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Lind CM, Rhen IM, Forsman M. Reliability and Accuracy of Standard Reference Procedures for Measurements of Trunk and Arm Postures in Ergonomics. Bioengineering (Basel) 2025; 12:50. [PMID: 39851325 PMCID: PMC11761571 DOI: 10.3390/bioengineering12010050] [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: 12/04/2024] [Revised: 01/03/2025] [Accepted: 01/07/2025] [Indexed: 01/26/2025] Open
Abstract
Adequate reference procedures for obtaining the reference zero-angle position are important for precise and accurate posture measurements, but few studies have systematically investigated these. A limited number of previous studies suggest differences in accuracy between procedures, with some causing an underestimation of the true arm elevation angle when sensors are taped to the skin. The reliability of commonly used reference procedures for the measurement of the trunk posture is also not well explored, and alternative procedures may improve precision. Based on this identified gap, this study evaluated the test-retest reliability of the N-position (I-pose), i.e., the standard procedure for recording trunk postures, and compared it with two new alternative procedures. Additionally, the accuracy of the N-position for measuring arm elevation angles was compared with one alternative procedure. A total of 40 participants (22 women and 18 men) aged 26-70 years performed the reference procedures in a laboratory setting. Postures were recorded using a smart workwear system equipped with two inertial measurement units (IMUs) embedded in pockets within the workwear. For the trunk posture, the N-position showed a slight lack of test-retest reliability, while one of the alternative procedures demonstrated better test-retest reliability. For the arm posture, the N-position, which does not include lateral trunk inclination, resulted in a substantial underestimation of the arm elevation angle of approximately 15°, which is a novel finding. In contrast, the posture involving trunk inclination closely matched the targeted reference, with a difference of less than 2°. This study underscores the importance of selecting appropriate reference procedures to ensure precise and accurate posture measurements.
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Affiliation(s)
- Carl M. Lind
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Ida-Märta Rhen
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, 113 65 Stockholm, Sweden
- Department of Industrial and Materials Science, Chalmers University of Technology, 412 96 Gothenburg, Sweden
| | - Mikael Forsman
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, 113 65 Stockholm, Sweden
- School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, 141 57 Stockholm, Sweden
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Krishna K, Hegde S, G T M, Shenoy B S. Whole body vibration and rider comfort determination of an electric two-wheeler test rig. F1000Res 2024; 12:559. [PMID: 38813349 PMCID: PMC11134141 DOI: 10.12688/f1000research.131105.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/24/2024] [Indexed: 05/31/2024] Open
Abstract
Background Two-wheeled vehicles are the major mode of transportation in India. Such vehicles are exposed to excessive vibration on the road when compared to four-wheeled vehicles. However, the research on the reduction of whole body vibration in the case of two-wheelers is not explored in detail. The present study predicts rider comfort in the case of an electric two-wheeler as per ISO 2631-1, by obtaining the finding the weighted acceleration at the strategic locations of vibration at the test rig. Methods An electric two-wheeler test rig is used in the study. The values of acceleration from the test rig in running conditions are obtained by using NI LabVIEW 2019. The drive cycle of the electric vehicle (EV) test rig is controlled by Sync sols' EV lab software. Obtaining the weighted root mean square (RMS) acceleration from running the test setup, it is compared with the ISO 2631-1 standard to obtain the rider comfort. Results Loading area, traction motor, base mount, and suspension were found to be the strategic points of vibration. Frequency weighted RMS acceleration of 0.3 to 0.4 m/s 2 obtained at these points are prone to cause discomfort for the rider. Vehicle speed, road profile, and duration of exposure were found to be important parameters affecting the rider's comfort. A maximum of 4.6 m/s 2 amplitude was observed. The loading area, which corresponds to a rider's seat in actual vehicle, is important and reduction of these vibrations make the ride comfortable for the rider. Suspension and base mount of the test rig are found to be uncomfortable observing the weighted RMS acceleration. Conclusions A suitable damping technique design is very much essential in reducing these vibrations and improve the rider comfort, as many more non-deterministic vibrations are prone to cause dis-comfort in case of actual on road riding conditions.
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Affiliation(s)
- Keerthan Krishna
- Department of Aeronautical and Automobile Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Sriharsha Hegde
- Department of Aeronautical and Automobile Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Mahesha G T
- Department of Aeronautical and Automobile Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Satish Shenoy B
- Department of Aeronautical and Automobile Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
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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: 23] [Impact Index Per Article: 11.5] [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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Loslever P, Schiro J, Gabrielli F, Pudlo P. Introducing coordination in hand position analysis during a steering wheel-based tracking task using fuzzy sets. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2021. [DOI: 10.1080/1463922x.2021.1983886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Pierre Loslever
- Laboratory of Automation, Mechanics and Human Computer Science, CNRS, UMR 8201, Polytechnic University of Hauts de France, Valenciennes, France
| | - Jessica Schiro
- Laboratory of Automation, Mechanics and Human Computer Science, CNRS, UMR 8201, Polytechnic University of Hauts de France, Valenciennes, France
| | - François Gabrielli
- Laboratory of Automation, Mechanics and Human Computer Science, CNRS, UMR 8201, Polytechnic University of Hauts de France, Valenciennes, France
| | - Philippe Pudlo
- Laboratory of Automation, Mechanics and Human Computer Science, CNRS, UMR 8201, Polytechnic University of Hauts de France, Valenciennes, France
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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: 3.5] [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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Fethke NB, Schall MC, Merlino LA, Chen H, Branch CA, Ramaswamy M. Whole-Body Vibration and Trunk Posture During Operation of Agricultural Machinery. Ann Work Expo Health 2019; 62:1123-1133. [PMID: 30239568 DOI: 10.1093/annweh/wxy076] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 08/09/2018] [Indexed: 11/13/2022] Open
Abstract
Exposure to whole-body vibration (WBV) is common among agricultural workers and is associated with musculoskeletal health outcomes such as low back pain. Little is known, however, about the characteristics of exposure experienced during actual production practices. We measured WBV levels during agricultural machinery use among a sample of farmers (n = 55) performing routine agricultural activities and explored machinery attributes that may explain WBV summary measures. We also measured trunk posture to provide additional information about physical exposures during machinery operation. Measurements were made on-farm and during actual work conditions of a sample of agricultural machines (n = 112), including tractors, combines, heavy utility vehicles, and all-terrain vehicles (ATVs). Results indicated the presence of high levels of vibration (median frequency-weighted root-mean-square acceleration of approximately 0.8 m s-2) with time signatures that include high-amplitude mechanical shocks (median crest factor of nearly 23). Compared to other machinery types, combines exhibited the lowest WBV levels and among the most favorable trunk postures. Substantial variability was observed in both the WBV and trunk posture summary measures, suggesting for future studies that alternative sampling strategies are needed to fully capture temporal patterns of machinery use.
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Affiliation(s)
- Nathan B Fethke
- Department of Occupational and Environmental Health, University of Iowa, Suite Iowa City, IA, USA
| | - Mark C Schall
- Department of Industrial and Systems Engineering, Auburn University, Shelby Center Auburn, AL, USA
| | - Linda A Merlino
- Department of Occupational and Environmental Health, University of Iowa, Suite Iowa City, IA, USA
| | - Howard Chen
- Department of Mechanical Engineering, Auburn University, Wiggins Hall Auburn, AL, USA
| | - Cassidy A Branch
- Department of Occupational and Environmental Health, University of Iowa, Suite Iowa City, IA, USA
| | - Maya Ramaswamy
- Department of Occupational and Environmental Health, University of Iowa, Suite Iowa City, IA, USA
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Khan MI, Bath B, Kociolek A, Zeng X, Koehncke N, Trask C. Trunk Posture Exposure Patterns among Prairie Ranch and Grain Farmers. J Agromedicine 2019; 25:210-220. [PMID: 31517593 DOI: 10.1080/1059924x.2019.1659200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objectives: Low back disorders (LBD) are the most common musculoskeletal disorder among farmers, and awkward trunk postures such as repetitive bending are often cited as a contributor. However, it is not clear whether trends of increasing mechanization in agriculture may be impacting the requirement for trunk-intensive tasks. This study compared the patterns of working trunk posture among prairie farmers during both machine-intensive and non-intensive work days.Methods: Forty-nine adult farm workers from 22 farms participated in this study. Individual and farm characteristics were documented via questionnaire. Trunk angles and velocities were measured with an I2M inertial sensor placed on the chest. Participants completed electronic posture assessments during up to three regular work days throughout the growing season for a total of 91 electronic posture measurements. Forward and lateral trunk bending patterns were expressed in three domains: magnitude, duration, and frequency.Results: Working tasks were categorized into driving, manual, and mixed. Driving was the most commonly measured task (52% of work days), and mixed tasks the least (12%). Both 90th percentile trunk flexion-extension angles and velocities were significantly higher for manual as compared to driving tasks. Participants spent 38% of their working time in trunk forward flexion ≥ 20°, which, according to previous epidemiological studies, may increase their risk for LBD.Conclusion: The directly-measured trunk posture exposure patterns in this study suggest that machinery-intensive workdays result in less awkward trunk posture and lower velocities. Increasing mechanization invites more research on the exposures associated with machinery operation and increasing automation.
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Affiliation(s)
- Muhammad Idrees Khan
- Canadian Centre for Health and Safety in Agriculture (CCHSA), University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Brenna Bath
- Canadian Centre for Health and Safety in Agriculture (CCHSA), University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Aaron Kociolek
- School of Physical and Health Education, Nipissing University, North Bay, Ontario, Canada
| | - Xiaoke Zeng
- Canadian Centre for Health and Safety in Agriculture (CCHSA), University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Niels Koehncke
- Canadian Centre for Health and Safety in Agriculture (CCHSA), University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Catherine Trask
- Canadian Centre for Health and Safety in Agriculture (CCHSA), University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Sekkay F, Imbeau D, Chinniah Y, Dubé PA, de Marcellis-Warin N, Beauregard N, Trépanier M. Risk factors associated with self-reported musculoskeletal pain among short and long distance industrial gas delivery truck drivers. APPLIED ERGONOMICS 2018; 72:69-87. [PMID: 29885729 DOI: 10.1016/j.apergo.2018.05.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 05/09/2018] [Accepted: 05/10/2018] [Indexed: 06/08/2023]
Abstract
AIM This study investigated and compared the associations between self-reported exposures to individual as well as work-related physical and psychosocial risk factors for musculoskeletal (MS) disorders and the prevalence of MS symptoms in different body areas among short- (P&D) and long-distance (Bulk delivery) truck drivers working for the same large gas delivery company in Canada. METHODS 123 truck drivers nationwide participated in this questionnaire-based cross-sectional study. Univariate and multivariate logistic regression analyses were performed. RESULTS 43.1% of drivers reported MS pain in at least one body area over the past 12 months and 26.8% over the past 7 days. Bulk drivers had a significantly higher prevalence of MS pain than P&D drivers for both periods. When P&D and Bulk drivers were pooled together, belonging to the Bulk subgroup emerged as the strongest factor for low back pain (OR = 8.45, p = 0.002), for shoulder pain (OR = 3.70, p = 0.027) and for MS pain in any body area (OR = 4.05, p = 0.006). In Bulk drivers "High effort-reward imbalance" was strongly associated with MS pain in any body area (OR = 6.47, p = 0.01), with shoulder pain (OR = 4.95, p = 0.016), and with low back pain (OR = 4.51, p = 0.02). In P&D drivers MS pain in any body area was strongly associated with "Working with hands above shoulders" (OR = 6.58, p = 0.009) and "Whole-body vibration" (OR = 5.48, p = 0.018), while shoulder pain was strongly associated with "Hand-arm vibration" (OR = 7.27, p = 0.041). CONCLUSIONS Prevalence of MS pain was higher among industrial gas delivery truck drivers than in the general Quebec male worker population, and higher for Bulk drivers compared to P&D drivers. MS pain in Bulk drivers was mainly associated with psychosocial risk factors and lifestyle; MS pain in P&D drivers was mainly associated with physical risk factors.
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Affiliation(s)
- Firdaous Sekkay
- Department of Mathematics and Industrial Engineering, Polytechnique Montreal, Montreal, Canada.
| | - Daniel Imbeau
- Department of Mathematics and Industrial Engineering, Polytechnique Montreal, Montreal, Canada
| | - Yuvin Chinniah
- Department of Mathematics and Industrial Engineering, Polytechnique Montreal, Montreal, Canada
| | - Philippe-Antoine Dubé
- Department of Mathematics and Industrial Engineering, Polytechnique Montreal, Montreal, Canada
| | | | - Nancy Beauregard
- School of Industrial Relations, University of Montreal, Montreal, Canada
| | - Martin Trépanier
- Department of Mathematics and Industrial Engineering, Polytechnique Montreal, Montreal, Canada
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Raffler N, Rissler J, Ellegast R, Schikowsky C, Kraus T, Ochsmann E. Combined exposures of whole-body vibration and awkward posture: a cross sectional investigation among occupational drivers by means of simultaneous field measurements. ERGONOMICS 2017; 60:1564-1575. [PMID: 28402232 DOI: 10.1080/00140139.2017.1314554] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 03/23/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Multifactorial workloads such as whole-body vibration (WBV), awkward posture and heavy lifting are potential predictors for low back pain (LBP). In this study, we investigate the association between LBP and these exposures among 102 professional drivers. METHODS The combined exposures of WBV and posture are measured at different workplaces. Health and personal data as well as information about lifting tasks are collected by a questionnaire. RESULTS The daily vibration exposure value (odds ratio 1.69) and an index for awkward posture (odds ratio 1.63) show significant association with the occurence of LBP. Awkward posture and heavy lifting appear to be more strongly associated with sick leave than WBV exposure. Furthermore, a combination of the measurement results of WBV and awkward posture into one quantity also shows significant correlation to LBP. CONCLUSION The combined exposure of WBV and awkward posture can be described in terms of the daily vibration exposure and the index for awkward posture. This facilitates work place assessments and future research in this area. Practitioner Summary: For the first time, quantitative measures combining whole-body vibration and awkward posture exposures have shown to correlate with the occurrence of low back pain significantly. This validates the proposed quantities and measurement methods, which facilitate workplace assessments and assist in the design of further studies which are necessary to establish a causal exposure-response relationship.
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Affiliation(s)
- Nastaran Raffler
- a Institute for Occupational Health and Safety of the German Social Accident Insurance (IFA) , Sankt Augustin , Germany
- b Institute and Outpatient Clinic for Occupational Medicine, University Hospital, Aachen University of Technology , Aachen , Germany
| | - Jörg Rissler
- a Institute for Occupational Health and Safety of the German Social Accident Insurance (IFA) , Sankt Augustin , Germany
| | - Rolf Ellegast
- a Institute for Occupational Health and Safety of the German Social Accident Insurance (IFA) , Sankt Augustin , Germany
| | - Christian Schikowsky
- b Institute and Outpatient Clinic for Occupational Medicine, University Hospital, Aachen University of Technology , Aachen , Germany
| | - Thomas Kraus
- b Institute and Outpatient Clinic for Occupational Medicine, University Hospital, Aachen University of Technology , Aachen , Germany
| | - Elke Ochsmann
- b Institute and Outpatient Clinic for Occupational Medicine, University Hospital, Aachen University of Technology , Aachen , Germany
- c Faculty of Health Care and Health Sciences, Zwickau University of Applied Sciences , Zwickau , Germany
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Haslam R. Ergonomics at 60: mature, thriving and still leading the way. ERGONOMICS 2017; 60:1-5. [PMID: 28027697 DOI: 10.1080/00140139.2016.1275150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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