Quantifying the physical demands undertaken by offshore wind technicians during a working day and casualty evacuations.

BACKGROUND: Offshore wind technicians (WTs) have been identified as having an occupation with high physical demands. OBJECTIVE: To characterise the physical demands of WTs, during the working day and when performing casualty rescues. METHODS: Data collection consisted of two components. Component A, 14 WTs (n = 13 male, 1 female) were monitored over three consecutive working days. The data collected consisted of: a questionnaire; heart rate and movement data; and accelerometer data. Component B, 5 WTs (n = 5 male) were assessed undertaking two simulated casualty evacuations. Heart rate and metabolic data were collected. RESULTS: A working day lasted 7.5 hrs to 9 hrs, with WTs covering, on average, 4.7 km on the turbine. WTs spent 28% of their time undertaking "light activity", 69% "moderate activity" and 3% working "vigorously". The greatest amount of time in a day was spent working on manual handling tasks such as torque and tensioning (up to 4 hours in total). Both rescues were performed largely aerobically, with similar cardiac and metabolic demands (14.56 (4.84) mL.kg-1.min-1 vs. 17.07 (3.54) mL.kg-1.min-1). Higher RPE values were reported for the rescue from within the Hub (median (range), 13 (12-14)) compared to down the ladder (11 (7-12)), likely due to a greater requirement to manoeuvre the casualty in tight spaces. CONCLUSION: The results presented characterise the physical requirements of WTs during the working day and two casualty evacuations. These data play an important role in supporting the job task analysis for WTs working in the offshore wind industry.

Quantifying the essential tasks of offshore wind technicians.

BACKGROUND: Offshore wind technicians (WTs) have been identified as having an occupation with varying physical demands. Therefore, in order to assess WTs capability to undertake the job, there was a need to identify and quantify the physical requirements of the essential tasks. OBJECTIVE: To establish the essential tasks and quantify the associated minimum physical demands of being an offshore WT. METHODS: Wind Farm organisations (n = 10) across five countries, undertook a multi-modal observational approach comprising of semi-structured interviews (n = 45), focus groups (n = 14), survey (n = 167). In addition, observations, objective measurements, video footage and standard operating procedures were reviewed. A service campaign was broken down into component tasks, and analysed in terms of technical specifications, e.g. equipment, frequency, duration, rest breaks, clothing ensembles, and the methods of best practice for undertaking each of the tasks. Task descriptions were produced and minimum performance standards recommended. RESULTS: The job tasks associated with WTs can be broken down into two categories and five areas of work (Essential infrequent = casualty evacuation and prolonged ladder climbing; Essential frequent = short ladder climbs, manual handling and working in restricted spaces). CONCLUSIONS: The results presented constitute work carried out in Phases 1 and 2 of a three phased work programme to establish a physical employment standard required by WTs working in offshore wind. These findings will underpin the development of a minimum performance standard for the global offshore wind industry.

Examining the relationship between inflammatory biomarkers during COVID-19 hospitalization and subsequent long-COVID symptoms: A longitudinal and retrospective study.

INTRODUCTION: Long-COVID is a heterogeneous condition with a litany of physical and neuropsychiatric presentations and its pathophysiology remains unclear. Little is known about the association between inflammatory biomarkers, such as interleukin-6 (IL-6) and C-reactive protein (CRP) in the acute phase, and persistent symptoms after hospitalization in COVID-19 patients. METHODS: IL-6, CRP, troponin-T, and ferritin were analyzed at admission for all patients with COVID-19 between September 1, 2020 to January 10, 2021. Survivors were followed up 3-months following hospital discharge and were asked to report persistent symptoms they experienced. Admission data were retrospectively collected. Independent t-tests and Mann-Whitney U tests were performed. RESULTS: In a sample of 144 patients (62.5% male, mean Age 62 years [SD = 13.6]) followed up 3 months after hospital discharge, the commonest symptoms reported were fatigue (54.2%), breathlessness (52.8%), and sleep disturbance (37.5%). In this sample, admission levels of IL-6, CRP and ferritin were elevated. However, those reporting myalgia, low mood, and anxiety at follow-up had lower admission levels of IL-6 (34.9 vs. 52.0 pg/mL, p = .043), CRP (83 vs. 105 mg/L, p = .048), and ferritin (357 vs. 568 ug/L, p = .01) respectively, compared with those who did not report these symptoms. Multivariate regression analysis showed that these associations were confounded by gender, as female patients had significantly lower levels of IL-6 and ferritin on admission (29.5 vs. 56.1, p = .03 and 421.5 vs. 589, p = .001, respectively) and were more likely to report myalgia, low mood and anxiety, when compared to males. CONCLUSIONS: Our data demonstrate that female patients present more often with lower levels of inflammatory biomarkers on admission which are subsequently associated with long-term post-COVID symptoms, such as myalgia and anxiety, in those discharged from hospital with severe COVID-19. Further research is needed into the role of serum biomarkers in post-COVID prognostication.

The Effects of Compression Garments on Stability and Lower Limb Kinematics During a Forward Lunge.

Compression garments have been used to minimise injury risk, through improvements in stability and joint positioning; yet, it is unclear whether there is an optimal length or tightness of these garments that may maximise observed benefits. This study measured the effect of three different garment types, at two different tightness levels, on lower extremity stability and alignment during a forward lunge movement. Sixteen healthy adults (7 female, 9 male; 24.3 ± 2.9 years) were recruited as participants. Stability of the lead foot, as well as lower body joint kinematics, were recorded using an Oqus 12-camera system, surrounding participants as they executed three forward lunges onto a Matscan pressure mat under seven compression conditions (Control, Light/Heavy Calf, Light/Heavy Socks, Light/Heavy Leggings). Mean minimum time-to-boundary (mmTtB) (derived from centre of pressure measures) and frontal plane kinematics (lateral pelvic tilt, knee valgus, ankle inversion/eversion) were used to assess the effect of garment tightness and length on lunge stability and joint alignment, respectively. A significant effect of tightness on mmTtB was observed (F(1,105) = 8.192; p = .005, η2 = .072), with Heavy garments eliciting longer mmTtB compared to their corresponding Light (-.18 ± .06 s; p = .015) or Control (-.28 ± .09 s; p = .007) conditions. No significant effects of garment tightness or length on lower body kinematics were evident. The results of this study suggest stability during a forward lunge is improved through the use of tight-fitted compression garments.

An ergonomics assessment of three simulated 120 m ladder ascents: A comparison of novice and experienced climbers.

This study investigated the ergonomics of three simulated 120 m vertical ladder ascents and differences between novice (NC) and experienced climbers (EC). Seven EC and 10 NC undertook three 120 m climbs; comprising of four 30 m climbs. Ascending 120 m was reported as a high physical demand, supported by high peak HRs (~173 b.min-1 across the three climbs) and V˙ O2 (~3.1 L.min-1 across the three climbs). Grip strength and endurance were significantly (p < 0.05) impaired by ascents. With multiple ascents, toe clearance was reduced (Climb 1 - 0.0515 m; Climb 3 - 0.046 m), and participants reached higher with their arms (shoulder angle: Climb 1 - 117°; Climb 3 - 136°). NC demonstrated less range of movement through the hips (NC - 46°; EC - 58°), and higher muscle activation in the upper body (NC - 60%; EC - 49%). Experience reduced cumulative climbing times (exercise + rest), whilst maintaining the same physiological demand as NC and maintained optimised movement patterns for longer.

A Job Task Analysis for Technicians in the Offshore Wind Industry.

BACKGROUND: To establish whether an organization has a valid Physical Employment Standard (PES), it is important to determine those aspects of the job that are critical to operational success. OBJECTIVE: To determine the tasks of the Offshore Wind Industry (OWI) and whether the ability to undertake these tasks is adequately assessed. METHODS: The task analysis was completed through: observations; the research team undertaking tasks; reviewing operational manuals; and focus groups. In addition, a review of existing PES for the OWI was completed to determine whether standards matched with the results of the task analysis. RESULTS: Five critical tasks were identified: transfer from the vessel to the Transition Piece; ascent of the internal ladder; manoeuvre through hatches; torque and tensioning; and hauling a casualty up the tower. With the exception of aerobic capacity, the physical components required by Technicians are not assessed by the current medical standards, nor are these assessments standardized across companies. CONCLUSIONS: The Job Task Analysis undertaken can be used to inform decisions regarding the physical fitness requirements (selection), assessments and training of Technicians, with a view to ensuring that they are physically capable of undertaking the critical tasks without undue risk of injury to themselves or others.

Confirmation of suboptimal protocols in spinal immobilisation?

BACKGROUND: Spinal immobilisation during extrication of patients in road traffic collisions is routinely used despite the lack of evidence for this practice. In a previous proof of concept study (n=1), we recorded up to four times more cervical spine movement during extrication using conventional techniques than self-controlled extrication. OBJECTIVE: The objective of this study was to establish, using biomechanical analysis which technique provides the minimal deviation of the cervical spine from the neutral in-line position during extrication from a vehicle in a larger sample of variable age, height and mass. METHODS: A crew of two paramedics and four fire-fighters extricated 16 immobilised participants from a vehicle using six techniques for each participant. Participants were marked with biomechanical sensors and relative movement between the sensors was captured via high-speed infrared motion analysis cameras. A three-dimensional mathematical model was developed and a repeated-measures analysis of variance was used to compare movement across extrication techniques. RESULTS: Controlled self-extrication without a collar resulted in a mean movement of 13.33° from the neutral in-line position of the cervical spine compared to a mean movement of 18.84° during one of the equipment-aided extrications. Two equipment-aided techniques had significantly higher movement (p<0.05) than other techniques. Both height (p=0.003) and mass (p=0.02) of the participants were significant independent predictors of movement. CONCLUSIONS: These data support the findings of the proof of concept study, for haemodynamically stable patients controlled self-extrication causes less movement of the cervical spine than extrications performed using traditional prehospital rescue equipment.

Biomechanical analysis of spinal immobilisation during prehospital extrication: a proof of concept study.

BACKGROUND: In most countries, road traffic collisions (RTCs) are the main cause of cervical spine injuries. There are several techniques in use for spinal immobilisation during prehospital extrication; however, the evidence for these is currently poor. OBJECTIVE: The objective of this study is to establish which technique provides the minimal deviation of the cervical spine from the neutral inline position during the extrication of the RTC patient using biomechanical analysis techniques. METHODS: A crew of two paramedics and four fire-fighter first responders extricated a simulated patient from a prepared motor vehicle using nine different extrication techniques. The patient was marked with biomechanical sensors and relative movement between the sensors was captured via high speed infrared motion analysis cameras. A 3D mathematical model was developed from the recorded movement. RESULTS: Control measurements were taken from the patient during self-extrication and movement was recorded of 4.194° left of midline (LOM) to 2.408° right of midline (ROM) resulting in a total movement of 6.602°. The least deviation recorded during equipment aided extrication was movement of 3.365° LOM and 8.352° ROM resulting in a total movement of 11.717°. The most deviation recorded during equipment aided extrication was movement of 1.588° LOM and 24.498° ROM resulting in a total movement of 26.086°. CONCLUSIONS: Conventional extrication techniques record up to four times more cervical spine movement during extrication than controlled self-extrication. This proof of concept study demonstrates the need for further evaluation of current rescue techniques and the requirement to investigate the clinical and operational significance of such movement.

Locomotor-respiratory coupling patterns and oxygen consumption during walking above and below preferred stride frequency.

Locomotor respiratory coupling patterns in humans have been assessed on the basis of the interaction between different physiological and motor subsystems; these interactions have implications for movement economy. A complex and dynamical systems framework may provide more insight than entrainment into the variability and adaptability of these rhythms and their coupling. The purpose of this study was to investigate the relationship between steady state locomotor-respiratory coordination dynamics and oxygen consumption [Formula: see text] of the movement by varying walking stride frequency from preferred. Twelve male participants walked on a treadmill at a self-selected speed. Stride frequency was varied from -20 to +20% of preferred stride frequency (PSF) while respiratory airflow, gas exchange variables, and stride kinematics were recorded. Discrete relative phase and return map techniques were used to evaluate the strength, stability, and variability of both frequency and phase couplings. Analysis of [Formula: see text] during steady-state walking showed a U-shaped response (P = 0.002) with a minimum at PSF and PSF - 10%. Locomotor-respiratory frequency coupling strength was not greater (P = 0.375) at PSF than any other stride frequency condition. The dominant coupling across all conditions was 2:1 with greater occurrences at the lower stride frequencies. Variability in coupling was the greatest during PSF, indicating an exploration of coupling strategies to search for the coupling frequency strategy with the least oxygen consumption. Contrary to the belief that increased strength of frequency coupling would decrease oxygen consumption; these results conclude that it is the increased variability of frequency coupling that results in lower oxygen consumption.