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

Abstract

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.

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

“…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 .…”

“…Many studies have examined the relationship between physically demanding occupations such as farming , mining , and floor laying and the onset of knee OA. The underlying mechanistic links between occupations and knee OA are believed to be biomechanical, with excessive knee forces generated during strenuous work tasks . Several studies have identified frequent workplace kneeling, squatting, and heavy lifting as risk factors for development and progression of knee OA .…”

Kneeling ability after total knee replacement

“…37–39 Kneeling is an important activity for a number of occupations, including floor laying, roofing, joinery, nursery teaching, painting and decorating, plumbing and cleaning. 40 Systematic reviews have found evidence that occupational kneeling is a risk factor for osteoarthritis, suggesting that kneeling ability may be a particularly important occupational factor for patients after TKR. 41,42…”

The comparative analysis of postural and biomechanical parameters of preschool teachers pre- and post-intervention within the ErgoKiTa study

“…The postural data and durations for the different tasks were determined by segmenting the 4-h data into the individual tasks observed. The individual task segments were then used in addition to the documented schedule for a characteristic 8-h work day and calculated as a shift value for the percentages of body angles for each assessment day using the method verified by Ditchen et al (2014).…”