Introduction to Human Factors and Ergonomics - 4th Edition (by R. S. Bridger) - PDFCOFFEE.COM (2024)

Introduction to Human Factors and Ergonomics Fourth Edition

Introduction to Human Factors and Ergonomics Fourth Edition

R. S. Bridger

CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2018 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Printed on acid-free paper International Standard Book Number-13: 978-1-4987-9594-4 (Hardback) This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use. The authors and publishers have attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www.copyright.com (http:// www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data Names: Bridger, R. S., author. Title: Introduction to human factors and ergonomics / Robert Bridger. Other titles: Introduction to ergonomics Description: Fourth edition. | Boca Raton : Taylor & Francis, CRC Press, 2018. | Earlier editions published under title: Introduction to ergonomics. | Includes bibliographical references. Identifiers: LCCN 2017023573| ISBN 9781498795944 (hardback) | ISBN 9781498796118 (ebook) Subjects: LCSH: Human engineering. | Work environment. Classification: LCC TA166 .B72 2018 | DDC 620.8/2--dc23 LC record available at https://lccn.loc.gov/2017023573 Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com

Contents Preface.......................................................................................................................................... xxiii Author...........................................................................................................................................xxvii Prologue: Human Factors and Ergonomics in Systems Design and Project Management............xxix Chapter 1 Human Factors and Ergonomics from the Earliest Times to the Present..................... 1 Core Knowledge: Understanding Human Factors and Ergonomics.............................1 Compatibility: Matching Demands to Capabilities.................................................. 1 Brief History of Ergonomics....................................................................................2 Scientific Management and Work Study.................................................................. 2 Human Relations and Occupational Psychology...................................................... 4 Hawthorne Experiments........................................................................................... 4 Sociotechnical Systems Theory............................................................................... 6 Participation.............................................................................................................. 7 Occupational Medicine............................................................................................. 7 Human Performance Psychology.............................................................................7 Operations Research................................................................................................. 8 Fit the Man to the Job versus Fitting the Job to the Man......................................... 8 Human Factors and Ergonomics..............................................................................9 Will Taylorism Ever Go Away? Modern Work Systems and Neo-Taylorism........ 10 Attempts to Humanize Work.................................................................................. 10 Success of Work Humanization Programs............................................................. 11 The Fourth Industrial Revolution........................................................................... 12 Basic Applications....................................................................................................... 12 Tools and Processes..................................................................................................... 14 HFE Checklists...................................................................................................... 14 Task Analysis.......................................................................................................... 19 Status of Risk Assessment and Design Tools......................................................... 23 Systems Integration.....................................................................................................24 Cost–Benefit Models and Methods.........................................................................24 Oxenburgh Productivity Model..............................................................................24 Prevention is Better Than Cure..............................................................................25 Examples of Industrial Ergonomics Programs.......................................................26 Economics of Participation....................................................................................28 Future Directions for HFE..........................................................................................28 Summary..................................................................................................................... 29 Tutorial Topics............................................................................................................. 29 Essays and Exercises................................................................................................... 29 Chapter 2 The Body as a Mechanical System............................................................................. 31 Core Knowledge: The Human Body as a Mechanical System................................... 31 Postural Stability.................................................................................................... 32 Some Basic Body Mechanics................................................................................. 32 Anatomy of the Spine and Pelvis Related to Posture.............................................34 Spine....................................................................................................................... 35 Pelvis...................................................................................................................... 37 Lumbo-Pelvic Mechanism...................................................................................... 37 v

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Basic Applications....................................................................................................... 38 Standing.................................................................................................................. 38 Understanding Low Back Pain and the Role of HFE............................................. 41 Causes of Low Back Pain....................................................................................... 43 Back Pain and Muscular Fatigue............................................................................ 43 Psychosocial Factors and Physical Stressors.......................................................... 43 Can Low Back Pain Be Prevented?........................................................................44 HFE and the Musculoskeletal System in General..................................................46 Tools and Processes..................................................................................................... 47 Tolerance for Forces of Rapid Onset...................................................................... 47 Falls into Water...................................................................................................... 47 Tolerance for Collisions and Shocks...................................................................... 49 Shock...................................................................................................................... 49 Occupational Exposure to High Forces: How to Calculate Spinal Compression...................................................................................................... 50 Spinal Compression Tolerance Limits.................................................................... 55 Measurement of Musculoskeletal Pain in the Workplace...................................... 57 System Integration....................................................................................................... 57 Analyze Legacy Data............................................................................................. 57 Proactive Approach to Prevention.......................................................................... 59 High Costs of Injury............................................................................................... 59 Role of Occupational Factors.................................................................................60 Research Directions.................................................................................................... 61 Summary..................................................................................................................... 61 Tutorial Topics............................................................................................................. 61 Essays and Exercises................................................................................................... 62 Chapter 3 Anthropometry, Workstation, and Facilities Design................................................... 65 Core Knowledge: Understanding Human Physical Variability................................... 65 Anthropometry: Definition..................................................................................... 65 Measurements of the Body Used in HFE.......................................................... 65 Functional Anthropometry..................................................................................... 65 Sources of Human Variability...........................................................................66 Factors Influencing the Change in Body Size of Populations........................... 70 The Obesity Epidemic............................................................................................ 71 Anthropometry Surveys......................................................................................... 71 Implications for HFE......................................................................................... 72 Statistical Essentials for Using Anthropometric Data in HFE............................... 72 The Normal Distribution................................................................................... 72 Variability and the “Distance” from the Middle............................................... 73 The Standard Normal Deviate: Z....................................................................... 73 Percentiles to Real Measurements and Back Again.......................................... 74 Estimating the Range......................................................................................... 74 Accuracy of the Measurements......................................................................... 75 Patterns of Variability in Human Body Size and Shape........................................ 76 Basic Applications....................................................................................................... 79 Design to Fit a Target Population........................................................................... 79 Anthropometry and Clothing Corrections........................................................ 82 How to Deal with Anthropometric Constraints on Product Dimensions............... 82 Find the Minimum Allowable Dimensions....................................................... 82 Find the Maximum Allowable Dimensions....................................................... 83

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Tools and Processes.....................................................................................................84 Cost–Benefit Analysis and Trade-Offs................................................................... 85 Digital Human Models........................................................................................... 86 Anthropometric Scaling Techniques...................................................................... 87 Workstation Design and Reach..........................................................................90 Make Different Sizes......................................................................................... 91 Design Adjustable Products...............................................................................92 System Integration....................................................................................................... 93 Understand the Context of Use...............................................................................94 Design from the “Inside Out” Not the “Outside In”..............................................94 Anthropometry, Workstation Design, and Task Analysis......................................94 Space Planning for Offices..................................................................................... 95 “Fit for Use” Surveys and Acceptance Testing......................................................96 Psychosocial Factors: Anthropometry and Personal Space...................................96 Benefits of Protective Clothing That Fits...............................................................97 Industrial Workplace Layout.................................................................................. 98 Adjustability and Adjustment of Office Furniture............................................. 98 Effectiveness of Office HFE Interventions............................................................99 Status of Anthropometry in HFE...........................................................................99 Research Directions.................................................................................................. 102 Summary................................................................................................................... 102 Tutorial Topics........................................................................................................... 103 Essays and Exercises................................................................................................. 103 Chapter 4 Standing and Sitting at Work.................................................................................... 107 Core Knowledge: Understanding Posture and Movement........................................ 107 Anatomy of Human Posture and Its Evolutionary Origins.................................. 107 Posture............................................................................................................. 110 Fundamental Aspects of Sitting and Standing..................................................... 112 Anatomy of Standing....................................................................................... 112 Basic Applications..................................................................................................... 119 Three Steps to Effective Workstation Design...................................................... 120 Visual Requirements....................................................................................... 120 Postural Requirements..................................................................................... 122 Temporal Requirements................................................................................... 123 Holding Times for Static Postures........................................................................ 124 Standing Aids....................................................................................................... 124 Footrests and Footrails.................................................................................... 124 Anti-fatigue Mats............................................................................................. 125 Compression Stockings and Rubber Floor Mats............................................. 125 Toespace.......................................................................................................... 126 Shoes................................................................................................................ 126 Ergonomics of Seated Work................................................................................. 126 How Does a Lumbar Support Work?............................................................... 126 Adjustable Backrests........................................................................................ 129 Getting the Fit Right............................................................................................. 129 Forward Tilting Seats...................................................................................... 129 Dynamic Postures................................................................................................. 129 Foot Pump Devices.............................................................................................. 130 Visual Display Terminals..................................................................................... 130

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Standing to Work at VDTs................................................................................... 131 Laptops and Tablets.............................................................................................. 131 Guidance for Office Workstation Design............................................................. 132 Forward Tilting Seats........................................................................................... 133 Lumbar Supports.................................................................................................. 133 Dynamic Sitting............................................................................................... 133 Work Surface Design............................................................................................ 134 Mouse-Intensive Tasks.................................................................................... 135 Tools and Processes................................................................................................... 135 Office Environment.............................................................................................. 135 Static Work-Risk Assessment.......................................................................... 137 Rapid Entire Body Assessment............................................................................ 137 Assessment of Working Posture Using Composite Risk Zone Ratings............... 139 Trunk Inclination.................................................................................................. 141 Consulting Users for Furniture Selection: A Structured Approach..................... 142 System Integration..................................................................................................... 148 Analyze Legacy Data........................................................................................... 148 Workstation Design and Viewing Angles............................................................ 149 Systems Furniture................................................................................................. 149 Cost-Benefit and Payback Analysis................................................................. 150 Improvement of Work Conditions of Data Entry Clerks................................. 150 Ergonomics Program in a Large Company..................................................... 150 Training Programs for VDT Ergonomics............................................................ 150 Workstation Design and Viewing Angles............................................................ 151 Research Directions.................................................................................................. 151 Summary................................................................................................................... 151 Tutorial Topics........................................................................................................... 152 Essays and Exercises................................................................................................. 152 Chapter 5 Repetitive Tasks: Risk Assessment and Task Design................................................ 155 Core Knowledge: Functional Anatomy and Epidemiology of Injury Caused byRepetitive Work.................................................................................................... 155 Specific versus Nonspecific WMSDs................................................................... 156 Risk Factors Associated with Pain and Injury................................................ 157 Models of the Development of WMSDs.............................................................. 160 Review of Tissue Pathomechanics and WMSDs................................................. 160 Muscle Pain..................................................................................................... 160 Tendon Pain..................................................................................................... 162 Injuries to the Upper Body at Work..................................................................... 165 Disorders of the Neck...................................................................................... 166 Carpal Tunnel Syndrome...................................................................................... 168 Evidence for Work Relatedness....................................................................... 168 Possible Causal Pathways................................................................................ 168 Tennis Elbow (Epicondylitis)............................................................................... 169 Evidence for Work Relatedness....................................................................... 169 Possible Causal Pathways................................................................................ 170 Disorders of the Shoulder..................................................................................... 170 Evidence for Work Relatedness....................................................................... 170 Possible Causal Pathways................................................................................ 171 Lower Limbs......................................................................................................... 173

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Basic Applications..................................................................................................... 174 Hand Tools............................................................................................................ 174 Handle Design................................................................................................. 174 Limits for Hand/Wrist Exertions in Repetitive Work.......................................... 177 Wrist Flexion and Extension................................................................................ 178 Keyboard Design............................................................................................. 178 Cell phones and E-Games.................................................................................... 181 Cursor Control Devices........................................................................................ 182 Tools and Processes................................................................................................... 183 Identifying Repetitive, Monotonous Work........................................................... 183 The Strain Index (SI): Assessing the Risk of Injury to the Distal Extremities...................................................................................................... 183 Example........................................................................................................... 184 Preventing Overuse of the Thumb........................................................................ 187 Checklists............................................................................................................. 188 Questionnaires...................................................................................................... 188 System Integration..................................................................................................... 188 Effectiveness and Cost Effectiveness................................................................... 194 Productivity and the Use of Bent-Handled Pliers............................................ 195 Managing Musculoskeletal Pain in Aircraft Assembly................................... 195 Reduction of WMSDs at the Ford Motor Company........................................ 195 Controlling WMSDs in the Telecommunications Industry............................. 196 Training to Prevent WMSDs........................................................................... 197 Shorter Workday.............................................................................................. 198 Research Directions.................................................................................................. 198 Summary................................................................................................................... 198 Tutorial Topics........................................................................................................... 198 Essays and Exercises................................................................................................. 199 Chapter 6 Design of Manual Handling and Load Carriage Tasks............................................. 203 Core Knowledge: Functional Anatomy and Biomechanics of Manual Handling and Load Carriage..................................................................................................... 203 Standing and Walking.......................................................................................... 203 Biomechanics of Human Walking (Gait).............................................................204 Postural Control in Dynamic Tasks.....................................................................205 Other Factors Influencing Postural Stability...................................................205 Effects of Age..................................................................................................205 Attentional Demands of Maintaining Posture.....................................................206 Anatomy and Biomechanics of Manual Handling...............................................206 Back Injuries and Lifting and Carrying..........................................................207 Basic Applications.....................................................................................................209 Foot–Floor Interface: Coefficients of Friction for Safety.....................................209 Slips, Trips, and Falls: Catastrophic Failure of the Erect Position.......................209 Preventing Falls from a Height............................................................................. 210 Abdominal Belts for Manual Handling Safety: Health or Hoax..................... 210 Summary......................................................................................................... 212 Precautions....................................................................................................... 213 Training People to Lift “Safely”........................................................................... 213 Why Is Training in Lifting Technique So Often Ineffective? False Assumptions about Manual Handling Safety.................................................. 214 Content of Safety Training Programs.............................................................. 216

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Design of Manual Handing Tasks........................................................................ 216 Task Requirements.......................................................................................... 216 Personal Characteristics of Workers................................................................ 217 Maximum Loads for Lifting and Lowering.................................................... 218 Carrying............................................................................................................... 219 Postural Stability and Postural Control........................................................... 219 Manual Handling Outdoors: Effects of Wind on Postural Stability............... 220 Design of Carrying Tasks................................................................................ 221 Pushing and Pulling............................................................................................. 223 Size–Weight Illusion: Minimize the Amount of Packaging............................224 Tools and Processes...................................................................................................224 Low Back Disorder Models, Risk Assessment, and Task Redesign....................224 The NIOSH Lifting Equation............................................................................... 225 Several Lifting Tasks....................................................................................... 228 Biomechanics of Pushing and Pulling Trucks and Trolleys................................. 231 Implications..................................................................................................... 233 Identify the Risk Factors in Pushing and Pulling................................................ 233 Task-Trolley-Operator Interaction................................................................... 233 Design of Load................................................................................................ 234 Wheels/Castors................................................................................................ 234 Work Environment........................................................................................... 234 Other................................................................................................................ 234 System Integration..................................................................................................... 234 Prevention of Falls................................................................................................ 234 Validity of the Low Back Disorder Model........................................................... 235 Reliability of the NIOSH Equation...................................................................... 235 Validity of the NIOSH Lifting Equation.............................................................. 235 Sensitivity, Diagnosticity, Intrusiveness, and Cost............................................... 235 Effectiveness and Cost Effectiveness................................................................... 236 Does Manual Handling Add Value?................................................................ 236 Basic Ergonomics in Action............................................................................ 236 Research Issues......................................................................................................... 237 Summary................................................................................................................... 238 Tutorial Topics...........................................................................................................240 Essays and Exercises.................................................................................................240 Chapter 7 Work Capacity, Stress, Fatigue, and Recovery.......................................................... 243 Core Knowledge: Fundamentals of Work Physiology.............................................. 243 Muscles, Structure and Function, and Capacity................................................... 243 Energy for Action............................................................................................ 245 Oxygen-Dependent and Oxygen-Independent Systems...................................246 Implications.....................................................................................................246 Efficiency of Muscle Contraction....................................................................246 Muscle Function.............................................................................................. 247 Control of Muscle Function.............................................................................248 Cardiovascular System.........................................................................................248 Blood Pressure................................................................................................. 250 Respiratory System............................................................................................... 250 Physical Work Capacity........................................................................................ 251 Basal Metabolic Rate....................................................................................... 251

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Maximum Oxygen Uptake.............................................................................. 252 Factors Affecting Work Capacity......................................................................... 252 Aging Population............................................................................................. 254 Removal of Waste Products............................................................................. 255 VO2 Max and Fatigue...................................................................................... 255 Stress and Fatigue................................................................................................. 256 Stress................................................................................................................ 256 Fatigue............................................................................................................. 257 Biochemistry and Physiology of the Stress Response..................................... 258 Basic Applications..................................................................................................... 259 Recovery from Work Demands............................................................................ 259 Antecedents of recovery.................................................................................. 259 Immediate Antecedents of Recovery (Initiation of Recovery Process).......... 259 Is Recovery an Automatic Process?.................................................................260 Can Recovery Be Facilitated?.........................................................................260 Dynamics of Recovery.................................................................................... 261 Conceptual Issues in the Identification of Recovery....................................... 261 Tools and Processes................................................................................................... 262 Heart Rate Recovery and Work Intensity............................................................. 262 Cardiac Stress Index............................................................................................. 262 Evaluation of Nonphysical Stress.................................................................... 263 Fatigue and Discomfort........................................................................................264 Fatigue and Pain................................................................................................... 265 Electromyography................................................................................................. 267 Rest Periods for Static Exertions.......................................................................... 269 Absolute VO2........................................................................................................ 269 Indirect Measures of Energy Expenditure........................................................... 269 Assessment of Physical Work Demands: Ambulatory Monitoring................. 271 Aerobic Capacity of U.S. Workers: NIOSH Guideline........................................ 272 VO2 Max and Industrial Work.............................................................................. 272 Subjective Measures of Physical Effort................................................................ 275 Measuring Recovery from Work..................................................................... 276 System Integration..................................................................................................... 277 Effectiveness and Cost Effectiveness................................................................... 277 Evaluation of Job Aids..................................................................................... 278 Productivity Improvements in Developing Countries.......................................... 278 Pedal Power and Its Uses in Developing Countries............................................. 279 Research Issues......................................................................................................... 279 Summary...................................................................................................................280 Tutorial Topics...........................................................................................................280 Essays and Exercises.................................................................................................280 Chapter 8 Job Demands, Health, and Well-Being for a Changing Population.......................... 283 Core Knowledge: Workload, Fitness for Work, and Health...................................... 283 Energy Costs of Physical Activities...................................................................... 283 Fitness for Work................................................................................................... 287 Fitness and Health........................................................................................... 287 Metabolic Demands and Food Consumption....................................................... 287 Physical Inactivity: A Major Challenge to Public Health and Employee Well-Being............................................................................................................ 288

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Insulin Resistance................................................................................................. 288 Type II Diabetes................................................................................................... 289 Defining Overweight and Obesity........................................................................ 290 Changes in Work Capacity................................................................................... 290 Psychological Stress and Health........................................................................... 290 Sleep..................................................................................................................... 291 Sleep Quality................................................................................................... 292 Sleep Inertia..................................................................................................... 293 Circadian Rhythms............................................................................................... 293 The Aging Population........................................................................................... 293 Basic Applications..................................................................................................... 294 Build Movement into Sedentary Jobs................................................................... 294 Exercise Breaks for Visual Display Terminal (VDT) Workers....................... 294 Standing and Moving after Lunch................................................................... 294 Fitting the Job to the Obese Worker..................................................................... 296 Don’t Design an “Obesogenic” Workplace.......................................................... 296 Countering Sleep Disruption................................................................................ 296 Jet Lag.................................................................................................................. 298 Daylight Saving Time........................................................................................... 298 Design of Shiftwork Systems............................................................................... 298 Hours of Work per Day.................................................................................... 299 Hours of Work......................................................................................................300 Accidents and Fatigue.......................................................................................... 301 Regulations Concerning Working Hours........................................................302 Evaluation of Organizational Interventions to Reduce Exposure to Psychosocial Hazards...........................................................................................302 Computer Stress....................................................................................................302 Methods of Reducing Computer Stress........................................................... 303 Tools and Processes................................................................................................... 303 Understanding the Risk: Hazard Ratios............................................................... 303 Assessing Fitness for Work..................................................................................304 Assessment of Physical Work Demands: Ambulatory Monitoring.................304 Quick Activity Checklist......................................................................................307 Assessment of Physical Work Demands: MET Tables.........................................307 Work Ability Index..........................................................................................308 Fitness Apps......................................................................................................... 310 System Integration..................................................................................................... 310 Work Hardening Programs................................................................................... 311 Work Hardening Programs and Rehabilitation............................................... 311 Participation in Decision Making......................................................................... 312 Status of Physiological Methods in Risk Assessment and Task Design.............. 312 Effectiveness and Cost Effectiveness................................................................... 312 Target High-Risk Groups................................................................................. 313 Reduce Long Work Hours and Badly Designed Shift Systems....................... 313 Reduce Psychosocial Hazards......................................................................... 313 Participation, Job Enlargement, and More Control.............................................. 313 Research Issues......................................................................................................... 314 Summary................................................................................................................... 315 Tutorial Topics........................................................................................................... 315 Essays and Exercises................................................................................................. 316

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Chapter 9 Working in Hot and Cold Climates........................................................................... 317 Core Knowledge: Fundamentals of Human Thermoregulation................................ 317 Thermal Balance.................................................................................................. 317 Skin Temperature............................................................................................. 319 Units of Clothing Insulation: Clo.................................................................... 319 Dry Bulb Temperature..................................................................................... 320 Relative Humidity and Wet Bulb Temperature............................................... 320 Globe Temperature.......................................................................................... 321 Thermoregulatory Mechanisms........................................................................... 321 Peripheral Vasomotor Tone............................................................................. 321 Countercurrent Heat Exchange........................................................................ 322 Sweating.......................................................................................................... 322 Shivering.......................................................................................................... 323 Heat Tolerance................................................................................................. 323 Age................................................................................................................... 323 Sex................................................................................................................... 324 Physical Fitness................................................................................................ 324 Body Fat........................................................................................................... 324 Basic Applications..................................................................................................... 324 Work in Hot Climates........................................................................................... 324 Relative Humidity............................................................................................ 324 Heat Acclimatization....................................................................................... 324 Heat Illnesses................................................................................................... 325 Heat Stress Management................................................................................. 326 Work in Cold Climates......................................................................................... 326 Core Temperature in the Cold......................................................................... 327 Peripheral Temperatures and Repetitive Work................................................ 327 Acclimatization to Cold................................................................................... 328 Immersion in Cold Water................................................................................ 328 Perception of Cold........................................................................................... 329 Cold Injury....................................................................................................... 329 Protection against Extreme Climates................................................................... 330 Specify Safe Work–Rest Cycles...................................................................... 330 Design Cool Spots........................................................................................... 330 Issue Protective Clothing................................................................................. 331 Cool the Extremities........................................................................................ 331 Cold Climate Protection.................................................................................. 332 Comfort and the Indoor Climate.......................................................................... 332 Building Design and the Indoor Climate......................................................... 332 Thermal Comfort in Buildings........................................................................ 333 Ventilation............................................................................................................ 335 Thermal Comfort When Sleeping........................................................................ 336 Tools and Processes................................................................................................... 337 Wet Bulb GT Thermometers................................................................................ 337 Measuring Thermal Comfort.......................................................................... 339 Air Movement and Wind Chill........................................................................ 339 System Integration..................................................................................................... 339 Thermal Comfort, Air Quality, and Sick Buildings............................................. 339 ISO Standards.......................................................................................................340

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Status of Methods Used in Risk Assessment and Task Design............................ 342 Limitations of WBGT...................................................................................... 342 Effectiveness and Cost-Effectiveness................................................................... 342 Physical Tasks.................................................................................................. 342 Mental Tasks.................................................................................................... 343 Cost-Effective Interventions............................................................................344 Protection against Heat.................................................................................... 345 Ventilation........................................................................................................ 345 Mobile Workforces: Establishing Safe Systems of Work in the Heat............. 345 Research Directions..................................................................................................346 Summary...................................................................................................................346 Tutorial Topics........................................................................................................... 347 Essays and Exercises................................................................................................. 347 Chapter 10 The Visual Environment: Measurement and Design................................................ 349 Core Knowledge: Fundamentals of Vision and Lighting.......................................... 349 Vision and the Eye................................................................................................ 349 Refractive Apparatus of the Eye........................................................................... 349 Blinking................................................................................................................ 351 Accommodation................................................................................................... 352 Optical Defects................................................................................................ 353 Chromatic Aberration........................................................................................... 354 Convergence......................................................................................................... 355 Resting Posture of the Eye.................................................................................... 355 Retina.................................................................................................................... 356 Melanopsin...................................................................................................... 356 Peripheral Vision and the Visual Field of the Stationary Eye.............................. 356 Retinal Adaptation................................................................................................ 357 Color Vision.......................................................................................................... 358 Color Perception................................................................................................... 359 The Purkinje Shift...........................................................................................360 The Pulfrich Pendulum....................................................................................360 Measurement of Light..........................................................................................360 Derivation of Terms.........................................................................................360 Basic Applications..................................................................................................... 362 General Recommendations for Restful Viewing.................................................. 362 Visual Acuity........................................................................................................ 363 Color and Visual Acuity....................................................................................... 366 Lighting Standards............................................................................................... 366 Contrast and Glare................................................................................................ 368 Visual Fatigue, Eyestrain, and Near Work........................................................... 369 Prevention of Visual and Upper Body Fatigue..................................................... 370 Tools and Processes................................................................................................... 371 Lighting Design Considerations........................................................................... 371 Illumination Levels............................................................................................... 371 Lighting Surveys................................................................................................... 371 Balance of Surface Luminances........................................................................... 371 Avoidance of Glare............................................................................................... 374 Glare and VDTs.................................................................................................... 375 Temporal Uniformity of Lighting......................................................................... 377

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Color Rendering and Artificial Light................................................................... 377 Color Temperature and Color Rendering........................................................ 379 Surveys of Visual Function and VDTs................................................................. 380 Surveying Satisfaction with Lighting.............................................................. 380 Perimetry: Peripheral Vision Testing.............................................................. 381 System Integration..................................................................................................... 382 Psychological Aspects of Indoor Lighting........................................................... 382 Vitamin D and Calcium Metabolism............................................................... 383 Depression............................................................................................................ 383 Status of Methods in Risk Assessment and Task Design..................................... 384 Effectiveness and Cost-Effectiveness................................................................... 384 Effects of Controllable Task Lighting on Productivity........................................ 384 Effects of Rest Breaks on VDT Symptoms and Productivity.............................. 385 Safety.................................................................................................................... 385 Illumination Levels............................................................................................... 386 Lines of Sight and Visual Access......................................................................... 386 Benefits of Exposure to Daylight..................................................................... 387 Target Detection When Driving: Center High-Mounted Brake Lights........... 387 Research Issues......................................................................................................... 388 Summary................................................................................................................... 388 Tutorial Topics........................................................................................................... 388 Essays and Exercises................................................................................................. 389 Chapter 11 Hearing, Sound, Noise, and Vibration...................................................................... 391 Core Knowledge: Hearing and Sound....................................................................... 391 Terminology......................................................................................................... 391 Sound Transmission......................................................................................... 392 Frequency Analysis......................................................................................... 393 The Ear................................................................................................................. 394 Outer Ear......................................................................................................... 394 Middle Ear....................................................................................................... 395 Inner Ear.......................................................................................................... 395 Sensitivity of the Ear....................................................................................... 396 Noise-Induced Pathology of the Ear................................................................ 398 Tinnitus............................................................................................................ 398 Psychosocial Aspects of Noise-Induced Hearing Loss and Hearing Impairment...................................................................................................... 399 Basic Applications.....................................................................................................400 Design of the Acoustic Environment...................................................................400 Specification of Noise Levels at the Design Stage..........................................400 Reverberation................................................................................................... 401 Speech Intelligibility and the Speech Transmission Index.............................402 Auditory Startle Response...............................................................................402 Industrial Noise Control.......................................................................................402 Noise Insulation...............................................................................................404 Screens, Carpets, Curtains, and Tiles.............................................................405 Active Noise Control.......................................................................................405 Noise and Communication...................................................................................405 Outdoor Noise..................................................................................................405 Hearing Protection...............................................................................................406

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Nonlinear Ear Plugs.........................................................................................406 Training in the Use of HPDs...........................................................................408 Tools and Processes...................................................................................................408 Measurement of Sound.........................................................................................408 Speech Interference Level...............................................................................409 Several Sound Sources....................................................................................409 Measuring Noise Exposure.............................................................................. 410 Safe Exposure Levels....................................................................................... 411 Noise Dosimeters............................................................................................. 411 Integrating SL Meters...................................................................................... 414 Noise Surveys.................................................................................................. 414 Vibration............................................................................................................... 419 Human Responses to Vibration....................................................................... 419 Vibration and Back Injury............................................................................... 420 Exposure to Shock................................................................................................ 422 System Integration..................................................................................................... 423 Effects of Noise on Task Performance................................................................. 423 Industrial Music............................................................................................... 423 Nonauditory Effects of Noise on Health.............................................................. 423 Noise and Blood Pressure................................................................................ 424 Noise and Stress............................................................................................... 424 Noise and Satisfaction..................................................................................... 425 Vibration and Health....................................................................................... 426 Prevention of VWF.......................................................................................... 427 Vibration and Public Transport....................................................................... 427 Mitigating Exposure to Vibration and Shock.................................................. 427 Status of Methods in Risk Assessment and Task Design................................ 427 Effectiveness and Cost Effectiveness................................................................... 429 Avoidance of Retrofitting................................................................................. 429 Hearing Conservation Programs Do Work...................................................... 429 Costs and Benefits of Hearing Conservation Programs.................................. 429 Cost Effectiveness of Different Noise Control Strategies............................... 430 Noisy Machines are Often Inefficient Machines............................................. 431 Reduced Noise Improves Productivity and Reduces Absenteeism and Human Error.................................................................................................... 431 Research Issues......................................................................................................... 432 Summary................................................................................................................... 432 Tutorial Topics........................................................................................................... 433 Essays and Exercises................................................................................................. 433 Chapter 12 The Mind at Work: Intention, Action and Interpretation.......................................... 435 Core Knowledge: Processing Information in Everyday Life.................................... 435 Executive Control................................................................................................. 437 Self-Regulation................................................................................................ 438 Self-Regulation and the Role of Glucose......................................................... 438 Fatigue.................................................................................................................. 439 Sustaining Task Performance............................................................................... 439 People Make Errors When System 2 Is Disengaged............................................440 Cognitive Fatigue and Human Performance........................................................ 441

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Basic Applications..................................................................................................... 442 Human Error......................................................................................................... 443 Perception: How the Design of the World Affects the Ease with Which We Interact with It...................................................................................................... 443 Keeping Stuff in Your Head: Paying Attention to Short-Term Memory..............444 Chunking......................................................................................................... 445 Attention: A Usable Resource That Gets Used Up..............................................446 How Many Tasks Can We Do Simultaneously?................................................... 447 Should People Be Allowed to Use Cell Phones While Driving?.........................448 Sustained Attention: Vigilance As a Self-Control Problem.................................449 Aiding Vigilance Task Performance.................................................................... 450 LTM: Our Model of the World............................................................................. 450 How to Make Things Easier to Remember and to Recall.................................... 450 Mnemonics, Verbal Elaborative Processing, and Visual Imagery....................... 451 Visual Imagery................................................................................................ 451 Network Theories of Memory.............................................................................. 452 Relationship between STM and LTM.................................................................. 453 Response Selection and Execution....................................................................... 453 Feedback............................................................................................................... 453 Tools and Processes................................................................................................... 454 Mental Workload.................................................................................................. 454 Factors Affecting Mental Workload................................................................ 455 Modeling the Breakdown of Task Performance................................................... 457 Measuring Mental Workload.................................................................................... 462 Executive Control in Skilled Performance and the “Dysexecutive Syndrome”...464 System Integration..................................................................................................... 467 Behavioral Design: Nudging and Friction............................................................ 467 Learning to Use New Systems.............................................................................469 Massed versus Spaced Practice............................................................................469 Transfer of Learning from One System to Another.............................................469 Demands on Attention of Mobile Electronic Devices.......................................... 470 Preventing Driver Distraction............................................................................... 470 Interacting with Websites Using Passwords......................................................... 471 Attention Restoration Theory: Designing for Recovery of Mental Resources.... 471 Status of Mental Workload Methods Used in Ergonomics.................................. 471 Research Issues......................................................................................................... 472 Summary................................................................................................................... 472 Tutorial Topics........................................................................................................... 473 Essays and Exercises................................................................................................. 473 Pedro Ruiz’s Paella Recipe................................................................................... 474 Chapter 13 Displays and Controls................................................................................................ 477 Core Knowledge: Interaction at the Interface........................................................... 477 Is There Anything There? Signal Detection Theory............................................ 478 Trade-Offs....................................................................................................... 479 Sensitivity........................................................................................................ 479 Reaction Time When a Target Is Detected...........................................................480 Population Stereotypes......................................................................................... 481 Control Order and System Dynamics................................................................... 482

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Automation...................................................................................................... 483 Cursor Control Devices................................................................................... 483 Position Effects When Viewing Simultaneous Displays...................................... 483 Basic Applications: Designing Displays and Controls to Support System 1............ 483 Key Principles for Display Design....................................................................... 483 Design to Promote Figure–Ground Differentiation........................................ 483 Enhance Contours............................................................................................484 Promote Closure..............................................................................................484 Use Skeuomorphs............................................................................................ 486 Grouping.......................................................................................................... 487 Color................................................................................................................ 489 Resolution of Detail: Object Size and Viewing Distance..................................... 490 Color Coding of Dials...................................................................................... 490 Digital Displays............................................................................................... 490 Multiple Displays and Control Rooms............................................................. 491 Guiding Visual Search in Complex Displays....................................................... 492 Maps and Navigation Aids.............................................................................. 492 Three-Dimensional Displays........................................................................... 493 Head-Mounted Displays.................................................................................. 494 HMDs and Space Navigation.......................................................................... 495 Auditory Displays................................................................................................. 495 Synthetic Speech.............................................................................................. 495 Auditory Warnings and Cues.......................................................................... 496 Auditory Cueing in Visual Search................................................................... 497 Advantages of Auditory Displays.................................................................... 497 Voice Warnings................................................................................................ 497 Representational Warnings and Displays........................................................ 498 Auditory Alarms: Compatibility with Other Auditory Displays..................... 498 Haptic (“Tactile”) Displays.............................................................................. 498 Design of Controls................................................................................................ 499 Vehicle Controls.............................................................................................. 499 Control Distinctiveness....................................................................................500 Keyboards........................................................................................................500 Pointing Devices.............................................................................................. 501 Touchscreens.................................................................................................... 503 Voice Control........................................................................................................504 Problems the Voice Recognizer Faces.............................................................504 Hearing Lips and Seeing Voices......................................................................504 Tools and Processes................................................................................................... 505 Avoid Spatial Transformations.............................................................................509 System Integration..................................................................................................... 510 Control Room Design........................................................................................... 510 Displays and Controls in Complex Systems......................................................... 510 Status of Ergonomic Principles Used in Control and Display Design................. 510 Effectiveness and Cost-Effectiveness................................................................... 511 Specialist Soft Keyboards for Improved Productivity.......................................... 511 Warnings............................................................................................................... 512 Research Issues......................................................................................................... 512 Summary................................................................................................................... 513 Tutorial Topics........................................................................................................... 514 Essays and Exercises................................................................................................. 514

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Chapter 14 Interactive Devices and the Internet.......................................................................... 517 Core Knowledge: Usability in a World of Intelligent Devices.................................. 517 Cognitive Systems................................................................................................ 518 Mental Models...................................................................................................... 519 Mental Models of the World Wide Web............................................................... 519 Utility of Mental Models...................................................................................... 521 Gaps in Users’ Models of Search Engines........................................................... 522 Modes................................................................................................................... 522 Automated Systems and Mental Models.............................................................. 523 Designing Language: Principles for Comprehension........................................... 523 Sound and Spelling of Words.......................................................................... 523 Normal Meanings of Words............................................................................ 524 Grammatical Rules for Acceptable Utterances............................................... 524 Metaphorical/Idiomatic Usages....................................................................... 525 Contextual Knowledge.................................................................................... 525 General (World) Knowledge............................................................................ 525 Basic Applications: Supporting System 2 in Everyday Life..................................... 525 Design of Visible Language................................................................................. 525 Few Clauses..................................................................................................... 526 Active versus Passive Voice............................................................................. 526 Negative versus Affirmative Sentences........................................................... 527 Concrete versus Abstract Words...................................................................... 527 Instructions and Warnings.................................................................................... 527 Composite Signs Work Better.............................................................................. 528 Designing Codes and Keywords: Keywords and Names Should Reflect Common Usage.................................................................................................... 529 Design of Alphanumeric Codes....................................................................... 529 Reversal Errors................................................................................................ 529 Code Content................................................................................................... 529 Coding in Errors by Design............................................................................. 530 Communicating with Codes............................................................................ 530 Retrieval Cues for Web Pages.............................................................................. 531 Waiting in the Web: System Response Time........................................................ 531 Designing Icons for Ease of Recognition............................................................. 531 Human–Computer Interaction.............................................................................. 532 Implementation Modes for Human–Computer Interaction............................. 533 Virtual (“Synthetic”) Environments..................................................................... 536 Cyber Sickness................................................................................................. 537 Interacting with VEs........................................................................................ 537 VE Technological Limitations are HFE Issues.................................................... 539 Self-Driving Vehicles........................................................................................... 539 Tools and Processes...................................................................................................540 User Consultation.................................................................................................540 Active Involvement of Users and a ClearUnderstandingoftheUser and Task Requirements.......................................................................................... 541 Measuring the Mind: Psychometrics.................................................................... 543 How Do People Think About Cell Phones?.................................................... 543 Data Reduction................................................................................................544 Reducing the Items and Constructing Composite Scales................................ 545 Internal Reliability........................................................................................... 547

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Benefits of Using Summative Scales............................................................... 547 External Reliability.......................................................................................... 548 Validity and Standardization........................................................................... 554 Usability Questionnaires...................................................................................... 555 Readability Metrics.............................................................................................. 555 System Integration..................................................................................................... 556 Design Goals for Interactive Systems.................................................................. 556 Summary of Design Guidelines for Usability in HCI..................................... 557 Status of Ergonomic Principles Used in Human–Computer Interaction............. 557 Effectiveness and Cost Effectiveness................................................................... 558 If It’s Hard to Read, It’s Hard to Understand and Hard to Do......................... 558 Making Public Information Easy to Understand............................................. 558 Costs and Benefits of Iterative Usability Testing............................................. 560 VEs for Training.............................................................................................. 560 Research Issues......................................................................................................... 561 Summary................................................................................................................... 562 Tutorial Topics........................................................................................................... 563 Essays and Exercises................................................................................................. 563 Chapter 15 HFE in Accident Investigation and Safety Management.......................................... 567 Core Knowledge: HFE and System Safety............................................................... 567 Risks and Hazards................................................................................................ 567 What is Safety?..................................................................................................... 567 HFE and Safety.................................................................................................... 568 Macroergonomics and Swiss Cheese: Looking Backward and Outward............ 569 Bridging the Microergonomics and Macroergonomic Approaches..................... 569 What is “Human Error”?...................................................................................... 569 Error Categorization........................................................................................ 570 Error Production.............................................................................................. 570 Auto-Detection of Error.................................................................................. 571 “Situational Awareness”?..................................................................................... 572 Heuristics and Biases: Making Life Easier for System 2..................................... 574 Recognition...................................................................................................... 574 Take the Best................................................................................................... 574 Choose the Default.......................................................................................... 574 Tallying............................................................................................................ 574 Representativeness........................................................................................... 575 Availability...................................................................................................... 576 Adjustment and Anchoring.............................................................................. 576 The Dunning–Kruger Effect................................................................................ 577 Heuristics and Biases: Pros and Cons.............................................................. 577 Breakdown of Problem-Solving Behavior............................................................ 577 The Psychology of Violations............................................................................... 578 What Determines the Target Level of Risk?................................................... 579 Is There Such a Thing as Accident Proneness?.................................................... 579 Basic Applications..................................................................................................... 580 Microergonomics of Safety: Identifying Risk Factors......................................... 580 No Single Point of Failure.................................................................................... 582 Macroergonomics of Safety: Why Were Risk Factors Present?........................... 584 Improving Safety at the Human–Machine Interface............................................ 585

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Provide Decision Support Systems....................................................................... 585 Training................................................................................................................ 587 Support Problem Solving................................................................................. 588 Tools and Processes................................................................................................... 588 Error or Violation?................................................................................................ 588 Performance Shaping Factors............................................................................... 589 Macroergonomic Investigations........................................................................... 589 Directing Recommendations................................................................................ 590 If Human Factors Contributed to the Accident, What Can We Do to Remove Them to Prevent Recurrence?............................................................ 590 Building Reliability into Systems......................................................................... 591 Problems in Accident Investigation...................................................................... 594 Methods of Data Capture for the Analysis of Cognitive Tasks............................ 597 System Integration..................................................................................................... 598 Safety Culture....................................................................................................... 599 Measurement of Safety Culture.......................................................................600 Safety Culture Maturity.......................................................................................600 Indicators of Safety Culture Maturity............................................................. 601 Cross-Cultural Considerations.............................................................................602 Social Beliefs and Ergonomic Controls...........................................................603 Effectiveness and Cost Effectiveness...................................................................604 Automatic Teller Machines and Human Error................................................604 Incentive Schemes for Health and Safety Promotion...........................................606 Advanced Driver Training....................................................................................606 Research Issues.........................................................................................................607 Summary...................................................................................................................607 Tutorial Topics...........................................................................................................608 Essays and Exercises.................................................................................................608 Chapter 16 System Stability andSustainability........................................................................... 611 Core Knowledge: General Characteristics of Stable and Sustainable Systems........ 611 Humans in Equilibrium with the Rest of the Ecosystem..................................... 611 System Stability.................................................................................................... 612 Inertia............................................................................................................... 612 Resilience......................................................................................................... 612 Succession........................................................................................................ 613 Sensitivity to Feedback.................................................................................... 615 System Evolution............................................................................................. 615 Systems of Systems.............................................................................................. 616 System Sustainability: A User-Centered Approach Is Not Enough..................... 617 Levels of Sustainability................................................................................... 617 Sustainable Organizations Must Be Human-Centered.................................... 617 Basic Applications..................................................................................................... 618 Domestic Energy Consumption............................................................................ 618 Home Heating.................................................................................................. 618 Using Locally Produced Energy...................................................................... 618 Electric Vehicles: Range Anxiety......................................................................... 619 Human-Centered Organizations...................................................................... 620 Overall Design of the Physical Environment.................................................. 620 Psychosocial Environment................................................................................... 620

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Motivation........................................................................................................ 621 Job Enlargement and Job Enrichment............................................................. 621 Job Enrichment................................................................................................ 621 Job Satisfaction................................................................................................ 622 Evidence for the Effectiveness of Job Design...................................................... 623 Aggregate Levels of Job Satisfaction............................................................... 623 Other Psychosocial Stressors and Stress Buffers................................................. 623 General Principles of Stress Management........................................................... 624 New Ways of Working..................................................................................... 625 Tools and Processes................................................................................................... 625 Questionnaire Design in HFE.............................................................................. 625 More about Reliability and Validity..................................................................... 626 Assessing Reliability and Validity: Pilot Studies Are Essential.......................... 627 A Structured Approach to Questionnaire Design................................................ 629 Generation of Items for Questionnaires........................................................... 629 Wording of Items............................................................................................. 629 Sources of Bias in the Design of Experiments, Surveys, and Field Trials........... 632 Subject Reactivity............................................................................................ 632 Experimenter Effects....................................................................................... 633 Placebo Effect.................................................................................................. 633 Reduction of Bias in Field Trials, and Surveys.................................................... 634 Survey Design in HFE.......................................................................................... 634 Sample Size and Participant Response Rates....................................................... 634 Reasons for Nonresponse and How to Improve Response Rates.................... 635 Tactics to Maximize Response Rates.............................................................. 635 Reduction of Bias in Surveys........................................................................... 635 How to Deal with Low Response Rates............................................................... 637 The Deterministic Model................................................................................ 637 The Stochastic Model...................................................................................... 638 Multiple Surveys and Repeats.............................................................................. 639 Computer-Administered Questionnaires and Internet Surveys............................ 639 Big Data................................................................................................................640 System Integration.....................................................................................................640 Economic Growth and Environmental Pressure: Putting HFE “Back intheBox”............................................................................................................ 641 Containerization—A Worked Example........................................................... 642 Influencing What Happens at the End of the Chain............................................. 642 Barriers to Sustainable Behavior: Temporal Discounting.................................... 642 Underweighting the Future.............................................................................. 643 Population Growth and Immigration...................................................................644 Research Directions..................................................................................................644 Summary................................................................................................................... 645 Tutorial Topics........................................................................................................... 645 Essays and Exercises................................................................................................. 645 Appendix A: Probabilities Associated with Values of z in Normal Distribution.................... 649 Glossary......................................................................................................................................... 651 References...................................................................................................................................... 663 Index............................................................................................................................................... 695

Preface My main objective in writing this new edition has been to put Human Factors and Ergonomics (HFE) into a bigger box: to provide first-time students with a greater awareness of the systems context in which HFE is used; systems lifecycle concepts such as the CADMID cycle and to make this book more usable than it was by project teams. To this end, I have added a new Prologue dealing with system concepts and included more material on general aspects of systems design and evaluation throughout this book. Some key concepts in systems thinking are introduced early on and are illustrated using HFE examples including gathering and writing requirements; functional design and allocation of function; and the use of HFE in quality assurance. These ideas have been carried forward into all of the subsequent chapters, such that the reader can learn how to write specific requirements in particular domains and carry out acceptance testing to check whether the requirements have been met.

Systems design Integrate

Validate Human factors and ergonomics

Evaluate

Ameliorate

System operation and management

HFE WORKS BEST IN A BIGGER BOX A human-centered approach has been taken to organize the sequence of chapters in this book, as is illustrated in the model below. This way of presenting the information reflects the maturity of the underlying disciplines as reflected in international standards, where our knowledge within a particular domain is much more developed than our knowledge of the interactions between different domains. The model also serves to organize the chapters in relation to core scientific concepts and their basic applications.

A HUMAN–MACHINE MODEL (ADAPTED FROM PREN 14386: 2002(E) In accordance with the model, there are chapters on body mechanics and dimensions, the senses, human information processing, and so on. The interactions between these elements of the human subsystem and the corresponding controls, displays, and other elements of the technical subsystem are described. Requirements for optimal design of systems are derived from an understanding of the human/technical subsystem interactions between the different elements. Each chapter begins with a list of general human requirements that must be met when a system is designed. These requirements will help HFE specialists put HFE “on the table” early in the design cycle. Within each chapter, the knowledge is organized using the standard model below in order to make it easier for readers to navigate HFE across the core disciplines. xxiii

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Organisation General environment

L E G A L F R A M E W O R K

Lighting; thermal conditions; noise; vibration

Task output (real display)

Sensory mechanisms

Display(s) (artificial) Feedback Control(s)

Force

Central processor Effector mechanisms

Age; training; motivation; mental and physical workload

E C O S Y S T E M

Workplace design; controls and display design; posture Immediate environment

Social environment

System integration Tools and processes Basic applications Core knowledge

STANDARD MODEL FOR THE ORGANIZATION OF HFE MATERIAL IN EVERY CHAPTER Each chapter begins with a review of the core knowledge concerning the particular human elements, the scientific terminology, definitions, units and descriptions, and discussions of human physical and psychological subsystems. Some basic applications of this knowledge are then described followed by the tools and processes and a discussion of some of the wider issues of systems integration, including cost effectiveness and considerations of how the basic concepts of HFE can interact with each other when systems are put together. From the core knowledge and basic applications, requirements can be derived and developed and examples are given throughout this book. The tools and processes can be used for assurance purposes at any point in the system lifecycle, but

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preferably before the system is accepted for use. Cost-effectiveness arguments can be used during the design process and afterward to promote proper integration of HFE into the system and counter the ­arguments that inevitably arise when requirements are “traded-off” against each other. In revising a textbook such as this, a compromise has to be made between presenting the latest research, without knowing how long it will be relevant and preserving the best research of the past without turning this book into a museum. Readers of previous editions will find much that is familiar: a focus on core knowledge across HFE; citations of classic research; examples of statistical; and other methods such as risk assessment tools—all of which are essential and widely used today. Ascore application areas mature and as tools are better validated, the need for lengthy discussions of supportive research diminishes and the need for explanation and validation of methods increases. Similarly, changing content reflects a changing world as the need for material on “information technology” is superseded by the need for more discussion of the Internet and issues such as sustainability; similarly, the traditional emphasis on physically demanding work gives way to the problems of occupational inactivity and associated problems such as obesity.

INSTRUCTOR’S MANUAL, TUTORIAL GUIDE, AND POWER-POINT PRESENTATIONS For instructors, the manual is available from the publisher. This gives advice on the preparation of lectures and demonstrations and it gives the solutions to the problems at the end of the chapters. There is a new “Tutorial Guide” that gives advice for instructor’s wishing to engage with their ­students using the tutorial topics at the end of the chapters. A full set of power point presentations is available from the publisher.

GUIDANCE FOR READERS This book can be used in different ways: as a course text, it can be studied in a linear fashion with students completing some or all of the essays and exercises at the end of each chapter. Chapters can be studied independently to refresh knowledge of particular topics and it can be used as a reference text by professionals seeking examples of assessment tools and methods or in support of HFE requirements or interventions. For this reason, examples of tools, requirements, and so on are embedded throughout the text in the context of the evidence they are derived from. HFE is an applied science that is becoming increasingly important in the design of complex systems. Practitioners need tools to apply the subject and systems developers need assurance that requirements have been met. Overall, I would like to believe that this book sends out a clear message: modern HFE has the knowledge, the tools, and the processes to apply them to support the design of future systems. R. S. Bridger Consultant in Human Factors and Ergonomics Hampshire, United Kingdom www.rsbridger.com August 8, 2017

Author Dr. R. S. Bridger is an independent consultant and educationalist in human factors and ergonomics. He is author of more than 250 articles, conference papers and official reports. He acts as an expert witness in personal injury litigation, provides support in human factors to official inquiries into major accidents and presents workshops and seminars on his work to international audiences. To view Dr. Bridger’s profile and services, and to contact him for further advice, please visit his website: www.rsbridger.com. To discuss academic support, training courses and workshops contact Mrs. B. E. Parodi at [emailprotected].

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Prologue: Human Factors and Ergonomics in Systems Design and Project Management General Requirements for Successful Integration of Human Factors and Ergonomics in Systems Design and Management

1. Develop a Human Factors and Ergonomics (HFE) Integration Plan 2. Specify the Requirements for Humans in Systems to a. Make best use of human capabilities b. Understand and provide for human needs c. Provide mitigation for human limitations d. Use people in ways that maximize system safety e. Use people cost-effectively f. Optimize whole-life costs through the appropriate use of people 3. Understand How to Test Whether Requirements have been met

To think about anything requires a concept or model, not just of the thing itself, but also of the context in which it is being observed. Gharajedaghi, 1985, p. 269

CORE KNOWLEDGE: INTRODUCTION TO SYSTEMS THINKING IN HFE HFE is never applied on its own. HFE specialists work with project and management teams to design new systems or products or to assess and minimize risk in existing systems. For this reason, we will begin this book by looking at HFE in a “bigger box”— as an enabling discipline that helps teams to build better systems and to manage existing systems more effectively. In the subsequent chapters, we will “look inside the box” and learn more about the knowledge and tools of HFE. This opening chapter stands outside the rest of this book, and the rest of this book fits inside it. I’ve called this chapter, the “Prologue,” but you can read it any time you like—but make sure you do read it before you finish the rest of this book or get a job in HFE!

WHAT IS A SYSTEM? There is a difference between a system and an assembly or collection of “things.” Systems are purposeful and their purpose is to deliver capability of some kind. A system is a set of elements, the relations between these elements, and the boundary around them. Most systems consist of people and devices that perform one or more functions (activities) on their inputs to produce some form of output. Inputs are received in the form of matter, energy, and information. All work systems have a physical or functional boundary around them, which separates them from adjacent systems. Systems analysis is the name of the discipline that studies the structure and function of work systems and provides the means by which simple systems may be combined to form more complex systems. Systems analysis is an integral part of all advanced work in HFE. xxix

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(a)

B

E

E H M

H

Simple ergosystems C

E

D M H M M M

E

H H H M H

Complex ergosystems Recycling

Matter Energy

Waste products Rejects Accidents E

By-products

Products Energy (transformation) Knowledge

H M

Outputs

(b)

Information

Recycling

Heat

Injuries Absenteeism

By-products

FIGURE 0.1  (a) A structural ergonomic view of the work system showing the components. The focus is on how the components fit together and interact and (b) a process ergonomic view of the work system. The focus is on system performance parameters such as productivity, capacity, and effectiveness. Note: E, environment; H, human; and M, machine.

When you design a system you design the interactions between the elements as well as the elements themselves (Figure 0.1). Much of the complexity of systems lies in these interactions because there are many more interactions than elements. In Table 0.1, for example, there are six interactions arising from three elements. People are elements in systems (H) and HFE studies the interactions involving people (HE, HM, HH). Complexity arises as we add more elements because the number of interactions increases very quickly. Even in a simple system consisting of one person, one machine, and an environment, six directional interactions are possible (H>M, H>E, M>H, M>E, E>H, E>M), and four of these involve the person. Each of the components of a particular work system may interact either directly or indirectly with the others (Table 0.1). For example, the machine may change the state of the environment (by emitting noise or heat, for example), and this may affect the user.

HFE and Systems HFE is the study of the interactions between people and technology and the factors that affect the interactions. Its purpose is to assure the performance of system so that defined users with defined skills and knowledge can carry out defined tasks, using defined equipment, to defined

Prologue

xxxi

TABLE 0.1 Basic Interactions in a Work System and Their Evaluation H > M: The basic control actions performed by the human on the machine. Application of large forces, “fine tuning” of controls, stocking raw materials, maintenance, etc. Evaluations: Anatomical: Body and limb posture and movement, size of forces, cycle time and frequency of movement, muscular fatigue Physiological: Work rate (oxygen consumption, heart rate), fitness of workforce, physiological fatigue Psychological: Skill requirements, mental workload, parallel/sequential processing of information, compatibility of action modalities H > E: Effects of the human on the local environment. Humans emit heat, noise, carbon dioxide, etc. Evaluations: Physical: Objective measurement of working environment. Implications for compliance with standards M > H: Feedback and display of information. Machine may exert forces on the human due to vibration, acceleration, etc. Machine surfaces may be excessively hot or cold and a threat to the health of the human Evaluations: Anatomical: Design of controls and tools Physical: Objective measurement of vibrations, reaction forces of powered machines, noise, and surface temperatures in the workspace   Physiological: Does sensory feedback exceed physiological thresholds?   Psychological: Application of grouping principles to design of faceplates, panels, and graphic displays. Information load. Compatibility with user expectations M > E: Machine may alter working environment by emitting noise, heat, noxious gases Evaluations: Mainly by industrial/site engineers and industrial hygienists E > H: The environment, in turn, may influence the human’s ability to interact with the machine or to remain part of the work system (due to smoke, noise, heat, etc.) Evaluations:   Physical/physiological: Noise, lighting, and temperature surveys of entire facility E > M: The environment may affect the functioning of the machine. It may cause overheating or freezing of components, for example. Many machines require oxygen to operate. Oxygen is usually regarded as an unlimited and freely available rather than part of the fuel Evaluations: Industrial/site engineers, maintenance personnel, facilities management, etc. Note: E, environment; H, human; M, machine; >, causal direction.

standards under defined conditions. Thus, HFE is concerned with identifying and defining user characteristics; understanding and documenting existing skills and knowledge; designing and understanding the tasks; defining and operationalizing the required level of task performance and understanding the environmental and psychosocial conditions in which work takes place (the “context of use”). Systems can be improved by

1. Designing the user interface to make it more compatible with the task and the user. This makes work easier, can improve efficiency and may render the system more resistant to the kinds of errors which people are known to make. 2. Changing the work environment so that people can work productively and safely. 3. Changing the task to make it more compatible with user characteristics, education, and skills, reducing the need for training. 4. Changing the way work is organized to accommodate people’s psychological and social needs, helping to develop and retain a skilled workforce.

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In order to make these improvements, designers must understand the requirements for usability, safety, and so on, and a large part of this book is devoted to describing the knowledge needed to generate these requirements in detail. The rationale behind requirements and the methods of assurance (confirming that the requirements have been met) are also explained.

HFE and Risk HFE is about managing risk, by designing the hardware and software interfaces and the where and how work takes place, so as to avoid adverse outcomes, such as • Inefficiency—when worker effort produces suboptimal output • Fatigue—in badly designed jobs people tire unnecessarily • Accidents, injuries, and errors—due to hazards such as badly designed interfaces, poor organization, and/or excess stress either mental or physical • User difficulties—due to inappropriate combinations of subtasks making the dialogue/ interaction cumbersome and unnatural • Low morale and apathy

EMERGENT PROPERTIES AND EMERGENT PROBLEMS The Gestalt psychologists of the early twentieth century held that The whole is greater than the sum of its parts

meaning that a system has a capability and properties over and above that of the aggregate capability of its constituent elements—an emergent property. At one level, this is merely a pleasant way of stating the obvious because usually the emergent property is the very reason the system was built in the first place. If the wings fall from an aircraft in flight, it falls to the ground, as do the wings because they cannot fly by themselves either. In practice, integration of elements during systems design gives rise to emergent problems. For example, the solution to a problem in one subsystem may affect the solution to other problems in other subsystems when the subsystems are integrated (Singleton, 1974). Emergent problems are often found at the human interfaces, arising when technical subsystems are integrated with people or teams of people. Designers then have to find a way of solving these emergent problems and can choose from “top-down,” “bottom-up,” and “same-level” interventions or a combination of these (Figure 0.2). Real work systems are hierarchical. This means that the main task is made up of subtasks (the next level down) and is governed by higher level constraints, which manifest as production targets, style of supervision, type of work organization, working hours, shift work, etc. If we want to optimize a task in practice, we can focus on the task itself and redesign it entirely (e.g., automate a manual handling task), or we can change or reorganize the elements of the task (at the next level down), or change the higher level variables (Figure 0.2). For example, to optimize a data entry task we might look at the style of human computer dialogue in use. We might find there are aspects of the dialogue that cause errors to be transmitted to the hardware and change the dialogue to eliminate these errors (e.g., the operator mistakenly reverses two numbers in a code and it is recognized as a different code rather than being rejected—change the codes). Alternatively, we might find there are insufficient rest periods, that most errors occur during the night shift or that the whole system needs reorganizing and new tasks designed. To optimize a manual handling task, we first have to identify the level of the task itself, the next level down (the weight and stability of the load and the container), and the next level up (the workload and work organization). We can either redesign it from the bottom-up (e.g., use lighter containers and stabilize the load) or the top-down (introduce job rotation or more rest periods) or both. At the same time, we can look at extraneous or environmental factors at the level of the task but external to it, factors that also degrade performance (e.g., slippery floors in the lifting example

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Prologue Top-down intervention:

Same level intervention: Improve the environment Redesign the workspace

Task design/redesign

Bottom-up intervention:

Change work organization Change shift system New work roles Job enlargement Task rotation Automate or mechanize process Improve feedback and communication Same level intervention

Change the tools Lower the loads Provide job aids Redesign the layout Improve the displays

FIGURE 0.2  Ergonomic interventions can be carried out at one level or at several levels simultaneously.

or bad lighting and stuffy air in the data entry example). Having carried out an intervention, we then monitor it over time to detect improvements in system performance. In summary, micro ergonomic task design involves one or more of the following: • Design of the procedures (rules and steps that govern how the task is carried out) • Design of the context (workspace and surroundings) • Design or selection of the task objects (equipment and tools used to perform the task) In the wider context, macro ergonomic task design involves one or more of the following: • • • •

Design of work organization (combining small systems into larger systems) Design of jobs (packaging system functions together into jobs) Optimal choice of technology (in relation to the needs of the system and the individual) Work roles, communication, and feedback (information flow throughout the larger system)

In practice, solutions to emergent problems involve trade-offs, which typically involve some consideration of the costs and benefits of meeting HFE requirements. Being effective is not enough and cost-effectiveness is a key criterion of successful systems integration. Fortunately, there is a burgeoning literature on the costs and benefits of ergonomics, with examples at the end of each chapter in this book in the sections on Systems Integration.

DESIGN OF COMPLEX SYSTEMS Complex systems have • • • • •

Long development times Many components and subcomponents “Roles” rather than “people” Iterative “top-down” processes as the system concept develops No “reverse gear”

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TABLE 0.2 HFE in the CADMID Cycle • • • • • •

Conception: statement of system/user requirements Assessment: HFE in design concepts Design: application of HF guidelines and tools Manufacture: build to meet the standards and test for acceptance In-use: identification/solution of operational problems Decommission: plan for safe decommission/disposal

And they are underpinned and constrained by complex contractual and legal processes. Systems engineering provides the overall context for systems design and operation over the life of the system. By “fitting the HFE” to the systems lifecycle the use of expertise in HFE can be optimized (the “CADMID” cycle in Table 0.2).

SYSTEMS ENGINEERING The International Council on Systems Engineering (2014) defines systems engineering as follows: Systems engineering is an interdisciplinary approach and means to enable the realization of successful systems. It focuses on defining customer needs and required functionality early in the development cycle, documenting requirements, then proceeding with design synthesis and system validation while considering the complete problem. Systems engineering integrates all the disciplines and specialty groups into a team effort forming a structured development process that proceeds from concept to production to operation. Systems engineering considers both the business and the technical needs of all customers with the goal of providing a quality product that meets the user needs.

Systems engineering brings together and integrates the knowledge of many other disciplines under a common framework. It takes a “top-down” approach which, in practice, means that it begins with an analysis of the capability to be delivered by the system, the requirements that must be met to deliver the capability and the functions (activities) that must take place to meet the requirements. Table 0.3 summarizes a systems engineering design process and the corresponding HFE activities that should take place at each stage of the process. Note that the activities of other disciplines such as industrial engineering, mechanical and aeronautical engineering, and logistics are also integrated into the Systems engineering process in a similar way. Thus, in complex system development, systems engineering provides the overall context for the application of HFE.

SYSTEMS DESIGN AND HFE According to ISO/DIS 6385 (Ergonomic Principles in the Design of Work Systems), the steps needed for an ergonomic approach to design are • • • • • •

Formulation of the system’s goals Analysis and allocation of functions Design concept Detailed design Realization, implementation, and validation Evaluation

These are described below.

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TABLE 0.3 Stages in a Systems Engineering (SE) Process and Common HFE Activities by Stage SE Stage

HFE Contribution

Identification of capability need/user Concept of operation General system requirements Detailed requirements Functional design Technical design Component integration Unit/device testing Subsystem verification System verification System validation In-use a

Identify users and tasks requirement HFE in mission analysis General human requirements Generate specific HFE requirements Allocation of function Human engineering and ergonomicsa Human engineering and ergonomicsa User trials and workplace design Usability and workload assessment Safety HAZOPS analysis, etc. System-level trials Postinstallation assessment/user feedback

Includes task analysis and application of standards.

Understanding the Context of Use Context of Use is a usability term, used to frame the assessment of the usability of equipment. The context of use is defined within ISO9241-11 and can be considered in terms of • • • •

Users Tasks Equipment Environment

A description of the context of use includes details of the organization, its location, and the physical environment and hardware that will house the new system. The system goals are specified together with the tasks needed to accomplish those goals to ensure that the system has the right level of functionality. Inadequate functionality simply means that the system does not provide all the tools needed to carry out the tasks required to achieve the goals. Excess functionality usually results in unnecessary complexity reflected in excessive learning time; too many ways of carrying out the same task or cluttered displays.

Formulation of Goals and Requirements Specification Deciding what the system has to do is the first stage in design. This often takes the form of a mission statement or a statement of the required capability, and consists of a concise statement of what needs to be done without mention of the means by which it will be done. This is illustrated in the quotation below: This nation should commit itself to achieving the goal, before this decade is out, of landing a man on the Moon and returning him safely to the Earth. President John F. Kennedy, May 25, 1961

This statement is then decomposed into a set of User Requirements (what must happen for the mission to be accomplished) and System Requirements (what the system must deliver in order to meet the user requirement). In the moon mission example above, some key user requirements might be

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User Requirement 1. Send astronaut to the Moon 2. Land on surface 3. Explore locality and collect samples 4. Return astronaut to Earth Examples of Systems Requirements: Level 1 3.1 Provide habitable environment on the surface of the Moon from which exploration can take place 3.2 Provide personal protective clothing (PPC) to protect astronaut while exploring 3.3 Provide vehicle to extend range of surface exploration As the concept develops, more detailed requirements can be derived: Examples of Systems Requirements: Level 2 3.2.1 PPC must enable wearer to walk 3.2.2 PPC must enable wearer to sit and operate exploration vehicle 3.2.3 PPC must provide protection for the duration of a sortie on the Moon’s surface 3.2.4 PPC must be durable At the requirements’ specification stage, the focus is on what is needed, not how it is to be achieved. When existing systems are being upgraded, the requirements may already be known and only the parameter values may need to be changed (e.g., the new requirement is to deliver 100 tons of product per hour, instead of 50). With new systems, information about the performance requirements of the work process may need to be gathered, including information about the role of human operators. In both cases, design should be regarded as an opportunity to solve any existing HFE problems and to avoid generating new ones. Two central issues at this stage concern the choice of techniques used to specify the requirements and the choice of people to sit on the design team. A common mistake is to leave requirements specification to technical managers, engineers, or business experts and ignore the potential contributions of operators or users. This can be avoided using a participatory approach. The involvement of people closer to the actual work situation provides more information because it takes into account the informal structure and actual working arrangements of the organization (how work is really carried out as opposed to how it is supposed to be carried out). Critical information regarding health and safety and productivity may be fed into the requirements at this stage. Systems design is an open-ended process and open-ended methods can be used to gather information for requirements specification. Some examples are given in Table 0.4.

TABLE 0.4 Data Capture Methods for Requirements Specification

1. Analysis of legacy data: safety records, production and performance, maintenance schedules 2. Focus groups 3. Unstructured interviews 4. Structured interviews 5. Unobtrusive observation of the current system 6. Brainstorming sessions 7. Questionnaire surveys 8. Market research 9. Crowdsourcing and serious games

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The idea is not to describe how the system is to work so much as its purpose—what it must do. In the design of a new airplane or motor car the requirements specification is not that the airplane flies or that the car’s wheels stay on but the characteristics of the product with respect to a defined section of the market. For example, the number of passengers the airplane should carry, the routes it would operate, its performance characteristics, fuel consumption, etc. Thus, the requirements for an airplane would be designed through an analysis of the functioning of the parent system—the air transport system. Similarly, the requirements for an electrically powered automobile would be arrived at through an understanding of the personal transport system.

Writing Requirements Well-written requirements are SMART (specific, measureable, achievable, realistic, and timely) • • • • •

Explicit, quantified, and testable Use single-sentence statements Can be prescriptive or proscriptive Do not use narrative descriptive paragraphs other than for contextual and supporting information Define for each requirement: who the owner is, what the need is, how much, in what circ*mstances, and how acceptance is to be tested

In the examples below, some badly written requirements are shown. They are vague, use undefined or poorly defined terms, or are open to interpretation in ways that would make acceptance difficult to test. For example, the first requirement has no definition of usability, who the users are, how usability might be tested, or what the context of use is. The second requirement is badly phrased because 5th and 95th percentile users do not exist and cannot be found to test the system. The “relevance” of any legislation in the third requirement is open to interpretation. SMARTER examples follow. Bad • The system shall be usable • The system shall fit the 5th to the 95th percentile users • The system shall comply with all relevant legislation Better • The system shall be compatible with user training, expectations, and work demands and facilitate the attainment of user goals during the execution of all tasks • Where human physical variability places constraints on the design, the system shall be designed to accommodate the 5th to 95th percentile on all relevant user dimensions for males and females in the user population • The system shall comply with the Control of Vibration at Work Regulations, 2005 under all conditions of use

Generation of Detailed Requirements As the system concept develops, more detailed requirements can be derived from the general requirements above. For example, as the functional design is converted into a technical design, we will gain a better understanding of how human physical variability will place constraints on the solution and the particular anthropometric dimensions that must be accommodated.

Degrees of Compliance The degree of compliance is reflected in the way the requirement is written. The word “must” is used to denote requirements mandated by law, the word “should” is used to reflect requirements mandated by policy, and the word “may” provides discretion for the interpretation of policy.

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Analysis and Allocation of Function A system’s functions are the activities that enable it to produce its outputs. In the case of new systems, they may first have to be identified before they can be allocated to different operators or machines. Functions are often defined in the simplest terms possible, using only one verb and one noun. For a cash withdrawal from an ATM, for example, Enable Transactions • Accept card • Read card • Identify user • Determine user need • Check status (as required by need) • Accept command(s) • Return card • Dispense cash Identification and description of functions: Information on functions can be obtained in several ways. Panel discussions, interviews with users and experts, and observation can provide function-related information. System design methods often stress that initially functions be identified and described in abstract terms. Some advantages of abstract functional thinking (Singleton, 1974) are

1. It encourages the search for new methods. 2. It provides a common language across disciplines. 3. The range of solutions is not limited by particular components or methods.

Avoidance of solution-eering: “Solution-eering” is the practice of deciding upon a technical solution to a problem before the requirements and functions to deliver them have been specified. When designing complex systems, the proper focus should be on requirements, rather than solutions, because complex systems take a long time to build and rapid technological change may render early solutions obsolete. In general, we are not good at predicting the future as is illustrated in the following quotations: • “Man will never reach the moon regardless of all future scientific advances.” Dr. Lee DeForest, Father of Radio & Grandfather of Television. • “Where a calculator like the ENIAC today is equipped with 18,000 vacuum tubes and weighs 30 tons, computers in the future may have only 1000 vacuum tubes and perhaps weight only 1.5 tons.” Hamilton, 1949. • “I think there is a world market for maybe five computers.” Thomas Watson, CE of IBM 1940s. • “640K ought to be enough for anybody.” Bill Gates, 1981 • “There is no reason anyone would want a computer in their home.” Ken Olson, president, chairman and founder of Digital Equipment Corp., 1977. Figure 0.3 shows a product that was developed during the heyday of Victorian inventing. Following the success of a range of products such as steam engines, flush toilets and bicycles, which had made fortunes for their inventors, new products appeared in the absence of any kind of market research. The “Nautilus” rocking and wave bath in Figure 0.3 is an example. Believing that trips to the seaside were healthy, the product was designed to deliver the benefits by bringing the seaside into the home—an example of “solution-eering” a product in search of a market.

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FIGURE 0.3  Seaside at Home? “In this bath the water can be set in motion by rocking, producing a sensation very much like the waves of the sea, which will delight and benefit especially invalids, delicate people and children. Only three pails of cold or hot water are required, and there is no splashing in the room to be apprehended. By placing a wedge under the curve of the back the bath can be made to serve the ordinary purposes of the tub.” The Nautilus wave and rocking bath – a solution in search of a requirement? (Courtesy of Seaside at Home: The “Nautilus” Wave and Rocking Bath, advert from ‘Pick-me-Up’ Magazine, 1891 (http:// Victorianlondon.org)).

Allocation of function: Allocation of function between operators and machines determines the level of automation in a system. In practice, functions usually fall into one of several categories:

1. Those that must be carried out by machines (because it is impossible or unacceptable for humans to do them). 2. Those that must be carried out by humans (because no adequate machines are available or machine execution of function is not appropriate). In general, functions should be allocated to humans if sensitivity to context and change of context is required. 3. Those that might be carried out by either humans or machines or both.

According to Dearden etal. (2000), the goal of allocation of function is to design a system for which the performance is high; the tasks of the operator are achievable and appropriate to the operator’s role; and the development of the system is technically and economically feasible. When allocating functions, then, designers need to consider safety, reliability, and psychosocial factors to arrive at a set of tasks for the operator that will be coherent, consistent, and provide the basis for a satisfying job. Candidate functions for total automation can be selected on the basis of the feasibility and cost of developing automated means of implementing them. The relation of the function to the operator’s role also needs to be considered. According to Dearden etal. functions should be automated if they are separable from the operator’s role and do not interact with it. Functions that are central to the operator’s role, or provide information that critically affects the performance of the role, should not be automated. Workload analysis is a critical part of the function allocation process. Dearden etal. recommend that scenario analysis be used to assess the effects of different allocation strategies on the operator’s workload, awareness of the situation, and performance (including safety and reliability). Under normal conditions of operation, a set of functions allocated to the operator may appear to provide optimal work loading and a coherent and compatible set of tasks. However, under foreseeable emergencies or hazardous states, the workload maybe too high or the tasks incompatible. In such cases, partial or flexible allocation of function maybe needed so that the operator can delegate control of a chosen function to the system for the duration of the problem. Piecemeal allocation of several human functions to one operator can create potentially stressful jobs if there is a conflict between the requirements and responsibilities of the different functions.

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Role ambiguity is an example of a type of job stress in which the worker is unclear about where his real responsibilities lie and what he is really rewarded for by the organization. Role conflict occurs when the successful achievement of one function negates the achievement of another. Function allocation decisions may differ over time, depending on the economic climate and availability of labor, and across cultures. With the advancement of technology, the range of functions that can be allocated to machines has increased and many functions require both people and machines working together.

Sociotechnical Requirements When designing complex systems, we are also designing jobs, relationships between people, and feedback loops between and within levels of an organization. The sociotechnical view takes us beyond allocation of function and the traditional HM interactions of HFE and provides a perspective on the interactions between people in the system (HH). Most human–machine systems are “sociotechnical systems.” There is a technical subsystem (which integrates the machines themselves and the interconnections between them, the infrastructure, power supply, etc.) and a social subsystem (which integrates the activities of the people involved in operating and maintaining the machines and the relationships between them). Work organization is the link between machines and the social organization of the individuals who operate them. The optimal utilization of technology depends on an appropriate system of work organization, which itself determines the social organization of the workforce and the relations and interdependencies between individuals. For example, in a classical production line system of manufacture, workers form a hom*ogenous group in terms of status and skill. The relationship between them is one of linear dependency in one direction (the direction of the production line). Control is exercised by supervisors, foremen, and managers. This can be contrasted with a patient care team in a hospital. Here, the members of the team differ in status, individuals perform different functions, have different expertise, and are mutually interdependent. Individuals can use their own initiative about matters falling within their own area of expertise and can contribute to decision making at the group level. Sociotechnical systems theory was developed by members of the Tavistock Institute of Human Relations in the years following the World War II. Cherns (1976) has summarized the design principles derived from sociotechnical systems theory (Table 0.5).

Design Concept The translation of the requirements specification and the function allocation into a design concept maybe facilitated using brainstorming techniques or structured methods of concept generation techniques, such as value engineering. The concept itself should be detailed enough to describe the structure of the work system and the interactions between the components. Those functions allocated to workers are organized into tasks, roles, and jobs as part of the emerging design concept. The concept is reified, iteratively, using methods such as task description and analysis, the construction of scale models and mock-ups and discussions with users and consultants.

Detailed Design The key to modern systems design is that the human and machine components are designed in parallel to save development time. Traditional ergonomics acts as a link between these activities. It is not necessary for the system to be complete before training and job design can take place. The Apollo space program is an example where all training and development took place off-line using simulators and prototypes. It is during the detailed design phase that jobs are designed, either implicitly or explicitly. Singleton (1974) described how workers have sometimes been thought of as the “elastic glue,” which holds the system together. The operator’s function is simply to do all those things that the machines

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TABLE 0.5 Principles of Sociotechnical Job Design 1. Compatibility. The way that sociotechnical design is carried out must be compatible with the changes that are made. For example, if one of the reasons for change is to make the most of the cognitive skills of the workforce, these skills must be utilized in the process of change itself. 2. Minimal critical specification. In the design of new systems, no more should be specified than is absolutely essential. This leaves individuals with freedom to determine the precise details of how a task is to be carried out. It also leaves open options for change and improvement and enhances adaptability to unanticipated events. Strictly specified rules and procedures can inhibit an organization’s ability to adapt. 3. The sociotechnical criterion. This states that variance in a system (the occurrence of unspecified and unprogrammed events) should be reduced by controlling it as close to its source as possible. Much of the system of supervision, inspection, and maintenance in industry is an attempt to reduce variance from a distance—to correct the consequences of variance rather than control it. If operators carry out their own inspection, the size of the variance control “feedback loop” is reduced. 4. The multi-function principle. This is aimed at increasing the adaptability of the organization by allowing workers to fulfil more than one role, while designing jobs so as to reduce the interchangeability of people. 5. Boundary location. In all organizations, boundaries between different departments have to be drawn up. This is usually on the basis of function, technology, territory, or time. For example, engineering products often pass through several different departments such as milling or grinding shops in the manufacturing process. Of the total time taken to manufacture a product, only a portion is spent with the item in contact with machines. The rest is taken up by transport, storage, etc. An alternative is the “group” or “unit” production method where each department makes a complete product. This approach has been tried in motor car assembly, for example. 6. Information flow. This principle states that information should go where it is needed in the first instance rather than via senior management to subordinates. The tendency for information to “filter down” from above can have disadvantages as well as being inefficient. Managers may become preoccupied with matters for which their subordinates should be responsible. An information system designed according to sociotechnical principles should direct information efficiently to those parts of the organization where it is needed and acted upon. It should also support two-way communication. 7. Support congruence. Administrative and management systems should be designed to reinforce those behaviors that the organization wishes to encourage. If an aim is to encourage employees to take a more responsible attitude to their jobs, then supervision and payment systems should be designed to be congruent with this. 8. Design and human values. This principle emphasizes that systems must be designed to provide high-quality jobs. This is a difficult principle to apply—individuals may respond differently to changes in job design and have different needs. 9. Incompletion. Design never ends. Source: Cherns, A. 1976. Human Relations, 29:783­–792.

cannot do for themselves. Occupational psychologists, however, have proposed alternative ways of designing jobs. Job-centered approaches attempted to optimize the content of jobs so that they will be perceived as satisfying to do. Person-centered approaches are based on the idea that people are motivated to work well if the work satisfies their needs. Thus, it was thought that successful job design required some consideration of people’s needs. The sociotechnical systems approach attempted to optimize the design of a social system of work to support the technical system. These approaches are described in more detail below. ISO 6385 suggests that detailed design should include all of the following: • • • • • •

Design of work organization Design of work tasks Design of jobs Design of the work environment Design of the work equipment, hardware, and software Design of workspaces and workstations

Ergonomic principles for the design of the above are described in this book.

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Realization, Implementation, and Validation Realization involves the procurement and installation of the new system on site. Implementation involves management of the changeover from the old system and introduction and training of operators. If necessary, a temporary back-up system may be installed or there may be a handing over period in which both systems run in parallel. Validation requires that the system be shown to function according to the requirements specified earlier on—that it achieves its goals as intended.

Evaluation Evaluation occurs after the system is up and running. The integration and implementation phase is often characterized by “teething troubles,” which are temporary phenomena, not characteristic of the final design. It is for this reason that in activities such as facilities design, a delay is introduced between implementation and final evaluation. This enables teething troubles to be overcome so that true pros and cons of the facility can be more easily identified. For example, postoccupancy evaluations of new buildings are usually only carried out after 1 year of occupation. Evaluation seeks to determine how well the system achieves its goals in practice. Many criteria can be used in evaluation and these are well summarized by simple human–machine models. For example, evaluations of noise, lighting, temperature, the health and safety of the workforce including the prevalence of any medical conditions, and the occurrence of errors and accidents may all be carried out at this stage.

Safety Safety is dealt with in a later chapter and there is much information in this book that can be used to ensure that systems are safe to use and are used safely. For present purposes, it is sufficient to say that risk in systems design can never be eliminated completely and that the principle of ALARP should apply—risk should be “as low as reasonably practical,” risk must also be considered in relation to hazards—what happens if something goes wrong. The risk of meltdown in a nuclear power station may be very low but the hazards, if it does meltdown, very high (Table 0.6).

Quality Control and Quality Assurance A system is of good quality if it meets the standards that were set at the requirements’ specification stage. A high-quality system is simply one that meets high standards. There is a growing body of standards, such as those of the ISO, quoted throughout this book, which can be used to design systems with high-quality HFE. Quality control takes place throughout the design stage to ensure that all relevant standards are being used as the design progresses. Once the system has been built and is functioning, assessments are made to check compliance. If the system does comply with the ergonomic standards, then we are assured that it is of the appropriate ergonomic quality. Quality control is not possible without reference to some kind of standard. TABLE 0.6 Both Risk and Hazard Must Be Considered in Safety Cases Hazard Minor

Severe

Low

Benign system

Safe system

High

Unstable system

Dangerous system

Risk

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TABLE 0.7 Relationship between User Requirements, System Requirements, and Acceptance Tests User Requirement

System Requirement

Acceptance

1. Minimal effect on agility and joint mobility

1.1 Restriction of joint mobility less than 5% 1.2 No reduction in time to climb test wall 1.3 Comfort in use 1.4 Minimize battery mass 2.1 Controls are operable in extreme climates 2.2 Controls can be operated with finger temperatures of 5°C 2.3 Auditory as well as visual display options 2.4 Interface compatible with past experience 2.5 Easily detachable 3.1 No more than 10% increase in aerobic demands

User trials in testing room Indoor tests on wall User feedback Measurement Climate chamber test Climate chamber test User trials User trials

2. Ease of use in all conditions

3. Minimal effect on sustained performance

Treadmill testing

Acceptance testing is a key quality assurance activity and is part of system verification. In complex systems, it depends on clear traceability of requirements. For example, suppose we want to design wearable information and communications technology for mountaineers and explorers of isolated and extreme environments. The overall capability requirement is to link the explorer to the world wide web for the duration of the mission with minimal physical or psychological intrusion. Clearly, there would be many user requirements over and above access to the web itself. The context of use would demand a high level of resilience because of the mechanical and environmental stressors to which the system was exposed. There would be many user requirements almost all of which would consist of integrating the equipment with the user in the extreme environments both when being worn while other tasks were carried out and when being used (Table 0.7). There are many kinds of acceptance tests that can be used in systems verification. As HFE matures as a discipline, the findings of research become translated into legislation and standards, which greatly simplifies the assurance process. There is a hierarchy of acceptance in terms of the forcefulness of the criteria that apply: • Legal requirements: Does the system comply with the law? • Standards: Does the system comply with standards such as ISO standards? If not, has a case been made and a waiver granted? • Guidelines: Does the system comply with published guidelines on, for example, usability, manual handling of loads, and so on? • Risk assessments: Has risk assessment been conducted using a reliable and valid tool? • Best practice: Does the system comply with best practice in HFE? If not, what mitigation has been put in place? • User trials: Are the findings of user trials favorable? • Experiments (rarely): Experimental research is rarely needed to demonstrate acceptance; except in cases where there is a high level of novelty or exposure to extreme conditions or isolated environment. Acceptance testing is part of system verification and examples of simple methods of acceptance testing are given throughout this book in the worked examples and workshop sections.

MANAGING COMPLEXITY IN HFE HFE is a mature discipline and much of the scientific knowledge is already embedded in existing technology and products. An intelligent design team does not need to know how to design an office

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FIGURE 0.4  A modern office chair that meets the HFE requirements for sedentary work. The “Science of Seating” is embedded in the technology and tested at acceptance. NB. The requirement for sedentary work is considered much earlier in the design process. (Courtesy of Maria Andreu, Herman Miller Inc, 2007.)

chair, for example. It needs to decide whether there is a requirement for sedentary work and, only if there is such a requirement, how to distinguish between appropriate and inappropriate solutions (in Figure 0.4, much of the science of HFE related to seating is already embedded in the product). It can be seen from this example that functional HFE occurs at the requirements specification stage, whereas much of traditional HFE is used for acceptance testing. In effect, the top-down approach of systems engineering combined with the iterative, user-centered approach of HFE enables design teams to take a stepwise approach to the management of complexity.

Trade-Offs, Costs, and Benefits The need for trade-offs is almost inevitable when complex systems are designed, due to the length of the development times, changes to requirements, or the introduction of new requirements. Changes to the external environment may also introduce the need for trade-offs. Although there is a growing literature on HFE in complex systems, less is said about the complex contractual relationships that the design of such systems requires. There is normally a contractual relationship between a “customer” (the organization that wants the system) and the “solution provider” (the organization building it). These parties have the same objective (to build a successful system) but their interests may differ and when this happens it may be reflected in the ways in which requirements are “traded-off” during design. Intangible requirements are likely to be traded-off against more tangible requirements (which is why requirements in HFE must be SMART (written as simply and objectively as possible, with minimal scope for interpretation). Costs may be pushed “downstream” as design and manufacturing costs are traded-off against increased operational and maintenance costs. Instead of high usability and reliability, the system may require ongoing investment in training and maintenance throughout the rest of its life.

Capability and Competence in HFE One way of reducing the likelihood of such trade-offs is for the customer organization to employ its own specialists in HFE to ensure that requirements are properly written and met and also that the solution provider also employs properly qualified people. In the United States, the Human Factors and Ergonomics Society (HFES) has a Board of Certification of Professional Ergonomists (BCPE) and can therefore endorse the competence of its members. In the United Kingdom, the Chartered

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Institute of Ergonomics and Human Factors (CIEHF) has a Royal Charter and has Chartered Members and Fellows with proven competence. In the European Union, there is a Centre for Registration of European Ergonomists (CREE) and the International Ergonomics Association has a list of member societies worldwide that have acceptable professional accreditation procedures. The employment of competent specialists is key to developing effective working relationships in HFE with a clear separation of responsibilities: the customer specifies and owns the requirements and acceptance process and the supplier designs and tests the solution. Once the requirements have been successfully identified, gathered and specified, and communicated to a supplier who understands both HFE and the meaning of the acceptance tests, both then share the responsibility to ensure that the roles assigned to people in the solution enable required system performance to be achieved under all conditions of use.

Systems Evaluation: Key Performance Indicators How will we decide whether our new system was worth the investment? Identification of Key Performance Indicators (KPIs) is essential but can sometimes be problematic. When offices were first automated in the 1970s and 1980s, the intent was to improve productivity. However, most of the traditional KPIs relating to industrial productivity showed no benefits of office automation. Why was this?

1. New technologies take time to mature. Computers were first used to automate existing processes and failed to exploit the advantages of automation. The real benefits lay in using new technologies as a platform for new and better ways of working (as in, “when you automate a mess, you get an automated mess”). 2. Constraints on IT productivity. Initial productivity gains were consumed by the additional costs of owning, maintaining, and replacing technology, which rapidly became obsolete. 3. Underinvestment or misplaced investment. The decisions about how and where to automate offices were influenced by the costs of doing so. Those aspects of the business that were easiest or cheapest to automate may not have been those that would benefit the most from automation. 4. Time lags—new technologies can take time to mature. The real benefits start to appear with the emergence of networks as everyone, including customers and suppliers, starts using the technology. 5. Growth in administrative activity—activity increases to use-up the increased capacity (the new bottle gets filled with old wine). 6. Nonproductive uses of IT include a. Waiting for programs to run or for help to arrive b. Excessive drafting and redrafting c. Computer games d. The Internet. Despite its popularity, the Internet itself consumes time because of its large response time and response time variability—even when used for productive work tasks. e. Overemphasis on quality out of proportion to the value of what is being produced. f. Employees coping with ever more complex programs. Much modern interactive software is “generic” rather than specific. New packages contain ever more features—many of which will only ever be used by a small percentage of users. Lack of a good mapping between the software interface and the user’s work task. Generic software interfaces may not map well onto specific jobs causing unanticipated rigidities and constraints.

The real benefits of office automation were less easy to measure and perhaps related more to better control of quality and work flow and, for many competitive businesses the ability to respond to customer needs, plan ahead more quickly, and to access and process performance data more rapidly.

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A CHECKLIST FOR INTEGRATING HFE INTO SYSTEMS DESIGN It was stated at the beginning of this chapter that the application of HFE does not just happen. It only happens if the right processes are in place to link HFE with what everyone else is doing— to integrate it with the rest of the project team. These processes are often described as Human Factors Integration or HFI and are distinct from HFE itself. HFI is a management process; it does not generate any new knowledge of its own, it is essentially an exercise in knowledge management that ensures that the right knowledge gets used in the right way, at the right time. It can be argued that many examples of badly designed systems, accidents, failures, and so on are not caused by bad design, rather the solution and the knowledge to implement it was there all the time but poor knowledge management and failure to find an exploitation pathway for the knowledge resulted in a suboptimal design. HFI seeks to remedy this state of affairs and the checklist in HFE is givenbelow: 1. Is there a mission statement or statement of what is required and how HFE can contribute? 2. Is the technical subsystem understood (constraints and dependencies)? 3. Is the human subsystem understood (teams, structure, staffing, and skills)? Have users of existing systems been consulted? 4. Has the context of use been defined to enable definition of the required system? Inertia Resilience Scope for succession of elements Feedback 5. Does the project team include a certified specialist to oversee the HFE activities? 6. Has an initial HFE analysis been carried out? Review of current or past systems HFE issues identified HFE process lessons Health hazards 7. Have key HFE activities been integrated into the project planning? Number of specialists required Deadlines and milestones Link with systems engineering process Detailed HFE integration plan: What HF activities will be conducted? When will they be conducted? Who will do the work? How? What assumptions are being made? What constraints will apply? How will progress be monitored? How will the findings be reported? How will trade-offs be managed and resolved? Have human factors activities or inputs been included within project team development activities? 8. Has a forum been defined for discussing and addressing human factors issues between parts of the design team? Are there sufficient resources for specialist human factors activities? Has an HFI risk register been put in place? Does the forum have formal links with the safety management team?

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9. Do project plans, processes, or activities include HFE? Specification of the context of use Inclusion of user requirements in system or project specifications Human factors specialist input to design 10. Is allocation of function considered at the functional design stage? 11. Is there an iterative approach to the integration of HFE involving users? 12. Is consideration of HF regulations, standards, and guidelines mandatory? 13. Has an evaluation, testing, and acceptance plan been formulated? Who will conduct the testing? Will users be involved? Have criteria for acceptance been identified? 14. Have human factors activities been included at each stage of the development lifecycle? Are human factors activities compatible with other development activities in the current development stage? 15. Are the potential impacts of the design of the new system on the rest of the organization understood? Training needs and impact on training budget Human resource requirements, recruitment (availability and cost), and retention of trained employees, redundancies, retraining Long-term organizational objectives and growth, acquisition, and partnership strategies Infrastructure (buildings, IT capacity, bandwidth, etc.) Equipment (availability, cost, procurement timescales, and through-life costs) Information Organization (structure, interfaces with internal and external stakeholders) Logistics (supply chain definition and management) Has mitigation been considered for Are there implications for recruitment of new skills (e.g., availability and cost)? 16. Have the future requirements for decommissioning and disposal been considered? 17. Is there a plan to archive HFE information?

CHECKPOINTS FOR INTEGRATING NEW SYSTEMS INTO ORGANIZATIONS Systems are never designed in a vacuum—they are always part of a larger organization, and project teams must focus not just on how to design a good system but how to integrate it with its parent. Summary questions include the following: • How will the new system be maintained—what additional resources will be needed (supplies, procurement of service contracts, etc.)? • How will the new system be supplied and supported with spare parts and materials? • Will new skills be needed? Will extra staff have to be recruited to operate the system? • How will the new system be monitored? What data will be needed? Will new interfaces with existing information systems be required? • How will the new system be embedded into the organizational structure—what department or group will “own” it? • What personnel, training, and medical aspects should be taken into account in the development and exploitation of technology, now and in the future? How will the training be designed and embedded into careers? • What operational guidance will be needed? What will be the policy regarding usage, safety auditing, record keeping, and so on? • How can more effective ways be developed to understand the through-life cost effectiveness of the system to enable cost-effective delivery of capability?

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Prologue

• How will these considerations change over time with the advent of new technologies and increased human augmentation? • Are there any ethical, legal, or moral issues around the implementation of the new system?

SUMMARY HFE can be used in any stage in a system’s lifecycle: • Reactive HFE: to solve a problem in an existing system using “palliative ergonomics.” • Proactive HFE: to specify HFE requirements in the design of new systems. • Generative HFE: integrate HFE into a larger organizational plan to achieve organizational objectives. In order to utilize HFE most effectively, it has to be integrated with the rest of system design activities and integrated into project planning. In this chapter, we have looked at some of key concepts in Human Factors Integration for complex system design, originally derived from systems engineering. HFE specialists also work in smaller project teams with designers or with health and safety managers. In all cases, though, the activity takes place “in a bigger box” and the main message of this prologue is to show that success depends on integrating HFE activities with the activities of other specialists. Requirements specification is a good place to start, irrespective of the size of the project or the main driver (system design, product design, health, and safety) because it focuses the team on what needs to be done rather than choosing a “solution” prematurely without considering what need the solution will meet or how it will meet it (the mechanism). The organizational requirements determine the target performance of the system. This will be centered on performance metrics concerning output, capacity, processing times for key tasks, and so on. Other requirements will include health and safety, training times, workstation design and implementation, and running costs. Design solutions are produced iteratively to obtain feedback from multidisciplinary groups. Concrete proposals using mock-ups, storyboards, sample screens, etc. are presented first. Users are allowed to perform simulated tasks at the early stages of design and real tasks, once working prototypes have been developed. The design is modified in accordance with feedback received and the process is managed, often by the HFE specialist. Evaluation should begin as early as possible in the design process. In general, changes are less costly to make at the early, rather than the later stages. Although early evaluations using crude mock-ups may lack realism, large savings can be made. Evaluation is centered on how well the proposed design will enable the goals to be achieved in relation to the performance metrics. Some assessment criteria are that commands function as specified, that the data base is secure and with modern systems, and that WYSIWYG applies (that “what you see is what you get”). We have also looked at some of the processes and activities that HFE specialists must carry out in order to be effective team members: • Determine capability need (user requirement for HFE) • Learn from user experiences of legacy systems to strengthen the link between design and operation (consult operators and learn from users) • Gather and write system requirements for HFE (what needs to be done?) • Evaluate supplier capabilities in HFE (who is qualified to deliver it?) • Develop and assess system concepts • Derive detailed requirements from generic requirements as the systems concept develops. At the same time, develop acceptance criteria (what exactly needs to be done and how will we ensure that it has been done?) • Evaluate prototypes

Prologue

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• Verify system—conduct acceptance tests (traditional ergonomics) • Validate system (does it actually work when you put it all together?) In the next chapter, we will review HFE, its history and current scope, and look at some basic HFE tools.

TUTORIAL TOPICS

1. HFE can be studied as a stand-alone discipline but can never be applied this way. 2. What is the difference between a system and a collection of objects? 3. Old people living alone. Your task is to consider the problem from the perspective of the agencies responsible for the care and well-being of older people and to • Write, in one sentence, a single statement of user-need (SSUN) from which the necessary capability can be delivered. Derive the “user requirements” the solution must meet. Derive the system requirements—what the system must do to satisfy the user requirements • Describe, in general terms, any acceptance tests You should take a systems approach and aim to develop a set of overarching requirements that can be used to build an integrated solution. The solution might be technology, people, or a combination of the two. * Hint: A user requirement may need to be met with several system requirements and vice versa.

Problems of Old People Living Alone

1. People who live alone are more likely to be poor, and poverty is increasingly more likely the longer they live alone 2. Many older people who live alone say they feel lonely and isolated 3. Because eating is a social activity for most people, some older people who live alone do not prepare full, balanced meals. Thus, undernutrition becomes a concern 4. Among people with health problems or difficulty seeing or hearing, it is all too easy for new or worsening symptoms of disease to go unnoticed 5. Many older people who live alone have problems following directions for prescribed treatments 6. Medication management issues 7. Poor eyesight 8. Social isolation 9. Forgetting appointments 10. Unable to keep up with daily chores and housekeeping 11. Poor nutrition or malnutrition 12. Home safety hazards such as poor lighting and loose carpeting 13. Unable to pay bills on time

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Human Factors and Ergonomics from the Earliest Times to the Present

General Requirements for Humans in Systems 1.1 Equipment is operable and safe 1.2 Tasks are compatible with people’s expectations limitations and training 1.3 An environment that is comfortable and appropriate for the task 1.4 Job aids and training are appropriate to the work 1.5 A system of work organization that recognizes peoples’ social and economic needs In the past, the man has been first; in the future, the system must be first. Taylor, 1911

CORE KNOWLEDGE: UNDERSTANDING HUMAN FACTORS AND ERGONOMICS Every time we use a tool or a machine we interact with it via an interface (a handle, a steering wheel, a computer keyboard and mouse, etc.). The core knowledge of HFE describes how best to design tools and machines in order to optimize these interactions and also the effect of the ambient environmental conditions when the interaction takes place. The aim is to maximize compatibility between system components with the main focus on the user.

Compatibility: Matching Demands to Capabilities Compatibility between the user and the rest of the system can be achieved at a number of levels: biomechanical, anatomical, physiological, behavioral, and cognitive levels. In order to achieve compatibility, we need to assess the demands placed by the technological and environmental constraints and weigh them against the capabilities of the users. The database of modern HFE contains much information on the capabilities and characteristics of people, and one of the main purposes of this book is to introduce the reader to this information and show how it can be used in practice. Poor system functioning can be caused by a lack of compatibility in some or all of the interactions involving the human operator. This incompatibility can occur due to a variety of reasons. For example, • Human requirements for optimum system functioning were never considered at the design stage (a failure to integrate HFE in the design process). • Inappropriate task design (e.g., new devices introduce unexpected changes in the way tasks are carried out and these are incompatible with user knowledge, habits, or capacity or they are incompatible with other tasks)—essentially a failure of succession. • Lack of prototyping (e.g., modern software development is successful because it is highly iterative. Users are consulted from the conceptual stage right through to preproduction prototypes). 1

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Introduction to Human Factors and Ergonomics

Brief History of Ergonomics Ergonomics came about as a response to the design and operational problems presented by technological advances in the twentieth century. It is a hybrid discipline that emerged when applied scientists came together to solve complex cross-disciplinary problems, and it owes its development to the same historical processes that gave rise to other disciplines such as industrial engineering and occupational medicine. The core sciences from which ergonomics is drawn are as follows: • • • • •

Psychology Anatomy Physiology Physics (particularly mechanics and environmental physics) Engineering

It has also been heavily influenced by other emergent disciplines, notably, • Industrial engineering • Industrial design • Systems theory

Scientific Management and Work Study Scientific management, developed by Taylor, and work study, developed by the Gilbreths, are precursors of ergonomics. Both were developed at the beginning of the twentieth century and were based on the realization that productivity could be improved by redesigning the way work was done and not just by using better machines. Taylor (1911) was a mechanical engineer who is famous for his book, The Principles of Scientific Management (although he also wrote a book about concrete, for which he is not famous). Scientific management was a reaction against the prevalent management methods inherited from the Victorians. Factory owners supplied premises, power, raw materials, etc., and hired foremen to organize the work. These foremen acted rather like subcontractors and were left to themselves to organize the basic industrial tasks as best they could. Management was concerned only with output and had just a global notion of productivity, regarding the work itself with disdain. Incentives were provided for employees to suggest improvements and profits depended on getting a “good man” in to organize the workers. Taylor realized that there were many drawbacks to this “incentive and initiative” style of management. Nobody was directly responsible for productivity and the system was open to corruption and exploitation of workers. Weekly “kickbacks” to supervisors were common as was the sexual harassment of women workers (Stagner, 1982). There were few formal ways of generating better designs of systems or work procedures or of evaluating current practice on a day-to-day basis. Workers, by being too narrowly focused on carrying out daily work activities, might be unaware of the scope for improvement through the implementation of new methods, or even unaware of the methods themselves. They might be unwilling to suggest changes that might be in the best interests of the company, but not in their own best interests. Management, on the other hand, through its failure to focus on the way basic tasks were carried out, was incapable of maximizing productivity. As Taylor, himself, put it (1911, p. 7): … the remedy for this inefficiency lies in systematic management, rather than in searching for some unusual or extraordinary man.

Taylor emphasized that every job, no matter how small, was worthy of study and improvement. Furthermore, he emphasized that it was management’s responsibility to see that this was done in order to maximize returns, for the financial benefit of the company, its shareholders, and its employees. In practice, tasks were to be broken down into their simplest possible form, and by introducing

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Human Factors and Ergonomics from the Earliest Times to the Present

an appropriate bonus scheme, it was assumed that workers would maximize their output. Production targets were set in advance and production closely monitored. Workers lost what little autonomy and control they may have had and were reduced to carrying out mundane and highly repetitive tasks throughout the day. One of the main lessons to be learned from the writings of F.W. Taylor is that it is management’s job to manage and this means having formal systems in place to monitor working practices and their relationship to productivity. However, there are many criticisms on Taylor’s approach—the social aspects of work and the intrinsic satisfaction that could be gleaned from carrying out work tasks were ignored. A more fundamental criticism though is that throughout Taylor’s writings, he assumes that all parties in an industry can and do have the same interests. It is assumed that all will cooperate to maximize their own economic returns: Scientific management, on the contrary, has for its very foundation the firm conviction that they (i.e.,theinterests of employer and employee) are one and the same. Taylor, 1911

Clearly, the interests of the management and workers are not the same. One of management’s main goals is to maximize profits for shareholders and one of the best ways to do this is to minimize the cost of labor. This is as true today as it was in Taylor’s time—witness the modern trend for companies to outsource functions such as software design and departments, such as call centers, to developing countries where the cost of labor and the regulatory burden are lower. This conflict of interest between management and workers had implications for the way Taylor’s ideas were implemented. It also provided the impetus for the infamous “Hawthorne experiments.” Work study was developed by the Gilbreths at around the same time. They developed methods for analyzing and evaluating the way tasks were performed. A task would be broken down into “elements”—the basic movements and procedures required to perform it. Inefficient or redundant movements would be eliminated. By redesigning and reconfiguring the remaining elements, productivity was enhanced. Work study and scientific management were the forerunners of motion and time study and human engineering. Companies employed a new breed of specialists to investigate human–machine interaction and to design tasks. Working practices were no longer assumed to be at the worker’s discretion or determined by tradition or technology, but were regarded as something to be bought under management control. This change in outlook was an essential requirement for the introduction of mass assembly and production line techniques. Time and motion study (methods engineering) can be criticized on many grounds; for example, that it only looks at the superficial features of task performance, it makes unwarranted assumptions about people, and it is little more than common sense. Many have argued that Taylorism succeeded in “de-skilling” craftsmen and created mundane, repetitive jobs. An alternative view is that it was the reengineering of products for mass production that really de-skilled the Victorian craftsmen, giving rise to a whole generation of mass-produced products that were increasingly affordable by large numbers of people, including those who produced them. To the modern consumer, the idea that products such as toothbrushes or personal consumer electronic devices should be assembled using craft skills seems absurd. Taylorism had many advantages for management: 1. Greater flexibility in allocating operators to easily learnt tasks. 2. Fewer skilled workers were needed. Skill shortages were avoided and training costs and wages could be more easily contained. 3. Introduction of paced work enabled production schedules to be more rigorously quantified. Better predictions of output could be made. 4. If everyone worked at the same pace, the result was always a finished product.

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Introduction to Human Factors and Ergonomics

Human Relations and Occupational Psychology Occupational psychology developed in the 1920s and 1930s. The essence of Taylorism had been to regard the worker as an isolated individual whose output was determined by physical factors such as fatigue, poor job design, and economic incentives. A job would be redesigned to make it as simple as possible to learn and to perform. A production standard and rate of pay would be set and a bonus scheme introduced as an incentive for workers to produce more than the standard. It was assumed that “rational economic men” would maximize their productivity to maximize the bonus. The social context in which work took place was ignored. Despite its advantages, Taylorism also presented management with a dilemma. Continually increasing productivity had to be met with continual increases in pay. To avoid this, new techniques were employed. New and higher production standards were introduced whenever sustained increases in output were achieved; bonuses only being paid when the new standard was exceeded. Not surprisingly, workers reacted by restricting their output to prevent the standard being raised and placed social pressure on “rate-busters.”

Hawthorne Experiments In the 1920s and early 1930s, a series of experiments were carried out over a period of 12 years by Elton Mayo and his colleagues at the Hawthorne Works of the Western Electric Company in the United States. The experiments are of historical interest more for their influence, which was to draw attention to social factors at work, than for their findings. The investigators began by examining the effects of illumination, rest pauses, and shorter hours on productivity and fatigue but soon ran into difficulties because they were … trying to maintain a controlled experiment in which they could test for the effects of single variables while holding all other factors constant … . By Period XIII it had become evident that in human situations, not only was it practically impossible to keep all other factors constant but trying to do so in itself introduced the biggest change of all; in other words, the investigators had not been studying an ordinary shop situation but a socially contrived situation of their own making. Rothlisberger and Dickson, 1939

The most often quoted experiment concerned a relay assembly task. The experimenters began by manipulating the lighting levels to observe the effect on output. Unexpectedly, it was found that output increased even when the illumination was reduced. This result is the basis of belief in the “Hawthorne effect” and is used as evidence for the importance of social rather than physical factors in determining worker performance. The usual interpretation is that the changes in lighting levels reminded workers that they were in an experiment, being observed, and that this motivated them to work harder. The Hawthorne experiments earned their place in history, ushering in a new era of research into human relations in the workplace and drawing attention to the importance of social and personal determinants of worker behavior. However, the experiments themselves and their interpretation have always been controversial. Gilson, in 1946, after berating the researchers for failing to“acquaintthemselves with the experience of others before they began their experiment” put it this way: The elaborate charts indicating production curves of five segregated workers mean little or nothing because the effect of various factors in relation to outside episodes cannot be estimated and because the sample is inadequate … . The question, “Which would you like better, a man or a woman supervisor?” brought an almost unanimous vote for a man, which, considering the fact that it was put to only five girls and a man was supervising the investigation, has doubtful significance … . Someday a study should be made of “Researches into the Obvious Financed by Big Business.”

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5

Gillespie (1991) provides fascinating insights into the historical context of the Hawthorne experiments and the motives of the principal players, particularly Elton Mayo. Mayo had been impressed by the advances in industrial efficiency brought about by engineering and by the introduction of mass production methods. He had also been impressed by the work of Sigmund Freud, in particular Freud’s writings on the Psychopathology of Everyday Life, and had formed the opinion that uncooperative workers were suffering from a kind of psychopathology amenable to treatment. These ideas were behind his interest in human relations in the workplace and his belief that the next wave of productivity increases would be achieved using psychological techniques, rather than economic incentives, to motivate workers and to prevent industrial discord fueled by “futile hatreds and strife.” The possibility that productivity might be increased by manipulating the social environment rather than by paying workers more money was obviously attractive to Western Electric management, although there is scant evidence that the Hawthorne experiments provided any support for these claims. Hawthorne effect: The Hawthorne effect is a myth that is often mistaken for a fact. There is no standard definition. Sundstrom defined it as “the motivating effect of being observed” and Kroemer as the fact that people behave differently when they know they are in an experiment. The term was coined by French (1953), referring to the Hawthorne experiments as follows: From a methodological point of view, the most interesting finding was what one may call the “Hawthorne effect—a marked increase in production related only to special social position and social treatment.”

Many have challenged such interpretations of the Hawthorne experiments and called into question the existence of any “Hawthorne effect.” Parsons (1974) reviewed the experimental procedures at Hawthorne and proposed that the increase in productivity, although still an artifact of the experimental situation, was due to changes in the way bonuses were paid and the provision of performance feedback. Instead of receiving a bonus on the basis of the output of a department of 100 workers, the five workers in the experimental test room received a bonus on the basis of the output of their own group. Furthermore, feedback on output was collected and displayed continuously, giving the workers accurate information on their performance at any time. Parsons interpreted the productivity increase as nothing more than operant conditioning of the workers. The Hawthorne researchers had, unwittingly, created the ideal conditions for skill acquisition. Parsons redefined the Hawthorne effect as, “the confounding that occurs if experimenters fail to realize how the consequences of subjects’ performance affect what subjects do.” Franke and Kaul (1978) reanalyzed the data from the Hawthorne experiments using multiple regression analysis. Contrary to the Hawthorne experimenters view that the increase in output was difficult to explain without considering the “human relations” between supervisors, workers, and the experimenters themselves, they found that 90% of the variance in the output data could indeed be accounted for. Most of the variance was accounted for by the imposition of managerial discipline, economic adversity (the work took place during the economic depression of the 1930s and improvements in the quality of raw materials). There was also evidence that fatigue reduction, through the design of rest periods and the economic incentives of the new bonus scheme, also increased output. The paradox of Hawthorne is that the improvements in output were attributed, at the time, to better “human relations,” although the researchers made no attempt to measure these “human relations.” More conventional explanations such as better work organization, better economic incentives, and good industrial engineering, were discounted and, even though these variables were measured, the appropriate analyses of the data were not done. Reanalysis by Franke and Kaul, 40years later, demonstrated that very little of the variance in output could not be explained by the more mundane, some would say “Tayloristic,” changes to work practices that the researchers made when setting up the experiment. The Hawthorne effect fails the repeatability test. Rubeck (1975) described field trials of teaching carried out to determine whether performance would improve if students knew they were in an

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Introduction to Human Factors and Ergonomics

experiment. The results were negative—there was no evidence to show that telling students that they were subjects in an experiment on teaching methods had any effect on their performance in reading or mathematics. Kompier (2006) launched a stinging attack on the Hawthorne myth and on those who perpetuate it. His is the latest in a long series of articles that have analyzed the original reports and concluded that there is no evidence for the existence of any Hawthorne effect. It is indeed remarkable that the term, derived from 80-year-old experiments lacking both control groups and with insufficient statistical power to demonstrate anything at all, should continue to be quoted in the twenty-first century. Kompier offers the following explanations for “what keeps the story going”: • Students are often taught about it at the beginning of their courses and remember it due to the primacy effect (see Chapter 12). Any story in which workers improve their output irrespective of working conditions and pay is too good not to be true. • The original researchers, particularly Mayo, were selective in the presentation of their data. Subsequent researchers never checked the original reports. A similar observation might be made about those who make disparaging remarks about the work of FW Taylor— few have ever read anything written by the man himself. • The Hawthorne researchers wanted to demonstrate a link between social science and everyday working life and were loath to cite evidence that might weaken their arguments. • The story is in accord with the cognitive world and interests of psychologists. Psychologists tend to be the main peddlers of the Hawthorne myth, because they have a vested interest in seeing it perpetuated (management will make more use of their services if social and interpersonal factors are perceived to be important). • The story is in accord with the cognitive world and interests of management. If social factors are so important in determining productivity, then there is no need to improve working conditions or pay. One of the immediate consequences of Mayo’s experiments was the introduction of a personnel counseling service at the factory. In 1950, Western Electric employed 20,000 workers at Hawthorne and had a counseling department of about 40 people who interviewed over half the worker force over a 10-year period. The method used was nondirective, confidential, and neutral, similar in some ways to the client-centered psychotherapy of Carl Rogers, which dates from the same era. The costs and benefits of the service do not seem to have been assessed, although Wilensky and Wilensky (1951) concluded that counseling appeared to be effective as a supplementary means of exerting management control over workers, by draining off resentment and bitterness that might otherwise have gained expression through militant unionism. Some have claimed that the counseling service was really a kind of surreptitious continuous attitude survey that enabled management to preempt and deal with industrial relations problems. Again, Gilson (1946), put it this way: From 1933 to 1936 the Western Electric Company paid out $25,825.76 for espionage. The interviewers who engaged in “counselling” service subsequent to the interviewing experiment of 1928–31 surely must have had some echoes of dissatisfaction due to lack of recognition of unions. We know of no instance where spies have been employed without some fear of unionism on the part of management … . We are also surprised that in twenty thousand interviews the workers are reported to have “criticized the company in no instance.”

Sociotechnical Systems Theory Sociotechnical systems theory emerged in the United Kingdom after World War II. Trist and Bamforth (1951) investigated the social and psychological consequences of mechanized coal mining in the context of a reportedly higher incidence of psychosomatic disorders among miners working

Human Factors and Ergonomics from the Earliest Times to the Present

7

under mechanized conditions. They pointed out that the mechanized method owed its origins and scale to the factory floor rather than to coal mines. In coal mines, a different form of social organization was necessary because of the intrinsically unpredictable nature of the working environment in a mine compared to a factory. The organization of technology, the social organization, and the local environment had to be seen as interconnected and designed to be mutually compatible if low productivity and pathological and psychological stresses were to be avoided.

Participation The idea that workers should participate in decisions about work dates from the same era. Coch and French Jr. (1948) carried out an investigation of participation in a U.S. pajama factory staffed by young, unskilled women. Staff turnover was high and workers were paid on the basis of individual performance. Management collaborated with two sociologists in an attempt to deal with the problems. Unusually for such studies, it was possible to introduce a degree of experimental control with a control group, where change was introduced by management without the involvement of employees, a “representative group,” where change was introduced after discussions with employee representatives and a “total participation” group in which all employees were involved. Production fell by 10%–20% in the control group immediately after the change, whereas it was maintained in the representative group, rising 10%–15% after a few weeks. In the participation group, production rose immediately and the gains were maintained for several months. It was argued that the participatory approach had produced better group cohesion, which countered any frustrations bought about during the change and that people will accept change more readily if they feel they have some control over its effects. If this explanation is correct, then participation has to become an established management process if its benefits are to be sustained.

Occupational Medicine Occupational medicine had its origins in the eighteenth century when Ramazini (1717) wrote his Treatise on the Diseases of Tradesmen but became more formalized at the beginning of the twentieth century. Around 1914–1918, a number of government institutions were founded in Britain as interest in working conditions spread to scientists and medical doctors. The Health and Munitions Workers Committee studied conditions in munitions factories and the factors influencing productivity such as the length of the working day. It subsequently became the Industrial Health Research Board and its area of interest was fairly wide covering ventilation, the effects of heat, and shift work and training. Recommendations were made at about this time for a variety of aspects of industrial work including the types of food served in factory canteens, taking into account the likely nutritional deficiencies of the workforce and the demands of work. This was appropriate in Britain in the early years of the twentieth century and is still appropriate in developing countries today. Attention was also directed at fatigue and the problems of repetitive work. Vernon (1924) investigated postural and workspace factors related to fatigue and concluded that Any form of physical activity will lead to fatigue if it is unvarying and constant.

It is from foundations such as these that industrial physiology and occupational health have arisen (it is surprising, given the current high incidence of cumulative trauma disorders, how few industries have acted upon Vernon’s conclusion).

Human Performance Psychology Human performance psychology had its roots in the practical problem of how to reduce the time taken to train a worker to carry out a task. Taylor and the Gilbreths had gone some way to the solution of this problem by simplifying tasks. However, the emergence of new, more complex machines

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Introduction to Human Factors and Ergonomics

and manufacturing processes created new jobs whose skill requirements could not be met from the existing labor pool. Traditional methods of training (such as apprenticeship to a skilled craftsman and “sitting by Nellie”) were not always appropriate to the industrial system with its fundamental requirement to standardize all aspects of the production process. Psychologists began investigating the variables influencing the learning of work skills, for example, whether tasks should be broken down into elements to be learnt separately and then bought together, the advantages and disadvantages of “massed” versus “spaced” practice, and the duration of rest periods. After World War II, interest in training continued. The cybernetic approach investigated the use of feedback (knowledge of results) and its effects on learning. The theoretical ideas of Skinner and the behaviorist school of psychology were implemented in the form of “programmed learning.” Behaviorism saw learning as the chaining together of stimulus–response pairs under the control of reinforcing, or rewarding stimuli from the environment. In programmed learning, the material to be learnt was presented in a stepwise fashion and the order of presentation of information to be learned was determined by whether the trainees’ previous responses were correct or incorrect. The pressure for the productive and efficient use of machines was amplified by the demands of World War II and brought psychologists into direct contact with the problems of human–machine interaction. The famous Cambridge psychologist Sir Frederick Bartlett built a simulator of the Spitfire aircraft and investigated the effects of stress and fatigue on pilot behavior. This led to an increased understanding of individual differences in response to stress and enabled the breakdown of skilled performance to be described in psychological, rather than machine-based terms. Perceptual narrowing, which occurs as a result of fatigue or as a maladaptive response to severe stress, is an example. Craik studied a class of tasks known as “tracking tasks” (which involve following a target as in gunnery or steering a vehicle). The beginnings of user-interface (display and control) design emerged from this in the form of recommendations for gear ratios and lever sizes. This became an important area of ergonomics, particularly in postwar military applications and also in civilian vehicle design and the aerospace industry.

Operations Research Operations research attempts to build mathematical models of industrial processes. It was also stimulated to grow by the demands for prediction and control brought about to satisfy the requirements of the military during World War II. It had become clear that further advances in system performance would depend on how well technology was used, not just how well it was designed. This shift in attention from the machine to the man–machine system gave birth to the field of ergonomics.

Fit the Man to the Job versus Fitting the Job to the Man A number of general trends can be identified in the historical review. First, organizations attempted to increase their productivity by introducing new methods and machines. In the era of pure engineering, this worked because great improvements in machine design were possible (many existing processes had not been mechanized at all until then). Second, attempts to increase productivity tried to optimize the design of tasks to minimize apparently unproductive effort. After World War I, a movement arose stimulated by the development of psychometric testing, which tried to develop tools to objectively measure various human characteristics such as intelligence or personality. Attempts to “fit the man to the job” (FMJ) were based on the idea that “productivity or efficiency could be improved by selecting workers with the right aptitudes” for a particular job. This approach, which forms one of the roots of modern occupational psychology, is based on the assumption thatimportant aptitudes for any particular job really do exist and that they can be identified and objectively measured. This is certainly true in the sense of selecting people with formal qualifications or skills to fill particular posts and there is plenty of evidence that it is cost effective (see Anastasi, 1990).

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It is also true for some jobs—even today firemen, lifesavers, and those working in the armed services are restricted to individuals with certain specific aptitudes and physical characteristics. Historically, anthropometric selection criteria were made use of. Stature is generally a good surrogate measure for strength and size. However, due to changes in labor legislation and the increased emphasis on equal opportunities, static anthropometric criteria have given way to functional tests. Instead of selecting on the basis of size or chest circumference, recruitment depends on the applicant’s ability to carry out some generic or job critical task under defined conditions and to a preset standard. However, selection tests are still a source of controversy. Trade unions, for example, may object to management attempts to select workers with “strong backs” for a particular job, arguing that the problem lies with the job, not the worker and that the job should be redesigned to be performable by anyone in the workforce. An alternative approach, which is the guiding philosophy of ergonomics, is known as “fitting the job to the man” (FJM). Much of the early human engineering and workspace design attempted to design tasks to suit the characteristics of the worker. The underlying assumptions of the FJM approach are that a suitable set of worker characteristics can be specified around which the job can be designed and that this can be done for any job. A large part of this book is devoted to describing these characteristics at the anatomical, physiological, and psychological levels and explaining their design implications. FMJ came about at a time when the demographics of the populations of many countries were very different from that of today. There were many young people, no shortages of the necessary skills, and there was a great deal of unskilled work. With few options for alternative employment, it was common for workers to remain in a job for life. Management could afford to be selective. In many countries, this is no longer true, due to demographic aging of the workforce and no shortage of vacant jobs. FJM seems to be the most practical of the two approaches, wherever it can be implemented, since many organizations now find themselves with a dwindling applicant pool and are loath to reject otherwise suitable people. There are also political pressures on organizations in many countries to make employment as widely available as possible. Equal opportunities legislation prevents discrimination against women and minorities and employers are being forced to select on the basis of functional tests of task performance rather than applicant characteristics. Under extreme circ*mstances, the FMJ approach has to be taken, as when acclimatizing workers who have to work in hot conditions, which cannot be changed. Stature is still used to select military pilots in some cases, due to limited leg room in the co*ckpit and the dangers of knee amputation during ejection. However, in less extreme conditions, there are usually many FJM options such as designing a better work–rest schedule, providing protective clothing, or building a “cool spot.”

Human Factors and Ergonomics In 1857, Jastrzebowski produced a philosophical treatise on Ergonomics: The Science of Work, but it seems to have remained unknown outside Poland, until recently (Jastrzebowski, 1857). In Britain, the field of ergonomics was inaugurated after World War II. The name was reinvented by Murrell in 1949, despite objections that people would confuse it with economics. The emphasis was on equipment and workspace design and the relevant subjects were held to be anatomy, physiology, industrial medicine, design, architecture, and illumination engineering. In Europe, ergonomics was even more strongly grounded in biological sciences. In the United States, a similar discipline emerged (known as human factors), but its scientific roots were grounded in psychology (applied experimental psychology, engineering psychology, and human engineering). Human factors and ergonomics have always had much in common but their development has moved along somewhat different lines. Human factors put much emphasis on the integration of the

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Introduction to Human Factors and Ergonomics

human considerations into the total system design process. It has achieved remarkable success in the design of large systems in the aerospace industry and notably NASA and the U.S. space program. European ergonomics is sometimes more piecemeal and has traditionally been more tied to its basic sciences or to a particular topic or application area. Despite these differences, the reader should not be concerned about the two terms. In the United States, the Human Factors Society has recently changed its name to the Human Factors and Ergonomics Society. Presumably this was done to indicate that the two areas now have so much in common that one society can represent the interests of people who see themselves as working in only one or the other area. Both human factors and ergonomics take the FJM approach and state that jobs should be made appropriate for people rather than the other way around.

Will Taylorism Ever Go Away? Modern Work Systems and Neo-Taylorism A major criticism of both Taylorism and the Hawthorne counseling program is that both did nothing to ameliorate the alienation of workers from their work and from the products of their work. Taylorism may have been appropriate in the early twentieth century, acting as a catalyst for industrialization and mass production, but its legacy endures—even in modern organizations, workers have little scope for organizing, implementing, and completing their daily tasks, as these are firmly under management control. Whether this style of management is still appropriate is far from obvious. Despite calls for job reform in Sweden, for the humanization of work in Germany in the 1970s and 1980s, and for a renewed emphasis on the quality of working life in the United Kingdom, there has been arguably little change. Many modern jobs in the twenty-first century (such as call centers) are intrinsically fragmented, piecemeal, or extremely repetitive. Indeed, the United Kingdom’s National Health Service, the country’s largest employer, has introduced a system of “Clinical Governance,” which has many Tayloristic components including the specification of the best way of performing a task (including treatment of patients), setting of targets for service delivery, optimization of the workspace to support the method, and regular clinical audits by management to ensure that standards and targets are being met. Depending on one’s point of view, this can be seen both as a way of de-skilling clinicians or as a way of optimizing service delivery to patients. Margulies (1981) complained that few designers of the modern computer systems neither felt responsible for ergonomic issues nor did they feel the need to consult users about anything other than minor issues. New designs were justified by claiming that the constraints imposed on users were enforced by the requirements of implementing the technology. Margulies called for a change in outlook based on the fact that computer systems are not intrinsically deterministic and that people have a need for a satisfying work over which they have some control—a need for psychological ownership of the job. This was to be achieved by means of participation between employees and their representatives, computer systems designers, and social scientists (Margulies, 1981): Why should it not be possible to initiate preparations for a new computer system by informing everybody involved in its use about the qualities, possibilities, and limitations of the system and then ask them to consider in small working groups what part of their work they would like to assign to the computer and what other tasks they would like to assume instead? … . It is for the human being, individually and collectively that the optimal operating mode must be found, and not for the computer.

Attempts to Humanize Work In the 1960s, 1970s, and 1980s, a number of large-scale programs were initiated in several European countries. These programs were motivated by a variety of factors. For example, successive

Human Factors and Ergonomics from the Earliest Times to the Present

11

generations of school leavers in the countries in question had increasingly higher levels of education and higher expectations of work. The programs attempted to provide higher quality jobs through changes in work organization. Some general characteristics of a good (psychologically rewarding) job are given in Table 1.3. In Sweden, the Volvo motor car company (which was suffering from high absenteeism and labor turnover in the 1960s) tried to find new ways of assembling cars in an attempt to have a more stable, motivated, and productive workforce. Conventional production line methods were replaced by “unit production.” Teams of workers manned electric assembly wagons, which moved around the assembly area stopping at centralized stores to collect the various components. It is frequently difficult to disentangle the effects of such programs on either productivity or the psychological rewards of work because many different factors are involved. Unit production changes the social relations between people but it also eliminates pacing (where the rate of work is set by machines) and lengthens cycle times. Both of these latter factors are known to influence job satisfaction. The British Quality of Working Life program (Tynan, 1980) attempted to combine new approaches to job design with technological change under the premise that since technological change forces job redesign anyway, the opportunities presented by new technologies could best be realized by optimizing the work organization and design of jobs. Management, trade unions, and workers were to be included in a participatory approach toward job design.

Success of Work Humanization Programs The modern workplace, according to this view, is characterized by flexibility and individual discretion over work elements. Traditional, fragmented, repetitive tasks, and rigid organizational hierarchies have been replaced with more decentralized systems. The extent to which this thinking has really penetrated organizations and replaced traditional styles of management is a question open to empirical investigation. It has been investigated by Boreham (1992), who carried out an international comparative study on the organization of work and the amount of discretion available to employees in a variety of organizations in the United States, Australia, Britain, Canada, Germany, Japan, and Sweden. The following employee groups were sampled: managers, professionals, clerks, skilled workers, semiskilled, and unskilled workers. More than half of the employees sampled reported negligible freedom to put their ideas into practice or to introduce new tasks. Autonomy was found to be a property of higher status individuals. Lower status individuals were almost totally excluded from participation in decisions about production in their organizations. Citing such findings as evidence for the “myth of post-Fordist management,” Boreham concluded that there was scant evidence to suggest that truly participative organizational practices had been implemented in the countries studied. In one sense, then, Taylorism lives on, alive and well in the call centers of modern computerized offices. Despite these reservations, participative practices have been accepted in some organizations and in some countries (e.g., Germany). According to Bernoux (1994), the requirements for effective participation are as follows:

1. Employees have to acknowledge the need for participation. 2. Employees have to trust that their participation will not have negative effects and that they will have some control over the final decisions. 3. Employees have to perceive that changes are being introduced in a legitimate way. 4. Employees believe that change is being implemented correctly. 5. Employees have to be given a real role to play in the introduction and testing of new ways of working.

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Introduction to Human Factors and Ergonomics

The Fourth Industrial Revolution The Fourth Industrial Revolution is the name given to the fusion of different technologies that started at the end of the twentieth century.

1. The pace of change has increased due to the confluence of key enabling technologies; principally machine-based learning (essentially neural network technology, which is not new but is a lot more powerful nowadays). Together with near real-time speech recognition and natural language processing (SIRI for example) and the Internet, these technologies are now far more accessible and usable. 2. Key jobs likely to be automated are those that are routine, rule-, and process-based. 3. The link with the Internet, principally the Internet of things, is that chatbots, cameras with face recognition technology, voice recognizers, and so on will be embedded all around us—we will soon be living inside the Internet in a physical sense and not just via our laptops and terminals. 4. Algorithms in search engines already monitor our online behavior and tailor our interactions accordingly. This will increase and the amount of personal information available to these systems will continue to grow. The same methods can be used in the management of organizations to automate any form of consultative process involving employees.

Developments in the physical, digital, and biological spheres are converging in a way that will have effects that are difficult to anticipate. Containerization in the 1960s enabled transportation networks to integrate supply chains for a wide variety of products—all that had to be moved were containers of “things” yielding great increases in efficiency. The Internet has given rise to a network of interconnected “things”—physical goods, people, and information can now be connected. People can communicate with their friends, with databases, and with their domestic appliances at home using their cellphones. Increased automation and integration of transportation may make some jobs redundant (e.g., self-driving cars may make taxi-drivers redundant). With everyone connected to an Internet of “things,” the need to travel anywhere, for any reason, may be reduced giving more freedom to work, shop, and socialize at home. At the same time, new forms of relaxation and recreation may emerge. Artificial intelligence may develop to the extent that many middle-class occupations may be automated with profound implications for the education systems of the future.

BASIC APPLICATIONS Many ergonomists specialists work in research organizations or universities and carry out basic research to discover the characteristics of people that need to be allowed for in design. This research often leads, directly or indirectly, to the drafting of standards, legislation, and design guidelines. Others work in a consultancy capacity, either privately or in an organization. They work as part of a design team and contribute their knowledge to the design of the human–machine interactions in work systems. This often involves the application of standards guidelines and knowledge to specify particular characteristics of the system. Modern ergonomics contributes to the design and evaluation of work systems and products. Unlike in earlier times when an engineer designed a whole machine or product, design is a team effort nowadays. The ergonomist usually has an important role to play both at the conceptual phase and in detailed design as well as in prototyping and the evaluation of existing products and facilities. Modern ergonomics contributes in a number of ways to the design of the work system (Table1.1). These activities should be seen as an integral part of the design and management of systems. The basic applications of HFE are to meet the general requirements for the integration of human operators with technology. Compatibility can best be achieved by focusing design efforts on the interactions between people and the devices they use to achieve work goals using a participatory approach.

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13

TABLE 1.1 Contribution of Modern Ergonomics to Systems Design and Management 1. A standard format for describing and assessing human–machine systems: System-level model: Organization of subsystems Human–machine-level model (use checklists for assessment): Description of technology Description of interfaces Description of users Physical dimensions Abilities/training/experience Age Fitness Language/literacy 2. Identification, classification, and resolution of design issues involving the human component Workload Work organization Work environment Work psychosocial factors Work scheduling 3. Task and human–machine interaction analysis Description of human–machine interaction Optimum level of description 4. Specification of system design and human behavior. Advice on implementation of controls. Legislative force Regulations (legal imperative to comply) Standards (contractual/strategic imperative to comply) Guidelines (best practice) 5. Identification of core trends in human and biological science and their implications for system design and management Scientific input Consultative advice on technical matters and trends Strategic planning Advice on employers’ liability for accidents and injuries 6. Generation of new concepts for the design and analysis of human–machine systems Human–machine modeling to generate design concepts Physical models (e.g., SAMMIE, JACK) Task models (task analysis and description) 7. Devise and prioritize implementation plan for ergonomic improvements Implement immediately (current arrangements are hazardous or contravene legislation) Implement soon (no immediate danger but current arrangements are unsatisfactory) Implement when equipment is shut down (if stoppages are expensive and there is no immediate danger, wait until system is shut down for regular maintenance) Implement when cost–benefit is acceptable (wait until financial situation improves or when costs are lower) Implement when new equipment is built or purchased: incorporate ergonomic requirement into the procurement process

Participative practices have been accepted in some organizations and in some countries (e.g., Germany). The requirements for effective participation according to Bernoux (1994), are as follows: • Employees have to acknowledge the need for participation. • Employees have to trust that their participation will not have negative effects and that they will have some control over the final decisions. • Employees have to perceive that changes are being introduced in a legitimate way.

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Introduction to Human Factors and Ergonomics

TABLE 1.2 Success Factors in Management–Worker Participation Involvement

Commitment

Climate

Management

Resources

Partnerships of stakeholders especially for development or use of standards Manufacturer involvement Trade Union involvement Driven by user and company needs Multidisciplinary Participation through all stages of design Commitment of all stakeholders Real support from senior management Someone to champion the process Clear perceived need for change Urgency Appropriate knowledge levels among stakeholders Track record of success Acceptable industrial relations Open, communicative organization Clearly defined actors and roles Structured process that matches organization’s structure Clear, single, well-defined project Clear identification of resource availability: time, money, equipment “Rich” information from real users

Source: Reproduced from Wilson, J. and Morris, W. TUTB Newsletter, 24–25: 22–25, 2004. With permission.

• Employees believe that change is being implemented correctly. • Employees have to be given a real role to play in the introduction and testing of new ways of working. Table 1.2 summarizes the key ingredients for successful participatory design of work equipment, according to Wilson and Morris (2004).

TOOLS AND PROCESSES Ergonomics is a broad subject, but there are two main classes of tools that span the entire discipline. These are

1. Ergonomics checklists 2. Task analysis

To use a theatrical analogy, checklists are used to assess the design of the set upon which the performance takes place and task analysis is used to describe the performance of the actors.

HFE Checklists The use of checklists has a long history in ergonomics. One of the founding fathers of ergonomics, the late professor E. Grandjean, published one of the first comprehensive checklists to aid in the investigation of working conditions. The most basic checklists lists are nothing more than an aide memoire to ensure that an investigation is thorough and not one that merely reflects the investigator’s

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Human Factors and Ergonomics from the Earliest Times to the Present

main area of expertise or interest. Grandjean compared his ergonomics checklist to those that pilots use before takeoff. Existing regulations and guidelines are often context- or issue-specific, which is why generic checklists can help to ensure that no possible ergonomic factors are overlooked. HFE Workshop 1.1 presents a general ergonomics checklist that is context-independent and conforms to the human– machine model in the Preface. It can be used anywhere to investigate any job and should be seen as complementary to standards and regulations. More detailed checklists for investigating specific issues are available and some examples appear in later chapters. HFE WORKSHOP 1.1 General Ergonomics Checklist The general ergonomics checklist is used for the preliminary investigation of working conditions and is derived from a variety of sources: E. Grandjean’s original list, that of the International Ergonomics Association, defense standards, and other “mini” checklists that have appeared over the years.

1. Job analysis 1.1 What are the main assignments and segments of the job? 1.2 Is there high physical workload? 1.3 Is there high mental workload? 1.4 Does the operator have a high level of responsibility? 1.5 What are the skill/knowledge requirements of the job? 2. Work organization 2.1 Does the operator work alone or with others? 2.2 Is the work machine- or self-paced? 2.3 What is the system of supervision and accountability? 2.4 What shift system is in operation, if any? 2.5 What are the hours of work and rest periods? 2.6 Is overtime worked? 2.7 What are the arrangements for meal breaks and refreshments? 2.8 Is there time pressure due to deadlines or meeting production targets? 2.9 Is the work carried out on a piece-rate basis? 2.10 Does the work organization automatically ensure that periods of work and rest occur naturally, as part of the work itself? 2.11 Is the work adapted to the needs of older workers in terms of physical or mental demands? 3. Workspace design 3.1 Is there sufficient space for the operator to work? 3.2 Can the worker sit while working at all? 3.3 Does the position of the body demand static muscular work? 3.4 Does the workspace permit a stable, neutral posture? 3.5 Is the work surface appropriate for the visual and manual requirements? 3.6 Are foot controls necessary? Do they permit a suitable posture? 3.7 Are hand controls correctly placed and designed to allow a good upper limb posture? 3.8 Is the seat height adjustable? 3.9 Does the chair have a backrest?

(Continued)

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Introduction to Human Factors and Ergonomics

HFE WORKSHOP 1.1 (Continued) 3.10 Can seated workers use footrests, armrests, lumbar pads if needed? 3.11 Are hand tools correctly designed? 3.12 Are any body parts exposed to constant pressure? 3.13 Is adequate personal protective clothing provided where needed? 3.14 Is there any vibration? 3.15 Are any surfaces hot enough to cause burns or cold enough to freeze skin? 4. Physical demands 4.1 Is manual handling required? 4.2 Do large forces have to be exerted? 4.3 Does the work involve lifting or twisting, bending, stooping, or reaching? 4.4 Is muscular work mainly static or dynamic? 4.5 Are movements centered around the midpoint of the joint range? 4.6 Can static work be eliminated by providing clamps or vices? 4.7 Can loads be lifted and carried safely? 4.8 Is the workload greater than 40% of maximum aerobic capacity? 4.9 Are large or small muscle groups involved? 4.10 Can the operator vary the work rate or take rest periods at will? 4.11 Are lifting aids or powered tools available? 4.12 Are cycle times less than 30 s? 4.13 Are job aids provided to reduce high physical demands? 4.14 Are the patterns of movement efficient, inefficient, or are any movements unnecessary? 4.15 Does the task demand highly accurate movements? 5. Mental demands 5.1 Is the mental workload too low, too high, or about right? 5.2 Is the task carried out at a predominantly skill-, rule-, or knowledge-based level? 5.3 Does the task place high demands on the perceptual or attentional systems or on short- or long-term memory? 5.4 How must information be processed before a response can be made? 5.5 Can mental workload be reduced using external memory aids, predictor displays decision support systems, navigation aids, etc.? 5.6 Does the operator have to carry out more than one task at a time and are the task modalities compatible? 5.7 Are the sequences of mental operations compatible with the physical layout? 5.8 Is the representation of the system compatible with the operator’s representation? 5.9 Does information from different channels/modalities have to be integrated? 5.10 Are great demands made on visual search, can cueing be used to reduce these? 5.11 Is proper feedback provided in accordance with task demands? 5.12 Can controls, displays, and task demands be recognized easily and is proper support provided? 5.13 Does the task require a high level of individual judgment; can decision support be provided? 5.14 Are memory aids hardwired into the design of the hardware, software, and work organization? (Continued)

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Human Factors and Ergonomics from the Earliest Times to the Present

HFE WORKSHOP 1.1 (Continued) 6. Human–machine interaction 6.1 Does the information presented satisfy the operator’s requirements? 6.2 Is the rate of information flow too high or too low? 6.3 How many sources of information does the operator use to work? 6.4 Are data readily available, in the right form, and unambiguous? 6.5 Are data embedded in noise? 6.6 Are there many distractions due to noise, speech, or other disturbances? 6.7 Is the layout of controls and displays compatible with prevailing stereotypes? 6.8 Are controls close to their corresponding displays? 6.9 Are control/display ratios and control dynamics compatible with system order? 6.10 Is the “grain size” of feedback appropriate for the control actions and decisions that have to be made? 6.11 Does the operator have to monitor several channels simultaneously? 6.12 Are warnings, instructions, and other displays suitably designed and accessible? 6.13 Does the system provide timely feedback or other indications of response adequacy? 6.14 Are verbal instructions/displays in the correct language and easily comprehensible? 6.15 Are human–computer dialogues user-friendly? 6.16 Is the human–computer interaction style appropriate given the expertise of users? 6.17 Are colors used in an appropriate way? 6.18 Are coding systems compatible with human memory limitations? 6.19 Do the task demands form a predictable pattern of stimuli and responses? 7. Work environment 7.1 Are temperature, noise, lighting, and vibration within recommended limits? 7.2 Is there excessive brightness or glare in the workspace? 7.3 Are there sudden loud noises? 7.4 Does temperature vary throughout the day and are there hot or cool spots? 7.5 Are there reflective surfaces or hot or cold surfaces? 7.6 Does the room have an appropriate reverberation time? 7.7 Are the colors and reflectances of objects in the environment appropriate for the work? 7.8 Are the relative humidity and ventilation satisfactory? 7.9 Are protective clothing and devices available for workers in extreme environments? 7.10 Can exposure be reduced by taking rest periods in suitable areas or by rotating workers? 7.11 Are there toxic or radioactive chemicals or other hazards in the work environment? 7.12 Are warning signs or other notices placed in appropriate places? 8. Workforce characteristics 8.1 Is the anthropometry of the workforce known? 8.2 Are the workers mainly male or female? 8.3 What language(s) are spoken proficiently by the workers? 8.4 What is the average age of the workers? (Continued)

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Introduction to Human Factors and Ergonomics

HFE WORKSHOP 1.1 (Continued) 8.5 What is the educational level of workers? 8.6 Are all workers literate? 8.7 What is the level of health and fitness in the workforce? 8.8 Are the workers suitably nourished? 8.9 Are the workers mainly full-time, part-time, or seasonal? 9. Job stress 9.1 Does the user have sufficient resources to do the work? 9.2 Are proper systems of appraisal and feedback in place? 9.3 Is the employee’s work role clear and unambiguous? 9.4 Are performance standards clear and unambiguous? 9.5 Are standards realistic or constraints too limiting? 9.6 Is the system of work likely to cause conflict (work–life balance)? 9.7 Is support from peers or supervisors available? 10. Occupational background 10.1 Is the work system the result of tradition or custom and practice? 10.2 Has the work been planned from the beginning with the operator in mind? 10.3 Is training formal or “on the job?” Is it adequate? 11. Safety 11.1 Is there a formal safety management system in place? 11.2 Do employees receive adequate safety training? 11.3 Are employees aware of the main risks and hazards? 11.4 Is there a proper reporting system available to employees? 11.5 Are alarms appropriate to the task and the work environment? 11.6 Are employees supplied with the necessary safety equipment? 11.7 Are sufficient safety constraints in place? 11.8 Is there a positive safety culture? Example Suppose we are called in to advise a company on its cargo handling operations, loading and unloading specialized equipment onto ships using cranes. The main focus is on the health and safety and efficiency of the operation and the avoidance of accidents. The company wishes to consider upgrading the system. The key word here is system. The company has not asked for a health and safety evaluation, although it is interested in health and safety. It does not necessarily wish to buy new cranes, although it will be interested to know of any reasons for doing so. Thepurpose is to conduct an ergonomic assessment of the system, making suggestions for improvement, where possible. The checklist provides a framework for this assessment. Information is gathered by direct and detailed observation of the work, by interviews with workers, and by taking basic measurements of the physical environment, including the forces required to operate heavy controls and the weight of objects to be handled. Information about accidents, absenteeism, and job training is also sought. Following the investigation, we might arrive at the following conclusions about the crane operators’ job. The job is routine crane operation involving high mental workload and responsibility. The work is nominally self-paced, but deadlines are rigid. The operator works with others and rest periods are regular and formalized. Physical demands are low but awkward static work postures have to be adopted, due to poor visibility. There are no ergonomic hazards due to (Continued)

Human Factors and Ergonomics from the Earliest Times to the Present

19

HFE WORKSHOP 1.1 (Continued) the cab design itself. Highly accurate movements are required, which interact with the poor posture and mental demands to increase the risk of musculoskeletal problems. Operators are trained both formally and on the job, have adequate resources and a clear, unambiguous task, and the resources to perform efficiently. Regular feedback is provided and esprit de corps is good due to well-organized teamwork and a group bonus plan. No serious incidents have been reported in the last 12 months. The next stage would be to recommend to the management that the postural problems be investigated further and solved. The postural problems could undoubtedly have been identified at the outset; so how has the checklist helped? By providing a solid platform for looking at a specific issue, knowing that others, and potentially more serious problems, have now been ruled out.

Task Analysis Before ergonomic principles can be applied to the design of systems, a sound understanding ofthe task is needed. There are many ways of capturing data on task performance, the simplest being observation in usability laboratories in the field. Typically, the interaction is recorded andany errors are noted. Users may be debriefed after the interaction so that further information can be obtained. Task analysis is widely used and is an essential prerequisite for some of the riskassessment techniques described in later chapters. Task analysis was defined by Snyder (1991) as … an ordered sequence of tasks and subtasks, which identifies the performer or user; the action, activities or operations; the environment; the starting state, the goal state; the requirements to complete the task such as hardware, software or information.

Task analysis drives human-centered design by providing a system-specific context for the application of the fundamental ergonomics principles. The general procedure for carrying out a task analysis is as follows (Rasmussen 1983):

1. Identify a prototypical task by collecting detailed descriptions from expert users of what different people do. 2. Identify all the processes that comprise the activity. 3. Analyze the descriptions in terms of the various options for action and the criteria used to select between them. 4. Generate a prototypical task specification by selecting a characteristic set of tasks and specifying the work sequences common to them: • Who must be involved? • What are the subcomponents of the activity? • How are participants involved in the various tasks? • What information is required at each stage in the task? • Where does the information come from? • How is the information exchanged? • How might any of the above be improved? The outcome of a task analysis consists of the following:

1. Description of the behaviors required to carry out the task 2. Description of the system states that occur when the task is carried out 3. Mapping of the task behaviors onto the system states

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Introduction to Human Factors and Ergonomics

TABLE 1.3 Levels of Description in Task Analysis: An Example Assignments A1 A2 A3 A4 A5

Inspection of environment, equipment, and machinery Execution of start-up procedures for pumping Monitoring of system condition when running Execution of close-down procedures General maintenance

(A1) (A2) (A3) (A4) (A5)

S1 S2 S3 S4 S5

Segments General inspection; safety, lighting, housekeeping Start-up filtration of fuel in reservoir tank Periodic inspections of pumps Close down pump motors Changing the filter elements

(A1S1) (A2S2) (A3S3) (A4S4) (A5S5)

T1 T2 T3 T4 T5

Tasks Replace broken lamps in station Start-up transfer pump Check torque settings on pump retaining clamps Close down pump motor 1 Remove filter element 1

(A1S1T1) (A2S2T2) (A3S3T3)

O1 O2 O3

(A4S4T4) (A5S5T5)

O4 O5

Operations Switch-off power to lighting unit at wall switch Press green button on transfer pump housing Using a torque wrench, tighten nuts in clockwise direction until torque setting is displayed Press red button on pump motor 1 with an 8 mm spanner, loosen nuts retaining filter element housing

Note: There are many more segments, tasks, and operations. Those that are shown are included to illustrate the details required at the different hierarchical levels.

This information can be used for a variety of purposes:

1. Evaluation or the design of the human–machine interface 2. Identification of the skills needed by an operator of the system 3. Design of training materials and operating instructions 4. Identification of critical elements of the task to predict or evaluate the reliability of the system

Table 1.3 gives an example of the stages involved in the hierarchical decomposition of a job from a job title to specific operations. This type of analysis can produce enormous quantities of documentation, as can be imagined. However, in complex systems, it is often essential to describe tasks at this level of detail because even small changes in equipment or procedures can affect the mapping between required human behaviors and system states. Table 1.4 gives examples of the types of questions the systems designer must ask when looking at the mapping between individual task behaviors and system states. A basic question is, “How are operator task behaviors to be invoked and how will the system respond to their execution?” Ergonomics Workshop 1.2 gives an example of a basic task analysis using a task flow format.

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Human Factors and Ergonomics from the Earliest Times to the Present

TABLE 1.4 Example of Mapping of Task Behavior and System Operation in System Design and Evaluation Mapping elements 1. Indications and when to do the task: When requested by captain When indicated by fuel gauge With engines switched-off 2. Control objects and operation: Transfer valves Transfer hose Hose retaining clamps Transfer pump controls Slide hose into transfer valve orifices on tanker and storage unit (outlet and inlet) Use retaining clamps to secure hose to transfer couplings on tanker and storage unit Open transfer valves on tanker and storage unit Press green button on transfer pump 3. Precautions: valves in open position and hose secured Fuel level in mobile tanker above red line Tanker on level surface and brakes in “on” position 4. Feedback modality and indication of response adequacy Visual/kinesthetic: valves “click” into open position Auditory/kinesthetic: pump vibrates/“whines” if flow impeded Visual: transfer pump pressure gauge reads 150–250 kPa Absence of leaks Fuel level in storage unit gauge rises 5. Fault diagnosis and maintenance If pump “whines” or flowmeter indicates blockage, press red button to stop pump Check: Transfer valves open Hose not twisted or crushed Fuel level in tanker Pressure gauge on transfer pump

HFE WORKSHOP 1.2 Introduction to Task Analysis It was Professor J. Annett who developed hierarchical task analysis in the 1970s. It has its origins in time and motion study (methods engineering), which was developed by the Gilbreths at the beginning of the twentieth century. Taylor, the founder of scientific management, believed that even the simplest tasks were worthy of study and improvement. This is still true today, especially so in the light of our increasingly regulated, yet highly competitive business environments. Task analysis must not be allowed to become too complicated, and there are two main ways of ensuring that it does not: Decide, first of all on the boundaries of the task. When does it begin and when does it end? Think hierarchically but do not go into too much detail in the early stages. Begin by analyzing the task from the beginning all the way to the end at a high level (i.e., at the simplest level first, before going into detail). Do not go into more detail than you need to make the assessment.

(Continued)

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Introduction to Human Factors and Ergonomics

HFE WORKSHOP 1.2 (Continued)

No

Hungry?

End task

Yes Make sandwich

Eat sandwich

FIGURE 1.1  High-level description of “make cheese sandwich” task.

Below is a basic task analysis for making a sandwich (Figure 1.1). The boundaries of the task are clear. Below that, the task is expanded to give details of the main operations required to make the sandwich. The expanded task has two levels of analysis. Running along the top of the page is a high-level description of the entire task (make a cheese sandwich). One of the subtasks is also broken down into its constituent operations. The simplest way to understand Yes Begin

Prepare work area

Prepare ingredients

Make sandwich

Serve sandwich

Make another?

End

Wash and dry hands Clean work surface No Work surface clean? Yes Get knives Get cheese grater End

FIGURE 1.2  Detailed analysis of subtask “prepare work area.”

(Continued)

Human Factors and Ergonomics from the Earliest Times to the Present

23

HFE WORKSHOP 1.2 (Continued) the task flow diagram is to begin at the top left of the diagram and read across the page. This is a high-level description of the entire task, which consists of five operations and one decision. Note that as far as the decision is concerned, the information about whether to make another sandwich comes from outside the task itself. This is often the case and in our hypothetical example it might come from a higher-level task, of which “make sandwich” is but a subtask (such as “serve customer,” for example). “Prepare work area” is the first subtask of make sandwich and it has been analyzed at the next level down in detail (Figure 1.2). As with the main task, the entire subtask has been analyzed from beginning to end. In practice, we would then proceed to analyze the next subtask from beginning to end (prepare ingredients) and so on until we have analyzed the entire task at that level. Depending on the nature of the project, it might be necessary to analyze one or more of the lower-level operations in more detail; for example, “get knives” might be a good candidate for closer inspection because of potential safety, hygiene, transport, and storage issues.

Status of Risk Assessment and Design Tools The ergonomist’s toolkit is expanding rapidly with the development of tools for carrying out risk assessments and design activities. Examples of these methods are presented in the following chapters. These tools vary in the extent to which they have been tested. For present purposes, it is sufficient to alert the reader to the criteria that would have to be satisfied for the tool to be considered to be the gold standard in its area of application. To be of use any tool, be it a questionnaire, rating scale, or risk assessment technique must the valid and reliable. These concepts are illustrated in Figure 1.3. In later chapters, these issues will be discussed in relation to specific tools. 1. Validity: Does the tool measure what it is supposed to measure? Do its contents reflect the domain under investigation (content validity); does it adhere to or reflect appropriate theory or knowledge in the domain (construct validity); do its predictions or assessments concur with actual outcomes (criterion validity)? 2. Reliability: Does the tool give the same result when applied to the same problem under the same circ*mstances, when used by the same assessors (test–retest reliability); does it give the same result when used in the same circ*mstances by different assessors (intertester reliability); if the tool, using multiple measures of the same underlying problem (or ­theoretical “construct”) at the same time, yields an aggregate measure of risk, is the ­aggregate measure internally consistent? 3. Sensitivity: Is the tool able to resolve differences of the size that occur in the real situation or that are important in determining real outcomes? 4. Diagnosticity: Is the tool sufficiently detailed to provide information about the reasons why one situation is different from another? (a)

(b)

(c)

FIGURE 1.3  Validity and reliability (a) neither reliable nor valid, (b) reliable but not valid, and (c) reliable and valid. The tighter the clustering around the bull’s-eye, the more accurate the tool.

24

Introduction to Human Factors and Ergonomics

5. Intrusiveness: Can the tool be used without disrupting the process that it is designed to assess? 6. Acceptability: Is the tool acceptable for general use? Is it harmless or is permission required before it can be used with human subjects (e.g., permission from a research ethics committee or from an occupational medical officer)? 7. Assessment of costs: The real costs both financial and in terms of human resources and d­ isruption to normal operations should be reasonable in relation to the value of the ­information provided.

SYSTEMS INTEGRATION Three key concepts in any discussion of the economic benefits of HFE are 1. Efficacy: Whether the applications work under ideal circ*mstances. 2. Effectiveness: Whether the applications work under normal conditions of use. 3. Efficiency: Whether the applications save more resources than they consume. Most of the material presented in this book is of an introductory and explanatory nature and describes the basic concepts used in ergonomics. Throughout each chapter, the results of efficacy studies are included. In addition, at the end of each chapter is a section devoted to effectiveness and efficiency studies—wherever possible in the form of field trials with data on costs and benefits. It is not the purpose of this book to introduce the reader to techniques of cost–benefit analysis, since this is an application of economic theory and is a field of study in its own right. The goal is to illustrate to the reader the kinds of analyses that have been done and, more importantly, to show how the findings demonstrate the efficacy and efficiency of the application of HFE measured by means of “key performance indicators.”

Cost–Benefit Models and Methods In general, there is more information on the cost of problems rather than the economic benefits of solving them. However, the main approaches are as follows.

Oxenburgh Productivity Model The approach is to identify jobs with a high level of absenteeism, injury, or staff turnover. Ergonomic modifications are made to the workplace, tools, equipment, or work organization. The costs of these modifications can be calculated in terms of the materials and labor charges needed to implement them, as well as any downtime during redesign. The benefits are expressed in terms of the ­reductions in absenteeism, expressed as a monetary value made up of direct and indirect costs:

Direct wage costs = wage + obligatory charges to the wage + personnel + administrative costs Indirect costs = costs of losing trained employees + costs of hiring and training new employees + costs of additional overtime + overemployment costs

There may be other benefits as well, such as productivity improvements, and these then have to be included in the cost–benefit calculations. Oxenburgh (1994) provides a detailed step-by-step ­procedure for carrying out cost–benefit analyses using the productivity model. In practice, an ­ergonomics consultant would need the assistance of the client company’s finance department to

Human Factors and Ergonomics from the Earliest Times to the Present

25

make detailed calculations of the cost savings bought about by reductions in absenteeism. However, once an estimate has been made, the payback period for the investment in ergonomic improvements is simple to calculate by dividing the costs of the improvements by the monthly savings due to reductions in work loss, plus the value of any productivity gains. Oxenburgh gives some examples of cost-­effective modifications to single machines or workplaces (similar to many of the examples described in this book) that paid for themselves in less than 1 year and often in less than 6months. The model can be used in a wide variety of industries in different countries. The cost savings will vary between countries due to differences in employment practices—in particular, the social costs of the wage depend on whether the country has some kind of worker’s compensation and social security scheme and how it is funded—by private insurance or by general taxation. As a rule of thumb, Oxenburgh suggests that, in developed country businesses, 1 day of absenteeism costs up to 3.5 times 1 day’s pay when all the direct and indirect costs are included. It is easy to see how ergonomic improvements can be cost effective when the approach is used to justify change in highrisk jobs. Used correctly, the model should not overestimate the costs of absenteeism because it takes into account the costs of employing temporary workers or of paying others overtime. It would seem to be most applicable to blue-collar jobs where output is tightly managed and easily quantified. The productivity model has a number of limitations. It is only usable in companies or jobs with high absenteeism. It assumes that changes that will increase the scope for productivity gains and savings will do so in practice, that is, productivity will go up and stay up. Tight control over the life of the exercise is needed to implement the changes, control the costs, and demonstrate the benefits. The “time saved” hypothesis is based on simplistic notions such as “time is money.” This may work in rigid production line environments but not in others because workers may perceive sick leave as part of the package and take time-off anyway or in nonpaced jobs; the work may “expand to use up the time available.” Insome occupations, it may be possible to postpone work or there may be fl ­ exibility in the remainder of the workforce (everyone else has to work harder). In service industries, the penalties of failure to deliver (e.g., patients may have to wait longer to be admitted to hospital) are social rather than financial. Although time is money, time saved does not always save money. Change needs to be managed to ensure that the extra time made available by ergonomic improvements is used productively. In­production line systems, for example, speeding up one part of the line may be ineffective if the rest of the system is unable to keep up with the new pace. Improvements need to be carried out ­systematically and integrated into the rest of the system.

Prevention is Better Than Cure One of the commonest arguments for the application of ergonomics is to prevent accidents, ­illnesses, and low productivity. Stamper (1987) reported that, at that time, Boeing spent $3500 per year on employee health care ($350 million annually), more than it spent on aluminum to build airplanes. In a similar vein, in the 1980s, Chrysler found that its healthcare obligations amounted to 10% of the cost of one of its basic models of car. An insurance carrier, not a steelmaker, was the company’s biggest supplier. Shelton and Mann-Janosi (1992) demonstrated that between 1985 and 1989, the cost of employer-provided employee health care rose by an annual compound rate of 13%, much higher than inflation at the time. This led many companies to implement cost-containment ­programs, including ergonomics programs. The results of effectiveness and efficiency studies of these programs are reported in later chapters. Despite the moral and ethical arguments for prevention, it is not always cost effective, according to some studies. An investigation into the costs and benefits of preventative health care was carried out by the U.S. Office of Technology Assessment (Leutwyler, 1995). Historically, public health measures such as sanitation and immunization have had a massive impact on life expectancy and quality of life. However, of all modern preventative health measures only prenatal care for poor women, testing neonates for congenital diseases, and most childhood immunizations ultimately paid for themselves. Screening for high blood pressure was found to cost more than treating stroke

26

Introduction to Human Factors and Ergonomics

victims and preventing disease was often more expensive than treating it. These are salutary lessons for ergonomists using cost–benefit arguments to justify their recommendations. Preventative efforts can be cost effective, but only when

1. Measure is inexpensive and only has to be applied once 2. Incidence of the problem is high 3. Cost of dealing with it is high 4. Measure is effective in preventing the problem and has few side effects

In practice, cost-effective interventions should be targeted at high-risk groups and should be similar to primary prevention used in medicine (e.g., redesign the task to reduce stresses on the back) rather than secondary prevention (do not allow people with a history of back problems to do the job because even those who get through the screening process may still injure themselves later on). In some countries, reductions in injury may have few immediate benefits for the employer, if worker’s compensation and health care are funded indirectly via taxation than directly through employer’s insurance premiums.

Examples of Industrial Ergonomics Programs Ergonomics programs are often introduced via the existing safety infrastructure. A survey may be carried out to determine the scope and cost of any existing ergonomic problems. In the Goodyear study by Geras and his colleagues, an ergonomics section was added to the safety program audit manual. Goodyear plants were required to establish ergonomics committees, give general awareness training to personnel, and carry out audits to identify ergonomic problems in the plant. In this way, an “internal market” was created for ergonomics and the program proceeded with a reactive phase in which existing problem areas were identified and problems rectified. An ergonomics training program was set up and aimed at plant nurses, industrial engineers, safety managers, training specialists, industrial hygienists, industrial relations personnel, production specialists, workers’ compensation personnel, union safety personnel, and engineering maintenance personnel. Participants were trained to conduct ergonomics surveys and use techniques such as video to present the results of their findings. They were also trained in problem solving and general awareness training skills. In practice, trainees were encouraged to “get their hands dirty” by tackling small, simple problems first (positive feedback gives confidence and encourages people to tackle further problems), to combine training with practical intervention, to develop and maintain an operational ergonomics group, to review existing and new equipment, to communicate, and to look at problems as opportunities. The success of the program was quantified overall, in terms of a reduction in lost time incidents (Table 1.5).

TABLE 1.5 Goodyear Accident Rates before and after an Ergonomics Program was Implemented Plant 1 Plant 2

1984

1985

1986

1987

1988

4.9 9.7

4.4 5.6

4.5a 8.9

0.8 7.4/0.8

0.9 2.6b

Source: From Geras, D.T. et al. Advances in Industrial Ergonomics and Safety, I, Taylor & Francis, London, 1989. a Start of ergonomics program. b Ergonomics program implemented midyear (Figure 4.5a shows incident rate before/ after program).

27

Human Factors and Ergonomics from the Earliest Times to the Present

Plant 2 went from being the plant with the highest incident rate to one of the lowest after introduction of the program. The program was also evaluated using productivity data from sections of plants in which redesign efforts have been carried out. In one section, 60% increase in productivity was achieved by reducing fatigue caused by unnecessary operator movement and movements requiring extended hand reach. Eklund (1995) investigated the relationship between ergonomics and quality in a Swedish car assembly plant and found clear relationships between ergonomic demands and quality problems. One of his suggestions was that the quality was degraded by the sociotechnical design, which separated inspection from quality and that better quality could be obtained by making production line workers responsible for their own quality control and inspection. Three categories of ergonomic problems were identified across a range of jobs; musculoskeletal loading due to the task or the posture, “difficult to do” tasks (due to the design of task objects), and psychologically demanding tasks. Next, quality control data from the assembly of 2000 cars were obtained. Quality data from 12 finished cars were also obtained. The cars were randomly sampled and disassembled in a special department for quality control purposes. Finally, quality inspectors were given a list of tasks and asked to identify those that were associated with quality control problems. Only 25% of all tasks were ergonomically demanding, but generated 50% of all quality defects. Almost 40% of the faults found in the disassembly exercise arose from the ergonomically demanding tasks. Eklund estimated that the risk of quality deficiencies was almost three times as large for the ergonomically demanding tasks as for the other tasks. Difficult to do tasks accounted for most of the problems and psychologically demanding tasks the least. However, 66% of tasks that had been identified as ergonomically demanding had some kind of quality deficiency. There was evidence from interviews with workers that they would settle for imperfect results in order to avoid physical discomfort or “pass-on” uncompleted work or problems when under time pressure. Quality could be improved, it was concluded, by redesigning problem tasks to reduce the ergonomic demands. Kochan (1988) reviewed the implementation of advanced technology by car manufacturers in the United States, Europe, and Japan. He argued that the implementation of new technologies works best when it is integrated with the human resource function. In a graphic example, he described how, on a visit to the most high-tech U.S. car assembly plant, he was shown a room in which car door panels, sourced from external suppliers, were inspected for quality by lasers. The suppliers used the same system, which enabled both parties to ensure high quality both when the products left the supplier and when they arrived at the assembly plant. While visiting the U.S. assembly plant of a Japanese car manufacturer, Kochan asked to see the area where incoming door panels were checked and was told that there was no such room. The company regarded it as the supplier’s responsibility to deliver door panels of the required quality and, having worked with the supplier from the early

TABLE 1.6 Quality and Productivity Comparison of Car Assembly Plants

Honda, Ohio Nissan, Tennessee NUMMI, California Toyota, Japan GM, Michigan GM, Massachusetts

Productivity (Man Hours/Car)

Quality (Defects/100 Cars in First 6 Months)

Automation (0 = No Automation)

19.2 24.5 19.0 15.6 33.7 34.2

72.0 70.0 69.0 63.0 137.4 116.5

77.0 89.2 62.8 79.6 100.0 7.3

Source: From Kochan, T.A. ICL Technical Journal, November: 391–401, 1988. With permission.

28

Introduction to Human Factors and Ergonomics

stages, was now able to assume that the quality met the required standard. The cost (in 1988) for the inspection room in the other car plant was $5 million. Kochan presents data on the productivity of several different car assembly plants (Table 1.6). The two General Motors (GM) plants differed strongly in level of automation (a value of 100 is the normalized highest level of automation) but had the same Fordist management style (traditional hierarchical management with high job specialization and close supervision of workers). The Japanese plants’ management style, in contrast, was marked by few job classifications, flexible work organization, and extensive communication. The NUMMI plant, a joint venture between GM and Nissan, had a moderate level of automation but was managed by Nissan. Kochan concluded that • Although GM invested $650 million in automating the Michigan plant, the quality and productivity was barely superior to the old, almost completely, nonautomated Massachusetts plant. • NUMMI plant with moderate automation but revamped management style and human resource strategy took 60% of the time to produce cars with 60% of the defects. • NUMMI was unionized, whereas Nissan and Honda were not. Unionization does not seem to be a barrier to productivity and quality. Organizational performance thus depends not just on technology, but on how it is used, in other words, on sociotechnical considerations. In modern organizations, companies have access to the same technology, therefore management and human factors have a main role to play in determining company competitiveness. Kochan advocates the “Human ware” approach to management in which a high degree of skill, motivation, and adaptability is expected from workers who, in turn, are encouraged to suggest improvements continuously and are made responsible for quality control.

Economics of Participation Many of the arguments for participation are strategic or humanistic rather than economic. Gold (1994) argued that the burden of proof should be reversed and that there is little evidence for negative effects of participation on performance. N. Wilson of the University of Bradford Management Center reported 5%–10% productivity difference in favor of companies adopting a participatory approach. O’Brien (1994) reported that the implementation of autonomous working groups in an Irish food company resulted in 36% increase in throughput and increases in maintenance efficiency with savings of 25%. Carter (1994) reports that the introduction of changes centered around a partnership scheme in a UK environmental engineering company, led to massive reductions in manufacturing cycle times, an 18-month cut in new product development times, and a reduction in manufacturing time for boilers from 6 h to 52 min.

FUTURE DIRECTIONS FOR HFE “Technology push” is one of the main factors influencing the direction and growth of HFE. Improvements in processing power and speed coupled with machine learning and artificial intelligence will have major changes on the world of work. Computationally difficult problems such as supply chain management, manpower planning, and maintenance scheduling are amenable to automation using intelligent systems; these systems might either replace middle managers by t­ aking over the management of the process or aid them through the ability to run large numbers of complex simulations to support planning. Tasks that are of high priority to organizations, amenable to the new technologies, and currently difficult or challenging are likely to be automated first. With rapid improvements in speech recognition and natural language processing, even more “humancentered” functions such as human resources might be automated. Interactive chatbots linked to personnel databases might lead to automated versions of the Hawthorne Counseling program where employees can voice their opinions and concerns online. Rapid development of usable systems is a

Human Factors and Ergonomics from the Earliest Times to the Present

29

priority in many organizations. Demographic change in industrially developed countries is imposing new constraints. An aging workforce and shortages of skilled people, coupled with the obesity epidemic and unhealthy lifestyles have resulted in a reduction in the percentage of people capable of normal work. At the same time, equal opportunities legislation demands that employers make work available to all. These trends place pressure on traditional “FMJ” approaches involving personnel selection in favor of “FJM”—redesign the work so that anyone can do it. System designers are responding by making more use of automation in new “lean-manned” systems. Paradoxically, ­having fewer people around increases the need for HFE as the role of those remaining becomes more critical. Physical ergonomic issues are taking on a new importance as workforces age and as more women take on jobs previously done by men. In developing countries, there is still a need for basic ergonomic design of factories and offices. One of the main braking factors on the introduction of AI (and one of the reasons that they did not roll out expert systems in health care 30 years ago) is that somebody has to be legally responsible for the decisions and actions made by the AI system. In other words, it is technologically possible to automate the decision in a variety of fields but not the legal responsibility for the decision, therefore, at the level of the job, rather than the task, people are still needed—processes can be automated but you cannot automate responsibility for the outcome of the automation. Another caveat, and a fascinating research problem for HFE is trust—if drivers do not trust their self-driving cars to drive properly, they will not use the functionality. If the trust is misplaced, they may not take over when they should. A final braking factor is that many AI systems that use neural networks (“machine learning”) are neither self-aware and cannot explain their decisions, nor is the process auditable (i.e., there is no traceability except to the database used to train the system).

SUMMARY HFE occupies the no man’s land between engineering and medicine, architecture, health and safety, computer science, and consumer product design. It is the only scientific subject that focuses specifically on the interaction between people and machines. Historically, HFE can be seen to have arisen as a response to the need for rapid design of complex systems. The modern ergonomist has an important role to play as a member of the design team, providing scientific information about personnel (a scarce commodity in many organizations), and ensuring that all aspects of the system are evaluated from the users’ or operators’ point of view. Many tools are now available for the systematic analysis and specification of system ergonomics. The participatory approach seems to be the best way to ensure that the implementation of ergonomics will be effective. Further guidance can be found in ISO/TC 159/SC 1 General Ergonomics Principles.

TUTORIAL TOPICS 1. What impact will the fourth industrial revolution have on HFE? 2. Will technological change make HFE obsolete? 3. In the year 2030, a university wishes to introduce a new course on “Human-Robot Symbiosis.” Discuss the main lecture topics to be covered in the syllabus and suggest ideas for lab work and practicals (using real robots, of course).

ESSAYS AND EXERCISES

1. Was ergonomics invented, discovered, or is it just a buzzword for what happens anyway? Discuss. 2. Refer to the cheese sandwich task analysis in Workshop 1.2. Specify the main operations and any decisions required to complete the subtask “Prepare Ingredients.” (Hint: use the description of the subtask “Prepare work area” as your model.)

30

Introduction to Human Factors and Ergonomics

3. Analyze the task of making a telephone call using a conventional phone. Using task flow format, construct a description of this task. 4. Using a format of your choice, analyze and describe the task of brushing your teeth with a toothbrush. 5. Join an Internet-based ergonomics discussion group and seek to generate debate on a controversial question of your choice. (Hints, e.g.: Does repetitive strain injury (RSI) exist and if it does should it be regarded as a compensable workplace injury? Is there such a thing as the Hawthorne effect and, if there is, what is the definition? Do we still need graphic user interfaces?) 6. Search the web for sources of information about ergonomics. Use the categories in the human–machine model to guide your search. 7. Contact five different manufacturers across a range of industries. Find out from them whether they use ergonomic principles in the design of their products. For those companies that do use ergonomics, find out who is responsible and how ergonomics is applied. (Hint: choose a white goods manufacturer, a car manufacturer, computer hardware and software manufacturers, and one other such as a manufacturer of medical equipment or of garden tools.) 8. Describe the present scope and concerns of ergonomics. Obtain back issues for the last 5 years of two or more of the journals Human Factors, Ergonomics, and International Journal of Industrial Ergonomics and Applied Ergonomics. Summarize, using keywords of your choice, the topics and research questions being dealt with in each of the articles in these journals. 9. Use the ergonomics checklist in Workshop 1.1 to develop a taxonomy of standards for ergonomics. The standards should provide criteria or limits to support the use of the ­checklist—try to make a link between each item in checklist and one of more standards. (Hint: visit the web sites of the American National Standards Institute and the International Standards Organization.) 10. To what extent are the following industries aware of the need for ergonomics in their shortor long-term planning? What mechanisms do they have in place to ensure that ergonomics principles are applied? • Railways • Maritime (commercial shipping) • Air traffic control • NASA • Health care

2

The Body as a Mechanical System

General Requirements for Humans in Systems 2.1 External forces acting on the human body must not exceed its mechanical tolerance limits. 2.2 Where the exertion of forces on external objects is required, the magnitude of forces must be within the strength and endurance limits of members of the user population. 2.3 The task must be designed to minimize postural load (ALARP). 2.4 Biomechanical risk factors for musculoskeletal injury must be identified and eliminated in the design. In biological terms, posture is constant, continuous adaptation. . . . Standing is in reality movement upon a stationary base. . . . From this point of view, normal standing on both legs is almost effortless. Hellebrandt, 1938

CORE KNOWLEDGE: THE HUMAN BODY AS A MECHANICAL SYSTEM The human body is a mechanical system that obeys physical laws. Many of our postural and ­balancecontrol mechanisms, essential for even the most basic activities, operate outside of conscious awareness. When these mechanisms break down—as in slipping or losing balance—we are rudely reminded of our physical limitations. The skeleton plays the major supportive role in the body. It can be likened to the scaffolding to which all other parts are attached. The functions of the skeletal and muscular systems are summarized in Table 2.1. Like any mechanical system, the body may be stable or unstable and is able to withstand a ­limited range of physical stresses. Stresses may be imposed internally or externally and may be acute or chronic. A useful starting point in the discussion on mechanical loading of the body is to distinguish between postural stress and task-induced stress. • Posture: Is the average orientation of the body at a point in time • Postural stress: The mechanical load on the body by virtue of its posture • Task stress: The forces acting on the body while performing the task There are two different kinds of task-induced stress. 1. Extrinsic task stress: The mechanical load on the body by exposure to external forces 2. Intrinsic task stress: The mechanical load on the body by exposure to internally generated forces Task and postural stresses can vary independently of each other (Table 2.2). Some tasks, such as lifting a barbell, are high in task stress but can be performed in nonstressful postures. Painting 31

32

Introduction to Human Factors and Ergonomics

TABLE 2.1 Functions of the Skeletal and Muscular Systems Skeletal System 1. Support 2. Protection (the skull protects the brain and the rib cage protects the heart and lungs) 3. Movement (muscles are attached to bone and when they contract movement is produced by lever action of bones and joints) 4. Hemopoiesis (certain bones produce red blood cells in their marrow) Muscular System 1. To produce movement of the body or body parts 2. To maintain posture 3. Heat production (muscle cells produce heat as a by-product and are an important mechanism for maintaining body temperature)

a ceiling requires little effort to apply the paint but much effort to maintain the posture. Much biomechanical stress is unnecessary because it is postural and can be reduced by redesigning the task to improve the posture.

Postural Stability In order for the body to be stable, the combined centers of gravity (COG) of the various body parts must fall within a base of support (the contact area between the body and the supporting surface). In standing, the weight of the body must be transmitted to the floor through the base of support described by the position of the feet (Figure 2.1). The alignment of the body parts must be maintained to ensure continuing stability, and it is in the maintenance of posture that much stress arises.

Some Basic Body Mechanics The basic limiting condition for postural stability in standing is that the combined COG of the various body parts fall within the base of support described by the position of the feet (assuming no other external means of support). Ideally, the lines of action of the masses of the body parts should pass through or close to the relatively incompressible bones of the skeleton (Figure 2.2). The jointed skeleton thus supports the body parts and is itself stabilized by the action of muscles and ligaments, which serve merely to correct momentary displacements of the mass centers from above their bony supports. Using a rather crude analogy, the skeleton can be likened to an articulated tent pole with guy ropes (postural muscles) on every side. The fabric of the tent corresponds to the soft tissues of the body. Any displacement of the COG of the structure in a given direction leads to tension in the guy ropes on the opposite side. Ligaments can be likened to the springs and rubber fittings, which stabilize the articulations of the tent pole and tendons to the ends of the guy ropes where they insert into the poles.

TABLE 2.2 Task Stress and Postural Stress Task Stress Postural Stress High Low

High

Low

Digging a trench Painting a ceiling Competitive weight lifting Reading a book

33

The Body as a Mechanical System (a)

(b)

(c)

(d)

FIGURE 2.1  Stability of the body parts depends on the shape of the base of support described by the position of the feet: (a) unstable, (b) fairly stable in all directions, (c) stable anteroposteriorly, and (d) laterally stable.

Postural stress can cause pain. Workers who have to work with the spine flexed forward (by 60° for more than 5% of the day or 30° for more than 10% of the working day) or rotated (more than 30°) suffer back pain (Hoogendoorn etal., 2000). Without its associated trunk muscles, the human spine is very weak—it buckles under a compressive load of only 90 N. Cholewicki etal. (1997) have shown that the function of the trunk muscles is

FIGURE 2.2  Tent analogy. The skeleton is the tent pole, the muscles are the guy ropes, and the soft tissues are the canvas.

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Introduction to Human Factors and Ergonomics

Demonstration To demonstrate the “tent” analogy, stand upright and relaxed with body weight equally distributed between the feet, and neither on the heels nor the balls of the feet. Place one hand on the low back muscles (you should feel a muscular ridge in the center of your back). Place the other hand on your abdominal muscles. Palpate both sets of muscles, which should feel soft. Next, let your weight move to the balls of your feet and lean forward slightly. As you do this, tension should appear in the lower back muscles as they act to maintain equilibrium. Repeat by swaying backward, slightly, with the weight on your heels. Your abdominal muscles will begin to tense and your back muscles will relax as the weight moves onto the heels. In the middle, there will be a neutral position, where your upright stance can be maintained with minimal muscular load. This neutral position is one of the low postural loads. critical in giving the spine its compressive strength. They demonstrated that although a neutral position of minimal postural stress does exist, it depends on low-level antagonistic co-contraction of the trunk flexors and extensors. This activity increases when the person carries a load and is an example of true postural muscle activity—the muscles act like guy ropes to stiffen the intervertebral joints. The main cost of the co-contraction is increased spinal loading. In upright postures, the benefits of increased spinal stability outweigh these costs (Granata and Marras, 2000).

Anatomy of the Spine and Pelvis Related to Posture The spine and pelvis support the weight of the body parts above them and transmit the load to the legs via the hip joints. They are also involved in movement. Almost all movements of the torso and head involve the spine and pelvis in varying degrees. The posture of the trunk may be analyzed in terms of the average orientation and alignment of the spinal segments and pelvis. Figure 2.3 depicts the spine and pelvis viewed sagittally and posteriorly.

Cervical

Iordosis

Thoracic

Kyphosis

Lumbar Iordosis c a

b

c

Sacral d

FIGURE 2.3  The lumbar, thoracic, and cervical spines and the pelvis (a) and sacrum (b). The weight of theupper body is transmitted through the lumbar spine, the iliac bones of the pelvis (c) to the hip joints (d) and legs.

35

The Body as a Mechanical System

Spine Quadrupedal animals and human babies have a single spinal curve running dorsally from pelvis to head. The thorax and abdomen hang from the spine and exert tension, which is resisted by the spinal ligaments, the apophyseal (facet) joints, and the back muscles. In adult humans, the spine is shaped such that it is close to or below the COG of the superincumbent body parts, which are supported “axially”—that is, the effect of weight-bearing in the standing posture is to compress the spine (Adams and Hutton, 1980). This compression is resisted by the vertebral bodies and the intervertebral disks. The “cervical” and “lumbar” spines are convex anteriorly—a spinal posture known as “lordosis.” It is the presence of these lordotic curves that positions the spine close to or directly below the line of gravity of the superincumbent body parts. The effect is to reduce the energy requirements for the maintenance of the erect posture and place the lumbar motion segments in an advantageous posture for resisting compression (Klausen and Rasmussen, 1968; Adams and Hutton, 1980, 1983). The thoracic spine is concave anteriorly and is strengthened and supported by the ribs and associated muscles. The term “spinal column,” although universally accepted, is something of a misnomer; “spinal spring” might be more appropriate. The “S” shape of the spine of a person standing erect gives the entire structure a “spring-like” quality such that it is better able to absorb sudden impacts, such as the mechanical shock, when the heel strikes the ground when walking (Schultz, 1969), than if it were a straight column. The loss of the “S” shape in sitting may be one of the reasons why drivers of trucks and farm vehicles who are exposed to vibration in the vertical plane are so prone to back trouble. The cervical and lumbar spines are not fixed in lordosis. Each vertebral body is joined to its superior and inferior counterpart by muscles, ligaments, and joints. The spine takes part in functional movements of the body—part of the postural adaptation required to carry out many activities takes place in the lumbar and cervical spines. The spine can be considered simplistically to consist of three anatomically distinct but functionally interrelated columns (Figure 2.4). The anterior column, consisting of the vertebral bodies, intervertebral disks, and anterior and posterior longitudinal ligaments, is the main support structure of the axial skeleton. It resists the compressive stress of the superincumbent body parts. The two identical posterior columns are positioned astride the neural arch (which forms a bony cavity through which passes the spinal cord), and consist of the zygapophyseal (or facet) joints and the associated bony projections, ligaments, and muscles. The posterior elements of the spine act as jointed columns, which control the movement of the complete spine and provide attachment points for the back muscles. The vertebral bodies and their related structures increase in size from the top to the bottom of the spine in accordance with the increased load that they must bear.

1

1 2

2

FIGURE 2.4  Function of (1) intervertebral disk and (2) facet joints. The disk resists the compressive load and the facets resist the intervertebral shear force. (From Kapandji, I.A. 1982. The Physiology of the Joints. Vols. 1–3. Churchill Livingstone, Longman Group, Edinburgh, UK. With permission.)

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Introduction to Human Factors and Ergonomics (a)

(b) A

B C

FIGURE 2.5  Intervertebral disk and vertebral body. (a) In this view, the superior vertebral body has been removed to reveal the intervertebral disk below. A is the nucleus pulposus, B is the annulus fibrosus, and C is the inferior facet joints at the rear. (From Kapandji, I.A. 1982. The Physiology of the Joints. Vols. 1–3. Churchill Livingstone, Longman Group, Edinburgh, UK. With permission.) (b) Details of the structure of the annulus fibrosus. The annulus consists of a number of layers of cartilage. The fibers in the layers run obliquely and in different directions, somewhat like the layers of a cross-ply tire. The outer layers run perpendicular to each other. (From Vernon-Roberts, B. 1989. The Lumbar Spine and Back Pain, III, M.I.V. Jayson, ed. Churchill Livingstone, Oxford, Edinburgh, UK. With permission.)

The intervertebral disks act as spacers. They separate the vertebrae and enable them to coarticulate, whereas the facet joints limit the amount of movement that can occur in any direction. Each disk consists of concentric layers of cartilage whose fibers are arranged obliquely in a manner similar to a cross-ply tire (Figure 2.5). The layers of cartilage enclose a central cavity, which contains a protein–mineral solution (proteoglycans). Positive osmotic pressure ensures that water is always tending to enter the disk. Thus, the disks are prestressed to withstand loading (in a manner analogous to reinforced concrete beams used in the construction of modern buildings). According to Kapandji (1982), the nucleus pulposus functions as a swivel joint. Intervertebral disks exhibit viscoelastic behavior. Forces of rapid onset are resisted in an elastic manner—the disk deforms initially then returns rapidly to its original shape when the force is removed. Under continuous loading, however, the disk exhibits a type of viscous deformation known as “creep.” Creep occurs as a result of loading above or below a threshold level. Under compressive loading, the disk narrows as fluid is expelled and the superior and inferior vertebral bodies move closer together (Eklund and Corlett, 1984). Under traction (stretching or pulling forces), fluid moves into the disk and the disk space widens (Bridger etal., 1990). The narrowing and expansion of the disk spaces is natural and occurs due to the forces exerted on the spine during activities of daily life. Since there are 24 vertebral bodies, all with disks between them, the shrinkage and expansion of the disk spaces result in measurable changes in stature—most people are about 1% taller when they wake up in the morning than when they go to bed at night for this reason (de Puky, 1935). Stature change varies exponentially with loading time—almost 50% of the stature gained after a night’s sleep is lost in the first half hour after rising. Grieco (1986) suggests that, since the disks have no direct blood supply, the daily ingress and egress of fluid due to variations in loading is the mechanism whereby nutritional exchange with the surrounding tissues takes place. Postures that exert static loads on the body will interfere with this mechanism and are hypothesized by Grieco to accelerate the degeneration of the disks. Static compression of cells in the disks has been linked to an increase in the rate of cell death (Lotz and Chin, 2000). Although it is too early to specify what the tolerance limits would be for safe exposure to static compression, there is some empirical support for the view that such loading should be avoided. Stressful postures adopted for 8 h per day would be regarded as a health hazard according to this view.

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The Body as a Mechanical System

Stature change also occurs with age—after about 30 years of age, the intervertebral disks degenerate, developing micro tears and scar tissue, fluid is lost more readily, and the disk space narrows permanently. At this stage, the spinal motion segments lose stability. It is not surprising then that most occupationally induced low back pain occurs in middle-aged people. In the elderly, disk degeneration reaches a stage where, together with other degenerative processes, the spine is restabilized but with a corresponding loss of mobility.

Pelvis The pelvis is a ring-shaped structure made up of three bones, the sacrum and the two innominate bones. The sacrum extends from the lumbar spine and consists of a number of fused vertebrae. The three bones are held together in a ring shape by ligaments (Figure 2.6). The innominate bones are themselves made from the fusion of three other bones: ilium, ischium, and pubis. The pubis lies at the anterior part of the pelvis. It joins the other bones together completing the ring shape and acting like a strut to prevent the pelvis from collapsing under weight-bearing (Tile, 1984). The posterior structures of the pelvis, sacrum, and ilia, carry out the actual weight-bearing function. The pelvis can be likened to an arch, which transfers the load of superincumbent body parts tothe femoral heads in standing and to the ischial tuberosities (part of the two ischia) in sitting (Figure 2.6). When viewed from the rear (Figure 2.6), it can be seen that the sacrum resembles the keystone of the arch. The load from above is transmitted through the innominates to the femoral heads. However, when viewed from above, the sacrum has the wrong shape for a keystone—it tends to slide forward, out of the arch (Figure 2.6). Under weight-bearing, the tendency for the sacrum to slide forward anteriorly is resisted by the strong ligaments between the sacrum and the ilia. It is these posterior sacroiliac ligaments that stabilize the joint between the sacrum and the ilia. DonTigny (1985) has pointed out that standing postures in which the person has to bend forward slightly from the hip (such as washing dishes at a sink) increase the tendency for the sacrum to be anteriorly displaced thereby increasing the tension in the sacroiliac ligaments. Small displacements of the sacrum can occur causing soft tissues to be “pinched” and cause pain (Figure 2.7). This pain can be mistaken for low back pain.

Lumbo-Pelvic Mechanism The lumbar spine arises from the sacrum, and the degree of lumbar lordosis depends on the sacral angle which, in turn, depends on the tilt of the pelvis (Figure 2.8). The pelvis can be represented, as in Figure 2.9, as part of a lever system, with the hip joint regarded as a fulcrum.

B B

A

B A

B

C

C

FIGURE 2.6  The pelvis as an arch. The pelvis viewed from the rear. A is the sacrum, B is the ilium, and C is the ischium. The sacrum acts like a true keystone in this plane. (Redrawn from Tile, M. 1984. Fractures of the Pelvis and Acetabulum. Williams & Wilkins, Baltimore, MD, London. With permission.)

38

Introduction to Human Factors and Ergonomics A

C

B

FIGURE 2.7  View of the sacroiliac joint from above. A represents the ligaments, B is the sacrum, and C is the pelvis. The ligaments act like the cables of a suspension bridge preventing the sacrum from slipping forward. If the joint is deformed by loading, the ligaments can be pinched by bone causing pain in the very low back usually on one side. (Redrawn from Tile, M. 1984. Fractures of the Pelvis and Acetabulum. Williams & Wilkins, Baltimore, MD, London. With permission.) (a)

(b) (c)

40°

15°

–5°

FIGURE 2.8  Relationship between sacral and lumbar angles. (a) Sacral angle and lumbar lordosis, as in standing, (b) Moderate sacral angle and fattened lordosis as in sitting on a chair with a backrest, and (c)Minimal sacral angle and tendency to lumbar kyphosis as in sitting on a low stool.

Many muscles attached to the pelvis can be considered as guy ropes or stays, which fixate the pelvis onto the heads of the femora. These muscles can exert torques on the pelvis, which cause change in pelvic tilt (even though this is not their main function). The hamstring, gluteal, iliopsoas, erectores spinae muscles, and other muscles together with the ligaments of the hip joint are part of the lumbo-pelvic system. The tilt of the pelvis in the anterior/posterior plane depends on equilibrium of the torques exerted by the antagonistic muscles in the system.

BASIC APPLICATIONS Standing An understanding of biomechanics and simple anatomy enables us to analyze body positions and movements at work and use the findings of these analyses to assess working arrangements and propose improvements.

39

The Body as a Mechanical System Abdominals

Hip flexors

Erector spinae

Hip extensors

FIGURE 2.9  Schematic representation of the muscular system of the pelvis (sagittal view). When the abdominal or hip extensor muscles shorten, the pelvis tilts backward. The result is a flattening of the lumbar spine to maintain the trunk erect. When the hip flexors or erector spinae muscles shorten, the pelvis tilts forward. This is accompanied by a compensatory increase in the lumbar lordosis.

Standing upright is a position of low postural stress. The additional energy expenditure required to maintain the postural stability is about 6% above the resting level. The main postural muscles are • Plantar flexors: extend the ankle joint and prevent the body swaying forward • Iliopsoas: maintain the pelvis in an anteriorly tilted posture to maintain the lumbar lordosis • Erectores spinae and short, deep muscles of the back: maintain the spinal integrity by stabilizing the joints of the spine • Neck extensors: prevent the neck from flexing (chin dropping onto the chest) • Temporalis: one of the main muscles that controls the jaw—keeping it closed These are sometimes called “antigravity muscles.” With the exception of temporali, which prevent the jaw from dropping under the influence of gravity, these muscles maintain the alignment of body segments such that their mass is supported by the skeleton. From this point of view, quiet standing is nothing more than a finely tuned balancing act in which the antigravity muscles carry out small adjustments to correct momentary displacements of body mass. In standing, the line of gravity falls slightly behind the center of the hip joint causing the pelvis to “tend” to tilt backward. This relieves the abdominal muscles of a postural role and explains why these muscles are relaxed in standing (this applies to normal standing, when carrying a load on the back, or walking down a steep hill, the abdominal muscles do play a role). A stable posture can only be maintained if the various body parts are supported and maintained in an appropriate relation to the base of support such as the feet (Figure 2.1). The line of gravity of the body parts must fall within the base of support, and postural reflexes exist to ensure that, as one body part moves, the total body mass remains balanced over the feet. For example, when a standing person leans forward, as if to touch the toes, the pelvis moves rearward to compensate for the forward displacement of the COG of the upper body (Figure 2.10). It is impossible to carry out this movement without falling over if there is insufficient space at the rear to allow for compensatory projection of the buttocks, unless one foot is placed in front of the other. A simple demonstration of the principle can be achieved by standing with one’s back and heels against a wall and attempting to pick up an object off the floor in front without moving the feet.

40

Introduction to Human Factors and Ergonomics (a)

(b)

FIGURE 2.10  When the base of support is constrained, compensatory movements occur automatically to maintain postural stability demonstrating that the “attitudinal as well as the righting reactions” are indeed involuntary. (a) Balanced erect standing posture and (b) as the hip joints flex and the upper body moves forward, the ankle joints plantar flex to compensate and the lower body moves rearward, maintaining balance.

It is important to provide “sufficient space” around standing operators and plenty of “room for the feet” if losses of balance are to be avoided. For the body to be in a condition of static equilibrium the following conditions must be met: 1. Upward forces (from floor) = Downward forces (body weight plus any objects held) 2. Forward forces (e.g., bending forward) = Backward forces (extension of back muscles) 3. Clockwise torques (e.g., from asymmetric load) = Anticlockwise torques (back and hip muscles) Ideally, the skeleton should play the major role in supporting the various body parts since this is its function. However, muscles, ligaments, and soft tissues can also play a role but at a cost of increased energy expenditure, discomfort, or risk of soft-tissue injury. When leaning forward in the manner shown in Figure 2.10, a stable posture can be maintained indefinitely, although the posture itself is uncomfortable. This is because strain is placed on the posterior spinal ligaments and lumbar intervertebral disks—the upper body load is no longer supported by axial compression of spinal structures but by tension in ligaments and asymmetric compression (wedging) of the intervertebral disks (Figure 2.11). Postures can be stable but stressful if support of body mass depends on soft tissues rather than bone. Ligaments are able to resist high tensile forces, particularly if these forces are exerted in the direction of their constituent fibers. They play a major role in protecting joints by limiting the range of joint movement and resisting sudden displacements, which might damage the joint. However, injuries can occur if ligaments are exposed to sudden forces when prestressed by extreme joint positions or by complex movements. This is one of the reasons why ergonomists stress the importance of the posture of the hands, wrists, elbows, and trunk when tools or controls are operated or when loads are lifted. Poor equipment design, which forces the adoption of extreme joint positions when

The Body as a Mechanical System

41

FIGURE 2.11  In this position, postural stress occurs in the form of compression of abdominal contents and intervertebral disks and stretching of the posterior spinal ligaments.

holding an object, predisposes the joint to injury. Good design enables equipment to be used with the joints in the middle of their range of movement. When a person leans forward in the manner described above but “arches” the back in an effort to prevent the spine from losing its shape, the posture that is produced is still stable but a different cost is incurred. In this position, the muscles of the back must carry out static work to maintain the shape of the spine against the pull of gravity, which is causing it to flex. Static muscle contractions lead rapidly to fatigue.

Understanding Low Back Pain and the Role of HFE Low back pain is a nonspecific health outcome. It is not a disease, although it can be a symptom of one. It can also be the natural response of healthy tissue to biomechanical loading, in which case it disappears rapidly after the loading ceases. Back pain can also be a symptom of a debilitating, degenerative condition that leads to long-term disability. Acute back pain lasts no more than a few weeks, and is usually a response to biomechanical loading or its consequences, such as muscle fatigue. Acute pain can arise from herniated intervertebral disks, muscle tears, or ligament strains. Subacute back pain lasts up to 3 months and is indicative of a more complex picture such as a more severe injury or of reinjury of an injured part. Chronic pain is pain lasting more than 3 months and may be part of an even more complex picture in which an initial injury resulted in tissue damage that changed the mechanical function of one or more motion segments, leading to a cascade of maladaptation, as one problem leads to another. Specialist rehabilitation services may be required in these cases. Table 2.3 summarizes the known nonoccupational risk factors for back disorders (Valat etal., 1997; Rozenberg etal., 1998; Carter and Birrell, 2000). Clearly, there is not much that ergonomics alone can do to lessen the burden of chronic back pain or disability in society “as a whole” (the lifetime prevalence rate of back pain in developed countries is around 70%). However, there is strong evidence of ergonomic risk factors for some of the back pain in society and that these risk factors can be modified to reduce pain in people exposed to them (Table 2.4).

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Introduction to Human Factors and Ergonomics

TABLE 2.3 Risk Factors for Back Disorders Factor Work-related psychosocial factors Congenital abnormalities of the spine Spondylosis and spondylolisthesis Idiopathic scoliosis Anthropometric factors Participation in sports

Smoking Pregnancy Osteoporosis Initial treatment

Psychological factors

General health

Comments Includes job dissatisfaction, avoidance of pain, expectation of sickness payments, and stress Transitional (extra) vertebrae and spina bifida Pain is more severe when it occurs Lateral curvature of the spine Evidence for greater risk in obese people and in people with reduced lumbar lordosis High-level participation in gymnastics, weight lifting, soccer, and tennis associated with increased risk of back pain; degenerative disk disease in those who start at a young age. Recreational sports may protect adults Evidence of a small but significantly increased risk in smokers Increased risk in pregnancy especially among younger, overweight people Pain associated with osteoporotic fractures Bed rest in first 2 days of an acute episode seems to lengthen recovery. Encouragement to return to work as soon as possible shortens recovery time, even if there is still pain Depression and stress increase the risk of chronic pain. Negative beliefs and “fear avoidance” coping strategies also play a role. A lack of formal education, living alone, being divorced or widowed all increase the risk Chronic pain, musculoskeletal pain in other parts of the body, self-reported disability, and systemic health complaints associated with increased stress increase the risk

TABLE 2.4 Strength of the Evidence for Major Mechanical Risk Factors for Low Back Disorders Source Heavy physical work Lifting and forceful movements Bending and twisting Whole-body vibration Static work postures Length of exposure to physical stressors Sedentary work

NIOSH

FOM

Adams

McGill

xx xxx xx xxx I 0 0

xxx xxx xxx xxx 0 x x

xxx xxx xxx xxx 0 x 0

xx xx xx xx xx 0 xx

Source: From U.S. National Institute of Occupational Safety and Health (NIOSH), 1981; Carter, J.T. and Birrell, L.N. 2000. Occupational Health Guidelines for the Management of Low Back Pain at Work—Principal Recommendations. Faculty of Occupational Medicine, London; Adams, M.A. etal. 2000. The Biomechanics of Back Pain. Churchill Livingstone, Edinburgh; McGill, S. 2002. Low Back Disorders: Evidence-Based Prevention and Rehabilitation. Human Kinetics Publishers, Champaign, IL. Note: xxx = strong evidence of an association, xx = moderate evidence, and x = weak evidence. I = insufficient evidence, 0 = no conclusion reached. Strength of evidence based on author’ scrutiny of source documents.

The Body as a Mechanical System

43

Psychosocial factors, including depression, fear of pain, and lack of job satisfaction play a role in the development of disability and ergonomists can help here by designing jobs that are intrinsically satisfying and rewarding to do. Back pain sufferers who are motivated to return to work will find ways of coping with their pain and are more likely to get better.

Causes of Low Back Pain Pain is unlikely to arise from the intervertebral disks themselves since only the outer parts contain nerve endings in the adult. Similar reasoning rules out pain from the capsules of the apophyseal joints. Likely sources of pain are the posterior ligaments and the back muscles. Nerve root compression can also be a source of pain. Pain from the sacroiliac joint can sometimes be mistaken for low back pain (DonTigny, 1985), and evidence is accumulating to show that the sacroiliac joint is the source of pain below L5–S1 (Schwarzer etal., 1995). There is some evidence that chronic low back pain sufferers exhibit inefficient co-contraction of the transversus abdominus muscle—a muscle which is thought to play a role in stiffening the trunk during postural movements (Hodges and Richardson, 1996). Soft tissues in the spine are then exposed to greater load and, over time, this sets up a cascade of maladaptation as one problem causes another. Jayson (1997) suggested that vascular damage due to disk degeneration causes nerve root damage leading to a chronic pain syndrome.

Back Pain and Muscular Fatigue It has been shown that the lumbar muscles of chronic low back pain sufferers fatigue more rapidly than those of nonsufferers. Presumably, pain occurs both directly, as a result of stimulation of pain receptors in the muscles due to the biochemical changes that accompany fatigue, and indirectly due to the increased load on soft tissues in the lumbar spine itself. Roy etal. (1990) found that the median frequency of the electromyographic signal from the back extensor muscle could be used to reliably classify 91% of the low back pain sufferers and 84% of the healthy subjects. Klein etal. (1991) compared the median frequency technique with conventional clinical diagnostic tests for low back pain (range of motion of the lumbar spine and maximum voluntary contraction). The conventional tests correctly identified 57% of the pain sufferers and 63% of pain-free individuals, whereas median frequency analysis correctly identified 88% of pain sufferers and 100% of pain-free individuals. It seems that a lack of back muscle endurance, rather than a lack of strength, is the key characteristic of the type of chronic low back pain sufferers who suffer no other obvious physical abnormalities or pathological conditions. Chronic low back pain sufferers, in particular, are at increased risk in tasks that involve repetitive lifting, carrying of weights in front of the body, leaning forward, or working with the trunk extended— all these activities require sustained activity of the back extensors. Gilad and Kirschenbaum (1988) investigated back pain across a broad spectrum of jobs. More back pain was found in groups that worked in unusual body positions or with the trunk flexed laterally or forward in standing or sitting. Keyserling etal. (1988) came to similar conclusions after investigating back problems in an automobile assembly plant. Persistent back pain was associated with forward and lateral flexion and twisting (axial rotation) of the spine. Pain prevalence increased substantially if a nonneutral posture was held for more than 10% of the work cycle suggesting that such postures be designed out of the work cycle or minimized. Back pain sufferers were five times more likely than matched controls to work with the trunk in mild flexion and almost six times more likely to work with the trunk in severe flexion.

Psychosocial Factors and Physical Stressors Psychosocial factors have been found to account for significant amounts of the variability in the prevalence of musculoskeletal disorders. Modern studies of WMSD prevalence take into account not just the prevalence of a disorder, but also the behaviors associated with it. These disability behaviors include the frequency with which medical treatment is sought, absenteeism, interference

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Introduction to Human Factors and Ergonomics

TABLE 2.5 Psychosocial Risk Factors for Back and Neck Pain

1. Psychosocial factors influence the transition from acute pain to chronic pain disability and have predictive value 2. Psychosocial factors are associated with the onset of pain 3. Back pain disability depends more on psychosocial factors than on biomedical factors or biomechanical exposures 4. There is no simple “pain prone” personality and the role of personality traits is unclear 5. Cognitive factors are related to pain development and disability: • Fear avoidance facilitates pain development • Passive, rather than active, coping strategies facilitate pain development • Over-reaction (catastrophizing) of back pain enhances pain disability • Depression, anxiety, and stress increase pain disability • Self-perceived poor health increases pain disability

Source: Adapted from Lindon, S.J. 2000. Spine, 25: 1148–1156.

with work activities (including job change due to the disorder), interference with activities of daily living (ADLs), and fear avoidance behavior. Psychosocial factors such as self-reported stress, unhappiness, and a sense of hopelessness seem to amplify the deleterious effects of the disorder itself. Psychosocial factors can mediate the prevalence of a disorder or the behaviors associated with it (mediating factors increase or reduce the size of the outcome). They can also moderate the effects of the exposure, reducing the severity of the outcome. Moderating factors include the individual’s coping style and the presence of social support. Lindon (2000) reviewed 37 studies on back and neck pain for evidence of the role of psychosocial factors. The findings are summarized in Table 2.5. Burton (1997) pointed out that the lifetime prevalence of back pain is about 60% and that it occurs most often in people of working age. Although ergonomic factors may precipitate a first back injury, the transition to chronic back pain and back pain disability depends on a number of psychosocial factors including the presence of fatalistic beliefs about back problems, a lack of job satisfaction and social support at work, and a mentally stressful job. Much of the back pain experienced at work by people with these beliefs may be erroneously attributed to the work. In fact, back pain is part of life and is exacerbated by strenuous activities both at work and outside of work. Workers may develop inappropriate beliefs about their back pain—that certain work activities should therefore be avoided and that they need special treatment. These beliefs may reinforce the very behaviors that prevent proper recovery and re-integration at work. Fear avoidance prevents the kinds of muscular stimulation that facilitates restoration of function. Rest and the avoidance of exertion, together with restricted work duties, may reinforce disability behaviors and actually smooth the transition to chronic disability. Burton has argued that back problems at work should be dealt with by stressing return to normal duties as soon as possible, countering negative beliefs with information booklets and advice, and fostering active coping strategies instead of coping strategies based on the avoidance of normal activities. Boos etal. (2000) found that medical consultation for low back trouble in individuals with intervertebral disc herniation was predicted, over a 5-year period, by listlessness, job dissatisfaction, and shiftwork. Work incapacity was predicted by physical job characteristics (acombined score including lifting and carrying, working in a forward flexed posture, exposure to vibration, and sedentary work), job dissatisfaction, and shiftwork. It seems that psychosocial factors mediate withdrawal by back pain sufferers, causing them to avoid physically stressful work.

Can Low Back Pain Be Prevented? In general, the evidence that low back pain can be prevented in the general population is not promising. Linton and van Tulder (2001) reviewed controlled trials of prevention programs and found that

45

The Body as a Mechanical System

exercise had a mild protective effect. Van Tulder etal. (2000) found that exercise was ineffective as a form of therapy for acute low back pain but that there was some evidence that it was effective as therapy for chronic low back pain in facilitating the return to normal daily activities, including work. On balance, there seems to be some evidence that exercise is beneficial, particularly if it strengthens the trunk or improves endurance of the trunk muscles. The mechanisms by which exercise may help are unknown. It is of interest that Stevenson etal. (2001) found that personal fitness is an important defense against low back pain. Their prospective study of manual workers handling more than 5000 kg/day showed that those who did not get back problems had stronger static leg strength and endurance and could move their upper bodies faster than those who went on to develop problems. These results, together with those presented in the previous section, suggest that back pain, when its cause is fatigue in the back muscles, is preventable by means of ergonomic redesign. Any factors that reduce the strength of body parts will increase the risk of injury. McGill has argued that fatigue is such a factor and that attempts to specify a maximum “safe” load are limited. Rather, the injury threshold varies throughout the day, or over the work shift depending on the level of fatigue. Figure 2.12 illustrates this concept diagrammatically. Forward bending is more hazardous in the early morning than at other times of the day. On rising, increased fluids in the disk may escape into the outer annulus through radial tears carrying inflammatory material to nerve endings in the outer annulus and resulting in back pain. Snook etal. (1998) report significant reductions in back pain in a group of sufferers trained to avoid early morning flexion of the spine. Examples of avoidance strategies were techniques of rising from bed without flexion, avoidance of sitting or squatting for 2 h after rising, the use of reachers to pick things up, etc. The evidence suggests that back pain in the workplace can be prevented by ergonomic design of tasks. Specific ergonomics risk factors (Carter and Birrell, 2000) for priority redesign are (b)

Demand on tissues

Demand on tissues

(a)

Threshold of damage

Time

Time Threshold of damage

Demand on tissues

(c)

Threshold of damage

Time

FIGURE 2.12  The specification of force limits for safety (a and b) is complicated by factors such as fatigue that can lower the threshold for injury of the tissues (c). (From Professor S. McGill, University of Waterloo, Canada. With permission.)

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Introduction to Human Factors and Ergonomics

• • • • • • •

Repetitive heavy lifting Lifting, pulling, and pushing of objects over 11 kg Lifting objects from the ground in a twisted position Jobs with high physical demands Exposure to whole-body vibration Prolonged sitting at work (>95% of the workday) Nonneutral trunk postures held for >10% of the work cycle in repetitive jobs

The main risk factors for musculoskeletal injury in the workplace are force, posture, repetition rate, and fatigue and their external (task) counterparts are load, layout, cycle time, and work organization (shifts and rest periods)—all of which can be modified by ergonomic redesign, as is discussed in the rest of this book.

HFE and the Musculoskeletal System in General Biomechanical analysis can be applied to all the joints of the body. Dempster (1955) viewed the body as an open-chain system of links. Each joint of the body has a freedom for angular motion in one or more directions. A complex linkage such as that between the shoulder, arm, and hand has many degrees of freedom of movement and power transmission is impossible without accessory stabilization of the joints by muscle action. For example, supination of the wrist may be required to turn a door handle but this is only possible if the elbow and shoulder joints are stabilized and can counter the reaction at the hand–handle interface. Behaviors such as folding the arms and crossing the legs are postural strategies, which turn open chains of body links into approximate closed chains stabilized by friction. Closed chains have fewer degrees of freedom for movement and move in more predictable ways when subjected to destabilizing forces. The net effect of such postural control strategies is to reduce the postural load on the muscles involved. This may be perceived as being “comfortable.” Snijders etal. (1995) found that EMG activity of the internal and external oblique abdominals was higher in standing than in sitting, and was further reduced when the legs were crossed. Leg crossing stabilizes the sacroiliac joint by compressing it and therefore relieves muscles, such as the oblique abdominals. EMG activity in rectus abdominis (which runs parallel to the joint and is not involved in its stabilization) was not influenced by leg crossing. Individual muscles never work in isolation to produce a movement. Rather synergistic recruitment of muscles takes place in which contraction of the prime mover is accompanied by contraction of surrounding muscles to position and stabilize the joints. In few activities do the trunk and limb muscles exert direct forces on the environment—rather they maintain joint postures such that shifts in body weight can be transmitted via the chain of body links to exert a force. The use of body weight when kneading dough is a simple example of the importance of joint stabilization, which enables shifts in body weight to be used to carry out a task. The same principle also underlies the performance of almost all highly skilled activities in which very large forces are exerted or where body parts or external objects undergo rapid acceleration through pivoting actions. Throwing a discus and swinging a golf club or a tennis racket are excellent examples of this principle. One of the key features of this behavior is the efficient stabilization of joint postures and the use of a back swing involving eccentric contraction of muscles and stretching of tendons to store energy. This back swing can be likened to an archer pulling back the bowstring before releasing the arrow. In the case of club and racket sports and hand tools, it is the hands, rather than the arrow, which are released when sufficient tension has built up. When walking, the stretching and release of the Achilles tendon throughout the gait cycle stores some of the energy when the foot is planted on the ground, which is released during the push-off phase. The deformation of the arch of the foot at these times serves a similar function. The combined effect is to increase the energy efficiency of walking. Excessive tension and compression or a regime of loading cycles, which exceeds the body’s repair

47

The Body as a Mechanical System

capability, can occur in industrial jobs as well as in sports if tasks or tools are badly designed. The outcome is pain and diminished capability.

TOOLS AND PROCESSES Tolerance for Forces of Rapid Onset Figure 2.13 (from Glaister, 1978) shows human tolerance to whole-body acceleration in different body positions and restraints for pulse durations of one thousandth of a second to 1 second. In a standing position with no external support, the body can tolerate 2.5 G for pulse durations between 0.1 and 1 second. As can be seen, tolerance is greater when lying down or sitting than in standing.

Falls into Water LaFave etal. (1995) reported injuries to 297 people attempting to commit suicide by jumping from the Golden Gate Bridge in San Francisco, USA. The bridge is 67 m high on average and jumpers enter the water at velocities of around 120 kph (∼75 mph). Most jumpers died when they entered the water because of the very high impact forces caused by the sudden deceleration. However, 16 (5.1%) survived. All survivors entered the water feet first and were rescued from the generally cold water before they drowned. LaFave etal. quote a maximum survival velocity of 102 kph (63.4 mph) for water entry in the “belly-flop” position and 127 kph (79.1 mph) for feet-first water entry. This explains why so few survive the jump—the velocity at entry is close to the maximum survival velocity in the ideal position. When falling into water, it is not the speed of entry into the water that is the critical risk factor for injury; rather the rate of deceleration on entry, which determines the magnitude of the forces acting on the body. When entering the water side-on or in a prone position, the pressure acting on the body is less than when entering water feet or head first. However, the mass of water displaced on entry is very much larger and jumpers decelerate more quickly. Typical injuries include crush fractures of the chest. For those entering the water feet first, the rate of deceleration is less; they come to a 1000

Plateau (average) acceleration G

m/s 7.6

24.4

100

Inertial force vector

4.6

G

6.1

3.0

40 20

10

4

2.5

t 1 0.001

5

2 0.01

0.1 Pulse duration t (s)

1

FIGURE 2.13  The tolerance to human whole-body impact for critical velocity change, critical acceleration level, and critical duration. (From Glaister, D.H. 1978. Injury, 9: 191–198. With permission.)

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Introduction to Human Factors and Ergonomics

standstill over a greater distance and are therefore at greater risk of drowning thereafter. In many of the cases investigated by LeFave etal., the jumpers were severely injured on entering the water, but the cause of death was drowning. Synder (1965) reviewed human tolerance limits in water impact. G forces acting on the body are 5–7 times greater in the supine, prone, or lateral positions than in the feet or head-first positions Velocity on entry 21.9 kph 32.9 kph 54.9 kph 87.8 kph

Deceleration (feet first versus prone or lateral) 3.5 versus 21.9 G 6 versus 40 G 16 versus 112 G 43 versus 300 G

Figure 2.14 shows the world champion shallow diver, “Professor Splash” (a.k.a. Darren Taylor) performing a dive from a height of 8m into a child’s plastic swimming pool filled to a depth of 30 cm with tomato sauce. In the light of the discussion above, how is he able to survive? As a first approximation, we can perform some simple calculations to generate data for use with Figure 2.13. Ignoring air resistance: Let V = velocity on entering the water U = initial velocity = 0 m/s A = acceleration due to gravity = 9.81 m/s2 S = vertical distance = 8 m

V2 = U 2 + 2AS

V = √ 2AS = 12.5 m/s

(2.1)

or, approximately 45 kph.

FIGURE 2.14  Darren Taylor, also known as Professor Splash, dives from 8 m high into a 30-cm shallow pool of tomato sauce during a promotion at Darling Harbor in Sydney, Australia. Note the “belly flop” technique. (Courtesy of Darren Taylor.)

49

The Body as a Mechanical System

Assuming Professor Splash decelerates completely before reaching the bottom of the pool, his deceleration is given by −2AS = U 2 −A = U 2 /2S

(2.2)

2

= 260.4 m/s

or, approximately 26 G. And the duration of the deceleration phase is given by

V = U + AT T = V/A = 12.5/260.4 = 0.048 s

(2.3)

or 48 ms. Figure 2.13 does not provide limits for the prone position, only for its inverse—the supine position—and also for sitting and standing. However, it does give a broad idea of the kind of pulse durations that can be tolerated and suggests that the forces to which Professor Splash is exposed are within the tolerable range (in the supine position, the critical velocity change is 24 m/s, for a pulse duration of 60 ms and 40 G). This conclusion is based on the questionable assumption that deceleration after contact with the tomato sauce is constant to a depth of 30 cm. It may well be thatthe instantaneous deceleration on contact is much higher due to factors such as the viscosity of the sauce. However, Figure 2.13 shows that much higher values can be tolerated for very short periods. Success at shallow diving depends on posture on contact with the liquid. The “belly-flop” posture in Figure 2.14 no doubt maximizes the mass of fluid displaced on contact and leads to maximum deceleration. Failure to do so would lead to impact with the bottom of the pool and very serious injury or even death.

Tolerance for Collisions and Shocks Figure 2.15 shows road accident data from Richards (2010). An analysis was made of pedestrian casualties in the United Kingdom for 1976 and included 2333 fatalities, 18,168 serious injuries, and 46,217 slight injuries. These data were weighted to match national statistics, and the result is shown in Figure2.15. This figure shows that the estimated risk of a pedestrian being killed is approximately 9% at a speed of 30 mph. The risk at an impact speed of 40 mph is much higher, at approximately 50%.

Shock Figure 2.13 has varied application. Operators are sometimes exposed to high G forces, when operating vehicles that move over rough terrain or when operating small, fast craft on water. Operators are most at risk when the rate of acceleration or deceleration (otherwise known as “shock”) is large. The spine is most at risk when under G forces in the vertical axis and vertebral fracture is a common injury. Figure 2.16 shows an anterior wedge fracture of the 12th thoracic vertebrae caused by rapid deceleration when a small, fast craft reentered the water after cresting a wave. The thorax flexes forward over the lumbar spine, which is held in place by the pelvis—crushing the anterior part of the vertebra like a “nutcracker.” The injury is also common in those with osteoporosis, particularly old people, when they fall backwards on slippery floors.

50

Introduction to Human Factors and Ergonomics Ashton data (all ages, front of cars, n = 358) 100%

Risk of pedestrian fatality

90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

10

20

30 40 Impact speed (mph)

50

60

70

FIGURE 2.15  Risk of pedestrian fatality at different automobile impact speeds.

The lumbar–thoracic junction is at great risk under these circ*mstances because the thoracic spine, stabilized by the ribs can jack-knife forward over the lumbar spine, which is stabilized by the pelvis, acting like a nutcracker to crush the anterior part of the vertebral body. Such injuries are usually suffered by seated operators. Suspension seats are often fitted to small, fast craft to minimize exposure to vibration and shock. Standing operators often suffer knee injuries because the legs are used to absorb shock.

Occupational Exposure to High Forces: How to Calculate Spinal Compression The ergonomic risk factors for back pain as shown in Table 2.4 have a common feature—exposure increases the compression on the lumbar spinal motion segments (Figure 2.4). The mechanism by which spinal compression causes injury is likely to be fracture of the vertebral end plates, which are the weak link in the chain (and not, as is sometimes supposed, the intervertebral disks) (Adams

FIGURE 2.16  Wedge fracture at T12–S1.

51

The Body as a Mechanical System

FIGURE 2.17  Sample output of SSPP (University of Michigan). Lifting a mooring bollard weighing 38.6 kg. Joint angles, measured from the photograph, were entered into the SSPP together with the mass of the operator. 3D SSPP analysis revealed an estimated 6880 ± 503 N in the lower back during this one-person lift. This is in excess of the recommended limit. The hip joints were the limiting joints in this posture and lift, with sufficient strength capability estimated in 58% of people, that is, 58% of males have sufficient hip strength to perform the lift.

etal., 2002). The U.S. National Institute for Occupational Safety and Health (NIOSH) has specified an action limit for spinal compression (NIOSH, 1981) of 3400 N. What this means is that work tasks that impose a compressive load greater than 3400 N on the lumbar motion segments are deemed to be hazardous and in need of redesign. Surveys of certified professional ergonomists in the United States by the Liberty Mutual Research Center for Safety and Health (2004) revealed that the most often used manual handling assessment techniques are the NIOSH lifting equation (83.1%); biomechanical models (74.3%); psychophysical data (73.1%); body discomfort maps (55.6%); and rapid upper limb assessment (51.6%). The most accessible biomechanical modeling tool currently available is probably the Static Strength Prediction Program (SSPP) developed by the University of Michigan. Figure 2.17 shows the output of the program in the assessment of a potentially hazardous manual handling task. After the ergonomist has entered data on the posture of the worker and the mass of the load lifted, the program calculates the joint forces needed to perform the task, the spinal compression, and the percentage of the U.S. population capable of performing the task. Use of the SSPP obviates the need for tedious mechanical calculations that would otherwise be necessary. Ergonomics Workshop 2.1 provides an introduction to biomechanical modeling for spinal compression estimation that can be used as a first approximation in risk assessment if the SSPP is not available. The main limitation of these methods is that they are designed for use in the assessment of static tasks. In dynamic situations, the accelerations acting on the body have to be measured to obtain accurate estimates of loading, although in most industrial tasks, the accelerations of body parts are low and do not greatly distort the output of the models (Chaffin and Andersson, 1984). Table 2.6 gives information on the distribution of mass in different parts of the body. ERGONOMICS WORKSHOP 2.1 Introduction to Biomechanical Modeling of the Spine Suppose we want to estimate the compressive force acting on the intervertebral disk at the L5/ S1 level. The simplest model is of L5/S1 as the fulcrum in a first-class lever system. Any loads in front of the fulcrum exert a moment about L5/S1. If this moment is not resisted, the person (Continued)

52

Introduction to Human Factors and Ergonomics

ERGONOMICS WORKSHOP 2.1 (Continued) will either fall forward or the trunk will flex. Resistance is provided by the back extensor muscles, which exert a counter moment to maintain a static posture. Spinal Compression When Standing Erect Let us suppose that a person is standing erect and carrying no load. His upper body, above L5/ S1 and including the head, trunk, and arms, has a mass of 45 kg. What is the spinal compression at L5/S1? The compression is found by calculating the force (F) acting on L5/S1, where F = m × a m = body mass above L5/S1 = 45 kg a = acceleration due to gravity = 9.81 m/s2 Therefore, F = 45 × 9.81 = 441.5 N (N stands for “newton,” the SI unit of force) Spinal Compression When Standing with a 20 kg Load on the Head Suppose the person places a 20 kg bag of feathers on his head. What is the spinal compression at L5/S1? The spinal compression at L5/S1 is the sum of the compression due to the upper body weight and the compression due to the load on the head, which is transmitted all the way down the axial skeleton to the floor. Let m1 = mass of upper body m2 = mass of load F = (m1 + m2)a F = (45 + 20) × 9.81 = 637.7 N Spinal Compression When Standing Erect and Holding a 20 kg Load in Front of the Body Suppose that the person removes the bag of feathers from his head and holds it in front of his abdomen. There are three loads that have to be considered. First, there is the 20 kg bag in front of the body; second there are the arms, which are now in front of the body rather than hanging by the sides; and third, there is the head and torso, directly above L5/S1. In order to calculate the spinal compression, we need to know the value of the moment of flexion acting on the lumbar spine. This moment (L) is the effect of the load, acting at a ­distance from L5/S1 that has to be resisted by the back extensor muscles in order for the ­person to remain standing erect: L = F × d F = the force in Newtons due to the action of gravity on the mass d = the distance of the center of gravity (COG) of the mass from L5/S1 The units are Newton meters (N m). Let us suppose that the COG of the bag of feathers is 40 cm (i.e., 0.4 m) in front of L5/S1. What is the flexion moment about L5/S1 due to the 20 kg bag of feathers?

L bag = F × d = (20 × 9.81)× 0.4 = 78.5 N m

(Continued)

53

The Body as a Mechanical System

ERGONOMICS WORKSHOP 2.1 (Continued) Similarly, we can estimate the distance of the COG of the arms in front of the body, assuming a symmetrical posture and that the combined mass of the arms is about 12 kg. If the COG of the arms is 20 cm (0.2 m) in front of the body, the load moment due to the arms is then L arms = F × d = (12 × 9.81)× 0.2 = 23.5 N m

The total flexion moment about L5/S1 is therefore L total = L bag + L arms = 78.5 + 23.5 = 102 N m

In order for the person to maintain a static, erect posture while holding the bag, the back muscles have to exert a counter moment (or moment of extension) of the same size. They act at an average distance of 7 cm from L5/S1. Therefore, we can find the back muscle force needed to exert this counter moment as follows: L back muscle = Fback muscles × d

Now, L back muscle = 102 N m and d = 0.07 m

Thus,

Fback muscles = 102 / 0.07 = 1457.1 N

The total spinal compression, then, is the sum of the compression due to the bag, the upper body, and the compression due to the back muscle force needed to maintain the erect posture: Cbag = 20 × 9.81 = 196.2 N Cbody mass = 45× 9.81 = 441.5 N Ctotal = Cbag + Cbody mass + Cback muscles

= 196.2 + 441.5 + 1457.1 = 2094.8 N

Interpretation By far the biggest factor contributing to the compression at L5/S1 is the back muscle force needed to maintain posture. When carrying the load on the head, the spinal compression was 637.7 N, whereas carrying it in front of the body brings about a more than threefold increase in compression. This example illustrates the importance of carrying loads as close to the body as possible, so as to minimize “load moments.”

(Continued)

54

Introduction to Human Factors and Ergonomics

ERGONOMICS WORKSHOP 2.1 (Continued) Forward-Flexed Postures The simple model illustrated above can also be applied to situations where the worker has to lean forward to hold or lift a load. There are two main considerations that have to be accounted for in calculating spinal compression in forward-flexed postures. The first is that the mass of the upper body itself is displaced in front of L5/S1 and the second is that L5/S1 has both shear and compression forces. In the example below, we will calculate the compression and shear forces acting at L5/S1 when a person leans forward in a static posture. Let us assume that his upper body, above L5/ S1 weighs 45 kg. First, we have to locate the COG of the upper body, which, viewed sagittally, is approximately at the axilla (the crease at the bottom of the armpit). Next, we have to measure the approximate horizontal distance of the upper body COG from L5/S1. We need the following data: Distance (D) between upper body COG and L5/S1 (measured using a tape measure) Angle of forward flexion of the trunk (φ, measured by observation or from photographs) Let us suppose we get the following results:

D = 30 cm

φ = 35° The horizontal distance (d) of the upper body COG from L5/S1 is given by d = D × cos 55 = 17.2 cm

The load moment is therefore

L upper body = (45× 9.81)× 0.172 = 75.9 N m

The back extensor force needed to maintain posture is therefore

Fback muscles = 75.9/ 0.07 = 1084 N

The total spinal compression is given by Ctotal = (Cbody mass × cos 35) + Cback muscles

= 361.6 + 1084 = 1445.6 N

(Continued)

The Body as a Mechanical System

55

ERGONOMICS WORKSHOP 2.1 (Continued) The shear is given by Cshear = (45× 9.81)sin 35 = 253.2 N

The back muscles run at a very shallow angle relative to the axis of the spine; therefore, they contribute little to the shear component of the loading. As can be seen, large forces are generated when the trunk is in flexed postures. Postural load can be quantified using biomechanical models and is often found to exceed task load. Summary This simplistic biomechanical model is sometimes called a cantilever model. The lumbar spine is regarded as the fulcrum. In front of the lumbar spine is the load. The total spinal compression is the sum of the component compressive forces: the compression due to body weight, compression due to any external load, and compression due to the back muscle force needed to maintain a static posture. In an erect posture, the upper body weight can be regarded as being directly above the spine, imposing a load but no moment. The load moment is the product of the load and its moment arm (horizontal distance from the lumbar spine). The counter moment produced by the back extensors is the product of the back muscle force and the lever arm (distance of the back extensors from the lumbar spine). In forward-flexed postures, the COG of the trunk moves in front of the lumbar spine and an additional load moment is created (the product of the weight of the upper body and its horizontal distance from the lumbar spine). The back muscles have to counter two load moments (due to postural load and task load). At the level of the lumbar spine, the forward-flexed posture introduces two components of force: one of compression and one of shear. In order to use biomechanical models in practical situations, we need to measure or estimate the following: • • • • •

The magnitude of any loads The COG of the load and its distance from L5/S1 The body mass of the operator The distance of the body part COG from L5/S1 The angle of asymmetry of the trunk (if any)

This can be done using simple equipment such as spring balances to measure loads and tapemeasures to measure distances. Body angles can be measured from photographs (e.g., see Figure 4.5).

Spinal Compression Tolerance Limits Much is now known about the strength of spinal motion segments and their component disks and intervertebral bodies, due to the in vitro studies of Yamada (1970), Adams and Hutton (e.g., 1980, 1985), and others. For a comprehensive review, see Adams and Dolan (1995). These studies typically involve the removal of motion segments from cadavers and testing them for failure in a compression testing machine. Variations on the method include placing the motion segment into a flexed posture before compressing it or combining compression with axial rotation. The load at which failure occurs is recorded and the specimen is removed from the machine and examined to determine where and how failure has occurred (the vertebral body itself can fail or the bony end plates can fail; the disk can also fail).

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Introduction to Human Factors and Ergonomics

TABLE 2.6 Percentage Distribution of Body Mass Body Part Head and neck

Percentage of Total Body Mass

Percentage of Segment

8.4 Head (73.8) Neck (26.2)

Torso

50 Thorax (43.8) Lumbar (29.4) Pelvis (26.8)

Single arm

5.1 Upper (54.9) Lower (33.3) Hand (11.8)

Single leg

15.7 Thigh (63.7) Shank (27.4) Foot (8.9)

Average U.S. Male (kg)

Average U.S. Female (kg)

6.9 5.1 1.8 41.1 18.0 12.1 11.0 4.2 2.3 1.4 0.5 12.9 8.2 3.5 1.2

5.8 4.3 1.5 34.7 15.2 10.2 9.3 3.5 1.9 1.2 0.4 10.9 6.9 3.0 1.0

Source: Adapted from Chaffin, D.B. and Anderson, G.B.J. 1984. Occupational Biomechanics. Wiley & Sons, New York. With permission.

The data obtained from mechanical testing of spinal motion segments enable tolerable loads to be identified, which will not cause failure of lumbar motion segments. The spinal compression tolerance limit (SCTL) is the maximum compressive load that a specified motion segment can be exposed to without failure. In practical situations, manual handling tasks can be evaluated using biomechanical models to estimate the compression load. If the estimated load exceeds the SCTL, then the tasks must be redesigned, either by reducing the load or the load moment. According to Genaidy etal. several factors reduce the SCTL and, therefore, increase the risk of injury. SCTL is greatest in 20–29-year-olds declining by 22% in the next 10 years, 26% in the next 10, and 42% in the following 10. At 60 years of age or more, the SCTL has declined by 53%. Female SCTLs are approximately 67% of male values. SCTLs are lower when spinal motion segments are loaded in complex ways, as when compression and bending are combined. A hyper-flexed lumbar spine has a lower SCTL than a flexed lumbar spine (Adams and Hutton, 1985). In a flexed position, however, the compressive load on the thicker part of the disk (the anterior annulus) is increased and the load on the facet joints is reduced. Physical activity seems to strengthen both the vertebral bodies and the intervertebral disks. Women, older workers, and those unaccustomed to lifting should not be expected to carry out forceful exertions at work. Ayoub and Mital (1997) quote SCTLs of 6700 N for people under 40 years of age and 3400 N for people over 60. The regression equation below (Genaidy etal., 1993) can be used to calculate SCTLs for a given lumbar motion segment:

CS = –13331.2 – (73.7× Age) – (962.6 ×Sex) + (403× LMS) + (79.8× BW )

where CS = compressive strength (N) Age = age in years Sex—use 1 for male and 2 for female

(2.4)

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The Body as a Mechanical System

LMS = lumbar motion segment (L1 – L2 = 44, L2 – L3 = 45, L3 – L4 = 46, L4 – L5 = 47, L5 – S1 = 48) BW = body mass (kg) For risk assessment purposes, a margin of safety is needed. For one-off tasks, the task load should be less than 60% of the SCTL, and for repetitive loads less than 30% (Sandover, 1988). For example, let us suppose that a 43-year-old female worker, weighing 58 kg, has to lift 25 kg bags of wet laundry from the floor and load them into a trolley. We use the model in Workshop 2.1 to calculate the compression at L5/S1 at the start of the lift and find it to be 4350 N. Is this safe? Substituting these data into the equation above, we find

CS = –13331.2 – (73.7× 43) – (962.6 × 2) + (403× 48) + (79.8× 58) = 5546.9 N

(2.5)

The estimated compression tolerance limit for this worker’s L5/S1 spinal motion segment is 5546.9 N. Taking a margin of safety of 60%, we obtain a damage load of 60% of 5546.9 or 3328.1 N. The applied load is 4350 N and the ratio of job demands to biomechanical tolerance is 1.3 (4350/3328.1); thus the applied load is unsafe and the task needs to be redesigned to bring the ratio below 1 (Genaidy, 1993). There are probably many ways of doing this, but since the load has to be lifted from the floor, a large component of the spinal compression is probably postural, caused by stooping; thus, we might start by asking why the load has to be lifted from the floor in the first place!

Measurement of Musculoskeletal Pain in the Workplace Probably the simplest and most widely used tool available for the assessment of musculoskeletal pain is the pain-rating diagram (Figure 2.18). Personnel are invited to rate any musculoskeletal pain on a scale of one to ten and to write the score on the part of the body diagram corresponding to the body region where the pain is experienced. The method is valid and reliable, sensitive enough for the purpose, moderately intrusive, acceptable, and inexpensive. It is not diagnostic and tells us nothing about the reasons for any pain experienced. A variety of specialized checklists (e.g., see Table 2.7) and other tools are available for the identification of ergonomic risk factors in the work environment. Such checklists provide ergonomists with measures of work exposures that might cause the pain indicated on the body diagrams.

SYSTEM INTEGRATION Analyze Legacy Data Designing new systems provides an opportunity to eliminate existing hazards. Legacy data from existing systems can be used to pinpoint areas of risk. The US Bureau of Labor Statistics publishes data on injuries across the United States. Table 2.8 presents an extract for illustrative purposes. Clearly, the risk of musculoskeletal injury is greatest in industries requiring heavy work and exposure to large objects, such as machines and tools. Repetitive motion is the exception and happens more in manufacturing and financial services. The data present clear evidence that heavy work is associated with injury. Within any given project, legacy data on occupational injuries should be gathered and risk factors sought, using the analytical approach described in this chapter. Harmful exposures can be identified and designed out of new systems. The tools described in this chapter are valid in the sense that they measure the risk factor of interest, which is spinal compression due to task demands. However, the validity is restricted to the assessment of static or quasistatic tasks (tasks with no rapid movements). The reliability of biomechanical methods depends on the reliability of the instruments used to make measurements

58

Introduction to Human Factors and Ergonomics 0 1 2

Not uncomfortable A little uncomfortable

3 4 5 6

Fairly uncomfortable

Uncomfortable

7 8

Very uncomfortable

9 10

Extremely uncomfortable

FIGURE 2.18  Body diagram for pain rating. These are often included in questionnaires for use in ergonomic surveys. Pain is often rated on a 10-point scale where 1 = mild discomfort and 10 = the pain could not be worse.

TABLE 2.7 NIOSH Hazard Evaluation Checklist Risk of Back Pain in Manual Tasks Risk Factors

Yes

1. General 1.1 Does the load handled exceed 23 kg? 1.2 Is the object difficult to bring close to the body because of its size, shape, or bulk? 1.3 Is the load hard to handle because it lacks handles or cut-outs or does it have slippery surfaces or hard edges? 1.4 Is the footing unsafe? For example, are the floors slippery, inclined, or uneven? 1.5 Does the task require fast movement, such as throwing, swinging, or rapid walking? 1.6 Does the task require stressful body postures such as stooping to the floor, twisting, reaching overhead, or excessive lateral bending? 1.7 Is most of the load handled by only one hand, arm, or shoulder? 1.8 Does the task require working in environmental hazards, such as extreme temperatures, noise, vibration, lighting, or airborne contaminants? 1.9 Does the task require working in a confined area? 2. Specific 2.1 Does lifting exceed five lifts per minute? 2.2 Does the vertical lift distance exceed 1 m? 2.3 Do carries last longer than 1 min? 2.4 Do tasks that require large sustained pushing or pulling forces exceed 30 s duration? 2.5 Do extended reach static holding tasks exceed 1 min? Note: “Yes” response indicates risk of low back pain. The larger the number of “yes” responses, the greater the risk.

No

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The Body as a Mechanical System

TABLE 2.8 Incident Rates of MSDs in Selected U.S. Industries in 2013 Industry Mining Agriculture Construction Manufacturing Financial Professional/ Business

MSDs

Contact with Objects

Fall Lower Level

Fall Same Level

Slip Trip

Lift/Lower

Repetitive Motion

32.8 41.5 41.9 36.1 13.9 13.3

53.2 66.4 53.4 37.2 8.2 10.5

13.3 20.3 18.0 3.7 2.7 2.9

17.0 23.9 16.1 10.7 7.7 8.1

4.5 6.2 5.7 3.2 1.7 2.4

11.9 15.7 16.0 10.0 5.5 4.2

1.2 2.2 1.5 6.8 2.3 1.4

of the parameters required in the equations. In general, observational methods and simple manually operated instruments are reliable. In field settings, these methods are not very accurate and so assessments may lack sensitivity. There is a trade-off between intrusiveness, cost-effectiveness, and acceptability, on the one hand and accuracy on the other because the use of video and electronic devices such as goniometers intrudes into the work situation. Biomechanical models are eminently diagnostic in that they enable task load and postural load to be assessed independently. However, the models are blind to the personal and psychological/psychosocial risk factors that are particularly important in determining whether or not back pain becomes a chronic health complaint. In conclusion, the models are best used for initial screening and redesign of tasks likely to cause an acute injury due to excessive loading of the spine.

Proactive Approach to Prevention Back injuries often occur at work when people are handling heavy objects manually. They can also occur outside of work. These injuries are often the result of many years of stress both inside and outside of work. We can use an analogy with noise-induced hearing loss. People exposed to loud noises eventually go deaf. It makes no difference whether the exposure occurs at work or at home or both. The way to delay or prevent people going deaf is to lower the total exposure. Similarly, people chronically exposed to back stress eventually develop back problems. The way to delay or prevent the occurrence of these problems is to lower the total exposure to back stress. At work, this means identifying stressful tasks and redesigning them to reduce the stress.

High Costs of Injury The high costs of low back injury have been confirmed by a study by Webster and Snook (1990) who analyzed data from the Liberty Mutual Insurance Company in the United States. The mean cost per back pain case was $6807, and this cost appears to have remained fairly stable since the 1960s (taking inflation into account). Medical costs were 31.5% of the total and indemnity costs 67.2%. The total direct cost (i.e., compensation) to the U.S. economy was estimated to be $11.1 billion. Snook (1978) has presented evidence that ergonomic workplace design can reduce back pain by up to one-third. Snook’s work has been followed up over many years both by himself and by his colleagues at Liberty Mutual in the United States. Using Snook’s data on maximum acceptable loads for industrial workers, Ciriello etal. (1993) report that if a manual handling task is acceptable to less than 75% of workers, the probability of compensable back pain is three times greater than if the job is acceptable to more than 75% of the population. Thus, by redesigning jobs to reduce the

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Introduction to Human Factors and Ergonomics

weight handled, large reductions can be made in back pain compensation claims with immediate and continuing benefits to the company. Many writers have presented statistics, which indicate that back problems are a major cost to many industries and to the national economies of many countries. In the United States, low back pain accounts for 18% of workers’ compensation claims and 30% of the costs (Liberty Mutual Group, 1996). In 1995, there were 900,000 cases of back injury in the United States. Webster (1990) analyzed records of the Liberty Mutual Insurance Company in the United States. In 1986, the mean cost of low back pain claims was $6807 and the median was $391 (suggesting that there are a large number of fairly low-cost claims and a small number of very expensive ones—that is, a few cases account for most of the costs). The total cost of claims handled by Liberty Mutual was $673,884,128. From this, Webster extrapolated that the total cost to the United States as a whole was $11.1 billion in 1986—241% greater than the 1980 cost. It would seem that there is great scope for cost savings. Webster argued that, on average, $6000 spent on a control measure in the United States would pay for itself in 1 year if it prevented oneinjury. A recent report by the UK Health and Safety Executive estimates the total cost to Britain of work-related accidents and ill health to be between 5% and 10% of all UK industrial companies’ trading profits. The total cost to society as a whole, including direct and indirect costs, is estimated to be 2%–3% of gross domestic product or the equivalent of 1 year’s economic growth (Davies and Teasdale, 1994). Approximately 43.4% of the UK sickness and injury absence is due to musculoskeletal conditions (49% if so-called “repetition strain injuries” are included). Similar losses occur in other developed countries. Much of this absence is either caused, exacerbated, or triggered by ergonomic risk factors in the work environment (see Pheasant, 1991; or Bridger, 1995; Kuorinka and Forcier, 1995). A study by safety managers at Goodyear Tire and Rubber Company in 1986, revealed that 62% of the company’s total workers’ compensation payouts resulted from strains due to lifting, pushing, and bending. Ergonomic problems were costing millions of workers’ health care dollars.

Role of Occupational Factors How much of the high incidence of back pain is actually caused by work is open to debate. Eightyfive percent of all low back pain has no identifiable cause (Liberty Mutual Group, 1996). However, it is likely that much of the pain, if not directly caused by occupational factors may well be exacerbated or amplified by work activities. Pathological degeneration of the components of the human spine occurs with age in most people but it is eminently feasible that this process of degeneration can be accelerated by work-imposed stress. Similarly, people with an existing medical condition may find it difficult to cope at work if excessive demands are placed on their musculoskeletal systems. It is likely, therefore, that much of the disabling back pain at work is preventable, can be reduced or delayed, and that significant savings could accrue through well-designed ergonomic intervention programs. Anema etal. (2004) carried out a study on worker’s sick listed for 3–4 months due to back pain. Six cohorts amounting to 1631 workers were studied in Denmark, Germany, Israel, the Netherlands, Sweden, and the United States. Time to return to work for workers receiving ergonomic interventions in the workplace was compared with time to return in those not receiving such interventions. Three types of intervention were made: workplace adaptation, adaptation of job tasks, and adaptation of working hours. The outcome variables studied were the date of first return to work and working status 1 and 2 years after date of first injury. Adaptation of the workplace resulted in earlier return to work in those workers who received it compared to those who did not (median 206 days to return to work compared to 311 days, respectively). Workplace adaptations included changes to chairs and desks, provision of special

The Body as a Mechanical System

61

tools, or lifting aids. Adaptation of working hours resulted in significantly earlier return to work in those who received it than in those who did not (270 days compared to 291 days, respectively). Adaptations included changes in the number and/or pattern of working hours, different shifts, and more variation in hours of work. Adaptation of job tasks did not result in reductions in time taken to return to work. All interventions were applied in the first year after the start of sick leave. The interventions did not differ in their effectiveness in the different countries, suggesting that those interventions that are effective are generally applicable. No details of the costs and benefits of the interventions or of their cost-effectiveness are reported by Anema etal. However, it is noteworthy that the study was carried out on patients falling into the chronic back pain category, an ­impressive demonstration of the effectiveness of ergonomic interventions. As the faculty of occupational medicine in the United Kingdom has pointed out, this is a particularly difficult group to ­rehabilitate—the longer the patient is off work, the less likely is he or she to return to work, irrespective of the intervention.

RESEARCH DIRECTIONS Basic modeling of spine biomechanics at work is now well developed and many tools are available to assess risk and reduce injury. However, disability due to back injury remains a major cost to the healthcare systems of many countries. The transition from acute injury to chronic disability, when it happens, is not as well understood as the initial injury mechanisms. Further work is needed to understand how biomechanical factors interact with psychosocial and psychological factors that can mediate recovery. Changing demographics and increasing sedentary lifestyles present new challenges for the interpretation of risk assessments.

SUMMARY Evaluation of the physical workplace requires a basic knowledge of human anatomy and body mechanics. In order to carry out a physical task in a safe and comfortable manner, a number of physical requirements must be met. First, the body must be stable. This depends on the mechanical relationship between the task objects, the body parts, and the base of support provided by the feet, the seat, and any other surfaces in the workplace, which can be used to support body weight. The design of a work space can determine the range of stable postures, which can be adopted and evaluated from this point of view. In vehicles, destabilizing external forces due to motion may also have to be accounted for. If a task requires a posture to be held for any length of time, posture analysis is necessary. A starting point for such an analysis is to determine the mechanisms by which the posture is maintained, whether static muscular effort is required, whether ligaments are being strained, and whether parts of the work surface such as the backrest of a chair or a work surface are providing support. Knowledge of the anatomy of the spine and pelvis is particularly valuable here as is an understanding of the mechanisms of physical fatigue. Biomechanical models provide important insights into the mechanisms of spinal loading even if, as is the case with the model presented above, they are nothing more than first approximations. Key characteristics of a good static posture are symmetry; an erect trunk, minimal static muscle activity, and some kind of external support. Further guidance can be found in ISO/TC 159/SC 3 Anthropometry and Biomechanics

TUTORIAL TOPICS

1. What is a “good” posture? How would you decide? 2. Are biomechanical models for estimating spinal compression too simplistic? 3. Would it be possible to “re-engineer” the human body when designing life-like robots?

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ESSAYS AND EXERCISES

1. One of the best ways to develop an understanding of anatomy is to practice drawing anatomical structures. Copy the anatomical drawings in this book and label the various structures using the appropriate terms. 2. Observe people carrying out the following or similar activities: Students sitting for an exam A bus driver behind the wheel A person washing dishes A computer programmer at work An archer aiming at a target A gardener digging a hole A mother holding a young child A person operating a lathe Draw stick figures to indicate the position of the main body parts and the base of support at the feet. Indicate where you think the main areas of static and dynamic body load are by considering how the person maintains the posture. Try to visualize the load on underlying structures and indicate whether the task load is greater than the postural load. 3. NIOSH specifies a maximum spinal compression of • 3400 kg • 34,000 N • 45 kg • 85 dB(A) • 3400 N • None of the above 4. The function of the intervertebral disks is to act as shock absorbers. True or false? 5. Use Equation 2.1 to estimate the SCTL at L3 for a 35-year-old female of body mass 61 kg. 6. A 57-year-old male worker weighing 58 kg lifts 25 kg bags of cement onto a conveyor belt. His spinal compression at L5/S1 is 5100 N. Calculate the SCTL and comment on the safety of the task. 7. Define the terms “mass” and “weight” and distinguish between them. Why do domestic weighing scales read in units of mass, such as kilograms? 8. A person is standing erect in an upright, balanced posture with his arms hanging freely by his sides. His upper body, above the L5/S1 intervertebral disk has a mass of 45 kg. What is the compressive force acting on the disk? • 45 kg • 45 N • 441.45 N • 441.45 N m • Other 9. What is the difference between the terms mass and weight? • No difference. They mean the same thing. • Mass refers to force and the effect of one body on another, whereas weight refers to the amount of matter in a body. • Mass is the inertial property of a body, whereas weight is plain English for “static force.” • For every action there is an equal and opposite reaction and this applies to mass but not weight. • None of the above. 10. An astronaut has a mass of 80 kg. He visits the moon, where gravity is one-fifth of what it is on earth. What is his mass under these conditions?

The Body as a Mechanical System

• 16 kg • 16 N • The same • 784.8/5 N = 156.96 N 11. A person, standing upright, holds a mass of 10 kg in front of his body. The moment arm of the load is 50 cm. What force must the back muscles exert to maintain postural stability, assuming that the back muscles have a lever arm of 7 cm and that the COG of the upper body is located directly above the lumbar spine? • 701 N • 700 kg • Other • 70 kg 12. What does the term “load moment” mean when used in ergonomics? 13. In which of the following age groups is low back pain most commonly found: • Under 20 years • 20–40 years • 40–60 years • Over 60 years 14. A worker has a mass of 85 kg. Use Table 2.5 to estimate the masses of his head and neck, torso, arms, and legs. 15. Following the example in Workshop 2.1, calculate the additional spinal compression due to the load held when a worker holds a 20 kg box of lead in front of his body at a distance of 15 cm from L5/S1. 16. A worker has to carry 20 kg sacks of feathers from a packing machine to a dispatch zone. He is able to walk in an erect posture. The COG of the sack is 70 cm from his lumbosacral (LS) joint. Given that his upper body weighs 40 kg, what is the total spinal compression in Newtons? Comment on the difference between the task load and the postural load and suggest ways of reducing the task load. 17. You have decided to redesign a shovel for shoveling snow. In normal shoveling, people typically flex their trunks by 90° and the distance from the LS joint to the blade of the shovel is about the same as the distance of the upper body COG from the LS joint. In your redesign, the handle is lengthened so that the person only leans forward by 10°. However, the loaded blade is now 1.2 m from the LS joint. Given the following body dimensions, would you say that your redesign is really an improvement, given that when the blade of the shovel is laden with snow it weighs 15 kg? Upper body weight = 45 kg. Distance of upper body COG from the LS joint = 45 cm. 18. Mr. Smith is about to drive to the airport before going on holiday. He carries his suitcase to the car, places it on the ground to the right of his body. He opens the trunk of his car and laterally flexes and bends his upper body to reach for the suitcase handle. As he lifts the suitcase in this posture he suffers an acute herniated intervertebral disk at L3. Review this chapter to determine whether there is any evidence that he placed himself at unnecessary risk of injury. How would you advise Mr. Smith to perform this task in future?

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Anthropometry, Workstation, and Facilities Design

General Requirements for Humans in Systems 3.1 Where human physical variability places constraints on the design, the system shall be designed to accommodate the majority of operators on all relevant user dimensions for males and females in the target population 3.2 The design solution shall fit at least the 5th percentile female to 95th percentile male on that dimension 3.3 The physical characteristics of the target population of users must be identified and planned for in advance 3.4 Subgroups with special anthropometric needs such as pregnant females, the disabled, or obese employees must be catered for: either in the design solution; or in bespoke arrangements to enable them to work safely and efficiently

The people in power have created an obesity epidemic. Dr. Robert Atkins, Nov 27, 1996 Interviewed by Alex Witchel for the New York Times

CORE KNOWLEDGE: UNDERSTANDING HUMAN PHYSICAL VARIABILITY Anthropometry: Definition The word “anthropometry” is derived from the Greek words “Anthropos” (man) and “Metron” (measure), and means measurement of the human body. Anthropometric data are used in HFE to specify the physical dimensions of workspaces, equipment, vehicles, and clothing to ensure that these products physically fit the target population. Figure 3.1 provides some examples in which the physical dimensions of workspaces do NOT fit the employees. Measurements of the Body Used in HFE Table 3.1 summarizes the main types of anthropometric data used in HFE. Figure 3.2 provides a basic set of numbered static anthropometric variables and brief descriptions of their use. Table 3.2 provides mean and standard deviation values of the corresponding numbered variables for different populations. The variable numbers in the table correspond to the numbered variable descriptions in the figure (data derived mainly from estimated values from a variety of sources including Pheasant, 1986; Peebles and Norris, 1998).

Functional Anthropometry Figure 3.3 illustrates the basic terminology used to describe movement of the joints. ISO 11226 (2000-12-15) gives estimates of the limits of motion of different joints of the body (Table 3.3) with reference to a relaxed standing position.

65

66 (a)

Introduction to Human Factors and Ergonomics (b)

(c)

FIGURE 3.1  Anthropometric mismatches in the workplace: (a) conveyor too high, (b) hopper too high, and (c) no clearance space for the knees causing twisted sitting posture.

These data are of use in both design and assessment and provide absolute limits for both static and dynamic postures. The data also provide the basis for the risk assessment tools described in this chapter and also chapter 4. Ideally, work postures should vary around the midpoint of the joint ranges (van Wely, 1961) given in the table. The exception, of course, is the standing posture, in which the knees are almost fully extended. Functional data are often used to assess clothing assemblies and personal protective equipment (PPE). Well-designed PPE should provide the maximum amount of protection while minimizing restriction of movement. Sources of Human Variability Humans vary due to genetic differences (in inherited characteristics); plasticity (the capability of being molded by the environment when young); acclimatization; and over the very short term, behavioral adaptation. Only the last two of these forms of adaptation are reversible. TABLE 3.1 Types of Anthropometric Data Used in Ergonomics Structural data: Measurements of bodily dimensions of subjects in static postures. Anatomically rigorous, in that measurements are made from clearly identifiable anatomical sites, usually bony landmarks under the skin. Typically used to optimize furniture, clothing, and vehicle cab dimensions. Functional data: Collected from subjects who are allowed to move one or more limbs in one or more planes with respect to a fixed point. The shape of the 3D surface swept by moving the arm with the elbows extended or the amount of forward reach when the subject can bend at the hip. Takes into account the fact that in natural movements, several joints are involved and generates workspace “envelopes” whose size increases with the number of joints allowed to move. Newtonian data: This included both body segment mass data (Chapter 2) and data about the forces that can be exerted in different tasks.

Anthropometry, Workstation, and Facilities Design

67

1. Sitting height. Vertical distance from seat to top of head. Use 99th percentile male sitting height to specify minimum overhead clearance. Allow 20 mm if hard hats are worn. 2. Sitting eye height. Gives the center of the visual field of a seated worker and maximum height of a visual display. Use 1st or 5th percentile female eye height. 3. Sitting shoulder height. Distance from enter of rotation of the upper limb from seat. Use 1st, 3rd, or 5th percentile female height to specify maximum height of hand controls. Also used to calculate the radius of the zone of convenient reach on horizontal surfaces and the maximum reach height on vertical surfaces. 4. Sitting elbow height. Seat surface to underside of the elbow. Use as a reference point for the height of work surfaces in relation to the seat. Work surface height should approximate sitting elbow height. 5. Thigh clearance height. Vertical distance from top of thigh to stool. Use 95th or 99th percentile male height to specify the minimum thigh clearance between seats and the underside of work surfaces, controls, or other obstacles. 6. Popliteal height. Height of the popliteal fossa (underside of knee) above the floor. Use the 1st or 5th percentile female popliteal height to specify the maximum height of fixed-height seats. Add 2.5 cm if shoes are worn.

7. Forward reach. Horizontal distance from the back of the wall to the fingertip. Use to estimate upper limb length when estimating zones of convenient reach. Work objects to be placed within 5th percentile female upper limb length.

8. Vertical functional grip reach. Vertical distance from stool to knuckles. First or fifth percentile female values specify the maximum height of overhead controls.

9. Abdominal depth. Back of wall to front of stomach. Use to specify the minimum clearance between the seat back and other obstacles.

10. Knee height. Floor to top of knee. Use to specify the minimum height of the underside of a desk or console above the floor. Add 2.5 cm to male 95th or 99th percentile knee height when using.

11. Buttock-popliteal length. Horizontal distance from wall to underside of knee. Use to specify the maximum allowable depth of a seat to accomodate 1st or 5th percentile females.

12. Buttock-knee length. Horizontal distance from wall to front of knee. Use 95th or 99th percentile male value to specify minimum horizontal distance of a seat from a wall in front.

FIGURE 3.2  Static anthropometric measurements commonly used in ergonomics. (Refer to Table 3.2 for mean and standard deviations of these in a variety of populations.) (Continued)

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Introduction to Human Factors and Ergonomics 13. Inter-elbow span. Tip of right elbow to tip of left elbow. Minimum width of passageways where clothing has to be donned. Also used to specify zones of convenient reach for elbow functional reach.

14. Standing shoulder height. Vertical distance from floor to shoulder. Use to specify the maximum allowable height of controls for standing workers and for zone of convenient reach calculations (1st or 5th percentile female values, adding 2.5 cm for shoes).

15. Waist circumference. Use a range of percentiles to design belt sizes and degree of adjustment.

16. Crotch height. Floor to crotch. Clearance for obstacles. Use 5th percentile female value to specify the maximum height of a rail that may be crossed.

17. Hip breadth. Breadth of the hips at the widest point. Can be used to specify the minimum width of a seat. Use 95th or 99th percentile female width (add 5 cm if heavy clothing is worn).

18. Elbow functional reach. Horizontal distance from wall to fingertip with the elbow flexed 90°. Use 5th percentile to define the radius of a zone of convenient reach in front of the worker.

22. Bideltoid breadth. Maximum width at shoulders. Use 99th or 95th percentile male breadth to specify the width of a backrest or estimate the number of occupants on a bench seat of a given dimension.

19. Stature. Floor to top of head. Vertical clearance for low ceilings and doorways. To 99th percentile male stature, add 10 cm for walking, 2 cm for hard hats, and 5 cm as a margin of safety.

20. Standing eye height. Height of the eyes above the floor. Use to specify the maximum height of visual displays (1st or 5th percentile eye height plus 2.5 cm for shoes).

21. Standing elbow height. Height of the elbows above the floor. Use 50th percentile male or female height to specify height of desks and consoles above the floor.

23. Body breadth at elbows. Use 95th percentile male breadth to specify the minimum separation of armrests.

FIGURE 3.2 (Continued)  Static anthropometric measurements commonly used in ergonomics. (Refer to Table 3.2 for mean and standard deviations of these in a variety of populations.)

Roberts (1995) cites evidence of plasticity in a population where the heads of people who were habitually placed in a supine position in the first years of life grew to be broader than those that were more often placed on their sides. Boas (1910) found that children born to immigrant parents after arrival in the United States were larger and had different shaped heads to those born before the parents migrated. This challenged prevailing views about the fixity of racial or ethnic “types.”

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TABLE 3.2 Selected Anthropometric Data: Means and Standard Deviations Males No.

United States

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24b

923(37) 806(38) 637(30) 245(28) 171(24) 450(28) 909(40) 1322(54) 287(49) 546(29) 524(40) 620(41) 949(45) 1460(64) 1011(83) 819(49) 420(39) 479(22) 1755(71) 1643(70) 1099(51) 584(44) 450(40) 82.1(17)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

United States 861(36) 745(36) 583(31) 233(27) 160(39) 400(28) 811(40) 1221(53) 280(80) 496(29) 503(50) 599(56) 860(48) 1336(67) 874(122) 742(46) 426(70) 433(23) 1625(64)

United Kingdom 920(36) 803(37) 635(30) 244(27) 169(19) 449(27) 811(40) 1318(53) 280(39) 544(28) 517(35) 613(37) 946(44) 1455(63) 985(66) 816(48) 393(31) 477(21) 1755(70) 1638(69) 1096(50) 570(35) 449(39) 80(13)

China 906(36) 785(37) 624(33) 236(22) 138(15) 410(23) 820(38) n/a 206(24) 502(28) 452(29) 556(31) 890(51) 1389(53) 750(67) 780(45) 336(20) 450(21) 1691(62) 1573(59) 1021(42) 442(31) n/a 60(8)

Brazil 880(35) 775(34) n/a 230(28) 150(16) 425(24) n/a 1220(56) 245(33) 530(27) 480(29) 595(30) 925(44) 1410(60) n/a n/a 340(25) 475(22) 1700(66) 1595(66) 1045(49) n/a n/a 66(11)

Indiaa 840(25) 740(26) 555(21) 205(20) 135(13) 415(21) 725(24) 1190(44) 185(33) 510(30) 465(18) 555(21) 880(33) 1345(49) n/a n/a 310(16) 460(20) 1620(50) 1510(52) 1025(40) 410(19) n/a 49(6)

Females United Kingdom 858(33) 742(33) 580(29) 232(25) 154(23) 399(26) 808(36) 1216(49) 270(47) 494(27) 495(37) 589(41) 856(44) 1331(61) 840(71) 739(43) 412(41) 431(21) 1620(64)

China 840(35) 720(33) 573(28) 223(19) 133(14) 378(23) 753(35) n/a 208(24) 456(25) 438(28) 531(29) 775(49) 1265(49) 692(64) 717(39) 351(25) 411(20) 1554(57)

Sri Lankac 775(32) 675(30) 525(29) 185(20) 85(9) 335(27) 670(30) 1090(5) 175(28) 420(27) 445(35) 535(29) 795(46) 1270(60) n/a n/a 245(22) 410(29) 1525(59) (Continued )

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TABLE 3.2 (Continued) Selected Anthropometric Data: Means and Standard Deviations Females 20 21 22 23 24b

United States 1517(64) 1000(52) 471(75) 447(40) 69(23)

United Kingdom 1511(62) 996(48) 455(44) 445(37) 67(13)

China 1434(55) 935(39) 415(35) n/a 50(8)

Sri Lankac 1420(59) 940(62) 295(14) n/a 43(7)

Note: The mean and standard deviation values are in millimeters. See Figure 3.2 for key to variable numbers. Agricultural workers, from Pheasant, 1986. b Body mass in kilograms. c Nearest complete data set for females on the Indian subcontinent. a

Children born in Canada of Punjabi parents are taller and weigh more than those born in India (Bogin, 1995). Factors Influencing the Change in Body Size of Populations Better living conditions are associated with larger body size. Smallness does not appear to be intrinsic to many groups of people, but it is related to development in a biologically stressful environment, a plastic response to deprivation. Many industrialized countries have witnessed an increase in population size over the last 150 years. This in, part, due to better diet, better sanitation, childhood

A

B C

FIGURE 3.3  Terminology used to describe the movement of joints: (A) hip flexion, (B) hip extension, and (C)knee flexion. Adduction and abduction of the shoulder; internal and external rotation of the hip joint.

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Anthropometry, Workstation, and Facilities Design

TABLE 3.3 Limits of Joint Ranges of Motion (from ISO 11226 2000-12-15) Body Segment/Joint Upper arm external rotation Elbow flexion Elbow extension Forearm pronation Forearm supination Wrist radial deviation Wrist ulnar deviation Wrist flexion Wrist extension Knee flexion Ankle dorsiflexion Ankle plantarflexion

Range of Motion (degrees) 90 150 10 90 60 20 30 90 90 40 20 50

immunization, refrigerated transportation making available a year-round supply of fresh food, and supplementation of dairy products and cereals with vitamin D. In the United States, Britain, and parts of Northern Europe, this trend seems to have slowed among children of indigenous families (Cole, 2000; McCook, 2001). According to the U.S. Center for Disease Control and Prevention the mean stature of U.S. males and females (175.25 and 162.56 cm, respectively) has not changed since the 1960s; therefore, data from that era are still usable for ergonomic purposes. In the United Kingdom, however, mean male stature increased by 1.7 cm between 1981 and 1995 and mean female stature increased by 12 mm (Peebles and Norris, 1998). With industrialization came scattering of previously isolated rural communities, resulting in outbreeding or heterosis, which is thought to result in a genetically healthier population. Boldsen (1995) investigated the secular trend in stature of Danish males over the last 140 years. He found an increase of 13 cm in mean male stature over this time, 45% of which was due to a change in the population structure, that is, due to heterosis, and the rest a plastic response to improved living conditions.

The Obesity Epidemic The U.S. Center for Disease Control and Prevention reports that in 2011–2012, 31.5% of U.S. adults over 20 years of age were obese and 69% were obese or overweight. In the 1950s, 9.7% were obese and 33% obese or overweight. Similar trends have been reported in the United Kingdom and several other countries. Much anthropometric data were gathered many years ago and are often presented today after small corrections to allow for an increase in the stature of the population over time. Measurements of dimensions, which depend on the length of the bones, are more valid than those which are dependent on body composition (e.g., measures of circumference and body depth). The latter should be used with caution because of the dramatic increase in the number of overweight and obese people in the last 50 years.

Anthropometry Surveys Anthropometric surveys are expensive to conduct, since large numbers of measurements have to be made on sizeable samples of people representative of the population under study. Traditionally,

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measurements are made using manually operated instruments such as anthropometers and calipers. Automated or semiautomated systems have been developed. Whole body scanners (Daanen and Water 1998) are commercially available and cost from $50,000 to $410,000, depending on resolution and speed of operation. Problems with much of the anthropometric data from the United States and Europe are the age of the data and the lack of standardization across surveys. Marras and Kim (1993) note that the first large-scale survey of civilian women in the United States was carried out in 1941 for garment sizing purposes. From 1960 to 1962, the National Center for Health Statistics carried out a survey of 20 anthropometric variables of both men and women. A survey of civilian weights and heights was carried out between 1971 and 1974. In Britain, Peebles and Norris (1998) provide a comprehensive data set largely based on data from older services that has been statistically corrected for secular growth. Marras and Kim (1993) present recent measurements of 12 anthropometric variables from 384 males and 124 females. Abeysekera and Shahnavaz (1989) present data from industrially developing and developed countries and discuss some of the problems of designing for a global marketplace. Implications for HFE These findings have far-reaching implications when designing to accommodate a wide range of people. The structure of populations and the shapes of people are changing in many parts of the world, and anthropometric data captured in the past may no longer be valid. When designing for international markets, then, each target country has to be considered separately. “Self-selection” often occurs in some occupations and when it does, in no sense are employees representative of the population of the country in which they work. The Healthy Worker Effect is an example of selfselection in which, for example, more robust individuals tend to seek more strenuous jobs. Methods of dealing with these challenges are described below.

Statistical Essentials for Using Anthropometric Data in HFE Anthropometric variables in the healthy population usually follow a normal distribution, as depicted in Figure 3.4.

No. of people

The Normal Distribution The two key parameters of the normal distribution are the mean and the standard deviation. The mean is the sum of all the individual measurements divided by the number of measurements. It is a

90% of area

–1.645

x–

+1.645

Anthropometric variable

FIGURE 3.4  The normal distribution. Ninety percent of the measurements made on different people will fall in a range whose width is 1.645 standard deviations above and below the average.

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Anthropometry, Workstation, and Facilities Design (a) x– =

n

∑ xi

i=1

n

(b) S=

n

∑ (xi – x–)2

i=1

n–1

FIGURE 3.5  Equations used to calculate (a) the mean and (b) standard deviation from measurements sampled from a population, where x is the individual measurement and n is the number of measurements. The mean is the sum of all the measurements divided by the number of measurements. The standard deviation is the square root of the mean squared difference between each score and the mean.

measure of central tendency. The standard deviation is a measure of dispersion. It is calculated from the sum of the differences between all of the individual measurements and the mean—the larger these differences, the more “spread-out” is the distribution and the larger the value of the standard deviation. Thus, the value of the mean determines the position of the normal distribution along the x (horizontal) axis in Figure 3.4. The value of the standard deviation determines the shape of the normal distribution. In a normal distribution with a small standard deviation, most of the measurements are close to the mean value (the distribution has a high peak that tails off rapidly at both sides). A large value of the standard deviation means that the measurements tend to be scattered more distantly from the mean. The distribution has a flatter shape. In order to estimate the parameters of stature in a population (the mean and standard deviation), it is necessary to measure a random sample of people who are representative of that population. The formulae given in Figure 3.5 can then be used to estimate the mean and standard deviation. Estimates of population parameters obtained from calculations on data from samples are known as sample statistics. An important characteristic of the normal distribution is that it is symmetrical—as many observations lie above the mean as below it (or in terms of the figure, as many observations lie to the right of the mean as to the left). If a distribution is normally distributed, 50% of the scores (and thus the individuals from whom the scores were obtained) lie on either side of the mean. This simple statistical fact applies to very many variables, yet it is often ignored or misunderstood by both specialists and laymen alike. It is common to hear statements such as “your child is below average height for his age” or “you are above average weight for your height” both pronounced and perceived in a negative way. The statistical reality is that half of any normally distributed population is either above or below “average,” which is why it is unwise to design for “Mr. Average,” a mythical person with the mean stature because very few individuals will be exactly of “average” height and, therefore, it is necessary to design to accommodate a range of people. Variability and the “Distance” from the Middle The difference between any particular measurement and the mean of the sample can be thought of as the “distance” of that measurement from the mean (how far away it is along the x-axis). The “distance” of a measurement from the mean can be described in two ways—in terms of the variable being measured (e.g., height or weight in millimeters of kilograms, for example), or as the number of standard deviations from the mean, in either direction. For example, suppose Sarah is 1600 mm tall and the mean height of females in the population is 1650 mm. We can say that Sarah is 50 mm shorter than average. Now, suppose that the standard deviation of the distribution of female height is 100 mm. We can say that Sarah is one half of a standard deviation below the average height. Using a statistic called the standard normal deviate, Z, we can calculate how tall Sarah is compared to all other females in the population. The Standard Normal Deviate: Z The table in Annex A gives the area under the normal curve to the left of the particular z-value. The values of z apply to a normal distribution that has a mean of zero and a standard deviation of one.

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The total area under the whole of this standard normal distribution has a value of one, by definition. As z increases, distance from the mean increases and the area under the normal curve to the left of z decreases. We can take any value of z for any normal distribution and draw an imaginary vertical cut-off point through the curve (Figure 3.4). The numbers in the table in Appendix A give us the proportion of the curve to the left of the z cut-off point. For any normal distribution, the value of z can be calculated for any observation (i.e., for any value of x) if the mean and standard deviation are known. In the example above, we saw that Sarah was one half of a standard deviation shorter than the average female in her group. For all normal distributions, any measurement (or score or observation) in the distribution can be described in this way. Equation 3.1 defines the “z” score as follows:

z=

(x − x ) sd

(3.1)

Sarah is 1600 mm tall and the mean stature was 1650 mm and standard deviation 100 mm. Therefore, for Sarah, her z score is (1600–1650)/100 or −0.5. The minus sign indicates that Sarah is shorter than average by half a standard deviation. From the table in Annex A, we can see that for z = −0.5, the area under the normal curve to the left of z is 0.3085. This is the proportion of the normal distribution that lies to the left of z = −0.5. In other words, approximately 31% of females are shorter than Sarah—Sarah is of 31st percentile stature. The “z-value” for any observation is just the difference between that observation and the mean, expressed in standard deviations. Thus, if the mean stature in a population was 1700 mm and the standard deviation 100 mm, a person of stature of 1850 mm would be 1.5 standard deviations above the mean or 93rd percentile (see Annex A, where the area to the left of Z = 1.5 is 1 − 0.0668, or 0.9332). Percentiles to Real Measurements and Back Again To find the measured value of a given percentile, use

x = x + ( z ×sd)

(3.2)

If Karen were 25th percentile stature and the mean and standard deviation female stature were 1650 and 100 mm, respectively, how tall would she be? First, we look up the value of z in Annex A. The value of z corresponding to the 25th percentile is z = −0.68 (the actual area in the table is 0.2483, rounded up to 0.25). This means that Karen is 0.68 of a standard deviation shorter than the mean. Therefore, Karen’s stature, x, is

x = 1650 + (−0.68×100) = 1650 − 68 = 1582 mm

(3.3)

Table 3.4 contains z-values and their corresponding areas under the normal curve. Crosscheck these values with the table in Annex A to confirm that you can find z-values for different areas under the normal curve, and vice versa. Estimating the Range We can use z scores to estimate proportions and ranges for all kinds of normal distributions— even those in which the standard deviation is not one and the mean is not zero. For any normal

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TABLE 3.4 Constants Used to Estimate Population Proportions z-Value (No. of Standard Deviations to be Subtracted from the Mean)

Required Percentile

Area to Left of z

0.5

0.0049

−2.58

1

0.0102

−2.32

2.5

0.0250

−1.96

3

0.0301

−1.88

5

0.0505

−1.64

10

0.1003

−1.28

15

0.1492

−1.04

20

0.2005

−0.84

25

0.2414

−0.67

75

0.7486

+0.67

80

0.7995

+0.84

85

0.8508

+1.04

90

0.8997

+1.28

95

0.9495

+1.64

97

0.9699

+1.88

97.5

0.9750

+1.96

99

0.9898

+2.32

99.5

0.9951

+2.58

Note: The total area under the normal curve is taken to be 1 (Appendix A).

distribution, approximately two-thirds of the observations in the population fall within one standard deviation above and below the mean. Thus, for a population with a mean stature of 1650 mm andstandard deviation of 100 mm, approximately two-thirds of the population would be between 1550 and 1750 mm tall. The remaining third would lie beyond these two extremes (one-sixth at either side). Table 3.4 gives us a quick method to calculate the percentiles of a body measurement and from these, how far apart they are (the range). For example, 95% of users will fall within

x ±1.96 sd

(3.4)

Accuracy of the Measurements The World Health Organization recommends that if anthropometric data are to be used as reference standards, a minimum sample size of 200 individuals is needed (this gives a standard deviation around the 5th percentile of about 1.54 percentiles—a 95% probability that the true 5th percentile falls within ±2.25 percentiles of the estimate, approximately). The more the number of individuals who can be measured in an anthropometric survey, the more accurate the estimates will be. A statistic­known as the standard error of the mean (se) is calculated to enable accuracy to be estimated, where

se = sd/ √ n

(3.5)

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where sd = the standard deviation of the mean n = number of people measured in the survey For example, if the mean stature in a sample was 1650 mm and the standard deviation 100 mm and 100 (n = 100) people had been measured, the standard error of the mean would be 100/√100 = 100/10 = 10 mm. We do not know what the real mean stature of the population is (to find the population parameter we would have to measure everyone). However, we do know (from statistical theory) that there is a 95% probability that our statistical estimate of the mean falls somewhere in a range on either side of the sample mean. This range is 1.96 standard errors wide. In other words, the 95% confidence interval for the mean is x ±1.96 se

(3.6)

For our stature example,

1650 mm ± 19.6 mm

Going back to our previous example, we found that Sarah was 31st percentile stature—she was taller than 31% of females in the population. However, if we had only measured 100 females, our estimate of the mean stature, on which our percentile calculation was based would lack statistical accuracy. What percentile stature would Sarah be if the true mean was not 1650 mm but 1650 +19.6 mm?

z = (1600 −1669.6) /100 z =− 0.69

(3.7)

Referring to Annex A, we find that Sarah is now approximately 25th percentile stature as opposed to 31st percentile. Similarly, if the true mean had been 1630.4 mm, z will equal −0.34 and Sarah would now be at the 37th percentile stature. Clearly, if we want to use anthropometric data to design range of clothing or adjustable equipment for large numbers of people, we need large samples and accurate measurements because both large ‘n’ and low measurement error reduce the size of the standard error, otherwise our estimates of the true dimensions of different percentiles may be completely wrong. If our statistical accuracy is low, we won’t really know how many customers will want to buy different sizes or how many people will need to adjust our equipment by different amounts. Accurate estimates will, on the other hand, provide clear guidance for the design and manufacturing of products.

Patterns of Variability in Human Body Size and Shape Tables of data such as that in Table 3.2 may appear to represent the values of different (independent) variables. However, these anthropometric variables are abstractions—they are ways of mapping the human body to yield data useful to designers but the measurements themselves are not independent of each other. People vary according to the length of their long bones and body composition. “Ectomorphs” tend to be slim and gracile. “Endomorphs” tend to have a high proportion of body fat, and “mesomorphs” tend to be muscular. The lengths of the long bones co-vary within a population (people with long legs tend to have long trunks, hands, and feet). People with a high percentage

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of body fat tend to have a high waist and chest circumference, and muscular people tend to have a narrow waist but large chest and limb circumferences. The covariance of anthropometric measures can be explored statistically in several ways. HFE Workshop 3.1 explains.

HFE WORKSHOP 3.1 Covariance and Correlation in Applied Anthropometry The correlation coefficient is a statistic that describes the amount of covariance between two or more variables that are paired in some way. Correlation coefficients vary between −1.0 and +1.0, where “0” indicates that the variables are independent of each other—there is no covariance between them. A positive value indicates that the variables co-vary directly in the same direction and a negative correlation coefficient indicates that they vary in inverse proportion (when one increases, the other decreases). The correlation coefficient is purely descriptive—no causal mechanism is implied or is to be inferred—the covariance might be due to the operation of other, unmeasured or unknown variables. For the purpose of the present discussion, a positive correlation between two anthropometric variables might indicate that they reflect the operation of the same underlying biological mechanisms or body type. The most commonly used correlation coefficient is the Pearson product moment correlation coefficient, Pearson’s r. The correlation between two sample variables, x and y, is given by rxy = Sxy / √ Sxx.Syy

where Sxy = ∑( x − x )( y − y ) Sxx = ∑( x − x )2 Syy = ∑( y − y )2

As can be seen from the formula above, if x and y are identical, then the numerator in the expression is the same as the denominator and the result is +1. If there is perfect negative agreement between x and y (e.g., if y = -x), then the expression in the numerator will be negative and the result will be −1. Let us suppose we calculate Pearson’s r for some anthropometric variables from a large sample of females: • • • • • • • • •

Abdominal depth: ABDP Head circumference: HEDC Buttock–knee length: BTKL Chin height (sitting): CHST Hip breadth: HPBR Biacromial depth: BIAD Foot length: FOOL Chest circumference at bust: CCBU Chest depth: CHDP (Continued)

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HFE WORKSHOP 3.1 (Continued) And generate a matrix of correlation coefficients: ABDP HEDC BTKL CHST HPBR BIAD FOOL CCBU CHDP

ABDP

HEDC

BTKL

CHST

HPBR

BIAD

FOOL

CCBU

CHDP

1.00 0.16

0.18 1.00

0.06 −0.3 0.02 0.03 0.09 1.00 0.04 0.11 0.13

0.06 0.00 0.02 0.94

0.81 −0.01 0.98

0.48 0.14

−0.01 0.00 0.18 0.00 −0.1 0.14 0.15

0.040 0.00 0.93 1.00

0.67 0.18

−0.04 −0.04 0.67 0.06 −0.05 0.81 0.48

0.040 −0.01 1.00 0.93 −0.05 0.02 0.98

−0.04 0.03 0.94

−0.03 −0.05

−0.04 −0.04

−0.05 −0.04 1.00 0.09 −0.04 0.63 0.33

−0.04 0.04 1.00 −0.04 −0.05

−0.04 0.63 0.11 0.54 1.00 0.67

−0.05 −0.04 0.33 0.13 0.40 0.67 1.00

The square of r gives an estimate of the covariance between x and y. For example, the correlation between foot length and chin height (sitting) is 0.94, which means that 88% of the variance between chin height and foot length is shared—probably because both variables are influenced by biological factors that influence the length of the bones. Further analysis is possible to explore these concepts using a technique known as p­ rincipal components analysis (PCA). PCA is a descriptive technique for reducing large numbers of variables into smaller, higher-order components. Variables within a component “belong” together in the sense that they share common variance. Different components are independent of each other. The table below shows the results of a PCA of the data in this example. Component

Eigenvalue

1 2 3 4 5

3.034 2.767 1.010 0.932 0.693

% Variance

Cumulative %

33.710 30.744 11.219 10.357 7.704

33.710 64.454 75.673 86.030 93.734

The analysis has found five main components accounting for nearly 94% of the variance in the dataset. By convention, only components with eigenvalues greater than 1 are selected for further analysis. Rotated Component Matrixa Component 1 ABDP HEDC BTKL CHST HPBR BIAD FOOL CCBU CHDP

−0.019 0.012 0.984 0.976 −0.022 0.031 0.992 −0.011 −0.031

2 0.884 0.257 −0.023 −0.027 0.779 0.199 −0.026 0.928 0.729

3 −0.102 −0.513 0.003 0.004 −0.094 0.851 0.016 −0.006 0.083

(Continued)

Anthropometry, Workstation, and Facilities Design

79

HFE WORKSHOP 3.1 (Continued) The relationship between a variable and a component is expressed by its “loading” on thecomponent. Buttock–knee length, chin height, and foot length load strongly (>0.05) onto component 1. Abdominal depth, hip breadth, chest circumference, and chest depth load onto component 2, and biacromial depth onto component 3. These results might be taken to mean that measurements that depend on the length of bones vary together in a population in support of some of the scaling techniques described later in this chapter (component 1). Component 2 includes variables that depend on body composition rather than bone length, and component 3 might indicate that muscularity is a separate factor. Interestingly, head circumference does not load onto any of these factors. If we had included more measures of the head, a separate component “head size” might have emerged, indicating that the size of people’s heads does not depend on their height, body composition, or muscularity and cannot be estimated from these variables. The components identified by the PCA may enable us to infer that independent factors influence how human physical variability is expressed in a population. Component 1 may reflect the operation of genetic factors in well-nourished populations. Component 2, the operation of health and lifestyle influences on body composition (particularly obesity in the English-speaking world) and Component 3, the expression of different body “types” due to a combination of both. The number of components identified depends, of course, on the set of anthropometric variables measured in the first place.

BASIC APPLICATIONS Design to Fit a Target Population

1. Identify the user population 2. Define the task and workspace and identify where human physical variability might place constraints on the design 3. Identify the body measurements in Figure 3.1 that constrain the design 4. Specify the range of users to be accommodated 5. Calculate the range (see “statistical essentials”) 6. Use the limits in (5) to specify the dimensions of the workspace

The word “population” refers to groups of people sharing the following common factors: jobs; ancestors; occupations; geographical locations; age groups; race (ancestors); and ethnicity (culture, dress, customs, language, and so on). The criteria for deciding what constitutes a “target population” are functional and relate directly to the problem at hand—if we want to design a cab for bus drivers in Chile, we require data on the anthropometry of Chilean bus drivers. Consider product dimensions in human terms in view of the constraints placed on their design by body size variability, for example, seats should be wide enough for large users and low enough for small users. Body size and proportion vary greatly between different populations. A U.S. manufacturer ­hoping to export to Central and South America or Southeast Asia would need to consider in what ways product dimensions optimized for a large US population and probably male user group would suit Mexican or Vietnamese users. Ashby (1979) illustrated the extent of anthropometric variability as follows: If a piece of equipment was designed to fit 90% of the male US. population, it would fit roughly 90% of Germans, 80% of Frenchmen, 65% of Italians, 45% of Japanese, 25% of Thais and 10% of Vietnamese.

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TABLE 3.5 Self-Reported Work Problems of Nurses Related to Their Anthropometry Reported problem/complaint

Associated anthropometric variable

Reaching for work objects

Low stature and grip reach

Buying clothes

Large hip breadth

Buying shoes

Foot breadth and length

Lower backache

Large stature and abdominal depth

Shoulder/arm pain

Low stature and grip reach

Handles on equipment too small

Large hand and palm length hand breadth

Handles that hurt the hands

Short hand length

Work surfaces too low

High stature and standing elbow height

Work surfaces too high

Low stature and standing elbow height

Inadequate legroom in seated workspaces

High popliteal height and buttock–knee length

Information about body size is not, in itself, directly applicable to a design problem. First, the designer has to analyze in what ways (if any) anthropometric mismatches might occur and then decide which anthropometric data might be appropriate to the problem. In other words, the designer has to develop some clear ideas about what constitutes an appropriate match between user and product dimensions. Next, a suitable percentile has to be chosen. In many design applications, mismatches­only occur at one extreme (only very tall or very short people are affected, for example) and the solution is to select either a maximum or a minimum dimension. If the design accommodates people at the appropriate extreme of the anthropometric range, less extreme people will be accommodated. Matching product and user dimensions is important for reasons of safety, health, and usability. Botha and Bridger (1998) carried out an anthropometric survey of nurses in a hospital in Cape Town. They also captured data on problems of musculoskeletal pain and equipment usability. The anthropometric variables were divided into quartiles and the frequency of occurrence of problems was counted for each quartile. Many problems were found to be more common in the extreme quartiles. Table 3.5 summarizes the findings and demonstrates that many of the reported problems were caused or exacerbated by a work environment that did not fit its occupants. It is noteworthy that the sample of nurses in the study bore no resemblance to the local population of females in the Western Cape—many of them were not even from South Africa! It is often fallacious to assume that a group of workers in a particular occupational group are representative of the population of the parent country. If they are not representative, then anthropometric data from national databases (if available) cannot be used. An alternative approach (see below) is to use statistical scaling techniques to estimate the required anthropometric data. A basic set of strength data for pushing, pulling, and twisting is given in Table 3.6. Table 3.7 provides data on maximum grip and pinch strength for U.S. adults from 20 to over 75 years of age. These data may be of use considering the design trend of miniaturization made possible by microelectronics and resulting in smaller products. Figure 3.6 illustrates the three kinds of pinch action: tip pinch, where the thumb contacts the tip of the index finger, as in picking up a small object; key pinch, where the thumb pad touches the lateral aspect of the middle phalanx of the index finger, as when turning a key; and palmer pinch, where the thumb pad touches the pads of the index and middle fingers. Grip strength drops by about 20% from the age of 20 to 60 years and by about 50% by age 75 and above. For pinch strengths, the age-related reductions are not as large—75-year-olds having about 75% of the strength of 20-year-olds.

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TABLE 3.6 Selected Strength Data for Males and Females Pushing (N)a

Mean Handle Height (m) Males 300 Females 181 Males 337 Females 221 Males 393 Females 185

1.7 1.3 0.7 Pulling (N)a Handle height (m) 1.7

Males Females Males Females Males Females

1.3 0.7 Wrist twisting Strength (Nm)b Males only Knob diameter (mm) 9.5 12.7 19.1 a b

Standard Deviation

50 75 83 103 134 57

263 196 347 223 541 292

60 56 55 80 81 97

52.75 65.21 111.65

12.8 12.54 26.2

Daams, B.J. 1993. Ergonomics, 36: 397–406. Swain, A.D., Shelton, G.C., and Rigby, L.V. 1970. Ergonomics, 13: 201–208.

TABLE 3.7 Selected Grip and Pinch Strength Data for U.S. Adults 25–75 Years Males Mean

Females

Standard Deviation

Mean

Standard Deviation

Right hand

46.2

Grip strength 12.6

27.9

7.6

Left hand

41.4

12.3

24.0

7.0

Right hand Left hand

7.6 7.3

Tip pinch 1.8 1.8

5.0 4.8

1.2 1.1

Right hand Left hand

10.9 10.5

Key pinch 2.0 2.0

7.2 6.8

1.3 1.4

Right hand Left hand

10.4 10.2

Palmar pinch 2.2 2.4

7.2 7.0

1.7 1.6

Source: From Mathiowetz, V. etal. 1985. Archives of Physical Medicine and Rehabilitation, 66: 69. Note: The strength is denoted in kilograms (kg).

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Introduction to Human Factors and Ergonomics (a)

(b)

(c)

FIGURE 3.6  (a) Tip pinch, (b) key pinch, and (c) palm pinch.

Anthropometry and Clothing Corrections Most anthropometric data are captured on nude or seminude subjects, whereas most workers wear clothing of some kind. The following corrections are often used: • Shoes: add 25 mm to stature • Hats and helmets: add 90 mm to stature • Protective clothing: add 40 mm to stature

How to Deal with Anthropometric Constraints on Product Dimensions Find the Minimum Allowable Dimensions A high percentile value of an appropriate anthropometric dimension is chosen. When designing a doorway, for example, sufficient head room for very tall people has to be provided and the 95th or 99th percentile (male) stature could be used to specify a minimum height. The doorway (a)

(b)

(c)

(d)

(e)

(f )

FIGURE 3.7  Some minimum dimensions. (a) The height of a doorway must be no lower than the stature of a tall man (plus an allowance for clothing and shoes), (b) the width of a chair must be no narrower than the hip breadth of a large woman, (c) a toothbrush must be long enough to reach the back molars of someone with a deep mouth, (d) a door handle must not be lower than the highest standing knuckle height in a population so that all users can open the door without stooping, (e) the distance from the kneepad to the back of the seat of a “kneeling chair” must exceed the longest buttock–knee lengths in the population of users, and (f) the length of a wheel brace must provide sufficient leverage for a weak person to generate sufficient torque to loosen the wheel nuts.

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Anthropometry, Workstation, and Facilities Design

should be no lower than this minimum value and additional allowance would have to be made for the increase in stature caused by items of clothing such as the heels of shoes, protective headgear, etc. Seat breadth is also determined using a minimum dimension—the width of a seat must be no narrower than the largest hip width in the target population (Figure 3.7). Minimum dimensions are used to specify the placement of controls on machines, door handles, etc. Controls must be sufficiently high off the ground so that tall operators can reach them without stooping—that is, no lower than the 95th percentile standing knuckle height. In the case of door handles, the maximum vertical reach of a small child might also be considered (to prevent young children opening doors when unsupervised). Circulation space must be provided in offices, factories, and storerooms to allow for ingress and egress of personnel and to prevent collisions. In a female or mixed-sex workforce, the body width of a pregnant women would be used to determine the minimum (some anthropometric data of the seated pregnant woman can be found in Culver and Viano, 1990). About 60 cm of clearance space is needed for passages, the separation of machines, and the distance of furniture from walls or other objects in a room. Find the Maximum Allowable Dimensions A low percentile is chosen as in determining the maximum height of a door latch so that the smallest adult in a population will be able to reach it. The latch must be no higher than the maximum vertical (a)

(b)

(c)

(d)

FIGURE 3.8  Some maximum allowable dimensions. (a) A door lock must be no higher than the maximum vertical reach of a small person. (b) Seat heights and (c) depths must not exceed the popliteal height and buttock–knee lengths of small users. (d) Screw-top lids must be wide enough to provide a large contact area with the skin of the hand to provide adequate friction, so that pressure “hot spots” are avoided. They must not exceed the grip diameter of a small person though.

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Introduction to Human Factors and Ergonomics

grip reach of a small person. The height of nonadjustable seats used in public transport systems and auditoria is also determined using this principle—the seat must be low enough so that a short person can rest the feet on the floor when using it. Thus, the seat height must be no higher than the first or fifth popliteal height in the population. Figure 3.8 gives examples of some maximum allowable dimensions. Anthropometric data must always be used in a cautious manner, with a sound appreciation of the design requirements and the practical considerations. In particular, the designer should try to predict the consequences of a mismatch—how serious they would be and who would be affected. The height of the handle of a door leading to a fire escape in an apartment block dramatizes the seriousness of such mismatches—it is essential that a very wide range of users—­including children—be able to reach and operate the handle in an emergency. The design of passenger seats for urban transportation systems is also important—although somewhat more mundane. Because the seats are used regularly by a very wide range of users even small imperfections will affect the comfort of a very large number of people every day. When using anthropometric data, the selection of a suitable cut-off point depends on the consequences of an anthropometric mismatch and the cost of designing for a wide range of people. One of the most important tasks is to predict and evaluate what any mismatches are going to be like. It is not normally sufficient only to specify the required dimensions without considering other aspects such as usability and misuse.

TOOLS AND PROCESSES HFE Workshop 3.2 provides more worked examples to illustrate the statistical essentials of anthropometry in HFE. It describes how to use these equations and the z scores in Appendix A to estimate ranges and body sizes with known accuracy.

HFE WORKSHOP 3.2 Use of Statistics and Statistical Tables with Anthropometric Data Suppose we wish to estimate the 5th percentile popliteal height of Indian males. FromTable3.3,we find that

x = 415 mm and sd = 21 mm

Table 3.1 indicates that the 5th percentile value will be 1.64 standard deviations below the mean:

Popliteal height (5th percentile) = 415 – (21×1.64) = 415 – 34.4 = 381 mm

This implies that a fixed height seat for Indian males should be no higher than about 380 mm. This seat height will fit 95% of males even if shoes are not worn. If we want to design to fit down to the first percentile male then, from Table 3.1

Popliteal height (1st percentile) = 415 – (21× 2.32) = 415 – 48.7 = 366 mm

Let us suppose, in another example, we wish to sell prefabricated fitted kitchen furniture to China, for the burgeoning home products market. We want to know whether our kitchen (Continued)

Anthropometry, Workstation, and Facilities Design

85

HFE WORKSHOP 3.2 (Continued) table tops, cupboards, and work surfaces, designed for sale in the United States and Northern Europe, will fit Chinese housewives. Our kitchen work surface is 1 m above the floor, which is the mean U.S. female standing elbow height. The standard deviation female standing elbow height is 52 mm, so for 90% of our users the work surface will be, at most, 1.64 × 52 mm or 85 mm too high or too low. This is unlikely to affect the ability of most of our customers to carry out their kitchen chores comfortably. What about female Chinese users? From Table 3.3 the standing elbow height is

x = 935 mm and sd = 39 mm

This means that for the average Chinese female user, the work surface is 1000 – 935 mm or 65 mm too high. For Chinese females 65 mm above the mean corresponds to

65/ 39 = 1.67 standard deviations above the mean

From the z-values in Appendix A, an z score of 1.67 above the mean corresponds to an area of 0.0475 under the normal curve. In other words, only 4.75% of Chinese females have a standing elbow height of 1000 mm or greater—so the worktop is above the elbow height of about 95% of our Chinese users. Is this a design fault that needs to be rectified? For our U.S. users, we were prepared to allow the worktop to be up to 85 mm above or below the mean U.S. female elbow height. We know that for 5% of U.S. females it will be too high and for 5th too low. For what percentage of Chinese females will the work surface be too high?

The criterion for acceptance = 1000 – 85 mm = 915 mm

This is 935 – 915 = 20 mm below the mean elbow height or 20/39 or 0.51 standard deviations. From Appendix A, an z score of 0.51 corresponds to an area to the left of 0.305. In other words, for 30.5% of Chinese females, the work surface will be too high. Should we be concerned? If 30% of customers are potentially inconvenienced, then further investigations should be carried out. We might look and see what kind of tasks are carried out, do task objects raise the functional work surface height even more (e.g., thick chopping boards, deep pots, etc.). Perhaps, we should gather a focus group of users to discuss the issue further (see Chapter 14 for advice on focus groups).

Cost–Benefit Analysis and Trade-Offs Sometimes it is not necessary to use anthropometric data because there may be no costs incurred in designing to suit everyone (a doorway or entrance is a hole and the bigger it is, the less building materials are used). However, there are often trade-offs between the additional costs of designing to suit a wide range of people and the number of people who will ultimately benefit. As can be seen from the normal distribution, the majority of individuals in a population are clustered around the mean and attempts to accommodate more extreme individuals soon incur diminishing returns since fewer people are accommodated into the range. Example 1: Let us suppose that the minimum height of a car interior has to be specified. Increases in roof height increase wind resistance and construction cost but provide head clearance for tall drivers. Thus, there are both costs and benefits of building cars with plenty of headroom for the

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occupants. If the mean sitting height for males is 90 cm with a standard deviation of 5 cm, a ceiling height of 91 cm (measured from the seat) will accommodate 50% of drivers with 1 cm clearance to allow for clothing or hair (except hats). An increase in ceiling height of 5 cm will accommodate a further 34% of drivers so that a total of 84% are now catered for. A further increase of 5 cm will accommodate an extra 14% of drivers bringing the total to 98%. However, a further increase of 5 cm will only accommodate an extra 2% of drivers in the population. Because this 2% probably represents a very small number of potential customers, the additional costs of accommodating their anthropometric requirements into the design of every car built become significant. It may be more cost effective to exclude these individuals in the generic design but retrofit the finished product to accommodate one or two extremely tall buyers (e.g., by making it possible to lower the seat). This example should illustrate why the 5th and 95th percentiles of anthropometric variables are often used to determine the dimensions of products. Ninety percent of potential users are accommodated using this approach and further sizable alterations to product dimensions will only accommodate a small number of additional users—the point of diminishing returns has been reached. Example 2: The designers of a new ship wish to specify the minimum deck height to allow sufficient headroom for the crew. The ship will be built in 2 years and in service for 30 years. Assume a stature increase due to the secular trend of 1.5 mm/year and recommend an appropriate height, DH DH = SHx + CA + DA + STA(Yt − Yb) + PA

(3.8)

where DH is the deck height SHx is the x percentile stature CA the clothing allowance (shoes, helmets, when worn) = 70 mm DA the dynamic allowance (accommodates head movements when walking) = 100 mm STA* the secular trend allowance = 1.5 mm/year Yt the target year for specifying deck height = 2035 Yb the base year (in which the height data were captured) = 1986 PA the psychological allowance (perception of head room) = 50 mm Use 95th percentile male stature for the UK population, measured in 1986 at 1870 mm.

DH = 1870 + 70 + 100 + 1.5(2035 −1986) + 50 = 2163.5 mm

Using this value, 95% of personnel would not be at risk of head injury during normal operation. However, as can be seen from the shape of the normal distribution, even small increases in deck height will provide a large additional margin of safety. This margin of safety can be expected to last the lifetime of the ship because we have designed to accommodate the 95th percentile stature at the end of the product life cycle.

Digital Human Models Computerized design aids now exist to facilitate visualization of the physical interaction between users and hardware. SAMMIE (system for aiding man–machine interaction evaluation, SAMMIE CAD Ltd.) is an example of such a system (Figure 3.9). The anthropometry of a three-dimensional * Repeat calculations depending on whether we wish to assume that the secular trend in stature has now ceased.

Anthropometry, Workstation, and Facilities Design (a)

87

(b)

FIGURE 3.9  Computerized anthropometry: (a) JACK (From JACK is a registered trademark of the University of Pennsylvania. With permission.) and (b) SAMMIE. (From SAMMIE CAD Ltd., Loughborough, United Kingdom. With permission.) (a)

(b)

(c)

FIGURE 3.10  Digital human modeling in a virtual environment in the design of an emergency recovery vehicle: (a) view of general arrangement to estimate capacity, (b) use of digital tape measure to assess headroom, and (c) use of digital tape measure to assess clearance. (From Bridger R.S. et al. 2002. Sick bay design for autonomous rescue and recovery craft. Unpublished MOD Report. Ministry of Defence, London, UK. Crown Copyright, contains public sector information licensed under the Open Government Licence v2.0.)

(3D) “man-model” displayed on the computer screen can be manipulated and the consequences evaluated using a computer-generated representation of the product being designed. Several CAD systems are available, which incorporate model humans whose body dimensions can be manipulated using anthropometric data. The JACK system (Maida, 1993) has 88 articulated joints of the human body, a 17 segment torso, and incorporates data on human body contours and strength limits. Figure 3.10 shows digital human modeling being used in a virtual environment to design a recovery vehicle with severe space restrictions.

Anthropometric Scaling Techniques Scaling techniques are used when designing for users whose anthropometry is unknown—for example, a group of workers known to differ from the general population for some reason. HFE Workshop 3.3 gives an example of a scaling technique described by Pheasant (1986) known as

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“Rapid Anthropometrics Scaled for Height.” The method requires that the mean and standard deviation of the target group is known. The mean and standard deviation of linear anthropometric measures (measures that depend on the length of the bones) are estimated using data from a reference population thought to be similar in terms of body proportion. HFE WORKSHOP 3.3 RASH Anthropometry Pheasant (1986) recommended the use of rapid anthropometrics scaled for height (RASH) technique to estimate the body dimensions of populations whose anthropometry is unknown. The technique requires data on the stature of the target population. These data are normally available from medical records. RASH estimates are made by calculating scaling factors for the anthropometric variables of interest using data from a known population and then applying these scaling factors to the height data in the target population. Suppose we want to estimate the sitting height of Chilean bus drivers, but have no data on the anthropometry of the Chilean population, where do webegin? 1. Obtain data on the stature of the drivers from medical records and calculate the mean and standard deviation stature (all data are in centimeters).

x = 166, sd = 5.5

2. Obtain data on the mean and standard deviation stature and popliteal heights of a similar group of people, assuming that body proportions will be similar. We will use data for Brazilian males. Stature: x = 170, sd = 6.6;  sitting height: x = 88, sd = 3.5

3. Calculate scaling ratios for the mean and standard deviation stature.

SR (mean sitting height) = 88/170 = 0.518  SR (sd sitting height) = 3.5/6.6 = 0.53

4. Multiply the mean and standard deviation stature of the Chilean bus drivers by the scaling ratios.

Estimated mean sitting height = 166 × 0.518 = 86 Estimated sd sitting height = 5.5× 0.53 = 2.92 5. Calculate 5th percentile sitting height by subtracting 1.64 standard deviations from the estimated mean sitting height. Estimated 5th percentile sitting height of Chilean bus driv vers = 86 − (1.64 × 2.92) = 81.2

6. Calculate 95th percentile sitting height by adding 1.64 standard deviations to the estimated mean sitting height.

Estimated 95th percentile sitting height of Chilean bus driivers = 86 + (1.64 × 2.92) = 90.8 (Continued)

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HFE WORKSHOP 3.3 (Continued) Use of the technique is best limited to body dimensions that depend on the length of bones, sitting eye height, popliteal height and is not recommended to estimate circumferential ­dimensions such as girth or measures, such as hip breadth, which also depend on the distribution of adipose tissue in the body.

Sometimes, we are dealing with a subset of the general population, in which case scaling techniques can be used to make simple proportional estimates of body dimensions. Figure 3.11 (from Keyserling etal., 1988) expresses the lengths of several linear anthropometric dimensions as a proportion of stature, for the U.S. population. If the mean stature of a group of male U.S. workers in a target population were 1800 mm (compared to 1755 mm in the general population), then the mean standing elbow height would be Standing elbow height =1800 × 0.63 =1134 mm

(3.9)

Similarly, if the mean and standard deviation of stature in the target population were known, we would be able to generate estimates of the smaller and larger percentile statures and scaled estimates of linear dimensions using the proportions in Figure 3.11.

0.13 0.186

0.129

0.146

0.936

H

0.259

0.108

0.52

0.818

0.870

0.174

0.630

0.191

0.485

0.720

0.377

0.530 0.285 0.039

0.056 Foot breadth

0.152 Foot length

FIGURE 3.11  Linear body dimensions expressed as a percentage of stature. (Redrawn from Keyserling, W.M. etal. 1988. Applied Industrial Hygiene, 3: 87.)

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d

r ZCR

(b) d

r ZCR

(r) ZCR radius (c) r d HD

FIGURE 3.12  The radius of the ZCR can be calculated using Pythagoras’ theorem. If the reach fingertip or palm reach distance (r) and the height of the shoulder above the horizontal work surface (d) are known (a and b). For wall-mounted controls, the maximum height of a control above the workers’ shoulder can be calculated if reach (r) and the HD of the shoulder from the wall are known (c).

Workstation Design and Reach One of the most basic applications of anthropometric data in HFE is the specification of reach distances to ensure that controls and other work objects are placed within a “zone of convenient reach (ZCR).” The reach zone is such that the worker can reach work objects, either from standing or from a sitting position, without having to lean forward. The ability to do this depends on two variables, the forward reach distance (variable number 7 in the table) and the vertical distance (d) between the shoulder and the work object. Pheasant (1986) has pointed out that the geometry of forward reach follows Pythagoras’ theorem, since the arm can be considered as the hypotenuse of a right-angled triangle (Figure 3.12). For a seated worker (Figure 3.12a and b), the radius of the ZCR (ZCR radius) is given by

ZCR 2 = r 2 − d 2

(3.10)

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Arc of rotation of upper limb outer limit for frequently used controls

Shoulder height Generally preferred heights for controls Elbow height

Lowermost limit For controls

Preferred heights for working surfaces Fingertip height

FIGURE 3.13  Recommendations for the height of controls. (Redrawn from DefStan 00–25 [Defence standard 00–25, Ministry of Defence UK].)

And for a standing worker (Figure 3.12c), the maximum horizontal distance (HD) for the placement of controls on a wall in front of the operator is given by

HD = r 2 − d 2

(3.11)

In practice, we would usually base our ZCR radius and HD estimates on the 5th percentile female forward reach since forward reach is normally regarded as a maximum allowable dimension. Figure 3.13 summarizes general recommendations for workstation layout for standing operators. The problem of designing to suit a range of users can be approached in several other ways. Make Different Sizes In clothing and school furniture design, a common solution is to design the same product in several different sizes. Anthropometric data can be used to determine a minimum number of different sizes (and the dimensions of each size), which will accommodate all users. Mass production or long production runs often bring economies of scale in product design through reduced retooling and stoppages. This usually has economic benefits and demonstrates why it is important to determine the minimum number of sizes in a product range that will accommodate most of the users in the population in question. Clothing design is the best example of fitting the product to the user. There are standards, such as ISO 3636 for the designation of clothing sizes. It is left to the manufacturer to decide what sizes

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to make and this is often done by trial and error or “knowing the market” rather than by carrying out an anthropometric survey. Head girth, neck girth, chest girth, bust girth, under bust girth, waist girth, hip girth, stature, outside leg, and inside leg length are dimensions used to designate the size of a piece of clothing. National and international standards only specify which dimensions the manufacturer must use to designate sizes; they neither specify the number of sizes in a range, nor what actual size the clothing should be. Clothing sizing systems divide a variable population into roughly hom*ogenous subgroups (McCullogh et al. 1998). It is assumed that members of a subgroup are a single size and shape so that a single garment can fit everyone in the group. The simplest approach is to choose one or two dimensions, which are thought to be crucial if a good fit is to be achieved, and then divide the range into an equally spaced series of sizes according to these dimensions. The remaining variables are adjusted across the range in proportion to the criterion sizes. Sizing is difficult because many anthropometric dimensions are not highly correlated—long bone measures and girth measures, for example, and users may struggle to find a shirt in which the collar size and the sleeves both fit. Because anthropometric variables are usually normally distributed, a far greater number of people will fit clothes in the middle of the range and only short production runs are needed to accommodate the extreme sizes, which may be difficult to find in the shops. An alternative is to expand the range around each size. The best recent example of this approach was the Levi-Strauss mass customization experiment in which women’s jeans were offered in 16 hip sizes. For each hip size, there were 11 waist sizes, 4 crotch depths, and 6 lengths resulting in 4224 different sizes of jeans. This approach is probably only practical for mass-produced items. More recently, clothing researchers (e.g., Ashdown, 1998) have turned to multivariate statistical methods to tackle the problem. The goal of achieving as good a fit as possible can be restated as • Accommodate as large a percentage of the population as possible with ready-made garments • For accommodated individuals, provide as good a fit as possible • Use as few sizes as possible A statistical technique, known as cluster analysis, is used to search for groups, or clusters, of anthropometric variables in the target market. It is neither necessary to specify criterion variables, nor to adjust the remainder proportionally. Rather, any number of variables can be used, so that the combination of dimensions will fit people of a particular size. Each size selected is defined by a set of “prototype” design values. The cluster analysis approach is an example of an “optimization” technique. The optimization criterion is to select a set of values that will minimize the average distance, where distance corresponds to a lack of fit. Because this applies to all the anthropometric variables selected, an item of clothing that fits the neck will tend to fit the chest and sleeves as well. The result is that clothing sizes do not increase in fixed intervals, but according to the make-up of the target market. Some jumps may be bigger than others between sizes in the range and some measures may change more than others in a single jump. Sizes may sometimes differ in terms of proportion and not in terms of largeness or smallness and this may mean that potential buyers would have to try on more sizes before finding one that fits. However, from the retailer’s point of view, the distribution of people fitted by each size is likely to be more uniform, and this may simplify the ordering of stock. Design Adjustable Products An alternative is to manufacture products the critical dimensions of which can be adjusted by the users themselves. A first step is to determine what the critical dimensions for use are, then design the mechanism of adjustability with the emphasis on ease of operation. Finally, some instructions or a training program may be needed to explain to users the importance of adjusting the product and on how to adjust it correctly. In seated work, for example, the height of the seat and desk is critical for seated comfort. The seat height should be no higher than the popliteal height of the user so that both feet can be rested

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firmly on the floor to support the weight of the lower legs (otherwise the soft tissues on the underside of the thigh take the weight, and blood circulation is impeded due to compression of these tissues). Second, the desk height (or middle row of keys on a keyboard) should coincide with the user’s sitting elbow height. Since popliteal height and elbow height do not correlate strongly in practice (Verbeek, 1991) adjustable seat and desk heights are needed. Shute and Starr (1984) investigated the effects of adjustable furniture on visual display unit (VDU) users. On-the-job discomfort was reduced when either adjustable chairs or desks were used in place of nonadjustable furniture. The greatest reductions in discomfort were found when the two adjustable items were used in combination. One problem with adjustability is that users may not use the adjustment facility if they do not expect a product to be adjustable or if they do not understand the reason for incorporating adjustability into the product. Verbeek (1991) investigated the effect of an instruction program for office workers on the anthropometric fit between users and their chair/desk workstations. Before the program, a survey of chair/desk settings in an office revealed mean deviations from the ideal of 71 mm for seat height and 70 mm for desk height. A model of “correct” sitting was used as a criterion to evaluate the chair/desk settings. After the program, these deviations were reduced by 11 and 18 mm, respectively. However, only 7% of users adjusted their seat heights as advised and only 13% adjusted their desk heights as advised. It was concluded that this meagre result was due to practical difficulties, the unaesthetic appearance of adjacent desks having different heights and the suspect validity of the model of “correct sitting,” which had been used to specify the method of adjustment (further discussion of concepts of “correct sitting” can be found in Chapter 4).

SYSTEM INTEGRATION There are a number of key considerations throughout the design process that can be used to integrate anthropometric considerations with the rest of the design process. Clearly, the specification of the user population comes directly from the description of the target users for whom the system is being designed. Some key design decisions early on are as follows.

FIGURE 3.14  Understand the context of use. Escape hatches are used in emergencies when people are wearing protective clothing and apparatus. This adds to the body circumference and must be considered during the design.

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Understand the Context of Use Anthropometric data alone is not sufficient to ensure good fit. Designers must also consider the context of use as is illustrated in Figure 3.14.

Design from the “Inside Out” Not the “Outside In” When designing any large facility, it is imperative to specify in advance, the space requirements for human operators to work in when carrying out operational and nonoperational tasks. Spatial requirement templates can be developed to support volumetric analyses for defined activities, which can be used to determine specific requirements (Figure 3.15). Based on the number of people engaged in these activities at any one time, the total amount of space required can be estimated. The templates do not contain anthropometric data themselves. Their dimensions are selected during the early stages of design when decisions are made about the precise population to be accommodated, the optimal percentile range, and the requirements for a good anthropometric fit. Trade-offs between anthropometric requirements and other requirements might be needed. For example, the designers may decide that the costs of designing to fit 99% of users are too great in relation to the engineering and operational costs of designing a larger building (or aircraft, ship, and so on) and that the risks posed by anthropometric mismatches are not severe or can be managed operationally.

Anthropometry, Workstation Design, and Task Analysis Anthropometric data help designers to optimize the dimensions of workspaces and furniture but are of limited use in optimizing the final design. Some kind of task analysis is always needed sothat the anthropometric recommendations can be considered in relation to the task demands. Figure 3.16 presents the results of a very simple observational task analysis known as “link analysis” used to investigate alternative layouts for domestic kitchens. Two plan views are presented and the black lines show the movements of the user when working in the kitchen. The thicker the lines, the more frequently the user moves between linked objects (e.g., there is much movement between the work surfaces and the sink and less between the refrigerator and the stove). The U-shaped kitchen layout

FIGURE 3.15  Specification of the minimum dimensions of a bunk space. Length—99th percentile stature plus 10% for movement, width—99th percentile girth plus 20% for bedding and movements, height—99th percentile sitting height plus 10% for ingress and egress. Note, dimensions and allowances are decided first and specified later when the target population is better understood.

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7

1

4

3

5

16

5

3

7

1

4

2 16

14

15

13

Two-sided kitchen, 7 m2 1, 5, 7 = places where things are put down, or work is carried on 4 = cooker, 3 = Sink 14, 15, 16 = crockery cupboard and refrigerator

13

6 14

15

19

U-shaped kitchen, 6.2 m2 1, 2, 5, 6 = places where things are put down, or work is carried on 4 = cooker, 3 = sink 13, 14, 15, 19 = cupboards and refrigerator

FIGURE 3.16  Link analysis of a user’s movements when working in two alternative kitchen layouts. (Redrawn from Grandjean, E. 1973. Ergonomics of the Home. Taylor & Francis, London.)

requires less walking but more twisting and turning. In general, objects that are used in succession are positioned close together and vice versa.

Space Planning for Offices Margaritis and Marmaras (2007) proved guidance for optimizing the use of space in offices for more than one person: Step 1: Determine the number of people who will work permanently in the office. Step 2: Determine the organizational structure (see Chapter 16). Step 3: Describe the main activities, the need for interaction between different employees, the need for privacy, reception of visitors, etc. Step 4: Determine the equipment needed for each activity (e.g., VDT, printer, storage requirements, etc.). Step 5: Detailed layout: Allow 50 cm free space in front of windows. Allow 3 m to the front and 1 m either side of the main entrance. Allow 1.5 m in front of and 0.5 m to the side of all other doors. Allow 0.5 m in front of heating units. Free space around desks: Allow 55 cm along front of desks for passage Allow 50 cm along the sides of workstations for ingress and egress Allow 75 cm at the back of desks for seating space Allow 100 cm at the back of desks if there are cabinets behind the desk Step 6: Determine requirements for proximity: physical separations should be compatible with task separations (the more two workstations collaborate, the closer they should be). Place the units that interact most with other units toward the center of the space. Step 7: Arrange individual workstations in accordance with local health and safety regulations for office work (see Chapter 4).

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TABLE 3.8 Questionnaire Items for a Basic Survey of Anthropometric Fit Personal Characteristics (Self-Reported or Measured)

Difficulties with Equipment Items

Age Sex Height Weight Chest circumference Department Job title Length of time in job Any work-related injuries?

Equipment difficult to operate Requires too much force Parts that are difficult to grip Have to reach too far forward Have to reach too far up Have to reach too far down Have to stand in an awkward posture Have to sit in an awkward posture Unable to see parts of the equipment Equipment too heavy Equipment too bulky Straps do not fit/uncomfortable Cannot get access Problems with ingress

“Fit for Use” Surveys and Acceptance Testing There are many ways of assessing how well a work environment fits its users. We can measure the critical features of the equipment and compare them with user anthropometry, we may unobtrusively observe people at work and note any apparent problems. Alternatively, we may carry out some kind of task analysis and consult the users—asking them to report any problems ­experienced. A minimal set of items for a questionnaire designed to assess “fit” is given in Table3.8. Fit-for-use surveys can be conducted on existing systems to facilitate learning from experience and support the design of better systems, or they can be conducted as part of a “post-implementation evaluation” to determine how well the objectives have been met.

Psychosocial Factors: Anthropometry and Personal Space Personal space can be defined as the area immediately around the body. Argyle (1975) describes personal space in the context of territorial behavior. Many animals regard a certain area of space as their exclusive preserve. The area immediately around an individual’s body is usually regarded in this way—two important issues in “psycho-anthropometry” are the volume of space regarded as personal territory and the consequences of an invasion of this space by others. Large individual and cultural differences exist. Argyle reports the results of studies that indicate that Arabs stand closer together than Europeans and North Americans, with Latin Americans and Asians intermediate. Invasion of personal space and crowded conditions appears to be stressful (Dabbs, 1971). In an experiment that is now infamous, Middlemist etal. (1976) tested the hypothesis that personal space invasion increases arousal. They measured the time to onset and duration of micturition (urination) of 60 men using a public lavatory under one of three conditions—subject alone (control condition), subject standing next to a confederate (adjacent invasion), and subject one urinal removed from the confederate (moderate invasion). The confederate was an accomplice of the experimenters and arrived after the subject had unwittingly taken his place. Onset time of micturition increased from 4.9 s in the control condition to 6.2 (moderate space invasion) and 8.4 s for adjacent invasion.

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Micturition duration dropped from 24.8 s in the control condition to 23.4 and 17.4 s in the space invasion conditions, respectively. In the context of public lavatory use, the minimum required personal space would appear to be about the distance of one urinal. The degree of stress depends on the context. Invasion of personal space in a library, for example, is much more stressful than in a crowded train or lift. Personal space is another important consideration in addition to the purely dimensional ones. Design decisions regarding the size and spacing of seats in public areas, the proximity of desks, and so on need to take account of people’s personal space requirements and the particular social context. In the workplace, a minimum separation of desks or benches of approximately 1.2 m is thought to be necessary. See Argyle (1975) for further discussion of these issues.

Benefits of Protective Clothing That Fits Many companies spend large amounts of money on protective clothing and equipment for their employees. Ensuring correct fit is one of the most basic requirements for the item to function correctly. Warktosch (1994) carried out an investigation of leg protectors used by forestry workers in South Africa, a group with considerable ethnic diversity. The existing leg protectors were imported from Brazil and had not succeeded in preventing injury—five injuries were occurring per day among the 300 workers. The protectors were modified to suit the anthropometry of the users. Together with improvements to the materials and fastenings, the result was complete prevention of leg injuries due to axes and hatchets in the 1-year follow-up period. The cost saving was approximately $250,000 and was expected to provide even greater savings when implemented on a larger scale. When designing protective clothing, there may be a requirement to minimize the restriction of movement of the arms and legs while maximizing the protection. Such requirements sometimes have to be traded off against one another and it is useful to be able to quantify movement range. Figure 3.17 shows a gravity inclinometer that can be used to measure functional movement range in a variety of applications. The device is essentially a protractor with an embedded spirit level. An angular reading is taken at a starting position and again after a prescribed movement has been made. The difference in the angles gives an indication of the functional movement range and can be used to compare difference clothing assemblies. Such devices can also be used to quantify movement restriction. In Figure 3.17b, the effectiveness of a neck brace for restricting head movement in rescue stretchers is being assessed. (a)

(b)

FIGURE 3.17  (a) Gravity inclinometer (™ MIE instruments). (b) Assessing the effectiveness of a neck brace in a rescue stretcher devices.

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Industrial Workplace Layout Lim and Hoffman (1997) investigated the performance of a light assembly task when components were laid out within the “ZCR.” ZCR is defined, for each hand, as the area of the table within the arc swept by the hand with the elbow extended (within this zone is the “normal working area” defined by a similar sweep of each hand but with 90° of elbow flexion). An approximately 10% improvement in assembly time was achieved when items were placed within the ZCR and arranged in an ergonomically designed jig. These improvements led to more efficient hand movements (reducing lengthy reaches and contralateral movements and increasing the number of simultaneous hand actions). That the naïve operators participating in the experiment did not spontaneously optimize the working arrangements (even though they were permitted to) highlights the need for this to be done when the task is designed and included in the initial training. Adjustability and Adjustment of Office Furniture A number of studies have been carried out into productivity in office environments. Some took place in the early 1980s when desktop computers were first being introduced into offices, often without any modification to the rest of the workspace. Modern office work is heavily computerized and requires the adoption of static postures for long periods as people have less reason to leave their desks. It would be expected that a good fit between workers and their equipment is one of the requirements for improved productivity. In 1981, the Merck company (Ruff, 1985) decided to upgrade its office facilities in an attempt to create a more productive and healthier environment. Two thousand office workers were sent a questionnaire and asked to rate 29 features of workstations regarding job effectiveness and satisfaction. The greatest mismatches between workstations and satisfaction were in air-conditioning, the ability to concentrate and privacy, overall workspace size and work area. Equally important were lighting and adjustability. Merck then selected office furniture to renovate its offices and canvassed the opinions of user-groups at a test facility. Training videos on how to use and adjust the new workstations were also produced. The return on all renovation projects was 25%, for one, an installation for 74 international workers the return was 50% with an improvement in turnaround of jobs from 4 days to 6 h. A limitation of practical case studies, such as that at Merck is the inability to disentangle the effects of specific interventions in the context of an overall refurbishment project in which many different aspects of the work environment are changed. Springer (1982, quoted from Dainoff, 1986) evaluated four new workstations in a recently computerized office. Two were easily adjustable, a third was less adjustable, and a fourth was new but nonadjustable. One hundred and ten employees compared these with their old office furniture while performing tests lasting less than half an hour. At the beginning of the trial, they adjusted the adjustable workstations to their own requirements. The adjustable furniture yielded 15% faster performance than the nonadjustable furniture, thus demonstrating that the improvement was a result of the adjustability of the furniture rather than a novelty effect. A study by Cushman (1984), while lacking the “real world” feel of the Merck study, does provide evidence for a link between productivity and good anthropometric fit. Twenty female employees of Eastman Kodak took part in a trial in which they copy typed for 10 min at each of five keyboard heights (70, 74, 78, 82, and 86 cm). Their mean stature was 164.3 cm with a standard deviation of 8.0 cm. Performance was measured by number of words typed per minute and error rate. Keying rate was relatively unaffected by keyboard height. The error rate was about 20% lower when the keyboard was at the 74 cm height. Posture discomfort ratings were positively associated with the number of errors made. An interesting finding was that errors increased when the difference between the keyboard height and each subject’s sitting elbow height was negative (keyboard too low). Subject’s made fewer errors when the keyboard was reported to be “at about the right height.” However, the “right height” was reported to be 5–10 cm above the subjects’ sitting elbow height, contrary to the usual recommendation that it should be at elbow height. Nevertheless, these findings demonstrate the importance of adjustability in workstation design so that workers can achieve

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a good anthropometric fit, that a good fit feels comfortable and that when people feel comfortable because the furniture fits, they make fewer mistakes.

Effectiveness of Office HFE Interventions Evanoff etal. (2000) evaluated an office HFE intervention in a U.S. hospital billing department in which the injury and lost day rates were higher than in the hospital as a whole. One hundred and fifteen employees were offered a 1-h educational session covering workstation adjustment and arrangement, office HFE, and prevention of musculoskeletal disorders. Each employees’ workstation was then assessed by an ergonomist over the next six months. Where needed, adjustments were made and job aids (e.g., armrests, wrist rests, and footrests) were provided and leg room was increased. After 18 months, a 15-min follow-up educational session was given. Data on work-related injuries and illnesses (OSHA 200 log), workers’ compensation records, and self-assessment were collected. Total injuries fell from 24 in the 18 months prior to the intervention to 26 in the following 4years, and total lost days as a result of the injury fell from 126 to 31. Workers’ compensation costs in the 18 months prior to the intervention amounted to $86,144. In the following 3 years, these costs were $89,331—an annualized reduction of 57%. These improvements occurred despite an increase in workload of 100% in the follow-up period. As with many such studies, this one is limited by the lack of a control group. Injury rates dropped in the hospital as a whole over the follow-up period, but the authors report that the observed reductions in the billing department were still significant after correcting for this underlying trend.

Status of Anthropometry in HFE Most anthropometric databases are derived from surveys in which the reliability of the ­instruments was demonstrated in the early stages at the time when the anthropometric technicians were trained. HFE Workshop 3.4 illustrates a method used to assess the reliability of measuring instruments. HFE WORKSHOP 3.4 Determining the Reliability of Posture Measuring Devices A study to determine the effect of protective clothing (PPE) on functional movement is carried out. Subjects are measured when wearing light clothing and when wearing the PPE while performing standardized flexion, extension, and abduction of the hip and shoulder using a simple gravity goniometer. The researchers want to know how reliable the procedure is when the measurements are carried out by one researcher only (the “intra-tester” reliability). They decide to perform a pilot study taking five repeated sets of measurements from five subjects. The data shown below are from the hip flexion measurement (angles of hip flexion, in degrees, with the goniometer set to “zero” at the starting position—feet flat on floor, subject looking straight ahead). Trial Number Subject 1 2 3 4 5 Σ

1

2

3

4

90 91 89 92 85 87 88 88 93 97 96 96 79 81 83 82 87 85 85 89 434 441 441 447

5

Σ

94 456 85 433 95 477 84 409 87 433 445 2208

(Continued)

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HFE WORKSHOP 3.4 (Continued) One way to analyze these data to determine the reliability of the procedure is to calculate the intraclass correlation coefficient (ICC). Theoretically, the ICC can be written as follows:

ICC = σ2 (b) / (σ2 (b) + σ2 (w))

where σ2(b) = the variance of the hip flexion measure between the subjects σ2(w) = the variance of the hip flexion measure within subjects If the measuring procedure (goniometer and the researcher using it) was 100% reliable, the only source of variance in the data would be σ2(b), and so the ICC would equal “1.” If the measuring procedure was completely unreliable, differences between subjects would not be detectable and the ICC would equal “0.” Tss, is a measure of the total amount of dispersion (“sum of squares”) in the data, givenby

Tss = Σ( x − x )2

which, for ease of calculation, can be written as

Tss = ∑ x 2 −(Σx )2 / n

To calculate Tss, we would simply sum all the measurements to obtain (Σx = 2208) and then square each measurement before summing the squared measurements to obtain ∑x2. These values would then be inserted in to the expression above. We could calculate another sum of squares from the row totals—a measure of the variability between subjects—“B”ss

Bss = (4562 / 5 + 4332 / 5……. + 4332 / 5) −(Σx )2 / n

and

Tss = Bss + Wss

Worked Example We run a one-way analysis of variance (ANOVA) on the data above and find Wss = 59.20 Bss = 534.24 Tss = 593.44 And the reliability, R, of the method can be estimated as

R = 1 − (Wss/Tss) = 1 − (59.20 / 593.44) = 0.90 (Continued)

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HFE WORKSHOP 3.4 (Continued) The standard deviation of the method is given by √(Wss/n–1) = 3.85°. Therefore, our measuring procedure is very reliable. In practice, as long as the measurements are all made by the same person, we will have very little measurement variance in the data. Interpretation In this example, we had only one rater; so our ICC is a measure of the intra-rater reliability of the method—we can only say that our inclinometer is reliable when used by that individual. We cannot say that the inclinometer gives the “right” answer, only that it gives more or less the same reading each time a measurement is made. In practice, this means that we can carry out our trials with fewer subjects and fewer repeated measures of the same movements but only if the same person takes all the measurements). Advantages of the ICC Correlation coefficients, such as Pearson’s r only tell us about colinearity between paired scores, which may be unrelated in all other respects, whereas the ICC tells us the extent to which repeated measures of the same thing agree with each other. Of course, the ICC does not tell us that our inclinometer is valid—only that it gives a reliable reading when used repeatedly by the same person. If we wanted to compare hip flexion movements of people wearing different types of clothing, the measurements’ variance, due to the inclinometer would not prevent us from detecting a real difference if it were large enough to be detected. Before carrying out our reliability trial, we would first consider how accurate we needed to be to detect meaningful differences between clothing in the context of use. ICCs could also be calculated for different raters, with each rater making one or more measurements each, and in practice we would calculate ICCs for all the different postural measurements we were interested in. Caveats The example above has been simplified to illustrate the mechanics of the ICC. In practice, there are several different ways of calculating ICCs depending on the overall measurement model and the assumptions made. Here, we have assumed a “random effects” model and ignored the possibility that trial order might be an additional source of systematic variance (e.g., subjects “loosen-up” after repeated testing causing the movements to increase each time they are measured). nb. When reliability is expressed in relation to the total variability in the data, a measuring device can appear unreliable if the total variance in the sample is small (as is the case when the subjects are all very similar). The device should, therefore, be tested on a sample of subjects that is representative of the target population. The software used in whole body scanners is normally tested for reliability and validity prior to a large survey. The validity of basic data is limited to static situations—structural data may be used for design in situations where people are adopting static postures. Caution should be used when applying these data to design problems that involve movement, particularly skilled movement. Bilzon etal. (2000) investigated the associations between user anthropometry and the ability to escape through vertical hatches and bulkhead doors on ships. It was hypothesized that subjects with large bi-deltoid breadth and abdominal depth would find it more difficult to move through the small spaces. However, even when subjects were encumbered by bulky protective clothing, it was found that subjects with broad shoulders could escape through the hatch more quickly than those

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with narrow shoulders. There was a strong positive association between escape time and lean body mass. In dynamic tasks such as these, performance appears to depend more on strength and technique than on body size. Man-models in systems such as JACK and SAMMIE are valid for use as visualization aids in engineering design, but their underlying functional anatomy has limited fidelity. They are as valid as the assumptions used to enter anthropometric data in their databases. However, they can have good diagnosticity in the evaluation of human–machine fit and are very useful in enabling ergonomists to explore possible design solutions in a cost-effective way. Anthropometric surveys are extremely expensive to carry out, and are also intrusive because subjects normally have to disrobe and undergo measurement in a specially designed facility. Ethical approval needs to be obtained before the survey can commence and personnel have to be trained. Much existing data were obtained many years ago and have been “modernized” using assumptions about the secular trends in body size and so may be of limited validity when designing for populations that may have changed in other ways in the intervening years (due to immigration or increasing levels of obesity, for example). The validity of scaling techniques depends to a large degree on whether body proportions are the same in the target and reference populations. Clothing companies often have proprietary anthropometric data, which they make commercially available (SizeUK is one such company in the United Kingdom).

RESEARCH DIRECTIONS In the light of the increasingly international nature of business and trade, an urgent area of research is to fill-in the gaps in the world anthropometric database. Data are lacking on the anthropometry of many populations. Another challenge is to develop inexpensive automated methods of capturing data—traditional methods requiring the use of manual instruments are prohibitively expensive. Also of interest is the increase in body size of populations that occurs as countries develop industrially. This is known to have happened in Western Industrial Countries and Japan and more recently in Southern Europe and parts of South America. In developing countries, there may be differences in the anthropometry of urban versus rural people. In developed countries, there is a severe obesity crisis with over half the population overweight or obese. Many existing databases, based on old survey data corrected for the secular increase in stature, will underestimate all measures that depend on body composition. Available data are being incorporated into computer-based design aids. Several packages have been developed and they all assist in integrating data with 3D representations of the human form to improve the visualization and solution of problems of anthropometric fit. Further development of these aids will no doubt take place.

SUMMARY Anthropometric data provide the designer with quantitative guidelines for dimensioning ­workspaces.However, a number of precautions are needed if data are to be used correctly. Always, 1. Define the user population and use data obtained from measurements made on that population. 2. Consider factors that might interfere with the assumption of normal distribution of scores. For example, in some countries, stature may be negatively skewed because many individuals do not attain their potential stature due to disease or malnutrition. 3. Remember that many anthropometric variables are measured using seminude subjects. Allowance for clothing is often necessary when designing for real users. Centimeter ­accuracy is usually appropriate because the effect of clothing on the estimates of user anthropometry can never be accurately predicted. These considerations are particularly

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important when using data on stature and leg length—allowances for heel heights of 5 cm or more may be needed depending on the user population and current fashions of dress. The effect of clothing also depends on climate—the colder the climate the bulkier the clothing and the greater the importance of allowing for this in design. In many parts of the world, biological and social changes will cause plastic changes in population parameter values over relatively short time periods. Drift in the anthropometric parameter values should be expected. In practical design situations, the data required for a particular body dimension or population may not be available. However, techniques are available for estimating unknown dimensions and the literature on anthropometry can still be of use to the designer in drawing attention to the various body dimensions that need to be considered in the design and the types of human–machine mismatches that could occur. Anthropometry can provide the designer with a very useful perspective on usability issues at the very early stages of the design process. Later, the designer might then take a more empirical approach and test out prototypes using a small sample of users from the extremes of the anthropometric range. Further guidance can be found in ISO/TC 159/SC 3 Anthropometry and Biomechanics.

TUTORIAL TOPICS

1. About 30 years ago, only 5% of the U.S. or UK population were obese. Now, more than 20% are obese. Has the 95th percentile waist circumference of 30 years ago now become the 80th percentile? 2. If it has, how might the shape of distribution have changed? 3. Should HFE specialists advise on how to accommodate obese workers or should they just tell them to lose weight?

ESSAYS AND EXERCISES

1. Find the mean and standard deviations of the popliteal height, sitting eye height, and forward reach of U.S. adult females. 2. Refer to Appendix A. Find the value of z that corresponds to the 17th percentile value of a normally distributed variable. 3. Calculate the mean and standard deviation of the following data on stature (show all your steps in the calculations to arrive at the answers): Stature mm 1650 1760 1665 1720 1810 1690 1850 4. The 95th percentile value of a normally distributed variable is found by adding 1.64 standard deviations to the mean. If the mean body mass of U.S. males is 82.1 kg and the standard deviation is 17.1 kg, what is the 95th percentile body mass? 5. The 5th percentile of a normally distributed variable is found by subtracting 1.64 standard deviations from the mean. If the sitting height of U.S. females is 861 mm and the standard deviation is 36 mm what is the 5th percentile sitting height? 6. Use the table of Z-values in Appendix A to find out the number of standard deviations below the mean that gives the 28th percentile value of a normally distributed variable. 7. A 5th percentile U.S. male has forward reach of 843 mm. His shoulder is 450 mm above a horizontal work surface. Calculate the radius of the ZCR on the desktop.

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8. Mr. Smith’s stature is 0.4 standard deviations below the mean stature for UK males. a. What percentile is his stature? (Hint: refer to the table in Appendix A.) b. What percentage of UK males is taller than he is? c. Suppose the mean stature was 1700 mm and the standard deviation 200 mm. How tall would Mr. Smith be? 9. Using the data in this chapter, specify seat and work surface dimensions to fit 95% of VDT users in two different populations. Comment on any design and equipment procurement implications of this exercise. 10. Carry out an anthropometric evaluation of either a commercial kitchen or of a number of domestic kitchens. Measure and comment on the following: The heights of all major work surfaces including the sink. The heights of all cupboards and shelves. The reach requirements of all major work and storage areas. The amount of space for movement and foot position. Interview users to find out how they spend their time in the kitchen. List the most to the least common tasks and note any problems and difficulties experienced. Use all of the above information to suggest improvements. 11. Write a report that explains to a design engineer why anthropometric data should be used in the design of human–machine systems. Give examples from everyday life to support your arguments. 12. You have been asked to help a large financial institution in Cape Town, South Africa, to assist with office chair selection. The workforce is a mixture of different racial and ethnic groups. Because of the cost savings involved in making one large order for 2500 identical chairs, the company wishes to standardize on office chairs. One chair must fit all. You decide to get information on the stature of employees from their company medical records (a medical is a requirement for membership of the company pension scheme). From this, you decide to use the RASH technique to estimate 5th and 95th percentile measurements used in chair design. a. List the anthropometric variables you would need to estimate to help the company choose a chair. b. Given that the mean and standard deviation heights of males and females in the company are (in mm) as follows:

Males Females

Mean

SD

1700 1580

80 70

Estimate 5th and 95th percentile values of the variables of your choice using­scalingfactors calculated from the tables in this chapter (RASH technique). c. You decide that seat depth is a critical factor. The company has a shortlist of 14 chairs but none of them has adjustable seat depth. You measure the depth of the seats with the following results: Seat Depth (mm) 450 420 400 390 370

Number of Chairs at That Depth 3 4 3 1 3

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What percentage of the company’s female workers will be able to sit on the seats without having to adopt a posture in which they are “perched” on the edge of the seat? 13. Specify chair and desk dimensions to fit a 95ile male and a separate set of dimensions to fit a 5th percentile female using anthropometric data from a country of your choice (i.e., all the male’s dimensions will be 95th %ile and all the female’s 5th %ile. Comment on the anthropometric mismatches that will occur if the male sits at the female’s workstation and vice versa. Describe how you would design one set of furniture to suit both of the above users and everyone in between (specify any dimensions and ranges of adjustment). 14. Specify the radius of the ZCR on a conveyor belt for U.S. females of 5th percentile standing shoulder height and reach. The belt is 1000 mm above the floor. Comment on the design of this workstation. 15. A “panic button” is to be placed on a wall above a console in the control room of a nuclear power station (see figure). The console is 500 mm deep from front to back. Calculate the maximum acceptable height above the floor of the panic button, that would enable a female with 5th percentile shoulder height and reach to reach it without jumping. 16. You have been asked to advise a bank that wishes to replace all its existing office workstations with new “sit–stand” workstations that enable workers to work in either a standing or in a sitting position. Use the RASH technique to estimate appropriate values of elbow and popliteal height using the data below. (Hint: first calculate scale ratios from the data for the reference population.) Using these estimates, specify the maximum allowable height for the desk in its lowest position and the minimum allowable height for the desk in its highest position. Reference Population Mean stature sd stature Mean popliteal height sd popliteal height Mean elbow rest height** sd elbow rest height Mean elbow height (Standing) sd elbow height * **

Company Workers*

Males

Females

Males

Females

172 10 44 4 25 2 120

168 10 40 4 20 2 95

178 7

155 5

6

5

All dimensions are in centimeters. Height of elbows above seat.

17. To answer this question, you will also need to refer to the biomechanics equations in chapter 2. A nurse has to reach onto a badly designed shelf and pick up, at arm’s length, a defibrillator of mass 10 kg. At the moment, she picks it up, she pauses, and her arms are horizontal to the ground and fully extended.   Assume that the mean and standard deviation of stature in the population of nurses are as follows:

Mean = 1620 mm

Standard Deviation = 64 mm

a. Estimate the reach distance at the moment she picks up the defibrillator assuming that the nurse is 73rd percentile stature and that forward grip reach is 0.42 of stature. (Hint: use the accompanying tables of Z, the standard normal deviate, to calculate her stature.)

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b. Use a simple biomechanical model to estimate the L5/S1 spinal compression due to the load. You may assume that the lever arm of her back extensor muscles is 7 cm and that her posture is upright and symmetrical. c. Calculate the total spinal compression by including the compression due to the nurse’s body mass above L5/S1. The nurse is of 55th percentile body mass and the mean and standard deviation of body mass for the population of nurses are as follows: Mean = 66 kg

Standard Deviation = 13 kg

Assume that the mass of the upper body above L5/S1 is 37% of total body mass. Ignore the contribution caused by the load moment of the extended arms, butinclude their mass. d. Calculate the ratio between the spinal compression due to the load and the spinal compression due to body weight and comment on your findings. 8. Mrs. Smith is on holiday in Sri Lanka with her husband. She persuades him to buy her a new dress in a local village market. She is horrified to discover that all of the dresses on sale are too small for her around the hips. She has always considered herself to be fairly slim. Her hip breadth is 335 mm. Assume that the dresses are designed to fit local females and use Figure 3.4 and the data in Table 3.3 to answer the following questions: a. Is Mrs. Smith justified in considering herself to be “fairly slim”? b. Why won’t any of the dresses fit her?

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General Requirements for Humans in Systems 4.1 Jobs should be designed to allow both sedentary and standing work. 4.2 Tasks should be designed to minimize the adoption of static standing or seated postures. 4.3 Where static postures must be held, the limits set out in ISO 11226 must not be exceeded. 4.4 Computer workstations must be designed in accordance with ANSI/HFES 1002007 “Human Factors Engineering of Computer Workstations,” the EU “Display Screen Equipment Regulations,” or national legislation in other parts of the world. 4.5 Employees should receive training in how to adjust and use their workstations and furniture. 4.6 Frequently viewed objects must be positioned within the optimum viewing zones such that a neutral neck posture can be maintained.

The simplest country man understands that one cannot put on the top story of a house until one has built the ground floor and foundations; yet medical men are constantly trying to alter the position of the upper bricks of the spinal column without adjusting the base on which they stand. Forrester-Brown, 1930

CORE KNOWLEDGE: UNDERSTANDING POSTURE AND MOVEMENT Humans are designed to walk on two legs, but they are not designed to stand still. FA Hellebrandt, writing in 1938, put it this way. In biological terms, posture is constant, continuous adaptation … . Standing is in reality movement upon a stationary base … . From this point of view, normal standing on both legs is almost effortless.

Anatomy of Human Posture and Its Evolutionary Origins The upright posture and bipedal gait of human beings has a long evolutionary history. Modern humans belong to a family of primates known as “hominids,” all of which appear to have anatomical adaptations that enabled them to walk upright on two legs. Humans, like other members of the genus hom*o differ anatomically from other primates such as chimpanzees. The latter are primarily quadrupedal but able to walk on two legs for short periods, whereas members of the genus hom*o, including modern humans, are bipedal. Figure 4.1 depicts the bipedal posture adopted by a modern human and a chimpanzee. The CoG of the chimp’s body lies anterior to its lumbar spine and pelvis whereas in the human, it lies just above the hip joint. Postural muscle activity is required for the chimp to maintain a standing posture because the masses of superincumbent body parts lie anterior to the joints, causing it to fall forward. In humans, the CoGs of superincumbent body parts lie above or close to the joints, such that the bending moments are minimized and standing can be maintained 107

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COG

COG

FIGURE 4.1  Upright bipedal posture in a human and a chimpanzee. Note the location of the COG in relation to the hip joint.

with little muscle activity. The mechanical advantage of the gluteal muscles makes it easy to stop the trunk from jackknifing forward over the legs. To achieve an upright posture, the chimp has to flex its knees because it lacks sufficient hip extension to position the femur perpendicular to the ground. This increases the postural load on the legs when standing and prevents chimps from striding when walking upright (limited hip extension means that the trailing leg has to be lifted early, thereby shortening the stride). Lovejoy (1988) summarizes some of the main anatomical adaptations to bipedalism as follows: 1. Lower CoG of the body due to the broadening and flattening of the ilium and sacrum, shortening of the arms, and lengthening of the legs results in increased postural stability. 2. Change in the shape of the iliac blades and function of the gluteal muscles. In chimps, the pelvis is flat (Figure 4.2) and all three gluteal muscles act as hip extensors used in locomotion. In humans, the ilia are curved and the gluteus medius muscles displace laterally and act as hip abductors. 3. For a major part of the gait cycle, the pelvis is supported on only one leg. To stabilize the upper body, the lateralized medial gluteal muscles on the supporting side prevent the pelvis from tilting to the unsupported side (the hip joint can be considered as the fulcrum). At the top of the femur, the bone protrudes away from the hip joint (at the greater trochanter) and the ilium flares outward, giving the anterior gluteal muscles on the supporting side greater mechanical advantage. 4. When humans stand upright, they do so only partly by extending the hip joint. The upright posture cannot be achieved by extending the hip joint by 90° because this leaves insufficient extension for walking because movement of the trailing leg beyond vertical is impeded by the ischium (Figure 4.3). The evolutionary solution has been to rotate the sacrum forward on the ischium and increase the extension of the lumbar spine. In effect, humans attain the upright posture by extending the hip joint by about 60° and the lumbar spine by about 30°, with plenty of hip extension left for long strides when walking and running.

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(d)

(b)

(c)

FIGURE 4.2  The hip joint and pelvis related to posture. (a) Frontal view of the human pelvis and hip joint. The joint acts as a fulcrum during walking. The anterior gluteal muscles are hip abductors and counteract the adductor moment exerted by the upper body and swinging leg, preventing the trunk from tilting to the side of the swinging leg. (b) Top view of the pelvis of a chimpanzee. The ilia are flat and lie almost in a single plane. The gluteal muscles are all hip extensors. (c) Top view of a human pelvis. Note the curved ilia that provide lateral attachment points for the anterior gluteals. (d) “Trendelenburg” posture. Weakness in the anterior gluteals causes deviation of the pelvis to the right and tilting to the left. The spine exhibits scoliosis to compensate. Functionally, this can be observed when people stand on an uneven surface to work.

These anatomical adaptations account for the origin of the lumbar lordosis, which is effectively an adaptation to bipedalism without which, modern human locomotion would be impossible. The pelvis can be likened to the platform that supports the superincumbent body parts and transmits the weight to the ground via the legs. Several muscle groups, which in other species provide locomotive power take on new roles. The anterior gluteals stabilize the pelvis in the frontal plane;

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(b)

(c)

FIGURE 4.3  Orientation of the ischium with respect to the hip joint. (a) Human standing erect. (b)Chimpanzee standing erect. (c) Chimpanzee in a quadrupedal posture. In B, the ischium prevents extension of the hip joint beyond vertical. Comparison of A and C reveals the fundamental nature of the lumbar lordosis as an adaptation to bipedalism.

the iliopsoas muscles initiate “swing-through” of the trailing leg when walking and stabilize the lumbar spine when standing. The hamstrings decelerate the swinging leg prior to heel strike. Only the quadriceps and the plantar flexors provide a ground reaction force for locomotion. The posture of the spine, particularly the lumbar spine is of great interest in workspace design. From the above, it can be seen that it is only one of a number of anatomical adaptations which characterise human biepdalism. Posture Posture is defined as the average orientation of the body over time. Figure 4.4 depicts the static posture of an astronaut asleep under weightless conditions. The skeleton is in a “neutral” posture—the internally generated torques acting on the joints as a result of tissue elasticity and muscle tone are in balance. Many readers will recall waking in the morning, lying on one side in bed, in such a posture. The joints are close to the mid-point of their ranges of motion and there is a slight lumbar lordosis. This restful posture is readily observed in the workplace—when people sit on a stool to work at a bench or recline in a modern office chair when using a computer. When a person flexes the hip and knee joint to sit down, the iliopsoas muscles immediately shorten and the hip extensors lengthen (Link etal., 1990). The balance of antagonistic muscle forces, which kept the pelvis in its anteriorly tilted position, is changed and the pelvis tilts posteriorly almost immediately and continues in proportion to the flexion at the hip. In order to maintain the head erect, the lumbar spine flexes to compensate for the tilting pelvis and the lumbar lordosis diminishes and eventually disappears (Figure 4.5). The lumbar spine is under constant load in all upright body positions, but the load varies, depending on the posture. Degeneration of the intervertebral discs is thought to be influenced by exposure to high loads. McGill concluded that although there are several occupational risk factors for low back pain, increased spinal compression is common to all of them. The spine of a person seated erect exhibits greatly diminished lumbar curvature (mean angle of curvature of 34° compared to 47° in standing, according to Lord etal. [1997]), and increased intradiscal pressure (Figure 4.6) due

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Vertical reference 90°

Horizontal reference One–g line of sight Zero –g li ne o f sig ht

10° 15° ± 2°

122° ± 24° 36° ± 19°

128° ± 7°

133° ± 8°

111° ± 6°

Horizontal reference

FIGURE 4.4  Posture of an astronaut resting in zero gravity showing the neutral positions of the joints in the sagittal plane. (Redrawn from Niebel, N.W. and Frievalds, A. 1993. Methods, Standards and Work Design. 10th Edn. WCB, McGraw-Hill, New York.)

to the increased flexion moment, putting the posterior spinal ligaments under tension. The intervertebral discs are “wedged” anteriorly and protrude into the intervertebral foramen (Keegan, 1953, Figure 4.7). This wedging action causes back pain in people with instability in the lumbar motion segments. In standing, the load is shared between the facet joints. In sitting, the discs bear more of the load (Adams and Dolan, 1995), whereas when lying the absolute load on all structures is lowered. This implies that seated workers should be able to adopt relaxed posture and recline against a backrest at will.

Forward flexed postures in which a load is held can more than double the disc pressure, particularly when sitting. Clearly, handling loads in a seated position is to be avoided. Further, Beach etal. (2005) demonstrated that lumbar spine stiffness increased after only 1 h of sitting and concluded that this may contribute to low back pain in sitting and increase the risk of injury if people have to handle loads after sitting (such as truck drivers manually offloading a delivery).

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4

3

5

6

7

2 8 0° 1

9 20°

–20°

(b)

(c)

(e)

(d)

(f )

FIGURE 4.5  (a) Angles of pelvic tilt in different body positions. On the left, posterior pelvic tilt with flattened lumbar curve. On the right, anterior pelvic tilt with exaggerated lumbar lordosis. Neutral postures in the center. (b–f) Posterior tilting of the pelvis and flattening of the lumbar curve during the transition from standing to squatting (i.e., increasing hip flexion in the upright position). (From Bridger, R.S., Orkin, D., and Henneberg, M. 1992. International Journal of Industrial Ergonomics, 9: 235–244. With permission. Figure concept by TomBendix.)

Fundamental Aspects of Sitting and Standing Anatomy of Standing The pelvis is held in an anteriorly tilted position by the iliopsoas muscles and the hip joint is free to extend as happens during the stance phase of gait. The trunk and head are rotated until these are vertically above the legs. This is achieved by extension of the lumbar and cervical spines, and this

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Total load on third lumbar disk in a subject of 70 kg

300 275 250 225 200 175 150 125 100 75 50 25 0

Position of body

FIGURE 4.6  Lumbar disc pressures in different positions of the body. (Redrawn from Nachemson, A. 1966. The load on the lumbar discs in different positions of the body. Clinical Orthopaedics, 45: 107–122.)

is why the vertically held spine is S shaped in humans and is “C” shaped and held horizontal to the ground in quadrupeds. Bones and Joints In the erect posture, the line of gravity of superincumbent body parts passes through the lumbar, the sacral and hip joints, and in front of the knee and ankle joints. This places an extension torque around the knee joint, which is resisted because the joint is already fully extended. The flexion torque around the ankle is resisted by the plantar flexors.

A

A

FIGURE 4.7  Anterior wedging of the intervertebral disc occurs in the slumped sitting position (A = posterior ligaments). Soft tissues between the anterior and posterior elements of the spine may be pressurized resulting in pain. (Adapted from Keegan, J.J. 1953 Alterations of the lumbar curve related to posture and seating. Journal of Bone and Joint Surgery, 35A: 589–603. With permission.)

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Muscles and Ligaments A person standing erect under the influence of gravity is never in a state of passive equilibrium. The body can be conceived of as a pillar of segments stacked one on top of the other and linked by joints. It is momentarily balanced when the resultant of all forces acting on it is zero. The system is designed to minimize any displacement of the line of action beyond the base of support described by the position of the feet and compensatory mechanisms come into play to maintain balance immediately after this happens. Muscles and ligaments play a stabilizing role by means of the active and passive torques. These exert around joints to correct small, fleeting displacements of the lines of action away from the joints. A good posture may be defined as one in which the destabilizing moments are minimized and the posture is maintained by the resistance of the relatively incompressible bones (as well as interleaved soft tissues such as the intervertebral discs). When the body is pulled off balance by the requirements of badly designed jobs or workspaces, the antigravity muscles come into play and a new equilibrium position is established but with the associated cost of isometric muscle activity. Erector Spinae Muscles These are the main extensors of the trunk and are also used to control flexion. During relaxed standing, very little muscle activity occurs since the lumbar lordosis minimizes the trunk flexion moment. When the trunk is flexed even slightly forward or when a weight is held in front of the body, the erector spinae muscles come into play. Leg Muscles The soleus and gastrocnemius muscles are true postural muscles in the sense that these are always switched-on when standing. When leaning forward, the activity of the gastrocnemius muscle increases. Prolonged standing causes significant localized leg muscle fatigue and is one of the causes of leg discomfort. Abdominal Muscles There is very little abdominal muscle activity in standing and even less in sitting (Burdorf etal., 1993) postures. These muscles may help to maintain a proper relationship between the thorax and pelvis by preventing excessive anterior pelvic tilt and hyperlordosis. The abdominals can prevent trunk extension caused, for example, by loads placed high on the back (e.g., or when putting on a backpack) or when walking down steep hills. Hamstring and Gluteal Muscles The hamstring and gluteal muscles are hip extensors. The gluteal muscles exhibit hypertrophy in humans and their function is to stop the trunk from jackknifing forward over the legs—unlike in quadrupeds where the trunk is already jackknifed and the gluteals are used for locomotion. The gluteals are, however, used for locomotion in ladder or stairs climbing. Activity in the hamstrings is less in the standing position but increases when the stander leans forward, holds a weight, or pulls. Iliopsoas Muscles Psoas major and iliacus are hip flexors and are constantly active in normal standing as these prevent extension of the hip joint (the trunk jackknifing backward over the legs or the loss of lumbar lordosis if the head position is maintained). The iliopsoas muscles act against the hip extensors. Adductors and Abductors of the Hip When standing on two feet, these muscles provide lateral stability, preventing translation of the pelvis in the frontal plane. When standing on one foot (and also during the stance phase of gait),

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the pelvis tends to tilt in the direction of the unsupported side. The hip abductors on the side of the supporting leg contract to maintain the pelvis level. The Extensor Muscles of the Neck In normal standing and sitting, the neck extensors are active because the CoG of the head is anterior to the cervical lordosis, placing a flexion moment around the cervical spine. The greater the angle of flexion of the head, the greater the extensor moment and muscle force required to maintain equilibrium. One of the first signs of sleepiness in sedentary workers is “chin-drop” as the extensor muscles relax. Static Postures In everyday life, people rarely adopt static postures for any length of time—if not walking or moving, they adopt a variety of resting positions which vary, depending on the culture (Hewes, 1957; Bridger etal., 1994). Short periods of walking and gross body movements are vital to activate the venous pump and assist the return of blood from the lower limbs (Cavanagh etal., 1987; Stranden, 2000); so the idea that anybody should stand or sit still is physiologically and mechanically unacceptable. Anecdotal evidence across many cultures and over time tells us that people who do, have to stand for long periods use standing aids such as the staff of the Nilotic herdsman or the spear of the sentry. An experiment on constrained standing by Whistance (1996) demonstrated that even unpracticed users spontaneously make use of such aids when they are provided. Prolonged daily standing is known to be associated with low back pain. Where possible, jobs which that require people to stand still for prolonged periods without some external from form of aiding or support must be redesigned to allow more movement, or the work to be done in a combination of standing and sitting postures. Figure 4.8 gives examples of naturalistic standing postures. Epidemiological research cited in this and other chapters can be summarized in the conceptual diagram of Figure 4.9. Health risks increase when postures are static and when tasks are highly repetitive. Static work should be avoided and, where possible, tasks should be varied to provide relief from static postures (e.g., sitting should be combined with standing, standing should be combined with walking, etc.). Where static postures are unavoidable, the risk can be reduced by designing to accommodate the limitations of human anatomy, as described below.

FIGURE 4.8  One-legged standing postures. Humans are designed to walk using two legs, one at a time, standing still on two legs is rarely adopted for any length of time (Ramzzini first noted that even chickens tended to alternate between one-legged standing postures—“because an alternate succession of actions is agreeable to nature.”)

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Health risk

Static posture

Movement low frequency

Movement high frequency

FIGURE 4.9  Health risks increase with highly static and highly repetitive work.

Physiology of Standing and Sitting The increase in energy expenditure when a person changes from a supine to a standing position is only about 8% (Grandjean, 1980). However, erect standing imposes a hydrostatic handicap that makes humans liable to peripheral circulatory collapse. Peak plantar (foot) pressures of 137 kPa exceed the normal systolic pressure of 17 kPa, resulting in occlusion of blood flow through the foot (Cavanagh et al., 1987). Walking and fidgeting temporarily reduce the pressure, allowing fresh blood to pervade the tissues. Venous and circulatory insufficiencies in the lower limbs also contribute to the discomfort that results from prolonged standing. It has been shown that venous reflux is more common in symptom-free surgeons (who stand for long periods) than in a comparison group who experience discomfort in standing. Prolonged standing causes physiological changes including peripheral pooling of blood, a decrease in stroke volume and increase in heart rate, diastolic and mean arterial pressure, peripheral resistance and thoracic impedance. Standing from a supine position is accompanied by an increase in the dimensions of the nasal passages (Whistance, 1996). Constrained standing is particularly troublesome for older workers or those with peripheral vascular disease because the “venous muscle pump,” which returns blood to the heart, ceases to function. Fidgeting is a preconscious defense against the postural stresses of constrained standing or sitting. Its purpose is to redistribute and relieve loading on bones and soft tissues and to rest muscles. Musculoskeletal Problems in Standing Low back pain is common in standing workers and several authors have suggested various reasons for this. In extended postures (e.g., when standing with a pronounced lumbar lordosis), the facet joints may begin to take on some of the compressive load. If the lumbar intervertebral discs are degenerated, the space between adjacent vertebrae decreases and the load on the facet joints increases even more. Adams and Hutton (1985) suggest that excessive facet joint loading may be a causal factor in the incidence of osteoarthritis. Bough etal. (1990) have shown that degeneration of the facet joints is a source of low back and sciatic pain. Excessive loading of the facet joints stresses the soft tissues around the joint and causes low back pain. For these reasons, excessive lumbar lordosis should be avoided when standing. Extrapolating from this, any workspace or task factors that require workers to arch the back greater than they would normally do should be designed out. However, there is evidence to show that hyperextension of the lumbar spine can be beneficial in temporarily relieving the load on the intervertebral discs (Magnusson etal., 1996c), and so there are grounds for recommending that short periods of lumbar hyperextension be introduced to relieve disc compression in standing

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tasks, particularly if forward flexion is also required. Sustained hyperextension in the upright position should be avoided. Low back pain can also be caused by muscular fatigue if a standing person has to work with the trunk inclined forward (e.g., when washing or ironing). Spinal problems in standing work are often due to static loading of the back extensor muscles and/or excessive extension, lateral flexion, or twisting of the trunk. Figure 4.10 depicts some stressful standing postures caused by poor workstation design. Messing etal. (2008) concluded that standing workers should have freedom to sit, because 9.4% of standing workers reported ankle or foot pain and 6.4% lower leg or calf pain in the 12 month period preceding their investigation. Constrained standing (standing in the same place) and older age were associated with increased risk of pain. Spinal Problems in Sitting Despite the popular myth that everyday occupational sitting is a risk factor for low back pain, evidence suggests that sitting at work, in itself, is quite harmless (Hartvigsen etal., 2000). However,

(a)

(b)

(d)

(c)

(e)

FIGURE 4.10  Spinal posture when standing is affected by workspace design: (a) unconstrained relaxed standing posture, (b) no toespace, causing compensatory lumbar and hip extension, (c) lumbar extension caused upward reaching, (d) poor foot position causing extension, and (e) relaxed standing with a footrest to prevent excessive lumbar extension.

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prolonged sitting at work (more than 95% of the day) is associated with back pain (Hoogendoorn etal., 2000). Further, many people with bad backs gravitate toward sedentary work. Poor design of workstations causing flexed sitting postures may exacerbate existing ­problems (Figure 5.7). In a study at the Eastman Kodak Company in New York, 35% of sedentary workers visited the medical department with complaints of low back pain over a 10-year period. People with existing low back problems often cannot tolerate the sitting position for more than a few hours over the workday. All the more reason to combine sitting with standing and walking. Static seated work is the norm for professional drivers, pilots, and operators of machines such as forklift trucks. Back pain in these occupations is endemic. For example, Krause etal. (2004) carried out a 7.5-year prospective study of compensable back pain in San Francisco transit operators. Drivers reporting ergonomic problems in the design of their cabs were approximately 1.5 times more likely to experience a compensatable back injury than drivers not reporting problems. The risk increased with the number of problems, which included lack of seat adjustability and back support; reaching across the steering wheel; and reaching for work objects. Total weekly driving hours also increased the risk. For severe back injuries, 30–50 h of driving more than doubled the risk compared to less than 30 h. The risk was over 5 times greater in drivers working more than 50h per week. Chen etal. (2005) investigated low back pain in taxi drivers. Drivers who sat with a trunk–thigh angle less than 91° were over five times more likely to suffer back pain than those with a trunk–thigh angle greater than 91° (odds ratio 5.11). Drivers who did not use a lumbar support were three times as likely to suffer low back pain compared to those who did (odds ratio 0.33). Bridger etal. (2002) investigated the prevalence of acute back pain in Royal Navy helicopter pilots in a cross-sectional survey based on a task analysis of flying operations. Royal Navy helicopter pilots typically work in pairs, with one in the flying pilot role and the other in a nonflying pilot role. Their seats, clothing, and workstations in the co*ckpit are identical and adjacent in these roles. A task analysis revealed that there were three main flying tasks—visual forward flying, instrument flying, and prolonged hover. Pilots rated the severity of any back pain in each of the different roles. It was found that the prevalence of back pain was greatest in instrument flying (over 75% complained) and least when the pilot was in the nonflying pilot role (20% complained, which approximates the background prevalence of back pain in the comparable population and is therefore no higher than would be expected in the absence of exposure to any additional risk factors). Postural analysis revealed large differences in posture between these different roles. All the flying tasks caused the pilots to adopt a forward-flexed sitting posture (to operate the cyclic control with the right hand, which is on a pillar between the pilot’s knees) with the trunk tilted to the left (to operate the collective control with the left hand). The most extreme forward flexion was in instrument flying, due to the need to scrutinize the display console. In the nonflying pilot role, pilots were able to recline against the backrest. The study indicated that the problem was postural back pain caused by poor workstation ergonomics (poor posture caused by the need to operate the controls and see the displays) rather than poor seating or exposure to vibration. This example illustrates the importance of carrying out some kind of task analysis in ergonomic studies of back pain because not all tasks carried out in a seated position increase the risk of back pain. Taken together these findings support designs of vehicle interiors in which controls are bought within the zone of convenient reach of a seated operator, reclining slightly against a backrest with a lumbar support and with a trunk-thigh angle greater than 90 degrees. The knee joint should be flexed at least 30 degrees. Displays should be visible from this posture. ’“Sedentarism”: A Modern Health Complaint Our understanding of human anatomy in interaction with work demands suggests that there is no “correct” sitting or standing posture appropriate for all employees. Rather, postural variety and

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movement should be designed into jobs. Evidence is mounting that sedentarism at work and after work is harmful. Greer etal. (2015) found that men with middle to high sedentary behavior had 65% and 76% greater risk of developing metabolic syndrome (inability to control blood sugar levels effectively, see Chapter 8 for further information) than those less sedentary. The harmful effects of sedentary lifestyles remained statistically significant when cardio-respiratory fitness and physical activity were controlled for (and vice versa). Van der Ploeg etal. (2012) found no increased risk of mortality in a sample of 222,497 individuals over 45 years of age if they sat for 4–8 h per day or less. The risk increased by 15% for those sitting 8–11 h per day and by 40% for those sitting 11 or more hours per day. Again, sitting and physical activity were independent predictors of mortality. Finally, Wilmot etal. (2012) reviewed 18 studies of a total of 794,577 participants and found that sedentarism was associated with a 112% increased risk of diabetes, 147% increase in the risk of cardiovascular events, 90% increase in the risk of cardiovascular mortality, and 49% increase in the risk of all-cause mortality. Different time periods were used in the different studies to classify participants into sedentary and non-sedentary groups—approximately 7 h/day (high sedentary). Although the evidence is not yet definitive, there appears to be sufficient evidence to suggest that sitting time at work should be limited—possibly by as much as 4 h/day (Katzmarzyk etal., 2009).

BASIC APPLICATIONS Ergonomic workstation design encourages good posture. Figure 4.11 presents a framework for posture. It emphasizes the interaction of three classes of variables (Table 4.1). Van Dieen etal. (2001) in a study of word processing, CAD work and reading found that trunk loading and trunk kinematics were more affected by the task carried out than the chair that was sat in. Figure 4.12 depicts a forward flexed sitting posture caused by a lack of fit between a visual and manual task demands, workspace layout, and user characteristics. When should workers stand? Some advantages of the standing work position are are summarised in Table 4.2. When should workers sit? The modern view is that workers should not sit for 8 h per day, every day and that sitting should be combined with standing. Sitting at work does have benefits compared to standing: static, low-level activity of the soleus and tibialis anterior muscles is required in standing and these muscles can fatigue. Because the lower limbs drain blood against gravity, venous pooling may occur when standing still for long periods, causing swelling at the ankles. In extreme circ*mstances, reduced return of blood to the heart may cause a drop in blood pressure and the person may faint. The hydrostatic head, which has to be overcome to return blood to the heart from the lower limbs, is less in sitting than in standing, if the seat is correctly designed.

Task requirements

Working posture

Workspace design

Personal factors

FIGURE 4.11  The postural triangle. A person’s working posture is a result of the requirements of the task, the design of the workspace, and personal characteristics such as body size and shape and eyesight. Consideration of all three components is needed in posture analysis and workspace design.

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TABLE 4.1 Examples of Factors that Influence Working Posture Factor User characteristics

Task requirements

The design of the workspace

Example Age Anthropometry   Body weight  Fitness   Joint mobility (range of movement)   Existing musculoskeletal problem   Previous injury/surgery  Eyesight  Handedness  Obesity Visual requirements   Manual requirements   Positional   Forces   Cycle times   Rest periods   Paced/unpaced work Seat dimensions   Work surface dimensions   Seat design   Workspace dimensions   Headroom   Legroom   Footroom  Privacy   Illumination levels and quality

Three Steps to Effective Workstation Design Carry out a task analysis to determine the

1. Visual requirements 2. Postural (effector) requirements 3. Temporal requirements

Visual Requirements The visual requirements determine the position of the head and, therefore, the posture of the neck. According to Woodson (1981), the eye is sensitive to stimuli up to 95° to the left and right, assuming binocular vision—15° either side of the straight-ahead line of sight is the region of binocular overlap (Figure 4.13). These limits describe a visual field in which objects may be placed such that they can be viewed without moving the head from its comfortable erect position. Thus, static loading of neck muscles and other soft tissues in the neck can be avoided if the visual component of the task is kept within a cone from “straight-ahead” line of sight to 30° below and 15° to the left and right. A gaze angle of 6–9° below the horizontal appears to be optimal for minimizing postural stress (Delleman and Berndsen, 2002).

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FIGURE 4.12  Application of the postural triangle to workspace evaluation. The illustration depicts a monk transcribing a text. The slumped sitting posture is a result of the low seat, excessive task distance, and the visually demanding task. The right elbow is resting on the thigh to improve the stabilization of the writing hand. The left hand is steadying the book and the left elbow is resting on the work surface to close the postural chain and reduce load on the left-hand side of the body. The left foot is resting on a footrest. How would you redesign this workspace to improve the posture?

TABLE 4.2 Some Advantages of the Standing Work Position

1. Reach is greater in standing than in sitting. 2. Body weight can be used to exert forces. 3. Standing workers require less leg room than seated workers. 4. Legs are very effective at damping vibration. 5. Lumbar disc pressures are lower. 6. It can be maintained with little muscular activity and requires no attention. 7. Trunk muscle power is twice as large in standing than in semi-standing or sitting.

Source: Based on Singleton, W.T. 1972. Man–Machine Systems, Penguin Books, London; Nachemson, A. 1966. Clinical Orthopaedics, 45: 107–122; Hellebrandt, F.A. 1938. American Journal of Physiology, 121: 471–474; Cartas, O., etal. 1993. Spine, 18: 603–609.

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C A

B B C B C

A

B C

FIGURE 4.13  Regions of high (A), medium (B), and low (C) resolution in the visual field. A and B are preferred regions for placement of objects. Objects should not, however, be placed above the straight-ahead line of sight, particularly at fixed workstations.

If the visual requirements exceed worker abilities, poor postures may well result despite careful attention to the furniture design. When the head is erect, the “straight-ahead” line of sight, parallel to the ground, can be comfortably maintained. However, most people will not maintain the head in this position in order to look at objects on a horizontal work surface if this requires the eyes to be rotated downward by more than 30°. If the main visual area is more than 30° below the “straight ahead” line of sight, it is viewed by tilting the head forward. The tilted posture places a static load on the neck muscles and displaces the COG of the body anterior to the lumbar spine, causing the characteristic forward “slumped” posture in which the backrest or lumbar support of the chair is no longer used. If objects are placed above the line of sight, the neck is extended to tilt the head backward. Frequently used displays should not be above the standing or sitting eye height of a short worker. For VDTusers carrying out editing tasks, document holders should be provided and placed orthogonal to the line of sight and adjacent to the VDT screen. Brand and Judd (1993) found that this configuration produced significant reductions in text editing time (of around 15%). Postural Requirements Task objects should be placed in the zone of convenient reach—a major determinant of posture and postural load. In vehicle design, the comfort of the driver’s seat depends on its positioning in relation to the foot pedals and manual controls as well as its design. Work Surface Design Important considerations are the provision of tilt in the work surface and/or of document holders and the provision of free space. Zacharkow (1988) provides illustrations of Victorian school desks having a 15° slope for writing and an integral book holder for reading, angled at 45°. Mandal (1991) suggested that chairs with forward tilting seats be used with desktops that tilt toward the user by about 15° to lessen the visual angle and encourage a more upright posture of the trunk (Figure4.14). Tilted desktops (of 15° or even 10°) reduce trunk and neck flexion of seated persons engaged in reading and writing (Bridger, 1988). Burgess and Neal (1989) found that using a document holder

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FIGURE 4.14  Modern school furniture based on ergonomic principles. Note the high desk that slopes toward user and the seat designed to permit a trunk–thigh angle greater than 90°. (Courtesy of Dr. A.C. Mandal, Copenhagen, Denmark, [emailprotected].)

when writing on a flat desk significantly reduced the moment of flexion of the head and neck at the C7–T1 level of the spine and was rated by the subjects as more comfortable than not using one. For both standing and sedentary workers, the main working area should be directly in front of the worker’s body, not to the side, to minimize any twisting of the trunk. This is particularly important in seated work. Pearcy (1993) has shown that the twisting mobility of the human back is increased in sitting compared with standing either in an upright or a forward flexed position. The increase occurs because, the morphology of the lumbar facet joints permits more axial rotation of the superior vertebral body over the inferior body when the spine is flexed. The increase is considerable (38% more twisting in 90° sitting and 44% more twisting in long sitting over the whole spine or about 2° more at each intervertebral joint). Because, the posterior fibers of the annulus are already stressed when the spine is flexed, the additional stress of twisting may result in very high annular stresses—predisposing the fibers to rupture. Jobs involving the asymmetric handling of loads from a seated position (such as supermarket checkout personnel) are being particularly hazardous. Seated workers who have to resist sudden, external twisting forces (such as catching an object falling from a supermarket conveyor) have a high risk of injury. For work involving keyboards, there is evidence that shoulder muscle load can best be reduced by placing the keyboard as low as possible (Bendix and Jessen, 1986) or by using a negative tilt keyboard (with the keys tilting away from the user). Temporal Requirements The temporal requirements of tasks influence the standard of workstation design. For example, in a multiuser computer workstation in which individuals spend only 15–20 min at a time interrogating the system, a sit–stand workstation using a high bench and stool might be appropriate. At the other extreme, certain data entry jobs require users to carry out a repetitive task over the whole day. These jobs impose a high degree of postural constraint as the position of the hands and head are fixed by that of the keyboard, documents, and screen. It is particularly important when analyzing physically constraining jobs to characterize task components in terms of frequency and importance of operation and ensure that the workspace is arranged optimally for high ranking elements.

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Holding Times for Static Postures Task objects are best placed between hip and shoulder height to minimize postural stress caused by stooping or working with the hands and arms elevated (see Chapter 3). Work surface heights should approximate the standing elbow height of workers depending on the task—when carrying out fine work, a higher work surface is appropriate to reduce the visual distance and allow the worker to stabilize the forearms by resting them on the work surface. When carrying out heavy work, a lower work surface is needed to permit the worker to apply large vertical forces by transmitting part of the body weight through the arms. Figure 4.15 presents data on the maximum acceptable durations of 19 static standing p­ ostures, without rest, applicable to 95% of workers (Dul etal., 1993). The durations are given in minutes and the postures are expressed in relation to the position of the hands when holding each static posture. For example, the first posture on the left of the diagram is labeled “75/50.” This means that the hands are held at a working height that is 75% of shoulder height and are at a distance from the body of 50% of horizontal, forward reach. The maximum acceptable durations were derived by taking 20% of the maximum holding time for each particular posture. The limits given in Figure 4.15 are used to determine the maximum allowable time for aworker to adopt a static posture (e.g., to hold or steady a work object) without discomfort. Ascan be seen, for stooped postures or those at the extremes of reach, the maximum durations are less than 1 min. Work surface heights should take into account the height of the worker and the height (vertical depth) of any work objects to enable the hands to be held in a comfortableposition in relation to the body. The shoulder angle resulting from the combination of these­factors can be assessed using the four-zone rating system presented in Table 4.3 and Figure 4.16. Postural constraint in standing workers can be relieved by providing stools to enable workers to rest during quiet periods or to alternate between sitting and standing. Adequate space for the feet should be provided to permit workers to change the position of their feet at will.

Standing Aids Footrests and Footrails Bridger and Orkin (1992) determined the effect of a footrest on pelvic angle in standing. The footrest raised the resting foot 250mm above the level of the floor and resulted in a net posterior rotation of the pelvis of 4°–6°. Whistance and Bridger (1995) confirmed this finding—use of a footrail reduced 10 8 6 4 2 0

75 75 100 50 125 50 100 100 75 125 75 50 100 50 50 25 50 25 50 50 25 100 100 100 75 100 75 75

25 25

25 150 25 25 50 50 75 100 Postures

FIGURE 4.15  Maximum recommended holding times for static postures in minutes. (Redrawn from Dul, J., Douwes, M., and Miedema, M. 1993. Aguideline for the prevention of discomfort in static postures. In: Advances in Industrial Ergonomics and Safety, R.Nielsen and K. Jorgensen, eds. Taylor & Francis, London. With permission.)

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TABLE 4.3 Evaluation of Upper Arm Posture Movement Zone 1 2 3 4

Posture Static

Low Frequency (2/min)

Acceptable Conditionally acceptable Not acceptable Not acceptable

Acceptable Acceptable Conditionally acceptable Conditionally acceptable

Acceptable Conditionally acceptable Not acceptable Not acceptable

anterior pelvic tilt, straightened the supporting leg, and increased the plantar flexion of the supporting foot. The footrest would appear to be a valid way of reducing lumbo-pelvic constraint in standing workers and help prevent discomfort in the lumbo-pelvic region. Rys and Konz (1994) found that a 100 mm foot platform used by subjects was perceived as more comfortable than normal standing in 9 of 12 body regions, including the neck. Use of either a flat or a 15° tilted platform was perceived to be better than a simple footrail, but all standing aids were preferred to standing on a bare floor. During a 2-h period of standing, subjects placed one foot on the platform 83% of the time switching their foot from the platform to the floor every 90 s on average. The freedom to stand with one foot forward and elevated seems to be an important feature of a well-designed standing workplace. Anti-fatigue Mats Stuart-Buttle et al. (1993) report that prolonged standing causes significant localized leg muscle fatigue, particularly in the gastrocnemius muscles. Footrests seem to relieve some of the load on the resting leg. Mats do not seem to reduce lower leg fatigue although they do reduce discomfort in the lower leg, feet, and back (Rys and Konz, 1994), and muscle fatigue in the erectores spinae muscles. Resilient rubber mats, being slightly unstable, may stimulate postural muscle activity in the lower legs and activate the venous pump. There are many reasons why standing workers should not have to stand on hard and sometimes cold concrete floors to work. Mats, wooden, rubber or plastic platforms, and carpets provide a more yielding surface and better insulation. They may also offer better friction and, therefore, aid postural stability and help prevent accidents. In a comparison of three different mats, Konz etal. (1990) found that a mat with 5.8% compression was perceived as more comfortable than mats of 7.4% and 18.6% compression. All were preferred over concrete. Compression Stockings and Rubber Floor Mats Varicose veins are superficial veins, often in the legs, in which the valves function ineffectively, resulting in pooling of blood and painful swelling. With deep veins, the problem is more serious and can cause

3

4

1 0°

2 20°

60°

60°

3 2 20°

1

4

FIGURE 4.16  Static holding times for work objects. (From prEN 614. Safety of machinery. Ergonomic design principles–Part 2: Interactions between the design of machinery and work tasks. With permission.)

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blood to return along abnormal pathways resulting in long-term health problems, including chronic edema and leg ulcers. Risk factors include obesity, cigarette smoking, high blood pressure, and lack of exercise. The disease is one of the 10 leading causes of hospitalization in Denmark. Occupational standing is associated with varicose veins in the lower extremities. Tuchsen etal. (2000) followed a sample of 1.6 million working Danes for 3 years from 1991. Men who worked mostly in a standing position were almost twice as likely to experience a first hospitalization for varicose veins compared to all other men. Women who worked mostly in a standing position, were two and a half times at risk than all other women. Tomei etal. (1999) compared the prevalence of chronic venous diseases in office workers, industrial workers, and stoneworkers. The prevalence of the disorders increased with age and number of hours spent standing at work. Controlling for age, the prevalence was higher for workers who stood for 50% or more of their shift. Krijnen etal. (1997) evaluated the effects of rubber floor mats and compression stockings on the leg volume of standing workers suffering from chronic venous insufficiency. Although there was some evidence for a reduction in complaints of pain and tiredness in the legs among those using rubber floor mats, leg swelling over the workday did not differ from a control group. The wearing of compression stockings bought about a significant reduction in leg swelling and in complaints (from 70% complaining at the beginning of the trial to 27% after 3 months). The wearing of the stockings was found to be acceptable to the male workers in the study. Toespace Panels or obstructions in front of benches cause users to stand further away from the work surface. The postural adaptation is for people to bend forward. Whistance and Bridger (1995) found that this was achieved by a combination of pelvic tilting and lumbar flexion—placing more stress on the spine. Fox and Jones (1967) observed that, after having to lean forward to work for many years, dentists did so by arching the back in the thoracic region or by flexing the lumbar spine—using the lumbar spine as a false joint and the pelvis as if it were part of the legs. Toespace (Figure 4.17) can prevent this from happening (Whistance and Bridger, 1995). Shoes High-heeled shoes are not advised if workers have to stand or walk for long periods, although this does not appear to deter shop assistants and waitresses from wearing them. High heels change standing posture by throwing the pelvis forward and cause compensatory hyperextension of the lumbar spine to restore balance (Bendix and Beiring-Sorensen, 1983). When high-heeled shoes are worn, the plantar flexors are shortened and therefore weakened according to the muscle length–tension relationship, affecting gait, the toe-off phase of gait, and causing muscles further up the legs to contribute more to the gait cycle. Lee etal. observed four major effects of wearing high-heeled shoes: increased trunk extension, increased tibialis anterior muscle activity, increased low back muscle activity, and increased vertical oscillation of the body center of mass while walking. Taken together, these findings suggest that wearing high-heeled shoes increases postural load in standing and reduces walking efficiency. By implication, standing workers who choose to replace their high-heeled shoes with flat shoes should expect less physical fatigue during a work shift and less fatigue-related musculoskeletal pain.

Ergonomics of Seated Work The basic postural requirements for sedentary work are to be achieved using a combination of modern office chairs with lumbar supports and adjustable backrests, footrests, as required and an appropriate placement of task objects and visual targets within the zone of convenient reach and the optimal visual field. Key features of chair design are summarized in Table 4.4. How Does a Lumbar Support Work? A lumbar support works by providing space for the buttocks to protrude when a person sits down (Figure 4.18). The convex lumbar support then uses the lumbar spine as a lever to tilt the pelvis

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Bent forward

Erect

X Y No toespace

A B Toespace

(b)

FIGURE 4.17  (a) Toespace is needed if standing workers are to stand up straight. (b) Sit–stand industrial production line. Note the use of height adjustable sit–stand stools and a large sloping footrest to accommodate a variety of trunk–thigh angles.

forward, preventing complete loss of the lumbar lordosis. The location of the lumbar support with respect to the level of the lumbar spine (L1/L2 or L4/L5) does not seem to be of importance. This suggests that a height adjustable lumbar support is not necessary since the height of a fixed lumbar support can be optimized to contact the lumbar spines of a wide range of users (population differences in stature are largely due to differences in the lengths of the long bones rather than the lumbar vertebrae). The modern office chair works on the principle espoused by Dr. Forrester-Brown at the start of this chapter—it “traps” the pelvis in the wedge-shaped space between the seat pan and the backrest. The pelvis is stabilized in an anteriorly tiled position to provide a firm foundation for an upright sitting posture. To the extent that lumbar supports extend the lumbar spine, their use may improve breathing. Slumped sitting postures increase intra-abdominal pressure, as the ribs approximate the pelvis and therefore prevent the downward movement of the diaphragm and the expansion of the chest wall. Landers et al. (2003) showed a significant (and over 10%) reduction in tidal volume and minute ventilation of the lungs when subjects sat in a slumped, as opposed to an upright posture. Since breathing frequency did not increase, these findings imply that slumped sitting postures may cause drowsiness and lumbar support may improve pulmonary efficiency in otherwise healthy people.

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TABLE 4.4 Key Features of Chair Design Seats should swivel and have heights adjustable between 38 and 54 cm. Footrests should be provided for short users. Free space for the legs must be provided both underneath the seat to allow the user to flex the knees by 90° or more and underneath the work surface to allow knee extension when reclining. A 5-point base is recommended for stability if the chair has castors. The function of the backrest is to stabilize the trunk. A backrest height of ∼50 cm above the seat is required to provide both lumbar and partial thoracic support. If the backrest reclines, it should do so independently of the seat to provide trunk–thigh angle variation and consequent variation in the distribution of forces acting on the lumbar–pelvic region. Lumbar support can be achieved either by using extra cushioning to form a lumbar pad, or by contouring the backrest. In either case, there must be open space between the lumbar support and the seat pan vertically below it to allow for posterior protrusion of the buttocks. The seat pan must have a slight hollow in the buttock area to prevent the user’s pelvis from sliding forward. This keeps the lower back in contact with the backrest when reclining. The leading edge of the seat should curl downward to reduce the underthigh pressure. Armrests should be high enough to support the forearms when the user is sitting erect. These should also end well short of the leading edge of the seat so as not to contact the front edge of the desk. If the armrests support the weight of the arms, less load is placed on the lumbar spine. Modern chairs tend to have a thin layer of high-density padding. Layers of thick foam tend to destabilize the sitter. The foam can collapse after constant use. Cloth upholstery provides friction to enhance the stability of the sitter.

Thoracic support Lumbar support Sacral space

FIGURE 4.18  Modern office chair with lumbar support.

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Adjustable Backrests Office chairs should have a tilt facility to support the trunk at different angles of repose (Figure 4.18). Ergonomically designed workplaces must be flexible if postural fixity, causing static loading of the musculoskeletal system, is to be avoided. Flexibility implies that the worker can carry out the task, at least some of the time, in more than one working posture with a workspace designed to accommodate both postures. A “designed-in” resting posture is also desirable. Well-designed seats may enable the user to “take the weight off of the feet” but will not take the weight off of the spine unless the user reclines against a tilted backrest.

Getting the Fit Right Anthropometric mismatches can have serious consequences for health and efficiency. Short users, may have to raise seat heights beyond popliteal height in order to gain access to the desk. As a consequence, the feet no longer rest firmly on the floor and the floor cannot be used by the legs as a fulcrum for stabilizing and shifting the weight of the upper body. The load of stabilization is now transferred to the muscles of the trunk. The weight of the legs, instead of being borne by the feet, is borne by the underside of the thigh. This can restrict blood flow and is particularly undesirable for those with varicose veins. It can also cause a condition known as “Lipoatrophia Semicircularis” (band-like circular depressions and isolated atrophy of subcutaneous fatty tissue on the thighs). Hermans etal. (1999) found postural differences between LS sufferers and non-sufferers—static sitting postures, less use of lumbar support, chair too high, and higher pressures at the seat surface. When seats are too high the feet can no longer be used to extend the base of support beyond the base of the chair. This makes activities such as reaching and picking up heavy objects more hazardous. Continuous compensatory movements of body parts may be necessary to maintain stability. An alternative to raising the chair is for the short user to work with the elbows below desk height, increasing the static loading of the upper body—particularly the shoulder girdle as the elbows are held in an elevated position. Computer and typewriter keyboards increase the effective work surface height; hence, the use of sliding keyboard drawers for programmers. Tall users may find desk heights of approximately 70–75 cm too low since, even with the chair at its lowest level, the distance between the eyes and the work surface may be too long for comfortable viewing causing the user to slump over the desk when writing. Lack of footspace may also be a problem for tall workers. Short users can be given footrests as standard equipment to ensure anthropometric fit. This is similar to the industrial practice of designing high benches to suit taller standing workers and providing raised platforms for those of lesser height. Height adjustable desks are available and were proposed many years ago (Ostberg etal., 1984) for use with height adjustable chairs in order to increase the range of users accommodated by a workstation. The correct way to adjust one of these workstations is

1. First adjust the chair height so that the feet are resting firmly on the floor. 2. Adjust the work surface height for comfortable access to the desktop or keyboard.

Forward Tilting Seats Chairs with forward tilted seats permit the user to sit with an erect trunk because the seat slope tilts the pelvis forward. Comparisons of lumbar angles of people sitting on conventional and forward sloping chairs indicate that this is the case (Bendix and Beiring-Sorensen, 1983; Bridger, 1988).

Dynamic Postures Van Dieen etal. (2001) found greater stature gains (indicative of lower trunk loading) when subjects sat on a dynamic chair compared to a chair with a fixed seat and backrest. Van Deursen etal. (2000) designed a dynamic office chair in which rotations about an axis perpendicular to the seat were

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applied by a motor at an amplitude of 0.6° and a frequency of 0.08 Hz. The application of these gentle twisting motions were found to result in increases in spinal length over a 1-h period of sitting—significantly more so than when subjects sat in a static control chair. These findings support the hypothesis that rotation applied to the vertebrae during sitting, reduces pressure in the nucleus pulposus, allows fluid to enter, increases disc thickness, and improves the nutritional status of the disc. When provided with additional workstation flexibility in the form of a tilting seat, subjects do use it and appear to prefer it to similar chairs with fixed seats. Interestingly, the tilt facility was used less frequently and the muscular load was higher in a typing task compared to the subject’s ordinary desk work not involving typing. This indicates that tasks involving typing are constraining and should be combined with other work. Stranden (2000) found that tilting seats produced a significant reduction in leg swelling (note the difference was small—of the order 1% of calf volume).

Foot Pump Devices There is a 66% reduction in venous blood flow through the lower leg when sitting for long periods, which is why prolonged, inactive sitting is a risk factor for deep vein thrombosis and why lower leg volume can increase by over 5% on an inactive day. According to Stranden, the key to venous pump activation is leg movement. Plantar flexion, in particular, is immediately effective and can be elicited by reclining on a tilting seat or by resting the feet on dynamic footrests that are pivoted to allow a “treadle pumping” kind of action. Wentzel and McKune (2013) evaluated the effects of a foot pump device designed to encourage plantar flexion against resistance, on lower leg swelling of seated workers. The device was found to prevent leg swelling over an 8-h day. In general, leg swelling can be prevented by walking for about 2 min every 15 min during an otherwise inactive day. When employees have to sit for 8 h, foot pump devices may be beneficial.

Visual Display Terminals Figure 4.19 summarizes the important considerations in the design of the VDT workstation for static work.

1. Seat back adjustability 2. Good lumbar support 9

1 8 7

2

10

3

6

4

5

FIGURE 4.19  Essential furniture considerations in VDT work. Seating and posture for typical office tasks. (From Display Screen Equipment—Work Guidance on Regulations, copyright HMSO, 1992. With permission.)

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3. Seat height adjustability 4. No excess pressure on underside of thighs and backs of knees 5. Foot support if needed 6. Space for postural change, no obstacles under desk 7. Forearms approximately horizontal 8. Minimal extension, flexion, or deviation of wrists 9. Screen height and angle should allow comfortable head position 10. Space in front of keyboard to support hands/wrists during pauses in keying Standards for the design of these workspaces include ANSI Standard No.100-1988, BS 7179, 1990, BS 5940, 1980, BS 3044, 1990, Health and Safety Commission (1991). The guidelines proposed in the above documents attempt to specify user space requirements and to define appropriate furniture in functional as well as physical terms. Readers are referred to these documents for detailed information.

Standing to Work at VDTs Sit–stand workstations for office workers are widely available. To obtain a good posture when standing to work at a VDT, the screen should be at standing eye height and the space around the feet should be clear (Foster etal., 1998). One foot can be placed on a footrest when standing. Discomfort in the legs increases steadily over time and increases after 45 min, suggesting that workers should sit very 30–45 min.

Laptops and Tablets User interaction with laptops and tablets is not the same as with VDTs. Straker etal. (2008) compared the postures of children using a conventional VDT screen, a tablet, and paper. Musculoskeletal stresses using the tablet and paper were higher than with the conventional screen with a more asymmetrical trunk posture, greater elevation of the shoulders, and increased muscle activity around the neck (Figure 4.20). However, this was offset by greater variation in posture and muscle activity. One of the challenges facing employers nowadays is that employees can work at home, in cafes, and on public transport using mobile IT devices. At present, validated guidance is limited and HF&E specialists should adhere to first principles as espoused in this and other chapters.

FIGURE 4.20  Unconventional postures when using personal electronic devices at home. (Courtesy of Professor Leon Straker, Curtin University.)

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TABLE 4.5 Product Features and Accessories for Enhancing VDT Workstation Flexibility Item Source documents

VDT screen

Keyboard Seating

Desks

Accessory Document holders Bookstands Tilted area of work surface Shelving Notice board Moveable screens Tilt and swivel adjustment Screen holders Detached from VDT Keyboard drawer Footrest Armrest Lumbar pad Narrow backrest (permits trunk lateral flexion and rotation) Lumbar and thoracic support Recline mechanism Height adjustable Tilt adjustable Extensions can be fitted

Guidance for Office Workstation Design Table 4.5 summarizes some design solutions for increasing the flexibility of VDT workstations, and Table 4.6 gives dimensions for U.S. workers. A participatory approach is often the most effective way to decide which product features and accessories are likely to have the greatest cost-benefits for different groups of workers in an organization. For example, document holders are often of great benefit to copy typists and data entry clerks, whereas systems designers may regard increased ­storage space and shelving as a higher priority. Standards vary between countries, but normally the following requirements apply:

TABLE 4.6 VDT Workspace Dimensions (cm) for U.S. Users Seat height Elbow rest height Work surface height Screen height Eye height (90° sitting)

95th Percentile Male

5th Percentile Female

49 29 71 Adjust screen so that top of screen is no higher than horizontal sight line when reclining by 15° 130

41 18 58

103

Source: From ANSI/HFS 100. 1988. American National Standard for Human Factors Engineering of Visual Display Terminal Workstations. Human Factors Society Inc., Santa Monica, CA. With permission.

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• Screen: A stable image, adjustable, legible, and reflection-free. • Anthropometry: Desks should have free space underneath (“leg room”) and the workstation should allow postural changes. • Software: Appropriate to the task, adaptable by the user, providing feedback on system operation and status. No undisclosed monitoring. • Adequate contrast: No glare or distracting reflections, particularly on the computer screen. • Work chair: Adjustable and suited to the user, task, and furniture. • Adequate lighting: About 300 lux of desktop illumination is needed. • Distracting noise minimized: An ambient noise level of about 60 dB(A) is the maximum window covering. Vertical blinds are preferred to provide a view of the outside world • Work surface: Sufficient space to allow for flexibility and increased workload. Appropriate job aids such as in-trays, desk lamps. Glare-free and adjustable. • Footrest/footstool: Normally tilted toward the user at 5°–15°. May have “treadle” action. Some important features of office chairs are summarized in Table 4.6.

Forward Tilting Seats A number of researchers have suggested that chairs should be designed with forward tilted seats. These chairs should permit a user to sit with an erect trunk and less posterior pelvic tilting and flattening of the lumbar curve because the tilt of the seat increases the trunk–thigh angle. Comparisons of lumbar angles of people sitting on conventional and forward sloping chairs indicate that this is the case (Bendix and Beiring-Sorensen, 1983; Bridger, 1988).

Lumbar Supports It is sometimes stated in the literature that the lumbar supports of conventional chairs can preserve the lumbar lordosis in sitting (Figure 4.18). The modern office chair in Figure 4.18 works on the principle espoused by Dr. Forrester-Brown at the beginning of this chapter—it traps the pelvis in the wedge-shaped space between the seat pan and the backrest. The pelvis stabilized in an anteriorly tiled position provides a firm foundation for an upright sitting posture. To the extent that lumbar supports prevent the adoption of forward slumped sitting postures, their use may improve breathing. Slumped sitting postures increase intra-abdominal pressure as the ribs approximate the pelvis and, therefore, prevent the downward movement of the diaphragm and the expansion of the chest wall. Landers etal. (2003) showed a significant (and over 10%) reduction in tidal volume and minute ventilation of the lungs when subjects sat in a slumped, as opposed to an upright posture. Since breathing frequency did not increase, these findings imply that slumped sitting postures may cause drowsiness and lumbar support may improve pulmonary efficiency in otherwise healthy people. Dynamic Sitting Branton (1969) used the body-link concept described in a previous chapter to evaluate the comfort of train seats by observing sitting behavior. An open-chain system of body links can behave in unpredictable ways when subject to internal or external forces. The prime function of a seat is to support body mass against the forces of gravity. A second function, which was emphasized by Branton, was to stabilize the open-chain system. In the absence of external stabilization, tonic muscle activity is required leading to discomfort if sustained. Behaviors such as folding the arms and crossing the legs can be seen as postural strategies to turn open chains into approximate closed chains stabilized by friction. The comfort of a seat depends, in a dynamic sense, on the extent to which it permits muscular relaxation while stabilizing the open-chain system of body links.

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Bendix etal. (1985) evaluated an office chair with a seat that could tilt from 5° backward to 10° forward over a transverse axis. The purpose of the seat was to prevent postural fixity by providing users with the ability to rock backward and forward at will. Subjects were found to prefer the tiltable seat and use the flexibility provided to change posture—tilts exceeding 2° were observed each minute, on average with up to 10 smaller tilts each minute. The seat was moved more frequently and with a greater range when the seat height was 6 cm above the subjects’ popliteal height compared to 1 cm below. Foot swelling was found to be greater with the higher seats, whether tiltable or fixed forward sloping but there were no effects of seat type on lumbar muscle activity. However, van Dieen etal. (2001) found greater stature gains (indicative of lower trunk loading) when subjects sat on dynamics chairs compared to a chair with a fixed seat and backrest. Van Deursen etal. (2000) designed a dynamic office chair in which rotations about an axis perpendicular to the seat were applied by a motor at an amplitude of 0.6° and a frequency of 0.08 Hz. The application of these gentle twisting motions was found to result in increases in spinal length over a 1-h period of ­sitting—significantly more so than when subjects sat in a static control chair. These findings support the hypothesis that rotation applied to the vertebrae during sitting reduces pressure in the nucleus pulposus, allows fluid to enter increasing the disc thickness, and improves the nutritional status of the disc. When provided with additional workstation flexibility, in the form of a tilting seat, subjects do use it and appear to prefer it to similar chairs with fixed seats. Interestingly, the tilt facility was used less frequently and the muscular load was higher in a typing task compared with the subjects’ ordinary desk work not involving typing. This indicates that tasks involving typing are constraining and should be combined with other work. Udo et al. (1999) compared a tilting seat with a fixed seat during the performance of a word processing task. The tilting frequencies were much lower than in Bendix’s experiments (25 per hour) but a reduction in back discomfort was reported when the tilting seat was used. Greater low back EMG activity was recorded with the tilting seat, suggesting that the reduction in pain was brought about by the reduction of static back muscle activity. As with Bendix’s experiments, no differences in lower leg swelling were found. However, Stranden (2000) did find that tilting seats produced a significant reduction in leg swelling (note the difference was small—of the order 1% of calf ­volume—which may explain why previous researchers found no difference). According to Stranden, the key to venous pump activation is leg movement. Plantar flexion, in particular, is immediately effective and can be elicited by reclining on a tilting seat or by resting the feet on dynamic footrests that are pivoted to allow a treadle pumping kind of action.

Work Surface Design Workstations can be improved by considering various aspects of desk and bench design (Table4.7). Some important considerations are the provision of tilt in the work surface or of document holders and the provision of free space. Zacharkow (1988) provides many interesting illustrations of

TABLE 4.7 Recommended Work Surface Heights for Standing Workers (cm) Task Requirements Precision work Light assembly work Heavy work

Male

Female

109–119 99–109 85–101

103–113 87–98 78–94

Source: From Ayoub, M.M. 1973. Work place design and posture. Human Factors, 15: 265–268. With permission.

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Victorian school desks having a 15° slope for writing and an integral bookholder for reading, angled at 45°. Mandal (1991) suggested that chairs with forward tilting seats be used with desktops that tilt toward the user by about 15° to lessen the visual angle and encourage a more upright posture of the trunk. Several studies have indicated that tilted desktops (of 15° or even 10°) do reduce the trunk and neck flexion of seated persons engaged in reading and writing (de Wall etal., 1991), and thus reduce the load on the corresponding parts of the spine. Significant effects have been found on subjects seated on both conventional and forward-sloping seats. Porter et al. (1992) have reported similar benefits with a sloping computer desk. Burgess and Neal (1989) found that using a document holder when writing on a flat desk significantly reduced the moment of flexion of the head and neck at the C7–T1 level of the spine and was rated by the subjects as more comfortable than not using one. The use of the horizontal desktop for reading and writing would appear to be a rather new and inferior development in the history of furniture design. Mouse-Intensive Tasks Recent research by Dennerlein and Johnson (2006) suggests that although use of a mouse is common in most computer tasks it is characterized by static, nonneutral postures of the wrist and ­shoulder—more so than keyboarding. Investigations of musculoskeletal complaints among dedicated computer users might benefit from some simple task analyses to describe the different tasks users perform and the amount of time spent using the mouse. Mouse control functions can be executed in other ways, via the keyboard or alternative pointing devices such as trackballs, or by using touch screens.

TOOLS AND PROCESSES Table 4.8 presents items for a subjective chair evaluation checklist that can either be used as an ergonomist’s aide-memoir or a source of items for questionnaire surveys of sedentary workers. Table 4.9 presents a quick VDT checklist. For both standing and sedentary workers, work surfaces should be arranged so that the worker does not have to work continually with objects placed at one side or reach excessively to the side. The main working area should be directly in front of the worker’s body to minimize any twisting of the trunk when carrying out task-related movements.

Office Environment Standards vary between countries, but normally the following requirements apply: • Screen: A stable image, adjustable, legible, and reflection-free. • Anthropometry: Desks should have free space underneath (leg room) and the workstation should allow postural changes. • Software: Appropriate to the task, adaptable by the user, providing feedback on system operation and status. No undisclosed monitoring. • Adequate contrast: No glare or distracting reflections, particularly on the computer screen. • Work chair: Adjustable and suited to the user, task, and furniture. • Adequate lighting: About 300 lux of desktop illumination is needed. • Distracting noise minimized: An ambient noise level of about 60 dB(A) is the maximum window covering. Vertical blinds are preferred to provide a view of the outside world. • Work surface: Sufficient space to allow for flexibility and increased workload. Appropriate job aids such as in-trays, desk lamps. Glare-free and adjustable. • Footrest/footstool: Normally tilted toward the user at 5°–15°. May have treadle action.

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TABLE 4.8 Quick Chair Design Usability Checklist Seat design   Any discomfort due to    The shape of the seat    Pressure under the thighs    Pressure under the buttocks    Pressure from the leading edge of the seat   Is the seat    Too narrow    Too wide    Too shallow    Too deep    Slope too far forward    Slope too far backward    Too restrictive   Not supportive   Unstable    Too high    Too low   Can you    Get in and out easily Chair adjustment   Any difficulty in    Locating the height controls    Adjusting the height controlsa    Controlling the chair when adjusting the height    Obtaining a comfortable height Backrest   Does the backrest support your lower back?    When reclining slightly    When reclining fully   Does the backrest support you at shoulder level?    When reclining slightly    When reclining fully   Do you feel cramped when using the backrest?   Does the backrest fit your back? Lumbar support   Does the lumbar support your lower back?   Does the lumbar support feel comfortable?    When sitting upright    When reclining   Does the lumbar support relieve any backache?   Does the lumbar support help you to sit up straight? Chair-user fit   Can you recline and keep your feet on the floorb?   Do you feel stable when you reclineb?   Is the seat too deep for you to use the lumbar support? (Continued )

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TABLE 4.8 (Continued) Quick Chair Design Usability Checklist Backrest articulation   Is the backrest spring tension too high?   Is the backrest spring tension too low?   Can you change position in the chair easily? Elbow rests   Are the elbow rests too high?   Are the elbow rests too low?   Do they make you feel locked-in?   Are they too close together?   Are they too far apart?   Do they prevent you from moving your chair close to your desk? Upholstery and material   Does the material provide adequate friction?   Is the padding adequate:    On the seat    On the backrest   Does the chair feel hot in summer? Others   Does the seat swivel easily?   Does the chair feel stable?   Can you tuck your feet under the seat when you want to?   Can you move easily when seated (chairs with castors) ? a

b

Pneumatic controls are generally preferred as manually operated height controls are invariably difficult to adjust and cause problems for less strong users. Negative response indicates that a footstool is needed.

Table 4.9 presents items for a VDT workspace evaluation checklist that can either be used as an ergonomist’s aide-memoir or as a source of items for questionnaire surveys of sedentary workers. Subjective data obtained by such questionnaires are best interpreted together with objective measurements made according to applicable standards. Static Work-Risk Assessment There are many tools available for the assessment of workstations where static work is carried out. Rapid entire body assessment (REBA; Hignett and McAtamney, 2000) is a postural analysis tool that gives a composite risk rating. ISO 11226 (2000) gives acceptability ratings and holding times for static postures. The quick exposure checklist (David etal., 2008) has the disadvantage of being applicable only to upper body risk assessment. However, it has two distinct advantages over other tools: it takes psychosocial stressors into account (see Chapters 5, 8, and 16) and also a participatory approach (see Chapter 1) by inviting employees to rate their own jobs themselves.

Rapid Entire Body Assessment REBA is based on valid scientific principles and data. The tool itself has not been extensively validated and, therefore, it is recommended that it be used to support the systematic assessment of work postures. The results of a REBA analysis should then be interpreted together with data on real injury rates, absenteeism, and any scientific literature relevant to the industry under investigation.

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TABLE 4.9 Quick VDT Workspace Evaluation Checklist Office desk   Have you enough space on your desktop?   Have you enough storage space?   Is your desk    Too high    Too low    Too large    Too small   Are the drawers easy to operate?   Is there enough space for your legs under the desk?   Is there a modesty board? Computers   Can you adjust the screen brightness?   Can you change the screen colors?   Is there any glare on the screen?   Can you adjust the screen position and tilt?   Are the cables neatly tucked away?   Are the screen characters the right size?   Is the screen image stable?   Does the screen flicker?   Is there sufficient contrast?   Is the screen color acceptable? Keyboard   Does the keyboard have a QWERTY layout?   Is the keyboard detachable?   Can you operate the keyboard with your wrists in   a comfortable position?   Are the characters on the keys legible? Mouse   Is the mouse cable long enough?   Does the mouse move easily?   Is the mouse comfortable to use?   Does the cursor stick when using the mouse?   Is there enough space for the mouse and mouse pad? Workspace   Can you rest your feet on something if you need to?   Can you change posture at will?  Does the backrest support your back when you are doing your normal work?   Can you adopt more than one comfortable work posture?   Does your chair recline?   Can you look out of a window when you want to?   Can you reach down and into drawers and trays easily?   Can you get in and out of your workspace easily? Office environment   Are the lighting levels comfortable? (Continued)

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TABLE 4.9 (Continued) Quick VDT Workspace Evaluation Checklist   Are the office lights fitted with diffusers?   Is there enough natural light in the office?   Are the lights flicker-free?   Are there pleasant visual objects (e.g., plants) ?   Are there enough windows?   Is the temperature comfortable?   Is the air pleasant to breathe?   Are you free of unwanted noise?   Is there enough space in your office? Job content   Is there sufficient variety in your work?   Can you leave your desk from time to time?   Do you have enough work to keep you busy without being over-loaded?   Do you see other people during the day?   Do you work with others during the day?   Are you happy with the way you are supervised?   Can you get on with your job without distraction?   Do you have enough privacy?   Do you find your job interesting?   Do you have enough responsibility? Aches and pains   Do you get low back pain at work?   Do you get neck or shoulder pain at work?   Do your eyes feel tired at work?   Do you get pins and needles in any part of your body?   Do you have difficulty focusing your eyes at the end of the day?   Do you get pains in your hands, wrists, or arms at work?   Do you usually feel tired at the end of the day?   Do you get headaches at work?   Do you often suffer colds and flu?   Does your skin ever feel itchy or irritated at work?

Assessment of Working Posture Using Composite Risk Zone Ratings Ratings can be done either by direct observation or from photographs, by following certain simple steps as listed: 1. Observe the angle of the following body segments and assign each segment a rating depending on its orientation/posture using the zone rating system as provided in Table 4.10 and Figure 4.21: Trunk, neck, legs, upper arms, lower arms, and wrists. 2. Collate the body segment ratings using the REBA scoring sheet (Table 4.11). Obtain scores A and B by cross-referencing the ratings using Tables 4.12 and 4.13. 3. Write scores A and B on the REBA scoring sheet. 4. Find score C by cross-referencing scores A and B in Table 4.13. 5. Add score C to the activity score from Table 4.14 to obtain the REBA score. 6. Refer to Table 4.15 to obtain the REBA action level. 7. Make recommendations for change (refer to Chapter 1 for details of change prioritization schemes).

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TABLE 4.10 REBA Body Part Risk Zone Ratings Body Part Trunk Movement  Upright   0°–20° flexion or extension   20°–60° flexion/>20° extension   >60° flexion Neck Movement   0°–20° flexion   >20° flexion or any extension Legs Position   Bilateral weight bearing, walking, or sitting   Unilateral weight bearing or unstable Upper arms Position   20° extension to flexion   >20° extension, 20°–45° flexion   45°–90° flexion   >90° flexion Lower arms Movement   60°–100° flexion   100° flexion Wrists Movement   0°–15° flexion/extension   >15° flexion/extension

Score

1 2 3

Change Score

Add 1 if trunk is twisted or laterally flexed

4

1 2

Add 1 if trunk is twisted or laterally flexed

1 2

Add 1 if knees are between 30° and 60° of flexion

1 2

Add 1 if arm is abducted or rotated Add 1 if shoulder is raised

3

Deduct 1 if weight is supported or if posture is gravity assisted

Add 2 if knees are >60° flexion (except for sitting)

4

1 2

1 2

Add 1 if wrist is deviated or twisted

Source: From Hignett, S. and McAtamney, L., Applied Ergonomics, 31, 201, 2000. With permission.

HFE Workshop 4.1 presents a REBA analysis of the sitting posture in Figure 4.12. HFE WORKSHOP 4.1  Using REBA to Evaluate a Static Work Posture Refer to Figure 4.2. Step 1: Zone ratings (from Table 4.11): Trunk: 3 (there is between 20° and 60° of trunk flexion) Neck: 2 (the upper part of the neck is in extension) Legs: 1 (person is sitting) (Continued)

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HFE WORKSHOP 4.1 (Continued) Upper arms: Right arm 1 (there is between 20° extension and 20° flexion) Left arm 3 (from the position of the left hand we infer 45°–60° of flexion) Lower arms: Right arm 2 (borderline, but possibly >100° of flexion at the elbow) Left arm 2 (from the position of the left hand, we infer 60°

20°

20°

30°–60°

+2

4

2 1

1

100° 2

1 2

20°

3

°

2

2

1 60°

1 2

15°

15°

FIGURE 4.21  REBA joint angle observational scoring system. (Redrawn from Hignett, S. and McAtamney, L. 2000. Rapid entire body assessment. Applied Ergonomics, 31: 201–205. With permission.)

Consulting Users for Furniture Selection: A Structured Approach Irrespective of whether anthropometric data are available for furniture selection, or whether task analyses have been conducted, HFE takes a user-centered approach to gather the opinions and thoughts of users about the choice of furniture. The Display Screen Equipment regulation in the EU specifically require assessors to look, not just for problems, but also to enquire about the positive aspects of workstations and furniture so that when offices are redesigned, positive aspects can be carried forward. HFE Workshop 4.2 describes two methods for analyzing user opinions about office chairs that can be used to make evidence-based purchasing decisions.

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HFE WORKSHOP 4.2 User-Centered Office Chair Selection A large financial institution wishes to purchase 1000 new office chairs for its headquarters. It wishes to benefit from a bulk purchase of identical chairs, but has concerns about whether a “one size fits all” approach will work. HFE specialists at the company carry out an anthropometric study of available chairs using the methods described in the previous chapter. A shortlist of six chairs (A–F) is drawn-up and these chairs are tested for a day each by three employees—a female of 5th percentile stature and healthy body composition and waist circumference (see Chapter 8), a male of 95th percentile stature, and an obese female. All employees try each chair for a day in a different order. Testing for Preference: Do the Judges Agree? The three judges rank order the chairs according to their preference (1 = “most” to 6 = “least” preferred). The ranks are summarized below. Office Chair

5th %ile ♀ 95th %ile ♂ Obese ♀ Rj

A

B

C

D

E

F

1 1 2 4

6 6 4 16

2 2 3 7

3 3 1 7

5 4 6 15

4 5 5 14

The study has been conducted using the “beauty contest paradigm” where the aim is to determine whether the judges agree on which chair is preferable. If there was complete agreement, then the most preferred chair would have a score of Rj = 3, the second most preferred chair a score of Rj = 6, and the least preferred chair a score of Rj = 18. Kendall’’s Coefficient of Concordance “W” is a statistical test used to determine whether the level of agreement between n judges about k items is statistically significant. Most statistical packages support this test; therefore, details of the calculation of the test statistics are not included here. The test is a nonparametric test that can be used for small samples. The data above yield a value of

W = 0.81 (P < 0.05)

showing statistically significant agreement between the preferences of three physically different judges. Note, a significant result would not mean that the chair with the lowest ranking was the “best” chair—only that the judges agree on which chairs they prefer. It may well be that the “most” preferred chair was still “unacceptable” for the majority of users (the judges agree that it is the “best of the worst”), so it is always wise to de-brief participants after such exercises to find out what lies behind their rankings. If the judges had been found not to agree, then further investigation would be needed to determine the reasons. Close inspection of the rankings might reveal that one or more of the chairs was preferred by the short and tall judges but not by the obese judge. Testing for Acceptability: Is There a Trend? Suppose we carry out further investigations and select the four most preferred chairs as in the table above—that is chairs A, C, D, and F. We want to know whether the chairs differ in (Continued)

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HFE WORKSHOP 4.2 (Continued) acceptability (all or none might be acceptable) and whether there is a trend in acceptability from the most to the least preferred. In other words, given that the judges have their preferences, does it really matter which one we choose? Chairs A and C were preferred but if they are more expensive than D and F, would it really make a difference if we purchased D or F, rather than A or C? One way of looking at this, is to ask users to rate the acceptability of the chairs. Eight users unfamiliar with the chairs, try them out for a few days, the order in which they try them being varied between the users. Each of eight users tries each of four chairs for a day and then rates each chair in terms of acceptability on a 20-point scale (1=“completely unacceptable to me to as my office chair” to 20=“completely acceptable as my office chair,” 10 being “neutral”). The data are shown below with the chairs ordered in terms of increasing preference. User

Chair F

Chair D

Chair C

Chair A

1. ♀ 2. ♀ 3. ♀ 4. ♀ 5. ♂ 6. ♂ 7. ♂ 8. ♂

5 3 8 3 6 8 5 4

8 11 8 6 6 10 7 9

12 11 12 9 6 14 12 15

15 14 12 13 15 15 13 15

Pages’ L test is the name of the statistical test used to investigate trends when there is an ordered series of treatments scored using rank (ordinal) data. The procedure for calculating L is given below. Procedure 1. Arrange the chair columns in the order predicted by the preference scores 2. Take each user’s acceptability scores in turn and rank them (1 to 4) 3. Sum the ranks for each chair 4. Multiply each sum by its weighting coefficient 5. Add the weighted sums to calculate “L” 6. Refer to tables of critical values of “L”* User 1. ♀ 2. ♀ 3. ♀ 4. ♀ 5. ♂ 6. ♂ 7. ♂ 8. ♂ Totals Weighting

Chair F

1 1 1.5 1 2 1 1 1 9.5 1 9.5 L = 9.5 + 32 + 70.5 + 124 = 236 *

Chair D

Chair C

Chair A

2 2.5 1.5 2 2 2 2 2 16 2 32

3 2.5 3.5 3 2 3 3 3.5 23.5 3 70.5

4 4 3.5 4 4 4 4 3.5 31 4 124

Page, E.B., 1963. Ordered hypotheses for multiple treatments: A significance test for linear ranks. Journal of the American Statistical Association, 58:216–230.

(Continued)

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HFE WORKSHOP 4.2 (Continued) With n = 4 treatments (chairs) and n = 8 subjects (users), L = 236 exceeds the critical value of L at the 0.01 level of statistical significance; hence, we can conclude that there is a statistically significant trend in acceptability across the chairs. The preferred chairs were judged to be more acceptable. Therefore, our small user trial has shown that the users have clear preferences about which chair they prefer and that the most preferred chairs are judged to be more acceptable than the least preferred. A recommendation can be made to the company that Chair A will deliver the most benefit in terms of preference and acceptability. Note also, that chair D was rated close to “neutral” in terms of acceptability and that none of the chairs was rated as “completely acceptable.” This latter fact might be used to make the case for job redesign to increase the amount of time spent standing or away from the desk. We could repeat the trial in other parts of the company and use judges from different departments, with different work roles and seniority levels, or we might test a wider range of chairs. In this example, we have deliberately used small numbers of judges and raters to demonstrate that even with limited time and resources, HFE specialists can take a structured approach that yields data amenable to statistical testing and external scrutiny. This is the kind of “hard data” on a “soft topic” that might help to persuade a budget manager to buy Chair A, if it turned out to be more expensive than the others.

TABLE 4.11 REBA Scoring Sheet Step 1 Step 2 Step 3 Step 4 Step 5 Step 6 Step 7

Group A

Group B

Trunk score Neck score Legs (left and right) Group A score (from Table 4.13) + load force score (from Table 4.13) Score A

Upper arm scores (left and right) Lower arm scores (left and right) Wrists (left and right) Group B score (from Table 4.14) + coupling score (from Table 4.14) Score B Score C (from Table 4.15) Score C + activity score (from Table 4.15) = REBA score

Refer to Table 4.16 Recommend action

TABLE 4.12 Group A Scores and Load/Force Scores for Trunk, Neck, and Leg Ratings Table A Leg rating Trunk rating  1  2  3  4  5 Load/force   10 kg 2

Shock or sudden loading +1

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TABLE 4.13 Group B Scores and Coupling Scores for Upper Arm, Lower Arm, and Wrist Table B Lower Arm Rating 1 Upper arm rating 1 2 3 4 5 6 Coupling Well-fitted handle and a mid-range power grip 0 Good

2

Wrist rating

1 1 1 3 4 6 7

2 2 2 4 5 7 8

3 3 3 5 5 8 8

1 1 2 4 5 7 8

2 2 3 5 6 8 9

3 3 4 5 7 8 9

Hand hold acceptable but not ideal or coupling is acceptable via another part of the body 1 Fair

Hand hold not acceptable, though possible

Awkward, unsafe grip, no handles Coupling is unacceptable using other parts of the body

2 Poor

3 Unacceptable

TABLE 4.14 Score C and Activity Scores Table C Score B Score A

1 2 3 4 5 6 7 8 9 10 11 12

1 1 1 2 3 4 6 7 8 9 10 11 12

2 1 2 3 4 4 6 7 8 9 10 11 12

3 1 2 3 4 4 6 7 8 9 10 11 12

4 2 3 3 4 5 7 8 9 10 11 11 12

5 3 4 4 5 6 8 9 10 10 11 12 12

6 3 4 5 6 7 8 9 10 10 11 12 12

7 4 5 6 7 8 9 9 10 11 11 12 12

Activity Score +1 One or more body parts are static—e.g., held for longer than 1 min +1 Repeated small range actions—e.g., repeated >4 times/min (excluding walking) +1 Action causes rapid large range changes of postures or base is unstable

8 5 6 7 8 8 9 10 10 11 12 12 12

9 6 6 7 8 9 10 10 10 11 12 12 12

10 7 7 8 9 9 10 11 11 12 12 12 12

11 7 7 8 8 9 10 11 11 12 12 12 12

12 7 8 8 9 9 10 11 11 12 12 12 12

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TABLE 4.15 REBA Action Levels Action Level

REBA Score

Risk Level

Action

1 2–3 4–7 8–10 11–15

Negligible Low Medium High Very high

None necessary May be necessary Necessary Necessary soon Necessary now

0 1 2 3 4

TABLE 4.16 General Guidelines for Workstation Design Provide clearance under desks and benches so that foot and knee position are not constrained. Do not use the area around the bench or the desk as storage space. The feet must never be confined to a small area as this degrades balance and shifts the load of postural adaptation to vulnerable structures higher up the kinetic chain. For every task, find an optimal visual and manual distance that will minimize forward flexion of the trunk and flexion of the neck. Offer pregnant workers seats with a forward slope of 10°. Provide footrails for standing workers and footrests for seated workers. Enrich or enlarge the job to increase postural variety. Differentiate new tasks by introducing configurations demanding alternate postures. Activate the venous muscle pump. Require walking, wherever possible. Five minutes per hour may be optimal. Design sit–stand workstations. Allow standing workers to sit and work for 50% of the day. If multiuser work surfaces are of fixed height, provide height adjustable platforms for standing workers.   For seated workers, choose a height that will fit taller workers and provide footrests for shorter workers. The height of floors is always adjustable in the upward direction. Alternating between asymmetric postures is a strategy for minimizing static loading. Design workstations and jobs to encourage this strategy. Redesign jobs if head inclination is   >85°   25°    1) due to mobile phone use (see Chapters 12 and 13 for more information on cell phones).

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Models of the Development of WMSDs Armstrong et al. (1993) have developed a model which emphasizes exposure, dose, capacity, and response (summarized in Table 5.3). Exposure refers to work demands such as posture, force, and repetition rate which have an effect (the dose) on the internal body parts. Metabolic changes in the muscles, stretching of tendons or ligaments, and compression of the articular surfaces of joints are examples of what is meant by a dose. The dose may produce a response such as a change in the shape of a tissue, the death of cells, or accumulation of waste products in the tissues. These primary responses can be accompanied by secondary responses such as pain or a loss of coordination. A response (such as pain) can be a dose which causes another response (e.g., increased muscle contraction). Capacity refers to an individual worker’s ability to cope with the various doses to which his musculoskeletal system is exposed. An individual’s capacity is not fixed—it may change over time as the person ages or the development of skill may improve the ability to generate large forces with less effort. Training can increase strength or endurance, whereas the development of scar tissue to replace injured muscle tissue may impair strength or endurance. Armstrong etal. point out that m ­ uscles can adapt to work demands faster than tendons and that this may lead to reduced (­relative) tendon capacity. We might speculate that one of the dangers faced by athletes who use illegal ­anabolic steroids to produce rapid increases in muscle bulk is injury to the tendons because tendon strength does not have time to “catch up” with the increased muscle strength. Some common musculoskeletal conditions and their work relatedness are described in the ­following sections.

Review of Tissue Pathomechanics and WMSDs The mechanism of WMSDs is thought to be repeated microtrauma at the cellular level. Repair capacity is exceeded due to a lack of rest during the day and repeated daily exposure (Pitner, 1990). Muscle Pain In general, human muscle has excellent endurance capacity for loads less than 15% of the muscle’s maximum voluntary contraction (Putz-Anderson, 1988). Above this threshold, rest periods are needed if acute or chronic problems are to be avoided. TABLE 5.3 Key Elements of Armstrong etal.’s Model of the Development of Work-Related Upper Body MSDs Element Exposure

Dose

Primary responses

Secondary responses Capacity

Examples Physical factors: workplace layout; tool design; size, shape, weight of work; objects Work organization: cycle times; paced/unpaced work; spacing of rest periods Psychosocial factors: job dissatisfaction; quality of supervision; future uncertainty Mechanical factors: tissue forces; tissue deformations Physiological factors: consumption of substrates; production of metabolites; ion displacements Psychological factors: anxiety Physiological: change in substrate levels; change in metabolite levels; accumulation of waste products; change in pH Physical: change in muscle; temperature; tissue deformation; increase in pressure Physical: change in strength; change in mobility Psychological: discomfort Mechanical: soft tissue strength; bone density/strength Physiological: aerobic capacity; anaerobic capacity; homeostatic control Psychological: self-esteem; tolerance of discomfort; tolerance of stress

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Pain due to the accumulation of waste products in the muscles is called cramp and can be a­ ccompanied by muscle weakness or spasm (the muscle may temporarily lose up to 50% of its normal strength when fatigued). Cramp in the hand or forearm is known to be more common in those whose jobs involve prolonged handwriting, typing, or other repetitive movements. Cramp is more likely when extreme postures have to be adopted since these postures weaken muscle joint systems. Patkin (1989) reports that cramp can be caused while using badly designed ballpoint pens that require undue pressure to write well. Fountain pen use is compulsory for schoolchildren in some countries because these pens can be used with lower forces. There is little information on the onset times for cramp in repetitive work. Roze etal. (2009) found that writer’s cramp was 4.7 times more prevalent in people who wrote for 1–3 h/day and 10.1 times more prevalent in people who wrote for more than 3 h/day in the previous year. A triggering effect seems to occur—early episodes make further cramp more likely if the workload remains unchanged. Delayed onset muscle soreness (DOMS) is a natural response to abnormal loading. Pain, due to inflammation, appears up to 12–24 h after the exposure, peaking 1–3 days after, before gradually decreasing. DOMS is indicative of muscle damage. It can occur after exposure to sudden high forces, particularly during eccentric contractions (as, e.g., when trying to hold a falling object or resist a sudden reaction torque of a powered tool). At the tissue level, there may be evidence of ­damage such as muscle fiber z-line rupture, ragged type 1 (red) muscle fibers, decreased intracellular adenosine triphosphate (ATP), and reduced local blood flow (Hales, 1994). Normally, the muscle will recover and even strengthen but some researchers believe that chronic exposure to static load prevents proper recovery leading to permanent damage (see Chapter 7 for explanations of muscle structure and physiology). This primary response may be accompanied by a feeling of soreness in the muscle, which diminishes as the damaged muscle fibers regenerate (Armstrong etal., 1993). In a conscious person, skeletal muscles always have a certain degree of “tightness.” There is a baseline level of muscle fiber recruitment even during relaxation. This is known as muscle tone and it is controlled by the central nervous system and by a feedback system involving the spinal cord and the muscle spindles. Muscle tone is essential for the maintenance of posture. People under mental stress may, without realizing it, develop increased tension in their muscles which they cannot control. At work, the prestressed body part may be a source of pain even though the task loading is mild. A chronic, stereotyped pattern of recruitment of motor units may be the dose which leads to damage of the muscle tissues. Roman-Liu etal. (2013) found increased levels of muscle activity (electromyography [EMG]) of approximately 10%–25% when subjects engaged in sustained attention and vigilance tasks compared to control conditions. Increases in EMG activity were greatest in the shoulder muscles (deltoids and trapezius). Exertional compartment syndromes normally occur in the lower limbs with dull aching in a given muscular compartment and increased pressure in the muscle. The pain is triggered by activity. Muscle is known to increase in volume by up to 20% during exercise (Pitner, 1990) and it is thought that the accompanying pressure increase is sufficient to degrade blood flow through the muscle. Thepain subsides after cessation of the activity. Work versus Exercise: Two Sides of the Same Coin In properly designed weight training programs, the goal is, in fact, to cause such damage because the body responds by increasing the size of the contractile elements in the muscle, resulting in improved strength. However, a rest period of at least 48 h is usually an intrinsic part of strength training programs—the time needed to allow the exercised muscles to recover. The pattern of activity in many industrial jobs bears little resemblance to that in proper muscle training programs. One of the main differences is that rest periods are far more frequent and far longer in muscle training regimes than at work, which is why work does not normally have the same beneficial effects as exercise or training. Damage to muscle tissue on a daily basis may exceed the repair capability leading to a decrease rather than an increase in strength or endurance and chronic pain in the muscle (­myalgia). It is thought that the tissue changes responsible for chronic pain, in the absence

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of inflammation, is due to a buildup of tissue in the extracellular matrix (Cutlip and Marras, 2000). The matrix is a barrier to nutrients and contains pain receptors. There may also be an increase in collagen in the muscles causing an increase in muscle stiffness. The end result is a loss of strength, endurance, and the ability to absorb shocks or vibration without further damage. Tendon Pain Tendons have a tensile strength of 50–100 MPa. They consist of bundles of collagen microfibrils with many cross linkages between them. At rest, the fibrils have a “crimped” appearance. Under tension, the tendons elongate nonlinearly as the fibrils straighten. Under further tension, the fibrils elongate by 1%–5% of their length. Beyond this, individual fibers fail, putting more stress on those remaining. Under constant load, tendons exhibit “creep”—viscous lengthening takes place. Tendinitis (inflammation of tendons) can be caused by force, posture, and repetition and the risk is greater when workers are exposed to these stressors in combination. When highly repetitive movements are required, the increase in blood supply to the muscles may be associated with a decrease in blood supply to the adjacent tendons and ligaments of the associated joints. As Hagberg (1987) puts it, the muscles “steal” blood from the insertions of the ligaments and tendons. “Policeman’s heel” (caused by the repetitive microtrauma of walking long distances every day) is an example. Problems of this kind are sometimes referred to as “insertion syndromes.” Impaired blood supply to the tendons is thought to be the cause of much occupational shoulder pain because it increases the rate of cell death within the tendon. This is thought to provide sites in which chalk (calcium carbonate) is deposited. It seems that increased tension in tendons reduces their blood supply, which may explain why static work positions are associated with tendon problems. Armstrong etal. (1993) describe an interesting hypothesis which states that the accumulation of dead cells in tendons can cause an inflammatory response in the tendon by the immune system. Inflammatory responses normally occur when there is an injury such as a cut—the blood supply to the affected region is increased to attack any incoming foreign bodies and the part of the body in question normally feels hot and swollen. According to Armstrong etal., if the person already has an infection such as influenza, the immune system will have been activated and the local inflammatory response described above is more likely to be triggered by the accumulation of dead cells in the tendon. This may underlie the popular conception that we are more prone to injury when suffering from colds or flu or other diseases. Frequent mechanical loading can cause tendonitis or inflammation of the cartilage surrounding a joint. Extreme positions of the wrist can press the flexor tendons of the fingers against the bones of the wrist, increasing the friction in the tendons. Rapid, repetitive movements of the hand or fingers can cause the sheaths surrounding tendons to produce excess synovial fluid (Figure 5.1). Theresultant swelling causes pain and impedes movement of the tendon in the sheath. This is known as “tenosynovitis.” Repeated exposure can ultimately leave scar tissue which impedes m ­ ovement of the tendon in its sheath and thus degrades function. Joint structure may be degraded by the ­formation of bony spurs around damaged areas. Reduced mobility, pain, and weakness may result. Sudden large forces may cause tendons to separate from bones. Trigger Finger (Stenosing Flexor Tendinitis) Stiffness and “snapping” of fingers during volitional flexion are thought to be caused by thickening of the fibro-osseous canal through which the finger flexors pass. A higher prevalence has been foundin certain meatpacking jobs that require static grasping of powered knives activated by a­trigger (Gorsche etal., 1998). However, nonoccupational factors such as thyroid disease, diabetes, and arthritis are usually the cause (Trezies etal., 1998). De Quervain’s Tenosynovitis Characterized by pain on the thumb side of the wrist and impaired thumb function, it is more common in the preferred hand of middle-aged women, suggesting that it is activity related (Moore,

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Repetitive Tasks (a)

(b)

A B C

FIGURE 5.1  Wrist posture and tendon function. (a) Extreme postures can preload the finger tendons. (b)Simplified view of a flexor tendon of the fingers. The tendon (A) is surrounded by a synovial sleeve consisting of an outer (C) and an inner layer (B). When the tendon moves, the inner layer glides over the outer layer, lubricated by synovial fluid. If the layers become inflamed or scar tissue builds up, the layers cannot glide smoothly over one another. The tendon then behaves like a rusty brake cable and smooth, pain-free movement is impossible.

1997). Activities that require heavy use of the thumbs seem to be associated with the disorder (­fitting rubber rings on a pipe, sewing, weaving, and cutting). The avoidance of ulnar deviated wrist postures when operating tools would seem to be indicated. Bursitis A “bursa” is a sac containing viscous fluid situated at places in tissues where friction would o­ therwise occur (bursa is the Greek word for wine skin and is related to the English word purse). There are about 150 bursae in the body and they act like cushions which protect muscles and tendons from rubbing against bones during movements of the body. Overexertion and injury can cause inflammation of bursae or bursitis. “Housemaid’s knee” is a well-known type of occupational bursitis. Bunions are also a form of bursitis which is caused by wearing ill-fitting shoes—friction of the shoe on the bursa on the joint of the big toe causes it to become inflamed. Bursitis can be distinguished from tendonitis anatomically and because of the dull, aching pain that accompanies it—in contrast to the sharper pain of tendonitis. Neuritis Repeated or prolonged exertion can cause damage to the nerves supplying a muscle or passing through it. This can cause sensations of numbness or tingling (pins and needles) in areas of the body supplied by the nerve. The model of Armstrong etal. states that the response to a given dose can itself be a dose that leads to a response. In the case of nerves, overexertion can cause increased pressure in a muscle due to edema or scar tissue formation. The increased pressure can itself be a dose which results in impaired nerve function. Impaired nerve function, destruction of fibers, or damage resulting in reduced nerve conduction velocity may cause muscle weakness. All of these problems are more likely to occur if the joints are held in an awkward posture (at the extremes of the ranges of movement) since this “preloads” tendons and ligaments and stretches muscles and nerves. There are several common “compression neuropathies”—“bowler’s thumb” involving the ulnar digital nerve of the thumb and “handlebar palsy” which involves the ulnar nerve in cyclists.

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Therelative roles of interference with blood supply and direct mechanical trauma to the nerve are not well understood but the pressure threshold limit for nerve viability is approximately 40–50 mmHg. Rydevik etal. (1981) found that blood flow in nerves ceased at a pressure of 60 mmHg. Furthermore, after 2 h compression at 40 mmHg, blood flow in the compressed segment was severely reduced up to 7 days afterward. Any activities or conditions that increase the pressure are likely to degrade nerve function. Peripheral Neuropathies and Non-Localized Arm Pain Several researchers have suggested that much of the diffuse and difficult to diagnose arm pain, often labeled RSI, may really be peripheral nerve pain (Quinter and Elvey, 1993). The pain is the result of a disorder of the pain receptors and occurs independently of the person’s mental state. Unlike neuritis, there is no inflammation of the nerve itself. Disorders of nerve function are known as neuropathies. Chronic abnormal inputs from peripherally damaged nerves can sensitize nerve cells within the spinal cord, resulting in the hypersensitivity to painful stimuli characteristic of RSI. According to the theory, RSI is really a form of peripheral neuropathy in which “damaged nerves can come to contribute actively to chronic pain by injecting abnormal discharge into the nervous system and by amplifying and distorting naturally generated signals.” Butler (1991) points out that nerves are “bloodthirsty” structures—the nervous system constitutes 2% of body weight and consumes 20% of the oxygen in the blood. The nervous system is also the most extended and connected system in the body. What this means is that nerves have to accommodate postural movements. When, for example, a person flexes the elbow, the nerves on the flexion side of the joint shorten and may be pinched by other tissues and nerves on the opposite side are stretched. It is conceivable that both these accommodations may interfere with the nerve’s blood supply. According to Butler, movements at joints such as the ankle can increase the tension in the nerves in distant parts of the body. For example, the angle through which the straight leg of a person lying supine can be flexed depends on whether the person’s neck is flexed. Cervical flexion pre-tenses the nervous system and hastens the onset of pain during the straight leg raising maneuver. In these situations, the nerve is susceptible to injury, not just at the joint that moves, but at any point along its length where adverse neural tension occurs. Vulnerable areas are where nerves pass through tunnels, where the nervous system branches and is less able to glide over surrounding ­tissues, where the nerve is relatively fixed (at some points in the spine, for example), and where the nerve passes close to unyielding surfaces. It is interesting to speculate whether the flexed cervical postures of many office workers predispose them to pain in the upper limbs through the mechanism of adverse neural tension. Pritchard et al. (1999) proposed that nonlocalized arm pain may have vascular origins. They measured the vascular response of muscular work in the radial arteries of patients with diffuse forearm pain compared to control patients who had localized forearm pain. They found that the radial artery was relatively constricted in the patients with diffuse pain and did not vasodilate with exercise, as it did in control patients. The pain, therefore, was the result of restriction of blood s­ upply to the muscles. Another puzzling feature of some activity-related upper limb pain is its task specificity. The person may complain of pain only when carrying small repetitive motions such as typing or playing the piano but be perfectly capable of carrying out similar activities which require a wider range of joint movement. Butler (1991) uses the term “activity specific mechanosensitivity” to describe this phenomenon. It is hypothesized to occur when, during movement, a small region of scarred nerve tissue moves, in a particular direction, against a damaged or pathological surface such as bony outgrowth. Bones and Joints Repeated, heavy loading is essential for the proper formation and maintenance of bone. Wolff’s law states that bone grows in proportion to and in opposition to the forces imposed on it. Under repeated loading, particularly of the lower extremities, stress fractures can occur. Stress fracturing, like many

Repetitive Tasks

165

WMSDs, is a process rather than an event (Pitner, 1990). Repeated loads (below the threshold for acute fracture) damage bone eventually leading to acute fracture. It is thought that these injuries are more likely to occur if the loading is accompanied by muscle fatigue. Mechanical trauma seems to be a contributory factor in the development of osteoarthritis (OA) in joints. OA is a noninflammatory disease characterized by degeneration of the articular cartilage, hypertrophy of bone, and changes to the synovial membrane which causes stiffness and pain in the joints. There is plenty of evidence that joint diseases in later life are more common in some occupations than others (see Kuorinka and Forcier, 1995, for a review). Retired farmers and dockyard workers, for example, have a higher prevalence of knee and hip joint problems (and indeed of surgical joint replacements) than office workers. The risk factor seems to be working on different levels and jumping from one level to another. When a muscle/joint system is placed in an extreme posture, the muscles on one side of the joint will be lengthened and their antagonists shortened, resulting in a strength imbalance in the ­antagonistic pair. The ability of the muscles to protect the joint against external forces is degraded and the joint itself is more easily damaged when the limb is exposed to high forces. An analysis of joint posture is particularly important when evaluating the design of hand tools, particularly in heavy work where the joints may be exposed to high forces.

Injuries to the Upper Body at Work The most clear-cut work-related upper body injuries occur as a result of accidents at work and many occur when hand tools are being used. Aghazadeh and Mital (1987) carried out a questionnaire survey to determine the frequency, severity, and cost of hand tool-related injuries in the U.S. industry and to identify the main problem areas. The hand-powered tools most commonly involved in injury were knives, hammers, wrenches, shovels, and ropes and chains. The powered tools most commonly involved were saws, drills, grinders, hammers, and welding tools. Of the main incidents which precipitated an injury, the majority involved the tool striking the user. This was the case with both powered and non-powered tools. However, a significant minority of injuries were caused by overexertion (∼25%–30%). The upper extremities were the body area most commonly injured and the most common injuries were cuts and lacerations followed by strains and sprains. A “strain” may be defined as overexercise or overexertion of some part of the musculature, whereas a “sprain” is a joint injury in which some of the fibers of a supporting ligament are ruptured although the ligament itself remains intact. Many powered tools can cause strains or sprains because of the reaction force they exert on the user—particularly if these forces are unexpected or occur suddenly due to irregularities at the interface between the tool and the workpiece. Percussive tools, such as paving breakers, exert a reaction force which has to be opposed by the user. In practice, if the tool is well designed and used on a flat surface, the weight of the tool will dampen much of this force. Rotary powered tools such as drills, sanders, and screwdrivers can exert a reaction torque on the user which may force the wrist into ulnar or radial deviation causing a strain or sprain. The design of handles for holding powered tools in place has received the attention of ergonomists, as is described below. It should not be forgotten, however, that additional handles may need to be fitted to provide the user with sufficient mechanical advantage to overcome the reaction torque of the tool or to carry it. It appears that there are several different classes of hand tool-related injury and that several different approaches for prevention may be needed. The most common injury would seem to be of a catastrophic nature in which the tool itself suddenly strikes the user causing a laceration, bruise, or sprain. A second, more pernicious, type of injury involves sprains or strains which appear to result from the handling of the tool itself over longer periods of time. A third type of injury occurs to the skin in the form of blisters due to pressure “hot spots” caused by poor handle design. Attempts to prevent the first type of injury might emphasize training workers in safe tool-handling techniques

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and to think ahead—to recognize potentially dangerous situations and to prepare the workplace to minimize the likelihood of unforeseen events. Attempts to prevent the second type of injury might concentrate on the redesign of the tool itself and training workers to recognize the onset of fatigue and avoid stressful work postures. Handle redesign can prevent the third type of injury as can increasing the task variety of the job. Prevention usually requires a multilayered approach involving training, safety propaganda, and work space design. Of particular relevance to the present discussion is the ergonomics of equipment design in relation to the prevention of strains and sprains. This is discussed in a later part of this chapter. Disorders of the Neck Ariens etal. (2000) reviewed recent literature on the work relatedness of neck pain. Relationships were found between neck pain and neck flexion, arm force, arm posture, duration of sitting, twisting or bending of the trunk, hand–arm vibration, and workplace design. However, owing to the low quality of many of the studies, the only factors for which there was firm evidence were sedentary posture and twisting and bending of the trunk. Cote etal. (2000) carried out a population-based survey of neck pain among 1131 randomly selected people. Unfortunately, their survey instrument did not contain items relating to occupational exposures. There was a high prevalence of neck pain—54% had experienced neck pain in the past 6 months. A history of having injured the neck in a motor vehicle accident was found to be strongly associated with pain in the past 6 months (ORs of between 3 and 5 depending on pain severity). Other factors positively associated with pain included comorbidities (headaches, cardiovascular, and digestive disorders), suggesting that chronic health problems tend to cluster in some individuals and reinforcing the view that personal characteristics also play a role. Reinforcing these findings, Korpinen etal. (2013) investigated self-reported neck problems in over 6000 Finns aged 18–65, finding that people suffering neck pain very often were more likely to be blue-collar workers or lower and higher level white-collar workers. They were more likely to report pain in the wrist and fingers (21.3% vs. 5.4%), elbows or forearms (14.1%vs. 3.1%), and shoulders (44.8% vs. 8.0%) than people who suffered less neck pain and reported more use of cell phones and computers. Grooten etal. (2007) followed 803 people with neck pain. Only 36% were free of neck pain 5–6 years later. Those with two of three biomechanical stressors (manual handling, working with the hands above the shoulders, or with vibrating tools) were less likely to be symptom free (OR = −0.61), whereas sedentary workers were more likely to be s­ ymptom free (OR = 1.32). Possible Causal Pathways The cervical spine has several functions—principally to support the weight of the head and to provide a conduit for nerves and attachment points for the muscles which control the position of the head. It consists of seven vertebrae designed to permit complex movements of the head. The first two cervical vertebrae (known as the atlas and the axis) are different from other vertebrae in the spinal column. The remaining vertebrae have the same general structure as vertebrae in other parts of the spine and are surrounded by anterior and posterior ligaments. The cervical spine consists of vertebral bodies and intervertebral disks, facet joints, bony processes for the attachment of ligaments and muscles, and the intervertebral foramen through which the spinal cord passes. The head can be thought of as being balanced on top of the cervical spine with the fulcrum directly above the first cervical vertebra. The head can be considered to be in balance when a person looks directly forward. Since the center of gravity (COG) of the head lies in front of the cervical spine, the head has to be held erect by contraction of the posterior neck muscles. These powerful muscles are true postural muscles—they are essential to the maintenance of the erect posture and constantly work to prevent the head from falling forward due to gravity. The role of the posterior neck muscles in the maintenance of posture becomes clear when it is recalled how a sitting person’s head droops forward onto the chest when the person is overcome by sleep. It can

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be appreciated that in ordinary standing and sitting postures, the structures of the cervical spine are “prestressed” by the need to maintain the head in an erect position. They are therefore prone to overexertion by any additional stresses imposed by work tasks. In the balanced position, a cervical lordosis is present. Movements of the head are accomplished by the muscles attached to it and to the surrounding parts of the skeleton. The arrangements of the muscles, like the movements of the head, are complex and will only be discussed in greatly simplified form. The deep, short muscles of the neck serve to stabilize the individual vertebrae, whereas the longer, more superficial muscles produce movements of the spine and head as a whole. The posterior muscles which extend the neck are stronger than the anterior muscles, which flex the neck, because the latter are assisted by gravity, whereas the former have to work against gravity. The erector muscles of the neck produce extension of the head and neck if they contract bilaterally (i.e., together). If they contract unilaterally (on one side only), lateral flexion and rotation of the head are produced. The trapezius muscle plays a very important role in many work activities. Owing to its oblique orientation, it produces extension, lateral flexion, and rotation of the head toward the side of contraction. It is also involved in elevating the shoulders. Static contractions of the trapezius muscle as low as 10% of maximum voluntary contraction appear sufficient to cause electromyographic changes in the muscle indicative of muscle fatigue. According to Kapandji (1982), prolapse of the intervertebral disks of the cervical spine is rare. However, the disks can certainly degenerate as can the intervertebral joints and this can cause irritation of the nerve roots in the cervical spine. Pain in the neck and shoulder may result. Degeneration of the cervical spine, sometimes known as “cervical spondylosis,” can have serious consequences. Compression of the spinal cord at the level of the cervical spine can take place, resulting in weakness and wasting of the upper limbs. This may then spread to the lower limbs. As is the case with the lumbar spine, some of the degeneration of the cervical spine is part of the natural process of aging. According to Barton etal. (1992), by the age of 65, 90% of the population have radiological evidence of cervical spondylosis. Cervical spine degeneration is a potential cause of neck pain due to the mechanical changes that occur as a result of age-related degenerative processes. Static flexion of the cervical spine increases the moment arm of the head according to the sine of the angle of flexion. This increases the load on the soft tissues in the cervical region and the ­posterior neck muscles are placed under increased static load in order to maintain the forwardflexed head in equilibrium with gravity. According to Wall etal. (1991), the increased static load on these muscles may cause pressure ischemia and starve the muscle tissues of fuel and oxygen. Pain in the neck and shoulders may result causing “muscle spasm” (reflex contraction of the muscles). This, in turn, may exacerbate the pain and lead to a vicious circle. The forward-flexed position may subject the cervical intervertebral disks to increased compression and the posterior ligaments to increased tension. Poor work space design, if it requires workers to adopt flexed cervical postures, may be a cause of reversible pain or may amplify pain due to existing degenerative changes. Highly repetitive, low load exertions may cause a gradual deterioration of tissue strength, eventually ­resulting in deformation of the tissues and pain on use. Control of Neck Problems at Work Grandjean (1987) concluded that the head and neck should not be flexed forward by more than 15° if undue postural stress is to be avoided. There is considerable evidence that frequent or sustained flexion of the head and neck beyond this is related to chronic neck and shoulder pain. This is exacerbated if the flexion is accompanied by rotation of the head and if the shoulders and arms have to be held in an elevated position at the same time (as is common in certain occupations such as dentistry and hairdressing). Bendix and Hagberg (1984) compared the trunk posture of subjects sitting at horizontal and sloping desks of 22° and 45°. A more upright trunk posture was adopted when the sloping desk was used. The authors suggested that reading matter should be placed on a sloping surface and writing done on a horizontal surface—that is, desks should have different sloped surfaces to account for

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differences in visual and manual requirements of reading and writing. Wall etal. (1991) investigated the effect of using a 10° sloping desk and found average reductions in cervical and thoracic spine load of 15% and 22%, respectively. Elbow Rests  They appear to be beneficial for both sitting and standing workers—by stabilizing and supporting the arms, they reduce the load on the shoulder musculature (by supporting the weight of the arms, elbow rests would also reduce the load on the lumbar spine). Monitor Heights  Wall etal. (1992) found that more upright postures were obtained if the monitor was raised such that the middle of the monitor was at eye height rather than at 15°–25° below eye height as is usually recommended.

Carpal Tunnel Syndrome Evidence for Work Relatedness Carpal tunnel syndrome (CTS) is associated with forceful and repetitive work alone or in combination with other factors. Vibration of the hand and wrist is also associated with the condition but extreme postures on their own are not. Combined stressors such as force and extreme posture or repetition are strongly associated with CTS. As with tennis elbow, it seems that CTS is more common in “hand-intensive jobs” in fish processing, supermarkets (checkout workers), etc. Roquelaure etal. (1997) found six occupational risk factors for CTS: exertion of force over 1 kg; length of the shortest elementary operation 15% of the day; manual supply of parts and equipment to the workstations; and lack of job rotation. The only personal factor associated with CTS was having >3 children (for women). ORs of five to six were found when three risk factors were present, rising to >90 when all six were present. Harris-Adamson etal. (2015) found that the main risk factor was the forceful hand exertion repetition rate—high forces (greater than 45 N grip or 9 N pinch forces), high repetitions (around 30 per minute), and extreme wrist postures on their own were not associated with CTS. Possible Causal Pathways The muscles that flex the fingers lie in the forearm and have long tendons that pass through a narrow opening in the wrist before inserting into the fingers. This opening, known as the carpal tunnel, is also traversed by the nerves and blood vessels of the hand (Figure 5.2). An increase in the pressure in the carpal tunnel can cause CTS if it affects (entraps) the median nerve or reduces the blood supply to the nerve by compressing the capillaries, resulting

A

B

C

FIGURE 5.2  Carpal tunnel. Section through the wrist showing (A) carpal bones, (B) tendons, and (C) carpal tunnel containing finger flexor tendons, blood vessels, and nerves. If the wrist is held in extreme postures, the tendons rub against the bone when the fingers move and friction is increased. (Courtesy of Dr. Douglas A. Bauk of IBM Brazil.)

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in nerve damage and reduced conduction velocity of neural signals. The result is a sensation of tingling and numbness in the palm and fingers. (However, degenerative changes in the cervical spine can interfere with the spinal cord and nerve roots causing referred pain in the arms according to Smythe, 1988.) Numbness and tingling in the hands by the same cause might be mistaken for CTS. In severe cases, surgery may be required to relieve the pressure. CTS has been reported in jobs requiring rapid finger movements, such as typing, and is found among professional ­musicians. However, Barton et al. (1992), in their review of the literature, concluded that the majority of cases are not caused by work. CTS can have many nonoccupational causes. It is common during pregnancy and may be a co-condition of a range of other disorders as diverse as diabetes, high blood pressure, kidney disorders, use of oral contraceptives, and arthritis (Hales, 1994). Concerning sensory conduction of the median nerve, CTS is associated with slower median nerve conduction. Nathan and colleagues have carried out numerous studies of the relationship between median nerve conduction velocity, CTS, and the factors that are associated with slowed nerve conduction. Nathan etal. (1987) were unable to find an association between slowed median nerve conduction and occupational hand activity or with length of employment in the current job. Furthermore, Nathan et al. (1988) found that slowing of median nerve conduction was age related in a non-­ pathological way, although the frequency of CTS did also increase with age. The evidence for agerelated s­ lowing of median nerve conduction was similar in women and men despite the fact that CTS is often perceived to be more common in women. Nathan etal. (1992a) found that nerve conduction velocity was associated with body mass index (weight/height2) being significantly slower among obese compared with slender subjects. Other factors associated with nerve conduction were the wrist depth/width ratio and exercise level. Finally, in a follow-up of their longitudinal study, Nathan etal. (1992b) confirmed the relationship between CTS, slower nerve conduction, and age and the unrelatedness of occupational factors. This led them to conclude that the health of the median nerve is linked to the health of the rest of the body and that median neuropathy is closely related to l­ ifestyle and only peripherally to work activities. CTS, like back pain, is a nonspecific health outcome. You etal. (2004) compared personal and physical risk factors in subjects with work-related CTS, CTS not related to work, and controls with no CTS. CTS not related to work was associated with being hard driving and competitive, female, and older. Work-related CTS was associated with use of high pinch grip forces and very high repetitive motions at work. Loslever and Ranaivosoa (1993) investigated the prevalence of CTS in light industrial work. The syndrome was found to occur twice as often in both hands as in either the ­preferred or non-preferred hand which, they suggest, is evidence that nonoccupational factors are more important than occupational factors. However, the prevalence in both hands was found to correlate positively with measures of wrist flexion and high grip forces.

Tennis Elbow (Epicondylitis) Evidence for Work Relatedness Overexertion of the extensor muscles of the wrist can lead to a condition known as “tennis elbow” (lateral humeral epicondylitis) (Figure 5.3). In severe cases, the muscle and tendon may separate from the bone. The risk of injury is said to be increased by activities requiring large grasping forces. Bernard and Fine (1997) concluded that there was strong evidence for an association between combined stressors (e.g., force and posture) and tennis elbow. Elbow problems are found among mechanics, butchers, and construction workers. Haahr and Anderson (2003) found that new cases of tennis elbow were related to non-neutral hand/arm postures at work and the use of heavy handheld tools in physically demanding jobs. Low social support was an additional risk factor in females. Walker-Bone etal. (2012) found that 11% of 6038 workers reported pain in the past week, of whom 0.7% were diagnosed with lateral epicondylitis and 0.6% with medial epicondylitis. Tennis elbow

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Tennis elbow site

Radial deviation Radial styloid

Radius Ulna

Ulnar deviation

FIGURE 5.3  General view of the forearm, wrist, and hand showing injury sites.

was four times more likely in manual workers and was associated with bending/straightening of the elbow at work. Possible Causal Pathways The elbow can be considered a weight-bearing joint. Many of the muscles that control movements of the hand are extrinsic to it and have their origins higher up. Some cross the elbow joint. The act of grasping and holding objects is only possible if the wrist is stabilized by the muscles of the forearm, many of which originate at the elbow. For example, when the finger flexors contract to enable an object to be grasped, the wrist extensors also have to contract to prevent the wrist itself from flexing. These contractile forces are transmitted across the elbow to the distal end of the humerus where the wrist extensors originate. The elbow joint is compressed and the tendons are under ­tension and may become swollen at the point they insert into the humerus. Clearly, any activity which requires a strong grip to be maintained for long periods will place a high load on the elbow joint and ­associated structures. It seems to be the case that elbow problems are not particularly prevalent compared to other conditions and, although they can be caused by occupational exposures, they are not specific to them. From the evidence available, it would seem that a “high-risk” job for epicondylitis will be one which requires high grip forces combined with repetitive work in extreme postures or pronation and supination of the wrist—essentially factors that increase the stress on the tendon insertions. Lowfriction handles and contaminants such as sweat, oil, and lard that reduce friction (Bobjer etal., 1993) would seem to increase the risk by causing people to grip harder. Perhaps, this is why the disorder has been found in occupations such as fish processing where several different factors operate together.

Disorders of the Shoulder Evidence for Work Relatedness Punnett etal. (2000) found an increased risk of shoulder disorder when the shoulder was abducted or flexed more than 90°, with the risk increasing in proportion to the percentage of the work cycle that the arm was held in that position. The ORs for these exposures ranged from 1.5 to 6.5 but high risks were found to occur when the flexion or abduction was held for more than 10% of the work cycle. There is evidence for a positive association between highly repetitive work (cycle times less than 30 s or spending more than 50% of the time doing the same task) and shoulder problems.

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Repeated or static shoulder postures (more than 60° of shoulder flexion or abduction with increased risk when posture is combined with other stressors such as holding a tool) also increase the risk. There is evidence that shoulder problems increase with the duration of employment and with the length of the workday. Dalbǿge etal. (2014) found that 24% of all first-time surgery for impingement syndrome of the shoulder was related to occupational exposures (working with elevated arms, forceful exertions, and repetitive movements). Possible Causal Pathways Most work involving hand tools imposes a combination of repetitive and static loads on the body which usually involve the shoulder, if only indirectly. There is no single shoulder joint—the arms join the scapula at the glenohumeral joint and the scapula joins the body at the scapulothoracic joint. Not surprisingly, the shoulder “joint” is the most mobile in the body and, together with its related soft tissues, is particularly prone to injury in any activities where the arms are held above the horizontal. Working with the hands above shoulder height is stressful and may increase the risk of developing the so-called “impingement syndrome,” otherwise known as “swimmer’s shoulder,” “pitcher’s arm,” or rotator cuff syndrome. The disorder is known to be more common in sportsmen who use high overhead actions. When the arm is held in front of the body, the muscles around the glenohumeral joint (rotator cuff muscles) contract to stabilize the joint. Figure 5.4 depicts in broad outline the anatomy of the shoulder joint and related structures.

D Tendon Bursa

C

Head of humerus Acromion A

Scapula

B

Scapulohumeral joint

Humerus

FIGURE 5.4  Shoulder joint: (A) rear view, (B) front view, (C) expanded view, and (D) scapulohumeral joint itself.

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The shoulder joint is a kind of ball and socket joint but the ball part, the head of the humerus or upper arm bone, represents only a third of the surface of a sphere when it engages the socket. The socket (the glenoid cavity of the scapula, or shoulder blade) is correspondingly shallow. The head of the humerus has to be held in place by tonic muscle activity. This explains why the shoulder joint is so easily dislocated. This can be contrasted with the much more stable hip joint where over 50% of the femoral head is enclosed by the acetabulum. That the shoulder joint requires muscle activity to be held in place might alert the ergonomist to its likely susceptibility to rapid fatigue and damage when exposed to static loads or repetitive actions. One of the simplest ways to reduce occupationally induced shoulder stress in many jobs is to provide armrests, slings, or other means of supporting the weight of the arms to enable the shoulder muscles to relax. Whenever the hands or arms are used, muscle activity is necessary to keep the humerus in its socket and to hold the scapula in place on the thorax. The stabilizer muscles of the scapula are at a great mechanical disadvantage when the arms are held forward of the body (or cantilevered) and static muscle contractions are needed to resist the resulting moments. One of these muscles, the serratus anterior, acts to pull the scapula into the thorax. Excessive load or fatigue of this muscle may cause pain in the upper back. Damage to the serratus anterior can result in a condition known as a “winged scapula” where the scapula protrudes because it is no longer held close to the thorax due to muscle weakness. Carrying heavy rucksacks can damage the nerve supply to this muscle resulting in a condition known as “rucksack palsy.” Above the humeral head lie the acromion and the coracoacromial ligaments and in between lies a bursa. In this narrow space pass many tendons, nerves, and blood vessels. The space can easily be taken up by the growth of bony spurs, by bleeding, or by soft tissue swelling due to overexertion (the subacromial bursa can become inflamed, for example). If this happens, the range of motion of the shoulder joint is reduced because the impingement of the subacromial structures causes pain when the joint is moved. Sufferers cannot raise their arms above shoulder height. It is likely that jobs which require the hands to be chronically elevated above elbow height can cause short-term changes which, over time, may ultimately lead to disorders of the shoulder joint. Shoulder pain can also be caused by localized muscle fatigue—particularly if the arms have to be held above shoulder height for long periods of time (as in painting a ceiling or pruning a tree)—and by mental stress that increase shoulder muscle tension (Roman-Liu etal., 2013). Some recommendations for preventing shoulder pain are given in Table 5.4.

TABLE 5.4 Methods of Reducing Shoulder Stress 1. If possible, work with the hands near waist level and close to the body 2. If the hands have to be positioned above shoulder level, their elevation above the shoulders should be no more than 35°. Hand loads should not exceed 0.4 kg and the posture should be held for no more than 20 s for each minute of work

3. Avoid shoulder flexion/abduction >90° for >10% of cycle time 4. Select taller workers for workplaces which cannot be modified 5. Take regular rest breaks 6. Minimize handheld weight 7. Provide external support for the weight of the arms (slings, ledges, etc.) 8. Confine work objects within the zone of convenient reach 9. Provide wrist rests for keyboard workers

Sources: Adapted from Punnett, L., etal. 2000. Scandinavian Journal of Work, Environment & Health, 26: 283; Sommerich, C.M., McGlothlin, J.D., and Marras, W.S. 1993. Ergonomics, 36: 697.

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Lower Limbs There is extensive literature on lower limb injuries in sports. The main occupational causes of lower limb injury (excluding falls) appear to be walking while carrying heavy loads and jobs that require excessive use of the knees. Reynolds etal. (1999) followed infantrymen on a 160 km march over 5days. The soldiers carried heavy packs. Of them, 36% suffered one or more injuries and 8% were unable to complete the march. The main injuries were blisters (48%) and foot pain (18%). Other ­injuries included ankle and knee strain, foot swelling, hip and thigh pain, and metatarsal stress fracture. Risk of injury was higher among smokers and lower among older people. Knee disorders, including OA and bursitis, are associated with squatting and with heavy physical work (Jensen and Eenberg, 1996). The 12-month prevalence of knee problems in the Danish population was reported to be 19%. Unsurprisingly, kneeling work was associated with bursitis (housemaid’s knee). Table 5.5 summarizes the main risk factors for knee disorders (see, e.g., Sandmark etal., 2000). TABLE 5.5 Summary of Occupational and Personal Risk Factors for Knee Disorders Occupational Factors Associated with Increased Risk   Occupational knee bending  Kneeling >1 h/day  Squatting >1 h/day   Getting up from kneeling/squatting >30 times per day  Climbing >30 stairs per day  Climbing >10 flights of stairs per day   Jumping from one level to another   Caring for disabled relative at home (females only)   Working in a heavy job >10 years Occupational Factors Associated with No Increased Risk  Sitting >2 h/day  Standing/walking >2 h/day  Driving >2 h/day Personal Factors Associated with Increased Risk   Previous knee injury for any reason   Previous meniscectomy  Age  Obesity  Gender   Cigarette smoking (lower prevalence in smokers)  Chondrocalcinosis   Heberden’s nodesa High-Risk Occupations  Firefighter  Farmer   Construction worker   Forestry worker  Miner   Carpet and floor layers and tilers Sports   High risk for soccer and rugby and knee injury   No evidence for increased risk for running, team sports, or racket sports, in the absence of previous injury a

The presence of nodes suggests genetic predisposition to OA.

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Cumulative exposure to heavy work increases the risk of both hip and knee OA (Anderson etal., 2012). Farmers, floor and bricklayers, and care assistants all have an increased risk with years of exposure (in farmers, the risk increases after as little as 5 years and is 2–4 times greater after 20 years, compared to controls [office workers]). OA has a genetic component and takes time to develop, often after the worker has retired, and has less visibility as occupational ergonomic problems. However, the cost to society, in terms of hip replacement surgery and possible disability, should not be forgotten.

BASIC APPLICATIONS Hand Tools The control of finger movements depends on many small muscles which can easily become fatigued, particularly during prolonged work with inadequate rest periods and poorly designed tools (Figure5.5). One of the most fundamental problems in hand tool design is to optimize the ­dimensions of the tool in relation to the hand anthropometry of the population under study. Ducharme (1977) found that many women working in previously male craft skills in the U.S. Air Force were dissatisfied with the design of the tools they used. Crimping tools, wire strippers, and soldering irons were said to have grips that were too wide or required the use of two hands to operate. Other tools were said to be too heavy and awkward to use. Pheasant and Scriven (1983) report that motorcar wheel braces provide inadequate mechanical advantage for both male and female users. Although a greater proportion of females than males are affected, both sexes would benefit from improved designs offering greater mechanical advantage. Handle Design Pheasant and O’Neill (1975) investigated handle design in a gripping and turning task (such as using a screwdriver). They found that strength deteriorated when handles greater than 5 cm in diameter were used and that, to reduce abrasion of the skin, hand–handle contact should be maximized. Knurled cylinders were found to be superior to smooth cylinders due to the increase in friction at the hand– handle interface. The authors concluded that, for forceful activities, the size of a handle rather than its

Using a scraper

Using a pencil

Tightening a screw cap

Fitting a screw cap before tightening

Power grips

Precision grips

FIGURE 5.5  Precision versus power grips.

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shape was most important. A useful rule of thumb for evaluating handle diameters is that the handle should be of such a size that it permits slight overlap of the thumb and fingers of a worker with small hands. The larger the handle diameter, the bigger the torque that can be applied to it, in principle, but people with small hands must be able to enclose the handle with their fingers. The maximum handle diameter for male users seems to be 40 mm, smaller still if gloves are to be worn. Cylindrical handles are better than handles with finger grooves since these cause pressure hot spots and blistering of the skin of hands they do not fit. Handle lengths should be at least 11.5 cm plus clearance for large (95th percentile) hands. An extra 2.5 cm should be added if gloves need to be allowed for (NIOSH, 1981). Some examples of screwdriver handles designed for one- and two-handed operation are shown in Figure 5.6. Grip strength depends very largely on the posture of the wrist. When the wrist is extended, the finger flexors are lengthened and can therefore exert more tension resulting in a stronger grip. When the wrist is flexed, the opposite occurs and grip strength is severely weakened. Ageneral requirement of handle design is that the wrist joints should be kept in a neutral position (in the middle of their ranges of movement) when tools are being used. Pheasant (1986) describes how the axis of a handle is at an angle of 100°–110° with respect to the forearm when the wrist is in a neutral position (Figure 5.7). Tools such as soldering irons can be redesigned using a “pistol grip” handle rather than the more traditional straight handle for the same reason (Figure 5.8). When using straight-handled tools, there is a tendency for the wrist to be bent outward (ulnar deviated). This stretches the tendons of the forearm muscles on one side, causing them to rub against a bony protrusion on the thumb side of the wrist (known as the radial styloid). Repeated exposure can cause the sheath (synovium) within which the tendon runs to become inflamed. This is known as “de Quervain’s syndrome.” Inflammation of tendons and tendon sheaths can occur in other parts of the hand and other body structures. In the long term, permanent damage to the tendon and its sheath may result. The buildup of scar tissue in the tendon may ultimately reduce the range of movement of the wrist. The idea of “bending the handle instead of the wrist” is a valid one and has many potential applications. It has been incorporated into the design of such diverse products as hammers (Knowlton and Gilbert, 1983). Konz (1986) sums up the use of bent handles in tool design as follows: … When a tool, gripped with a power grip has its working part extend above the hand, then a curve in the handle may be beneficial … . A small bend (5 to 10 deg) seems best.

FIGURE 5.6  Some innovative screwdriver handle designs for one- and two-handed operation. (After the Ergonomic Design Group, Stockholm, Sweden.)

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FIGURE 5.7  Angle of grip when the wrist is in the neutral position.

FIGURE 5.8  When working at a vertical surface, an in-line grip reduces wrist strain. Note in the large moment of ulnar deviation when the tool is not engaged with the workpiece. This can be minimized by locating handles below the mass center of the tool.

For powered tools, pistol grips seem most appropriate when the task is oriented vertically with respect to the operator (as when drilling a hole into a wall). When the task is a horizontal one (as in fastening a screw into a horizontal desktop with a powered screwdriver), an in-line tool may be better (Figure 5.9). Powered tools tend to be considerably heavier than their non-powered counterparts and a potential source of wrist strain comes from the weight of the tool itself—particularly if the handle is placed at one end of the tool rather than in the middle. Having to hold a heavy drill with a pistol grip while positioning the drill bit exemplifies this problem. Wrist loading can be reduced by fitting the handle at the tool’s center of mass so that the tool is counterbalanced. Johnson (1988) investigated the design of powered screwdrivers in relation to operator effort and concluded that grip diameters should be at least 5 cm. Vinyl sleeves fitted over too narrow handles were effective in reducing effort. A “biomechanical” brace was designed to fit over the screwdriver handle and run along the palmar (inside) side of the forearm. The brace transmitted the reaction torque to the user’s forearm and enabled the tool to be used with reduced grip force.

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FIGURE 5.9  When working at a horizontal surface, a perpendicular grip may be better.

(a)

(b)

(d)

(c)

FIGURE 5.10  Redesigned tools with improved hand–handle interfaces: (a) socket wrench with T-bar for greater mechanical advantage, (b) pliers with bent handles to maintain neutral wrist posture, (c) drill with handle at appropriate wrist angle, and (d) paint scraper with thumb stall to relieve pressure on the palm of the hand and prevent blistering of the skin on the palm.

Finally, tools can be redesigned and fitted with longer handles or handle extensions can be fitted to increase the worker’s vertical reach, obviating the need for the hands to be raised above shoulder height. Some examples are handle extenders for paint brushes when painting ceilings and longhandled secateurs for pruning the higher branches of trees. Figure 5.10 shows some redesigned tools with improved hand–handle interfaces.

Limits for Hand/Wrist Exertions in Repetitive Work Ciriello etal. (2002) obtained data on the maximum exertions acceptable to 10 females carrying out repetitive hand/wrist exertions for 7 h/day, 5 days/week for 4 weeks. Table 5.6 summarizes the findings for the right hand carrying out the following tasks: • Screw driving clockwise (handle diameter 31 mm; handle length 155 mm) • Screw driving clockwise (handle diameter 40 mm; handle length 158 mm) • Screw driving clockwise with a yoke (T-bar) handle (handle diameter 31 mm; handle length 139 mm) • Screw driving counterclockwise (handle diameter 31 mm; handle length 155 mm) • Ulnar deviation with a power grip • Gripping task with a power grip

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TABLE 5.6 Maximum Acceptable Torques (Nm) and Forces (N) for U.S. Females Repetition Rate Percentage of Population

5/Min Torque

20/Min Torque

25/Min Torque

75 50 25 75 50 25 75 50 25 75 50 25 75 50 25 75 50 25

0.16 0.43 0.70 0.14 0.49 0.84 0.27 0.65 1.03 0.19 0.47 0.75 0.48 1.13 1.78 2.03 4.83 7.63

0.12 0.40 0.73 0.13 0.43 0.73 0.20 0.53 0.86 0.13 0.41 0.69 0.43 1.10 1.77 2.25 4.80 7.35

0.07 0.33 0.59 0.13 0.43 0.73 0.12 0.61 1.10 0.14 0.38 0.62 0.44 1.08 1.72 2.38 4.85 7.32

Force

Force

13.4 31.8 50.2

14.8 31.6 48.4

Screw Driving Clockwise 31 mm handle Clockwise 40 mm handle Clockwise Yoke handle Counterclockwise 31 mm handle Ulnar deviation

Handgrip task

Handgrip task

75 50 25

Force 15.7 31.9 48.2

Source: Adapted from Ciriello, V.M., Webster, B.S., and Dempsey, P.G. 2002. AIHA Journal, 63: 594. With permission.

Wrist Flexion and Extension Snook etal. (1995) published tables of maximum acceptable forces for female wrist extension and flexion in the workplace. Table 5.7 summarizes these limits. Keyboard Design With old-fashioned mechanical typewriters, the typist had to stop to manually return the carriage after each line. Errors had to be manually corrected using erasers or correcting fluid and the paper had to be changed after each page had been typed. All of these secondary tasks provided changes of posture and broke up the continuity of the typing task. Brief periods of rest were intrinsic to the operation of mechanical typewriters. With word processors, the secondary tasks are carried out automatically or via special keys on the keyboard, so the work is intrinsically less varied and more likely to cause fatigue. Before the introduction of desktop computers, almost the only people who ever used keyboards were typists who had received special training in keyboard skills (e.g., how to use the fingers most efficiently and to type without looking at the keyboard). A very large proportion of today’s desktop computer users have never undergone formal training and do not possess these keyboard skills. Patkin (1989) has suggested that poor motor skill leads to excess co-contraction of muscles and temporary muscle aches which may be mistaken for tenosynovitis (which is rare among typists).

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TABLE 5.7 Maximum Acceptable Forces (N) for U.S. Female Wrist Flexion and Extension Repetition Rate Percentage of the Population

2/Min

5/Min

10/Min

15/Min

20/Min

13.5 20.9 29.0 37.2 44.6

12.0 18.6 26.0 33.5 40.1

10.2 15.8 22.1 28.4 34.0

7.4 11.5 16.0 20.6 24.6

7.4 11.5 16.0 20.6 24.6

6.0 9.3 12.9 16.6 19.8

Wrist Extension (Power Grip) 8.8 8.8 7.8 13.6 13.6 12.1 18.9 18.9 16.8 24.2 24.2 21.5 29.0 29.0 25.8

6.9 10.9 15.1 19.3 23.2

5.4 8.5 11.9 15.2 18.3

Wrist Flexion (Power Grip) 90 75 50 25 10

90 75 50 25 10

90 75 50 25 10

14.9 23.2 32.3 41.5 49.8

14.9 23.2 32.3 41.5 49.8

Wrist Flexion (Pinch Grip) 9.2 8.5 14.2 13.2 19.8 18.4 25.4 23.6 30.5 28.2

Source: Adapted from Snook, S.H. etal. 1995. Ergonomics, 38: 1488. With permission.

Several researchers have focused on the design of keyboards as a means of reducing musculoskeletal problems in keyboard operators. Zipp etal. (1983) investigated the posture of the hands and wrists noting marked ulnar variation and fatigue (Figure 5.11). They concluded that keyboards should be designed with separate banks of keys (one for each hand), each bank being inclined and contoured to be compatible with the functional anatomy of

FIGURE 5.11  Conventional keyboards cause ulnar deviation.

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Introduction to Human Factors and Ergonomics

FIGURE 5.12  Separate banks of keys for each hand may relieve wrist strain. (Courtesy of Kinesis Corporation, Bellevue, Washington, USA.)

the hand. Keyboards based on this design are commercially available (Figure 5.12), are perceived as comfortable to use, and give fair performance. Fernstrom et al. (1994) measured EMG activity from the forearm and shoulder muscles of eight typists using mechanical, electromechanical, and ­electronic typewriters, a PC keyboard, and a PC keyboard with the keys angled at 20° to the ­horizontal. The mechanical typewriter required a higher keystroke force which placed greater strain on the muscles investigated (although the difference was small). The electronic typewriter placed more strain on the right shoulder than the mechanical typewriter. This appeared to be due to the low keystroke force that made it impossible to rest the fingers on the keyboard without typing a ­character. A keystroke force of about 0.5 N is recommended. Tittiranonda etal. (1999) compared several alternative geometry keyboards and a placebo over a 6-month period. Although there was no improvement in clinical findings, self-reported pain severity was lower and hand function improved with the Microsoft natural keyboard compared to the placebo. Gerard etal. (2002) provide evidence that conventional computer keyboards can be improved by enhancing the auditory feedback when keys are depressed. Their experimental keyboard was designed to produce a tone at 1.2 dB above the ambient noise whenever a threshold value of either keying force or finger flex or EMG was exceeded. The tone increased by further increments of 1.2 dB the higher the keying force or EMG was above the threshold. The feedback produced a 10%–20% reduction in 90th percentile keying force in under 3 min. Further exposure to the feedback did not bring about more reductions in keying force. These findings may mean that augmented auditory feedback will help to prevent upper extremity discomfort in keyboard users. Acontrolled trial would be needed to determine whether these reductions are sufficient to reduce the incidence of disorders. Feuerstein etal. (1997) found that subjects with more severe upper extremity symptoms typed with higher finger forces than those with less severe symptoms. The keying rate was the same for both groups, and both groups used four to five times the minimum force needed to activate the keys. In a review of research up to 2000, Lincoln etal. (2000) reported that they could find no ­evidence for the effectiveness of alternative keyboards in the prevention of CTS. Managing upper body disorders at work involves work design, education, training, and job design. Training programs to increase a worker’s capacity have received little attention in

Repetitive Tasks

181

ergonomics, although they are regarded as fundamental in sports science to avoid the very similar types of musculoskeletal problems which can occur when engaging in sport. Table 5.10 summarizes ­complementary approaches to the reduction of WMSDs.

Cell phones and E-Games Between 1995 and 2004, the number of cell phone users increased from 91 million to 1.75 billion worldwide (Xiong and Muraki, 2014). Users of phones with touchscreens often use the thumb to operate the keypad using a combination of flexion/extension and adduction/abduction. The human thumb is capable of opposition where the fleshy part of the thumb pad had contact with that of the opposing fingers. It does this by rotating about its axis as it flexes. Unlike the power grip (Figure5.5), opposition involves all the muscles of the thumb, which can be likened to guy ropes supporting a tent pole. Clearly, the human thumb did not evolve to press buttons and the adductor and abductor muscles; in particular, it did not evolve to stabilize the thumb in flexion—rather to position it for grasping large objects in a power grip. Xiong and Muraki used electromyography to investigate thumb muscle fatigue when using cell phones with 3 and 9 mm buttons. The muscles fatigued more quickly in the direction flexion–extension and adduction to abduction and with smaller rather than larger buttons. The first dorsal interosseous muscle (extending from the ventral base of the thumb to the index finger) fatigued most quickly. The findings suggest that buttons should be as large as possible and that pain in the back of the hand between the thumb and the index finger may be a symptom of excessive touchscreen use on cell phones. Chany etal. (2007) compared a traditional office handset telephone (operated with a power grip) to a clamshell design more reminiscent of a cell phone (and held in a modified pinch grip). They found that discomfort increased with the clamshell design, as did EMG changes indicative of fatigue in the deltoid and thenar muscles. For long-term office use, the traditional handset design seems best. For cell phone use, Gustafsson (2011) recommends that pain and injury can be avoided if the forearms are supported, both thumbs are used, sitting with the neck flexed is avoided as is typing at high velocity when texting. Many users, particularly children and young people, do not appear to be aware of these guidelines (Figure 5.13).

FIGURE 5.13  Freestyle use of a cell phone. (Courtesy of Professor Leon Straker, Curtin University.)

182

Introduction to Human Factors and Ergonomics

Straker et al. (2014) provide the following guidance for reducing the risk of musculoskeletal injury to children using e-games: • • • • • • • • • • • •

Keep the e-game equipment, surrounding furniture, and yourself safe when you play Swap sedentary with active e-games—you will enjoy the feeling of your body moving Minimize the time spent on e-games that require repetitive button clicking or wrist actions Be aware of being in awkward postures (being uncomfortable) when playing—try and be comfortable Break up your e-games every 30 min to give both your body and eyes rest Be aware of how long you play, and try to minimize the time when you are sitting still— making time for active play both inside and outside For any new active e-game, or after a break, start with short turns to allow your muscles to get used to the activity** Parents should encourage real-world physical activity and ensure that it does not get displaced by e-games Parents should encourage good “technique” and safe playing space to avoid muscle and bone discomfort and injury Encourage limiting sedentary leisure and enhancing active leisure—virtual and preferably real world Discourage poor and sustained postures, repetitive actions, high accelerations, high forces during e-game play Encourage breaking up SEG bouts every 30 min to provide an active break for the body and eyes

Cursor Control Devices There is no evidence that occupational use of computer mice causes CTS (Thomsen etal., 2008). Lee etal. (2007) investigated hand muscle fatigue in several designs of computer mouse, varying in the placement and number of keys. They found that removal of the right-hand key lowered finger extensor muscle activity but there were trade-offs with performance. The short-term benefits of new mouse designs need to be considered in relation to longer term usability issues, with the caveat that Lee’s short-term laboratory study may not have given users sufficient practice with the different designs. Clearly, CCD design has the potential to induce injury in high-demand, long exposure tasks if the small muscles of the hand are involved in CCD operation. Figure 5.14 shows a CCD

FIGURE 5.14  Thumb-operated trackball.

183

Repetitive Tasks

TABLE 5.8 Criteria for Defining Repetitive, Monotonous Worka Working cycle Postures and movements Freedom of action

Work content learning

a

Red

Yellow

Green

Repeated several times per minute Fixed, uncomfortable postures and movements Work is completely governed by something or someone else

Repeated several times per hour Limited positions to alter postures and movements Work is governed externally to some extent. Opportunities for influencing work are limited Several tasks in process. Job rotation may be present. Training provided

Repeated some times per hour

Employee performs one isolated task. Short training time

Good workplace layout and opportunity to vary posture Good opportunities to fit the work to own ability and influence planning and organizing the work Employee takes several parts of process including planning and control. Competence develops continuously

Assumes a full day’s work. If work is in the red zone, change is required.

with a thumb controlled trackball—clearly an efficient use of the thumb for short-term, intermittent ­operations but also a potential cause of fatigue in intensive work—particularly if the control-display ratio requires significant rotation of the trackball to traverse the cursor across the screen.

TOOLS AND PROCESSES Many tools have been developed for use in the assessment of WMSD risk. Some are based on visual observation of tasks, whereas others require measurement using goniometers or other devices (seeDavid, 2005 for a review of these methods and Ringelberg and Koukoulaki, 2002 for ­descriptions of them).

Identifying Repetitive, Monotonous Work Table 5.8 (Hedén etal., 1993) defines the criteria for repetitive, monotonous work which is to be avoided to reduce the risk of WMSDs. The Strain Index (SI): Assessing the Risk of Injury to the Distal Extremities The SI is an observational tool for the assessment of jobs for risk of upper extremity WMSDs (Moore and Garg, 1995). Note that the index measures the risk associated with a job, not the risk to particular individuals performing the job. It requires an assessor to measure or estimate six task variables: • • • • • •

Intensity of exertion Duration of exertion per task cycle Number of efforts per minute Wrist posture Speed of exertion Duration of task/day

The procedure for calculating the SI is as follows:

1. After observing the task, each task variable is rated by the assessor, using the criteria in Table 5.9.

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Introduction to Human Factors and Ergonomics

TABLE 5.9 Rating Criteria and Multipliers Used to Calculate the SI Rating

Intensity of Exertion

Duration of Exertion (% Cycle)

Efforts/min

Hand/Wrist Posture

Speed of Work

Duration per Day (h)

≤1 1–2 2–4 4–8

Rating Criteria 1

Light

2 3 4 5

Somewhat hard Hard Very hard Near maximal

20 Very bad Very fast 2–4 h

1 5 3

5 5 3

See Table 5.6. The ratings are in the left-hand column and are read from the descriptors given for each task factor.

Multiplier Table Left Hand (Apple)

Intensity of exertion Duration of exertion Efforts/minute Hand/wrist posture Speed of work Duration per day a

Rating

Multiplier

1 3 5 1 5 3

1.0 1.5 3.0 1.0 2.0 0.75

Right Hand (Paper) a

Rating

Multipliera

1 3 5 5 5 3

1.0 1.5 3.0 3.0 2.0 0.75

See Table 5.6. The multipliers for each task factor are read by referring to the ratings given in the left-hand column for each task factor.

SI (left hand) = 1.0 × 1.5 × 3.0 × 1.0 × 2.0 × 0.75 = 6.75 SI (right hand) = 1.0 × 1.5 × 3.0 × 3.0 × 2.0 × 0.75 = 19.5 Remarkably, although the apple weighs far more than the tissue paper, it is the hand/forearm that picks up the paper that is at greatest risk of injury (high as compared to medium risk). This is due to the poor posture. Despite the fact that the task involves very high repetitions, there are natural breaks throughout the cycle that are not repetitive. Modernizing the packing sheds to improve productivity would increase the risk of injury if the natural breaks were removed by simplifying the work cycle (e.g., by using a conveyor to deliver empty boxes and remove full boxes). The risk of injury could be reduced by redesigning the packing stand so that the paper tray was lower and placed so as to slope away from the hand at an angle of 45°. Paper might then be lifted by flexing the elbow with the wrist in a neutral position. Further mechanization of this task might improve efficiency, but at the cost of increased unemployment in developing countries where low-level agricultural jobs are still an important part of the economy.

187

Repetitive Tasks

TABLE 5.10 Task Analysis of Apple Packing Task and Times (Seconds) of Main Operations Operation

Left Hand

Right Hand

1. Assemble Box   Take flat box from stack

X

X

  Open and assemble

X

X

  Place in holder

X

X

X

X

Time 20 s

2. Pack Box   Layer 1    Insert cardboard sleeve    Pack 24 apples

5 s 15 s

   Pack 1 apple     Grasp apple

X

    Take tissue paper      Wrap apple in paper

X X

     Place wrapped apple in sleeve

X X

    Repeat  × 23   Layer 2: Repeat as layer 1

20 s

  Layer 3: Repeat as above

20 s

  Layer 4: Repeat as above

20 s

3. Seal Box

20 s

  Close lids

X

X

  Seal with tape

X

X

  Lift box from holder

X

X

5 s

  Carry to pallet

X

X

25 s

  Stack and sign off

X

X

10 s

4. Stack Box

5. Return to Carousel (Next Box)

20 s – 180 s

Note: Times are means of 500 cycles.

Preventing Overuse of the Thumb Sonne and Potvin (2015) provide an equation to enable the maximum acceptable exertion (MAE) of the thumb to be derived for tasks requiring repetitive thumb motions. The MAE is the percentage of a single maximum effort (MVC) of the thumb in the operation of a particular piece of equipment, such as the thumb-operated trackball in Figure 5.1. MAE, for an 8-h day of 28,800 s, is given by:

MAE = 1 – [ DC – 1/ 28, 800]0.24

(5.1)

where, DC = duty cycle (ratio of the duration of effort to duration of the cycle). So if the duty cycle were 0.5, the MAE would be 15.3% of MVC. If the duty cycle were 0.9, the MAE would be 2.5% of MVC and if the duty cycle were 0.10, the MAE would be 42% of MVC. Clearly, whether or not the resistance of a thumb-operated trackball such as that in Figure 5.14 is

188

Introduction to Human Factors and Ergonomics

appropriate depends on the design of the task and how this influences the duty cycle. It will also depend on the design of the trackball itself, such as its size and location in relation to the thumb and the effect on MVC. Generally, the better the design, the greater the MVC and the longer the duty cycle for acceptable operation.

Checklists There are several checklists available. The “Quick Exposure Checklist” (David etal., 2008) takes a participatory approach and gathers data from both observers and employees themselves, also accounting for psychosocial stress (Figure 5.16).

Questionnaires Questionnaires are available to assess both acute pain during work and the disabling effects of chronic conditions that may be associated with work. Of the former, The Nordic questionnaire is well established and there is evidence for its reliability and validity (Descatha et al., 2007). The 30-item DASH questionnaire (Kitis etal., 2009) enables WMSDs to be contextualized in terms of their disabling effects in daily life. It has good reliability (ICC = 0.92) and good ­agreement with other self-report measures of quality of life. The questionnaire measures disabilities of the arm, shoulder, and hand. The first five items are listed below. Please rate your ability to do the following in the past week. No

Mild

Moderate

Severe

Unable

Open a tight or new jar Write Turn a key Prepare a meal Push open a heavy door

Used together, the NORDIC and DASH questionnaires enable investigators to estimate the p­ revalence of WMSDs in a facility and understand the consequences of any WMSDs on the daily life of the employees.

SYSTEM INTEGRATION There is now plenty of epidemiological evidence that tasks requiring excessive force, poor posture, high repetition, long duration, and which are stressful carry increased risk of MSDs. Thus, ergonomic methods which seek to assess risk are valid in that they focus on factors that are theoretically and empirically related to the outcomes of interest (i.e., the methods have both construct and content validity). In addition, there is evidence that the SI itself has predictive (or criterion) validity. In one study of single task jobs (Rucker and Moore, 2002), its sensitivity, specificity, and positive predictive value (PPV) and NPV were 1.00, 0.84, 0.47, and 1.00, respectively (see HFE Workshop 5.3 for explanations of these terms). As is demonstrated in a later section, there is evidence that redesign of high-risk jobs to remove exposure to ergonomic stressors can reduce work loss. However, many jobs expose workers to stressors not currently included in the current ergonomic WMSD assessment tools (such as vibration, cold, and psychosocial stress)—the tools are likely to be less accurate when used to assess more complex jobs involving multiple, nonmechanical exposures (Table 5.11).

189

Repetitive Tasks

Quick Exposure Check (QEC)

QEC has been designed to: assess the changes in exposure to musculoskeletal risk factors of the back, shoulders and arms, hands and wrists, and neck before and after an ergonomic intervention involve the practitioner (i.e. the observer) who conducts the assessment, and the worker who has direct experience of the task indicate change in exposure scores following an intervention The QEC Guide gives more detailed information about each question and the background to QEC.

Worker’s name: Worker’s job title: Task: Assessment conducted by: Date:

Time:

Action(s) required:

For more information on the Quick Exposure Check contact: The Robens Centre for Health Ergonomics European Institute of Health and Medical Sciences University of Surrey, Guildford GU2 7TE Telephone 01483 689 213 www.surrey.ac.uk/robens/erg

© Copyright University of Surrey

FIGURE 5.16  The quick exposure checklist. (Courtesy of Professor P. Buckle, University of Surrey, UK.) (Continued)

190

Introduction to Human Factors and Ergonomics

Worker’s name

Date

Observer’s Assessment

Worker’s Assessment

Back

Workers

A

When performing the task, is the back (select worse case situation)

A1

Almost neutral?

A2

Moderately flexed or twisted or side bent?

A3

Excessively flexed or twisted or side bent?

B

Select ONLY ONE of the two following task options:

H

Is the maximum weight handled MANUALLY BY YOU in this task?

H1

Light (5 kg or less)

H2

Moderate (6 to 10 kg)

H3

Heavy (11 to 20kg)

H4

Very heavy (more than 20 kg)

EITHER For seated or standing stationary tasks. Does the back remain in a static position most of the time?

J

On average, how much time do you spend per day on this task?

B1

No

J1

Less than 2 hours

B2

Yes

J2

2 to 4 hours

J3

More than 4 hours

OR For lifting, pushing/pulling and carrying tasks (i.e. moving a load). Is the movement of the back

K

When performing this task, is the maximum force level exerted by one hand?

B3

Infrequent (around 3 times per minute or less)?

B4

Frequent (around 8 times per minute)?

K1

Low (e.g. less than 1 kg)

B5

Very frequent (around 12 times per minute or more)?

K2

Medium (e.g. 1 to 4 kg)

K3

High (e.g. more than 4 kg)

L

Is the visual demand of this task

Shoulder/Arm C

When the task is performed, are the hands (select worse case situation)

C1

At or below waist height?

C2

At about chest height? At or above shoulder height?

C3 D

Is the shoulder/arm movement

L1

Low (almost no need to view fine details)?

High (need to view some fine details)? *L2 * If High, please give details in the box below M At work do you drive a vehicle for M1

Less than one hour per day or Never?

D1

Infrequent (some intermittent movement)?

M2

Between 1 and 4 hours per day?

D2

Frequent (regular movement with some pauses)?

M3

More than 4 hours per day?

D3

Very frequent (almost continuous movement)? N

Wrist/Hand E

Is the task performed with (select worse case situation)

Less than one hour per day or Never?

N2

Between 1 and 4 hours per day?

N3

More than 4 hours per day?

An almost straight wrist?

E1

A deviated or bent wrist?

E2 F

Are similar motion patterns repeated

F1

10 times per minute or less?

F2

11 to 20 times per minute?

F3

More than 20 times per minute?

P

When performing the task, is the head/neck bent or twisted?

G1

No

G2

Yes, occasionally

G3

Yes, continuously

Do you have difficulty keeping up with this work?

P1

Never

P2

Sometimes

Often *P3 * If Often, please give details in the box below Q

Neck G

At work do you use vibrating tools for

N1

In general, how do you find this job

Q1

Not at all stressful?

Q2

Mildly stressful?

Moderately stressful? *Q3 Very stressful? *Q4 * If Moderately or Very, please give details in the box below

* Additional details for L, P and Q if appropriate *L *P *Q

FIGURE 5.16 (Continued )  The quick exposure checklist. (Courtesy of Professor P. Buckle, University of Surrey, UK.) (Continued)

191

Repetitive Tasks

Exposure Scores Worker’s name

Date

Back

Shoulder/Arm

Wrist/Hand

Neck

Back Posture (A) & Weight (H)

Height (C) & Weight (H)

Repeated Motion (F) & Force (K)

A1

A2

A3

F1

F2

F3

Neck Posture (G) & Duration (J) G1 G2 G3

H1

2

4

6

H1

2

4

6

K1

2

4

6

J1

2

4

H2

4

6

8

H2

4

6

8

K2

4

6

8

J2

4

6

8

H3

6

8

10

H3

6

8

10

K3

6

8

10

J3

6

8

10

H4

8

10

12

H4

8

10

12

C1

C2 C3

Score 1

Score 1 Back Posture (A) & Duration (J) A1 A2 A3 J1 J2 J3

2 4 6

4 6 8

6

Score 1

Score 1 Height (C) & Duration (J) C1

Repeated Motion (F) & Duration (J)

C2 C3

F1

F2

F3

Visual Demand (L) & Duration (J) L1 L2

6

J1

2

4

6

J1

2

4

6

J1

2

4

8

J2

4

6

8

J2

4

6

8

J2

4

6

10

J3

6

8

10

J3

6

8

10

J3

6

8

Score 2

Score 2

Score 2

Score 2

Duration (J) & Weight (H) J1

J2

J3

H1

2

4

6

H2

4

6

8

H3

6

8

10

H4

8

10

12

Duration (J) & Weight (H)

Score 3

J1

J2

J3

H1

2

4

6

H2

4

6

8

H3

6

8

10

H4

8

10

12

B1

B2

J1

2

4

J2

4

6

J3

6

8 Score 4

B3

B4

B5

2

4

6

H2

4

6

8

H3

6

8

10

H4

8

10

12

D1

D2

D3

H1

2

4

6

H2

4

6

8

H3

6

8

10

H4

8

10

12

B4

B5

2

4

6

J2

4

6

8

J3

6

8

10

K1

2

4

6

K2

4

6

8

K3

6

8

10

Total score for Neck Sum of Scores 1 to 2

Driving Workers

Assessment M1 M2 M3 1

Wrist Posture (E) & Force (K) E1

E2

K1

2

4

K2

4

6

K3

6

8

9

Total for Driving

Vibration N1

N2 N3

1

4

9

Score 4

Wrist Posture (E) & Duration (J)

Work pace

D1

D2

D3

E1

E2

J1

2

4

6

J1

2

4

J2

4

6

8

J2

4

6

P1

P2

P3

J3

6

8

10

J3

6

8

1

4

9

Score 5

Score 5 Total for Work pace

Stress Q1

Score 6

1 Total score for Back Sum of scores 1 to 4 OR Scores 1 to 3 plus 5 and 6

4

Total for Vibration

Frequency (B) & Duration (J) B3

J3

Score 4

Frequency (D) & Duration (J)

Score 5

J1

J2

Score 3

Frequency (D) & Weight (H)

Frequency (B) & Weight (H)

H1

J1

Score 3

Now do ONLY 4 if static OR 5 and 6 if manual handling Static Posture (B) & Duration (J)

Duration (J) & Force (K)

Total score for Shoulder/Arm Sum of Scores 1 to 5

Q2 Q3 4

9

Q4 16

Total score for Wrist/Hand Sum of Scores 1 to 5 Total for Stress

FIGURE 5.16 (Continued )  The quick exposure checklist. (Courtesy of Professor P. Buckle, University of Surrey, UK.)

192

Introduction to Human Factors and Ergonomics

TABLE 5.11 Simple Measures for Managing WMSDs of the Upper Limbs Tool Design and Posture Bend the handle (5°–10°), not the wrist Avoid excessive use of “pinch grip” (thumb and fingers) Maintain neutral wrist posture Reduce required grip forces:   Use high-friction materials for handles   Longer handles increase mechanical advantage Maximum allowable grip force (holds for less than 3 s):   Handgrip: 26.2 kg   Pinch grip: 5.8 kg Maximum allowable grip force (holds for more than 3 s):   Handgrip: 15.6 kg   Pinch grip: 3.6 kg Add handles for carrying tool and resisting reaction torque Damp vibration from powered tools Encourage use of large muscle groups Upper arm posture to be

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