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Test methods that use pushing forces to evaluate the maximal load capacities of carts in design standards require a flat, smooth and horizontal steel plate and thus do not take into account the real conditions of work. Resistive forces of a single wheel of a cart in a uniform rectilinear motion were measured using a unique test bench with five loads. Forty-four wheels were tested (varying diameters, treads and bearings) with one steel plate and four resilient floor coverings. Based on a linear mixed model, all the following results were significant (p < 0.05). Resistive forces were increased linearly with the load and depended on the characteristics of both the wheel and floor. These forces decreased as the diameter increased. They were important for wheels with sleeve bearings but decreased for cone ball bearings and precision ball bearings. Resistive forces depended on the material of the tread and were higher for solid rubber treads. In contrast, the hardness of the tread had little effect. Resistive forces strongly depended on the hardness of the base foam of resilient floor coverings: the softer the base foam, the higher the resistive forces. Test methods in design standards should be reviewed, using corrective forces based on these present results, to prevent musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

There is disagreement regarding the efficacy of 'safe' lifting recommendations for reducing low back disorder risk. These recommendations commonly focus on minimising lumbar spine flexion, which limits the range of allowable starting lift positions for that person. This study evaluated whether starting postural adaptations could allow a person to reach down further without rounding their lumbar spine before beginning a lift. Reach displacement was measured as participants performed a series of maximal reach tasks under different combinations of stance width, foot orientation and trunk inclination, with their lumbar spine motion restricted. There were no interactions between any of the three postural adaptations or any effect of stance width or trunk inclination. Seventy-nine percent of participants achieved their greatest reach displacement with their feet externally rotated, which contributed to a 4 cm greater reach displacement compared to a neutral foot orientation (p < 0.001). Practitioner summary: This study examined whether aspects of initial posture could influence the ability to adhere to 'safe' lifting recommendations across a range of lift heights. As a component of lifting (re)training interventions, practitioners should consider starting lift posture adaptations (e.g. manipulating foot external rotation) to improve capacity to adhere to recommendations. [ABSTRACT FROM AUTHOR]

Musculoskeletal disorders (MSDs) are the main contributor to disability levels, which are rising as populations age. Workplace hazard exposures are a major source of this problem, and current workplace risk management practices require substantial changes to tackle it more effectively. Most importantly, the current focus of risk management on "manual handling" tasks must broaden to encompass the whole job. This is necessary because a wide range of psychosocial hazards, most of which operate across the whole job rather than particular tasks, are significant contributors to risk. To ensure that risk‐control actions are effective, a recurring risk management cycle that includes worker participation and addresses risk from both biomechanical and psychosocial hazards will be essential. Legislation that mandates workplace management of psychosocial hazards would be helpful. Amendment by regulatory bodies of MSD‐related guidance and codes of practice so that they reflect current research evidence would also be helpful in communicating the need for change to workplace stakeholders. [ABSTRACT FROM AUTHOR]

The global surge in demand for courier services has introduced both benefits and challenges. Courier workers face immense pressure to handle large volumes of orders, leading to increasing cases of health and occupational injuries. The lack of ergonomic interventions in their work highlights the urgent need for ergonomic assessments in the courier industry. In Malaysia, current ergonomic risk assessments for warehouse courier workers are insufficient, making it essential to identify prevalent musculoskeletal disorders (MSDs) and determine the associated risk factors and levels posed by their daily tasks. This study aimed to address this gap by conducting ergonomic risk assessments among 35 warehouse workers using the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), the Initial Ergonomic Risk Assessment (ERA) Checklist, and Rapid Entire Body Assessment (REBA). Three different work tasks were observed: scanning and sorting, tiered storage and stacking, and load unloading. The findings revealed that lower back pain was the most common ailment (14.5%), followed by hip pain (8.39%) and neck pain (7.89%). The tiered stacking storage activity posed the highest ergonomic risk, with identified risk factors including awkward postures, static and sustained activity, and repetitive tasks. The REBA analysis indicated a very high-level risk for tiered stacking storage, necessitating immediate ergonomic interventions. These findings contribute to the field of ergonomics and provide valuable insights for safety practitioners, ergonomists, researchers, and academicians in occupational safety and health and the courier service industries.

Test methods that use pushing forces to evaluate the maximal load capacities of carts in design standards require a flat, smooth and horizontal steel plate and thus do not take into account the real conditions of work. Resistive forces of a single wheel of a cart in a uniform rectilinear motion were measured using a unique test bench with five loads. Forty-four wheels were tested (varying diameters, treads and bearings) with one steel plate and four resilient floor coverings. Based on a linear mixed model, all the following results were significant (p < 0.05). Resistive forces were increased linearly with the load and depended on the characteristics of both the wheel and floor. These forces decreased as the diameter increased. They were important for wheels with sleeve bearings but decreased for cone ball bearings and precision ball bearings. Resistive forces depended on the material of the tread and were higher for solid rubber treads. In contrast, the hardness of the tread had little effect. Resistive forces strongly depended on the hardness of the base foam of resilient floor coverings: the softer the base foam, the higher the resistive forces. Test methods in design standards should be reviewed, using corrective forces based on these present results, to prevent musculoskeletal disorders.

Introduction: Manual handling personnel and those performing manual handling tasks in non-traditional manual handling industries continue to suffer debilitating and costly workplace injuries. Smart assistive devices are one solution to reducing musculoskeletal back injuries. Devices that provide targeted assistance need to be able to predict when and where to provide augmentation via predictive algorithms trained on functional datasets. The aim of this study was to describe how an increase in load impacts spine kinematics during a ground-to-platform manual handling task. Methods: Twenty-nine participants performed ground-to-platform lifts for six standardised loading conditions (50%, 60%, 70%, 80%, 90%, and 100% of maximum lift capacity). Six thoracic and lumbar spine segments were measured using inertial measurement units that were processed using an attitude-heading-reference filter and normalised to the duration of the lift. The lift was divided into four phases weight-acceptance, standing, lift-to-height and place-on-platform. Statistical significance of sagittal angles from the six spine segments were identified through statistical parametric mapping one-way analysis of variance with repeated measures and post hoc paired t-tests.Results: Two regions of interest were identified during a period of peak flexion and a period of peak extension. There was a significant increase in spine range of motion and peak extension angle for all spine segments when the load conditions were increased (p < 0.001). There was a decrease in spine angles (more flexion) during the weight acceptance to standing phase at the upper thoracic to upper lumbar spine segments for some condition comparisons. A significant increase in spine angles (more extension) during the place-on-platform phase was seen in all spine segments when comparing heavy loads (>80% maximum lift capacity, inclusive) to light loads (

The center of mass dynamics of the seated posture of humans in a work environment under hypogravity (0 < g < 1) have rarely been investigated, and such research is yet to be carried out. The present study determined the difference in the body system of 32 participants working under simulated 1/6 g (Moon) and 1 g (Earth) for comparison using static and dynamic task measurements. This was based on a markerless motion capture method that analyzed participants' center of mass at the start, middle and end of the task when they began to get fatigued. According to this analysis, there is a positive relationship (p < 0.01) with a positive coefficient of correlation between the downward center of mass body shift along the proximodistal axis and gravity level for males and females. At the same time, the same positive relationship (p < 0.01) between the tilt of the body backward along the anterior–posterior axis and the level of gravity was found only in females. This offers fresh perspectives for comprehending hypogravity in a broader framework regarding its impact on musculoskeletal disorders. It can also improve workplace ergonomics, body stability, equipment design, and biomechanics. [ABSTRACT FROM AUTHOR]

It is vital to assess workplace pushing and pulling (PP) activities to manage musculoskeletal injuries among employees. However, there is still no clearly-suited risk assessment method. This systematic review aims to provide an overview of risk assessment methods for PP activities at the workplace. Thus, the review employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two primary journal databases were searched, namely Scopus and Science Direct. Furthermore, to ensure the robustness of the study, the searches were expended via handpicking, snowball identification, and consultation with ergonomics experts. Atlas.ti version 8 software was used to analyse the identified articles thematically. The search resulted in nine articles eligible for the systematic analysis. From the articles, six assessment methods used force measurement as the main indicators, while three assessment methods used the weight of the load as measurement indicators. The assessment tools did not cover all the risk factors for PP activities. Besides, there was a lack of evidence showing the assessment tools or methods' reliability, validity, and usability. This systematic review highlighted the advantages and limitations of existing assessment methods, and no one method fits all. The findings showed that the assessment methods for PP activities still needed a force measurement and did not cover all the significant risk factors associated with PP. In addition, no clarifications were presented regarding the assessment methods' reliability, validity, and applicability. [ABSTRACT FROM AUTHOR]

Background: Low-friction slide sheets (SS) are designed to reduce compression loads on the body during manual handling tasks, such as boosting patients. Using SS has been shown to decrease muscle activity in the lower back and upper extremities. However, it is unclear if this effect varies with different bed positions. To investigate this, we studied the effects of SS use, bed height, and their combination on muscle activity during a simulated patient boost. Methods: Thirty-three Japanese undergraduate students (age 21.0 ± 1.1 years; 14 men, 19 women) participated. Participants were asked to boost a dummy figure on the bed three times each using four conditions. During the repositioning task, electromyography of eight muscles of the lower back and upper and lower extremities, hip and knee joint flexion angles, pelvic forward tilt angle, and position of the center of mass based on the posterior superior iliac spine were evaluated. Findings: Electrophysiological activities of muscles of lower back and upper extremities were significantly lower with SS than without it in both bed positions (30% and 40% of body height); the reduction in muscle activities with SS use was 20% to 40%. Lowering the bed did not affect the SS effect magnitude on reducing muscle activities, although postural changes, including hip and knee joint flexion, were observed. Conclusions/Application to Practice: SS reduced muscle activities in the back, upper, and lower extremities when the bed was in the low position, and this effect persisted at a bed height of ≥30% of the participant's height. [ABSTRACT FROM AUTHOR]

Background: Emergency medical services often have to extricate patients from their location and take them to an ambulance. High-quality training is required to ensure patient and staff safety during moving, handling and extrication manoeuvres. This study aimed to determine student satisfaction and selfconfidence regarding what they had learnt after a novel moving, handling and extrication simulation exercise in a children's soft play area. Methods: A mixedmethods cross-sectional survey was adopted, using the validated Student Satisfaction and Self-Confidence in Learning survey tool. Qualitative data were collected from an open question for additional comments. Student paramedics and student emergency medical technicians from one higher education institution completed four time-limited scenarios, each of which involved moving an immobile patient away from their environment. Descriptive statistics were determined for the participant characteristics and survey responses. Thematic analysis was performed on the qualitative data. Results: The student participants were aged 18--47 years and the majority were women. They were satisfied with both their learning and their self-confidence in what they had learnt after the simulation event, and felt their communication and teamwork skills had improved. They enjoyed the event more than classroom-based simulation. While they felt the simulation was realistic, suggestions were made to make it more so. Conclusion: Use of a children's soft play area for a moving, handling and extrication simulation provided student satisfaction and self-confidence in learning. [ABSTRACT FROM AUTHOR]

Abstract Background The Risk Assessment for moving Individuals SafEly (RAISE) program is a hospital-based manual handling nursing training program. RAISE involves upskilling on continual risk assessment during patient-assisted movements. RAISE aims to optimise staff and patient safety while providing the patient with movement and rehabilitation opportunities. Implementation of RAISE in the hospital setting has been established. The aim of this study was to explore the feasibility of implementing RAISE in the long-term care setting. Methods We examined three feasibility domains: acceptability, practicality, and limited efficacy (observed nursing behaviour change which has the potential to reduce nursing injuries), using a prospective pilot pre-post design in the long-term care setting. Staff completed a 4-hour training session on RAISE delivered by two physiotherapists, followed by 8 h of supported behaviour change in the workplace. Staff acceptability and practicality of incorporating risk assessment strategies into manual handling approaches were explored through pre- and post-training staff surveys and a semi-structured interview. Resident acceptability of manual handling practices was explored via survey data collected after the RAISE training. Pre to post-training changes in staff knowledge and behaviour were examined through the pre- and post-training staff survey, and observation of staff assisting resident movement. Results Two enrolled nurses and five residents participated. Staff reported the RAISE program was acceptable and practical to implement in the long-term care setting. There were no adverse events or safety concerns. Staff reported the RAISE program provided guidance and enhanced staff empowerment to make decisions during assisted resident movement. There were 26 observed resident-staff manual handling interactions recorded, with 13 pre-training and 13 post-training. Post-training, RAISE skills had improved and were completed 100% of the time, except for completing a physical risk assessment which improved from 46 to 85%, demonstrating limited efficacy. Residents reported it’s important for staff to be trained on how to assist them to mobilise and they found the concept of the RAISE program acceptable. Conclusions This pilot study supports the feasibility of long-term care facilities participating in future studies testing the effectiveness and cost-effectiveness of the Risk Assessment for moving Individuals SafEly (RAISE) patient and resident manual handling program.

BACKGROUND: Manual handling injuries amongst physiotherapists are common and the need to improve our understanding of causal influences is imperative. OBJECTIVE: The objective was to determine whether intra-shift variations in manual handling task performance occurred in our cohort, which may inform mechanisms underpinning related injuries. METHODS: We used motion capture, force plate dynamics and electromyography to identify variations in task performance, loading forces and muscle activity, during the performance of one static and one dynamic standardized manual handling task, pre- and post-shift, by 40 physiotherapists. Participants also rated their pain and fatigue on a visual analogue scale (VAS). Statistical analysis utilised paired samples Student's t tests. RESULTS: Significant differences were seen in the EMG activity in the quadriceps during the static task only. No significant differences were seen for any of the kinematic variables. Significant differences in fatigue (p < 0.005) were seen between the pre- and post-shift sessions. Notably, there were significant differences in pain between the pre- and post-shift sessions in the static (p < 0.01) and dynamic tasks (p < 0.05). This increase in pain was at a level which impacted on function. CONCLUSION: Whilst significant variations in task performance were not observed, our findings indicate that physiotherapists frequently experience task-related pain towards the end of their shift. Contemporary research indicates that frequent transient low back pain may transition to a chronic disabling condition, as such we posit that the effects of intra-shift pain, and its causative factors, should be more widely considered in a 'whole-of-job' approach to mitigating risk in this demographic. [ABSTRACT FROM AUTHOR]

Objective. Nursing workplace injuries related to staff-assisted patient/resident movement occur frequently, however, little is known about the programs that aim to prevent these injuries. The objectives of this study were to: (i) describe how Australian hospitals and residential aged care services provide manual handling training to staff and the impact of the coronavirus disease 2019 (COVID-19) pandemic on training; (ii) report issues relating to manual handling; (iii) explore the inclusion of dynamic risk assessment; and (iv) describe the barriers and potential improvements. Method. Using a cross-sectional design, an online 20-min survey was distributed by email, social media, and snowballing to Australian hospitals and residential aged care services. Results. Respondents were from 75 services across Australia, with a combined 73 000 staff who assist patients/residents to mobilise. Most services provide staff manual handling training on commencement (85%; n = 63/74), then annually (88% n = 65/74). Since the COVID-19 pandemic, training was less frequent, shorter in duration, and with greater online content. Respondents reported issues with staff injuries (63% n = 41), patient/resident falls (52% n = 34), and patient/resident inactivity (69% n = 45). Dynamic risk assessment was missing in part or in whole from most programs (92% n = 67/73), despite a belief that this may reduce staff injuries (93% n = 68/73), patient/resident falls (81% n = 59/73) and inactivity (92% n = 67/73). Barriers included insufficient staff and time, and improvements included giving residents a say in how they move and greater access to allied health. Conclusion. Most Australian health and aged care services provide clinical staff with regular manual handling training for staff‐assisted patient/resident movement, however, issues with staff injuries, as well as patient/resident falls and inactivity, remain. While there was a belief that dynamic in‐the‐moment risk assessment during staff‐assisted patient/ resident movement may improve staff and resident/patient safety, it was missing from most manual handling programs. [ABSTRACT FROM AUTHOR]

Back pain (BP) is a major cause of absenteeism in National Health Service (NHS) staff in the UK. However, the back beliefs of NHS staff with BP are unknown. To explore the BP beliefs of UK NHS staff presenting with BP, and how these beliefs are constructed. Purposive sampling of NHS staff with BP who had self-referred to University Hospitals of Leicester NHS Trusts occupational health physiotherapy service. 30 participants completed the Back-Pain Attitudes Questionnaire. Ten participants with a range of BP beliefs also completed semi-structured interviews. Mean responses, and frequency of different responses were reported, for the questionnaire data. Interviews were analysed using thematic analysis. Total Back-PAQ scores (mean −9.6, SD 9.16) indicated unhelpful BP beliefs overall, though some BP beliefs such as the potential benefit of exercise were more positive. Key themes identified from the interviews were; (i) the uniquely vulnerable nature of BP, (ii) the need to protect the back through avoidance behaviours, and (iii) the importance of being active for BP. NHS staff presenting with BP generally held negative BP beliefs, based on both questionnaire responses and the qualitative interviews. Awareness of the potential benefits of activity contrasted with the notion that ongoing protection of the back was required, and was evident in questionnaire data and interviews. Back pain beliefs were influenced by health care professional advice (both formal and informal settings), moving and handling training, family opinion and childhood experiences, offering insights into the settings where BP beliefs could be targeted. [ABSTRACT FROM AUTHOR]

Low back pain (LBP) is one of the most common occupational health problems affecting the working adult population. The study aimed to identify the ergonomic factors associated with LBP among ambulance workers in emergency departments. This cross-sectional study of 143 ambulance workers was conducted in 10 government hospitals. An English version of the questionnaire, including a Nordic Musculoskeletal Questionnaire and an LBP Risk Factor Questionnaire, was distributed to each respondent. Logistic regression analysis was used to analyse the results. The overall response rate was 85%. The majority of respondents who experienced LBP were aged 30 to 39 years (48.4%), male (69.9%), and of Malay ethnicity (98.5%). Handling difficult-to-grip objects (adjusted odds ratio [OR]: 0.12; 95% confidence interval [CI]: 0.02, 0.55; p-value: 0.007) and carrying heavy loads (adjusted OR: 17.44; 95% CI: 2.00, 151.69; p-value: 0.010) were associated with the occurrence of LBP among ambulance workers. The results highlighted the potential risks for ambulance workers in terms of carrying difficult-to-grasp and heavy loads. Hence, preventive measures, such as an ergonomic awareness programme, should be undertaken to increase awareness of proper ergonomic techniques in order to reduce the risk of LBP among ambulance workers.

Abstract Background Many workers performing manual handling tasks suffer from musculoskeletal disorders (MSD). Previous research has identified several loading aspects associated with manual handling, but it is still unknown if lifting on an unstable surface is associated with increased biomechanical loading of different body parts. Aim This proof-of-concept study aims to study what kinematic and kinetic movement parameters, such as movement time, joint angles, torque, and muscle activity are feasible and of importance when studying the effect of lifting on surfaces with varying degrees of stability in an experimental set-up. Methods Measurements were taken during three different surface conditions: stable, slightly unstable, and unstable. The participants were instructed to lift a box from the floor and place it on a table in front of them. The weight of the box varied from 0.5 to 15.5 kg. By using a motion capture system (VICON) with 28 reflective markers placed on the participants and one on the box, one Kistler force plate for measuring force levels and center of pressure movements (CoP), and four electromyographic transmitters (EMG), we analyzed the downward and upward phases of the lifting movement, using the Friedman’s test for repeated measures. Results Statistically significant results with less joint movements in the lower and upper back were seen with increased instability during both the downward and upward phases. The decrease in trunk movements with increased instability resulted in a somewhat more flexed knee position during the movement, a lower torque in the lower back, and a decrease in CoP movements, but no differences in movement time or muscle activity in back and knee muscles. Conclusion Lifting while standing on unstable surfaces resulted in an alteration of both kinematics and kinetics parameters; however, further studies regarding whether this is an additional risk factor for developing lower back pain are needed. Muscle activity levels were not altered due to instability and due to the complexity of the measurement, and we suggest not including EMG measures in future experiments of this type.

Background: The Risk Assessment for moving Individuals SafEly (RAISE) program is a hospital-based manual handling nursing training program. RAISE involves upskilling on continual risk assessment during patient-assisted movements. RAISE aims to optimise staff and patient safety while providing the patient with movement and rehabilitation opportunities. Implementation of RAISE in the hospital setting has been established. The aim of this study was to explore the feasibility of implementing RAISE in the long-term care setting. Methods: We examined three feasibility domains: acceptability, practicality, and limited efficacy (observed nursing behaviour change which has the potential to reduce nursing injuries), using a prospective pilot pre-post design in the long-term care setting. Staff completed a 4-hour training session on RAISE delivered by two physiotherapists, followed by 8 h of supported behaviour change in the workplace. Staff acceptability and practicality of incorporating risk assessment strategies into manual handling approaches were explored through pre- and post-training staff surveys and a semi-structured interview. Resident acceptability of manual handling practices was explored via survey data collected after the RAISE training. Pre to post-training changes in staff knowledge and behaviour were examined through the pre- and post-training staff survey, and observation of staff assisting resident movement. Results: Two enrolled nurses and five residents participated. Staff reported the RAISE program was acceptable and practical to implement in the long-term care setting. There were no adverse events or safety concerns. Staff reported the RAISE program provided guidance and enhanced staff empowerment to make decisions during assisted resident movement. There were 26 observed resident-staff manual handling interactions recorded, with 13 pre-training and 13 post-training. Post-training, RAISE skills had improved and were completed 100% of the time, except for completing a physical risk assessment which improved from 46 to 85%, demonstrating limited efficacy. Residents reported it's important for staff to be trained on how to assist them to mobilise and they found the concept of the RAISE program acceptable. Conclusions: This pilot study supports the feasibility of long-term care facilities participating in future studies testing the effectiveness and cost-effectiveness of the Risk Assessment for moving Individuals SafEly (RAISE) patient and resident manual handling program. [ABSTRACT FROM AUTHOR]

In manufacturing companies, manual material handling (MMH) involves lifting, pushing, pulling, carrying, moving, and lowering objects, which can lead to musculoskeletal disorders (MSDs) among workers, resulting in high labor costs due to excessive overtime incurred for manual product preparation. The aim of this study was to show how ergonomic measures were used to reduce the risk of MSDs and to reduce operating costs in the warehouse department of an oil and gas service company. A preliminary study using the Nordic Body Map survey showed that the workers experienced pain in various parts of the body, indicating the presence of MSDs. The researchers then used methods such as the Rapid Upper Limb Assessment (RULA), Rapid Entire Body Assessment (REBA), and National Institute for Occupational Safety and Health (NIOSH) assessments to verify whether the MMH activities had an acceptable level of risk. The results revealed that certain manual material handling (MMH) activities were assessed as low–very high risk, with RULA scores ranging from 3 to 7 and REBA scores ranging from 4 to 11. An immediate solution was to replace the manual process with a semi-automatic process using a vacuum lifter. A feasibility study was conducted using the net present value (NPV), internal rate of return (IRR), and payback period to justify the economic viability of the solution. The analysis indicated that implementing the vacuum lifter not only mitigated the risk of MSDs but also reduced the operating costs, demonstrating its viability and profitability. Overall, this study suggests that implementing a vacuum lifter as an assistive device in the warehouse would be a beneficial investment for both the workers and the company, improving both well-being and finances. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to evaluate the suitability and usability of the Pro-Mobility patient/person handling assessment tool (ProMob) within residential aged care. Physiological changes associated with ageing influence an older person’s ability to perform functional mobility tasks such as transferring from furniture and walking. Strategies that improve capability and/or reduce the physical demands of the task have the potential to promote an older person’s mobility, independence and wellbeing. Environment-related strategies in Manual Handling of People (MHP), such as optimum seated heights, in part address this challenge, as they can promote resident functional mobility while also protecting staff from injury. The ProMob tool was developed to address this issue through systematic evaluation of these environmental factors.Methods: The participants in this study were seven (7) residential aged care facilities (RACFs) operated by a not-for-profit aged care organization. A qualified assessor evaluated MHP risk management with the ProMob tool at each RACF through collection of data for a random sample of residents (n = 67) regarding their living environments and available mobility information. Data was transferred to an SPSS-22 statistical software database for analysis which involved descriptive statistics and cross tabulations.Results: Application of the ProMob tool provided effective quantification of the nature and extent of environment-related MHP interventions that may influence resident mobility. Areas for improvement with MHP risk management were identified, with variation evident across RACF’s within the same organisation, which was not consistent with levels of care (e.g., lack of clear space to facilitate mobility). Low level care facilities were observed to have fewer adaptive environmental features that could potentially slow decline in independence.Discussion: Features of the aged care environment can be used to facilitate the functional mobility of aged care residents, and simultaneously reduce injury risk for staff in MHP interactions. The ProMob tool can be used for auditing care facilities, planning re-development, and continual improvement in provision of care and management of staff injury risk exposure.

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Advances in assistive exoskeleton technology, and a boom in related scientific literature, prompted a need to review the potential use of exoskeletons in defence and security. A systematic review examined the evidence for successful augmentation of human performance in activities deemed most relevant to military tasks. Categories of activities were determined a priori through literature scoping and Human Factors workshops with military stakeholders. Workshops identified promising opportunities and risks for integration of exoskeletons into military use cases. The review revealed promising evidence for exoskeletons' capacity to assist with load carriage, manual lifting, and working with tools. However, the review also revealed significant gaps in exoskeleton capabilities and likely performance levels required in the use case scenarios. Consequently, it was recommended that a future roadmap for introducing exoskeletons to military environments requires development of performance criteria for exoskeletons that can be used to implement a human-centred approach to research and development. We assessed the state-of-the-art for the use of wearable assistive exoskeletons in UK defence and security use cases. A full systematic review of the literature was undertaken, informed by use cases developed in military stakeholder workshops. Clear gaps in exoskeleton capability and use case requirements were identified, leading to recommendations for future work. [ABSTRACT FROM AUTHOR]

The center of mass dynamics of the seated posture of humans in a work environment under hypogravity (0 < g < 1) have rarely been investigated, and such research is yet to be carried out. The present study determined the difference in the body system of 32 participants working under simulated 1/6 g (Moon) and 1 g (Earth) for comparison using static and dynamic task measurements. This was based on a markerless motion capture method that analyzed participants’ center of mass at the start, middle and end of the task when they began to get fatigued. According to this analysis, there is a positive relationship (p < 0.01) with a positive coefficient of correlation between the downward center of mass body shift along the proximodistal axis and gravity level for males and females. At the same time, the same positive relationship (p < 0.01) between the tilt of the body backward along the anterior–posterior axis and the level of gravity was found only in females. This offers fresh perspectives for comprehending hypogravity in a broader framework regarding its impact on musculoskeletal disorders. It can also improve workplace ergonomics, body stability, equipment design, and biomechanics.

Tea plantation in Neglasari Pangalengan, Bandung, West Java, is a smallholder tea plantation. In the picking process, there are many manual activities, from picking tea shoots to transferring the pickings to transport trucks. The picking process is carried out for 4 hours starting. Most of this time is spent picking the tea shoots. Farmers must carry baskets where empty baskets weigh between 3.6 and 5.1 kg, while 10 - 15 kg is the weight of filled baskets. Manual handling of this material causes various risks to occupational safety and health, loads are often above the workers' ability limit and they are faced with non-ergonomic work facilities. In the picking process, workers lift weights of more than 5 kg. Workers who lift loads > 5 kg have a 2.3 times higher risk of experiencing low back pain compared to workers who lift loads = 5 kg. Therefore, this study measured occupational risks and recommendations for improvements to minimize the risk of occupational diseases. The method used is the Key Indicator Method-Awkward Body Postures (KIM-ABP). The result from the risk assessment was 268 where a score greater than 100 indicates high risk and the need for improvements in the workplace. [ABSTRACT FROM AUTHOR]

This article presents an analysis of the static loads on the human body during selected manual unloading tasks carried out by warehouse workers in a logistics company. The aim of the presented analyses is to minimize static loads in the work process and thus make the employees' work more comfortable. A tool in the form of 3D SSPP software for ergonomic workload assessment was used to carry out static load analyses. For the two selected activities, the values of the developed forces of statically working muscles and the forces acting on the vertebrae of the spine were determined. For the values of static loads identified, based on the simulation of the 3D SSPP program, modifications in work posture and a change in the manner of performing the tested activities were devised. Moreover, the proposed reorganization of the tasks examined was verified by the reassessment of the static loads on the muscles using the 3D SSPP tool. The analyses carried out after the reorganization of work confirmed the reduction in static loads and the improvement in work comfort for the analyzed manual tasks. [ABSTRACT FROM AUTHOR]

Advice to limit or avoid a flexed lumbar curvature during lifting is widely promoted to reduce the risk of low back pain (LBP), yet there is very limited evidence to support this relationship. To provide higher quality evidence this study compared intra-lumbar flexion in manual workers with (n = 21) and without a history of LBP (n = 21) during a repeated lifting task. In contrast to common expectations, the LBP group demonstrated less peak absolute intra-lumbar flexion during lifting than the noLBP group [adjusted difference −3.7° (95%CI −6.9 to −0.6)]. The LBP group was also further from the end of range intra-lumbar flexion and did not use more intra-lumbar range of motion during any lift condition (both symmetrical and asymmetrical lifts and different box loads). Peak absolute intra-lumbar flexion was more variable in the LBP group during lifting and both groups increased their peak absolute intra-lumbar flexion over the lift repetitions. This high-quality capture of intra-lumbar spine flexion during repeated lifting in a clinically relevant cohort questions dominant safe lifting advice. Practitioner summary: Lifting remains a common trigger for low back pain (LBP). This study demonstrated that people with LBP, lift with less intra-lumbar flexion than those without LBP. Providing the best quality in-vivo laboratory evidence, that greater intra-lumbar flexion is not associated with LBP in manual workers, raising questions about lifting advice. [ABSTRACT FROM AUTHOR]

Healthcare workers have a high rate of low back injury due to patient handling tasks. These workers receive training in patient handling methods such as adjusting bed height, but often ignore them. In this study, 35 healthcare workers completed patient boosts at a self-chosen bed height and again with the bed in a higher standardised position. Motion capture and force data were collected for analysis. Given the choice, less than half of participants adjusted the bed at all and none of them moved the bed to the highest position (99.1 cm). The self-chosen bed position yielded significantly higher low back force than the higher position at L4-L5 and L5-S1 (p = 0.02, p = 0.01 respectively). Low back forces can be reduced by raising the bed prior to engaging in patient handling tasks, which is a simple step that can reduce forces placed on healthcare workers' low backs. Practitioner summary: Healthcare workers experience high rates of low back pain secondary to patient handling tasks. In this cross-sectional crossover study, healthcare workers consistently chose a low bed height when boosting a patient, which resulted in higher low back loads compared to the highest bed height. [ABSTRACT FROM AUTHOR]

Background: Many workers performing manual handling tasks suffer from musculoskeletal disorders (MSD). Previous research has identified several loading aspects associated with manual handling, but it is still unknown if lifting on an unstable surface is associated with increased biomechanical loading of different body parts. Aim: This proof-of-concept study aims to study what kinematic and kinetic movement parameters, such as movement time, joint angles, torque, and muscle activity are feasible and of importance when studying the effect of lifting on surfaces with varying degrees of stability in an experimental set-up. Methods: Measurements were taken during three different surface conditions: stable, slightly unstable, and unstable. The participants were instructed to lift a box from the floor and place it on a table in front of them. The weight of the box varied from 0.5 to 15.5 kg. By using a motion capture system (VICON) with 28 reflective markers placed on the participants and one on the box, one Kistler force plate for measuring force levels and center of pressure movements (CoP), and four electromyographic transmitters (EMG), we analyzed the downward and upward phases of the lifting movement, using the Friedman's test for repeated measures. Results: Statistically significant results with less joint movements in the lower and upper back were seen with increased instability during both the downward and upward phases. The decrease in trunk movements with increased instability resulted in a somewhat more flexed knee position during the movement, a lower torque in the lower back, and a decrease in CoP movements, but no differences in movement time or muscle activity in back and knee muscles. Conclusion: Lifting while standing on unstable surfaces resulted in an alteration of both kinematics and kinetics parameters; however, further studies regarding whether this is an additional risk factor for developing lower back pain are needed. Muscle activity levels were not altered due to instability and due to the complexity of the measurement, and we suggest not including EMG measures in future experiments of this type. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To increase your knowledge of the principles of moving and handling the body of a deceased child • To enhance your decision-making about the practical aspects of the care of children after death • To consider the development of policies and training to standardise care after death in children's hospices Background: Children's hospices provide a range of services for babies, children and young people who have a life-limiting or life-threatening condition, including care after death in specialist 'cool bedrooms'. Care after death is a challenging but important element of hospice care. Aim: The aims of the study were to identify the practices of staff providing care after death in UK children's hospices, notably their moving and handling practices and their management of physiological deterioration, and to produce recommendations that promote safe and consistent practice in moving and handling and in managing physiological deterioration after death in UK children's hospices. Method: An electronic survey was sent to all 54 UK children's hospices. Free-text responses were analysed using deductive content analysis and used to add depth to the quantitative findings. Findings: Out of 54 children's hospices, 33 responded to the survey. There were great variations in the way hospices delivered care after death, notably in length of stay, interventions and equipment. The lack of consistent practice grounded in evidence-based policy and training may mean that some staff experience higher levels of stress and anxiety than others and that some staff take risks when providing care after death, particularly to express empathy towards bereaved families. Conclusion: Recommendations are made about moving and handling a child's body after death and managing its physiological deterioration. Hospices can use these recommendations to develop policy and training, standardise what is expected of staff and support practitioners in adequately caring for children after death. [ABSTRACT FROM AUTHOR]

Objectives To investigate and characterize the influence of sex, age, muscle strength, and cardiovascular fitness on manual lifting patterns using exposure variation analysis (EVA) during a full working day among blue-collar workers. Methods Muscular activity (surface electromyography [sEMG]) of the thigh, low-back, and shoulder was measured throughout the working day in 173 employees with manual lifting tasks from 14 workplaces. Relative sEMG loading was expressed as % of maximal voluntary contraction (MVC). As an additional and more practically oriented analysis, calibration of load from standardized box lifts (5, 10, 20, and 30 kg) identified corresponding sEMG values in kg. Using an EVA 'lifting periods' of [1 to 5, >5 to 10, >10 to 20, >20 to 30, and >30] kg in time intervals [0 to 0.5, >0.5 to 1, >1 to 2, >2 to 5, >5 to 10, and >10] s were identified. Arm elevation and back inclination were measured using accelerometers. Results Females and older workers (≥50 years) primarily used the thighs for lifting and were exposed to more frequent thigh muscle 'lifting periods' of varying duration and load and performed more thigh lifts >30 kg and >60% of MVC compared with males and younger workers (P < 0.05). Females had less brief shoulder lifting periods and more work with bent back >30° than the males (P < 0.05), whereas stronger workers performed more work with elevated arm >60° and >90° than workers with low muscle strength (P < 0.05). However, besides a single difference where workers with lower cardiovascular fitness were exposed to more light (1–5 kg) and moderate duration (5–10 s) trapezius loading, the number of lifting periods was not affected by muscle strength nor cardiovascular fitness (P > 0.05). Conclusions This EVA demonstrated sex- and age-related differences in exposure to lifting periods involving shoulder and thigh muscles. [ABSTRACT FROM AUTHOR]

The objective of this research is to determinate the level of risk associated with the Manual Handling of Loads (MHL) and its impact on the Musculoskeletal Disorders (MSDs) among workers of a tannery. For the present case study, four methodologies were used: Nordic questionnaire, ISO 11228-1 on lifting loads, ISO 11228-2 on pushing and pulling, and the Guide on load lowering and handling of the National Institute of Occupational Health and Safety (INSHT). The posts analyzed are exposed to an unacceptable level of risk, both in the case of unhairing and fleshing, while in the case of splitting the risk level is moderate. The Nordic musculoskeletal questionnaire reveals that 100% of workers suffer from musculoskeletal disorders; 83% of them have back problems mainly. In conclusion, the research evidenced that all pre-tanning workers suffer musculoskeletal discomfort in different body regions related with manual handing of loads. [ABSTRACT FROM AUTHOR]

• Obesity affects the kinematics of manual lifting, increasing horizontal reach. • Healthy weight and obese lifters adopt similar knee flexion when lifting. • Obese handlers experience higher moments on the lower back. • Perceived ratings of maximal acceptable weight of lift are not affected by BMI. • Obese lifters have higher heart rates compared with those of a healthy weight. Obesity is a growing health concern worldwide and musculoskeletal disorders (MSD) are the leading cause of injury, disability, and work-related sickness absence globally. A systematic literature review and meta -analysis was undertaken to investigate the effects of increased body weight on the biomechanical, physiological, and psychophysical responses to manual handling. A literature search was conducted on five electronic databases (EBSCO Health, SCOPUS, OVID (AMED), ProQuest, Google Scholar) that followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Studies were included if they investigated a manual handling activity comparing responses of obese/overweight adults to those with a healthy body weight. Included studies had to report on at least one biomechanical, physiological, or psychophysical outcome measure. The Joanna Briggs Institute (JBI) Critical Appraisal Tool was used to assess risk of bias (RoB) and methodological quality. A narrative synthesis of the findings was conducted and where possible, a meta -analysis was performed using random-effects models. Eighteen cross-sectional studies met the inclusion criteria. Participants were predominately male (22% female) and were primarily classified into obese, overweight, or healthy body weight based on their body mass index (BMI). A task involving symmetrical box lifting was the most frequently performed activity. Pooled estimates of effect sizes suggest obesity increases the horizontal reach distance when lifting, and repetitive lifting leads to higher heart rates compared with healthy weight participants. There was moderate evidence of increased moments and compression forces in the lower spine. Factors unaffected by obesity were knee flexion and perceived estimates of the maximum acceptable weight of lift (MAWL). Differences in the kinematics and kinetics of lifting between obese or overweight handlers and those of a healthier weight, suggest that approaches to preventing and managing work-related musculoskeletal conditions should consider a worker's body weight when designing workplaces, work practices, and training. To develop appropriate interventions, more high-quality studies are needed involving a range of industry and service sector handling tasks. [ABSTRACT FROM AUTHOR]

In manufacturing companies, manual material handling (MMH) involves lifting, pushing, pulling, carrying, moving, and lowering objects, which can lead to musculoskeletal disorders (MSDs) among workers, resulting in high labor costs due to excessive overtime incurred for manual product preparation. The aim of this study was to show how ergonomic measures were used to reduce the risk of MSDs and to reduce operating costs in the warehouse department of an oil and gas service company. A preliminary study using the Nordic Body Map survey showed that the workers experienced pain in various parts of the body, indicating the presence of MSDs. The researchers then used methods such as the Rapid Upper Limb Assessment (RULA), Rapid Entire Body Assessment (REBA), and National Institute for Occupational Safety and Health (NIOSH) assessments to verify whether the MMH activities had an acceptable level of risk. The results revealed that certain manual material handling (MMH) activities were assessed as low–very high risk, with RULA scores ranging from 3 to 7 and REBA scores ranging from 4 to 11. An immediate solution was to replace the manual process with a semi-automatic process using a vacuum lifter. A feasibility study was conducted using the net present value (NPV), internal rate of return (IRR), and payback period to justify the economic viability of the solution. The analysis indicated that implementing the vacuum lifter not only mitigated the risk of MSDs but also reduced the operating costs, demonstrating its viability and profitability. Overall, this study suggests that implementing a vacuum lifter as an assistive device in the warehouse would be a beneficial investment for both the workers and the company, improving both well-being and finances.

To investigate cross-sectional associations between heavy occupational lifting and cardiac structure and function. Participants from the 5th round of the Copenhagen City Heart Study, aged < 65 years old, answering a questionnaire regarding occupational physical activity, heavy occupational lifting, use of anti-hypertensive and heart medication, and data on blood pressure, cardiac structure and function, from an echocardiographic examination, were included. Adjusted linear regressions and logistic regressions were applied to estimate the cross-sectional association between heavy occupational lifting and cardiac structure and function across all included participants and in groups stratified by hypertension status, and the risk for having abnormal values of cardiac structure and function. 2511 participants were included. The cross-sectional standardized associations between heavy occupational lifting and measures of cardiac structure and function showed a trends for raised left ventricular mass index (LVMi) (β 0.14, 99% CI − 0.03 to 0.31). The standardized associations stratified by hypertensive status showed significant associations between exposure to heavy occupational lifting and LVMi (β 0.20, 99% CI − 0.002 to 0.40) and a trend of a raised end-diastolic interventricular septal thickness (IVSd) (β 0.15, 99% CI − 0.03 to 0.33) among normotensives. Exposure to heavy occupational lifting increased the odds for an abnormal IVSd (OR 1.42, 99% CI 1.07–1.89). This cross-sectional study shows heavy occupational lifting to associate with indices of abnormal cardiac structure and function among normotensives, indicating an increased risk for cardiovascular disease. [ABSTRACT FROM AUTHOR]

Summary: Ergonomics in relation to anaesthesia is the scientific study of the interaction between anaesthetists and their workspace environment in order to promote safety, performance and well‐being. The foundation for avoiding pain or discomfort at work is to adopt and maintain a good posture, whether sitting or standing. Anaesthetists should aim to keep their posture as natural and neutral as possible. The successful practice of anaesthesia relies on optimisation of ergonomics and lack of attention to detail in this area is associated with impaired performance. The anaesthetic team should wear comfortable clothing, including appropriately‐sized personal protective equipment where necessary. Temperature, humidity and light should be adequate at all times. The team should comply with infection prevention and control guidelines and monitoring as recommended by the Association of Anaesthetists. Any equipment or machinery that is mobile should be positioned where it is easy to view or reach without having to change the body or head position significantly when interacting with it. Patients who are supine should, whenever possible, be raised upwards to limit the need to lean towards them. Any item required during a procedure should be positioned on trays or trolleys that are close to the dominant hand. Pregnancy affects the requirements for standing, manually handling, applying force when operating equipment or moving machines and the period over which the individual might have to work without a break. Employers have a duty to make reasonable adjustments to accommodate disability in the workplace. Any member of staff with a physical impairment needs to be accommodated and this includes making provision for a wheelchair user who needs to enter the operating theatre and perform their work. [ABSTRACT FROM AUTHOR]

Background: Many tasks in industrial and health care setting are involved with pushing and pulling tasks up or down on a ramp. An efficient method of moving cart which reduces the risk of low back pain should be concerned. This study aimed to investigate the effects of handling types (HTs) and slope on lumbar spinal load during moving a cart on a ramp. We conducted a 2 × 2 × 4 factorial design with three main factors: 2 HTs, 2 handling directions of moving a cart and 4 degrees of ramp slope. Methods: Thirty healthy male workers performed 14 tasks consist of moving a cart up and down on the ramp of 0°, 10°, 15°, and 20° degrees with pushing and pulling methods. Joint angles from a 3D motion capture system combined with subject height, body weight, and hand forces were used to calculate the spinal load by the 3DSSPP program. Results: Our results showed significant effect of HT, handling directions and slope on compression and shear force of the lumbar spine (p

Abstract Background The impact of work-related musculoskeletal symptoms (WMSS) permeates various occupations. Objective To compare WMSS and associated risk factors among domestic gas workers (DGWs) and staff of Works Department (SWD) in Enugu. Methods One-hundred adults (DGW = 50, SWD = 50) participated in this cross-sectional study. The Nordic Musculoskeletal Questionnaire and a demographics questionnaire were used to assess the prevalence of WMSS and related risk factors. Data were analysed using independent t-test or Mann-Whitney U, chi-square, and logistic regression at p 8 h/day (OR = 0.001, p = 0.028), female gender (OR = 6.98–10.26, p

Feed mills of low capacities have become the major source of feeds for the agrarians in developing countries. Operations carried out in these feed mills do not totally conform to the standard operations and safety requirements in large scale feed mills. Therefore this paper is aimed at assessing the possibility of work-related musculoskeletal disorders (WMSDs) in these feed mills. A preliminary assessment of the risk was carried out using onsite investigation, interview of workers and a pen-and-paper based analytical tools. Feed discharge, weighing and manual material handling (lifting) operations were evaluated with Quick Exposure Check (QEC) and Rapid Entire Body Assessment (REBA) tools. Results showed that 70 and 60% of the workers experience body pains after and during work respectively. The workers expressed dissatisfaction due to the pains experienced in different body regions. QEC and REBA evaluation showed that the body regions with a high risk of WMSDs are back, shoulder and neck regions for discharge operation; wrist, back, shoulder and neck regions for weighing operation; and back, shoulder, neck, wrist, legs, and elbow regions for manual material handling. WMSDs mitigation measures were suggested for each operation based on identified cause.