Tak et al COHP 2011 App Erg

Applied Ergonomics 42 (2011) 665e671 Contents lists available at ScienceDirect Applied Ergonomics journal homepage: www.elsevier.com/locate/apergo Physical ergonomic hazards in highway tunnel construction: Overview from the Construction Occupational Health Program SangWoo Tak a, *, Bryan Buchholz a, Laura Punnett a, Susan Moir a, b, Victor Paquet a, c, Scott Fulmer a, Helen Marucci-Wellman a, d, David Wegman a a Department of Work Environment, University of Massachusetts Lowell, Lowell, MA 01854, USA University of Massachusetts Boston, Boston, MA, USA University at Buffalo, SUNY, 411 Bell Hall, Buffalo, NY 14260-3302, USA d Liberty Mutual Research Institute, Hopkinton MA 01748, USA b c a r t i c l e i n f o a b s t r a c t Article history: Received 24 November 2009 Accepted 2 October 2010 This report provides an overview of physical ergonomic exposures in highway construction work across trades and major operations. For each operation, the observational method “PATH” (Posture, Activity, Tools and Handling) was used to estimate the percentage of time that workers spent in specific tasks and with exposure to awkward postures and load handling. The observations were carried out on 73 different days, typically for about 4 h per day, covering 120 construction workers in 5 different trades: laborers, carpenters, ironworkers, plasterers, and tilers. Non-neutral trunk postures (forward or sideways flexion or twisting) were frequently observed, representing over 40% of observations for all trades except laborers (28%). Kneeling and squatting were common in all operations, especially tiling and underground utility relocation work. Handling loads was frequent, especially for plasterers and tilers, with a range of load weights but most often under 15 pounds. The results of this study provide quantitative evidence that workers in highway tunnel construction operations are exposed to ergonomic factors known to present significant health hazards. Numerous opportunities exist for the development and implementation of ergonomic interventions to protect the health and safety of construction workers. Ó 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved. Keywords: PATH Trade Operation Postural load Highway tunnel construction 1. Introduction Construction workers are exposed to a variety of ergonomic hazards, including awkward postures, heavy lifting, forceful exertions, vibrations, and repetitive motions (Schneider and Susi, 1994; Hartmann and Fleischer, 2005). They also experience an elevated risk of musculoskeletal disorders (Latza et al., 2000; O’Reilly et al., 2000; Sandmark et al., 2000; Schneider, 2001; Goldsheyder et al., 2002; Holmstrom and Engholm, 2003; Forde et al., 2005). Much of the work performed in construction is non-routinized (Buchholz et al., 1996). This is due both to the dynamic nature of construction work itself and the changing external environment, which may impact the content and frequency distribution of job tasks across individuals and over time (Paquet et al., 2005). The dynamic nature of construction work also makes it difficult to measure ergonomic exposures systematically. A few investigators * Corresponding author. National Institute for Occupational Safety and Health, 4676 Columbia Parkway, R-17, Cincinnati OH 45226, USA. Tel.: þ1 513 458 7117; fax: þ1 513 841 4489. E-mail address: STak@cdc.gov (SangWoo Tak). have used observational methods to determine the distribution of ergonomic exposures in specific construction trades or tasks (Wickstrom et al., 1985; Kivi and Mattila, 1991; Bhattacharya et al., 1997; Jensen and Eenberg, 2000). However, there have been few or no large-scale comparisons of exposure to physical ergonomic hazards among different trades or stages of the construction process. The objective of this report is to provide an overview of ergonomic exposures in highway construction work and to describe the frequency of known health hazards by the major trades and operations involved. 2. Methods 2.1. Study site and population Data were compiled from 9 field studies that were carried out by ergonomists from the Construction Occupational Health Program (COHP) at the University of Massachusetts Lowell during the last decade (Buchholz et al., 1996; Kittusamy and Buchholz, 2001; Paquet et al., 2001; Buchholz et al., 2003; Paquet et al., 2005; Tak et al., 2009). All the studies took place at a very large highway 0003-6870/$ e see front matter Ó 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved. doi:10.1016/j.apergo.2010.10.001 666 SangWoo Tak et al. / Applied Ergonomics 42 (2011) 665e671 construction site in Boston, Massachusetts. The operations were characterized according to a taxonomy that was created based on the Massachusetts Highway Department specifications (Moir et al., 2003). All observed workers were unionized, so the scope of work by each trade followed Massachusetts union jurisdictions. This study has been approved by the Institutional Review Board of the University of Massachusetts Lowell. All construction workers gave their informed consent prior to their inclusion in the study. 2.2. Data Collection PATH (Posture, Activities, Tools, Handling) incorporates a modified work-sampling approach into observational job analysis. It provides unbiased estimates of the frequency of ergonomic exposures such as tasks, postures and load in the hands, linked to the tasks in which they are performed through concurrent recording of both, over multi-hour observation periods (Buchholz et al., 1996). Based on the Ovako Working Posture Analysis System (OWAS) (Karhu et al., 1977), the posture codes in PATH are defined as ranges of angles; for example, mild trunk flexion is defined as 20e45 of forward bending. Codes for tasks, activities, and other exposures were developed de novo; many were customized to the specific trades following informal observations and discussions with workers and supervisors. Observers were rigorously trained and inter-observer agreement was confirmed before field data were collected. In each study, we observed a single team of workers performing one operation on multiple days. A series of PATH observations were made at fixed intervals, either 45 or 60 s apart, typically for about 4 h per day. The observations cycled through all workers in the team, so multiple observations were made for each worker present on site each day. 2.3. Description of operations A total of 9 separate operations were observed. To build concrete structures, ironworkers engaged in Concrete Reinforcing are responsible for placing and connecting steel rods (rebar) that reinforce concrete structures on construction sites. Carpenters then build forms around the steel rods (Concrete Form Building); the form-building operations are building, erecting and stripping forms. Construction laborers pour concrete into the forms (Concrete Pouring). Concrete is poured from a concrete pump truck through a hose. Some laborers use short handled shovels, lutes, or rakes to spread the concrete. Other laborers use large and small trowels to smooth out the concrete. Laborers also perform a variety of support tasks, such as erecting scaffolding, housekeeping, stripping forms, and manually excavating and fortifying shafts and tunnels. Pipejacking is a common method to install underground piping, sewer lines, and electrical ducts 30 feet below the surface. It is an alternative to the traditional ’excavate, lay, and fill’ pipe installation method, used especially when it is very important to minimize disruptions to surrounding activities or structures. Instead of digging deep trenches, two pitsea jacking pit and a receiving piteare built initially. Jacking Pit Construction results in a pit that houses the equipment used to jack pipes through the soil. The pit is usually 30 feet  30 feet  30 feet with lagging installed around the sides to prevent the soil from caving in on the tunnelers while they work. After the jacking pit is completed, the pipes are then “jacked” through the soil to the receiving pit. Laborers assist the Tunnelers during both Jacking Pit Construction and Pipe-jacking. The purpose of Slurry Wall Construction is to provide a barrier between a trench and the adjacent earth, to prevent earth from spilling into the trench (caving) and water intrusion. This requires below-grade excavation, through stabilizing slurry, to support the excavation walls. Due to the dangers of trenching and excavating, the use of slurry walls has increased greatly since it was first introduced in 1980’s. Laborers perform manual excavation and housekeeping, often by breaking up large clumps of concrete that were not broken down by mixing, or rinsing any clay or slurry back into the trench to avoid slippage on the working surface. Plastering, Tiling, and Grouting operations take place in the stage of tunnel wall finishing. During Plastering, plasterers apply finish coats of plaster to sections of the tunnel walls. After the first coat of concrete is applied, the “brown coat” is applied the next day on top of the first coat. Tilers then install and grout the tiles on the plastered section. During the Wall Tiling operation, tile finishers mix mortar, prepare the tile for setting and prepare the base of the wall for tiling, while tile mechanics are responsible for tile setting and supervising of the operation. In Grouting, tile finishers prepare the joints between the tiles, prepare the grout, grout and clean the tiles. 2.4. Data analysis The proportion of observations for each task was estimated by operation. Exposure measures were computed as the percentage of the total work time accounted for by each exposure, i.e., proportion of time spent in trunk flexion, kneeling and squatting, etc. Descriptive data for trunk, leg and arm postures, and loads handled, were tabulated to provide operation- and trade-specific estimates of the proportion of time that workers were exposed to each ergonomic factor. Observations with missing information on trunk, leg, or arm postures were excluded from the analysis. Chi-square tests were performed to determine whether exposures varied among operations or trades. 3. Results A total of 15,141 PATH observations were made on 73 days. These observations covered 120 construction workers in 5 different trades performing 9 operations (Table 1). Most operations had more than 5 days of observations except Slurry Wall (3 days), whereas four operations, ConcreteForm Building, Concrete Reinforcing, Jacking Pit and Tiling, had more than 12 days of observation. Each operation consisted of at least four or more tasks; usually one or two primary tasks accounted for more than 20% of the total work time (Table 2). Of the 46 tasks observed, most were specific to Table 1 Highway construction operations and workers observed on Central Artery/Third Harbor Tunnel project, Boston, MA, USA, 1995e2005. Operation No of Trade days observed Concrete Form Building Pipe Jacking 14 5 Concrete Pouring 6 Concrete 13 Reinforcement Grouting 7 Jacking Pit 12 Plastering Slurry Wall Tiling Total 8 3 14 73 Carpenters Laborer Tunnelera Laborer Laborer Ironworker Tiler Tunnelera Laborer Plasterer Laborer Tiler No of Tasks No of workers observed observations observed 15 2 3 1 7 17 18 1 11 11 13 21 120 8 1663 4 1317 5 6 743 2027 5 5 1564 3094 4 4 5 46 1642 931 2160 15,141 a Tunneler is a subspecialty of laborer, included within Laborers in subsequent tables and figures because of the small number of workers. SangWoo Tak et al. / Applied Ergonomics 42 (2011) 665e671 Table 2 Tasks observed in highway construction, by operation (all trades combined): Central Artery/Third Harbor Tunnel project, Boston, MA, 1995e2005. Operation Task Number of observations Percent Concrete Form Building Assembly PlF Building form Erecting form House keeping Material moving Saw/Cut Stripping form Supervising Totala 89 456 325 57 271 269 11 101 1663 5.4 27.4 19.5 3.4 16.3 0.7 6.1 16.20 100 Concrete Pouring Pour concrete Preparation Smooth concrete Spread concrete Clean and Misc. Totala 229 4 121 187 194 743 31.2 0.5 16.5 25.4 26.4 100 Concrete Reinforcing Caisson Horizontal (road) Preparation Supervising Ventilation Vertical (wall) Totala 2 601 644 165 168 446 2027 0.1 29.7 31.8 8.1 8.3 22.0 100 Clean Grout Misc Prepare-Grouting Prepare-Joint Totala 802 343 232 56 113 1564 51.3 21.9 14.8 3.6 7.23 100 Pit Jacking Construct Pit Wall Manual Excavation Misc. Preparation Work Top Work Totala 537 1365 522 3 667 3094 17.4 44.1 16.9 0.1 21.6 100 Pipe Jacking Bottom Work Manual Excavation Misc. Top work Totala 409 528 9 370 1317 31.1 40.1 0.7 28.1 100 Plastering Apply Concrete Brown Coating Misc Prepare Apply Concrete Totala 226 1051 283 52 1642 14.0 65.2 17.6 3.2 100 Slurry wall Construct Pit Wall Manual Excavation Misc Top Work Total 172 278 185 296 931 18.4 29.9 19.8 31.8 100 Tiling Ground level Supervising Tile prepare Tile setting Wall base Total 240 79 770 1051 20 2160 11.1 3.7 35.7 48.7 0.9 100 Grouting a Total numbers include observations with task missing: 84 (ConcreteForm Building), 8 (Concrete Pouring), 1 (Concrete Reinforcement), 18 (Grouting), 1 (Pipe Jacking), and 30 (Plastering). individual operations, while a few tasks, such as supervising, were common in multiple operations. Thus, there were 35 unique tasks. 3.1. Trunk postures Non-neutral trunk postures were frequently observed in almost every operation. Concrete Form Building, Concrete Reinforcement, 667 Plastering, Grouting, and Tiling each involved non-neutral trunk postures for more than 40% of the work time (Fig. 1). The frequency of non-neutral trunk postures differed significantly across operations. Workers performing Tiling were the most exposed to ’flexed and twisted’ trunk posture (15%), followed by those doing Concrete Reinforcement (14%). Laborers had the least exposure to non-neutral trunk posture (28%). 3.2. Leg postures The frequency of non-neutral leg postures differed significantly among operations and trades (Fig. 2). The Jacking Pit operation presented the highest percentage of ’knees bent’ (26%), followed by Concrete Reinforcement and Pipejacking (17%). Squatting was observed most frequently when tilers were performing Grouting (11%). During ConcreteForm Building, Grouting, and Tiling, kneeling was observed in over 7% of work time (Fig. 2). Carpenters spent the least time with ’knees bent’ (5%) and the most time in ’walking’ (21%). 3.3. Arm postures The frequency of arm elevation differed significantly among operations and trades (Fig. 3). One or both arms were elevated at or above shoulder height for more than 10% of the time during Tiling, Plastering, Grouting and Pipejacking (Fig. 3). Both arms above shoulder height were observed most frequently during Tiling (3.5%) and least often during Slurry Wall Construction (1.2%). 3.4. Loads handled The frequencies of load weights varied significantly across operations and trades (Fig. 4). Plasterers handled loads of 5e14.9 lbs for 54% of the time in Plastering. Loads of 15e50 lbs were handled frequently in Concrete Form Building (11%) and Pipe Jacking (23%). Loads exceeding 50 lbs were observed most frequently for ironworkers (5%) and during Concrete Reinforcement (4%). 4. Discussion The construction workers on this major highway and tunnel project had high exposure to multiple ergonomic hazards which are known to represent risk of musculoskeletal disorders to the back, knees, and other joints. The predominant exposure in the operations observed was to awkward postures of the back. Trunk flexion ranged from 35% to 55% of work time, on average, by trade. Squatting and kneeling were uncommon overall but represented more than 10% of work time in certain operations. Construction workers also regularly handled materials or tools. Loads handled in construction vary tremendously in terms of object or tool type, size, and weight. Most of those that we observed weighed less than 15 pounds, but occasional very heavy loads were handled. The results of this study can be used to target job tasks that are hazardous and thus deserve intervention. Non-neutral postures and work locations, the size and weights of tools and objects handled, and lifting frequency should be considered in order to reduce the hazards associated with highway tunnel construction operations. For example, Concrete Pouring by laborers should be targeted specifically to reduce the frequency of severe trunk flexion. Lower extremity exposures have received little attention to date, with a few exceptions (e.g., Jensen and Eenberg, 2000; Jensen and Mikkelsen, 2000), but may represent important hazards for certain trades or specialties within trades. Our findings can also be used to evaluate specific interventions for reducing ergonomic exposures among construction workers. For example, the frequency of non-neutral knee postures in workers 668 SangWoo Tak et al. / Applied Ergonomics 42 (2011) 665e671 Fig. 1. Distributions of trunk postures (as percentage of all observations) by operations and trades: Central Artery/Third Harbor Tunnel project, Boston, MA, 1995e2005 * Note: chi-square test on operations with 32 d.o.f. (p < 0.001) and trades with 16 d.o.f. (p < 0.001). All bars are stacked within each category. performing Tiling and Grouting that we observed could be compared to that in workers performing the same tasks but with different equipment. The frequency and magnitude of ergonomic exposures in construction tasks have previously been reported (Kivi and Mattila, 1991; Holmstrom et al., 1992; Mattila et al., 1993; Stenlund et al., 1993; Schneider and Susi, 1994; Spielholz et al., 1998; Latza et al., 2000; Latza et al., 2002). However, the scope of the job tasks covered in those studies was usually limited to one or a few trades. In contrast, in COHP we collected data on multiple Fig. 2. Distributions of leg postures (as percentage of all observations) by operations and trades: Central Artery/Third Harbor Tunnel project, Boston, MA, 1995e2005 * Note: chi-square test on operations with 24 d.o.f. (p < 0.001) and trades with 12 d.o.f. (p < 0.001). All bars are stacked within each category. SangWoo Tak et al. / Applied Ergonomics 42 (2011) 665e671 669 Fig. 3. Distributions of arm postures (as percentage of all observations) by operations and trades: Central Artery/Third Harbor Tunnel project, Boston, MA, 1995e2005 * Note: chisquare test on operations with 16 d.o.f. (p < 0.001) and trades with 8 d.o.f. (p < 0.001). All bars are stacked within each category. operations with the same observational procedures and metrics, providing a broader scope of physical ergonomic exposures in heavy construction and permitting the systematic comparison of several trades and operations. Our data also include observed task frequency and task-specific exposures, permitting evaluation of variability by operation and task and facilitating generalizability to other jurisdictions as long as the task content of specific construction trades can be defined. Fig. 4. Distributions of loads handled (as percentage of all observations) in highway tunnel construction by operations and trades: Central Artery/Third Harbor Tunnel project, Boston, MA, 1995e2005 * Note: chi-square test on operations with 24 d.o.f. (p < 0.001) and trades with 12 d.o.f. (p < 0.001). All bars are stacked within each category. 670 SangWoo Tak et al. / Applied Ergonomics 42 (2011) 665e671 In addition, many previous studies relied on worker self-report, without any evaluation of validity. While assessment of one’s own job demands may be reliable for short periods of time, the highly variable nature of construction work means that long-term recall and mental averaging or other summing processes are required to provide an assessment of exposure for extended periods. To avoid these pitfalls we obtained observational data for both exposures and tasks. The exposure frequencies obtained for these construction operations are based on the assumption that the selection of time period and workers observed allow both an unbiased and representative estimate of the exposure for each operation. We believe that the estimates are unbiased; dates were selected as a convenience sample and to ensure observation of key tasks in each operation, but without regard to expected exposure frequencies. Our estimates of ergonomic exposures in this study may not be readily comparable to previous studies due to differences in the methods of measurement and tasks performed, as well as random sampling error. For example, we observed non-neutral knee postures in about 15% of working time for carpenters whereas Jensen and Mikkelsen (2000) reported that knee-straining work postures constituted 27% of working time for carpenters using video-recording method. Nonetheless, both studies indicate high exposures that likely represent high risk for biomechanical strain on carpenters’ knees. The ergonomic exposures measured in the present study might not be perfectly representative, in that we may have missed infrequent tasks and because conditions in construction work change rapidly due to a variety of factors, such as different project settings, equipment or tool use and weather (Tak et al., 2009). For example, the increasing height of a wall being built over the course of a day would likely require work with more overhead reaching, or on a higher scaffold with more stooping, later in the day. If the assessments were not made on a representative sample of workers, or when members of these groups do not, in fact, have similar exposures, or if we missed important conditions or tasks for any trade, these data might not be generalizable to other settings. Our measurements were made on fairly large groups of workers over periods of several weeks. However, measurements were not made on all possible environmental conditions that construction workers might experience while performing the tasks; cold weather and night work in particular were probably under-represented. We do not know whether these conditions would affect work postures or load handled, but if they do the exposure values reported here might not apply. Nevertheless, anecdotal information from construction workers, foremen, and safety supervisors indicated that the jobs and the exposures described in this study are indeed common in construction. Hence, future epidemiologic and intervention studies could benefit from the highly detailed exposure assessments that we have obtained. PATH provides quantitative information about the percent of time spent in specific body postures, and activities, such as load handling. There are several potential limitations related to the use of PATH or any other observational methods. The amount of dynamic work may affect the reliability of observations of posture (Burdorf et al., 1992; Leskinen et al., 1997; Park et al., 2009). Most of the operations in this study required the subjects to change posture frequently; rapid motions could easily introduce measurement error. The accuracy of the observations is also likely dependent on the expertise and experience of the observer (Park et al., 2009). In this study we used well-trained observers, all graduate students in occupational ergonomics. We evaluated observer reliability and validity on multiple occasions and the results were consistently favorable (Buchholz et al., 1996; Paquet et al., 1999; Paquet et al., 2001; Park et al., 2009). 5. Conclusion In this study of a large highway tunnel construction project, multiple ergonomic exposures were observed. The most frequent exposures were non-neutral trunk postures and, in some operations, kneeling and squatting. These exposures have already been demonstrated to represent important risk of musculoskeletal disorders, particularly affecting the back and knees (Jensen and Mikkelsen, 2000; National Research Council, 2001; Manninen et al., 2002). Each construction trade presents different ergonomic challenges. Therefore, obtaining trade and operation-specific information on tools, exposures, worker tasks, and work conditions is an important first step in: 1) comparing risks, 2) identifying priorities for reduction of hazardous ergonomic exposures, and 3) determining the most appropriate intervention measures for each trade. Acknowledgment The Center to Protect Workers’ Rights (CPWR) supported this research with grants provided by the National Institute for Occupational Safety and Health (NIOSH) (grants #U02/CCU308771, U02/CCU312014, and U02/CCU317202). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIOSH or CPWR. The authors are grateful for the cooperation of many construction workers who answered our questions and permitted us to observe their daily work. The data tables with detailed information will be shared upon request from any interested readers. References Bhattacharya, A., Greathouse, L., et al., 1997. 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