Exposure assessment of kneeling work activities among floor layers

Jensen, Louise Kruse; Rytter, Søren; Bonde, Jens Peter

doi:10.1016/j.apergo.2009.08.004

Cited by 24 publications

(8 citation statements)

References 19 publications

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“…This reflected the fact that we did not have the constraints faced by the authors of the just-mentioned study with respect to the grouping of occupational titles, and the fact that their comparisons were based on initial ratings, whereas our comparisons were made after correction of outlying estimates. We estimated that floor-layers were exposed to kneeling/squatting for on average 3.5 hours/day, which is comparable to estimates based on observations and measurements [13-15,44]. It seems reasonable that no job groups obtained a higher mean for this exposure.…”

Section: Discussionsupporting

confidence: 80%

An expert-based job exposure matrix for large scale epidemiologic studies of primary hip and knee osteoarthritis: The Lower Body JEM

Rubak

Svendsen

Andersen

et al. 2014

BMC Musculoskelet Disord

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BackgroundWhen conducting large scale epidemiologic studies, it is a challenge to obtain quantitative exposure estimates, which do not rely on self-report where estimates may be influenced by symptoms and knowledge of disease status. In this study we developed a job exposure matrix (JEM) for use in population studies of the work-relatedness of hip and knee osteoarthritis.MethodsBased on all 2227 occupational titles in the Danish version of the International Standard Classification of Occupations (D-ISCO 88), we constructed 121 job groups comprising occupational titles with expected homogeneous exposure patterns in addition to a minimally exposed job group, which was not included in the JEM. The job groups were allocated the mean value of five experts’ ratings of daily duration (hours/day) of standing/walking, kneeling/squatting, and whole-body vibration as well as total load lifted (kg/day), and frequency of lifting loads weighing ≥20 kg (times/day). Weighted kappa statistics were used to evaluate inter-rater agreement on rankings of the job groups for four of these exposures (whole-body vibration could not be evaluated due to few exposed job groups). Two external experts checked the face validity of the rankings of the mean values.ResultsA JEM was constructed and English ISCO codes were provided where possible. The experts’ ratings showed fair to moderate agreement with respect to rankings of the job groups (mean weighted kappa values between 0.36 and 0.49). The external experts agreed on 586 of the 605 rankings.ConclusionThe Lower Body JEM based on experts’ ratings was established. Experts agreed on rankings of the job groups, and rankings based on mean values were in accordance with the opinion of external experts.

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Section: Discussionsupporting

confidence: 80%

An expert-based job exposure matrix for large scale epidemiologic studies of primary hip and knee osteoarthritis: The Lower Body JEM

Rubak

Svendsen

Andersen

et al. 2014

BMC Musculoskelet Disord

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“…Similarly, a 63% increased odds of knee OA was observed in builders and floor layers. It has been shown that floor layers kneel and squat for a large proportion of their working time, especially during gluing and filling, thereby generating high external knee forces . The prevalence of patellofemoral radiologic changes and prepatellar, infrapatellar bursitis, however, does not seem to increase in floor layers .…”

Section: Discussionmentioning

confidence: 99%

Occupational Risk in Knee Osteoarthritis: A Systematic Review and Meta‐Analysis of Observational Studies

Wang

Perry

Arden

et al. 2020

Arthritis Care & Research

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Objective To assess the association between occupational exposures and knee osteoarthritis (OA). Methods We systematically searched for observational studies that examined the relationship between occupational exposures and knee OA and total knee replacement. Four databases were searched up to October 1, 2019. Two reviewers independently assessed study quality using the Newcastle‐Ottawa Scale and evidence quality using the Grading of Recommendations Assessment, Development and Evaluation approach. Subgroup meta‐analyses were conducted for important study characteristics and each type of occupational exposure. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated for the meta‐analysis using random‐effects models. Results Eighty eligible studies were identified including 25 case–control (n = 20,505 total participants), 36 cross‐sectional (n = 139,463 total participants), and 19 cohort studies (n = 16,824,492 total participants). A synthesis of 71 studies suggested increased odds of knee OA (OR 1.52 [95% CI 1.37–1.69]) by combining different physically demanding jobs and occupational activities as compared to sedentary occupations and/or low‐exposure groups. Odds of knee OA were greater in males and in industry‐based studies and studies assessing lifetime occupational exposures. There were 9 specific job titles that were associated with knee OA, including farmer, builder, metal worker, and floor layer. Occupational lifting, kneeling, climbing, squatting, and standing were all associated with higher odds of knee OA as compared to the odds of knee OA in sedentary workers. Conclusion Strenuous, physically demanding occupations and occupational activities were associated with increased odds of knee OA as supported by moderate‐quality evidence. Specifically, agricultural and construction sectors, which typically involve heavy lifting, frequent climbing, prolonged kneeling, squatting, and standing, carried increased odds of knee OA.

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“…By extrapolating their findings on the duration of kneeling and squatting to a whole work shift, they stated an average daily percentage of time spent in these postures of approximately 56 % (floor layers) and 25 % (carpenters). In a second study, the authors videotaped each of four floor layers for an entire work shift and analysed the duration of kneeling, squatting, kneeling back on heels, and crawling tasks (Jensen et al 2010). The average percentage of time spent in these postures was 41.0 % (SD = 7.5), which is consistent with our result of 39.0 % (SD = 16.3) from analysing all floor layers’ tasks measured in our study.…”

Section: Discussionmentioning

confidence: 99%

“…The authors filmed short working sequences and extrapolated the duration of knee-straining postures to an entire work shift. This procedure may have led to overestimation of the daily knee-loading, as critically stated by the authors in a recent publication (Jensen et al 2010). …”

Section: Introductionmentioning

confidence: 96%

Occupational kneeling and squatting: development and validation of an assessment method combining measurements and diaries

Ditchen

Ellegast

Gawliczek

et al. 2014

Int Arch Occup Environ Health

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ObjectivesAs knee-straining postures such as kneeling and squatting are known to be risk factors for knee disorders, there is a need for effective exposure assessment at the workplace. Therefore, the aim of this study was to develop a method to capture knee-straining postures for entire work shifts by combining measurement techniques with the information obtained from diaries, and thus avoiding measuring entire work shifts. This approach was applied to various occupational tasks to obtain an overview of typical exposure values in current specific occupations.MethodsThe analyses were carried out in the field using an ambulatory measuring system (CUELA) to assess posture combined with one-day self-reported occupational diaries describing the durations of various work tasks. In total, 242 work shifts were measured, representing 81 typical tasks from 16 professions. Knee-straining postures were analysed as daily time intervals for five different postures. The accuracy of the method was examined by comparing the results to measurements of entire work shifts.ResultsUnsupported kneeling was the most widely used knee posture in our sample (median 11.4 % per work shift), followed by supported kneeling (3.0 %), sitting on heels (1.1 %), squatting (0.7 %), and crawling (0.0 %). The daily time spent in knee-straining postures varied considerably, both between the individual occupations, within an occupation (e.g. parquet layers: 0.0–88.9 %), and to some extent even within a single task (e.g. preparation work of floor layers (22.0 ± 23.0 %). The applied measuring method for obtaining daily exposure to the knee has been proven valid and efficient randomly compared with whole-shift measurements (p = 0.27).ConclusionsThe daily degree of postural exposure to the knee showed a huge variation within the analysed job categories and seemed to be dependent on the particular tasks performed. The results of this study may help to develop an exposure matrix with respect to occupational knee-straining postures. The tested combination of task-based measurement and diary information may be a promising option for providing a cost-effective assessment tool.

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Exposure assessment of kneeling work activities among floor layers

Cited by 24 publications

References 19 publications

An expert-based job exposure matrix for large scale epidemiologic studies of primary hip and knee osteoarthritis: The Lower Body JEM

An expert-based job exposure matrix for large scale epidemiologic studies of primary hip and knee osteoarthritis: The Lower Body JEM

Occupational Risk in Knee Osteoarthritis: A Systematic Review and Meta‐Analysis of Observational Studies

Occupational kneeling and squatting: development and validation of an assessment method combining measurements and diaries

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