Evaluation of a Workplace Exercise Program for Control of Shoulder Disorders in Overhead Assembly Work.

OBJECTIVE: The aim of this study was to assess effects of exercise on shoulder musculoskeletal symptoms among employees with overhead assembly work exposures. METHODS: A voluntary workplace shoulder exercise program was offered to employees in two automotive assembly departments, while two similar departments served as controls. N = 76 total workers participated. Shoulder Rating Questionnaire (SRQ) and Discomfort of the Arm Shoulder and Hand (DASH) symptoms were queried monthly for 7 baseline months, followed by 6 months that included exercise. RESULTS: SRQ scores were higher for exercisers than among controls in the 6 exercising months, but not in the baseline months. Although the group x month interaction was significant (P < 0.05), the temporal trend was inconsistent. CONCLUSIONS: Exercise may have temporarily lessened decline in SRQ. It is not clear whether shorter term differences were clinically meaningful or predictive of longer term disability prevention.

Serious injury and fatality investigations involving pneumatic nail guns, 1985-2012.

BACKGROUND: This article examines serious and fatal pneumatic nail gun (PNG) injury investigations for workplace, tool design, and human factors relevant to causation and resulting OS&H authorities' responses in terms of citations and penalties. METHODS: The U.S. Occupational Safety and Health Administration (OSHA) database of Fatality and Catastrophe Investigation Summaries (F&CIS) were reviewed (1985-2012) to identify n = 258 PNG accidents. RESULTS: 79.8% of investigations, and 100% of fatalities, occurred in the construction industry. Between 53-71% of injuries appear to have been preventable had a safer sequential trigger tool been used. Citations and monetary penalties were related to injury severity, body part injured, disabling of safety devices, and insufficient personal protective equipment (PPE). CONCLUSIONS: Differences may exist between construction and other industries in investigators interpretations of PNG injury causation and resulting citations/penalties. Violations of PPE standards were penalized most severely, yet the preventive effect of PPE would likely have been less than that of a safer sequential trigger.

Unstable sitting in the workplace--are there physical activity benefits?

The increasingly popular practice of using a stability ball (exercise/fitness ball) as a sitting surface runs counter to conventional human factors/ergonomics guidelines for seated workspace design. Employees sitting on stability balls in an office environment present safety risks that might be justifiable if the practice has a definitive benefit to the promotion of health. However, the published studies and best evidence to date call into question even the theoretical basis for this practice and do not suggest significant health benefits. First, biomechanical studies do not confirm the intended trunk muscle activation. Second, energy expenditure studies show a small (if any) increase in metabolic demand that is unlikely to be effective in combating sedentary work risk factors. Until studies demonstrate more conclusive benefits, the practice of stability ball sitting should be viewed skeptically as a general workplace recommendation in the interest of health or wellness.

Provisional recommended weight limits for manual lifting during pregnancy.

OBJECTIVE: The National Institute for Occupational Safety and Health (NIOSH) Revised Lifting Equation (RNLE) was adapted to derive recommended weight limits (RWLs) for pregnant workers and to develop corresponding guidelines for clinicians. BACKGROUND: In the past three decades there has been a large increase in the number of women employed outside the home and remaining in the workforce during pregnancy. Practical authoritative guidelines based on accumulated evidence are needed to inform allowable work activity levels for healthy pregnant workers. METHOD: Empirically based lifting criteria established by NIOSH to reduce the risk of overexertion injuries in the general U.S. working population were evaluated for application to pregnant workers. Our evaluation included an extensive review of the literature linking occupational lifting to maternal and fetal health. Decision logic and supporting literature are presented, along with computational details. RESULTS: Provisional RWLs for pregnant workers were derived from the RNLE, along with guidelines for clinicians. The guidelines advise against pregnant workers lifting below midshin and overhead. CONCLUSION: Based on our review of the available evidence, we present lifting thresholds that most pregnant workers with uncomplicated pregnancies should be able to perform without increased risk of adverse maternal and fetal health consequences. Except for restrictions involving lifting from the floor and overhead, the provisional guidelines presented are compatible with NIOSH lifting recommendations adopted in the early 1990s for the general working population. APPLICATION: Implementation of these provisional guidelines could protect millions of female workers in the workplace from fetal and maternal lifting-related health problems.

A Biomechanical Assessment of Hand/Arm Force with Pneumatic Nail Gun Actuation Systems.

A biomechanical model is presented, and combined with measurements of tip press force, to estimate total user hand force associated with two pneumatic nail gun trigger systems. The contact actuation trigger (CAT) can fire a nail when the user holds the trigger depressed first and then "bumps" the nail gun tip against the workpiece. With a full sequential actuation trigger (SAT) the user must press the tip against the workpiece prior to activating the trigger. The SAT is demonstrably safer in reducing traumatic injury risk, but increases the duration (and magnitude) of tip force exertion. Time integrated (cumulative) hand force was calculated for a single user from measurements of the tip contact force with the workpiece and transfer time between nails as inputs to a static model of the nail gun and workpiece in two nailing task orientations. The model shows the hand force dependence upon the orientation of the workpiece in addition to the trigger system. Based on standard time allowances from work measurement systems (i.e. Methods-Time Measurement - 1) it is proposed that efficient application of hand force with the SAT in maintaining tip contact can reduce force exertion attributable to the sequential actuation trigger to 2-8% (horizontal nailing) and 9-20% (vertical nailing) of the total hand/arm force. The present model is useful for considering differences in cumulative hand/arm force exposure between the SAT and CAT systems and may explain the appeal of the CAT trigger in reducing the user's perception of muscular effort.

Clinical guidelines for occupational lifting in pregnancy: evidence summary and provisional recommendations.

Empirically based lifting criteria established by the National Institute for Occupational Safety and Health (NIOSH) to reduce the risk of overexertion injuries in the general US working population were evaluated for application to pregnant workers. This report proposes criteria to guide decisions by medical providers about permissible weights for lifting tasks performed at work over the course of an uncomplicated pregnancy. Our evaluation included an extensive review of the literature linking occupational lifting to maternal and fetal health. Although it has been 29 years since the American Medical Association's Council on Scientific Affairs published its report on the Effects of Pregnancy on Work Performance, these guidelines continue to influence clinical decisions and workplace policies. Provisional clinical guidelines derived from the NIOSH lifting criteria that account for recent evidence for maternal and fetal health are presented and aim to improve the standard of care for pregnant workers.

Residential building stakeholders' attitudes and beliefs regarding nail gun injury risks and prevention.

Pneumatic nail guns are ubiquitous at residential construction sites across the United States. These tools are noted for the traumatic injuries that can occur from their operation. Different trigger mechanisms on these tools are associated with different levels of risk. Residential building subcontractors and workers, both native-born and immigrant, were brought together in focus groups to discuss their attitudes and beliefs regarding risk factors for nail gun injury as well as barriers to the adoption of safer technology. Participants' comments are organized first by influences on traumatic injury occurrence or prevention and later by sociotechnical system category. Participants attributed influences on injury risk to personal and external causation factors in all sociotechnical system categories; however, participants more frequently described influences on injury prevention as related to workers' behaviors, rather than to external factors. A discussion of these influences with respect to attribution theory and sociotechnical models of injury causation is presented.

Biomechanical assessment of three rebar tying techniques.

The National Institute for Occupational Safety and Health (NIOSH) conducted a study of ironworkers to evaluate their risk for developing back and hand injuries from hand-tying reinforcing steel bar and to investigate whether power tying tools can be an effective intervention for the prevention of work-related musculoskeletal disorders. A field investigation of biomechanical loading when using 3 techniques to tie together rebar was conducted. Researchers measured employees' wrist and forearm movement with goniometers and videotaped and analyzed trunk postures. Manually tying rebar at ground level involved sustained deep trunk bending and rapid, repetitive, and forceful hand-wrist and forearm movements. Using a power tier significantly reduced the hand-wrist and forearm movements and allowed the ironworkers to use one free hand to support their trunk posture while tying. Adding an extension handle to the power tier allowed the ironworkers to tie rebar while standing erect, minimizing sustained trunk flexion.

The characterization of airborne occupational safety and health hazards in selected small businesses; manufacturing wood pallets.

Researchers from the National Institute for Occupational Safety and Health (NIOSH) investigated occupational safety and health concerns in the small business wood pallet manufacturing industry because of an injury rate (2000) 226% greater than that for general industry. NIOSH investigators conducted walk-through evaluations at seven wood pallet manufacturing companies, and returned to four of them to take environmental measurements. Carbon monoxide (CO) levels, noise levels, and total particulate were measured, ergonomic observations made, and occupational safety practices analyzed at each of the four facilities where measurements were taken. The focus of this study is the evaluation of airborne particulate and carbon monoxide exposures for the purpose of determining areas of potentially high exposures. This knowledge can guide the plant owner or health professional to determine whether further measurements are necessary and where they might be needed. Safety factors and physical stressors (noise and ergonomic stressors) were described in a previously published companion paper. Although we did not take 8 h samples, we did find certain exposures that were potentially of concern to the small business owner. The main findings of this investigation were as follows: 1) CO levels in three plants, for the time periods measured, were less than the OSHA permissible exposure limit (PEL) of 50 parts per million (ppm) for an 8-h TWA. Three measurements, all from one plant, were due to a older and defective forklift and were above 50 ppm. 2) Total dust measures ranged from 0.86 to 1.67 mg/m3, taken adjacent to an operating machine cutting hardwood and measured up to 6 min. The American Conference of Governmental Industrial Hygienists (ACGIH) guideline for hardwood dust is 1.0 mg/m3, again for an 8-h TWA.