Industrial exoskeletons: Need for intervention effectiveness research

Abstract

Exoskeleton devices are being introduced across several industry sectors to augment, amplify, or reinforce the performance of a worker's existing body components-primarily the lower back and the upper extremity. Industrial exoskeletons may play a role in reducing work-related musculoskeletal disorders arising from lifting and handling heavy materials or from supporting heavy tools in overhead work. However, wearing an exoskeleton may pose a number of risks that are currently not well-studied. There are only a few studies about the safety and health implications of wearable exoskeletons and most of those studies involve only a small number of participants. Before the widespread implementation of industrial exoskeletons occurs, there is need for prospective interventional studies to evaluate the safety and health effectiveness of exoskeletons across various industry sectors. Developing a research strategy to fill current safety and health knowledge gaps, understanding the benefits, risks, and barriers to adoption of industrial exoskeletons, determining whether exoskeleton can be considered a type of personal protective equipment, and advancing consensus standards that address exoskeleton safety, should be major interests of both the occupational safety and health research and practice communities. K E Y W O R D S exoskeleton, human augmentation, intervention effectiveness, PPE

Envisioning the future of work to safeguard the safety, health, and well‐being of the workforce: A perspective from the CDC's National Institute for Occupational Safety and Health

“…These new types of robots are designed for use across industry sectors and often in environments that are minimally controlled or uncontrolled, such as in community settings (both workers and the general public), outdoor worksites, and disaster sites. Examples include: Service robots that perform specific tasks (e.g., clean public spaces; deliver items in hospitals and hotels; fight fires; and perform inspections, maintenance, and repair in confined spaces); Social robots that sense and express human emotion under development for healthcare and social services; Automated industrial vehicles such as driverless forklifts and tractors; Fully automated vehicles currently used to haul materials in mining and being piloted for transit of people and commercial goods delivery; Unmanned aerial vehicles (UAVs or drones) increasingly being used to evaluate worksites and structures, 94 and being piloted for delivery of goods; Wearable robotics, such as exoskeletons and exosuits designed to reduce stress on some body parts and augment human workers' physical capacity 95 ; and Digital and managerial robots that conduct complex tasks such as writing, data and information synthesis, and project management.…”

The Effects of Upper-Body Exoskeletons on Human Metabolic Cost and Thermal Response during Work Tasks—A Systematic Review

“…The American Society for Testing and Materials (ASTM) standard F3323 (ASTM F3323−19 [ 1 ]) defines an exoskeleton as a “wearable device that augments, enables, assists, and/or enhances physical activity through mechanical interaction with the body” [ 1 ]—i.e., it enhances the power and ability of a person during walking, bending, and lifting [ 2 ].…”

“…Active exoskeletons use actuators (electrical motors, hydraulic, or pneumatics-driven [ 4 ]) to support human movement, providing additional strength and increasing the performance of the user. Passive exoskeletons harness the storage energy of springs, dampers, or other materials harvested from human movement to support postures and motions [ 2 , 3 , 5 ]. Semi-active exoskeletons are a combination of passive and active actuators [ 3 ], but they will not be discussed in this review.…”

“…Considerations on the suitability of exoskeletons, their costs, and their impacts on the occupational safety and health of workers are required [ 25 ]. For this reason, the benefits and risks need to be elucidated in order to investigate their effectiveness [ 2 , 25 ], while also trying to involve a large number of participants in the studies. The European Agency for Safety and Health at Work individualizes some potential risks of injuries due to malfunctioning or during a slip, trip, or fall incident or in terms of the limitation of the user’s overall mobility and possible collisions between exoskeletons and work equipment [ 25 ].…”

“…Workers’ acceptance can be tested by performing subjective measurements aiming to investigate aspects related to the physical demand, constraints, perceived usefulness, ease of use, intention to use and performance [ 26 ]. There are some issues that remain open regarding the long-term effects of exoskeletons on human biomechanics and physiology [ 25 ], the “transference of risk” [ 2 ]—i.e., the occurrence of other risks caused by the presence of exoskeletons—and the lack of scientific evidence on the ergonomic aspects related to the use of exoskeletons in workplaces [ 25 ].…”