Skip to main content
Top
Published in: International Archives of Occupational and Environmental Health 2/2015

Open Access 01-02-2015 | Original Article

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

Authors: Dirk M. Ditchen, Rolf P. Ellegast, Tom Gawliczek, Bernd Hartmann, Monika A. Rieger

Published in: International Archives of Occupational and Environmental Health | Issue 2/2015

Login to get access

Abstract

Objectives

As 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.

Methods

The 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.

Results

Unsupported 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).

Conclusions

The 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.
Literature
go back to reference Baty D, Buckle PW, Stubbs DA (1986) Posture recording by direct observation questionnaire assessment and instrumentation: a comparison based on a recent field study. In: Corlett N, Wilson J, Manenica I (eds) The ergonomics of working postures: proceedings of the first international occupational ergonomics symposium. Taylor & Francis, London, pp 283–91. ISBN:0850663385 Baty D, Buckle PW, Stubbs DA (1986) Posture recording by direct observation questionnaire assessment and instrumentation: a comparison based on a recent field study. In: Corlett N, Wilson J, Manenica I (eds) The ergonomics of working postures: proceedings of the first international occupational ergonomics symposium. Taylor & Francis, London, pp 283–91. ISBN:0850663385
go back to reference Benke G, Sim M, Fritschi L, Aldred G (2000) Beyond the job exposure matrix (JEM): the task exposure matrix (TEM). Ann Occup Hyg 44(6):475–482CrossRef Benke G, Sim M, Fritschi L, Aldred G (2000) Beyond the job exposure matrix (JEM): the task exposure matrix (TEM). Ann Occup Hyg 44(6):475–482CrossRef
go back to reference BMGS (Bundesministerium für Gesundheit und Soziale Sicherung) (2005) Bekanntmachung des BMGS vom 1. Oktober 2005, Ärztlicher Sachverständigenbeirat, Sektion “Berufskrankheiten”, Wissenschaftliche Begründung für die Berufskrankheit Gonarthrose, Bundesarbeitsblatt. [Scientific justification of the occupational disease “knee osteoarthritis“] 10:46–54 BMGS (Bundesministerium für Gesundheit und Soziale Sicherung) (2005) Bekanntmachung des BMGS vom 1. Oktober 2005, Ärztlicher Sachverständigenbeirat, Sektion “Berufskrankheiten”, Wissenschaftliche Begründung für die Berufskrankheit Gonarthrose, Bundesarbeitsblatt. [Scientific justification of the occupational disease “knee osteoarthritis“] 10:46–54
go back to reference Burdorf A, Laan J (1991) Comparison of methods for the assessment of postural load on the back. Scand J Work Environ Health 17:425–429CrossRef Burdorf A, Laan J (1991) Comparison of methods for the assessment of postural load on the back. Scand J Work Environ Health 17:425–429CrossRef
go back to reference Burdorf A, Windhorst J, van der Beek AJ, van der Molen H, Swuste PHJJ (2007) The effects of mechanised equipment on physical load among road workers and floor layers in the construction industry. Int J Ind Ergonom 37:133–143CrossRef Burdorf A, Windhorst J, van der Beek AJ, van der Molen H, Swuste PHJJ (2007) The effects of mechanised equipment on physical load among road workers and floor layers in the construction industry. Int J Ind Ergonom 37:133–143CrossRef
go back to reference Caruntu DI, Hefzy MS, Goel VK, Goitz HT, Dennis MJ, Agrawal V. (2003) Modeling the knee joint in deep flexion: “thigh and calf” contact. In: Summer bioengineering conference; 2003 June 25–29; Sonesta Beach Resort in Key Biscayne, FL Caruntu DI, Hefzy MS, Goel VK, Goitz HT, Dennis MJ, Agrawal V. (2003) Modeling the knee joint in deep flexion: “thigh and calf” contact. In: Summer bioengineering conference; 2003 June 25–29; Sonesta Beach Resort in Key Biscayne, FL
go back to reference Coggon D, Croft P, Kellingray S, Barrett D, McLaren M, Cooper C (2000) Occupational physical activities and osteoarthritis of the knee. Arthritis Rheum 43(7):1443–1449CrossRef Coggon D, Croft P, Kellingray S, Barrett D, McLaren M, Cooper C (2000) Occupational physical activities and osteoarthritis of the knee. Arthritis Rheum 43(7):1443–1449CrossRef
go back to reference Cooper C, McAlindon T, Coggon D, Egger P, Dieppe P (1994) Occupational activity and osteoarthritis of the knee. Ann Rheum Dis 53:90–93CrossRef Cooper C, McAlindon T, Coggon D, Egger P, Dieppe P (1994) Occupational activity and osteoarthritis of the knee. Ann Rheum Dis 53:90–93CrossRef
go back to reference Ditchen DM, Ellegast RP, Hartmann B, Rieger MA (2013) Validity of self-reports of knee-straining activities at work: a field study with 6-month follow-up. Int Arch Occup Environ Health 86(2):233–243. doi:10.1007/s00420-012-0758-4 (Epub 2012 Mar 18)CrossRef Ditchen DM, Ellegast RP, Hartmann B, Rieger MA (2013) Validity of self-reports of knee-straining activities at work: a field study with 6-month follow-up. Int Arch Occup Environ Health 86(2):233–243. doi:10.​1007/​s00420-012-0758-4 (Epub 2012 Mar 18)CrossRef
go back to reference Ellegast RP (1998) Personengebundenes Messsystem zur automatisierten Erfassung von Wirbelsäulenbelastungen bei beruflichen Tätigkeiten [Ambulant measuring system for automatic recording of occupational spinal loads; in German only]. BIA-Report 5/98. HVBG, Sankt Augustin Ellegast RP (1998) Personengebundenes Messsystem zur automatisierten Erfassung von Wirbelsäulenbelastungen bei beruflichen Tätigkeiten [Ambulant measuring system for automatic recording of occupational spinal loads; in German only]. BIA-Report 5/98. HVBG, Sankt Augustin
go back to reference Ellegast RP, Hermanns I, Schiefer C (2009) Workload assessment in field using the ambulatory CUELA system. In: Duffy VG (ed) Second international conference digital human modeling—ICDHM 2009, held as part of HCI international 2009, July 19–24; San Diego/USA. Springer, Berlin, pp 221–226 Ellegast RP, Hermanns I, Schiefer C (2009) Workload assessment in field using the ambulatory CUELA system. In: Duffy VG (ed) Second international conference digital human modeling—ICDHM 2009, held as part of HCI international 2009, July 19–24; San Diego/USA. Springer, Berlin, pp 221–226
go back to reference Felson DT, Hannan MT, Naimark A, Berkeley J, Gordon G, Wilson PWF, Anderson J (1991) Occupational physical demands, knee bending, and knee osteoarthritis: results from the Framingham Study. J Rheumatol 18(10):1587–1592 Felson DT, Hannan MT, Naimark A, Berkeley J, Gordon G, Wilson PWF, Anderson J (1991) Occupational physical demands, knee bending, and knee osteoarthritis: results from the Framingham Study. J Rheumatol 18(10):1587–1592
go back to reference Freitag S, Ellegast R, Dulon M, Nienhaus A (2007) Quantitative measurement of stressful trunk postures in nursing professions. Ann Occup Hyg 53(4):385–395CrossRef Freitag S, Ellegast R, Dulon M, Nienhaus A (2007) Quantitative measurement of stressful trunk postures in nursing professions. Ann Occup Hyg 53(4):385–395CrossRef
go back to reference Freitag S, Fincke-Junod I, Seddouki R, Dulon M, Hermanns I, Kersten JF, Larsson TJ, Nienhaus A (2012) Frequent bending—an underestimated burden in nursing profession. Ann Occup Hyg. doi:10.1093/annhyg/mes002 Freitag S, Fincke-Junod I, Seddouki R, Dulon M, Hermanns I, Kersten JF, Larsson TJ, Nienhaus A (2012) Frequent bending—an underestimated burden in nursing profession. Ann Occup Hyg. doi:10.​1093/​annhyg/​mes002
go back to reference Glitsch U, Ottersbach HJ, Ellegast R, Schaub K, Franz G, Jäger M (2007) Physical workload of flight attendants when pushing and pulling trolleys aboard aircraft. Int J Ind Ergonom 37:845–854CrossRef Glitsch U, Ottersbach HJ, Ellegast R, Schaub K, Franz G, Jäger M (2007) Physical workload of flight attendants when pushing and pulling trolleys aboard aircraft. Int J Ind Ergonom 37:845–854CrossRef
go back to reference Jensen LK, Mikkelsen S, Loft IP, Eenberg W, Bergmann I, Logager V (2000a) Radiographic knee osteoarthritis in floor layers and carpenters. Scand J Work Environ Health 26(3):257–262CrossRef Jensen LK, Mikkelsen S, Loft IP, Eenberg W, Bergmann I, Logager V (2000a) Radiographic knee osteoarthritis in floor layers and carpenters. Scand J Work Environ Health 26(3):257–262CrossRef
go back to reference Jensen LK, Eenberg W, Mikkelsen S (2000b) Validity of self-reporting and video-recording for measuring knee-straining work postures. Ergonomics 43(3):310–316CrossRef Jensen LK, Eenberg W, Mikkelsen S (2000b) Validity of self-reporting and video-recording for measuring knee-straining work postures. Ergonomics 43(3):310–316CrossRef
go back to reference Jensen LK, Rytter S, Bonde JP (2010) Exposure assessment of kneeling work activities among floor layers. Appl Ergon 41:319–325CrossRef Jensen LK, Rytter S, Bonde JP (2010) Exposure assessment of kneeling work activities among floor layers. Appl Ergon 41:319–325CrossRef
go back to reference Kivimäki J, Riihimäki H, Hänninen K (1992) Knee disorders in carpet and floor layers and painters. Scand J Work Environ Health 18:310–316CrossRef Kivimäki J, Riihimäki H, Hänninen K (1992) Knee disorders in carpet and floor layers and painters. Scand J Work Environ Health 18:310–316CrossRef
go back to reference Klussmann A, Gebhardt H, Nuebling M, Liebers F, Quirós Perea E, Cordier W, von Engelhardt LV, Schubert M, Dávid A, Bouillon B, Rieger MA (2010) Individual and occupational risk factors for knee osteoarthritis: results of a case control study in Germany. Arthritis Res Ther 12:R88. doi:10.118/ar3015 CrossRef Klussmann A, Gebhardt H, Nuebling M, Liebers F, Quirós Perea E, Cordier W, von Engelhardt LV, Schubert M, Dávid A, Bouillon B, Rieger MA (2010) Individual and occupational risk factors for knee osteoarthritis: results of a case control study in Germany. Arthritis Res Ther 12:R88. doi:10.​118/​ar3015 CrossRef
go back to reference Liebers F, Caffier G. (2009) Berufsspezifische Arbeitsunfähigkeit durch Muskel-Skelett-Erkrankungen in Deutschland. [Work incapacity with regard to musculoskeletal disorders in specific occupations] Forschungsbericht Projekt F 1996 der Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (Hrsg.). Dortmund/Berlin/Dresden. ISBN:978-3-88261-107-6 Liebers F, Caffier G. (2009) Berufsspezifische Arbeitsunfähigkeit durch Muskel-Skelett-Erkrankungen in Deutschland. [Work incapacity with regard to musculoskeletal disorders in specific occupations] Forschungsbericht Projekt F 1996 der Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (Hrsg.). Dortmund/Berlin/Dresden. ISBN:978-3-88261-107-6
go back to reference Mathiassen SE, Burdorf A, van der Beek AJ, Hansson GA (2003) Efficient one day sampling of mechanical job exposure data—a study based on upper trapezius activity in cleaners and office workers. AIHA J 64:196–211CrossRef Mathiassen SE, Burdorf A, van der Beek AJ, Hansson GA (2003) Efficient one day sampling of mechanical job exposure data—a study based on upper trapezius activity in cleaners and office workers. AIHA J 64:196–211CrossRef
go back to reference Mathiassen SE, Nordander C, Svendsen SW, Wellman HM, Dempsey PG (2005) Task-based estimation of mechanical job exposure in occupational groups. Scand J Work Environ Health 31(2):138–151CrossRef Mathiassen SE, Nordander C, Svendsen SW, Wellman HM, Dempsey PG (2005) Task-based estimation of mechanical job exposure in occupational groups. Scand J Work Environ Health 31(2):138–151CrossRef
go back to reference Muraki S, Akune T, Oka H, Mabuchi A, En-Yo Y, Yoshida M, Saika A, Nakamura K, Kawa-guchi H, Yoshimura N (2009) Association of occupational activity with radiographic knee osteoarthritis and lumbar spondylosis in elderly patients of population-based controls: a large-scale population-based study. Arthritis Rheum 61(6):779–786CrossRef Muraki S, Akune T, Oka H, Mabuchi A, En-Yo Y, Yoshida M, Saika A, Nakamura K, Kawa-guchi H, Yoshimura N (2009) Association of occupational activity with radiographic knee osteoarthritis and lumbar spondylosis in elderly patients of population-based controls: a large-scale population-based study. Arthritis Rheum 61(6):779–786CrossRef
go back to reference Sandmark H, Hogstedt C, Vingard E (2000) Primary osteoarthrosis of the knee in men and women as a result of lifelong physical load from work. Scand J Work Environ Health 26(1):20–25CrossRef Sandmark H, Hogstedt C, Vingard E (2000) Primary osteoarthrosis of the knee in men and women as a result of lifelong physical load from work. Scand J Work Environ Health 26(1):20–25CrossRef
go back to reference Schiefer C, Kraus T, Ochsmann E, Hermanns I, Ellegast R (2011) 3D human motion capturing based only on acceleration and angular rate measurement for low extremities. In: Duffy VC (ed) Lecture notes in computer science—digital human modeling. Springer, Berlin, pp 195–203. ISBN 978-3-642-21798-2CrossRef Schiefer C, Kraus T, Ochsmann E, Hermanns I, Ellegast R (2011) 3D human motion capturing based only on acceleration and angular rate measurement for low extremities. In: Duffy VC (ed) Lecture notes in computer science—digital human modeling. Springer, Berlin, pp 195–203. ISBN 978-3-642-21798-2CrossRef
go back to reference Seidler A, Bolm-Audorff U, Abolmaali N, Elsner G, the Knee Osteoarthritis Study-Group (2008) The role of physical work load in symptomatic knee osteoarthritis—a case–control-study in Germany. J Occup Med Tox 3(14) Seidler A, Bolm-Audorff U, Abolmaali N, Elsner G, the Knee Osteoarthritis Study-Group (2008) The role of physical work load in symptomatic knee osteoarthritis—a case–control-study in Germany. J Occup Med Tox 3(14)
go back to reference Semple SE, Dick F, Cherrie JW, on behalf of the Geoparkinson Study Group (2004) Exposure assessment for a population-based case–control study combining a job-exposure matrix with interview data. Scand J Work Environ Health 30(3):241–248CrossRef Semple SE, Dick F, Cherrie JW, on behalf of the Geoparkinson Study Group (2004) Exposure assessment for a population-based case–control study combining a job-exposure matrix with interview data. Scand J Work Environ Health 30(3):241–248CrossRef
go back to reference Svendsen SW, Mathiassen SE, Bonde JP (2005) Task based exposure assessment in ergonomic epidemiology: a study of upper arm elevation in the jobs of machinists, car mechanics, and house painters. Occup Environ Med 62:18–26CrossRef Svendsen SW, Mathiassen SE, Bonde JP (2005) Task based exposure assessment in ergonomic epidemiology: a study of upper arm elevation in the jobs of machinists, car mechanics, and house painters. Occup Environ Med 62:18–26CrossRef
go back to reference Tak S, Paquet V, Woskie S, Buchholz B, Punnett L (2009) Variability in risk factors for knee injury in construction. J Occup Environ Hyg 6(2):113–120CrossRef Tak S, Paquet V, Woskie S, Buchholz B, Punnett L (2009) Variability in risk factors for knee injury in construction. J Occup Environ Hyg 6(2):113–120CrossRef
go back to reference Trask C, Mathiassen SE, Wahlström J, Forsman M (2014) Cost-efficient assessment of biomechanical exposure in occupational groups, exemplified by posture observation and inclinometry. Scand J Work Environ Health (online first). doi:10.5274/sjweh.3416 Trask C, Mathiassen SE, Wahlström J, Forsman M (2014) Cost-efficient assessment of biomechanical exposure in occupational groups, exemplified by posture observation and inclinometry. Scand J Work Environ Health (online first). doi:10.​5274/​sjweh.​3416
go back to reference Viikari-Juntura E, Rauas S, Martikainen R, Kuosma E, Riihimäki H, Takala EP, Saarenmaa K (1996) Validity of self-reported physical work load in epidemiologic studies on musculoskeletal disorders. Scand J Work Environ Health 22:251–259CrossRef Viikari-Juntura E, Rauas S, Martikainen R, Kuosma E, Riihimäki H, Takala EP, Saarenmaa K (1996) Validity of self-reported physical work load in epidemiologic studies on musculoskeletal disorders. Scand J Work Environ Health 22:251–259CrossRef
go back to reference Vingard E, Alfredsson L, Goldie I, Hogstedt C (1991) Occupation and osteoarthrosis of the hip and knee, a register-based cohort study. Int J Epidemiol 20:1025–1031CrossRef Vingard E, Alfredsson L, Goldie I, Hogstedt C (1991) Occupation and osteoarthrosis of the hip and knee, a register-based cohort study. Int J Epidemiol 20:1025–1031CrossRef
go back to reference Wickström G, Hänningen K, Mattison T, Niskanen T, Riihimäki H, Waris P, Zitting A (1983) Knee degeneration in concrete reinforcement workers. Br J Ind Med 40:216–219 Wickström G, Hänningen K, Mattison T, Niskanen T, Riihimäki H, Waris P, Zitting A (1983) Knee degeneration in concrete reinforcement workers. Br J Ind Med 40:216–219
go back to reference Zelle J, Barink M, De Malefjit Waal M, Verdonschot N (2009) Thigh-calf contact: does it affect the loading of the knee in the high-flexion range? J Biomech 42(5):87–93CrossRef Zelle J, Barink M, De Malefjit Waal M, Verdonschot N (2009) Thigh-calf contact: does it affect the loading of the knee in the high-flexion range? J Biomech 42(5):87–93CrossRef
Metadata
Title
Occupational kneeling and squatting: development and validation of an assessment method combining measurements and diaries
Authors
Dirk M. Ditchen
Rolf P. Ellegast
Tom Gawliczek
Bernd Hartmann
Monika A. Rieger
Publication date
01-02-2015
Publisher
Springer Berlin Heidelberg
Published in
International Archives of Occupational and Environmental Health / Issue 2/2015
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI
https://doi.org/10.1007/s00420-014-0946-5

Other articles of this Issue 2/2015

International Archives of Occupational and Environmental Health 2/2015 Go to the issue