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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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Petersen JA, Lund CB, Flachs EM, Petersen R, Mikkelsen S, Thomsen JF. Validity of an expert-based job exposure matrix of hand-wrist physical exposures and their prospective associations with carpal tunnel syndrome. Am J Ind Med 2024. [PMID: 39187745 DOI: 10.1002/ajim.23651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 08/07/2024] [Accepted: 08/14/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Epidemiological studies of occupational risk factors for rare disorders require large study populations with adequate exposure estimates. Job exposure matrices (JEMs) linked to national information on standardized job titles may enable such large studies. We aimed to establish and validate a JEM for occupational hand-wrist exposures that could be linked to Danish national register data on job titles and hand-wrist disorders. METHODS We developed a JEM for hand-wrist repetition, force, vibration, and computer work in 96 job groups covering 91% of the 2227 occupational titles in the Danish version of the International Standard Classification of Occupation-88, and examined inter-rater reliability of five expert ratings. Poisson regression models were used to estimate incidence rate ratios for the association of carpal tunnel syndrome (CTS) with the level of repetitive movements, force, vibration, and hours of computer work described by the JEM, adjusted for relevant confounders. RESULTS The JEM based on expert ratings had fair to good interrater reliability. The incidence of CTS increased with increasing levels of force, hand-wrist repetition, and vibration, Exposure-response patterns for repetition and vibration became less consistent after adjustment for force. The interaction between repetition and force was complex and did not support an overall positive interaction. Computer work was negatively associated with incident CTS. CONCLUSION The JEM was able to identify known risk factors for CTS consistent with current evidence, and provided further associations on exposure-response patterns, mutual exposure adjustment, and interaction effects between repetition and force. The reliability of expert assessments of hand-wrist physical exposures was fair to good.
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Affiliation(s)
| | - Christina Bach Lund
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Rolf Petersen
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Sigurd Mikkelsen
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Jane Frølund Thomsen
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
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Macdonald WA, Oakman J. Changes needed to reduce risk of musculoskeletal disorders. Am J Ind Med 2024; 67:575-581. [PMID: 38752696 DOI: 10.1002/ajim.23613] [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] [Received: 12/08/2023] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 06/14/2024]
Abstract
Musculoskeletal disorders (MSDs) are the main contributor to disability levels, which are rising as populations age. Workplace hazard exposures are a major source of this problem, and current workplace risk management practices require substantial changes to tackle it more effectively. Most importantly, the current focus of risk management on "manual handling" tasks must broaden to encompass the whole job. This is necessary because a wide range of psychosocial hazards, most of which operate across the whole job rather than particular tasks, are significant contributors to risk. To ensure that risk-control actions are effective, a recurring risk management cycle that includes worker participation and addresses risk from both biomechanical and psychosocial hazards will be essential. Legislation that mandates workplace management of psychosocial hazards would be helpful. Amendment by regulatory bodies of MSD-related guidance and codes of practice so that they reflect current research evidence would also be helpful in communicating the need for change to workplace stakeholders.
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Affiliation(s)
- Wendy A Macdonald
- School of Psychology and Public Health, Centre for Ergonomics and Human Factors, La Trobe University, Melbourne, Victoria, Australia
| | - Jodi Oakman
- School of Psychology and Public Health, Centre for Ergonomics and Human Factors, La Trobe University, Melbourne, Victoria, Australia
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Lind CM. A Rapid Review on the Effectiveness and Use of Wearable Biofeedback Motion Capture Systems in Ergonomics to Mitigate Adverse Postures and Movements of the Upper Body. SENSORS (BASEL, SWITZERLAND) 2024; 24:3345. [PMID: 38894134 PMCID: PMC11175029 DOI: 10.3390/s24113345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 05/16/2024] [Accepted: 05/19/2024] [Indexed: 06/21/2024]
Abstract
Work-related diseases and disorders remain a significant global health concern, necessitating multifaceted measures for mitigation. One potential measure is work technique training utilizing augmented feedback through wearable motion capture systems. However, there exists a research gap regarding its current effectiveness in both real work environments and controlled settings, as well as its ability to reduce postural exposure and retention effects over short, medium, and long durations. A rapid review was conducted, utilizing two databases and three previous literature reviews to identify relevant studies published within the last twenty years, including recent literature up to the end of 2023. Sixteen studies met the inclusion criteria, of which 14 were of high or moderate quality. These studies were summarized descriptively, and the strength of evidence was assessed. Among the included studies, six were rated as high quality, while eight were considered moderate quality. Notably, the reporting of participation rates, blinding of assessors, and a-priori power calculations were infrequently performed. Four studies were conducted in real work environments, while ten were conducted in controlled settings. Vibration feedback was the most common feedback type utilized (n = 9), followed by auditory (n = 7) and visual feedback (n = 1). All studies employed corrective feedback initiated by the system. In controlled environments, evidence regarding the effectiveness of augmented feedback from wearable motion capture systems to reduce postural exposure ranged from strong evidence to no evidence, depending on the time elapsed after feedback administration. Conversely, for studies conducted in real work environments, the evidence ranged from very limited evidence to no evidence. Future reach needs are identified and discussed.
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Affiliation(s)
- Carl M Lind
- IMM Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
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5
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Fan X, Yang L, Young N, Kaner I, Kjellman M, Forsman M. Ergonomics and performance of using prismatic loupes in simulated surgical tasks among surgeons - a randomized controlled, cross-over trial. Front Public Health 2024; 11:1257365. [PMID: 38264242 PMCID: PMC10803506 DOI: 10.3389/fpubh.2023.1257365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/26/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction Recently developed prismatic loupes may mitigate the high physical workload and risk of neck disorders associated with traditional surgical loupes among surgeons. However, research in this area, particularly among surgeons, is sparse. This study examines the impact of prismatic loupes on surgeons' physical workload, musculoskeletal discomfort, and performance during simulated surgical tasks. Materials and methods Nineteen out of twenty recruited surgeons performed three tasks in a fixed-order with their own loupes and both low-tilt (LT) and high-tilt (HT) prismatic loupes, in a randomized order. The primary outcomes were the median inclination angles and velocities of the head, trunk, and upper arms, along with the median muscle activity of the cervical erector spinae (CES), upper trapezius (UT), and lumbar erector spinae (LES) for each pair of loupes. The secondary outcomes included performance (completion time and errors), perceived body-part discomfort, and subjective evaluation of the three pairs of loupes. Results Using prismatic loupes, either LT or HT, compared with the surgeons' own loupes yielded lower head inclinations (all p < 0.001), lower neck muscle activity (all p < 0.05), and lower neck discomfort in indirect comparisons (p < 0.01) with no significant difference in surgical errors (p = 0.628). However, HT loupes resulted in a longer task completion time in two tasks (p < 0.001). Most surgeons preferred LT loupes (N = 12) for their comfort and visual functions. Discussion The results indicate that prismatic loupes can reduce physical workload in the neck during simulated surgical task, with no significant difference in surgical errors. Future studies are needed to investigate the long-term effects of prismatic loupes among surgeons.
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Affiliation(s)
- Xuelong Fan
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Liyun Yang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nathalie Young
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Ilayda Kaner
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Kjellman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Forsman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), KTH Royal Institute of Technology, Huddinge, Sweden
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Langenskiöld C, Berg A, Yang L. The Effect of Corrective and Encouraging Accumulated Vibrotactile Feedback on Work Technique Training and Motivation-A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6741. [PMID: 37754601 PMCID: PMC10531452 DOI: 10.3390/ijerph20186741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023]
Abstract
Encouraging feedback is shown to increase motivation and facilitate learning in different settings, though there is a lack of knowledge of applying it in work technique training. This pilot study aimed to evaluate two accumulated vibrotactile feedback strategies for work technique training using a smart workwear system. Eight women and two men participated in the study. They were divided into two groups, receiving the corrective feedback or the combined corrective and encouraging feedback while doing simulated manual handling tasks in a lab environment. Questionnaires and semi-structured interviews were used to evaluate the motivation, learning, and user experiences. In this small sample size, we saw that both groups significantly improved their work technique of upper arm and trunk postures, and no significant difference between groups was seen. In addition, both groups reported increased ergonomic awareness, were satisfied with the feedback training, and considered the system useful. However, the combined feedback group had slightly lower ratings of motivation and more negative experiences of the corrective feedback itself compared to the corrective feedback group. Both groups had positive experiences with the encouraging feedback. Future research should consider investigating the long-term learning effects of using solely corrective or encouraging accumulated feedback for work technique training with such systems.
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Affiliation(s)
- Charlotta Langenskiöld
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, SE-113 65 Stockholm, Sweden
| | - Annelie Berg
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, SE-113 65 Stockholm, Sweden
| | - Liyun Yang
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, SE-113 65 Stockholm, Sweden
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57 Huddinge, Sweden
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Dahlgren G, Liv P, Öhberg F, Slunga Järvholm L, Forsman M, Rehn B. Correlations between Ratings and Technical Measurements in Hand-Intensive Work. Bioengineering (Basel) 2023; 10:867. [PMID: 37508893 PMCID: PMC10376394 DOI: 10.3390/bioengineering10070867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/11/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
An accurate rating of hand activity and force is essential in risk assessment and for the effective prevention of work-related musculoskeletal disorders. However, it is unclear whether the subjective ratings of workers and observers correlate to corresponding objective technical measures of exposure. Fifty-nine workers were video recorded while performing a hand-intensive work task at their workplace. Self-ratings of hand activity level (HAL) and force (Borg CR10) using the Hand Activity Threshold Limit Value® were assessed. Four ergonomist observers, in two pairs, also rated the hand activity and force level for each worker from video recordings. Wrist angular velocity was measured using inertial movement units. Muscle activity in the forearm muscles flexor carpi radialis (FCR) and extensor carpi radialis (ECR) was measured with electromyography root mean square values (RMS) and normalized to maximal voluntary electrical activation (MVE). Kendall's tau-b correlations were statistically significant between self-rated hand activity and wrist angular velocity at the 10th, 50th, and 90th percentiles (0.26, 0.31, and 0.23) and for the ratings of observers (0.32, 0.41, and 0.34). Significant correlations for force measures were found only for observer-ratings in five of eight measures (FCR 50th percentile 0.29, time > 10%MVE 0.43, time > 30%MVE 0.44, time < 5% -0.47) and ECR (time > 30%MVE 0.26). The higher magnitude of correlation for observer-ratings suggests that they may be preferred to the self-ratings of workers. When possible, objective technical measures of wrist angular velocity and muscle activity should be preferred to subjective ratings when assessing risks of work-related musculoskeletal disorders.
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Affiliation(s)
- Gunilla Dahlgren
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, S-901 87 Umeå, Sweden
| | - Per Liv
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, S-901 87 Umeå, Sweden
| | - Fredrik Öhberg
- Radiation Physics, Department of Radiation Sciences, Umeå University, S-901 87 Umeå, Sweden
| | - Lisbeth Slunga Järvholm
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, S-901 87 Umeå, Sweden
| | - Mikael Forsman
- IMM Institute of Environmental Medicine, Karolinska Institutet, S-171 77 Stockholm, Sweden
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, S-141 57 Huddinge, Sweden
| | - Börje Rehn
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, S-901 87 Umeå, Sweden
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Chen H, Schall MC, Fethke NB. Gyroscope vector magnitude: A proposed method for measuring angular velocities. APPLIED ERGONOMICS 2023; 109:103981. [PMID: 36739779 DOI: 10.1016/j.apergo.2023.103981] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/07/2022] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
High movement velocities are among the primary risk factors for work-related musculoskeletal disorders (MSDs). Ergonomists have commonly used two methods to calculate angular movement velocities of the upper arms using inertial measurement units (accelerometers and gyroscopes). Generalized velocity is the speed of movement traveled on the unit sphere per unit time. Inclination velocity is the derivative of the postural inclination angle relative to gravity with respect to time. Neither method captures the full extent of upper arm angular velocity. We propose a new method, the gyroscope vector magnitude (GVM), and demonstrate how GVM captures angular velocities around all motion axes and more accurately represents the true angular velocities of the upper arm. We use optical motion capture data to demonstrate that the previous methods for calculating angular velocities capture 89% and 77% relative to our proposed method.
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Affiliation(s)
- Howard Chen
- Industrial & Systems Engineering and Engineering Management Department, The University of Alabama in Huntsville, Huntsville, AL, USA; Department of Mechanical Engineering, Auburn University, Auburn, AL, USA.
| | - Mark C Schall
- Department of Industrial & Systems Engineering, Auburn University, Auburn, AL, USA
| | - Nathan B Fethke
- Department of Occupational & Environmental Health, The University of Iowa, Iowa City, IA, USA
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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: 16] [Impact Index Per Article: 16.0] [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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Hoareau D, Fan X, Abtahi F, Yang L. Evaluation of In-Cloth versus On-Skin Sensors for Measuring Trunk and Upper Arm Postures and Movements. SENSORS (BASEL, SWITZERLAND) 2023; 23:3969. [PMID: 37112309 PMCID: PMC10142577 DOI: 10.3390/s23083969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/03/2023] [Accepted: 04/06/2023] [Indexed: 06/19/2023]
Abstract
Smart workwear systems with embedded inertial measurement unit sensors are developed for convenient ergonomic risk assessment of occupational activities. However, its measurement accuracy can be affected by potential cloth artifacts, which have not been previously assessed. Therefore, it is crucial to evaluate the accuracy of sensors placed in the workwear systems for research and practice purposes. This study aimed to compare in-cloth and on-skin sensors for assessing upper arms and trunk postures and movements, with the on-skin sensors as the reference. Five simulated work tasks were performed by twelve subjects (seven women and five men). Results showed that the mean (±SD) absolute cloth-skin sensor differences of the median dominant arm elevation angle ranged between 1.2° (±1.4) and 4.1° (±3.5). For the median trunk flexion angle, the mean absolute cloth-skin sensor differences ranged between 2.7° (±1.7) and 3.7° (±3.9). Larger errors were observed for the 90th and 95th percentiles of inclination angles and inclination velocities. The performance depended on the tasks and was affected by individual factors, such as the fit of the clothes. Potential error compensation algorithms need to be investigated in future work. In conclusion, in-cloth sensors showed acceptable accuracy for measuring upper arm and trunk postures and movements on a group level. Considering the balance of accuracy, comfort, and usability, such a system can potentially be a practical tool for ergonomic assessment for researchers and practitioners.
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Affiliation(s)
- Damien Hoareau
- Department of Mechatronics, École Normale Supérieure de Rennes, 35170 Bruz, France
- Laboratoire SATIE, CNRS UMR 8029, École Normale Supérieure de Rennes, 35170 Bruz, France
| | - Xuelong Fan
- Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, SE-171 77 Stockholm, Sweden
| | - Farhad Abtahi
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57 Huddinge, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, SE-171 77 Stockholm, Sweden
- Department of Clinical Physiology, Karolinska University Hospital, SE-141 57 Huddinge, Sweden
| | - Liyun Yang
- Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, SE-171 77 Stockholm, Sweden
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57 Huddinge, Sweden
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Dahlgren G, Liv P, Öhberg F, Slunga Järvholm L, Forsman M, Rehn B. Ratings of Hand Activity and Force Levels among Women and Men Who Perform Identical Hand-Intensive Work Tasks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16706. [PMID: 36554587 PMCID: PMC9779452 DOI: 10.3390/ijerph192416706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
We compared hand activity and force ratings in women and men doing identical hand-intensive work tasks. Musculoskeletal disorders are more common in women and hand-intensive work leads to an increased risk of these disorders. Knowledge of the gender influence in the rating of work exposure is lacking. The aim of this study was to investigate whether women and men performing identical hand-intensive work tasks were equally rated using hand activity and normalized peak force levels with the Hand Activity Threshold Limit Value®. Fifty-six workers participated, comprising 28 women-men pairs. Four observers-two woman-man pairs-were also involved. Self-ratings and observers' ratings of hand activity and force level were collected. The results of these ratings showed no significant gender differences in self-rated hand activity and force, as well as observer-rated hand activity. However, there was a significant gender difference in the observer-rated force, where the women were rated higher (mean (SD): women 3.9 (2.7), men 3.1 (1.8) (p = 0.01)). This difference remained significant in the adjusted model (p = 0.04) with grip strength and forearm-finger anthropometrics. The results provide new insights that observers' estimates of force can be higher in women compared with men in the same work tasks. Force should be further investigated and preferably compared to objective measurements.
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Affiliation(s)
- Gunilla Dahlgren
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, S-901 87 Umeå, Sweden
| | - Per Liv
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, S-901 87 Umeå, Sweden
| | - Fredrik Öhberg
- Radiation Physics, Department of Radiation Sciences, Umeå University, S-901 87 Umeå, Sweden
| | - Lisbeth Slunga Järvholm
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, S-901 87 Umeå, Sweden
| | - Mikael Forsman
- IMM Institute of Environmental Medicine, Karolinska Institutet, S-171 77 Stockholm, Sweden
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, S-141 57 Huddinge, Sweden
| | - Börje Rehn
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, S-901 87 Umeå, Sweden
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12
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Fan X, Forsman M, Yang L, Lind CM, Kjellman M. Surgeons' physical workload in open surgery versus robot-assisted surgery and nonsurgical tasks. Surg Endosc 2022; 36:8178-8194. [PMID: 35589973 PMCID: PMC9613719 DOI: 10.1007/s00464-022-09256-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 04/08/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Musculoskeletal disorders (MSDs) are common among surgeons, and its prevalence varies among surgical modalities. There are conflicting results concerning the correlation between adverse work exposures and MSD prevalence in different surgical modalities. The progress of rationalization in health care may lead to job intensification for surgeons, but the literature is scarce regarding to what extent such intensification influences the physical workload in surgery. The objectives of this study were to quantify the physical workload in open surgery and compare it to that in (1) nonsurgical tasks and (2) two surgeon roles in robot-assisted surgery (RAS). METHODS The physical workload of 22 surgeons (12 performing open surgery and 10 RAS) was measured during surgical workdays, which includes trapezius muscle activity from electromyography, and posture and movement of the head, upper arms and trunk from inertial measurement units. The physical workload of surgeons in open surgery was compared to that in nonsurgical tasks, and to the chief and assistant surgeons in RAS, and to the corresponding proposed action levels. Mixed-effects models were used to analyze the differences. RESULTS Open surgery constituted more than half of a surgical workday. It was associated with more awkward postures of the head and trunk than nonsurgical tasks. It was also associated with higher trapezius muscle activity levels, less muscle rest time and a higher proportion of sustained low muscle activity than nonsurgical tasks and the two roles in RAS. The head inclination and trapezius activity in open surgery exceeded the proposed action levels. CONCLUSIONS The physical workload of surgeons in open surgery, which exceeded the proposed action levels, was higher than that in RAS and that in nonsurgical tasks. Demands of increased operation time may result in higher physical workload for open surgeons, which poses an increased risk of MSDs. Risk-reducing measures are, therefore, needed.
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Affiliation(s)
- Xuelong Fan
- IMM Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, 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, Hälsovägen 11C, 14157 Huddinge, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, 113 65 Stockholm, Sweden
| | - Liyun Yang
- IMM Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Carl M. Lind
- IMM Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Magnus Kjellman
- Department of Molecular Medicine and Surgery, Department of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
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Tjosvoll SO, Seeberg TM, Fimland MS, Wiggen Ø, Jahren SE. Classification of kneeling and squatting in workers wearing protective equipment: development and validation of a rule-based model using wireless triaxial accelerometers. ERGONOMICS 2022; 65:1410-1420. [PMID: 35133239 DOI: 10.1080/00140139.2022.2039410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
Several professions in industries, such as petroleum, manufacturing, construction, mining, and forestry require prolonged work tasks in awkward postures, increasing workers' risks for musculoskeletal pain and injury. Therefore, we developed and validated a rule-based model for classifying unilateral and bilateral kneeling and squatting based on 15 individuals wearing personal protective equipment and using three wireless triaxial accelerometers. The model provided both high sensitivity and specificity for classifying kneeling (0.98; 0.98) and squatting (0.96; 0.91). Hence, this model has the potential to contribute to increased knowledge of physical work demands and exposure thresholds in working populations with strict occupational safety regulations. Practitioner summary: Our results indicate that this rule-based model can be applied in a human-factors perspective enabling high-quality quantitative information in the classification of occupational kneeling and squatting, known risk factors for musculoskeletal pain, and sick leave. This study is adapted for working populations wearing personal protective equipment and aimed for long-term measurements in the workplace.
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Affiliation(s)
- Svein O Tjosvoll
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Trine M Seeberg
- Smart Sensor Systems, SINTEF Digital, SINTEF AS, Oslo, Norway
| | - Marius S Fimland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- Unicare Helsefort Rehabilitation Centre, Rissa, Norway
| | | | - Silje E Jahren
- Smart Sensor Systems, SINTEF Digital, SINTEF AS, Oslo, Norway
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14
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Schall MC, Chen H, Cavuoto L. Wearable inertial sensors for objective kinematic assessments: A brief overview. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2022; 19:501-508. [PMID: 35853137 DOI: 10.1080/15459624.2022.2100407] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Mark C Schall
- Department of Industrial and Systems Engineering, Auburn University, Auburn, Alabama
| | - Howard Chen
- Department of Mechanical Engineering, Auburn University, Auburn, Alabama
| | - Lora Cavuoto
- Department of Industrial and Systems Engineering, University at Buffalo, Buffalo, New York
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15
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Norasi H, Tetteh E, Sarker P, Mirka GA, Hallbeck MS. Exploring the relationship between neck flexion and neck problems in occupational populations: a systematic review of the literature. ERGONOMICS 2022; 65:587-603. [PMID: 34477048 DOI: 10.1080/00140139.2021.1976847] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
A systematic review was conducted to evaluate the relationship between occupational neck flexion angles and neck problems. The synthesised findings were used to answer three research questions: (1) Is there a positive/negative relationship between neck flexion and neck problems? (2) What is the appropriate angular threshold for neck flexion as a risk factor for neck problems? (3) What are the gaps in our current knowledge? A review of 21 papers revealed (1) a consistent positive correlation between neck flexion and neck problems, and (2) a neck flexion angle of 20° as the most evidence-based (not necessarily the best) cut-off angle separating high- and low-risk neck flexion postures. Future research should focus on the (1) continuous collection of three-dimensional neck postures through longitudinal studies to quantify cumulative exposures of neck postures, and (2) development of standard descriptions of 'neck problems' and 'neck flexion' to facilitate the development of a dose-response relationship. Practitioner summary: Practitioners depend on thresholds for evaluating neck postural exposure using work assessment tools; however, the scientific basis for this is unclear. This systematic review investigated the angular threshold for neck flexion and found 20° of neck flexion with the greatest evidence-based support as the threshold for high-risk neck postural exposure.
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Affiliation(s)
- Hamid Norasi
- Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA
- Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
- Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA
| | - Emmanuel Tetteh
- Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA
- Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
- Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA
| | - Pramiti Sarker
- Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA
- Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - Gary A Mirka
- Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA
- Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
- Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA
| | - M Susan Hallbeck
- Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA
- Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
- Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA
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16
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Evaluation of a New Simplified Inertial Sensor Method against Electrogoniometer for Measuring Wrist Motion in Occupational Studies. SENSORS 2022; 22:s22041690. [PMID: 35214592 PMCID: PMC8874503 DOI: 10.3390/s22041690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/26/2022]
Abstract
Wrist velocity is an important risk factor for work-related musculoskeletal disorders in the elbow/hand, which is also difficult to assess by observation or self-reports. This study aimed to evaluate a new convenient and low-cost inertial measurement unit (IMU)-based method using gyroscope signals against an electrogoniometer for measuring wrist flexion velocity. Twelve participants performed standard wrist movements and simulated work tasks while equipped with both systems. Two computational algorithms for the IMU-based system, i.e., IMUnorm and IMUflex, were used. For wrist flexion/extension, the mean absolute errors (MAEs) of median wrist flexion velocity compared to the goniometer were <10.1°/s for IMUnorm and <4.1°/s for IMUflex. During wrist deviation and pronation/supination, all methods showed errors, where the IMUnorm method had the largest overestimations. For simulated work tasks, the IMUflex method had small bias and better accuracy than the IMUnorm method compared to the goniometer, with the MAEs of median wrist flexion velocity <5.8°/s. The results suggest that the IMU-based method can be considered as a convenient method to assess wrist motion for occupational studies or ergonomic evaluations for the design of workstations and tools by both researchers and practitioners, and the IMUflex method is preferred. Future studies need to examine algorithms to further improve the accuracy of the IMU-based method in tasks of larger variations, as well as easy calibration procedures.
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Forsman M, Fan X, Rhén IM, Lind CM. Concerning a Work Movement Velocity Action Level Proposed in "Action Levels for the Prevention of Work-Related Musculoskeletal Disorders in the Neck and Upper Extremities: A Proposal" by Inger Arvidsson et al. (2021). Ann Work Expo Health 2021; 66:130-131. [PMID: 34469509 PMCID: PMC8751788 DOI: 10.1093/annweh/wxab075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Mikael Forsman
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, SE-14157 Huddinge, Sweden.,IMM Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Stockholm County Council, SE-113 65 Stockholm, Sweden
| | - Xuelong Fan
- IMM Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Ida-Märta Rhén
- IMM Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Stockholm County Council, SE-113 65 Stockholm, Sweden.,Department of Industrial and Materials Science, Chalmers University of Technology, SE-412 96 Gothenburg, Sweden
| | - Carl Mikael Lind
- IMM Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden
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Fan X, Lind CM, Rhen IM, Forsman M. Effects of Sensor Types and Angular Velocity Computational Methods in Field Measurements of Occupational Upper Arm and Trunk Postures and Movements. SENSORS 2021; 21:s21165527. [PMID: 34450967 PMCID: PMC8401405 DOI: 10.3390/s21165527] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/05/2021] [Accepted: 08/12/2021] [Indexed: 12/15/2022]
Abstract
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.
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Affiliation(s)
- Xuelong Fan
- IMM Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (X.F.); (I.-M.R.); (M.F.)
| | - Carl Mikael Lind
- IMM Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (X.F.); (I.-M.R.); (M.F.)
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57 Huddinge, Sweden
- Correspondence:
| | - Ida-Märta Rhen
- IMM Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (X.F.); (I.-M.R.); (M.F.)
- Centre for Occupational and Environmental Medicine, Stockholm County Council, SE-113 65 Stockholm, Sweden
- Department of Industrial and Materials Science, Chalmers University of Technology, SE-412 96 Gothenburg, Sweden
| | - Mikael Forsman
- IMM Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (X.F.); (I.-M.R.); (M.F.)
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57 Huddinge, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, SE-113 65 Stockholm, Sweden
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