Quality, productivity, and economic implications of exoskeletons for occupational use: A systematic review.

The objective of this systematic review was to synthesize the current state of knowledge on the quality and productivity of workers and their work while wearing exoskeletons, as well as the economic implications of exoskeletons for occupational use. Following the PRISMA guidelines, six databases were systematically searched for relevant journal articles, written in English, and published since January 2000. Articles meeting the inclusion criteria had their quality assessed using JBI's Checklist for Quasi-Experimental Studies (Non-Randomized Experimental Studies). A total of 6,722 articles were identified and 15 articles focusing on the impact of exoskeletons on quality and productivity of exoskeleton users while performing occupational tasks were included in this study. None of the included articles evaluated the economic implications of exoskeletons for occupational use. This study revealed several quality and productivity measures (e.g., endurance time, task completion time, number of errors, number of task cycles completed) used to evaluate the impact of exoskeletons. The current state of the literature suggests that quality and productivity impacts of exoskeleton use are dependent on task characteristics that should be considered when adopting exoskeletons. Future studies should evaluate the impact of exoskeleton use in the field and on a diverse pool of workers, as well as its economic implications to better support decision-making in the adoption of exoskeletons within organizations.

Synthesis of Evidence to Support EMS Personnel's Mental Health During Disease Outbreaks: A Scoping Review.

Emergency medical services (EMS) personnel are at high risk for adverse mental health outcomes during disease outbreaks. To support the development of evidence-informed mitigation strategies, we conducted a scoping review to identify the extent of research pertaining to EMS personnel's mental health during disease outbreaks and summarized key factors associated with mental health outcomes. We systematically searched three databases for articles containing keywords within three concepts: EMS personnel, disease outbreaks, and mental health. We screened and retained original peer-reviewed articles that discussed, in English, EMS personnel's mental health during disease outbreaks. Where inferential statistics were reported, the associations between individual and work-related factors and mental health outcomes were synthesized. Twenty-five articles were eligible for data extraction. Our findings suggest that many of the contributing factors for adverse mental health outcomes are related to inadequacies in fulfilling EMS personnel's basic safety and informational needs. In preparation for future disease outbreaks, resources should be prioritized toward ensuring adequate provisions of personal protective equipment and infection prevention and control training. This scoping review serves as a launching pad for further research and intervention development.

Organizational strategies to address posttraumatic stress injuries among Canadian paramedics.

BACKGROUND: Paramedics are a high-risk occupational group for posttraumatic stress injuries (PTSI), and increasingly, evidence suggests that organizational factors play a significant role. While several resources for paramedic services to address PTSI exist, there is limited knowledge as to which PTSI-related programs and practices are implemented and how they are perceived in the workplace. OBJECTIVES: This research aimed to explore key informants' perspectives on existing and desired organizational-wide initiatives for, as well as the challenges and potential solutions to, the primary prevention, early detection and intervention, and disability management of PTSI in Canadian paramedic services. METHODS: Semi-structured interviews were conducted with 12 key informants from jurisdictions across Canada who have over five years of work experience in prehospital care. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. RESULTS: Eight recurrent organizational elements (themes) for addressing PTSI emerged: psychologically safe and healthy work culture; consistent supervisor support, mental health training and awareness, opportunities for recovery and maintaining resiliency, recognition of PTSI and its diverse risk factors, access to a variety of support initiatives for PTSI, communication during medical leave, and meaningful work accommodations. CONCLUSIONS: While organizational-wide initiatives were in place for the primary prevention, early detection and intervention, and disability management of PTSI, systemic challenges with coordination, resource allocation, and worker engagement were also identified. These challenges prevented paramedic services from optimally addressing PTSI in their workplace. Integrating considerations from the eight organizational elements to address PTSI into broader existing management systems may have merit in overcoming the systemic challenges.

Exposure to Whole-Body Vibration in Commercial Heavy-Truck Driving in On- and Off-Road Conditions: Effect of Seat Choice.

Trucking is a key industry in Canada with around 180 000 professional drivers. As an industry it has a disproportionately high injury claim rate, particularly for back injuries. Whole-body vibration (WBV) can contribute to the onset and development of low back disorders, and is a well-documented exposure among driving professions. A widely adopted WBV mitigation measure focuses on hydraulic and/or pneumatic passive suspension systems both in the driver's seat and underneath the vehicle cab. Passive suspension 'air-ride' seats are the current industry standard but new technologies such as the electromagnetic active vibration cancelling (EAVC) seats offer potentially substantial improvements in WBV reduction. In this paper, we evaluate and compare four commonly used truck seats (three air-ride, one EAVC) for their vibration damping characteristics and WBV exposure attenuation in on- and off-road conditions. We recruited 24 professional truck drivers who drove 280 km (mixed on-road and off-road) in ore-haul trucks under four different seating conditions. Following the ISO 2631-1 WBV standard, vibration measurements were made on the cab floor and seat pad, and 8-h average weighted vibration (A(8)) and 8-h vibration dose values (VDV(8)) were calculated, as well as the Seat Effective Amplitude Transmissibility (SEAT), and daily vibration action limits (DVALs). These measures were compared between seat types, as well as road conditions. The EAVC seat gave best performance for both A(8) (0.27 m s-2) and VDV(8) (6.6 m s-1.75). The EVAC seat had the lowest SEAT tested (36.2%) and the longest DVAL. However, among the three passive air-suspension seats, two showed significantly reduced A(8) (0.43 and 0.44 m s-2) and VDV(8) (9.1 and 9.3 m s-1.75) exposures relative to the third passive air-suspension seats [A(8) (0.54 m s-2) and VDV(8) (11.1 m s-1.75)]. These differences in exposures among the three passive air-suspension seats resulted in varying DVAL times, with the worst performing seat reaching the DVAL after only 6.3 h of driving. There was also a seat by road type interaction; there were performance differences between the passive air-suspension seats on-road, but not off-road. The observed reduction of the WBV exposures measured from the EAVC seat was consistent with previous results. But we showed that there can also be substantive differences among seats that are the current industry standard. These differences were more evident on-road than off-road, which suggests that more work needs to be done to understand seat performance characteristics, and in matching the correct seat technology to the driving task. We demonstrated that WBV exposures in current industry conditions may exceed health-based exposure limits; this has policy relevance because WBV exposures are linked to prevalent and costly adverse health conditions in a working population that is ageing. Increased WBV measurement collection is recommended to ensure the anticipated exposure attenuations are achieved when seats are relied upon as an engineered control against WBV.