of categorical exposure variables: a simulation approach illustrated using PATH data

Objectives:

Observational work sampling is often used in occupational studies to assess categorical biomechanical exposures and occurrence of specific work tasks. The statistical performance of data obtained by work sampling is, however, not well understood, impeding informed measurement strategy design. The purpose of this study was to develop a procedure for assessing the statistical properties of work sampling strategies evaluating categorical exposure variables and to illustrate the usefulness of this procedure to examine bias and precision of exposure estimates from samples of different sizes.

Methods:

From a parent data set of observations on 10 construction workers performing a single operation, the probabilities were determined for each worker of performing four component tasks and working in four mutually exclusive trunk posture categories (neutral, mild flexion, severe flexion, twisted). Using these probabilities, 5000 simulated data sets were created via probability-based resampling for each of six sampling strategies, ranging from 300 to 4500 observations. For each strategy, mean exposure and exposure variability metrics were calculated at both the operation level and task level and for each metric, bias and precision were assessed across the 5000 simulations.

Results:

Estimates of exposure variability were substantially more uncertain at all sample sizes than estimates of mean exposures and task proportions. Estimates at small sample sizes were also biased. With only 600 samples, proportions of the different tasks and of working with a neutral trunk posture (the most common) were within 10% of the true target value in at least 80% of all the simulated data sets; rarer exposures required at least 1500 samples. For most task-level mean exposure variables and for all operation-level and task-level estimates of exposure variability, performance was low, even with 4500 samples. In general, the precision of mean exposure estimates did not depend on the exposure variability between workers.

Conclusions:

The suggested probability-based simulation approach proved to be versatile and generally suitable for assessing bias and precision of data collection strategies using work sampling to estimate categorical data. The approach can be used in both real and hypothetical scenarios, in ergonomics, as well as in other areas of occupational epidemiology and intervention research. The reported statistical properties associated with sample size are likely widely relevant to studies using work sampling to assess categorical variables.

Automated video exposure assessment of repetitive hand activity level for a load transfer task

OBJECTIVE

A new method is described for automatically quantifying repetitive hand activity with the use of digital video processing.

BACKGROUND

The hand activity level (HAL) is widely used for evaluating repetitive hand work. Conventional methods involving either a trained observer on- or off-site or manual off-site video analysis are often considered inaccurate, cumbersome, or impractical for routine work assessment

METHOD

A cross-correlation-based template-matching algorithm was programmed to track the motion trajectory of a selected region of interest across successive video frames for a single camera to measure repetition frequency, duty cycle, and HAL. A simple, paced, load transfer task was used to simulate a repetitive industrial activity. A total of 12 participants were videoed performing the task for varying HAL conditions. The automatically predicted HAL was compared with the manually measured HAL with the use of frame-by-frame video analysis.

RESULTS

Predicted frequency, duty cycle, and HAL were in concert with the manually measured HAL conditions. The linear regression slopes of the automatically predicted values with respect to the manually measured values were 0.98 (R2 = .79), 1.27 (R2 = .63), and 1.06 (R2 = .77) for frequency, duty cycle, and HAL, respectively.

CONCLUSION

A proof-of-concept for automatic video-based direct exposure assessment was demonstrated.

APPLICATION

The video assessment method for repetitive motion is promising for automatic, unobtrusive, and objective exposure assessment, which may offer broad availability with the use of a camera-enabled mobile device for helping evaluate, prevent, and control exposure to repetitive motions related to upper-extremity injuries in the workplace.

Occupational posture exposure among construction electricians

The aim of this study is to record, objectively describe and compare working postures of Brazilian and Norwegian construction electricians. Postures of the upper arms, head, and neck during work and breaks were quantified by means of inclinometry for a representative sample of 12 Brazilian and 12 Norwegian electricians in the construction industry during a full work-shift. Despite that differences were found between specific work-related factors, Brazilian and Norwegian workers revealed a high and very similar level and pattern of postures for all evaluated body regions, suggesting that results could be extrapolated to other electricians. Upper arm elevation was high and similar for both groups and head flexion and extension was pronounced compared to other occupations. Thus, extreme postures were identified for construction electricians in both countries, with similar exposure pattern also for defined tasks (planning, support and wiredraw), suggesting that this job is risky regardless organizational differences.

Changes in ergonomic exposures of nursing assistants after the introduction of a safe resident handling program in nursing homes

We evaluated the effect of a nursing home safe resident handling intervention on the ergonomic exposures of nursing assistants. The healthcare version of the Postures, Activities, Tools and Handling (PATH) method was used by 12 observers to examine postures, manual handling, and resident handling pre-intervention and at three months, 12 months, 24 months, and 36 months post-intervention. There were marked downward trends in proportion of work time spent repositioning and transferring residents, and an increased use of handling equipment in transferring (Cochran-Armitage tests: all p-values <0.001). While resident handling, nursing assistants were also more likely post-intervention to be in neutral trunk postures, walking rather than standing still, working with both arms below 60°, and less likely to lift loads greater than 22.7 kg. Lateral transfer devices were infrequently observed in use for repositioning; additional training on the use of this equipment is recommended to increase the benefits from the intervention program.

RELEVANCE TO INDUSTRY

The study describes reductions in postural and manual handling loads of nursing assistants in nursing homes resulting from increased use of resident handling equipment following equipment installation with training and administrative support.

An ergonomic assessment of the long handle blueberry harvesting rake

BACKGROUND

Previous work shows the superiority of the long-handled blueberry harvesting rake (LHR) for worker preference and productivity compared to the short-handle rake (SHR).

METHODS

Post-shift interviews on occurrence, location, and severity of pain, and video-based observation of body postures enabled ergonomic assessment of Maine workers harvesting blueberries. Workers randomly crossed between LHR and SHR on consecutive work days. Wilcoxon tests compared proportions of specific body postures between LHR and SHR.

RESULTS

Subjects used SHR for shorter work periods than LHR. Thirty workers provided interviews for both one LHR and one SHR shift. Assessment of these matched pairs suggested a trend toward less frequent overall pain (P = 0.07) and back pain (P = 0.11) with the LHR versus the SHR. Video tape analysis included 17 sets of observations (8 SHR and 9 LHR) on 12 individuals. Posture assessment showed more severe forward bend and squatting with the SHR and more moderate/neutral postures with the LHR.

CONCLUSION

Harvesting with the traditional SHR is likely to be associated with increased frequency of pain in general, and mid-low back pain in particular, when compared to the newer LHR. This may well relate to the work postures associated with each rake. Periodicals, Inc.

In search of a representative sample of residential building work

Most research investigating injuries in construction work is limited by reliance on work samples unrepresentative of the multiple, variable-cycle tasks involved, resulting in incomplete characterisation of ergonomic exposures. In this case study, a participatory approach was used including hierarchical task analysis and site observations of a typical team of house builders in New Zealand, over several working days, to obtain a representative work sample. The builders' work consisted of 14 goal-defined jobs using varying subsets of 15 task types, each taking from less than 1 s to more than 1 h and performed in a variety of postures. Task type and duration varied within and between participants and days, although all participants spent at least 25% of the time moving from place to place, mostly carrying materials, and more than half the time either reaching up or bending down to work. This research has provided a description of residential building work based on a work sample more nearly representative than those previously published and has demonstrated a simple, low-cost but robust field observation method that can provide a valid basis for further study of hazard exposures.

Wrist activity monitor counts are correlated with dynamic but not static assessments of arm elevation exposure made with a triaxial accelerometer

There is evidence in the literature of a link between workplace arm elevation exposure and atraumatic shoulder injuries. However, there are several methods that can be used to assess this exposure. The goal of the present study was to compare the outcomes of an activity monitor attached to the wrist and a triaxial accelerometer mounted on the humerus. Twenty-one workers wore both sensors over the course of a full workday. While the activity monitor data was not significantly correlated with any static humeral parameters, it was strongly correlated with all dynamic parameters. The use of a simple, commercially available activity monitor might offer an inexpensive alternative for the assessment of a large number of subjects over multiple workdays to determine the relationship between dynamic motion and occupation shoulder injuries in the future.

PRACTITIONER SUMMARY

Arm overuse has been linked to occupation-related shoulder injuries. An activity monitor attached to the wrist and a triaxial accelerometer mounted on the humerus were compared in a field trial. The results demonstrate that, under certain conditions, a commercially available activity monitor might be a useful tool for exposure assessment.

Comparison of biomechanical loading during use of conventional stud welding equipment and an alternate system

We investigated the effect of an alternative welding system designed to reduce exposure to extreme trunk flexion on measures of trunk inclination and muscle activity. Among 10 participants, data were collected while using conventional stud welding equipment and while using the alternate system. Paired t-tests were used to compare results between the two welding systems. Mean trunk inclination angle was reduced with the alternate system (34.4° versus 9.7°, p < 0.01). Percent time with trunk inclination angles greater than 60° was also reduced (40.0% versus 4.7%, p < 0.01). In general, the alternate system resulted in less desirable upper trapezius muscle activity levels. The alternate system appears to be effective in reducing exposure to extreme trunk flexion among stud welders. Continued development of the system should explore features designed to reduce shoulder forces and improve productivity.

Physical ergonomic hazards in highway tunnel construction: overview from the Construction Occupational Health Program

This report provides an overview of physical ergonomic exposures in highway construction work across trades and major operations. For each operation, the observational method "PATH" (Posture, Activity, Tools and Handling) was used to estimate the percentage of time that workers spent in specific tasks and with exposure to awkward postures and load handling. The observations were carried out on 73 different days, typically for about 4 h per day, covering 120 construction workers in 5 different trades: laborers, carpenters, ironworkers, plasterers, and tilers. Non-neutral trunk postures (forward or sideways flexion or twisting) were frequently observed, representing over 40% of observations for all trades except laborers (28%). Kneeling and squatting were common in all operations, especially tiling and underground utility relocation work. Handling loads was frequent, especially for plasterers and tilers, with a range of load weights but most often under 15 pounds. The results of this study provide quantitative evidence that workers in highway tunnel construction operations are exposed to ergonomic factors known to present significant health hazards. Numerous opportunities exist for the development and implementation of ergonomic interventions to protect the health and safety of construction workers.

The reliability of side to side measurements of upper extremity activity levels in healthy subjects

Background

In both clinical and occupational settings, ambulatory sensors are becoming common for assessing all day measurements of arm motion. In order for the motion of a healthy, contralateral side to be used as a control for the involved side, the inherent side to side differences in arm usage must be minimal. The goal of the present study was to determine the reliability of side to side measurements of upper extremity activity levels in healthy subjects.

Methods

Thirty two subjects with no upper extremity pathologies were studied. Each subject wore a triaxial accelerometer on both arms for three and a half hours. Motion was assessed using parameters previously reported in the literature. Side to side differences were compared with the intraclass correlation coefficient, standard error of the mean, minimal detectable change scores and a projected sample size analysis.

Results

The variables were ranked based on their percentage of minimal detectable change scores and sample sizes needed for paired t-tests. The order of these rankings was found to be identical and the top ranked parameters were activity counts per hour (MDC% = 9.5, n = 5), jerk time (MDC% = 15.8, n = 8) and percent time above 30 degrees (MDC% = 34.7, n = 9).

Conclusions

In general, the mean activity levels during daily activities were very similar between dominant and non-dominant arms. Specifically, activity counts per hour, jerk time, and percent time above 30 degrees were found to be the variables most likely to reveal significant difference or changes in both individuals and groups of subjects. The use of ambulatory measurements of upper extremity activity has very broad uses for occupational assessments, musculoskeletal injuries of the shoulder, elbow, wrist and hand as well as neurological pathologies.

Inter-rater reliability of PATH observations for assessment of ergonomic risk factors in hospital work

This study examined the inter-rater reliability of expert observations of ergonomic risk factors by four analysts. Ten jobs were observed at a hospital using a newly expanded version of the PATH method (Buchholz et al. 1996), to which selected upper extremity exposures had been added. Two of the four raters simultaneously observed each worker onsite for a total of 443 observation pairs containing 18 categorical exposure items each. For most exposure items, kappa coefficients were 0.4 or higher. For some items, agreement was higher both for the jobs with less rapid hand activity and for the analysts with a higher level of ergonomic job analysis experience. These upper extremity exposures could be characterised reliably with real-time observation, given adequate experience and training of the observers. The revised version of PATH is applicable to the analysis of jobs where upper extremity musculoskeletal strain is of concern.

Relationships between observational estimates and physical measurements of upper limb activity

This study examined the internal validity of observational-based ergonomic job analysis methods for assessing upper limb force exertion and repetitive motion. Six manual tasks were performed by multiple 'workers' while direct measurements were made to quantify force exertion and kinematics of the upper limb. Observational-based analyses of force and upper limb motion/repetition were conducted by 29 professional ergonomists. These analysts overestimated the magnitude of individual force exertions - temporal aspects of force exertion (duty cycle) were estimated more accurately. Estimates of the relative severity of repetitive motions among the jobs were accurate. Absolute counts of repetitive motions were less accurate. Modest correlations (r(2) = 0.28 to r(2) = 0.50) were observed between ratings of hand activity level and measured joint velocities. Ergonomic job analyses relying on systematic observation should be applied and interpreted with consideration given to the capabilities and limitations of analysts in estimating the physical risk factors. These findings are relevant to a better understanding of the internal validity of ergonomic job analysis methods based on systematic observation.

Development and evaluation of an observational Back-Exposure Sampling Tool (Back-EST) for work-related back injury risk factors

We developed and evaluated an observational Back-Exposure Sampling Tool. A literature review suggested 53 exposure variables; these were reduced to 20 following field trials. Kappas for agreement beyond chance between six observers assessing exposures in 72 photos ranged from 0.21 to 1.0, with the highest values for posture type, trunk angle, manual materials handling, hands on item, and load weight. Intraclass correlations for agreement between pairs observing 17 workers once per minute for a full-shift were >0.74 for most postural, trunk angle, and manual materials handling variables. In validity testing, the proportions of shifts in flexion/extension and lateral bending observed for 169 full-shifts were compared to inclinometer measurements. Pearson correlations were 0.42 for 45-60 degrees flexion and 0.9 for >60 degrees flexion, but only 0.11-0.19 for lateral bending and trunk flexion less than 45 degrees . When lower flexion angles were collapsed to include trunk extension, correlations increased to >0.5.

The association between back pain and trunk posture of workers in a special school for the severe handicaps

Background

The present study aims to determine the time spent in different static trunk postures during a typical working day of workers in a special school for the severe handicaps.

Methods

Eighteen workers with low back pain (LBP) and fifteen asymptomatic workers were recruited. A cross-sectional design was employed to study the time spent in different static trunk postures which was recorded by a biaxial accelerometer attached to the T₁₂ level of the back of the subjects.

Results

The results of ANCOVA revealed that subjects with LBP spent significantly longer percentage of time in static trunk posture when compared to normal (p < 0.05). It was also shown that they spent significantly longer time in trunk flexion for more than 10° (p < 0.0125).

Conclusion

An innovative method has been developed for continuous tracking of spinal posture, and this has potential for widespread applications in the workplace. The findings of the present investigation suggest that teachers in special schools are at increased risk of getting LBP. In order to minimise such risk, frequent postural change and awareness of work posture are recommended.

Variability in risk factors for knee injury in construction

This study investigated sources of variance in exposure to risk factors for knee pain in a variety of highway construction trades, operations, and tasks. Over 15,000 discrete observations of leg postures and weights handled were made on 120 construction workers in five construction trades, in nine operations over 79 days. The contributions of trade, operation, task, and worker to the variability in work time spent kneeling, squatting, and carrying loads were evaluated with multilevel random effects models. Construction operation and task explained about 20% to 30% of total variation in kneeling, squatting, and carrying loads. There was a large unexplained component of variance thought to represent day-to-day variability of exposure within task. Reliable assessments of knee exposures require multiple days to accommodate the high variability of exposures among operations and tasks and over time. These sources of variability should be carefully considered in efforts to estimate exposures to knee loading for epidemiologic or intervention studies. Homogenous exposure groups are not easily defined from the readily available organizational features of construction work.

Evaluating ergonomic stresses in North Carolina commercial crab pot and gill net fishermen

There are challenges in evaluating physical demands of commercial fishing, including identifying sources of exposure variability. Low back biomechanical stresses associated with crab pot and gill net fishing were estimated; the variability was partitioned between and within fishing type, crew size, job title, and worker to improve understanding of risk factors for low back injury. The authors observed 162 person-hours of work among 25 North Carolina commercial fishermen on 16 crews. Postures and forces during fishing tasks were measured through direct and indirect observation using two methods to determine the percentage of time fishermen were exposed to high levels of low back stress. A multilevel linear model estimated exposure variability for the dependent variables by four nesting variables: fishing type, crew size, job title, and worker. Fishermen set and pulled crab pots or gill nets for 80% of the workday. Twenty-five percent of that time was spent handling gear. For both fishing types, handling heavy loads produced high peak compression values (3586 N to 5315 N) and high NIOSH lifting index values (3.3 to 5.4), but these tasks represent a small percentage of the overall work time (0 to 14%). The majority of exposure variation in non-neutral trunk posture and/or force > 9 kg, handling materials, NIOSH Lifting Index > 1, and Lumbar Motion Monitor probability of high-risk group membership > 70% was accounted for by fishing type (range 60 to 91%). Crew size was not an important source of variability for these six variables when fishing type and job title were accounted for in the model; but in the model restricted to crab pot fishing, crew size accounted for 51 to 88% of the variability in low back stress. For both models, job title comprised the majority of exposure variability for NIOSH Lifting Index > 3.0 (46 and 65%) and worker comprised the majority of variability for spine compression > 3400 N (54 and 65%). The magnitude and duration of musculoskeletal loads experienced by fishermen vary by the type of fishing and the tasks performed by the worker. Understanding this variability may help researchers target ergonomic interventions for this work population.

Estimation of compressive forces on lumbar spine from categorical posture data

To combine estimates of trunk posture and force into an integrated measure of load on the low back, continuous variables for body angles were estimated by assuming specified distributions within corresponding posture categories with Monte-Carlo (MC) simulation. The estimated posture angles were compared with reference measurements from the Lumbar Motion Monitor and inclinometers. The lumbar compression estimates, generated from simulated posture angles and from direct measurement, were compared. Trunk flexion showed high correlation between direct measurements and simulated angles, as did L5/S1 compression. The MC approach to extracting continuous posture angles from categorized observations did not appear to introduce large error in the variables used to estimate spinal compressive forces. When instrumentation methods of postural assessment are not feasible, a simulation approach combined with biomechanical modelling could be used to integrate multiple external exposure variables into estimates of compressive forces acting on the low back.

Measuring low back injury risk factors in challenging work environments: an evaluation of cost and feasibility

BACKGROUND

Measuring low back injury risk factors in field research presents challenges not encountered in laboratory environments.

METHODS

We compared the practical application of five measurement methods (observations, interviews, electromyography (EMG), inclinometry, and vibration monitoring) for 223 worker days in 50 heavy-industry worksites in western Canada. Data collection successes, challenges, costs, and data detail were documented for each method.

RESULTS

Measurement success rates varied from 42.2% (seatpan accelerometer) to 99.6% (post-shift interview) of worker days assessed. Missed days for direct monitoring equipment were primarily due to explosive environments, workplace conditions likely to damage the equipment, and malfunctions. Costs per successful measurement day were lowest for interviews (approximately 23 dollars), about 10-fold higher for observations and inclinometry, and more than 20-fold higher for EMG and vibration monitoring.

CONCLUSIONS

Costs and successful field performance need to be weighed against the added data detail gained from monitoring equipment when making choices about exposure assessment techniques for epidemiological studies.

Musculoskeletal problems among workers of an Iranian communication company

Introduction:

Work-related musculoskeletal disorders (WMSDs) are a common health problem throughout the world and a major cause of disability in the workplace. Awkward working posture is a main risk factor for developing WMSDs. Assessment of exposure level to WMSDs risks can be an appropriate base for planning and implementing interventional ergonomics program in the workplace. This study was conducted among workers of an Iranian communication company with the objectives of a) determination of WMSDs prevalence and b) assessment of exposure level to WMSDs risks.

Materials and Methods:

In this cross-sectional study, 85 randomly selected workers from assembly line and closed circuit TV (CCTV) participated. Nordic musculoskeletal questionnaire (NMQ) was used to study prevalence of WMSDs and rapid upper limb assessment (RULA) technique was applied to assess physical exposure to the risks.

Results:

The results of NMQ revealed that WMSDs occurred at an high rate. The highest rates of WMSDs prevalence were reported in shoulders (73%), knees (67.1%) and back (66.7%). RULA showed that the Grand Score of 88.1% of cases were high and very high (action levels 3 and 4). Significant association was found between risk level and musculoskeletal symptoms in lower back (P < 0.05).

Conclusion:

Given the association between RULA score and the prevalence of the problems, reducing RULA score by designing ergonomic workstation may reduce the prevalence of WMSDs among the workers.

Ergonomics of abrasive blasting: a comparison of high pressure water and steel shot

Abrasive blasting with silica sand has long been associated with silicosis. Alternatives to sand are being used increasingly. While NIOSH has done extensive investigations of the respiratory effects of the substitutes for sand, the ergonomic effects of the substitutes have not been examined. Too often, hazards are shifted, and technologies that might save workers' lungs could do so at the expense of their musculoskeletal systems. Hence, the objective of this study was to examine the ergonomic effects of alternatives to sand. Multiple methods, both qualitative and quantitative, were used to yield numerous kinds of data for the analysis of exposures to abrasive blasters. PATH, a method for quantifying ergonomic exposure in non-routine work, was combined with interviews with workers, biomechanical modeling and noise level readings to assess the ergonomics of two abrasive blasting operations: high-pressure water and steel shot. Advantages and disadvantages of each medium are discussed. High-pressure water was slightly less ergonomically stressful, environmentally cleaner, much quieter and less dusty that steel shot, and it was reported to be slower on those tasks where both media could be used.

Measuring the physical demands of work in hospital settings: design and implementation of an ergonomics assessment

BACKGROUND

Assessing the physical demands of the heterogeneous jobs in hospitals requires appropriate and validated assessment methodologies.

METHODS

As part of an integrated assessment, we adapted Rapid Entire Body Assessment (REBA), using it in a work sampling mode facilitated by a hand-held personal digital assistant, expanding it with selected items from the UC Computer Use Checklist, and developed a scoring algorithm for ergonomics risk factors for the upper (UB) and lower body (LB).

RESULTS

The inter-rater reliability kappa was 0.54 for UB and 0.66 for LB. The scoring algorithm demonstrated significant variation (ANOVA p<0.05) by occupation in anticipated directions (administrators ranked lowest; support staff ranked highest on both scores). A supplemental self-assessment measure of spinal loading correlated with high strain LB scores (r=0.30; p<0.001).

CONCLUSION

We developed and validated a scoring algorithm incorporating a revised REBA schema adding computer use items, appropriate for ergonomics assessment across a range of hospital jobs.

Work routinization and implications for ergonomic exposure assessment

Jobs in many modern settings, including manufacturing, service, agriculture and construction, are variable in their content and timing. This prompts the need for exposure assessment methods that do not assume regular work cycles. A scheme is presented for classifying levels of routinization to inform development of an appropriate exposure assessment strategy for a given occupational setting. Five levels of routinization have been defined based on the tasks of which the job is composed: 1) a single scheduled task with a regular work cycle; 2) multiple cyclical tasks; 3) a mix of cyclical and non-cyclical tasks; 4) one non-cyclical task; 5) multiple non-cyclical tasks. This classification, based primarily on job observation, is illustrated through data from a study of automobile manufacturing workers (n = 1200), from which self-assessed exposures to physical and psychosocial stressors were also obtained. In this cohort, decision latitude was greater with higher routinization level (p < 0.0001), and the least routinized jobs showed the lowest self-reported exposure to physical ergonomic stressors. The job analysis checklist developed for non-routinized jobs is presented, and limitations of the task analysis method utilized in the study are discussed. A work sampling approach to job analysis is recommended as the most efficient way to obtain a comparable unbiased exposure estimate across all routinization levels.

Reliable exposure assessment strategies for physical ergonomics stressors in construction and other non-routinized work

The objective of this research was to provide guidelines for the reliable assessment of ergonomics exposures in non-routinized work. Using a discrete-interval observational sampling approach, two or three observers collected a total of 5852 observations on tasks performed by three construction trades (iron workers, carpenters and labourers) for periods of several weeks. For each observation, nine exposure variables associated with awkward body postures, tool use and load handling were recorded. The frequency of exposure to each variable was calculated for each worker during each of the tasks on each of the days. ANOVA was used to assess the importance of task in explaining between-worker and within-worker variability in exposures across days. A statistical re-sampling method (bootstrap) was used to evaluate the reliability of exposure estimates for groups of workers performing the same task for different sampling periods. Most exposures were found to vary significantly across construction tasks within trade, and between-worker exposure variability was generally smaller than within-worker exposure variability within task. Bootstrapping showed that the reliability of the group estimates exposure for the most variable exposures within task tended to improve as the assessment periods approached 5-6 d, with marginal improvements for longer assessment periods. Reliable group estimates of exposure for the least variable exposures within task were obtained with 1 or 2 d of observation. The results of this study demonstrate that an initial estimate of the important environmental or task sources of exposure variability can be used to develop an efficient sampling strategy that provides reliable estimates of ergonomics exposures during non-routinized work.

Task based exposure assessment in ergonomic epidemiology: a study of upper arm elevation in the jobs of machinists, car mechanics, and house painters

AIMS

To explore the precision of task based estimates of upper arm elevation in three occupational groups, compared to direct measurements of job exposure.

METHODS

Male machinists (n = 26), car mechanics (n = 23), and house painters (n = 23) were studied. Whole day recordings of upper arm elevation were obtained for four consecutive working days, and associated task information was collected in diaries. For each individual, task based estimates of job exposure were calculated by weighting task exposures from a collective database by task proportions according to the diaries. These estimates were validated against directly measured job exposures using linear regression. The performance of the task based approach was expressed through the gain in precision of occupational group mean exposures that could be obtained by adding subjects with task based estimates to a group of subjects with measured job exposures in a "validation" design.

RESULTS

In all three occupations, tasks differed in mean exposure, and task proportions varied between individuals. Task based estimation proved inefficient, with squared correlation coefficients only occasionally exceeding 0.2 for the relation between task based and measured job exposures. Consequently, it was not possible to substantially improve the precision of an estimated group mean by including subjects whose job exposures were based on task information.

CONCLUSIONS

Task based estimates of mechanical job exposure can be very imprecise, and only marginally better than estimates based on occupation. It is recommended that investigators in ergonomic epidemiology consider the prospects of task based exposure assessment carefully before placing resources at obtaining task information. Strategies disregarding tasks may be preferable in many cases.

Work above shoulder level and degenerative alterations of the rotator cuff tendons: A magnetic resonance imaging study

OBJECTIVE

To determine whether work performed with the arms in a highly elevated position is associated with alterations in the rotator cuff tendons as assessed by magnetic resonance imaging (MRI).

METHODS

A cross-sectional study was performed in a historical cohort of male machinists, car mechanics, and house painters. The participants were right-handed, ages 40-50 years, and had been employed in their trades for not less than 10 years. Seventy-one percent of invited subjects participated (136 of 192). Lifetime upper arm elevation was assessed by direct measurements combined with individual work histories obtained by questionnaire and from registry data. Supraspinatus tendinopathy was evidenced by MRI signal intensity changes and morphologic alterations. Infraspinatus and subscapularis tendinopathy were also assessed. Additional outcomes were acromioclavicular joint degeneration and humeral head cysts. The MRI findings were evaluated by radiologists who were blinded to exposure status and symptoms.

RESULTS

An exposure-response relationship was found between lifetime upper arm elevation and supraspinatus tendinopathy, with an age-adjusted odds ratio of 1.27 (95% confidence interval 1.02-1.60) for a 5-month increase in the total number of full-time working months spent with the arm elevated >90 degrees .

CONCLUSION

Work with the arms in a highly elevated position is associated with MRI-diagnosed alterations in the supraspinatus tendon. By demonstrating the first part of a possible biologic pathway, the study corroborates the work-relatedness of rotator cuff disorders.

Accuracy and validity of observational estimates of shoulder and elbow posture

This study investigated the accuracy of video-based observational posture analysis for the elbow and shoulder. Posture analyses were conducted by 28 ergonomists for four jobs presented on a traditional VHS format video recording. Estimates of posture from the observational-based methods were compared with values measured directly with an optical motion capture system. Ergonomists used categorical posture scales and a continuous visual analog scale to estimate the peak and most frequently occurring or average posture for each job. Use of a three-category scale resulted in misclassifications of peak and most frequently occurring elbow and shoulder posture with a probability averaging 30.1%. With the six-category posture scale this average probability of misclassification increased to 64.9%. Using a continuous visual analog scale peak shoulder elevation was the only posture for which the average error among ergonomists' estimates was significantly different from zero (p<0.05). Correlations between the estimated postures and measured postures were higher and statistically significant (p<0.05) for elbow flexion and shoulder elevation (r2 between 0.45 and 0.66) but were considerably lower and not significant (r2 between 0.03 and 0.18) for the peak and average horizontal shoulder abduction. Ergonomists' estimates of the temporal distribution of shoulder posture, indicating the duration severity of the posture, appeared to be biased such that the percentage of the cycle time in each posture category was estimated as more uniformly distributed than the measured values indicated.