Heart Rate Monitoring for Physiological Workload in Forestry Work: A Scoping Review
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsDear Authors,
I had the pleasure to review your manuscript titled: Heart-rate–monitoring for physiological workload in forestry work: a scoping review.
This work is useful and timely. This paper is written very competently, and the presented results are valuable.
However, there are some shortfalls in the manuscript preparation, which should be attended to, in order to improve the quality.
Introduction
The "introduction" chapter seems very short to me. I would recommend including a section that focuses on the magnitude of fatigue on individual body parts of the forest worker's body / chainsaw operator. I think this topic should be mentioned in this article. It is related to the workload in forestry. Further mention the issue of musculoskeletal disorders and the working position of the body of workers in forestry.
Materials and Methods
Line 91: I would recommend writing the keywords more clearly. As it is, it is not clear.
Results
Line 130: "We selected 22 studies published from 1984-2022 (Figure 2 and Table 1)". In Figure 2, the last column is 2020-2024, shouldn't the year 2022 be there instead of 2024?
Discussion
Line 244: I would recommend including a reference to BMI here. BMI has a big impact on workload. I think it would be good to mention the article "Effect of the body mass index and length of work on the stress of individual body parts of chainsaw operators" (DOI: 10.17221/26/2024-JFS), which was recently published. This particular article deals with this issue.
Part of the discussion is clearly described.
Comments on the Quality of English Language
-
Author Response
Dear Reviewer 1,
We appreciate reviewing our manuscript and providing encouraging suggestions. The comments help us to improve the manuscript. We have responded to the comments of Reviewer 1 as follows.
Introduction
Comments 1: The "introduction" chapter seems very short to me. I would recommend including a section that focuses on the magnitude of fatigue on individual body parts of the forest worker's body / chainsaw operator. I think this topic should be mentioned in this article. It is related to the workload in forestry. Further mention the issue of musculoskeletal disorders and the working position of the body of workers in forestry.
Response 1: Thank you for your suggestion. Physical workload includes various concepts. Energy expenditure measured by heart rate and other devices does not fully correlate with muscle contraction measured by electromyogram, especially for localized muscle loads (Åstrand 1986). We have added a sentence “Extra energy used during work activities generally comes from muscle work; however, monitoring muscle activity is inappropriate to measure energy expenditure” in L43–45.
Nevertheless, the suggested point is unavoidable in discussion. We added the following references and a limitation. “Second, work practices may vary by region. In addition to vegetation and climate, work methods such as devices used postures adopted may influence energy expenditure [65-67]. Unique work practice is familiar to each region/author, who might not report the difference in detail,” in L328–331
Åstrand P-O, Rodahl K. Chapter 11 Applied work physiology. Textbook of Work Physiology: Physiological bases of exercise, 3rd ed. McGraw-Hill, Inc.; 1986.
Harstela P. Work postures and strain of workers in nordic forest work: A selective review. International Journal of Industrial Ergonomics. 1990/05/01/ 1990;5(3):219-226.
Tsioras PA, Khooshdohbat M, Nikooy M, Naghdi R, Heidari M. The Impact of Body Posture on Heart Rate Strain during Tree Felling. Int J Environ Res Public Health. Sep 6 2022;19(18)
Grzywiński W, Jelonek T, Tomczak A, Jakubowski M, Bembenek M. Does body posture during tree felling influence the physiological load of a chainsaw operator? Ann Agric Environ Med. Sep 21 2017;24(3):401-405.
We have added the explanation of a scoping review in the Introduction (L66–70). “A scoping review includes narrative commentary but is distinct from a narrative literature review [23]. It addresses broader topics through systematic literature research without combining quantitative and qualitative studies, performing quality assessments, or being limited to a specific research question [24]. It can identify gaps in existing research necessary for summarizing and sharing research findings [25].”
Materials and Methods
Comments 2: Line 91: I would recommend writing the keywords more clearly. As it is, it is not clear: “the keywords “forest”, “forestry”, “silviculture”, “harvest”, “workers”, “heart rate”, “heart pulse”, and “cardiovascular workload”; (L99–100)
Response 2: Thank you for pointing this out. Keywords were revised and the explanation: “When adding other detail keywords, such as “planting”, “nursery”, “brush-cutting”, “felling”, “trimming”, “delimbing”, “thinning”, “bucking”, “logging”, “cross-cutting”, “winching”, “yarding”, and “skidding”, selected articles were the same.” has been added.
Results
Comments 3: Line 130: "We selected 22 studies published from 1984-2022 (Figure 2 and Table 1)". In Figure 2, the last column is 2020-2024, shouldn't the year 2022 be there instead of 2024?
Response 3: Thank you for pointing this out. We have corrected in L140.
Discussion
Comments 4: Line 244: I would recommend including a reference to BMI here. BMI has a big impact on workload. I think it would be good to mention the article "Effect of the body mass index and length of work on the stress of individual body parts of chainsaw operators" (DOI: 10.17221/26/2024-JFS), which was recently published. This particular article deals with this issue.
Response 4: Thank you for your suggestion. This article dealt with energy workload measurable by heart rate monitoring, which is related to physical and mental exertion. The reference suggested by the reviewer deals with muscle fatigue (self-reported, subjective feelings of fatigue), which is related to physical workload. Both concepts are physiological workload and overlap but are slightly different as described in Response 1. Instead of this reference, we have added three references measuring heart rate. Body weight is indeed a determinant of energy expenditure, but it is correlated with activity intensity (1 MET is equivalent to 3.5 ml/kg/min uptake of oxygen, L284
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for AuthorsThis study used literature review of 22 selected studies from which 468 participants’ data was extracted for measurement of Working HR, resting HR, HR index, and HR reserve percentage (%HRR) in forestry workers. The main issue with this study is that the data is very varied with each of the 22 studies selected measuring the parameters very differently. The concern here is that with the data extracted it is very difficult to come to any conclusion.
Figure 4 A is a good example of this. There are four different conditions where the resting and working heart rate was measured. In some studies from the published data it is not clear as to how or when they were measured. This will definitely confound the results if this analysis.
Figure 3 shows a 2X 3 table of work conditions. Does this mean that there is overlap. Can a worker who is planting manually also perform work with a portable machine. Was the data collected specifically for one task only? Was this consistent in all the studies selected.
Figure 3 and Table 2 are not properly correlated. The row under Labors††, how does it correlate with the tasks described in figure 3?
Figure 3 Sentence incomplete “hoe and”?
Supplementary figure S1: States that studies are grouped into Silviculture, harvest and Machine- does this mean that each study only looked at one task if so this is not clear. Between the closed and open circles and the triangle the way the measurements were taken is varied.
Discussion: there is no discussion about what this study has added to the existing literature. The authors have taken data from 22 studies what is the collective conclusion that they can draw.
Paragraph starting with Line 244- “Workloads may vary depending on not only the type, height,…” is a generic statement. What bearing does this have in this study.
The subsequent two paragraphs are also generic about the published literature, this has to be correlated to this study results of this manuscript. What has this study added to the available information.
The authors do agree that there a limitations in this study being lack of universal measurement criteria.
My suggestion is to take the extracted data and find the information that is as uniformly measured as possible. This will provide some certainty that the comparisons are with reasonably uniform data. Even is the sample size is smaller the parameters and therefore the conclusions may lead to better insight.
Author Response
Dear Reviewer 2,
We appreciate reviewing our manuscript and providing inspiring suggestions. The comments help us to improve the manuscript. We have responded to the comments of Reviewer 2 as follows.
Comments 1: This study used literature review of 22 selected studies from which 468 participants’ data was extracted for measurement of Working HR, resting HR, HR index, and HR reserve percentage (%HRR) in forestry workers.
Response1: Thank you for reviewing this manuscript. This is not a narrative literature review, but a scoping review aiming to identify nature and extent of research, and to describe quantity and quality of literature. We have added the explanation of a scoping review in the Introduction: “A scoping review includes narrative commentary but is distinct from a narrative literature review [23]. It addresses broader topics through systematic literature research without combining quantitative and qualitative studies, performing quality assessments, or being limited to a specific research question [24]. It can identify gaps in existing research necessary for summarizing and sharing research findings [25] (L66–70)” and references.
Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies. Health Info Libr J. Jun 2009;26(2):91–108.
Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005/02/01 2005;8(1):19–32.
Miake-Lye IM, Hempel S, Shanman R, Shekelle PG. What is an evidence map? A systematic review of published evidence maps and their definitions, methods, and products. Systematic Reviews. 2016/02/10 2016;5(1):28.
Comments 2: The main issue with this study is that the data is very varied with each of the 22 studies selected measuring the parameters very differently. The concern here is that with the data extracted it is very difficult to come to any conclusion. Figure 4 A is a good example of this. There are four different conditions where the resting and working heart rate was measured. In some studies from the published data it is not clear as to how or when they were measured. This will definitely confound the results if this analysis.
Response 2: Thak you for pointing this out. The variety of quality is one of the main findings of the scoping review, as responded in Response 1. We have added the purpose to conduct the comparison in L132: “to elucidate characteristics of the HR variables.” Measurement methods were presented in Supplementary Tables, and we have added it in the main text: “Measurement devices and time were presented in Supplementary Table S4. Most studies used Polar devices. Measurement time was 4–8.5 h, but six studies did not report it (195–197).”
Comments 3: Figure 3 shows a 2 × 3 table of work conditions. Does this mean that there is overlap. Can a worker who is planting manually also perform work with a portable machine. Was the data collected specifically for one task only? Was this consistent in all the studies selected. Figure 3 and Table 2 are not properly correlated. The row under Labors††, how does it correlate with the tasks described in figure 3?
Response 3: Thank you for pointing this out. The authors of these articles reported combined heart rate levels of different labors (double lines in Figure 3). They might focus on operations, such as those conducted by a team. In comparison based on labor, the studies with two kinds of labor were excluded, and thus the sample size was smaller than that for operations (two studies were excluded in the footnote of Table 3). For clarity, the explanation "excluding two additional studies with different kinds of labor" has been amended in L232.
Comments 4: Figure 3 Sentence incomplete “hoe and”?
Response 4: Thank you for pointing this out. We deleted “and.”
Comments 5: Supplementary figure S1: States that studies are grouped into Silviculture, harvest and Machine- does this mean that each study only looked at one task if so this is not clear. Between the closed and open circles and the triangle the way the measurements were taken is varied.
Response 5: Thank you for pointing this out. Table 1 presents the classification of operations. A silviculture study involving manual and machinery labor (Marogel-Popa, 2019) was included in the "silviculture" group after researcher discussion, as it is not exclusively a machinery operation. The explanation "One study with manual and machinery labor {Marogel-Popa, 2019 #126} was included in the silviculture operation after researcher discussion, as it is not exclusively a machinery operation." has been added for clarity in L225–226. We found only two studies reporting enough information in L158–162
Comments 6: Discussion: there is no discussion about what this study has added to the existing literature. The authors have taken data from 22 studies what is the collective conclusion that they can draw.
Response 6: As a scoping review to identify nature and extent of literature, it does not provide summary of literature. We have added the explanation of a scoping review in the Introduction. “A scoping review includes narrative commentary but is distinct from a narrative literature review [23]. It addresses broader topics through systematic literature research without combining quantitative and qualitative studies, performing quality assessments, or being limited to a specific research question [24]. It can identify gaps in existing research necessary for summarizing and sharing research findings [25] (L66–70).”
Comments 7: Paragraph starting with Line 244- “Workloads may vary depending on not only the type, height,…” is a generic statement. What bearing does this have in this study.
The subsequent two paragraphs are also generic about the published literature, this has to be correlated to this study results of this manuscript. What has this study added to the available information. The authors do agree that there is a limitation in this study being lack of universal measurement criteria.
Response 7: Agree. Although these factors and parameters are generic, the previous reports did not mention their information. It does not allow us and readers to compare or combine the results, as seen in a meta-analysis. To get to know insufficiency of quantity and quality is needed as presented in the Conclusion, while studies with heart rate monitoring during work have been continuously reported. We and readers need high quality reports. Additionally, a scoping review addresses broader topics. We have added sentences in the Conclusion (L334–337): “and found that the literature did not provide enough data for a comprehensive analysis of the combined results due to insufficient measurement quality and a small sample size. The gap between the current literature and the requirement for future studies needs to be bridged.”
Comments 8: My suggestion is to take the extracted data and find the information that is as uniformly measured as possible. This will provide some certainty that the comparisons are with reasonably uniform data. Even if the sample size is smaller the parameters and therefore the conclusions may lead to better insight.
Response 8: Thank you for your suggestion. This scoping review is not a review, like a meta-analysis for assessment of combined results. Combined results must attract readers’ interest. However, results from comparison are not a target of this scoping review, but difficulty of comparison due to various quality and small sample size was shown in this scoping review aiming to identify naturae and extent of research, for a future meta-analysis of high-quality research.
Author Response File: Author Response.pdf
Round 2
Reviewer 2 Report
Comments and Suggestions for AuthorsOverall the manuscript has been modified to read better. Based on the revised manuscript the authors have added more information in the introduction section to explain the term scoping review. The conclusion section has been revised to explain this and the limitations such a review poses. Authors have added that the “The gap between the current literature and the requirement for future studies needs to be bridged” this needs to be reflected in the Abstract.
Authors have also expanded the words that were searched in lines 98-105.
The main results is in table 2, which shows statistically significant differences in HR work, HRI and % HRR during different tasks. This is the most important table in results which summarizes all the information that can be obtained in such a scoping review of existing knowledge.
Authors state in lines 58-60 that “This study aimed to explore how cardiovascular workloads are measured through HR monitoring in forestry and reported, in terms of the factors of forestry work and the influence of HRrest on HR indicators”.
From this statement the reader can assume that HR is used as a measure of cardiovascular workload in forestry in order to improve work conditions. If this is indeed the aim of this study, then discussion needs to be more focussed on what research can be undertaken to fill the gaps identified.
Discussion can at best be limited because of the variations in the measurements taken in the different studies. However, discussion needs to bring into focus the gaps that were identified even if they are broad, and some indication of what future research can be undertaken to fill the gaps. Such future research should add to existing body of knowledge which based on the authors own words: “It can identify gaps in existing research necessary for summarizing and sharing research findings [25]”
Example Lines 269-270 : “However, information about procedures, working conditions, and employment remain insufficiently reported.” Some indication on what needs to be studied in future research to ensure that this is sufficiently reported. Adding these future research suggestions will make this a very good paper for other research groups to design their work not only in forestry but in any other labor-intense industry.
Author Response
Comment 1: Overall the manuscript has been modified to read better. Based on the revised manuscript the authors have added more information in the introduction section to explain the term scoping review. The conclusion section has been revised to explain this and the limitations such a review poses. Authors have added that the “The gap between the current literature and the requirement for future studies needs to be bridged” this needs to be reflected in the Abstract.
Response 1: Thank you for pointing this out. We have added the sentence in L26: “This insufficiency should be addressed before future research.”
Comment 2: Authors have also expanded the words that were searched in lines 98-105.
The main results is in table 2, which shows statistically significant differences in HR work, HRI and % HRR during different tasks. This is the most important table in results which summarizes all the information that can be obtained in such a scoping review of existing knowledge.
Authors state in lines 58-60 that “This study aimed to explore how cardiovascular workloads are measured through HR monitoring in forestry and reported, in terms of the factors of forestry work and the influence of HRrest on HR indicators”.
From this statement the reader can assume that HR is used as a measure of cardiovascular workload in forestry in order to improve work conditions. If this is indeed the aim of this study, then discussion needs to be more focused on what research can be undertaken to fill the gaps identified.
Discussion can at best be limited because of the variations in the measurements taken in the different studies. However, discussion needs to bring into focus the gaps that were identified even if they are broad, and some indication of what future research can be undertaken to fill the gaps. Such future research should add to existing body of knowledge which based on the authors own words: “It can identify gaps in existing research necessary for summarizing and sharing research findings [25]”
Example Lines 269-270 : “However, information about procedures, working conditions, and employment remain insufficiently reported.” Some indication on what needs to be studied in future research to ensure that this is sufficiently reported. Adding these future research suggestions will make this a very good paper for other research groups to design their work not only in forestry but in any other labor-intense industry.
Response 2: Thank you for your suggestions. I think that these comments, which consist of several paragraphs, encourage us to infer what studies are required to address the gaps. Two points have been added. “It is also essential to conduct studies that validate the reliability and stability of HRrest measurement criteria in practice for future research of combined evidence,” in L346–347. “The scoping review did not provide enough information to classify and differentiate the operations and labor adequately, despite some comparisons revealing significant differences. Research is needed to standardize the terminology related to forestry tasks and to classify them. Furthermore, research about each task with a large sample size needs to be carried out,“ in L354–358.
Author Response File: Author Response.pdf
