Comparison of multi-task ergonomic assessment methods for risk of upper extremity and low back musculoskeletal disorders.

Work-related musculoskeletal disorder of upper extremity multi-task assessment methods (Revised Strain Index [RSI], Distal Upper Extremity Tool [DUET]) and manual handling multi-task assessment methods (Revised NIOSH Lifting Equation [RNLE], Lifting Fatigue Failure Tool [LiFFT]) were compared. RSI and DUET showed a strong correlation (rs = 0.933, p < 0.001) where increasing risk factor exposure resulted in increasing outputs for both methods. RSI and DUET demonstrated fair agreement (κ = 0.299) in how the two methods classified outputs into risk categories (high, moderate or low) when assessing the same tasks. The RNLE and LiFFT showed a strong correlation (rs = 0.903, p = 0.001) where increasing risk factor exposure resulted in increasing outputs, and moderate agreement (κ = 0.574) in classifying the outputs into risk categories (high, moderate or low) when assessing the same tasks. The multi-task assessment methods provide consistent output magnitude rankings in terms of increasing exposure, however some differences exist between how different methods classify the outputs into risk categories.

The ACGIH TLV for lifting: Estimated TLVs for torso asymmetry beyond 30 degrees.

BACKGROUND: The American Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Values (TLVs) for Lifting is a manual material handling (MMH) assessment method to identify weight limits that nearly all workers may be exposed to without developing work-related low back disorders (LBD). However, this assessment method only applies to lifting with the torso within 30° asymmetry of the sagittal plane. OBJECTIVE: Estimate TLV weight limits while lifting with torso asymmetry greater than 30° beyond the sagittal plane. METHODS: Lifting tasks were performed from various horizontal and vertical locations, at torso asymmetry angles of 0°, 15°, 30°, 45°, 60°, 75° and 90°, using ACGIH identified TLVs. Validated MMH assessment methods (NIOSH Lifting Equation, Ohio State University LBD Risk Model) were utilized to estimate TLVs at torso asymmetries greater than 30°. RESULTS: The current ACGIH TLVs resulted in low- to moderate-risk risk levels for torso asymmetries from 0° to 30°, and the risk incrementally increased as torso asymmetry increased to 90°. With the intention to keep the risk levels to that found at 30° torso asymmetry, lower TLV weight limits in the vertical and horizontal zones investigated were estimated for torso asymmetries from 45° to 90°. The resulting adjusted TLVs were consistent with weight limits identified for similar lifting conditions from other assessment methods that account for torso asymmetry. CONCLUSIONS: This research found current ACGIH-defined TLVs possess less than high-risk for LBD, and provided guidance to practitioners for reduced TLVs when torso asymmetry is greater than 30° from the sagittal plane.

Comparison of ACGIH lifting threshold limit values to validated low back disorder lifting assessment methods outcomes.

BACKGROUND: Work-related low back pain (LBP) increases the workforce disability and healthcare costs. This study evaluated the LBD risk level associated with handling the ACGIH TLVs in lifting tasks corresponding to various horizontal and vertical zones. OBJECTIVE: The aim of this study was to compare the low-risk ACGIH TLV to risk outcomes from various validated lifting assessment methods, including the OSU LBD Risk Model, NIOSH Lifting Equation, and LiFFT. METHODS: Twenty-four subjects were recruited for this study to perform various lifting conditions. The various ergonomic assessment methods were then used to obtain the risk assessment outcomes. RESULTS: The selected assessment methods showed that the ACGIH-defined TLVs are associated with less than high-risk for LBD for all the assessed tasks. The findings showed a moderate agreement (Kendall's W = 0.477) among the various assessment methods risk outcomes. The highest correlation (ρ= 0.886) was observed between the NIOSH Lifting Equation and LiFFT methods risk assessment outcomes. CONCLUSION: The findings showed that ACGIH-defined TLVs possesses less than high-risk for LBD. The outcomes of the selected ergonomic assessment methods moderately agree to each other.

Influence of different passive shoulder exoskeletons on shoulder and torso muscle activation during simulated horizontal and vertical aircraft squeeze riveting tasks.

Aircraft manufacturing involves riveting utilizing squeeze riveting tools at heights from below elbow to overhead levels. This study assessed utilization of passive shoulder exoskeletons on shoulder and torso muscle activation during simulated squeeze riveting. Horizontal and vertical riveting tasks using squeeze riveting tools were performed by 16 aircraft workers wearing three different shoulder exoskeletons and a no-exoskeleton condition capturing electromyographic signals from shoulder and torso muscles. Exoskeletons reduced normalized EMG for the left anterior deltoid at both heights (6.6% and 15.7%), the right anterior deltoid (8.3%) and the right and left medial deltoid (9.3% and 8.9%) at the upper height for horizontal squeeze riveting. Exoskeletons reduced normalized EMG for the right and left anterior deltoids (7.0%-10.6%) and medial deltoids (1.3%-7.1%) within the upper zones during vertical squeeze riveting. Participants felt exoskeletons would be beneficial for squeeze riveting, however no preference was found among the exoskeletons used.

The effects of a fatiguing lifting task on postural sway among males and females.

Lifting and falls comprise a large proportion of work related injuries. Repetitive lifting to the point of fatigue can affect postural sway, which is associated with fall risk. To investigate the effects of lifting and fatigue on postural sway in males and females, 35 participants (18 male, 17 female) were asked to lift a weighted box in sets of 25 lifts at 5 different incremental weights (10, 15, 20, 25, and 30 kg) until fatigue. Before and after each lifting set, participants performed a single leg balance test on a force platform to assess postural sway by means of center of pressure mean velocity. Analysis of pre-fatigue to post-fatigue postural sway measurements indicated that there were no significant differences in mean velocity when males and females were grouped together. However, when analyzed as separate groups, mean postural sway center of pressure velocity increased for males but did not for females, indicating that males and females use different strategies to maintain balance when fatigued.

Repeatability of a checklist for evaluating cab design characteristics of heavy mobile equipment.

Risk factors associated with the development of musculoskeletal discomfort and disorders during the operation of heavy mobile equipment include whole-body vibration and awkward and sustained joint postures of the shoulders, neck, and trunk. Cab design may influence awkward postures of the joints, and task duration may influence duration of exposure to awkward and static postures and whole-body vibration. To reduce exposure to risk factors related to the interface between cab design and task, it may be necessary for manufacturers to address cab design. This study assessed the repeatability of a cab design checklist developed to evaluate various design characteristics that can influence exposure to risk factors for musculoskeletal discomfort. The ability of the cab design checklist to identify posture-related deficiencies of design was also assessed. The checklist was used by two administrators across 10 pieces of heavy construction equipment. Video analysis was performed to quantify postures of the neck, shoulder, and trunk; correlation analysis was used to determine whether specific questions from the checklist were associated with the identification of awkward postures. The repeatability assessment resulted in kappa coefficients ranging from 0.52 to 1.0 (good-to-excellent reproducibility) across each piece of equipment, and an overall kappa coefficient of 0.77 (excellent reproducibility) when considering all equipment together. Results from the correlation analysis showed that shoulder flexion posture was correlated with scores from the cab design checklist. However, results of the cab design checklist were not significantly correlated with shoulder abduction or awkward postures of the neck and trunk. Results suggest that the cab design checklist may be useful for identifying cab design characteristics that need further improvement and for identifying design characteristics that increase shoulder flexion. The strength of the repeatability assessment suggests that outcomes of the cab design checklist administered by different individuals may be consistent, independent of the type of equipment being assessed.

The effect of pallet distance on torso kinematics and low back disorder risk.

Intervention research for prevention of occupational low back injuries has focused on the effects of reducing extreme torso flexion and the external moment. Little is known about prevention strategies for torso twisting and lateral bending. The objective of this study was to assess the effect of pallet distance with regard to a constant lift origin on the torso kinematics and a measure of low back disorder risk. Fifteen male participants transferred 11.3 kg boxes from a constant origin to six different regions on a pallet. Two pallet distances with regard to the lift origin were investigated. ANOVA indicated that increasing the pallet distance resulted in increases in torso kinematics (velocities and accelerations) as well as a measure of risk of low back disorder. The increases in torso kinematics (e.g. twisting and lateral awkward postures and bending velocities) occurred mostly at the lower height regions on the pallet. It is concluded that increasing the pallet distance with regard to the lifting origin, with the intention to influence the participant to take a step during a palletizing task does not appear to be an effective intervention strategy to reduce the risk of low back disorder associated with torso kinematics.

Sagittal plane moment arms of the female lumbar region rectus abdominis in an upright neutral torso posture.

BACKGROUND: Prior imaging studies of torso muscle moment arms for use as inputs into biomechanical models have been derived from subjects lying supine. Recent research suggests moment arms of the rectus abdominis are larger when standing versus lying supine. METHODS: Axial MRI images, through and parallel to the intervertebral discs were obtained from five females in a standing upright neutral posture. Digitizing software was utilized to quantify the distance in the sagittal plane between the centroids of the intervertebral disc and the rectus abdominis muscle, and converted to the transverse plane to allow comparisons with studies with subjects in a supine posture. FINDINGS: The mean sagittal plane moment arms in the transverse plane were 9.7, 9.1, 8.5, 8.5 and 9.8 cm at the L(1)/L(2), L(2)/L(3), L(3)/L(4), L(4)/L(5) and L(5)/S(1) intervertebral levels, respectively. Compared with a study on females of a similar age group, the moment arms from this study were larger at each level, increasing from 7.3% larger at L(1)/L(2) to 43.7% larger at L(5)/S(1). INTERPRETATION: Accurate anatomical geometrical representation in biomechanical models is necessary for valid estimates of internal loading. Sagittal plane rectus abdominis moment arms were larger from the upright neutral torso posture in this study compared to studies with subjects lying supine. This suggests the torso internal moment generating capability would be represented differently in biomechanical models that use data from studies where subjects were upright, which is more reflective of the postures biomechanical models are utilized for, than when using anatomical geometry derived from supine postures.

Effect of torso flexion on the lumbar torso extensor muscle sagittal plane moment arms.

BACKGROUND CONTEXT: Accurate anatomical inputs for biomechanical models are necessary for valid estimates of internal loading. The magnitude of the moment arm of the lumbar erector muscle group is known to vary as a function of such variables as gender. Anatomical evidence indicates that the moment arms decrease during torso flexion. However, moment arm estimates in biomechanical models that account for individual variability have been derived from imaging studies from supine postures. PURPOSE: Quantify the sagittal plane moment arms of the lumbar erector muscle group as a function of torso flexion, and identify individual characteristics that are associated with the magnitude of the moment arms as a function of torso flexion. STUDY DESIGN/SETTING: Utilization of a 0.3 Tesla Open magnetic resonance image (MRI) to image and quantify the moment arm of the right erector muscle group as a function of gender and torso flexion. METHODS: Axial MRI images through and parallel to each of the lumbar intervertebral discs at four torso flexion angles were obtained from 12 male and 12 female subjects in a lateral recumbent posture. Multivariate analysis of variance was used to investigate the differences in the moment arms at different torso flexion angles, whereas hierarchical linear regression was used to investigate associations with individual anthropometric characteristics and spinal posture. RESULTS: The largest decrease in the lumbar erector muscle group moment arm from neutral to 45-degree flexion occurred at the L5-S1 level (9.7% and 8.9% for men and women, respectively). Measures of spinal curvature (L1-S1 lordosis), body mass and trunk characteristics (depth or circumference) were associated with the varying moment arm at most lumbar levels. CONCLUSIONS: The sagittal plane moment arms of the lumbar erector muscle mass decrease as the torso flexes forward. The change in moment arms as a function of torso flexion may have an impact on prediction of spinal loading in biomechanical models.