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PubMed2004

The physical demands upon (Dutch) fire-fighters in relation to the maximum acceptable energetic workload.

The aim of this study was to assess the tasks and activities that make physical demands on Dutch fire-fighters and to compare them with a guideline related to the development of excessive fatigue. The occupational physical demands on Dutch fire-fighters were assessed by conducting a task analysis during 85 24-h shifts. While workplace observations on the duration and frequency of physical tasks and activities were recorded, the heart rate was measured. This was then used to calculate the heart rate reserve percentage (%HRR) for predefined working periods, tasks and activities during 24-h shifts. The findings indicate that actual fire-fighting during 24-h shifts is characterised by a low frequency of incidents, a short 'turn-out' time, short tasks, and activities with a moderate to occasionally high energetic workload. Two tasks which sometimes occur in actual fire-fighting exceeded the guideline on energetic workload. The conclusion was that, though the number of incidents and the occupational demands are low during 24-h shifts, the peak loads for these two tasks are energetically high and could lead to excessive fatigue. Consequently, attention may need to be paid to health surveillance for persons exposed to such energetic peak loads, the development of physical and medical selection procedures, training, and workplace adjustments.

Fatigue↗

PubMed1990

The ergonomic evaluation of eye movement and mental workload in aircraft pilots.

This paper presents an experiment which examines characteristics of pilots' scanning behaviour when using integrated CRT displays, and the changes in characteristics when pilots face abnormal situations. The subjects were five experienced pilots. They performed two modes of flight tasks, under normal and abnormal situations, in flight simulators with standard settings. The flight simulators were for a Boeing 747-300 (B747), which made use of electromechanical displays, and for a Boeing 767 (B767), equipped with integrated CRT displays. The results showed that the B767 pilots tended to gaze at the attitude director indicator which was displayed in the integrated CRT display. It was assumed that 'gaze-type scanning' might be one of the characteristics of pilots' scanning behaviour in cockpits which use the integrated display. By employing subjective ratings and heart rate variability to measure mental workload, no differences in mental workload between the B767 pilots and the B747 pilots were observed. However, in abnormal situations, the changes in scanning pattern for B767 pilots were found to be smaller than those of the B747 pilots. It is concluded that the application of integrated displays helps pilots to obtain sufficient information more easily than electromechanical displays do, even under abnormal situations.

Adult↗

PubMed1995

Comparative analysis of the workload in seated and standing horizontal submaximal lifting tasks.

The objective of the present laboratory study was to analyse physiological responses of horizontal lifting tasks when they were performed in sitting and standing positions. Heart rate and blood pressure were used as indices of circulatory strain. Lifting tasks were performed under four lifting positions: sitting-forward lift, sitting-twist lift, standing-forward lift, and standing-twist lift. The weights of the loads were 3, 5 and 7 kg and the frequencies of handling were 1, 4 and 6 lifts/min. This study supports the idea that heart rate is a sensitive measure for evaluating the effects of seated horizontal lifting tasks. The lifting positions and workload (frequency x load x distance) are important parameters in the design of these types of tasks. It appears that within the experimental values examined in this study, a seated position could be recommended while performing horizontal lifting tasks at workloads < or = to 4.6 kg.m.min-1. The results are supported by smaller physiological responses.

Adult↗

PubMedDate not supplied

The effect of automatic speech recognition systems on speaking workload and task efficiency.

PURPOSE: This investigation explored the speech-production behaviors associated with the use of automatic speech recognition (ASR) software for dictation of spontaneous and scripted material by individuals with and without spinal cord injury (SCI). The variables of interest in determining speaking workload and efficiency included syllables per breath group, frequency of breath groups, frequency of apnea, time needed for dictation and number of words spoken during a dictation task. METHOD: Twelve individuals participated, six with SCI and six able-bodied cohorts matched for age, sex and height. Subjects dictated with continuous-speech ASR, discrete-word ASR and no ASR in a spontaneous-speaking situation, as well as in a scripted speaking situation. RESULTS: For all variables, differences amongst dictation conditions were significant. No significant differences were found between speaker groups. Dictation with both discrete-word and continuous-speech ASR resulted in a decrease in the number of syllables produced per breath group, increases in the frequency of breath groups and apnea, with differences from normal being greater for dictation with discrete-word ASR. In addition, when participants dictated with either type of ASR, the amount of time and number of words produced were significantly greater than that associated with production of the same message without ASR, requiring 'more work' on the part of the speaker and ultimately reducing the efficiency with which a message was produced. CONCLUSIONS: From a human factors perspective, these results suggest that ASR software, especially discrete-word ASR, has the potential to increase energy expenditure during dictation over a prolonged period of time, thereby increasing speech workloads and the potential for overuse of the laryngeal system.

Adult↗

PubMed1996

Physical Workload Analysis Among Small Industry Activities Using Postural Data.

Small industry workers are often involved in manual handling operations that require awkward body postures, therefore, musculoskeletal disorders and occupational injuries are a major problem. In this study, various types of tasks were recorded with a video camera to chart and analyze different postures by computerized OWAS (Ovako Working Posture Analysing System). Collected data showed that poor postures were adopted not only for lifting or hammering operation but also for other tasks; mostly with bent and twisted back. The main aim was to determine the physical workload by identifying harmful postures and to develop recommendations for improving the existing situation. Forty-eight male workers from eight different units (M age = 37 years) participated. The performed activities were then divided into 26 subtasks. Altogether, 1,534 postures were selected for analysis and then classified into different OAC (OWAS Action Categories). From all observations, unhealthy postures, for which corrective measures had to be considered immediately (i.e., 10.6% classified as OAC III, and 3.3% as OAC IV), were found. The applied method was useful in determining the physical workload by locating potential activities due to harmful postures, providing a detailed description with analysis, and suggesting successful means to reduce postural load.

OWAS↗

PubMed1984

Workload involved in routine breast examination and instruction in breast self-examination in the primary care clinic.

This study evaluates the impact of breast examinations and instruction in breast self-examination as a routine for women aged 30 years and over on the workload in a primary care clinic of the Workers' Sick Fund (Kupat Holim) in Israel. It covers a three-year period from 1977 to 1980. Clinic sessions of four hours duration with an average of 21 patients each were held five times a week. Women who were considered high risk for breast cancer were to be examined twice a year, low risk women once a year. A first breast examination with instruction required on average 10 minutes, a subsequent examination seven minutes. A total of 696 breast examinations were performed, averaging 1.2 breast examinations per clinic session. This resulted in a maximum extra workload of 12 minutes per clinic session of four hours.

Adult↗

PubMed1984

Relationship between perceived workload and manpower in general practice.

A survey of general practitioners in nine local government areas representative of metropolitan Sydney allowed comparison of self-perceived workload and manpower as measured by population per general practitioner. Thirty-one per cent of general practitioners felt themselves to be too busy, 54% just right and 15% not busy enough. The overall manpower level was a population of 1108 people per general practitioner. There was no direct relationship between workload perception and general practice manpower. The implications of this for manpower planning are discussed.

Australia↗

PubMed1987

Variable threshold of exertional ischaemia in patients with positive exercise test at low workload.

In order to determine individual variability of ischaemic threshold on different days, 18 patients with exertional ischaemia at low workload were studied. All patients performed two exercise tests during different days in the morning and three on the same day at 9 am, 2 pm and 5 pm. The test performed in the morning on different days resulted in a significant difference in the mean values of rate pressure product at the ischaemic threshold as a consequence of individual variability observed in 10 patients. In 8 of these patients the differences were greater than 4000 mmHg beats min-1. Two patients showed respectively, 1 and 5 negative exercise tests despite the greater values of rate pressure product reached. Only 3 patients showed circadian variation of the ischaemic threshold; in these 3 patients variations of rate pressure product at the ischaemic threshold were also observed between different days. These data indicate that in patients with exertional ischaemia at low workload the rate pressure product at the ischaemic threshold shows considerable variability between tests performed on different days.

Angina Pectoris↗

PubMed2000

Effect of patient-triggered ventilation on respiratory workload in infants after cardiac surgery.

BACKGROUND: Patient-triggered ventilation (PTV) is commonly used in adults to avoid dyssynchrony between patient and ventilator. However, few investigations have examined the effects of PTV in infants. Our objective was to determine if pressure-control PTV reduces infants' respiratory workloads in proportion to the level of pressure control. We also explored which level of pressure control provided respiratory workloads similar to those after the extubation of the trachea. METHODS: When seven post-cardiac surgery infants, aged 1 to 11 months, were to be weaned with the pressure-control PTV, we randomly applied five levels of pressure control: 0, 4, 8, 12, and 16 cm H2O. All patients were ventilated with assist-control mode, triggering sensitivity of 1 l/min, and positive end-expiratory pressure of 3 cm H2O. After establishing steady state conditions at each level of pressure control, arterial blood gases were analyzed and esophageal pressure (Pes), airway pressure, and airflow were measured. Inspiratory work of breathing (WOB) was calculated using a Campbell diagram. A modified pressure-time product (PTPmod) and the negative deflection of Pes were calculated from the Pes tracing below the baseline. The measurement was repeated after extubation. RESULTS: Pressure-control PTV supported every spontaneous breath. By decreasing the level of pressure control, respiratory rate increased, tidal volume decreased, and as a result, minute ventilation and arterial carbon dioxide partial pressure were maintained stable. The WOB, PTPmod, and negative deflection of Pes increased as pressure control level was decreased. The WOB and PTPmod at 4 cm H2O pressure control and 0 cm H2O pressure control and after extubation were significantly greater than those at the pressure control of 16, 12, and 8 cm H2O (P < 0.05). The WOB and PTPmod were almost equivalent after extubation and at 4 cm H2O pressure control. CONCLUSIONS: Work of breathing and PTPmod were changed according to the pressure control level in post-cardiac surgery infants. PTV may be feasible in infants as well as in adults.

Cardiac Surgical Procedures↗

PubMedDate not supplied

Workload management system for nurses: application to the burn unit.

A patient acuity classification is required by the Joint Commission on Accreditation of Healthcare Organizations, and this is vital in providing safe, cost-effective nursing care. The Workload Management System for Nurses (WMSN), which is based on direct and indirect nursing care research, prospectively classifies patients on the basis of direct care requirements and then establishes staffing levels on the basis of both direct care and indirect care workloads. Application of the Department of Defense WMSN to the military burn research center is feasible and has provided data for objective staffing adjustments and validated staffing requirements. In addition, several other quality assurance implications have been realized as a result of implementation of the system.

Burn Units↗

PubMed1994

The influence of obstetric workload on cesarean section rate.

The cesarean section rate in a busy obstetric unit was studied in relation to the monthly confinement rate. A total of 30,825 births over a period of 5 years were analyzed. There was a negative correlation between the emergency cesarean section rate and the unit workload (correlation = -.498, 2 tailed p = 0.0001) whilst there was no relationship between workload and the elective cesarean section rate. This suggested that the unit may reach a certain saturation level as far as the emergency cases were concerned during the busy periods. However, there was no evidence that the perinatal outcome was affected by this variation in emergency cesarean section rate.

Cesarean Section↗

PubMed1989

The impact of a manufacturer's revision of pacemaker service life on the workload of a large pacing center.

In certain batches of a manufacturer's pacemakers, inadequate insulation of the battery cell feed-through mechanism led to internal short-circuiting and premature battery depletion. We describe the impact of the consequent reduction in service life and recommended close supervision of these generators on the follow-up clinics and inpatient workload at a large pacing center. One-hundred and ninety patients had Cordis Gamma series pacemakers implanted between September 1981 and July 1985; 135 have had to undergo premature generator replacement. Eleven of these pacemakers had developed early depletion of rate and 12 no-output failure. Within 3 months of their generator change, 12 patients developed wound sepsis, three of them requiring further system replacement. We calculate that at least 540 extra outpatient appointments, 400 in-hospital patient days and 12 full working days in one of our catheterization laboratories were required to deal with the problems. The pacemaker industry, as well as doctors and technicians involved in pacemaker purchase and implantation, should be aware of the consequences of a major recall not only on workload but also on patient morbidity and anxiety.

Electric Power Supplies↗

PubMed2001

A monitor unit "odometer" for measuring linac workload.

The annual linac workload is often required by regulatory agencies to assess compliance with license conditions. Summation of the monitor units produced by the machine is generally used for this purpose. Various methods of estimating this value have inherent inaccuracies. We have built an integrating Monitor Unit "odometer" that is able to automatically accumulate all MUs delivered by the linac and segregate the total by mode (photon or electron) and energy. The device has been used to record clinical linac MU workloads for 10 months, and was installed in a new dual-energy linac during the acceptance and commissioning process.

Electrons↗

PubMed1990

Six years' audit of laboratory workload and rates of referral for colposcopy in a cervical screening programme in three districts.

OBJECTIVE: To determine laboratory workload and rates of referral for colposcopy in a three district cervical screening programme during 1983-9 to assess the feasibility of accommodating call up of all women at risk, recall at three year intervals (now five year intervals), and investigation of women with all degrees of abnormality. DESIGN: Analysis of computerised screening histories dating back to 1977 of women screened in the Avon cervical screening programme. SETTING: Three district health authorities covering the population of Bristol and Weston-super-Mare, comprising 800,000 people, of whom 250,000 were female residents aged 20 to 64. SUBJECTS: 196,977 Women aged 20 to 64 screened in cervical screening programme since 1983. RESULTS: Laboratory workload devoted to follow up of women with abnormalities increased sharply between 1987-8 and 1988-9, with increases of 54% (from 2075 to 3196) in the number of smears for follow up of severe dyskaryosis and invasive cancer, 40% (from 1925 to 2695) for mild and moderate dyskaryosis, and 49% (from 1793 to 2677) for borderline change. The increases were partly explained by the introduction in April 1988 of protocols for follow up and investigation based on guidance in an intercollegiate working party report. The proportion of women with mild and moderate dyskaryosis who were recommended for referral for colposcopy increased steadily from 9.9% in 1983-4 to 79.9% in 1988-9, and for borderline change the proportions were 3.5% and 13.6% respectively. Of all women tested in 1988-9, referral for colposcopy was recommended in 3%. CONCLUSIONS: The increase in laboratory follow up work identified, if it continued, could result in half of existing laboratory capacity in Avon being devoted to follow up work by 1993, with little prospect of maintaining call, recall, and quality control. Investigation of all women with minor cytological abnormalities is neither justifiable nor sustainable and will undermine the benefits of screening by increasing the rate of false positive results and the financial costs.

Clinical Laboratory Techniques↗

PubMed1986

The urgency distribution of an accident and emergency department's workload.

The perceived urgency of 2000 consecutive patients attending the Accident and Emergency Department of the Royal Infirmary, Edinburgh, was assessed using a Linear Analogue Scale. Each patient was assessed by the receptionist, the receiving nurse and the treating doctor. The distribution of urgency rating produced for this patient group was shown to be comparable for each status of assessor, and to correlate with other outcome criteria such as admission and referral rates. The linear scale was also shown to correlate with retrospective assessment using a time-guided category scale. The accident and emergency department workload is predominantly of low urgency (90% less than 5 on a 0-10 scale). Older patients tend to have higher urgency ratings than younger patients and those referred by ambulance, either via general practitioner or 999 calls, have similarly higher urgency distributions. This study provides a basis for the development of a guided category scale for functional triage of accident and emergency departments. Other scoring systems have attempted to similarly quantify the medical component of the workload (Coira & Rothstein, 1983; Peel et al., 1962). However, the complexity of many of these scales, together with the difficulty in usage of so many different scales, begs a reappraisal of the overall triage of patients attending the emergency department. The aim of this study was to look at the perceived urgency distribution of patients presenting to the emergency department. We wished to compare the relative assessment of urgency by various levels of treating staff and to compare those assessments with the referral and outcome of these patients to provide the basis for the development of a comparative Triage Scale.

Accidents↗

PubMed1989

Neurology in Gloucestershire: the clinical workload of an English neurologist.

Attempts to determine the ideal number of consultant neurologists that will be required in the United Kingdom in the future are hampered by a lack of information on a variety of topics, one of which concerns the workload of the average neurologist at the present time. This paper attempts to correct this deficiency by examining the clinical workload of a single handed neurologist practising in the south west of England. Diagnostic information is given on the 3020 new patients seen during 1984-1986 and is compared with similar data on 836 new patients seen in 1975. The pattern of diagnoses on these patients varies little from year to year, indicating a constancy of referral habit of those who seek neurological advice. However, the referral rates for different conditions do not correspond with what would be expected from epidemiological data, for when the incidence of particular conditions in the neurology clinic is compared with the calculated incidence in the community, very wide variations are noted. The implications of these data are discussed and it is suggested that further studies should be performed before detailed predictions are made on how many neurologists will be needed in this country in the future.

Cross-Sectional Studies↗

PubMed1991

The workload of neurosurgeons: implications of the 1987 practice survey in the USA.

The number of neurosurgeons per million population is much lower in Europe than in the USA, where the point prevalence of neurosurgeons doubled between 1963-87. Results of a 1987 survey of USA neurosurgical practice show that surgery filled 25% of total time in professional activity. Of all cases treated, 64% were spinal disorders and 24% were intracranial disorders. Use of a relative value scale for neurosurgical procedures makes possible a rough and ready estimate of a neurosurgeon's weekly aggregate workload. However, the concept of a mean surgical workload must be examined within the context of the known variation of case mix and volume of surgical services in different practices.

Central Nervous System Diseases↗

PubMed1988

Occupational class, physical workload, and musculoskeletal morbidity in the engineering industry.

In 1973, 502 employees in three metal industry plants, stratified by age, sex, and occupational class, were examined for physical workload by interview and observation at the workplace and for musculoskeletal disorders by questionnaire, interview, and clinical examination. Five years later, 88% of the sample were re-examined for their musculoskeletal status. The work of the blue collar groups was heavier as measured by indices of physical work load based on the observation and interview (physical strain, physical load, static phases, and stereotypy). Rheumatic symptoms, clinical findings in the musculoskeletal system, and chronic musculoskeletal diseases were more frequent in both female and male blue collar workers than in the respective white collar groups on the first occasion and the increase in morbidity during follow up was higher in the blue collar groups. At an individual level within the blue collar class, however, associations between indices of physical workload and musculoskeletal morbidity were weak or non-existent. The associations were weakened by selective movement of people with musculoskeletal disorders from heavy jobs to premature retirement or to lighter jobs. Physical strain and physical load were negatively associated with the incidence of long term musculoskeletal disorders in the female blue collar group.

Bone Diseases↗