Effectiveness of powered hospital bed movers for reducing physiological strain and back muscle activation

Battery powered bed movers are becoming increasingly common within the hospital setting. The use of powered bed movers is believed to result in reduced physical efforts required by health care workers, which may be associated with a decreased risk of occupation related injuries. However, little work has been conducted assessing how powered bed movers impact on levels of physiological strain and muscle activation for the user. The muscular efforts associated with moving hospital beds using three different methods; manual pushing, StaminaLift Bed Mover (SBM) and Gzunda Bed Mover (GBM)were measured on six male subjects. Fourteen muscles were assessed moving a weighted hospital bed along a standardized route in an Australian hospital environment. Trunk inclination and upper spine acceleration were also quantified. Powered bed movers exhibited significantly lower muscle activation levels than manual pushing for the majority of muscles. When using the SBM, users adopted a more upright posture which was maintained while performing different tasks (e.g. turning a corner, entering a lift), while trunk inclination varied considerably for manual pushing and the GBM. The reduction in lower back muscular activation levels and the load reducing effect of a more upright posture may result in lower incidence of lower back injury.

Can perceptual indices estimate physiological strain across a range of environments and metabolic workloads when wearing explosive ordnance disposal and chemical protective clothing?

Objective Explosive ordnance disposal (EOD) often requires technicians to wear multiple protective garments in challenging environmental conditions. The accumulative effect of increased metabolic cost coupled with decreased heat dissipation associated with these garments predisposes technicians to high levels of physiological strain. It has been proposed that a perceptual strain index (PeSI) using subjective ratings of thermal sensation and perceived exertion as surrogate measures of core body temperature and heart rate, may provide an accurate estimation of physiological strain. Therefore, this study aimed to determine if the PeSI could estimate the physiological strain index (PSI) across a range of metabolic workloads and environments while wearing heavy EOD and chemical protective clothing. Methods Eleven healthy males wore an EOD and chemical protective ensemble while walking on a treadmill at 2.5, 4 and 5.5 km·h− 1 at 1% grade in environmental conditions equivalent to wet bulb globe temperature (WBGT) 21, 30 and 37 °C. WBGT conditions were randomly presented and a maximum of three randomised treadmill walking trials were completed in a single testing day. Trials were ceased at a maximum of 60-min or until the attainment of termination criteria. A Pearson's correlation coefficient, mixed linear model, absolute agreement and receiver operating characteristic (ROC) curves were used to determine the relationship between the PeSI and PSI. Results A significant moderate relationship between the PeSI and the PSI was observed [r = 0.77; p < 0.001; mean difference = 0.8 ± 1.1 a.u. (modified 95% limits of agreement − 1.3 to 3.0)]. The ROC curves indicated that the PeSI had a good predictive power when used with two, single-threshold cut-offs to differentiate between low and high levels of physiological strain (area under curve: PSI three cut-off = 0.936 and seven cut-off = 0.841). Conclusions These findings support the use of the PeSI for monitoring physiological strain while wearing EOD and chemical protective clothing. However, future research is needed to confirm the validity of the PeSI for active EOD technicians operating in the field.

Physiological tolerance times while wearing explosive ordnance disposal protective clothing in simulated environmental extremes

Explosive ordnance disposal (EOD) technicians are required to wear protective clothing to protect themselves from the threat of overpressure, fragmentation, impact and heat. The engineering requirements to minimise these threats results in an extremely heavy and cumbersome clothing ensemble that increases the internal heat generation of the wearer, while the clothing’s thermal properties reduce heat dissipation. This study aimed to evaluate the heat strain encountered wearing EOD protective clothing in simulated environmental extremes across a range of differing work intensities. Eight healthy males [age 25±6 years (mean ± sd), height 180±7 cm, body mass 79±9 kg, V˙O2max 57±6 ml.kg−1.min−1] undertook nine trials while wearing an EOD9 suit (weighing 33.4 kg). The trials involved walking on a treadmill at 2.5, 4 and 5.5 km⋅h−1 at each of the following environmental conditions, 21, 30 and 37°C wet bulb globe temperature (WBGT) in a randomised controlled crossover design. The trials were ceased if the participants’ core temperature reached 39°C, if heart rate exceeded 90% of maximum, if walking time reached 60 minutes or due to fatigue/nausea. Tolerance times ranged from 10–60 minutes and were significantly reduced in the higher walking speeds and environmental conditions. In a total of 15 trials (21%) participants completed 60 minutes of walking; however, this was predominantly at the slower walking speeds in the 21°C WBGT environment. Of the remaining 57 trials, 50 were ceased, due to attainment of 90% maximal heart rate. These near maximal heart rates resulted in moderate-high levels of physiological strain in all trials, despite core temperature only reaching 39°C in one of the 72 trials.

Heat strain and hydration status of surface mine blast crew workers

Objective Dehydration and symptoms of heat illness are common among the surface mining workforce. This investigation aimed to determine whether heat strain and hydration status exceeded recommended limits. Methods Fifteen blast crew personnel operating in the tropics were monitored across a 12-hour shift. Heart rate, core body temperature, and urine-specific gravity were continuously recorded. Participants self-reported fluid consumption and completed a heat illness symptom inventory. Results Core body temperature averaged 37.46 +/- 0.13[degrees]C, with the group maximum 37.98 +/- 0.19[degrees]C. Mean urine-specific gravity was 1.024 +/- 0.007, with 78.6% of samples 1.020 or more. Seventy-three percent of workers reported at least one symptom of heat illness during the shift. Conclusions Core body temperature remained within the recommended limits; however, more than 80% of workers were dehydrated before commencing the shift, and tended to remain so for the duration.

Inside the ‘Hurt Locker’: The combined effects of explosive ordnance disposal and chemical protective clothing on physiological tolerance time in extreme environments

Background Explosive ordnance disposal (EOD) technicians are often required to wear specialised clothing combinations that not only protect against the risk of explosion but also potential chemical contamination. This heavy (>35kg) and encapsulating ensemble is likely to increase physiological strain by increasing metabolic heat production and impairing heat dissipation. This study investigated the physiological tolerance times of two different chemical protective undergarments, commonly worn with EOD personal protective clothing, in a range of simulated environmental extremes and work intensities Methods Seven males performed eighteen trials wearing two ensembles. The trials involved walking on a treadmill at 2.5, 4 and 5.5 km.h-1 at each of the following environmental conditions, 21, 30 and 37°C wet bulb globe temperature (WBGT). The trials were ceased if the participants’ core temperature reached 39°C, if heart rate exceeded 90% of maximum, if walking time reached 60 minutes or due to volitional fatigue. Results Physiological tolerance times ranged from 8 to 60 min and the duration (mean difference: 2.78 min, P>0.05) were similar in both ensembles. A significant effect for environment (21>30>37°C WBGT, P<0.05) and work intensity (2.5>4>5.5 km.h-1, P< 0.05) was observed in tolerance time. The majority of trials across both ensembles (101/126; 80.1%) were terminated due to participants achieving a heart rate equivalent to greater than 90% of their maximum. Conclusions Physiological tolerance times wearing these two chemical protective undergarments, worn underneath EOD personal protective clothing, were similar and predominantly limited by cardiovascular strain.

Heat stress, heat strain, and productivity in Washington State tree fruit harvesters

Thesis (Master's)--University of Washington, 2016-06

Thermoregulatory responses to ice-slush beverage ingestion and exercise in the heat

We compared the effects of an ice-slush beverage (ISB) and a cool liquid beverage (CLB) on cycling performance, changes in rectal temperature (T (re)) and stress responses in hot, humid conditions. Ten trained male cyclists/triathletes completed two exercise trials (75 min cycling at similar to 60% peak power output + 50 min seated recovery + 75% peak power output x 30 min performance trial) on separate occasions in 34A degrees C, 60% relative humidity. During the recovery phase before the performance trial, the athletes consumed either the ISB (mean +/- A SD -0.8 +/- A 0.1A degrees C) or the CLB (18.4 +/- A 0.5A degrees C). Performance time was not significantly different after consuming the ISB compared with the CLB (29.42 +/- A 2.07 min for ISB vs. 29.98 +/- A 3.07 min for CLB, P = 0.263). T (re) (37.0 +/- A 0.3A degrees C for ISB vs. 37.4 +/- A 0.2A degrees C for CLB, P = 0.001) and physiological strain index (0.2 +/- A 0.6 for ISB vs. 1.1 +/- A 0.9 for CLB, P = 0.009) were lower at the end of recovery and before the performance trial after ingestion of the ISB compared with the CLB. Mean thermal sensation was lower (P < 0.001) during recovery with the ISB compared with the CLB. Changes in plasma volume and the concentrations of blood variables (i.e., glucose, lactate, electrolytes, cortisol and catecholamines) were similar between the two trials. In conclusion, ingestion of ISB did not significantly alter exercise performance even though it significantly reduced pre-exercise T (re) compared with CLB. Irrespective of exercise performance outcomes, ingestion of ISB during recovery from exercise in hot humid environments is a practical and effective method for cooling athletes following exercise in hot environments.

Bomb disposal in the tropics : a cocktail of metabolic and environmental heat

Bomb technicians perform their work while encapsulated in explosive ordnance disposal (EOD) suits. Designed primarily for safety, these suits have an unintended consequence of impairing the body’s natural mechanisms for heat dissipation. Purpose: To quantify the heat strain encountered during an EOD operational scenario in the tropical north of Australia. Methods: All active police male bomb technicians, located in a tropical region of Australia (n=4, experience 7 ± 2.1 yrs, age 34 ± 2 yrs, height 182.3 ± 5.4 cm, body mass 95 ± 4 kg, VO2max 46 ± 5.7 ml.kg-1.min-1) undertook an operational scenario wearing the Med-Eng EOD 9 suit and helmet (~32 kg). The climatic conditions ranged between 27.1–31.8°C ambient temperature, 66-88% relative humidity, and 30.7-34.3°C wet bulb globe temperature. The scenario involved searching a two story non air-conditioned building for a target; carrying and positioning equipment for taking an X-ray; carrying and positioning equipment to disrupt the target; and finally clearing the site. Core temperature and heart rate were continuously monitored, and were used to calculate a physiological strain index (PSI). Urine specific gravity (USG) assessed hydration status and heat associated symptomology were also recorded. Results: The scenario was completed in 121 ± 22 mins (23.4 ± 0.4% work, 76.5 ± 0.4% rest/recovery). Maximum core temperature (38.4 ± 0.2°C), heart rate (173 ± 5.4 bpm, 94 ± 3.3% max), PSI (7.1 ± 0.4) and USG (1.031 ± 0.002) were all elevated after the simulated operation. Heat associated symptomology highlighted that moderate-severe levels of fatigue and thirst were universally experienced, muscle weakness and heat sensations experienced by 75%, and one bomb technician reported confusion and light-headedness. Conclusion: All bomb technicians demonstrated moderate-high levels of heat strain, evidenced by elevated heart rate, core body temperature and PSI. Severe levels of dehydration and noteworthy heat-related symptoms further highlight the risks to health and safety faced by bomb technicians operating in tropical locations.

Chancen und Risiken der Arbeit im E-Business

E-Business, verstanden als ganzheitliche Strategie zur Reorganisation von Geschäftsprozessen, Strukturen und Beziehungen in Unternehmen, bietet für die Arbeitsgestaltung in einer digital vernetzten Welt Chancen und Risiken in Hinblick auf die Humankriterien. Empirische Untersuchungen in 14 Unternehmen zeigen „good practice“-Ansätze im B2B-Feld (Business-to-Business). Untersucht wurden die Tätigkeiten der elektronisch vernetzten Auftragsbearbeitung, des Web-, Content-Managements, der digitalen Druckvorlagenherstellung sowie der CAD- Bauplanzeichnung. Die beobachteten Arbeitsplätze zeigen, dass Arbeitsinhalte eher ganzheitlich und komplex gestaltet sind. Planende, ausführende, kontrollierende und organisierende Anteile weisen auf eine vielfältige Aufgabengestaltung hin, die hohe Anforderungen beinhaltet. Während alle beobachteten Tätigkeiten mit Aufnahme-, Erarbeitungs-, Verarbeitungs-, Übertragungs- und Weitergabeprozessen von Informationen zu tun haben, gibt es Differenzen in Bezug auf den Arbeitsumfang, den Zeitdruck, Fristsetzungen, erwartete Arbeitsleistungen sowie die Planbarkeit der Aufgaben. Die vorgefundenen Aufgabentypen (wenig bis sehr anforderungsreich im Sinne von Denk- und Planungsanforderungen) sind gekennzeichnet durch eine unterschiedlich ausgeprägte Aufgabenkomplexität. Interessant ist, dass, je anforderungsreicher die Aufgabengestaltung, je höher die Aufgabenkomplexität, je größer die Wissensintensität und je niedriger die Planbarkeit ist, desto größer sind die Freiräume in der Aufgabenausführung. Das heißt wiederum, dass bei zunehmenden E-Business-Anteilen mehr Gestaltungsspielräume zur Verfügung stehen. Die bestehenden Chancen auf eine humane Aufgabengestaltung sind umso größer, je höher die E-Business-Anteile in der Arbeit sind. Diese Wirkung findet sich auch bei einem Vergleich der Aufgabenbestandteile wieder. Die negativen Seiten des E-Business zeigen sich in den vorgefundenen Belastungen, die auf die Beschäftigten einwirken. Diskutiert wird die Verschiebung von körperlichen hin zu psychischen und vorrangig informatorischen Belastungen. Letztere stellen ein neues Belastungsfeld dar. Ressourcen, auf welche die Mitarbeiter zurückgreifen können, sind an allen Arbeitsplätzen vorhanden, allerdings unterschiedlich stark ausgeprägt. Personale, organisationale, soziale, aufgabenbezogene und informatorische Ressourcen, die den Beschäftigten zur Verfügung stehen, werden angesprochen. In Bezug auf die Organisationsgestaltung sind positive Ansätze in den untersuchten E-Business-Unternehmen zu beobachten. Der Großteil der untersuchten Betriebe hat neue Arbeitsorganisationskonzepte realisiert, wie die vorgefundenen kooperativen Organisationselemente zeigen. Die kooperativen Organisationsformen gehen allerdings nicht mit einer belastungsärmeren Gestaltung einher. Das vorgefundene breite Spektrum, von hierarchisch organisierten Strukturen bis hin zu prozess- und mitarbeiterorientierten Organisationsstrukturen, zeigt, dass Organisationsmodelle im E-Business gestaltbar sind. Neuen Anforderungen kann insofern gestaltend begegnet und somit die Gesundheit und das Wohlbefinden der Mitarbeiter positiv beeinflusst werden. Insgesamt betrachtet, zeigt E-Business ein ambivalentes Gesicht, das auf der Basis des MTO-Modells (Mensch-Technik-Organisation) von Uhlich (1994) diskutiert wird, indem vernetzte Arbeitsprozesse auf personeller, technischer sowie organisationaler Ebene betrachtet werden. E-business, seen as more than only the transformation of usual business processes into digital ones, furthermore as an instrument of reorganisation of processes and organisation structures within companies, offers chances for a human oriented work organisation. Empirical data of 14 case studies provide good practice approaches in the field of B2B (Business-to-Business). The observed work contents show, that tasks (e.g. order processing, web-, contentmanagement, first print manufacturing and architectural drawing) are well arranged. Executive, organising, controlling and coordinating parts constitute a diversified work content, which can be organised with high demands. Interesting is the result, that the more e-business-parts are within the work contents, on the one hand the higher are the demands of the type of work and on the other hand the larger is the influence on workmanship. The observed enterprises have realised new elements of work organisation, e.g. flexible working time, cooperative leadership or team work. The direct participation of the employees can be strengthened, in particular within the transformation process. Those companies in which the employees were early and well informed about the changes coming up with e-business work, the acceptance for new technique and new processes is higher than in companies which did not involve the person concerned. Structured in an ergonomic way, there were found bad patterns of behaviour concerning ergonomic aspects, because of missing knowledge regarding work-related ergonomic expertise by the employees. E-business indicates new aspects concerning requirements – new in the field of informational demands, as a result of poorly conceived technical balance in the researched SME. Broken systems cause interruptions, which increase the pressure of time all the more. Because of the inadequate usability of software-systems there appear in addition to the informational strains also elements of psychological stress. All in all, work contents and work conditions can be shaped and as a result the health and well-being of e-business-employees can be influenced: Tasks can be structured and organised in a healthfulness way, physiological strain and psychological stress are capable of being influenced, resources are existent and developable, a human work design within e-business structures is possible. The ambivalent face of e-business work is discussed on the basis of the MTO- (Mensch-Technik-Organisation) model (Ulich 1994). Thereby new and interesting results of researches are found out, concerning the personal/human side, the technical side and the organisational side of e-business work.

Phylogenetic and physiological characterization of a heterotrophic, chemolithoautotrophic Thiothrix strain isolated from activated sludge

The sheathed filamentous bacterium known as strain CT3, isolated by micromanipulation from an activated sludge treatment plant in Italy, is a member of the genus Thiothrix in the gamma-Proteobacteria according to 16S rDNA sequence analysis. The closest phylogenetic neighbours of strain CT3 are strains I and Q(T), which were also isolated from activated sludge and belong to the species Thiothrix fructosivorans. These strains have respectively 99.2 and 99.4 % similarity to CT3 by 16S rDNA sequence comparison. CT3 shows 63-67 % DNA-DNA hybridization with strain I, which is the only currently viable strain of T. fructosivorans. CT3 is the second strain in the genus Thiothrix that has been shown to be capable of growing autotrophically with reduced sulfur compounds as the sole energy source; autotrophy was also confirmed in strain I. The first reported chemolithoautotrophic isolate of this genus was a strain of 'Thiothrix ramosa' that was isolated from a hydrogen sulfide spring and is morphologically distinguishable from all other described strains of Thiothrix, including CT3. CT3 is an aerobic organism that is non-fermentative, not capable of denitrification and able to grow heterotrophically. Autotrophy in the genus Thiothrix should be investigated more fully to better define the taxonomy of this genus.

Physiological and symptomatic responses to cycling and walking in intermittent claudication

To shed light on the potential efficacy of cycling as a testing modality in the treatment of intermittent claudication (IC), this study compared physiological and symptomatic responses to graded walking and cycling tests in claudicants. Sixteen subjects with peripheral arterial disease (resting ankle: brachial index (ABI) < 0.9) and IC completed a maximal graded treadmill walking (T) and cycle (C) test after three familiarization tests on each mode. During each test, symptoms, oxygen uptake (VO2), minute ventilation (VE), respiratory exchange ratio (RER) and heart rate (HR) were measured, and for 10 min after each test the brachial and ankle systolic pressures were recorded. All but one subject experienced calf pain as the primary limiting symptom during T; whereas the symptoms were more varied during C and included thigh pain, calf pain and dyspnoea. Although maximal exercise time was significantly longer on C than T (690 +/- 67 vs. 495 +/- 57 s), peak VO2, peak VE and peak heart rate during C and T were not different; whereas peak RER was higher during C. These responses during C and T were also positively correlated (P < 0.05) with each other, with the exception of RER. The postexercise systolic pressures were also not different between C and T. However, the peak decline in ankle pressures from resting values after C and T were not correlated with each other. These data demonstrate that cycling and walking induce a similar level of metabolic and cardiovascular strain, but that the primary limiting symptoms and haemodynamic response in an individual's extremity, measured after exercise, can differ substantially between these two modes.

Heat strain, hydration status, and symptoms of heat illness in surface mine workers

The aim of the research program was to evaluate the heat strain, hydration status, and heat illness symptoms experienced by surface mine workers. An initial investigation involved 91 surface miners completing a heat stress questionnaire; assessing the work environment, hydration practices, and heat illness symptom experience. The key findings included 1) more than 80 % of workers experienced at least one symptom of heat illness over a 12 month period; and 2) the risk of moderate symptoms of heat illness increased with the severity of dehydration. These findings highlight a health and safety concern for surface miners, as experiencing symptoms of heat illness is an indication that the physiological systems of the body may be struggling to meet the demands of thermoregulation. To illuminate these findings a field investigation to monitor the heat strain and hydration status of surface miners was proposed. Two preliminary studies were conducted to ensure accurate and reliable data collection techniques. Firstly, a study was undertaken to determine a calibration procedure to ensure the accuracy of core body temperature measurement via an ingestible sensor. A water bath was heated to several temperatures between 23 . 51 ¢ªC, allowing for comparison of the temperature recorded by the sensors and a traceable thermometer. A positive systematic bias was observed and indicated a need for calibration. It was concluded that a linear regression should be developed for each sensor prior to ingestion, allowing for a correction to be applied to the raw data. Secondly, hydration status was to be assessed through urine specific gravity measurement. It was foreseeable that practical limitations on mine sites would delay the time between urine collection and analysis. A study was undertaken to assess the reliability of urine analysis over time. Measurement of urine specific gravity was found to be reliable up to 24 hours post urine collection and was suitable to be used in the field study. Twenty-nine surface miners (14 drillers [winter] and 15 blast crew [summer]) were monitored during a normal work shift. Core body temperature was recorded continuously. Average mean core body temperature was 37.5 and 37.4 ¢ªC for blast crew and drillers, with average maximum body temperatures of 38.0 and 37.9 ¢ªC respectively. The highest body temperature recorded was 38.4 ¢ªC. Urine samples were collected at each void for specific gravity measurement. The average mean urine specific gravity was 1.024 and 1.021 for blast crew and drillers respectively. The Heat Illness Symptoms Index was used to evaluate the experience of heat illness symptoms on shift. Over 70 % of drillers and over 80 % of blast crew reported at least one symptom. It was concluded that 1) heat strain remained within the recommended limits for acclimatised workers; and 2) the majority of workers were dehydrated before commencing their shift, and tend to remain dehydrated for the duration. Dehydration was identified as the primary issue for surface miners working in the heat. Therefore continued study focused on investigating a novel approach to monitoring hydration status. The final aim of this research program was to investigate the influence dehydration has on intraocular pressure (IOP); and subsequently, whether IOP could provide a novel indicator of hydration status. Seven males completed 90 minutes of walking in both a cool and hot climate with fluid restriction. Hydration variables and intraocular pressure were measured at baseline and at 30 minute intervals. Participants became dehydrated during the trial in the heat but maintained hydration status in the cool. Intraocular pressure progressively declined in the trial in the heat but remained relatively stable when hydration was maintained. A significant relationship was observed between intraocular pressure and both body mass loss and plasma osmolality. This evidence suggests that intraocular pressure is influenced by changes in hydration status. Further research is required to determine if intraocular pressure could be utilised as an indirect indicator of hydration status.