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Tjøsvoll SO, Steiro Fimland M, Gonzalez V, Seeberg TM, Holtermann A, Færevik H, Wiggen Ø. Physical Work Demands of Maintenance Workers on Onshore Petroleum Facilities in Norway: An Observational Study Utilizing Wearable Sensor Technology. Ann Work Expo Health 2023; 67:706-719. [PMID: 37171985 PMCID: PMC10324642 DOI: 10.1093/annweh/wxad022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/05/2023] [Indexed: 05/14/2023] Open
Abstract
OBJECTIVES High physical work demands can cause musculoskeletal disorders and sick leave in petroleum workers. However, our knowledge of their physical work demands is scarce and based on self-report. The objective of our study is to work towards closing this knowledge gap by assessing the physical work demands of onshore petroleum maintenance workers using body-worn sensors. METHODS A total of 46 of 69 eligible maintenance workers (37 mechanics and 9 process technicians) from three onshore petroleum facilities in Norway filled in a questionnaire and diary and wore five accelerometers and a heart rate sensor for up to six consecutive workdays. Work-related physical activity and postures were classified using rule-based modelling in a modified version of the validated Acti4 software. RESULTS The onshore maintenance petroleum workers were working an average of 10 h a day and spent on average this time with 48% (SD = 16.5) sitting, 1% (SD = 2.8) lying down, 39% (SD = 16.2) in light physical activity, and 9% (SD = 3.8) in moderate to vigorous physical activity. During work hours while at feet, we found arm elevation ≥60° to be 11% (SD = 7.1) (68 min), and forward bending of the trunk ≥60° to be 2% (SD = 2.2) (14 min). The workers spent 2% (SD = 2.5) (12 minu) of the workhours kneeling. We observed a high inter-individual variation for all these work exposures. Moreover, 26% (12) of the workers conducted static standing for >30% of the workday, and 17% (8) spent more than half of the work hours >33% of their estimated maximal cardiovascular capacity. CONCLUSIONS While onshore maintenance petroleum workers on average spend about half of the workday sitting or lying down, the remaining worktime is spent with a rather high duration of arm elevation and forward bending. Quite high fraction of the workers spends much of the workhours in static standing and kneeling. We see a substantial variation in these work exposures between the workers. The findings indicate a need for preventive measures in how work is organized and performed.
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Affiliation(s)
- Svein O Tjøsvoll
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Edvard Griegs gate 8, Trondheim N-7491, Norway
| | - Marius Steiro Fimland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Edvard Griegs gate 8, Trondheim N-7491, Norway
- Unicare Helsefort Rehabilitation Centre, Rissa, Hysnesveien 11, 7112 Hasselvika, Norway
| | - Victor Gonzalez
- Department of Smart Sensor and Microsystems, SINTEF Digital, SINTEF AS, Dept. of Health Research, P.O. Box 124 Blindern, NO-0314 Oslo, Norway
| | - Trine M Seeberg
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Edvard Griegs gate 8, Trondheim N-7491, Norway
- Department of Smart Sensor and Microsystems, SINTEF Digital, SINTEF AS, Dept. of Health Research, P.O. Box 124 Blindern, NO-0314 Oslo, Norway
| | - Andreas Holtermann
- Department of Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, Denmark
| | - Hilde Færevik
- Department of Health Research, SINTEF Digital, SINTEF AS, P.O. Box 4760 Torgaarden, NO-7465 Trondheim, Norway
| | - Øystein Wiggen
- Department of Health Research, SINTEF Digital, SINTEF AS, P.O. Box 4760 Torgaarden, NO-7465 Trondheim, Norway
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Tjøsvoll SO, Wiggen Ø, Gonzalez V, Seeberg TM, Elez Redzovic S, Frostad Liaset I, Holtermann A, Steiro Fimland M. Assessment of Physical Work Demands of Home Care Workers in Norway: An Observational Study Using Wearable Sensor Technology. Ann Work Expo Health 2022; 66:1187-1198. [PMID: 35959647 PMCID: PMC9664225 DOI: 10.1093/annweh/wxac052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/24/2022] [Accepted: 07/20/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES High physical work demands are believed to be partly responsible for the high sickness absence among home care workers, but no studies have assessed their physical work demands using precise device-based measurements. Hence, the objective of this observational study was to assess physical work demands in home care, using wearable sensors. METHODS From six home care units in a large municipality in Norway, 114 of 195 eligible home care workers filled in a questionnaire, a diary about work hours, and wore five accelerometers, and a heart rate sensor for up to six consecutive workdays. RESULTS On average, the homecare workers spent 50% of the working hours sitting, 25.2% standing, 11.4% moving, 8.3% walking fast, 1.9% walking slow, 1.2% stair-climbing, 0.3% cycling, and 0.05% running. We found the following exposures to demanding postures: arm-elevation in an upright body position ≥30° was 36.7%, ≥60° was 4.1%, and ≥90°was 0.5%; forward trunk inclination in an upright body position ≥30° was 9.9%, ≥60° was 4%, and ≥90° was 1%; and for kneeling it was 0.8%. We found the average cardiovascular load (%heart rate reserve) during work to be 28%. There was considerable individual variation in these physical exposures at work. CONCLUSIONS This study presents precise information on various physical work demands of home care workers in Norway. Home care workers spent on average half the workday sitting and the remaining time in various occupational physical activities. Presently, few device-based exposure limits have been proposed for acceptable amounts of occupational physical exposures, but the level of arm-elevation, forward trunk inclination, and the considerable variation of physical workloads among home care workers, indicate that preventive measures should be taken.
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Affiliation(s)
| | - Øystein Wiggen
- Health Research, SINTEF DIGITAL, SINTEF AS, Trondheim, Norway
| | - Victor Gonzalez
- Smart Sensor Systems, SINTEF DIGITAL, SINTEF AS, Oslo, Norway
| | - Trine M Seeberg
- Smart Sensor Systems, SINTEF DIGITAL, SINTEF AS, Oslo, Norway
| | - Skender Elez Redzovic
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Ingeborg Frostad Liaset
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Lerso Parkalle, Copenhagen, Denmark
| | - Marius Steiro 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
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Lunde LK, Merkus S, Koch M, Knardahl S, Wærsted M, Veiersted KB. Associations of objectively measured total duration and maximum bout length of standing at work with lower-extremity pain intensity: a 2-year follow-up of construction and healthcare workers. BMC Musculoskelet Disord 2021; 22:43. [PMID: 33413254 PMCID: PMC7791765 DOI: 10.1186/s12891-020-03868-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 12/09/2020] [Indexed: 11/28/2022] Open
Abstract
Background Musculoskeletal disorders are among the major reasons for years lived with disability. Approximately one third of the European working population report lower-extremity discomfort and many attribute these discomforts to work-related factors. Employees in the healthcare and construction sectors reports high levels of lower-extremity pain and commonly relate the pain to their profession. These workers spend a large part of their workday standing. Periods of prolonged standing is suggested to increase lower-extremity symptoms, but this cannot be concluded on, since limited evidence is available from longitudinal studies using objective measures. This study aimed to determine possible associations between objectively measured total duration and maximum bout length of static- and dynamic standing at work and lower-extremity pain intensity (LEPi) among Norwegian construction- and healthcare workers. Methods One-hundred and twenty-three construction and healthcare workers wore two accelerometers for up to four consecutive days, to establish standing behavior at baseline. The participants reported LEPi (Likert scale 0–9) for the preceding 4 weeks at baseline and after 6, 12, 18, and 24 months. We investigated associations between standing at work and average and change in LEPi using linear mixed models with significance level p ≤ 0.05. Results Total duration of static- and dynamic standing showed weak associations with average LEPi, for the total sample and for construction workers. Maximum bout of static- and dynamic standing was associated with average LEPi in construction workers, but not in healthcare workers. Furthermore, we found no associations between standing and change in LEPi over the 2-year follow-up in any of our analyses. Conclusions This study indicate that objectively measured standing is associated with average LEPi over 2-years follow-up in construction workers, and that maximal bout of standing have a stronger association to LEPi than total duration. For every 10 min added to the maximal length of continuous standing during an average workday, we found approximately one unit increase in pain on a 0–9 scale. The lack of significant findings in analyses on healthcare workers suggest that the association between standing and LEPi depend on work-tasks, gender and/or other sector-specific factors. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-020-03868-0.
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Affiliation(s)
- Lars-Kristian Lunde
- National Institute of Occupational Health, P.O. Box 5330, Majorstuen, 0304, Oslo, Norway.
| | - Suzanne Merkus
- National Institute of Occupational Health, P.O. Box 5330, Majorstuen, 0304, Oslo, Norway
| | - Markus Koch
- National Institute of Occupational Health, P.O. Box 5330, Majorstuen, 0304, Oslo, Norway
| | - Stein Knardahl
- National Institute of Occupational Health, P.O. Box 5330, Majorstuen, 0304, Oslo, Norway
| | - Morten Wærsted
- National Institute of Occupational Health, P.O. Box 5330, Majorstuen, 0304, Oslo, Norway
| | - Kaj Bo Veiersted
- National Institute of Occupational Health, P.O. Box 5330, Majorstuen, 0304, Oslo, Norway
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Can a metric combining arm elevation and trapezius muscle activity predict neck/shoulder pain? A prospective cohort study in construction and healthcare. Int Arch Occup Environ Health 2020; 94:647-658. [PMID: 33278002 PMCID: PMC8068682 DOI: 10.1007/s00420-020-01610-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 11/09/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To determine whether a composite metric of arm elevation and trapezius activity (i.e. neck/shoulder load) is more strongly associated with the 2-year course of neck and shoulder pain intensity (NSPi) among construction and healthcare workers than each exposure separately. METHODS Dominant arm elevation and upper trapezius muscle activity were estimated in construction and healthcare employees (n = 118) at baseline, using accelerometry and normalized surface electromyography (%MVE), respectively. At baseline and every 6 months for 2 years, workers reported NSPi (score 0-3). Compositions of working time were determined for arm elevation (< 30°; 30-60°; > 60°), trapezius activity (< 0.5%; 0.5-7.0%; > 7.0%MVE), and a composite metric "neck/shoulder load" (restitution, low, medium, and high load). Associations between each of these three compositions and the 2-year course of NSPi were determined using linear mixed models. RESULTS Associations between exposure compositions and the course of NSPi were all weak and in general uncertain. Time spent in 0.5-7.0%MVE showed the largest and most certain association with changes in NSPi during follow-up (β = - 0.13; p = 0.037; corresponding to a -0.01 change in NPSi every 6 months). Among pain-free workers at baseline, medium (β = - 0.23; p = 0.039) and high (β = 0.15; p = 0.031) neck/shoulder load contributed the most to explaining changes in NSPi. CONCLUSION The composite metric of neck/shoulder load did not show a stronger association with the course of NSPi than arm elevation or trapezius activity alone in the entire population, while some indications of a stronger association were found among those who were pain-free at baseline.
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Work above shoulder level and shoulder complaints: a systematic review. Int Arch Occup Environ Health 2020; 93:925-954. [PMID: 32572582 PMCID: PMC7519900 DOI: 10.1007/s00420-020-01551-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 05/09/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To investigate the association and the exposure-response relationship between work above shoulder height and shoulder pain or disorders. METHODS A systematic search was performed in Medline, Embase, and Health and Safety Science Abstracts. Included were articles with prospective cohort, case-control, cross-sectional, or intervention study designs. Quality assessment was based on an evaluation scheme adjusted to study design and normalized to 100%. The cut-off for sufficient quality to include articles was above 40% and cut-off for high-quality articles was above 50% of maximal score. The level of strength of evidence for an association between exposure and effect was assessed according to the GRADE guidelines. RESULTS Thirty-four articles were included. Articles that document large effects (higher risk estimates; OR ≥ 2) have higher quality score, include analyses of severe arm elevation, more often use clinical outcome, and report an exposure-response relationship compared to studies reporting lower risk estimates. The studies that reported large effects were all significant. An exposure-response relationship was found in many high-quality studies when relating exposure intensity of arm elevation (level of arm elevation, amplitude) as well as duration of arm elevation, especially > 90°. CONCLUSION We conclude on a limited evidence for an association between arm elevation at work and shoulder disorders. Severe arm elevation with elbows above shoulder level (i.e., > 90°) shows a moderate evidence for an association with shoulder disorders.
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Lunde LK, Koch M, Merkus SL, Knardahl S, Wærsted M, Veiersted KB. Associations of objectively measured forward bending at work with low-back pain intensity: a 2-year follow-up of construction and healthcare workers. Occup Environ Med 2020; 76:660-667. [PMID: 31413188 PMCID: PMC6824615 DOI: 10.1136/oemed-2019-105861] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/26/2019] [Accepted: 07/06/2019] [Indexed: 12/05/2022]
Abstract
Objectives This study aimed to determine possible associations between objectively measured forward bending at work (FBW) and low-back pain intensity (LBPi) among Norwegian construction and healthcare workers. Methods One-hundred and twenty-five workers wore two accelerometers for 3–4 consecutive days, during work and leisure to establish duration of ≥30° and ≥60° forward bending. The participating workers reported LBPi (0–3) at the time of objective measurements and after 6, 12, 18 and 24 months. We investigated associations using linear mixed models with significance level p≤0.05 and presented results per 100 min. Results The duration of ≥30° and ≥60° FBW was not associated with average LBPi during follow-up, neither for the total sample nor stratified on work sector. Furthermore, analyses on all workers and on construction workers only found no significant association between ≥30° or ≥60° FBW and change in LBPi over the 2-year follow-up. For healthcare workers we found a consistent significant association between the duration of ≥30° FBW at baseline and the change in LBPi during follow-up, but this was not found for ≥60° FBW. Conclusions This study suggests that objectively measured duration of FBW in minutes is not associated with average levels of, or change in LBPi in construction workers over a 2-year period. In healthcare workers, exposure to ≥30° FBW was associated with change in LBPi, while we did not find this for ≥60° FBW. Results may indicate that the associations between FWB and LBP vary depending on type of work tasks, gender or sector-specific factors.
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Affiliation(s)
- Lars-Kristian Lunde
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Markus Koch
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Suzanne Lerato Merkus
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Stein Knardahl
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Morten Wærsted
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Kaj Bo Veiersted
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
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Baracco A, Coggiola M, Bosio D, Perrelli F, Garzaro G, Turcu V, Pira E. Whole body biomechanical burden of healthcare workers: proposal for a complementary risk assessment and management tool (HOARA). LA MEDICINA DEL LAVORO 2019; 110:372-388. [PMID: 31659994 PMCID: PMC7810019 DOI: 10.23749/mdl.v110i5.7624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 08/01/2019] [Indexed: 11/17/2022]
Abstract
Introduction: We have developed a new tool, named Holistic Approach Risk Assessment (HOARA), to support occupational safety and health professionals (OSH) in risk assessment and management when evaluating the biomechanical load of healthcare workers. Objectives: The primary aim of the HOARA is to support OSH in risk assessment and management of biomechanical hazards in healthcare facilities. This tool ensures a superior level of analysis by targeting independently various body compartments during all activities completed throughout the work shift. These include: head, neck, back and upper and lower limbs. Methods: For each body segment, ergonomic determinants were defined on the basis of previous literature, according to which task and job analyses were performed. Upon direct observation, ergonomic factors were given a score based on their temporal extent. Subsequently, action-body segment raw indices and weighted indices were calculated. Results: Results of the application of the method are shown. Of note, a relational database was set up to improve its usability. Conclusions: From an occupational health perspective, the HOARA, integrated with other methods, is expected to allow a more effective management of human resources, especially when assigning workers to specific jobs or tasks. Overall, the HOARA will be instrumental in assessing the impact of fitness for work judgments on work organization and its resources, in compliance with the guidelines from the Società Italiana di Medicina del Lavoro (SIML).
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Palm P, Gupta N, Forsman M, Skotte J, Nordquist T, Holtermann A. Exposure to Upper Arm Elevation During Work Compared to Leisure Among 12 Different Occupations Measured with Triaxial Accelerometers. Ann Work Expo Health 2019; 62:689-698. [PMID: 29945157 PMCID: PMC6037214 DOI: 10.1093/annweh/wxy037] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 06/21/2018] [Indexed: 01/15/2023] Open
Abstract
Regarding prevention of neck and shoulder pain (NSP), unsupported arm elevation is one factor that should be taken into account when performing work risk assessment. Triaxial accelerometers can be used to measure arm elevation over several days but it is not possible to differentiate between supported and unsupported arm elevation from accelerometers only. Supported arm elevation is more likely to exist during sitting than standing. The aim of the study was to evaluate the use of whole workday measurements of arm elevation with accelerometers to assess potentially harmful work exposure of arm elevation, by comparing arm elevation at work with arm elevation during leisure, in a population with diverse work tasks, and to assess how the exposure parameters were modified when upper arm elevation during sitting time was excluded. The participants, 197 workers belonging to 12 occupational groups with diverse work tasks, wore triaxial accelerometers on the dominant arm, hip, and back for 1–4 days to measure arm elevation and periods of sitting. None of the groups were found to have higher exposure to arm elevation during work compared to leisure. Even though some occupations where known to have work tasks that forced them to work with elevated arms to a large extent. A high proportion of arm elevation derived from sitting time, especially so during leisure. When arm elevation during sitting time was excluded from the analysis, arm elevation was significantly higher at work than during leisure among construction workers, garbage collectors, manufacturing workers, and domestic cleaners. Together this illustrates that it is not suitable to use whole workday measurments of arm elevation with accelerometer as a sole information source when assessing the risk for NSP due to arm elevation. Information on body posture can provide relevant contextual information in exposure assessments when it is known that the potential harmful exposure is performed in standing or walking.
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Affiliation(s)
- Peter Palm
- Department of Medical Sciences Occupational and Environmental Medicine, Dag Hammarsjköldsväg, Uppsala, Sweden.,Occupational and Environmental Medicine, Akademiska sjukhuset, Dag Hammarsjköldsväg, Uppsala, Sweden
| | - Nidhi Gupta
- National Research Centre for the Working Environmnent, Lersø Parkallé, Copenhagen Ø, Denmark
| | - Mikael Forsman
- IMM Institute of Environmnental Medicine, Nobels väg, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Solnavägen, Stockholm, Sweden
| | - Jørgen Skotte
- National Research Centre for the Working Environmnent, Lersø Parkallé, Copenhagen Ø, Denmark
| | - Tobias Nordquist
- Department of Medical Sciences Occupational and Environmental Medicine, Dag Hammarsjköldsväg, Uppsala, Sweden
| | - Andreas Holtermann
- National Research Centre for the Working Environmnent, Lersø Parkallé, Copenhagen Ø, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Odense, Campusvej, Odense, Denmark
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