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.

How do women feel cold water swimming affects their menstrual and perimenopausal symptoms?

OBJECTIVE: This study aimed to determine how women felt cold water swimming affected their menstrual and perimenopausal symptoms. STUDY DESIGN: An online survey that asked women who regularly swim in cold water about their experiences. The survey was advertised for 2 months on social media. Questions related to cold water swimming habits and menstrual and perimenopausal symptoms were analysed. MAIN OUTCOME MEASURES: Quantitative and qualitative data including; frequency of menstrual and menopause symptoms, the effect of cold water swimming on these symptoms. RESULTS: 1114 women completed the survey. Women reported that cold water swimming reduced their menstrual symptoms, notably psychological symptoms such as anxiety (46.7%), mood swings (37.7%) and irritability (37.6%). Perimenopausal women reported a significant improvement in anxiety (46.9%), mood swings (34.5%), low mood (31.1%) and hot flushes (30.3%). The majority of women with symptoms swam specifically to reduce these symptoms (56.4% for period and 63.3% for perimenopause symptoms). Women said they felt it was the physical and mental effects of the cold water that helped their symptoms. For the free text question, five themes were identified: the calming and mood-boosting effect of the water, companionship and community, period improvements, an improvement in hot flushes and an overall health improvement. CONCLUSION: Women felt that cold water swimming had a positive overall effect on menstrual and perimenopause symptoms. Studies on other forms of exercise to relieve menstrual and perimenopause symptoms may show similar findings.

Association between air temperature and unintentional drowning risk in the United Kingdom 2012-2019: A nationwide case-crossover study.

OBJECTIVE: Drowning is a leading cause of death. The World Health Organization (WHO) and United Nations (UN) emphasise the need for population-level data-driven approaches to examine risk factors to improve water safety policies. Weather conditions, have the potential to influence drowning risk behaviours as people are more likely to spend time around water and/or undertake risky activities in aquatic spaces as a behavioural thermoregulatory response (e.g., seeking coolth). METHODS: A case-crossover approach assessed associations between changes in daily maximum air temperature (data from the nearest weather station to each drowning event) and unintentional drowning risk using anonymous data from the validated UK Water Incident Database 2012-2019 (1945 unintentional deaths, 82% male). Control days were selected using a unidirectional time-stratified approach, whereby seven and 14 days before the hazard day were used as the controls. RESULTS: Mean maximum air temperature on case and control days was 15.36 °C and 14.80 °C, respectively. A 1 °C increase in air temperature was associated with a 7.2% increase in unintentional drowning risk. This relationship existed for males only. Drowning risk was elevated on days where air temperature reached 15-19.9 °C (Odds Ratio; OR: 1.75), 20-24.9 °C (OR: 1.87), and ≥ 25 °C (OR: 4.67), compared with days <10 °C. The greatest elevations in risk appeared to be amongst males and when alcohol intoxication was suspected. Precipitation showed no significant association with unintentional drowning risk. CONCLUSIONS: Identifying such relationships highlights the value of considering weather conditions when evaluating environmental risk factors for drowning, and may inform water safety policy and allocating resources to prevention and rescue.

Prevention and Treatment of Nonfreezing Cold Injuries and Warm Water Immersion Tissue Injuries: Supplement to Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Frostbite.

We convened an expert panel to develop evidence-based guidelines for the evaluation, treatment, and prevention of nonfreezing cold injuries (NFCIs; trench foot and immersion foot) and warm water immersion injuries (warm water immersion foot and tropical immersion foot) in prehospital and hospital settings. The panel graded the recommendations based on the quality of supporting evidence and the balance between benefits and risks/burdens according to the criteria published by the American College of Chest Physicians. Treatment is more difficult with NFCIs than with warm water immersion injuries. In contrast to warm water immersion injuries that usually resolve without sequelae, NFCIs may cause prolonged debilitating symptoms, including neuropathic pain and cold sensitivity.

Deaths in Open Water Swimming Races in Brazil from 2009 to 2019.

Since the inclusion in the Olympic Games (2008), open swimming races have attracted greater media attention and, therefore, have a greater number of practitioners, especially in Brazil, an extremely favorable country for this sport. However, increasing reports of fatal incidents in open water races brought the medical and scientific community to attention. The aim of this study was to review the characteristics of deaths in open waters events in Brazil from 2009 to 2019. The survey was divided into 3 steps: 1) contacting sports-related federations and companies, including swimming and triathlon federations, master associations and event organizing companies; 2) internet search; and 3) personal communication with athletes, coaches, organizers, and health personnel. A total of 12 deaths were observed in open water swimming races, including triathlon swimming segment races in Brazil from 2009 to 2019. The average was 1.1 deaths per year, whereas in the last 3 years (2017-2019) the average was 3 deaths per year. The male participants accounted for 11 deaths (91.7%), the average age was 47 years old, experienced athletes were more affected (80%), and incidents occurred mainly in ocean waters (75%). The increase of deaths in the last 3 years draws attention, and the best way to reduce the deaths by drowning in open waters in Brazil, is to understand the profile and causes, to propose solutions.

Quantifying Risk in Air Sports: Flying Activity and Incident Rates in Paragliding.

INTRODUCTION: The volume, nature, and risks of paragliding are poorly quantified. More comprehensive understanding, including incident rates allowing comparison to similar disciplines, will help direct and appraise safety interventions. METHODS: Paraglider pilots were surveyed regarding experience, incidents, recordkeeping, and risk perception. The survey could not capture those who had left the sport or died, so a subset of responses from UK pilots was compared to records from an incident database. RESULTS: There were 1788 (25%) responses from 7262 surveyed. Respondents flew a total of 87,909 h in 96,042 flights during 2019. Local flying was most frequent (n=37,680 flights, 39%) but a higher proportion of hours were spent flying cross-country (n=33,933 h, 39%). The remainder were spent in competition, hike and fly, tandem, aerobatic, or instructional flight. Flying incidents led to 103 (6%) respondents seeking medical attention, attending hospital, or missing a day of work in 2019. Near misses were reported by 423 (26%) pilots. Asymmetry and rotational forces typically led to incidents, and limb and back injuries resulted. Pilots frequently failed to throw their reserve parachutes. Only 3 (0.6%) incidents involved equipment failure, with the remainder attributed to control or decision errors. Incident rates of paragliding were estimated as 1.4 (1.1-1.9) deaths and 20 (18-27) serious injuries per 100,000 flights, approximately twice as risky as general aviation and skydiving. CONCLUSIONS: Incidents usually resulted from pilot error (control and decision), rather than equipment failure. Future safety interventions should focus on improving glider control skills and encouraging reserve parachute deployment.

Thirst-guided participant-controlled intravenous fluid rehydration: a single blind, randomised crossover study.

BACKGROUND: Dehydration is common in hospitals and is associated with increased mortality and morbidity. Clinical assessment and diagnostic measures of dehydration are unreliable. We sought to investigate the novel concept that individuals might control their own intravenous rehydration, guided by thirst. METHODS: We performed a single-blind, counterbalanced, randomised cross-over trial. Ten healthy male volunteers of mean age 26 (standard deviation [sd] 10.5) yr were dehydrated by 3-5% of their baseline body mass via exercising in the heat (35°C, 60% humidity). This was followed by a 4 h participant-controlled intravenous rehydration: individuals triggered up to six fluid boluses (4% dextrose in 0.18% sodium chloride) per hour in response to thirst. Participants undertook two blinded rehydration protocols which differed only by bolus volume: 50 ml (low volume [LV]) or 200 ml (high volume [HV]). Each hour during the rehydration phase, plasma osmolality (pOsm) was measured and thirst score recorded. Nude body mass was measured at baseline, after dehydration, and after the rehydration phase. RESULTS: In both conditions, the mean dehydration-related body mass loss was 3.9%. Thirst score was strongly associated with pOsm (within-subject r=0.74) and demand for fluid decreased as pOsm corrected. In the HV condition, participants rapidly rehydrated themselves (mean fluid delivered 3060 vs 981 ml in the LV condition) to body mass and pOsm no different to their euhydrated state. CONCLUSION: Healthy individuals appear able to rely on thirst to manage intravenous fluid intake. Future work must now focus on whether patient-controlled intravenous fluids could represent a paradigm shift in the management of hydration in the clinical setting. CLINICAL TRIAL REGISTRATION: NCT03932890.

Considerations for physical employment standards in the aging workforce.

BACKGROUND: If current population and health trends continue, workplace demographics will look significantly different by the turn of the century. Organizations will no longer have a steady pipeline of younger workers and will likely need to rely on older workers to remain competitive in the global marketplace. The future multi-generational workforce will bring with it the challenge of maximizing contributions from each generation whilst at the same time addressing the health, safety and wellbeing needs of all workers. OBJECTIVE: This review provides an insight into aging and older workers, and presents recommendations to promote worker longevity. METHODS: This narrative review draws on evidence from 108 published sources. RESULTS: The relationship between age and work is not simple; factors including the physical nature of the job and worker's health and fitness interact with age to either increase or decrease the potential effect of age. Evidence suggests that the issues arising from an aging workforce can be managed through polices that focus on active aging through: attitude management; flexible working and the provision of occupational health. CONCLUSION: The integration of such interventions would require company and organizational commitment from the top down with educational programs at all levels to ensure understanding and participation.

Core Temperature in Triathletes during Swimming with Wetsuit in 10 °C Cold Water.

Low water temperature (<15 °C) has been faced by many organizers of triathlons and swim-runs in the northern part of Europe during recent years. More knowledge about how cold water affects athletes swimming in wetsuits in cold water is warranted. The aim of the present study was therefore to investigate the physiological response when swimming a full Ironman distance (3800 m) in a wetsuit in 10 °C water. Twenty triathletes, 37.6 ± 9 years (12 males and 8 females) were recruited to perform open water swimming in 10 °C seawater; while rectal temperature (Tre) and skin temperature (Tskin) were recorded. The results showed that for all participants, Tre was maintained for the first 10-15 min of the swim; and no participants dropped more than 2 °C in Tre during the first 30 min of swimming in 10 °C water. However; according to extrapolations of the results, during a swim time above 135 min; 47% (8/17) of the participants in the present study would fall more than 2 °C in Tre during the swim. The results show that the temperature response to swimming in a wetsuit in 10 °C water is highly individual. However, no participant in the present study dropped more than 2 °C in Tre during the first 30 min of the swim in 10 °C water.