Ergonomics in gynecologists' daily practice: A nationwide survey in The Netherlands.

BACKGROUND: Gynecologists are exposed to multiple risk factors for developing physical complaints. To enhance the workplace ergonomics in gynecological practice, a more detailed insight about job content and associated demands is necessary to subsequently decrease the exposure to risk factors. OBJECTIVE: The aim of this study was to investigate the prevalence of physical complaints and the presence of ergonomic constraints in Dutch gynecological practice. METHODS: A questionnaire was distributed among the 1200 members of the Dutch Society of Obstetrics and Gynecology. It consisted of 52 Dutch questions derived from the validated Dutch Musculoskeletal Questionnaire. RESULTS: A total of 227 respondents completed the questionnaire (response rate 18.9%). Overall, 99.5% of the respondents rated their health status as reasonable or good. However, the twelve-month prevalence of physical complaints in one or more body part was 89.4%. Sustained adverse body postures were particularly reported for performing abdominal, and endoscopic surgery, and for assisting in vaginal surgery. Limited workspace, instruments, and patient size were reported by more than 60% of the respondents as constraints for adopting a neutral body posture during vaginal, endoscopic and abdominal surgery respectively. CONCLUSION: The results emphasize the necessity of enhancing ergonomics in gynecological practice. Better ergonomic circumstances will most likely benefit both the health of the gynecologists as well as the quality of surgical care.

Comparison of the postural and physiological effects of two dynamic workstations to conventional sitting and standing workstations.

Increasing evidence is being found for the association of health risk factors with work-related physical inactivity. An increasing number of people are being exposed to this form of inactivity, and as a result, various interventions aimed at increasing physical activity during working hours are being developed. This study aims to investigate the differences in postural, muscular and physical activities resulting from two dynamic workstations, namely an elliptical trainer and a treadmill workstation, compared with a conventional sitting and standing workstation. Twelve participants completed five standardised office tasks in a laboratory setting at all workstations. No significant effect was found regarding changes in posture and the muscular activity was only significantly higher for the trapezius muscle (50th percentile: 8.1 %MVC) at the dynamic workstations. For the dynamic workstations, physical activity ranged from 4.0 to 14.9 × 10(-2) g, heart rate from 14.3 to 27.5 %HRR and energy expenditure from 1.8 to 3.1 METs. Practitioner Summary: Work-related physical inactivity is associated with health risk factors. In this study, physiological and postural effects of dynamic workstations were assessed in comparison to conventional workstations. No significant effects were found regarding changes in posture and muscular activity. Physical activity, heart rate and energy expenditure increased for the dynamic workstations.

Effects of a standing and three dynamic workstations on computer task performance and cognitive function tests.

Sedentary work entails health risks. Dynamic (or active) workstations, at which computer tasks can be combined with physical activity, may reduce the risks of sedentary behaviour. The aim of this study was to evaluate short term task performance while working on three dynamic workstations: a treadmill, an elliptical trainer, a bicycle ergometer and a conventional standing workstation. A standard sitting workstation served as control condition. Fifteen Dutch adults performed five standardised but common office tasks in an office-like laboratory setting. Both objective and perceived work performance were measured. With the exception of high precision mouse tasks, short term work performance was not affected by working on a dynamic or a standing workstation. The participant's perception of decreased performance might complicate the acceptance of dynamic workstations, although most participants indicate that they would use a dynamic workstation if available at the workplace.

Effect of canopy shape on physical load when holding an umbrella.

The aim of the current study was to investigate the effect of the canopy shape of an umbrella on physical load when holding the umbrella in different circumstances. For this purpose, thirteen subjects participated in this study and muscle activity of seven muscles of the upper limb (including the forearm) was measured for 5 wind speeds (4, 5, 6, 7, 8 Bft) and two wind directions (front and side). From the results, it was seen that for the p50 value of the muscle activity, the umbrella with the asymmetric canopy required 62% and for the p90 value of the muscle activity 74% of the muscle activity, on average, over all wind speeds - compared to the traditional umbrella. Based on these results, we can conclude that the physical load of holding the traditional umbrella is significantly higher than holding the umbrella with the asymmetric canopy shape in windy conditions.

Movement strategy and performance in a high-volume order picking workstation.

The design of a work station generally prescribes a global movement pattern of the operator, but also leaving some degrees of freedom regarding movement strategy. For a specific order picking work station, we studied the movement strategies, the underlying factors and its impact on performance. Eight subjects performed a task comprising, the picking and placing of an object and pressing a button in eight conditions varying in product weight, movement direction (left vs. right), and placing distance. Movements were analyzed and cycle times were obtained from video-recordings. We observed various types of strategy regarding hand use and global placing mode (reaching vs. placing). The different strategies did not show clear relationships with performance (in contrast to the various work place factors). Ergonomically spoken, the fact that the workstation allows movement variation without loss of performance, is favorable.

Mechanics of toe and heel landing in stepping down in ongoing gait.

When stepping down from a height difference in ongoing gait, subjects are known to use a heel landing at small height differences and switch to toe landing for larger height differences. We hypothesized that in toe landing, the leading leg can perform more negative work, to control the momentum gained during the descent, than in heel landing. Ten young male participants walked over a 10-m walkway at 5km/h to step down a height difference of 10cm halfway, using a heel or toe landing in five trials each. Kinematic data and ground reaction forces under the leading and trailing legs were recorded. Inverse dynamical analysis of both strategies showed that the leading leg performed more negative work in toe landing, while the vertical velocity at ground contact was lower. In addition, the impact forces were lower in toe landing than in heel landing. Toe landing was found to reduce gait velocity in the first step on the lower level and required higher moments and negative power around the ankle joint than heel landing. Our results indicate that heel landing may be preferred when stepping down small height differences, because it is less demanding especially for the plantar flexor muscles, while toe landing may be preferred for stepping down larger height differences, because it improves control over the momentum gained during the descent.

Balance control in stepping down expected and unexpected level changes.

Stepping down an elevation in ongoing gait is a common task that can cause falls when the level change is unexpected. The aim of this study was to compare expected and unexpected stepping down. We hypothesized that unexpected stepping would lead to loss of control over the movement and potentially falls due to buckling of the leading leg at landing. Ten male subjects repeatedly walked over a platform on which they stepped down an expected 10-cm height difference. In 5 out of 50 trials, the height difference was encountered unexpectedly early. Kinematics and ground reaction forces under both feet were measured during the stride in which the height difference was negotiated. Stepping down involved a substantial increase in forward horizontal and angular momenta (approximately 40 Ns and 20 N ms). In expected stepping down, step length was significantly increased (17%), which allowed control of these forward horizontal and angular momenta immediately following landing. In unexpected stepping down, the time between expected ground contact and actual ground contact (110 ms) appeared too short to substantially adjust leg movement and increase step length. Although buckling of the leg did not occur, presumably due to its more vertical orientation at landing, momentum could not be sufficiently attenuated at landing, but a fall was prevented by a rapid step of the trailing limb. The lack of control of momentum might cause a fall, when the capacity to make such a rapid step falls short, as in the elderly, or when the height difference is larger.