High-risk Tasks Research Articles

Determinants of Respirable Crystalline Silica Exposure Among Stoneworkers Involved in Stone Restoration Work

Crystalline silica occurs as a significant component of many traditional materials used in restoration stonework, and stoneworkers who work with these materials are potentially exposed to stone dust containing respirable crystalline silica (RCS). Exposure to RCS can result in the development of a range of adverse health effects, including silicosis and lung cancer. An understanding of the determinants of RCS exposure is important for selecting appropriate exposure controls and in preventing occupational diseases. The objectives of this study were to quantify the RCS exposure of stoneworkers involved in the restoration and maintenance of heritage properties and to identify the main determinants of RCS exposure among this occupational group. An exposure assessment was carried out over a 3-year period amongst a group of stonemasons and stone cutters involved in the restoration and maintenance of heritage buildings in Ireland. Personal air samples (n = 103) with corresponding contextual information were collected. Exposure data were analysed using mixed-effects modelling to investigate determinants of RCS exposure and their contribution to the individual's mean exposure. Between-depot, between-worker, and within-worker variance components were also investigated. The geometric mean (GM) RCS exposure concentrations for all tasks measured ranged from <0.02 to 0.70mg m(-3). GM RCS exposure concentrations for work involving limestone and lime mortar were <0.02-0.01mg m(-3), tasks involving granite were 0.01-0.06mg m(-3), and tasks involving sandstone were <0.02-0.70mg m(-3). Sixty-seven percent of the 8-h time-weighted average (TWA) exposure measurements for tasks involving sandstone exceeded the Scientific Committee on Occupational Exposure Limits recommended occupational exposure limit value of 0.05mg m(-3). Highest RCS exposure values were recorded for the tasks of grinding (GM = 0.70mg m(-3)) and cutting (GM = 0.70mg m(-3)) sandstone. In the mixed-effects analyses, task was found to be significantly associated with RCS exposure, with the tasks of grinding and cutting resulting in average exposures of between 32 and 70 times the exposures recorded for the task of stone decorating. The between-depot, between-worker, and within-worker variance components were reduced by 46, 89, and 49%, respectively, after including task in the mixed effects model. Restoration stoneworkers are regularly overexposed (compared with 0.1 and 0.05mg m(-3) 8-h TWA) to RCS dust when working with sandstone. The results indicate that the tasks of cutting and grinding sandstone are predictors of increased exposure to RCS dust. In order to decrease exposure to RCS, efforts should be focused on developing and implementing interventions which focus on these high-risk tasks.

Advantages of Using Ceiling Mounted Lifts in Acute Stroke Rehabilitation

Background and Purpose: Physical therapists are involved in high-risk patient-handling tasks on a daily basis, which include patient transfers, repositioning, and gait training. The primary purpose of this risk management case report was to describe a therapeutic approach to the treatment of a patient after sustaining a cerebrovascular accident (CVA) while using ceiling mounted lifts (CMLs) to lessen the fatigue of the therapist. Case Description: The patient was a 40-year-old man admitted to an acute care hospital for medical management of an extensive CVA. Progressive mobilization was performed using both standard methods of patient-handling and ceiling mounted lifts. During all treatment sessions, with and without the use of the CML, the patient's and the physical therapist's rates of perceived exertion (RPEs) were measured. Outcome: The patient was treated by a physical therapist or physical therapy assistant for a total of 52 visits over the course of his 97-day hospital stays. The patient continued to ambulate with a slightly hemiparetic gait pattern but advanced each leg independently in a reciprocal fashion. The RPE for the patient ranged from 5 to 9 during sessions and averaged 6 overall. For the physical therapist, the RPE averaged 2 when the CML was used, and averaged 5 when it was not. Discussion: This case report has highlighted the potential benefit of incorporating overhead lifts into physical therapy treatment for patients recovering from a CVA. The RPEs measured during transfer and gait training demonstrated a reduced fatigue level for the therapist when using the CML. Future research studies will benefit from clinical trials that incorporate outcome measures and the treatment of patients recovering from a CVA with mechanical lifts versus conventional care.

Ergonomic risks in fish processing workers in Atlantic Canada

Background: The aquaculture industry is growing in Canada and is particularly strong in Atlantic Canada. Workers in the fish processing industry are required to complete a variety of tasks in a typical day and there is concern for musculoskeletal disorder. Objective: The purpose of this study was to examine the daily operations of fish processing workers to determine any musculoskeletal concerns. Methods: The ergonomic assessment consisted of several plant visits to observe the processing line and the requirements of the workers. Video recordings were made of each stage of the assembly lines. The video data was analyzed to determine high-risk jobs and to identify areas of concern. Cumulative loading was assessed using posture matching software and the video data. A Job Strain Index (JSI), Rapid Upper Limb Assessment (RULA) and the revised NIOSH lifting equation were used to identify high-risk tasks. Results: The data showed that six tasks were considered high risk; sorting fish, removal of fish bones, trimming of fish, pallet loading/conveyor operation, fish processing and cleaning of the trim machine. In addition, four categories of occupational health and safety (OHS) hazard concerns were identified (physical, chemical, biological, and psychosocial). Each category was then broken into their causative agents and potential health effects on the worker. Conclusions: Several areas for improvement were identified at this seafood processing plant. Six jobs were identified as high risk and in need of intervention. Changes in pace of work, workstation height, and new equipment would also help reduce the number of musculoskeletal injuries. The issue of job rotation should also be examined to determine its impact on musculoskeletal health. Implementation of strategies to reduce musculoskeletal disorders will help to improve the health of these workers.

Diagnostic Value of Knee Arthrometry in the Prediction of ACL Strain During Landing

Objectives:Excessive knee joint laxity may decrease overall joint stability and increase the risk of anterior cruciate ligament (ACL) injury during high risk activities. Despite the frequent clinical use of knee arthrometry, as an accurate and valid method for evaluation of knee laxity, no data exists to correlate instrumented laxity measures and ACL strain during dynamic high-risk activities. The purpose of this study was to evaluate relationships between instrumented anterior knee laxity measurements and ACL strain during simulated bi-pedal landing (as an identified high-risk injurious task). We hypothesized that a strong correlation would be observed between ACL strain and arthrometry displacement, and that specimens with greater anterior knee laxity would demonstrate increased peak ACL strain during landing.Methods:20 cadaveric lower limbs (46±6 years, 10 female and 10 male) were tested using a CompuKT knee arthrometer to measure anterior knee joint laxity. Each specimen was tested under four continuous cycles of A-P shear force (±134 N) applied to the tibial tubercle. To quantify ACL strain, a DVRT displacement transducer was arthroscopically placed on the ACL (AM-bundle), and specimens were retested. Subsequently, bi-pedal landing from 30 cm was simulated on a subset of 14 specimens (45±5 years, 6 female and 8 male) using a novel custom-designed drop-stand. Paired sample t-tests, and a general linear model were used to evaluate changes in joint laxity and ACL strain. Results:During simulated drawer tests, 134 N of applied anterior drawer load produced an average 3.1±1.1 mm peak anterior tibial translation and 4.9±4.3% peak ACL strain. Anterior drawer load was a significant determinant of anterior tibial translation (p<0.0005) and peak ACL strain (p=0.02). A strong correlation (r=0.78, P<0.0005) was observed between anterior tibial translation and ACL strain during simulated drawer tests. Cadaveric simulations of landing produced an average 4070±732 N axial impact load representing the generated ground reaction force during landing following a jump. Simulated landing significantly increased peak anterior tibial translation to 10.4±3.5 mm and peak ACL strain to 6.8+2.8 % (p<0.0005) compared to pre-landing conditions. Impact-induced anterior tibial translation was a significant factor in peak ACL strain (p=0.001). Strong correlations were observed between peak ACL strain during landing and anterior tibial translation quantified by knee arthrometry (Figure 1). Conclusion:This work represents the first cadaveric study to establish a strong correlation between arthrometrically measured anterior knee joint laxity and peak ACL strain during dynamic landing (as a high-risk injurious condition). Experimental findings support the tested hypothesis, as a strong correlation between arthrometry displacement collected during laxity tests and concurrent calculated ACL strain was demonstrated. Instrumented measures of anterior knee laxity were predictive of peak ACL strain during landing, while specimens with greater knee laxity demonstrated higher levels of peak ACL strain during landing. Considering ACL strain as an established quantifiable measure of ACL injury risk, current findings highlight the importance of instrumented anterior knee laxity assessments as a potential indicator of ACL injury risk in addition to its clinical utility in the evaluation of ACL integrity.

Circadian Rhythms as a Basis for Work Organization

With the assumption that circadian rhythms influence human performance, the work of live line electricians was reorganized and evaluated. The hypothesis was that in highly physical and attention-demanding work, the organization of tasks, according to the ideal period of day and day of week, should diminish stress and consequent work risks. There are only a few studies reporting the work of electricians and even fewer approaching work organization. Moreover, these investigations often do not consider human physiological limitations and capabilities as well as task demands. A new work system was proposed with consideration of (a) the circadian cycles and homeostatic processes; (b) the effect of heat, which is a zeitgeber (synchronizer) for the biological clocks; and (c) the degree of physical and mental demands of the different performed tasks, which was assessed on the basis of opinions of the electricians and physiological markers of stress that are controlled by circadian rhythms. The traditional and new systems were compared on the basis of two cognitive indices (the arrangement of matchsticks and the perception of a minute) and three physiological markers of mental-to-physical loads (heart frequency and the level of adrenaline and noradrenaline). Both physical and mental loads were reduced in the new system. Work organization should include consideration of human circadian rhythms, mainly when stressful and high-risk tasks are involved. The findings can be applied in any work design, but they are especially suited for highly demanding work carried out outdoors.

Knowledge and Attitudes of Healthcare Workers in Umraniye, Turkey Regarding Crimean-Congo Haemorrhagic Fever

OZET Objective: The study aimed to assess the knowledge and attitudes of healthcare workers in primary health care centres regarding Crimean-Congo haemorrhagic fever (CCHF) in Umraniye. Material and Methods: This cross-sectional study was conducted from July-August 2008 in 18 primary healthcare centres in the Umraniye Provincial Health Directorate. The study sample was not selected and we approached 229 healthcare workers working in these primary health care centres; 144 participants (62.8%) completed the study. Study data were collected using a three-part questionnaire including 35 questions. The data were evaluated by descriptive statistics and t-tests. Results: Of the participants (72.2% women), 68.7% thought they had sufficient knowledge about the disease. 99.3% knew the aetiological factor of CCHF is a virus, and 92.4% specified that people who go picnicking and camping without protection are a risk group. The mean CCHF knowledge points was 17.48±3.37; the mean score of doctors (18.31±3.24) was significantly higher that that of nurses (17.01±3.36, p<0.05). 72.2% thought caring for a CCHF patient was a high risk task. Conclusion: The knowledge level of healthcare workers was found to be low compared to other studies performed in Turkey. The knowledge level of doctors was higher than that of nurses. In general, the answers of healthcare workers on the attitude questions were negative.

Corrective Organizational Action in Response to Adverse Events at an Academic Medical Center

This paper explores the planning and implementation of corrective action in response to identified adverse events at a large high-performing teaching hospital. A mixed methodological approach that combined interviews with clinical and administrative actors and statistical analysis of 405 non-routine adverse events that occurred at the hospital over a 30-month period was employed to identify factors associated with corrective action prescription and completion. Analysis of qualitative and quantitative data indicated that corrective action planning and implementation in response to adverse events were shaped by institutional influences on the hospital’s quality management practices, predominantly state-level regulation that required corrective action for externally-reportable events and professional norms that discouraged organizational intervention in autonomous clinician practice. In logistic regression models, odds of planning a corrective action in response to an adverse event increased with regulatory reportability of the event, litigation risk of the event, number of departments involved in the event, and full or partial event causation by protocol violation or coordination error. Severity of injury to the patient was not identified as a predictor of corrective action planning. The odds of corrective action implementation were greater for action types involving remedial retraining or reinforcement of standards and those involving interventions in the task environment, while corrective actions involving interventions in professional roles and interactions were associated with a statistically-significant decreased odds of completion. Rates of completion were generally low across action categories, which interviews and medical case data analysis indicate may have been a product of diffuse responsibility for implementation among practicing clinicians untrained in process change, unrealistic action planning, and normative barriers to intervention in professional practice. Findings from this case study site shed light on the resilience of work process failure in health care delivery organizations and emphasize the importance of resource appropriation, goal-setting and change management support that meet the formidable challenges of effecting change in these and other complex, high-risk task settings.

Ergonomics in design: interventions for youth working in the agricultural industry

Youth and adolescents make up a substantial segment of the working population in the agricultural industry and many of these young workers are required to perform physically demanding jobs that put them at significant risk for developing work-related musculoskeletal disorders (MSDs). Although there are no surveillance systems in place to track these potential injuries for youth who work in agriculture, based on our understanding of the magnitude of risk for these tasks, a number of interventions have been developed and evaluated that should reduce the risk of MSDs for youth who perform these high risk tasks. The purpose of this article is to raise the research community’s awareness to the risk of work-related MSDs for youth who work in agriculture and to demonstrate that ergonomic designers are best suited to develop cost-effective interventions for use in these tasks that can be easily implemented.

Intelligent Risk Assessment for Dewatering of Metro‐Tunnel Deep Excavations

In recent years, China has been undergoing a metro railway construction boom in order to alleviate the urban traffic congestion problem resulting from the rapid urbanization and population growth in many metropolises. In the construction of metro systems, deep excavations and continuous dewatering for construction of the metro tunnels and stations remain a challenging and high risk task in densely populated urban areas. Intelligent computational methods and techniques have exhibited the exceptional talent in dealing with the complicated problems inherent in the deep excavation and dewatering practice. In this paper, an intelligent risk assessment system for deep excavation dewatering is developed and has been applied in the project of Hangzhou Metro Line 1 which is the first metro line of the urban rapid rail transit system in Hangzhou, China. The specific characteristics and great challenges in deep excavation dewatering of the metro‐tunnel airshaft of Hangzhou Metro Line 1 are addressed. A novel design method based on the coupled three‐dimensional flow theory for dewatering of the deep excavation is introduced. The modularly designed system for excavation dewatering risk assessment is described, and the field observations in dewatering risk assessment of the airshaft excavation of Hangzhou Metro Line 1 are also presented.

Genome-wide analysis of alternative reproductive phenotypes in honeybee workers

A defining feature of social insects is the reproductive division of labour, in which workers usually forego all reproduction to help their mother queen to reproduce. However, little is known about the molecular basis of this spectacular form of altruism. Here, we compared gene expression patterns between nonreproductive, altruistic workers and reproductive, non-altruistic workers in queenless honeybee colonies using a whole-genome microarray analysis. Our results demonstrate massive differences in gene expression patterns between these two sets of workers, with a total of 1292 genes being differentially expressed. In nonreproductive workers, genes associated with energy metabolism and respiration, flight and foraging behaviour, detection of visible light, flight and heart muscle contraction and synaptic transmission were overexpressed relative to reproductive workers. This implies they probably had a higher whole-body energy metabolism and activity rate and were most likely actively foraging, whereas same-aged reproductive workers were not. This pattern is predicted from evolutionary theory, given that reproductive workers should be less willing to compromise their reproductive futures by carrying out high-risk tasks such as foraging or other energetically expensive tasks. By contrast, reproductive workers mainly overexpressed oogenesis-related genes compared to nonreproductive ones. With respect to key switches for ovary activation, several genes involved in steroid biosynthesis were upregulated in reproductive workers, as well as genes known to respond to queen and brood pheromones, genes involved in TOR and insulin signalling pathways and genes located within quantitative trait loci associated with reproductive capacity in honeybees. Overall, our results provide unique insight into the molecular mechanisms underlying alternative reproductive phenotypes in honeybee workers.

Six sigma tools for a patient safety-oriented, quality-checklist driven radiation medicine department

The purpose of this work was to develop and implement six sigma practices toward the enhancement of patient safety in an electronic, quality checklist-driven, multicenter, paperless radiation medicine department. A quality checklist process map (QPM), stratified into consultation through treatment-completion stages was incorporated into an oncology information systems platform. A cross-functional quality management team conducted quality-function-deployment and define-measure-analyze-improve-control (DMAIC) six sigma exercises with a focus on patient safety. QPM procedures were Pareto-sorted in order of decreasing patient safety risk with failure mode and effects analysis (FMEA). Quantitative metrics for a grouped set of highest risk procedures were established. These included procedural delays, associated standard deviations and six sigma Z scores. Baseline performance of the QPM was established over the previous year of usage. Data-driven analysis led to simplification, standardization, and refinement of the QPM with standard deviation, slip-day reduction, and Z-score enhancement goals. A no-fly policy (NFP) for patient safety was introduced at the improve-control DMAIC phase, with a process map interlock imposed on treatment initiation in the event of FMEA-identified high-risk tasks being delayed or not completed. The NFP was introduced in a pilot phase with specific stopping rules and the same metrics used for performance assessments. A custom root-cause analysis database was deployed to monitor patient safety events. Relative to the baseline period, average slip days and standard deviations for the risk-enhanced QPM procedures improved by over threefold factors in the NFP period. The Z scores improved by approximately 20%. A trend for proactive delays instead of reactive hard stops was observed with no adverse effects of the NFP. The number of computed potential no-fly delays per month dropped from 60 to 20 over a total of 520 cases. The fraction of computed potential no-fly cases that were delayed in NFP compliance rose from 28% to 45%. Proactive delays rose to 80% of all delayed cases. For potential no-fly cases, event reporting rose from 18% to 50%, while for actually delayed cases, event reporting rose from 65% to 100%. With complex technologies, resource-compromised staff, and pressures to hasten treatment initiation, the use of the six sigma driven process interlocks may mitigate potential patient safety risks as demonstrated in this study.

Identification of Safety Risks for High-Performance Sustainable Construction Projects

The United States Green Building Council (USGBC)-sponsored Leadership in Energy and Environmental Design (LEED) green building program represents the largest program in the United States for the measurement, verification, and certification of green buildings. A recent study found that LEED-certified buildings have accounted for a higher injury rate than comparative traditional non-LEED buildings. This finding served as the impetus for the present study, which aimed to identify and evaluate the safety and health risks associated with the design elements and construction management practices implemented to achieve LEED certification. To explore this topic, six detailed case studies and two validation case studies were conducted following a strict protocol developed from guiding literature. The results indicate that (1) workers on LEED construction projects are exposed to work at height, with electrical current, near unstable soils, and near heavy equip- ment for a greater period of time than workers on traditional projects; (2) workers are exposed to new high-risk tasks such as constructing atria, installing green roofs, and installing photovoltaic (PV) panels; and (3) some credits result in a positive impact on construction worker safety and health when low volatile organic compound (VOC) adhesives and sealants are specified. It is expected that these results can be used by practitioners to focus attention and resources on new highrisk work environments. DOI: 10.1061/(ASCE)CO.1943-7862.0000446. © 2012 American Society of Civil Engineers.

WE‐C‐214‐02: Six‐Sigma Tools for a “No‐Fly”Patient Safety Oriented, Quality‐Checklist Driven, Paperless Multi‐Center Radiation Medicine Department

Purpose: The purpose of this study was to develop six‐sigma practices towards the enhancement of patient safety in an electronic, quality checklist (QCL) driven, multi‐center, paperless radiation medicine department. Methods:A baseline QCL process map (QPM), stratified into consultation through treatment‐completion stages was incorporated into the Mosaiq Oncology‐Information‐Systems platform. A cross‐functional quality management team conducted Quality‐Function‐Deployment (QFD) and DMAIC [Define/Measure/Analyze/Improve/Control] six‐sigma exercises with a focus on patient safety. QPM procedures were ranked in order of patient‐safety risk with Failure‐Modes‐and‐Effects‐Analysis (FMEA). Quantitative metrics for a grouped set of nine highest‐risk procedures were established. These included procedural delays, associated standard deviations and Z‐scores. Custom Crystal reports to extract QCL procedural data from Mosaiq were created. Baseline performance of the QPM was established over the previous year of usage. Data driven analysis led to simplification, standardization and refinement of the QPM with standard deviation, slip‐day reduction and Z‐score enhancement goals. In addition to standard‐deviation reduction, a No‐Fly‐Policy (NFP) for patient safety was introduced at the control DMAIC phase, with a process‐map interlock imposed on treatment initiation in the event of FMEA‐identified high risk tasks being delayed or not completed. The NFP was introduced in a pilot study with specific stopping rules and the same metrics used for performance assessments. A custom root‐cause‐analysis (RCA) database was deployed to monitor patient safety events. Results: Relative to the baseline phase, average slip days and standard deviations for the risk‐enhanced QPM procedures improved by over three‐fold factors in the NFP phase. Z‐scores improved by 25%. A trend for proactive delays instead of reactive hard stops was observed with no adverse effects of the NFP. Conclusions: With complex technologies, resource‐compromised staff and pressures to hasten treatment initiation, the use of six‐sigma driven process interlocks may mitigate patient safety risks as demonstrated in this study.

Introduction to the Safe Patient Handling and Movement Series

Musculoskeletal injuries can occur when the physical work demanded by a job exceeds a worker's ability to respond safely. In perioperative nursing, and nursing in general, patient handling and movement demands commonly lead to injury and are considered high-risk activities. In 2005, the AORN Workplace Safety Task Force was charged with identifying high-risk tasks performed in the perioperative area and developing evidence-based solutions to help establish an ergonomically safe workplace. The work of the task force was incorporated into the “AORN guidance statement: Safe patient handling and movement in the perioperative setting,” which includes seven ergonomic tools to help determine best practices for safe movement and handling of patients, supplies, and equipment in the OR. Members of the AORN Perioperative Environment of Care Task Force have collaborated to author seven articles that help explain the rationale behind and use of these ergonomic tools. The articles will appear in the Journal beginning in this issue.

A framework of task demand factors for residential framing

In the USA, framing contractors consistently have the highest rate of non-fatal injuries of all speciality contractors. Residential framing contractors face additional challenges, partly due to the exception of ‘residential type’ activities from fall protection regulations. This study investigated residential framing accidents with a focus on the task features that affect the task difficulty of the residential framing activities and consequently the likelihood of errors and accidents. The study analysed 654 safety incidents that occurred over a period of 5 years 6 months in a large residential framing company. Accident analysis and interviews with safety and production experts identified the high-risk tasks, the errors that lead to incidents and the task elements that increase the likelihood of errors. The study identified five task factors that increase the task difficulty of residential framing activities and consequently the likelihood of accidents: (a) support conditions; (b) body posture constraints; (c) load-handling requirements; (d) tool accuracy requirements; and (e) external forces. The combination of these factors generates high task demands that can lead to errors and accidents. Reducing the task difficulty (independent of the hazards) is an important safety strategy that can reduce the likelihood of accidents while at the same time it can increase productivity.

Operator Performance in Exploration Robotics

Mobile robots can accomplish high-risk tasks without exposing humans to danger: robots go where humans fear to tread. Until the time in which completely autonomous robots are fully deployed, remote operators will be required in order to fulfill desired missions. Remotely controlling a robot requires that the operator receives the information about the robot’s surroundings, as well as its location in the scenario. Based on a set of experiments conducted with users, we evaluate the performance of operators when they are provided with a hand-held-based interface or a desktop-based interface. Results show how performance depends on the task asked of the operator and the scenario in which the robot is moving. The conclusions prove that the operator’s intra-scenario mobility when carrying a hand-held device can counterbalance the limitations of the device. By contrast, the experiments show that if the operator cannot move inside of the scenario, his performance is significantly better when using a desktop-based interface. These results set the basis for a transfer of control policy in missions involving a team of operators, some equipped with hand-held devices and others working remotely with desktop-based computers.

An evaluation of nursing tasks

Functional capacity evaluations have been criticized as being too general in theory and not being accurate enough to determine what tasks an employee can perform. This paper will describe results of a descriptive study that was conducted in a laboratory setting to objectively determine the physical demands of patient transfer tasks performed by nurses. Fifty three tasks were analyzed and broken down into sub-tasks to quantify the peak force required to perform each sub-task in order to determine which tasks pose healthcare workers at highest risk of injury. Dissecting the transfer task into segments allows us to see which part of the task requires high forces on the part of the caregiver. The task can then be modified to eliminate the risk of injury to the caregiver. This modification can be accomplished by using healthcare technology, such as floor based or overhead lifts, friction reducing devices, sit to stand lifts, properly designed slings, and motorized beds/trolleys. Technological solutions are available for some of these high risk tasks and should be implemented where applicable to reduce the force demand and eliminate or reduce the risk of injury to healthcare workers in nursing.

How to lift a box that is too large to fit between the knees

Many studies compared lifting techniques such as stoop and squat lifting. Results thus far show that when lifting a wide load, high back loads result, irrespective of the lifting technique applied. This study compared four lifting techniques in 11 male subjects lifting wide loads. One of these techniques, denoted as the weight lifters' technique (WLT), is characterised by a wide foot placement, moderate knee flexion and a straight but not upright trunk. Net moments were calculated with a 3-D linked segment model and spinal forces with an electromyographic-driven trunk model. When lifting the wide box at handles that allow a high grip position, the WLT resulted in over 20% lower compression forces than the free, squat and stoop lifting technique, mainly due to a smaller horizontal distance between the l5S1 joint and the load. When lifting the wide box at the bottom, none of the lifting techniques was clearly superior to the others. Statement of Relevance: Lifting low-lying and large objects results in high back loads and may therefore result in a high risk of developing low back pain. This study compares the utility of a WLT, in terms of back load and lumbar flexion, to more familiar techniques in these high-risk lifting tasks.

Establishing a Safe Patient Handling/Minimal Lift Program

To improve the safety of healthcare workers, a movement is gaining support in this country to limit the manual performance of high-risk patient care tasks. Many states have passed legislation-mandating policies aimed at protecting employees from injuries related to patient handling. Federal legislation has been proposed 3 times, each time moving farther along the process toward passage into law. This article describes the steps taken in the planning and implementation of a Safe Patient Handling/Minimal Lift Program in a 380-bed, licensed, not-for-profit, east coast acute care hospital.

Exploratory Analysis of Operator:Robot ratio in Search and Rescue Missions

Mobile robots are increasingly becoming an aid to humans in accomplishing dangerous tasks. Examples of such tasks include search and rescue missions, military missions, surveillance, scheduled operations (such as checking the reactor of a nuclear plant), and so forth. The advantage of using robots in such situations is that they accomplish high-risk task without exposing humans to danger: robots go where humans fear to tread. When dealing with robot teams for exploration missions, the human operator needs to control simultaneously multiple robots. This paradigm highly increases the difficulty of the operator task. In this paper, based on extensive experimental data, we are studying the problematic associated to the Single- Operator-Multiple-Robot Interaction. This analysis can help to ascertain the critical points in multi-robot control and supervision. The experiments have been done in a Search and Rescue scenario using USARSim.