Effects of a Participatory Ergonomics Intervention With Wearable Technical Measurements of Physical Workload in the Construction Industry: Cluster Randomized Controlled Trial

Ergonomic interventions to improve musculoskeletal disorders among vehicle assembly workers: a one-year longitudinal study

BACKGROUND

Musculoskeletal disorders (MSDs) constitute a significant challenge in the realm of occupational health, especially in the manufacturing sector, necessitating the development of efficacious intervention strategies to enhance musculoskeletal health and reduce the incidence of MSDs. The present study is designed to assess the efficacy of a comprehensive ergonomic intervention, specifically tailored to diminish ergonomic risk factors and the prevalence of MSDs among workers engaged in vehicle assembly line operations.

METHOD

This interventional study, conducted over a one-year period, was implemented among assembly line workers within a rail bound vehicle manufacturing shop. The study engaged 181 participants who were subjected to a comprehensive ergonomic intervention plan. This intervention encompassed an ergonomic training program, enhancements in auxiliary tool, and the distribution of an ergonomic educational brochure. Workstation ergonomics, including postures and movements, vibrations, and work stress, were evaluated using the Quick Exposure Check (QEC). Participants scored their postural exposure and the intensity, duration, and frequency of musculoskeletal symptoms at nine anatomical sites in the modified Nordic Musculoskeletal Questionnaire. All evaluations were conducted at baseline and after a one-year follow-up.

RESULTS

After the one-year intervention, the QEC scores for the neck, back, shoulders/arms, and wrists/hands decreased significantly (p < 0.01). The self-rated exposure scores for 22 awkward postures and repetitive movements were much lower than at baseline (p < 0.05). Moreover, the self-reported intensity, duration, and frequency of musculoskeletal symptoms in nine body areas all decreased significantly (p < 0.05).

CONCLUSIONS

The findings from this prospective study indicated enhancements in ergonomic conditions and a reduction in musculoskeletal disorders (MSDs) among vehicle assembly workers following a comprehensive ergonomic intervention.

Wearable Sensors in Industrial Ergonomics: Enhancing Safety and Productivity in Industry 4.0

The fourth industrial revolution has transformed industrial ergonomics through the adoption of wearable technologies to enhance workplace safety and well-being. This study conducts a comprehensive scoping review, structured according to PRISMA guidelines, examining how wearable devices are revolutionizing ergonomic practices within Industry 4.0. After analyzing 1319 articles from major databases including SpringerLink, MDPI, Scopus, and IEEEXplore, 36 relevant studies were selected for detailed analysis. The review specifically focuses on how wearable technologies improve worker comfort and safety, promoting more productive work environments. The findings reveal that wearable devices have significantly impacted ergonomic conditions in industrial settings, with artificial intelligence integration showing the highest presence in analyzed applications. Over the past years, wearable technology implementations have demonstrated a 38% improvement in optimizing ergonomic conditions compared to traditional approaches.

Self-Management Strategies for Low Back Pain Among Horticulture Workers: Protocol for a Type II Hybrid Effectiveness-Implementation Study

BACKGROUND

Low back pain (LBP) is highly prevalent and disabling, especially in agriculture sectors. However, there is a gap in LBP prevention and intervention studies in these physically demanding occupations, and to date, no studies have focused on horticulture workers. Given the challenges of implementing interventions for those working in small businesses, self-management offers an attractive and feasible option to address work-related risk factors and manage LBP.

OBJECTIVE

This study will (1) investigate the effectiveness of self-management strategies for nursery and landscape workers by comparing within-subject control and intervention periods and (2) determine if adoption and effectiveness differs between participants randomly assigned to review self-management videos only and those who also receive multimodal implementation support. We will also identify contextual factors impacting effectiveness and implementation.

METHODS

A pragmatic, mixed methods, hybrid effectiveness and implementation design will be used to compare back pain with work tasks, disability, medication and substance use, and psychological factors between a baseline control and intervention periods. We aim to recruit 122 English- and Spanish-speaking horticulture workers with back pain, 30 supervisors, and 12 focus group participants. Participants will review short video modules designed to increase awareness of opioid risk and introduce self-management and ergonomic choices and use 1 self-management and 1 ergonomic strategy for 10 weeks. They will be randomly assigned to 2 implementation groups: video modules only or video + multimodal personalized support (checklist guidance, review of video feedback for ergonomic problem-solving, and text message reminders). Questionnaires will be administered at 3-month time points: baseline, pre- and postintervention, and at 3 and 6 months. Qualitative analysis of field notes, open-ended comments, and focus groups will expand understanding of results with comprehensive documentation of the context, barriers and facilitators, and reasons for adoption.

RESULTS

The project was funded on September 29, 2023 (Centers for Disease Control and Prevention National Institute of Occupational Health and Safety, CDC NIOSH; U54OH011230-07S1), as a core research grant for the Southeast Coastal Center for Agricultural Health and Safety. The design, creation, and editing of English and Spanish videos was completed in June 2024 after comprehensive formative evaluation. Enrollment began in June 2024 with anticipated completion in 2027.

CONCLUSIONS

We hypothesize that both self-management interventions will result in reductions in work task pain and disability and that the video enhanced with multimodal personalized support will result in greater reductions than the video alone. If self-management is effective, mitigating pain positively impacts quality of life, productivity, and retention, while increasing the use of nonpharmacological alternatives to opioids addresses an important public health issue. Implementation aims will help inform reasons for results, barriers and facilitators, and potential for similar interventions in these and similar industries with physically challenging outdoor work.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06153199; http://clinicaltrials.gov/study/NCT06153199.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/64817.

Effectiveness of workplace health promotion programs for industrial workers: a systematic review

BACKGROUND

Workplace health promotion is essential for individual and organisational well-being and disease prevention, also in industrial workers. As the transfer of the evidence on the effectiveness of such programs into practice is limited due to scattered effects, the need for a consolidation of the available studies is given. The purpose of this systematic review was to synthesise the evidence on the effectiveness of workplace health promotion programs for industrial workers.

METHODS

An electronic literature search was conducted in PubMed, Cochrane Library, Web of Science™, Scopus, and EBSCOHost until July 26th 2023. Studies investigated industrial workers who performed manual labour for at least 20 h per week were included. They had to receive a workplace health promotion intervention under any control condition. Outcomes were workplace health interventions' safety and corresponding health-related outcomes. The revised Cochrane risk-of-bias assessed the risk of bias (Rob 2) tool for randomised control trials (RCT) and cluster RCT. Quality assessment was performed using a modified Downs and Black Checklist.

RESULTS

Of the 25,555 studies initially identified, 39 were included. Generally, the mean quality of the studies was moderate, with most studies judged with a high overall risk of bias. Twenty-seven studies employed a behavioural approach, while one study adopted an organisational one. Ten studies utilised a multicomponent approach, and one intervention improved safety outcomes. The analysis of the results indicated an overall positive but heterogeneous effect across the different approaches.

CONCLUSIONS

The studies included in this review provide evidence that workplace health promotion can be effective. However, the overall findings are inconclusive due to the high risk of bias. Therefore, the results should be interpreted cautiously. Despite the considerable amount of research conducted in this field, additional well-designed studies are needed to fully confirm the effectiveness and determine the most promising types of interventions for improving and maintaining industrial health.

The Use of Wearable Systems for Assessing Work-Related Risks Related to the Musculoskeletal System-A Systematic Review

Work-related musculoskeletal disorders (WRMSDs) are a leading cause of chronic conditions among working-age adults. Preventing these disorders is crucial to reducing their impact, and quantitative analysis through sensors can help identify their causes and guide ergonomic solutions. This systematic review aims to compile research from 2000 to 2023 published in English and sourced from Web of Science, Scopus, or PubMed that examines workers' movements during tasks using wearable sensor systems that are applicable in workplace settings. The goal is to identify the job sectors that have been studied and highlight tasks lacking ergonomic risk research. A total of 111 papers were selected through a screening process across three databases, assessed using the McMaster risk of bias tool. The studies span various job sectors and report on the use of different technologies for data collection and study population sizes. The review identifies existing research on WRMSD risks utilizing wearable systems in different job sectors, drawing attention to under-researched areas that warrant further study. It serves as a foundation for future research aimed at understanding the causes of WRMSDs and developing solutions supported by wearable technologies to mitigate these risks.

Frequency of breaks, amount of muscular rest, and sustained muscle activity related to neck pain in a pooled dataset

BACKGROUND

Neck pain remains a persistent challenge in modern society and is frequently encountered across a wide range of occupations, particularly those involving repetitive and monotonous tasks. It might be expected that patterns of trapezius muscle activity at work, characterized by few breaks and prolonged periods of sustained muscle activity, are linked to neck pain. However, previous cross-sectional studies have generally failed to establish a definitive association. While some longitudinal studies have suggested that extended periods of heightened muscle activity could be a risk factor for neck pain, these findings often relied on limited participant numbers or specific professional groups. This study aimed to investigate the relationship between trapezius muscle activity and neck pain by pooling data from seven Scandinavian research institutes encompassing a diverse range of occupational backgrounds.

METHODS

Electromyographic (EMG) data for the upper trapezius muscle, collected during working hours, were coupled with questionnaire responses pertaining to neck pain, individual characteristics, and potential confounding variables for a total of 731 subjects. Additionally, longitudinal data from 258 subjects were available. The various EMG datasets were consolidated into a standardized format, and efforts were made to harmonize inquiries about neck pain. Regression analyses, adjusting for sex and height, were conducted to explore the associations between muscle activity variables and neck pain. An exposure index was devised to quantify the cumulative neck load experienced during working hours and to differentiate between various occupational categories.

RESULTS

The cross-sectional data displayed a distinct pattern characterized by positive associations for brief periods of sustained muscle activity (SUMA) and negative associations for prolonged SUMA-periods and neck pain. The longitudinal data exhibited a contrasting trend, although it was not as pronounced as the cross-sectional findings. When employing the exposure index, notable differences in cumulative muscle load emerged among occupational groups, and positive associations with longitudinal neck pain were identified.

DISCUSSION

The results suggest that individuals with neck pain experience higher cumulative workloads and extended periods of muscle activity over the long term. In the short term, they appear to compensate by taking frequent short breaks, resulting in a lower cumulative workload. Regardless of their occupation, it is crucial to distribute work breaks throughout the workday to ensure that the cumulative load remains manageable.

Acute Effects of a Warm-Up Intervention on Pain, Productivity, Physical Capacities and Psychological Perceptions Among Vineyard Workers: a Cluster Randomized Trial

PURPOSE

Agriculture is one of the sectors that are the most concerned by musculoskeletal disorders (MSDs). Workplace physical activity programs are one of the most promising solutions to prevent adverse consequences of MSDs such as pain or impairment in physical capacities. The aims of this study were twofold: (1) to investigate the acute effect of a warm-up session on pain, work performance, physical capacities and psychosocial perceptions among vineyard workers; (2) to determine the most beneficial warm-up modality for vineyard workers.

METHODS

A cluster randomized study was implemented among 92 French vineyard workers. A 15 min single session of warm-up was implemented among four groups corresponding to four different conditions: (1) hybrid warm-up intervention (HWU); (2) dynamic warm-up intervention (DWU); (3) stretching warm-up intervention (SWU); (4) no warm-up intervention (CONTROL).

RESULTS

DWU showed significant increased performance (p < 0.05), increased heart rate (p < 0.001), better readiness to work (p < 0.05) and lower workload (p < 0.05) than the CONTROL. HWU showed a better readiness to work (p < 0.01). SWU showed better work quality (p < 0.05). However, the three different warm-up protocols did significantly not differ from the CONTROL group in terms of perceived pain intensity, and physical capacities.

CONCLUSION

The present findings confirm some beneficial acute effects on performance, heart rate and psychological perceptions of a single warm-up session performed before pruning. The DWU seems to be the most beneficial warm-up modality.

TRIAL REGISTRATION

NCT05425693. Registered 06/16/2022 in www.

CLINICALTRIALS

gov .

Association of objectively measured lifting load with low-back pain, stress, and fatigue: A prospective cohort study

OBJECTIVES

Limited knowledge exists about the association of lifting loads on a daily basis with physical and mental symptoms among warehouse workers. This study investigated associations between objectively measured lifting load and low-back pain (LBP), mental stress, and bodily fatigue after work and the following morning.

METHODS

Warehouse workers (N=85) from the retail industry replied to daily questionnaires before and after work for 21 days about LBP intensity, mental stress, and bodily fatigue (outcome, all scales 0-10). We assessed lifting exposure using company records from the warehouse logistic systems on total lifting load (kg) per workday. Associations between variables were tested using linear mixed models with repeated measures controlling for relevant confounders.

RESULTS

Mean daily lifting load was 1667.2 kg (range: 0-9998.4 kg). Compared to lifting 0-499 kg during a workday, lifting 500-1999 kg was associated with 0.59 points [95% confidence interval (CI) 0.10-1.08] elevated LBP intensity after work, while lifting ≥5000 showed a higher LBP intensity of 1.26 points (95% CI 0.48-2.03). LBP intensity remained elevated the following morning. Lifting ≥5000 kg was associated with higher mental stress after work of 0.74 points (95% CI 0.10-1.37), while no association was observed for bodily fatigue.

CONCLUSIONS

Higher daily lifting loads were associated with higher LBP intensity after work and the following morning. These findings suggest that warehouses should consider the daily lifting loads when organizing warehouse work to prevent development of LBP, eg, using company records to provide a more equal distribution of daily lifting loads between workers.

Influence of brick laying height on biomechanical load in masons: Cross-sectional field study with technical measurements

BACKGROUND

Work-related musculoskeletal disorders (WMSDs) located in the low back and neck/shoulder regions are major concerns for both workers, workplaces, and society. Masons are prone to WMSD, because their work is characterized by repetitive work and high physical workload. However, the knowledge on the physical workload during bricklaying is primarily based on subjective measurements.

OBJECTIVE

This cross-sectional field study with technical measurements aimed to quantify physical workload in terms of muscular activity and degree of forward bending during bricklaying at different working heights among masons, i.e., knee, hip, shoulder, and above shoulder height.

METHODS

Twelve male (36.1±16.1 years) experienced masons participated in a cross-sectional field study with technical measurements. Surface electromyography from erector spinae longissimus and upper trapezius muscles and an inertial measurement unit-sensor placed on the upper back were used to assess the physical workload (level of muscle activation and degree of forward bending) different bricklaying heights. Manual video analysis was used to determine duration of work tasks, frequency, type, and working height. The working heights were categorized as 'knee', 'hip', 'shoulder', and 'above shoulder'. The 95 percentiles of the normalized Root Mean Square (RMSn) values were extracted assess from erector spinae and trapezius recordings to assess strenuous level muscle of muscle activation.

RESULTS

The RMSn of dominant erector spinae muscle increased from hip- to shoulder height (from 26.6 to 29.6, P < 0.0001), but not from hip to above shoulder height and decreased from hip to knee height (from 26.6 to 18.9, P < 0.0001). For the dominant trapezius muscle, the RMSn increased from hip- to shoulder- and above shoulder height (from 13.9 to 19.7 and 24.0, respectively, P < 0.0001) but decreased from hip- to knee height (from 13.9 to 11.5, P < 0.0001). Compared to hip height (27.9°), an increased forward bending was detected during bricklaying at knee height (34.5°, P < 0.0001) and a decreased degree of forward bending at shoulder- and above shoulder height (17.6° and 12.5°, P < 0.0001, respectively).

CONCLUSION

Based on technical measurements, bricklaying at hip height showed the best compromise between muscular load and degree of forward bending. This study contributes to the development of the work environment for masons and can help guide preventive initiatives to reduce physical workload.

Postural analysis and ergonomic intervention of unorganized workers in indian construction sectors

BACKGROUND

In India's fast-growing economy, the construction sector offers significant developments with huge employment opportunities but poses risks due to poor working environments and uncomfortable postures. Traditional methods, such as manual material handling, can lead to health hazards and musculoskeletal disorders such as overexertion, low back pain, etc.

OBJECTIVE

The purpose of this study was to analyze the working postures of unorganized employees engaged in residential buildings using Ergofellow software and to recommend changes in their unsafe working postures.

METHODS

Participants' working positions were video recorded and the postures were analyzed using Rapid Upper Limb Assessment (RULA), Rapid Entire Body Assessment (REBA) and Ovako Working Posture Analysis (OWAS). Paired sample t-tests were used to analyze significant differences between the RULA and REBA scores after the ergonomic interventions were implemented.

RESULTS

From the analysis of RULA, REBA and OWAS, the working postures showed a high risk of potential injury and required an immediate change in employees' working postures. The RULA and REBA scores were subsequently lower after the ergonomic interventions, which were based on ergonomic and safety principles. The paired sample t-tests with p-values of less than 0.05 demonstrated decreased risks after ergonomic interventions.

CONCLUSION

Working postures of the construction workers exposed to musculoskeletal disorders were examined and the ergonomic interventions were implemented. According to the recommendations, working positions were changed, and employee well-being was enhanced by reduced operational risks.

A Bibliometric Analysis of Neuroscience Tools Use in Construction Health and Safety Management

Despite longstanding traditional construction health and safety management (CHSM) methods, the construction industry continues to face persistent challenges in this field. Neuroscience tools offer potential advantages in addressing these safety and health issues by providing objective data to indicate subjects' cognition and behavior. The application of neuroscience tools in the CHSM has received much attention in the construction research community, but comprehensive statistics on the application of neuroscience tools to CHSM is lacking to provide insights for the later scholars. Therefore, this study applied bibliometric analysis to examine the current state of neuroscience tools use in CHSM. The development phases; the most productive journals, regions, and institutions; influential scholars and articles; author collaboration; reference co-citation; and application domains of the tools were identified. It revealed four application domains: monitoring the safety status of construction workers, enhancing the construction hazard recognition ability, reducing work-related musculoskeletal disorders of construction workers, and integrating neuroscience tools with artificial intelligence techniques in enhancing occupational safety and health, where magnetoencephalography (EMG), electroencephalography (EEG), eye-tracking, and electrodermal activity (EDA) are four predominant neuroscience tools. It also shows a growing interest in integrating the neuroscience tools with artificial intelligence techniques to address the safety and health issues. In addition, future studies are suggested to facilitate the applications of these tools in construction workplaces by narrowing the gaps between experimental settings and real situations, enhancing the quality of data collected by neuroscience tools and performance of data processing algorithms, and overcoming user resistance in tools adoption.

A Scoping Review of Interventions to Improve Occupational Safety and Health of Construction Workers

OBJECTIVE

This review comprehensively examines interventions which sought to improve the occupational safety and/or health of construction workers. Factors that explain the (in)effectiveness of interventions were also summarized.

DATA SOURCE

This review consisted of a search using two electronic databases, PubMed and Web of Science.

STUDY INCLUSION AND EXCLUSION CRITERIA

Targeted workers in the construction industry; had at least one primary outcome that aimed to improve occupational safety and/or health; were published between January 01, 1990 and December 01, 2019; and were written in English.

DATA EXTRACTION AND SYNTHESIS

Two researchers independently carried out the process of reviewing the titles, abstracts and full texts, and extracted all data. If there were differences, discussions were held until a consensus was reached.

RESULTS

A total of 1297 articles were retrieved and 24 were selected for final evaluation. Seventeen studies reported significant intervention effects, while 7 found their primary outcome not significantly improved.

CONCLUSION

Future research should place more effort on interventions aimed at improving both occupational safety and health outcomes in an integrated manner, with environmental interventions that accompany behavioral interventions at the individual level. Besides, additional effort is also needed to ensure the involvement of relevant stakeholders in designing the intervention, avoiding contamination effects (through cluster randomization), optimizing the "dosage" of intervention, and improving measurement of outcomes.

Biomechanical Assessments of the Upper Limb for Determining Fatigue, Strain and Effort from the Laboratory to the Industrial Working Place: A Systematic Review

Recent human-centered developments in the industrial field (Industry 5.0) lead companies and stakeholders to ensure the wellbeing of their workers with assessments of upper limb performance in the workplace, with the aim of reducing work-related diseases and improving awareness of the physical status of workers, by assessing motor performance, fatigue, strain and effort. Such approaches are usually developed in laboratories and only at times they are translated to on-field applications; few studies summarized common practices for the assessments. Therefore, our aim is to review the current state-of-the-art approaches used for the assessment of fatigue, strain and effort in working scenarios and to analyze in detail the differences between studies that take place in the laboratory and in the workplace, in order to give insights on future trends and directions. A systematic review of the studies aimed at evaluating the motor performance, fatigue, strain and effort of the upper limb targeting working scenarios is presented. A total of 1375 articles were found in scientific databases and 288 were analyzed. About half of the scientific articles are focused on laboratory pilot studies investigating effort and fatigue in laboratories, while the other half are set in working places. Our results showed that assessing upper limb biomechanics is quite common in the field, but it is mostly performed with instrumental assessments in laboratory studies, while questionnaires and scales are preferred in working places. Future directions may be oriented towards multi-domain approaches able to exploit the potential of combined analyses, exploitation of instrumental approaches in workplace, targeting a wider range of people and implementing more structured trials to translate pilot studies to real practice.

Association between long-term static postures exposure and musculoskeletal disorders among university employees: A viewpoint of inflammatory pathways

Background

Musculoskeletal disorders (MSDs) are critical occupational and social problems. With the improvement of production mechanization and automation, and the widespread application of computers, more occupations are exposed to static postures and load. This study explored the role of inflammation in the association between static postures exposure and MSDs.

Methods

This study adopted a prospective nested case-control design in which 66 lower back MSDs cases and 66 healthy controls were selected from a cohort study of university employees. The personal information, postural load, musculoskeletal symptoms, pressure pain thresholds (PPTs), and inflammatory cytokines were collected. Logistic and linear regressions were used to investigate the association among postural load, inflammatory cytokines, and lower back MSDs. Mediation analysis was used to calculate the mediation effect.

Results

The results of logistic and linear regressions showed that postural load and inflammatory cytokines were positively associated with lower back MSDs (P < 0.05), and postural load was positively associated with inflammatory cytokines (P < 0.05). Further, mediation analysis showed that the mediation effect of postural load on the lower back MSDs through TNF-α was 0.073 (95%CI: 0.025-0.128), and the mediation effect of posture load on the lower back MSDs through IL-6 was 0.098 (95%CI: 0.041-0.179), respectively.

Conclusion

Static postures were associated with the occurrence of MSDs through inflammatory cytokines, and low-level inflammation may be a critical early event in the generation of MSDs. This study may help bridge the gap of potential mechanisms linking static postures to increased risks of MSDs, and provide new evidence for targeted protection against the global increasing MSDs.

Evaluating the Effect of Supported Systematic Work Environment Management During the COVID-19 Pandemic: Protocol for a Mixed Methods Study

BACKGROUND

The work environment is a complex phenomenon in which many factors interact. Scientific research indicates a relation between the work environment and employee health, staff turnover, patient satisfaction, and patient safety. There is a great need for knowledge on how to conduct work environment interventions and practical work environment management to maximize benefits to the employees.

OBJECTIVE

The aim of this study is to explore how Occupational Health Service (OHS) support will affect the work environment, sick leave, staff turnover, patient satisfaction, and patient safety during and following the COVID-19 pandemic in a medical ward setting.

METHODS

A mixed methods evaluation of a concurrent work environment quality improvement project at the Department of Internal Medicine and Geriatrics in a local hospital in the south of Sweden will be performed.

RESULTS

The mixed methods evaluation of the quality improvement project received funding from Futurum-Academy for Health and Care, Jönköping County Council and Region Jönköping County, and the study protocol was approved by the Swedish Ethical Review Authority. The work environment quality improvement project will continue between May 2020 and December 2021.

CONCLUSIONS

The study might contribute to increased knowledge of how work environment interventions and practical work environment management can impact the work environment, and employee health, staff turnover, patient satisfaction, and patient safety. There is a need for knowledge in this area for OHS management to provide increased benefits to employees, employers, and society as a whole.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/34152.

The Importance of Lifting Height and Load Mass for Muscular Workload during Supermarket Stocking: Cross-Sectional Field Study

High physical work demands increase the risk of musculoskeletal disorders and sickness absence. Supermarket work involves a high amount of manual material handling. Identifying specific ergonomic risk factors is an important part of occupational health and safety efforts in the supermarket sector. In this cross-sectional field study among 64 supermarket workers, we used electromyography during the workday to determine the influence of lifting height and load mass on muscular workload of the low-back and neck/shoulder muscles during un-restricted manual material handling (grocery stocking). We found a significant effect of load mass, i.e., higher loads associated with higher muscular workload in the low-back and neck/shoulder muscles. We demonstrated a significant interaction between start and end position, i.e., lifts performed from 'Low' start positions to 'High' end positions demonstrated the highest low-back muscular workload, whereas 'High' positions were associated with increased neck/shoulder workload. In conclusion, lifting higher loads and lifting goods from low to high positions (low-back) and at high positions (neck/shoulder) are associated with higher muscular workload. These results can be used to guide highly warranted preventive initiatives to reduce the physical workload during supermarket work.

A vision for the future of wearable sensors in spine care and its challenges: narrative review

OBJECTIVE

This review aimed to: (I) provide a brief overview of some topical areas of current literature regarding applications of wearable sensors in the management of low back pain (LBP); (II) present a vision for a future comprehensive system that integrates wearable sensors to measure multiple parameters in the real world that contributes data to guide treatment selection (aided by artificial intelligence), uses wearables to aid treatment support, adherence and outcome monitoring, and interrogates the response of the individual patient to the prescribed treatment to guide future decision support for other individuals who present with LBP; and (III) consider the challenges that will need to be overcome to make such a system a reality.

BACKGROUND

Advances in wearable sensor technologies are opening new opportunities for the assessment and management of spinal conditions. Although evidence of improvements in outcomes for individuals with LBP from the use of sensors is limited, there is enormous future potential.

METHODS

Narrative review and literature synthesis.

CONCLUSIONS

Substantial research is underway by groups internationally to develop and test elements of this system, to design innovative new sensors that enable recording of new data in new ways, and to fuse data from multiple sources to provide rich information about an individual's experience of LBP. Together this system, incorporating data from wearable sensors has potential to personalise care in ways that were hitherto thought impossible. The potential is high but will require concerted effort to develop and ultimately will need to be feasible and more effective than existing management.

Technical field measurements of muscular workload during stocking activities in supermarkets: cross-sectional study

Multiple studies have reported high prevalence of musculoskeletal disorders among supermarket workers. Technical field measurements can provide important knowledge about ergonomic risk factors for musculoskeletal disorders in the physical working environment, but these measurements are lacking in the supermarket sector. Therefore, using wearable electromyography and synchronous video recording in 75 supermarket workers, this cross-sectional study measured muscular workload during stocking activities in six different types of general store departments and during the thirteen most common work tasks across five different supermarket chains. Our results showed that muscular workload varies, especially for the low-back muscles, across (1) supermarket chains, (2) departments, and (3) specific stocking activities. Highest workloads of the low-back and neck/shoulders were seen in the fruit and vegetables department and during heavy, two-handed lifts of parcels (especially without using technical aids). In conclusion, physical work demands during supermarket stocking activities differ between chains, departments, and work tasks. These results can be used by company representatives and work environment professionals to specifically address and organize the stocking procedures to reduce the muscular workload during supermarket stocking.

Psychological Effects of Heart Rate and Physical Vibration on the Operation of Construction Machines: Experimental Study

BACKGROUND

A construction method has emerged in which a camera is installed around a construction machine, and the operator remotely controls the machine while synchronizing the vibration of the machine with the images seen from the operator's seat using virtual reality (VR) technology. Indices related to changes in heart rate (HR) and physical vibration, such as heart rate variability (HRV) and multiscale entropy (MSE), can then be measured among the operators. As these indices are quantitative measures of autonomic regulation in the cardiovascular system, they can provide a useful means of assessing operational stress.

OBJECTIVE

In this study, we aimed to evaluate changes in HR and body vibration of machine operators and investigate appropriate methods of machine operation while considering the psychological load.

METHODS

We enrolled 9 remote operators (18-50 years old) in the experiment, which involved 42 measurements. A construction machine was driven on a test course simulating a construction site, and three patterns of operation-riding operation, remote operation using monitor images, and VR operation combining monitor images and machine vibration-were compared. The heartbeat, body vibration, and driving time of the participants were measured using sensing wear made of a woven film-like conductive material and a three-axis acceleration measurement device (WHS-2). We used HRV analysis in the time and frequency domains, MSE analysis as a measure of the complexity of heart rate changes, and the ISO (International Standards Organization) 2631 vibration index. Multiple regression analysis was conducted to model the relationship among the low frequency (LF)/high frequency (HF) HRV, MSE, vibration index, and driving time of construction equipment. Efficiency in driving time was investigated with a focus on stress reduction.

RESULTS

Multiple comparisons conducted via the Bonferroni test and Kruskal-Wallis test showed statistically significant differences (P=.05) in HRV-LF/HF, the vibration index, weighted acceleration, motion sickness dose value (MSDVz), and the driving time among the three operation patterns. The riding operation was found to reduce the driving time of the machine, but the operation stress was the highest in this case; operation based on the monitor image was found to have the lowest operation stress but the longest operation time. Multiple regression analysis showed that the explanatory variables (LH/HF), RR interval, and vibration index (MSDVz by vertical oscillation at 0.5-5 Hz) had a negative effect on the driving time (adjusted coefficient of determination R2=0.449).

CONCLUSIONS

A new method was developed to calculate the appropriate operating time by considering operational stress and suppressing the physical vibration within an acceptable range. By focusing on the relationship between psychological load and physical vibration, which has not been explored in previous studies, the relationship of these variables with the driving time of construction machines was clarified.

Engaging Occupational Safety and Health Professionals in Bridging Research and Practice: Evaluation of a Participatory Workshop Program in the Danish Construction Industry

Engaging occupational safety and health (OSH) professionals has scarcely been evaluated as a means for transferring knowledge to practice about physical workload in the construction industry. The aim of this work was to examine how participants used and incorporate research-based knowledge from a three-day training course into practice. Twenty OSH professionals from the Danish construction industry participated in a workshop-training course. Researchers presented new knowledge and results about physically demanding work. The participants selected which themes they wanted to work with and developed an action plan. Evaluation was done using surveys and phone interviews. Analysis was based on how the OSH-professionals describe themselves, organizations, and the construction industry. Participant’s average scores on the level of implementation of their chosen action plans were 3 (on a response scale from 1–5, where 1 is ‘to a very low degree’ and 5 is ‘to a very high degree’) immediately after the workshop program and 2.5 at follow-up. Qualitative evaluations showed that actions had been initiated, and some progress had been made. The participants were satisfied with the workshop course and the possibility to increase their knowledge through inputs from researchers and colleges and strongly believe that they would succeed with implementing their action plans in the future.

Interventions to Mitigate Fatigue Induced by Physical Work: A Systematic Review of Research Quality and Levels of Evidence for Intervention Efficacy

OBJECTIVE

We present a literature review on workplace physical fatigue interventions, focusing on evaluating the methodological quality and strength of evidence.

BACKGROUND

Physical fatigue is a recognized workplace problem, with negative effects on performance and health-related complaints. Although many studies have focused on the mechanisms and consequences of fatigue, few have considered the effectiveness of interventions to mitigate fatigue.

METHOD

A systematic review of the workplace safety literature for controlled trials of physical fatigue interventions was conducted. Data on intervention type, subject characteristics, targeted tasks and body locations, outcome measures, and study design were extracted. The methodological quality for each study was evaluated using the PEDro scale, and the level of evidence was based on quality, amount, and consistency.

RESULTS

Forty-five controlled trials were reviewed, examining 18 interventions. We categorized those interventions into individual-focused (N = 28 studies, nine interventions), workplace-focused (N = 12 studies, five interventions), and multiple interventions (N = 5 studies, four interventions). We identified moderate evidence for interventions related to assistive devices and task variation. There was moderate evidence supporting no fatigue attenuation for the garment change category of interventions. The interventions in the remaining categories had limited to minimal evidence of efficacy. The heterogeneity of the included trials precludes the determination of effect size.

CONCLUSION

This review showed a lack of high levels of evidence for the effectiveness of most physical fatigue interventions.

APPLICATION

Due to a lack of high levels of evidence for any category of reviewed physical fatigue interventions, further high-quality studies are needed to establish the efficacy of others.

A Systematic Review of Workplace Interventions to Rehabilitate Musculoskeletal Disorders Among Employees with Physical Demanding Work

Purpose This systematic review investigates the effectiveness of workplace interventions to rehabilitate musculoskeletal disorders (MSDs) among employees with physically demanding work. Methods A systematic search was conducted in bibliographic databases including PubMed and Web of Science Core Collection for English articles published from 1998 to 2018. The PICO strategy guided the assessment of study relevance and the bibliographical search for randomized controlled trials (RCTs) and non-RCTs in which (1) participants were adult workers with physically demanding work and MSD (including specific and non-specific MSD and musculoskeletal pain, symptoms, and discomfort), (2) interventions were initiated and/or carried out at the workplace, (3) a comparison group was included, and (4) a measure of MSD was reported (including musculoskeletal pain, symptoms, prevalence or discomfort). The quality assessment and evidence synthesis adhered to the guidelines developed by the Institute for Work & Health (Toronto, Canada) focusing on developing practical recommendations for stakeholders. Relevant stakeholders were engaged in the review process. Results Level of evidence from 54 high and medium quality studies showed moderate evidence of a positive effect of physical exercise. Within this domain, there was strong evidence of a positive effect of workplace strength training. There was limited evidence for ergonomics and strong evidence for no benefit of participatory ergonomics, multifaceted interventions, and stress management. No intervention domains were associated with "negative effects". Conclusions The evidence synthesis recommends that implementing strength training at the workplace can reduce MSD among workers with physically demanding work. In regard to workplace ergonomics, there was not enough evidence from the scientific literature to guide current practices. Based on the scientific literature, participatory ergonomics and multifaceted workplace interventions seem to have no beneficial effect on reducing MSD among this group of workers. As these interventional domains were very heterogeneous, it should also be recognized that general conclusions about their effectiveness should be done with care.Systematic review registration PROSPERO CRD42018116752 ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=116752 ).

A field study on spinal postures and postural variations during smartphone use among university students

This field study compared the real-time spinal movements and postural variations during smartphone-use versus non-use in university students. Ten males and eight females (mean age of 21.5 ± 2.6 years) participated, with similar daily phone use time between the two sexes. Five inertial motion sensors were attached to the cervical, thoracic and lumbar spinal regions, and kinematics was recorded for 3 h while participants went about their usual academic activities within the university campus. Significantly greater degrees of cervical and upper thoracic flexion were adopted during phone use versus non-use time (p < 0.01). There were also significantly greater frequency of postural variations (zero crossing per min) in all spinal regions in the sagittal plane (all p < 0.05), and in some of the movements in transverse and frontal planes comparing phone use vs non-use. The postural variables also showed some significant correlations with self-reported pre-existing neck and upper back pain scores.

Physical and psychosocial work environmental risk factors of low-back pain: protocol for a 1 year prospective cohort study

Background

Musculoskeletal disorders, and in particular low-back pain (LBP), are common among blue collar workers. In the work environment, both physical- and psychosocial risk factors exist. Working in warehouses in Denmark involve large quantities of occupational lifting, high work pace and a low degree of influence at work. This study investigates both acute and long-term associations between physical- and psychosocial work environmental factors and risk of LBP in warehouse workers. The specific study aims are to investigate 1) exposure-response associations between quantity of occupational lifting and short-term (day-to-day) changes in LBP, 2) the influence of accumulated workdays and rest days during a working week on LBP, 3) long-term association between occupational lifting exposure and LBP when assessed over 1 year, and 4) the role of psychological and social factors on the above associations.

Methods

The present study is designed as a 1-year prospective cohort study that will examine full-time warehouse workers from up to five retail chains in Denmark. Study aims 1 and 2 will be addressed using objective data based on company records with information on weight of all the goods handled by each warehouse worker during every single workday for 3 weeks. During this period, each worker will reply to text messages received before and after every workday (also on days off work) in which study participants will score their pain in the low back, bodily fatigue and perceived mental stress (scale 0–10). Long-term pain development is assessed using questionnaire surveys before and after 1 year. Further, pressure pain threshold (PPT) will be measured for selected trunk extensor muscles in approximately 50 workers using algometry along with measurements of maximal trunk extensor strength. Associations are modelled using linear mixed models with repeated measures between variables and LBP controlled for relevant confounders.

Discussion

This study provides knowledge about the acute and long-term associations between physical- and psychosocial work environmental factors and LBP. The obtained data will have the potential to provide recommendations on improved design of the working week to minimize the risk of LBP among warehouse workers, and may potentially enable to identify a reasonable maximum lifting threshold per day (ton lifted/day).