Effects of activity-rest schedules on physiological strain and spinal load in hospital-based porters

Workers in physically demanding occupations require rest breaks to recover from physiological stress and biomechanical loading. Physiological stress can increase the risk of developing musculoskeletal disorders and repeated loading of the spine may increase the potential for incurring back pain. The aim of the study was to assess the impact of an altered activity-rest schedule on physiological and spinal loading in hospital-based porters. An existing 4-h activity-rest schedule was obtained from observations on eight male porters. This schedule formed the normal trial, which included two 5- and one 15-min breaks. An alternative 4-h schedule was proposed (experimental condition) that had two breaks each of 12.5 min. It was hypothesized that the experimental trial is more effective in promoting recovery from physiological strain and spinal shrinkage than the normal trial, due to the 5-min breaks being insufficient to allow physiological variables to return to resting levels or the intervertebral discs to reabsorb fluid. Ten males performed both test conditions and oxygen uptake VO2, heart rate, minute ventilation VE, perceived exertion and spinal shrinkage were recorded. There were no significant differences in any of the measured variables between the two trials (p > 0.05). Median heart rates were 78 (range 71-93) and 82 (71-90) beats.min(-1) for the normal trial and the experimental trial respectively, indicating that the activity was of low intensity. The light intensity was corroborated by the oxygen uptakes (0.75, range 0.65-0.94 1.min(-1)). Spinal shrinkage occurred to the same extent in the two trials (2.12 +/- 3.16 mm and 2.88 +/- 2.92 mm in the normal trial and the experimental trial respectively). Varying the length and positioning of the rest breaks did not significantly affect the physiological responses or magnitude of spinal shrinkage between the two trials. More physically demanding work than the porters' schedule should induce greater physiological fatigue and spinal shrinkage. The ratio between activity and rest breaks would then become more important.     

Effects of activity-rest schedules on physiological strain and spinal load in hospital-based porters

Workers in physically demanding occupations require rest breaks to recover from physiological stress and biomechanical loading. Physiological stress can increase the risk of developing musculoskeletal disorders and repeated loading of the spine may increase the potential for incurring back pain. The aim of the study was to assess the impact of an altered activity-rest schedule on physiological and spinal loading in hospital-based porters. An existing 4-h activity-rest schedule was obtained from observations on eight male porters. This schedule formed the normal trial, which included two 5- and one 15-min breaks. An alternative 4-h schedule was proposed (experimental condition) that had two breaks each of 12.5 min. It was hypothesized that the experimental trial is more effective in promoting recovery from physiological strain and spinal shrinkage than the normal trial, due to the 5-min breaks being insufficient to allow physiological variables to return to resting levels or the intervertebral discs to reabsorb fluid. Ten males performed both test conditions and oxygen uptake VO₂, heart rate, minute ventilation VE, perceived exertion and spinal shrinkage were recorded. There were no significant differences in any of the measured variables between the two trials (p >0.05). Median heart rates were 78 (range 71–93) and 82 (71–90) beats.min ^{- 1} for the normal trial and the experimental trial respectively, indicating that the activity was of low intensity. The light intensity was corroborated by the oxygen uptakes (0.75, range 0.65-0.94 l.min ^{- 1}. Spinal shrinkage occurred to the same extent in the two trials (2.12±3.16 mm and 2.88±2.92 mm in the normal trial and the experimental trial respectively). Varying the length and positioning of the rest breaks did not significantly affect the physiological responses or magnitude of spinal shrinkage between the two trials. More physically demanding work than the porters' schedule should induce greater physiological fatigue and spinal shrinkage. The ratio between activity and rest breaks would then become more important.     

The impact of shift and night work on health

Shift work, in particular night work, can have a negative impact on health and well-being of workers as it can cause: (a) disturbances of the normal circadian rhythms of the psychophysiological functions, beginning with the sleep/wake cycle; (b) interferences with work performance and efficiency over the 24 hour span, with consequent errors and accidents; (c) difficulties in maintaining the usual relationships both at family and social level, with consequent negative influences on marital relations, care of children and social contacts; (d) deterioration of health that can be manifested in disturbances of sleeping and eating habits and, in the long run, in more severe disorders that deal prevalently with the gastrointestinal (colitis, gastroduodenitis and peptic ulcer), neuro-psychic (chronic fatigue, anxiety, depression) and, probably, cardiovascular (hypertension, ischemic heart diseases) functions. Besides, shift and night work may have more specific adverse effects on women's health both in relation to their particular hormonal and reproductive function, and their family roles. It has been estimated that about 20% of all workers have to leave shift work in a very short time because of serious disturbances; those remaining in shift work show different levels of (mal)adaptation and (in)tolerance, that can become more or less manifest in different times, and with different intensity. In fact, the effects of such stress condition can vary widely among the shift workers in relation to many 'intervening variables' concerning both individual factors (e.g. age, personality traits, physiological characteristics), as well as working situations (e.g. work loads, shift schedules) and social conditions (e.g. number and age of children, housing, commuting).     

A polysomnographic study of morning and afternoon sleep quality during simulated night shift work

Shiftworkers differ as to scheduling their day sleep between night shifts. An experimental study was carried out to compare the effects of morning and afternoon sleep behaviour on sleep quality within and after a period of seven night shifts. Twelve young males participated in a repeated–measures design, six sleeping in the morning and six in the afternoon after night shifts. Sleep quality was evaluated by polysomnographic and subjective measures. Morning and afternoon sleepers showed some differences in the trend of sleep changes over successive sleep periods. However, at the end of the night shift week, there were no marked differences in sleep quality. Both morning and afternoon sleep were characterized by deep sleep, and short sleep onset latencies.     

Component contribution of personal protective equipment to the alleviation of physiological strain in firefighters during work and recovery

The purpose of this study was to investigate the components contributions of personal protective equipment on physiological strain in firefighters during exercise and recovery. Eight firefighters participated in trials in which various combinations of personal protective equipment components weighing from 1.3 to 15.1 kg were worn. The results showed that rectal temperature, changes in rectal temperature, mean skin temperature, heart rate, oxygen consumption and blood lactate concentration were smaller in conditions without boots (no-boots) than in other conditions with no helmet, gloves or self-contained breathing apparatus (P < 0.05). Increases in rectal temperature per unit mass of personal protective equipment were approximately twice as small in no-boots condition as the other conditions. These results suggest that the reduction of the boots' mass might be more efficient to alleviate heat strain of firefighters wearing personal protective equipment, rather than the reduction of the mass of self-contained breathing apparatus, helmet or gloves.     

Effects of oxygen concentrations on driver fatigue during simulated driving

Driver fatigue has been the cause of traffic accidents. Despite this, the amount of time that drivers spend within cars has been increasing due to complex city life, traffic congestion, and particular occupational requirements. Consequently, fatigue and stress cannot be avoided. In present study, in order to find out the possibility for reducing fatigue while driving due to the supply of oxygen, driver fatigue resulting from the passage of time when different oxygen concentrations are supplied has been examined through subjective evaluations and reaction times using driving simulator for 10 male subjects. The results revealed the subjective fatigue feeling was highest in the low rate (18%) oxygen condition, while in the high rate (30%), it decreased to a certain extent. The feeling of sleepiness also showed the tendency to decrease somewhat in the case of the driving time having passed over 1h in the high-rate conditions. Also, the reaction time for braking after being instructed to suddenly stop following more than 2h of driving was reduced in the high-rate oxygen conditions compared to the low-rate oxygen condition. From the above results, it was shown that while driving a car, if the oxygen rate is lowered, fatigue is felt severely, and that in the case of supplying a high-rate of oxygen, the feeling of fatigue is lowered to some extent and the reaction time is shortened. It was suggested that the driver's fatigue can be reduced according to the supply of oxygen.     

Work/rest cycles in railroad operations: effects of shorter than 24-h shift work schedules and on-call schedules on sleep

The current study examined the frequency with which shorter than 24-h work/rest cycles occur in locomotive engineer work schedules, and what effects these work/rest cycles had on sleep quantity and sleep quality. The results indicated that shorter than 24-h work/rest cycles occurred in 33.6% of the work days reported by 198 locomotive engineers. In addition, the shorter than 24-h work/rest cycles occurred more frequently in work schedules that created an on-call work system, such as road pool turn and extra board assignments, than in work schedules that used more predictable or regular work times, such as regular road assignments and yard/local work. As would be expected, when engineers worked shorter than 24-h work/rest cycles, they reported less sleep and poorer sleep than under the longer than 24-h work/rest cycles. Similarly, on-call work assignments resulted in less sleep and poorer sleep than regular work assignments. These results indicate that specific aspects of the work schedules used in railroad operations, particularly on-call operations that result in shorter than 24-h work/rest cycles, can lead to increased sleep-related problems. Although the North American railroad industry is making significant changes in on-call operations to minimize sleep-related problems from on-call schedules, better fatigue-related models validated within the railroad industry are needed.     

Work/rest cycles in railroad operations: effects of shorter than 24-h shift work schedules and on-call schedules on sleep

The current study examined the frequency with which shorter than 24-h work/rest cycles occur in locomotive engineer work schedules, and what effects these work/rest cycles had on sleep quantity and sleep quality. The results indicated that shorter than 24-h work/rest cycles occurred in 33.6% of the work days reported by 198 locomotive engineers. In addition, the shorter than 24-h work/rest cycles occurred more frequently in work schedules that created an on-call work system, such as road pool turn and extra board assignments, than in work schedules that used more predictable or regular work times, such as regular road assignments and yard/local work. As would be expected, when engineers worked shorter than 24-h work/rest cycles, they reported less sleep and poorer sleep than under the longer than 24-h work/rest cycles. Similarly, on-call work assignments resulted in less sleep and poorer sleep than regular work assignments. These results indicate that specific aspects of the work schedules used in railroad operations, particularly on-call operations that result in shorter than 24-h work/rest cycles, can lead to increased sleep-related problems. Although the North American railroad industry is making significant changes in on-call operations to minimize sleep-related problems from on-call schedules, better fatigue-related models validated within the railroad industry are needed.     

The effect of night-time naps on recovery from fatigue following night work

Abstract

A questionnaire was performed in order to investigate the effect of naps during duty on recovery from fatigue. Studies were performed on 12 male computer operators in each of two chemical plants working a four-team three-shift system. In one of the plants, the shift workers were able to take a 2 h nap during the night shift (nap group). In the other plant, no nap was taken (no-nap group). Before and after the two consecutive night shifts, both the nap and no-nap groups greatly extended their night sleeps, but the daytime sleep taken by the no-nap group during this period was significantly longer than that of the nap group on both the first and second days. No significant difference was found when comparing the length of the day sleep of the no-nap group with the total sleeping time (night-time nap plus subsequent day sleep) of the nap group. Therefore a night-time nap enables part of the essential sleep to be taken in advance of the day sleep following night work. During night work, both tbe nap and no-nap groups exhibited an increase in the sleepiness scores and also in the subjective feelings of fatigue concerning the complaints related to drowsiness, dullness and difficulty in concentration. However, it was found that for the no-nap group these effects continued for a large part of the recovery period following night work. It can therefore be surmised that naps taken during night-time work can be to a certain extent aid recovery from the fatigue caused by that work.     

The effects of a self-selected nap opportunity on the psychophysiological,performance and subjective measures during a simulated industrial night shift regimen

This study compared the effects of a 1 h self-selected recovery period to those of a standard night shift arrangement (with a total break time of 1-h) over a simulated three-day night shift schedule in a laboratory setting. Results showed that the inclusion of the flexible nap scheme resulted in higher performance output, improvements in physiological strain responses and reduced sleepiness during each night shift and generally over the three-night cycle. Certain variables also revealed the impact of napping compared with the standard rest break condition on the circadian rhythm. The sleep diary records show that the inclusion of the current intervention did not significantly reduce daytime recovery sleep. The results suggest that the potential benefits of flexible napping may outweigh the logistical effort it requires in a workplace environment.

Practitioner summary: Consensus on appropriate napping strategies for shift work remains a challenge. This simulated night shift laboratory study sought to determine the effects of a 1-h self-selected nap opportunity relative to a normal shift set-up. The nap improved performance and decreased sleepiness, without affecting daytime sleep.     

Effects of intermittent odours on cognitive-motor performance and brain functioning during mental fatigue

Effects of intermittent presentation of odours on cognitive-motor performance and brain activity during mental fatigue were examined using event-related brain potentials. Participants performed a Go/NoGo task for 60 min, in both odour and air control conditions. The time-on-task reaction time increase was significantly smaller in the odour condition than in the air control condition. Go- and NoGo-P3 amplitudes were larger in the presence of odours than during the air control, during mental fatigue. There were no effects of odours on error negativity (Ne)/error-related negativity (ERN) amplitude and latency. These results suggest that the presence of intermittent odours improves attentional/effortful control of response selection, and that this effect mitigates the deterioration of cognitive-motor performance during mental fatigue. PRACTITIONER SUMMARY: The present study provides evidence for a potentially effective strategy, the use of odours, to mitigate deficits in cognitive-motor performance during time-on-task. The results show that the presence of intermittent odours is an efficient tool for maintenance of attention and reaction time during a prolonged task.     

Muscular fatigue and endurance during intermittent static efforts: effects of contraction level, duty cycle, and cycle time

OBJECTIVE: To determine the effects of intermittent task parameters on muscle fatigue and endurance time during static shoulder abductions, with a long-term goal of establishing relationships between intermittent task parameters and short-term performance. BACKGROUND: Effects of intermittent work on endurance and fatigue development have been reported, and certain combinations of contraction levels and duty cycles have been proposed as design guidelines. These findings, however, were not derived from systematic manipulations of the task parameters. METHOD: Prolonged (1-hr maximum) intermittent shoulder abductions were performed at different combinations of contraction level (12% or 28% of muscle strength), duty cycle (.25 or .75), and cycle time (34 or 166 s). Fatigue was measured based on reductions in muscle strength and indirectly by changes in ratings of discomfort, electromyographic (EMG) amplitude, and EMG spectral distribution. RESULTS: Contraction level and duty cycle significantly affected endurance time and muscle fatigue, and interactive effects between these parameters were observed for some of the measures. Significant effects of cycle time were found only for EMG spectral measures. CONCLUSION: Endurance time and local fatigue were dependent on the comprehensive effects of the different task parameters. APPLICATION: Design changes to reduce the occurrence of localized fatigue during intermittent work need to take into account all the task parameters simultaneously.     

Comparison of measured and self-reported anthropometric information among firefighters: implications and applications

This study evaluated the accuracy of self-reported body weight and height compared to measured values among firefighters and identified factors associated with reporting error. A total of 863 male and 88 female firefighters in four US regions participated in the study. The results showed that both men and women underestimated their body weight ( ? 0.4 ± 4.1, ? 1.1 ± 3.6 kg) and overestimated their height (29 ± 18 , 17 ± 16 mm). Women underestimated more than men on weight (p = 0.022) and men overestimated more than women on height (p < 0.001). Reporting errors on weight were increased with overweight status (p < 0.001) and were disproportionate among subgroups. About 27% men and 24% women had reporting errors on weight greater than ± 2.2 kg, and 59% men and 28% women had reporting errors on height greater than 25 mm.

Practitioner Summary: This study along with literature revealed that the self-reported approach is not a sustainable option for anthropometric surveys, even for gathering data from physically active professional groups, such as firefighters, who presumably are knowledgeable of their body dimensions. Self-reported anthropometric information is undependable in important population subgroups.     

Effects of lumbar extensor fatigue and surface inclination on postural control during quiet stance

A number of work environments require workers to perform tasks on inclined surfaces. Such tasks, along with muscle fatigue, can impair postural control and increase falling risks. The objective of this study was to determine the effects of surface inclination angle, standing direction, and lumbar extensor fatigue on postural control during quiet standing. A group of 16 young, healthy participants were tested while standing on inclined surfaces before and after lumbar extensor fatigue (induced by repetitive isotonic exercise). Three inclination angles (0°, 18° and 26°) and three standing directions (uphill, downhill, and lateral facing) were examined. Postural control was assessed using several measures derived from center-of-pressure time series and subjectively perceived stability. Significant main and interactive effects of inclination angle and standing direction were found for all dependent measures. The adverse effects of standing on inclined surfaces were found to differ between the three standing directions. In general, dose-response relationships with inclination angle were evident, particularly in the lateral-facing direction. Fatigue-related effects differed between conditions, suggesting that the adverse effect of lumbar extensor fatigue on postural control depend on inclination angle and standing direction. These findings may facilitate the development of fall prevention interventions for work involving inclined surfaces.     

The effect of different work-rest schedules on fatigue and performance of a simulated directory assistance operator's task

The directory assistance operators' task with a visual display terminal was simulated to determine the preferable work-rest schedule from among the three different work-rest schedules: 30min of work followed by 5min break (30-5); 60min of work followed by l0min break (60-10); and 120min of work without any break (120-0). The total working duration was 2h. The errors made during the work and the subjective responses before and after the working period (2 h) were recorded and analysed. The results showed that the first two work-rest schedules were preferable to the third condition (120-0) as significantly fewer errors were made (p≥0.01) when a short break was provided. There was no significant difference (p≥0.10) in errors between (30-5) and (60-10) schemes. Fewer before and after subjective responses differed significantly for(30-5) and (60-10) schemes than for the (120-0) scheme. The overall effect of schemes on subjective responses, however, was not statistically significant at the 5% level. Since both (30-5) and (60-10) schemes were found acceptable, the (60-10) scheme is recommended since it is easy to implement, causes fewer breaks and therefore, fewer work interruptions, and leads to fewer total minutes of break.     

Subjective symptoms and physiological measures of fatigue in air traffic controllers

This study measured the correlation between fatigue and physiological stress symptoms in 102 air traffic controllers (ATCs) in Taiwan. The subjects were asked to complete a fatigue questionnaire and physiological measurement before and after work. The study results showed that nearly 50% of the subjects felt tired and weary after work. However, according to the results of the critical flicker frequency test, all ATCs performed better after work, and the strength of masculine index fingers improved. The systolic and diastolic blood pressure decreased after work. In addition, the levels of urinary 17-hydroxycorticosteroids (17-OHCS) at the pre-shift and post-shift stages were 1.91 ± 1.01 mg/g cr. and 1.50 ± 0.95 mg/g cr., respectively. This study indicated that, while the ATCs' subjective ratings showed possible work-induced fatigue, it did not affect their physiological response. The findings suggested that ATC is a stressful job, and that complaints regarding excess work stress should be taken seriously. Subsequently the study proposed appropriate intervention strategies to address the identified problems.Relevance to industryThis paper presents the subjective and objective measures of fatigue in ATCs. Recommendations are proposed with respect to potentially viable countermeasures to reduce the impact of fatigue in ATC operations, and achieve a broader understanding of the causal factors for fatigue in ATC.     

Physiological responses of firefighters and performance predictors during a simulated rescue of hospital patients

There is incomplete information about how physically demanding rescue work may be. The aim therefore of this paper was to examine the physiological responses of firefighters during a simulated rescue of hospital patients and to relate the firefighters' performance to their endurance, strength and working technique. Fourteen part-time male firefighters with a maximal oxygen uptake (VO(2max)) of 4.4 +/- 0.3 l/min (mean +/- SD) served as subjects in this study. First, each firefighter ascended six floors (a 20.5 m vertical ascent) carrying tools, wearing protective clothing and a breathing apparatus, an extra mass of 37 kg. He thereafter 'rescued' six persons by dragging each person on a fire-sheet on a flat floor. The technique used was recorded and the O(2) uptake and the heart rate were measured continuously during the whole operation. The blood lactate concentration and the subjective rating of perceived exertion were measured during and just after the rescue. The VO(2max) and the muscle strength were measured in the laboratory. The whole operation was carried out in the course of 5-9 min. The operation was a virtual all-out effort and the peak blood lactate concentration was 13 +/- 3 mmol/l. The peak oxygen uptake was 3.7 +/- 0.5 l/min (84% of the VO(2max)) during the operation. Large and heavy firefighters carried out the task faster than smaller ones. The VO(2max) in absolute terms and the dragging technique used were both related to the rescue performance. Rescuing patients at a hospital was physically very demanding and the time needed to complete the task depended on the VO(2max) in absolute values and the working technique used. A minimum VO(2max) of 4 l/min for firefighters was recommended.     

Physiological responses of firefighters and performance predictors during a simulated rescue of hospital patients

There is incomplete information about how physically demanding rescue work may be. The aim therefore of this paper was to examine the physiological responses of firefighters during a simulated rescue of hospital patients and to relate the firefighters' performance to their endurance, strength and working technique. Fourteen part-time male firefighters with a maximal oxygen uptake (VO_2max) of 4.4 ± 0.3 l/min (mean ± SD) served as subjects in this study. First, each firefighter ascended six floors (a 20.5 m vertical ascent) carrying tools, wearing protective clothing and a breathing apparatus, an extra mass of 37 kg. He thereafter ‘rescued’ six persons by dragging each person on a fire-sheet on a flat floor. The technique used was recorded and the O₂ uptake and the heart rate were measured continuously during the whole operation. The blood lactate concentration and the subjective rating of perceived exertion were measured during and just after the rescue. The VO_2max and the muscle strength were measured in the laboratory. The whole operation was carried out in the course of 5–9 min. The operation was a virtual all-out effort and the peak blood lactate concentration was 13 ± 3 mmol/l. The peak oxygen uptake was 3.7 ± 0.5 l/min (84% of the VO_2max) during the operation. Large and heavy firefighters carried out the task faster than smaller ones. The VO_2max in absolute terms and the dragging technique used were both related to the rescue performance. Rescuing patients at a hospital was physically very demanding and the time needed to complete the task depended on the VO_2max in absolute values and the working technique used. A minimum VO_2max of 4 l/min for firefighters was recommended.     

Effects of age and illumination on night driving: a road test

OBJECTIVE: This study investigated the effects of drivers' age and low light on speed, lane keeping, and visual recognition of typical roadway stimuli. BACKGROUND: Poor visibility, which is exacerbated by age-related changes in vision, is a leading contributor to fatal nighttime crashes. There is little evidence, however, concerning the extent to which drivers recognize and compensate for their visual limitations at night. METHOD: Young, middle-aged, and elder participants drove on a closed road course in day and night conditions at a "comfortable" speed without speedometer information. During night tests, headlight intensity was varied over a range of 1.5 log units using neutral density filters. RESULTS: Average speed and recognition of road signs decreased significantly as functions of increased age and reduced illumination. Recognition of pedestrians at night was significantly enhanced by retroreflective markings of limb joints as compared with markings of the torso, and this benefit was greater for middle-aged and elder drivers. Lane keeping showed nonlinear effects of lighting, which interacted with task conditions and drivers' lateral bias, indicating that older drivers drove more cautiously in low light. CONCLUSION: Consistent with the hypothesis that drivers misjudge their visual abilities at night, participants of all age groups failed to compensate fully for diminished visual recognition abilities in low light, although older drivers behaved more cautiously than the younger groups. APPLICATION: These findings highlight the importance of educating all road users about the limitations of night vision and provide new evidence that retroreflective markings of the limbs can be of great benefit to pedestrians' safety at night.