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BACKGROUND: Militaries have historically utilised generic physical fitness tests to assess physical readiness, but there has been a recent shift to develop physical employment standards (PES) based on actual job demands. OBJECTIVE: The purpose of this investigation was to characterise the physical demands of critical tasks performed by Royal Australian Air Force (RAAF) personnel to inform PES development. METHODS: Job task analysis were performed for 27 RAAF trades. Criterion tasks were identified through a systematic approach involving workshops and field-observations. The identified tasks were assessed for dominant physical capacity and grouped into movement-based clusters. Psychophysiological measures were collected from personnel performing the tasks. RESULTS: Of 87 criterion tasks, 92% were characterised as manual handling dominant. Across these 87 tasks the principal physical capacities were: muscular strength (59%), muscular endurance (52%) and cardiorespiratory endurance (39%). The most common movement clusters were Lift to Platform (44%) and Lift and Carry (38%). Lift to Platform tasks required lifting to a median height of 1.32 m (1.20 –1.65 m) and a median mass of 25.0 kg (21.0 –28.9 kg) per person. Median carry mass was 25.0 kg (22.4 –36.1 kg) per person and distance was 26.0 m (17.5 –50.0 m). Median task mean 'Vdot;O2, HR and RPE were 1.8 L.min- 1 (1.5–2.2 L.min- 1), 137 b.min- 1 (120–144) and 13 (12–14). CONCLUSIONS: The high proportion of manual handling criterion tasks emphasises the importance of these activities and the underlying physical capacities for RAAF personnel. Current fitness assessments are unlikely to predict job task performance. [ABSTRACT FROM AUTHOR]

The construction industry in many countries is faced with skill shortages. Attracting more female workers in the male-dominated construction industry can help alleviate this issue. However, perceived concerns of increased or specific Occupational Health and Safety (OHS) risks for females could be a significant deterrent. Due to their marginal representation in various trade roles, the overall analyses of OHS incident data fail to capture the specific OHS concerns that apply to female construction workers. This study presents an empirical analyses of workers' compensation data obtained from Safe Work Australia for 12 years (2008–2019) to investigate specific OHS risks for female construction workers. The annual average incident trend does not present a steady increase or decrease in permanent and temporary incapacities among female construction workers. Moreover, the incident number, severity, and employment data together reveal that female workers in both professional and manual or trade occupations have lower incident rates than their male counterparts. However, the findings also reveal that: (1) building and plumbing women laborers and earthmoving plant operators are more prone to injuries that result in permanent incapacities; (2) fractures, soft tissue injuries, deafness, anxiety, stress, and depression lead to permanent incapacities among female workers; and (3) falls on the same level, muscular stress while handling objects, long-term exposure to sounds, work pressure, workplace harassment, and bullying result in permanently incapacitating injuries. The study also noted the differences in the occupations, mechanisms of incidents, and injury types that contribute to most incidents among male and female construction workers. The findings of this study can help training providers, construction organizations, and practitioners identify specific OHS concerns for developing more comprehensive OHS management plans, training, and awareness programs for female construction workers. The existing OHS management and training programs should be remodeled accordingly to incorporate gender-specific OHS risks and injury mechanisms rather than a one-size-fits-all approach. Clients, specifically in public projects, may stipulate that the contractor provides gender-specific OHS management plans to ensure the OHS of workers of different genders. It is vital to educate female construction workers from various occupations about specific OHS risks, incident mechanisms, and preventive actions. The higher occurrence of musculoskeletal disorders due to handling objects demands redesigning work processes to reduce female construction workers' manual handling of objects. The present study also shows that work pressure, anxiety, and depression are prevalent among female construction workers, taxing their mental health and causing permanent incapacities. The psychosocial conditions and work pressure resulting from these health conditions must be managed at both the project and organizational levels to attract and retain more female workers in the construction industry. Such efforts are expected to improve female representation and their OHS, well-being, and job satisfaction and reduce skill shortages in the long run. [ABSTRACT FROM AUTHOR]

Introduction: Validity is a dynamic process and as part of a continual process of evaluation of tools, this study aimed to evaluate content validity of the WorkHab functional capacity evaluation, a tool used in occupational rehabilitation. Methods: A cross sectional survey of health professionals who conduct FCEs investigated their ratings of item relevance and item difficulty across different categories of work and injuries. The survey also explored the relationship of the WorkHab FCE items with the physical demand items of the Dictionary of Occupational Titles (DOT). Results: The majority of items of the WorkHab FCE were rated as relevant for manual work and vocational retraining with over 90% agreement between the 106 respondents. Therapists identified the WorkHab items of climbing, crawling and balance as less relevant for sedentary work. Lifting items were perceived as the most difficult for those with a lower back injury, or an upper limb injury. Sixteen of the 18 WorkHab FCE items had 100% agreement with the equivalent items on the DOT. The WorkHab FCE items that had poor agreement with the DOT were mainly sensory items such as see, feel, talk and hear. Conclusions: The findings of this study support the content validity for the WorkHab FCE specifically in relation to manual work and for vocational retraining purposes. [ABSTRACT FROM AUTHOR]

Purpose To examine factors associated with Functional Capacity Evaluation (FCE) results in patients with painful musculoskeletal conditions, with focus on social factors across multiple countries. Methods International cross-sectional study was performed within care as usual. Simple and multiple multilevel linear regression analyses which considered measurement's dependency within clinicians and country were conducted: FCE characteristics and biopsychosocial variables from patients and clinicians as independent variables; and FCE results (floor-to-waist lift, six-minute walk, and handgrip strength) as dependent variables. Results Data were collected for 372 patients, 54 clinicians, 18 facilities and 8 countries. Patients' height and reported pain intensity were consistently associated with every FCE result. Patients' sex, height, reported pain intensity, effort during FCE, social isolation, and disability, clinician's observed physical effort, and whether FCE test was prematurely ended were associated with lift. Patient's height, Body Mass Index, post-test heart-rate, reported pain intensity and effort during FCE, days off work, and whether FCE test was prematurely ended were associated with walk. Patient's age, sex, height, affected body area, reported pain intensity and catastrophizing, and physical work demands were associated with handgrip. Final regression models explained 38‒65% of total variance. Clinician and country random effects composed 1-39% of total residual variance in these models. Conclusion Biopsychosocial factors were associated with every FCE result across multiple countries; specifically, patients' height, reported pain intensity, clinician, and measurement country. Social factors, which had been under-researched, were consistently associated with FCE performances. Patients' FCE results should be considered from a biopsychosocial perspective, including different social contexts. [ABSTRACT FROM AUTHOR]

A mismatch between physical ability and task requirements can increase the risk of on-the-job injury. Therefore, understanding key anthropometric characteristics associated with job performance is important in developing targeted training programs and selecting employees in physically demanding occupations. The aims of this study were to understand which anthropometric and demographic (age/sex) characteristics were associated with performance in a unilateral stretcher carry and bilateral jerry can and kettle bell carries. Sixty-seven enlisted Australian Army soldiers (46 men and 21 women) participated in this investigation. Body composition was quantified using dual-energy X-ray absorptiometry. Univariate and multivariable regression techniques were used to quantify correlations between anthropometric characteristics and carry performance. Median carry distance was 650 m (interquartile range [IQR] = 425-1,025 m) in the stretcher carry, 300 m (IQR = 215-445 m) in the jerry can carry, and 265 m (IQR = 200-400 m) in the kettle bell carry. Univariate analyses demonstrated that whole body, trunk, upper arm, forearm, and leg lean mass, as well as stature and body mass were associated with performance across the 3 carry tasks. Of these, leg lean mass was shown to be a key characteristic associated with carry performance. Subsequently, it is suggested that training programs focus on whole-body lean mass with specific emphasis on leg lean mass. Additionally, we demonstrated that age and sex were not significantly associated with carry performance when controlling for leg lean mass, indicating that modifiable factors can be targeted in training programs to improve job performance. [ABSTRACT FROM AUTHOR]

BACKGROUND: Workplace injuries place a significant physical, social and financial burden on organisations globally. Paramedics provide emergency management of workplace injuries, and are subjected to heightened injury risk as a direct consequence of providing such care. OBJECTIVE: This review aims to identify the current evidence reporting workplace musculoskeletal injury generally, and to relate this to pre-employment physical capacity testing within the paramedic industry specifically. METHOD: A search of the electronic databases (Ovid Medline, Cochrane Database of Systematic Reviews, NIOSHTIC- 2, RILOSH, CISDOC and HSELINE) was completed using the keywords musculoskeletal, workplace, injury, industrial, accident, pre-employment physical capacity testing, paramedic, emergency service employee, firefighter, and police. Articles were excluded if they did not describe pre-employment physical capacity testing, musculoskeletal injuries, or were not available in English. RESULTS: The electronic literature search identified 765 articles, following application of exclusion criteria: based on title/abstract of article (669); no relevance (62) or unavailable in English (4), 30 articles were included in this review. The review identified that physical fitness, gender, age, equipment and demographic variables were key factors in the current high rate of paramedic workplace injury. However, there is little evidence available to quantify the relationship between pre-employment physical capacity testing and subsequent injury amongst the paramedic cohort. CONCLUSION: Despite evidence suggesting that pre-employment physical capacity testing scores may be predictive of subsequent musculoskeletal injury in paramedics, there are currently no studies in this area. Quantifying the potential association between factors affecting the conduct of paramedic work and the type of injuries that result requires examination through future research. [ABSTRACT FROM AUTHOR]

Musculoskeletal injuries are reported as burdening the military. An identified risk factor for injury is carrying heavy loads; however, soldiers are also required to wear their load as body armour. To investigate the effects of body armour on trunk and hip kinematics during military-specific manual handling tasks, 16 males completed 3 tasks while wearing each of 4 body armour conditions plus a control. Three-dimensional motion analysis captured and quantified all kinematic data. Average trunk flexion for the weightiest armour type was higher compared with control during the carry component of the ammunition box lift (p < 0.001) and sandbag lift tasks (p < 0.001). Trunk rotation ROM was lower for all armour types compared with control during the ammunition box place component (p < 0.001). The altered kinematics with body armour occurred independent of armour design. In order to optimise armour design, manufacturers need to work with end-users to explore how armour configurations interact with range of personal and situational factors in operationally relevant environments. Practitioner Summary:Musculoskeletal injuries are reported as burdening the military and may relate to body armour wear. Body armour increased trunk flexion and reduced trunk rotation during military-specific lifting and carrying tasks. The altered kinematics may contribute to injury risk, but more research is required. [ABSTRACT FROM AUTHOR]

Carrying a casualty on a stretcher is a critical task conducted in a range of occupations. To ensure that personnel have the requisite physical capacity to conduct this task, two bilateral jerry can carries were used to predict individual performance in a four-person stretcher carry. Results demonstrated a bilateral 22-kg jerry can carry (R2 = 0.59) had superior predictive ability of stretcher carry performance than a bilateral 15-kg jerry can carry (R2 = 0.46). Pre- to post-carry changes in grip endurance (p > 0.05), back–leg isometric strength (p > 0.05) and leg power (p > 0.05) were not significantly different between carry tasks. There was no significant difference in heart rate (p > 0.05) and oxygen consumption (p > 0.05) between the stretcher carry and either jerry can carry. Thus, on the basis of performance correlations and physiological measures, the 22-kg jerry can carry is an appropriate predictive assessment of four-person stretcher carriage. Practitioner Summary:This study investigated the ability of a jerry can carry to predict individual performance on a four-person stretcher carry. Performance correlations were substantiated with physiological measures to demonstrate similar physical requirements between task and test. These results can be used to set physical employment standards to assess stretcher carriage. [ABSTRACT FROM AUTHOR]

The aim of this study was to simultaneously assess the changes in physiology, and kinematic and spatiotemporal features of gait, during prolonged load carriage in individuals without load carriage experience. Eleven males, representative of new military recruits, walked for 120 min at 5.5 km h− 1, 0% grade, on a motorised treadmill while carrying a 22 kg load. The load ( ≤ 30% body mass) was distributed over a weighted vest, combat webbing and replica model firearm, to reflect a patrol order load. Oxygen consumption and heart rate increased throughout the trial; however, apart from a minor increase in step length, there were no changes in the kinematic or spatiotemporal parameters, despite an increase in perceived exertion and discomfort. These data suggest that individuals with no experience in load carriage are able to maintain normal gait during 2 h of fixed speed walking, while carrying a patrol order load ≤ 30% body mass. Practitioner Summary:It is presumed that lower limb injury is associated with prolonged load carriage, especially in new military recruits. Our results suggest that prolonged carriage of a 22 kg load does not cause any functionally relevant gross biomechanical changes despite an increase in the physiological demands and perceived intensity of the task. [ABSTRACT FROM AUTHOR]

Introducing valid physical employment tests requires identifying and developing a small number of practical tests that provide broad coverage of physical performance across the full range of job tasks. This study investigated discrete lifting performance across various platform heights reflective of common military lifting tasks. Sixteen Australian Army personnel performed a discrete lifting assessment to maximal lifting capacity (MLC) and maximal acceptable weight of lift (MAWL) at four platform heights between 1.30 and 1.70 m. There were strong correlations between platform height and normalised lifting performance for MLC (R2 = 0.76 ± 0.18,p < 0.05) and MAWL (R2 = 0.73 ± 0.21,p < 0.05). The developed relationship allowed prediction of lifting capacity at one platform height based on lifting capacity at any of the three other heights, with a standard error of < 4.5 kg and < 2.0 kg for MLC and MAWL, respectively. Practitioner Summary:Physical employment tests must be both practical and reflective of job task demands. This study illustrates the potential for the implementation of a single discrete lifting assessment to predict performance across numerous occupational lifting heights. [ABSTRACT FROM AUTHOR]

BACKGROUND: The safe maximal lift for a person is often determined during a functional capacity evaluation. This determination is based upon observation of unsafe lifting techniques, however there is limited information on specific kinematic changes that assist a therapist's clinical reasoning and determination of the safe maximal lift. OBJECTIVE: To evaluate any change in kinematics between safe minimum and safe maximum floor-to-bench lifts during the WorkHab Functional Capacity Evaluation. METHOD: Twenty-eight healthy participants (age range 18-22 years) were digitally recorded completing the evaluation. Lumbar spine, hip, knee and ankle joint angles were measured using Dartfish Pro-suite software at the beginning (0/3), one third (1/3), two thirds (2/3) and end (3/3) of the lift in descending and ascending phases. Paired t-tests were used to compare joint angles at each point of minimum and safe maximum lifts. RESULTS: Significant changes in joint angles occurred lifting safe maximum weight compared to minimum weight. The lumbar spine was in greater flexion [4.9, 95% CI 2.1:7.7, p=0.001]; the knee joint was in less flexion descending [-4.5, 95% CI -8.1: -0.8, p=0.004 (3/3)] and ascending [-9.7, 95% CI -18.3: -1.16, p=0.027 (0/3)] and hip flexion increased at all points of the ascending phase (p&les; 0.021). The ankle joint was in less dorsiflexion while descending [8.0, 95% CI 3.4:12.7, p=0.001(2/3); 6.7, 95% CI 4.4:9.0, p&les;0.001(3/3)] and ascending [8.9, 95% CI 6.24:11.6, p=0.001(0/3); 3.6, 95% CI 1.5:5.7, p&les;0.001(3/3)]. CONCLUSIONS: This study provides insight into kinematic changes and support observations made by the WorkHab assessor in determining a safe maximal lift during floor-to-bench lifts. [ABSTRACT FROM AUTHOR]

The article reports on research which was conducted to investigate the relationship between discrete and repetitive military lifting and to assess the validity of implementing a discrete lifting test. Researchers evaluated 21 soldiers from the Australian Army who completed a whole-body box-lifting assessment as a one repetition maximum (1 RM) and a series of submaximal lifting repetitions (% 1 RM). They concluded that a discrete functional assessment should be used when providing coverage of a broad range of military lifting tasks.

Objective: The role of biomechanics during the overhead lift has not been widely investigated. This study aimed to evaluate any change in biomechanics between safe minimum and safe maximum overhead lifts during the WorkHab Functional Capacity Evaluation. Method: Thirty healthy participants (age range 18-22 years) were videotaped completing the overhead lift. Images at the beginning (0/3), one-third (1/3), two-thirds (2/3), and end of lift (3/3) were collected for the minimum and safe maximum lifts Measurement of joint angles of the wrist, elbow, shoulder and sagittal spine using Dartfish Prosuite software was completed. Paired t-tests were used to analyse the differences in joint angles between lifts. Results: Participants' biomechanics changed between the minimum and maximum lifts In comparison to minimum lifts, there was increased wrist ulnar deviation (10.50, 95% CI 4.39, 16.61, p=0.002), increased shoulder flexion (7.26, 95% CI 0.50, 14.01, p=0.036), increased thoracic extension (-3.40, 95% CI -5.36, -1.45, p=0.001), increased lumbar extension (3.75, 95% CI 1.39, 6.12, p=0.003), and decreased elbow flexion (-11.28, 95% CI -18.57, -4.00, p=0.004) in the maximum lifts. Conclusions: The results of this study provide insight into biomechanical changes during the overhead lifting, and support the clinical judgements made by the WorkHab assessor in determining safe maximal lift. [ABSTRACT FROM AUTHOR]

The article reports on research which was conducted to investigate the relationship between maximal lifting capacity and a self determined tolerable lifting limit and maximum acceptable lift across a range of military-relevant lifting tasks. Researchers evaluated 70 male soldiers from the Australian Army who performed seven strength based lifting tasks. They found that there was a consistent relationship between maximum lifting capacity and maximum acceptable lift for single lifting tasks.

Background. Sternal precautions are utilized within many hospitals with the aim of preventing the occurrence of sternal complications (eg, infection, wound breakdown) following midline sternotomy. The evidence base for sternal precaution protocols, however, has been questioned due to a paucity of research, unknown effect on patient outcomes, and possible discrepancies in pattern of use among institutions. Objective. The objective of this study was to investigate and document the use of sternal precautions by physical therapists in the treatment of patients following median sternotomy in hospitals throughout Australia, from immediately postsurgery to discharge from the hospital. Design. A cross-sectional, observational design was used. An anonymous, Web-based survey was custom designed for use in the study. Methods. The questionnaire was content validated, and the online functionality was assessed. The senior cardiothoracic physical therapist from each hospital identified as currently performing cardiothoracic surgery (N=51) was invited to participate. Results. The response rate was 58.8% (n=30). Both public (n=18) and private (n=12) hospitals in all states of Australia were represented. Management protocols reported by participants included wound support (n=22), restrictions on lifting and transfers (n=23), and restrictions on mobility aid use (n=15). Factors influencing clinical practice most commonly included "workplace practices/protocols" (n=27) and "clinical experience" (n=22). Limitations. The study may be limited by response bias. Conclusions. Significant variation exists in the sternal precautions and protocols used in the treatment of patients following median sternotomy in Australian hospitals. Further research is needed to investigate whether the restrictions and precautions used are necessary and whether protocols have an impact on patient outcomes, including rates of recovery and length of stay. [ABSTRACT FROM AUTHOR]

Kay K, Glass N. International Journal of Nursing Practice 2011; : 231-237 Nursing care involves complex patient handling tasks. Strategies to address associated manual handling issues commonly include training programmes, despite conflicting evidence regarding training efficacy for manual handling injury reduction. Resultant knowledge acquisition and skills transfer from training programmes are prerequisites for subsequent practice changes in the clinical setting. This paper draws upon the findings from a questionnaire completed by 100 nurses in an Australian private hospital in 2008. A substantial knowledge deficit was identified, despite previous training undertaken by participants. A striking finding was that although 82% ( n = 82) of nurses surveyed believed they used safe manual handling practices, only 18% ( n = 15) of these nurses correctly answered items assessing manual handling knowledge. The study suggests prudence in the assumption of skills and knowledge acquisition during manual handling training. It informs the development of future implementation strategies, and provides a contributory explanation for the limited application of recommended practices after training completion. [ABSTRACT FROM AUTHOR]

Abstract: The No Lifting Policy has been adopted in Australia to prevent back pain and injuries among nurses. The present study focuses on the intervention of the “No Lift System” (NLS). The purpose of this cross-sectional study was to evaluate the use of transfer equipment, number of injuries, pain/symptoms and absence from work among nurses after the intervention of the NLS (), and compare to nurses at two control hospitals (). A comprehensive questionnaire was used for data collection. The results show that at the hospital where the NLS had been introduced, the nurses used the purchased transfer equipment regularly. They had significantly fewer back injuries, less pain/symptoms and less absence from work due to musculoskeletal pain/symptoms compared with nurses at the control hospitals. The study showed strong evidence for supporting the implementation of the NLS. The positive results shown in the present study can probably be explained by the agreement between the management, the union and the nurses concerning the implementation of the NLS, as well as its comprehensive approach and participatory design. [Copyright &y& Elsevier]

The aims of this study were to identify patterns of manual handling activities and their associated injuries and consequences among nurses working at a large teaching and referral medical centre in Melbourne, Australia. A self-report 140-item questionnaire was distributed to 523 registered nurses working full time at the medical centre. Of the 269 (51.4%) nurses who completed the questionnaire, 108 (40.1%) retrospectively reported an injury associated with manual handling activity, of which 75.9% (82) comprised back injuries. When all full-time nurses working at the medical centre are considered, the prevalence of all manual handling injuries was 20.6% (n=108) and 15.7% (n=87) for back injuries. About two-thirds (67.6%) of all manual handling injuries were associated with direct patient care activities and another third (32.4%) with non-direct patient care activities. Approximately one-third (34.3%) of all injuries were associated with lifting patients and this activity comprised one half of all causes associated with injuries arising from direct patient care activities. The consequences of injuries were significant. Recommendations for reducing manual handling activities and injuries are made and future research directions are discussed. [ABSTRACT FROM AUTHOR]