Postoccupancy Evaluation of a Neighborhood Concept Redesign of an Acute Care Nursing Unit in a Planetree Hospital.

OBJECTIVE: A comparative study was undertaken to survey nurses working in an acute care nursing unit before and after moving to a new hospital to investigate the impact of a nursing unit designed utilizing Planetree build criteria. BACKGROUND: The physical and emotional demands of frontline practitioners is a serious concern for patient safety and staff retention as the environmental design of nursing units can influence human errors from fatigue and interruption. METHOD: A pre-move survey was conducted with acute care nurses in a conventional design nursing unit who were moving to a new facility. After the move to the new hospital design, the same survey was readministered to obtain comparative performance information. Qualitative responses were analyzed for triangulation with survey responses. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and Press Ganey scores were collected over a 5-year period. RESULTS: There were statistically significant improvements for most of the survey questions, especially for work efficiency and productivity, the design of the patient room and of support spaces, the information systems, and the environmental conditions. There were statistically significant improvements in the HCHAPS and Press Ganey survey questions. CONCLUSIONS: The postoccupancy survey showed statistically significant improvements in most of the concerns highlighted in the pre-move survey and significant improvements in the workflow and overall satisfaction of nurses. Press Ganey results revealed all but five domains fell in the significantly improved category.

Ergonomic lighting considerations for the home office workplace.

BACKGROUND: The COVID-19 pandemic has resulted in a large increase in the use of the home office environment. Compared to traditional commercial offices, home offices typically have more variable lighting conditions that can affect the worker's performance and well-being. OBJECTIVE: To review and discuss various lighting sources and their ergonomic impacts on the population of office employees now working from home. Specifically addressing the impacts of electronic light from screens, daylight, and task lighting's impact on health and well-being in the frame of the COVID-19 pandemic. METHODS: Over 75 ergonomic and lighting literature publications covering various work environments were reviewed, with a focus on the health effects of screen light, daylight, and task light. RESULTS: Resulting from the literature review, design recommendations regarding the safety and health of home office lighting conditions are discussed. CONCLUSION: As COVID-19 continues to encourage remote working, individuals will be exposed to daylight and screen light in different ways compared to a traditional office environment. The impact of these different lighting conditions should be further studied to understand best design and well-being practices.

Effect of workstation configuration on musculoskeletal discomfort, productivity, postural risks, and perceived fatigue in a sit-stand-walk intervention for computer-based work.

OBJECTIVE: Compare musculoskeletal discomfort, productivity, postural risks, and perceived fatigue for a sit-stand-walk intervention between two workstation configurations - one, individually customized for office workers according to ergonomic guidelines (Ergo-Fit); another, self-adjusted by office workers according to their preference (Self-Adjusted). METHODS: 36 participants performed a 60-min computer typing task in both configurations using a within-participants, counterbalanced design. Musculoskeletal discomfort and perceived fatigue were reported through surveys; productivity was operationalized by typing speed and typing error; postural risks were assessed by RULA for seated work, and REBA for standing work. RESULTS: Musculoskeletal discomfort and perceived fatigue did not vary significantly between configurations. Postural risks for seated and standing work were significantly lower for Ergo-Fit configuration; productivity was significantly higher for Self-Adjusted configuration. CONCLUSION: Use of Ergo-Fit configuration for a sit-stand-walk intervention can facilitate postural transitions and increase physical activity, while enabling neutral postures in seated and standing work to minimize postural risks.

Re-evaluation of a LEED Platinum Building: Occupant experiences of health and comfort.

BACKGROUND: There is a need to better understand the perceived experiences of workers in green buildings as the literature to this point has been mixed. OBJECTIVES: To re-evaluate occupant experiences within a LEED platinum building and investigate current experiences in general. METHODS: An online post occupancy evaluation (POE) survey of 62 occupants of LEED Platinum building on a US college campus is reported. The online survey addressed indoor environmental quality in relation to health, productivity and satisfaction. RESULTS: Of the respondents, 38.7% had participated in a prior POE of this building in 2011 and results were compared for this subgroup, as well as for overall results. There was a significant increase in satisfaction with office workstations and air freshness as compared to 3 years earlier. However, there was also a significant increase in reported frequency of all physical symptoms. When looking just at the current POE results, control over features of the workstation had a significant relationship with most outcomes of interest. CONCLUSION: While improvements have been noted, issues continue to exist that have implications for health, productivity and satisfaction. The results of this study have implications for the ergonomic design of workstations and indoor environmental quality within LEED buildings.

Thermal sensation, rate of temperature change, and the heat dissipation design for tablet computers.

Past research has shown that the rate of change of skin surface temperature can affect thermal sensation. This study investigated users' thermal responses to a tablet heating surface with different heat pads and different temperature change rates. The test conditions included: A. keeping the surface at a constant 42 °C, B. increasing the surface temperature from 38 °C to 42 °C at a rate of 0.02 °C/s in progressive intervals, C. increasing the temperature at 0.15 °C/s in progressive intervals, and D. Heating two left and right side pads alternately from 38 °C to 42 °C at 0.15 °C/s in progressive intervals. Overall results showed the lowest temperature change rate of 0.02 °C/s was most preferred in terms of thermal comfort. The findings suggest a potential to improve user thermal experience by dissipating tablet computer heat at a lower temperature change rate, or by alternating the dissipation areas.

Differential patterns of laptop use and associated musculoskeletal discomfort in male and female college students.

BACKGROUND: Laptop computers have surpassed desktop computers in popularity, especially among college student users. The portability of these devices raises concerns regarding healthy usage patterns in different settings and there is a need to investigate the postures with which these devices are being used and associated reports of musculoskeletal discomfort. OBJECTIVE: This study investigated the configurations in which laptops are used and the prevalence of musculoskeletal discomfort associated with laptop use in a survey of college students. The purpose of this was to identify differences in discomfort and/or postural choice between males and females. METHODS: A sample of 90 male and 96 female college students completed an online questionnaire consisting of demographic questions, musculoskeletal discomfort indicators and questions regarding configurations of laptop use. RESULTS: Over 53% of participants reported experiencing musculoskeletal discomfort while using a laptop computer, with females reporting a higher prevalence of neck discomfort (p = 0.05) and shoulder discomfort (p = 0.006) than males. Participants reported using a laptop most commonly in positions at a  desk and on a bed. Females were more likely than males to use a laptop on a bed with the computer positioned on their lap or with their legs crossed (p < 0.05). Males were more likely than females to work in positions necessitating a large trunk deviation to operate the laptop (p < 0.05), such as "sitting on a  sofa with your feet on the floor (knees at 90°), bending over to use laptop that is resting on a  coffee table or ottoman in front of you". CONCLUSIONS: A significant proportion of college students report experiencing musculoskeletal discomfort associated with laptop computer use. Sex differences exist in both choice of configurations and musculoskeletal discomfort associated with laptop use. Due to the portability of laptop computers, they are used in a variety of configurations and environments. This study identifies a number of different ways that laptop computers are used that have not been considered in previous research. These patterns of laptop use can be used to inform future work on the impact of technology use on discomfort.

The sedentary office: an expert statement on the growing case for change towards better health and productivity.

An international group of experts convened to provide guidance for employers to promote the avoidance of prolonged periods of sedentary work. The set of recommendations was developed from the totality of the current evidence, including long-term epidemiological studies and interventional studies of getting workers to stand and/or move more frequently. The evidence was ranked in quality using the four levels of the American College of Sports Medicine. The derived guidance is as follows: for those occupations which are predominantly desk based, workers should aim to initially progress towards accumulating 2 h/day of standing and light activity (light walking) during working hours, eventually progressing to a total accumulation of 4 h/day (prorated to part-time hours). To achieve this, seated-based work should be regularly broken up with standing-based work, the use of sit-stand desks, or the taking of short active standing breaks. Along with other health promotion goals (improved nutrition, reducing alcohol, smoking and stress), companies should also promote among their staff that prolonged sitting, aggregated from work and in leisure time, may significantly and independently increase the risk of cardiometabolic diseases and premature mortality. It is appreciated that these recommendations should be interpreted in relation to the evidence from which they were derived, largely observational and retrospective studies, or short-term interventional studies showing acute cardiometabolic changes. While longer term intervention studies are required, the level of consistent evidence accumulated to date, and the public health context of rising chronic diseases, suggest initial guidelines are justified. We hope these guidelines stimulate future research, and that greater precision will be possible within future iterations.

Optimizing the physical ergonomics indices for the use of partial pressure suits.

This study developed an ergonomic evaluation system for the design of high-altitude partial pressure suits (PPSs). A total of twenty-one Chinese males participated in the experiment which tested three types of ergonomics indices (manipulative mission, operational reach and operational strength) were studied using a three-dimensional video-based motion capture system, a target-pointing board, a hand dynamometer, and a step-tread apparatus. In total, 36 ergonomics indices were evaluated and optimized using regression and fitting analysis. Some indices that were found to be linearly related and redundant were removed from the study. An optimal ergonomics index system was established that can be used to conveniently and quickly evaluate the performance of different pressurized/non-pressurized suit designs. The resulting ergonomics index system will provide a theoretical basis and practical guidance for mission planners, suit designers and engineers to design equipment for human use, and to aid in assessing partial pressure suits.

An experimental study on the ergonomics indices of partial pressure suits.

Partial pressure suits (PPSs) are used under high altitude, low-pressure conditions to protect the pilots. However, the suit often limits pilot's mobility and work efficiency. The lack of ergonomic data on the effects of PPSs on mobility and performance creates difficulties for human factor engineers and cockpit layout specialists. This study investigated the effects of PPSs on different ergonomic mobility and performance indices in order to evaluate the suit's impact on pilot's body mobility and work efficiency. Three types of ergonomics indices were studied: the manipulative mission, operational reach and operational strength. Research results indicated that a PPS significantly affects the mobility and operational performance of the wearers. The results may provide mission planners and human factors engineers with better insight into the understanding of pilots' operational function, mobility and strength capabilities when wearing PPS.

Alternative computer mouse designs: performance, posture, and subjective evaluations for college students aged 18-25.

BACKGROUND: Students are faced with work demands requiring intense computer use throughout the week, often with cumulative hourly use per day exceeding that of adult workers. Extended daily computer use has been associated with a reported increase of musculoskeletal symptoms for college-aged students. New mouse designs offer alternative movement and postural strategies to potentially mitigate musculoskeletal stress for students. OBJECTIVE: This study investigates the use of alternative computer mouse designs by college-aged students (18-25) through a precision task (point-and-click an on-screen target). Wrist movements, hand posture, and associated subjective user data were collected across innovative mouse designs to understand the physical impact and basic usability issues for this population. PARTICIPANTS: Twenty-one (21) healthy, right handed students (11 female; 10 male) were enrolled in this study. METHODS: Five mouse designs were assessed by investigating hand fit, wrist movements, and subjective accounts of ease of use, perceived control, comfort and aesthetics. Human performance was captured for each mouse design in terms of peak velocity, average movement time, and fastest movement direction using an electrogoniometer as participants performed the ISO 9241 multipoint standard Fitts' task using the Generalized Fitts' Law Model Builder software (GFLMB v.1.1C; [1]) within a zero-error setting (point-and-click task). Hand measurements were taken in both standardized anthropometric positions and adapted hand positions on five alternative mouse designs for a total of seven sets of measurements for each participant. Subjective data was collected through a series of questionnaires that were administered before, during, and after the mouse tasks. RESULTS: Results for human performance, distal upper extremity posture (hand/wrist), and subjective data such as overall preference, ease of use, perceived control, and comfort are given for this population. Wrist extension exceeded 30 degrees for over 50% of the total movement time for 3 out of 5 mouse designs. Postural variations in hand molding of the metacarpophalangeal arch (MCP angle) across mouse design was shown to be related to mouse control and ease of use. Subjective evaluations showed no differences between males and females, and overall preference was correlated to subjective evaluations of comfort, ease of use, perceived control, and, to a lesser extent, product attractiveness. CONCLUSIONS: Individual performance across the alternative mouse designs in this study showed overall faster movement speeds than the `conventional' mouse design, while exhibiting similar wrist posture behavior for extension and ulnar deviation. Wrist extension is a risk factor for musculoskeletal injuries such as carpal tunnel syndrome. The current ergonomic standard calls for wrist extension to be below 30 degrees, and 3 of the 5 mouse designs exceeded this value. Guidance and adherence to proper use techniques for alternative mouse designs for this population is warranted and will help mitigate potential musculoskeletal risks.

Measures of fit and discomfort for elementary school children in Serbia.

BACKGROUND: Assessing physical ergonomic factors within the classroom environment creates new opportunities to support designs that promote student well-being. Student-aged anthropometric data helps guide proper desk fit assessment, therefore facilitating scholastic performance through the reduction of distractions such as physical discomfort. OBJECTIVE: This study reports dimensions of fit between student anthropometry and the desk environment (classroom seating conditions), for grade-school aged children in Serbia. Measurements of the children and their desks are compared to subjective reports of discomfort. PARTICIPANTS: Fifty-seven elementary school students, grade 2 (ages 7-8; n=29) and grade 4 (ages 9-10; n=28), were enrolled in this study. All participants were from the same elementary school in the city of Nis, Serbia. METHODS: Seventeen anthropometric measurements of students were collected using standard anthropometric instruments. Eight measurements of student work desks and chairs were also collected. Students were evaluated by a physiatrist to assess health issues and completed a novel questionnaire about musculoskeletal discomfort for different body parts. Student fit to the classroom seat and desk was assessed structurally and subjectively. Data analysis included descriptive anthropometric measurements and inferential statistics including Chi square analysis. RESULTS: Results indicated age-related differences in body part discomfort for grade 2 and grade 4 students, arm discomfort reported over 50% of second grade students, and neck/upper back discomfort was reported as the highest of all body parts (32%) for students in the fourth grade. CONCLUSION: Anthropometric variables and preliminary analysis of fit as it relates to reported discomfort are discussed, as are external factors of backpack use and seated video/computer-game use. International comparisons of anthropometric data are discussed and serve to inform new considerations of ergonomics research for school children.

User evaluation of an innovative digital reading room.

Reading room design can have a major impact on radiologists' health, productivity, and accuracy in reading. Several factors must be taken into account in order to optimize the work environment for radiologists. Further, with the advancement in imaging technology, clinicians now have the ability to view and see digital exams without having to interact with radiologists. However, it is important to design components that encourage and enhance interactions between clinicians and radiologists to increase patient safety, and to combine physician and radiologist expertise. The present study evaluates alternative workstations in a real-world testbed space, using qualitative data (users' perspectives) to measure satisfaction with the lighting, ergonomics, furniture, collaborative spaces, and radiologist workstations. In addition, we consider the impact of the added collaboration components of the future reading room design, by utilizing user evaluation surveys to devise baseline satisfaction data regarding the innovative reading room environment.

Shining new light on the Hawthorne illumination experiments.

OBJECTIVE: This study provides an historical and statistical analysis of archival data from the Hawthorne illumination experiments. BACKGROUND: Previous accounts of the illumination experiments are fraught with inconsistencies because they have been based on secondary sources. The general consensus has been that variations in light levels had no effect on worker productivity at Hawthorne. All reports and data were thought to have been destroyed, but an archive at Cornell University was found to contain copies of the original documentation and much of the data from all three illumination experiments. Conclusions were originally drawn from visual comparisons of productivity graphs, and the data have never been properly statistically analyzed. METHOD: Archival reports, notes, photographs, and letters on the experiments were consulted. Productivity data were extracted from the tables and graphs in the reports and statistically analyzed for each experiment. RESULTS: Previously unpublished details of the illumination experiments emerged. An effect of lighting on productivity was found in the first treatment sequence for the first experiment, but this finding was not confirmed in the second sequence or in the second and third experiments. CONCLUSION: Experimental results provided inconsistent evidence of an association between light levels and productivity. All three experiments were found to be seriously flawed. APPLICATION: This study challenges popular accounts of the "Hawthorne effect," and the shortcomings of these experiments also have implications for the design of field studies.

Effect of acute exposure to a complex fragrance on lexical decision performance.

This study tested the effect of acute exposure to a commercial air freshener, derived from fragrant botanical extracts, at an average concentration of 3.16 mg/m(3) total volatile organic compounds on the lexical decision performance of 28 naive participants. Participants attended two 18-min sessions on separate days and were continuously exposed to the fragrance in either the first (F/NF) or second (NF/F) session. Participants were not instructed about the fragrance. Exposure to the fragrance did not affect high-frequency word recognition. However, there was an order of administration effect for low-frequency word recognition accuracy. When the fragrance was administered first before the no-odor control condition, it did not affect accuracy, but when it was administered second after the control condition, it significantly decreased low-frequency word recognition accuracy. Reaction times to low-frequency words were significantly slower than those for high-frequency words, but no effect of either fragrance or order of administration on reaction times was found. The presence of fragrance in the second session apparently served as a distraction that impaired lexical task performance accuracy. The introduction of fragrances into buildings may not necessarily facilitate all aspects of work performance as anticipated.

Carpal tunnel syndrome and cubital tunnel syndrome: work-related musculoskeletal disorders in four symptomatic radiologists.

OBJECTIVE: This report describes work-related upper extremity musculoskeletal disorders in four radiologists and identifies risk factors and preventive measures for these syndromes. SUBJECTS AND METHODS: Four radiologists with complaints of upper extremity pain, numbness, and weakness or a combination of symptoms were examined by an occupational therapist. The work activities and duties of all 12 staff radiologists in our filmless department were subsequently evaluated. Time working as staff, workday hours, and academic activities were recorded. Nonoccupational activities were also noted. An industrial hygienist evaluated the department work areas and staff offices. RESULTS: One radiologist had bilateral carpal tunnel syndrome, and all four radiologists had cubital tunnel syndrome (two [50%] unilateral, two [50%] bilateral). The four spent 3.4 +/- 0.3 years (mean +/- standard error of the mean) as staff radiologists in our filmless department, performing computer keyboard and mouse or trackball image manipulation and work list navigation, typing preliminary reports and telephone notifications, and editing electronically and approving dictated final reports. All four are academically active and had significantly greater workday hours (p < 0.05) and performed more research (p < 0.003) than the asymptomatic radiologists. Three (75%) of four radiologists routinely performed sonography. The industrial hygienist identified hazardous working conditions, especially related to ergonomics, in the reviewing areas and staff offices. CONCLUSION: Current technology renders staff radiologists at risk for work-related, upper extremity musculoskeletal disorders, including carpal and cubital tunnel syndromes. Proper equipment, ergonomics, and professional consultation should be used in all radiology departments.

Computer environments for children: a review of design issues.

Ergonomic design considerations for computer use in schools are reviewed. Evidence for the postural effects of ergonomic furniture from worldwide studies is evaluated. Issues of furniture sizing and allocation methods are discussed. The limited evidence for effects of input device design on schoolchildren is summarized. Future directions for ergonomic research studies are presented.