The impact of remote work using mobile information and communication technologies on physical health: a systematic review.

Remote e-working with information and communication technology (ICT) has long been on the rise, with its implementation accelerated by mandatory working from home regulations during the COVID-19 pandemic. This systematic literature review summarises the influencing factors of ICT-based remote e-working (device types, duration of use, user interfaces, etc.) on the physical health (musculoskeletal system and eyes) of knowledge workers. A search in four electronic databases and a manual search in four German journals resulted in 21 articles being included in this review. A bias analysis was conducted for all articles. Unfavourable postures, inappropriate working devices and certain environmental factors may cause a range of physical complaints, even after comparably short periods of time. Mostly, these complaints are greater compared to those experienced when working on a fully equipped stationary computer. Therefore, remote e-working requires careful planning, awareness, and the willingness to embrace working situations that counteract these problems.

Different factors associated with remote e-working may influence physical health. This systematic literature review found that unfavourable postures, inappropriate working devices and certain environmental factors may cause physical complaints, even after short periods of time. Mostly, these complaints are greater compared to those experienced when working on a stationary computer.

Healthy working in inclusive companies - a study protocol of the GAIN project.

BACKGROUND: The research project GAIN (working healthy in inclusion companies) deals with the topics of health and work in inclusive companies. Due to a great need for research on (occupational) health (e.g. physical and mental health status) and workplace design in companies employing people with disabilities, this project pursues the primary goal of generating information for the development and implementation of health-preserving measures within the framework of occupational health and safety, and risk assessment, for employees with and without impairments in inclusive companies. METHODS: Within the framework of the project, the employees of three inclusive companies will be examined with the help of an interdisciplinary and triangulative approach. Using quantitative and qualitative methods, specific physical workloads and hazards will be investigated by means of baseline screening methods and measurement techniques, specifically among employees with physical disabilities and impairments. In the statistical analysis, descriptive methods will be used to record the current state, while inferential statistical methods will be used to evaluate health maintenance measures. Inferential statistics for continuous data with confidence intervals based on the statistical parametric mapping (SPM) method will also be performed. The significance level will be set at 5%. Qualitative methods will be used to analyse structures and working conditions within the companies, with particular attention to the specific construction of the relationship between work, health and disability. CONCLUSIONS: The structures in inclusion companies must be specifically designed to support and promote the understanding of work and health in relation to the idea of one's own body, its positioning in space and its performance. These characteristics are to be identified in the course of the project and bundled into best-practice recommendations. Furthermore, it is the aim of the research project to derive recommendations for action at its conclusion and to present further advice for the promotion of health in inclusive companies.

Improvement of short-term outcomes with VR-based safety training for work at heights.

Serious games and virtual reality offer engaging learning opportunities and a cost-effective solution within an immersive and safe environment for safety training in construction. However, there have been few examples of safety training for work at heights developed using these technologies, especially commercial training. To fill this literature gap, a new VR-based safety training was developed and compared with lecture-based training across time. We conducted a quasi-experiment with a non-equivalent group design with 102 workers from six construction sites in Colombia. Learning objectives, observations from training centers, and national regulations were considered during the design of the training methods. Training outcomes were assessed using Kirkpatrick's model. We found that both training approaches were effective in improving knowledge test results and self-reported attitudes in the short-term; and risk-perception, self-reported behavior and safety climate in the long-term. In particular, participants of the VR-based training got significantly higher results in knowledge and reported higher attitudes (commitment and motivation) than participants of the lecture-based training. We suggest that safety managers and practitioners should invest in VR using serious games as an alternative to training programs based on short-term outcomes. Future work is needed to test VR for long-term outcomes.

The burden of conveyor belt work in the canteen kitchen: A question of working height?

BACKGROUND: Working in forced postures and standing continuously can be classified as straining the musculoskeletal system. OBJECTIVE: Since such postures are frequently used in hospital canteen kitchens, we used kinematic analysis to determine the working postures of canteen kitchen staff. METHODS: In this study, the daily work routine of 18 (11 w/7 m) workers of a hospital canteen kitchen (Frankfurt Main/Germany) aged 21-62 years (46±13 years) was examined by means of kinematic analysis (CULEA system; IFA; Sankt Augustin/Germany) and a detailed computerized analysis of the activities performed on-site. Angle values of the head and trunk were evaluated in accordance with ergonomic standards and presented using percentile values (P05-P95). The OWAS method was also employed to capture the proportions of standing, walking and sitting work. RESULTS: The kinematic posture analysis showed for all activities on the conveyor belt a tendency towards a dorsally inclined body position: trunk inclination (-7.5° to 0), thoracic spine inclination or a bending forward (-11.3° to 0°) and curvature of the back within the thoracic spine (-15.2° to 0°). In addition, >90% of the "activities on the belt" (46% of the daily working routine) were carried out standing. CONCLUSION: The activities on the conveyor belt were characterized by a tendency towards hyperextension of the trunk, possibly due to a too high working environment. Furthermore, an increased burden on body structures while standing can be concluded. From a primary prevention perspective, this increased standing load should be reduced by behavioral and relational prevention measures.

The ability to increase the base of support and recover stability is limited in its generalisation for different balance perturbation tasks.

BACKGROUND: The assessment of stability recovery performance following perturbations contributes to the determination of fall resisting skills. This study investigated the association between stability recovery performances in two perturbation tasks (lean-and-release versus tripping). METHODS: Healthy adults (12 young: 24 ± 3 years; 21 middle-aged: 53 ± 5 years; 11 old: 72 ± 5 years) were suddenly released from a forward-inclined position attempting to recover stability with a single step. In a second task, all participants experienced a mechanically induced trip during treadmill walking. To assess dynamic stability performance, the antero-posterior margin of stability (MoS), the base of support (BoS), and the rate of increase in BoS were determined at each foot touchdown (TD) for both tasks. RESULTS: Only weak to moderate correlations in dynamic stability performance parameters were found between the two tasks (0.568 > r > 0.305, 0.001 < p < 0.04). A separation of participants according to the number of steps required to regain stability in the lean-and-release task revealed that multiple- (more than one step) compared to single-steppers showed a significantly lower MoS at TD (p = 0.003; g = 1.151), lower BoS at TD (p = 0.019; g = 0.888) and lower rate of increase in BoS until TD (p = 0.002; g = 1.212) after release. Despite these profound subgroup differences in the lean-and-release task, no differences between multiple- and single-steppers were observed in the stability recovery performance during tripping. CONCLUSION: The results provide evidence that the ability to effectively control dynamic stability following a sudden balance disturbance in adults across a wide age range is limited in its generalisation for different perturbation tasks.

The effectiveness of virtual safety training in work at heights: A literature review.

Virtual environment techniques are technologies that can be used for safety training, and deliver significant advantages (e.g. risk-free, immersive learning). However, no studies have assessed the effectiveness of this training for work at heights (WAH). This paper aimed to synthesize the outcomes criteria for measuring the effectiveness of virtual safety training of WAH in different work sectors. A total of 658 records were identified through an explorative search of relevant citations from 2010 onwards. Only 21 documents were considered and classified according to the training goal: improvement of knowledge, skills or attitudes. Outcomes criteria of virtual safety training were analyzed according to Kirkpatrick's model. The results support practitioners and safety managers by providing an inventory of training methods, evaluation indicators and evaluation effects. Further recommendations are made for the design of an effective training assessment.

Assessment of work-related hand and elbow workloads using measurement-based TLV for HAL.

Direct-measurement-based methods for assessing workloads of the hand or elbow in the field are rare. Aim of the study was to develop such a method based on the Threshold Limit Value for Hand Activity Level (TLV for HAL). Hence, HAL was quantified using kinematic data (mean power frequencies, angular velocities and micro-pauses) and combined with electromyographic data (root-mean-square values) in order to generate a measurement-based TLV for HAL (mTLV for HAL). The multi-sensor system CUELA including inertial sensors, potentiometers and a 4-channel surface electromyography module was used. For wrist and elbow regions, associations between mTLV for HAL and disorders/complaints (quantified by odds ratios (OR [95%-confidence interval])) were tested exploratively within a cross-sectional field study with 500 participants. Higher workloads were frequently significantly associated with arthrosis of distal joints (9.23 [3.29-25.87]), wrist complaints (2.89 [1.63-5.11]) or elbow complaints (1.99 [1.08-3.67]). The new method could extend previous application possibilities.

Effects of two types of dynamic office workstations (DOWs) used at two intensities on cognitive performance and office work in tasks with various complexity.

This study examines the possible effects on objective work performance while using two types of dynamic office workstations (DOWs). 20 participants each used one type with three intensities (seated, light, moderate) and completed a task battery assessing cognitive performance and office work with two levels of complexity. Repeated measures MANOVA showed a significant interaction effect for work performance between the type of workstation and intensity for the simple level and a significant main effect for intensity for the complex level. Comparing the types of DOWs to each other, accuracy of text processing differed when working sedentary. Using both devices with light and moderate intensity had a significant detrimental effect on mouse tasks compared to working sedentary, but none comparing the intensities. No further results indicated neither a detrimental nor an enhancing effect of using DOWs on cognitive performance and office-work related tasks, regardless of the intensity of use or the task complexity. Practitioner Summary: By using DOWs, light physical activity can be integrated while working at a desk. Results showed that using different types of DOWs with different intensities does have a detrimental effect on tasks requiring a high motor control, but not on cognitive or further office work-related tasks of various complexity. Abbreviations: DOW: dynamic office workstation; aLT: activeLife Trainer; DB: deskbike; RPE: rated perceived exertion; MANOVA: multivariate analysis of variance; ANOVA: analysis of variance.

A kinematic posture analysis of neurological assistants in their daily working practice-a pilot study.

BACKGROUND: The aim of this pilot study was to analyze postures during the work of neurologists with respect to their occupational activities. METHODS: A total data material of 64.8 h (3885.74 min) of nine (three m/six f) neurologists (assistant physicians) was collected. Kinematic data were collected using the CUELA system (electro-goniometry). In addition, the occupational tasks performed on-site were subject to a detailed objective activity analysis. All activities were assigned to the categories "Office activities" (I), "Measures on patients" (II) and "Other activities" (III). The angle values of each body region (evaluation parameters) were evaluated according to ergonomic ISO standards. RESULTS: Only 3.4% of the working hours were spent with (II), while 50.8% of time was spent with (I) and 45.8% with (III). All tasks of category (II) revealed an increased ergonomic risk to the head, neck, trunk and back areas. During category (I) especially neck and back movements in the sagittal plane showed higher ergonomic risk levels. CONCLUSION: Despite frequently performed awkward body positions in (II), the ergonomic risk is considered as rather low, since the percentage time share totaled only 3.4%. As a result, "Office activities" have been detected as high predictor to cause stress load on the musculoskeletal system in the daily work of neurologists.

[Workshop on Health Risks of Sedentary Behavior at Workplace - Solutions Part II]. / Workshop Gesundheitsgefährdung durch langes Sitzen am Arbeitsplatz ­ Teil II Betriebliche Lösungsansätze.

AIM: Health risks of prolonged periods of sitting at work are a matter of concern. Solutions are needed based on interdisciplinary collaborations of research experts and practitioners in occupational safety and health areas. METHODS: In February 2019, at a workshop in Berlin of experts from different fields, issues of scientific evidence on the health risks of sedentary behaviour at work were presented in 6 lectures and solutions for the workplace were discussed. The workshop is documented here in 2 parts. Gender relevant aspects are distinguished where possible. RESULTS: Part II describes solution approaches for practice in the workplace. The results of a recent evaluation of dynamic workplaces are presented. Two examples provide insight into ongoing workplace health promotion measures addressing sedentary behavior in Germany which currently mainly target measures to increase physical activity rather than measures to interrupt long sedentary bouts. The documentation of the plenary discussion summarizes how interventions addressing sedentary behaviour at the workplace can be successful. CONCLUSIONS: Decision makers increasingly realize that there is a trend in the 21st century towards low physical demands due to increasingly sedentary tasks in the workplace. Despite research gaps, there is a need for evidence-based decisions in policy and workplace practices. Germany can learn from the experiences of other countries.

Dynamic Office Workstations: Initial Insights into User Usability Evaluations and Motivation.

Dynamic office workstations present a promising way to address the problem of inactivity at work, as they combine light physical activity with office tasks. In order to overcome the lack of structured implementation of such devices in office environments and the difficulty of stimulating employees to engage in healthy behaviors, the aim of this study was to investigate employees' motivation and perceived usability (e.g. operability) regarding the use of dynamic office workstations. Two different types of devices were made available to 30 employees (13 females, 17 males, mean ± SD = 43 ± 11.51 years) for 6 weeks. Motivation to the use of the workstations was assessed pre- and post-intervention, and usability was assessed post-intervention. Descriptive statistics and Wilcoxon tests were conducted. Employees reported the usability of the workstations to be acceptable, as they did not impede their work activities, whilst they were autonomously motivated towards using either workstation. Dynamic office workstations are suitable for daily use, although a flexible use of such devices should be guaranteed, depending on the task at hand.

Introducing a Dynamic Workstation in the Office: Insights in Characteristics of Use and Short-Term Changes of Well-Being in a 12 Week Observational Study.

The present field study evaluates the use of dynamic workstations (cycling devices) in a real-life office environment. Specific characteristics of use were recorded and possible relationships with short-term changes in well-being were investigated. For a period of 12 weeks, 36 employees were given free access to eight devices. Frequency, duration and speed of use were self-determined but registered objectively for every event of use. Immediately before and after using a cycling device, employees rated their well-being with a modified version of the EZ-scale from Nitsch to assess changes in the short-term. In total, 817 events of use were registered. On each day of the intervention period one of the devices was used. Participants used the devices between one day to all days present at the office, for 21.09 (SD 0.58) to 31.58 (SD 2.19) minutes on average per event of use per day. Comparing the pre- and post-measurements, a significant increase in well-being after using a cycling device was found. Results of a Generalized Estimating Equations (GEE) analysis showed mixed effects for the duration of use, the speed and variation of speed on the probability of reporting positive changes in recovery, calmness and mood. Therefore, using cycling devices in the office might improve short-term well-being.

Work-relatedness of lumbosacral radiculopathy syndrome: Review and dose-response meta-analysis.

OBJECTIVE: Clinicians need to know whether lumbosacral radiculopathy syndrome (LRS) can be attributed to work. This review describes what work-related risk factors are associated with LRS. METHODS: A systematic review was performed in PubMed and Embase. Inclusion criteria were that LRS was diagnosed by a clinician and workers exposed to work-related risk factors were compared to workers less or not exposed. A quality assessment and a meta-analysis were performed, including a dose-response analysis. RESULTS: The search resulted in 7,350 references and 24 studies that fulfilled the inclusion criteria: 19 studies were rated as having a high risk of bias and 5 as having a low risk of bias. The median number of LRS patients per study were 209 (interquartile range 124-504) and the total number of participants was 10,142. The meta-analysis revealed significant associations with heavy physically demanding work (odds ratio [OR] 2.03, 95% confidence interval [CI] 1.48-2.79), bending or twisting of the trunk (OR 2.43, 95% CI 1.67-3.55), and lifting and carrying in combination with bending or twisting of the trunk (OR 2.84, 95% CI 2.18-3.69). No significant associations were found for professional driving (OR 1.46, 95% CI 0.90-2.35) or sitting (OR 1.08, 95% CI 0.49-2.38). A dose-response relation was present per 5 years of exposure for bending (OR 1.12, 95% CI 1.04-1.20), lifting (OR 1.08, 95% CI 1.02-1.14) and the combination of bending and lifting (OR 1.14, 95% CI 1.01-1.29). CONCLUSIONS: Moderate to high-quality evidence is available that LRS can be classified as a work-related disease depending on the level of exposure to bending of the trunk or lifting and carrying. Professional driving and sitting were not significantly associated with LRS.

Use and physiological responses of portable dynamic office workstations in an occupational setting - A field study.

OBJECTIVE: The aim of this study was to investigate the use of two types of dynamic workstations (Deskbike, activeLife Trainer) and their effects on physiological activation in an occupational setting. METHODS: 30 employees were given access to the devices for 28 days. Frequency and duration of borrowing and use was recorded by a Chipcard-system. Physiological activation (energy expenditure, heart rate) while working in a seated position and using the workstations was measured with the activity tracker Fitbit Charge HR. RESULTS: Participants used dynamic workstations on 40% of their working days for an average of 54.3 ±â€¯23.9 min per day. Energy expenditure and heart rate increased significantly while using the workstations compared to working seated. The Deskbike was used more frequently and resulted in greater heart rate elevation. CONCLUSION: Both types of dynamic workstations were used by the employees and had positive effects on physiological activation. The implementation of either type can be recommended.

Constrained posture in dentistry - a kinematic analysis of dentists.

BACKGROUND: How a dentist works, such as the patterns of movements performed daily, is also largely affected by the workstation Dental tasks are often executed in awkward body positions, thereby causing a very high degree of strain on the corresponding muscles. The objective of this study is to detect those dental tasks, during which awkward postures occur most frequently. The isolated analysis of static postures will examine the duration for which these postures are maintained during the corresponding dental, respectively non-dental, activities. METHODS: 21 (11f/10 m) dentists (age: 40.1 ± 10.4 years) participated in this study. An average dental workday was collected for every subject. To collect kinematic data of all activities, the CUELA system was used. Parallel to the kinematic examination, a detailed computer-based task analysis was conducted. Afterwards, both data sets were synchronized based on the chronological order of the postures assumed in the trunk and the head region. All tasks performed were assigned to the categories "treatment" (I), "office" (II) and "other activities" (III). The angle values of each body region (evaluation parameter) were examined and assessed corresponding to ergonomic standards. Moreover, this study placed a particular focus on static positions, which are held statically for 4 s and longer. RESULTS: For "treatment" (I), the entire head and trunk area is anteriorly tilted while the back is twisted to the right, in (II) and (III) the back is anteriorly tilted and twisted to the right (non-neutral position). Static positions in (I) last for 4-10s, static postures (approx. 60%) can be observed while in (II) and (III) in the back area static positions for more than 30 s are most common. Moreover, in (II) the back is twisted to the right for more than 60 s in 26.8%. CONCLUSION: Awkward positions are a major part of a dentists' work. This mainly pertains to static positions of the trunk and head in contrast to "office work." These insights facilitate the quantitative description of the dentist profession with regard to the related physical load along with the health hazards to the musculoskeletal system. Moreover, the results allow for a selective extraction of the most unfavorable static body positions that dentists assume for each of the activities performed.

The comparative analysis of postural and biomechanical parameters of preschool teachers pre- and post-intervention within the ErgoKiTa study.

The ErgoKiTa study aimed to determine the musculoskeletal strain of preschool teachers and to identify and evaluate suitable prevention measures to reduce this strain. A comprehensive work analysis using objective and subjective methods was performed to determine the present work situation in preschools in Germany, and the results were used to derive suitable intervention measures. The musculoskeletal strain was determined by means of a comprehensive analysis of postures, forces and movements using the CUELA system and calculated as cumulative shift workloads. The intervention measures were evaluated in a pre- and post-intervention assessment for 12 participants. Significant alterations in the duration of postures were determined, specifically for the daily duration of knee-straining postures as well as the degree of trunk flexion between 60° and 90°, which were reduced from 8.4 to 3.1% and from 3.7 to 2.4%, respectively, following the intervention. Practitioner Summary: Research has shown that preschool teachers are at risk of developing musculoskeletal disorders. The effects of a situation-orientated and behaviour-orientated intervention approach were assessed with regard to awkward working postures. Significant alterations in the duration of postures following the intervention were found, specifically for knee-straining postures.

Restricted posture in dentistry - a kinematic analysis of orthodontists.

BACKGROUND: This study aims at identifying orthodontic activities with the highest frequency of unfavorable/awkward and static postures held over a period of more than 4 s based on kinematic analysis. Moreover, a separate analysis of static postures for orthodontic and non-orthodontic activities serves to evaluate the duration for which these particular postures are assumed. METHODS: In total, 21 (13f/8 m) orthodontists (age: 31.5 ± 3.8 years) participated in this study. CUELA, a personal measurement system, was used to collect kinematic data for all orthodontic activities in a working day. Angle values of the head and torso were evaluated in accordance with ergonomic standards. Only those postures that were held statically for 4 s and longer were selected for further analysis. Alongside the kinematic analysis, the activities performed on-site were also subject to a detailed computerized analysis. The synchronization of data collected from both measurements arranges the patterns of posture found chronologically and in conjunction with the orthodontic activities performed ((I) "treatment" (II) "office" and (III) "other activities"). RESULTS: For (I) we observed an anterior inclination of the head and torso area as well as a twist of the head and neck area to the right. We found anterior back inclination and lateral back torsion to the right for (II) and (III). If, furthermore, we differentiate the duration of static postures, there are primarily short to medium-term (4-30s) static postures identified for (I). Also, categories (II) and (III) predominantly demonstrate static back postures with a duration of up to 30 s. With regard to (II) we observed that the back is ventrally inclined for 10.1% of the total activity duration. CONCLUSIONS: During treatment static strains are observed in the entire head and torso area. On the contrary, static postures prevalent in the torso area are essential for activities of the other categories, particularly office work. These findings allow for a careful selection of unfavorable and static postures for each of the activities performed and help to develop specific preventive measures.

Do Occupational Risks for Low Back Pain Differ From Risks for Specific Lumbar Disc Diseases?: Results of the German Lumbar Spine Study (EPILIFT).

STUDY DESIGN: A multicenter, population based, case-control study. OBJECTIVE: The aim of the present analysis is to clarify potential differences in the "occupational risk profiles" of structural lumbar disc diseases on the one hand, and low back pain (LBP) on the other hand. SUMMARY OF BACKGROUND DATA: Physical workplace factors seem to play an important etiological role. METHODS: We recruited 901 patients with structural lumbar disc diseases (disc herniation or severe disc space narrowing) and 233 control subjects with "low-back-pain." Both groups were compared with 422 "low-back pain free" control subjects. Case history, pain data, neurological deficits, and movement restrictions were documented. LBP was recorded by the Nordic questionnaire on musculoskeletal symptoms. All magnetic resonance imaging, computed tomography, and X-rays were inspected by an independent study radiologist. The calculation of cumulative physical workload was based on a computer-assisted interview and a biomechanical analysis by 3-D-dynamic simulation tool. Occupational exposures were documented for the whole working life. RESULTS: We found a positive dose-response relationship between cumulative lumbar load and LBP among men, but not among women. Physical occupational risks for structural lumbar disc diseases [odds ratio (OR) 3.7; 95% confidence interval (95% CI) 2.3-6.0] are higher than for LBP (OR 1.9; 95% CI 1.0-3.5). CONCLUSION: Our finding points to potentially different etiological pathways in the heterogeneous disease group of LBP. Results suggest that not all of the structural disc damage arising from physical workload leads to LBP. LEVEL OF EVIDENCE: 4.

A practical guidance for assessments of sedentary behavior at work: A PEROSH initiative.

Sedentary behavior is defined as sitting or lying with low energy expenditure. Humans in industrialized societies spend an increasing amount of time in sedentary behaviors every day. This has been associated with detrimental health outcomes. Despite a growing interest in the health effects of sedentary behavior at work, associations remain unclear, plausibly due to poor and diverse methods for assessing sedentary behavior. Thus, good practice guidance for researchers and practitioners on how to assess occupational sedentary behavior are needed. The aim of this paper is to provide a practical guidance for practitioners and researchers on how to assess occupational sedentary behavior. Ambulatory systems for use in field applications (wearables) are a promising approach for sedentary behavior assessment. Many different small-size consumer wearables, with long battery life and high data storage capacity are commercially available today. However, no stand-alone commercial system is able to assess sedentary behavior in accordance with its definition. The present paper offers decision support for practitioners and researchers in selecting wearables and data collection strategies for their purpose of study on sedentary behavior. Valid and reliable assessment of occupational sedentary behavior is currently not easy. Several aspects need to be considered in the decision process on how to assess sedentary behavior. There is a need for development of a cheap and easily useable wearable for assessment of occupational sedentary behavior by researchers and practitioners.