Roger Haslam

The effect of military load carriage on 3-D lower limb kinematics and spatiotemporal parameters

The 3-D gait analysis of military load carriage is not well represented, if at all, within the available literature. This study collected 3-D lower limb kinematics and spatiotemporal parameters in order to assess the subsequent impact of carrying loads in a backpack of up to 32 kg. Results showed the addition of load significantly decreased the range of motion of flexion/extension of the knee and pelvic rotation. Also seen were increases in adduction/abduction and rotation of the hip and pelvis tilt. No changes to ankle kinematics were observed. Alterations to the spatiotemporal parameters of gait were also of considerable interest, namely, an increase in double support and a decrease in preferred stride length as carried load increased. Analysing kinematics during military or recreational load carriage broadens the knowledge regarding the development of exercise-related injuries, while helping to inform the human-centred design process for future load carrying systems. The importance of this study is that limited available research has investigated 3-D lower limb joint kinematics when carrying loads.

The Effectiveness of Interventions for Preventing Injuries in the Construction Industry A Systematic Review

BACKGROUND Occupational injury rates among construction workers are the highest among the major industries. A number of injury-prevention interventions have been proposed, yet the effectiveness of these is uncertain. Thus a systematic review evaluating the effectiveness of interventions for preventing occupational injuries among construction workers was conducted. METHODS Seven databases were searched, from the earliest available dates through June 2006, for published findings of injury prevention in construction studies. Acceptable study designs included RCTs; controlled before-after studies; and interrupted time series (ITS). Effect sizes of similar interventions were pooled into a meta-analysis in January 2007. RESULTS Of 7522 titles found, four ITS studies and one controlled ITS study met the inclusion criteria. The overall methodologic quality was low. No indications of publication bias were found. Findings from a safety-campaign study and a drug-free-workplace study indicated that both interventions significantly reduced the level and the trend of injuries. Three studies that evaluated legislation did not decrease the level (ES 0.69; 95% CI=-1.70, 3.09) and made the downward trend (ES 0.28; 95% CI=0.05, 0.51) of injuries less favorable. CONCLUSIONS Limited evidence was found for the effectiveness of a multifaceted safety campaign and a multifaceted drug program, but no evidence was found that legislation is effective to prevent nonfatal or fatal injuries in the construction industry.

Slip, trip and fall accidents occurring during the delivery of mail

This study sought to identify causal factors for slip, trip and fall accidents occurring during the delivery of mail. Analysis of in-house data produced information about accident circumstances for 1734 fall cases. The most common initiating events in delivery falls were slips and trips. Slips most often occurred on snow, ice or grass, while trips tended to involve uneven pavements, obstacles and kerbs. Nearly one-fifth of falls occurred on steps, with step falls requiring longer absence from work than falls on the level. Half of all falls occurred during November-February and three-quarters of falls occurred between 7 and 9 a.m. Incidence rates for female employees were 50% higher than for their male colleagues. Accident-independent methods included interviews with safety personnel and managers, discussion groups with delivery employees, and a questionnaire survey of employees and managers. These techniques provided data on risk factors related to the task, behaviour, footwear and equipment. Arising from these accident-independent investigations, it is suggested that unsafe working practices, such as reading addresses while walking and taking shortcuts, increase the risk of falls. Organizational issues include management safety activities, training and equipment provision. Measures are discussed that might lead to a reduction in the incidence of delivery fall accidents.

The effect of load distribution within military load carriage systems on the kinetics of human gait.

Military personnel carry their equipment in load carriage systems (LCS) which consists of webbing and a Bergen (aka backpack). In scientific terms it is most efficient to carry load as close to the bodys centre of mass (CoM) as possible, this has been shown extensively with physiological studies. However, less is known regarding the kinetic effects of load distribution. Twelve experienced load carriers carried four different loads (8, 16, 24 and 32 kg) in three LCS (backpack, standard and AirMesh). The three LCS represented a gradual shift to a more even load distribution around the CoM. Results from the study suggest that shifting the CoM posteriorly by carrying load solely in a backpack significantly reduced the force produced at toe-off, whilst also decreasing stance time at the heavier loads. Conversely, distributing load evenly on the trunk significantly decreased the maximum braking force by 10%. No other interactions between LCS and kinetic parameters were observed. Despite this important findings were established, in particular the effect of heavy load carriage on maximum braking force. Although the total load carried is the major cause of changes to gait patterns, the scientific testing of, and development of, future LCS can modify these risks.

Identification of risk factors and countermeasures for slip, trip and fall accidents during the delivery of mail

Risk factors for slip, trip and fall accidents (STFA) during the delivery of mail were identified using a range of accident-centred and accident-independent methods. Key factors included slippery underfoot conditions, non-weather related environmental hazards (e.g., uneven paving, steps, inadequate lighting), poor slip resistance from footwear, unsafe working practices, management safety practices, and underlying organisational influences. Intervention measures were recommended that target STFA risks at three levels: slip resistance, exposure to hazardous conditions, and employee behaviour in the face of hazardous conditions. The use of a participative approach to intervention selection and design enabled allowance for the organisational context to be made.

Influence of the visual environment on the postural stability in healthy older women.

Background: A poor postural stability in older people is associated with an increased risk of falling. It is recognized that visual environment factors (such as poor lighting and repeating patterns on escalators) may contribute to falls, but little is known about the effects of the visual environment on postural stability in the elderly. Objective: To determine whether the postural stability of older women (using body sway as a measure) differed under five different visual environment conditions. Methods: Subjects were 33 healthy women aged 65–76 years. Body sway was measured using an electronic force platform which identified the location of their centre of gravity every 0.05 s. Maximal lateral sway and anteroposterior sway were determined and the sway velocity calculated over 1-min trial periods. Body sway was measured under each of the following conditions: (1) normal laboratory lighting (186 lx); (2) moderate lighting (10 lx); (3) dim lighting (1 lx); (4) eyes closed, and (5) repeating pattern projected onto a wall. Results: Each measure of the postural stability was significantly poorer in condition 4 (eyes closed) than in all other conditions. Anteroposterior sway was greater in condition 3 than in conditions 1 and 2, whilst the sway velocity was greater in condition 3 than in condition 2. Lateral sway did not differ significantly between different lighting levels (conditions 1–3). A projected repeating pattern (condition 5) did not significantly influence the postural stability relative to condition 1. Conclusions: The substantially greater body sway with eyes closed than with eyes open confirms the importance of vision in maintaining the postural stability. At the lowest light level, the body sway was significantly increased as compared with the other light levels, but was still substantially smaller than on closing the eyes. A projected repeating pattern did not influence the postural stability. Dim lighting levels and removing visual input appear to be associated with a poorer postural stability in older people and hence might be associated with an increased risk of falls.

Follow-up investigations of slip, trip and fall accidents among postal delivery workers

Abstract A sample of 40 slip, trip and fall accidents occurring during the delivery of mail were subject to detailed follow-up investigation. Interviews were conducted with accident-involved employees as soon as possible after each incident (mean time between accident and interview=9.5 days). Interviews were held at the location of the accident and covered the sequence of events and related individual, equipment and organisational aspects. The study took place October–March, reflecting the period when most accidents occur. The majority of accidents involved snow or ice (70%). A combination of slippery conditions, use of footwear with worn tread, and time-saving behaviour was found in 50% of accidents. It is suggested that a second important combination is the presence of tripping hazards and the unsafe practice of preparing mail for the next delivery while walking. Poor lighting was considered a problem in 20% of cases. Other problems identified included deficiencies with training and a low level of safety-related activity by local managers. It is concluded that there are opportunities for intervention that should reduce the frequency of these accidents.

The quality of accident and health data in the construction industry: interviews with senior managers

Despite recent changes in legislation and advances towards an integrated project-wide approach, health and safety management in the construction industry is still a major problem, involving a substantial cost to business, society and individuals. A prerequisite to improving the situation and developing an effective management strategy is monitoring, providing a detailed understanding of the effectiveness of different approaches to intervention. This paper describes a feasibility study using in-depth interviews with senior managers to explore the quality of accident and health data of nine large, high profile companies from the engineering construction sector. The interview dialogue comprised a series of questions and issues to be explored on the organizations accident reporting systems (e.g. what is reported, analysis performed, computerization), unsafe act and near miss auditing (e.g. definition, validity), failure type indicators (e.g. auditing, quantification) and safety culture indicators (e.g. commitment, health). Although safety was a priority for companies, health (i.e. medicals and monitoring systems) had not been given the same consideration, especially with regard to subcontracted labour. This study shows that the validity of accident statistics as a measure of safety remains a limitation, and that there is a requirement for a consistent and integrated approach to the measurement of health and safety performance.

What constitutes effective manual handling training? A systematic review

BACKGROUND Injuries caused by manual handling are a major burden to society. Manual handling training programmes have been designed to reduce the likelihood of injury among the workforce; however, concerns have been raised over the efficacy of current manual handling training methods. AIMS To undertake a systematic review of the literature examining the effectiveness of different approaches to training in manual handling. METHODS Peer-reviewed publications along with published conference proceedings published in English, between 1980 and 2009, on the topic of manual handling training comprised the search criteria. A published checklist for reviewing papers was selected, which formed the basis for assessing the quality of the papers reviewed. RESULTS A total of 1827 papers were located. Following elimination of duplicates, 221 papers were collected and reviewed. Of these, 53 papers were intervention studies with the primary aim of investigating the effectiveness of manual handling training. The review identified little evidence supporting the effectiveness of both technique- and educational-based manual handling training. In addition, there was considerable evidence supporting the idea that the principles learnt during training are not applied in the working environment. Strength and flexibility training shows promise; however, further research is needed to ascertain whether such an intervention is sustainable over the long term. CONCLUSIONS The evidence collected indicates that manual handling training is largely ineffective in reducing back pain and back injury. High priority should be given to developing and evaluating multidimensional interventions, incorporating exercise training to promote strength and flexibility, which are tailored to the industrial sector.

Ergonomics and Sustainability

This editorial was published in the journal Ergonomics [© Taylor & Francis] and the definitive version is available at: http://dx.doi.org/10.1080/00140139.2013.786555