Assessment of Physical Work Demands of Home Care Workers in Norway: An Observational Study Using Wearable Sensor Technology

Abstract

Objectives High physical work demands are believed to be partly responsible for the high sickness absence among home care workers, but no studies have assessed their physical work demands using precise device-based measurements. Hence, the objective of this observational study was to assess physical work demands in home care, using wearable sensors. Methods From six home care units in a large municipality in Norway, 114 of 195 eligible home care workers filled in a questionnaire, a diary about work hours, and wore five accelerometers, and a heart rate sensor for up to six consecutive workdays. Results On average, the homecare workers spent 50% of the working hours sitting, 25.2% standing, 11.4% moving, 8.3% walking fast, 1.9% walking slow, 1.2% stair-climbing, 0.3% cycling, and 0.05% running. We found the following exposures to demanding postures: arm-elevation in an upright body position ≥30° was 36.7%, ≥60° was 4.1%, and ≥90°was 0.5%; forward trunk inclination in an upright body position ≥30° was 9.9%, ≥60° was 4%, and ≥90° was 1%; and for kneeling it was 0.8%. We found the average cardiovascular load (%heart rate reserve) during work to be 28%. There was considerable individual variation in these physical exposures at work. Conclusions This study presents precise information on various physical work demands of home care workers in Norway. Home care workers spent on average half the workday sitting and the remaining time in various occupational physical activities. Presently, few device-based exposure limits have been proposed for acceptable amounts of occupational physical exposures, but the level of arm-elevation, forward trunk inclination, and the considerable variation of physical workloads among home care workers, indicate that preventive measures should be taken.

Can home care work be organized to promote musculoskeletal health for workers? Study protocol for the Norwegian GoldiCare cluster randomized controlled trial

“…To measure the physical behavior (e.g., sitting, standing, walking and running etc.) and its intensity during a typical workday, an observational study involving 6 units in Trondheim municipality was conducted using accelerometers and heart rate monitors [ 2 ]. Analysis of the data revealed a considerable variation between home care workers in the time spent in awkward postures, i.e.…”

“…arm elevation and forward trunk inclination. Also, a high proportion of workers reported long-term (≥3 consecutive months in the past year) neck/shoulder pain (36%) and lower back pain (34%) [ 2 ].…”

“…As a part of an earlier investigation, we noted a high prevalence of musculoskeletal pain in the neck/shoulder area (36%) and lower back (34%) among home care workers in Trondheim, Norway [ 2 ]. Further, we found long durations of awkward postures such as forward trunk inclination and arm elevation during the working day [ 2 ] which is documented to increase the risk of sick leave [ 18 , 19 ].…”

“…As a part of an earlier investigation, we noted a high prevalence of musculoskeletal pain in the neck/shoulder area (36%) and lower back (34%) among home care workers in Trondheim, Norway [ 2 ]. Further, we found long durations of awkward postures such as forward trunk inclination and arm elevation during the working day [ 2 ] which is documented to increase the risk of sick leave [ 18 , 19 ]. In addition, the strenuous tasks were unevenly distributed among workers and a substantial proportion of employees were exposed to very high levels of physical strain [ 2 ], likely to lead to a substantial risk of musculoskeletal pain and sickness absence.…”

“…Further, we found long durations of awkward postures such as forward trunk inclination and arm elevation during the working day [ 2 ] which is documented to increase the risk of sick leave [ 18 , 19 ]. In addition, the strenuous tasks were unevenly distributed among workers and a substantial proportion of employees were exposed to very high levels of physical strain [ 2 ], likely to lead to a substantial risk of musculoskeletal pain and sickness absence. Available evidence indicates that strenuous activities such as pulling, pushing, lifting, and leaning forward are frequently performed by home care workers caring for patients with extensive care needs [ 20 , 21 ].…”