Physical capability limits for right-angle power tool operation.

Automotive assembly operations require power tools to secure fasteners and these operations have been linked to increased risk of musculoskeletal disorders. This work was designed to develop physical capability limits for direct current right-angle power tool (RAPT) operations using psychophysics. Forty females fastened joints of different hardness's using three fastening strategies, at three fastening frequencies. Participants chose to fasten, independent of orientation, joints up to 89 (10.6) Nm using Atlas Copco's TurboTight®, compared to 51.8 (8.1) Nm using Atlas Copco's Quickstep and 48.6 (10.2) Nm using Stanley's Automatic Tightening Control. The differences between fastening strategies were not as large when fastening soft joints; 59.2 (16.2), 52.3 (14.6), and 53.5 (11.3) Nm, respectively. As fastening frequency increased, participants chose lower target torque magnitudes to fasten. Based on this work, RAPT manufactures can adjust fastening strategies to improve their tool's ergonomics performance. Practitioner summary: Fastening tasks was identified as posing an injury risk to workers performing automotive assembly, yet presently there are no published physical capability limits for direct current right-angle power tool operation. Using a psychophysical methodology, physical capability limits for RAPT fastenings were established for different joint hardness, fastening frequencies and RAPT position/orientation.

Scoping review on the state of the integration of human physiological responses to evaluating heat-stress.

OBJECTIVES: To determine the state of the literature on assessing heat-stress using physiological parameters. To provide recommendations to the nuclear industry regarding worker heat-stress management practices. METHODS: A scoping review identified relevant articles. A search strategy was developed based on a research question concepts. Identified records were screened with inclusion-exclusion criteria. Included articles underwent data extraction using a qualitative data charting method. A thematic analysis and frequency counts were performed. RESULTS: 1687 articles were identified through four databases. The final inclusion consisted of 34 studies. Articles were classified by determinants of heat exposure risks: core body temperature (direct and indirect), scoring scale including core body temperature, scoring scale including human perception, and others. Heart rate and rectal temperature were the two most utilized physiological measurements. CONCLUSION: A significant amount of literature examined estimation of core temperature using non-invasive methods, sometimes integrated into wearables. Heat-stress management practices could include perceptual measures to better evaluate heat-strain.

Left Ventricular Pressure Ratio Predicts In-Hospital Outcomes in Hospitalized Heart Failure With Reduced Ejection Fraction.

BACKGROUND: Given the risk of hemodynamic compromise in heart failure with reduced ejection fraction (HFrEF) patients undergoing left heart catheterization (LHC), there is a need for a simple parameter that can predict clinical outcomes. We hypothesize that left ventricular pressure ratio (LVPR), calculated as left ventricle systolic/left ventricle end-diastolic pressure, is a strong predictor of hemodynamic collapse in these patients. METHODS: Retrospective analysis of consecutive hospitalized HFrEF patients undergoing combined LHC and right heart catheterization (RHC) at a single institution from 2015-2017 was performed. LVPR was compared with standard RHC hemodynamic variables. The primary outcome was in-hospital escalation of therapy, defined as ≥40 mm Hg drop in systolic blood pressure (SBP), SBP ≤90 mm Hg for ≥15 minutes, start or escalation of vasoactive medications, cardiopulmonary resuscitation, or in-hospital death. Receiver-operating characteristic (ROC) analysis and Kaplan-Meier survival analysis were performed for prediction of the primary outcome. RESULTS: A total of 176 patients were included in this study. ROC analysis determined an optimal cut-off value of ≤3.96, which correlated with an area under the curve (AUC) of 0.65 (sensitivity, 45.9%; specificity, 83.2%; correctly classified, 64.9%). AUC was similar to other variables obtained using RHC. In-hospital survival free of escalation of therapy was lower in the low LVPR group vs the high LVPR group (0% vs 33%, respectively; P<.01). CONCLUSION: LVPR is an easily measured index obtained during LHC that can risk stratify hospitalized patients with HFrEF at the time of LHC.

A survey of right-angle power tool use in Canadian automotive assembly plants.

Right-angle power-tools (RAPT) employed in automotive manufacturing promote greater productivity and quality fastenings, as well as, improve process efficiency. Due to RAPT technological advances automotive manufactures desire to understand their ergonomics consequences within a laboratory environment, however, laboratory-based representation must accurately represent the real world. A survey within automotive assembly plants was conducted to capture RAPT operation data. After examining 80 total RAPT operations, we logged the 3D locations of the fastener location (with respect to the operator), direction and the hand placement location used by operators. Four common locations with respect to the midpoint between the ankle (in cm; X = sagittal plane, Y = transverse plane, Z = coronal plane): 1) 2, 113, 62; 2) 42, 104, 45; 3) -26, 151, 36; 4) -37, 92, 52. These locations can be used to simulate RAPT operations within a laboratory. The survey provided insight into current workstation layout when operating RAPTs and, knowledge for laboratory-based RAPT examinations so that simulated tasks best represent their operation in automotive manufacturing.

The Effects of Lower Extremity Strengthening Delivered in the Workplace on Physical Function and Work-Related Outcomes Among Desk-Based Workers: A Randomized Controlled Trial.

OBJECTIVE: The aim of this study was to assess the effectiveness of a workplace leg-strengthening program on self-reported function, physical capacity, and work-related outcomes among desk-based workers. METHODS: Forty-three desk-based workers were randomized to a 12-week exercise program or no exercise control. The primary outcome was change in self-reported physical function on the Lower Extremity Functional Scale (LEFS) from baseline to follow-up. Secondary outcomes were physical capacity (mobility, strength), self-reported outcomes (pain, depressive symptoms), and work-related outcomes (resilience, work ability). RESULTS: The exercise group showed greater improvements in LEFS and mobility. No significant between-group differences existed in knee strength or remaining self-reported and work-related outcomes. CONCLUSION: Workplace implemented leg-strengthening exercises are effective at improving self-reported and physical health outcomes of desk-based workers. Moving forward, occupational exercise interventions may be essential to enhance worker longevity among the aging, sedentary workforce.