Search Results (409)

Background: Low back pain (LBP) is a major cause of disability in later life. We aimed to assess the population-level burden, demographic and epidemiological drivers, GBD-defined risk attribution, and future trajectory of LBP among Chinese adults aged 45 years and older. Methods: Using population-level estimates from the Global Burden of Disease Study 2023 (GBD 2023), we analyzed incidence, prevalence, and years lived with disability (YLDs) among Chinese adults aged 45 years and older from 1990 to 2023. We assessed temporal trends, decomposed changes in burden, evaluated age–period–cohort patterns, quantified YLDs attributable to three GBD-defined risk factors—high body mass index, occupational ergonomic factors, and smoking—and projected burden to 2040 using Bayesian age–period–cohort models. Results: In 2023, population-level GBD estimates indicated that LBP accounted for 30.29 million incident cases, 71.54 million prevalent cases, and 7.90 million YLDs among Chinese adults aged 45 years and older. Compared with 1990, these numbers increased by 101.54%, 97.08%, and 96.11%, respectively, despite declining age-restricted age-standardized incidence, prevalence, and YLD rates. Expansion of the population aged 45 years and older was the main driver of the increasing absolute burden, whereas favorable epidemiological change offset part of this increase. High body-mass index showed the largest increase in attributable burden and was the only risk factor with rising age-standardized attributable YLD rates. Model-based projections suggested that age-restricted age-standardized burden would continue to decline through 2040. Conclusions: LBP remains a growing absolute burden among middle-aged and older adults in China despite declining age-restricted age-standardized rates. Future disability reduction will require integrated strategies combining risk-factor control, rehabilitation, functional support, and age-sensitive care. Full article

Retail service workers face complex occupational demands across psychosocial, environmental, and physical domains; however, integrated multidomain workload assessments remain limited. A cross-sectional study among 253 retail workers used the Find My Stress Progressive Web Application (PWA)—a digital tool assessing subjective workload (Subjective Workload Index; SWI), psychosocial factors, environmental discomfort, musculoskeletal symptoms, and handgrip strength. Hierarchical multiple regression identified four significant SWI predictors: postural difficulty (β = 0.176, p = 0.012), workplace bullying (β = 0.175, p = 0.008), task duration (β = −0.179, p = 0.004), and air quality (β = 0.171, p = 0.011; Adjusted R² = 0.199, ΔR² = 0.227, p < 0.001; VIF: 1.03–1.57). Grip strength was retained as a functional capacity indicator. Sex-stratified analyses revealed distinct risk profiles: postural difficulty and task duration predicted SWI in men (Adjusted R² = 0.224); workplace bullying was the sole predictor in women (Adjusted R² = 0.170). The PWA demonstrated excellent reliability (α = 0.97) and usability (87%; n = 359). The Find My Stress PWA provides a scalable platform for multidomain stress screening. Integrated ergonomic, organisational, and environmental interventions guided by digital screening offer targeted strategies for reducing occupational workload burden in retail settings. Full article

Healthcare professionals must acquire and maintain both declarative knowledge and fine psychomotor skills across a wide range of clinical procedures. Human working memory is physiologically limited, and the high cognitive demands of clinical environments frequently contribute to medical errors and adverse events. Intra-individual performance variability—driven by fatigue, stress, and motivation—represents a further challenge that conventional medical safety education has not adequately addressed. According to the World Health Organization, patient harm ranks fourteenth in the global burden of disease, with approximately 10% of hospitalised patients in high-income countries experiencing harm within healthcare facilities. This study reports the design, theoretical rationale, and preliminary outcomes of an augmented reality (AR) glasses system for hands-free, self-directed medical procedural training, developed from a human factors and ergonomics (HFE) perspective. The system integrates a see-through head-mounted display (HMD; Epson Moverio BT-40S), bone-conduction earphones (Shokz OpenComm), and an industrial-grade voice recognition application (NEC Solution Innovators), achieving fully hands-free operation compatible with aseptic technique. Content design is grounded in cognitive load theory (CLT) and the cognitive theory of multimedia learning (CTML), extended by neuroscientific evidence on multisensory integration and memory consolidation. More than 40 procedure-specific modules have been developed in-house at Tokyo University of Technology, spanning airway management, vascular access, respiratory therapy, dialysis, and cardiac support. In a four-year longitudinal survey (virtual reality (VR) simulator; n = 286), major satisfaction items consistently exceeded the scale midpoint. In an AR endotracheal suctioning cohort (n = 38/22), procedural flow understanding was rated 3.95/5.0. A peer-reviewed randomised controlled trial (Clinical Simulation in Nursing, n = 36) demonstrated significantly superior skill improvement (p < 0.001) and learning motivation (p = 0.001) in the AR group versus textbook self-practice. Principal ergonomic limitations of current HMD hardware—excessive weight, narrow field of view, and absence of medical-grade certification—are documented, and AI-based real-time procedural assessment is identified as a priority for the next research phase. Full article

Background/Objectives: Robot-assisted surgery (RAS) has grown rapidly over the past few decades. To determine the effect of high stress levels on the performance of RAS, monitoring some parameters of surgeons is critical. This can be aided by the development of Artificial Intelligence (AI), which has exponentially grown in recent years. This study aims to predict the surgeon’s stress level based on ergonomic, kinematic and physiological parameters of the surgeon obtained in the immediately previous situation during RAS activities. Methods: Physiological data were recorded from surgeons during twenty-six surgical sessions involving twelve participants with different levels of experience and surgical specialties. After dataset generation, two preprocessing procedures (scaling and normalization) were applied to the recorded signals. The processed data were then partitioned into two subsets: 80% of the samples were used for model training and cross-validation, while the remaining 20% were reserved for testing. Six AI approaches were evaluated to build predictive models: multiple linear regression (MLR), a support vector machine (SVM), a multilayer perceptron (MLP), a convolutional neural network (CNN), random forest (RF), and a U-Net algorithm (UNET). These algorithms were trained using the training dataset and subsequently assessed on the independent test set. In addition, after each surgical session, surgeons completed a questionnaire reporting their perceived stress level, which was later compared with the stress estimates generated by the predictive models. Results: The results obtained showed that MLR and scaling pre-processing reached the highest R² coefficients and the lowest error for each studied parameter. The results of the surgeons’ surveys were highly correlated for microsurgery activities (R² = 0.7989) and for laparoscopy RAS (R² = 0.8381). Conclusions: The linear models proposed were correctly validated on cross-validation and the test dataset. This fact demonstrates the possibility of predicting factors that help us to improve the surgeon’s health during RAS. Full article

(1) Background: The global expansion of teleworking has increased concern regarding musculoskeletal pain associated with home-based working conditions. This study quantified the prevalence of musculoskeletal pain among Brazilian teleworkers and explored ergonomic and environmental factors associated with the distribution of physical symptoms and the multisite pain burden. (2) Methods: A cross-sectional survey was conducted between June and August 2024, analyzing 184 valid responses from teleworkers across various professional sectors. Data were collected via an online questionnaire assessing sociodemographic characteristics, workstation ergonomics, and musculoskeletal symptoms using the Nordic Musculoskeletal Questionnaire (NMQ). Statistical analyses included Pearson’s chi-square tests, logistic regression, and exploratory Random Forest modeling to prioritize predictors. (3) Results: Musculoskeletal pain was reported by 74% of participants, with the lower back (40.8%), neck (36.4%), and upper back (30.4%) being the most frequently affected anatomical regions. The primary ergonomic and environmental factors associated with pain reports included discomfort with the desk and mouse, suboptimal thermal comfort, and prolonged sitting. Odds ratios demonstrated strong statistical co-occurrence between recent and 12-month pain reports, particularly for the shoulders, reflecting overlapping recall indicators rather than temporal symptom progression. (4) Conclusions: Musculoskeletal pain is highly prevalent among Brazilian teleworkers, showing clear links to localized workstation inadequacies and overlapping short- and long-term symptom reporting. These findings highlight the need for targeted institutional occupational health policies, such as ergonomics training and adjustable furniture provision, while future longitudinal research remains essential to confirm causal pathways. Full article

Healthcare professionals, including those working in assisted reproduction, are characterized by high levels of stress and burnout, with embryologists showing the highest levels. The aim of this study was to identify both the stressors that contribute to burnout and the potential prevention strategies they considered useful. For this, a qualitative study based on a semi-structured interview was conducted in a panel of 12 senior embryologists from eight countries in four continents. The interviews were recorded and thematic analysis was performed using MAXQDA^® 26 software From a deductive approach, stressors were those inherent to the embryologist profession such as excessive demands; physical and organizational stressors, such as high workload and ergonomic issues; and patient-related stressors, such as difficult communication and interactions. On the other hand, preventive/mitigating factors were classified, according to their nature, as physical (natural light), relational (conflict management), organizational (organizational planning) and psychological (stress management). From an inductive approach, lack of professional recognition arose as an additional theme, where embryologists complained about the unfair situation when comparing themselves with other team members, as healthcare professionals, or even in the wider social context. The results of this work should be considered in interventions that seek to improve the well-being of these professionals by reducing their burnout. Full article

The increasing number of end-of-life (EOL) products has raised new challenges for sustainable manufacturing, especially when recycling efficiency, structural modularity and worker well-being must be considered simultaneously. From the perspective of symmetry and asymmetry in mechanical product design, this study proposes a Design for human-centric Modular Recycling (DFHMR) approach to improve EOL product recycling while reducing ergonomic risks in disassembly operations. In the proposed framework, functional similarity, structural correspondence and spatial association among components are used to characterize symmetry-oriented modular relationships, whereas asymmetric factors such as disassembly difficulty, carbon emissions, recycling profit and worker-related ergonomic risks are incorporated to describe the heterogeneity of practical recycling processes. A multi-objective optimization model is developed to maximize green disassembly performance and intra-module relevance while minimizing inter-module coupling and human-factor risks. To solve the constrained modular design problem, an enhanced social engineering optimizer (SEO) is introduced to balance global exploration and local exploitation. A turbo reducer case study is conducted to validate the proposed model, and comparative experiments with several multi-objective optimization algorithms demonstrate the effectiveness and robustness of the enhanced SEO. The results indicate that the DFHMR framework can provide decision-makers with a set of balanced modular recycling schemes, offering a practical reference for symmetry-oriented, sustainable and human-centered mechanical design under Industry 5.0. Full article

Background: The widespread prevalence of neck pain (NP) is a serious healthcare and social problem, and the question of which components of physiotherapy are most effective is still valid. Objectives: The objective of this study was to assess the effect of the type of electrotherapy applied on the outcomes of complex physiotherapy administered to individuals with NP. Methods: In line with the study protocol, 100 individuals with NP were enrolled and randomly divided into four groups. All groups received kinesiotherapy and phototherapy. Additionally, each group also received electrotherapy treatment, which was a differentiating factor. Participants were assessed at baseline, post-intervention, and after six months. The examination involved evaluation of pain using VAS and measurement of the cervical range of motion (ROM). Overall, seven parameters were assessed during each examination. Results: Pain intensity decreased in all individuals across the three study periods. A large effect size and changes exceeding the Minimal Clinically Important Difference (MCID) were observed only in the electrotherapy groups. The improvement in cervical spine ROM was comparable in the HF and LF TENS groups in the short- and long-term perspectives; however, a greater number of effects (p < 0.05) was observed in the HF TENS group. TC resulted only in large and moderate short-term effects reflected by improvements in cervical spine ROM. In the PLACEBO group, moderate long-term effects were observed. Conclusions: Low-frequency currents appear to improve the analgesic effectiveness of complex physiotherapy implemented in individuals with NP. TC may provide better short-term effects compared to long-term effects reflected by improvements in cervical spinal ROM. The effects in the PLACEBO group may suggest that phototherapy and kinesiotherapy are more effective due to the continuation of exercise and the education in ergonomics of work. Full article

This study examines organisational and ergonomic predictors of safety compliance in automotive just-in-time (JIT) production environments. Drawing on the theory of safety climate and the literature on organisational control, we developed a multivariate regression model to analyse how managerial commitment, production pressure, technological safeguards, training quality, severity of sanctions, and ergonomic prevention relate to employee safety compliance. A cross-sectional survey was conducted among the employees of five Central European Tier 1 and Tier 2 automotive suppliers (n = 221). The results show that organisational factors play a central role in explaining compliance behaviour. Management commitment and training quality emerged as the strongest positive predictors of safety compliance, while production pressure showed a significant negative association. Ergonomic prevention was also positively related to compliance, suggesting that workplace design and physical risk reduction contribute to safer behaviour. The severity of sanctions showed only a weak relationship with compliance. In general, the findings indicate that supportive organisational practices and preventive safety management are more strongly associated with compliance than sanctions-based control mechanisms alone. The results highlight the importance of integrating management commitment, training systems, and ergonomic design into safety strategies in high-pressure manufacturing environments. Full article

Constructing age-friendly residential environments is essential for supporting aging in place among the growing population of urban empty-nest older adults in China. Grounded in person–environment fit theory, this study developed and validated a multidimensional Aging-Suitability Index (ASI) to examine how residential environmental factors shape housing suitability and perceived independence. In this study, “aging suitability” refers to the degree of fit between residential environments and older adults’ needs for safety, functionality, accessibility, social support, and technological support, with the central aim of enabling aging in place and independent living. Questionnaire data were collected from 753 urban empty-nest older adults across 19 provinces in China and analyzed using partial least squares structural equation modeling (PLS-SEM). The structural model showed strong explanatory power (R² = 0.754). The results revealed a clear hierarchy of environmental influences. Safety facilities and physical design were the strongest direct predictors of residential aging suitability, indicating that risk reduction and ergonomically appropriate spatial design constitute the foundation of age-friendly housing. Although accessibility showed a smaller direct effect, it exerted a significant indirect effect through perceived independence, with 67.35% of its total effect mediated through this pathway, highlighting the importance of barrier-free design in maintaining autonomy. Social support and smart technology also contributed positively as complementary resources that strengthened person–environment fit. These findings suggest that age-friendly housing interventions should move beyond fragmented modifications toward integrated residential renewal strategies that prioritize safety and physical design, improve accessibility to support independent living, and combine community support with age-friendly technologies. This study provides empirical evidence to inform built-environment decision-making in the design and renewal of housing for older adults in rapidly aging urban contexts. Full article

Background/Objectives: Disc herniation, also termed herniated nucleus pulposus (HNP), is a common spinal disorder affecting approximately 10% of the global population, associated with pain, neurological complications, and diminished quality of life. Despite its global burden, regional variations in public awareness and sociodemographic determinants remain inadequately characterized, particularly in Middle Eastern populations. This study aimed to assess the prevalence, public awareness, and sociodemographic determinants of HNP among adults in Saudi Arabia at a nationwide level. Methods: An analytical cross-sectional study was conducted from December 2024 to July 2025. Using a convenience sampling approach via social media platforms, an online questionnaire was distributed nationwide across Saudi Arabia. Data from 1112 participants were analyzed using descriptive statistics and multiple logistic regression. The questionnaire comprised two sections: sociodemographic characteristics and knowledge and awareness of HNP. Results: The prevalence of disc herniation was 8.9%, consistent with global estimates. Overall awareness was relatively high at 67.6%, though knowledge of specific risk factors varied considerably. Most participants recognized obesity (88.0%), poor sitting posture (85.8%), history of lower back trauma (86.2%), and work requiring physical effort (88.8%) as risk factors, while fewer acknowledged smoking (46.4%), diabetes (51.2%), sleeping on a soft bed (36.9%), and increased height (35.9%). Multiple logistic regression, adjusted for all sociodemographic, lifestyle, and health-related covariates, identified significant independent predictors of HNP including marital status (married OR = 2.90), current smoking (OR = 2.91), hyperlipidemia (OR = 1.86), family history (OR = 8.95), and prior knowledge of the condition (OR = 2.28). Knowledge of HNP was significantly associated with university education (OR = 1.70), higher income levels (OR = 2.23 for ≥15,000 SAR; OR = 2.07 for 5000–9999 SAR), and family history (OR = 4.70), while those in low and medium workload jobs demonstrated lower knowledge. Conclusions: Although overall public awareness of HNP is relatively high in Saudi Arabia, substantial gaps persist in knowledge of modifiable risk factors, particularly smoking and diabetes mellitus. Targeted smoking cessation campaigns, diabetes awareness programs, and ergonomic education initiatives delivered through primary healthcare centers, workplaces, and schools are recommended. Full article

Wearable technologies have emerged as promising tools for supporting Occupational Safety and Health through continuous and multimodal monitoring of physiological, biomechanical, and environmental risk factors. However, evidence regarding their real-world effectiveness and implementation remains fragmented. This study presents a systematic literature review conducted in accordance with PRISMA 2020 guidelines, synthesizing evidence from 60 studies addressing wearable-based monitoring, assessment, and intervention in occupational contexts. The review examines the types of technologies applied, the risks and functions addressed, the evidence on effectiveness, the evaluation metrics used, and the main barriers affecting implementation. The findings show that wearable technologies are mainly applied to ergonomic, physiological, environmental, and critical-event risks, using devices such as inertial sensors, biosensors, smart personal protective equipment, and exoskeletons. While the evidence indicates strong potential for real-time monitoring, risk detection, and data-informed decision-making, most studies rely on controlled or short-term evaluations, and consistent evidence of sustained accident reduction remains limited. The results also highlight technical, organizational, ethical, and human-related barriers, including usability, interoperability, privacy concerns, worker acceptance, and data governance. Based on this synthesis, a conceptual human-centered implementation model is proposed to support responsible and context-sensitive adoption. Full article

Agriculture is a hazardous industry, and working in livestock production has been linked to musculoskeletal disorders (MSDs). However, limited research has examined work-related risk factors contributing to MSDs among livestock workers especially in small and family-owned operations, like most of the companies located in the Friuli-Venezia Giulia (FVG) region of Italy. This cross-sectional study conducted in July 2024 investigates self-reported musculoskeletal pain and discomfort and occupational exposures among dairy and swine farmworkers (N = 50; mean age = 37 years) in FVG. We assessed musculoskeletal exposures, self-reported pain and discomfort, and the use of preventive techniques to maintain musculoskeletal health. Participants reported a high prevalence (80%) of musculoskeletal pain and discomfort, particularly among those working in family operations. While lower back and knee pain were most common, work-related exposures were most strongly associated with pain in the lower back and neck. These findings highlight the need to address occupational health risks related to MSDs in livestock operations, including possible prevention and intervention strategies. This may be especially important for small and family-owned farms where preventive and ergonomic interventions may yield substantial benefits. Full article

The growing integration of immersive technologies into education is opening new possibilities for teaching and learning, while also raising concerns about the reliability and potential distortion of knowledge in artificial intelligence-mediated environments. Understanding how users perceive and accept artificial intelligence-generated content in immersive learning systems is therefore essential. This study explores the factors that influence user acceptance of artificial intelligence-driven virtual reality educational applications and explains it through a multidimensional framework that extends the Technology Acceptance Model, the Theory of Reasoned Action, and the Theory of Planned Behavior—a new ED-SCALE model. We innovated the previous models by adding an ergonomic dimension, often overlooked in virtual reality-based education. To test the model, we developed an artificial intelligence-driven virtual reality educational escape room designed to simulate adaptive and interactive learning experiences. Data were collected from 213 participants using a questionnaire measuring subjective norms, perceived behavioral control, attitudes toward artificial intelligence-mediated instruction, perceived informational efficacy, and ergonomic quality. The findings show that ergonomic quality, intuitive interfaces, physical comfort, and social influence play an important role in shaping user trust and long-term adoption intentions. The results suggest that the success of artificial intelligence-driven immersive learning systems depends not only on technological performance but also on user experience and social context, confirming our first hypothesis regarding new variables that are conditional for virtual technology acceptance. Full article

Sustainable forklift technologies have become essential in modern industrial logistics due to increasing environmental regulations, rising energy costs, and heightened occupational safety requirements. Given the complexity and variety of sustainable forklift options, selecting the most appropriate one has become a critical multi-criteria decision-making (MCDM) problem for companies. This study aims to determine the most appropriate sustainable forklifts by considering multiple qualitative and quantitative criteria that play a critical role in the forklift selection process of companies. To this end, meetings are conducted with managers possessing expertise in sustainability and logistics at companies operating in Turkey. Based on these insights, ten forklift alternatives and six evaluation criteria are identified. This is the first time, in this study, sustainability criteria such as sustainability in occupational health and safety, sustainability in agility, sustainability in ergonomics, durability and material sustainability, sustainability in load lifting capacity and sustainability in price are incorporated into the evaluation. To the best of our knowledge, no study in existing literature has specifically focused on sustainable forklift selection, incorporating the comprehensive sustainability-oriented criteria considered in this study. The Analytic Hierarchy Process (AHP) is employed to determine the weight of each criterion. Subsequently, forklift alternatives are ranked using the Multi-objective Optimization by Ratio Analysis (MOORA) ratio approach, the Additive Ratio Assessment (ARAS), and the Elimination and Choice Translating Reality (ELECTRE) methods. Moreover, weights derived based on different subjective and objective weighting schemes, specifically FUCOM, BWM, and Entropy, as well as the resulting ranking outcomes are comparatively examined to assess the impact of varying weighting structures on the robustness and consistency of the final decision results. The proposed methodology is applied within manufacturing and logistics companies in Turkey to assess its practical effectiveness. As a result of this study, the most appropriate sustainable forklifts for the companies are identified. Furthermore, the outcomes of the applied methods yield consistent/similar results. The results emphasize that managers should place greater importance on the criteria of sustainability in occupational health and safety—identified as the most critical factor—followed by durability and material sustainability, and sustainability in load lifting capacity when selecting forklifts. Sensitivity analyses indicate that the method yields consistent and effective results. Moreover, it demonstrates the robustness and accuracy of the forklift evaluations. In this context, this study serves as a guided reference for companies in the selection of sustainable forklifts. Full article