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Methods to assess physical load at work: With a focus on the neck and upper extremities
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. (Arbets- och miljömedicin)ORCID iD: 0000-0001-9354-6704
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Description
Abstract [en]

To prevent work-related musculoskeletal disorders (MSDs), useful, reliable and valid methods for assessing physical workload and risks for MSDs are needed. Ergonomists often assess work by short visual observations without a specific tool. A branch-specific tool was developed for assessing working technique during cash register work (BAsiK observation protocol).

Inclinometers are an alternative for assessing upper arm postures - over several days. Ergonomists need guidelines explaining how to analyze and interpret such data.

The aim was to examine and investigate methods for assessing physical load at work, with focus on the neck and upper extremities.

In Paper:

I, the reliability and criterion validity of the BAsIK observation protocol were assessed.

II, the reliability of risk assessments of repetitive work, based on visual observations performed by 21 ergonomists without a specific tool, was assessed.

III, whole-day inclinometer measurements of upper arm elevation were compared between work and leisure, across 13 different occupations – before and after arm elevations during sitting time was excluded.

IV, the association between inclinometer-based upper arm elevation and neck/shoulder pain was assessed among 654 blue-collar workers.

 

The intra-observer reliability of the BAsIK protocol was deemed acceptable, but only 3 of 10 questions in the protocol showed acceptable inter-observer reliability, and 3 showed acceptable criterion validity.

Neither the inter- or intra-observer reliability of risk assessment without any specific method was acceptable for any upper body regions.

None of the occupation groups, in paper III, had higher proportion of time with arm elevation during work than leisure. However, when arm elevation during sitting was excluded, 8 occupation groups had higher proportion of time with elevated arms during work than leisure.

Whole-workday inclinometer-based upper arm elevation was not associated with neck/shoulder pain within the assessed population.

   The results indicate that, in most cases, a single visual observation of a work sequence is not a reliable means of assessing repetitive work. A large proportion of arm elevation may derive from sitting time. At low exposure levels, arm elevation per se may not be a risk factor for neck/shoulder pain.

This must be taken into account when evaluating the risk for MSDs.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2017. , 52 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1388
Keyword [en]
risk assessment, physical load, upper extremities, ergonomics
National Category
Environmental Health and Occupational Health
Research subject
Occupational and Environmental Medicine
Identifiers
URN: urn:nbn:se:uu:diva-329801ISBN: 978-91-513-0118-1 (print)OAI: oai:DiVA.org:uu-329801DiVA: diva2:1150530
Public defence
2017-12-14, Konferensrummet Arbets- och miljömedicin, Daghammarskjölds väg 60, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Funder
AFA Insurance, 150035Swedish Retail and Wholesale Development Council, 2008:2Forte, Swedish Research Council for Health, Working Life and Welfare, 2012-1202
Available from: 2017-11-17 Created: 2017-10-19 Last updated: 2017-11-17
List of papers
1. Reliability and criterion validity of an observation protocol for working technique assessments in cash register work
Open this publication in new window or tab >>Reliability and criterion validity of an observation protocol for working technique assessments in cash register work
2016 (English)In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 59, no 6, 829-839 p.Article in journal (Refereed) Published
Abstract [en]

We evaluated the intra- and inter-observer reliability and criterion validity of an observation protocol, developed in an iterative process involving practicing ergonomists, for assessment of working technique during cash register work for the purpose of preventing upper extremity symptoms. Two ergonomists independently assessed 17 15-min videos of cash register work on two occasions each, as a basis for examining reliability. Criterion validity was assessed by comparing these assessments with meticulous video-based analyses by researchers. Intra-observer reliability was acceptable (i.e. proportional agreement >0.7 and kappa >0.4) for 10/10 questions. Inter-observer reliability was acceptable for only 3/10 questions. An acceptable inter-observer reliability combined with an acceptable criterion validity was obtained only for one working technique aspect, 'Quality of movements'. Thus, major elements of the cashiers' working technique could not be assessed with an acceptable accuracy from short periods of observations by one observer, such as often desired by practitioners. Practitioner Summary: We examined an observation protocol for assessing working technique in cash register work. It was feasible in use, but inter-observer reliability and criterion validity were generally not acceptable when working technique aspects were assessed from short periods of work. We recommend the protocol to be used for educational purposes only.

Keyword
Repetitivt arbete, muskeloskeletala besvär
National Category
Other Medical Sciences not elsewhere specified Environmental Health and Occupational Health
Identifiers
urn:nbn:se:uu:diva-276838 (URN)10.1080/00140139.2015.1098734 (DOI)000380150600010 ()26538287 (PubMedID)
Funder
Swedish Retail and Wholesale Development Council, 2008:2
Available from: 2016-02-16 Created: 2016-02-16 Last updated: 2017-10-19
2. Inter- and intra-observer reliability of risk assessment of repetitive work without an explicit method
Open this publication in new window or tab >>Inter- and intra-observer reliability of risk assessment of repetitive work without an explicit method
2017 (English)In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 62, 1-8 p.Article in journal (Refereed) Published
Abstract [en]

A common way to conduct practical risk assessments is to observe a job and report the observed long term risks for musculoskeletal disorders. The aim of this study was to evaluate the inter- and intra-observer reliability of ergonomists' risk assessments without the support of an explicit risk assessment method. Twenty-one experienced ergonomists assessed the risk level (low, moderate, high risk) of eight upper body regions, as well as the global risk of 10 video recorded work tasks. Intra-observer reliability was assessed by having nine of the ergonomists repeat the procedure at least three weeks after the first assessment. The ergonomists made their risk assessment based on his/her experience and knowledge. The statistical parameters of reliability included agreement in %, kappa, linearly weighted kappa, intraclass correlation and Kendall's coefficient of concordance. The average inter-observer agreement of the global risk was 53% and the corresponding weighted kappa (K-w) was 0.32, indicating fair reliability. The intra-observer agreement was 61% and 0.41 (K-w). This study indicates that risk assessments of the upper body, without the use of an explicit observational method, have non-acceptable reliability. It is therefore recommended to use systematic risk assessment methods to a higher degree.

Keyword
Inter-observer reliability, Intra-observer reliability, Risk assessment, Observational methods
National Category
Environmental Health and Occupational Health
Identifiers
urn:nbn:se:uu:diva-276859 (URN)10.1016/j.apergo.2017.02.004 (DOI)000401206600001 ()28411720 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 1212-1202
Note

Title in thesis list of papers: Inter- and intra-observer reliability of risk assessment of repetitive work without any specific method

Available from: 2016-02-16 Created: 2016-02-16 Last updated: 2017-10-19Bibliographically approved
3. Exposure to upper arm elevation during work compared to leisure among 13 different occupations measured with tri-axial accelerometers
Open this publication in new window or tab >>Exposure to upper arm elevation during work compared to leisure among 13 different occupations measured with tri-axial accelerometers
Show others...
(English)In: Annals of work exposures and health, ISSN 2398-7308Article in journal (Refereed) Submitted
Place, publisher, year, edition, pages
Oxford University Press
Keyword
ergonomics, leisure, occupation, arm elevation, inclinometer, measurement strategy, neck and shoulder load, risk assessment
National Category
Environmental Health and Occupational Health
Research subject
Occupational and Environmental Medicine
Identifiers
urn:nbn:se:uu:diva-329790 (URN)
Available from: 2017-09-21 Created: 2017-09-21 Last updated: 2017-10-19
4. Whole workday measurements of arm elevation and associations with neck shoulder pain among blue-collar workers in the DPHACTO cohort
Open this publication in new window or tab >>Whole workday measurements of arm elevation and associations with neck shoulder pain among blue-collar workers in the DPHACTO cohort
Show others...
(English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474Article in journal (Refereed) Submitted
Place, publisher, year, edition, pages
BioMed Central
Keyword
Neck and shoulder pain, arm elevation, inclinometer, occupational, work load, musculoskeletal disorders, cleaners, manufacturing workers, transportation workers
National Category
Environmental Health and Occupational Health
Research subject
Occupational and Environmental Medicine
Identifiers
urn:nbn:se:uu:diva-329797 (URN)
Funder
AFA Insurance, 150035
Available from: 2017-09-21 Created: 2017-09-21 Last updated: 2017-11-29

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