Effect of hypoxia,safety shoe type,and lifting frequency on cardiovascular and ventilation responses

ObjectiveThere is limited work on the physiological demands of lifting activities at different altitudes and different lifting frequencies when wearing different types of shoes. This study aimed to examine the heart rate variability (HRV) and ventilation responses of individuals in normobaric hypoxia (ambient oxygen of 15%, 18%, and 21%) while doing lifting tasks and wearing three types of different safety shoes (“light, medium, and heavy-duty”) at two different lifting frequencies (“1 lift/min and 4 lifts/min”).MethodsUsing an experimental study design, two sessions were conducted by ten male university students that included an acclimatization and training session followed by experimental lifting. The study used a four-way repeated measures design (4 independent and twenty-one responses, i.e., twelve HRV and nine ventilation responses).ResultsThe findings highlighted substantial low HRV and ventilation parameters for the light workload stress in the form of higher ambient oxygen content and lowered lifting frequency while wearing light safety shoe type. It also presented an increase in the physical demand, followed by increased lifting frequency and replication with increased mean heart rate and decreased mean RR, very low frequency (VLF) power, low frequency (LF) power, and low frequency to a high-frequency ratio (LF/HF).ConclusionOur findings suggest that if a safe lifting load limit is applied for workers in the industrial environment, the risk of musculoskeletal disorders will be mainly decreased, and the rate of production will be better with ambient oxygen content and appropriate safety shoes. This research would safeguard industrial workers' physical capacities and future health risks.     

Psychophysical and physiological responses to lifting symmetrical and asymmetrical loads symmetrically and asymmetrically

Eighteen adult males (mean age 22·6 years, weight 78·6kg and height 176·6cm) participated in a study designed to investigate the effects of symmetrical and asymmetrical lifting on the maximum acceptable weight of lift and the resulting physiological cost. Each subject performed sixty different lifting tasks involving two lifting heights, three lifting frequencies and five containers. For each lifting task, the load was lifted either symmetrically (sagittal lifting) or asymmetrically (turning 90^° while continuing to lift). The heart rate and oxygen uptake of the individuals at the maximum acceptable weight of lift were measured. At the end of the experiment, subjects also verbally indicated their preference for symmetrical and asymmetrical lifting. When lifting asymmetrically, subjects accepted approximately 8·5% less weight. There was, however, no difference in the physiological costs when lifting symmetrically or asymmetrically. Lifting asymmetrical loads also resulted in lower maximum acceptable weights. No difference in either oxygen uptake or heart rate was observed when the centre of gravity of the load was offset by 10·16 or 20·32 cm from the mid-sagittal plane in the frontal plane towards the preferred hand. All subjects indicated, verbally, that asymmetrical lifting tasks were physically more difficult to perform.     

Effects of age and its interaction with task parameters on lifting biomechanics

This study investigated the age-related differences in lifting biomechanics. Eleven younger and 12 older participants were instructed to perform symmetric lifting tasks defined by different combinations of destination heights and load magnitudes. Lifting biomechanics was assessed. It was found that the trunk flexion in the starting posture was 32% lower and the peak trunk extension velocity was 46% lower in older participants compared with those in younger ones, indicating that older adults tended to use safer lifting strategies than did younger adults. Based on these findings, we recommend that physical exercise programmes may be a more effective ergonomic intervention for reducing the risks of low back pain (LBP) in lifting among older workers, compared with instructions of safe lifting strategies. As for younger workers, instructions of safe lifting strategies would be effective in LBP risk reduction.     

The work load of warehouse workers in three different working systems

An investigation was conducted in five companies in the distribution branch. These companies were divided into three different working systems, i.e., highly mechanized (HM), moderately mechanized (MM), and slightly mechanized (SM). The three systems differed in logistics and kind of appliances used. The purpose of this study was to compare the three working systems with different degrees of mechanization concerning the time spent on tasks, activities during the working day, postures that occurred, physiological work load, perceived exertion and recovery from work. To investigate the different tasks, activities and working postures, 50 warehouse workers, originating from the three working systems, were observed by means of a direct observation method, called: ‘TRAC’. To investigate the physiological work load the heart rate was recorded continuously during the working day and related to the individually determined relation between heart rate and oxygen uptake. This relation was constructed with the results of a cycle ergometer test done in the laboratory. During lunch and at the end of the working day the warehouse workers filled in a questionnaire concerning their perceived exertion and recovery from work.

In the slightly mechanized system more time was spent with the trunk flexed more than 75° as compared with the other two systems. This posture was very common during lifting of objects, and lifting was done more often in this system than in the other systems. In the MM system the warehouse workers had the highest estimated oxygen uptake and reported the highest perceived exertion at the end of the working day. The workers in the HM system had a shorter working day and had less problems with recovery from work than the workers of the other two systems. Poor working postures like rotation and lateroflexion were commonly found in the HM working system. An important explanation was the difference in time spent driving an electric car. This activity was done mostly in the HM system. In conclusion, the HM system was considered most favourable when it concerned work load and recovery from work. The appliances used in the HM system, and especially the electric car, need to be designed according to ergonomic guidelines to avoid poor working postures.     

Psychophysically determined symmetric and asymmetric lifting capacity of Chinese males for one hour's work shifts

A laboratory experiment was conducted to determine the effects of asymmetric lifting on psychophysically determined maximum acceptable weight of lift (MAWL) and the resulting heart rate, oxygen uptake and rating of perceived exertion. Thirteen male college students were recruited as participants. Each participant performed 12 different lifting tasks involving three lifting frequencies (one-time maximum, 1 and 4 lifts/min) and four twisting angles (including the sagittal plane and three different angles of asymmetry, i.e., 0, 30, 60, and 90°) from the floor to a 76 cm high pallet for one hour's work shift using a free-style lifting technique. The results showed that: (1) The MAWLs were significantly lower for asymmetric lifting than for symmetric lifting in the sagittal plane. The MAWL decreased with an increase in the angle of asymmetry, however, the heart rate, oxygen uptake and RPE remained unchanged; (2) Lifting frequency had no significant effect on the percentage decrease in MAWL from the sagittal plane values. Correction factors of 4, 9, and 13% for MAWL at 0, 30, 60, and 90°of asymmetric lifting, respectively, are recommended; (3) Both the physiological costs (heart rate and oxygen uptake) and rating of perceived exertion increased with an increase in lifting frequency though maximum acceptable weight of lift decreased. The most stressed body parts were the lower back and the arm; and (4) The percentage decrease in MAWL with twisting angle for the Chinese participants was somewhat lower than those of the Occidental participants. In addition, even though there was a decrease in MAWL, heart rate and RPE increased with an increase in the angle of a symmetric lifting for the Occidental participants, it was different from that of the Chinese participants.

Relevance to industry

It is generally believed that asymmetric lifting involving torso twisting is more harmful to back spine than symmetric lifting. However, the previous studies were conducted in Europe and North America, and the data were obtained from the Caucasian populations. This work, therefore, aims to investigate the influence of asymmetric lifting on the lifting capacity of the Chinese participants, and to compare the differences with the Occidental populations.     

A physiological study of manual lifting of loads in Indians

The employment of workers solely for lifting of loads is common in the developing countries. This task can be described in terms of its three principal variables, viz. the weight of the load, the height of the lift and the rate of lifting, but Jew attempts to quantitate the contributions of these variables in determining its strenuousness have been made.

Based on the observed range of variation in an industrial lifting operation, a total of 525 lifting experiments comprising combinations of three different weights of compact loads, lifts to three separate heights from the ground level and three different rates of lifting were carried out on 21 subjects selected from amongst the load lifters.

Comparison of the observed energy expenditures of these tasks with the maximum working capacities of the subjects showed that many of the tasks were unduly heavy. Regression equations depicting the relation between the energy expenditure of lifts of different heights with the other two variables are given. A chart linking these variables has also been prepared; this may be helpful in adjusting those lifting tasks which are continued for prolonged periods so that they are of ‘acceptable’ heaviness.     

The effects of task duration on psychophysically-determined maximum acceptable weights and forces

The purpose of this experiment was to investigate maximum acceptable weights and forces when performing manual handling tasks continuously for four hours at frequencies of 4.3 min-1 or slower. Twelve female and ten male second shift industrial workers performed 18 varieties of lifting, lowering, pushing, pulling, and carrying. A psychophysical methodology was employed, whereby the subjects were asked to select a workload they could sustain for 8 h 'without straining themselves or without becoming unusually tired, weakened, overheated or out of breath'. Measurements of heart rate, oxygen consumption, dynamic and static strengths were also taken. The weights selected after 40 min were not significantly different from the weights selected after four hours. The average oxygen consumption for the fast tasks was 28% VO2 max, within physiological guidelines for eight hours. The results also revealed that the maximum acceptable weights for the combination task of lifting, carrying, and lowering were limited by the lifting and lowering components. It is concluded from the results of this study that the psychophysical methodology is appropriate for determining maximum acceptable weights for task frequencies of 4.3 min-1 or slower. It is also concluded that the maximum acceptable weight for a combination task is limited by the lowest acceptable weight of any of the components.     

The psychophysical lifting capacities of Chinese subjects

The psychophysical lifting capacity (MAWL) of twelve subjects was determined in this study. The subjects were all young Chinese males who performed lifting tasks in three lifting ranges (floor to knuckle, floor to shoulder, and knuckle to shoulder) and four lifting frequencies (one-time maximum, 1 lift/min, 4 lifts/min, and 6 lifts/min). The oxygen uptake (1/min) and heart rate (beats/min) were recorded while subjects were lifting. Upon completion of each lifting task, the subjects were required to rate their perceived exertion levels. The statistical analyses results indicated the following. Chinese subjects have smaller body size and MAWLs compared with past studies using the US population. The MAWLs decreased with an increase in lifting frequencies. The decrements of MAWL due to lifting frequencies were in agreement with the results of past studies. However, there were larger decreases due to lifting ranges. The MAWLs of the floor to knuckle height lift were the largest, followed by the MAWLs of the floor to shoulder height lift, and the MAWLs of the knuckle to shoulder height lift. The measured physiological responses were considered similar to those obtained in past studies. Subjects' perceived stress levels increased with the lifting frequency and the upper extremities received the most stress for the total range of lifting tasks. The comparisons of the Chinese MAWLs with the NIOSH lifting guidelines for limits (AL and MPL) indicated that the vertical discounting factor in the guidelines should be modified before the NIOSH limits can be applied to non-Western populations.     

The design of manual handling tasks: revised tables of maximum acceptable weights and forces.

Four new manual handling experiments are reviewed. The experiment used male and female subjects to study lifting, lowering, pushing, pulling, and carrying tasks. Each experiment used a psychophysical methodology with measurements of oxygen consumption, heart rate, and anthropometric characteristics. Independent variables included task frequency, distance, height and duration; object size and handles; extended horizontal reach; and combination tasks. The results of the four experiments were integrated with the results of seven similar experiments published previously by this laboratory. The integrated data were used to revise maximum acceptable weights and forces originally published in 1978. The revised tables are presented and compared with the original tables.     

Effects of box weight,vertical location and symmetry on lifting capacities and ratings on category scale in Japanese female workers

The aim was to clarify the effects of box weight, vertical location and symmetry on the lifting capacities and subjective burden in Japanese female workers with manual material handling tasks. Sixteen healthy females were tested. They performed 12 different lifting tasks (three heights * two weights * two symmetries). It is difficult for Japanese women to exert dynamic force in lifting a 15-kg weight from the elbow to the shoulder level. A remarkable increase was observed in heart rate and category scale with ratio properties (CR-10) on large muscle group in lifting a 15-kg weight as compared with lifting a 10-kg one. Judging from calculation of the Recommended Weight Limit using the application manual by the National Institute for Occupational Safe and Health, it was also suggested that lifting the 15-kg weight from the elbow to the shoulder level was difficult for female workers. Not only peak force, but also the average upward acceleration and peak velocity were lower in asymmetric liftings than those in symmetric liftings. CR-10 for the left back and right thigh were also higher in 90° right lateral plane lifting than in the mid-sagittal plane. Thus, asymmetric lifting was supposed to impose higher stress on the back contralaterally and thigh ipsilaterally to the location of the weight.     

Effects of box weight, vertical location and symmetry on lifting capacities and ratings on category scale in Japanese female workers

The aim was to clarify the effects of box weight, vertical location and symmetry on the lifting capacities and subjective burden in Japanese female workers with manual material handling tasks. Sixteen healthy females were tested. They performed 12 different lifting tasks (three heights * two weights * two symmetries). It is difficult for Japanese women to exert dynamic force in lifting a 15-kg weight from the elbow to the shoulder level. A remarkable increase was observed in heart rate and category scale with ratio properties (CR-10) on large muscle group in lifting a 15-kg weight as compared with lifting a 10-kg one. Judging from calculation of the Recommended Weight Limit using the application manual by the National Institute for Occupational Safe and Health, it was also suggested that lifting the 15-kg weight from the elbow to the shoulder level was difficult for female workers. Not only peak force, but also the average upward acceleration and peak velocity were lower in asymmetric liftings than those in symmetric liftings. CR-10 for the left back and right thigh were also higher in 90 degrees right lateral plane lifting than in the mid-sagittal plane. Thus, asymmetric lifting was supposed to impose higher stress on the back contralaterally and thigh ipsilaterally to the location of the weight.     

Workplace design guidelines for asymptomatic vs. low-back-injured workers

While numerous efforts have attempted to provide quantitative guidelines for the prevention of initial low back disorders during material handling tasks, none have appeared in the literature that address the issue of recurrent low back disorders due to materials handling when returning to the workplace. A study comparing the spine loads of low back pain patients and asymptomatic controls was conducted. Subjects lifted weights varying from 4.5-11.4 kg at four vertical heights, two horizontal distances and five task asymmetries collectively representing common industrial lifting situations. Spine loading was calculated using a validated EMG-assisted biomechanical model. Spine loads observed during lifting tasks were compared to spine tolerance values believed to initiate low back injuries. In addition, the percentage of patients successfully performing the lift was noted and used as an indication of the willingness of the subject to perform the task. These evaluations are summarized in a series of three lifting guidelines indicating safe, medium risk and high risk lifting tasks for low back patients as well as asymptomatic workers. It is believed that adherence to these guidelines can minimize the risk of recurrent low back disorders due to occupational lifting.     

Experienced workers exhibit distinct torso kinematics/kinetics and patterns of task dependency during repetitive lifts and lowers

Individual differences in work methods may be related to the risk of injury during manual material handling tasks, yet existing evidence comparing experienced workers and novices is mixed. This study assessed torso kinematics and kinetics among six experienced workers and six novices during repetitive lifts/lowers under different task configurations (symmetric vs. asymmetric and lift vs. lower). Several important potential confounding effects were controlled. Peak kinematic and kinetic measures were typically higher among experienced workers and suggestive of exposure to higher levels of low back injury risk, though overall exposure levels were moderate. Work methods used by experienced workers were modified between task conditions, whereas novice behaviours were more consistent. Control of torso kinematics/kinetics may thus not be a primary factor in determining experienced worker's work methods, and future investigation is needed to establish if, or under what conditions, these methods are protective and/or should be the basis for interventions including training.

Practitioner Summary: Whether lifting experience reduces low back injury risk is unclear from earlier findings. Results from a controlled experiment suggest that lifting experience may not be associated consistently with reduced physical demands or injury risk. Further investigation is needed to assess the utility of training based on the methods of experienced workers.     

Effect of an on-body ergonomic aid on oxygen consumption during a repetitive lifting task

The purpose of this study was to determine if an on-body personal lift assistive device (PLAD)¹ affected oxygen consumption during a continuous lifting task and to investigate if any effect could be explained by differences in muscle activity or lifting technique. The PLAD, worn like a back-pack, contains a spring-cable mechanism that assists the back musculature during lifting, lowering, and forward bending tasks. Males (n = 15) lifted and lowered a box loaded to 10% of their maximum back strength at 6 times/minute for 15-minutes using a free-style technique under two conditions: wearing and not wearing the PLAD. Oxygen consumption was collected continuously for the first condition; then the participants rested until their heart rates returned to resting levels before repeating the protocol for the second condition. Knee flexion was monitored using Liberty sensors at the hip, knee, and ankle. EMG of the thoracic and lumbar erector spinae (TES, LES), biceps femoris, rectus femoris and gluteus maximus were gathered using a Bortec AMT-8 channel system. VO2 measures were averaged across the duration (15 min) for each condition. Results showed no differences between oxygen consumption during the PLAD and no PLAD conditions. When wearing the PLAD, the TES demonstrated an 8.4% EMG reduction when lowering the box while the biceps femoris showed a 14% reduction while lifting the box. Knee angles, used as a proxy for stoop or squat lifts, were highly variable for both conditions. In conclusion, the PLAD had no effect on oxygen consumption and, therefore, neither workers nor employers should increase the tasks demands when wearing this ergonomic aid.     

Endurance time and physiological responses to prolonged arm lifting

The main objective of this study was to examine the effects of prolonged arm lifting tasks on endurance time and physiological responses. Ten male college students participated in the study. The independent variables were the frequency of handling and weight of load. The dependent variables were endurance time, oxygen consumption, minute ventilation, heart rate, and ratings of perceived exertion of the shoulder, arm, back, leg and overall body. The results indicated that: (1) endurance time decreased with an increase in frequency or load; (2) oxygen consumption and heart rate limits were dependent on the interaction of frequency and load; (3) oxygen consumption and heart rate limits for arm lifting were generally lower than limits for leg lifting tasks; and (4) for arm work, average physiological responses recorded over short durations were not significantly different from those based on long durations.     

Acceptable weights and physiological costs of performing combined manual handling tasks in restricted postures

Eight healthy, male underground coal miners (mean age = 36.9 yrs +/- 4.5 SD) participated in a study examining psychophysically acceptable weights and physiological costs of performing combined lifting and lowering tasks in restricted head-room conditions. Independent variables included posture (stooping or kneeling on two knees), task symmetry (symmetric or asymmetric), and vertical lift distance (35 cm or 60 cm). All tasks were 10 min in duration and were performed under a 1.22 m ceiling to restrict the subject's posture. Subjects were required to raise and lower a lifting box every 10s, and asked to adjust the box weight to the maximum amount they could handle without undue strain or fatigue. During the final 5 min of each test, data were collected to determine the energy expenditure requirements of the task. Results of this study demonstrated that psychophysical lifting capacity averaged 11.3% lower when kneeling as compared to stooping. Subjects selected 3.5% more weight in asymmetric tasks, and lifted 5.0% less weight to the 60 cm shelf compared to the 35 cm shelf. Heart rate was not significantly affected by posture, but was increased an average of 4 beats/min in asymmetric conditions, and by 3.5 beats/min while lifting/lowering to/from the high shelf. Oxygen uptake was increased by 9% when stooped, by 10% when lifting/lowering asymmetrically, and by 8.2% when performing the task to the high shelf. Results of this study indicate that, wherever possible, materials that must be lifted manually in low-seam coal mines be designed in accordance with the decreased lifting capacity exhibited in the kneeling posture.     

Maximum acceptable weights for asymmetric lifting of Chinese females

This study used the psychophysical approach to evaluate the effects of asymmetric lifting on the maximum acceptable weight of lift (MAWL) and the resulting heart rate, oxygen uptake and rating of perceived exertion (RPE). A randomized complete block factorial design was employed. Twelve female college students lifted weights at three different lifting frequencies (one-time maximum, 1 and 4 lifts/min) in the sagittal plane and at three different asymmetric angles (30 degrees, 60 degrees, and 90 degrees ) from the floor to a 68-cm height pallet. This lifting experiment was conducted for a 1-h work period using a free-style lifting technique. The MAWLs for asymmetric lifting were significantly lower than those for symmetric lifting in the sagittal plane. The MAWL decreased with the increase in the angle of asymmetry. However, the heart rate, oxygen uptake and RPE remained unchanged. Though the MAWL decreased significantly with lifting frequency, both the physiological costs (heart rate and oxygen uptake) and rating of perceived exertion increased with the increase in lift frequency. The most stressed body part was the arm. Lifting frequency had no significant effect on the percentage decrease in MAWL from the sagittal plane values. On average, decreases of 5%, 9% and 14% for MAWL at 30 degrees, 60 degrees and 90 degrees asymmetric lifting, respectively, were revealed. This result was in agreement with the findings of Chinese males studied by Wu [Int. J. Ind. Ergonom. 25 (2000) 675]. The percentage decrease in MAWL with twisting angle for the Chinese participants was somewhat lower than those for Occidental participants. In addition, even though there was an increase in heart rate and RPE with the increase in the symmetrical lift angle for Occidental participants, it was different from the Chinese participants. Lastly, the 1991 NIOSH equation asymmetry multiplier is more conservative in comparison with the results of the present study.     

Acceptable weights and physiological costs of performing combined manual handling tasks in restricted postures

Eight healthy, male underground coal miners (mean age=36·9 yrs±4·5 SD) participated in a study examining psychophysical acceptable weights and physiological costs of performing combined lifting and lowering tasks in restricted headroom conditions. Independent variables included posture (stooping or kneeling on two knees), task symmetry (symmetric or asymmetric), and vertical lift distance (35 cm or 60cm). All tasks were 10min in duration and were performed under a 1·22 m ceiling to restrict the subject's posture. Subjects were required to raise and lower a lifting box every 10 s, and asked to adjust the box weight to the maximum amount they could handle without undue strain or fatigue. During the final 5 min of each test, data were collected to determine the energy expenditure requirements of the task. Results of this study demonstrated that psychophysical lifting capacity averaged 11·3% lower when kneeling as compared to stooping. Subjects selected 3·5% more weight in asymmetric tasks, and lifted 5·0% less weight to the 60 cm shelf compared to the 35 cm shelf. Heart rate was not significantly affected by posture, but was increased an average of 4 beats/min in asymmetric conditions, and by 3·5 beats/min while lifting/lowering to/from the high shelf. Oxygen uptake was increased by 9% when stooped, by 10% when lifting/lowering asymmetrically, and by 8·2% when performing the task to the high shelf. Results of this study indicate that, wherever possible, materials that must be lifted manually in low-seam coal mines be designed in accordance with the decreased lifting capacity exhibited in the kneeling posture.     

A comprehensive lifting model: beyond the NIOSH lifting equation

A comprehensive lifting model (CLM) for the evaluation and design of manual tasks was developed in two stages using 11 task, personal and environmental variables. In the first stage, the model was built using the psychophysical data. In the second stage, discounting factors of various variables were tested and adjusted using the physiological and biomechanical data. Two lifting indices are proposed to evaluate lifting tasks for a group of workers (relative lifting safety index or RLSI) and for an individual worker (personal lifting safety index or PLSI).     

Evaluating lifting tasks using subjective and biomechanical estimates of stress at the lower back

The objective of this study was to evaluate five different lifting tasks based on subjective and biomechanical estimates of stress at the lower back. Subjective estimates were obtained immediately after the subjects performed the lifting tasks. Rankings for different tasks were obtained according to the perceived level of stress at the lower back. A biomechanical model was used to predict the compressive force at the L5/S1 disc for the weight lifted considering link angles for the particular posture. The tasks were also ranked according to the compressive force loading at the L5/S1 disc. The weight lifted in these tasks for obtaining the subjective estimate of stress was the maximum acceptable weight of lift (MAWOL). This was determined separately for each subject using a psychophysical approach. Subjective estimates of stress were obtained for infrequent lifting, specifically for a single lift, as well as for lifting at a frequency of four lifts per min. The results showed that a lifting task acceptable from the biomechanical point of view may not be judged as a safe or acceptable task by the worker based on his subjective perception. This may result in a risk of the worker not performing the recommended task or not following the recommended method.