NES2022 WORK WELL Conference Proceedings

Abstract

Conference proceedings from the 51st NES Conference Work Well - Ergonomics in an unpredictable world, 23-25 October 2022 in Uppsala, Sweden.
Editors Jessica Lindblom and Cecilia Österman.

Full text

Conference
Proceedings
of
the 51st NES Conference
23-25 October 2022
Uppsala Sweden
Editors: Jessica Lindblom and Cecilia Österman
ISBN: 978-91-506-2975-0

The second edition published on October 28th 2022
Cover and logotype: EHSS and Mari Forsell Design Åre
Copyright©2022: The authors
Authors may self-archive their articles on their own websites or the repositories of their
academic institutions provided the source is credited.
ISBN: 978-91-506-2975-0
Published by Uppsala University and EHSS
Available at: http://uu.diva-portal.org/smash/record.jsf?pid=diva2:1705093

Table of Content
PART I
Preface: Wellcome to NES2022 – Work Well ........................................................................................... 1
Organisers ........................................................................................................................................................... 2
Sponsors and Exhibitors ................................................................................................................................ 3
Sponsors ............................................................................................................................................... 3
Exhibitors ............................................................................................................................................. 3
Keynote Speakers ............................................................................................................................................. 4
Dinner Speech by the Deputy President of Uppsala City Council………………………………………..8
Call for Papers for NES2022 Special Issue ............................................................................................. 10
Conference Programme ............................................................................................................................... 11
PART II
Book of Abstracts and
Papers
..................................................................................................................... 18

51st Nordic Ergonomics and Human Factors Society Conference 2022
Preface: Welcome to NES2022 – Work Well!
We are pleased to welcome you to Uppsala for participating in the 51st NES Conference
“Work Well – Ergonomics in an unpredictable world”, at the venue Norrlands Nation Fest &
Konferens, located in the heart of the city of Uppsala, Sweden! Uppsala University was
founded in 1477 and is the oldest university in Sweden and the Nordic countries still in
operation. We cordially welcome you to join us in celebrating its 545-year anniversary!
The NES 2022 Conference invites you to explore and discuss the role of ergonomics, human
factors, and ergonomics professionals in an increasingly complex and unpredictable world.
The NES 2022 Conference is arranged by the Swedish Ergonomics and Human Factors Society
(EHSS), together with representatives from the Department of Information Technology, Vi3
Human-Machine Interaction and the Department of Medical Sciences, Occupational and
Environmental Medicine, Uppsala University. EHSS is a federated member of The Nordic
Ergonomics and Human Factors Society (NES). NES is a member of the International
Ergonomics Association (IEA) and the NES2022 Conference is endorsed by the IEA.
These are the Proceedings of the 51st Nordic Ergonomics and Human Factors Society
Conference. The papers are organised according to the sessions at the conference. Each
paper has been peer-reviewed before acceptance for the conference. We hope the collection
of papers is contributing to exploring the overall conference theme “Work Well – Ergonomics
in an unpredictable world” from several perspectives. A warm thanks to all members of the
Scientific Committee for doing a great job in reviewing papers, and to the student volunteers
for assisting.
We are happy to be the host of this exceptional gathering of participants after a tough
pandemic period and now we are looking forward to meeting you all in person again to share
ideas, discuss and reflect upon what the future of ergonomics in the work environment holds
in this unpredictable world.
Finally, we want to direct special thanks to Forte and AFA Försäkring for supporting the
organisation of the NES 2022 Conference through funding and sponsoring.
Welcome to enjoy the conference, engage in discussions and share your knowledge!
Cecilia Österman and Jessica Lindblom on behalf of the NES2022 Organising Committee
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51st Nordic Ergonomics and Human Factors Society Conference 2022
Organisers
NES 2022 Organising Committee
Cecilia Österman, Chair of the Organising Committee and EHSS President
Jessica Lindblom, Uppsala University
Kristina Eliasson, Uppsala University and EHSS board
Wessel van Leeuwen, Stockholm University and EHSS board
Johanna Morin, Feelgood and EHSS board
Anna-Lisa Osvalder, Chalmers University of Technology and EHSS board
Kerstin Tegbrant, Scania and EHSS board
Jenny Tolf, ADDQ and EHSS treasurer
Elin Vidlund, Swedish Work Environment Authority and EHSS board
Liyun Yang, Karolinska Institute and EHSS board
NES 2022 Scientific Committee
Jessica Lindblom, Uppsala University, Chair of the Scientific Committee
Bijan Aryana, Chalmers University of Technology
Cecilia Berlin, Chalmers University of Technology
Denis A. Coelho, Jönköping University
Kristina Eliasson, Uppsala University
Hillevi Hemphälä, Lund University
Päivi Kekkonen, Oulu University
Josué Maia França, Linnaeus University
Steven Mallam, University of South-Eastern Norway
Johanna Morin, Feelgood
Teresia Nyman, Uppsala University
Thomas Porathe, Norwegian University of Science and Technology
Arto Reiman, Oulu University
Carina Rislund, Hokahey
Catherine Trask, KTH Royal Institute of Technology
Wessel van Leeuwen, Stockholm University
Elin Vidlund, Swedish Work Environment Authority
Liyun Yang, Karolinska Institute
Cecilia Österman, Linnaeus University
2

51st Norrdic Ergonomiics and Human Factors Society Conference 2022
2022
Sponsors and Exhibitors
Sponsors
NES 2022 is kindly sponsored by Forte and Afa Försäkring.
Exhibitors
The following companies and organisations participate in the NES2022 exhibition.
AFA Försäkring Swedish Institute for Standards AJM Robotics AB
WorkMotions AB Stiftelsen Sveriges Sjömanshus Spineband AB
OptErgo AB Malmstolen
3

51st Nordic Ergonomics and Human Factors Society Conference 2022
Keynote Speakers
Åsa Cajander
Monday, 24 October, 09:15-09:45 in room: Gamla salen
Åsa Cajander is a Professor of Human-Computer Interaction (HCI) at Uppsala University,
Uppsala, Sweden. The goal of her research is to contribute to improved digitisation with
human needs at the centre. Specifically, she researches methods for organisations and IT
projects for developing and implementing IT. She has also researched the skills that people in
the rojects need to master to work with the development of complex systems that support
people.
Her keynote is entitled “Digitalisation and the work environment“. Software engineering is
complex, and many IT systems do not work satisfactorily despite intensive technology
development. Digitisation today has a significant impact on our work environment. In this
keynote, Åsa presents research on the causes of the problems and what can be done to
improve the situation.
Home page: https://www.katalog.uu.se/profile/?id=N2-392
Contact: asa.cajander@it.uu.se
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51st Nordic Ergonomics and Human Factors Society Conference 2022
Ole Andreas Alsos
Monday, 24 October, 09:45 - 10:15 in room: Gamla salen
Ole Andreas Alsos is an Associate Professor at the Department of Design and Vice Dean for
Innovation and Dissemination at the Department of Design at the Faculty of Architecture and
Design, the Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
His keynote is entitled “Human factors in the age of autonomous systems” and is based on
experiences of the design and development of the world’s first urban city ferry that will be
put into operation in just a couple of weeks! When the operator is moved from ship to shore,
a number of consequences follow on how we must think about human factors in the future.
Home page: https://www.ntnu.edu/employees/oleanda
Contact: oleanda@ntnu.no
5

51st Nordic Ergonomics and Human Factors Society Conference 2022
Cecilia Berlin
Tuesday, 25 October, 08:30-09:00 in room: Gamla salen
Cecilia Berlin is an Associate Professor of Production Ergonomics and Socially Sustainable
workplace design at Chalmers University of Technology in Gothenburg, Sweden. She has
written a textbook on the subject of Production Ergonomics that is freely available online, and
created a series of short films on the topic of cognitive ergonomics at work with the Swedish
organization Prevent. Besides carrying out research in a variety of work contexts (most
recently in VR!), she is also frequently recruited as a public speaker for public and private
organisations in and outside of Sweden. Cecilia always wishes she had more time to dance,
and has recently attempted to blend it with work by trying out dancing in VR and in an
exoskeleton.
Her keynote is entitled “Meet the world – the extended family tree of the Ergonomics and
Human Factors professional”. Drawing on her practical experiences of discussing Ergonomics
and Human Factors (E/HF) in many different settings and with a variety of stakeholders from
different sectors, Cecilia reflects on the variety of professional and academic disciplines that
the E/HF community may encounter and have a possibility of influencing. The challenge is
how to seem very broad and very specialised at the same time, and also how to seem new
and fresh while also seeming very familiar.
Home page: https://www.chalmers.se/en/staff/Pages/cecilia-berlin.aspx
Contact: cecilia.berlin@chalmers.se
6

51st Nordic Ergonomics and Human Factors Society Conference 2022
Magnus Svartengren
Tuesday, 25 October, 09:00-09:30 in room: Gamla salen
Magnus Svartengren is a qualified specialist in Occupational and Environmental Medicine. He
is a Professor and currently research group leader for Occupational and Environmental
Medicine at Uppsala University. He has a broad experience from human experimental and
epidemiological research mainly regarding environmental effects primarily in the
cardiorespiratory field and intervention studies aiming at healthy workplaces. Svartengren is a
member of the scientific advisory board for the Swedish Agency for Health Technology
Assessment and Assessment of Social Services (SBU). He has experience from working for the
National Swedish Board of Health and Welfare and the Swedish Work Environmental
Authority.
His keynote is entitled “Research and development for future working life“. There is a need to
develop methods in changing environments for long-term resilience. The goal is to improve
job attractiveness. The system needs to be inclusive and based on data on what the actual
challenges are. Magnus will present results from ongoing work in this area.
Home page: https://www.katalog.uu.se/profile/?id=N12-1954
Contact: magnus.svartengren@medsci.uu.se
7

Dinner Speech by the Deputy President of Uppsala
City Council
by
Carl Lindberg, the Deputy President of Uppsala city council
“Dear NES President Denis A. Coelho and EHSS President Cecilia Österman and Dear
participants and friends at the conference NES 2022 Work Well – Ergonomics in an
unpredictable world.
I would like to warmly welcome you all to Uppsala and at the same time express my great
gratitude that you have chosen Uppsala as the location for your important conference. My
name is Carl Lindberg and I am doing it in my capacity as Deputy President of Uppsala City
Council.
The theme of your conference reveals that you are all engaged in research of great importance
to our societies. For me, it is also particularly satisfying that you are doing it within the
framework of a Nordic research collaboration. I learned to appreciate the Nordic research
collaboration very much during my 10 years as a political official responsible for these issues at
the Swedish Ministry of Education. Even though we in our Nordic countries have chosen to
meet our societies' challenges with many times different measures and solutions, we have still
had the Nordic welfare model with its basic values as a common starting point
You are honoring our city with your conference, which truly strives to contribute through
research to finding solutions to the challenges that our citizens face in everyday working life.
The research that you present during your conference includes large and exciting fields, but
the common idea is of course how working life should be designed to be adapted to people's
conditions and thereby minimize harmful effects as much as possible on the individual and on
society at large.
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51st Nordic Ergonomics and Human Factors Society Conference 2022
You do this by highlighting many important issues, wise leadership, how safety cultures can be
strengthened, the importance of employees' well-being and job satisfaction, how to avoid
errors caused by fatigue, the importance of tacit knowledge, the importance of staff training
and, not least, the possibilities of digitization means, among other things, in homecare and
primary care. At the same time, you show the major risks that exist within various sectors, e.g.,
in the Norwegian oil industry, in train traffic, risks of frostbite in the Arctic regions, on fishing
vessels in the Nordic waters, during manual sorting, risks in professions where the body is
exposed to strong vibrations.
In addition to the exchange of experience in your research areas, I hope that you will have the
opportunity to get to know our city of Uppsala. Sweden's fourth largest city with over 240,000
inhabitants originating from over 150 different countries, with two world-leading universities,
- Uppsala University and the Swedish University of Agriculture - many government agencies,
and a lively business community largely consisting of highly innovative companies.
And, not least, 40 000 students and a student life based on our 13 student nations, often
dating back more than 300 years. Norrland nation - where we are now - is the largest of the
nations. It also happens to place where I met my wife 60 years ago.
I would also point out Uppsala's new City Hall, a building inaugurated as recently as just over a
month ago - built to live up to the highest standards as regards work environment and
ergonomics.
Finally, I would also like to take the opportunity to remind you about one of our oldest
buildings, Uppsala Castle, which began to be built as early as 1547, not because the then king
Gustav Vasa was particularly interested in ergonomics, but above all, because one hundred
years ago the castle was home to a 17-year-old young man, a man whose father was the
governor here, a young man who later became the United Nations Second Secretary General,
Dag Hammarskjöld, In the same way as you today, when you use your skills and your
commitment to work to improve people's working environments in various sectors he was
committed to improving the living conditions of women and men around the world through
the United Nations, regardless of race, color of the skin or religion, an activity that feels
particularly urgent in the time in which we now live.
Last but not least, I would like to wish you a fruitful conference here in Uppsala and thereafter
continued success in your various research fields.
Carl Lindberg, the deputy president of Uppsala city council, Uppsala 24 of October, 2022
9

Call for Papers for NES2022 Special Issue
Selected authors will be invited to elaborate on their research topic and submit the results
from NES2022 to the conference’s special issue in the scientific journal International Journal of
Human Factors and Ergonomics (IJHFE) for review and potential publication. The deadline is
December 31 2022.
Please, be aware of the specific notes to authors on the journal home page that state:
Authors can submit an article that is based on a conference paper, so long as it has been
substantially revised, expanded and rewritten so that it is significantly different from the
conference paper or presentation on which it is based. The article must be sufficiently
different to make it a new, original work. As a guideline, the rewritten article can have a
similarity index with the original conference paper of no more than 50%. These articles will be
treated like any other article submitted to Inderscience, and will go through our plagiarism
checker and also undergo a double-blind peer-review process, all using Inderscience’s online
submissions system.”
Manuscript word count should add to at least 5000 and up to 7000 words (excluding Figures,
Tables, References and any Appendices).
PhD holders within the authorship teams will likely be invited to double-blind peer-review
another submission to the journal.
Selected papers may only appear on the web as part of any freely-available proceedings or
the like if they are the author’s original (prior to peer review) or accepted (but not corrected,
i.e. not the proof) manuscript.
For more information, see the Call for Papers at journal’s homepage
https://www.inderscience.com/info/ingeneral/cfp.php?id=5641 as well as other relevant
information at International Journal of Human Factors and Ergonomics (IJHFE) Inderscience
Publishers - linking academia, business and industry through research
10

NES 2022 Work Well - Ergonomics in an unpredictable world
Sunday, 23 October Norrlands Nation Fest & Konferens
17:00
Registration opens
18:00 ‐ 20:00
Get‐together session
Monday, 24 October Norrlands Nation Fest & Konferens
08:00 ‐ 09:00
Registration
09:00 ‐ 09:15
ROOM: Gamla salen
Welcome address and opening ceremony
Robin Strand, Professor of Computerised Image Analysis and Deputy Head of the IT department, Uppsala University
Denis A. Coelho, NES President and Cecilia Österman, EHSS President
Fanfare by Hornboskapen, the world's oldest student orchestra
09:15 ‐ 09:45
KEYNOTE Digitalisation and the work environment
Åsa Cajander, Professor of Human‐Computer Interaction, Uppsala University
09:45 ‐ 10:15
KEYNOTE Human Factors in the age of autonomous systems
Ole Andreas Alsos, Associate Professor of Interaction Design, Norwegian University of Science and Technology (NTNU)
10:15 ‐ 10:30
Coffee break & Exhibitions
51st Nordic Ergonomics and Human Factors Society Conference 2022
Conference
Programme
11

Session 1
10:30 ‐ 12:00
ROOM: Gamla salen
ROOM: Strömholm
ROOM: Inre läsrummet
Occupational safety and health management
Chair: Viktoria Wahlström
WORKSHOP: Using fatigue failure based exposure
assessment tools to evaluate the risk of distal
upper extremity MSDs
Sean Gallagher, Mark Schall, Richard Sesek
and Peter Johansson
This workshop will give some background regarding
fatigue failure theory, and will provide hands‐on
analysis of the Distal Upper Extremity Tool (DUET).
DUET is a new risk assessment tool for hand‐
intensive occupational tasks. It is easy to use and can
identify tasks responsible for higher proportion of
risk (most in need of intervention).
Transport
systems
Chair: Anna‐Lisa Osvalder
Managers organisational and social work
environment during the pandemic in Sweden
Rachael Berglund, Adesuwa Omorede
and Tomas Backström
Safety and human factors implications of RPAS
introduction in controlled airspace: a case study
Vittorio Sangermano, Gabriella Duca, Riccardo
Rocchio, Edoardo Filippone, Gunnar Schwoch,
Andreas Hasselberg, Jürgen Teutsch
and Co Christiaan Petersen
Organisational Capabilities for Developing the
System Operator Role in the Norwegian Power Grid
Asgeir Drøivoldsmo and Lars Hurlen
Training non‐technical competences ‐ potential
benefits and perceived needs for improvement
Karolina Stark and Gesa Praetorius
The key role of the employee in incident prevention
and ergonomics as a tool to achieve a safe working
environment
Petr Koutný, Ivana Bartlová and Hana Lehocká
A roadmap for UX in rail: Changing tracks in train
traffic research
Jessica Lindblom and Mikael Laaksoharju
Leadership quality ‐ video‐assisted work analysis of
leaders’ behaviours
Simon Elvnäs, Mikael Forsman and Ned Carter
Transferring tacit knowledge among operators in
safety‐critical systems
Rikard Eklund and Anna‐Lisa Osvalder
With the stable as a workplace – about attractive,
healthy and sustainable employments in the Swedish
equine sector
Åsa Bergman Bruhn, Cecilia Lindahl
and Ing‐Marie Andersson
How human skills and technology overcome
accidents in space (Apollo 13), in the air (US Airways
1549) and on land (San José Mine) building systems
resilience
Josue Franca, Erik Hollnagel and Brenda Coutinho
12:00 ‐ 13:00
Lunch break & Exhibitions
51st Nordic Ergonomics and Human Factors Society Conference 2022
12

Session 2
13:00 ‐ 14:30
ROOM: Gamla salen
ROOM: Strömholm
ROOM: Inre läsrummet
SPECIAL SESSION: Activity‐based work
environments – Perspectives on the
implementation process and employee well‐being
Chairs: Annu Haapakangas and Piia Markkanen
Physical
ergonomics
Chair: Liyun Yang
SPECIAL SESSION: A user‐centered product
development and evaluation of an equipment vest
with integrated ballistic protection for the Swedish
police force
Chair: Louise Bæk Larsen
Users’ insight of what promotes or hinders health
among office workers
Ulrika Florin and Susanna Lehtinen‐Jacks
Importance of good working gloves ‐ ErgoSleeve in
validating the gloves and measuring arm muscle load
Riitta Simonen, Samuli Pitkänen, Pekka Tolvanen and
Janne Pylväs
A user‐centered product development and
evaluation of an equipment vest with integrated
ballistic protection for the Swedish police force– a
participative project
Louise Bæk Larsen
Effects of workplace change on work engagement
and perceived work‐environment fit – the role of
change management
Pia Sirola, Annu Haapakangas and Virpi Ruohomäki
A comparative study regarding noise and hand‐arm
vibration exposure during self‐compacting and
conventional concrete casting
Inga Mikhaltchouk, Lars Kraft, Tohr Nilsson
and Mikael Forsman
Vest design and the development process
Linéa Stenfors
The important process when relocating to activity‐
based workplaces
Eva Bergsten, Katarina Wijk and David Hallman
An objective approach for assessment of hand‐arm
vibration dose
Guilherme Elcadi, Inga Mikhaltchouk, Tohr Nilsson,
Per Vihlborg and Mikael Forsman
Pressure measurements between shoulders and vest‐
Method
Roy Tranberg
Tools for creativity in co‐design workshop – Applying
participatory design methodology to support the
workplace design process
Piia Markkanen and Aulikki Herneoja
Feasibility of electromyographic measurements with
a new inexpensive wearable bluetooth device
Rosetta Maglio, Julia Osswald, Tobias Haraldsson,
Arvin Razavi, Nathalie Wehlin, Linus Remahl
and Mikael Forsman
Pressure measurements between shoulders and vest ‐
Result
Louise Bæk Larsen
Workspace use, perceived work environment and
employee well‐being – A case study of an activity‐
based office
Annu Haapakangas, Pia Sirola and Virpi Ruohomäki
Application of low‐cost accelerometers in risk
assessment of low back pain due to whole body
vibrations
Pasan Hettiarachchi, Peter J. Johansson and Adrian
Gomez Sanchez
Usability evaluation of an equipment vest with
integrated ballistic protection
Kristina
Eliasson
Interactive individual ergonomic report as means for
risk assessment and ergonomic education among
surgeons
Melanie Hensel, Xuelong Fan, Mikael Forsman,
Magnus Kjellman and Liyun Yang
Physical activity patterns among uniformed police
officers
Peter
Johansson
Effects of an equipment vest without integrated
ballistic protection as a rehabilitation measure for
police officers with low back pain
Teresia
Nyman
14:30 ‐ 15:00
Coffee break & Exhibitions
51st Nordic Ergonomics and Human Factors Society Conference 2022
13

Session 3
15:00 ‐ 16:00
ROOM: Gamla salen
ROOM: Strömholm
ROOM: Inre läsrummet
NES Student Prize session
Chair: Kristina Eliasson
SPECIAL SESSION: The European Work
Environment Authorities
Chair: Elin Vidlund
SPECIAL SESSION: Occupational health
challenges in the Arctic
Chair: Jens Wahlström
Visor adapted for headlamps, for ear‐nose‐
throat doctors
Gustav Brogren, Jens Junkers, Maja Kristensson,
Marcus Lidman, Alvina Ståhl and Adam Udén
,
Sweden
Ergonomic risk management strategy in Ireland: A
focus on risk exposure reduction
Frank Power
Cold exposure and MSD – a prospective population‐
based study
Charlotte Lewis, Albin Stjernbrandt
and Jens Wahlström
Sole entrepreneur’s networking and wellbeing at
work at the Savo region
Piia Kauhanen, Finland
Improving ergonomic risk assessments in the
Norwegian oil and gas industry
Brit Gullesen
Nordic Co‐operation for promoting occupational
health and safety (OHS) research and education in
the Arctic
Hans Pettersson
Managing bereaved employees at the workplace
Maria Bang Jensen, Denmark
What is going on at the Swedish Work Environment
Authority regarding the prevention of MSDs?
Elin Vidlund
Carpal tunnel syndrome and cold exposure – a
population based study
Jens Wahlström
16:00 ‐ 17:00
NES Annual General Meeting in Strömholm
19:00 ‐ 00:00
Conference dinner at Norrlands Nation
51st Nordic Ergonomics and Human Factors Society Conference 2022
14

Tuesday, 25 October Norrlands Nation Fest & Konferens
08:30 ‐ 09:00
ROOM: Gamla salen
KEYNOTE Meet the world – the extended family tree of the Ergonomics and Human Factors professional
Cecilia Berlin, Associate professor of production ergonomics and socially sustainable workplace design, Chalmers University of Technology
09:00 ‐ 09:30
KEYNOTE Research and development for future working life
Magnus Svartengren, Professor of occupational and environmental medicine, Uppsala University
09:30 ‐ 10:00
Coffee break & Exhibitions
Session 4
10:30 ‐ 12:00
ROOM: Gamla salen
ROOM: Strömholm
ROOM: Inre läsrummet
Advanced risk management tools
Chair: Liyun Yang
Ergonomics in healthcare
Chair: Päivi Kekkonen
Human factors in design
Chair: Catherine Trask
Improving safety culture in occupational contexts: an
actionable toolkit
Gabriella Duca, Raffaele d'Angelo, Vittorio
Sangermano and Antonio Di Palma
Management of well‐being at work in large Finnish
healthcare companies according to corporate social
responsibility reports
Päivi Kekkonen, Arto Reiman and Joakim Junnila
Building Safety into the Lifecycle: the potential for
Building Information Modelling (BIM) to Enhance
Occupational Health and Safety
Catherine Trask and Madeleine Hoeft
A usability study of the SRA Index (Sustainable Risk
Awareness Index), a KPI for management support
Helena Franzon, Jörgen Eklund and Linda M Rose
Digitalisation in primary healthcare ‐ the barriers and
facilitators for digital patient‐ and work management
to work well
Susanne Frennert, Gudbjörg Erlingsdóttir, Mirella
Muhic, Christofer Rydelfält, Veronica Milos Nymberg
and Björn Ekman
Ergonomic evaluation and social construction of a
petroleum refining unit project (in times of a
pandemic)
Cynthia
Alhadeff
The RAMP 2.0 project – Towards an enhanced MSD
risk management tool
Linda M Rose and Mikael Forsman
Meeting the Challenges of Home Care in Small
Residential Bathrooms: Creation of the Bathroom
Aid Inventory
Brenda Rodrigues Coutinho, Linda Rose
and Catherine Trask
Ergonomics early in the design phase at Scania
Kerstin
Tegbrant
Systematic risk management with RAMP for risk
assessment and adapted changes ‐ an
implementation study
Mikael Forsman, Liyun Yang, Andrea Eriksson,
Linda Barman and Linda M Rose
Digitalization of home care and home care nursing
during the Covid‐19 pandemic: initial findings
Christofer Rydenfält, Johanna Persson, Gudbjörg
Erlingsdottir, Roger Larsson and Gerd Johansson
Building information modelling and integration of
occupational health and safety in construction
project design
Kari Anne Holte, Leif Jarle Gressgård
and Kari Kjestveit
Results from biomechanical risk assessment aboard
fishing vessels
Francesco Draicchio, Alessio Silvetti, Adriano Papale,
Alberto Ranavolo, Ari Fiorelli, Giorgia Chini, Tiwana
Varrecchia, Antonella Tatarelli, Lorenzo Fiori
and Elio Munafò
Can journey mapping be used to visualize
information sharing in home care?
Johanna Persson, Niki Svensson, Alicia Lindmark,
Roger Larsson, Gudbjörg Erlingsdottir and Christofer
Rydenfält
Comfort, seat belt fit and misuse for older adults
when travelling in cars
Melina Makris and anna‐Lisa Osvalder
Evaluation of comfort and fit of personal protective
equipment
Anna‐Lisa Osvalder, Cecilia Österman and Per Nilsson
12:00 ‐ 13:00
Lunch break & Exhibitions
51st Nordic Ergonomics and Human Factors Society Conference 2022
15

Session 5
13:00 ‐ 14:30
ROOM: Gamla salen
ROOM: Strömholm
ROOM: Inre läsrummet
SPECIAL SESSION: Work well – by improving
working condition after risk assessment with
reliable technical methods
Chair: Mikael Forsman
Modern digitalisation technologies
Chair: Steven Mallam
Applications in ergonomics
Chair: Petr Koutný
Back bending at work influence risk of long‐term
sickness absence
Nidhi Gupta and
Liyun Yang
On a Quest: The Conundrums of Designing a
Scientific study of Office Tasks in a VR Environment
Cecilia Berlin and Maral Babapour Chafi
Effects of prismatic loupes on surgeons’ postural and
muscular neck workload
Xuelong Fan, Liyun Yang, Magnus Kjellman
and Mikael Forsman
ActiPASS a new improved tool to measure physical
behaviours 24/7 from thigh worn accelerometers
Peter Johansson
Ergonomics of Office Work in a VR Environment: A
State‐of‐the‐art review
Maral Babapour Chafi and Cecilia Berlin
Methodologies for a performance based approach to
ergonomics programs
Rachel
Michael
Effectiveness of vibrotactile feedback training to
reduce postural exposure in manual sorting
Liyun Yang
The use of STEP analysis supported by virtual
simulations in concept development
Johan Nordström and Kristofer Bengtsson
Resilience and preparedness in maritime training –
current approaches and research gaps
Gesa Praetorius, Charlott Sellberg and
Birgit Pauksztat
A new generation of smart T‐shirts with automatic
direct reports
Jörgen Eklund and Viktoria Wahlström
Exploring Augmented Reality for Advanced Maritime
Operations: Opportunities and Threats for Operators
Henrik Aasgaard Carho and Steven C. Mallam
Objective risk assessment of glare and subjective
rating of the frequency of glare ‐ a visual ergonomics
risk assessment, VERAM
Hillevi Hemphälä, Marina Heiden,
Camilla Zetterberg, Per Lindberg, Johannes Lindén
and Per Nylén
A sensor‐based smartphone app for cost and time
effective wrist velocity measurements
Mikael
Forsman
Heuristics for human multi‐purpose robot interaction
Susanna Aromaa, Hanna Lammi
and Taru Hakanen
Headaches in combination of visual ability,eye‐ and
muscoloskeletal strain in connection with visually
demanding work tasks
Susanne Glimne, Hillevi Hemphälä, Marina Heiden,
Camilla Zetterberg, Per Lindberg, Johannes Lindén
and Per Nylén
Financial effects of suggested work environment
improvements – Examples from applied Masters
students’ projects
Linda M Rose
14:30 ‐ 14:45
Coffee break & Exhibitions
51st Nordic Ergonomics and Human Factors Society Conference 2022
16

Session 6
14:45 ‐ 15:45
ROOM: Gamla salen
ROOM: Strömholm
ROOM: Inre läsrummet
WORKSHOP: Hands‐on training to use smart work
clothes
Chairs: Jörgen Eklund and Mikael Forsman
WORKSHOP: Crisis information design with a
human factors/ergonomics perspective
Chair: Bijan Aryana
WORSKSHOP: Visual ergonomics
Chairs: Hillevi Hemphälä and Cecilia Österman
Smart work clothes have been developed to measure
work postures. Based on these measurements an
automatic risk assessment for MSDs can be
obtained. Also, this system can be used for self‐
training of work technique.
The participants in the workshop will get an
opportunity to practice the use of smart work clothes
for risk assessment and work technique training.
They will start up the system, perform simulated
work sessions, get the automated result analysis and
discuss the findings.
The workshop will partly be a demonstration and
partly an applied hands‐on training session.
The human variable in societal resiliency to disasters:
the perspective of CORE project
Gabriella Duca, Consuelo Agnesi, Giovanni Gugg,
Elisabetta Schiavone, Raffaella Russo
and Stefano Zanut
Good lighting is important for visual comfort, safety
and productivity in workplaces. But what is good
lighting and how do we know if a lighting solution is
good?
This workshop includes a lecture and practical
demonstrations. A brief review will be given of
lighting recommendations and standards of for the
visual environment and how these can be sourced. A
short Visual Ergonomics checklist will also be
presented with instructions how to use the checklist.
It is suitable for all wishing to gain an understanding
of visual ergonomics for workplaces.
Many people are subject to information gap during a
crisis due to functional variations, age, and even
language.
Join us in this workshop to see how human factors
and ergonomics can contribute to an inclusive
information design for crisis.
15:45 ‐ 16:00
Closing session
Denis A. Coelho, NES President, announces NES2023
Closing remarks by Jessica Lindblom and Cecilia Österman, Organising committee
51st Nordic Ergonomics and Human Factors Society Conference 2022
17

51st Nordic Ergonomics and Human Factors Society Conference 2022
PART II
Book of Abstracts and Papers
18

NES 2022
Table of Contents
Table of Contents
Session:
Occupational
safety
and
health
management
Managers organisational and social work environment during the pandemic in Sweden
............
1
Rachael
Berglund,
Adesuwa
Omorede
and
Tomas
Backstr
¨
om
Organisational Capabilities for Developing the System Operator Role in the Norwegian
Power Grid
..............................................................................................................................................
9
Asgeir
Drøivoldsmo
and
Lars
Hurlen
The key role of the employee in incident prevention and ergonomics as a tool to achieve
a safe working environment
...............................................................................................................
17
Petr
Koutn
´
y,
Ivana
Bartlov
´
a
and
Hana
L
ehock
´
a
Leadership quality - video-assisted work analysis of leaders’ behaviours
.....................................
29
Simon
Elvn
¨
as,
Mikael
Forsman
and
Ned
Carter
With the stable as a workplace
–
about attractive, healthy and sustainable employments
in the Swedish equine sector
..............................................................................................................
31
˚
A s a
Bergman
Bruhn,
Cecilia
Lindahl
and
Ing-Marie
Andersson
Workshop:
Using
fatigue
failure
based
exposure
assessment
tools
to
evaluate the risk of distal upper extremity MSDs
Using Fatigue Failure Based Exposure Assessment Tools to Evaluate the Risk of Distal
Upper Extremity MSDs
.....................................................................................................................
33
Sean
Gallagher
and
Peter
Johansson
Session:
Transport
systems
Safety and human factors implications of RPAS introduction in controlled airspace: a
case study
..............................................................................................................................................
35
Vittorio
Sangermano,
Gabriella
Duca,
Riccardo
Rocchio,
Edoardo
Filippone, Gunnar
Schwoch, Andreas Hasselberg,
J
u
¨
rgen
Teutsch and Co Christiaan Petersen
Training non-technical competences - potential benefits and perceived needs for
improvement
.........................................................................................................................................
43
Karolina
Stark
and
Gesa
Praetorius
A roadmap for UX in rail: Changing tracks in train traffic research
...........................................
51
Jessica
Lindblom
and
Mikael
Laaksoharju
Transferring tacit knowledge among operators in safety-critical systems
....................................
59
Rikard
Eklund
and
Anna-Lisa
Osvalder
How human skills and technology overcome accidents in space (Apollo 13), in the air
(US Airways 1549) and on land (San Jos´e Mine) building systems resilience
.............................
61
Josue
Franca,
Erik
Hollnagel
and
Brenda
Coutinho
Special
session:
Activity-based
work
environments
–
Perspectives
on
the
implementation process and employee well-being

NES 2022
Table of Contents
SPECIAL SESSION: Activity-based work environments
–
Perspectives on the
implementation process and employee well-being
...........................................................................
69
Annu
Haapakangas,
Susanna
Lehtinen-Jacks, Pia
Sirola,
Eva
Bergsten
and
Piia
Markkanen
Users’insight of what promotes or hinders health among office workers
.......................................
71
Ulrika
Florin
and
Susanna
Lehtinen-Jacks
Effects of workplace change on work engagement and perceived work-environment fit
–
the role of change management
.........................................................................................................
72
Pia
Sirola,
Annu
Haapakangas
and
Virpi
R
uohom
¨
aki
The important process when relocating to activity-based workplaces
..........................................
74
Eva
Bergsten,
Katarina
Wijk
and
David
Hallman
Tools for creativity in co-design workshop
–
Applying participatory design methodology
to support the workplace design process
..........................................................................................
76
Piia
Markkanen
and
Aulikki
Herneoja
Workspace use, perceived work environment and employee well-being
–
A case study of
an activity-based office
.......................................................................................................................
83
Annu
Haapakangas,
Pia
Sirola
and
Virpi
R
uohom
¨
aki
Session:
Physical
ergonomics
Importance of good working gloves - ErgoSleeve in validating the gloves and measuring
arm muscle load
...................................................................................................................................
91
Riitta
Simonen,
Samuli
Pitk
¨
anen,
Pekka
Tolvanen
and
Janne
Pylv
¨
as
A comparative study regarding noise and hand-arm vibration exposure during
self-compacting and conventional concrete casting
........................................................................
92
Inga
Mikhaltchouk,
Lars
Kraft,
Tohr
Nilsson
and
Mikael
Forsman
An objective approach for assessment of hand-arm vibration dose
...........................................
100
Guilherme
Elcadi,
Inga
Mikhaltchouk,
Tohr
Nilsson,
Per
Vihlborg
and
Mikael
Forsman
Feasibility of electromyographic measurements with a new inexpensive wearable
Bluetooth device
................................................................................................................................
107
Rosetta
Maglio,
Julia
Osswald,
Tobias
Haraldsson, Arvin
Razavi, Nathalie
Wehlin,
Linus Remahl and Mikael Forsman
Application of low-cost accelerometers in risk assessment of low back pain due to whole
body
vibrations
..................................................................................................................................
113
Pasan
Hettiarachchi,
Peter
J.
Johansson
and
Adrian
Gomez
Sanchez
Interactive individual ergonomic report as means for risk assessment and ergonomic
education among surgeons.
...............................................................................................................
114
Melanie
Hensel,
Xuelong
Fan,
Mikael
Forsman,
Magnus
Kjellman
and
Liyun
Yang
Special session: A user-centered product development and evaluation of an
equipment vest with integrated ballistic protection for the Swedish police force

NES 2022
Table of Contents
Special Session: A user-centered product development and evaluation of an equipment
vest with integrated ballistic protection for the Swedish police force– a participative
Project [The special session includes eight papers]
...........................................................................
116
Louise Bæk Larsen, Linéa Stenfors, Roy Tranberg, Kristina Eliasson, Peter
Johansson and Teresia Nyman
Session: NES Student Prize
Visor adapted for headlamps, for ear-nose-throat doctors
..........................................................
124
Gustav
Brogren,
Jens
Junkers,
Maja
Kristensson,
Marcus
Lidman, Alvina
S
t
˚
a h l
and
Adam Udén
Sole
en
trepreneur
’s
networking and wellbeing at work at the Savo region
...............................
125
Piia Kauhanen
Managing bereaved employees at the workplace.
.........................................................................
127
Maria
Bang
Jensen
Special
session:
The
European
Work
Environment
Authorities
Ergonomic Risk Management Strategy in Ireland: A focus on Risk Exposure reduction .. .. 128
Francis
Power
ˆ
Wh at i s going on at the Swedish Work Environment Authority , regarding the prevention of
MS Ds ?
.
...............................................................................................................................................
130
Elin Vidlund
Special
session:
Occupational
health
challenges
in
the
Arctic
Occupational Health Challenges in the Arctic
...............................................................................
131
Jens
Wahlstr
¨
om,
Hans
Pettersson
and
Charlotte
Lewis
Cold exposure and MSD
–
a prospective population-based study
...............................................
133
Charlotte
Lewis,
Albin
Stjernbrandt
and
Jens
Wahlstr
¨
om
Nordic Co-operation for promoting occupational health and safety (OHS) research and
education in the Arctic
.....................................................................................................................
135
Hans
Pettersson
Carpal tunnel syndrome and cold exposure
–
a population based study
...................................
137
Jens
Wahlstr
¨
om
Session:
Advanced
risk
management
tools
Improving safety culture in occupational contexts: an actionable toolkit
..................................
139
Gabriella
Duca,
Raffaele
d’Angelo,
Vittorio
Sangermano
and
Antonio
Di
Palma
A usability study of the SRA Index (Sustainable Risk Awareness Index), a KPI for
Management Support
........................................................................................................................
147
Helena
Franzon,
J¨
or
gen
Eklund
and
Linda
M
Rose
The RAMP 2.0 project
–
Towards an enhanced MSD risk management tool
...........................
155
Linda M Rose and Mikael Forsman

NES 2022
Table of Contents
Systematic risk management with RAMP for risk assessment and adapted changes - an
implementation study
.......................................................................................................................
156
Mikael
Forsman,
Liyun
Yang,
Andrea
Eriksson,
Linda
Barman
and
Linda
M
Rose
Results from biomechanical risk assessment aboard fishing vessels
............................................
158
Francesco Draicchio, Alessio Silvetti, Adriano Papale, Alberto Ranavolo, Ari Fiorelli,
Giorgia
Chini,
Tiwana
Varrecchia,
Antonella
Tatarelli,
Lorenzo Fiori
and
Elio
Munaf
`
o
Session:
Ergonomics
in
healthcare
Management of well-being at work in large Finnish healthcare companies according to
corporate social responsibility reports
............................................................................................
166
P
¨
aivi
Kekkonen,
Arto
Reiman
and
Joakim
Junnila
Digitalisation in primary healthcare - the barriers and facilitators for digital patient-
and work management to work well
...............................................................................................
174
Susanne
Frennert,
Gudbj
¨
or
g
Erlingsd
´
ottir,
Mirella
Muhic,
Christofer
Rydelfalt,
Veronica Milos Nymberg and
Bj
¨
orn
Ekman
Meeting the Challenges of Home Care in Small Residential Bathrooms: Creation of the
Bathroom Aid Inventory
..................................................................................................................
176
Brenda
Rodrigues
Coutinho,
Linda
Rose
and
Catherine
Trask
Digitalization of home care and home care nursing during the Covid-19 pandemic:
initial findings
....................................................................................................................................
178
Christofer
Rydenf
¨
alt,
Johanna
Persson,
Gudbj
¨
or
g
Erlingsdottir,
Roger
Larsson
and
Gerd Johansson
Can journey mapping be used to visualize information sharing in home care?
........................
179
Johanna
Persson,
Niki Svensson,
Alicia
Lindmark,
Roger
Larsson,
Gudbj
¨
or
g
Erlingsdottir and Christofer Rydenf
¨
alt
Session:
Human
factors
in
design
Building Safety into the Lifecycle: the potential for Building Information Modelling
(BIM) to Enhance Occupational Health and Safety
.....................................................................
180
Catherine
Trask
and
Madeleine
Hoeft
Ergonomic evaluation and social construction of a petroleum refining unit project (in
times of a pandemic)
.........................................................................................................................
183
Cynthia
Alhadeff
Ergonomics early in the design phase at Scania
............................................................................
185
Kerstin Tegbrant
Building information modelling and integration of occupational health and safety in
construction project design
..............................................................................................................
186
Kari Anne Holte, Leif Jarle Gr
ess
g
˚
ard
and Kari Kjestveit
Comfort, seat belt fit and misuse for older adults when travelling in cars
................................
188
Melina
Makris
and
Anna-Lisa
Osvalder

NES 2022
Table of Contents
Evaluation of comfort and fit of personal protective equipment
................................................
190
Anna-Lisa
Osvalder,
Cecilia
O
¨
sterman
and
Per
Nilsson
Special
session:
Work
well
–
by
improving
working
condition
after
risk
assessment with reliable technical methods
Work well
–
by improving working condition after risk assessment with reliable technical
methods [This session includes five presentations]
............................................................................
192
Mikael
Forsman,
Nidhi Gupta,
Liyun
Yang,
Peter
Johansson,
Viktoria
Wahlstr
¨
om
and
J¨
or
gen
Eklund
Session:
Modern
digitalisation
technologies
On a Quest: The Conundrums of Designing a Scientific study of Office Tasks in a VR
Environment
.......................................................................................................................................
194
Cecilia
Berlin
and
Maral
Babapour
Chafi
Ergonomics of Office Work in a VR Environment: A State-of-the-art review
..........................
196
Maral
Babapour
Chafi
and
Cecilia
Berlin
The use of STEP analysis supported by virtual simulations in concept development
.............
204
Johan
Nor
dstr
¨
om
and
Kristofer
Bengtsson
Exploring Augmented Reality for Advanced Maritime Operations: Opportunities and
Threats for Operators
.......................................................................................................................
212
Henrik
Aasgaard
Carho
and
Steven
C.
Mallam
Heuristics for human multi-purpose robot interaction
..................................................................
220
Susanna
Aromaa,
Hanna
Lammi
and
Taru
Hakanen
Session:
Applications
in
ergonomics
Effects of prismatic loupes on surgeons’ postural and muscular neck workload
........................
228
Xuelong
Fan,
Liyun
Yang,
Magnus
Kjellman
and
Mikael
Forsman
Methodologies for a Performance Based Approach to Ergonomics Programs
..........................
230
Rachel
Michael
Resilience and preparedness in maritime training
–
current approaches and research gaps.... 231
Gesa
Praetorius,
Charlott
Sellberg
and
Birgit
Pauksztat
Objective risk assessment of glare and subjective rating of the frequency of glare
–
a
visual ergonomics risk assessment, VERAM
..................................................................................
232
Hillevi
Hemphala, Susanne Glimne,
Marina
Heiden, Camilla
Zetterberg,
Per
Lindberg, Johannes Lind´en and Per Nyl´en
Headaches in combination with visual ability, eye- and musculoskeletal strain in
connection with visually demanding work tasks
............................................................................
233
Susanne
Glimne,
Hillevi
Hemph
¨
al
¨
a,
Marina
Heiden,
Camilla
Zetterberg,
Per
Lindberg, Johannes Lind´en and Per Nylén

NES 2022
Table of Contents
Financial effects of suggested work environment improvements
–
Examples from applied
Masters students’ projects
.................................................................................................................
235
Linda M Rose
Workshop:
Hands-on training to use smart work clothes
Hands-on training to use smart work clothes
...................................................................................
243
Jörgen Eklund and Mikael Forsman
Workshop:
Crisis
information
design
with
a
human
factors/ergonomics
perspective
Workshop: Crisis Information Design with a Human Factors/Ergonomics Perspective
..........
244
Bijan
Aryana
and
Anna-Lisa
Osvalder
The human variable in societal resiliency to disasters: the perspective of CORE project
.......
246
Gabriella
Duca, Consuelo
Agnesi,
Giovanni
Gugg,
Elisabetta
Schiavone,
Raffaella
Russo and Stefano Zanut
Workshop:
Visual
ergonomics
and
lightning
Visual ergonomics and lightning
.......................................................................................................
248
Hillevi
Hemph
¨
al
¨
a and Cecilia Österman

51st Nordic Ergonomics and Human Factors Society Conference 2022
1
Managements organisational and social work environment during the
pandemic in Sweden
Rachael BERGLUND (1), Adesuwa Omorede (1) and Tomas Backström (1).
(1) Mälardalen University, Sweden.
Abstract:
Managements working conditions during the pandemic are important since they are the ones
who had to motivate, encourage, and navigate their team during this unique time in history.
Managers are vital in forming the working environment conditions for others. When they feel
stressed and overwhelmed, this acts as a barrier to caring for and supporting their team
members. Our study aimed to investigate managers’ organisational and social work
environment conditions and health when working from home during the pandemic.
This study has a cross-sectional design. Survey data were collected one year into the COVID-19
pandemic from April-May 2021. We used a survey with fixed questions to collect data from
four different organisations and through an open online survey. Data on the 161 managers out
of a total of 888 respondents is included in the present study. We compare the manager’s data
to pre-pandemic reference values.
The respondents report on average a PSC-score of 14. Quantitative demands, work pace, social
support from colleagues & supervisors and work life balance were better for managers during
the pandemic. There was no difference in burnout scores compared to pre-pandemic
reference values. Male managers reported significantly lower levels of work demands
compared to female managers and better work life balance. Male managers also reported
lower social support from their supervisor.
Workplaces should pay attention to differences in working conditions provided for male and
female managers going forward.
The way the data is presented in this paper could be useful for practitioners to use when
introducing PSC and COPSOQ to the workplace.
Keywords: Managers, COPSOQ III, Work from Home, Psychosocial Safety Climate.

51st Nordic Ergonomics and Human Factors Society Conference 2022
2
1. Introduction
Managements working conditions predicts how well they lead their own teams (Parent-Lamarche
& Biron, 2022). When managers experience favourable work environment conditions, they are
more equipped to care for their own group (Parent-Lamarche & Biron, 2022). The working
conditions of managers during the pandemic are of particular importance because they were
suddenly faced with a new challenge - how to lead their teams remotely while at the same time
being accountable for their employee’s working environment. This sudden move of work into the
home meant that the social part of work shifted immediately from the physical to digital space.
New tools and work practices had to be put in place as quickly as possible. This disruption in
working life had to be led and navigated by managers. Their ability to do this well has had
significant implications for productivity (Omorede, Berglund, & Backström, 2022). Little is
understood today about the organisational and social working conditions of managers during the
pandemic while working from home (WFH). Sweden is described as the odd one out compared
to other European countries, and even globally becuase their approach was less restrictive. We
will be providing some insight into organisational priorities, the organisational and social work
environment (OSWE) conditions and health of managers during the pandemic in Sweden and also
comparing them to pre-pandemic national reference data (Berthelsen, Muhonen, Bergstrom,
Westerlund, & Dollard, 2020; Berthelsen, Westerlund, Bergstrom, & Burr, 2020).
1.1 Psychosocial safety climate
Psychosocial safety climate (PSC) is a contextual measure of how well upper management shows
through what they say and do that employee mental health is important. PSC predicts managerial
quality, manager burnout (Parent-Lamarche & Biron, 2022), depression (Zadow, Dollard,
Dorrman & Landsbergis, 2021) and performance outcomes (Dollard, Opie, Lenthall, Wakeman,
Knight, Dinne, Rickard & McLeod (2021). PSC has four theoretical domains, each concerning
psychological health; manager support and commitment, management priority, organisational
communication & organisational participation and involvement (Hall, Dollard, & Coward, 2010).
The higher the level of PSC, the more positive the OSWE is likely to be, as are health-related
outcomes (Dollard & Bakker, 2010). Given the importance of PSC and its role as the cause of
causes of work-related stress and work engagement (Dollard & Bakker, 2010) - our first research
question is Q1. What is the level of psychosocial safety climate among managers working from
home during the pandemic?
1.2 Organisational and social work environment
The organisational work enivornment refers to how work is organised and includes aspects such
as work-load and work pace. The social work environment depicts relationships at work, such as
social interaction and support from peers and managers (Swedish Work Environment Authority,
2016). The social insurance agency in Sweden recognises that OSWE conditions are a significant
contributor to mental health problems (Forsäkringskassan, 2016). Research shows that the OSWE
contributes to stress-related ill-health, depression, anxiety and sleeping problems (Lytsy &
Friberg, 2020). In addition to mental health problems, there is an increased risk for heart attacks,
high blood pressure, strokes, and type-2 diabetes (Lytsy & Friberg, 2020). Being fairly treated
and able to influence the work environment is linked to positive outomes such as fewer incidences
of exhaustion and depression (Swedish agency for health technology assessment and assessment
of social services, 2014).
In Sweden, legislation requires companies to work systematically with their organisational and
social risks (Swedish Work Environment Authority, 2016; The Swedish Work Environment,
2001). This legislation is also valid for the managers working conditions. In this study, we address
the question: RQ2. How does managers’ organisational and social work environment compare to
pre-pandemic reference values? And because managers’ mental health impacts their ability to

51st Nordic Ergonomics and Human Factors Society Conference 2022
3
support their staff (Parent-Lamarche & Biron, 2022), we also ask RQ3. How does manager
burnout compare to pre-pandemic reference values?
2. Methodology/approach
This study has a cross-sectional design. Survey data was collected April-May 2021, one year into
the COVID-19 pandemic. The Ethics Review Authority approved the study (Dnr 2021-00106).
2.1 Sample
The data was collected through Survey Monkey in four organisations in Sweden: retail (n=60
managers), bank (n=11), construction (n=30) and municipality (n=33). The Swedish Institute for
Quality also shared the survey online, adding data to the sample (n=27). Sixty-nine of the
managers that answered the survey were male (mean age: 48), and 92 were female (mean age 46).
The sectors which participated were a convenience sample.
2.2 Measurement
We used the Swedish version of the four-item PSC questionnaire (Berthelsen, Muhonen, et al.,
2020) and some of the core items from the Swedish version of the Copenhagen Psychosocial
Questionnaire III (Berthelsen, Westerlund, et al., 2020). Two questions from a previous version
of the Copenhagen Psychosocial Questionnaire II were added to cover the effect of private life on
work (Pejtersen, Kristensen, Borg, & Bjorner, 2010). All items had five response options on a
Likert scale. The COPSOQ items were scored 100, 75, 50, 25, 0. Scale scores were calculated as
the mean item score and was set to missing if respondents had answered fewer than half of the
questions. Scales were scored in the direction indicated by its name.
2.3 Benchmark comparison
These results in this study are compared to the national reference values for Sweden (Berthelsen,
Muhonen, et al., 2020; Berthelsen, Westerlund, et al., 2020). Because of limitations in the number
of items we could include in the survey, some of the items in the survey we used have 1 item
fewer than the scale used to calculate the benchmark value (Table 1). This is important to take
into consideration when making the comparisons. The national benchmark values can be found
in Table 4 (Berthelsen, Westerlund, et al., 2020).
Table 1. Scale reliability
Measures
Number of
Items in our
survey
Number of items
used to calculate
national
benchmark values
Cronbach’s
Alpha
Psychosocial safety climate **
4
4
.89
Quantitative demands
2
3
,73
Work pace
1
2
-
Possibilities for development
2
3
.60
Meaning of work
1
1
-
Social support from colleagues
1
2
-
Quality of leadership
3
3
.83

51st Nordic Ergonomics and Human Factors Society Conference 2022
4
Social support from the supervisor
2
2
.73
Work-life conflict
2
3
.81
Life-work conflict*
2
0
.85
Burnout
3
3
.82
When the construct is written in italics this means that it was measured using same items as the
scale used to calculate the national benchmark values (Berthelsen, Westerlund, et al., 2020)
*COPSOQ II (Pejtersen et al., 2010) **PSC-4 scale (Berthelsen, Muhonen, et al., 2020)
3. Results
All managers worked similar hours before (42h per week) and during the pandemic (43h). The
number of hours worked from home increased from 6 hours before the pandemic to 38 during the
pandemic. There was no significant difference when comparing male and female managers.
3.1 Psychosocial safety climate results
PSC scores can range from 4 to 20. The respondents report on average a PSC-score of 14. The
pre-pandemic PSC score was 12.8 in a national sample for managers who have staff who report
to them (Berthelsen, Muhonen, et al., 2020).
3.2 Work environment and health results
We found that quantitative demands, work pace, social support from colleagues & supervisors
and work life balance were better for managers during the pandemic (Table 2) in our sample
compared to the pre-pandemic manager results for Sweden (Berthelsen, Westerlund, et al., 2020).
Male managers reported significantly lower levels of work demands compared to female
managers and a lower impact of work life on private life. Male managers also reported less social
support from their supervisor. The terms higher / lower means that there is difference of +/- 5 in
our data compared to the COPSOQ III benchmark values (Llorens, 2019). Possibilities for
development, meaning of work, quality of leadership and burnout are similar to the pre-pandemic
values.
Table 2. Managers work environment and health results compared to pre-pandemic benchmark
values.
Work factors
All
managers
Male
managers
Female
managers
Benchmark
values
Wanted value
(high or low)
Quantitative demands
42,77
36,7*
47,3*
51,5
Low
Work pace
58,01
58,2
57,6
63,3
Low
Possibilities for development
78,6
77,3
79,4
79,3
High
Meaning of work
81,2
78,9
82,8
83,3
High
Social support from colleagues
86,25
86,3
86,1
79,6
High
Quality of leadership
60,86
62,1
59,9
57,7
High
Social support from supervisor
83,46
79,5**
86,4**
77,7
High
Work life conflict
34,78
32,6**
36,4**
44,5
Low

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Life work conflict
11,8
13
10,1
none
Low
Burnout
28,8
27,6
29,7
29,5
Low
* (p <0.05 or less), ** (p <0.06) Italics – same items used in this study as used to calculate
benchmark values (Berthelsen, Westerlund, et al., 2020)
4. Discussion and practical implications
Working during 2020-2022 changed. Many people worked from home to save lives because of
the COVID-19 pandemic. We know that during this time, there were advantages such as being
able to work uninterrupted and saving time on commuting. On the other hand, staff missed the
social interaction with their colleagues (Ipsen, van Veldhoven, Kirchner, & Hansen, 2021), and
creative work was hampered (Backström, Berglund, & Omorede, 2022). There is, however, less
knowledge specifically about the working conditions of managers during this time. We add to the
body of knowledge by assessing managers’ PSC, OSWE, and burnout and comparing our data to
pre-pandemic reference values.
According to PSC theory, PSC predicts the organisations’ OSWE conditions and the managers’
ability to care for their teams. We wanted to know Q1. What is the level of psychosocial safety
climate among managers working from home during the pandemic? For managers, a PSC score
of 12 or above on a scale of 4-20 is considered high (Berthelsen, Muhonen, et al., 2020), and the
managers in this study reported a score of 14. The PSC scores in this sample show that
management perceives that their senior management prioritises, supports and is committed to their
psychological health. Furthermore, the managers in this sample report that their organisation
communicates about psychological health and involves all levels in work to improve working
conditions essential for good mental health. However, we do not know if the managers
experienced a good PSC before the pandemic or if senior management decided to “step up” during
the crisis, as in Australia (Dollard & Bailey, 2021).
Moving on to the manager’s working conditions, we asked RQ2. How does managers’
organisational and social work environment compare to pre-pandemic national reference values
for a corresponding group?
Although many workers across Europe experienced increased work intensity during the pandemic
(Eurofound 2021a), this is not the case for the managers in this sample. The managers in this
sample reported better work demands, work pace, social support from colleagues, supervisors,
and better work-life balance.
Quantitative demands were lower than pre-pandemic levels for all managers. However, male
managers reported significantly lower quantitative demands than female managers. Again, we
don’t know if this difference was present pre-pandemic however, this difference is interesting to
discuss. We know that men and women react similarly to the same OSWE conditions – their
reactions are not due to the managers being male or female but instead linked to the working
conditions they are exposed to (SBU, 2014). McKinsey and Company (2021) found that
“compared to men at the same level, women managers are taking more action to support their
teams, from helping employees manage their work-loads to checking in regularly on their overall
well-being” (McKinsey, 2021, p. 17). The McKinsey report refers to managers in the U.S. - could
this also be the case for managers in Sweden?
We also asked questions about the work-life balance of managers. WFH has implications for
work-life balance because of the increasingly unclear work-life boundaries (Eurofound, 2020b).
We could see from the manager’s data that the impact of work on home life was lower than pre-
pandemic levels, more so for male managers than female managers. What was most interesting
in this section of the data is that the impact of home life on work is low. There are no benchmark
scores available, but it seems very low compared to the effect of work on private life. This was

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surprising since the workplace moved into the private home. Backström, Berglund & Omorede
(2022) found that people were distracted by cues in their home, interrupting their train of thought
(Backström, Berglund & Omorede, 2021).
Ipsen (2020) reports that work-life balance improved while WFH in Europe, whereas studies in
specific countries such as Italy state that during the pandemic, “working women bear the brunt of
the increased time needed for household chores and childcare” (Del Boca, Oggero, Profeta, &
Rossi, 2020, p. 1013). Even countries rated as high in equality found that gender norms were
exaggerated during the pandemic, and there was an increase in expectations in the home toward
mothers (Hjalmsdottir & Bjarnadottir, 2020). Our data support Ipsen’s findings. However, there
does seem to be some support for the difference between male and female managers.
4.4 Limitations
Our data is compared to the COPSOQ III national benchmark levels (Berthelsen, Westerlund, et
al., 2020). For certain categories a one questions was removed because of limitations on the length
of the survey. However, given the expected correlation in responses between the questions in each
category, the comparison with the national benchmarks would be expected to be robust so as to
give a qualitatively similar picture. Future studies should use the complete Swedish version of the
COPSOQ III scale when comparing benchmark values. Our study builds on a convenience
sample, and therefore generalisation of the findings is limited. There are still many unanswered
questions. A new round of data collection is underway. As we advance, we will be able to compare
the managers OSWE during and after the pandemic, which will provide some further insights.
Qualitative data could help us understand the differences identified when comparing male and
female managers.
5. Conclusions
Managers report that their senior management prioritised psychological health during the
pandemic resulting in a higher PSC score than pre-pandemic benchmark levels. A high PSC can
be achieved when working almost entirely from home. Quantitative demands, work pace, social
support from colleagues and supervisors, and work-life balance were also higher than pre-
pandemic levels. Male managers’ report better work-life balance and demands than female
managers, and female managers’ report better levels of supervisor support. We know from
previous research that working conditions differ because work is organised and prioritised
differently for male and female employees (SBU, 2014). Workplaces should pay attention to
differences in working conditions provided for male and female managers going forward.
The way the data is presented in this paper could also be useful for practitioners to use when
introducing PSC and COPSOQ to the workplace.
References
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XXXIII ISPIM Innovation Conference “Innovating in a Digital World”, held in Copenhagen,
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Bakker, A. B., & Demerouti, E. (2016). Job Demands-Resources Theory : Taking Stock and
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Berthelsen, H., Muhonen, T., Bergstrom, G., Westerlund, H., & Dollard, M. F. (2020).
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and childcare, before and during COVID-19. Rev Econ Househ, 1-17. doi:10.1007/s11150-
020-09502-1.
Dollard, M. F., & Bailey, T. (2021). Building psychosocial safety climate in turbulent times: The
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Dollard, M. F., & Bakker, A. (2010). Psychosocial safety climate as a precursor to conducive
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Dollard, M. F., Opie, T., Lenthall, S., Wakerman, J., Knight, S., Dunn, S., Rickard, G., & McLeod,
M. (2012). Psychosocial safety climate as an antecedent to work characteristics and
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Eurofound (2021a), Working time in 2019–2020, Publications Office of the European Union,
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Eurofound. (2020b). Living, working and COVID-19, COVID-19 series. Retrieved from
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Forsäkringskassan. (2016). Sjukskrivning för reaktioner på svår stress ökar mest. Korta analyser
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Guidelines and questionnaire". Retrieved from https://www.copsoqnetwork.org/guidelines
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https://doi.org/10.1136/bmjopen-2020-044133.

51st Nordic Ergonomics and Human Factors Society Conference 2022
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Organisational Capabilities for Developing the System Operator Role in
the Norwegian Power Grid
Asgeir Drøivoldsmo (1) and Lars Hurlen (2)
(1) Institute for Energy Technology, Norway Asgeir.Droivoldsmo@ife.no,
(2) Institute for Energy Technology, Norway Lars.Hurlen@ife.no
Abstract: This paper describes a practical case with test of the capability approach for
development of operational capabilities for an electric power distribution system operator.
The purpose was to test the method regarding its usefulness in mapping of future resource
and competence needs in a situation where the company was given more responsibility in the
electricity grid. The method incorporates and integrates elements of change management,
applies a top-down perspective to define the organizational change and combines top down
and bottom-up perspectives to define the development of resources. Based on the identified
requirements from an organisational capability development analysis, steps relevant for
building an effective work system for supporting reorganised ownership in the electricity grid
are presented. The results further describe a model from offshore oil differentiating between
daily operations, operational support and strategy work adopted to the company. In the
resulting solution, capabilities for voltage and power optimisation are mapped out and
described in work processes and tools for the operational support functions in the company.
Keywords: Macroergonomics, Organisational capabilities, Work processes, Work system
design
1. Introduction
Norwegian electric grid distribution system operators (DSOs) are in a situation of major
technological and organisational changes due to increased introduction of renewable energy and
adaption to European Union standardisation of regulations. A change in the future organization
of the electricity grid with the implementation of the EU Electricity Directive 3 and the transition
from 3 to 2 grid levels lead to changes in tasks, roles and ownership (NVE, 2017). DSO grid
companies notice such changes in the form of more responsibility for the regional distribution
system. In the event of such a change, there is a need to establish knowledge about how the
organization is to be adapted to handle an extended responsibility and what organizational
measures can be taken to utilize the opportunities that lie in this. At the same time there is also a
need to establish knowledge about how organizations should be empowered to handle the
transition to a more digitalised way of working. Digitalisation cause a strong focus on technology
as the driver of change. However, to create value from the digitalisation, it is important to design
work systems that benefit larger parts of the organization’s and to achieve this, there is a need for

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holistic macroergonomic methods (Hendrick and Kleiner 2002, Kleiner 2006) that can contribute
to the early phases of design of work systems and harvest the added value made possible by new
technology. Reegård et al. (2020) propose the capability approach as a useful framework in this
setting:
“Although several other macroergonomic methods exist, these did not seem fitting to the task at
hand because they do not fully take into account the external environment and how that may
disrupt the organization’s existing way of working. The Capability Approach was developed for
organizational (re-)design in such settings. It builds on the theoretical basis of dynamic
capabilities that is specifically concerned with how organizations maintain evolutionary fitness
by responding to opportunities and threats in the business environment. The approach is further
operationalized within applied work system design and the field of macroergonomics”.
Development of desired organisational capabilities
must be based on peoples’ needs and solve problem
situations (Auernhammer and Leifer 2019). Using
Henderson (2013) a capability refers to the combined
capacity and ability to plan and execute in accordance
with the targeted business objective(s) through a
designed combination of people, processes,
organisation and technology. Hence, the approach
aims to design work systems, focusing on the
configuration of resources that, combined, enable the
delivery of targeted outcomes.
When addressing and developing new competences
in the organization, the company needs a framework
for selection, development and implementation of
appropriate measures. Henderson et al. (2013)
presents a framework for competence intensive
organizations as a capability stack model. In
(Reegård et al. 2019 and Reegård et al. 2020), this
model was adapted to represent the identified
organizational capabilities in the company stack to
support the further development of competences
Figure 1. Capability stack model with three layers.
From Reegård et al. (2019). A number of case
studies have been performed to test the model
(figure 1). The strength of such a model is that it
provides a logical division between a foundational
layer with technology and intelligent infrastructure
and more operational layers describing the required human, process, organisational and
technologic resources to produce effective work. The model highlights that to make this happen,
the needs of each operational task or service must be addressed through alignment of all layers.
2. Method/approach
The method used is based on the capability approach for integrated operations in the oil industry
and is a step in establishing a framework for work processes and the human, technological,
procedural, organisational, and regulatory elements that must be in place for work to be
implemented effectively (Henderson et al. 2012, Reegård et al. 2014, Reegård et al. 2015) The
method has been further developed and refined through a number of case studies and tested in
different domains (Reegård et al. 2020).

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As shown in figure 2, the capability approach method has four main steps. The first step is a
contextual analysis focusing on business drivers, opportunities and constraints of operations.
The purpose of this first step is to identify most influencing contextual aspects for delivering
performance. This analysis is done with the purpose of understanding the future situation
(to-be situation) and identify aspects of the future situation that make it necessary to
establish measures that differ from the current operational conduct. The next steps are to
identify the capabilities or new features that are critical to operation and detail these. In the
work with detailing, it may be appropriate to describe capabilities in a stack model to
distinguish between different types of resources the company possesses. Further
development of the capabilities will comprise clear goal definitions and hypothesis for their
deliveries in the organization. The final step is to design the combination of people,
processes, technology and management principles that capabilities are built up from, putting
up requirements for each of the four elements.
Figure 2. Process for targeting capability development
For the test case, data was collected over a 4-month period and semi structured interviews with 8
respondents covering both operations and the managerial roles in the organisation. Operational
principles and a work process developed for offshore oil, was adopted, and refined through several
iterations identifying content of the future work processes of the DSO. Capabilities were further
developed through interviews and a workshop. Data collection took place in the period October
2019 to February 2020. The respondents interviewed covered both management, operating
environment, and support functions. The 8 interviews were conducted a semi structured interview
in approx. 1 hour each where some questions were adapted to the role and responsibilities covered
by positions that were interviewed. In addition, a visit was made to the operations centre with a
review of the operation of the control systems. Finally, a mini workshop was arranged with three
participants from the DSO and a discussion of proposed solutions.

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3. Results and Discussion
The results describe the outcome of the analysis performed according to the description given in
the method chapter. The results describe areas that the company must develop to realize the
greatest possible benefit from utilizing new technologies, and this was identified by (1) mapping
drivers from the surroundings and assessing this against the status of digitalization work within
the organization. (2) Detailing new tasks and assigning them to different functions in the
organization. (3) Identification of key processes relevant for delivery of target capabilities, and
(4) development of requirements for key capabilities.
3.1 Contextual assessment – identifying the drivers, defining and detailing
capabilities
Using the Norwegian department of energy and regularity authority analysis of the industry as a
starting point, (OED 2015, NVE 2016) interviews revealed the following drivers for change as
relevant for the future role of the company. The following areas were identified as the most
prominent:
• Increased need for dynamic regulation:
• Changing consumption patterns (use of power, “plus customers” delivery)
• Increased flexibility in balancing the power system. Increasing demands and
expectations from the end customer
• Changes in climate – temperature/precipitation/wind
• New opportunities for optimisation in the DSO role:
• Reducing losses (finances and more efficient use of energy)
• Improve voltage quality (delivery)
• Handle nonconformities/operational disturbances better/more efficiently
• Opportunity for improved diagnostics in low grid levels, close to customer
• Stricter safety requirements
• Stricter access control
• Increased "bureaucracy"
• Safety of electricity supply
• Reduced tolerance for interruptions
• Increased interruption costs per kWh
• The value of power consumption in society is increasing
• Variations in voltage quality can increasingly cause damage to equipment
The contextual analysis described main drivers for transformation were identified and how these
were expected to impact on the DSO, and the organization’s readiness to meet the future demands
(see Reegård et al. 2020 for an elaboration). The analysis also revealed an additional need for
defining resources and requirements, not only as a resource stack, but different time scales,
considering both short loop and long loop work processes. For this development the model for
collaborative work and operational support by Van den Berg et al. (2015) was used as a basis.
Van den Berg divides between the more immediate day-to-day work, support functions and the
more long-term analysis and optimization work. The resulting mapping of need for work
processes is shown in figure 3.

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Figure 3. Necessary activities to operate both regional and distribution networks divided according to model adopted
from the petroleum industry
The most prominent area for improvement was reported to be grid losses. With good planning of
the distribution grid active and reactive power flow and voltage conditions, the various
considerations can be balanced for better utilisation of the grid, with the least possible loss. In the
as-is situation, seasonal calculations are essentially the basis for voltage optimization. Continuous
management of reactive power is not a high priority today but should be prioritised in the future.
The to-be analysis showed a clear potential to strengthen the company's ability to perform day-
to-day operational support in order to perform voltage optimization. Capabilities for supporting
the day-to-day operation and operational support were selected for further detailing. The resulting
capability definition for the operations and support is shown in table 1. For the purpose of
exemplifying, we will mainly rely on our work with the voltage optimisation capability in the
remainder of this paper.
Table 1. Defining and detailing capabilities
High level goal
To reduce losses in the grid
Situations for use
Continuous improvement, development projects,
Specific goals
Development and implementation of new work processes, tools, methods
and competence for functions in the organisation delivering operations
and support pertaining to grid losses.
Hypotheses for
deliveries in the
organization
Continuously handle voltage and reactive power flow in the regional
grid. Interpret and pursue opportunities made available through
development of analysis tools and improved information exchange
between higher and lower levels in the grid.
Hypotheses for
resource
development needs
Resource capacity, structural measures for coordination, communication,
selection, development and follow-up of key roles and required work
processes
Further detailing of the to-be situation was done in the interviews. The respondents from the
interviews saw a big upside of giving the DSO new responsibility in the regional grid. Especially
withing voltage quality and reduction of losses could be improved with the new responsibility.
Several prerequisites were mentioned for the benefits to be harvested. It was pointed out that the
work of gaining an improved overview of reactive components in the grid could provide many
future opportunities. Assumptions identified in the interviews were typically technical, like more
suitable capacitor batteries with improved optimisation and control. The future DSO role with

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responsibility for the regional grid was considered to be more about increased responsibility than
about increased workload. On the other hand, an increased workload was also expected as a result
of the more general drivers described, which is not necessarily related to the new DSO role alone.
The amount of short loop work with control was assumed to be dependent on the organisation of
the optimization tasks. Detailing of the to-be situation is shown in figure 4.
Figure 4. As-is situation and to-be situation where the DSO take more responsibility in the grid. The normal font/black
text describe current activities. The text marked in red italics font is describing additional activities due to more
responsibility. Division based on Van den Berg et al. (2015)
The final step of the capability approach was to put up requirements for the capabilities according
for each of the PPOT elements. The resulting requirements for the operations and support
capabilities are shown in table 2.
Table 2. Requirement definition
Voltage
optimization
People
Process
Organisation
Technology
Monitor voltage in
the local and
regional grid:
Respond to error
messages and
alarms and detect
deviations
Give feedback for
analysis and
optimization
planning
Monitoring
competence for
the regional grid
Work process for
weekly voltage
optimization
Defined support
resources and
developed and
quality assured
company
governing
documentation
Overview images for
voltage and alarming
Decision support to prevent
erroneous operations
Real-time voltage
problem solving:
Maintain voltage
quality
Handling
unplanned stops
Regulatory
competence for
the regional grid
General
descriptions/
problem solving
procedures
Defined support
resources
Decision-making
authority
Access to real-time values
and production schedules
currently not available from
the TSO and Improved
interface for efficient
production management
Monitor reactive
Monitoring
Work processes
Defined support
Overview images for TSO
power flow in the
competence for
for optimizing
resources
voltage and reactive power,
local and regional
the regional grid
voltage.
trending, and alarming
grid: Detect
Power flow
(real-time values currently
deviations from
optimization work
not available)
desired values
process
Components info in the
Feedback for
transmission gird
analysis and
optimization
planning

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Adjust reactive
power flow
(actions)
Respond to error
messages and
alarms
Technical and
strategic under-
standing of
reactive power
optimization,
instruments in
the local and
regional grid,
interaction skills
Work process for
optimizing
voltage and
reactive power
throughout the
week
Defined support
resources
Decision-making
authority
Active set-point control of
transformers
Direct voltage control from
generators to support set-
point voltage
Capacitor batteries
The results from our case-based method in defining and detailing the voltage optimization
capability are provided in Table 2. This description supported a set of business process swim-line
diagrams for the day-to-day optimisation of voltage and reactive power and operational planning.
The requirement table was not developed further according to the layered model presented in
figure 1, but has clear requirements pertaining to all levels of the stack model. The similarities
between the situation the oil industry was in a few years ago and the situation facing grid
companies today are several. There are large amounts of data available for analysis and retrieval
of information that can be used for more active management to avoid loss in the grid. Efficient
use of these data will depend on quality tools, clear processes for information sharing and follow-
up, dedicated roles/positions and the development of competence within multiple parties. The
need for the organisation to establish a supporting analytics capability to help the operational staff
is clearly present for the monitoring activities identified in table 2.
3.2 The capability approach for development of operational capabilities
In previous work with testing and verification of the capability approach, the focus has been more
on support capabilities and cross silos solutions for the organization (see figure 1). This case study
is about development of resources supporting a specific delivery from the organization. First part
of the analysis relates to the organizational level and the external environment in which the
company operates and in accordance with principles for macroergonomic methods it takes both
the top-down and bottom-up perspective into account and approaches the overall design task
through several iterations, each attempting to increasingly specify the design. This way of aligning
the goals of management with the needs and perspectives of the employees in an active design
process showed to be imperative for mapping the needs for competence in this case study. Along
with the petroleum industry inspired division of short loop and long loop processes the approach
showed effective for developing a structure for the data gathering and requirement development.
5. Conclusion
This study is one of a number of case studies performed to identify and describe capabilities grid
operators need to develop to meet the challenges from massive electrification of the society. As a
test of an macroergonomic method, this study has focused the definition and development of an
operational capability for voltage and reactive power optimisation, supporting the development
of business processes relevant for the DSO’s future operations. Other studies in this project have
focused development of organic capabilities that can support this type of operational capabilities
and that can be utilized in various situations that the DSO faces and across different functions in
the organization. In this paper we chose to focus the practical aspects of how the capability
approach method can be used in early project phases and deliver methodology and insights
through specification if competence (people), process development, organisation/governance and
technology requirements for the implementation of new capabilities in the organisation. We find
that the Capability Approach successfully delivered for the practical purposes and allowed us to
adhere to the macroergonomic principles, following a socio-technical systems approach.
Acknowledgments. This research was supported by the Research Council of Norway, grant no.
269358.

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References
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design practice?. In Proceedings of the Design Society: International Conference on
Engineering Design (Vol. 1, No. 1, pp. 1205-1214). Cambridge University Press.
Hendrick, H.W., and Kleiner, B.M. (Eds.) (2002). Macroergonomics: Theory, Methods, and
Applications. Mahway, New Jersey: Lawrence Erlbaum
Henderson, J., Hepsø, V. and Mydland, Ø. (2012): What is a Capability Platform Approach to
Integrated Operations? An Introduction to Key Concepts. In: T. Rosendahl and V. Hepsø
(Eds.) Integrated operations in the oil and gas industry: sustainability and capability
development. (pp. 1-19). Hersey, PA: IGC Global
Kleiner, B. M., (2006) Macroergonomics: Analysis and design of work systems. Applied
Ergonomics, 37(1), 81-89.
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Reegård, K., Drøivoldsmo, A., Rindahl, G. and Fernandes, A. Handbook - The Capability
Approach to Integrated Operations, IFE/HR/F-2014/1604 (2014), http://www.iocenter.no/
Reegård K., Rindahl G., Drøivoldsmo A. (2015) Strengthening the HF/E Value Proposition:
Introducing the Capability Approach. Proceedings of the Human Factors and Ergonomics
Society Annual Meeting. 2015;59(1):1192-1196. doi:10.1177/1541931215591186
Reegård, K., Drøivoldsmo, A., Farbrot, J. E. and Hurlen, L. Drivers for transforming the power
grid company. In: Broberg, O., & Seim, R. (Eds.) (2019). Proceedings of the 50th Nordic
Ergonomics and Human Factors Society Conference. https://doi.org/10.11581/dtu:00000061
Reegård, K., Drøivoldsmo, A., Farbrot, J.E. (2020). Defining Organizational Capabilities in an
Electric Power Distribution Grid Operator to Meet Future Demands. In: Kantola, J., Nazir, S.,
Salminen, V. (eds) Advances in Human Factors, Business Management and Leadership.
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https://doi.org/10.1007/978-3-030-50791-6_59
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Work Environments in Shell—Global Scale, Learning and Evolution SPE 167455, Intelligent
Energy, Dubai, 2013.

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The key role of the employee in accident prevention and ergonomics as
a tool to achieve a safe working environment
Petr KOUTNÝ (1), Hana LEHOCKÁ M.D., PhD. (2), Ivana BARTLOVÁ (3)
(1) Public Health Institute Ostrava
(2) Public Health Institute Ostrava
(3) VSB - Technical University of Ostrava - Faculty of Safety Engineering
Abstract: In today’s labour market environment, a question of an abundance or rather a
shortage of qualified workforce is becoming increasingly relevant. Any loss of a qualified
employee due to a work-related injury, occupational disease or illness (further on as incident)
poses a major problem for employers. In accordance with The Union's OHS strategic
framework for 2021-2027 published by the European Commission, the authors have defined
the incidents prevention process whilst focusing on the key cause investigation and
subsequently on the adoption of specific solutions with emphasis on musculoskeletal disorders
and psychosocial risks. To achieve the set goals, the authors have applied ergonomics – a
system comprising of human / technology / work-environment subsystems. Within the system,
a human is subjected to both short- and long-term hazard effects. To conclude, the authors
have presented practical examples of the mentioned measures being put into practice.
Keywords: Ergonomics, Incident, Psychosocial risks.

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1. Introduction
In today’s labour market environment, a question of an abundance or rather a shortage of qualified
workforce is becoming a more frequently discussed matter in many regions in the Czech Republic,
as well as in the EU. Comprehensive assurance of occupational health and safety matters is one
of the problems.
To reinforce the importance of implementing the OHS rules to their full extent, the European
Commission has issued communication to define the Union’s OHS strategic framework for 2021-
2027 (Communication COM/2021/323). This strategic framework focuses on three cross-
sectional targets. The authors of this article have chosen to look more closely on two of the targets
– Improving prevention of workplace accidents and illnesses and Anticipating and managing
change in the new world of work brought about by digital and demographic transitions with
focusing on psychosocial risks.
The authors’ objective was to define the accident prevention process (occupational injury,
occupational and work-related diseases). Within the accident prevention process, the authors have
focused on the accident investigation (finding the root cause), followed by adopting specific
solutions. International Labour Organization (ILO 2015) states that quality investigation should
uncover not only the most obvious but above all the root causes. These causes need to be
eliminated as soon as possible by adopting preventive and control measures which will disrupt
the chain of causes. ILO illustrates this with an example of weed where the weed represents the
accident, the stalk is the obvious causes and the root is the root causes. If the weed is cut down at
the stalk, it will die but can later grow again; taking out the roots will fully destroy the weed.
When looking for the root causes, it is crucial to focus on musculoskeletal disorders (MSD) and
psychosocial risks. This is because, according to the EU researches (de Kok et. al, 2019), 60% of
all employees state musculoskeletal disorders as the main problem and 16% of all employees then
consider this being stress, depression and anxiety. These problems are caused by the very
psychosocial risks. According to the European Agency for Safety and Health at Work, MSDs
affect millions of workers just within Europe. This brings a huge health but also social and
economic problem. Relatively young people are stigmatized even after a short-term exposure and
their further employability is reduced (Jirák & Lehocká, 2001). The need for addressing the MSD
issues is stressed by EU-OSHA in Healthy Workplaces Campaign 2020-2022 – Healthy
Workplaces Lighten the Load; it aims to raise awareness of work-related MSDs and to
disseminate information about how they can be prevented and managed (EU-OSHA, 2020).
Tomáš Baťa, a famous Czech businessman, was inspired by the industrial production in Ford
Motor Company and upon his return to Zlín, he realized that he too needs to provide his employees
with work not only as a source of livelihood but also with work that corresponds with the
employees’ physical and psychological abilities. It is further necessary to ensure such working
conditions that would prevent work accidents and other work-related damage to health. It should
also be ensured that work doesn’t become a stress matter but leads to satisfaction and sense of
belonging to the company. Baťa further understood the importance or relaxation, physical and
psychological, for restoration of manpower (Bakala et. al, 2002).

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1.1 Definitions
•
Hazard – according ISO GUIDE 73:2009 (International Standard for Standardization,
2009) is source of potential harm.
•
Risk identification – according ISO GUIDE 73:2009 (International Standard for
Standardization, 2009) involves the identification of hazard, events, their causes and their
potential consequences.
•
Risk assessment – according ISO GUIDE 73:2009 (International Standard for
Standardization, 2009) is process which contains: risk identification – risk analysis – risk
evaluation.
•
Accident (incident) - according ISO 45 001:2018 (International Standard for
Standardization, 2018a) is defined as occurrence arising out of, or in the course of work
that could or does result in injury and ill health.
•
Injury and ill health – according ISO 45 001:2018 (International Standard for
Standardization, 2018a) are defined as adverse effect on the physical, mental or cognitive
condition of a person. These adverse effects include occupation disease, illness and death.
•
Occupational injury – according International Labour Organization (ILO, 2020) is any
personal injury, disease or death resulting from an occupational accident. An occupational
injury is therefore distinct from an occupational disease, which is a disease contracted as
a result of exposure over a long period of time to risk factors arising from work activity.
•
Occupational disease – according European Agency for Safety and Health at Work (EU-
OSHA, 2022) is any disease caused primarily by exposure at work to a physical,
organisational, chemical or biological risk factor or to a combination of these factors.
Occupational diseases are mostly those listed in national legislation as resulting from
exposure to risk factors at work. The recognition of an occupational disease may be linked
to compensation if it is clear that there is a causal relationship between an occupational
exposure and the disease.
•
Work related diseases (illness) - according European Agency for Safety and Health at
Work (EU-OSHA, 2022) is any illness caused or made worse by workplace factors. This
includes many diseases that have more complex causes, involving a combination of
occupational and non-work-related factors.
1.2 Ergonomics as key instrument for reaching our goal
To apply ergonomics as a workplace accident prevention instrument we must devise its definition,
including its very goal, aiming for assuring OHS in its full extent – apart from prevention of long-
term risks exposure (work-related or occupational disease), it is important to also focus on
prevention of short-term risks exposure (occupational injury).
According to International Ergonomics Association (IEA, 2000), ergonomics is the “scientific
discipline concerned with the understanding of interactions among humans and other elements of
a system, and the profession that applies theory, principles, data, and methods to design in order
to optimize human well-being and overall system performance - Physical ergonomics is
concerned with human anatomical, anthropometric, physiological and biomechanical
characteristics as they relate to physical activity; Cognitive ergonomics is concerned with mental
processes, such as perception, memory, reasoning, and motor response, as they affect interactions
among humans and other elements of a system; Organizational ergonomics is concerned with

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the optimization of sociotechnical systems, including their organizational structures, policies, and
processes.”
International Ergonomics Association further states that ergonomics contributes to creating safe
and sustainable work systems by considering the elements’ mutual interconnection – human,
technology, work environment.
There are many goals of ergonomics. If we want to interlink ergonomics with the accident
prevention, we must combine more of those (due to the text reduction, only the key definitions
parts will be selected) - Champanis (Champanis, 1995) states the safety increase as one of the
goals and International Labour Organization (ILO, 2011) states that ergonomics standards were
created in order to prevent injuries or any harmful effects on health.
Based on the information provided above, we can conclude that ergonomics is a multidisciplinary
branch of science that deals with interlinks among human, technology and environment and is
split into three subject areas – physical ergonomics, cognitive (psychological) ergonomics and
organizational ergonomics. The ergonomics’ goal is to achieve balance among human, technology
and work environment by optimizing their interlinks which then leads to increased safety and
accident prevention.
Should we look closer at the definition of ergonomics, we could find references to
musculoskeletal disorders (MSD) and psychosocial risks.
2. Methodology/approach
2.1 Optimization process
According to International Labour Organization (ILO, 2011), there is an interconnection among
individual elements which means there are
certain links binding the individual
elements together and that creates a certain
system. To achieve the desired goal, the
optimizing process of the individual
elements’ links must be applied. In ideal
cases, a balanced state can be achieved
which can then be identified as optimal
work conditions.
There is a whole range of tools for applying
the optimization process. For the purposes
of this matter, we have chosen the system
defined by ISO 45 001 (International
Standard for Standardization, 2018a), based
on Plan-Do-Check-Act as its goal is
identical with the one of ergonomics: “The
aim and intended outcomes are to prevent
work-related injury and ill health to workers
and provide safe and healthy workplaces”.
The system’s individual steps are specified
in Figure 1.
Figure 1 – Process of optimalization

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2.2 Risk assessment
According to ISO 45 001:2018 (International Standard for Standardization, 2018a), risk
identification should include mainly - Work organization, social factors (e.g., work hours / night
shift) Routine and non-routine activities and situations including hazards arising from:
infrastructure, equipment, materials, physical condition of the workplace; Past relevant incidents
International Labour Organization in its definition of occupational injury (ILO, 2020) splits
possible consequences into two groups based on time. An occupational injury is therefore distinct
from an occupational disease, which is a disease contracted as a result of an exposure over a
period of time to risk factors arising from work activity.
Also Chundela (Chundela, 2001) defines a term very important for complex conception of
ergonomics. That is a threat factor which undermines human health and wellbeing or can cause a
danger event. This factor can also be split into two groups based on time – hazardous factor and
hazardous effect. A hazardous factor is an object with a certain hazardous property which can
cause damage to health or death and is not dependent on time - it will act in short term, suddenly
– we are talking about occupational injury. A hazardous effect is an element or situation acting
over long term which can cause occupational disease or work-related disease (illness).
According to Gilbertová and Matoušek (Gilberotvá & Matoušek, 2002), every work activity
means a certain strain on the organism, whether adequate (positive) or inadequate (negative). The
strain is determined by the extent of balance between the human performance capacity (a person’s
preparedness and competence for the given task), task requirements and the conditions under
which the work activity is carried out. If these factors are balanced, the work strain is adequate;
an unbalanced state means an inadequate, undesirable strain called an overload strain or an
underutilized performance capacity (over the limit and below limit strain). The unbalanced state
or better, the inadequate work strain then causes work stress as a person’s reaction to stressors.
Stressors are influenced mainly by person’s biological qualities – one's physical, sensory and
mental capacity, including the level of gained skills and abilities or physical and social workplace
conditions. It is important to remember here that stress means not only a psychological strain
(psychosocial risks) but also an inadequate physical strain which can then present itself as
musculoskeletal disorder. With regard to MSD, assembly line production with its pre-determined
hard-working pace and utilization of small muscle groups creates a significant risk. Work
stereotypes are further a source of stress and social tension amongst workers and also between
workers and management.
Issues dealing with risk assessment within the human-technology-environment system and work
strain can be recorded as shown by the diagram in Figure 2.
Figure 2 –Risk assessment within the human-technology-environment system and work strain

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If we look closely at the objective (external) sources, that is physical and psychosocial sources,
we will find similarities with individual areas of a ergonomics as per the IEA definition. Based
on these similarities, we can conclude that ergonomics is interlinked with accident-occupational
injury, ill health.
According to ISO 31 000:2018 (International Standard for Standardization, 2018b), the purpose
of risk analysis is to comprehend the nature of risk and its characteristic including, where
appropriate, the level of risk. Risk analysis involves detailed consideration of uncertainties, risk
sources, consequences, likelihood, events, scenarios, control and their effectiveness.
With reference to ISO 31 000:2018 (International Standard for Standardization, 2018b), risk
evaluation involves comparison of the risk analysis results with established risk criteria to
determine where additional action is required.
2.3 Planning and implementing process
According to ISO 45 001:2018(International Standard for Standardization, 2018a), the
organization must plan measures to eliminate hazards and to reduce risks by implementing the
following: elimination of hazards; replacement by a less hazardous process, action, material or
equipment; use of technical measures and work re-organization; use of administrative measures,
such as training courses; use of adequate PPE.
When looking at the occupational injury prevention, we can conclude (based on practical
experience) that majority of employers focus mainly on the environment and the technology in
their planning and implementing process. This means tackling the risk factor by implementing
above-mentioned actions such as a machinery covering, Log Out – Tag Out system (LOTO), job
instructions, PPE etc. This, of course, leads to a significant decrease in the accident rate but once
a limit value is reached after some time, no further decrease can be ascertained. That is the time
to look for further means to continue the accident rate decrease trend and focus on a human, more
precisely on his psycho-physical features and whether he is exposed to an inadequate strain.
Questions like the ones below should be
raised:
•
“Why did the employee not use
the LOTO system when he was
equipped with one and had been
properly trained?”
•
“Why did the employee’s fingers
get trapped in the car door?”
•
“Why did the employee trip over
material left on the floor?”
Procedures in cases of non-decreasing
accident rate is shown on Figure 3.
Figure 3 - procedures in cases of non-decreasing accident rate
According to Chundela (Chundela, 2001), a human is a crucial, limiting system component which
influences the system’s final behaviour. Dlugoš (Dlugoš et al., 2016) further states that an
employee's competences, that is his psycho-physical features (physical-sensory-mental) as shown
in picture 2, are the key factors in the process.
Boyatsiz (Boyatzis & Boyatzis, 2008) defines the competences as basic characteristics causally
linked to an individual’s work performance.
According to Spencer and Spencer (Spencer, 1993) the competences are individual characteristics
(motives, features, self-concept, values, knowledge, behavioural or cognitive skills) that display

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differences between above-average and below-average performance or effective and non-
effective performance.
Tucker and Cofsky (Tucker & Cofsky, 1994) describe the individual characteristics in more detail
and name practical examples - Knowledge – information and understanding; Skills – abilities to
carry out a certain task; Self-concept and values – personal attitude, values and image, believes;
Motives – emotions, desires, physiological needs.
Competence is a set of internal individual’s features – his knowledge, skills and values that
constitutes his performance capacity. According to Gilbertová and Matoušek (Gilberotvá &
Matoušek, 2002), this is the factor that, in connection with physical or social workplace conditions
(psychosocial risks), can cause an inadequate strain which then leads to an accident. Competence
is therefore perceived as one of the key factors in the accident prevention process.
In order for the prevention process to be successful, it needs to include the whole system of risk
formation: technical measures, interventions in the production technologies, organizational
measures (employee rotation in particular jobs), correct employee placement according to their
physical and psychosocial dispositions, regular employee occupational health screening checks
and their assessments for whole work areas; implementing of relaxation and rehabilitation
techniques; last but not least risk communication and cooperation with employee representatives
including a feedback after implementing the preventive measures (EU-OSHA, 2020).
2.4 Occupational Health and Safety objectives
According to ISO 45 001 (International Standard for Standardization, 2018a), the employer sets
the Occupational Health and Safety (OHS) objectives in order to maintain and further improve
the OHS system management and its efficiency. The objectives reflect the risk assessment results.
Applied in real life, the objectives should be defined based on the risk assessment carried out in
all relevant areas. As a result, actions required to be implemented in order that risk factors for
certain machinery or a certain job (including psychosocial risks) can be reduced are identified.
Next step arranges the measures according to lever of risk. Based on the criteria previously
defined within the risk evaluation process, measures are chosen; those measures then become the
objectives whose attributes need to be specified as required by ISO 45 001, including ascertaining
the process for fulfilling the objectives.
2.5 Implement the processes
Implement the processes as planned.
2.6 Check the processes
Monitor and measure the activities and processes with regard to the plan.
2.7 Take actions
Take actions to continually improve the OHS performance to achieve the intended outcome.
2.8 Root cause analysis
According to ISO 45 001 (International Standard for Standardization, 2018a), accidents are one
of the sources for carrying out risk identification. Root cause analysis must be carried out in order
to identify the real root causes. If root cause analysis is carried out insufficiently or not correctly,
the root causes are not identified and the employer cannot take adequate measures which can then
cause accident recurrence. If further occupational injury repeats when the root cause is the same,
it is considered a failure on the OHS specialist and supervising employee’s part.
Also International Labour Organization (ILO, 2015) states that it is crucial to carry out an
effective search for immediate root causes and base taking of the measures on the findings.

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According to International Labour Organization (ILO, 2015), we have to raise at least these 6
questions when investigating a work injury and looking for a root cause:
1. Who was injured? Did the person suffer an illness? Was the person involved in the
investigated incident?
2. Where did the incident occur?
3. When did the incident occur?
4. What happen at the time of the incident?
5. How did the incident happen?
6. Why did the incident happen?
The first five questions are usually easily answered. To find an answer to the sixth questions
(finding the root cause), an appropriate method needs to be applied.
There are several methods how to find the root cause. International Labour Organization
recommends the “WHY method”. This method reconstructs the events and conditions that lead
to the incident by continuously asking “Why?”
3. Results
In the following part, the authors present how selected parts of the optimalization process get
implemented in the field based on their research and own practical experience.
3.1 Hazard Identification
Hazard, or risk, can be sorted out into two categories. Short-term exposure which will present
itself as an occupational injury (working with sharp tools, uncovered rotating parts of machinery,
a hole in the ground etc.) and long-term exposure which will lead to occupational disease
(occupational cancers, pneumoconiosis, musculoskeletal disorders etc.) or work-related disease
(stress and mental health disorders, musculoskeletal disorders, skin diseases etc.).
3.2 Psychosocial risks (work-related stress)
According to International Labour Organization (ILO, 2022), work-related stress is the first sign
of a problem. If a human body undergoes continuous strain, the stress can cause acute and chronic
changes that can induce long-term damage to senses and organs, especially if the body isn’t
allowed to relax and recover. In the long term, stress can contribute to memory loss, peptic ulcers,
inflammatory bowel diseases and musculoskeletal disorders, as well as to hypertension and as a
result to heart and cardiovascular diseases. Stress can also change immunological functions,
which can then facilitate development of significant illnesses, including cancer. Work-related
stress is determined by psychosocial risks.
Johannessen (Johannessen et al., 2015) adds that adverse effects of work-related psychosocial
risks lead to work-related injuries and consequently to work absences.
Leka (Leka & Cox, 2008) defines these psychosocial risks:
•
“Job content – lack of variety or short work cycles, fragmented or meaningless work.
•
Workload and work pace – work over load or under load, machine pacing, high levels of
time pressure, continually subject to deadliness.
•
Work schedule – shift working, night shift, inflexible work schedules, unpredictable
hours, long or unsociable hours.
•
Control – low participation in decision making, lack of control over workload, pacing
shift working etc.

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•
Environment and equipment – inadequate equipment availability, suitability or
maintenance, poor environmental conditions such as lack of space, poor lighting,
excessive noise.
•
Organizational culture and function – poor communication, low levels of support for
problem solving and personal development, lack of definition of, or agreement on
organisational objectives.
•
Interpersonal relationships at work – social or physical isolation, poor relationships with
superiors or co-workers, interpersonal conflict, lack of social support.
•
Role in organization – role ambiguity, role conflict, and responsibility for people.
•
Career development – career stagnation and uncertainty, under promotion or over
promotion, poor pay, job security, low social value to work.
•
Home / work interface – conflicting demands of work and home, low support at home,
dual career problems.”
Based on the above, we can observe that psychosocial risks can also lead to occupational injuries.
3.5 MSDs
In the Czech Republic, the local muscular strain assessment (strain on forearm and hand muscles)
is ensured by measuring the forearm muscles strength, that helps carry out individual tasks, by an
integrated electromyography method. It is a highly sophisticated method that uses changes in
action potential during muscle work. Subsequent whole-shift strain assessment compares the
frequency of movement with limit values for established shift value and the employee’s maximum
hand and forearm muscle strength (Fmax).
In 2020-2021, Health Institute in Ostrava carried out an epidemiologic study, led by Dr. Lehocká,
Ph.D., which by using nearly 2,500 test subjects established that maximum muscle strength is a
highly variable value in population. Statistically significant differences were found based on sex
and limb dominance. In contrast, physiognomic parameters (hight, weight, laterality) resulted in
only insignificant differences. It was demonstrated, based on a regression model of annual
statistics, that maximum muscle strength significantly decreases in employees of either sex after
45 years of age. These are very important findings from occupational-medical point of view
mainly due to increasing retirement age. This study’s findings were published in professional
journal “Occupational Medicine” (Pracovní Lékařství) 1-2/2022 (in press).
Guided by a number of European countries, as of 1st January 2023 the Czech Republic will also
start recognizing lumbar spine diseases as an occupational illness (Gov Decree No 290/1995 Coll.,
as amended).
3.6 Risk analysis and evaluation
There are many methods and many materials where the methods are described. Selecting the
appropriate method is the key to identifying the real risks. A list of methods that can be used for
risk assessment is stated in IEC 31010 (International Standard for Standardization, 2019). The
appropriate method choice depends on the method’s characteristics: application; field of
application; time horizon; level of decision making; initial need of information/data; specialty
expertise; quality vs quantity; undertaken efforts.
3.7 Incident investigation
To successfully apply the method “WHY?” it is necessary to carry out brainstorming within the
expert team. The team asks “Why?” until the answer stops making sense, five times at the most
though. If the created diagram contains multiple possibilities, further information is needed until
individual possibilities are either disproved or confirmed (Chen & Cox,2012).

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4. Discussion
To help better understand the ergonomics and occupational injury interlinks the below mentioned
examples were divided into 3 groups. The first group describes situations when work environment
and machines negatively affect an employee, the second group describes situations when
individual’s inadequate actions towards machine equipment and work environment can cause an
injury. The third group then includes examples of mutual reciprocal influence (combination of
the first two groups).
Within the first group, we can observe situations like these: Situation 1 – a forklift driver hit a
night shift employee due to a microsleep. Wrong lighting can be one of the causes as yellow light
makes people sleepy whilst white light imitates daylight. The use of white lighting in night shift
areas can then be recommended as measures. Situation 2 – a reversing forklift driver hit an
employee who stepped into the forklift’s path as he overlooked it. It was reviewed on the camera
system that the forklift had the hazard lights and sounds on. As there are many forklifts in the
warehouse and they all can be using the hazard lights and sounds at the same time, the employee’s
hearing capacity can be overwhelmed. The use of “blue spots” instead of sound effects can then
be recommended as measures. Situation 3 – an employee after a night shift crashed a car due to a
microsleep (a regular night shift followed by an overtime day shift). Negligence due to tiredness
and lack of sleep is one of the causes. Recommended measures could include a ban on overtime
work immediately after a night shift, alternatively an individual approach to regular shift /
overtime rotation.
The second group can for example present a situation where an employee in a control room
panicked during a minor incident and pressed the wrong button which then led to a chemical
substance release and another employee suffered chemical burns. A wrong reaction to the
situation caused by the employee’s unsuitable personality nature for the given job position
(lability, indecision, hesitancy) can then be identified as the root cause. Recommended measures
would include jobs’ analysis, as well as defining of competences necessary for the effective task
performance in certain job positions.
In the third group, we would mention a real-life case which links long-term social problems within
work teams that resulted in a fight of two individuals. The situation took place at an assembly line
production and was linked to the line’s working pace. The two individuals were not friendly with
each other since the beginning of their employment and when one of them didn’t perform his task
in the required time, he then stepped into the other individual’s work space and slowed him down.
The affected employee perceived this as aggression and started the fight. The co-existence of two
strong personalities within one work team is the root cause of this incident. The direct supervisor
is decidedly reliable in this case as he did not discover the problem in its latent phase. An assembly
line production impact on social relationships in the work environment was demonstrated among
others by Charlie Chaplin in his film Modern Times from 1936 (Chaplin, 2018).
5. Conclusions
The authors introduced ergonomics as a scientific discipline which addresses accident prevention
(occupational diseases or work-related diseases and also occupational injuries) in order to propose
a process suitable for achieving the goals as defined by the European Commission in its document
“The Union’s OHS strategic framework for 2021-2027". Within the proposed process, the
ergonomics applicability to accident prevention was established and the need for addressing
psychosocial risks and employees’ competence was emphasized.
The significance of the occupational injury and its root causes in-depth investigation (the correct
procedure was described and a suitable method – Why? - was recommended), as well as the
significance of psychosocial risks and MSDs concerns were stressed out.

51st Nordic Ergonomics and Human Factors Society Conference 2022
27
References
Bakala, J., Rybka, J., Přehnal, J., Calábek, O., Hunák, I., Hejtmánková, M., Moravcová, M.,
Gröschlová, O., & Novák, P. (2002). Baťova nemocnice ve Zlíně 1927 – 2002. KODIAK print.
https://www.kntb.cz/media/files/page/unrelated/files-24/historie_Batovy_nemocnice.pdf.
Boyatzis, R., & Boyatzis, R. E. (2008). Competencies in the 21st century. Journal of Management
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2027 : Occupational safety and health in a changing world of work. European Commission,
Directorate-General for Employment, Social Affairs and Inclusion. https://eur-
lex.europa.eu/legal-content/EN/ALL/?uri=CELEX:52021DC0323.
de Kok, J., Vroonhof, P., Snijders, J., Roullis, G., Clarke, M., Peereboom, K., van Dorst, P., &
Isusi, I. (2019). Work-related MSDs: prevalence, costs and demographics in the EU.
Publications Office of the European Union. https://osha.europa.eu/cs/publications/msds-facts-
and-figures-overview-prevalence-costs-and-demographics-msds-europe.
Dlugoš, I., Kissiková, L., & Vála, J. (2016). Psychologické aspekty bezpečnosti práce z pohledu
rozdílů mezi jednotlivci. In A. Bernatík, XVI. Ročník mezinárodní konference: Bezpečnost a
ochrana zdraví při práci 2016 (pp.13-14). SPBI
European Agency for Safety and Health at Work. (2020). Healthy Workplaces: Lighten the load.
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workplaces.eu/sites/default/files/publications/documents/HWC20_Guide_TE0120122ENN.p
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European Agency for Safety and Health at Work. (2022). Work-related diseases.
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Chen, J. S., & Cox, R. A. (2012). Value Stream Management for Lean Office—A Case Study.
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International Labour Office. (2015). Investigation of occupational accidents and diseases : A
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https://www.ilo.org/wcmsp5/groups/public/---ed_dialogue/---
lab_admin/documents/publication/wcms_346714.pdf.

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28
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banding-platform/docview/216362458/se-2?accountid=2699.

29
Leadership quality -
video-assisted work analysis of leaders’ behaviours
Elvnäs, Simon; Forsman, Mikael; Carter, Ned
Division of Ergonomics, Royal Institute of Technology, Stockholm,
elvnas@kth.se,miforsm@kth.se, nedcarter52@outlook.com
Abstract
There are few methods for objectively measuring leadership behaviours in the field,
although characteristics associated with successful leadership have been proposed. The
Operant Supervisory Taxonomy Index (OSTI) has been used in numerous settings for
direct observations of leadership performance; all supervisory behaviours are classified
into one of seven categories of behaviour. The aim was to test OSTI with self-recorded
videos to assess crucial supervisory behaviours. Eight supervisors at a technical
company video-recorded themselves at standardised daily staff meetings for 10 weeks.
They participated in weekly structured dialogues focusing on their use of performance
consequences. A coder used OSTI to code 142 randomly selected videos (n=360). The
results showed differences among the supervisors’ use of crucial leadership behaviours.
Variability was found both within and between supervisors’ behaviours, providing
performance monitors, antecedents, and consequences. The findings indicate that this
novel combination of OSTI and self-recorded video is a useful and efficient technique to
objectively measure and analyse leadership behaviours.
Background and purpose
Despite the important role of management at the workplace – important for
employees’ perceived job satisfaction, productivity, and health – little is known
about what leaders and supervisors do in their contact with their co-workers.
Techniques for objectively describing and measuring leaders’ behaviour would
contribute to improved leadership and to organisational ergonomics. Judith
Komaki´s Operant Supervisory Taxonomy and Index (OSTI) has previously been
used in a broad context of work analysis with direct, on-site observations, which
addressed some of the challenges related to studying leadership. In this study, OSTI
was used with self-recorded videos to assess crucial supervisory behaviours at
recurrent workplace meetings.
Method
Eight supervisors at a technical company video-recorded themselves at standardised
daily staff meetings for 10 weeks. A coder used OSTI to code three crucial
supervisory
behaviours in 142 randomly selected videos (out of 360). The three
behaviours that were
coded when they were observed, were “giving instructions”,
“monitoring” and “giving feedback”.

30
Results
The results showed differences among the supervisors in the total numbers of, and
in the ratios among the three leadership behaviours. Variability was found both within
and between supervisors for all three behaviours.
Discussion
The use of video recordings permitted the unobtrusive collection of objective,
detailed, permanent data on the leaders’ behaviours in a field setting. The
comprehensive permanent record of the dynamics of the leaders’ behaviour could
subsequently be analysed with OSTI to assess the quality of the behaviours. The
results show inter- and intra-variation in leaders’ behaviours throughout the study,
despite the systematic use of a standardized meeting format.
Conclusion
The findings indicate that this novel combination of self-recorded videos and OSTI
enables objective observation of leadership behaviours, with a potential to contribute
to leader awareness and leadership improvement.
Keywords:
operant supervisory taxonomy index, OSTI, self-recording video,
feedback, management.

31
With the stable as a workplace – about attractive,
healthy and sustainable employments in the Swedish
equine sector
Bergman Bruhn ,Åsa; Lindahl, Cecilia
Dalarna University, RISE Research Institutes of Sweden
asa.bruhn@du.se, cecilia.lindahl@ri.se
Background and purpose
The equine sector has grown strongly in recent years in Sweden as well as in many
European countries. The sector includes a wide variety of activities, e.g. businesses
related to breeding, competition, tourism, and training, and more non-profit activities
such as association-run riding schools and leisure. Work environment issues are a major
concern for the sector since it is labor-intensive, and a majority of the work tasks are still
performed manually leading to high workloads and physical strain. Furthermore,
working with and handling horses is hazardous, and the sector has a relatively high
occupational injury rate. The Swedish Work Environment Authority has also reported a
lack of knowledge in the systematic work environment management and risk
assessments as well as shortcomings regarding working conditions in the Swedish
equine sector. The study is part of two larger research projects where the purpose is to,
in close collaboration with the equine sector, implement methods and practices for
systematic work environment management.
The purpose of this study is to gain in-depth knowledge about the occupational
characteristics of the Swedish equine sector and to identify strategies that are important
for the work to be considered attractive and sustainable over time. The study focuses on
the employee perspective.
Design/methodology/approach
This study is based on qualitative data collected through 47 individual interviews with
employees at riding schools (N=30) and trotting stables (N=17) and approximately 20
hours of observations. The content analysis, based on abductive reasoning, was inspired
by thematic analysis. The respondents’ age ranged from 20 to 60 years with an average
of 38 years, and all but seven were females. The professional experience was on average
12 years (range 1-40 years).
Results
The preliminary and as yet unpublished results indicate that the occupational
characteristics which provide and sustain work attractiveness, are the love of and care
for horses, stimulating and meaningful work tasks, and workplace relations. Barriers to

32
healthy and sustainable work seem to be inconvenient working hours, an imbalance
between work and leisure time as well as high physical workload and inadequate
equipment and facilities. The culture within the sector may slow down changes through
the common attitude that you should work hard and not complain.
Discussion with practical implications
The work in the Swedish horse sector offers satisfaction, attraction, and meaningfulness,
but at the same time, it may be physically demanding and stressful to the extent that it
challenges the ability to remain in the occupation. The analysis of the data is ongoing,
and more detailed results will be presented and discussed.
Conclusions.
Understanding the working conditions in the equine sector is an important step to find
approaches to enhance health and safety and in the longer-term increase sustainability
in horse-related occupations.
Keywords. Equine sector, occupational health and safety, sustainable employments, work
environment management, working conditions

33
Using Fatigue Failure Based Exposure Assessment Tools to
Evaluate the Risk of Distal Upper Extremity MSDs
Gallagher, Sean; Johansson, Peter
Auburn University, Uppsala University
seangallagher@auburn.edu, peter.johansson@medsci.uu.se
According to Swedish work environment regulations, employers shall perform risk of
assessments of musculoskeletal disorders (MSDs) due to hand intensive work. There are several
risk assessment tools available for assessing the risk in a specific work task. However, workers
are most often exposed to several different tasks over a day. Therefore, the practitioner needs
risk assessment tools that take the cumulative load over the full workday into account.
A growing body of evidence suggests that MSDs are the result of a fatigue failure process in
musculoskeletal tissues (Gallagher & Schall, 2017). This evidence includes results of MSD
epidemiology studies (Gallagher and Heberger, 2013), ex vivo testing of musculoskeletal tissues
(demonstrating typical fatigue failure stress versus number of cycles to failure relationships)
(Schechtman & Bader, 2002), and animal studies in which fatigue failure of musculoskeletal
tissues has observed in vivo (Barbe, et al., 2013).
In response to this evidence, the Distal Upper Extremity Tool (DUET) (Gallagher, Schall Jr,
Sesek, & Huangfu, 2018) , a MSD risk assessment tools based on fatigue failure principles have
been recently developed and validated. The tools have been developed with an eye towards
practitioner friendliness and their cumulative damage metrics have been shown to demonstrate
a dose-response relationship with adverse, upper extremity outcomes.
This workshop will provide some background regarding fatigue failure theory, introduce the new
risk assessment tools and will provide hands-on analysis of the Distal Upper Extremity Tool
(DUET).
Specifically, participants can use the DUET tool by watching videos of different work tasks. The
workshop will encourage hands-on learning and dialogue between the presenters and
attendees. Finally, workshop will focus on discussing future developments of the fatigue
failure-based tools and will include an extended feedback session between presenters and
attendees.

34
Bibliography
Bani Hani, D., Huangfu, R., Sesek, R., Schall, M., Davis, G., & Gallagher, S. (2021). Ergonomics,
64(1), 39- 64.
Barbe, M., Gallagher, S., Massicotte, V., Tytell, M., Popoff, S., & Barr-Gillespie, A. (2013). BMC
Musculoskskeletal Disorders, 14.
Brinckmann, P., Biggemann, M., & Hilweg, D. (1988). Clinical Biomechanics, 3 (Suppl. 1):, S1–S23.
Gallagher, S., & Heberger, J. (2013). Human Factors, 14, 108-124.
Gallagher, S., & Schall, J. M. (2017). Ergonomics, 60, 255-269.
Gallagher, S., Schall Jr, M., Sesek, R., & Huangfu, R. (2018).. Human factors, 60, 1146-1162.
Gallagher, S., Sesek, R., Schall Jr, M., & Huangfu, R. (2017). Applied ergonomics, 63, 142-150.
Schechtman, H., & Bader, D. (2002). J. Biomech, 35, 347-353.
Sun, H., Andarawis-Puri, N., Li, Y., Fung, D., Lee, J., Wang, V., . . . Flatow, E. L. (2010). Journal of
Orthopaedic Research, 28, 1380-1386.

35
Safety and human
factors implications of RPAS introduction in controlled
airspace: a
case study
Vittorio SANGERMANO (1), Gabriella DUCA (1), Riccardo ROCCHIO (2), Edoardo FILIPPONE (2), Gunnar SCHWOCH
(3), Andreas HASSELBERG (3), Jürgen TEUTSCH (4), Co Christiaan PETERSEN (4)
(1) Institute for Sustainable Society and Innovation (ISSNOVA)
(2) Centro Italiano Ricerche Aerospaziali (CIRA)
(3) Deutsches Zentrum für Luft- und Raumfahrt (DLR)
(4) Royal Netherlands Aerospace Centre (NLR)
Abstract: Nowadays, Remotely Piloted Aircraft Systems (RPAS) represent the new frontier of aerial vehicles.
The Air Traffic Management (ATM) system must ensure safety performances and smoothness of traffic
flows, where RPAS shall be accommodated as new entrant alongside other existing airspace users,
maintaining adequate levels of cooperation in a socio-technical human-machine system. The introduction
of RPAS increases the complexity of this system and needs to be properly evaluated from a safety and
Human Factors (HF) point of view. This paper discusses the approach and presents the results of the safety
and HF evaluations for RPAS integration conducted within the European research project INVIRCAT through
Real Time Simulation (RTS) campaigns performed in Italy, Germany and the Netherlands.
Keywords: Remote Piloted Aerial System, Human Factors, Safety, Real Time Simulation, Air Traffic
Management
1. Introduction
One of the key missions of the SESAR programme is the safe and efficient integration of RPAS into
controlled and uncontrolled airspace. These new aerial vehicles are expected to be used for transportation of
people and goods and for specific missions. The SESAR roadmap (SESAR, 2019) foresees the full integration
of the RPAS as additional airspace user from 2035 and onwards. Even if, today, it would be possible (from a
technological point of view) to conduct an operation with RPAS, the ATM is a complex socio-technical
system in which further investigations and improvements are needed to ensure the highest safety performance
and smoothness of traffic flows. The introduction of RPAS, with the necessary definition of new roles for
human actors, increases the complexity of this system and needs to be properly evaluated from a safety and
Human Factors (HF) point of view. The INVIRCAT project is a European exploratory research initiative that
aims at investigating the safe integration of RPAS into controlled airspace classes A-B-C with a focus on
Terminal Manoeuvring Areas (TMAs) and airports. The main scope of the project is the creation of a concept
of operations (ConOps) for RPAS, assessing it through RTSs and drafting a set of recommendations for rule
makers and standardisation bodies. To achieve this goal, sixteen Use Cases (UCs) were defined, detailing the
technical conditions, the human actors and the workflow of operations for some selected, highly significant
scenarios in nominal and contingency conditions. This paper focuses on the safety and HF assessment
activities that were performed to pave the way for the RPAS integration in controlled airspace.

36
2. Approach and methodology
The project identified several safety and HF validation objectives to support the detailed design of validation
exercises, held at three European aerospace research centres in the Netherlands (NLR), Germany (DLR) and
Italy (CIRA) hosting the execution of the Human-In-the-Loop (HIL) RTS (Narayanan et Al., 2011) campaigns
with Air Traffic Controller Officers (ATCO) and Remote PILots (RPIL). The following safety and HF
validation objectives were formulated and have been defined for the project:
a) To assess the acceptability of Instrumental Flight Rules (IFR) RPAS integration inside the TMA and at
airport environment in nominal and contingency conditions.
b) To assess that safety remains within acceptable levels in nominal and contingency conditions.
c) To assess that ATM procedures allowing the Automatic Take-off and landing (ATOL) of IFR RPAS in
non- segregated airport operations are acceptable in nominal and contingency conditions.
d) To assess whether the Command and Control link (C2-Link) and Receive/Transmit (R/T) voice latency,
based on a representative value of this latency (different for each infrastructure investigated in the project i.e.
RLOS, BRLOS and Ground-Ground), is acceptable to keep safety conditions within acceptable levels.
e) To assess that the Remotely Piloted Aircraft (RPA) handover procedure between RPILs is transparent to
the ATCO and that safety remains within acceptable levels.
f) To assess the adequacy of phraseology in communications between ATCOs and RPILs in nominal and
contingency conditions.
g) To assess that Human Machine Interface (HMI) satisfies the information requirements for RPILs and
ATCOs in nominal and contingency conditions.
h) To assess that the requested human contribution to the overall system in nominal and contingency
conditions is compatible with human capabilities.
i) To assess that ATCO workload remains within acceptable levels in nominal and contingency conditions.
For each validation objective, at least one corresponding success criterion was defined. For all criteria,
positive feedback, either qualitative or quantitative, had to be received by the RPILs and ATCOs to meet the
objective identified. In a second step, specific data collection tools were designed to record qualitative and
quantitative data by the means of data logs, audio recordings, ad-hoc questionnaires (divided for ATCOs and
RPIL) and focus groups. With specific reference to questionnaires, two types of questionnaires were used:
one to be filled in after each simulation (Post Run Questionnaire - PRQ), and one to be filled in after
completion of the entire completed local exercise (Post Exercise Questionnaire – PEQ).
The questionnaires included standard tools such as SASHA (Jeannot et Al., 2003), AIM-L/S (Doris, 2008)
CARS (Lee et Al., 2001), SATI (Doris, 2008), SUS (Brooke, 1996) as well as operations-related questions,
addressing what the human actors experienced during the run and possible suggestions addressing the
INVIRCAT ConOps at a more comprehensive level.. In addition Bedford scale (Roscoe at Al., 1990) was
used to identify the subject’s spare mental capacity while completing a task, the scale encompasses a
hierarchical decision tree that guides the subjects through a ten-point rating scale (1 lowest - 10 highest),
where each point is accompanied by a descriptor of the associated level of workload. Finally, the assessment
of the perceived level of SA was conducted using the China Lakes Situational Awareness (CLSA) (Adams,
1998) standard tool that encompasses a hierarchical decision tree that guides the simulation subjects through
a ten point rating scale (from 1 – low to 10 – perfect SA), where each point is accompanied by a descriptor
of the associated level of SA.

37
Questionnaires and focus groups have been exploited as deeply interconnected techniques, as data collected
through the questionnaires were verified and discussed during the debriefings; this combination of techniques
ensure the correctness and the reliability of the obtained results.
2.1 Scenarios Description
The CIRA simulation encompassed several UCs in a Bari-Palese Airport operating scenario, considering a
combination of both nominal and contingency situations. The following contingencies were simulated: a)
ATOL failure: refers to any kind of issue that this system can generate. b) C2 link failure: refers to a loss of
command and control with the RPAS, however, voice communication is still available. c) Conflict situation:
designed to be a situation where the manned aircraft blocks the runway while the RPAS executes a
landing/take-off procedure. In addition, different levels of C2 link roundtrip latency with the RPAS were
considered: low latency (0.5 seconds) and high latency (2 seconds). The combination of all these variables,
generated 19 different runs, each lasting 40 minutes: (i) One reference scenario without RPAS; (ii) Two
nominal scenarios in which the RPAS did not experience any failure; (iii) 16 contingency scenarios. The
validation facilities that were used by CIRA for this project are FLARE (Flight Laboratory for Aeronautical
REsearch) SIM, a Scenario Simulator and a CWP Emulator and two ATCOs and one RPIL were involved in
the simulation activities. The FLARE SIM is a complete real- time Hardware (HW) and HIL simulator and
its main goal is to perform ground testing of the Flight Control Computer and Remote Pilot Station (RPS)
HW/Software (SW). The following figures refer to the simulation campaign executed at CIRA:
Figure 1. FLARE simulator –
Bari Palese airport
Figure 2. CWP Emulator –
Bari Terminal Manoeuvring
Area (TMA)
The DLR simulation campaign focussed on the arrival phases of the IFR RPAS flights. The simulation was
carried out for the environment of Düsseldorf Airport. The following contingency situations were simulated:
a) C2 link failure for one RPAS and for multiple RPAS. b) Transponder failure: when the transponder of an
RPAS fails, ATC no longer has information on the RPAS altitude and speed nor its squawk/callsign. c)
Conflict situation: Forced imminent separation violation during the approach phase. In addition, different
levels of C2 latency with the RPAS were considered: low latency (1 second) and high latency (2 seconds).
The combination of all these variables generated 8 different runs per exercise, each lasting approx. 40 minutes:
(i) reference scenario without RPAS; (ii) nominal scenarios in which the RPAS did not experience any failure;
(iii) contingency scenarios. In total, four exercises were conducted with four different ATCOs and multiple
RPILs. The RPS was simulated by U-FLY, controlling the RPA simulated either by DLR’s proprietary Traffic
Sim.

38
Figure 3. U-FLY simulator
Figure 4. CWP
simulator –
Düsseldorf TMA
The NLR simulation campaign encompassed several UCs at the operational environment of Rotterdam The
Hague Airport with traffic on all SIDs and STARs for a chosen defined runway configuration. The following
scenarios were simulated: a) C2 link and R/T latency during nominal situations. b) R/T voice communication
loss. c) Conflict situations between RPAS and manned traffic in approach sectors. d) RPA handover procedure
between RPILs from one RPS to another one inside the TMA. In addition, different levels of C2 latency with
the RPAS (roundtrip) were considered: low latency (1 second), medium (1.5s) and high latency (2 seconds).
For the voice communication latency, the following values have been considered (one-way): no latency, 290
ms or 700 ms. A combination of these variables was simulated in 21 different runs, each lasting at least 45
minutes or longer: (i) reference scenario without RPAS; (ii) nominal scenarios in which the RPAS did not
experience any failure; (iii) contingency scenarios. The NLR simulation facilities that were used for the
INVIRCAT project are MUST, the Multi-UAS Supervision Testbed of NLR, as well as NARSIM Radar and
NARSIM Tower, two included a high- fidelity ATC real-time tower and approach simulation environment
(NARSIM Tower and NARSIM Radar) and a connected simulation platform front-ends connected to the NLR
ATC Research Simulator (NARSIM) software providing a generic RPA Ground Control Station facility
(called Multi Unmanned Aircraft Supervision Testbed, MUST). Experienced former air traffic and acting as
middleware controllers guided all aircraft in the traffic mix including the drone traffic. A military pilot was
responsible for control of the RPA and so-called pseudo-pilots controlled the remaining visual (VFR) and
instrument (IFR) traffic in the Terminal Manoeuvring Area (TMA) and at the airport.
Figure 5. Rotterdam airport
simulation environment as
presented by the MUST
Figure 6. Rotterdam
airport environment
simulated by the
NARSIM Tower
3 Results
Quantitative data, coming from both data logs and questionnaires with the Likert rating scale were analysed
according to a deterministic approach. Qualitative data, mainly obtained from the focus groups and the open
questions in the questionnaires were analysed, highlighting the rationale behind the statements. The
simulation

39
campaign resulted into very positive feedback coming from both ATCOs and RPILs. The main results of the
three simulations are showed below, according to the main topic investigated by the project.
IFR RPAS safe integration assessment:
Controller Acceptance Rating Scale (CARS) evaluation results (Figure 7 and Figure 8) on the integration of
IFR RPAS within TMA, as well as the assessment of effect on job satisfaction for ATCOs showed positive
acceptance. Indeed, the subjects in the simulations claimed that the RPAS, especially during nominal
situation, is managed as a conventionally-manned aircraft.
Figure 7. CIRA CARS assessment
Figure 8. DLR CARS assessment
Generally, feedback from the ATCOs and RPILs was positive with regard to the safety levels. The ATCOs
and RPILs strongly agreed/agreed that the IFR RPAS integration within the TMA would allow a sufficient
level of safety in nominal conditions. The following Figure 9 and Figure 10 refer to the results obtained in
the CIRA and DLR simulations.
Figure 9. CIRA RPAS integration
Figure 10. DLR RPAS integration
In addition, the integration of IFR RPAS did not negatively affect runway throughput. In the NLR simulations
the controllers tried to minimize delay whenever possible while adhering to the landing sequence. If
necessary, the RPAS as well as the manned IFR traffic would receive radar vectors in order to maintain
separation, i.e. the RPAS was not given priority on purpose. This resulted in increased track miles and flight
time. In the DLR exercise, ATCOs stated that the introduction of IFR RPAS into the TMA did not lead to
different priority considerations (within applicable rules) by ATCOs among airspace users. These results
were also confirmed by the ATCOs of the CIRA’s and NLR’s simulations where they stated that the IFR
RPAS were treated in the same way as manned traffic (the difference was only noticed in terms of
performances).

40
Figure 11 – NLR Validation Run NOM1 Ground tracks of inbound RPAS and IFR flights
Situational Awareness (SA):
The SA during most of the runs was excellent/good and no particular issues were raised. However, the C2
link failure represented the most critical contingency that can affect the RPAS, indeed in the CIRA simulation
the ATCOs stated that they “sometimes” felt comfortable during this contingency as the RPIL would not
receive any information regarding the status of the RPAS and the ATCO could deliver instructions or
clearances, but the RPIL cannot comply with instructions or clearances. The CLSA assessment conducted in
all simulations provided positive results, even in the contingency conditions. However, in the DLR
simulation, one ATCO stated that the SA was insufficient to complete the task due to a contingency.
Figure 12. CIRA SA assessment
Figure 13. DLR SA assessment
ATOL assessment:
The RPIL always felt comfortable during the execution of ATOL procedures and stated that it worked as
expected. In general, ATCOs felt safe managing traffic including RPAS that executed an ATOL procedure. In
particular, the SHAPE Automation Trust Index (SATI) standard tool was used for measuring human trust in
the ATOL system, highlighting its importance for the safe introduction of RPAS into controlled airspace. All
involved actors agreed that the ATOL was a useful and reliable system. Moreover, during the debriefing
sessions executed at the end of each run, in CIRA’s simulation campaign, the RPIL highlighted that the ATOL
was a necessary system to safely perform critical operations such as the landing and take-off procedure. In
his/her experience, even with a low C2 latency, the absence of the pilot-in-command might generate problems
regarding the awareness and understanding of the surrounding environment. The presence of the ATOL
system allowed to maintain an acceptable level of SA of both ATCO and RPIL.

41
C2 and R/T Voice latency/Failure:
In general, in the CIRA and DLR simulations, the simulated C2 link and R/T latencies were not noticed
thanks also to the use of the ATOL system as above mentioned. During one run of the NLR simulation
contingency scenario where the voice communication link was lost and the RPIL awaited the ATCO to initiate
contact via a back-up communication mean (conventional telephone line), the ATCO dialled the wrong
telephone number. Thus, no contact was made with the RPIL and the ATCO was unaware regarding the
RPAS status during the contingency until the RPIL contacted the ATCO. This situation resulted in a higher
workload for the ATCO. However, positive feedback was received by the participants.
Workload assessment:
The assessment of perceived workload was performed using the Bedford standard tool. The workload was
maintained at satisfactory levels for the subject involved in the simulation activities. The overall level of
workload experienced in all simulations during nominal and contingency situations was satisfactory.
Sometimes, the ATCOs claimed that there was enough spare capacity for all desirable additional tasks.
Figure 14. CIRA Workload assessment
Figure 15. DLR Workload assessment
In essence, for what above stated, the current ATM system would permit the integration of RPAS in the
Terminal Area and at airports. In all simulations, the ATCOs stated that the RPAS was managed in the same
manner as conventional-manned traffic and this fact did not represent an issue even in case where the
approach speeds of RPAS traffic was slower than the manned traffic. This kind of evaluations surely requires
further investigations also considering the possibility of autonomous landing during a C2 link failure under
pre-determined circumstances and if the RPIL is confident regarding the situation. The traffic density used for
the simulations was representative for the simulated airports. Future experiments could be carried out in busier
airspace in terms of traffic.
4 Conclusions
The participants involved in the simulations, i.e. ATCOs and RPILs, felt always comfortable in the execution
of the runs, even during the conflict situations, during C2 link failure and voice communication failure. The
ConOps developed by the INVIRCAT project allows the safe integration of RPAS into controlled airspace
evaluating it from a safety and HF point of view. In essence, for what is stated in the results section, and also
confirmed by the subjects during the debriefing sessions, the handling of RPAS by the ATCOs is not
considered much different from a conventional-manned aircraft in terms of carrying out ATC operations. In
general, most of time, especially in nominal conditions, all the systems worked as expected allowing the
RPAS to be managed as an additional airspace user. However, further investigations should be conducted on
the C2 link aspects in order to find a trade-

42
off to manage this contingency during the critical phases of the flight (i.e. landing/take-off). Finally, the
experiment participants provided a set of additional recommendations:
• Develop proper procedures for the C2 link failure in order to safely separate aircraft during critical
flight phases such as approach/landing and take-off.
• In the case of C2 link failure, declare emergency situations in order to safely conduct all the
other operations. However, it was recommended to further investigate the C2 link failure.
• The proposed phraseology was adequate most of the time, while a dedicated phraseology and training
was recommended for contingency and RPS handover cases.
• Tower controllers should use an Advanced Surface Movement Guidance and Control System (A-
SMGCS) equipment in order to enhance the concept.
5 Acknowledgment
This work has received funding from the SESAR Joint Undertaking with grant agreement No 893375
(INVIRCAT project) under European Union’s Horizon 2020 exploratory research programme.
References
Adams, S. (1998). Practical considerations for measuring Situational Awareness. Proceedings for the
Third Annual Symposium and Exhibition on Situational Awareness in the Tactical Air Environment,
157-164.
Brooke, J. (1996). SUS: A “Quick and Dirty” Usability Scale. In: Jordan, P.W., Thomas, B.,
Weerdmeester, B.A., McClelland (eds.) Usability Evaluation in Industry, pp. 189–194. Taylor &
Francis, London
Doris M. Dehn (2008). Assessing the Impact of Automation on the Air Traffic Controller: The
SHAPE Questionnaires; Air Traffic Control Quarterly, Vol. 16(2) 127-146.
Jeannot, E., Kelly, C., & Thompson, D. (2003). The Development of Situation Awareness Measures in
ATM Systems, EUROCONTROL Technical report.
Lee, K.K., Kerns, K., Bone, R. & Nickelson, M. (2001). The Development and Validation of the Controller
Acceptance Rating Scale (CARS): Results of Empirical Research. Proceedings of the 4th USA/Europe
Air Traffic Management R&D Seminar, Santa Fe, NM.
Narayanan, S. & Rothrock, L. (2011). Human-in-the-loop simulations: methods and practice. Springer
Science & Business Media, ISBN 0857298836.
Roscoe, A. H. & Ellis, G. A. (1990). A subjective Rating Scale of Assessing Pilot Workload in Flight: A
Decade of Practical Use, A technical Report, Procurement Executive, Ministry of Defence
Farnborough, Hampshire.
SESAR Joint Undertaking. (2019). "European ATM Master Plan (2020 edition)".
SESAR Joint Undertaking. (August 2020). SESAR Human Performance Assessment process V1 to V3
including VLD D27 Ed 00.03.02.

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Training non-technical competences - potential benefits and
perceived needs for improvement
Karolina STARK (1) and Gesa PRAETORIUS (2,3)
(1) Kalmar Maritime Academy, Linnaeus University
(2) Swedish National Road and Transport Research Institute (VTI)
(3) Faculty of Technology, Natural and Maritime Sciences, University of South-
Eastern Norway
Abstract: This article presents findings from a study focused on how maritime non- technical
skill training is perceived. Fourteen bridge officers serving in different segments of the maritime
industry were interviewed to explore the usefulness of the training, the applicability to work
onboard and to identify potential improvements. The results show that all participants perceived
the content as important, but that the teaching modality may hinder the learning outcome. As
the NTS course framework is based on an adaptive version of the aviation’s CRM training, some
participants highlighted that those tools and techniques may not be applicable to all segments
in the maritime domain. Potential improvements therefore include a course design that reflects
the work settings, as well as a stronger emphasis on reflection and on how participants can learn
from each other. Work at sea is unique and thus the current BRM approach needs a redesign.
Keywords: Crew Resource Management, BRM, Non-technical skills.
1. Introduction
In 2020, the global merchant fleet encompassed 98715 vessels with a carrying capacity of
2.1 billion dwt (UNCTAD, 2020). Thus, maritime transport can be considered as one of the major
transport modes and the backbone of the globalized economy. Furthermore, shipping can be
regarded as a high-risk industry (Perrow, 1999)with a potential to cause negative consequences
not only to those serving onboard, but also to the marine environment and the general public, in
case of an incident or accident.
To ensure safety of life at sea, and promote the protection of the marine environment, the
International Maritime Organization (IMO), a specialized agency of the United Nation, has
created a framework of international conventions, which regulate the shipping industry (IMO,
2012). One of the most important conventions to ensure appropriate training, education and
certification of mariners serving in the merchant fleet is the Convention on Standards for Training,
Certification and Watchkeeping (STCW) (IMO, 2017). The Convention states the basic
requirements for skills, knowledge, and qualifications for those serving in different positions
onboard. These requirements include technical skills, such as how to use certain equipment
onboard, as well as non-technical skills, such as communication, decision making and teamwork.
One of the mandatory requirements for officers introduced through the latest revision in 2010, is
to show sufficient knowledge about the human element, leadership, management, and teamwork.
This is normally trained in courses referred to as Bridge or Engine-room Resource Management
(IMO, 2017), sometimes called Maritime Resource

51st Nordic Ergonomics and Human Factors Society Conference 2022
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Management (MRM). These represent a maritime adaption of the commonly known Crew
Resource Management (CRM) training that was developed in the 1980s as a response to an
increasing number of accidents drawing attention to the importance of non-technical skills to
safety in operations. Non-technical skills (NTS) are defined as “the cognitive, social and personal
resources skills that complement technical skills, and contribute to safe and efficient task
performance” (R. H. Flin et al., 2008) p.1). NTS, or CRM, training normally contains the
following skills leadership, teamwork, situation awareness, communication, stress and fatigue
management, and decision making.
A first maritime version of the CRM approach was developed in 1992 with a focus on bridge
operations (Hayward et al., 2019), and in 1995 IMO introduced Bridge Resource Management
(BRM) ‐ the effective use and allocation of all resources available on the bridge ‐ into the STCW
Code (Chauvin et al., 2013). Since then, the concept has been transferred to other departments
onboard as the development of courses for ERM and MRM has continued. While CRM training
has been studied extensively in other domains, such as Oil & Gas (Crichton, 2016), aviation, and
healthcare (R. Flin et al., 2002), there is only a limited amount of research within the maritime
domain(Praetorius et al., 2020).
Furthermore, although the reported research overall emphasizes the usefulness of BRM training
and its contribution to improved safety in operations(e.g. Espevik, Rose Saus and Olsen, 2017),
there is little evidence about whether knowledge and techniques acquired in courses is transferred
into real life settings and work onboard. (Röttger et al., 2016), for example, reported that there was
no significant performance difference between the participants in their study that had undergone
a NTS course and those that had not. Further, (O’Connor, 2011)discusses that differences in
attitudes prior and after the completion of a NTS training course may not transfer into behaviour,
which addresses the lack of studies that explore how knowledge gained through courses is
perceived and used in the daily work settings.
This study has been part of a larger research project, “SjöResA”-project, financed by the Swedish
Mercantile Marine Foundation. While the larger project’s aim has been to explore the
applicability of resilience engineering concepts to the framework of MRM training, this study has
focused on exploring perceptions of BRM training among officers serving in the merchant fleet.
The aim has been to explore the usefulness of the training, the applicability to work onboard and
to identify potential improvements.
2. Methodology
In this study, data has been collected through 14 semi-structured interviews with bridge officers
serving within the merchant fleet.
2.1 Participants
Fourteen mariners serving within different segments in the maritime industry participated in this
study. Table 1 presents an overview of this study’s participants. The age of the participants ranged
from 27 to 50 years, and years at sea ranged from 4 to 25 years with an average of 15,6 years. The
interviewees work onboard a variety of ship types within different segments in the merchant ship.
All participants had undergone BRM training at least once, with most of the interviewees having
participated in 2 to 3 training courses.

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Table 1: Overview of the participants
Respondent
Age
Year at
sea
Position
Type of ship
No. (BRM
courses)
I1
45
15
Chief officer
Rig
4
I2
43
11
Master
Passenger ferry
3
I3
50
21
Pilot
Passenger ferry
6
I4
46
21
Chief officer
Product tanker
4
I5
42
15
Master
VLCC
4
I6
27
4
Second officer
VLCC
1
I7
28
4
Second officer
Passenger ferry
2
I8
48
30
Master
RoPax
2
I9
40
20
Master
Rig
3
I10
43
25
Master/ Chief
officer
PoPax
4
I11
50
24
Master
RoPax
2
I12
30
15
Chief officer
Product tanker
2
I13
41
10
Chief officer
Chem/prod
tanker
2
I14
44
19
Chief officer
Product tanker
2
2.2 Semi-structured interviews
Fourteen semi-structured interviews (Patton, 2014) were conducted within this study. The
interviews aimed to explore the officers’ perceptions of the courses they had undergone and the
usefulness of the knowledge and tools that they had been exposed to. The interviews followed an
interview guide that was split into four parts. The first part collected demographics (e.g., years at
sea, age, current position) and the second part focused on the officers’ experiences and perceptions
of the course, as well as how they perceived the usefulness of the training, they had been exposed
to everyday operations onboard. The third part of the guide concerned which parts of the training
as transferred to onboard practices and the final part aimed to identify potential improvements
from the participants’ perspective.
The interviews were conducted either face-to-face or through an online meeting platform, the
online meetings were conducted due to geographical distance or due to the COVID-19 pandemic,
the interviews took approximately 40 minutes each. All interviews were recorded and transcribed
verbatim.
2.2 Data analysis
The data analysis was conducted with the help of MAXQDA, a qualitative analysis software, and
followed an inductive approach. The transcripts of the interviews were analysed iteratively, and
the results were grouped according to emerging themes.
3. Results
The following section will present the results of the analysis in three sections

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3.1 BRM training and training modality
BRM training courses can differ greatly in content and training modality depending on the course
provider. Usually, a mixture for training methods and modality is used. Common are classroom-
based teaching, simulator exercises, computer-based training (CBT), communication and other
group exercises. Generally, the participants regard BRM courses as useful and important. They
often contain a good mixture of theoretical and practical parts. The respondents further emphasize
that simulator exercises are appreciated as they connect theory and practice and may provide
hands-on advice on how to use the acquired knowledge onboard.
While simulator training is appreciated, computer-based training within BRM is less
well-received. Although CBT being common as teaching modality, the respondents raised
concerns that the material, despite it being relevant and interesting, is outdated. They experienced
the CBT modules as old-fashioned and mention among others visual information, such as ship-
type, but also the reflected mindset, for example, when it comes to gender roles onboard.
Another recurring problem is the density of modules during a course, i.e. the material
becomes to theoretically intense, which leads to stress and impaired learning. An example on how
to avoid this problem was mentioned by some participants, who highlighted that some companies
have shorter BRM courses every year fewer selected CBT-modules, which allows time to go in
depth into these.
The respondents are overall satisfied with the courses they have undergone and consider these as
rewarding. However, some participants mention that there is too much focus on handling crisis
rather than on communication, teamwork, and leadership and other elements of BRM training,
which are applicable to regular work. Thus, the course content and exercises do not always reflect
everyday work.
The participants expressed that it would be desirable for the course design to reflect the reality of
work onboard in a better way. For example, the content could be adapted to the type of ship, trade
area and onboard situation concerning number of crewmembers, to match real-life work settings
onboard. According to respondents are courses arranged by a company, more ship specific, and
the BRM focus on ship specific moments and tasks reflecting everyday life onboard. Ship specific
courses are more often recurring in segments as offshore, VLCC and in the cruise ship industry.
3.2 BRM’s applicability to onboard settings
The overall perception, in terms of the respondents’ answers, is that BRM courses and how BRM
is used onboard may vary between different vessel types, crew sizes and dedicated trade area.
While lessons learned from other industries, the participants stress that not all content can simply
be transferred from aviation to the maritime domain. In the quote below the participants highlights
the difference in work procedure and work culture, which has also consequences for the role of
the operator within the system.
“Theory courses in all glory, but it is after all when you drive sharply in a simulator that you
can assimilate what you have gone through. (I14)
“Yes, that you can simply update. If one is to use the CBT now, there must be a new one that is
a little more 2020 than 1970 " (I6)

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“… there is a big difference between aviation checklists and shipping industry checklists. It's just
that if you think like a pilot who's in a Boeing when they do their tests with flaps and everything.
Then they both sit, and then they confirm: "Yes okay, the flap works…" o so, and then when
everything is done. Then both sign and have, as it were, double-checked it, and "no blame culture"
and all that that means. But in shipping, there is always only one who signs, so that then you get
a scapegoat as well.” (I 12)
This perspective is also shared by other participants who discuss the limited applicability of
aviation concepts to maritime operations.
While it is mentioned that certain practices may be applicable to operations onboard
cruise ships where the bridge is always manned by at least two officers, there is a consensus
among the participants that non-technical skills courses should be developed for and rooted in the
domain they are aimed for.
The results also show that the bigger the crew of a merchant vessel is, the more practices and tools
from BRM courses are implemented and used onboard. A higher number of crew means that the
bridge always is manned with more mariners at same time, which imposes a higher need of good
and concise communication to avoid misunderstandings. The most frequently BRM-tools used in
everyday work up at the bridge are, teamwork, closed loop communication, leadership, challenge
and response and situational awareness. These are important elements within the bridge team, to
create participation and safe navigation. The quote below also shows the importance of BRM
practices to ensure a common understanding of work tasks and procedure. Most of the respondents
mention that the working climate onboard decides how much and in which way BRM is used
onboard. Normally the master onboard sets the standard for how much and in which way BRM
will be used onboard. If the master is dedicated and committed to the BRM tools, they will be
implemented and used. As an example, BRM training emphasizes the importance of briefing and
debriefing for safety in operations. While both are considered important, the respondents
mentioned that these are mostly used in the cruise industry and VLCC as part of daily routines. In
other segments, such as onboard smaller vessels with minimum manned crew, briefing and
debriefing are used in connection with exercises or in case of special events that deviate from
everyday operations. One explanation can be found in the type of voyage and operation as
highlighted in the quote below
“In the training briefing before and afterwards was emphasized. And I don’t feel that this is really
applicable for the type of traffic I am in. We go from Helsinki to Porvo, which we do once a week,
we do not need to have a bridge meeting with everyone. More important that people are well rested
when it’s time” (I 14)
As the respondent works on a permanent route with fixed stops and foreseeable traffic, it is more
important that everyone onboard is well-rested than to conduct a briefing before and after every
operation. This stance is similar to what I6 expresses, that restrictions to resting hours set stop for
doing a briefing with the whole crew.
“We try to do it [briefings] as far as possible. Then there is unfortunately always someone who
needs to sleep as we are otherwise breaching resting hour restrictions. We can’t call everybody to
the bridge before departure (…)” (I 6)
“in a cockpit it is both physically limited and often limited to two people then, a captain and a
helmsman and to some extent cabin crew, but on the ship there are so many more, Yes! A little, a
little like that. Not quite the same no, as it is just o move from one to the other… “(I8)

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3.3 Potential improvements to BRM training
According to the respondents, BRM is an important course, consisting of key elements,
e.g. leadership, communication, and teamwork, for safe operations. However, as it is of
importance for safety in operations, BRM courses need to be taught through exercises and lectures
of high quality that foster reflection and learning, which can also trigger the participants to be
surprised and see operations in a new light.
The current course design experienced by the respondents shows certain shortages, such as
outdated material, unrealistic exercises and too much focus on handling crises instead of everyday
operations. Thus, potential improvements highlighted by the respondents are to connect course
material closer to everyday work and realistic work settings onboard. As an example, course
participants can be exposed to situations as fires onboard, heavy traffic, instrument failure, drunk
crew member, calls from shore personnel, which in the end may overshadow the purpose of non-
technical skill training. Furthermore, if CBT is used, the training material should be updated and
adapted to the target group for the training, such as adaptions to certain vessel types. Furthermore,
as mentioned by some participants, shorter and more focused courses specifically designed for
certain segments may allow a higher degree of participant engagement and trigger that the training
content is transferred into work settings.
The respondents discuss the need to be able to reflect as part of their learning. As trainees may come
from different vessels, or even different segments within the maritime domain, time for reflection
may allow to exchange experiences, learn from each other, and gain new insights. However, at
the same time some participants found that it is an advantage to train with their own officers, or
officers from similar vessel types, as the training can be designed closer to the actual operations
and help to train for everyday work.
4. Discussion
The aim of this study has been to explore how non-technical skills training is perceived by active
seafarers, how knowledge from training is used in the work onboard, and how it can potentially be
improved to increase the usefulness of training.
In line with results from previous research (e.g., O´Connor, 2011, Röttger et al., 2016), training
is perceived as important, but there is a lack of proof with regards to transfer between the training
settings and the work onboard. As the results show, transfer of techniques and tools, such as
briefing or debriefing, is very depending on the ship type, crew number and preconditions for
work. While respondents mention that they try to use what they have learned, it is not always the
case that work settings, such as crew- size, a vessel’s voyage type and time available for
operations, allow the application of what has been learned. Furthermore, another hindrance for
the transfer of knowledge, tools and practices may be that courses are not very well-adapted to
specific ship types and operations. As discussed above, courses focused on specific modules and
adapted to specific ship-types were perceived as more applicable and useful than those that are
more generic.
An essential part of non-technical skills training for professional mariners is to gain knowledge
about human performance, thus theories from the human factors discipline. While this knowledge
is perceived as important, this study clearly shows the need to reconsider training modality and
design in relation to learning goals and achievements.

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The results indicate that challenges arise due to the use of standardized computer-based training
modules, which lack to spark interest and create an engaging learning environment. Instead,
simulators serve as the primary learning arena and CBT only as loose theoretical backdrop. The
results thus highlight the need to create a clear connection between theoretical course modules
and practical exercises, as well as the need to carefully consider how the CBT is designed. These
findings are in line with earlier research (e.g., Crichton, 2016; Thomas, 2017) that discusses the
need to anchor learning modality and course design in clearly expressed learning goals and
measures on how to evaluate and assess these. While simulator exercises may be appealing, they
often appear to be far from the reality of work in everyday settings, which may hinder the learning
outcome. As discussed in O´Connor (2011) the outcome of a NTS course may not be as rewarding
in terms of safety as anticipated, nor do they show specified BRM courses let participants perform
better with regards to navigational and safety performance (Röttger et al, 2016).
Thus, it is advocated here that more focus should be put to integrating the participants’ own
expertise and tailor the training design more to their training needs. One way forward may
therefore be to listen to the participants, who have undergone several courses and hear what they
consider important and rewarding to improve safety of navigation. According to the interviewees,
there is a desire to adjust the course more like daily work onboard, reduce the crisis management,
to be able to emphasize the NTS knowledge and transfer into work practice on board better. In
line with this, another measure could potentially be to make better use of the participants’
experience and expertise from working onboard. The results clearly show both the willingness to
share, but also the need for joint reflection among participants as measure on how to increase
learning and engagement in the course. Especially participants with similar work experience from
the same or similar segment, can learn from one another and highlight reoccurring issues in the
daily work, as well as they can support each other in learning how to connect NTS tools and
techniques to work practices.
5. Conclusion
Work at sea is unique and thus the current BRM, or non-technical skills, training approach
deserves to be redesigned to be able to offer a knowledge and safety gain in the maritime industry.
While the aviation framework paved and highlighted the need for human factors knowledge in
other high-risk domains, it is time to reconsider how this framework is currently applied to the
maritime, and other domains. As this study shows, much of the potentially learning outcome is
hindered by a non-engaging training design where practical exercises are only loosely coupled to
standardized theoretical, often computer-based, lectures.
To increase the impact of BRM training in work onboard, the training design needs to be anchored
into experiences of everyday work where theoretical concepts and practical exercises reflect the
working settings of the participants. Furthermore, the training design should be inclusive
triggering reflection among participants and enable an arena for joint learning, where a focus is on
learning from each other through examples of everyday work, rather than on learning from
mishaps, crisis and seldomly experienced situations.

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6. References
Chauvin, C., Lardjane, S., Morel, G., Clostermann, J.-P., & Langard, B. (2013). Human and
organisational factors in maritime accidents: Analysis of collisions at sea using the HFACS.
Accident Analysis & Prevention, 59, 26–37.
https://doi.org/http://dx.doi.org/10.1016/j.aap.2013.05.006
Crichton, M. T. (2016). From cockpit to operating theatre to drilling rig floor: five principles for
improving safety using simulator-based exercises to enhance team cognition. Cognition,
Technology & Work, 1–12. https://doi.org/10.1007/s10111-016- 0396-9 LB - Crichton2016
Espevik, R., Rose Saus, E., & Olsen, O. K. (2017). Exploring the core of crew resource
management course: speak up or stay silent. International Maritime Health, 68(2), 126–132.
https://doi.org/10.5603/IMH.2017.0023
Flin, R. H., O’Connor, P., & Crichton, M. (2008). Safety at the Sharp End: A Guide to Non-
technical Skills. Ashgate. http://books.google.se/books?id=u22q5C0UXKoC
Flin, R., O’Connor, P., & Mearns, K. (2002). Crew resource management: improving team work in
high reliability industries. Team Performance Management: An International Journal,
8(3/4), 68–78. https://doi.org/10.1108/13527590210433366
Hayward, B. J. H., Lowe, A. R., & Thomas, M. (2019). The migration of crew resource
management training.
https://acquire.cqu.edu.au/articles/chapter/The_migration_of_crew_resource_man
agement_training/13452779
IMO. (2012). About IMO (Vol. 2012). International Maritime Organisation. http://www.imo.org
IMO. (2017). STCW - Including 2010 Manila Amendments : /: STCW Convention and STCW
Code : International Convention on Standards of Training, Certification and Watchkeeping
for Seafarers. April 2018 Erratum : STCW Consolidated 2017 Edition February 2019
Supplement: STC. International Maritime Organization.
O’Connor, P. E. (2011). Assessing the Effectiveness of Bridge Resource Management
Training. The International Journal of Aviation Psychology, 21, 357–374.
Patton, M. Q. (2014). Qualitative Research & Evaluation Methods: Integrating Theory and
Practice. SAGE Publications. https://books.google.se/books?id=-CM9BQAAQBAJ
Perrow, C. (1999). Normal Accidents. Living with High-Risk Technologies. Princeton University
Press.
Praetorius, G., Hult, C., & Österman, C. (2020). Maritime resource management: Current training
approaches and potential improvements. TransNav, 14(3).
https://doi.org/10.12716/1001.14.03.08
Röttger, S., Vetter, S., & Kowalski, J. T. (2016). Effects of a classroom-based bridge resource
management training on knowledge, attitudes, behaviour and performance of junior naval
officers. WMU Journal of Maritime Affairs, 15, 143–162.
Thomas, M. J. W. (2017). Training and Assessing Non-Technical Skills: A Practical Guide.
CRC Press. https://books.google.se/books?id=rqAvDwAAQBAJ
UNCTAD. (2020). UNCTAD Statistics. https://unctad.org/statistics

51st Nordic Ergonomics and Human Factors Society Conference 2022
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A roadmap for UX in rail: Changing tracks in train traffic research
Jessica Lindblom (1), Mikael Laaksoharju (1),
(1) Department of Information Technology, Division of Visual Information and Interaction,
Uppsala University, Sweden
Abstract: This paper presents a roadmap for promoting user experience (UX) in rail, in
particular for professional workers in train traffic operations. There is a general neglect of UX
aspects when designing for and interacting with various kinds of technology in the workplace,
especially in safety-critical domains. We provide motivations for considering UX in safety-
critical domains and present recent UX research. We outline a roadmap consisting of a
research agenda with five avenues for future research on train traffic operation. We argue that
our roadmap is well-aligned with the identified need for more research on UX at work. We
hope future research will contribute to a deeper understanding of how positive experience at
work matters in train traffic.
Keywords: Rail research, Safety-critical system, User experience
1. Introduction
It has been argued that rail is the forgotten branch of transport ergonomics (Wilson and Norris
2006). Increased demands on the railway, caused by growing numbers of passengers, more trains
running in the same time envelope and on the same infrastructure, and the added number of severe
accidents have increased the interest in railway research. The railway has developed gradually,
and only recently the interest in human factors research has emerged, in which task analysis,
investigations of human reliability, and human error are much studied areas, mainly focusing on
parameters of optimisation, efficiency, and resilience (Cort 2021, Wilson and Norris 2006).
The prevailing orientation toward human factors and cognitive ergonomics within the safety-
critical domain of rail is well justified and critically important, such as supporting traffic
controllers’ rapid decision-making processes in the development of technical systems for enabling
efficient planning and problem-solving (Andersson et al. 1998, Cort 2021, Sandblad et al. 1997).
However, the fields of ergonomics and human factors are not yet well-aligned with more modern
understandings of technology interaction (Grundgeiger et al. 2021, Savioja et al. 2014). This has
resulted in the neglect of user experience (UX) aspects when designing and interacting with
various kinds of technology in the workplace (Simsek Caglar et al. 2022), especially in safety-
critical domains, which recently has been pointed out (Gramlich et al. 2022, Grundgeiger et al.
2021, Hohm et al. 2022, Laschke et al. 2020). There are several reasons for the neglect of UX in
safety-critical systems. One reason is the common belief that UX is only associated with seeking
pleasure, fun, and stimulation when interacting with consumer products and applications (Simsek
Caglar et al. 2022). Another reason is that the concept of “experience” commonly equates to
something akin to a “number of years of service” rather than fulfilment of psychological needs
(Hassenzahl and Roto 2007). Further, it is problematic that UX is considered to be an umbrella
term (Roto et al. 2011, Simsek Caglar et al. 2022) rather than a strictly defined concept, despite
one common definition being “a person's perceptions and responses resulting from the use and/or

51st Nordic Ergonomics and Human Factors Society Conference 2022
52
anticipated use of a product, system or service” (ISO DIS 9241-210). It has been stressed that the
consideration of positive UX for professional workers is well-aligned with the ISO standards on
human factors and Human-Computer Interaction (HCI) (Grundgeiger, et al. 2021). Hence, it is
not enough to ensure pragmatic qualities, e.g., error reduction, effective performance, and reduced
cognitive load. To maintain safe and high-quality operations over time, much more attention
needs to be given to the hedonic and eudaimonic qualities of professional work (Hohm et al. 2022,
Grundgeiger et al. 2021). Consequently, the concepts of “well-being, health, and eudaimonia”
have recently been articulated as one of the seven grand challenges in HCI (Hohm et al. 2022,
Stephanidis et al. 2019), thereby suggesting increased attention to UX and related phenomena. To
the best of our knowledge, UX has received limited attention in rail research, both in theory and
practice (although Burkhardt and Milius, 2018 addressed usability).
This paper aims to describe and suggest some future perspectives on incorporating UX in rail
research, more specifically in train traffic operation. We present some examples of UX at work,
particularly in safety-critical domains, and then outline a roadmap for the future of UX within this
domain. We focus on the professional roles of train drivers and the personnel in the train traffic
control room, primarily the traffic controllers. These roles are central to keeping the train traffic
running, which is dependent on a multitude of humans and various tools working together
(Andreasson, et al. 2019, Cort 2021).
2. Prior UX at work research
Although existing research about UX at work is scarce, it indicates a complicated nature and
might challenge existing assumptions about what positive UX is (Simsek Caglar et al. 2022). We
do not intend to or have enough space to offer a comprehensive overview of the UX at work
literature, which spans several disciplines beyond UX and HCI. Instead, we motivate and present
some examples that promote (positive) UX at work, especially in safety-critical domains, being
inspired by Grundgeiger et al. (2021).
There are several motivations for considering UX in safety-critical domains (Grundgeiger et al.
(2021). First, it is argued that UX at work is a key characteristic of workers’ ordinary usage of
various tools and technical systems in the workplace. Therefore, it is of crucial importance that
UX at work is well researched, especially considering aspects that characterise the ordinary and
mundane of UX at work, and not only the extraordinary or critical situations (Clemmensen et al.
2020, Grundgeiger et al. 2021). Clemmensen et al. (2020) highlighted that although workplace
studies were so dominant back in the 1990s, there is an identified need to take a closer look at the
digital workplace of the future by incorporating UX at work. Similar lines of argument are
presented by Grundgeiger et al. (2021) who emphasised that interaction per se entails an ongoing
experience, implying that interaction with technology always has an associated UX, which is
ubiquitously present whether or not it is explicitly addressed by researchers or designers. This
stance has several consequences. On the one hand, by acknowledging that technology usage
always has an associated UX, it is not too surprising that UX is nowadays included in the ISO
9241-210 (2019). On the other hand, it should also be mentioned that the UX does not only occur
during a single interaction. There is also an additional need to consider the periods before, during,
and after usage (Roto et al. 2011). These spans are dynamic and can vary depending on the

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situation, being vital to consider at the workplace because several work tasks are conducted in
different timeframes, with varying frequencies, and with different tools.
Second, it is argued that more is known about usability and UX professionals in the literature than
about UX in work contexts (Clemmensen et al. 2020, Simsek Caglar et al. 2022). It is highlighted
that specific work domains are approached and discussed as mere “application domains”, rather
than addressing the unique UX characteristics and challenges in the actual work domain for
professional workers of various skill levels. Some positive examples exist, however, with
various recent studies of UX in the industry context that have identified and shown several
indicators and examples of hedonic qualities of technology usage (Clemmensen et al. 2020,
Savioja et al. 2014). Savioja et al. (2014) studied UX aspects of the tool transformation process
from an analogue to a digital one in the control room of a nuclear power plant. They developed
five positive UX indicators, five psychological experience indicators, and five communicative
experience indicators (Savioja et al. 2014). It was found that UX worked well as an indicator for
the quality in use by its ability to reveal the professional users’ experiences. Beyond developing
more general UX goals, it is suggested that the “do-goals” and the “be-goals” (Hassenzahl and
Roto 2007) are central for UX at work, as exemplified in recent work on good UX for greenhouse
workers (Clemmensen et al. 2020). They noticed greenhouse workers using a digitalised system
may experience pragmatic product qualities when the system can assist certain “do-goals”, like
the task of checking the temperature in a subsection of the greenhouse. They may also experience
hedonic product qualities when the system can assist certain “be-goals”, and enhanced
professional identity, like being viewed as “competent” by their colleagues for accurately
mastering the climate-management system.
Third, it has been argued that focusing on UX at work contributes to the design of better
technology in the workplace. Designing for positive UX in work contexts has roots in prior
research of workers’ experiences in the workplace, like user satisfaction. Already when digitalised
tools began to be frequently introduced in the workplace, it was revealed that workers often
experienced frustration, which sometimes correlated with loss of time and decreased task
performance (Clemmensen et al. 2020). During the development of digital tools, workers’ domain
competence, work experience, and tacit knowledge contribute to assessing the envisioned new
tool's potential and efficiency to promote positive UX (Savioja et al. 2014). Zumburch et al.
(2020) studied the development of clinical decision support systems (CDSS) for volume therapy
in intensive care units. They investigated what kind of work activities the nurses perceived as
being beneficial for their well-being at work (Zumburch et al. 2020). These findings provided the
basis for designing positive UX through the envisioned CDSS, with the purpose to fulfil the needs
for experiencing competence and popularity at work. Recently, Gramlich et al. (2022) applied a
UX-centred approach to the design of future tangible input and output devices for air traffic
controllers. Based on the air traffic controllers' need for haptic feedback, several tangible
interaction concepts were created, iterated and evaluated with air traffic controllers. Based on
their findings, three main positive dimensions emerged that promoted positive UX at work, such
as “familiarity”, “efficiency”, and “engagement”. Klüber et al. (2020) investigated how
psychological needs and embodied theories of UX, applied in the design of a CDSS, could reduce
prior negative problems when using these tools for anaesthetic teams in the operation room. They
iteratively developed a prototype of a CDSS to assist anaesthetics teams in crises, predominantly
focusing on psychological needs and fluent interaction within the socio-technical system. A pilot

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evaluation via a medical simulation of handling a crisis as a team revealed that the prototype
almost supported the fulfilment of the identified needs for “autonomy”, “competence”, and
“relatedness”. The prototype seemed to be mostly smoothly integrated into existing diagnostic
practices (Klüber et al. 2020). Laschke et al. (2020) described how medical technologies are of
relevance to radiologists’ well-being at work. Instead of focusing merely on technology-related
parameters like image quality, it was revealed via a case study that the functionalities of the
advanced image technology could be designed more holistically to cultivate their well-being. By
identifying current work practices that were experienced as especially beneficial, several insights
were extracted that were transformed into future ideal technology-mediated work practices. It was
demonstrated how the radiologists worked towards improving well-being through the
development of meaningful technology, implying that technology is not neutral in itself; its
features affect the design of meaningful technology-mediated practices, which has a positive
impact on well-being (Laschke et al. 2020).
Fourth, it is argued that UX can support contemporary safety management in the workplace
(Grundgeiger et al. 2021). Workers in safety-critical domains express that their complex work
rarely is performed flawlessly but rather has several imperfections as a response to the dynamic
nature of their work, entailing constant changes and unforeseen situations (Cort 2021). Hollnagel
(2015) distinguished between Safety-I and Safety-II. In Safety-I, the focus is on achieving a state
in which few errors occur. Professional workers can perceive and identify hazards, and manage
the associated problems by properly eliminating causes and minimising errors (Hollnagel 2015).
Cognitive ergonomics approaches provide necessary and valuable methods to improve Safety-I
(Grundgeiger et al. 2021, Savioja et al. 2014). However, modern socio-technical systems are often
too complex and varied to easily identify safe courses of action in the web of hazards, which led
to Safety-II. In Safety-II, the aim is to ensure that as many things as possible go right and that
workers are not considered hazards but rather resources that enable the sociotechnical system to
adapt to varying conditions (Hollnagel 2015). Based on Safety-II, professional workers need to
be supported to deal with varying conditions, instead of focusing on error reduction. Recent
advances in UX can contribute to Safety-II by considering eudaimonic qualities (Grundgeiger et
al. 2021, Hohm et al. 2022), and by cultivating workers’ potential through hedonic experiences
of feeling competent, efficient, related, and in control (Gramlich et al. 2022, Klüber et al. 2020,
Laschke et al. 2020, Savioja et al. 2014, Zumburch et al. 2020). Huber et al. (2020) studied the
changes in work practices when digital strips were introduced to air traffic controllers to increase
capacity and safety in aviation. Documentation speed was generally found to be faster with digital
strips, but the controllers still perceived a lot of tacit information from the radio communication,
which was combined with additional hints to make empathic decisions that occasionally were
outside the standard procedure. Two types of operation modes, called 'standard advocates’ and
‘tinkerers' were identified. It was revealed that tinkerers experienced work satisfaction when
“aircraft in the final line up like pearls on a necklace”, another controller said that he felt happy
when he left work and saw a “perfect final in the sky” (ibid. p. 28). Several studies from healthcare
have reported that staff preferably is a resource that contributes to bridging the gap if a particular
tool fails to assist certain work tasks (Grundgeiger et al. 2021, Hohm et al. 2022). Staff who
experience competence in the technology-mediated work seem to be better equipped to handle
this gap, enabling them to keep processes running, and simultaneously maintaining safety.

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Fifth, it is argued that UX can contribute to organisational development beyond the
individual. The tools provided for professional workers are often mandatory in the organisation
or company (Clemmensen et al. 2020), putting greater demands on technology to promote positive
UX. Apart from being humanistic, hedonic qualities also have instrumental value. Wright et al.
(2007) reported a strong correlation between psychological well-being and job performance,
showing that job satisfaction alone is not sufficient for efficient performance. Psychological well-
being is strongly connected with the psychological needs that are commonly applied in UX, i.e.,
autonomy, competence, and relatedness (Ryan and Deci 2000). The hedonic qualities are aligned
with issues of the workers’ acquired work-domain knowledge, computer proficiency, and their
experiences of credibility and trust in the work tools used for supporting their decisions.
Clemmensen et al. (2020) pointed out that workers may ask how adequate the underlying
algorithms and models in the tools are, how transparent the suggestions made by the systems are,
and what possible courses of action are provided by the system for colleagues with varying
experiences and work-domain knowledge. Lundström and Lindblom (2018) studied the use of an
agricultural decision-support system for the calculation of variable rate application files for
nitrogen fertilisation from satellite images. The farmers and their advisors initially questioned
whether they could trust the suggested nitrogen levels, although the images of the fields mostly
corresponded to their understanding of the crop’s condition. Farmers used the tool’s visualisations
to explore various scenarios and perceived them as interesting and amusing. Instead of arguing
that they spent time “playing around”, their actions may have additional benefits like facilitating
their decision-making and learning more about the fields, which in the long run may contribute
to increased sustainability. This demonstrates the associations between how actions are carried
out for pragmatic purposes, which then is embedded in the larger web of agricultural work
practices, producing more food with less fertilisation, and hence caring for the land from a
eudaimonic perspective. Leschke et al. (2020) revealed that medical technology provides some
surprising, but added value to managers and other stakeholders, like improved quality of reports,
employee retention, and increased attractiveness. Their study demonstrates the possibility for UX
goals and business goals to be well-aligned to cultivate positive experiences, by implementing
technology designed in a user-centred way. Similar thoughts are expressed by Clemmensen et al.
(2020) and Savioja et al. (2014) who emphasise that work tasks encompass several experience
dimensions simultaneously, ranging from the appropriate manner in which individual tasks are
carried out, and the psychological experience of competence, engagement, and trust, to the shared
related experience of being part of a community of practice.
3. Roadmap: A future research agenda for UX in rail
In summary, the current state of previous research on UX at work in safety-critical domains is
dispersed and underdeveloped (Grundgeiger et al. 2021, Simsek Caglar et al. 2022). Explicit UX
research in train traffic operation appears absent, although related work on experiential and
psychological aspects of technology usage could offer a solid foundation to advance future
research in this domain. Addressing this gap, we propose the following research agenda.
Clarifying the hedonic qualities of working with train traffic operation. To our knowledge,
there are no explicit UX studies that have investigated what train traffic controllers and train
drivers appreciate and do not appreciate in their work roles. What makes the work feel meaningful
and how do workers apperceive that they are contributing to something valuable? What causes
frustration? We expect to find that much like flight controllers (Huber et al. 2020), also train

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traffic controllers find satisfaction in achieving perfection in task fulfilment, but there are likely
other more domain-specific activities that fill the work with meaning. Similar hedonic qualities,
closely tied to the pragmatic values of train operation can likely be identified also among train
drivers. These qualities constitute the target for UX design and we need to study people in their
unique work contexts to learn what these are. This is well-aligned with recent requests for
understanding the hedonic qualities of different professional practices (Clemmensen et al. 2020,
Simsek Caglar et al. 2022).
Performing workplace studies of the tasks and tools used in train traffic operation. Once we
have gained a deeper understanding of which experiences train traffic controllers and train drivers
find meaningful at work, we can formulate central positive dimensions that promote positive UX,
similar to what Laschke et al. (2020) and Savioja et al. (2014) did, and what is asked for by Simsek
Caglar et al. (2022). We should turn to analyse their current material and social work
environments from a systems perspective, ethnographically studying the whole workscape, in
terms of how current work tasks and activities are mediated by various analogue and digital tools,
as well as the collaborative interdependencies that emerge between people and technology. Topics
include what workarounds exist as well as identifying work practices that support safety
(Hollnagel 2015) by distinguishing eudaimonic qualities (Hohm et al. 2022). Relevant findings
would be the key mediating tools’ pragmatic and hedonic qualities, how the roles in train traffic
operation deal with varying conditions, what possible gaps that need to be filled, and how workers
ensure that trains are kept running safely (Grundgeiger et al. 2021, Hohm et al. 2022).
Identifying potential value conflicts within train traffic operation. The operation of train
traffic involves a multiplicity of interacting values. Safety, passenger comfort, punctuality,
environmental sustainability, and economy are just a few (Cort 2021). Bringing UX into this mix
highlights good working conditions as a value, but it can also improve the fulfilment of other
values. UX should in this regard be understood as fulfilling the basic psychological needs of
autonomy, competence and relatedness (Ryan and Deci 2000), which increases engagement with
tasks; vigilance, a sense of responsibility and a feeling of ownership of possible problems. Within
safety-critical domains, conflicts between personal and operational/organisational goals are
potentially critical, so it is very important to acknowledge the former to avoid accidents caused
by misprioritisation, e.g., unsafe train operations to get home in time. When it comes to balancing
the fulfilment of different values, the agency following from being in control over what happens
avoids negative feelings of helplessness. If a train driver would need to sacrifice punctuality to
guarantee safe operation, understanding the reason behind it likely avoids the feeling of not being
part of the decision-making. There is also a challenge to align UX and business goals, which
otherwise could result in conflicting aims.
Addressing UX aspects in the ongoing digitalisation and automation of train traffic. The
rapid technological development in the train sector offers new possibilities and constraints to how
train drivers and traffic controllers interact with technology, especially when it comes to
automation and artificial intelligence (AI) (Cort 2021), This raises questions like how workers
will adapt to, or be transformed by, these continuous changes when the technologies are
incorporated into their everyday work practices (Huber et al. 2020, Savioja et al. 2014). One of
the key mediating tools for train traffic controllers is the analogue time distance graph that is
currently undergoing replacement by a digital one (Cort 2021). This is an interesting example of
the ongoing digitalisation of Swedish train traffic, and we intend to investigate and analyse the

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transformative development of new work practices as a result of the introduction and
embeddedness of this key mediating tool in the workscape. We expect to find similar insights as
with flight controllers who changed from paper strips to digital ones (Huber et al. 2020) or the
transformation process from analogue to a digital one in the control room of a nuclear power plant
(Savioja et al. 2014). The envisioning of AI systems, like driverless trains, is another work
engagement challenge from a UX perspective. It is argued that AI systems with high levels of
automation will make the human workers less involved, but their involvement becomes more
critical (Palanque et al. 2019). There is a risk that traffic controllers and train drivers may run into
being servants of AI systems, and how AI affects UX and work engagement in these foreseen AI
workplaces is a surprisingly understudied research topic in general (Palanque et al. 2019).
Clarifying what UX design means in the domain of train traffic operation. UX design in
safety-critical domains like train traffic operation is not about making work “fun” or “simple”
superficially. It is about preserving and augmenting the aspects of work that keep professionals
within the domain fully engaged in their activities. Arguably, when human lives are at stake, it
would be offensive to, e.g., prioritise a train driver’s amusement over the safety of the passengers,
but this does not mean that the experiences of the train driver are not important to consider. If the
work did not entail any component of satisfaction, it would likely reduce dedication which would
further lead to skill degradation. UX design entails acknowledging what workers find satisfaction
in, be it achieving safe, efficient operation or satisfied passengers, and ensuring that the
introduction of technological solutions does not interfere with this.
4. Concluding remarks
This roadmap offers initial steps in viewing rail research from an explicit UX perspective, without
throwing the cognitive ergonomics' baby out with the bathwater. We aim to conduct future
investigations and analyses on the specific and interrelated dimensions of work that train drivers
and train traffic controllers experience as meaningful and engaging at work, to generate the
requested context-specific knowledge (Simsek Caglar et al. 2022) for this safety-critical domain.
The intended contributions are to address the need to carefully reduce this gap by considering
meaningful, technology-mediated work practices in train traffic, and offering initial steps on how
it can be approached. To conclude, we want to emphasise that positive experience at work matters.
Increasing the engagement and well-being of train drivers, train traffic controllers and other
stakeholders, will hopefully, in the long run, improve the safety of the workers and passengers of
the rails of the future, by promoting the successful implementation of UX in rail.
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59
Transferring tacit knowledge among operators in
safety-critical systems
Eklund, Rikard; Osvalder, Anna-Lisa
Chalmers University of Technology, Industrial and Materials Science, Design &
Human Factors
rikard.eklund@chalmers.se
Safety-critical systems, such as process industry, aerospace, shipping, transportation,
and medical care, are dependent on the knowledge embedded within their operators.
Experienced operators, who have worked in a safety-critical organization for a long time,
possess extensive knowledge on operation and control of the technical systems. Over
time, operators might leave the organization, including the knowledge and experience
they have gained during their careers, subsequently leaving a partly depleted
organization behind. Embedded knowledge can be referred to as tacit knowledge,
implicit knowledge, know-how, or simply skill, all which are competences difficult to
verbalize or transform into written text. Therefore, it is vital for a safety-critical
organization to establish methods to identify, document, and transfer tacit knowledge
among the operators. By taking such actions, an organization can be more resilient in
terms of knowledge management.
The purpose of this paper is to discuss how tacit knowledge is transferred among
operators in safety-critical systems. Two empirical studies, complemented with a
systematic literature review, have been used for this purpose. The literature review
focused on establishing an overview of the research domain. The empirical studies
focused on maritime pilot training and process room control operation, respectively. A
mixed-method approach to achieve triangulation, including document analysis,
observations, interviews, and questionnaires was deployed. The methods established
how and when tacit knowledge was used in the two domains, how it had been acquired,
and how it was transferred.
The results showed that a significant amount of tacit knowledge was transferred in social
settings, such as on-the-job activities, apprentice- or internship, and in social contexts
during coffee breaks as well as in other informal and spontaneous settings. Tacit
knowledge was consequently transferred to others primarily through socialization, but
not clearly documented, which made it difficult to understand the processes of tacit
knowledge transfer. During the maritime pilot training learning activities included
interaction with experienced maritime pilot instructors during pilotage and with the
bridge crew, as well as with tug or mooring boats. In process control room environments,
experienced individual operators as well as complete teams, stood for vital tacit
knowledge about operation and control of the plant. This knowledge was not clearly
documented, and few formal methods were used for tacit knowledge transfer. The

60
literature review showed limited interest to the area of tacit knowledge transfer in safety-
critical systems. However, a few organizations have implemented an array of methods
assuring tacit knowledge transfer. The results showed that situated learning in
communities of practice, such as apprenticeship and interacting with others in a social
process, facilitates tacit knowledge transfer, while technical methods showed to have a
limited effect.
To conclude, operators in safety-critical systems show extensive embedded knowledge
in terms of how to establish continuous, effective, and safe operations. However, their
individual solutions are not easily available for others and are in essence informal. Some
organizations are using formal, standardized, or technical methods for transferring tacit
knowledge among their operators. Tacit knowledge transfer is, however, mainly
achieved in terms of socialization, a method that is effective yet difficult to document
and subsequently to study and improve.
Keywords. Tacit knowledge, Maritime pilotage, Operator control, Process industry,
Expertise, Socialization

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How human skills and technology overcome accidents in space (Apollo
13), in the air (US Airways 1549) and on land (San José Mine) building
systems resilience
Josué FRANÇA (1), Erik HOLLNAGEL (2), Brenda COUTINHO (3)
(1) Linnaeus University
(2) Jönköping University
(3) KTH - Royal Institute of Technology
Abstract: In the middle of space, about 400,000 kilometres from Earth, a fire followed by an
explosion severely destroys the Apollo 13 spacecraft on April 14th, 1970. Under the low
temperatures of New York's winter, the Airbus A320 of flight US Airways 1549 loses its two
engines at low altitude after a bird strike with Canada geese on January 15th, 2009. Deep in the
Atacama Desert, on August 5th, 2010, a series of explosions cause the collapse of San Jose
copper-gold mine, trapping workers 700 meters underground under tons of rock, debris and
explosives. Three completely different accidents, separated in time and space, which had a
perfect setting for a complete disaster, but was not. Based on the official reports of each of these
accidents, as well as the most recent publications in the areas of safety sciences and resilience,
a comparative and comprehensive study was developed, identifying how human skills
contributed to overcome the adversities arising from these accidents through technology. To
understand how the complexities of the chain of events of an accident occur and, also, how
human actions are inserted and interact on its stages, three different analyses were developed,
one for each event, using the FRAM (Functional Resonance Analysis Method) methodology. Each
FRAM model was systematically analysed and compared, identifying differences, coincidences
and convergences under a human factors approach. Based on that, it was possible to observe
how human skills are essential to not only promote safety in work activities, but also build the
resilience of a system, enhancing workplace’s capacity to receive disturbances and generate
stability.
Keywords: FRAM, Resilience, Accidents, Human skills.
1. Introduction
According to the Oxford Advanced Learner’s Dictionary (Hornby & Turnbull, 2013), the word
technology comes from the Greek “tekhne” which means technique, craft, art, know-how,
together with the suffix “logia” which means study, knowledge about something. In addition, the
Collins English Dictionary (Collins Dictionaries, 2019) defines that technology refers to methods,
systems, and devices which are the result of scientific knowledge being used for practical
purposes. In a concise and direct way, technology can be understood as the practical application
of scientific knowledge, through instruments, creating something useful for the development of

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Society. Having time as a defining element, (Kay, 2020) states that technology is everything
invented after someone is born. Adopting these references and contextualized in the industrial
accidents studied by this research, technology is defined as everything that is conceived, built,
manipulated, transformed and it is in constant interaction and evolution with human.
Therefore, technology forms, while is formed by, Society, from the simplest objects, such as a
fork or a pen, to the most complex, such as a spaceship or an aircraft. Technological evolution,
therefore, is intertwined with the social evolution of humanity itself, when, for example, a piece
of rock became a hunting and cooking resource, a heap of ores became a weapon and tool and a
set of simple elements, such as machines, process, procedures and workers, today, interacting
together, form a complex sociotechnical workplace. In this research, three of these workplaces
are the object of study, from the event of an accident. In this study, performed by FRAM
(Functional Resonance Analysis Method), it is possible to perceive that the interaction between
people (workers) and the technology present in these complex sociotechnical systems, enables an
enhancement in the emergency and contingency actions, allowing that even in a catastrophic
accident, human actions can result in system-wide recovery. In other words, the system’s
resilience, its ability to receive disturbances and continue to function, adapting to the imposed
changes, is the result of the interactions of this system itself, having as resources human skills -
technical and non-technical, as well as the available technology.
2. The FRAM (Functional Resonance Analysis Method)
The Functional Resonance Analysis Method is a methodology that enables a graphical analysis
of how things happen, from a simple production line, till a complex operational cockpit of a
spaceship or civil aircraft (Hollnagel, 2012). Due its structure, it can be used to analyse past
events, such as an accident investigation, as well as the actions to recover from this, as will be
presented by this study. The analysis performed by FRAM is not a mathematical analytic process,
but rather a gradual development of an integrated understanding among professionals over a given
situation, context and premises (França et al., 2022). To be able to properly analyse the complexity
behind systems, workplaces, sociotechnical interactions and other complex relationships, its
graphic representation has a broader structure than a simple flowchart, adopting a hexagon of
multiple inputs to represent the functions couplings on its models. Appling FRAM to analyse the
recovering actions of Apollo 13, US Airways 1549 and San José Mine accidents will conceive a
systematic and integrative view of the resilience behind these events.
3. The Apollo 13 accident (1970)
The Apollo 13 accident occurred on April 13, 1970, approximately 400,000 kilometres from
Earth, having a fire followed by an explosion that severely damaged the SM (Service Module) of
the CSM (Commander/Service Module), blasting away an external panel of the SM, as can be
seen in figure 1 (Lovell & Kluger, 1994). There was an explosion and rupture of oxygen tank
number 2 in the service module, rupturing a line (or damaged a valve) in other oxygen tank,
number 1, causing it to lose oxygen rapidly. The Service Module bay number 4 cover was
completely destroyed. All oxygen stores were lost within about three hours, along with loss of
water, electrical power, and use of the propulsion system (Clemons, 2018).

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Figure 1 – The external panel of the SM of Apollo 13 CSM.
Source: Lovell & Kluger, 1994.
A series of actions, onboard, in the spacecraft, and on land, in Mission Control, coordinated and
connected, made the accidental scenario of the Apollo 13 mission able to recover and bring the
entire crew back to Earth. But for that, it took many hours of training and preparation, refining
the technical and non-technical skills of pilots, navigators, engineers, leaders, mathematicians and
several other professionals. In fact, the Apollo 13 prime crew undertook over 1,000 hours of
mission-specific training, more than five hours for every hour of the mission’s ten-day planned
duration (Kranz, 2009). Each member of the prime crew spent over 400 hours in simulators of the
CM (Command Module) and of the LM (Lunar Module) at NASA’s training facilities, some of
which involved the flight controllers at Mission Control. The integration between different areas,
of a complex sociotechnical workplace, is a key-element for the emergencies preparedness,
enhancing the resilience of the entire system (Clemons, 2018). Additionally, for Apollo 13
mission, flight controllers participated in many simulations of problems with the spacecraft in
flight, which taught them how to react in an emergency scenarios and losses of system control,
working together with the crew mission (Kranz, 2009). Having this information and focusing on
emergency actions to bring the crew of Apollo 13 safely back to Earth, the FRAM of figure 2 was
developed, showing how the set of technological artifacts, human skills and training culminated
in recovery of the complex sociotechnical system.

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Figure 2 – The FRAM of the Apollo 13 recovering actions.
Source: The Authors, 2022.
4. The Flight US Airways 1549 accident (2009)
On 15 January 2009, in a cold morning of New York city, the US Airways Flight 1549 flight, an
Airbus 320 aircraft originating from LaGuardia Airport (LGA), experienced a birdstrike accident
involving multiple birds: Canada geese on its long-distance migration behaviour (Marra et al.,
2009). This accident occurred at approximately 885 m aboveground and 8 km from the airport,
causing both engines to have a catastrophic failure, an emergency scenario not previously trained
in simulators, since the probability of a total loss of an aircraft’s engines, at low altitude, due to
birdstrike, was very low, according to the registered risk assessment (NTSB, 2009). In view of
this unique and unprecedented situation and having as resources the entire technological apparatus
of the aircraft, operational procedures and their technical and non-technical skills, the two pilots,
also relying on their experience, made an emergency landing on the Hudson River, keeping the
aircraft integrate, which allowed the rescue of all passengers and crew alive – 155 people in total.
Figure 3 presents the aircraft in the Hudson River, few moments after this landing.
Figure 3 – The A320 aircraft of Flight 1549 landed in Hudson River.
Source: Otfinoski, 2019.
After landing on the river, all the 150 passengers and 5 crew exited the floating plane onto its
wings and emergency chutes. In less than four minutes, they were rescued by commuter ferries,
the NYPD Police Scuba Team and the US Coast Guard (Marra et al., 2009). Due to the crash
location, emergency teams realised that rescuing passengers from the slowly sinking plane would
be complicated due to the swift river currents that was dragging the plane south (Blumberg, 2009).
With surface water temperatures around 0°C, timing was critical for removing passengers from
the ice-cold waters, particularly those who had fallen into the water and those who had walked
out on the wings (Marra et al., 2009). Based on these data, the official NTSB accident report and
focusing on the cockpit actions of the captains to emergency land the aircraft in the Hudson River,
the FRAM of figure 4 was developed, showing how the complex interaction between the crew
skills (technical and non-technical), procedures, technological appliances and the environmental
conditions enabled the landing and rescue of all onboard.

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Figure 4 – The FRAM of the Flight 1549 landing and rescue.
Source: The Authors, 2022.
5. The San José mine (Copiapó) accident (2010)
The San José Mine accident happened in August 2010, inside of a copper-gold mine, located in
the Atacama Desert, at Copiapó, in Northern of Chile (Franklin, 2011). After the occurrence of a
series of explosions, 33 workers got trapped 700 m directly underground, but 5 km from the
mine’s entrance via spiralling underground ramps, as showed in figure 5.

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Figure 5: The San José mine spiralling underground ramps.
Source: Franklin, 2011.
After 69 days underground “Los 33” were rescue alive, owing to a joint effort of people and
technology: a complex sociotechnical combination of high-tech drilling equipment, human skills
(technical and non-technical), non-conventional operational procedures, psychological support
and a cooperation between entities. Soon after the accident, Codelco, the Chilean state-owned
mining company, took over rescue operations, and made few exploratory boreholes to assess and
develop a rescuing strategy (Aronson, 2019). From one of those, 17 days after the accident, a note
was sent from underground: “Estamos bien en el refugio los 33” (Franklin, 2011). After this, a
cooperation between drilling rig teams companies, Chile government, NASA, and few non-
mining companies around the World develop a tailored rescue system with special escape
capsules, using high-tech technologies from NASA and drilling companies (Aronson, 2019). On
13 October 2010, the miners were winched to the surface one at a time and, with few exceptions,
they were in good medical condition with no long-term physical effects anticipated. Analysing
these rescue actions with FRAM, the model of figure 6 was developed, showing how this complex
combination of high-tech equipment, human skills, psychological support and special procedures
culminated in one of the most successful rescues of the mining History.
Figure 6 – The FRAM of the rescue of the 33 miners “Los 33”.
Source: The Authors, 2022.
6. Results and findings
Examining the FRAM models of each of the analysis of the recovery and rescue actions of these
accidents, it’s possible to notice that, despite the difference in domain between them - mining,
space, civil aviation - there are more coincidences than differences in these actions. Some non-
technical skills are observed in the actions and activities performed by rescue teams, such as
communication and teamwork. This last one, in particular for San Jose accident, was present both
in rescue teams and in the trapped works, forming a self-sustain network of support to deal with
the reduced resources and the aggressive environmental conditions underground. The leadership
from the captains in Flight 1549 and Apollo 13 was a key-element to make efforts and resources

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during the crisis, holding the teams together and focusing on a common goal. Regarding
technology, the artifacts itself were essential not only for rescue actions, such as the Fénix rescue
capsules in San José mine, but also in the recovery actions of systems corrupted during the crisis,
such as the adaptation of the CO2 filter system for survival inside the LM of Apollo 13.
Additionally, it is noticed the teamwork of both, integrating NASA, ASMAR and the Chilean
Government for the Fénix, and Mission Control, Engineers and Apollo 13 crew for CO2 filter
adaptation. In the three modelled FRAM, it is possible to see that the function “Technical and
non-technical skills to deal with emergencies”, highlighted in green, is precisely the system
interaction representation of the presence of the non-technical skills during the emergency and
rescue activities performed by the workers. They adapt, overcome and manage situations as it
happens, giving the necessary resilience for the system functioning and recover. But to do so, it
is necessary resources from the system itself. In this sense, the function “Technological resources:
equipment, materials, tools etc”, also present in all three FRAM, is the set of technological
resources – equipment, machines, tools, procedures, materials etc – needed to deal with the
dynamic situations that happens in the workplaces. From a simple silver tape, needed to adapt a
hose connection inside the Apollo 13 LM, till the Fénix escape capsule, a non-standard
customized high-tech module of 3,95 m, the technology, combined with human skills – technical
and non-technical, were the responsible for the recovering actions of Apollo 13, US Airways 1549
and San José Mine accidents.
7. Conclusion
People fail, make mistakes, this is a proven fact both in the field of human sciences, such as
psychology and sociology, and in other sciences, such as engineering and chemistry. However, in
the same way, in the same dimension that the error is a fact, the success and, mainly, the recovery
from a failure, is also something inherently human. The human capacity to adapt, overcome and
evolve is something that has been demonstrated, not only in scientific studies, but in the evolution
of humanity itself, as something essential for the continuity of all Humankind, overcoming natural
disasters, pandemics, engineering accidents and so on. Examining closely the FRAM models of
each of the analysis present in this research, it is noticed how the combination of workplace
technologies, including those dedicated to rescue, with human skills, technical and non-technical,
allows a degree of adaptability possible to meet the dynamics demands of extremely complex
sociotechnical systems. Therefore, it seems a myopic conclusion to assume that the causes of an
industrial accident, in a complex workplace, are the mistakes that workers make. Analysing
human capacity associated with technology, contextualized in the current workplaces, it is
perceived that the error is indicative of a system failure, where a complex combination of factors,
including the human element, resulted in an accident. Considering this combined with the research
findings, when it comes to extremely complex workplaces, such as spacecraft, mining and civil
aviation, people, workers, are not the problem, but rather the solution.
References
Aronson, M. (2019). Trapped: How the World Rescued 33 Miners from 2,000 Feet Below the
Chilean Desert (Reprint edition). Atheneum Books for Young Readers.
Blumberg, A. F. (2009). Present in the moment — operational oceanography and emergency
response. Journal of Operational Oceanography, 2(2), 2–2.
https://doi.org/10.1080/1755876x.2009.12027736

51st Nordic Ergonomics and Human Factors Society Conference 2022
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Clemons, J. (2018). Safely to Earth: The Men and Women Who Brought the Astronauts Home
(1st Ed.). University Press of Florida.
Collins Dictionaries. (2019). Collins English Dictionary (Eighth Edition). HarperCollins
Publisher.
França, J. E. M., Hollnagel, E., & Praetorius, G. (2022). Analysing the interactions and
complexities of the operations in the production area of an FPSO platform using the
functional resonance analysis method (FRAM). Arabian Journal of Geosciences, 15(7).
https://doi.org/10.1007/s12517-022-09801-0
Franklin, J. (2011). 33 Men: Inside the Miraculous Survival and Dramatic Rescue of the Chilean
Miners (1st Edition). Penguin Books.
Hollnagel, E. (2012). FRAM: The Functional Resonance Analysis Method - Modelling Complex
Socio-technical Systems (1st Edition). Ashgate Publishing Company.
Hornby, A. S., & Turnbull, J. (2013). Oxford Advanced Learner’s Dictionary (D. Lea, D.
Parkinson, & P. Phillips, Eds.; 8th edition). Oxford University Press.
Kay, A. (2020). The Shock of the Invisible. In J. Schroeter (Ed.), After Shock: The World’s
Foremost Futurists Reflect on 50 Years of Future Shock - and Look Ahead to the Next 50
(9th Edition, pp. 48–67). John August Media, LLC.
Kranz, G. (2009). Failure Is Not an Option: Mission Control From Mercury to Apollo 13 and
Beyond (First Edition). Simon & Schuster.
Lovell, J., & Kluger, J. (1994). Lost Moon - The Perilous Voyage of Apollo 13 (1st Edition).
Houghton Mifflin.
Marra, P. P., Dove, C. J., Dolbeer, R., Dahlan, N. F., Heacker, M., Whatton, J. F., Diggs, N. E.,
France, C., & Henkes, G. A. (2009). Migratory Canada Geese Cause Crash of US Airways
Flight 1549. Frontiers in Ecology and the Environment, 7(6), 297–301.
NTSB. (2009). Loss of Thrust in Both Engines After Encountering a Flock of Birds and
Subsequent Ditching - US Airways Flight 1549 - Airbus A320‐214, N106US.
Otfinoski, S. (2019). Captain Sully’s River Landing: The Hudson Hero of Flight 1549 (1st Ed.).
Capstone Press.

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Activity-based work environments – Perspectives
on the implementation process and employee well-
being
Haapakangas, Annu
Finnish Institute of Occupational Health, Finland
annu.haapakangas@ttl.fi
Activity-based work environments are becoming increasingly popular due to
digitalization, multilocational working and growing pressures on organizations to
decrease their office space for environmental and financial reasons. This development is
expected to be accelerated due to the Covid-19 pandemic and increased working from
home. In activity-based work environments, workers do not usually have an assigned
desk but can flexibly use a variety of workspaces depending on their tasks and
preferences. Modern work environments play an important role in employee
satisfaction, productivity and well-being, but their implementation can be challenging
to organizations. There is still limited research on the effects of new work environments
on employee well-being, health, and productivity.
This special session seeks to understand the complexity of factors that contribute
to employee satisfaction and well-being in activity-based work environments. The
contributions explore the theme from various empirical and theoretical perspectives,
providing new insight for both researchers and practitioners. The presentations address
issues that are relevant to a successful implementation process, including change
management and participative design. Furthermore, the session explores factors that
contribute to a high person-environment fit as well as employee well-being and
productivity in activity-based work environments. In addition to office settings, results
are also presented on the perceived health effects of other environments of
multilocational knowledge work.
This special session sheds light into the importance of multidisciplinary research
on activity-based work environment. In terms of practical implications, the special
session provides information on various factors that are relevant to employee
satisfaction and well-being when designing, implementing or evaluating activity-based
work environments.
Keywords. Activity-based working, knowledge work, well-being

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Special session presentations
1. Novel understanding of what promotes or hinders health among office workers
– users’ insights elicited through a photo study. Susanna Lehtinen-Jacks,
Mälardalen University, Sweden. Email: susanna.lehtinen-jacks@mdh.se
2. Effects of workplace change on work engagement and perceived work-
environment fit – The role of change management. Pia Sirola. Finnish Institute
of Occupational Health, Finland. Email: pia.sirola@ttl.fi
3. The important process when relocating to activity-based workplaces. Eva
Bergsten. University of Gävle, Sweden. Email: Eva.Bergsten@hig.se
4. Tools for creativity in co-design workshop – Applying participatory design
process to support workplace satisfaction and need-supply fit formation. Piia
Markkanen. University of Oulu, Finland. Email: Piia.Markkanen@oulu.fi
5. Office use, well-being at work and perceived effects of office transformation –
Differences between four work profiles. Annu Haapakangas. Finnish Institute of
Occupational Health, Finland. Email: annu.haapakangas@ttl.fi

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Users’ insight of what promotes or hinders health
among office workers
Florin, Ulrika & Lehtinen-Jacks, Susanna
Mälardalen University, Sweden
ulrika.florin@mdu.se, susanna.lehtinen-jacks@mdu.se
Office work environments are an important arena for prevention of life-style related
diseases. We studied what office workers perceive as promoting, or hindering, health
when working, and formulated novel questions to the Swedish LifeGene study. In
February 2021 a photo-elicitation study was performed among 17 office workers at 5
partner companies in SOFCO (Concepts for the Sustainable Office of the Future). The
participants took photos of anything they considered promoting, or hindering, health
wherever they perform office work, and attached short comments. Of the 63 photos, 68%
were taken at home, 24% in an office and 8% outdoors. We performed formal, ad hoc and
semiotic analyses.
Four dominating metaphors were identified: light, sight, vegetation, and sound.
The latter only appeared in the comments and represented both well-being and
displeasure. Natural light, views of greenery, indoor plants, outdoor activities,
workstations close to windows, personal things and decorations, and pets around were
considered health-promoting. Less aspects of personalisation were seen at the office.
Home-offices were considered cosier than the office; laundry baskets, piles of books or
boxes under the laptops were used to compensate for poorer ergonomics. Office work
performed at home mixed with daily life, sometimes causing a disrupted focus. The
importance of having well-functioning Wi-Fi at home, mobile devices when working
outdoors, and physical meetings with colleagues at the office, were emphasised. Based
on the findings, and after considering questions in the Swedish Work Environment
survey, we formulated updated questions, which cover frequency and quality of office
work at the office, at home, at cafés, restaurants, and hotel lobbies, or outdoors, and two
separate time periods: before the Covid-19 pandemic, and at present.
The pandemic forced data collection digitally. However, what we saw because of
the pandemic, became major results. The photos and the comments were mostly
speaking in the same direction. Qualities like sound cannot be visualized, however, a
photo can capture also what is absent, for example lack of work equipment in a living
room described as a preferred work environment. The participants worked in companies
within the office market which may be a strength (knowledgeable about forefront in
office development) and a limitation (not representative of average office workers). To
conclude, some aspects identified were related to either promoting or hindering health,
while some were perceived as both, depending on the respondents’ specific living
situation. Regarding future research on lifestyles and health, we have a ground for
further novel questions about office work.
Keywords. Office work, user perspective, health

72
Effects of workplace change on work engagement
and perceived work-environment fit – the role of
change management
Sirola, Pia1, Haapakangas, Annu1, Ruohomäki, Virpi1
1Finnish Institute of Occupational Health, Helsinki, Finland
pia.sirola@ttl.fi
Background and purpose: Research on activity-based offices (ABOs) has expanded recently
since the concept has become more widespread due to new ways of working. However,
past research has mainly focused on perceptions of the physical office design rather than
investigating how factors related to the implementation process affect employee well-
being and other outcomes. In addition, little is known about the long-term effects,
particularly in terms of work-engagement when moving from private office to an ABO.
The aim of this case study was to investigate the effects of change from private offices to
an ABO on work engagement and the perceived fit between work and the environment.
Another aim was to study how assessments of change management practices before the
relocation were associated with work engagement a year after the relocation.
Design/methodology: A pre-post study design and mixed methods were used. Survey data
was obtained four months before (N=154) and a year after the relocation (N=146). Data
from 105 employees, who responded to both surveys, was statistically analysed.
Wilcoxon signed ranks test, t-tests and repeated measures ANOVA were used.
Employees who implemented the change were interviewed (N=17) as complementary
material.
Results: The perceived fit between work and the environment and work engagement
deteriorated after relocation to an ABO. Overall, the ABO was estimated as less
supportive for carrying out the work tasks. It supported individual tasks less than the
private office. No differences existed in how the ABO supported teamwork and
interaction. In addition, perceived productivity weakened at ABO compared to private
office. The employees ratings of the workplace change process before the relocation were
associated with work engagement a year after the relocation. Perceptions of change
management moderated the effects of relocation: work engagement decreased among
those who disagreed with managements reasons for change, did not find the goals
understandable, and perceived that the views of employees had not been taken into
account
Discussion: This study showed that the ABO was less supportive for carrying out the
work tasks. This is in line with similar relocation studies. As negative perceptions of the
process before the relocation were associated with a negative change in work
engagement even a year after the relocation, organisations should invest in change
management, that communicates reasons for change, ensures that the objectives are
comprehensible and that employees views are taken account.

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Conclusions: The quality of change management and ensuring that the workspace design
supports different work tasks are important for long-term effects on employee wellbeing
particularly when moving to an ABO from private offices. This emphasizes the need to
investigate change management practices in workplace change and use longer follow-up
times in future studies.
Keywords: Workplace change management, Work engagement, Perceived work-
environment fit

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The important process when relocating to activity-based
workplaces
Eva L. Bergsten1, Katarina Wijk1,2,3, David M. Hallman1
1. Faculty of Health and Occupational Studies, Department of Occupational Health
Sciences and Psychology, University of Gävle
2. Centre for Research and Development, Region Gävleborg/Uppsala University
3. Department of Public Health and Caring Sciences, Uppsala University
eva.bergsten@hig.se
The digitalization of today’s working life makes employees able to communicate and interact
with a greater flexibility [1], and activity-based workplaces (ABW), characterized by open
work areas with unassigned workplaces, is being implemented in many organizations [2].
Incentives for this office solution is to support employees’ different types of work activities
(e.g. digital meetings, collaboration, concentration work) by providing flexible workplaces,
and to increase flexibility for organizational changes and lower facility costs [3, 4]. However,
intervention studies have, to date, shown ambiguous effects on employees’ satisfaction with
ABW. The reasons for negative effects are less explored but can be due to a bad match with
employees’ task requirements [3], lack of manager support [5] or because of an
underestimation of the implementation process to prepare employees for another way of
working. To improve satisfaction with implementing ABWs (or not) evaluations of the
process are needed to increase knowledge about how to create a successful implementation
and satisfaction with the office solution [6, 7].
The aim was to describe the ABW relocation process of two offices in a Swedish
governmental agency, four activities used to facilitate the process, and elucidate factors
identified to influence the implementation process and satisfaction with it.
In collaboration with the company, qualitative and quantitative data were collected
during the implementation. Process variables (context, recruitment, reach, dose delivered,
dose received, satisfaction) [8], and barriers and facilitators to the process were explored in
focus group interviews. Immediate outcomes on the process activities (perceived knowledge,
understanding office rules, satisfying information and support) were measured by
questionnaires before and after relocation to ABW.
Evaluation of the process and immediate outcomes showed that the implementation and
program activities were carried out as planned, but the recruitment had failed. That is, reach was
insufficient meaning that the participation in activities was low for both offices. However, even
if participation was low, the intention to increase knowledge about ABW, understanding office
rules, and satisfaction with information was successful among those participating. Satisfaction
was higher among participants compared to non-participants after the relocation, and increased
with the number of activities attended. Reported barriers for not participating were unclear aims
of implementing ABW, lack of manager support and lack of communication. A well-planned
process, work groups, and program activities were reported as facilitators.

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Conclusion and practical implications: To increase satisfaction with relocation to ABW
our results suggest to administer communication of clear aims for ABW, an explicit
implementation design with use of activities involving employees to increase the readiness for
another way of working, and not the least, a very well planned recruitment process involving
managers’ support for a complete participation among the employees.
Keywords. Activity-based Flexible office, implementation, office design, working
environment
References
1. Blok, M., et al., New Ways of Working: does flexibility in time and location of work
change work behavior and affect business outcomes? Work, 2012. 41: p. 2605-2610.
2. Appel‐Meulenbroek, R., P. Groenen, and I. Janssen, An end‐user's perspective on activity‐
based office concepts. Journal of Corporate Real Estate, 2011. 13(2): p. 122-135.
3. Wohlers, C. and G. Hertel, Choosing where to work at work – towards a theoretical model
of benefits and risks of activity-based flexible offices. Ergonomics, 2017. 60(4): p. 467-486.
4. van der Voordt, T.J.M., Productivity and employee satisfaction in flexible workplaces.
Journal of Corporate Real Estate, 2004. 6(2): p. 133-148.
5. Bergsten, E.L., et al., Effects of relocation to activity-based workplaces on perceived
productivity: Importance of change-oriented leadership. Ergonomics, 2020.
Submitted
6. Nielsen, K. and R. Randall, The importance of employee participation and perceptions of
changes in procedures in a teamworking intervention. Work & Stress, 2012. 26(2): p. 91-
111.
7. Durlak, J.A. and E.P. DuPre, Implementation Matters: A Review of Research on the
Influence of Implementation on Program Outcomes and the Factors Affecting
Implementation. American Journal of Community Psychology, 2008. 41(3): p. 327.
8. Linnan, L. and A. Steckler, Process Evaluation for Public Health Interventions and
Research. 2002, United States: Jossey-Bass.

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Tools for creativity in co-design workshop – Applying participatory
design methodology to support the workplace design process
Piia MARKKANEN (1), Aulikki HERNEOJA (2)
(1) Oulu School of Architecture, Faculty of Technology, University of Oulu, Finland
(2) Oulu School of Architecture, Faculty of Technology, University of Oulu, Finland
Abstract: Interior design is an important yet elusive dimension of workplace design research. It
is the part of the office design with site-specific features that impact workplace satisfaction
and, if overlooked, influences the comparison of typologically similar offices. Our approach
builds upon workplace satisfaction and the need-supply fit theories. In addition, we apply the
multidimensional framework of instrumental, symbolic, and aesthetic dimensions to
communicate the user needs in the workplace design process. In this paper, we present the
participatory design workshop method and discuss how its facilitation impacts the outcome of
the participant activity and design thinking. This research was done in a multidisciplinary
research project and a workplace design intervention study. Our research provides a novel
approach to combing participatory design knowledge production and transfer of generated
design data into a design process and an academic workplace design research.
Keywords: workplace design, participatory design, workplace satisfaction.
1. Introduction
Health and well-being-focused reviews have acknowledged the importance of interior office
design (Colenberg et al., 2020; Colenberg & Jylhä, 2021). However, the analytical understanding
of how interior design impacts employees lacks a shared theoretical framework that would support
communication of spatial features beyond office typologies and the level of privacy different
workspaces offer. Typical research approaches include studying existing work environments
(Brunia et al., 2016; Budie et al., 2018), relocation studies (Rolfö, 2018; Sirola et al., 2021), or
typological studies (Bodin Danielsson & Bodin, 2008). There is a gap in work environment
research concerning workplace design and its processes (Colenberg et al., 2020; Gjerland et al.,
2019). In addition, co-design and participatory design methods are often used in organisational
change and office relocation processes, yet their documentation for research purposes is rare
(Rolfö et al., 2017).
We apply the design research approach to understand work environments and their design better.
We previously implemented participatory design methods to explore user needs in a small
knowledge work environment (Markkanen et al., 2022). Participatory design is a collaborative
approach that brings together the designers, users and stakeholders in a co-creation event to work
on suitable design solutions (Drain & Sanders, 2019; Holmlid, 2009). We studied our research
and design process to find applicable theoretical frameworks for follow-up studies (Markkanen
et al., 2022). Following theories and frameworks were selected: 1) the need-supply fit theory
(Kristof-Brown et al., 2005), 2) the affordance theory (Gibson, 1977), and 3) the multidimensional

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design framework of instrumental, symbolic, and aesthetic dimensions (Rafaeli & Vilnai-Yavetz,
2004). We have linked these theories and frameworks to the design process, from design aims
and affordance design to site-specific design. We argue that the participatory design approach can
guide and inspire the design proposals at different stages of the design process. Employee
satisfaction, e.g. how the physical work environment meets employees' needs (van der Voordt,
2004), has been addressed in several studies, such as (Bodin Danielsson & Bodin, 2008; Brunia
et al., 2016; Hoendervanger et al., 2019). Brunia et al. (2016) showed in their study that although
the interior design and spatial qualities, such as openness, subdivision, and diversity of spaces,
are essential in creating workplace satisfaction, the lack of quantitative methods retains the
research on an explorative level. Our design research approach includes understanding the need-
supply fit formation, a sub-theory of the person-environment fit theory (Edwards et al., 1998),
and it describes how employees' needs and supplies of the work environment pair (Kristof-Brown
et al., 2005). In activity-based offices, the need-supply fit formation has been shown to increase
work environment satisfaction (Gerdenitsch et al., 2017). We build our workplace design
framework on a combination of factors that have been shown to impact need-supply fit formation,
such as task complexity, the personal need for privacy and work setting (Hoendervanger et al.,
2019). Our design-supporting model includes task complexity, the need for privacy and
interaction, and the atmosphere to understand the need-supply fit model (Markkanen et al., 2022).
In addition, on the level of site-specific design, our design framework also includes the
instrumental, symbolic, and aesthetic dimensions.
We present our participatory design workshop method in detail in this paper. Such research
methods, especially in more extensive research projects, are often described briefly, thus lacking
the critical reflection of the method and its success. The intention of this paper is not to present
the generated data but to discuss how participants of the study were facilitated in their design
thinking that supported collecting rich design data.
2. Participatory design method
2.1 Organising an online participatory workshop
The study participants were recruited through HR management and an online event, during which
they were informed of the study and its requirements. The research approach was a multi-method,
and overall, it consisted of three phases: 1) participatory design phase, 2) intervention study phase,
and 3) participatory lighting design. This paper focuses on the study's participatory design phase
through the workshop methodology and its preliminary results. The results of the workshops and
intervention study will be presented elsewhere by Markkanen et al.
The research was organised from April 2021 to January 2022 in a company that provides smart
technology solutions for its customers. The participatory design workshop was organised during
the first phase of the study. Originally the workshops were intended to be organised on-site, but
due to COVID-19 pandemic-induced restrictions, they were organised online through the Zoom
platform. It is important to note that during the study's first phase, the participants partook in an
online survey concerning how the current work environment supported their well-being
(Haapakangas et al., unpublished results). Also, prior workshop, the participants were invited to
online semi-structured interviews to gain a detailed understanding of their job roles, daily tasks
and the needs related to activities (such as privacy, interaction, or online work) in addition to their
perception of the current office design. Subsequently, the participants were introduced to different
research question areas and concepts before participating in the workshop.
Participatory design workshops should be facilitated in a manner that supports ideation. A handy
tool for such events is post-it notes that enable easy idea-sharing with a low threshold to write
down ideas and post notes on the available surface, such as walls. Due to the pandemic, the
workshops in our study were organised online via the Zoom platform. As the ethical guidelines

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to this project enforced strict data safety protocols, collaborative design platforms such as Miro
and Mural were unavailable for workshop facilitation. Therefore, to facilitate and provide an
alternative solution, we designed the researcher's and participant's versions of PowerPoint files to
facilitate the workshop. The files were screen-shared during the workshop when necessary.
Workshop files were considered artefacts that influence the participant engagement and outcome
of the workshop; thus, care was taken in designing their visual look. The workshop files enabled
participants to make notes on the files. The role of these files was to serve as visual cues for
thinking and discussions. The final research data consisted of the discussions during the
workshop, i.e., the PowerPoint files were a tool to share information. The workshops were
recorded via the Zoom platform. The workshops were transcribed verbatim and thematically
analysed for a more detailed research analysis.
2.2 Participatory design workshop for workplace design intervention study
Altogether 15 employees participated in the interviews and workshops. The interviews were
organised with individual participants, but the workshops were organised with 3 or 6 participants.
The first connection between the workshop organiser and study participants occurred during the
semi-structured interviews; thus, the organiser had an in-depth understanding of the participants'
job descriptions, daily tasks, and needs. The intervention area for the second phase of the study
was predetermined to include a multifunctional workspace (for quick meetings and individual
work), formal meeting room (for board meetings and on-site visitors), informal meetings room
(for team meetings, product development, and brainstorming), and a breakout area (for lunches
and coffee breaks, and weekly hybrid meetings with remote offices and teams). The participatory
design workshop was modified based on a previously planned workshop (Markkanen et al., 2022),
and it included three tasks as follows:
During the first task, the participants were given an individual assignment to explore their
favourite place, their activities, and their companion. To inspire the participants for the task, they
were shown a presentation consisting of photographs from different seasons (e.g., summer,
winter), contexts (e.g., nature, urban), cultural events (e.g., concerts, stand-up, museums, outdoor
installations), and different atmospheres through natural light and scenery. The participants were
asked to explore how they feel and what kind of atmosphere the place has. The preliminary data
(Markkanen et al., manuscript in preparation) revealed that most of the favourite locations were
in nature: in summer cabins, outdoors, in the forest, or by water. The participants often considered
these locations as calming and their feelings as relaxed.
The second task in the workshop considered individual participants' workday. Participants filled
out a form with four available slots for daily situations: the situations were explored through time,
place, companion, activity, and how participants felt during the situations. Participants were
encouraged to think about the workday in a context of a good workday with supporting
surroundings. The preliminary analysis of the explored activities revealed typical daily work
situations: individual focused and routine work, participants' meetings related to their job
activities, and recovery situations.
The first and second tasks were intended to support participants' design thinking before
proceeding to the next task. The third task intended to collect design knowledge for work
environment research purposes and, given the project set up, support the intervention study's
design process. The third task focused on understanding the spatial qualities that support different
daily activities and situations. The organiser and participants selected three situations from the
second task for the participants to explore and discuss together. As the intervention area for the
following research phase had been decided previously, the situations were chosen to fit the design
area. Altogether 15 situations were explored in workshops. They were categorised into focused
individual work, ideation and brainstorming, technical problem solving, a hybrid meeting, and
recovery together and alone. The participants were instructed to forget about their current work

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environment and its limitations. Participants discussed the situations by exploring how they feel
during the situation, what the space is like, and what the atmosphere is like in the space. After
exploring the situations, the participants were encouraged to think about which spatial, functional,
and material properties would support the situation. Participants were shown a short presentation
of different spaces, lighting, materials, and colours to support the thinking process. The workshop
organiser facilitated this freeform discussion and aimed to gain knowledge of participants' needs
and preferences in explored situations.
The workshop data were combined into similar situations, and then the discussion dataset was
categorised according to questions presented in the third task: feelings, spatial characteristics, and
atmosphere to support the intervention design process. Also, the workspace, atmospheric
preferences, and the data from the follow-up discussion were combined and categorised into
instrumental, aesthetic, and symbolic properties. The aesthetic properties of the space were further
categorised into lighting, soundscape, and materials and colours.
3. Participant facilitation before and during the workshop support co-creating
design data
We argue that the following factors were critical to the successful outcome of this participatory
design workshop: First, the workplace survey and the semi-structured interviews were organised
before the workshop. This made the participants more aware of their current work environment
and activities, including their specific needs, such as privacy, collaboration, and interaction.
Second, the first two workshop tasks guided participants to think about how they feel in different
situations and what kind of atmosphere the place has. Third, after the participants were facilitated
towards sharing their thoughts, they had the opportunity to collaborate in co-designing the spaces
for the explored activities and discussing the activities and experiences or preferences of different
spaces through both personal perspectives and as a work community, giving participants the
ability to engage into thinking of work environments that are diverse and support different needs.
As the workshop organiser was also responsible for the intervention design, the discussion
concerning detailed spatial features was facilitated with the design process in mind. Importantly,
participants were given a tool for more detailed thinking through a brief visual presentation with
a joint explanation of different features of, for example, materials and colours. This, in addition
to the semi-structured interviews, provided a shared language between the participants and the
workshop organiser/designer. The workshop was modified to match our design framework (e.g.
need-supply fit formation through affordance design and instrumental, aesthetic and symbolic
dimensions on a site-specific design level). Applying the framework supported the quick analysis
process for the intervention design purposes, thus testing the method for its practical purposes.
The limitation of this study is the relatively small participant number and the organisation's
specific needs towards the intervention design process. In addition, the workshop was limited to
research purposes and needs. However, combining the participatory design workshop method and
the design framework has the potential to bridge the workplace design research and practice.
The preliminary results revealed distinct differences in interior design preferences for situations.
While the results are expected, the participatory design workshop results are rarely reported and
subjected to academic study. Here, the participants' atmospheric preferences are already a good
indicator for a designer to define design aims for different spaces: e.g., preferences for
brainstorming were defined through words such as stimulating, energising, inspiring, inviting to
move and touch, while the preferences for technical problem solving were described as relaxed,
creative non-distractive, collaboration supporting, non-hierarchical. Suppose a designer is given
only this data: In that case, the outcome of the design may not support the aesthetic preferences
of the future users of the space: for example, in this study, the participants defined their material
and colour preferences for brainstorming as light, green, colourful, natural with wooden surfaces;

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and for technical problem solving with neutral and reduced colour palette, but not white.
Altogether, the participatory design workshop generated a rich dataset that was used to design a
workplace intervention study.
4. Discussion
It is important to discuss different workshop methods in the context of workplace design, as the
method itself, the analysis of its outcome, and the knowledge transfer from employees to
workshop organiser to designers may support or hinder the design proposal formation of well-
being and workplace satisfaction supporting knowledge work environments. In this case study,
we organised an online participatory workshop and collected design data according to the design
framework developed (Markkanen et al., 2022). Altogether, the workshop supported the
following intervention design process and subsequently evaluated how participants experienced
the changes implemented in their work environment during the intervention.
It should be noted that in the participatory design workshop, the participants and the organiser
have different knowledge backgrounds: the participants of the study, the future users, provide
their tacit understanding of their daily activities, preferences, and needs. Designers participating
in the workshop, on the other hand, provide a domain-specific understanding of design concepts,
solutions, and techniques, in addition to the domain-independent process knowledge that enables
them to work towards the solution together with users with only incomplete information of the
context. (Drain & Sanders, 2019)
The design research and its methods, such as participatory design workshop, provides valuable
opportunities to share information between workplace design practitioners and researchers.
However, this requires a methodological setup that enables combining design data from multiple
case studies and appropriate frameworks and theories to link the design data into the research. In
this case study, the research project aimed to understand how knowledge work environments
support workplace satisfaction and need-supply fit formation. The survey methods used to study
the work environment features that impact workplace satisfaction and need-supply fit formation
do not consider the interior design of the individual spaces. Although participatory design study
can be considered a speculative approach, it outlines the connections between interior design,
affordances, and aesthetic experience with workplace satisfaction.
5. Conclusions
The connection between the interior office space and employees' workplace satisfaction and well-
being has become increasingly important due to the COVID-19 pandemic. For the time being, the
companies and organisations are adjusting to the hybrid work culture, and the current and future
needs for the office design are yet to be determined. Recent surveys have revealed that while some
employees prefer to continue work remotely and, in addition to individual work activities, also
collaborate online (Appel-Meulenbroek et al., 2022), the offices are still preferred for activities
such as formal and work meetings, socialising, and training (Yang et al., 2021). One of the aspects
of the post-pandemic design is the need to strengthen the social cohesion and work culture after
remote work (Pataki-Bittó & Kapusy, 2021). We propose applying the participatory design
approaches to understanding the evolving needs at workplaces: which spatial features are inviting
enough to relocate from home to offices, which changes are needed to respond to hybrid work-
induced privacy needs, and how can design increase workplace satisfaction to give a positive
impact in employee well-being and work engagement.

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Workspace use, perceived work environment and employee well-
being – A case study of an activity-based office
Annu HAAPAKANGAS (1), Pia SIROLA (1), Virpi RUOHOMÄKI (1)
(1) Finnish Institute of Occupational Health, Helsinki, Finland
Abstract: Activity-based offices, where workers lack assigned workstations and switch
between workspaces, have become popular. Yet, little is known about their implications for
employee well-being. The aim of this case study (N=322) was to investigate how workspace
use, the perceptions of person-environment fit, and the perceived effects of office re-design
on one’s work were associated with work engagement, burnout symptoms, and cognitive
stress. Based on Kruskal-Wallis tests, more active use of different workspaces was related to
higher work engagement and lower stress scores. The office was perceived to support
interaction whereas perceptions concerning support for individual work were divided. The
perceived fit to one’s work tasks and perceived effects of office re-design on one’s work were
associated with the three well-being outcomes. The results suggest that the work conditions of
activity-based offices are relevant to employee well-being. Organizations should pay attention
to different user groups and needs when implementing activity-based offices.
Keywords: Well-being, knowledge work, work environment.
1. Introduction
Activity-based offices (ABOs) have become more common due to various societal trends, such
as digitalization, multilocational working, the increase of knowledge work, and the climate
change. In activity-based offices, employees do not have assigned desks but are expected to switch
between workspaces designed for different activities based on their tasks and needs. As increased
teleworking has been one of the drivers of this development, the popularity of activity- based
office design could increase in the post-pandemic working life as teleworking is expected to
remain at above pre-pandemic levels (Eurofound, 2021).
How are workers affected by such a transformation of their workspaces? A systematic literature
review by Engelen et al. (2018) concluded that this design has merits regarding interaction,
control of time and space, and satisfaction with the work environment, but is less optimal for
concentration and privacy. Thus, the work environment of ABOs can contain both job resources
and job demands (cf. Bakker & Demerouti, 2007). The benefits and risks of activity-based offices
depend on which office type they are compared to. Compared to traditional open-plan offices,
activity-based offices appear to be an improvement, whereas negative reactions have been more
common among workers who have moved to an activity-based office from private offices (e.g.,
Haapakangas et al. 2019; van der Voordt, 2004).

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However, there is still limited knowledge on the effects of activity-based offices on employee
well-being. Only a few studies have investigated well-being outcomes (e.g., stress symptoms) and
most of these studies have not observed differences between activity-based offices and traditional
offices (Engelen et al. 2018). A few relocation studies have observed some negative effects on
psychological well-being after moving to activity-based offices (Wijk et al. 2020; Hodzic et al.
2021).
These inconsistent findings may be partly related to the methodological approach: Most previous
studies on well-being have compared activity-based offices with another office type. However,
all workers are likely not affected by the work environment in the same way (due to, e.g., different
job contents), and thus, attention to individual differences and different user groups is also needed.
In recent years, the person-environment (P-E) fit theory (Edwards et al. 1998) has proved useful
in investigating the role of individual behavior in activity-based offices (e.g., Gerdenitsch et al.
2018; Hoendervanger et al. 2022). A good P-E fit means that the work environment is perceived
to support one’s work and meet one’s needs. In ABOs, the active and flexible use of workspaces
is a key mechanism for achieving a good P-E fit which, in turn, is related to positive consequences
of ABOs (Gerdenitsch et al. 2018; Hoendervanger et al. 2022). However, workers differ greatly
in how actively they use workspaces at an ABO and frequent workspace switching appears rare
(Appel‐Meulenbroek et al. 2011; Haapakangas et al. 2018, 2022).
The purpose of this study was to gain more insight into employee well-being in activity-based
offices. As office use and perceived P-E fit have been associated with other outcomes in activity-
based, we assumed that they might also be related to well-being at work. Another aim was to
investigate employee well-being also in terms of work engagement which has been largely
overlooked in previous ABO research (for exceptions, see e.g., Hodzic et al. 2021). Work
engagement and stress symptoms (e.g., burnout) are related to different outcomes (Bakker et al.
2014) and, thus, including both types of measures gives a more comprehensive view of well-
being. As theoretical background, we applied the P-E fit theory (Edwards et al. 1998), Job
Demands-Resources model (Bakker & Demerouti, 2007), and a salutogenic approach to
workplace design (Ruohomäki et al. 2015).
The research questions were:
- How are office use and the perceptions of P-E fit associated with employee well-being
(measured as work engagement, burnout symptoms and cognitive stress)?
- How do employees evaluate the effects of office redesign on their work?
- How are the perceived effects of office re-design on one’s work associated with employee
well-being?
2. Methods
Survey data was gathered in 2019-2020 (before the Covid-19 pandemic) at a Finnish expert
organization that had redesigned its office into an activity-based office. The employees had
previously worked in private offices. Most of the respondents had worked in the activity-based
office for 7-11 months when responding to the survey (response rate 65%, N=322). The context
of the study and the office spaces have been described in more detail by Haapakangas et al. (2022).
Office use was measured by two items. Daily workspace switching measured the number of
switches between different workspaces (Haapakangas et al. 2018) while weekly workspace
variation measured the number of different workspace types used during a typical work week
(Haapakangas et al., 2022). For the analyses, the responses were merged to three categories.

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P-E fit was measured with three items: The general P-E fit measured the suitability of premises
to one’s work (Haapakangas et al. 2022), and the respondents also rated the extent that the office
supported interaction and individual tasks. The responses from the original 5-point scale were
merged to form three categories (poor, neutral, good fit).
Perceived effects of office redesign were measured by asking how the work environmental change
had affected possibilities to concentrate at the office, interaction, and one’s own productivity
(scale: 1 Impaired considerably, 5 Improved considerably). Responses were combined to form
three categories (impaired, no change, improved).
Well-being at work was measured with three variables: work engagement (UWES-3, Schaufeli et
al. 2019) and the burnout, and cognitive stress scales from COPSOQ-II (Pejtersen et al. 2010).
Statistical analyses were done with IBM SPSS Statistics, Version 27 using Pearson’s correlation
and the Kruskall-Wallis tests. Paired comparisons with Bonferroni corrections were done. The
analyses of work engagement were conducted with a smaller sample of 206 respondents (data
from 126 respondents were excluded because all response categories had not been available to
them due to a technical error).
3. Results
Overall, there was large variation in all independent variables, indicating individual differences
in how the office was used and perceived. Distributions of perceptions of P-E fit are shown in
Figure 1 and the perceptions of the effects of office re-design in Figure 2. The variation in office
use has been reported previously by Haapakangas et al. (2022) and was also great.
Burnout scores correlated strongly with cognitive stress (r = 0.73, p < 0.001), while work
engagement had a moderate negative correlation to burnout (r = -0.54, p < 0.001) and cognitive
stress (r = -0.51, p < 0.001).
General fit
Individual tasks
Interaction
Perceived P-E fit at the office
0 20 40 60 80 100
Poor Neutral Good
Figure 1. The perceived P-E fit regarding one’s work in general, individual tasks, and interactive
work. The proportions (%) of different responses are shown.

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The results of the Kruskal-Wallis tests are reported in Table 1 for office use and perceived P-E fit
and in Table 2 for the perceived effects of office re-design. As shown in the tables, all independent
variables were associated with at least one of the well-being outcomes.
Table 1. Descriptive statistics and the results of the Kruskal-Wallis tests concerning the relations
between daily and weekly office use, perceived person-environment fit, and three well-being
outcomes. The letters below p-values indicate the results of the paired comparisons, i.e., the
categories marked with the same letter differ statistically significantly from each other (non-
significant comparisons are not marked).
Work engagement
Burnout
Cognitive stress
Mean
SD
p
Mean
SD
p
Mean
SD
p
Daily workspace
switches
<.001
0.02
0.04
No switches
4.2
1.4
a, b
37.4
25.0
a
34.4
23.1
1-2 switches
4.9
1.2
a
31.6
22.2
28.2
21.5
3 or more switches
5.0
1.3
b
27.9
21.0
a
27.7
21.1
Weekly workspace
variety
0.001
ns
ns
1-2 workspaces
4.1
1.5
a
37.5
27.3
32.9
24.9
3-4 workspaces
4.5
1.3
b
34.4
22.4
33.6
21.8
over 4 workspaces
5.1
1.1
a, b
29.4
20.9
26.5
21.4
Perceived P-E fit, general
<.001
<.001
<.001
Poor
3.7
1.6
b
48.6
27.6
b
48.8
24.3
b
Neutral
3.9
1.0
a
43.2
26.2
a
41.1
20.5
a
Good
4.9
1.1
a, b
26.9
18.4
a, b
23.2
17.6
a, b
P-E fit, individual tasks
0.009
<.001
<.001
Poor
4.1
1.5
a
44.6
26.5
a
44.9
24.0
a, b
Neutral
4.6
1.0
34.2
21.8
30.7
18.4
b, c
Good
4.8
1.2
a
25.9
18.6
a
21.3
16.5
a, c
P-E fit, interaction
0.001
<.001
<.001
Poor
3.8
1.4
a
43.8
25.6
a
43.2
22.3
a
Neutral
4.1
1.5
43.9
26.8
b
41.8
21.8
b
Good
4.7
1.3
a
30.2
21.9
a, b
27.2
21.7
a, b
Scales: Work engagement, 0-6 (higher values indicate higher engagement); Burnout and Cognitive stress,
0-100 (higher values indicate higher stress)

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Perceived effects of office redesign
0 20 40 60 80 100
Possibilities to concentrate
Interaction
One's own productivity
Impaired No change Improved
Figure 2. Perceived effects of office re-design on possibilities to concentrate, interaction at the
workplace, and one’s own productivity. The proportions (%) of different responses are shown.
Table 2. Descriptive statistics and the results of the Kruskal-Wallis tests concerning the relations
between perceived effects of office re-design and three well-being outcomes. The letters below p-
values indicate the results of the paired comparisons as in Table 1.
Work engagement
Burnout
Cognitive stress
Mean
SD
p
Mean
SD
p
Mean
SD
p
Possibilities to concentrate
0.013
<.001
<.001
Impaired
4.3
1.4
a
39.7
25.2
a, b
38.5
22.7
a, b
No change
4.8
1.2
a
25.0
17.7
b
19.5
18.0
b
Improved
4.8
1.7
23.5
20.5
a
22.3
17.9
a
Interaction
0.01
0.001
<.001
Impaired
3.9
1.5
a
40.2
24.1
a
40.0
24.8
a
No change
4.3
1.3
39.8
25.5
b
37.6
23.7
b
Improved
4.7
1.3
a
30.1
22.5
a, b
26.9
20.6
a, b
One's own productivity
<.001
<.001
<.001
Impaired
3.9
1.5
a, b
49.4
26.0
a, b
48.9
21.9
a, b
No change
4.7
1.1
a
28.9
20.0
a
25.2
19.0
a
Improved
4.8
1.4
b
23.2
17.8
b
21.8
18.3
b
Scales: Work engagement, 0-6 (higher values indicate higher engagement); Burnout and Cognitive stress,
0-100 (higher values indicate higher stress)

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4. Discussion
This study provided new information on the relations between the physical work environment and
employee well-being in activity-based offices. The results extend current research on the role of
individual factors in the consequences of the ABO design. Specifically, we observed that
individual differences in both the use of workspaces and the perceived work environment were
associated with well-being outcomes. Furthermore, the results show that the work environment
of ABOs is not only associated with negative indicators of well-being (e.g., stress) but also with
work engagement. Interestingly, the pattern of results was slightly different for work engagement
and the stress variables which strengthens the view that both types of measures are valuable and
enable a more comprehensive understanding of the job resources and demands in activity-based
office.
Regarding individual differences in workspace use, daily and weekly office use were more
strongly related to work engagement than to the variables measuring stress. The workers who did
not switch workspace during the day had lower work engagement than those who did, whereas
the number of switches did not appear relevant. In terms of weekly workspace use, the workers
who used the greatest variety of workspaces (i.e., over 4 different workspace types per week) had
higher work engagement than the others. These results are in line with earlier findings that active
use of workspaces is related to positive outcomes in ABOs (Haapakangas et al. 2018, 2022,
Hoendervanger et al. 2016). However, causal interpretations about the possible effects of active
office use on work engagement should not be made due to the limitations of this study design. It
is also possible that high levels of well-being and energy precede the active use of workspaces.
The majority of respondents perceived a good P-E fit both regarding their work in general and
interactive work (Figure 1). Perceptions of P-E fit for individual tasks were more divided as 42%
of respondents perceived a poor fit and 47% a good fit. All P-E fit variables were associated with
the three measures of well-being. In terms of the general P-E fit and the fit for interactive work,
a good fit was related to higher work engagement and lower burnout and cognitive stress. The P-
E fit for individual tasks was particularly related to cognitive stress and any decrease in perceived
fit was associated with higher cognitive stress (that is, the difference between poor and neutral fit
was also statistically significant). These findings are in line with the P-E fit approach to ABOs
(e.g., Gerdenitsch et al. 2018) and the salutogenic approach to workplace design (Ruohomäki et
al. 2015).
Regarding the perceived effects of office re-design, the majority perceived that the possibilities
to concentrate had deteriorated but interaction had improved. These findings fit well with the
existing literature on the benefits and downsides of activity-based offices (Engelen et al. 2018).
The perceived decrease in possibilities to concentrate is logical as the respondents had previously
worked in private office rooms.
The perceived effects of office re-design were associated with all measures of well-being.
Interestingly, work engagement and stress measures were only related to perceived impairments,
but not improvements, in possibilities to concentrate and one’s productivity. That is, work
engagement was lower and stress scores were higher among those who perceived impaired
possibilities to concentration and impaired productivity, but there were no differences between
the employees who perceived an improvement or no effects. A different pattern emerged for
perceived effects on interaction: The respondents who perceived that the office re-design had
improved interaction had lower burnout and cognitive stress compared to those who perceived an
impairment or no change in interaction.
Overall, the findings of this study support the view that the physical environment of ABOs
contains both job resources and job demands which are relevant – and may have different relations
– to employee well-being. Further research is needed to gain more detailed and stronger evidence
of these relations.

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5. Conclusions
The results of this study suggest that the work environment of activity-based offices contains both
job demands and job resources which are related to employee well-being. An active use of
workspaces and the perception that the work environment supports one’s work performance are
associated with higher work engagement and lower stress levels. Organizations implementing
activity-based offices should pay attention to the needs of different user groups and the usability
of workspaces, to ensure that the variety of workspaces meets different user needs and that
switching workspace is easy.
References
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Bakker, A.B., Demerouti, E. (2007). The job demands-resources model: State of the art. Journal
of Managerial Psychology, 22(3), 309–328.
Bakker, A.B., Demerouti, E., Sanz-Vergel, A.I. (2014). Burnout and work engagement: The JD–
R approach. Annual review of organizational psychology and organizational behavior, 1(1),
389-411.
Edwards, J., Caplan, R., Harrison, R. (1998). Person-environment fit theory: Conceptual
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Engelen, L., Chau, J., Young, S., Mackey, M., Jeyapalan, D., Bauman, A. (2019). Is activity-
based working impacting health, work performance and perceptions? A systematic review.
Building Research & Information, 47(4), 468-479.
Eurofound (2021). Living, working and COVID-19 (Update April 2021): Mental health and trust
decline across EU as pandemic enters another year. Publications Office of the European
Union, Luxembourg. https://www.eurofound.europa.eu/publications/report/2021/living-
working-and-covid-19-update-april-2021
Gerdenitsch, C., Korunka, C., Hertel, G. (2018). Need–supply fit in an activity-based flexible
office: a longitudinal study during relocation. Environment and Behavior, 50(3), 273-297.
Haapakangas, A., Hallman, D., Mathiassen, S.E., Jahncke, H. (2018). Self-rated productivity and
employee well-being in activity-based offices – The role of environmental perceptions and
workspace use. Building and Environment, 145, 115-124
Haapakangas, A., Hallman, D.M., Mathiassen, S. E., Jahncke, H. (2019). The effects of moving
into an activity-based office on communication, social relations and work demands–A
controlled intervention with repeated follow-up. Journal of Environmental Psychology, 66,
101341.
Haapakangas, A., Sirola, P., Ruohomäki, V. (2022). Understanding user behaviour in activity-
based offices. Ergonomics (Accepted for publication). DOI: 10.1080/00140139.2022.2092654
Hodzic, S., Kubicek, B., Uhlig, L., Korunka, C. (2021). Activity-based flexible offices: effects on
work-related outcomes in a longitudinal study. Ergonomics, 64(4), 455-473.

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Hoendervanger, J.G., De Been, I., Van Yperen, N.W., Mobach, M.P., Albers, C.J. (2016).
Flexibility in use: Switching behaviour and satisfaction in activity-based work environments.
Journal of Corporate Real Estate, 18(1), 48-62.
Hoendervanger, J.G., Van Yperen, N.W., Mobach, M.P., Albers, C.J. (2022). Perceived fit and
user behavior in activity-based work environments. Environment and Behavior, 54(1), 143-
169.
Pejtersen, J.H., Kristensen, T.S., Borg, V., Bjorner, J.B. (2010). The second version of the
Copenhagen Psychosocial Questionnaire. Scandinavian journal of public health, 38(3_suppl),
8-24.
Ruohomäki, V., Lahtinen, M., Reijula, K. (2015). Salutogenic and user-centred approach for
workplace design. Intelligent Buildings International, 7(4), 184-197.
Schaufeli, W.B., Shimazu, A., Hakanen, J., Salanova, M., De Witte, H. (2019). An ultra-short
measure for work engagement: the UWES-3 validation across five countries. European
Journal of Psychological Assessment, 35(4), 577.
van der Voordt, T.J.M. (2004). Productivity and employee satisfaction in flexible workplaces.
Journal of Corporate Real Estate, 6(2), 133–148.
Wijk, K., Bergsten, E.L., Hallman, D.M. (2020). Sense of coherence, health, well-being, and work
satisfaction before and after implementing activity-based workplaces. International Journal
of Environmental Research and Public Health, 17(14), 5250.

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Importance of good working gloves - ErgoSleeve in
validating the gloves and measuring arm muscle load
Riitta Simonen, Riitta; Tolvanen, Pekka; Pylväs, Janne
Myontec
riitta.simonen@myontec.com
Project scope. Good working gloves help in maintaining a firm grip and lighten manual
handling and lifting work. In hand-intensive work arm muscle load evaluation by EMG
can be used in choosing the best glove to the industry. We compared different working
gloves in hand muscle EMG activation levels and motions in handling grocery store-
specific items.
Design. Four different working gloves and bare hands were used in hold and release
test with five grocery store products. Myontec’s ErgoSleeve is a smartwear measuring
wireless wrist flexor and extensor EMG and motions, integrating analytics of the
collected data with video in ErgoLink software. Arm muscle load was normalised to
maximum isometric load (MVC) of hand flexors and extensors.
Results. Mean combined flexor and extensor EMG in hold and release test varied from
8,3 % MVCmax to 10.2% MVCmax (SD 3,3-5,4). The EMG difference between the gloves
was greatest (9,5%MVCmax -17,1%MVCmax) in heavy 1,5 litres soft drink bottle
compared to the light bag of screws (2,6%MVCmax.2,9%MVCmax).
Discussion. Arm muscle load differences in grip hold and release test between the
gloves were notable, even double in handling heavy and slippery objects. The firm
working glove grip becomes extremely important in reducing hand fatigue in long work
shifts.
Conclusions. ErgoSleeve provides a fast tool in evaluating ergonomic task-specific
gloves which provide superior hand grip, diminish product damage and enhance
productivity.
Keywords: EMG, grip, hand intensive work, manual handling

92
A comparative study regarding noise and hand-arm vibration
exposure during self-compacting and conventional concrete
casting
Inga MIKHALTCHOUK(1), Lars KRAFT(2), Tohr NILSSON(3), Mikael FORSMAN(1,4)
(1) KTH Royal Institute of Technology, School of Engineering Sciences in Chemistry,
Biotechnology and Health, Department of Biomedical Engineering and Health Systems, Division
of Ergonomics, Hälsovägen 11C, 141 57 Huddinge, Sweden (SE).
(2) Cement och Betonginspektörerna NN AB, Gnarp, Sweden
(3) Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
(4) Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
Abstract: Sick leaves in construction industry caused by strain and vibration injuries are
common. When casting conventional concrete (CC), the workers are exposed to hand-arm
vibrations and other physical factors. With self-compacting concrete (SCC), vibration is
eliminated. SCC may also be cheaper due to reduced need of casting workers. This study
compared SCC and CC regarding exposures and costs at a large concrete tunnel wall and at a
concrete element factory. Noise and Hand-arm vibration amplitude and exposure time was
assessed. The measured LAeq noise values were 80.6-82.0 dB, hence above the action level. The
average hand-arm vibration amplitude (and exposure time) time was 13 m/s2 (1h50m) and 9.8
m/s2 (30m) in the tunnel and factory, respectively. In construction sites as in the tunnel, the
vibration dose from using CC can be above the action level. Therefore, the SCC is advantageous
from a health perspective. However, at working sites like the factory, usage of SCC may be both
more expensive and complicated, wherefore there may not be reasons enough to use SCC in the
production.
Keywords: Comparative, hand-arm vibration, self-compacting concrete.
1. Introduction
The construction industry is one of the toughest and most hazardous industrial sectors. In Sweden,
52% of all diagnosed work-related diseases in the construction industry during 2017-2018 were
various strain injuries and 36% were vibration related injuries (BCA, 2018). In Sweden sick leaves
in construction industry caused by strain and vibration injuries cost the society up to 120 million
euros per year (Rwamamara & Simonsson, 2012).
While performing various work tasks at a construction site a worker executes heavy lifts, subjects
himself to strenuous awkward body postures, and needs to handle vibrating tools and machinery
(Samuelsson, 2008). One demanding task after casting with conventional concrete (CC) is to use
so-called vibration rods, and manually vibrate the concrete to reduce the air content and fill the

93
formwork properly. During manual vibration the workers are exposed to forward bent postures,
repeated heavy lifts, noise and hand-arm vibrations. However, there exists a type of concrete that
does not require vibration after casting.
Self-compacting concrete (SCC) is a fluid concrete and as such, does not need vibrations to fill a
formwork. It is also denser, has a higher compressive strength and requires less post-production
treatment in general (Cussigh, 2007). As there is no need for vibrations when casting with SCC,
this strenuous, noisy and potentially harmful task is eliminated. This may improve concrete
workers’ work environment, health and safety (Simonsson, 2011b). In addition, one may also
expect economic benefits when using SCC. Total cost of SCC casting has been estimated to be
lower, since fewer workers are needed (Simonsson, 2000). At the same time, disadvantages such
as timing difficulties have been discussed (Simonsson & Emborg, 2009). Despite expected
advantages of SCC, its market share in Sweden is still between 15 - 30% (Staffan Carlström,
Swerock AB and Mats Emborg, Betongindustri AB, private communication. February 2022).
The aim of this study was to monitor construction workers’ exposure to noise and arm vibrations
during concrete casting with SCC and CC, respectively, and to compare the casting methods’
exposures and total costs. The aim also included comparisons of the daily vibration exposure of
the workers with health limit values.
2. Methods
2.1.
Construction
Objects
The study was conducted at two different construction locations.
Figure 1. The tunnel workplace. In front a
completed section of concrete reinforcement
of the tunnel. In the rear the actual workplace
for the study.
Figure 2. Part of the production line in the
concrete element factory where the second
study took place.
The first one was a construction site of an underground highway tunnel, where wall casting was
ongoing. At that location two similar construction objects were chosen. These were two vertical
concrete walls casted at different days, each being about several meters long, around 3 meter high
and more than 1 meter wide (Figure 1). Casting was done with CC on the first observation

94
occasion and with SCC on the second one. The walls had slightly different shapes but required
approximately same amount of concrete to be casted: 66 m3 for CC and 63 m3 for SCC. The
casting with CC took 4 hours without breaks or pauses. With SCC it took 6 hours with several
pauses due to delays in the delivery of concrete.
The second one was a factory producing prefab concrete elements, mostly walls. We chose а shop
where several teams were engaged in production of concrete elements for residential houses using
CC (Figure 2). We observed their work (reinforcement fabrication, casting and vibrating the
concrete) and did various measurements for the duration of 1 working day (8 hours).
2.2. Participants
At the tunnel site we engaged previously assembled casting teams of 4 male workers for CC, and
3 male workers for SCC. At the factory we engaged 3 voluntary male workers for vibration and
noise measurements. Subjects signed informed consents prior to participation in the study and
were given verbal and written descriptions of the experimental protocols.
2.3. Data collection
Hand-arm vibration amplitude was measured in accordance with ISO 5349 several times during
casting with CC both at the tunnel site and at the factory.
Noise was measured during a full working pass at each location and each observation occasion.
Noise measurements were performed with noise dosimeter SV 104 (Svantek, Warzaw, Poland).
At each location the dosimeter was placed on the right shoulder of one of the workers’, quite near
the ear. Measurement values were extracted to text file format (csv) using the Supervisor
application (the manufacturer’s software package). Additionally, in the factory, maximum noise
levels from working equipment were measured with the dosimeter KIMO DB 100 (Kimo
Instruments, France).
Video recordings were made at each observation occasion. At the tunnel site the workers were
working inside the form, so we used a GoPro camera attached to a piece of reinforcement above
the wall, pointing inside the form. At the factory we used 3 standard video cameras mounted on
tripods next to each team’s working place. The videos were used to identify vibration periods to
compute the total exposure time for vibration.
Additionally, a logging journal of external sounds, and specific work tasks was kept. Some of
those tasks were photographed as well, to ensure consistency and continuity of video recordings.
Data for economic analysis and comparison of costs, including costs for material, formwork and
labour hours for casting with SCC and CC were collected at the tunnel location by means of an
interview with the construction company’s foreman.
2.4. Data analysis
CSV files with noise measurements were analysed and visualised using the manufacturer’s
software package. Video recordings were analysed manually to identify start and stop seconds of
each vibration periods.

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3. Results
3.1 Noise
At the tunnel site
During casting with CC, 360 measurements were made over the course of the 4-hour work period
with the median LAeq value of 80.6 dB (Figure 3). The corresponding number of noise
measurements for SCC and 6-hour work period was 760 with the median LAeq value of 82.0 dB
(Figure 4). As seen from the graphs, the median values are very close, with the value for SCC
slightly larger.
Figure 3. Noise measurement, raw data for CC-casting, in the tunnel
Figure 4. Noise measurement, raw data for SCC-casting, in the tunnel
Human response depends greatly upon the range with which noise levels vary in a given
environment. For a given LAeq,T we would find a higher, more steady, level more tolerable than a
lower background level with frequent noise intrusions.
The statistical descriptor for the variation of noise is LAn,T, i.e. that dB(A) level exceeded for N%
of the time T. For example, LA90,T is used to estimate the residual background noise level in the
environment whereas LA1,T or LA10,T is used to estimate maximum levels. The complete range of
LAn,T levels, known as the cumulative distribution, can be measured directly using specially
designed Sound Level Meters or Noise Level Analyzers; these instruments are also capable of
measuring the corresponding probability distribution of the noise levels.
LAn,T and LAeq,T values are used to evaluate existing noise environments in order to control the
impact of predictable noise sources such as highways and construction sites.
Tables 1 and 2 describe the distribution of the noise levels in the tunnel casting with CC and SCC,
respectively.

96
Table 1. Percentiles of LAeq values [dB] of measured noise, CC, in the tunnel.
Percentile
10th
25th
50th
75th
90th
95th
dB
61.2
73.4
80.6
83.6
85.6
86.8
Table 2. Percentiles of LAeq values [dB] of measured noise, SCC, in the tunnel.
Percentile
10th
25th
50th
75th
90th
95th
dB
73.4
79.0
82.0
84.2
87.1
89.1
At the factory site
During casting with CC at the factory, 1193 measurements were made during 8 hours of the work
period with the median LAeq value of 75.5 dB (Figure 5).
Figure 5. Noise measurement, raw data för CC-casting, factory
Table 3. Percentiles of LAeq values [dB] of measured noise, CC, at the factory
Percentile
10th
25th
50th
75th
90th
95th
dB
64.5
71.4
75.5
80.3
85.0
88.4
With the help of the Supervisor application (Svantek, 2018) we calculated LpAeq for tunnel during
CC casting to be 83.0 dB. The corresponding value for SCC casting in the tunnel was 83.8 dB.
Using Swedish Work Environment Authority’s noise calculator, we could determine the 8-hour
daily exposure level, Lex, 8h. For CC it was 80 dB, and for SCC 82.6 dB.
Corresponding calculated values for the factory location were: LpAeq - 81.9 dB and Lex, 8h - 81.9
dB. Contrary to measurements in the tunnel, we had opportunity to measure noise with KIMO
DB 100 near the vibration rod at a moment (during lunch break) when there was almost no
background noise from the surroundings. The value of noise next to a working vibration rod at
that moment was measured to 91 dB. At other moments during lunch break, when the rod was
switched off, the value was measured to 78 dB.

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3.2. Vibrations
At the tunnel site
The average hand-arm vibration amplitude from 6 repeated measurements was 13 m/s2. The
observations and the quality of video recording were markedly impeded by the complexity of the
working environment in the tunnel; thus, we were not able to exactly calculate the total average
exposure time. From videos and logs we estimated it to be about 1 hour and 40 minutes.
At the factory site
The average hand-arm vibration amplitude from 6 repeated measurements was 9.8 m/s2.
Observations and video recording quality was good, and this enabled us to properly calculate
exposure times. The total average exposure time was 30 minutes.
3.3. Economy
The economy analysis from the tunnel showed that SCC in this case demanded more labor hours
for the formwork, but less hours for the casting. The total costs of the two types of concrete were
somewhat higher SCC, because of more time needed for the formwork (Table 4).
Table 4. Economy of casting, in the tunnel
Different costs
CC cost, SEK
SCC cost, SEK
Formwork
87200
107100
Casting
13260
6630
Dismantling & control
21420
28050
Concrete
82830
84420
Total costs
204720
226200
4. Discussion
This study included observations and measurements from two locations, a tunnel and a factory.
The tunnel included both CC and SCC, while the factory included only CC, for measurement of
exposure doses and to compare those with health limits.
The complexity of construction work in the tunnel made it difficult to conduct observations and
record videos wherefore less results than expected was obtained. The workplace on top of the
wall reinforcement made it impossible to stand close enough to a worker to log his actions in
detail. A single camera above the wall, pointing inside the form, turned out to be insufficient to
record all actions of a worker changing his body posture continuously, and frequently standing
with his back to the camera.
Furthermore, due to the high levels of noise coming from other sources of sound in the tunnel;
passing trucks, working equipment, people talking, sawing or drilling etc., it was difficult to
interpret the recorded sound in the video recordings.
The noise recorded from the dosimeters, were, in opposite to what we had expected, somewhat
higher with SCC than with CC. The calculated value of Lex, 8h for the concrete factory and for

98
tunnel SCC casting exceeds the low limit of Lex, 8h which is 80 dB according to the Swedish Work
Environment Authority (2005). When the value increases and is in between 80 dB and 85 dB, the
worker needs to use hearing protection. The daily exposure level Lex, 8h for CC casting in the
tunnel was 80 dB, which is on the threshold of the lower limit. Therefore, one should use hearing
protection even in this case.
However, the difference in overall noise level between casting with SCC or CC was very low,
and the dosimeter was only worn by one worker on each occasion. We believe that the noise
measurements in the tunnel cannot be interpreted either as that noise levels are lower during
casting with SCC or that they are higher when compared to casting with CC, since our noise
measurements were polluted with background sound from other sources. Other studies have
however indicated that casting with SCC gives a lower noise level than CC does (Cussigh 2007;
Emborg et al. 2007). The separated noise measurement from the factory, also showed that the
vibration tool in that case was a significant noise source.
The total daily exposure time with CC in the tunnel was estimated to 1 hour and 40 minutes,
which corresponds to the daily vibration exposure value A(8) of 4.6 m/s2 and exceeds the action
level of 2.5 m/s2 for daily vibration exposure (Directive 2002/44/EC; the Exposure Limit Value
is 5.0 m/s2). According to the Swedish Work Environment Authority (AFS, 2005:16) the exposure
time, at the measured vibration amplitude of 13 m/s2, should not exceed 30 minutes.
The difference in vibration dose during casting with CC vs SCC was of course expected, but since
the vibrations in the CC was found to be above the daily exposure limit, there is a clear advantage
of SCC usage in the long-term.
At the factory site the total exposure time was calculated to 30 minutes or less, at a measured
vibration amplitude of 9.8 m/s2. This gives the daily exposure value A(8) of 2.3 m/s2 which is
within the accepted range (below 2.5 m/s2). According to the Swedish Work Environment
Authority (AFS, 2005:16) the total exposure time at the observed vibration amplitude of 9.8 m/s2
should not exceed 1 hour and 30 minutes.
The costs were higher when casting at tunnel with SCC. However, the main part of the cost came
from the formwork construction. These castings were very complex and large with an unusually
thick wall-construction that demanded extraordinary strong and firm formwork. Since the
formwork pressure gets a lot stronger when using fluid SCC, the formwork for the SCC casting
demanded longer time to build. However, in this case, very advanced large concrete walls were
cast. If an ordinary wall of only 0.3 m width had been used for the study, the cost difference
probably would have been the opposite, since the price of the two concrete types did not differ
much.
5. Conclusions
It is very difficult to perform measurements at real working sites, especially at construction sites
of big complexity, such as highway tunnels. Therefore, observation-based results may not be as
detailed as expected. In contrary, the exposure time analyses were easy to observe in the concrete
construction factory.
The results however indicated that in construction sites as in the tunnel, the vibration dose from
using CC can be high and above the action level. Therefore the SCC is advantageous from a health
perspective.

99
At working sites like the factory, usage of SCC may be both more expensive and more
complicated, and in situations as shown here, when vibration time is short and the dose does not
exceed action limits, there may not be reasons enough to change to SCC.
Acknowledgements
This study was supported by AFA insurance, Stockholm, Sweden (Dnr 210137) and by the
Swedish Transport Administration.
References
Cussigh, F. (2007). SCC in practice: opportunities and bottlenecks. Proceedings of the 5th
International RILEM Symposium on SCC, Ghent, 21-27.
Simonsson, P. (2011b). Buildability of concrete structures – processes, methods and material.
structural engineering of Luleå University of Technology, Luleå.
Simonsson, J. A. (2000). Självkompakterande betong, utveckling och uppföljning vid
tunnellining i Stäket. Luleå Tekniska Universitet, Luleå.
Byggindustrins Centrala Arbetsmiljöråd (BCA), 2018. Available at:
https://www.byggnads.se/siteassets/rapporter/arbetsskador/arbetsskador-i-byggverksamhet-
2017.pdf
Simonsson, P. and Emborg, M. (2009). Industrialized construction:benefits using SCC in cast in-
situ construction. Nordic Concrete research, 39 (1), 33-52.
Samuelsson, B. (2008). Arbetsskador I byggverksamhet 2007. Privat och offentlig verksamhet.
BCA 2008:2
AFS, 2005:16. Buller, Arbetsmiljöverket Arbetsmiljöverket (2005). In Swedish
Emborg, M., Simonsson, P., Carlswärd, J., Nilsson. M. (2007). Industrial casting of bridges
combining new production methods and materials, like a robust SCC, utilizing lean construction
principles. Proceedings of the 5th international RILEM symposium on SCC, Ghent, 458-490.
Svantek, 2018. Supervisor, Available at: https://svantek.com/softwares/supervisor-software/
Kalkylator för buller - Arbetsmiljöverket (av.se)

100
An objective approach for assessment of hand-arm vibration dose
Guilherme H. ELCADI (1), Inga MIKHALTCHOUK (1), Tohr NILSSON (2), Per VIHLBORG (3),
Mikael FORSMAN (1,4)
(1) Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH
Royal Institute of Technology, 14157 Huddinge, Sweden
(2) Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
(3) Department of Geriatrics and Odensbackens Health Centre, Faculty of Medicine and Health,
Örebro University, Örebro, Sweden
(4) Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
Abstract
Working with vibrating handheld tools may lead to chronic injuries in the fingers, hands and arms, a
condition referred to as Hand-Arm Vibration Syndrome (HAVS). Estimating total vibration exposure
time is problematic. Self-estimation is commonly used as well as visual observations. However, self-
estimation most often overestimates exposure time, and observations, although accurate, are time
consuming. The aim of this study was to compare a novel objective method with a small accelerometer
to video observation, to assay vibration exposure dose in two types of work. After signal processing
that separates acceleration signals from other rapid movements in similar frequency, the method
yielded very similar results to visual observations in a mechanical workshop, while in a concrete wall
manufacturing plant, it failed to identify exposure times. The latter likely because the workers did not
need to firmly grip the tool. In conclusion, the new accelerometer method shows accuracy and has the
potential for being further developed into a smart, inexpensive, and advantageous method.
Keywords: vibration, accelerometer, technical measurement, exposure
1. Introduction
Accurate and useful methods for collecting and identifying data from daily work tasks are essential for
ergonomics, and can be used to estimate overall job exposure to risk factors (Mathiassen et al. 2005).
High exposure to risk factors may lead to work-related injuries (Winkel & Mathiassen 1994). Among
commonly reported injuries are disorders associated with frequent use of vibrating tools. Those
disorders range from chronic injuries in the fingers to injuries in the hands and arms, a condition often
referred to as Hand-Arm Vibration Syndrome (HAVS) (Heaver et al. 2011). A crucial factor for the
eventual occurrence of injuries resulting from work with vibration tools is the vibration exposure dose
of the worker, i.e., the vibration level and the total exposure time (Burström et al. 2015). Although the
vibration level of a tool can be obtained via a database where vibration levels for various tools are
registered or via direct measurements on the tool, the total daily exposure time is trickier to accurately
assess.

101
According to the Swedish Work Environment Authority, 15% of all employed men and 3% of all
employed women, are exposed to vibrating handheld tools at least 25% of their working day. The latter,
however, was estimated by subjective methods, simply by asking the workers how long they used the
vibrating tools or by observation of workers over an eight-hour workday. Subjective estimates although
a widely accepted praxis are known to be inaccurate and over-estimate exposure (Åkesson et al. 2001;
McCallig et al. 2010). For example, Åkesson and co-workers compared self-estimates of vibration
exposure to the times recorded from ultrasonic scaling of dental hygienists and found self-estimates to
over-estimate exposure by 3-9 times (Åkesson et al. 2001). They used visual observation of the worker
as the gold standard. McCallig and co-workers also used visual observations to compare exposure time
to self-estimated exposure time from engineering services and maintenance department workers and
concluded that observations are the best-suited method for the estimation of vibration exposure times.
Visual observation, however, is a time-consuming and expensive method, requiring hours of work by an
observer (Trask et al. 2014). Today, however, with modern electronic devices, quantification of vibration
exposure should be possible to be assessed by measuring vibration frequency using accelerometers. It
would allow for a cheap and simple method for measuring exposure that can be recorded from one or
more workers over an entire workday or multiple workdays. There is (at least) one commercial device,
the HAVi watch (www.thehavi.com), Nottingham, U.K.), that is worn on the wrist as a watch, that is said
to measure exposure time. We have, however, not found any scientific evaluation of this or any alike tool.
Thus, the aim of the present study was to use a novel accelerometer method to compare total vibration
exposure time to visual observations of vibration exposure dose. Allowing, hence, to easily and
inexpensively assay vibration dose, and together with an vibration level estimation determine the day-
to-day variation of vibration dose, average values over several days, and when desired an exact value of
an individual's exposure during a workday.
2. Materials and Methods
2.1 Participants
Two male workers representing two different types of work were included. The first one was a railway
track manufacturing (i.e. a mechanical workshop) worker in good health and free of discomfort related
to the hands or upper body were selected. The second participant was a healthy worker in a concrete
walls factory. Both subjects were right-handed. An informed consent was signed prior to participation
and verbal and written descriptions of the experimental protocols were given.
2.2 Methods
Vibration exposure data were collected from the dorsum of the hand using a small accelerometer (24 x
36 x 9 mm, weight 9 g) (Axivity AX6, Axivity Ltd, Newcastle upon Tyne, UK) with a maximum
sampling frequency of 3.200 Hz and an in-built USB-memory. The accelerometer was taped the dorsum
of the hand on the level of the mid-section between the 2nd and 3rd metacarpal bones with a double-
coated tape and a kinesiology tape to assure a secured positioning (Figure 1). An ulnar deviation was
performed to get a marker for the initial time for analysis. The worker was then instructed to carry out
normal daily tasks. The acceleration was sampled at a frequency of 800 Hz, and saved on the built-in
memory.
The measurement on the railway track manufacturing worker were carried out for 2 hours. The work
tasks were drilling and bolting using vibrating electrical power tools that were held with a consistent
grip.

102
Fig 1. The accelerometer placement showing the equipment placed on the dorsum of the hand with the
double-sided tape. Kinesiology tape was subsequently placed over the accelerometer.
For visual observation of vibration exposure, the workers were videotaped using a high-definition
camera with an in-built sensitive microphone (Sena Tube, Sena Technologies, Inc., Irvine, CA, USA).
The videotaped data were later used for visual analysis and the microphone recording was used in the
analysis to aid with the vibration exposure identification. After the completion of the data collection
all equipment was removed.
2.3 Data processing
Data from the accelerometers' USB memories were imported into MatLab r21b (MathWorks, Natick,
MA, USA) for analysis. Video-taped data were analysed, each tool handling period time was identified,
and the times were registered in relation to the beginning of the video recording. Visually observed times
were analysed by a researcher experienced with visual analysis and with the work tasks. The start and
stop times of each vibration period was registered.
The accelerometer data was first converted into a MatLab (.mat) file from the original accelerometer
.cwa file. Vibration times were then determined in MatLab using an in-house developed algorithm that
high-pass filtered the signal (a 6-order Butterworth filter with a cut-off frequency of 15 Hz), to separate
vibrations from hand movements. , Then the signal was rectified low-pass filtered (a 6-order Butterworth
filter with a cut-off frequency of 5 Hz). A moving median filter of 0.5 seconds was then employed, and
a cut-off level of 1.5 m/s2 was used to identify start and stop times (in ms) of vibration periods. Finally
short periods, of less than 1 s, which was suspected to be caused by other sudden accelerometer signal
changes, was omitted. Figures 2 illustrates the different processing steps, and Figure 3 shows the final
filtered signal and the video- and accelerometer- based identified periods from the mechanical workshop.
For visual observation data and accelerometer data, the number of vibration exposure periods and the
total vibration time were computed and compared.

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3. Results
The video and accelerometer identification were very similar for the mechanical workshop, see figures
2 and 3. While for the concrete wall factory workers, there were large discrepancies between the
accelerometer measurement and the observation-based time identifications.
In the mechanical workshop the observation method identified 139 vibration exposure episodes, and the
accelerometer method identified 138 episodes. One hundred and thirty seven (137) episodes were
identified by both methods (Fig 2 and 3). For the cumulative exposure time during the 2 hours of work,
the observation-based periods added up to 794 s, and for the accelerometer-based identifications the
total time 805 s.
Fig 2. Accelerometer signals in a window of 2 minutes, raw signal (top), high-pass filtered (second graph
from the top), rectified and low-pass filtered (third), and median-filtered signals (bottom graph). The
bottom graph also shows the identified vibration exposure periods by observation (black lines) and
accelerometer (red lines).

104
Fig 3. All vibration periods identified by both observation and accelerometer during 2 hours of work in
a railway track manufacturing plant. Black lines indicate the periods identified by observation and red
lines indicate periods identified by accelerometer.
The number of video observation-based identifications of vibration exposure periods of the concrete
worker was 34. The cumulative video-based exposure time was 914 seconds (about 15 minutes). In this
case, the measured acceleration was of much lower amplitude and the acceleration based method failed;
nine short periods were identified with a total time of 13 seconds. The acceleration-based periods did
not coincide with the video-based identifications.
4. Discussion
In this study, vibration exposure time observed from video-taped work tasks were compared to
accelerometer measured vibration exposure time.
In the mechanical workshop, the exposure total time identified by observation were shorter (794 s), than
that measured by accelerometer (805 s). The difference between methods, however, was ~ 1 percent,
hence negligible. The number of identified vibration periods was of 139 and 138 for the observed data
and for the accelerometer, respectively. Considering that the commonly detected number of vibration
periods was 137, the difference between methods was close to 1 percent. We consider, thus that this
study showed, in general, a good agreement between observation and accelerometer, both on overall
exposure proportions and on the mean duration. It is important to point out, however, that we present
here preliminary data, collected for one subject in specific work tasks. As always, i.e. even if this method
is accurate, a sampling strategy is needed for the sampling time. If there is a variation between job tasks
and power tool usage between hours or even between days, a longer sampling time is needed. This new
method can however easily be used for several days; the battery lasts at least for one week with this
sampling frequency (800 Hz in this case).
For the railway track manufacturing task, the accelerometer measurements were likely as accurate as the
observation. The work tasks of drilling and bolting were performed with the workers holding a tight grip
to their work tools. Hence, vibration was transferred to the hand and frequencies were correctly gauged
by the accelerometer. However, for the concrete wall manufacturing task there were large

105
discrepancies between the time identification methods. Although the tools used by the workers clearly
vibrated, and the accelerometer can be assumed to measure the acceleration of the back of the hand
correctly, the workers might not have had a firm grip when holding the work tool. We, therefore, attribute
the discrepancies found to be not related an accelerometer measurement inaccuracy, but to the work
technique itself, where no vibrations seemed to be transferred to the back of the worker’s hand. The
method, hence, was deemed not suitable for the latter work task.
We recommend the use of the method presented in this study for work tasks where it is know the workers
firmly grip their work tools. As of today, there are commercial systems with built-in accelerometers, as
for example a work glove that could in principle be used to measure vibration dose over a workday.
However, such a system requires the glove to be worn at all times, and it is therefore not suitable for
professions such as e.g. dental hygienists. Moreover the system is relatively expensive (approx. 4000
and euros ~ 60 euros for a new pair of gloves). Nevertheless some industries have tried the system, e.g.
assembly and construction industry, and found out that the gloves are quickly damaged and may only
be worn for 4 h a day for a week before needing replacement. In another attempt to objective measure
vibration exposure, in a collaboration between Umeå University and Västerbotten County Council in
Sweden, a sensor is being developed that is attached to a tool. The method, although intended to measure
vibration exposure wireless, and with a user-friendly interface presents a problem since it is common
for a person to use several different vibrating tools during a day (Morgan & Palmer 2000). Since this
system is based on a sensor being attached to a tool, it is not possible measure individuals' daily dose
when several different tools are used by several persons during a workday. A similar system is available
for some of the Husqvarna’s garden tools; a mobile phone app connects to tool and the tool’s run time
can be read (see https://www.husqvarna.com/se/tjanster/husqvarna-connect/#uppkopplade-produkter).
Hence, using a small accelerometer with a built-in memory, as in this study, allows for very simple all-
day measurements of vibration time at work, which together with amplitude data, facilitate a dose
estimation. With several accelerometers, one could effectively measure an entire work group. For now
the new method measures only vibration time, and dose not separate times for different tools. A
possibility for that is planned to be investigated.
Furthermore, we also determined the ease to import the data into MATLAB and apply the analysis.
Axivity's own analysis software has an attractive design, and it is of the "open-source" type, hence when
the analysis algorithms are fully developed, we can use Axivity's platform to make an appealing design
that is easy to use and understand, and can include input of tools’ vibration levels, and graphical result
presentations.
5. Conclusion
In conclusion, the use of accelerometers offer a unique method to assay the degree of vibration exposure
over time during work. Although, there are acceleration signals from other rapid movements that also
generates signals in the same frequency band, and may impose a risk for misclassifications, the
preliminary results indicate that the method provides accurate vibration exposure results and has the
potential for further development into a smart, cheap and useful method.
Acknowledgement
The study was supported by AFA insurance, Stockholm, Sweden (Dnr 210137).

106
References
Åkesson, I., Balogh, I., & Skerfving, S. (2001). Self-reported and measured time of vibration
exposure at ultrasonic scaling in dental hygienists. Applied Ergonomics, 32(1), 47–51.
https://doi.org/10.1016/S0003-6870(00)00037-5
Burström, L., Nilsson, T., & Wahlström, J. (2015). Whole-body vibration and the risk of low
back pain and sciatica: A systematic review and meta-analysis. International Archives of
Occupational and Environmental Health, 88(4), 403–418. https://doi.org/10.1007/s00420-
014-0971-4
Heaver, C., Goonetilleke, K. S., Ferguson, H., & Shiralkar, S. (2011). Hand–arm vibration
syndrome: A common occupational hazard in industrialized countries. Journal of Hand
Surgery (European Volume), 36(5), 354–363. https://doi.org/10.1177/1753193410396636
Mathiassen, S. E., Nordander, C., Svendsen, S. W., Wellman, H. M., & Dempsey, P. G.
(2005). Task-based estimation of mechanical job exposure in occupational groups.
Scandinavian Journal of Work, Environment & Health, 31(2), 138–151.
https://doi.org/10.5271/sjweh.861
McCallig, M., Paddan, G., Van Lente, E., Moore, K., & Coggins, M. (2010). Evaluating
worker vibration exposures using self-reported and direct observation estimates of
exposure duration. Applied Ergonomics, 42(1), 37–45.
https://doi.org/10.1016/j.apergo.2010.04.002
Morgan, T. C., & Palmer, G. (2000). A Model of Foreign Policy Substitutability: Selecting
the Right Tools for the Job(s). Journal of Conflict Resolution, 44(1), 11–32.
https://doi.org/10.1177/0022002700044001002
Standard - Mechanical vibration - Measurement and evaluation of human exposure to hand-
transmitted vibration - Part 2: Practical guidance for measurement at the workplace (ISO
5349-2:2001/Amd 1:2015) SS-EN ISO 5349-2/A1:2015 - Swedish Institute for Standards,
SIS. (n.d.). Svenska Institutet För Standarder, SIS. Retrieved August 9, 2022, from
https://www.sis.se/en/produkter/environment-health-protection-safety/vibration-and-shock-
with-respect-to-human-beings/sseniso53492a12015/
Trask, C., Mathiassen, S. E., Wahlström, J., & Forsman, M. (2014). Cost-efficient assessment
of biomechanical exposure in occupational groups, exemplified by posture observation and
inclinometry. Scandinavian Journal of Work, Environment & Health, 40(3), 252–265.
Winkel, J., & Mathiassen, S. E. (1994). Assessment of physical work load in epidemiologic
studies: Concepts, issues and operational considerations. Ergonomics, 37(6), 979–988.
https://doi.org/10.1080/00140139408963711

51st Nordic Ergonomics and Human Factors Society Conference 2022
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Electromyographic measurements with a new Bluetooth device
Tobias
HARALDSSON
(1),
Rosetta
MAGLIO
(1),
Julia
OSSWALD
(1),
Arvin
RAZAVI
(1),
Nathalie WEHLIN (1), Linus REMAHL (1) and Mikael FORSMAN (1,2)
(1) Department of Biomedical Engineering and Health Systems, School of Engineering Sciences
in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, 14157 Huddinge,
Sweden
(2) Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
Abstract: Electromyography (EMG) equipment is usually expensive and difficult to use,
preventing ergonomists and medical professionals from implementing it on a larger scale. In this
project, a low-cost, small and wireless EMG prototype device was compared with a commercial
EMG system. Muscle contractions were recorded with the new and the reference devices
simultaneously in sets of contractions of the biceps muscle of one healthy man (24 yrs). The
acquired data was analysed using an in-house MATLAB script. The results showed an overall
correlation of 94-98% between root-mean-square (RMS) signals of the two instruments.
Maximum EMG amplitudes (MVE) was measured and used for normalisation. The average
normalised RMS from 60 muscle contraction showed a mean difference of 3.8 %MVE between
the two systems. The comparison of the mobile EMG system with an established system was
very satisfactory. Although more studies are needed, this study indicates that the new EMG
system is may be useful in future laboratory and field ergonomic projects.
Keywords: Muscular load, Physical work load, Force, Technical measurement.
1. Introduction
Electromyography (EMG) has been used in ergonomics for many decades. In a recent study
including many subjects in different types of jobs, quantitative EMG exposure–response relations
were found for work-related neck and upper limb disorders (Balogh et al. 2019).
In today’s society where muscle activity for some occupational groups declines and everyday
activities become more stationary, while there are still jobs with high muscular force demands,
the need for high usability technical methods is still large. EMG is a diagnostic procedure, which
helps evaluate muscle behaviour during different scenarios and for different subjects. EMG
devices for this type of research are currently quite expensive, so there is a demand for less
expensive devices on the market. There have been attempts where researchers have tried to
implement their own low-cost EMG systems. Fuentes del Toro (2019) built and validated their
own EMG system using an Arduino board in which they compared it to a commercial device. The
authors were satisfied with the similarity, which was characterized e.g. as the cross-correlation in

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average being between 0.6 and 0.7. The system was however quite large and not suitable for
ergonomics field studies. Another example was reported by Supuk et al. (2014). They built an
EMG sensor for monitoring muscle activation during human activity. Their validation method
only focused on gait analysis. They were also satisfied with their results. However, they compared
their amplitudes to typical values of other studies and did not use a reference system, and their
system was large – too large to be used in ergonomics field studies. Further, Reinvee et al. (2015)
investigated the applicability of affordable EMG systems (with prices below $100) in ergonomics
practice, and concluded that low-cost measurement systems have the potential to be used in order
to detect muscle activation-deactivation patterns or at least the semi-quantitative assessment of
grip force. However, also those systems were rather large and the study only included to isometric
contractions.
In our group, Research Engineer Linus Remahl designed and built a wireless EMG system, with
inexpensive components. The system is small (see Figure 1), at 43 mm x 25 mm x 15 mm, with
two metal 2.5 mm female electrode snap buttons with a distance of 32 mm center-to-center on the
bottom. There are no cables involved – the device snaps directly to the electrodes. Because of the
short distance, there is also no need for a grounding electrode. The device is powered by a 200
mAh rechargeable lithium ion 3.7 V battery. It includes a battery charge controller, amplifier
circuit with an anti-aliasing band-pass filter, 8-370 Hz, a microcontroller with an AD-converter
(set for a sampling frequency of 1000 Hz), expandable memory, and Bluetooth module for
wireless connection. The prototype version runs approximately 8 hours on a charge together with
an Iphone, Ipad or an Apple computer. Initial tests of the device new EMG system have been
promising.
The aim of this project was to compare the signal of this new EMG system to the signal of a
modern commercial system.
2. Materials and Methods
Simoultanes measurements with two systems were carried out on one male subject. The signals
of the two systems were processing and statistical tools were used in the comparison.
2.1 The comparison procedure
To validate the mobile EMG system, a commercial system, the ErgoResearcher by
PluxBioSignals (pluxbiosignals.com) was used as a gold standard reference.
The two systems were used simultaneously. The test trials were performed on one subject, a
volunteering 24-year healthy man, in the following way: the subject’s upper arm were cleaned
with an antibacterial sanitizer. Four pre-gelled electrodes were placed in a line (with 2 cm between
their centres) on the biceps muscle and then connected to both EMG systems. A reference
electrode (needed by the commercial system) was placed on the collarbone. At first the
commercial system were connected to the more proximal electrodes, and for the last 3 repetitions
it was connected to the more distal electrodes, see Figure 1.

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Figure 1. Placement of the two EMG systems, altering position in the test.
The new EMG system includes a Bluetooth connector and needs no cables.
This was done to eliminate errors and to check that the result would be similar when the electrode
placement was switched between the systems. The subjects were then instructed to perform sets
of five repetitions of dumbbell bicep curls alternating between using a 15, 10 and 5 kg dumbbell.
Starting with the 15 kg dumbbell continuing to the 10 kg and lastly 5 kg dumbbell. This set was
performed 3 times and then for the last set the EMG systems placement were switched, so that
the mobile EMG sensor was connected to the two more proximal electrodes for the last 3
repetitions.
The bicep curl started in a relaxed position with the hand on the dumbbell that was on the ground.
The test subject then performed the bicep curl focusing on having the same rhythm and not trying
to touch the sensor, which would interfere with the signal. The test subject rested for 5 minutes
between each set.
At last a measurement of a MVC which stands for maximum voluntary contraction was
conducted. The test subject did a maximum contraction using heavy weights with all his force,
this was repeated three times with a short rest period between the contractions. The maximum
amplitude from the three repetitions were used as the maximum voluntary electrical activation
value (MVE).
Comparison between two channels within the commercial EMG system. The test described above
was performed with two different electrode pairs, which could not be assumed to show exactly
the same signal. As a comparison to the correlation between the two systems, another test was
conducted, to estimate the correlation within the ergoResearcher EMG when the signals was
picked-up from two electrode pairs. Hence, this test used two of the analogue inputs of the
ergoResearcher EMG. The test was conducted using the same method as described above with
the alterification that two ergoResearcher sensors were used instead of the new EMG device.
2.2 Signal Processing
The signal processing was performed as it is usually done for EMG signals. MATLAB version
R2021b was used for the processing.
Both system’s signals were set to be sampled at 1000 Hz, but since they were still not exactly the
same, they were resampled at 1024 Hz using MATLAB’s resample function. The new EMG has
a built-in analogue first order filter 10-400 Hz band-pass filter (the commercial system has likely

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a similar filter). On the sampled signal, a digital 4th-order Butterworth band-pass filter 10-400 Hz
was applied. To synchronize and eliminate the lags between the two acquired signals MATLAB’s
“alignsignals” function was used.
In order to evaluate the correlation between the two synchronized resampled signals, the signals
were root-mean-squared (RMS) converted, using a window size of 128 ms (hence to a frequency
of 8 Hz; Hansson et al. 2009). Then the cross-correlation function of MATLAB (xcorr) was used
for each pair of signals to determine their RMS-sample-to-sample-correlation.
The duration, maximum value, average value and the energy of every muscle activity were
extracted.
The MVE was calculated for both EMG devices. This was done to facilitate normalisation of the
two signals so they could be compared to each other. For each EMG pulse a max and average
value was calculated and then divided with the corresponding MVE.
3. Results
The new EMG system showed signal very similar to the commercial gold standard system. The
MVE values were 1.55 mV in the commercial system and 2.48 mV in the new system. Hence,
about 40% higher in the new EMG system than in the commercial system, so there is likely an
error in the amplification factor of the new system. However, for normalised values, which is
nearly always used (Hansson et al., 2009), a difference in amplification does not influence the
results. Figure 2 shows an example of EMG signals during a contraction trial, in this case with a
5-kg dumbbell.
Figure. 2. An example from the trials. In this set of five contractions, a 5-kg-dumbell was used.
The two EMG system measured simultaneously during the contraction from two different
electrode pairs. The RMS sample-to-sample cross-correlation coefficient was in this set, i.e.
comparing the red traces of the two systems, 0.957.
The correlations were between the two systems, averaged among all 12 sets of contractions (5,
10, 15 kg, 4 sets of each) to 0.957 (same as in the shown example in Figure 2), ranging from 0.941
to 0.976.
For the test with two different channels of the commercial system, the average RMS sample-to-
sample cross-correlation coefficient was 0.980.

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For all 60 contractions (12 sets of 5 contractions per set, see one example of a set in Figure 2), the
average normalised values were 11.4 %MVE for the new system and 13.4 %MVE for the
commercial system. The average of the absolute differences in the normalised averages was 1.95
%MVE with a standard deviation of 1.46 %MVE. Table 1 shows the average values and
differences for the three different dumbbells.
Table 1. Averages of normalised values and differences between the systems from the curls with
three different dumbbells. Twenty curls were performed with each dumbbell.
System
Dumbbell (kg)
New (%MVE)
Commercial (%MVE)
Average absolute difference (%MVE)
5
6.91
6.02
0.88
10
13.5
11.7
1.72
15
19.6
16.3
3.27
4. Discussion
In this project, a new EMG device was compared with an established one. The RMS traces
correlations between the two systems was high, above 0.94 in all of 12 sets of contractions.
When choosing the muscle for the test, it was first discussed to use a forearm muscle (e.g. flexor
carpi radialis), but since we needed two pairs of electrodes that should be comparable, the biceps
brachii was chosen for the measurements. We discussed using only one pair of electrodes –
connected to two systems. However, the commercial system uses a third electrode as a ground
reference, while the new EMG system uses the average of the two signals a reference signal.
Connecting them together would make the system exposed to each other and therefore likely
enable signals and noise to be transferred between them. Another option would be to use the same
electrode pair, and replicate the same sets repeatedly, alternating between the different systems.
But in that case the variation between the sets may be larger than between the systems. To use
two electrode pairs was also chosen by Fuentes del Toro et al. (2019) when validatede their EMG
system.
The RMS traces of the two systems ended up being highly similar regarding shape. The statistical
tests showed that there was close to perfect correlation; with an average correlation coefficient of
0.957 and with the lowest correlation among the sets being 0.941. This correlation is high in
comparison to previous studies (Fuentes del Toro et al. 2019; Reinvee et al. 2015). Is it also
known, generally, that different electrode placements give different results. This has been shown
also for biceps muscle (Ahamed et al. 2014). In line with this, also the tests two different
electrodes for the commercial system showed a correlation less than 1 (0.984). That correlation
was higher than for the main comparison, however not much higher, and not significantly so
(there were only three sets in the second comparison). The two comparisons were conducted at
different times, and the electrode placement may have differed which is also something to
consider when reviewing the results.
The normalised values (%MVE) were also similar, although the new system was in average 2
%MVE higher than the commercial system, the reason for this may be an investigation task for
our research engineer. That can possible be investigate using artificial signal. Still, the differences
were small, so, again, the results of the comparison must be considered positive.
This study has however limitations. Of course, to include only one subject is such; further studies
with more subjects need to be carried out, subject of different physical strength and sex, and with
use lighter weights to see if the correlation also applies also on lower amplitude signals. Also, the
sets were very experimental, field studies should be considered, or at least studies with simulated
work tasks.

51st Nordic Ergonomics and Human Factors Society Conference 2022
112
The prototype used in this study has a sampling program for iPhone or Apple computer, but that
needs to be improved for a higher usability. That work is now ongoing.
5. Conclusion
The comparison of the mobile EMG system with an established system was very satisfactory. The
new system has the advantages of being small and wireless.
Although more studies are needed, this study indicates that the new EMG system is may be useful
in future laboratory and field ergonomic projects.
Acknowledgement
This study was supported by Forte, Swedish Research Council for Health, Working Life and
Welfare (Dnr 2017-01209).
References
Ahamed NU, Sundaraj K, Alqahtani M, Altwijri O, Ali MA, Islam MA. (2014). EMG-force
relationship during static contraction: Effects on sensor placement locations on biceps brachii
muscle. Technol Health Care. doi: 10.3233/THC-140862.
Balogh I, Arvidsson I, Björk J, Hansson GÅ, Ohlsson K, Skerfving S, Nordander C. (2019).
Work-related neck and upper limb disorders - quantitative exposure-response relationships
adjusted for personal characteristics and psychosocial conditions. BMC Musculoskelet Disord.
20(1):139. doi: 10.1186/s12891-019-2491-6.
Fuentes del Toro S, Wei Y, Olmeda E, Ren L, Guowu W, Díaz V. (2019). Validation of a Low-
Cost Electromyography (EMG) System via a Commercial and Accurate EMG Device: Pilot
Study. Sensors, 19(23):5214. doi.org/10.3390/s19235214.
Hansson G-Å, Balogh I, Ohlsson K, Granqvist L, Nordander C, Arvidsson I, Åkesson I, Unge J,
Rittner R, Strömberg U, Skerfving S (2009). Physical workload in various types of work: part
I. Wrist and forearm. Int. J. Ind. Ergon. 39, 221–233.
Supuk TG, Skelin AK, Cic M. (2014). Design, development and testing of a low-cost sEMG
system and its use in recording muscle activity in human gait. Sensors (Basel). 2014 May
7;14(5):8235-58. doi: 10.3390/s140508235. Erratum in: Sensors (Basel). 2014;14(8):15639-
40.
Reinvee M, Vaas P, Ereline J, Pääsuke M. (2015). Applicability of Affordable sEMG in
Ergonomics Practice. Procedia Manufacturing, 3, 4260–4265.
https://doi.org/10.1016/j.promfg.2015.07.412

113
Application of low-cost accelerometers in risk
assessment of low back pain due to whole body
vibrations
Hettiarachchi, Pasan*; Johansson, Peter J.; Gomez Sanchez, Adrian
Occupational and Environmental Medicine
Department of Medical Sciences
Uppsala University
*pasan.hettiarchchi@medsci.uu.se
Mobile machine operators and drivers are often exposed to whole body vibrations at
work and this is related to low back disorders. According to AFS 2005:15 employers are
obligated to perform risk assessment of whole body vibrations. Measurements of whole
body vibrations using gold-standard instruments can be a relatively complex and costly
task. Previous studies have shown that consumer products such as IPods work in practice
for the collection and assessment of such vibrations. However, iPods are not robust
enough to use in different environments and are also not suitable to sit on. Axivity AX3 is
a small robust accelerometer with built-in logger that costs about 1400 SEK and which,
in a lab environment, has been shown to conform well to a gold-standard measurement
system that meets ISO2631 standard.
Our aim was to further validate and test the AX3 devices in real-world scenarios,
where we compare results of whole body vibration measurements conducted with AX3
with a gold-standard measurement system.
A total of 16 field measurements were carried out, where four AX3 devices were
mounted on top of the gold-standard Svantek SV106's seat plate. The plate was placed
on the driver's seat of various vehicles (Enduro motorbike, a front-
loader, forwarder, passenger car, tractor) as well as on office chairs. The measurement
time ranged from 9 min to 40 min. AX3 devices logged data at a sampling rate of 1600
Hz and a range of ± 16 g. Custom Matlab software with frequency weighing filters
according to ISO2631.1 processed raw data from AX3 and produced RMS and VDV
values. These were then compared with corresponding values from the Svantek system.
Vibration levels for RMS were measured between 0.00 - 3.88 𝑚𝑠−2 and for VDV
from 0.12 - 83.12 𝑚𝑠−1.75. The correlation between AX3 and SV106 was 0.99 or more for
both RMS and VDV values. The average difference (bias) between AX3 and SV106 for
RMS and VDV was 0.02 𝑚𝑠−2 and 0.56 𝑚𝑠−1.75 respectively while the mean absolute
differences for RMS and VDV were 0.11 𝑚𝑠−2 and 2.31 𝑚𝑠−1.75 respectively. The highest
percentage difference between AX3 and SV106 for all measurements was less than 3 %.
The results indicate that AX3 can be a sufficiently reliable instrument in risk
assessments of whole-body vibrations at work. In order to ensure that it works in all
types of situations, it should be tested in situations with more intense vibrations.
Keywords. Axivity-AX3, whole-body-vibrations, work-environment-measurements, AFS
2005:15.

114
Interactive individual ergonomic report as means for
risk assessment and ergonomic education among
surgeons
Hensel, Melanie1,2; Fan, Xuelong1; Forsman, Mikael1,2,3; Kjellman, Magnus1,4;,
Yang ,Liyun1,2
1. IMM Institute of Environmental Medicine, Karolinska Institutet, SE-
171 77 Stockholm, Sweden;
2. Division of Ergonomics, School of Engineering Sciences in Chemistry,
Biotechnology and Health, KTH Royal Institute of Technology, Halsovagen
11C, 14157 Huddinge, Sweden;
3. Centre for Occupational and Environmental Medicine, Stockholm County
Council, SE-113 65 Stockholm, Sweden
4. Department of Molecular Medicine and Surgery, Department of
Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden;
mashe@kth.se
Surgeons have been identified as one of the highest risk groups in healthcare to develop
work-related musculoskeletal disorders (WMSDs), which are associated with surgeon
burnout and early pension and can affect the quality surgical care and patient safety. The
upper body, especially the neck and shoulders, is found to be at high musculoskeletal
risk due to surgeons commonly operating in a static and awkward posture for a
prolonged time. Vision enhancing surgical loupes place additional weight on the head
and thereby increase the load on the neck when bending forward. New types of prismatic
loupes are designed to reduce surgeons’ forward bending of the neck in surgical
operations. At the same time, ergonomic education has been found to advantageously
impact the adherence to ergonomic principles among trainees and surgeons, which can
improve their performance and well-being.
The aim of this project is to design an interactive individual ergonomic
assessment report based on objectively measured postures and workload, and to further
examine the impacts of providing surgeons with such report as an in-person education
on their ergonomic awareness.
Nine participating surgeons are measured in real surgeries when performing
surgical cases with their own non-prismatic loupes and the new prismatic loupes. The
individual ergonomic assessment report is designed based on neck and shoulder muscle
activity (from surface EMGs) and the postures and movements of the head, upper arms,
and trunk (from inertial measurement units). Feedback on a preliminary version of the
report is gathered via user interviews of two of the participating surgeons and two
ergonomists and implemented in the design process of the report. The interviews are
conducted by applying the “think aloud” method and evaluated with thematic analysis.
The participating surgeons are divided into an intervention group and a control
group. The first group is provided with the individual ergonomic report of their results
from the measurements of the aforementioned surgical cases. The report is designed as

115
an interactive digital platform using the visual analytics software Tableau and shows
average postures, postural behaviour over time, the average muscle activity in different
load levels as well as muscular activity over time. The report includes thresholds of
postural risk, percentage of maximum voluntary muscle contraction in the 10th, 50th and
90th percentile as well as the indication of sustained low-level muscle activity (SULMA).
The report allows interactivity by selecting a body part for the postural data and a muscle
group for the presentation of muscular activity.
The control group is given a handout sheet of a basic surgical ergonomic
guideline that provides information about optimal posture during surgery and
recommendations on how to avoid prolonged static positions.
Both types of ergonomic education are assessed before and after the intervention
and control by a combination of survey and semi-structured interview about surgeons’
ergonomic awareness, and furthermore the perceived impact and usability of the
ergonomic education session.
Providing individual risk reports can be used as potential means for increasing
ergonomic awareness, improving adherence to ergonomic principles, and decreasing
risk of developing WMSDs among surgeons. In the long term, this can contribute to
better surgeons’ wellbeing, career longevity, as well as improved surgical performance
and patient safety.
Keywords. Surgical Ergonomics, Risk assessment, Ergonomic Awareness, Physical workload,
WMSDs

116
A user-centred product development and evaluation
of an equipment vest with integrated ballistic
protection for the Swedish police force– a
participative project
Nyman, Teresia, PhD, RPT, ergonomist
Occupational and environmental medicine, Uppsala University and
Uppsala University Hospital
teresia.nyman@medsci.uu.se
Low back pain (LBP) is common among police officers. One of the reasons is that the
regulated equipment that police officers wear around the waist e.g. radio, weapon,
baton, handcuffs, OC spray (pepper spray), etc. is both bulky and imposes an
unfavorable load on the lumbar spine. The bulkiness of the equipment belt leads to
unfavorable postures when sitting in, or driving, a police car. The equipment belt is also
perceived as an obstacle when foot patrolling and running.
In 2019, the Swedish Police Authority initiated a project to develop and evaluate
an equipment vest that allows for redistributing equipment from the waist whilst also
integrating the current ballistic protection that police officers today wear separately
under their clothing. A project team at the Swedish Police Authority’s department of
national operations led the development of the vest. One aspect during development
was the concern that moving equipment from the waist to the vest, might be unfavorable,
through the adding of load on the shoulders. For this reason, load relieving arches aimed
at decreasing the pressure on top of the shoulders was integrated in the vest.
The session will present different aspects of the project, from the design
development process to results from the different evaluations. The presenters will
represent all the participating organizations. The included presentations (1-7) will follow
on the next pages.
Keywords. Design, physical ergonomics, personal protective equipment,
usability testing, low back pain

117
A User-Centred Product Development and
Evaluation of an Equipment Vest with Integrated
Ballistic Protection for The Swedish Police Force– A
Participative Project
Bæk Larsen, Louise, PhD, CPO
Department of Rehabilitation, School of Health and Welfare, Jönköping
University
louise.baek-larsen@ju.se
Jönköping University, in collaboration with Uppsala University and the Sahlgrenska
University Hospital, were commissioned by the Swedish Police Authority to evaluate an
equipment vest concerning ergonomic aspects (physical load and comfort) and
functionality as well as the function and comfort of the relieving arches.
As the equipment vest is essential for safety and functionality in police work it
was from the beginning vital that the project was developed, planed and conducted in
collaboration between the Swedish Police Authority (the department of national
operations), the research team (external body), health and safety representatives from
the Police Authority and representatives from the end-users of the vest (police officers).
The project included police officers from five different regions in Sweden.
The project was initially carried out in two sub-studies. The first sub-study was
a field study where about 100 police officers wore the equipment vest during work for a
test period of four weeks. Data was collected through individual interviews before and
after the test period. Also, focus group interviews were conducted with all participants.
During the test period, data was collected through a repeated work diary survey and
during part of the test period (7 days) the police officers carried an accelerometer on the
thigh for collection of physical activity data.
The second sub-study was an experimental study in which 50 police officers
participated. The physical pressure load from the equipment vest, with and without the
load relieving arches, was measured under different situations. Data was collected using
pressure measurement sensors that were taped to the body under the clothing and
equipment vests. In addition to the pressure measurements, data on perceived comfort
and the possibility of adjusting the equipment vest during work was also collected.
During the evaluation period, a third sub-study targeting police officers with
on-going LBP was initiated. In this sub-study, the participants were offered an
equipment vest without integrated ballistic protection as a rehabilitation measure. The
participants wore the equipment vest during a test period of three months and at the
beginning and at the end of the test period they underwent a clinical examination and
answered questions regarding work-related exposures, pain and work ability.

118
Vest Design and Development Process
Stenfors, Linéa, Textile and material specialist. Project manager of the vest
development team.
Department of national operations, Swedish Police Authority, Stockholm
linea.stenfors@polisen.se
Today, there are a number of different equipment vests in use within the Swedish Police
Authority. These vests are not specially adapted for the authority but are the
manufacturer’s and supplier's proposed models. These equipment vests are only worn
in more specialized parts of the police force where the need for an equipment vest has
previously been very significant.
However, a need for developing an equipment vest for use more broadly by
police officers in active duty led to an assignment and funding from the Police
Authority’s HR department. With these funds, work began on developing an equipment
vest with integrated ballistic protection to improve the working environment for police
officers. Besides the obvious ergonomic challenges, the assignment also needed to
consider that the vest developed harmonizes with the standard regulations for Swedish
police uniforms, and that the vest allows for flexibility in terms of visibility with the aim
of ensuring the safety and security of both the public and the police officers. And finally,
that the equipment vest signals the Police Authority’s vision: “Your police make Sweden
safe and secure”.
The equipment vest is constructed as a vest cover, easily removable for laundry,
and fits the free-standing ballistic plates already in use within the Police Authority. In
the development, there were a number of initial considerations to be made; testing and
choosing the material of the vest cover (which needs to meet the requirements of e.g.
resisting fire, different weather conditions and hard wear); finding the best solution for
suspension of the vest (for speedy removal and for a snug fit); developing solutions for
placement of different equipment details on the vest (using the already well-known
system Modular Lightweight Load-carrying Equipment - MOLLE); designing a system
for easy adaptation of visibility (e.g. increased visibility on assignments in traffic or in
major sporting events); and designing the vest cover to allow for sufficient ventilation
during wear.
During the development two different versions of the equipment vest was
developed, and based on the findings in the evaluation studies, a third version has now
been developed and is planned to be implemented in the Swedish Police Force during
the coming years.

119
Pressure Measurements between Shoulders and
Equipment Vest- Method
Tranberg, Roy, Associate Professor, CPO
Research unit Orthopaedics, Sahlgrenska University Hospital
roy.tranberg@gu.se
The purpose of this study was to develop a method to measure contact pressure between
the external load represented by the equipment vest and the shoulder region of the
participant . The pressure measurement system was required to include sensors that were
flexible enough to adapt to the anatomy of the shoulder region and at the same time be
able to stay in place during the different tests. Also, it was important that the sensors
were thin enough, that they would not interfere with the participants movement during
the tests.
After a survey of available pressure measurement systems on the market, the
TeckscanTM system was found to meet these criteria with a number of smaller
adjustments to the system. This system offers several designs of pressure sensors, but no
one specific for shoulders which could be worn under uniform and equipment vest. This
was however solved by combining two sensors that in the first place were intended to
use for plantar pressure. Initial full-scale tests revealed that the range of the sensitivity
needed to be adjusted, thus adjustment of the software had to be done.
The pressure measurements were performed during maximal vertical excursing
(jumping) and simulated driving in a standard police vehicle. As this study is a part of a
product development project 14 participants wore vest version 1 and 35 participants
wore vest version 2. The pressure measurement sensors (FScan, Tekscan) were attached
directly on the body of the participant covering the shoulder region. Participants wore
their standard uniform and equipment vest on top of the pressure measurements sensors
while performing the tests. Pressure data was analyzed in three anatomical regions
representing front, proximal and posterior area of the shoulder region. All participants
performed the tests with and without the load relieving arches.

120
Pressure Measurements Between Shoulders and
Equipment Vest – Results
Bæk Larsen, Louise, PhD, CPO
Department of Rehabilitation, School of Health and Welfare, Jönköping
University
louise.baek-larsen@ju.se
The aim of this study was to investigate the load, expressed as contact pressure between
equipment vest and the shoulder region, with and without load relieving arches. Also,
self-reported discomfort associated with wearing the equipment vest with or without the
integrated load relieving arches was investigated.
Results showed that pressures were generally higher in vest version 2 compared
to vest version 1. The results implied that the integrated offloading arch had a decreasing
effect in the proximal region of the shoulder and that the pressures in the frontal and
posterior region increased at the same time. The subjective response to discomfort from
wearing the load relieving arches were mixed as some participants found them very
helpful whereas others experienced discomfort and pain using it.
The specific tests chosen in this study were designed to simulate a high load
onto the shoulder region of the participants representing a theoretical maximal exposure
while wearing the equipment vest during work. The result of this study should therefore
be interpreted as maximal vertical load exposure which is not likely to be representative
for the majority of the work time. The mechanism for suspension of the equipment vest
around the torso/waist was one of the design changes between vest version 1 and 2
which is thought to influence the result of this study. Also, the need for several
adjustments to the design and material of the load relieving arches were identified.
In summary, this study showed that an equipment vest with integrated load
relieving arches has the potential to decreases pressures in the proximal area of the
shoulder region but in the current development phase of this product the subjective
experience of discomfort from wearing the vest varied greatly. The vest design and
suspension methods should be monitored carefully while developing this type of
product.

121
A Usability Evaluation of an Equipment Vest with
Integrated Ballistic Protection
Eliasson, Kristina, PhD, RPT, Ergonomist
Occupational and environmental medicine, Uppsala University and Uppsala
University Hospital
kristina.eliasson @medsci.uu.se
The aim of this study was to evaluate the usability in terms of comfort,
functionality and physical load, of an equipment vest with integrated ballistic protection.
In total, 95 full-time police officers (26 female/69 male) from five different
regions in Sweden participated in the usability test. The equipment vest had integrated
ballistic protection and was designed in order to enable the use of load relieving arches,
aimed to reduce shoulder pressure. The police officers were instructed to use the vest
with load relieving arches inserted during half the time of the four-week long test period.
Usability was defined according to ISO 9241-11 definition: “the extent to which a system,
product or service can be used by specified users to achieve specified goals with
effectiveness, efficiency and satisfaction in a specified context of use”. Data was collected
through individual structured interviews before and after the test period. Also, eight
focus group interviews, with 6-8 participants in each group, were conducted after the
test period. The structured interviews were analyzed descriptively and thematic analysis
was used to analyze the focus group interviews.
The equipment vest was used for a total of 931 work shifts, about 40% of the
shifts, the vest was worn with the load relieving arches inserted. All participants were
very satisfied with the opportunity to wear their equipment on an equipment vest and
to move the ballistic protection outside the clothing instead of under the uniform. It was
emphasized that the equipment vest reduces the load on the hips and lumbar spine. The
vest facilitated the sitting position and the sitting comfort in vehicles considerably
compared to sitting in a vehicle with the equipment belt. Several participants experience
reduced discomfort from the lumbar spine after the test period. In total, 47% police
officers reported low back pain before the test period and 26% after the test. Furthermore,
the police officers expressed that the body temperature was more comfortable during
the entire work shift. Several participants also expressed that it was easier to reach the
equipment when it is placed on the equipment vest. The usability and effect of the load
relieving arches varied among the participants. For some it was experienced as positive
and gave a relieving effect during prolonged use of the vest, while some experienced the
load relieving arches as very uncomfortable.
In summary, the concept was perceived as usable and effective in terms of load
on the body, temperature control and flexibility.

122
Physical Activity Patterns among Uniformed Police
Officers
Johansson, Peter, PhD, RPT, Ergonomist
Occupational and environmental medicine, Uppsala University and Uppsala
University Hospital
peter.johansson@medsci.uu.se
The aim of this study was to objectively describe how much uniformed police are
exposed to sitting/lying, standing, walking, moving, running, stair-walking and cycling
during work.
During the test period with the equipment vest, 94 police officers wore an
accelerometer (Axivity AX3, Axivity Ltd. Newcastle, UK) attached on their thigh during
seven days, which should include at least three work shifts. The accelerometer data was
processed with a custom made MatLAB software, ActiPASS, that is based on the
validated Acti4 algorithm (1). This software estimates time in different activities.
Only worktime was considered in the analysis. When the work shift passed
midnight, it was considered as two separate workdays. Both the total time of each
activity per workday and the percentage of time per workday was calculated. Then the
mean, SD and range over all measured workdays were calculated.
In total, valid data from 73 police officers and 276 workdays were analyzed. The
mean workday length was 7.8 hours (SD 3.2; range 0.3-17 hours). The mean number of
steps taken per workday was 3864 (SD 2248; range 0-13979). The mean (SD; range)
minutes per day in walking was 31.5 (18.5; 0-112), sitting/lying: 312 (143; 6.6-768),
standing: 91.4 (55; 0-274), moving (being upright and taking a few steps): 29 (17; 0-93),
running: 0.5 (2.6; 0-40) cycling 0.78 (3.1; 0-32) and stair walking 2.9 (3.6; 0-23). The mean
percentage of worktime (SD; range) in: walking was: 6.7% (3.3; 0-23.3), Sit/lie: 66,7%
(13.7; 6.8-100), standing: 19.5% (9.3; 0-51.3), moving: 6.3% (2.9; 0-16.9), running: 0.1% (0.6;
0-7.78), cycling: 0.7% (0.9; 0-7.1) and stair walking 0.68% (0.92; 0-7.1).
Most of the police officer’s worktime was spent in stationary activities e.g.
sitting and standing. Only around 1/10 of the workday was spent ambulatory e.g.
moving, walking running, cycling or stair-walking. This means that it is of highest
importance that a carrying system for body worn equipment is well designed to be
comfortable during sitting and standing.
To our knowledge, this is the first study that present objective data on physical
activity and postures among Swedish police officers. The observed number of steps
during workdays is comparable with observations of American police officers that has
been observed to take 497 steps/hour (2) during workdays.
1. Skotte J, Korshøj M, Kristiansen J, Hanisch C, Holtermann A. Detection of physical
activity types using triaxial accelerometers. J Phys Act Health. 2014 Jan;11(1):76–84.
2. Ramey SL, Perkhounkova Y, Moon M, Tseng HC, Wilson A, Hein M, et al. Physical
activity in police beyond self-report. J Occup Environ Med. 2014 Mar;56(3):338–43

123
Effects of an Equipment Vest without Integrated
Ballistic Protection as a Rehabilitation Measure for
Police Officers with Low Back Pain
Nyman, Teresia, PhD, RPT, Ergonomist.
Occupational and environmental medicine, Uppsala University and Uppsala
University Hospital.
teresia.nyman@medsci.uu.se
The aim of this study was to evaluate if an equipment vest may be used as a
rehabilitation measure for police officers with clinically diagnosed LBP and/or hip pain.
In this intervention study, police officers with ongoing LBP and/or hip pain
were prescribed an equipment vest to use for three months during regular work. At both
baseline and at follow-up, the participants answered a questionnaire regarding pain
intensity and pain-related disability as well as self-rated work ability and perceived
health- and work environment related production loss. Additionally, the participants
were asked to describe their experiences and rate comfort regarding the carrying of
equipment during foot patrolling and driving a vehicle. Of the 69 police officers
recruited to the study, 44 participated in both the baseline and follow-up measurements.
The results showed that the proportion of participants having ongoing LBP
and/or hip pain decreased during the study period. Furthermore, the participants that at
follow-up still reported pain, showed a decrease in levels of both pain intensity and pain-
related disability. Also, self-rated work ability increased and perceived health- and work
environment related production loss decreased during the study period.
Concerning self-reported comfort during foot patrolling and driving a vehicle,
the participants expressed that the weight distribution had improved and that they felt
more agile and mobile when foot patrolling. Several participants reported that the
equipment became more accessible with a vest, and that the equipment was more
securely fastened during movement. Also, when patrolling in a vehicle, many
participants experienced ergonomic improvements, above all a better sitting position,
and easier to get in and out of the car.
For a small number of participants, the equipment vest gave rise to new
problems, especially in the neck and shoulders. This is something that should be taken
into consideration when prescribing an equipment vest as an ergonomic measure and
should be followed up after a period of use.
In studies regarding the course of musculoskeletal pain and discomfort, it has
to be considered that these ailments often are of a fluctuating and recurring nature. It
cannot be ruled out that improvement regarding pain and work ability would have
occurred even without the use of the equipment vest. A strength, however, is that the
participants in the present study specifically expressed the ways in which the equipment
vest had relieved and improved the ergonomic conditions at work.
In summary, this study shows that an equipment vest can have a beneficial
effect on pain and work ability and should therefore be tried as a rehabilitative measure
for police officers with LBP and/or hip pain.

124
Visor adapted for headlamps, for ear-nose-throat
doctors
Brogren, Gustav
Department of Industrial and Materials Science
Chalmers University of Technology
SE-412 96 Gothenburg, Sweden
gusbro@student.chalmers.se
Junkers, Jens
Department of Industrial and Materials Science
Chalmers University of Technology
SE-412 96 Gothenburg, Sweden
jensju@student.chalmers.se
Kristensson, Maja
Department of Industrial and Materials Science
Chalmers University of Technology
SE-412 96 Gothenburg, Sweden
majakr@student.chalmers.se
Lidman, Marcus
Department of Industrial and Materials Science
Chalmers University of Technology
SE-412 96 Gothenburg, Sweden
lidmanm@student.chalmers.se
Ståhl, Alvina
Department of Industrial and Materials Science
Chalmers University of Technology
SE-412 96 Gothenburg, Sweden
alvinas@student.chalmers.se
Udén, Adam
Department of Industrial and Materials Science
Chalmers University of Technology
SE-412 96 Gothenburg, Sweden
uadam@student.chalmers.se
Early 2020 COVID-19 started to spread across Sweden and on the 11’th of March 2020 WHO
declared the virus as a pandemic. For healthcare this meant increased pressure and a large
organizational readjustment. The cleaning routines had to change and the requirements of
using protective equipment increased. Problems occurred when the protective equipment was
not compatible with the medical equipment the doctors use to examine patients. Ear-nose-
throat doctors (ENT doctors) is a group that was affected by this. During examination of a
patient they use a headlamp to illuminate narrow canals in the ears, nose and throat.
Meanwhile, due to the pandemic, they have to wear a visor to protect themselves from
droplets and prevent the spread of infection. The compatibility between the visors on the
market and the headlamps they use was inadequate.
This project has been carried out on behalf of Region Västra Götalands (VGR), more
specifically the innovation platform of Sahlgrenska and the Northern Älvsborg County
Hospital (NÄL). The purpose of this project is to implement a user-centred product
development process required to create a face shield adapted to Ear-nose-throat doctor s
headlamps. The solution must provide adequate protection without having a negative impact
on the work performed.
The development process was initiated by a thorough study of the needs and
requirements to gain an understanding of the problem and doctor situation. Data was
collected through questionnaires and interviews with ENT doctors. The study of the needs
and requirements resulted in a list of requirements that was used as a base for the ideation
followed by concept development, user tests and finally refinement of a final concept.
The study resulted in a visor that is attached to the existing headlamp used by the
ENT doctors during examination. The visor meets the identified requirements and has been
tested during examinations of patients at NÄL. The tests show an initial promising result.
Keywords: Human-centred design, ear-nose-throat doctors, COVID-19

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Sole entrepreneur’s networking and wellbeing at
work at the Savo region
Kauhanen, Piia
University of Eastern Finland
piiakau@student.uef.fi
More than one-half of Finnish entrepreneurs are sole entrepreneurs and their number
has grown continuously in the 2000s. Self-employed persons' well-being at work and
their state of health have direct national economic impacts. Entrepreneurs suffer from
fatigue-related symptoms and exhaustion more than paid employees. Fatigue is also
reflected in the overall life of the entrepreneurs. Most of the challenges they face at work
are caused by their work-related loneliness and financial insecurity. Small businesses in
particular need support from comprehensive programs that include activities such as
networking with other entrepreneurs.
The purpose of the study was to describe how the sole entrepreneurs are
networking in the Savo region and how the local Entrepreneurship Association can
support sole entrepreneurs in networking. In addition, the aim was to find out how local
sole entrepreneurs feel about their well-being at work and what kind of benefits they felt
they would derive from networking from the point of view of well-being at work.
The research data consisted of sole-entrepreneur members of the Savo
Entrepreneurs' Register. The research data was collected in 2016 and 2017 and consisted
of an email survey sent to sole entrepreneurs (n=239) and individual interviews with five
(n=5) sole entrepreneurs. The survey data analyzed the frequency distributions of the
background variables and the necessary indicators, such as percentages and standard
deviations. Classification-scale variables were analyzed by crosstabing. The statistical
analysis was carried out using the SPSS program. The material of the interview was
analyzed inductively by means of a content analysis.
Sole entrepreneurs in the Savo region have a strong psychological and social capital
for entrepreneurship and their own well-being at work. The sole entrepreneurs who
participated in the study were persistent, hardworking, efficient, social, and positive.
From the point of view of their well-being at work and the company's operations, sole
entrepreneurs attached importance to their own comprehensive well- being, healthy
lifestyles and the separating work and leisure time. The networks of sole entrepreneurs
serve as versatile sources of support and assistance. Among other things, the networks
serve as a strong source of social capital for entrepreneurs.
Sole entrepreneurs wanted the Entrepreneurship Association to support
networking, for example through meetings. The wishes of sole entrepreneurs were
directed at developing self-confidence, optimism, and realistic optimism. Through these
areas, the Entrepreneurship Association can support the well-being of sole
entrepreneurs at work.

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In conclusion, sole entrepreneurs in the Savo region have a very strong
psychological and social capital. Cooperation networks help them to cope despite the
stressors of entrepreneurship. The Entrepreneurship Association is one of the key
channels for the development and expansion of business-to-business networks, and from
where sole entrepreneurs would like to receive more support and assistance for
networking.
Keywords. Sole entrepreneurs, well-being at work, networking

127
Work Well, NES 2022
UPPSALA 23-25 OCTOBER
Title:
Danish: Sorghåndtering på arbejdspladsen
English: Managing bereaved employees at the workplace.
Abstract:
The loss of a loved one is considered a major life event but also a common experience among
employees. Despite this, work-related research on the effects of loss and bereavement on
employees’ well-being is scarce in Denmark.
The aim of my master thesis was to examine how bereavement is affecting employees work
life and to outline the potential negative consequences on the organization if overlooked by the
management. To raise organizational awareness on the challenges that grieving employees face
and discuss possible actions to provide them with sustainable organizational support for the
future.
The results identified a great need for creating knowledge sharing and a practice on how to
manage bereaved employees at Danish workplaces. The findings point towards a
bereavement policy as a relevant action in staff management. Based on these findings, a
proposal to the content of a bereavement policy for the Danish workplaces was created.
The conclusion addresses the necessity to implement and use a bereavement policy to
ensure the acknowledgement of the bereaved employees. In doing so, the organization can
support well-being in the workplace, gain loyalty, and avoid the negative consequences
originating from not addressing the difficulties grieving workers face in the workplace.

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Ergonomic Risk Management Strategy in Ireland: A
focus on Risk Exposure reduction
Power, Francis
Senior Ergonomist (Inspector), Health and Safety Authority, Ireland
francis_power@hsa.ie
The Health and Safety Authority (H.S.A.) in Ireland decided to develop an ergonomics
strategy designed to place emphasis on increasing the knowledge and understanding
amongst internal (i.e. inspectors) and external (i.e. employers, employees, etc.)
stakeholders on how to recognise and manage work related musculoskeletal health risks.
Work on the strategy began in 2014 the goals were specific; increase knowledge and
understanding of musculoskeletal health risks and evidenced based ergonomic risk
assessment tools amongst stakeholders while also focusing on providing supports to
inspectors to ensure proportionate enforcement when addressing ergonomic and
manual handling issues at workplace level.
The nature of musculoskeletal injury or illness is that the symptoms often result in
cumulative damage to the musculoskeletal system over time due to exposure to
ergonomic risks including excessive force, awkward postures, high repetition and
poorly designed work systems. The narrative on managing ergonomic risk in the
workplace typically focuses on the rate of injury and illness rather than a focus on the
risk exposures. In this Ergonomic strategy, the interventions were designed to target risk
exposure management in the workplace. These interventions included the delivery of
Ergonomic Risk Assessment Tools training to the H.S.A. Inspectorate, the development
and roll out of nationwide Ergonomic Risk Assessment Workshops and Webinars for
stakeholders, the introduction of a policy of proportionate enforcement to address
musculoskeletal health issues and the development of Ergonomic Risk Management
Guidance and Good Practice Case Studies.
Since 2014, the Health and Safety Executive UK have delivered in house Mac and
Rapp Tool risk assessment tools training to over seventy H.S.A. Inspectors to allow them
to address ergonomic and manual handling risk in the workplace. Over one thousand
external stakeholder delegates have attended Ergonomic Risk Assessment Workshops.
These workshops were designed to encourage discussion amongst participants and to
give practical instruction on how the risk assessment tools can be used to reduce
ergonomic risk exposure at workplace level. Inspectors have increased their knowledge
and understanding of how to address ergonomic and manual handling issues during
inspection leading to a significant increase in Ergonomic Referral Inspections to ensure
satisfactory resolution of ergonomic issues in workplaces. The increased focus on work
related health issues during inspection identified the need for new guidance to inform
the ergonomic risk assessment process. A number of guidance documents were
published including the guide titled “Managing Ergonomic Risk to improve
Musculoskeletal Health”. Employers have

129
introduced innovative interventions to mitigate against ergonomic risk and this has resulted
in the H.S.A. publishing these case studies of Ergonomic Good Practice.
The rate of injures due to manual handling has reduced by 12% over the five
year period 2014-2019 which is a positive outcome however there is still a lot of work to
be done to ensure that musculoskeletal injury and illness rates as well as ergonomic risk
exposure rates are managed effectively into the future.
Keywords. Risk, ergonomics, strategy, stakeholders

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‘Healthy Workplaces Lighten the Load’
Swedish Work Environment Authority shares
learnings from inspection activities during the
European Weeks for Healthy Workplaces
Campaigns 2020-2022
Vidlund, Elin
Swedish Work Environment Authority
Elin.vidlund@av.se
Background and purpose
Every year, during week 43, the European “Healthy Workplaces Campaign (HWC)”
takes place. During 2020-2022, the focus is on prevention of Musculoskeletal Disorders
(MSDs), which are one of the largest work environment issues in European workplaces,
and the campaign is called “Healthy workplaces lighten the load”. Most EU countries
pay attention to the campaign by implementing communication activities. In addition,
The Swedish Work Environment Authority (SWEA), performs inspections during the
campaign week. The overall message is to include MSD prevention in the OSH-
management with a new theme for each year:
• 2020 – Manual handling of items
• 2021 – Sedentary work
• 2022 – Working with people - patient transfers
Design
The “Healthy workplaces lighten the load” campaign is carried out in collaboration with
the Focal Point Network and the Swedish Agency for Work Environment Expertise. The
goal is to perform approximately 5000 inspections, and to supervise both female- and
male-dominated workplaces. I addition, SWEA provides information to workplaces
about the campaign theme through the SWEA website.
Results
In the 2020 campaign, a broad range of industries was inspected. Out of the 1400
inspections, a majority were made in manufacturing, trade, funeral homes etc. About
46% of all workplaces we inspected were required to improve their work. The 2021
campaign focused on workplaces with office work, in transportation, and precision work
such as watchmakers and dental technicians. Out of 1400 inspections, 45% were required
to improve their work. The most common requirements in both 2020 and 2021 were
related to the systematic work environment management.
In the 2022 campaign, workplaces within health and social care will be inspected. At the
special session at NES 2022, we will tell you more about the structures and results of the
campaign.
Keywords. EU-OSHA, inspecting MSD prevention, manual handling, sedentary work

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Occupational Health Challenges in the Arctic
Wahlström, Jens
Sustainable Health, Umeå University
jens.wahlstrom@umu.se
In the future, a sustainable working life will be crucial for the development of Northern
Sweden and the Arctic. Economic activity in the north has increased over the past decade
and is expected to continue. Much of the growth is based on the wealth of natural
resources (minerals, rare earths, timber, hydropower, petroleum, fish and shellfish) as
well as Arctic tourism that is in demand globally. In northern Sweden, we now see a re-
industrialization as a result of large-scale battery production and production of steel
with more sustainable technologies. Common characteristics of industrial environments
in the Arctic are exposure to various physical, chemical and biological factors, such as
noise, mechanical vibration, poor ergonomics, dust, allergens and shift work. Especially
outdoor conditions with large temperature differences, slipperiness, wet and poor
lighting conditions pose risks for both accidents and disease development.
The scope of the special session is to provide presentations covering occupational
health challenges within an Arctic context with a focus on cold, ergonomics and
musculoskeletal disorders. In addition, a new Nordic network formed to promote
occupational health and safety research and education in the Arctic will also be
presented.

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Special session presentations
1. Associations between cold exposure at work and neck and low back pain – a
longitudinal cohort study. Charlotte Lewis. Sustainable Health, Umeå university.
charlotte.lewis@regionvasterbotten.se
2. Nordic Co-operation for promoting occupational health and safety (OHS)
research and education in the Arctic. Hans Pettersson. Sustainable Health, Umeå
university. hans.pettersson@umu.se
3. Carpal tunnel syndrome and cold exposure. Jens Wahlström. Sustainable Health,
Umeå university. jens.wahlstrom@umu.se

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Cold exposure and MSD
– a prospective population-based study
Lewis C1, Stjernbrandt A1, Wahlström J1
Section of Sustainable Health, Department of Public Health and Clinical
Medicine, Umeå University, 901 87 Umeå, Sweden
charlotte.lewis@regionvasterbotten.se
Work-related musculoskeletal disorders (WRMSDs) such as low back pain and neck pain
is a major public health problem, causing work disability, productivity loss and societal
costs. In addition to already established occupational risk factors for musculoskeletal
disorders, such as manual material handling, awkward body postures, and repetitive
movements, occupational cold exposure has been suggested. Cross- sectional studies
have shown an association between ambient cold exposure and neck pain, back pain and
lumbar radiculopathy.
The aim of the study was to determine the association between occupational
ambient cold exposure and neck pain, low back pain, and lumbar radiculopathy among
subjects of working age, living in northern Sweden.
Baseline data in this prospective survey-based, closed-cohort study was
extracted from a postal survey, administered between February and May of 2015
(N=12,627). Follow-up data was retrieved through a digital questionnaire collecting data
between March and April of 2021 (N=5,208). The study cohort available for analysis
included 3,843 (2,089 women and 1,754 men) currently working subjects. Pain in the
neck, lower back and lumbar radiculopathy were assessed in both surveys and
dichotomized. Occupational cold exposure was assessed in the baseline, given on whole
number numerical rating scales (NRS), ranging from one (‘do not agree’) to ten (‘fully
agree’), and categorized according to quartiles.
Binary logistic regression was used to determine the association between cold
exposure at work and incident pain in neck, low back and lumbar radiculopathy
respectively. In the analysis we adjusted for: age (years); sex (female/male); body mass
index (BMI; kg/m²); current daily smoking (yes/no); stress (low/high); and physical
workload (low/medium/high).
There were 183 women (8.8%) and 100 men (5.7%) reporting incident neck pain,
186 women (8.9%) and 124 men (7.1%) reporting incident low back pain and 81 women
(3.9%) and 45 men (2.6%) reporting incident lumbar radiculopathy. When stratifying on
sex, there were statistically significant crude associations between high occupational
ambient cold exposure (NRS 5-7 and NRS 8–10) and neck pain (OR 2.59; 95% CI 1.47-
4.57 and OR 2.87; 95% CI 1.64-5.02) and NRS 8-10 and lumbar radiculopathy (OR 2.75;
95% CI 1.31-5.77) for men but not for women. The association for neck was still present
when adjusting for confounders (OR 1.97; 95% CI 1.07-3.61 and OR 1.97; 95% CI 1.06-
3.67). For women a statistically significant crude association was found between NRS 8-
10 and low back pain (OR 1.96; 95% CI 1.25-3.08), and NRS 5-7 and lumbar radiculopathy

134
(OR 2.50; 95% CI 1.32-4.74). The associations remained after adjusting for confounders
(OR 1.82; 95% CI 1.14-2.91 and OR 2.20; 95% CI 1.15-4.24).
We conclude that ambient cold exposure during work was strongly associated
with neck pain for men, while for women for low back pain and lumbar radiculopathy.
Cold exposure should be recognised as a possible occupational risk factor for
musculoskeletal disorders.
Keywords. Occupational exposure; cold climate; ergonomics; neck pain; low back pain;
radiculopathy

135
Nordic Co-operation for promoting occupational
health and safety (OHS) research and education in
the Arctic
Pettersson, Hans
Arctic Five Chair in Occupational Medicine
Sustainable Health, Umeå university
hans.pettersson@umu.se
Background and purpose In recent decade the relative economic activity in Nordic countries
has been increasing and is expected to do so. The increase is mostly based on the vast
natural resources in the north such as metals and minerals, timber, hydro power,
petroleum, and seafood but also increasing tourism. Many workers in this area are
exposed to outdoor conditions with cold temperature, slipperiness, wetness, and poor
lighting conditions which is hazardous to work ability and health. Other workers are
exposed to low indoor temperatures in the food industry e.g., seafood processing.
Climate change causes other problems with enhance cold spells, and will affect
occupational health and safety (OHS) profoundly. These occupational hazards may
decrease work ability and productivity, increase the risk of occupational injuries.
Importantly, this causes reduced health of employees and can lead to sick leaves with
considerable cost and losses to the employers and societies at large. OHS is an
interdisciplinary field, and research and education units are often small throughout the
Nordic countries but share the mentioned challenges. These challenges can be solved
with Nordic co-operation to have the strength and joint capacity necessary for projects
of high quality. The purpose is to find possible collaborations to plan and develop a new
research project related to OHS in the north by expanding existing collaborations.
Identify needs and suggest content for OHS education that could be integrated to various
programs of the Nordic Universities.
Approach A new Nordic network formed to promote occupational health and
safety research and education in the Arctic is being develop within the Arctic Five
Universities. Researchers in occupational medicine at the Universities in Umeå, Oulu
and Tromsø are now developing this network with funding from Arctic Five. Arctic Five
is a partnership between University of Tromsø - Arctic University of Norway (No), Luleå
University of Technology (SE), Umeå University (SE), The University of Lapland (FI) and
The University of Oulu (FI) working to advance and share knowledge, education and
innovations for the development of our regions and a more sustainable Arctic. The Arctic
Five have also selected me to be an Arctic Five Chair so that I can further develop
connections with scholars at the universities. The Chair position enables researchers to
build research and/or education collaborations with other universities in the network,
whilst providing support for developing joint projects, as well as assistance with
applying for larger funding calls.
The NES conference is an opportunity for our Nordic network and as an Arctic
Five Chair to meet researcher within occupational medicine and to find possible co-

136
operation for research and educational challenges within the arctic setting. The goal is to
find other researcher within the field of Occupational Health and Safety among the
Arctic Five Universities and include other Universities. Hopefully, this network can
expand to interested partners to find joint solutions to future OHS challenges in the high
north.
Keywords. Occupational Health and Safety, co-operation, research, education, Arctic
Five.

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Carpal tunnel syndrome and cold exposure – a
population based study
Wahlström, Jens
Umeå University
jens.wahlstrom@umu.se
Carpal tunnel syndrome (CTS) is a common musculoskeletal disorder and symptoms of
CTS has been reported by around 14% in a Swedish population- based study. CTS has
also been reported to constitute around 60% of work- related upper limb
musculoskeletal disorders in Europe. Well established occupational risk factors for CTS
are exposure to highly repetitive work and forceful work, respectively. Indications on
increased risks for CTS due to ambient and contact cooling have been observed in a few
studies.
The aim of the present study was to determine if occupational exposure to ambient and
contact cooling was associated with self-reported carpal tunnel syndrome.
This population-based study was part of a large research project titled Cold and Health
in Northern Sweden (CHINS) that was initiated in 2015 to investigate adverse health
effects from cold climate exposure. In this cross-sectional study a population-based
sample of men (n=2314) and women (n=2703) between 18–70 years of age, living in
northern Sweden were included. Cold exposure and presence of symptoms suggestive
of carpal tunnel syndrome were subjectively reported. Associations between exposure
and outcome were assessed with logistic regressions and reported as odds ratios (OR).
The results from the study have been published by Stjernbrandt and (1).
CTS-symptoms were reported by 9% and being highly occupationally exposed to contact
cooling of the hands was associated with reporting CTS symptoms (OR 3.20), as was
ambient cooling (OR 2.00) and severe ambient cooling (OR 4.02;). There were positive
exposure-response trends for all three exposure variables, where increasing exposure
duration resulted in higher point estimates for reporting CTS symptoms. Besides cold
exposure, having actually sustained a local cold injury in the hands was also associated
with reporting CTS symptoms (OR 1.65). Analyses on interaction effects between cold
and hand-arm vibration (HAV) exposure were performed. For workers exposed to severe
ambient cooling for
more than
half of their
working
hours,
in addition to
almost
always

138
performing heavy manual handling, the OR for reporting CTS symptoms was 7.25, with
a positive additive interaction effect (expressed as relative excess risk due to interaction)
of 4.67.
Swedish workplace regulation cover exposure to HAV, hand-intensive work tasks, and
contact cooling, but not in any detailed manner the effects of ambient cooling. In light of
the findings in our study, we believe that ambient cold exposure during work could also
be more closely regulated.
Self-reported occupational exposure to contact and ambient cooling was associated with
self-reported symptoms suggestive of carpal tunnel syndrome. There were statistically
significant positive exposure-response patterns for time spent exposed to contact and
ambient cooling at work in relation to reporting symptoms of carpal tunnel syndrome.
Since there was important potential uncontrolled confounding regarding repetitive wrist
movements and forceful gripping, the results need to be confirmed by other studies.
References
Stjernbrandt, A. et al. Occupational cold exposure and symptoms of carpal tunnel
syndrome – a population-based study. BMC Musculoskelet Disord 23, 596 (2022).
Keywords. Cold, Carpal tunnel syndrome, Arctic

51st Nordic Ergonomics and Human Factors Society Conference 2022
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Improving safety culture in occupational contexts: an actionable toolkit
Gabriella DUCA (1), Raffaele D’ANGELO (2), Vittorio SANGERMANO (1), Antonio DI PALMA (1)
(1) ISSNOVA Institute for Sustainable Society and Innovation
(2) INAIL Istituto Nazionale per l'Assicurazione contro gli Infortuni sul Lavoro
Abstract: Organizations with a high level of Safety Culture (SC) are able to significantly reduce the
occurrence of accidents and occupational diseases. A top-down approach to safety often does
not take into account the many factors that influence and reinforce safety training and actual
behaviours. Safety Culture concept emerged as result of serious disasters that caused extensive
damage to people and the environment. Since then, the concept of SC and specific techniques for
its measurement within the organizations have become widely applied in many safety critical
contexts. Regardless this solid methodological background, the safety culture has not found yet
extensive application to workplace safety in general, despite the wide benefits that it could bring.
This paper discusses the methodological approach, technical contents and results of a project
aimed at building a tool kit for practical implementation of safety culture programs in
occupational context.
Keywords: Safety Culture, Safety performances, Occupational Health and Safety.
1. Introduction
All companies must comply with safety regulations, however safe procedures and safety training
are not in themselves sufficient to avoid accidents. It is important that companies have the basic
knowledge and organizational tools that help them build their own corporate culture about safety.
In fact, a top-down approach to safety often does not take into account many factors that influence
and reinforce safety education and actual behaviours. Often, few and targeted investments are
sufficient to trigger the optimization of safety management methods, the organization of
responsibilities and relationships between workers to increase the safety conditions of work
activities. A key concept allowing the effective implementation of this approach is that of the
Safety Culture (SC).
The concept of SC became widespread after being mentioned in the summary report of the
International Nuclear Safety Advisory Group (INSAG, 2002) as one of the causes of the
Chernobyl nuclear accident in Ukraine (Infield, 1987; Wiegmann et al., 2004). The report of the
IAEA (International Atomic Energy Agency) introduced this concept to explain the
organizational errors and transgressions of the operators that created the premises and then the
conditions for the disaster. The SC manages to find the answers relating to accidents that were
not foreseeable and shifts the attention from the worker, usually the first victim of injury or death,

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to the decision-making and organizational functioning process that allows the design and making
of safe operations.
Since then, a poor SC has been identified as the root cause for several major accidents in other
sectors, such as: the fire at London's King Cross Underground Station (Fennell, 1998); the sinking
of the Herald of Free Enterprise passenger ferry (Sheen, 1987), the passenger train crash at
Clapham Junction (Hidden, 1989), the Space Shuttles Challenger (Rogers, 1986) and Columbia
(Gehman, 2003) disasters, the mid-air collision plane crash (Masys, 2005) in Überlingen and the
British Petroleum explosion in the Gulf of Mexico (Baker et al., 2005). The growing awareness
of the need to define, study and implement initiatives to raise awareness on a good Safety Culture
has increased the interest in this issue by institutions and researchers, so that this concept is
becoming rather common in sectors such as: the oil and gas industry (Cox and Cox, 1991; Flin et
al., 1998; Mineral Council of Australia, 1999) and air transport (Gordon et al., 2006; Ek, 2006;
Wiegmann et al. 2004; Patankar et al. , 2005) and in the nuclear safety sector (Carroll, 1998;
Meshkati, 1997; Ostrom et al., 1993) and more recently in the railway and healthcare sectors (the
latter known as “patient safety”).
2. Safety Culture and occupational safety performances
Despite the wide benefits that could derive from SC programs implementation and its solid
methodological apparatus, Safety Culture has not yet found extensive application to occupational
safety in common workplaces within the programmes for accident prevention and health
protection. Since the issue of INSAG report (2002), a number of definitions have been developed
but the one most widely used is that developed by the Advisory Committee on the Safety of
Nuclear Installations (Advisory Committee on the Safety of Nuclear Installations (ACSNI)
(1993). Study group on human factors, Third report: Organising for safety. London:HMSO) (HSE
1993):
“The safety culture of an organisation is the product of individual and group values, attitudes,
perceptions, competencies and patterns of behaviour that determine the commitment to, and the
style and proficiency of, an organisation’s health and safety management. Organisations with a
positive safety culture are characterised by communications founded on mutual trust, by shared
perceptions of the importance of safety and by confidence in the efficacy of preventive measures”.
According to (CANSO, 2008), SC refers to the enduring value, priority and commitment placed
on safety by every individual, group and organisational attitudes, norms and behaviors related to
the safe provision of air navigation services. In other words, Safety culture refers to the norms,
values, and practices shared by groups in relation to risk (Noort et Al., 2016).
Being SC a proactive stance to safety (Lee & Harrison, 2000), organizations with a high level of
safety culture are able to significantly reduce the occurrence of accidents and occupational
diseases. A positive Safety Culture is in fact considered able to influence (Gadd and Collins,
2002):
- the success of safety initiatives
- the reporting of near-miss occurrences, incidents and accidents
- employees working safety (e.g. compliance with universal precautions)
- employees taking work related risks
- production pressures
- awareness on safety behaviour
- the effectiveness and credibility of safety officers
- the effectiveness and credibility of safety committees

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- process quality compliance.
3. The Tool Kit for Safety Culture project
3.1 Objectives
The ToKCS (Tool Kit for Safety Culture) project is an Italian best practice launched by the
Campania regional directorate of INAIL (Istituto Nazionale Assicurazione contro gli Infortuni sul
Lavoro, the Italian workers compensation authority) with two Italian research centres, Federico
II University and the Institute for Sustainable Society and Innovation. The project was launched
with the purpose to:
- bring to the attention of technicians and make available to them the main theoretical
references of the SC recognized in the international technical-scientific context but poorly
applied at national level in the field of health and safety in the workplace,
- provide the technicians operating in the occupational health and safety sector with an
operational guide for measuring the safety levels of the safety culture within an
organization
- provide technicians with practical reference material to implement company activities to
develop / strengthen the culture of safety
- increase the ability of technicians to identify latent organizational conditions that
determine risks that are not considered or underestimated.
To this goal, the project has delivered a system of guidelines and operational tools (a ToolKit) for
the assessment of the organizational culture towards the safety, freely available (in Italian) to any
organizations.
3.2 Methodology
The project relies on a SC model based on 8 elements: Just Culture, Reporting Culture, Informed
Culture, Learning Culture, Flexible Culture, Risk Perception, Attitudes to Safety and 3 aspects:
behavioural, situational, and psychological, according to the CANSO model (Mearns et Al.,
2009).
Table 1 Overview of proposed elements shaping the SC in occupational health and safety context
Just Culture
People trust each other and share essential safety-related information.
Acceptable and unacceptable behaviour are well clear and shared
Reporting Culture
Managers and operational personnel freely share critical safety
information without the threat of punitive action
Informed Culture
People has up-to-date knowledge about the human, technical,
organisational and environmental factors that determine the safety of the
system in its whole
Learning Culture
Willingness and the capability to derive proper knowledge from its
safety processes. Willingness to implement change following this
awareness.
Flexible Culture
Ability to reconfigure the organization to face unexpected situations,
even shifting from the conventional hierarchical mode to a flatter mode.
Risk Perception
All members in an organzation have the same perceptions and
judgments of the seriousness of risks, and are all able to make
appropriate decisions with regard to safety issues.

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Attitudes to Safety
Attitudes (especially management’s) in relation to safety, risk and
production
Safety-related
behaviour
Compliance with procedures, rules and regulations, as well as coaching,
recognising, communicating, demonstrating, and actively caring
Table 2 Overview of Safety Culture aspects in occupational health and safety context
Psychological aspects
How People Feel
Behavioural aspects
What People Do
Situational aspects
What the Organisation Has
The toolkit was designed to help all roles in an organization to overcome the current safety
mentality, centred on personal values and beliefs, in favour of organizational and collective
practices that are more aware of the role of individuals and of the system in achieving the
objectives of workers’ prevention and protection.
Figure 1 TOCKS Safety Culture pyramid (from Bernard, 2018).
4. Results
4.1 Roadmap for the Safety Culture measurement process in occupational contexts
TOKCS project proposes a 3-step approach for the continuous improvement of the safety culture
in occupational context:
Step 1 – Understanding: define the Safety Culture model fitting the organization nature, define
the suitable indicators for the specific safety culture
Step 2 – Assessing: measuring the Safety Culture, analysing collected data
Step 3 – Improving: defining a roadmap to improve weak points.
The first step launch a SC initiative is the collaboration between the members of the organization
and the safety culture assessment team, which should, preferably, be composed of independent
external experts, to collect relevant information, analyse the results and draw conclusions to plan
and implement improvements to the existing safety culture. External expertise should be
represented by an evaluation team rather than a single expert to avoid, as far as possible, any bias
or individual subjectivity. An external SC assessment team is preferable (i) to have a vision free

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from the specific organizational culture of the company, which helps to identify subtleties and
details, as well as (ii) to investigate the underlying values and experiences in daily behaviour,
appreciating the past and present culture and challenging the negative elements of the individual
and collective safety culture. The contribution of the organization's staff remains crucial to
provide the initial information on the basis of which to set up the measurement plan such as, for
example, opinions and experiences on risk awareness, actual behaviours, commitment and
involvement in safety issues, to assist the evaluation team in the collection and validation of data
and establish and prepare a process suited to the needs of the organization and viable.
This initial step brings to the outline of the personalized SC model desired for the specific
organization that, according to individual dimension, sector, geographical context and other
variables relevant for the company, can be depicted by different weight and indicators of SC
elements and dimensions.
The second step includes data collection and data analysis. Data collection phase can rely on
different techniques. In order to analyse as completely and correctly as possible and considering
the strengths and weaknesses of each of the methods, the most correct approach involves the
combination of different techniques, ranging from websurvey to interviews, workshops,
dramatization, and many more. Web surveys allow quick and not expensive data gathering from
a large population, interviews and workshops support the deeper understanding of the rationale
behind the results from the large-scale survey, whilst dramatization can help the unveiling of
unclear dynamics. From the combined analysis of these techniques, a comprehensive picture can
be built of the gaps between the SC specific model whished for a given organization and the
model that has been observed in the reality. This mapping of SC strength and weak points in the
organization will feed the last step of the process.
The third step focuses on SC strengths and weaknesses to develop an enhancement strategy,
which must take into account the mission and vision of the organization with the drafting of an
elaborate, feasible action plan. It is important that planned actions are consistent with the business
plan in order to ensure the management consent and the resources needed for the implementation.
This roadmap could to identify the cultural drivers of SC, to be constantly supported:
− organizational drivers, both internal and external, and relate to the reorganization of
responsibilities and roles, the drafting of new procedures and methods of compliance with
the provisions of the law
− key individuals, identified among senior management, staff and managers of the HSE
service, whose behaviour can significantly influence the improvement of culture through the
decisions and actions they take.
Several areas for improvement can be identified, some involving actions that can be quickly
implemented, such as improving safety communication strategies or sharing analysis of safety-
related events; other aspects could instead require initiatives that require longer times. In all cases,
it is up to the organization to decide which to implement, with what priority and time horizon,
even taking into consideration more alternatives: the resulting strategy must be accepted,
embraced and guided by the company.
An organization willing to improve its Safety Culture should follow a systematic closed-loop
process. After a reasonable period of time (at least two years), it is suggested to restart the cycle
of improving the safety culture, which can be re-evaluated in an iterative manner to determine if
the improvement objectives have been achieved. To carry out the assessment, definition and
implementation of an action plan aimed at improvement, a proper time span is required, possibly
not shorter than two years, since Safety Culture takes time to mature and improve.

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4.2 Tools for implementing a Safety Culture improvement process in occupational
contexts
TOKCS ToolKit consists of : (i) an introductory briefing on SC, its contextualization and value
within the health and safety management process, (ii) the toolkit for the implementation of a
Safety Culture improvement process, including template materials and guide to use to carry out:
− familiarization visits and observations
− SC questionnaire for the web survey
− discussion cards for
o interviews
o workshop
− data analysis and evaluation results
− definition of improvement actions.
The SC questionnaire template includes 46 items, classified in relation to their representativeness
of one or more elements and dimensions of the Safety Culture; questions can be applicable to the
whole population of an organization or to specific role (manager, front line personnel, and
technical personnel). Interviews can be conducted relying on a template of semi-structured
interview based on the following 8 topics, that have been elicited according several possible paths
for developing the conversation:
− updating and consistency of information that may be relevant for safety
− effectiveness of the reporting system of critical aspects for safety
− error tolerance
− involvement in safety improvement
− enhancement of the positive attitude towards safety
− promoting change
− propensity to share personal opinions on safety
− clarity and consistency of the understanding of risks at the various hierarchical levels.
Interviews can also be conducted using a set of 67 discussion cards, inspired to the “Safety Culture
Discussion Card” designed by Eurocontrol (Shorrock, 2012a; Shorrock, 2012b). These cards can
also be used to execute workshops; to this purpose, the ToolKit includes 13 questions to facilitate
discussions and 5 examples of applicable techniques and workshop settings.
The analysis is mainly based on the evaluation of the observable and discussed problems in the
real context of the organization, that is the results and safety performances, as well as the national
culture and the productive and social context in which the organization operates. The results of
the survey can be reported with respect to the elements and dimensions of the safety culture
expressed by the organization as a whole or for groups of the company population, always paying
attention to not stigmatize groups or categories of people. The quantitative data collected with the
questionnaire can be represented with histograms, pie charts but, particularly useful, is the use of
radar charts, where it is easy to read the strengths and weaknesses of the analysed safety culture.
Data collected through qualitative methods, such as workshops and interviews, can be used to
understand the causes of any weaknesses and therefore represents a valuable source for the
definition of improvement initiatives.
Several areas for improvement can be identified; among these, some involve actions that can be
quickly implemented, such as improving safety communication strategies or sharing analysis of
safety-related events; other aspects could instead require long term initiatives. The ToolKit
proposes a list of possible 24 actions, associated to the elements and dimensions of SC tackled by
each action.

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5. Conclusions
This guide aims to make available to any organization a system of knowledge and concepts
enabling all roles involved in health and safety of workers to evaluate the cultural attitude of the
entire organization towards safety and to implement actions that foster awareness and personal
and collective involvement of workers and management with respect to the issue. The application
of ToKCS principles and tools will provide the organizations an insight of their level of
proactivity with respect to safety, fostering:
− the actual participation of all levels of the organization in risk management, as required
by health and safety regulations
− the overcoming of purely formal responsibilities and regulation compliance
− continuous improvement of the results of prevention and protection actions
− the creation of a safety culture that individual workers will transfer from work experience
to personal and social life
− the increase in the sense of belonging and loyalty of workers
− the reduction of production defects or errors, turnover and absences due to injuries or
occupational diseases.
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Brown, J., Kelly, T., Patankar, M. S., & Piccione, M. D. (2005). A COMPARATIVE REVIEW
OF SAFETY CULTURES.
Carroll, J. S. (1998). Safety culture as an ongoing process: Culture surveys as opportunities for
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Ek*, Å., & Akselsson, R. (2005). Safety culture on board six Swedish passenger ships. Maritime
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134.

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A usability study of the SRA Index (Sustainable Risk Awareness Index)
-
a KPI for Management Support
Helena FRANZON (1, 2), Jörgen EKLUND (2), Linda ROSE (2)
(1) Praktikertjänst
(2) KTH Royal Institute of Technology, Stockholm, Sweden
Abstract:
Companies use risk observations and work environment (WE) deviations such as occupational
accidents and occupational illnesses to prevent injuries. There is no standard for how risks and
occupational injuries are reported. Praktikertjänst's management requests a standard as a
measure that can be used to work more proactively with health and safety and support
sustainable business development. Therefore, the SRA method was developed for calculating
and visualizing a work environment KPI related to the severity of WE deviations, the SRA Index.
(Sustainable Risk Awareness Index for management support). Existing data (risk observations,
near misses, work-related accidents and work-related illnesses) are used for calculating the SRA
Index. In this study the usability of the SRA Index was evaluated with a questionnaire among
work environment experts. They assessed the SRA method to be easy to understand, to have
high usability and to be valuable for assessing an organisation’s risk awareness.
Keywords: Management, Risk, Risk Management, Risk Awareness, Risk Awareness Triangle.
1. Introduction
1.1
Background
There are many Key Performance Indicators (KPIs) for management decision making in the fields
of production, quality and economics. However, few are used in the field of health and safety. A
method, the Sustainable Risk Awareness Index (the SRA Index) is under development. It is
visualized with the Risk Awareness Triangle (Franzon et al., 2021), see Figure 1. It displays the
proportion of the least severe type of work environment (WE) deviations, risk observations, in
relation to the sum of the three types of WE deviation often used in deviation report systems,
where the other two types are near misses and injuries (work-related accidents and work-related
illnesses). The index is calculated as the ratio between the number of risk observations divided
by the number of WE deviations during a certain period of time for parts of, or for the total,
organisation. This can also be expressed as:
SRA Index = [No. of risk observations/No. of work environment deviations] *100

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The purpose of calculating the SRA Index is to provide management teams with a decision basis
that can be used to:
• justify early reporting and management of risks to prevent injuries
• monitor the SRA Index as an indicator of the health and safety culture and risk awareness
in the organization over time as a basis for improvements
• compare the company's SRA Index with other companies.
In a larger time perspective, the intention with the development of the SRA Index is to contribute
to a work environment reporting standard for management, applying a KPI related to the quality
of the health and safety system.
More information can be found about the ongoing project at KTHs homepage:
https://www.kth.se/mth/ergonomi/forskning/sustainable-risk-awareness-1.1047540
Figure 1. The current version of the Risk Awareness Triangle, here with an example where SRA
Index = 43.
1.1 Objective
The purpose of this study was to evaluate usability aspects of the SRA method.

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2. Methods
The usability study was performed to get feedback from work environment experts in order to
evaluate different dimensions of the usability of the method. A questionnaire was developed
iteratively for this study, in cooperation with some ten managers and experts. The questionnaire
was thereafter sent to 19 work environment experts, where 4 represented the Confederation of
Swedish Enterprise, 3 the Swedish Trade Union, 2 Health and safety researchers, 3 experts from
the Swedish Work Environment Authority, 2 Occupational Health Services and 5 Health and
Safety Managers from larger industry companies.
The survey consisted of 15 statements, divided into three dimensions of how the participating
experts perceived:
A. the easiness of understanding the method’s manual
B. the usability of applying the method
C. the value of using the method
The 15 statements are presented in Figure 2, for each of the three dimensions. There were also
three open-ended questions after each dimension, presented in Table 1, divided into three groups
(positive and neutral responses, suggested improvements).
The usability aspects were assessed on a 5-degree scale from 1 = “Do not agree at all” to 5 =
“Agree completely” and a “Don't know” alternative.
Instructions to the participants were sent out by e-mail with information that participation was
voluntary, anonymous, an assessment of time needed for participation (15 minutes for answering
the questionnaire and reading a three-page manual), an instruction, and a link to a page where
they could calculate and visualize the SRA Index with the Risk Awareness Triangle.
The instruction was given in three steps:
1. Read the manual attached to the email.
2. Go to the website and test the method (link in the email).
3. Fill in the questionnaire (link in the email).
3. Results
Responses were received from in total 11 work environment experts, where 4 represented the
Confederation of Swedish Enterprise, 1 the Swedish Trade Union, 1 Health and safety
researchers, 2 experts from the Swedish Work Environment Authority and 3 Health and Safety
Managers from larger industry companies.
The 8 people who did not answer have all given feedback and explained why they did not answer.
One person who worked at the Swedish Work Environment Authority judged that he would not
participate due to his role in the authority. Other reasons were vacation, opened the email too late
and the email came into their spam box.

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In summary the results show that the easiness of understanding the manual (dimension A) was
estimated at 4.37 as mean. The usability of applying the method (dimension B) was estimated at
4.48 as mean. The value of using the method (dimension C) was estimated at 4.3 as mean. Highest
and lowest estimates are shown in Figure 2.
Figure 2. The results from the survey’s 15 statements, divided into the three dimensions of how
the participating experts perceived the SRA Index.
1
2
3
4
5
A1. The manual is valuable for understanding and being able to use
the Risk Awareness Triangle. (Min. 4, Max. 5)
A2. The manual is valuable for understanding and being able to
calculate the SRA Index. (Min. 3, Max. 5)
A3. It is clear what the SRA Index is. (Min. 3, Max. 5)
A4. SRA Index as a result is easy to interpret. (Min. 2, Max. 5)
A5. Det är lätt att förstå hur man har gjort beräkningen för att få
fram SRA Indexet. (Min. 3, Max. 5)
B1.It is easy to enter data into the risk awareness triangle. (Min. 3,
Max. 5)
B2. It is easy to see the SRA Index when I have entered data. (Min.
4, Max. 5)
B3. It is easy to get relevant input data. (Min. 2, Max. 5)
C1. The risk awareness triangle is useful for calculating the SRA
Index. (Min. 4, Max. 5)
C2. The risk awareness triangle is useful for visualizing the SRA
Index. (Min. 3, Max. 5)
C3. The risk awareness triangle is useful for gaining an overview of
how the three types of severity relate to each other in the current
case. (Min. 4, Max. 5)
C4. The SRA Index is useful for assessing an organization's risk
awareness.(Min. 3, Max. 5)
C5. The SRA Index is valuable as a basis for decision-making. (Min. 2,
Max. 5)
C6. The SRA Index is useful if you want to compare your own
organization's risk awareness with other organizations' risk
awareness. (Min. 2, Max. 5)
C7. The SRA Index is useful in the organization's sustainability
reporting. (Min. 3, Max. 5)

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The participating experts suggested several improvements, for example regarding the design and
how to register data easier in the calculation model (the Risk Awareness Triangle). Several
experts suggested a clearer explanation of why the relationship to risk observations in particular
is important in relation to more serious work environment deviations (WE). All results from the
open-ended questions are displayed in Table 1, divided into positive responses, neutral responses,
and suggested improvements and negative responses.
Table 1. The results from the open-ended questions.
Results from the open-ended questions (comments, suggested improvements etc.)
Positive responses
- Thank you, looks like a very good tool which I like to test live to evaluate and analyse
- Good work! Hope the tool comes to use! Maybe the manual can be built into the tool itself, but I
guess it will?
- I am not an expert on what is classified as near miss, risk observation, etc., but in what appears, it is
very easy to understand how the index emerges.
- The method looks very interesting and should be able to be built directly into the IA system. It
would also be interesting to see how many of the incidents and risk observations also receive a
measure, which should also be easy to get out of the IA system.
- Would really like to see the tool used in practice.
- Change over time would be clearer with line charts but otherwise the triangle is very illustrative.
- It is an interesting tool that will gain importance the more people use it.
Neutral responses
- Whether it is easy to obtain relevant input data depends entirely on what role you have in the
company and what the routines for collecting and reporting look like. Risk observation data is not
as easy as data on occupational injuries.
- It is likely that the method appeals to larger companies more than small companies.
- Should it be included in the IA system so that it is possible to share facts with other companies or
how is it intended?
Table 1 to be continued on the next page.

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Table 1 continued: The results from the open-ended questions.
Suggested improvements & negative responses
- Is there an explanation for why the relationship to risk observations in particular is important in this
context, something about risk observations preventing incidents and occupational injuries? If you
think in table 1 you can delete the lines about occupational accident and occupational disease, it is
well explained that these are included in occupational injury.
- It is new concepts and letter combinations that appear here that take some time to absorb. For
example, it is called Sustainable risk awareness that is measured with the SRA Index. No
explanation for the abbreviation or the letter combination is given, or have I missed it?
- Had been good if occupational accidents and occupational diseases were two separate entries, as the
figures retrieved from the system, we have are separate. Avoids any errors as you have to add as it
is now.
- Explain the abbreviations more clearly.
- I think you should click on the percentages in the triangle to enter data, it did not work.
- It can probably be a problem to get input data in some places. It may be that you use other concepts
in your organization. Are there other concepts that could be described and how they should be
classified?
- At first, I thought you would change the numbers in the pyramid itself, but they were not clickable.
Realized after a while that it is the numbers at the bottom to change. A clearer indication of where
to enter the figures would have been good.
- Uncertain is the factor how and what will be reported in, some report everything while others. . . It
is also important to balance the resources, I see several companies that put in unlimited resources
and even if they are good at reporting, it ʺ costs more than what they get outʺ it is like hiring more
salespeople than the organization needs, they all do good but ...
- Where can you see other organizations' SRA Index to compare? If you want to show the Risk
Awareness Triangle to managers who are not always familiar, it is an advantage if they can also see
in the explanatory text next to it that the lower the percentage at the top, the better, and that many
risk observations are good.
- Lacks a description of why there are naturally no limit values on what is good and what is a bad
SRA. The important thing is to keep track of SRA Index, follow trends, such as decision material,
compare, discussion material, etc. Would it be possible to describe what is desirable regarding the
relationships between the parts of the triangle? That there should be the most risk observations and
the least work accidents?
- The manual states: ʺSRA Index is a key figure that enables a standardized and easy-to-use way of
calculating and presenting work environment deviations. ʺ At the same time, it is written that the
index should show a company's degree of risk awareness. For me, these are two different objectives,
i.e., what is reported and an organization's degree of awareness. Furthermore, it says ʺA low SRA
Index signals low risk awareness while a high SRA Index signals high risk awareness in an
organizationʺ But just to have incidents / accidents etc reported, does not that implicitly mean a low
level of awareness? I do not understand how the numbers relate to how conscious the organization
is.
4. Discussion
The study showed that the proposed SRA Index was considered to have good usability, especially
regarding the calculation of the index and the easiness to understand the manual. The visualization
of the Risk Awareness Triangle could be improved, according to the participating experts.
The design of the triangle was decided to be changed according to the participants´ suggestions.
Occupational diseases will be fed into a separate field, will be given a lighter red colour and will
be placed next to accidents in the triangle. The text gets a larger font and the boxes to be filled
in get a clearer frame to be seen better.

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It should be pointed out that the SRA Index has a different name in Swedish (Hållbar
riskmedvetenhet, HRM-index). At Praktikertjänst, where the method is implemented and tested,
the Swedish abbreviation is used because risk awareness is a concept that fits well into the
company’s sustainability work. This paper uses the definition, “Risk awareness is the raising of
understanding within the population of what risks exist, their potential impacts, and how they are
managed.” (Jen, 2012).
The participating experts had several comments and questions, e.g. how the SRA Index relates to
risk awareness in the organization. Another comment was whether it is possible to provide
recommended values on what is a good and what is a bad SRA Index, respectively. There are
many studies confirming the relationship between near misses and accidents as an indicator of
safety culture (Yorio et al., 2018). In the 1930s, (Heinrich, 1931) established a well-known
accident prevention theory in the form of a "Safety triangle". He concluded that severe
occupational accidents are preceded by numerous less severe accidents and near misses. The
Safety Triangle has since been widely used and also been updated (Yorio et al., 2018).
There are many tools for identifying and assessing risks in risk management, e.g. (Garg et al.,
2017) and (Rose et al., 2020). In a risk assessment with a checklist, risks that need to be addressed
are discovered. In most IT systems for risk management, these are then reported as risk
observations. This means that risk observations can be detected in the daily work or in a risk
assessment that the employees do in collaboration, with a checklist as support. No studies have
been found that also include risk observations and work-related illnesses in the relationships
between the WE deviations. There is a lack of effective proactive indicators within occupational
safety and health management. Working with accidents at work and occupational diseases is
reactive. It is generally considered that proactive work is preferable, i,e. to use near misses and
even more preferably, risk observations. In the area of occupational health, risk assessments are
often carried out, which makes it possible to include this type of risk observations as well. In other
words, the SRA Index provides an opportunity to merge the areas of occupational safety and
health.
Another aspect of usability is that it should be easy to access input data for computing the SRA
Index, so that the method does not require new data collection. In this case existing data is used
in the calculation model.
The effects of long-term usage of the SRA Index are so far not evaluated. Future evaluations are
needed to assess what effects the implementation of the SRA Index has on risk management, and
in a longer perspective, on risk awareness in organisations.
5. Conclusion
To conclude, the evaluation shows that experts assess the SRA method to be easy to understand,
to have high usability and to be valuable from several relevant aspects, including for assessing an
organisation’s risk awareness. The SRA Index has been introduced as a KPI for management
support, and it is easy to apply since input data to the method already exist in many organisations.
Several of the participating experts expressed a hope that the method would come into broader
practical use.

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References
Franzon, H., Rose, L., The SRA Index (Sustainable Risk Awareness Index): A new KPI for
Management Support, IEA (2021).
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exposure assessment model, Ergonomics, 60:7pp. 912-922.
DOI:10.1080/00140139.2016.1237678. (2017).
Heinrich, H.W. Industrial accident prevention: A scientific approach. McGraw-Hill Book
Company, New York, USA, (1931).
Jen, R. How to increase risk awareness. Paper presented at PMI® Global Congress 2012—North
America, Vancouver, British Columbia, Canada. Newtown Square, PA: Project Management
Institute, (2012). Retrieved 2021-02-05. Available from:
https://www.pmi.org/learning/library/increase-risk-awareness-6067
Rose, L. M., Eklund, J., Nord Nilsson, L., Barman, L., Lind, C. M.: The RAMP package for
MSD risk management in manual handling – A freely accessible tool, with web-site and
training courses. Applied Ergonomics, 86. 103101 (online) (2020).
Yorio, P. L, Moore, S.M.: Examining Factors that Influence the Existence of Hein-rich’s Safety
Triangle Using Site-Specific H&S Data from More than 25,000 Establishments. Risk Analysis,
Vol. 38, No. 4, (2018).

155
The RAMP 2.0 project – Towards an enhanced MSD
risk management tool
Rose, Linda M & Forsman, Mikael
KTH Royal Institute of Technology, CBH School, Division of
Ergonomics, Hälsovägen 11C, 141 57 Huddinge, Sweden
lrose@kth.se
In 2017 RAMP (Risk Assessment and Management tool for manual handling – Proactively), a
risk management tool focusing on manual handling work, was launched with the
objective to contribute to reducing musculoskeletal disorders (MSDs). RAMP has since
then been spread to over 105 countries and is used as the standard method for MSD risk
management in several organisations. Different usability, reliability and validity aspects
of RAMP have been evaluated as being good. To enhance RAMP’s application range and
to further increase its usability, the RAMP 2.0 project started in 2018. Results from this
ongoing project have been reported at several conferences, e.g. IEA 2021.
The objective of this conference-contribution is to provide an overview of the results
of the project this far, whereas the objectives of the project are to: i) expand RAMP’s
application range to include hand-intensive work, ii) in addition to the existing Excel-
based version, provide RAMP in a system version, and iii) enable practitioners to use
RAMP results in forming key performance indicators, KPIs, as a means to follow the
results of systematic work environment progress at an organisation, and to provide
managers with relevant data for informed decision making.
The project is carried out with a participatory, iterative methodology. It is led by re-
searchers at KTH, and carried out in a collaboration between researchers and
practitioners from over a dozen organisations. Methods used include needs analyses,
literature studies and iterative development of the three parts, where workshops with
different types of experts are regarded as crucial.
The results this far for each one of the three parts are: i) Enhanced application range.
Based on a needs analysis among the participating organisations, the first version of
RAMP’s “Hand model” has been developed. An evaluation study of this model in
planned for the spring 2022 where usability and reliability are in focus; ii) Also a version
of the RAMP system version has been developed, as well as iii) methods for forming KPIs,
i.e. both KPIs formed by using only RAMP results data and KPIs formed by combining
RAMP results and company data, as for example quality and sick-leave data.
By the inclusion of hand intensive work in RAMP’s application range, a large part
of commonly performed work tasks can be assessed and managed. However, limitations
of the tool’s application range is discussed, as well as how adequate input data can and
determined.
Keywords. Ergonomics, Risk assessment, Risk management

156
Systematic risk management with RAMP for risk
assessment and adapted changes - an
implementation study
Forsman, Mikael; Yang, Liyun; Eriksson, Andrea;
Barman, Linda & Rose, Linda
KTH Royal Institute of Technology, CBH School,
Division of Ergonomics, Hälsovägen 11C, 141 57 Huddinge, Sweden
miforsm@kth.se
RAMP (Risk Assessment and Management tool for manual handling – Proactively), is a
risk management tool focusing on manual handling work. Since 2017 RAMP has been
spread to over 105 countries. More than other methods, RAMP supports the entire risk
management process. RAMP is based on risk factors documented in scientific literature,
and it has been evaluated regarding usability and reliability. It is now used for MSD
risk management in many organisations. The feedback from RAMP users is positive,
and there are indications of reductions in sick absence.
The purpose of the ongoing project is to investigate a selection of effects that
implementation entails and to examine the implementation of RAMP from a leadership
and system perspective. Specific questions are: What happens when a company
implements RAMP? Are the risk factors reduced? What affects the change? What
strategies do companies use when implementing RAMP? Are the effects of which
strategies companies apply when implementing affected? What are the facilitators and
barriers to the implementation of this risk management method?
The project is carried out as an implementation study based on mixed methods in
collaboration between researchers and four production companies and two FHV actors.
The effects and implementation of RAMP will be evaluated by comparing risk levels,
qualitative interviews, document analyses, questionnaires and structured observations
of work processes. For changes in risk factors, RAMP risk assessments, which include
observations and objective measurements of push-pull forces, carried out at baseline and
at follow-up will be compared. If possible, in addition to the above data collection, the
company's own data on sick leave, productivity and quality (eg quality deficiency data)
will be included and monitored over time.
Implementations and effects of RAMP will be summarized in so-called logical
models. These models will identify inputs (e.g. time and resources set aside for
implementation), activities (e.g. training and measures implemented), intermediate
(short-term) outcomes (e.g. the extent to which RAMP is used in the systematic work
environment work and in the entire process for risk management, how much of the high
risks have been reduced, what type of measures have been taken and how the risk
awareness has developed among employees), long-term outcomes (e.g. employees'
perception of the workload, perceived health and perceived problems), and possibly
long-term outcomes (e.g. changes in sick absence, quality and productivity as well as
sharing good examples within the organisation).

157
At this point in the project, the questionnaire has been designed, companies have
been contacted, and data collection at the first company, that now has assigned an
implementation strategy, is about to start.
The project is expected to show what effects on the work environment (possibly also
health, quality and productivity) that systematic application of the RAMP method can
have, as well as which of the studied factors affect the implementation and to what extent
they do so. The results are expected to lead to new knowledge in the area of systematic
risk management and implementation strategies.
Keywords. Ergonomics, Risk assessment, Risk management, Implementation, Intervention

51st Nordic Ergonomics and Human Factors Society Conference 2022
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Results from biomechanical risk assessment aboard fishing vessels
Francesco DRAICCHIO (1), Alessio SILVETTI (1), Adriano PAPALE (1), Alberto RANAVOLO (1),
Giorgia CHINI (1), Ari FIORELLI (1), Tiwana VARRECCHIA (1), Antonella TATARELLI (1), Lorenzo
FIORI (1), Elio MUNAFÒ (2)
(1) INAIL – Italian Workers’ compensation authority – Lab of Ergonomics and Physiology
(2) ITAL - UIL
Abstract: According to literature data, fishing is among the most dangerous working sectors.
Many authors reported that seamen had a high incidence of musculoskeletal disorders. We did
three experiences aboard fishing vessels in the Mediterranean Sea. We investigated two fishing
techniques (driftnet and rake trawl with depressor) through physiological parameters,
standardized protocols, and biomechanical software. Trunk flexion was the most relevant risk
factor during the sorting task. Workers flexed the trunk over 90° for approximately 10 minutes
for every catch exceeding maximum exposure time and maximum acceptable trunk flexion
according to ISO 11226. We assessed manual material handling inside the cold store and at the
dock through a heart rate monitor, NIOSH equation, and 3DSSPP software. All these techniques
showed the high biomechanical risk for the workers. Our results are consistent with those from
other studies. Activities onboard vessels could be optimized by introducing automated systems
financed through public funds to prevent seamen from disease.
Keywords: MSDs, fisheries, boat
1. Introduction
Bernardino Ramazzini (1633-1714) dedicated an entire chapter of his treatise, De morbis
artificum diatriba, to fishermen, stating: "how difficult this job is ... how difficult his life is ... for
fishermen the night is almost always busy and sleepless".
According to data from European Union, International Labour Organization, and the World
Health Organization, the fishing sector has one of the highest injury rates in the commercial
sectors. Several studies confirm these data (Matheson, 2001; Murray, 2007; Kucera, 2010). They
showed that musculoskeletal disorders (MSDs) are the most frequent diseases in seamen.
Several authors conducted investigations in the fisheries sector in Scandinavian countries. A
research (Grinde, 1985) found that during the six months before, 77% of 878 Norwegian seamen
suffered from MSDs. In another paper (Torner, 1988), authors did a survey questionnaire on 1243
Swedish professional seamen founding that in the 12 months before, 30% had musculoskeletal
symptoms at the shoulder, 21% at hand, and 13% at the elbow level. He also found that seamen
estimated an average working time of 68 h/week.
Recently other epidemiological surveys have been conducted in Northern Europe that confirm
how the MSDs in fisheries workers are still a common and widespread problem (Sønvisen, 2017;
Sandsund, 2019; Øren, 2019). These reports further confirm a high presence of MSDs in the
fishery sector. It also emerges that the design of ships still doesn't include technological
improvements to reduce biomechanical risk.
Several authors (Astrand, 2003; Biswas, 2003; Zhang, 2011) investigated seamen
biomechanical overload by means of physiological parameters as surface electromyography or
heart rate. Other authors used Digital Human Modelling (Zhang, 2011) and postural analysis
methods (Yusuff, 2008).

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Zhang (Zhang, 2011) states that the values obtained are probably understated.
The biomechanical overload risk is difficult to assess in this context. The standardized
protocols, are hardly usable for the specific characteristics of fishing (exposure to extreme
tempratures, instability of the boat, the slipperiness of the floor). Moreover a recent paper
correlated MSDs to low temperatures (Stjernbrandt. 2022).
Our activities focused on two kinds of fishing (driftnet and rake trawl with depressor) and two
different work organizations.
2. Material and methods
Depending on the task to be assessed, we utilized the method that best could describe the specific
features of each one.
We used NIOSH protocol (Waters, 1994) to assess unloading crates of fish (weight of 12 Kg
or 16 Kg) out of the boat to the van. Due to the large variability of duration, we hypothesized
short (working time < 1h) or moderate duration (working time between 1h < 2h).
A Heart Rate (HR) monitor has been used to estimate Relative Cardiac Cost (RCC) while handling
crates inside a refrigerator. We choosed RCC because it is a physiological parameter that
considers the worker's age (Vogt, 1972). We computed RCC according to the following formula
(Frimat, 1979):
HRmax = 220 – age
CCr = (HRpeak – HRrest) / (HRmax – HRrest) * 100%.
HRmax = maximum HR esteemed; HRmean = mean frequency of the entire recording; HRrest =
rest frequence of the subject; age = subject’s age in years.
We used the dynamic REBA protocol (Jones, 2007) to assess the task of sorting fish on the stern.
From video recordings we sampled about 150 frames, one every two seconds. We computed the
average REBA index (Hignett, 2000).
Sorting fish on a table and filling crates have been assessed through the OCRA checklist
(Colombini, 2011).
In the task of filling crates we used sEMG for the choice of OCRA checklist strength values.
We recorded electrical muscle activity using a 16-channel Wi-Fi surface electromyography
(sEMG) system (FreeEMG, BTS SpA, Milan, Italy) sampling at a 1 kHz frequency. We recorded
sEMG signals from the following muscles: the Extensor Carpi Radialis (EXTdx, EXTsx) and
Flexor Carpi Radialis (FLEXdx, FLEXsx) bilaterally. We placed the sEMG probes according to the
Atlas of muscle innervation (Barbero, 2012). The worker performed three isometric exertions to
elicit the maximal voluntary isometric (MVC) contraction. The sEMG signals were rectified,
integrated with a mobile window of 0.125 s, filtered with a 5 Hz Hamming low-pass filter, and
finally normalized to the maximum value of the MVC. We calculated the mean activation value
for each muscle as a percentage of MCV.
From the video, we also sampled some frames analyzed with 3DSSPP software (v 7.1.3)
(Chaffin, 1991; 1992). The software provides, among other things, an estimation of orthogonal
(OrtF) and shear forces (ShF) at L4/L5 and L5/S1 levels.
The thresholds of the orthogonal compression forces are those proposed by Jager (Jager,
2018). Unlike NIOSH, which recommends a single threshold value of 3400N, the thresholds
proposed by Jager are gender- and age-specific (Tab. 1). According to Gallagher's review
(Gallagher, 2012), the shear force threshold used as a reference is 700N. All thresholds refer to
healthy people working on stable ground.

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Tab. 1: gender-specific age-related
reference values for maximum lumbar
compressive forces according to the
Revised Dortmund Recommendations
(Jager, 2018)
Besides the 3DSSPP software, we evaluated the trunk posture in the sorting task with ISO 11226
standard (ISO, 2000). This old standard, unsupported by recent physiological data, remains an
international benchmark for static postures risk assessment. Fig. 1 shows a diagram that relates
trunk flexion (x-axis) and maximum exposure time (y-axis). According to figure 1, the limit for
trunk flexion is 60° and can be sustained for up to one minute continuously.
Fig.1: picture shows the thresholds for trunk flexion.
The x-axis shows trunk flexion (degrees), and the y-axis
exposure time (minutes). 3 identifies the acceptable
zone, 4 identifies the acceptably using trunk support, 2
identifies the unrecommended area, and 5 identifies the
unacceptability area. Modified from ISO standard 11226
3. Results
3.1 NIOSH protocol
Table 2 summarizes results carried out with the NIOSH protocol. We calculated the RWL and the
LI at the origin and the destination. The weights of the crates were 12 or 16 Kg. Job duration could
be less than an hour (t <1) or between one and two hours (1<t<2). Fig. 1a (left) and 1b (right)
show the crew involved in the investigated tasks. In Fig 1b, the NIOSH protocol has been applied
to have an early indication of risk, despite environmental conditions and the operator's stability
do not allow to use of this method (in mooring conditions and with a value of 0 on the Beaufort
wind force scale, we considered instability negligible)
Task
RWL
LI 12 Kg
LI 16 Kg
boat → van (origin and t<1)
4.32
2.77
3.7
boat → van (origin and 1<t<2)
2.52
4.76
6.34
boat → van (destination and t<1)
4.69
2.55
3.41
boat → van (destination and 1<t<2)
2.73
4.39
5.86
refrigerator → slipway (origin and t<1)
7.36
1.63
2.17
refrigerator → slipway (origin and 1<t<2)
4.29
2.79
3.72
refrigerator → slipway (destination and t<1)
4.70
2.55
3.40
refrigerator → slipway (destination and 1<t<2)
2.74
4.37
5.83
Tab. 2: The table below summarizes the NIOSH protocol results
Fig. 2: Pictures show the crew
involved in the two investigated
tasks, handling crates from the boat
to the van (left) and MMH from the
refrigerator to the slipway inside
the vessel (right).
Age
Female
Male
20 years
4.1 kN
5.4 kN
30 years
3.8 kN
5.0 kN
40 years
3.1 kN
4.0 kN
50 years
2.4 kN
3.1 kN
≥ 60 years
1.8 kN
2.2 kN

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3.2 Heart Rate monitor
We recorded the heart rate frequency of two workers and, using the described formula, had CCr
values of 42.7% and 40.5%. Both values correspond to a heavy work activity level according to
Chamoux’s scale (Chamoux, 1984).
3.3 REBA
Based on videos, we performed a postural analysis of sorting fish on the stern (Fig.3) through
"dynamic" REBA. The mean REBA score (150 frames analysis) for the right upper limb was 10,
and the mean REBA score for the left upper limb was 8.8. Both scores correspond to a high level
of risk.
3.4 ISO 11226
Seamen, while sorting, flexed their trunks beyond 90° in most cases for more than 10
minutes continuously (Fig.3). As described previously, according to ISO 11226
thresholds, trunk flexion over 60° is unacceptable.
Fig. 3: both pictures
show the members of
the crews involved in
the sorting task. The
reduced dimension of
the first boat (left)
avoids using a table
(right) for a more
confortable posture.
3.5 3DSSPP
3.5.1 Manual material handling
Table 3 summarizes, for each of the five analyzed frames of handling in the cold room and for the
twelve analyzed frames for the task of unloading boxes from the boat to the dock, the obtained
values of orthogonal and shear forces at the lumbosacral joints L4/L5 and L5/S1. Figure 4 shows
two reconstructions made with 3DSSPP.
Frame
L4/L5 OrtF
L4/L5 ShF
L5/S1 OrtF
L5/S1 ShF
coldstore1
3305
584
3706
586
coldstore2
3544
426
3799
484
coldstore3
4060
490
4390
506
coldstore4
3308
509
3646
529
coldstore5
3321
522
3679
542
Unloading1
4154
244
3524
404
Unloading2
3038
320
2317
368
Unloading3
3799
333
3109
383
Unloading4
3542
184
3005
391
Unloading5
2899
47
2511
400
Unloading6
3949
101
3336
498
Unloading7
4189
559
4542
559
Unloading8
5012
385
2990
441
Unloading9
3719
461
4003
460
Unloading10
4463
415
4745
443
Unloading11
2439
201
1747
349
Unloading12
2626
195
1228
343
Tab. 3: the table summarizes the results obtained by OrtF, ShF at L4/L5 and L5/S1 levels for the
five frames analyzed for the handling in the cold store and the twelve frames analyzed for the
unloading at the dock.

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Fig. 4: pictures show
two reconstructions
made with 3DSSPP.
Handling in the cold
store (left) and
unloading on the dock
(right)
3.5.2 Sorting
Table 4 summarizes, for the eighteen analyzed frames of the sorting task, the orthogonal force
and shear force values obtained at the L4/L5 and L5/S1 levels. Figure 5 shows three
reconstructions of the workers’ posture.
Tab. 4: the table
summarizes, for the
sorting task, results
obtained by OrtF and ShF
at L4/L5 and L5/S1
levels for the analysed
frames.
Fig. 5: pictures
show three
reconstructions
made with
3DSSPP of the
sorting task.
3.6 OCRA checklist and sEMG
Sorting fish on a table reported OCRA checklist values of 14.95 for the right upper limb and 12.35
for the left upper limb corresponding to medium (dark red) and a medium-low risk (light red).
We used the sEMG values of table 5 for force criteria selection, and we obtained OCRA checklist
scores of 13.5 for the left upper limb and 11.5 for the right upper limb. Both correspond to a
medium-low risk level (light red).
Table 5 resumes sEMG values (±SD) for each of the four muscles investigated. Figure 6 shows
the worker executing the task (left) and during the acquisition (right).
Tab 5: Mean activity (±SD) for each of the
four muscles investigated. Values
expressed as % MCV.
Muscle
% MCVi
Right extensor carpi radialis
16.2%±0.022
Left extensor carpi radialis
24.4%±0.014
Right flexor carpi radialis
20.3%±0.014
Left flexor carpi radialis
30.5%±0.018
Frame
L4/L5 OrtF
L4/L5 ShF
L5/S1 OrtF
L5/S1 ShF
Sorting1
2782
480
3070
486
Sorting2
3785
222
3438
467
Sorting3
2881
481
3209
486
Sorting4
2880
476
3204
486
Sorting5
2656
423
2947
439
Sorting6
2305
418
2597
442
Sorting7
1922
362
2167
379
Sorting8
2464
372
2446
399
Sorting9
2308
262
2366
360
Sorting10
2372
384
2544
409
Sorting11
2321
412
2540
425
Sorting12
2335
417
2547
427
Sorting13
2236
429
2292
425
Sorting14
1739
428
1786
377
Sorting15
1739
428
1786
377
Sorting16
1775
428
1825
377
Sorting17
2913
491
2699
440
Sorting18
2235
448
2443
438

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Fig. 6: seaman while filling crates of
fish (left). It is possible to note effort
from the right extensor carpi radialis.
Seaman while acquiring sEMG
(right). It is possible to see the four
probes used for sEMG acquisitions
are wrapped in tape to protect them.
4. Discussion
During our experiences, we observed several tasks that we considered worthy of attention from
the biomechanical overload point of view. We investigated only the most strenuous tasks
according to the information provided by the crew. Except for slight differences in the drop and
the set sail of the net, our results showed similar critical issues for all the three experiences.
NIOSH LI, heart rate monitor, and 3DSSPP orthogonal force show that handling the crates in
the cold store and unloading them on the dock are tasks with a high biomechanical load. The most
relevant risk factors were horizontal distance and frequency, particularly the unloading that needs
ending in a short time. Shear forces were very high (usually beyond 400N) but never exceeded
the threshold of 700N. It's important to underline that the shear and the orthogonal forces
thresholds's are referred to as workers not suffering from MSDs, often found in the crew.
For the tasks of sorting and cleaning, the most relevant risk factor found was trunk flexion, which
reached, and sometimes exceeded, 90°. The workers took this posture in static conditions for
times of up to fifteen minutes. This condition falls into the "not acceptable” zone of ISO 11226.
Also, REBA shows a high biomechanical risk for the sorting task. Part of the crew performs this
task upright on a table (Figure 3). In this case, we applied the OCRA checklist obtaining a medium
level of risk. 3DSSPP values are not high. It has to note that these values we found are the results
of the only posture of the workers. Finally, 3DSSPP applies mathematical models that consider
the worker's balance. Little continuous boat oscillations due to the waves increase the
biomechanical risk that isn't possible to quantify.
We applied the OCRA checklist in the task of filling fish crates using the sEMG to objectify
the muscle strenght. We found a medium-low risk level. The most relevant risk factor was the
number of technical actions per minute.
5. Conclusions
It's possible to reduce biomechanical overload in sorting and cleaning activities through
automated systems (Figure 7) in which the catch, once unloaded onto the stern, can be transported
on a conveyor belt to an automatic washing area and then onto a table. Here, the workers can sort
the catch without adopting awkward postures for prolonged times and protected from adverse
weather conditions (extreme temperatures, rain, wind).
Fig. 7: the figure shows an example of an
automation system for sorting and washing
the catch.

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We observed that workers adopted little enhancements to reduce biomechanical risk by reducing
vertical displacement and asymmetry angle (Figure 8) and adopting an internal rotation during
MMH tasks. They applied spontaneous enhancements also in the sorting task, by using a stool to
improve their sitting and by a mutual support of their back (Figure 9). The reduced dimension of
the Tunisian boat, if compared to both Italian ones, precludes the use of these enhancements .
There is, finally, the possibility of synergic effects with other risk factors (vibrations, weather
conditions, irregular sleep-wake rhythm, work-related stress, engine noise etc.) that, because of
their complexity, have not been taken into account in this paper. Particularly relevant in the
Northern seas are the low temperatures that may increase the biomechanical leading to MSDs
(Stjernbrandt, 2022).
Acknowledgments
UILA Pesca supported this research
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fish in their standard sitting posture on the
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Management of well-being at work in large Finnish healthcare
companies according to corporate social responsibility reports
Päivi KEKKONEN, Arto REIMAN, Joakim JUNNILA
Industrial Engineering and Management, University of Oulu, Finland
Abstract: Currently companies pay more and more attention to corporate social responsibility,
one part of which includes the responsibility towards its employees through well-being at work.
During the COVID19-time, especially healthcare employees’ well-being has been at the centre
of the discussion. This study provides new knowledge on how large healthcare companies voice
their practices in the management of well-being at work and how well-being at work is in general
seen as a part of the company’s social responsibility. The material consists of publicly available
CSR reports of six largest healthcare companies in Finland. Additionally, the roles and
contributions of the different stakeholders, both internal and external to the company, are
presented and discussed. Considering the current situation in the field of healthcare, the results
contribute to the topical discussion on the means and practices to manage well-being at work
and challenges that are related to it.
Keywords: Corporate responsibility reporting, healthcare, management of well-being at work.
1. Introduction
Today the role of corporate social responsibility (CSR) is a topical part of the strategic
management of companies. CSR is defined as the responsibility of enterprises for their impacts
on society and it covers social, environmental, ethical, human rights and consumer concerns
(European Commission 2011). CSR entails social responsibility towards both company’s external
stakeholders and internal stakeholders, such as employees. However, according to earlier research
the relationship between CSR and management of holistic well-being at work, including both
physical and psychosocial well-being, is often not considered deeply enough (Macassa et al.
2020).
Well-being at work can be defined in many ways and the term defies uniform definition. Instead,
it has been connected to both positive and negative feelings and experiences as well as physical,
material, social and emotional dimensions. (Schulte and Vainio 2010). In addition to focusing on
well-being in the workplace context solely, the term is nowadays also considered as a part of total
well-being of an individual extending to life outside work as well (Chari et al. 2018, Reiman &
Väyrynen 2018). Although several tools have been developed to measure well-being at work
(Schulte and Vainio 2010), the comprehensive nature of the concept poses challenges to its
management. Recently the holistic nature of well-being at work has been acknowledged in ‘a new
framework for worker well-being’ by Chari et al. (2018), which considers both work and nonwork
settings as well as subjective and objective perspectives. Especially when extending the
perspective to a nonwork context, a question arises on the roles of different stakeholders regarding

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well-being at work. In the context of human factors and ergonomics (HFE), different stakeholders
and their roles have been considered through a system perspective, yielding a classification of the
main stakeholder groups for system design (Dul et al. 2012).
During the last couple of years healthcare has been strained by the COVID-19 pandemic in a
manner unheard of before and the healthcare personnel have had a key role in the midst of the
pandemic. Their well-being at work has also risen to the public and scientific discussion (Mehta
et al. 2021). This study aims to create an overview on well-being at work in private healthcare
companies’ CSR reports. To facilitate discussion on this topic, two research questions are given:
1) How well-being at work is manifested in the CSR reports of large Finnish healthcare
companies?
2) Who are the relevant internal and external stakeholders and what is their role in the
management of these elements of well-being at work in healthcare companies?
2. Approach
The material of this study consists of publicly available CSR reports of the six largest private
healthcare employers in Finland (Attendo 2019; Esperi 2021; Humana 2021; Mehiläinen 2021;
Pihlajalinna 2021; Terveystalo 2021). These companies were identified based on the list of the
hundred largest employers in Finland published by a commercial economics magazine
Talouselämä (Talouselämä 2021). The reports are all from the year 2020 and were titled by the
companies either as responsibility reports, sustainability reports, or annual reports including a
section focused on CSR, except for one of the documents, which is a responsibility program
instead of a report. In the analysis, the companies are referred to by randomised acronyms A-F.
The contents of the reports related to the workforce of the company were analysed using content
analysis. The analysis was carried out utilising Microsoft Excel and NVivo software.
In the analysis, the framework for worker well-being proposed by Chari et al. (2018) is utilised.
Accordingly, worker well-being consists of five domains: (1) Workplace physical environment
and safety climate, which includes factors related to physical features such as workplace design
and safety conditions, (2) Workplace policies and culture, which consists of organisational
policies, programs and practices related to well-being, (3) Health status, which is related to both
physical and mental health and health-related behaviour of individuals, (4) Work evaluation and
experience, which considers individuals’ satisfaction and experience of the quality of work, (5)
Home, community, and society, which includes aspects related to life outside work, such as social
and community related issues (Chari et al. 2018). The aim of this part is to analyse the measures
related to the management of employee well-being brought up in the reports to answer research
question 1. In the analysis, a checklist of measures mentioned in the reports was formed, where
each measure was categorised to one of the five domains proposed by Chari et al. (2018). After
this the per cent amount of utilised measures mentioned in each report was calculated.
The aim of the second step of the analysis is to identify different stakeholders and discuss their
possibilities to contribute to the management of well-being at work and its development (RQ2).
The stakeholder groups for system design proposed by Dul et al. (2012) are utilised as a
framework for the analysis. These include 1) system actors, 2) system decision-makers, 3) system
experts and 4) system influencers. For each of these stakeholders, their possible goals and roles
in terms of management and development of well-being at work are identified. From the
perspective of well-being at work, system actors include employees, who can be seen both as

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objectives of physical, psychosocial and social well-being as well as actors affecting it. System
decision-makers, such as the management of the company, have a key role in the management of
well-being at work due to their power regarding both the practices of work and resources to
develop it. System experts include e.g., engineers, designers, human resources professionals and
occupational healthcare providers, who possess expertise that can be utilised to influence
individual employees’ well-being at work. In terms of well-being at work, system influencers
include e.g., governmental institutions, who influence work carried out at workplaces through
legislation and regulations as well as trade unions, who have an interest in the situation of
employees.
3. Results
The analysis shows how the companies emphasise healthy and satisfied personnel. The reports
contain various aspects that can be associated to employee well-being. To respond to the RQ1,
subsection 3.1 draws together these from the holistic well-being perspective. After that, internal
and external stakeholder aspects are considered in subsection 3.2 to respond to RQ2.
3.1 Well-being at work in CSR reports
Based on the reports, healthcare companies identified employees’ well-being at work as an
important issue. Employees were often mentioned as one of the most important assets of the
company and their well-being and satisfaction was considered being valued. Several tools and
indicators were utilised regularly for assessing the well-being of the employees. Typically, these
included for instance job satisfaction surveys, eNPS (employee net promoter score) indexes and
employee pulse questionnaires. However, there was variance in the measures taken to develop
the management of well-being at work according to the assessment results, and in some
companies’ reports not that many practical measures were mentioned (see Figure 1).
100%
80%
60%
40%
20%
0%
Company A Company B Company C Company D Company E Company F
Workplace physical environment and safety climate Workplace policies and culture
Health status Work evaluation and experience
Home, community, and society
Figure 1. The per cent amount of utilised measures mentioned in each company’s report according
to five domains for worker well-being by Chari et al. (2018).

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As can be seen in Figure 1, the measures categorised under the domain of ‘Workplace physical
environment and safety climate’ were the most pronounced in the results. On the other hand,
measures related to ‘Home, community, and society’ were the scarcest and even totally lacking
in some companies reports. Measures related to other domains fell in between these, but
noticeable was also the health status, which had quite a low per centage amount of measures in
use in each company, but in turn had a wide variety in individual measures for the companies to
choose.
Most mentioned individual measures for the management of well-being at work included those
related to the management of occupational health and safety. The engagement of the company’s
management in the development of well-being at work and developing the employee competences
through learning possibilities were also widely mentioned. Additionally, the empowerment of
employees and their participation in decision-making and development of their work gained a lot
of attention. Together with often mentioned possibilities for career development these measures
were considered creating a sense of positive work climate. Because of the time when the reports
were written - year 2020 - the COVID-19 situation and the measures taken to restrict the spreading
of the virus were naturally highlighted.
Some individual measures were scarcely mentioned, although one would assume that they have
a clear effect on the well-being of the employees. These included for instance different health and
wellness programs, such as sports and exercise benefits, and flexibility concerning work
arrangements and practices related to family-friendliness. Issues like sufficient nutrition, rest,
recovery, and free time of employees were lacking in the reports. There were some mentions of
special rewarding of the employees but for instance increases in the wages were not mentioned.
Although the meaningfulness of work was brought up, the practical measures to achieve it were
not widely mentioned. Measures related to the organisation of work also varied a lot – in some
companies more employees were hired to ease the workload whereas lay-offs took place in other
companies in 2020.
3.2 Stakeholder contributions to the management of well-being at work
Generally, different stakeholders of the company were identified in many of the studied CSR
reports. Typically, the mentioned stakeholders included employees, customers, shareholders and
investors, trade unions and local authorities. In terms of employees’ well-being at work, however,
the roles of these stakeholders were not discussed in the reports. In the following analysis, the
contributions of different stakeholders on the identified measures related to the management of
well-being at work are presented.
System actors include employees of the companies. Their role in the practical measures related to
the management of well-being at work can be summarised as active participation. The employees
were generally expected to comply with the company’s values, ethical behaviour and the code of
conduct, which was indeed mentioned by many companies as a practical guideline for their
employees. Engagement on safety as well as on promotion of equality and inclusion in the
workplace were mentioned by several companies. One company also mentioned rewarding
employees who acted as role models in their work. The employees’ own evaluation of their work
and experiences of it was often mentioned as an important issue. This included e.g., participating
in the employee surveys and development discussions, bringing up concerns related to safety
issues and taking actively part in constructive dialogue with the management of the company.
Participation in the development of work in terms of e.g., safety was also mentioned several times.
Employees were considered having an active role in developing their own competences starting
from the induction when entering the company and continuing throughout their career, also
enabling different kinds of individual career paths. Some companies also showed willingness to

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support the individual employee’s health and well-being outside work with both various benefits
and flexible practices, but in the end, it was considered being up to the individual employees how
they utilise these measures.
The actors who undoubtedly have the biggest effect on the management of well-being at work
were the system decision-makers, including the management of the company. They can be
considered the ones creating the organisational structures and workplace policies, starting from
the requirements set by legislation and trade agreements and extending to company values and
guidelines, such as code of conduct and diversity and inclusion plans, as well as various
information and participation channels. Measures by the decision-makers also included providing
resources for the development of the work organisation, well-being at work and safety as well as
enabling the cooperation between the different stakeholders on these issues. Decision-makers
were also often mentioned taking active role in creating the safety culture and enabling good
leadership through their engagement. Practical measures included gathering information on
employee well-being, following different indicators, providing possibilities for discussion
through e.g., development discussions, and making decisions based on the output. In terms of
occupational health and safety, the management of load factors, investigation of safety deviations
and supervision of the work environment were often mentioned, as well as the need to discuss
safety related issues on the level of top management. Decision-makers’ focus on employee
competence starting from the recruitment and induction followed by training possibilities for
employees and supervisors also played a major role in enabling the well-being of employees.
Paying attention to the health status of the employee through providing a variety of healthcare
services was mentioned in every report. However, the range and nature of provided healthcare
services varied. Some reports also mentioned well-being related benefits that were offered to the
employees as well as flexible practices to balance their work and family life.
Unlike system actors and decision-makers, system experts include a variety of agents with
differing roles in terms of management of well-being at work. System experts inside the company
include e.g., human resource experts and internal bodies for cooperation, such as occupational
health and safety organisation, who can be considered having a major role in different
development activities. Employee representatives naturally were considered having an important
role in the dialogue with the management regarding employee well-being. Also, internal support
service functions and their service provision were considered influencing the well-being of
employees. External system experts included e.g., pension insurance companies, who provide
well-being related cooperation possibilities for their clients. Additionally, external partners in the
areas of research and development and employee training were often utilised in companies to
develop employee well-being. The most often mentioned external expert was the occupational
healthcare provider, whose services cover those mandated by the Finnish occupational health
legislation, but often the companies also purchased supplementing services to enhance their
employees’ health and well-being. These ranged from preventive measures to specialised
healthcare services and included services to enhance both mental and physical health.
Similarly to system experts, system influencers include several agents. The most fundamental of
these are the government and authorities, who both provide legislation and regulations and
supervise how companies comply with them. In their reports, some companies also mentioned
engaging regularly in dialogue with decision-makers. Dialogue and cooperation regarding well-
being at work was also often carried out with the employee and employer organisations. One
channel for system influencers mentioned in all reports was an anonymous whistleblowing
channel, through which anyone, including members of public, were able to report concerns.

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4. Discussion with practical implications
The reports analysed provided a clear picture of the measures large healthcare companies had
taken in the management of well-being at work in 2020. The time on which the material focused
on - the COVID-19 era – likely affected the contents of the reports to some extent, as much
attention was naturally paid to measures related to the management of COVID-19.
The results of the analysis on the utilised measures, which showed that measures related to domain
of ‘workplace physical environment and safety climate’ were the most frequently mentioned, can
be considered somewhat expected as the work of healthcare employees includes a lot of physical
activities and safety issues are constantly present. On the other hand, the lack of measures on the
‘home, community and society’ domain raises a question if the holistic nature of well-being at
work is understood enough in the healthcare workplaces or whether it is too complicated to
consider affecting the employees outside their working hours. In terms of individual measures,
those related to ensuring work-life balance of the employees, such as practices related to
flexibility and ensuring sufficient rest and recovery were not widely mentioned. Also practices
that can enhance the work ability of the employees in the long-term, such as wellness programs,
exercise benefits and providing healthy lunches in the workplace could prove beneficial.
Many of the studied healthcare companies have responded to the strain experienced by their
employees by expanding the service provision of occupational healthcare services related to
psychosocial well-being. The measures include e.g., low-threshold services for mental well-
being. However, structural measures related to work organisation, sufficient workforce resources
and wages are not highlighted in the material. Currently the issue is very topical in Finland due
to the dispute between the nurse unions and employers (Yleisradio 2022).
In the second part of the analysis, several stakeholders were identified to have potential influence
in the management of well-being at work of the healthcare employees. Traditionally the role of
management is pronounced as the decision-maker, who provides the workplace setting, creates
organisational policies and makes decisions on the measures taken to enable the well-being of
employees. According to the utilised framework (Chari et al. 2018) and the discussion above, the
management, however, should include in their role a comprehensive understanding of the holistic
well-being at work, which extends to nonwork setting as well.
Respectively, the role of employees was identified to be that of active participation. The employee
is not only expected to comply with the guidelines and practices set up by the company, but also
actively to voice their experiences and concerns through various channels and participation
methods provided by the company. The active role of employees is also present in the competence
development, where desire for learning and building new competencies is needed. The role of
employee is also obviously highlighted in the nonwork setting, where the choices made by the
employee outside work influence their well-being also at work.
Additionally, according to the analysis, there are several stakeholders in groups of system experts
and system influencers that have possibilities in influencing the well-being at work. Based on the
studied material, several companies already consider cooperation with these groups in their
activities and utilise different sources of expertise to support the management of well-being at
work. Considering all these stakeholders and their possible influence mechanisms would be
beneficial in companies to achieve a holistic view on how well-being at work can be managed.

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Limitations of this study relate to only one researcher carrying out the analysis related to research
question 1 and another researcher carrying out the analysis related to research question 2. Both
researchers, however, have gone through the material. The qualitative analysis, although based
on categorisation provided by earlier research, was at some points difficult due to the variety of
ways the information was presented in the material. Additionally, the quantitative approach to the
utilised measures presented in Figure 1 does not make a difference between the weight of different
measures, and also does not consider those measures that have a negative effect on well-being at
work, such as lay-offs, which are left outside the categorisation. Another limitation to consider
relates to the material, which consists of documents published by the companies themselves. The
companies make decisions how and what kind of issues they bring up in their CSR reports. Several
of the companies, however, base their reporting to Global Reporting Initiative (GRI) reporting
principles (Global Reporting Initiative 2022) and provide different kinds of performance
indicators in their reporting. The chosen companies represent the largest in the field in Finland,
and thus the material can be viewed to provide a wide view on the situation in large private
healthcare companies’, who dominate this business branch, practices in the management of well-
being at work. The results also bring up information on the actions that could still be taken by the
companies to enhance their employees’ well-being at work.
5. Conclusions
The aim of this study was to find out how well-being at work is manifested in the CSR reports of
large Finnish healthcare companies and who are the relevant internal and external stakeholders
who influence the management of well-being at work and what is their role. The material is
publicly available on the internet. According to the results, measures related to workplace physical
environment and safety climate are most utilised, whereas measures extending to nonwork context
are least mentioned in the material. The analysis also identified several stakeholder groups that
can influence the well-being at work and whose cooperation is beneficial in terms of achieving a
holistic perspective on employee well-being. The results provide a wide view into the current
situation of Finnish healthcare organisations. This information can be utilised to further develop
the management of well-being at work in healthcare companies.
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12421759 (accessed 16 June 2022).

174
Digitalisation in primary healthcare
- the barriers and facilitators for digital patient- and
work management to work well
Susanne Frennert1, Gudbjörg Erlingsdóttir1, Mirella Muhic2, Christofer Rydelfält1,
Veronica Milos Nymberg1 och Björn Ekman1
1Lunds Universitet, 2Umeå Universitet
susanne.frennert@design.lth.se
Background and purpose: Today’s primary healthcare centres are exposed to high
demands resulting from increased requests of care due to an ageing population and high
patient transfer from hospitals, declining resources, rapid technology development and
social changes (Korlén et al., 2017). These demands result in high workload among
primary healthcare professionals (Birhanu et al., 2018; Sjöberg et al., 2020). To meet these
current and future challenges digital technologies for patient management may
constitute a possible solution. An important part of this development is to find technical
solutions that can support and streamline work processes in primary healthcare.
One such solution is the digital platform “Wolf”. The platform aims to improve patient
management and organization of the work / patient flow, reduce the workload and
cognitive load, strengthen the patient's participation, and increase cost efficiency. Via
automatic triage, the patient is directed to the right healthcare professional.
Communication and patient meetings can take place either synchronously or
asynchronously through digital or physical meetings with the different healthcare
professionals. The digital triaging is assumed to make the patient flow more efficient and
provide increased resource utilization. However, past research shows that introduction
of digital solutions in healthcare practices can also have negative effects, such as
information overload, increased stress, more interruptions, multitasking and increased
workload (Entezarjou et al., 2020; Fagerström et al., 2017; Heponiemi et al., 2017;
Salisbury et al., 2020; Stadin et al., 2021; Stadin et al., 2020). Our purpose is thus to
investigate how ‘well’ the digital platform Wolf works and how it affects working
conditions in practice.
Design/methodology/approach: In our ongoing research project we are exploring the
implementation and use of Wolf at primary healthcare centres in Sweden. First, a
qualitative pilot study, primarily through interviews with various healthcare
professionals from one healthcare centre, was performed. Currently, a series of
interviews and observations are carried out at two additional healthcare centres
exploring the effects of Wolf in more depth.

175
Results: The results indicate that although the three healthcare centres implemented the
same digital platform there is a difference in how well it works in practice. One of the
cases indicates certain facilitators that are important for the implementation/-
introduction to work well while two of the cases illuminate barriers and challenges.
Analyses are ongoing and further results will be presented at the conference.
Conclusions
It is essential to recognise that leadership, change management and context are crucial
for the digitalisation to work well for the healthcare professionals. Even though a digital
platform can work well per se it can have either positive or negative effects depending
on how the work is organised and it can thus provide the healthcare professionals with
conditions to work well as well as have negative effects on their work.
Keywords. Digital patient management; Patient accessibility; Working conditions

176
Meeting the Challenges of Home Care in Small Residential Bathrooms:
Creation of the Bathroom Aid Inventory
Rodrigues Coutinho, Brenda
Division of Ergonomics, KTH Royal Institute of Technology
brendarc@kth.se
Rose, Linda
Division of Ergonomics, KTH Royal Institute of Technology
lrose@kth.se
Trask, Catherine
Division of Ergonomics, KTH Royal Institute of Technology
ctrask@kth.se
Background and purpose
Our society is facing major demographic challenges in healthcare. The growing
population of older people is outpacing the creation of residential care facilities like
nursing homes, meaning that more and more people are ‘aging in place’. ‘Aging in place’
means continuing to reside in a private residence in the community even as care needs
intensify. It is an economically efficient option and often preferred by aging people, but
it also brings substantial challenges. Eventually people require support from home care
workers with the vital and personal tasks that take place in the bathroom: toileting and
bathing. However, residential bathrooms are often small and not designed to
accommodate a care recipient, care worker, and mobility aids such as a walker or
wheelchair. There is a growing need to update residential bathrooms to meet the
evolving needs of older residents. Although there exist several aids and assistive devices
intended to facilitate bathroom tasks, this can be hard for users and caregivers to
navigate. This project was undertaken as part of a larger study funded by AFA
Försäkring. The goal of this portion was to develop an inventory of currently-available
bathroom assistance devices for use by residents and their family members, health care
organizations, insurance agencies, and other stakeholders. The primary research
question was: What type of bathroom assistive devices are currently available, either
commercially or in prototype form, intended to assist users with the tasks of toileting,
bathing, and handwashing?
Methodology
The primary method was web search and document review across several domains:
regulations, assistive devices, and residential bathroom renovation examples. The first
set of searches investigated the legislation and guidelines on bathroom design both for
residential and healthcare settings; consistent and conflicting specifications were noted.
The second set of searches was for assistive devices that could be used to facilitate
bathing and toileting tasks in residential bathrooms. Examples of renovated residential
bathrooms were solicited through authors’ networks.

177
Results
When it came to guidelines and specifications for bathroom design, there was substantial
tension between the regulations set out by the Swedish Work Environment Authority
and the National Board of Housing, Building and Planning. The inventory includes
images of assistive devices as well as their main features: target task (bathing, toileting,
personal care, handwashing), dimensions, weight ratings, colors, materials, store,
website address, accessibility, and price. Documented assistive device categories include
shower benches, toilet aids, support handles, showers, washbasins, taps, alarm buttons,
contrast marks, and others, with approximately 20 examples for each.
Conclusions
This project developed an inventory of currently-available bathroom assistance devices,
intended to inform users’ selection of devices for growing care needs in realistic (i.e. non-
ideal) settings. However, it is not the intention for the inventory represent an assessment
of the quality, safety, effectiveness, or usability of the devices. While it is hoped this list
will represent the variety of available devices, it is also not intended to be exhaustive.
Together with an introduction that includes the examples of renovated bathrooms, the
inventory will be disseminated as a searchable web-based resource.
Keywords. Healthcare; Aging in Place; Injury Prevention, Autonomy

178
Digitalization of home care and home care nursing
during the Covid-19 pandemic: initial findings
Rydenfält, Christofer; Persson, Johanna; Erlingsdottír, Gudbjörg;
Larsson, Roger; Johansson, Gerd
Department of Design Sciences, Lund University
christofer.rydenfalt@design.lth.se
During the Covid-19 pandemic, municipal care personnel have been working in the
frontline with the responsibility to protect one of the largest risk groups from infection.
A majority of the Covid-19 related deaths in Sweden involve people that receive or are
subjects to municipal care. Despite this, comparably less attention from research has
been given to this type of care compared to more specialized Covid-19 related care.
Digitalization is envisioned to revolutionize care. However, its actual impact on home
care and home care nursing appears to be limited. Though, the question is whether the
needs brought on by the pandemic have influenced the digitalization process? In this
presentation we report on a study of how digital technology has been applied as part of
the crisis response to the Covid-19 pandemic in home care and home care nursing.
We conducted 26 semi-structured interviews with 14 home care nurses and 12 home
care managers from four municipalities. Here we report on the initial qualitative analysis
of those interviews regarding how digital technology was used during the pandemic.
When the pandemic hit, the municipalities had reached different levels of digital
preparedness. Some, already had equipment that enabled both distance work and video
meetings, others hastily procured new equipment. As soon as possible, video meetings
were used for most of the meetings, in particular bigger ones. This includes both internal
meetings and meetings with other organizations. Participants stressed that they would
continue with video meetings after the pandemic since it was time saving. It is important
to note that both the switch to video meetings and procurement of new equipment was
direct responses to local needs in the organizations. Another need that led to new digital
ways of working involved access to information. The participating organizations used
different means to share updated information also with those working in the patients
homes, for example through existing digital key applications or through documents
shared online that all employees could access.
While digitalization of municipal care has been encouraged on the national level for
a long time, the pandemic has been envisioned to accelerate the process. However, we
find that what is actually done with regards to digitalization during the pandemic, is
rather driven from below by local needs than by strategies and visions imposed from
above. This placed emphasis on the need to give further consideration to the local context
of use and to the potential users’ perceived usefulness of technologies being introduced.
I.e. it is important not only to consider how technology can be pushed into use, but also
to consider the pull mechanisms that is involved in successful use of digital technologies.
Keywords. Digitalization, Home care nursing, Organizational Change, Covid-19
pandemic.

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Can journey mapping be used to visualize information
sharing in home care?
Persson, Johanna; Svensson, Niki; Lindmark, Alicia; Larsson, Roger;
Erlingsdottir, Gudbjörg; Rydenfält, Christofer
Department of Design Sciences, Lund University
johanna.persson@design.lth.se
Home care nurses work in an organization that interacts with several other healthcare
settings and services, including basic home care services, rehabilitation, primary care
centres, nursing homes, different departments of hospital care, emergency care teams,
and pharmacies. In their daily work this means that they spend a lot of time on
communication and information sharing both within their own organisation, across
organisational borders and with the patients and their relatives. The interaction can be
handled using synchronous channels – talking in the phone, using video calls, or
walking to the home services office for a face‐to‐face meeting – or it must be done
asynchronously – using a fax machine, writing physical notes or printing documents,
sending e‐mail or text messages, or using messaging services in other digital systems.
In the daily work routine, the nurse needs access to various pieces of
information. This information is most often either prepared in the morning and carried
with them on physical paper, or is accessed by calling a colleague. Some information
must be brought back to the office for documentation or other follow‐up activities. Other
information must be shared, with home care services, with patient and relatives, or with
other care instances. This complex mesh of information that is handled and shared is
central for understanding how digital systems may support the daily work. The nurses
may have laptops with access to the electronic health record, but the information that
can be retrieved from this, or should be fed back into this, is only one piece of all
information that is handled throughout a day.
This study investigates the use of journey mapping as a tool for visualizing the
flow of information in home care. Journey mapping is a design method with the purpose
of visualizing the interaction of a user and a product or service. It tries to encompass the
whole user experience including actions and touch points between user and product,
feelings and other related information. Hence, the visualized journey in a journey map
is originally from one persons’ perspective. Here we will instead emanate from the
perspective of the information, and draw the journey map based on different pieces of
information, using a set of concrete scenarios from home care. The aim is to get a better
understanding of how information flows in the home care setting, and the journey map
will be a useful tool in the process of developing home care further. This can for example
be in the process of designing digital support systems, for designing the information
itself, or for developing work routines around the information.
Keywords. Journey mapping, home care, information, communication, digitalization

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Building Safety into the Lifecycle: the potential for Building Information
Modelling (BIM) to Enhance Occupational Health and Safety
Trask, Catherine
Division of Ergonomics, KTH Royal Institute of Technology
ctrask@kth.se
Hoeft, Madeleine
Department of Real Estate and Construction Management, School of
Architecture and Built Environment, KTH Royal Institute of Technology
Background and purpose
This article assessed how BIM-based digital processes can be leveraged for occupational
health and safety throughout the building lifecycle: design, construction, operation and
deconstruction. The work was guided by two questions: 1) What are the potentials for
lifecycle OHS management with a BIM-based digital platform, as described by the peer-
reviewed scientific literature? and 2) What characterizes current BIM-based OHS
practices in a Swedish context?
Methodology
The data collection followed a mixed-method approach, including: 1) a systematic
mapping review and 2) a series of focus group discussions with industry practitioners
from the Swedish construction and real estate industry. The literature search and
inclusion screening resulted in 51 articles. Focus groups with 3-6 participants were held
for each life cycle stage, including planning and design, construction, operation and
maintenance; no participants with BIM/OHS experience could be identified in the
demolition stage. Both these data courses were used to identify BIM use cases as well as
barriers, potential facilitators, best practices and future applications.
Results
A variety of use cases to leverage BIM for safety was identified in both academia and the
industry throughout the lifecycle with a current focus on the design and construction
phase. While academic literature mostly reported shortcomings in terms of technological
immaturity and missing complementary infrastructure on building sites, the Swedish
industry practitioners highlighted challenges in terms of technical skill shortages among
their staff and low user-friendliness of digital solutions. Even though safety is very
pertinent to the industry, it was noted that current BIM use cases are not typically
motivated by safety as the main driver, mostly due to the lack of relevant performance
metrics.
Synthesizing literature review and focus group findings resulted in a set of
principles intended to promote a higher degree integration between stakeholders and
lifecycle stages. The principles span 5 overarching themes: (1) technology, (2) data and
information, (3) business and organization, (4) people and communication and (5)
industry structure and governance aspects.

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Conclusions
Enhanced digital maturity in combination with an understanding for the respective
product and process impacts can prevent injury and illness and thereby enhance the
health, sustainability, and productivity of the construction and maintenance workforce.
Therefore, combining software expertise with building construction and maintenance
experience is a prerequisite to benefiting from BIM technologies and making informed
choices without blindly trusting auto-generated results. To fully leverage OHS benefits,
it must become an integral part of BIM methodology and data management discussions
linking various stakeholders throughout the lifecycle. It is hoped these findings can help
to define next steps in the implementation of BIM for safety, identify potential pitfalls
and contribute to learning from successful pilot projects in building design, construction,
operations and deconstruction. More research is needed to demonstrate quantifiable
benefits that justify potential higher initial costs and provide guidance in the
implementation process. It will also be important to define standards and information
requirements to make safety-related data an integral part of digital building models
throughout the lifecycle.
Keywords. Digital Twin; Construction Safety; Design for Safety

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Ergonomic evaluation and social construction of a
petroleum refining unit project (in times of a
pandemic)
Alhadeff, Cynthia Mosse
Petrobras
cmosse@gmail.com
cmosse@petrobras.com.br
This article presents the discipline of an ergonomic study carried out to contribute to the
basic construction design for a new Diesel Hydrotreating Unit – (DHT) best suited for
this specific refining scheme and increase the petroleum refinery productive capacity.
The main study focus was the suitability of premises working conditions in which
operational and maintenance teams performed, with the additional objectives to
optimise location activities and the unit’s productivity. Furthermore, to promote reliable
results and industrial workplace ambiental safety.
This 2020 study was conducted when field/site visits were still banned due to the
Covid-19 pandemic. Therefore, it was necessary to adopt several strategies to implement
and achieve the maximum understanding of improved activities, together with the
familiarity with the machines and equipment operated in the unit. This was only
possible through the dynamics of a social construction, which counted on the support
and input of different technical refinery teams (engineers and operational staff),
consultants and specialists responsible for the various project disciplines. This was
further bolstered by some experts often collaborating in additional progress meetings.
Nevertheless, it is important to note that the refinery project team counted on the
dedicated input and leadership of a civil engineer, a specialist in ergonomics.
There were numerous internet meetings, immersed in prolonged descriptions
using electronic models, plans, reports, photos, and videos. Often as a reference,
situations from previous studies were used, that had been applied in other units of the
same refining company. Above all, the highest cited among the reference situations, was
the latest HDT unit recently built in the same refinery, which apparently further
encouraged the involvement of specialists working there.
The integration between refinery teams, project engineering and ergonomic
disciplines was the main axis to promote and animate discussions to develop ideas.
These resulted in interventions in the equipment structure designs during this specific
basic project stage or future project proposals.
At the end of this basic project phase, the ergonomics discipline produced a
document that recorded the approach to items listed throughout the study. In this, each
item had its relation to inadequate situations presented as "attention points - analysis"

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(its characterization), followed by "recommendations" (orientation for treatment),
finalizing with the "implementation phase" (Guidance into which project phase it should
be studied, defined and/or implemented). Nevertheless, items already treated in this
basic project phase were registered with its settings. This document will accompany the
other project documents as a basis to monitor and supervise the adherence of its
recommendations.
Keywords. Ergonomic evaluation, social construction, Concept Ergonomics, petroleum
refinery

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Ergonomics early in the design phase at Scania
Tegbrant, Kerstin
Scania Occupational Health
kerstin.tegbrant@scania.com
Project scope:
Ergonomics early in the design process at Scania, a truck producer
Design/methodology/approach:
Teaching designers and production engineers a risk assessment method named Scania
Ergonomic Standard for Design. Assessment with Scania Ergonomic Standard Design is
performed by designers and production engineers and ergonomists in cooperation. Items
assessed are eg. work postures, weight of articles, pressure forces and duration of static
muscle work.
Results:
When the results of SES Design show a high risk of work-related musculoskeletal
disorders, redesign of articles and assemblies should take place. The cooperation with
industrial designers and production engineers is improving by the use of SES Design.
Participation of experienced operators is essential in the planning of new work positions.
Practising participative ergonomics is necessary throughout investment projects. KPI for
the result of SES Design was set in a large investment project at the Engine Assembly
and the KPI:s were achieved. The fact that KPI:s were set facilitated the improvement
process. The Ergonomist participated in a high number of systematic risk assessments
with SES Design.
Conclusion:
Participative ergonomics and systematic risk assessments early in the design phase can
be means to implement ergonomic improvements early in the design phase.
Keywords. Ergonomics, design phase, automobile industry

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Building information modelling and integration of
occupational health and safety in construction project
design
Holte, Kari Anne, Gressgård, Leif Jarle, and Kjestveit, Kari
Norce
Kaho@norceresearch.no
Background and purpose: The concept of Construction Hazard Prevention through Design
(CHPtD) is well accepted, emphasizing the design phase as important for construction
workers’ occupational health and safety (OHS) (Lingard et al., 2012). Building
information modelling (BIM), a commonly used design and planning tool in the
construction industry, is suggested to aid CHPtD (ibid). BIM can be understood as “a set
of interacting policies, processes and technologies generating a methodology to manage
the essential building design and project data in digital format throughout the building
life cycle” (Succar, 2009). However, integration of OHS into BIM is challenging, and
referred to a as potential that remains to be realized (Muzafar, 2020). The Norwegian
construction industry is part of a governmental program aiming to reduce sick-leave.
One of the appointed actions is to develop BIM into a design tool that integrates OHS,
and health-related risks in particular. This study explores the use of BIM in the design
phase of large construction projects, regards the integration of OHS.
Methodology: The study is designed as a qualitative interview study using focus group
and individual interviews. 16 informants representing design/planning and ten
informants representing OHS-departments/-services took part, representing three
entrepreneurs, one construction client and one consultancy. A semi-structured
interview-guide was used. The interviews were recorded and transcribed verbatim, and
thereafter analysed by use of content analysis.
Result: Although BIM has become advanced and many projects use BIM as the planning
tool, making the design phase “paper-free”, preliminary results show that OHS is not an
integrated part of BIM modelling in the early design phase. Informants describe
challenges due to OHS-professionals not being acquainted with modelling, and a
mismatch between the 3-dimensional models and OHS-information remaining written.
Still there are examples where 3D visualisation of buildings under construction entails
discussions around emerging OHS-risks. These OHS-risks are mostly related to safety
risks, and less to health-related risks.

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Discussion: OHS is on the agenda regarding integration in BIM-modelling, although not
included in a systematic way, particularly missing in the early stage of the design phase.
This might reflect professions, competencies, and interests of those included in early
design phase, as well as leadership. However, legislation and regulation may also play
a role. Fragmented examples on multidisciplinary discussions regarding risk show the
potential in combining OHS and BIM, but it is important that health risks become part
of these discussions.
Conclusion: The use of BIM is promising, but technology and methodology need to be
developed to ensure overall integration of OHS, as a tool for CHPtD
Keywords: Building and construction, Building information modelling, occupational
health and safety.
References
Lingard, H. C., Cooke, T., & Blismas, N. (2012). Designing for construction workers’
occupational health and safety: a case study of socio-material complexity. Construction
Management and Economics, 30(5), 367-382.
Muzafar, M. (2020). Building information modelling to mitigate the health and safety
risks associated with the construction industry: a review. International journal of
occupational safety and ergonomics, 1-9.
Succar, B. (2009). Building information modelling framework: A research and delivery
foundation for industry stakeholders. Automation in construction, 18(3), 357-375

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Comfort, seat belt fit and misuse for older adults
when travelling in cars
Makris, Melina; Osvalder, Anna-Lisa
Chalmers University of Technology
Melina.makris@chalmers.se,
Anna-lisa.osvalder@chalmers.se
The ageing population is growing rapidly, as well as the number of older adults
travelling in cars. Mobility, comfort, and safety are important issues for this generation.
Seat belts effectively reduce the risk of injury and protect a wide range of occupants, but
the design has supposed ‘the forward facing up-right sitting normal adult’ as the main
user group. Nevertheless, body proportions change with age, in terms of reduced fat on
the upper body and decreased muscle mass, as well as tendencies to a more kyphotic
posture, leading to a changed perception of comfort. Reasons for non-usage and misuse
of seat belts are often related to discomfort, convenience, or lack of knowledge.
The purpose of this paper is to discuss how today’s seat belt system fit the older adult
population, in terms of comfort and misuse. As a base for the analysis, the compiled
results from three empirical studies, including older adults (65-80 years) as car
passengers, have been used. The studies have been made both in stationary cars and in
real world driving. Anthropometric measures, photographs and video recordings have
been used in the objective data collection, while questionnaires and interviews have been
performed to collect subjective estimations regarding sitting comfort and belt fit.
The overall results of the empirical studies showed a wide range of seat belt positions
used, and part of these with non-optimal belt fit or misuse. Non-optimal belt fit was
mainly associated with higher BMI and larger waist circumference correlated to the
shoulder belt too high up on abdomen. Females tended to wear the lap belt too high up
and not in contact with the thighs, whereas males were more likely to route the lap belt
below their belly. The results also showed that the experience of seat belt discomfort was
high, which sometimes resulted in that the position of the seat belt on the body was
changed. Various types of accessories and add-on products were used to decrease
discomfort as well as to get higher up to improve the visibility out of the windows. The
safety awareness of non-optimal belt fit and misuse was limited. ‘As long as I wear the
seat belt it is all good’ was stated among older adults.
To conclude, there are challenges in achieving a comfortable sitting posture and well-
functioning seat belt fit for older adults, due to comfort reasons as well as body
composition, sitting postures and on-going activity. In the area of universal design, it is
a well-known problem, that one product or system cannot fit all users to the highest

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degree. By gaining deeper knowledge and understanding of older adults’ seat belt usage,
guidelines for adjustments can be made to customise the safety systems one step further
to include all users in one design.
Keywords.
Sitting comfort, sitting posture, car passenger, seat belt fit, older adults, universal design

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Evaluation of comfort and fit of personal protective
equipment
Osvalder, Anna-Lisa1; Österman, Cecilia2 & Nilsson, Per2
1 Chalmers University of technology
2 Linnaeus University
alos@chalmers.se
There are several reasons behind the use, non-use, or inadequate use of personal
protective equipment (PPE) during work. Comfort and accurate size support proper use,
while discomfort, misfit, and difficulties to understand how the PPE should be handled
inhibit correct use. The need of several types of protective equipment simultaneously
can also create problems.
The purpose of this study is to investigate comfort and fit of different types of PPE
often used in construction work, chimney sweeping and during work on board ships.
Also, the understanding of how to don, adjust and doff the PPE correctly was assessed
in terms of guessability.
A combination of different PPEs was tested individually and in combination, such
as helmet, ear protection, goggles, respiratory protection, gloves, safety harness and life-
vest. An analytical evaluation was performed with the methods ECW (enhanced
cognitive walkthrough) and PUEA (predictive use error analysis) to search for usability
problems and use errors during handling and use. Usability tests were made to evaluate
guessability, comfort and fit with test subjects of different heights and body constitutions.
The tests included observations when donning and doffing the equipment and during
different work tasks, followed by short interviews and subjective estimations. Further, a
questionnaire was distributed to workers in the three domains asking questions
regarding the use of PPE.
The analytical evaluation showed that some usability problems and use errors
could arise when donning and doffing the PPE, but the severity of these are minor,
mostly causing discomfort. For the safety harness a few use errors and usability
problems arose, especially for non-experts, where some could lead to high risk of severe
incidents.
The usability tests showed that discomfort arise for all test subjects when using a
combination of PPE, increasing by time. For instance, goggles together with the face
mask caused pressure, chafing at the nose and heat rash in the face. This combination
also limited the sight of vision. The helmet in combination with the goggles and ear
protectors did not fit well and caused uncomfortable pressure at the temples. No major
problems were found with the individual fit of the PPEs. The ear protectors, goggles and
face masks could be adjusted for different head sizes.
The guessability for how to don and wear the combination of PPE was moderate,
and it took some time to adjust for a good fit. For the safety harness the guessability was
poor, few clues in the design showed how it should be donned, adjusted, or worn on the

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correct skeletal bones. Discomfort pressure from the straps arise. All straps could not be
adjusted leading to non-optimal safety for some body constitutions.
To conclude, if several types of PPE are used together discomfort leading to pain
is likely to occur, which can lead to mis-use or non-use, or reduced performance. Safety
harnesses need to be easier to use correctly for non-experts and allow for better
individual adjustments. The results from this study can be used to find re-design ideas
for PPE.
Keywords. Personal protective equipment, PPE, comfort, fit, usability, evaluation, safety
harness

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Work well – by improving working conditions after
risk assessments with reliable technical methods
Mikael Forsman (1,2), Nidhi Gupta (3), Liyun Yang (2), Peter Johansson (4),
Viktoria Wahlström (5), Jörgen Eklund (1,2) and Co-authors of included contributions
(see below)
(1) School of Engineering Sciences in Chemistry, Biotechnology and Health,
KTH Royal Institute of Technology, Huddinge, Sweden
(2) Institute of Environmental Medicine, Karolinska Institutet, Stockholm,
Sweden
(3) National Research Centre for the Working Environment, Copenhagen,
Denmark
(4) Occupational and Environmental Medicine, Uppsala University and Uppsala
University Hospital, Sweden
(5) Department of Public Health and Clinical Medicine, Umeå University, Umeå
miforsm@kth.se
This Special Session concerns recently improved tools and new results of technical
measurements of work postures and movements. Measurements of this kind are,
because of decreased costs and improved usability, becoming more popular.
Musculoskeletal disorders (MSDs) are causing ill-health and high compensation costs of
occupational and work-related accidents and diseases at a global level. Assessments of
physical workload, postures and movements have most often, especially by ergonomists
in working life, been carried out by the use of observation-based methods. These
methods can collect information of different risk factors at a relatively low cost.
However, observation-based ratings of posture and movements are crude, and they
often have a low reliability. Technical measurements can, on the other hand, record
kinematics data with high precision, continuously throughout workdays, and can be
used for to compare different occupational groups, and to study exposure-effect
relationships. With improved usability, the usage of these technical methods may be
broadened to include regular usage by practicing ergonomists in risk assessments.
This special session includes five presentations:
Nidhi Gupta, Søren Skotte Bjerregaard, Liyun Yang, Mikael Forsman, Charlotte Lund
Rasmussen, Charlotte Diana Nørregaard Rasmussen, Els Clays, Andreas Holtermann.
Back bending at work influence risk of long-term sickness absence.
After analyzing 944 workers’ accelerometer measured upper back bending and
registered periods of long-term sick absence over four years follow-up, the results
showed a dose-response association between forward bending of the back and long-
term sick absence. This may increase the motivation of using technical risk assessment
methods in workplaces.

193
Liyun Yang, Bart De Clercq, Mikael Forsman, Alain Grootaers, Mathieu Verbrugghe,
Lieve Van Dyck, Carl Mikael Lind. Effectiveness of vibrotactile feedback training to reduce
postural exposure in manual sorting.
Fifteen warehouse workers who performed real manual sorting participated. Feedback
trainings for 30 minutes during normal work were carried out at two workdays. The
results showed statistically significant reduced trunk inclination during and
immediately after feedback, but did not show significant reductions at follow-up
occasions two and three weeks after the baseline.
Peter Johansson, Pasan Hettiarachchi, Andreas Holtermann, Nidhi Gupta, Patrick
Crowley, Magnus Svartengren. ActiPASS a new improved tool to measure physical
behaviours 24/7 from thigh worn accelerometers.
Acti-4 is a validated and proven algorithm to identify sitting, standing, walking,
running, bicycling, and stair-walking from thigh worn accelerometers. It is now
enhanced with identification of time of lying and sleep, and integrated into a new
streamlined data processing software – ActiPASS.
Jörgen Eklund, Viktoria Wahlström, Farhad Abtahi, Fernando Seoane, Mikael Forsman.
A new generation of smart T-shirts with automatic direct reports.
Technical measurements have for many years been seen as too complicated to be used
by practitioners in the field. However, they are now improved, and the new generation
methods are easy to use. Automatic reports are shown on a smartphone, and generated
into a pdf file. Specifically, one system, that is now being used and evaluated in field
measurements, will be presented.
Mikael Forsman, Ida-Märta Rhén, Axel Forsman, Guilherme Elcadi, Liyun Yang.
A sensor-based smartphone app for cost and time effective wrist velocity measurements.
A quantitative exposure-effect relationship between wrist angular velocity and upper
extremity musculoskeletal disorders has been reported. This velocity has been
complicated to measure. In this national project, a new sensor- and smartphone method
has been developed, and tested in lab and in field measurements, which showed
promising results.
Keywords: Ergonomics, Musculoskeletal disorders, Risk assessment, Accelerometer, IMU
Special session presentations
1. Back bending at work influence risk of long-term sickness absence. Nidhi Gupta. The National
Research Centre for the Working Environment, Denmark. ngu@nfa.dk.
2. Effectiveness of vibrotactile feedback training to reduce postural exposure in manual sorting. Liyun
Yang. Karolinska Institutet. liyun.yang@ki.se.
3. ActiPASS a new improved tool to measure physical behaviours 24/7 from thigh worn
accelerometers. Peter Johansson. Uppsala university. peter.johansson@medsci.uu.se
4. A new generation of smart T-shirts with automatic direct reports. Jörgen Eklund & Viktoria
Wahlström. Karolinska Institutet & Umeå University. jorgen.eklund@ki.se.
5. A sensor-based smartphone app for cost and time effective wrist velocity measurements. Mikael
Forsman. KTH Royal Institute of Technology, Stockholm, Sweden. miforsm@kth.se.

194
On a Quest: The Conundrums of Designing a Scientific
study of Office Tasks in a VR Environment
Berlin, Cecilia
Div. of Design & Human Factors, Dept. of Industrial and Material
Sciences, Chalmers University of Technology, Hörsalsvägen 5, 412 96,
Göteborg, Sweden
cecilia.berlin@chalmers.se
Babapour Chafi, Maral
Institute of Stress Medicine, Region Västra Götaland, Carl Skottsbergs
gata 22 B, 413 19, Göteborg, Sweden
maral.babapour.chafi@vgregion.se
Virtual Reality (VR) equipment (headsets, hand-controllers and app libraries) is an
increasingly accessible technology that has been marketed mainly as a platform for
games and recreation. A multitude of possibilities for increasing the use of VR in other
work domains have been proposed, among them being the introduction of “virtual
offices” to carry out office work. However, the most commonly explored aspects of this
VR application tend to concern social aspects, such as meetings, and surprisingly little
focus seems to be placed on how VR contributes to the efficacy, comfort, productivity
and performance of actual knowledge work tasks (such as writing texts, carrying out
calculations, performing research, drawing diagrams or creating presentations). This is
particularly surprising given the potential that VR has to change the way workers move
spatially. Instead of working at a physical desk with a monitor, mouse and screen, in
office spaces that are often shared with others, VR could allow each person to move
more dynamically by offering a much larger visual space to spread out the work in
(without encroaching on colleagues’ spaces), challenging the need for a conventional
office setup or sitting/standing still.
From a Human Factors research perspective, VR involves different biomechanical loads
on the body (particularly on the hands, head/neck and facial skin), exposes the senses to
new and varied experiences, and even offers a possibility to support focus and
concentration by being an “immersive” experience that can prevent other distractions.
But how can this possibility be tested from a research point of view, to offer decision
support and safer recommendations about VR use and exposure?
This paper presents a planned experimental procedure to explore and evaluate VR
equipment as a potential tool for carrying out administrative and knowledge work tasks.
Since ergonomics is about both productivity and human well-being, the experiment will
need to test objective aspects of task efficacy, as well as subjective aspects of user comfort,
preference, time-related use experience, and perceived ease of knowledge input (such as
typing and drawing).
As currently planned, the experiment will be carried out in a sequence of phases, where
the first three are carried out in a laboratory environment. Phase 0 (Habituation) is where
the research subjects are allowed a familiarization with the immersive VR environment,
controls, task inputs and comfort strategies. In Phase 1 (Individual work) the subjects are
asked to perform several pre-determined knowledge work tasks individually; Phase 2
(Tasks with colleagues) lets research subjects assemble in the same room and try to
collaborate together on tasks in a shared VR space. Finally Phase 3 (In the wild), where
the experimental setup is tested in a home or “real office” environment

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relevant for the research subject, and tasks are carried out virtually, but in a physical
environment that the subject has some control over.
The paper also discusses some issues with planning to securely handle the collected
personal data from an ethical and legal (GDPR) perspective, as this has profoundly
influenced the planning phase of the experiment.
Keywords: Virtual Reality, VR, Ergonomics, Office tasks, Methodology, Experiment.

51st Nordic Ergonomics and Human Factors Society Conference 2022
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Ergonomics of Office Work in a VR Environment: A State-of-the-art
Literature Review
Maral BABAPOUR CHAFI (1), CECILIA BERLIN (2)
(1)
Institute of Stress Medicine, Region Västra Götaland, Carl Skottsbergs gata 22 B, 413 19,
Göteborg, Sweden. maral.babapour.chafi@vgregion.se
(2)
Div. of Design & Human Factors, Dept. of Industrial and Material Sciences, Chalmers
University of Technology, Hörsalsvägen 5, 412 96, Göteborg, Sweden. cecilia.berlin@chalmers.se
Abstract: Virtual Reality (VR) holds promise as a potential professional work tool – one such
potential is to support office work tasks. VR is a simulated environment accessed via head-
mounted displays and hand-controlled devices for interacting with the virtual interface. This
paper aims to provide a state-of-the-art review of empirical research on VR-based office work,
focusing on ergonomics. A structured literature database search and criteria-based exclusion
led to a total of 5 papers addressing office work in a VR environment. The research on VR- based
office work identifies potentials and drawbacks relevant to consider for future research and
developments. The identified studies examine technical solutions, task performance, user
experience and comfort when using VR-based solutions. The fast pace of technology
development, e.g lighter headsets, increased field of vision and screen resolution, new controls,
and the emerging plethora of new software may resolve many identified challenges, while
perhaps introducing new problems.
Keywords: Virtual reality, Office work, Ergonomics.
1. Introduction
Virtual Reality (VR) holds many promises, one of which is to support office workers' increasingly
distributed work (Grubert et al 2018). It has received increased attention, particularly in the
aftermath of COVID-19 and the widespread adoption of remote work among office workers. The
increased interest in VR is also due to rapid technological breakthroughs, improved user comfort
and affordable pricing.
VR is a simulated environment that is accessed by wearing Head-mounted displays (HMD),
considered to provide visually immersive 3D experiences (in contrast to two-dimensional screen-
based user interfaces). To interact with VR, users wear a head-mounted display (HMD), enter the
simulated environment by turning on the device and starting an application, move and look around
to browse the visual environment, and use hand-controlled devices for navigation and data entry.
VR has been primarily used in the gaming industry. Other application areas include medical
purposes such as management of pain and anxiety, industrial purposes like product simulation
and visualisation, and training purposes.

51st Nordic Ergonomics and Human Factors Society Conference 2022
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The application of VR for office work has gained unprecedented attention in recent years as a
result of increased remote work, primarily touted as a way for colleagues to meet virtually.
We define “office work” as a combination of knowledge work and/or administrative work that is
traditionally carried out in an office environment that either functions as a stand-alone
environment or is in proximity to other types of work environments like laboratories, health-care
or manufacturing. However, the boundaries of where office work is conducted have been
increasingly blurred following increased digitalisation, technological advancements and remote
work policies (Kompast & Wagner 2002). Office workers have access to not only communication
tools but also tools such as word processors and spreadsheets on mobile phones and tablets. These
tools can be seen as infinite canvases that cannot be used to their full potential on smaller screens.
VR technology can provide means to utilise the potential of such tools without any limitations of
screen size and location of work (Grubert et al 2018).
This paper aims to provide a state-of-the-art review of research on VR-based office work, with a
focus on ergonomics, and highlight areas in need of future research. This paper focuses on
empirical studies that address VR-based office work, and excludes other domain applications.
2. Methodology
The structured literature review combined a search in Scopus and Web of Science (WoS) in order
to find peer-reviewed materials about the combination of VR and office work. The keywords and
operands used for database searches were: (“virtual reality” OR “VR”) AND (“office work” OR
“knowledge work”). Conference proceedings and journal articles from 2000-2021 were included
in the search strategy. In total, 52 abstracts were found (n=40 in Scopus, and n=12 in WoS). After
removal of duplicates (n=10) and abstracts that did not address aspects of office work with virtual
reality technology (n=32), 9 publications were identified for full-text review. After a full-text
review, five publications were found relevant for this review (removing 4 that were not empirical
studies). The Prisma diagram in Figure 1 illustrates the literature review process.

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Figure 1: Prisma diagram of the literature search and inclusion/exclusion process
3. Results
The identified five publications presented empirical studies that either (i) presented and evaluated
new prototypes or ways of using the VR-technology to conduct office work, or (ii) evaluated
existing VR technology. The studies were published between 2018-2021. All studies were
published as conference proceedings, except one in Ergonomics (Kim & Shin 2021).
All studies were conducted in laboratory settings. Four studies used the HTC Vive Pro (Biener et
al 2020; Shen et al 2019; Gesslein et al 2020; Kim & Shin 2021), and one study used Oculus rift
CV1 (Knierim et al 2018) for testing. The overall experiment duration in four studies was under
two hours (Knierim et al 2018; Gesslein et al 2020; Biener et al 2020; Kim & Shin 2021), while
one of the studies presented an experiment that took two full workdays (Shen et al 2019).
The experimental setting in four studies compared simulated tasks in a real environment with VR
conditions, having participants test the different conditions (Knierim et al 2018; Shen et al 2019;
Gesslein et al 2020; Kim & Shin 2021). The comparative set-up in Kim & Shin (2021) and Shen
et al (2019) was carried out on two separate days to prevent fatigue. The comparative data in the
studies by Gesslein et al (2020) and Knierim et al (2018) was collected in one day, with an overall
shorter task duration. The tasks that were simulated in the identified studies were: typing tasks
(Kim & Shin, 2021; Knierim et al 2018; Shen et al 2019), spreadsheet tasks (Gesslein et al 2020);
content transfer and puzzle tasks (Biener et al 2020); and editing, content searching and image
classification tasks (Shen et al 2019).

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The number of participants across the studies varied between 5 to 32 with a majority of male
participants (in total 95 participants; 26 Female and 74 male), with a mixed exposure to VR
devices prior to the experiment.
The identified studies addressed several aspects of user experience and workload. Two studies
evaluated simulator sickness based on subjective ratings (Biener et al 2020; Kim & Shin 2021)
using a validated questionnaire (SSQ) developed for evaluating simulator sickness (Kennedy et
al., 1993). Cognitive workload was assessed using NASA-Task Load Index (Hart & Staveland,
1988) in studies by Biener et al (2020) and Knierim et al (2018). One of the studies measured
physical workload by subjective (dis-)comfort ratings, Electromyographic (EMG) measurements
and observational data of posture neck movement (Kim & Shin 2021). Interviews and
observations were conducted to cover more general aspects of the user experience (Biener et al
2020; Knierim et al 2018). Biener et al (2020) evaluated usability aspects with the System
Usability Scale (SUS) questionnaire, a validated instrument for subjective ratings of usability
(Lewis, 2018). Performance outcomes were assessed based on objective data such as typing speed,
error rate, and reaction time (e.g. Shen et al 2019).
The insights from the identified studies are summarised in the following two sections: (1)
technical enablers of office work in VR, and (2) potential benefits and challenges of using VR for
office work.
3.1. Technical enablers of office work in VR
Three studies presented and evaluated new prototypes or ways of using the VR-technology that
can enable and/or facilitate office work tasks. Biener et al (2020) developed ways to make use of
a larger screen access in VR, both side-by-side and arranged in-depth (with a “show all” button
which was not used by the users; instead they browsed to the depth and back to scan the screens).
They demonstrated how to make use of multiple screens with micro-movements for input. This
application seems relevant in limited spaces (such as passenger seats). Other studies used two
side-by-side screens resembling desktop usage (e.g. Kim and Shin 2021). It appears that the
possible interaction patterns for utilising the large screen potentials in VR have not been
sufficiently mapped/explored.
Knierim et al (2018) developed a tool to facilitate effective typewriting in VR. The tool visually
represents hands and keyboards to counteract the downside of immersion in VR, specifically the
issue of not seeing hands and keyboards. Typewriting is the most common generic office work
that can be challenging for users who are not fluent touch typists. Other solutions in the market
are point and click solutions with tracked controllers, handwriting with a pen on a tablet, speech,
an overlay of the virtual environment with a cropped video stream of the real world, and “real
keyboards” developed to be used with VR-headsets.
Gesslein et al (2020) developed new functions and ways of interacting with spreadsheets in VR
for utilising the screen both in-depth and vertically. They also demonstrated that using a pen as
an input device enables accuracy, intuitive interaction, and also frees up one hand that can be
useful in small spaces.
3.2. Potential benefits and challenges of using VR for office work
The identified benefits relate to the context of VR-usage, particularly the access to a large screen
that can facilitate mobile office work, taking place on-the-go in small and possibly crowded spaces
(Biener et al 2020, Kim and Shin 2021). The immersion in a VR-environment also allows for
protecting sensitive information on the user’s screen (Kim and Shin 2021). It is relevant to note
that these benefits are raised as potential benefits and were not empirically tested in real
environments.

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The identified challenges covered risks associated with wearing HMDs such as physical
discomfort and fitting eyeglasses within the headsets (Kim and Shin 2021), visual discomfort
(ibid.), simulator sickness (ibid.), fatigue (Shen et al 2019), loss of productivity and higher
workload due to novelty of and usability issues with input devices (Knierim et al 2018). In
particular, having simulated keyboards limited the haptic feedback for experienced typists and
not seeing one’s hands when typing was a challenge for inexperienced typists (ibid.). These
limitations led to merely including experienced touch typists in one of the studies (Kim and Shin
2021), suggesting a potential loss of productivity for those office workers who are not necessarily
touch-typists. The interface and its general compatibility (in terms of controls, windows and
screens) with the real environment is another challenge raised in the literature. Table 1 provides
an overview of the identified benefits and challenges.
Table 1. Potential benefits and challenges of using VR for office work according to sources A
(Biener et al 2020), B (Gesslein et al 2020), C (Kim and Shin 2021), D (Knierim et al 2018) and
E (Shen et al 2019).
Benefits
related to
context of use
●
Access to large screens in small spaces for facilitating mobile work (A,C)
●
Overcome privacy issues in public spaces (C)
General
challenges
●
Limited evidence exists on mental fatigue (slower reaction time and more
lapses) when comparing long-term tasks in VR vs desktop situations (E).
It remains unclear which aspects of VR caused the reported mental
fatigue.
●
Simulator sickness ratings are higher in VR conditions compared to
desktop conditions, but not considered a major concern for users (C). The
authors conclude that VR can be appropriate for office work for mobile
workers provided enough breaks are taken.
Challenges
related to
wearing a
HMD
●
Increased neck rotation in combination with carrying the HMDs weight
was observed in an experimental study, leading to more use of neck
extensor muscles and higher ratings of shoulder and neck discomfort (C).
●
A recent study recruited users who do not wear eyeglasses to avoid
problems with fitting the HMD (C).
Challenges
related to the
display
●
Shifting the line of sight in VR seems to require more head rotation than
in desktop situations (C).
●
Visual discomfort is reported to a higher extent when comparing VR with
desktop use (C).
Challenges
related to
input devices
●
Neither the keyboard nor the hands were seen in earlier versions of VR,
leading to productivity loss in typing tasks, specifically for inexperienced
typists (D).
●
Having No Hands in VR causes a significantly higher workload than
having hand visualisations, for both experienced as well as inexperienced
typists (D).
Challenges
related to the
interface
●
The compatibility of representations between the VR and non-VR
workflows (E).
●
Challenges for utilising the limitless screen capacity include finding a
comfortable distance, readability of information presented in peripheries,
identifying an active window, and achieving an overview of information
that may be represented in-depth (A).

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4. Discussion
This review based on five articles may appear quite limited by virtue of sheer numbers. The
exclusion strategies were intended to focus the knowledge space to empirical studies of combining
VR technology and office work (as defined in the Introduction). The included papers nonetheless
offer important insights regarding benefits and challenges of VR use for this purpose (as well as
for carrying out studies of work-related VR use).
Some paradoxes of VR-usage become evident: for example, the VR environment offers the
possibility of greater freedom of movement, since the user is in theory no longer restricted to
placing work materials on a limited, designated desktop affected by gravity, or a limited screen
size. However, conventional reliance on physical keyboards for text entry in office work require
the users to sit or stand by a desk surface to support the input device. Recent studies point to the
usability problems of interacting with physical keyboards in the VR environment (e.g. McGill et
al 2015; Knierim et al 2018).
Further, VR offers a potentially “limitless” screen size on which to distribute information
(including above the user’s head), but in practice, human eyes are limited by having a restricted
field of vision where detailed viewing is only possible in the centre; also, having too-distant work
surfaces greatly reduces their utility and may end up causing the user visual clutter. One of the
studies (Biener et al 2020) tested side-by-side and layered windows for screen usage (resembling
desk-tops); their results may be an untapped potential for user interface development.
Possibilities to extend the literature review have been considered, particularly employing a
snowball-strategy search (where additional publications are identified from the reference lists of
the papers that were included after the full-text review). A preliminary attempt to do so is currently
being pursued, with approximately 40 additional papers (both journal articles and conference
proceedings) being evaluated for possible inclusion. The drawback of this strategy is that the five
original papers limit the search field to papers older than themselves. This may add some well-
needed established knowledge published before the year 2000 (in particular a seminal article by
Nichols (1999) that appears in most reference lists), as well as articles that were not captured by
our original keywords. The year limitation cutting off the Nichols (1999) paper is particularly
unfortunate, as the paper raised salient points like the risk for physical discomfort in the head/neck
region when wearing a HMD; that the user experience of older HMD displays may be negatively
affected by distortion, limited field of view, rendering problems, and low resolution; and learning
problems associated with the usage of the equipment, e.g. remembering which buttons to press on
the input devices.
A further enrichment strategy could be to also include grey literature (newspaper articles, white
papers, product reviews, blog posts etc.), but the likelihood of these offering insights from
empirical trials without an underlying marketing purpose is uncertain. However, their inclusion
might mitigate the fact that the development pace of VR technology is very rapid, in contrast to
the pace of academic publishing about the subject. Still, some of the included conference
proceedings report on tinkering with VR tools, and present and evaluate working prototypes.
The issue of whether search keywords have been sufficiently inclusive, and at the same time
sufficiently distinct, is worth discussing. While our keywords included the term “office work”, a
preliminary observation regarding the snowball-searched papers is that most of the ones chosen
for consideration do not use the term “office work”, but rather focus on office-related tools, like
keyboards. This indicates that a more technology-focused search might have yielded additional
relevant results, even if the context of office work were to be removed from the scope. This,
however, would require a qualitative interpretation of whether any technology being described
could have utility for office work, which could lead to some arbitrary inclusions. It is also worth
considering that the use of terms in a practitioner or VR-technology-developer context may differ
from the academic use of the same terms.

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Finally, the literature review indicates knowledge gaps worthy of further investigation, evoking
research questions such as;
-
Is the current technology “mature enough” for implementation in office work? If not,
what must be addressed?
-
How does a person’s presence/immersion in VR relate to alertness/attentiveness when
performing office tasks?
-
What other cognitive ergonomics considerations might affect the performance and
experience of the work?
-
What other text entry devices could be considered as a productive alternative to touch
type-keyboards, to enable freedom of movement?
-
What are the implications of using speech-to-text solutions as a replacement for typing
in a VR environment?
-
What are the practical limitations of “limitless screen space”?
-
What is a “healthy” or safe dose of VR usage for work, time-wise?
-
How does work in VR influence the social and organisational work environment? How
should work tasks be organised in VR environments?
-
What musculoskeletal considerations should be taken into account when designing
office work in VR?
-
What are the accessibility considerations in a VR environment?
The answers to these questions appear to require further empirical studies of an interventional or
experimental nature.
5. Conclusions
The research on use of VR technology for office work identifies potentials and drawbacks relevant
to consider for future research and developments. While the VR-technology enables access to
limitless screens that are not bound to desks and entail potentially new interaction patterns, the
identified studies replicate and simulate traditional ways of working with office tasks, i.e. seated
work with keyboards. The identified challenges include discomfort, fatigue, loss of productivity
and problems with usability of the examined interfaces. The fast pace of technology development
may resolve many identified challenges, while perhaps introducing new problems.
References
Biener, V., Schneider, D., Gesslein, T., Otte, A., Kuth, B., Kristensson, P. O., Ofek, E., Pahud,
M., & Grubert, J. (2020). Breaking the Screen: Interaction across Touchscreen Boundaries in
Virtual Reality for Mobile Knowledge Workers. IEEE Transactions on Visualization and
Computer Graphics, 26(12), 3490–3502. https://doi.org/10.1109/TVCG.2020.3023567
Gesslein, T., Biener, V., Gagel, P., Schneider, D., Kristensson, P. O., Ofek, E., Pahud, M., &
Grubert, J. (2020). Pen-based Interaction with Spreadsheets in Mobile Virtual Reality.
Proceedings - 2020 IEEE International Symposium on Mixed and Augmented Reality, ISMAR
2020, 361–373. https://doi.org/10.1109/ISMAR50242.2020.00063
Grubert, J., Ofek, E., Pahud, M., & Kristensson, P. O. (2018). The office of the future: Virtual,
portable, and global. IEEE computer graphics and applications – proceedings, 38(6), 125-
133. https://ieeexplore.ieee.org/document/8617763

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Hart, S. G., & Staveland, L. E. (1988). Development of NASA-TLX (Task Load Index): Results
of empirical and theoretical research. In Advances in psychology (Vol. 52, pp. 139–183).
Elsevier.
Kennedy, R. S., Lane, N. E., Berbaum, K. S., & Lilienthal, M. G. (1993). Simulator sickness
questionnaire: An enhanced method for quantifying simulator sickness. The International
Journal of Aviation Psychology, 3(3), 203–220.
Kim, E., & Shin, G. (2021). User discomfort while using a virtual reality headset as a personal
viewing system for text-intensive office tasks. Ergonomics, 64(7), 891–899.
https://doi.org/10.1080/00140139.2020.1869320
Knierim, P., Schwind, V., Feit, A. M., Nieuwenhuizen, F., & Henze, N. (2018). Physical
keyboards in Virtual reality: Analysis of typing performance and effects of avatar hands.
Conference on Human Factors in Computing Systems - Proceedings, 2018.
https://doi.org/10.1145/3173574.3173919
Kompast,
M.
&
Wagner,
I.
(2002).
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spatial,
temporal
and
cultural
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Lewis, J. R. (2018). The system usability scale: past, present, and future. International Journal
of Human–Computer Interaction, 34(7), 577–590.
https://doi.org/10.1080/10447318.2018.1455307
McGill, M., Boland, D., Murray-Smith, R., & Brewster, S. (2015). A Dose of Reality:
Overcoming Usability Challenges in VR Head-Mounted Displays. In Proceedings of the 33rd
Annual ACM Conference on Human Factors in Computing Systems (CHI '15). Association for
Computing Machinery, New York, NY, USA, 2143–2152.
https://doi.org/10.1145/2702123.2702382
Nichols, S. (1999). Physical ergonomics of virtual environment use. Applied Ergonomics, 30(1),
79–90. https://doi.org/10.1016/S0003-6870(98)00045-3
Shen, R., Weng, D., Chen, S., Guo, J., & Fang, H. (2019). Mental fatigue of long-Term office
tasks in virtual environment. Adjunct Proceedings of the 2019 IEEE International Symposium
on Mixed and Augmented Reality, ISMAR-Adjunct 2019, 124–127.
https://doi.org/10.1109/ISMAR-Adjunct.2019.00-65

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The use of STEP analysis supported by virtual simulations in concept
development
Johan NORDSTRÖM (1), Kristofer BENGTSSON (1)
(1) Department of C4ISR, Swedish Defence Research Agency
Abstract: Development of new concepts for operations is difficult in cases where the technical
system is not accessible. The objective of this study is to explore the use of the method
Sequentially Timed Events Plotting, supported by virtual simulations for concept development
in cases where it is not possible to carry out practical tests and experiments with equipment.
The work was carried out as a case study aligned with the development of a concept for the use
of a new anti-tank missile system. Experiences regarding the concept development
methodology were collected through participatory observations, focus group interviews and a
questionnaire. The results showed that the combination of Sequentially Timed Events Plotting
and virtual simulations provided valuable insights for the concept development and that the
methodology is viable for developing new concepts where it is not possible to carry out practical
tests and experiments.
Keywords: Sociotechnical systems, Concept development
1. Introduction
The Swedish government has decided on the acquisition of a new, 5th generation, anti-tank (AT)
missile system for the Armed Forces. In order to enable a rapid introduction of the new system,
the development of a concept for the use of the new weaponry system needed to take place in
parallel with the acquisition. This meant difficulties for the group that developed the new concept
of use since they had no experience available regarding the use of the 5th generation AT system.
It was not possible to acquire the knowledge needed for concept development through practical
tests and experiments since (1) the AT system had not yet been acquired, (2) such tests would
require a relatively large amount of personnel, and (3) no personnel was fully trained in the use
of a 5th generation AT missile system. In order to deal with this problem, it was suggested that
the development of the concept would take place using a combination of Sequentially Timed
Events Plotting (STEP) and virtual simulations.
The objective of this paper is to explore an approach for concept development based on STEP,
supported by virtual simulations. The study was carried out as a case study in which a concept for
the operational use of the AT missile system to be acquired was developed.
2. Background
This chapter presents Sequentially Timed Events Plotting (STEP), virtual simulations and the
case study context.

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2.1 Sequentially Timed Events Plotting (STEP)
Sequentially Timed Events Plotting (STEP) is a method for modelling flows of events. The
method was suggested by Hendric and Benner in the 1980s, for representing accident sequences
(Favarò et al., 2013).
The STEP process includes identifying the actors (persons and objects) that are part of an accident
process and how they contributed. This is documented graphically in a STEP worksheet, where
actors are represented on their own line in the worksheet and elapsed time is represented on the
x-axis. Actions taken by the various actors are then plotted on the row representing the actor and
in the column that represents the time when the action was taken. The different events are then
connected to each other using arrows (figure 1). The graphical representation can be used to
identify if there is any data missing, and to test the relationships between different events
(Hendrick & Benner, 1987). Finally, when the STEP worksheet is completed, the graphical
representation can be used to identify safety problems and/or suggest measures to increase safety
(Hokstad et al., 2007).
Figure 1: Example of a STEP-worksheet.
Although STEP was originally developed for accident investigations, Nordström et al. (2020)
suggested that the method could be used to analyse procedures for how a task should be performed
before an accident has occurred. However, such an analysis presupposes that there is a clear
description of how the work should be carried out and a clear division of tasks between the
involved actors.
2.2 Virtual simulations
Virtual simulations are simulations accomplished by use of computers, which provide an artificial
environment in which people can act. A typical example of virtual simulations are flight
simulators for training pilots (Ҫayirci & Marinčič, 2009). However, the use of simulators is not
limited to training. They are also frequently used for development, for example of advanced driver
assistance systems in the automotive industry (Colditz et al., 2007).
The virtual simulations in the present case study were carried out in the simulation software
Virtual Battle Space 3 (VBS3), developed by Bohemia Interactive Simulations. VBS3 is used for
training of military personnel. The software enables dynamic scenarios with regard to events,
terrain, weather, available communication systems (radio networks) and level of difficulty. The
scenarios are presented to the participants in a “first person shooter” view (figure 2), but units are
also visible on a digital map. Actors that are not occupied by real people can be simulated in the
system. To facilitate after-action reviews VBS3 continuously records the simulations. The system
is currently in use in the Swedish Armed Forces for training of personnel in lower tactical levels,
which means that most officers and non-commissioned officers (NCOs) are familiar with the
software.

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Figure 2: The “first person shooter” view in the simulation software VBS3 (Photo: Swedish
Defence Research Agency).
2.3 The case study context
The case study included the methodology used to develop the new AT concept. The concept
development was carried out in three phases. In the first phase, an analysis was carried out using
the STEP model for a task similar to firing an AT missile. This analysis included identifying the
different events (or subtasks) that occur when firing a projectile as well as the actors involved.
Personnel from both the Swedish Armed Forces and the Swedish Defence Research Agency (FOI)
were involved in this analysis, and the results were documented in a STEP worksheet. This
worksheet then became the starting point for the development of the new AT concept.
The second phase included the identification of significant differences between firing a 5th
generation AT missile and the similar task. This included analysing whether there was a need to
consider the weather and terrain to a greater extent, whether the system would be used different
tactically or if there were any other important differences between the tasks. When the differences
had been identified, a workshop was carried out with six officers and NCOs from the future user
group and one officer from the Land Warfare Centre. The identified differences between firing
an AT robot and the similar task were presented to the officers and NCOs at the beginning of the
workshop. During the rest of the workshop these differences were applied to the STEP worksheet
from the first phase, which resulted in the identification of several shortcomings. The workshop
participants proposed suggestions on how to change the concept to address the shortcomings, and
the STEP worksheet was revised accordingly. This resulted in the identification of new
shortcomings, new proposals for change of the concept and new changes to the STEP worksheet.
This process was repeated until all participants agreed that the concept was good enough to be
tested in a virtual environment.
In the third phase, simulations in a virtual environment were carried out. The same people who
were involved in the second step of the development participated in this phase (except two
officers/NCOs who were absent during the reconnaissance described later in this paper). Since
the officers and the NCOs worked closely together in the same military unit they could be
considered a “real group”, as described by Drabek and Haas (1967).
In the beginning of the third phase, the participants from the Armed Forces were given the task
of defending a bridge from enemy troops. This bridge exists in reality and in order to make the
virtual simulations more realistic, a reconnaissance was carried out in the physical world. After
the reconnaissance the participants were given time to plan how they would handle the task. When
a plan was decided upon for the task, the simulations were carried out.
After each simulation, experiences from the simulations were discussed. Based on these
discussions the concept was changed and the STEP worksheet updated accordingly. After two
simulations, no more changes to the concept were made. After an additional five simulations with
increasing difficulty, to verify the concept, it was considered complete.

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3. Method
The study was carried out as a case study aligned with the development of a concept for how a
new 5th generation anti-tank (AT) missile system could be used within the Swedish Armed
Forces.
A case study is an investigation of a specific phenomenon, e.g. an event, a person or a group, in
its context (MacNealy, 1997). In order for case study methodology to be used, it must be possible
to define or delimit the system that is the subject of the study (Merriam, 1994). A case study
should follow five sequential steps: (1) Decide on and define the problem to study, (2) plan the
study, (3) systematically collect data, (4) interpret data, and (5) spread the results (MacNealy,
1997).
Data collection during the present case study was carried out through three activities: Participatory
observations, focus group interviews and through a survey. In the analysis, the collected data was
categorised into four themes: (1) Shortcomings and suggestions for improvement of the
methodology, (2) the efficiency and effectiveness of the methodology, (3) the contribution of the
different phases to the methodology as a whole, and (4) other comments regarding the concept
development.
3.1 Participatory observations
The authors of this paper actively participated in the concept development. In addition to carrying
out observations, they were also involved in the concept development in the following ways:
• Led the concept development.
• Contributed with knowledge about how the STEP model is used.
• Documented the results of the analyses in the STEP worksheets.
• Analysed the differences between the task initially analysed with STEP and firing an AT
missile, in collaboration with one officer from the Land Warfare Centre.
• Facilitated the dialogues that took place during the workshop and after the virtual
simulations.
• Developed the scenario used in the virtual simulations, in collaboration with one officer
from the Land Warfare Centre.
• Acted as a counterplay during the virtual simulations.
The authors' experiences and reflections of the concept development methodology were
documented after the concept development was finished. They were then used as a basis for this
paper.
3.2 Focus group interviews
Immediately after the workshop in the second phase and after the last virtual simulation,
participants’ views and experiences regarding the methodology used were collected through focus
group interviews. These interviews were short (approximately 30 minutes) and consisted of two
open-ended questions: (1) Does the methodology work for concept development, and (2) is there
anything that needs to be changed regarding the methodology?
The purpose of the focus group interview after the second phase was to collect experiences and
views on the methodology in order to, during the ongoing concept development process, make
changes to the methodology and address identified shortcomings in the methodology. The purpose
of the focus group interview after the concept development was completed was to collect data to
assess whether the methodology was good enough to use in future concept development and, if
so, how the methodology could be improved.

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3.3 Survey
An online survey was distributed to the officers and NCOs who participated in the concept
development (FOI employees excluded). The questionnaire contained questions about the quality
of the final concept, how the methodology contributed to the quality of the concept and the
participants’ attitude to using the methodology in the future. Of the seven participants who were
involved in the concept development, six (86%) answered the questionnaire.
4. Results
In general, the results showed that the methodology was efficient and contributed positively to
the results from the development of the new AT-concept. The methodology also facilitated
dialogue between developers and user representatives, and made it possible to see how changes
to parts of the concept would influence the concept as a whole.
4.1 Participatory observations
The development of the new AT-concept was found to be straightforward. In addition to factors
that can be attributed to the early involvement of committed and competent officers and NCOs
from the Swedish Armed Forces, it was noted that the use of STEP worksheets to visualize the
concept facilitated dialogue regarding the concept. The STEP worksheets made it easy for the
participants to overview the concept, which counteracted misunderstandings between the
involved participants. The overview obtained by the worksheets enhanced the discussions about
how a proposed change would affect other parts of the concept. The STEP worksheets were easily
revised when changes to the concept were decided upon, since it only involved moving post-it-
notes representing the different events and arrows connecting the post-it-notes to each other.
4.2 Focus group interviews
The result from the focus group interviews with the officers and NCOs that participated in the
concept development was that the methodology worked well. The participants were of the opinion
that the used methodology had enabled an efficient concept development, and that the result was
sound and constituted a good foundation that could be used for further development by the
Swedish Armed Forces. Some negative remarks were made, but these mainly concerned factors
that did not concern the methodology itself. For example, there was a desire to carry out the virtual
simulations with more participants. The focus group interviews did not result in any changes in
the methodology.
4.3 Survey
All six of the officers and NCOs who answered the questionnaire considered the quality of the
developed AT concept to be good. They also believed that the used methodology contributed to
the quality of the concept (figure 3). All respondents answered that they found the methodology
efficient and that they were positive about using the methodology in future concept development.
In response to an open-ended question regarding what was the best thing about using the
methodology, one of the respondents wrote that “it [the methodology] is resource efficient. It is
easy to change and try different what-if cases” (translation from Swedish by the authors). Other
answers to the open-ended questions described that the methodology contributed to a common
picture for all those participating in the concept development, e.g. the methodology “may have
bridged cultural differences between the participants and contributed to a common picture”
(translation by the authors).

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The methodology's contribution to
concept quality
5
4
2
1
0
Very small Small Fairly large Large Very large
extent extent extent extent extent
Figure 3: The respondents’ perception of the methodology’s contribution to the quality of the
concept.
Regarding problems with the methodology, two respondents answered that the methodology was
resource-intensive in terms of time and staff. One respondent also believed that it is difficult to
include all the aspects of the real world in a virtual environment.
Regarding how the different parts of the methodology relate to each other, most of the respondents
believed that the quality of the concept would have been worse if the virtual simulations had been
carried out without the prior STEP analysis (table 1).
Table 1: The respondents’ view on whether it would have been possible to carry out virtual
simulations without the prior STEP analysis or reconnaissance
Yes, with
the same
result
Yes, with a
slightly
worse result
Yes, with a
significantly
worse result
No
Would it have been possible to conduct
virtual simulations without using the
STEP-model?
1
2
2
1
Would it have been possible to conduct
virtual simulations without the
reconnaissance?
2
4
0
0
According to the answers to an open-ended question regarding in what way STEP contributed to
the methodology, one respondent wrote that STEP provided structure and clarified the interaction
between the different actors. Another respondent wrote that STEP provided “clarity on the course
of events and traceability in the chain of events”. However, one respondent experienced
difficulties in seeing the whole picture, i.e. the connections between the different events in the
STEP worksheet, and wanted to see a clearer compilation after the work was completed.
A majority of the respondents felt that the quality of the concept would have been slightly worse
if the reconnaissance had not been carried out (table 1). According to the survey participants, the
reconnaissance contributed positively to the concept development by providing those involved
in the concept development with a common image of the real physical world where the virtual
simulations were carried out. According to one respondent it also “highlighted practical aspects
that are easily forgotten in theoretical reasoning” (translation by the authors).
Number of respondents

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5. Discussion
STEP analysis supported by virtual simulations was explored in order to study its usefulness,
efficiency and effectiveness in concept development. The approach made it possible to gain
experience of using military equipment that has not yet been implemented, which makes it
possible to further refine the concept prior to implementation or more practical tests. This makes
the methodology useful in areas where it can be difficult or resource-intensive to carry out realistic
tests of a concept, such as concepts for military, police or rescue operations.
It could be questioned whether the accident investigation method (STEP) that is included in the
methodology is suitable for concept development. For the analysis of the virtual simulations,
applying STEP is not a problem since there is a documented chain of events regarding what
happened during the simulations. However, it is more of a challenge to use STEP before the virtual
simulations are carried out. Since the order structure and communication channels when using an
AT missile are strict and determined in advance, it is possible to use STEP to detect weaknesses
in the prescribed way of working, i.e. the concept. However, it is important to remember that the
staff, when applying the concept in a real situation, can deviate from the concept, either
consciously or by mistake. This is why it is of importance to test the concept under as realistic
conditions as possible. Here, virtual simulations fulfil an important function as they make it
possible to carry out many, rather realistic, experiments, without access to technical systems or
large resources.
The main advantage of using STEP is that the model provides a clear graphical representation of
the use of the system, which facilitates dialogue. However, this presupposes that the worksheets
are easily updated when changes are made to the concept, i.e. it is recommended to use a roll of
paper with lines for each actor, post-it-notes and arrows with a sticky backside rather than a
computer software for visualisation during the development phase.
The results from the case study showed that using STEP supported by virtual simulations for
concept development are effective and efficient. However, two answers to one of the open-ended
questions indicated that the approach is resource-intensive. At the same time, all respondents who
answered the survey stated that the methodology is efficient, which is somewhat contradictory.
Therefore, it should be emphasised that although the methodology can be said to be resource-
intensive, it required significantly less resources than the alternative, i.e. conducting the tests in a
military command and control training facility, which would have required 60–80 people.
Another advantage of using the methodology was that it gave rise to double learning where the
participating officers and NCOs, due to new knowledge developed during the concept
development, spontaneously began to refine the tactics based on the new opportunities that the
concept was perceived to provide. It also contributed to early user participation in the concept
development.
The quality of the case study would have benefited from diary entries having been kept during
the concept development. In the present study, notes on the authors' perceptions regarding the
concept development were written down after the development had been completed. This may
have resulted in the loss of some relevant thoughts.
Other factors, beside the methodology itself, that may have contributed to the quality of the
concept include the authors being involved in the development sharing their thoughts and opinions
and asking critical questions. This may have had a positive effect on the concept development
since brainstorming activities in “real groups” can be limited due to various types of group
pressure or fear of criticism by other group members (Drabek & Haas, 1967). On the other hand,
the authors were surprised as to how smoothly the work with the concept development went, and
attribute this to the methodology used rather than their own contributions during brainstorming.

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6. Conclusion
Using STEP in combination with virtual simulations as an approach for development of concepts
for carrying out military engagements was found useful. The approach enabled the user
representatives’ active participation in the development. The notation used in STEP provides the
possibility to identify flaws in the design of the concept. The virtual simulation provided an
important tool for quality assurance of the concept.
7. Future work
Future work will include studying how the outcome of the approach can be used in further steps
of the development, for instance, determining requirement of method, training and exercises.
Furthermore, future work can also include the use of alternative approaches to the virtual
simulation, such as mock-ups.
References
Drabek, T. E. and Haas, J. E. (1967). Realism in laboratory simulation: myth or method?. Social
Forces, 45(3), 337-346.
Ҫayirci, E. and Marinčič, D. (2009). Computer assisted exercises and training: A reference guide.
John Wiley & Sons, Hoboken.
Colditz, J., Dragon, L., Rüdiger, F., Meljnikov, D., Schill, V., Unselt, T., & Zeeb, E. (2007). Use
of Driving Simulators within Car Development. In Conference Proceedings DSC North
America, Iowa, September 2007.
Favarò, F. M., Jackson, D. W., Saleh, J. H., Mavris, D. N. (2013). Software contributions to
aircraft adverse events: Case studies and analyses of recurrent accident patterns and failure
mechanisms. Reliability Engineering and System Safety, 113, 131-142.
Hendrick, K. and Benner, L. (1987) Investigating accidents with STEP. Marcel Dekker Inc, New
York.
Hokstad, P., Dagfinn, M., Sakshaug, K., Kviseth Tinmannsvik, R. (2007). Kombinert bruk av
barrieremodell og STEP-analyser ved ulykkesanalyse i vegtrafikken. SINTEF, Trondheim.
Nordström, J., Bengtsson, K., Levin, B. (2020). Teoretiska utgångspunkter för utveckling av en
värderingsmetodik för människans insatser inom skadetålighet: En förstudie. Swedish
Defence Research Agency, Stockholm.
MacNealy, M. S. (1997). Toward Better Case Study Research. In IEEE Transactions on
professional communication, 40(3), 182-196.
Merriam, S. B. (1994). Fallstudien som forskningsmetod (B. Nilsson, trans.). Studentlitteratur,
Lund (Original work published 1988).

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Exploring Augmented Reality for Advanced Maritime Operations:
Opportunities and Threats for Operators
Henrik Aasgaard CARHO, Steven Cater MALLAM
Department of Maritime Operations, Faculty of Technology, Natural Sciences and Maritime
Science, University of South-Eastern Norway
Abstract:
Dynamic Positioning is a highly automated computer-based system that enables a vessel to
maintain its exact position with a high degree of precision. Operators monitor and interact
with specific Dynamic Positioning screens and input devices, increasing head-down time and
decreasing time spent monitoring their surrounding environment. This paper explores the
potential for head-mounted Augmented Reality to enable differing workflows, and define
information needs and presentation to better support Dynamic Positioning operators. Eleven
Dynamic Positioning instructors and operators were interviewed in a semi-structured format
with data transcribed and analysed using thematic analysis. Maritime Augmented Reality use-
cases were described, and relevant information operators required during specific operational
scenarios were defined. These results will be utilized in the development phase of Augmented
Reality demonstrators for further exploration, user-testing and integration in real-world
maritime operations through the ongoing industry-academia innovation project OpenAR.
Keywords: Situational Awareness, Digitalization, User-Centred Design
1. Introduction
Automation on ship bridges has increased over the past several decades in an aim to improve
operational efficiency and safety in maritime operations. Highly skilled operators manage
complex and dynamic operations at sea requiring specialized training and certification of crew.
Although safety at sea has improved greatly in comparison to previous decades (Allianz, 2021)
incidents and accidents still occur (Petroliumstilsynet, 2022). Differing types of vessels are
designed and deployed for different operational purposes and goals, and thus can have different
types of equipment, capabilities and crew onboard.
One of the most technologically sophisticated automated systems found onboard specialized ships
is Dynamic Positioning (DP). DP systems gather data from a plethora of sensors monitoring
external forces and ship movement providing inputs for the ship’s propeller and thruster systems
to maintain a desired position and heading with a high degree of accuracy (<1.0 meter)
automatically (Bray et al., 2015). Dynamic Positioning Operators (DPO) are specifically trained
and certified to operate DP, requiring them to monitor the system, interact with other bridge or
ship crew and monitor their external environmental surroundings necessitating a high degree of
Situational Awareness (SA). Without obtaining all three levels of SA the operator will not be able
to perceive all information about their current situation, comprehend and process that information
and project all possible outcomes based on that information (1988). Furthermore, the increased

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workload and number of tasks a DPO experiences throughout an extended work shift may make
it challenging to fully obtain all three levels of SA at any one moment. DPOs are responsible not
only for sharp-end active operations, but also maintaining day-to-day work as a general bridge
officer and part of a general ship’s compliment, such as periodic foreseen and unforeseen
maintenance, paperwork and administrative duties, thus making the range of work tasks far
greater than only DP-related operations.
Contemporary accidents involving DP still routinely occur (Petroliumstilsynet, 2022). Thus,
emerging solutions that support operators in complex safety-critical operations should be explored
to better understand their potential added value to system performance and safety, as well as their
foreseen and unforeseen threats. In order to improve a DPO’s ability perceive information from
automated systems, reduce head-down time and obtain better Situational Awareness of vessels
surroundings and operations the introduction of Augmented Reality (AR) head-mounted displays
(HMD) are one such area to explore the possibility to improve safety in advanced maritime
operations. Proof-of-concept demonstrators and research has been conducted on various aspects
of applying AR to maritime operations and operators working at sea. For example, in an early
article exploring the potential of AR applications in the maritime domain Grabowski (2015)
investigated piloting and navigation information needs and capabilities for AR, developing a
conceptual model for studying the technology’s impact on maritime performance and safety.
Hareide and Porathe (2019) investigated the use of AR for coastal navigation by presenting
navigation-related information, whilst Frydenberg et al. (2018) completed a field study onboard an
ice-breaker studying the potential interface design and information needs for a AR systems in
Arctic waters and ice navigation activities. Rowen et al. (2019) performed an empirical study
finding that an AR solution for maritime navigation improved operator track keeping, seamenship
and SA, whilst reducing operator responsiveness. In a recent review performed by Gernez et al.
(2020) it was found that although many examples of AR concepts for maritime operations exist,
they were primarily for ship’s bridges and navigation activities, as well as currently unsuitable
for real-world implementation and commercialization, arguing the need for the establishment of
AR-specific design requirements.
The aim for this study is to explore the specific advanced maritime operation and operator: DP
operations as DP operators. We investigate how AR could support DP operations, including
required information, use-cases in order to develop fundamental data for future design and
development of an AR DP solution. The following research questions are asked:
RQ1: What type of dynamic positioning operations could the operator benefit from Augmented
Reality Head-Mounted Displays?
RQ2: What information is needed to be displayed in the Augmented Reality Head-Mounted
Displays in order for the operator to safely perform their work?
2. Methods
2.1 Procedure
Qualitative data was collected through semi-structured individual interviews performed and
recorded digitally through videocalls. The interview guide consisted of demographic questions
followed by seventeen questions across four defined areas: (i) What information is important to
DPOs in operations? (ii) What challenges arise with current DP systems and operations? (iii)

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What operations are suitable for AR technology? (iv) What are their perceptions and experiences
with bridge technology and operations? The interviews were performed in Norwegian with the
data manually transcribed verbatim and translated to English. Data was collected between
February and March 2022. This data collection was approved by the Norwegian Center for
Research Data (Project ID: 643226).
2.2 Sample
The participant sample consisted of eight DPOs (of which one is under training) and three DP
teaching instructors (N=11; Age Avg=32.2yrs; Min=23yrs; Max=65yrs; Sea Experience
Avg=11.6yrs; Min=3yrs; Max=45+yrs). The desired sampling aimed for diversity across the
participants, not only in age and experience, but across differing types of vessels and operations
served onboard, thus providing a wider range of knowledge and examples to draw from.
2.3 Data Analysis
The data was analysed using thematic analysis following its six phase procedure: (i)
familiarisation, (ii) coding, (iii) theme development, (iv) reviewing, (v) defining themes and (vi)
producing the final report (Terry et al., 2017). The coding and sorting of the data was performed
using the digital tool NVivo. Part of the coded data was also examined using content analysis to
map common phrases and words used by participants.
3. Results
A summary of the main findings is presented in Table 1.
Table 1. Summary of main findings in relation to each research question and defined theme
RQ Theme Main Findings
RQ1 Types of operation: Platform supply, Construction, Inspection, Maintenance, and
Repair above the sea surface (topside) or subsea, Anchor Handling
and Windmill construction or maintenance
RQ1 Section i: Any of the operations mentioned above where the DPO has a
visual reference or an object to watch over topside.
RQ1 Section ii: Any of the operations mentioned above where the DPO has NO
visual reference or an object to watch over topside.
RQ2 Data needed by a DPO: Position references, Thrusters, Position and Vessel movement,
Wind and Weather, Power consumption, Consequence analysis and
Cargo movement
RQ2 Suggested information by
participants: Alarms, Camera feeds and blind spot coverage, Traffic, No-go
zones, Dangers and Winch information
3.1 Operations
Two major themes emerged in analysing the data in relation to relevant types of operations where
AR would benefit DPO: (i) Operations where the DPO has a visual reference or an object to watch
over above the ocean surface (topside), (ii) Operations where the DPO has no visual reference or
object to watch over topside. As subsea is a collective term for many different types of operations
performed, the operations covered by the experience of the participants were then selected for
discussion during interviews (see Table 2). Participants described the potential benefits of AR in
reducing the head down time while maneuvering in complex operations. For example, one
participant described a typical scenario requiring vessel maneuvering very close to an offshore

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platform or windmill, where the situation is constantly evolving. Highly dynamic conditions,
variable loading and weather conditions must be managed by DPOs and the bridge team and in
many cases one’s attention must be split in order to receive the necessary information from
differing sources at differing points in time. Participants also discussed the relatively new, and
rapidly developing, area of offshore windmill construction and maintenance, noting that it lacks
regulatory framework for DP operations in comparison to the more established offshore oil and
gas industry, and thus standardized procedures are in place. However, the participants were
generally open to the concept of AR solutions in DP operations but described concerns on the
accuracy and latency of a future AR system. Participants described the need for high levels of
trust in the system, especially for the required high accuracy of DP systems, with one participant
noting: “S#&t in equals s#&t out, you see if you put bad information through the system, the
system is going to serve you bad information or actions.”
All operations discussed in section ii found all eleven participants generally negative towards the
use of AR solutions with no visual reference (see Table 2). The common factor in this category
was that if the DPOs are engaged in an operation where there is nothing surrounding the vessel in
close vicinity, they are locked to the DP screen to get an understanding of how the vessel is
moving and watch over operational data. One participant stated: “In subsea or construction when
you don’t have any visual reference nearby, I’m struggling to see the relevance. In cases where
you don’t have a reference you are so locked to the screen, and I fear that you will not be able to
get the amount of information needed to be projected on the glasses and the ability to easily control
or interact with the information through the glasses.” The one operation that was mentioned in
this section was inspection operations where the vessel has to move at a constant speed relative to
an object underwater and easily track the target.
Table 2. Summary of main findings for AR applications in Dynamic Positioning operations.
Theme
Operations
covered by
data:
Main findings
The following operations were covered by the
collected data: Platform supply, Construction,
Inspection, Maintenance and Repair above the sea
surface (topside) or subsea, Anchor Handling, and
Windmill construction or maintenance.
Feedback
All these operations were during data collection naturally divided into two subsections.
Type of
operation Section i:
Section ii:
Any of the operations mentioned above where the
DPO has a visual reference or an object to watch over
topside.
Any of the operations mentioned above where the
DPO has NO visual reference or an object to watch
over topside.
Mostly Positive
Mostly Negative
3.2 Information Type and Placement
The participants were asked two questions about what information is important to them in DP
operations. Table 3 presents the results of the content analysis of most commonly mentioned terms
and phrases. The theme all participants discussed were position reference data, these support
systems correct or support any position signal for the vessel allowing for the accurate positioning
and manoeuvring. Thruster direction and force was mentioned to be important not only to see how
the thrusters, and thus ship movement, are acting, but to understand how the DP

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system is currently working and thus have deeper knowledge of the current operational situation.
Similarly, position and vessel movement (Posplot), the visual representation of the vessel on the
Graphical User Interface at the DP control station, monitors, and plots where the vessel is in
relation to the set target position. This can vary (i.e. the reality of vessel position vs. the set desired
position) and thus the visual representation of the Posplot, paired with current thruster and posref
data, gives key information to provide a good understanding of real-time DP system functioning
and overall operational situation. Wind and weather conditions, power consumption, distance to
surrounding objects (e.g. offshore platforms, other ships, etc.), consequence analyses (i.e. real-
time probability analyses of differing operations) and cargo movement tasks are inputs which
affect the previously mentioned information sources, and thus decision-making, mentioned by
participants.
Table 3. Results of content analysis of common phrases on information.
Theme
Number of participants
mentioning
Number of times
mentioned
Position refrences (Posref)
11
16
Thrusters, direction and force
7
9
Position, Posplot
7
8
Wind and weather
4
4
Power consumption
2
3
Distance to object
2
3
Consequense analysis
1
1
Cargo movement
4
4
During the interviews participants made several suggestions on what type of information that
could be displayed in the AR HMD in addition to the types of information that was mapped as
important to them. The following subjects were mentioned. Alarms, some participants suggested
making a common alarm panel to gather all alarms at one place. Camera feeds and blind spot
coverage was one of the most mentioned. Moving all of the camera feeds that are used in some
types of operations removing unnecessary screens, and also use cameras to cover the many
possible blind spots that can be found on the bridge, there was also a suggestion of a “back-up”
camera for operations where the operator is seated with their back towards the direction of travel.
Traffic was also mentioned, when operating in areas of heavy traffic having vessel information
such as speed and direction of travel displayed. No-go zones and dangers around platforms and
windmills could be displayed to avoid the operating manoeuvring the vessel into these areas.
Winch information for anchor handling operations was suggested, with this suggestion also comes
a possibly new user, the winch operator.
4. Discussion
The collected data of this research sheds light on how DPOs perform their duties in a range of
operations. The results indicate what type of data and information is important to the DPO for
them to safely perform their work, and some suggestions on information was presented in relation
to future AR HMD solution development. The participants were overall largely positive towards
the AR solutions for operations proposed in section i and discussed the potential and how it may
benefit them as a DPO and stay in control during a DP operation. But as Grech & Horberry (2002)
mention, this type of technological solution may not necessarily improve SA, but actually
increased information processing and workload. As Rowen et al. (2019) found, although SA was

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found to be improved in maritime operators during navigation activities, their responsiveness was
reduced. Thus, trade-offs in differing aspects of operator performance may be introduced with
differing AR solutions. For the operations discussed in section ii the results were mostly negative,
with participants arguing a need for a large amount for information to be displayed. The selective
attention in human information processing may then be disturbed or controlled due to the salient
features of the information and how the information is presented very close to the users’ eyes.
This may turn the focus attention of the user to purely focusing on the information and not the
surroundings (Wickens & Carswell, 2012) and therefore in operations in section ii work against
its intended purpose. If not moderated to an appropriate level the information presented could also
challenge the working memory of the operator by it selves or if other outer factors raise the
difficulty of the operation, and an overload of the working memory could lead to failure of up to
level 2 SA (Wickens & Carswell, 2012).
A general argument that was raised by those negative towards the idea of the AR HMD for both
section i and ii was their uncertainty in the technology. A big part of introducing this new
technology will be to develop a proper training and certification program that will build the DPO’s
trust in the technology. To do this it will be important to show the accuracy and educate the
operators on the technology and its working properly (Lee & Moray, 1992). The history of new
technology on ships reflects this, as Kjerstad (2015) mentions in the history of ECDIS, the overall
intention was to improve maritime safety, but upon initial implementation actually negatively
impacted safety, causing an increase in the number of groundings due to poor training, design and
implementation. Tang and Sampson (2017) note the importance of training when introducing new
technologies in order to avoid “technology-assisted failures.” Governing rules from DNV (2021),
one of the largest class societies of DP vessels in the world, dictates that for thrusters it is not
enough to have information on them displayed on the DP control station, but they also need to
have individual displays for each thruster. These same rules also dictate that the display unit,
control station, shall display a position plot to monitor the vessel movement as well. However, as
Gernez et al. (2021) note, no such regulations or design guidance currently exist for maritime AR
solutions. In the development of the highly automated, highly complex DP system specific design
guidance and integration should be developed in order to ensure sufficient integration success into
the bridge and vessel operational system.
Regarding the suggestions from the participants, some are fitting others should possibly be
avoided. Alarms and creating a digital alarm central in the HMD due come with dangers. As
Bainbridge (1983) describes, a proliferation of flashing red lights may cause more harm than good
in emergencies. And in the case of an emergency, other than just the wearer of the HMD should
be able to monitor the same alarm panel, therefore, it might not be sound to place an alarm panel
in AR. Using AR to present camera feeds and to cover blind spots should, as long as it does not
take away the focus attention of the user, may not be a problem. Also, using the combination of
cameras and AR to cover what are normally blind spots would improve the vigilance of the
operator, and as Endsley and Kiris (1995) present, when trying to stay in the loop while working
with automation vigilance is key for the operator. Highlighting no-go zones and dangers around
platforms and windmills has some related existing research in Frydenberg et al. (2018) which
investigating using AR in ice navigation and highlighting dangers when navigation through the
ice. A potential bonus addition to the AR HMD is that they may improve ergonomics for the user
reducing needed head movements and strain on the wearer’s neck, but this would then depend on
the weight of the AR HMD and what they feel like to wear when the vessel is moving at sea over
longer periods of time. If this is not a problem and the ergonomics of the user improve, there are

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additional benefits or financial gain (Beevis & Slade, 2003), and this cost benefit could be what
is needed to convince ship owners to invest in the technology.
4.1 Limitations
The study sample was drawn from Norwegian seafarers, holding a mix of experience in years at
sea, number of vessels served on and types of operations, however not exhaustive. Given this
sample profile, and its smaller size, the validity and generalizability of findings may be debated.
However, it could be argued that for such specialized operations, specifically trained and certified
participants, the generalizability to other DP operations and operators is possible. There is no
standard for terminology within the field of DP, this made the data more complex to translate and
analyse. However, the flexibility of the semi-structure interview format and ability to clarify and
ask follow-up questions with participants and categorize similar meanings within themes using
thematic analysis allowed for clarification and improved outcomes.
5. Conclusions
This paper explored (i) what type of DP operations could the operator benefit from AR HMD and
(ii) what information is needed to be displayed in the AR HMD in order for the operator to safely
perform their work? Results defined scenarios and use cases where AR HMD was perceived to
be mixed, where added value for DPO in DP operations was argued for within specific scenarios,
but not necessarily for operations as a whole. This points towards the need for systematic, user-
centred implementation of the technology. These results will be utilized in the development phase
of Augmented Reality demonstrators for further exploration, user-testing and integration into real-
world maritime operations.
Acknowledgments
This work was partially funded by the Research Council of Norway through “OpenAR –
Framework for augmented reality in advanced maritime operations” (project no: 320247).
6. References
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and developments in shipping losses and safety.
https://www.agcs.allianz.com/content/dam/onemarketing/agcs/agcs/reports/AGCS-Safety-
Shipping-Review-2021.pdf
Bainbridge, L. (1983). Ironies of automation. Automatica, 19(6), 775–779.
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Beevis, D., & Slade, I. M. (2003). Ergonomics—Costs and benefits. Applied Ergonomics, 34(5),
413–418. https://doi.org/10.1016/S0003-6870(03)00061-9
Bray, D., Daniels, J., Fiander, G., Foster, D., & Nautical Institute (Eds.). (2015). DP operator’s
handbook (Second edition). Nautical Institute.
DNV. (2021). DNV RU-SHIP Part 6, Chapter 3: Navigation, manoeuvring and position
keeping. DNV.

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Endsley, M. (1988). Design and Evaluation for Situation Awareness Enhancement. Proceedings
of the Human Factors Society Annual Meeting, 32(2), 97–101.
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Endsley, M., & Kiris, E. (1995). The Out-of-the-Loop Performance Problem and Level of
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Heuristics for human multi-purpose robot interaction
Susanna AROMAA (1), Hanna LAMMI (1), Taru HAKANEN (1)
(1) VTT Technical Research Centre of Finland Ltd., P.O. Box 1300, 33101 Tampere, Finland
Abstract: Heuristic evaluation is a quick method for identifying possible design problems in the
development of technology solutions. This paper describes a development process of heuristics
for designing and evaluating interaction between humans and multi-purpose robots. The set of
heuristics was iteratively developed. As a result, eight heuristics for human multi- purpose robot
interaction are proposed. The heuristics can be used by human factors experts and others who
are designing and evaluating human-robot interaction.
Keywords: Heuristic evaluation, human-robot interaction, human factors method.
1. Introduction
Heuristic evaluation is a quick method for identifying possible design problems in the
development of technology solutions (Nielsen, 1994). “Heuristics describe essential attributes
that a system should feature to ensure that the user is able to perform a task within a specified
context in an effective, efficient, and satisfying way” (Weiss et al., 2011). The heuristic evaluation
is often conducted by experts who utilise heuristics as a checklist or rules of thumb. The basic
approach for creating new heuristics is to extract existing information and transform it into
heuristics (Hermawati & Lawson, 2016). In addition, more detailed process descriptions of
creating usability heuristics are introduced, e.g., Hermawati & Lawson (2015) and Quinones et
al. (2018). However, there is no established protocol of how to formulate, validate and refine
heuristics (Hermawati & Lawson, 2016; Quinones & Rusu, 2017).
While general usability heuristics are useful in the design of most interfaces, there is still a need
for heuristics that are specific to a certain domain (Hermawati & Lawson, 2016; Quinones &
Rusu, 2017). For example, when considering usability, robotics differ greatly compared to the
traditional screen-based computer systems: there are a variety of robot types; robots can be used
for many different purposes; robots are multimodal, intelligent and powerful, and robots are by
nature anthropomorphic (Shamonsky, 2021). For the human-robot interaction (HRI) domain,
some heuristics are proposed: e.g., Clarkson & Arkin (Clarkson & Arkin, 2007) and Shamonsky
(Shamonsky, 2021) provide general heuristics for HRI systems, Giang et al. (Giang et al., 2019)
propose heuristics for educational robotics systems and Tsui et al. (2010) describes heuristics for
assistive robotics. In the HRI domain, general heuristics are applicable and highlight topics
specific to HRI. However, the domain is board (e.g., industrial, service, military, space
exploration, education, health, entertainment (Onnasch & Roesler, 2021)) and therefore, the
development of HRI systems could benefit heuristics which are designed for a specific purpose.

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The new emerging HRI area concerns multi-purpose service robots. Multi-purpose robots can
perform complementing tasks, in addition to their primary task, either simultaneously with the
primary task or at a different time of day. Multi-purpose service robots operate in many kinds of
tasks (e.g., internal logistics, professional cleaning, inspection and maintenance) in many kinds
of environments (e.g., industrial settings, airports and shopping malls). In addition, these multi-
purpose robots may operate together and be orchestrated by a fleet management system. These
sorts of multi-purpose robots are currently emerging in the professional service robotic markets.
The motive for developing such robots is the need for gaining higher utilisation rate and
profitability in service robot utilisation (Hakanen et al., 2022).
Human-robot interaction design could benefit from a heuristic style of quick and cost-effective
human factors (HF) evaluation method, for example, when designing collaborative multi-purpose
robots. This could ensure that robots are applicable to perform multiple tasks, to collaborate with
multiple users and to fit different kinds of usage environments (e.g., a shopping mall or a factory
floor). The focus of this paper is on multi-purpose, professional service robots that robot suppliers
provide for business (B2B) customers. The paper describes a development process of heuristics
for human multi-purpose robot interaction. Section two describes the methodology used. Then,
the set of heuristics is proposed in section three, discussed in section four and finally, the main
conclusions are drawn in section five.
2. Methods
This section describes the iterative co-creation process of human multi-purpose robot interaction
heuristics. The development process of heuristics was adapted from Quinones et al. (2018). They
posed a seven-step process for creating usability heuristics: the exploratory stage, the descriptive
stage, the correlational stage, the selection stage, the specification stage, the validation stage, and
the refinement stage. In this study, steps from two to five were iteratively emerged as one step
and therefore, the final process included four main phases: (1) the exploratory phase, (2) the
iterative formulation of heuristics, (3) an expert review of heuristics and (4) the refinement phase
(Figure 1).
Figure 1. Iterative co-creation process of the heuristics.
The exploratory phase was conducted by two HF research scientists. A literature review was
conducted of HRI heuristics, other domain heuristics and general heuristics. In addition,
developed HRI-related questionnaires/frameworks, human-centred design approaches and
previous experience in HRI projects were explored.
After the exploration phase, the most critical themes for HRI were identified and then transferred
to a first draft of heuristics. In the initial version, there were seven heuristics (themes) which were
elaborated with a couple of sentences of description and with a longer description in a three-
column table. When formulating heuristics, the focus was on special characteristics related to HRI
and especially on multi-purpose robots. The proposed list was targeted to the HRI domain, and
the purpose was not to substitute current usability heuristics lists rather than propose a
supplementary one for a multi-purpose robot area.

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The proposed heuristics list was reviewed by an expert panel of three HF experts, each with more
than 15 years of experience in user studies in developing technologies primarily for an industrial
work context. Scenario-based design (Carrol, 1999) was used as an approach to support the expert
review. The scenario-based approach was chosen because it provides an easy way to illustrate
novel systems in a future context (Carrol, 1999). A scenario description contains actors and a
description of their environment, goals and objectives, as well as sequences of actions (Go &
Carroll, 2003). Two different illustrative scenarios were created to support the review of a
heuristics list: a multi-purpose mobile robot at a factory floor and an automated guided vehicle in
supporting assembly work (AGV) (Figure 2). First, an introductory meeting with the review panel
was arranged to present the heuristics and the two scenarios. Then, the expert panel members used
the heuristics for the evaluation of the two scenarios. Each did the task independently and wrote
down both HF issues related to the scenario as well as comments on the heuristics list. Finally,
there was a meeting in which all heuristics were gone through together, and the experts were able
to elaborate their comments. The experts signed a consent form and the final meeting was
recorded. All meetings were held online in Teams.
Figure 2. Human-robot interaction with a multi-purpose mobile robot at the factory floor (scenario
1) and a human-robot interaction with an automated guided vehicle (scenario 2).
All the HF experts agreed that the proposed heuristics were relevant for HRI. Most of the
comments were related to the consistency of the wording, unclear sentences, and a need for
improving the definitions. After the expert review, the heuristics were refined. The final version
of the heuristics list included eight heuristics with a description.
3. Results
Based on the iterative co-creation process, the set of heuristics was refined to following list: (1)
fit for users; (2) fit for tasks; (3) fit for usage environments; (4) target smooth interaction; (5) keep
users informed of the system status; (6) provide appropriate appearance and aesthetics; (7) ensure
safety and build trust, and (8) align with ethics (Table 1). The HRI heuristics template was updated
based on the expert review from the initial three-column template to a two-column template

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including heuristics and descriptions. In addition, the wording of the heuristics was homogenised
to have a standardised formulation. When developing heuristics, it is also possible to introduce a
rating or weighting system to judge the compliance level towards heuristics (Hermawati &
Lawson, 2016). At this stage, the rating system was not introduced due to the multi-purpose robot
approach. For example, it is challenging to propose only one rating value per theme if the robot
is used for different purposes by different users in different locations.
Table 1. Set of heuristics for human multi-purpose robot interaction.
Heuristics Description
Fit for users Define different user groups and understand their needs for human-robot
interaction. Interaction should not require physically or cognitively
challenging actions. If possible, adapt to users’ capabilities, skills and
preferences.
Fit for tasks Understand the goal of the task(s). Select or design a proper robot type
that is suitable for the task(s). Consider task allocation between the robot
and the human. Understand how different tasks affect one another
(correlation between tasks) and ensure multi-purpose service robots’
smooth transition from one task to another. Integrate smoothly with other
processes if needed.
Fit for usage
environments
Target to smooth
interaction
Keep users
informed of the
system status
Provide
appropriate
appearance and
aesthetics
Ensure safety and
build trust
Understand the usage environment where the robot is used. Select or
design a proper robot type that is suitable for the environment (e.g.,
robustness). Understand static and dynamic factors in the environment
that affect the use of the robot (e.g., other traffic, obstacles, climate).
Identify changes in the environment that are needed for robot use.
Users should be able to use existing and commonly agreed upon
interaction modalities which support natural and intuitive use. The robot
should be easy to use and easy to learn to use (i.e., effectiveness,
efficiency, learnability). Clear feedback from the robot is important. If
needed, also use other heuristics to support traditional user interface
design (e.g., Nielsen’s 10 heuristics).
Ensure availability of the system status. Inform users and other people
nearby of the robot’s current tasks, upcoming tasks, possible errors, need
to charge and/or other intentions (e.g., movements, change of direction).
Consider how much information is provided immediately and how
additional information can be retrieved. Keep relevant stakeholders
informed (i.e., in the loop).
Aesthetics and functions of the robot should be designed in such a way
that they evoke feelings suitable for the intended task and interaction. The
robot should be approachable and accepted by different user groups. Pay
attention to the issue that if the robot is used in a different context or
environment, the same function may evoke different kinds of feelings.
Follow safety standards and perform required risk analysis before
bringing the robot into use. The robot should not harm its users, people
passing by or itself. The users should be able to trust the robot and the

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information it is giving. Build trust, for example, by providing the logic
behind the robot’s actions and decisions. Minimise the risk of misuse.
Align with ethics The use of the robot should not feel questionable for users and other
stakeholders/passers-by. Identify the data the robot is collecting and how
data is stored and shared. If the robot is collecting data, the users’ and
other people’s privacy should be respected (e.g., GDPR). Follow ethical
guidelines to ensure privacy, autonomy, dignity, reliability, inclusion and
benefit to society.
The first three heuristics are essential to understand the context of use (International Organization
for Standardization, 2019). The purpose of fit for users is to pay attention to different users and
user groups. Especially concerning multi-purpose robots, there can be many kinds of users (e.g.,
shopping mall client or factory floor worker). This point also highlights the design of robots to
enhance human capabilities and support humans rather than humans adapting themselves to a
robot behaviour.
Fit for tasks is important to consider when designing which kinds of tasks multi-purpose robots
should perform. There need to be discussions regarding of which kinds of robots are suitable for
tasks and how tasks are allocated between robot(s) and human(s). The whole process should be
smooth when multi-purpose service robots are changing from one task to another.
In the context of use, fit for usage environments need to be carefully examined. For example, the
robot may have different requirements when operating in a shopping mall (clean environment but
lots of traffic/people) and a factory floor (the environment may be dirty but moving is easier
because of defined traffic rules). In addition to designing and modifying a robot to suit a specific
environment, it may be required to modify the environment to be suitable for the robot (e.g., no
obstacles on the robot’s route).
It is important to target a smooth interaction between humans and robots. Interaction modalities
should support natural and intuitive use. When interacting with multi-purpose robots, it could be
beneficial to have different modalities to choose from since some may be more suitable in a
different context than others (e.g., voice interaction could be suitable for a shopping mall, but it
is not the best solution for a noisy factory). When designing and evaluating interaction and user
interfaces, other applicable usability heuristics are also recommended for use.
In the human-robot interaction, it is a necessity to keep users informed of the system status. Multi-
purpose robots can have several different tasks to perform, for example, their main task could be
to deliver parts on a factory floor, and as a secondary task they could inspect machines’ condition.
In this example, a worker needs to know if they can intervene in the robot’s work and, for example,
request a part delivery from the robot. In addition to users, there can be other stakeholders that
need to be informed of the robot’s (or robot fleet’s) status.
How to provide appropriate appearance and aesthetics is noteworthy especially with the multi-
purpose robots. Multi-purpose robots may have a variety of users from the children to the expert
industry workers. The user groups have different expectations and needs for the robot interaction.
The same robot appearance may suit one use scenario, but in another scenario, it may raise some
concerns (e.g., a robot needs a smooth voice when guiding shopping mall customers to the right
shops, but in case of emergency, the voice needs to be loud and clear).

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When designing HRI, it is important to ensure safety and build trust. Comprehensive risk analyses
are highly recommended for the multi-purpose robots. In addition, the robots are becoming
smarter due to the emergence of artificial intelligence. In HRI, it is important to understand robots’
subsequent actions and the reasons behind them (e.g., why the robot didn’t finish the task at hand
but changed over to perform another task). This visibility and openness will increase the trust
towards the robots.
Interacting with the robots needs to be aligned with ethics. The use of robots should not feel
questionable for the users. Robots often sense their environment and collect data from it. Which
data is collected and how people in the vicinity are informed of the collection of data should be
thoroughly considered. For example, in the shopping mall, it is not appropriate if the robot is
video recording a person at a cashpoint/ATM. There can also be broader ethical issues to consider
in the use of robots, e.g., what the impacts are for society.
4. Discussion
In the iterative development of the heuristics, the most challenging part was to transform the
extracted information into the heuristics set that is comprehensive and easy to understand. There
are suggestions for heuristic creation processes, e.g., Hermawati & Lawson (2015); Quinones et
al. (2018) and reviews of how heuristics have been created e.g., Hermawati & Lawson (2016);
Quinones & Rusu (2017). These focus more on the process and its steps and do not provide details
concerning how to formulate good heuristics (e.g., which kind of wording to use). However, it is
identified that it is important to target for clear and homogenous heuristics, which are well-defined
and easy to understand (Quinones & Rusu, 2017). During the iterative co-creation process, the
HRI heuristics template was changed after the expert review from a three-column template to a
two-column template. The expert panel did not disagree with the three-column approach, but it
was seen as easier to achieve homogenous and clear heuristics with the two-column approach.
In the formulation of the heuristics, the nature and complexity of the human multi-purpose robot
interaction created challenges. Due to the multi-purpose nature, there can be multiple robot users,
multiple tasks to perform and the robot can operate in multiple locations. Shamonsky
(Shamonsky, 2021) already highlighted that the usability studies in HRI are more complex than
in a screen-based computer system design, but the “multi-dimension” drives the complexity even
further. This is a common challenge in the field of human-centred design: to provide HF methods
for complex intelligent systems design and evaluation rather than developing, e.g., heuristics to
be used in a design of a singular human-technology interaction system.
Utilising visualised scenarios as a part of the expert review was considered useful. The scenario-
based approach was easy to arrange and made it more concrete for HF experts to try out and
evaluate the relevant heuristics. However, HF experts stated that sometimes it was difficult to
evaluate the HRI because the scenarios were not detailed enough. To improve the level of details
in the scenario-based validation, a taxonomy to describe and illustrate interaction with the robot
(Onnasch & Roesler, 2021) could have been used.
As a limitation of the study, the proposed heuristics were validated by one group of experts by
using HRI scenarios. To refine and develop heuristics further, the effectiveness of the heuristics
should be considered within real use cases. Hermawati and Lawson (2015) state that including
users in the validation process, in addition to experts, could be beneficial.

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5. Conclusions
Heuristic evaluation is an easy-to-use method of analysis for identifying possible design
challenges. The goal of this paper was to introduce the development of the heuristics for the
human multi-purpose robot interaction. The goal was to strengthen the human factors (HF) aspect
of human-robot interaction (HRI) design and research. This paper is among the first ones to
address the HF perspective related to multi-purpose aspects of the service robotics domain.
Eight heuristics were suggested: (1) fit for users; (2) fit for tasks; (3) fit for usage environments;
(4) target to smooth interaction; (5) keep users informed of the system status; (6) provide
appropriate appearance and aesthetics; (7) ensure safety and build trust, and (8) align with ethics.
This set of heuristics is in addition to existing usability heuristics and does not replace them, but
instead complements them with a focus on multi-purpose robot use.
As a next step, the set of HRI heuristics will be tested within real use cases to gather feedback on
its usefulness, and iteratively develop it further. The HRI heuristics can be used by HF experts
and others who design and evaluate HRI.
Acknowledgements
This work was supported by Business Finland and VTT Technical Research Centre of Finland
Ltd. The authors are grateful to all who have contributed to and supported the work presented in
this publication.
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Clarkson, E., & Arkin, R. C. (2007). Applying Heuristic Evaluation to Human-Robot Interaction
Systems. Flairs Conference, 44-49.
Giang, C., Piatti, A., & Mondada, F. (2019). Heuristics for the development and evaluation of
educational robotics systems. IEEE Transactions on Education, 62(4), 278-287.
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for human-computer interaction (Vol. 117).
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Excellence in Management, QUIS17, Universitat Politècnica de València, 391-397.
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Nielsen, J. (1994). Enhancing the explanatory power of usability heuristics. In Proceedings of the
SIGCHI Conference on Human Factors in Computing Systems, 152-158.
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Quinones, D., Rusu, C., & Rusu, V. (2018). A methodology to develop usability/user experience
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centered HRI. New Frontiers in Human–Robot Interaction, 2, 89-110.

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Effects of prismatic loupes on surgeons’ postural and
muscular neck workload
Xuelong Fan1*, Liyun Yang1, Magnus Kjellman4, Mikael Forsman1,2,3
1. IMM Institute of Environmental Medicine, Karolinska Institutet, SE-
171 77 Stockholm, Sweden;
2. Division of Ergonomics, School of Engineering Sciences in Chemistry,
Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen
11C, 14157 Huddinge, Sweden;
3. Centre for Occupational and Environmental Medicine, Stockholm
County Council, SE-113 65 Stockholm, Sweden
4. Department of Molecular Medicine and Surgery, Department of
Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden;
*Corresponding author email: xuelong.fan@ki.se (X.F.)
Background and purpose
Work-related musculoskeletal disorders (WMSDs) are prevalent among surgeons who
perform open surgeries, especially in the neck. Surgeons traditionally use amplifying
loupes during precision surgeries, which induce a statically forward bent head and a
physical workload on the neck. This study aimed to evaluate the effects of prismatic
loupes on surgeons’ physical workload.
Methodology
Eight surgeons who performed open surgeries were included. A repeated measure
design was used where each surgeon conducted three surgical tasks (in order of peg
transfer, PT; basic suturing, BS; and precision cutting, PC) with surgeon’s own loupes,
low-tilt (LT) and high-tilt (HT) prismatic loupes in an order that was randomized and
balanced. The neck physical workload included: head inclination measured by inertial
measurement units and muscle activities of cervical spinae erector (CSE) measured by
electromyography. Friedman’s test was used for overall comparisons of the three loupes,
and Wilcoxon’s signed-rank test with Bonferroni’s correction was used for post-hoc
analyses.
Results
In comparison to the surgeons’ own loupes, the 50th percentile of head inclination was
significantly lower when using either pair of prismatic loupes during PT (median, own,
40°; LT, 26°; HT 19°; LT vs own, P = 0.035; HT vs own, P = 0.035), BS (median, own, 44°;
LT, 28°; HT 21°; LT vs own, P = 0.035; HT vs own, P = 0.035) and PC (median, own, 40°;
LT, 24°; HT 20°; LT vs own, P = 0.035; HT vs own, P = 0.035), and the peak CSE muscle
activity was significantly lower on both side only when using LT during BS (e.g., right
side median %MVE, own, 12.0; LT 10.0; own vs LT, P = 0.035) and when using HT during
BS (e.g., right side median %MVE, own, 12.0; HT 7.1; own vs HT, P = 0.035) and PC (e.g.,
right side median %MVE, own, 15.1; HT 9.8; own vs HT, P = 0.035).
Discussion with practical implications

229
Both prismatic loupes decreased head inclination for surgeons for all tested surgical
tasks, but only 1 task for the LT prismatic loupes and 2 tasks for the HT showed lower
neck muscle activity. This was the first study that systematically used multiple
instrumental measurements to investigate prismatic loupes' effects on surgeons.
Conclusions
Using prismatic loupes during open surgeries can reduce the surgeon's physical
workload in the neck with a lowered head inclination and neck muscle strain. This may
contribute to the well-being of the surgical workforce in the long term and better quality
of surgical care. The next phase of this project is to investigate the effects of prismatic
loupes over a longer duration during real surgery cases.
Keywords. Prismatic loupes, surgical ergonomics, neck workload

230
Methodologies for a Performance Based Approach to
Ergonomics Programs
Michael, Rachel
Exponent EHF, LLC
rachel.michael@exponentehf.com
Ergonomics programs have now been in place in industry for almost 30 years. While
there are many modalities to failure and a lack of sustainability, persistent organizations
consistently and continually see a clear financial return on investment. Ergonomics
program are largely performance, rather than specification, based and thus may see
greater performance from close alignment with departments and initiatives such as ISO
45001 rather than traditional employee health and safety.
Learning Objectives:
1. Attendees will learn the difference between specification and performance based
ergonomics programs.
2. Attendees will learn how to align performance based ergonomics approaches with
other similar programs such as ISO 45001
Keywords. Ergonomics, ergonomics programs, organizational performance, iso 45001

231
Resilience and preparedness in maritime training –
current approaches and research gaps
Praetorius, Gesa1; Sellberg, Charlott2 & Pauksztat, Birgit3
1 The Swedish National Road and Transport Research Institute (VTI)
2 Göteborg University, Sweden; 3 Uppsala University, Sweden
gesa.praetorius@vti.se
This study presents findings from a systematic literature review about resilience and
preparedness training in the maritime domain. The aim is to present an overview about
current research trends and gaps, as well as to discuss how this knowledge can guide
the further development and improvement of maritime training. The review used a
PRISMA approach to identify relevant literature in the following databases:
ScienceDirect, PubMed and Oria (discovery service offered by Norwegian university
libraries) published between 2017 and 2022. After an initial set of 107 items, 25 full text
articles were included in the dataset for this review.
The results show a wide variety of concepts and methods associated with resilience
and preparedness and how to foster and train these. While resilience is defined on both
an individual (psychological) and system (team and organization) level, the literature on
preparedness mostly focuses on groups and communities. Individual resilience is
identified to at least partially be a trait of a person’s personality, in contrast to the system
approach to resilience, which allows to identify methods and means to train a team’s
flexibility and adaptability for both challenging and normal operational circumstances.
In comparison to resilience, research on preparedness training focuses on how to prepare
adequate responses (resources, plans, role assignment) for extreme events, and on how
to best execute these when necessary. Thus, efforts in training highlight roles and
responsibilities, as well as cooperation and communication but only with a focus on
extreme operational scenarios, such as evacuation or search and rescue. While there is a
large overlap in the literature with regards to what is defined as preparedness and
resilience, there is still a gap concerning concrete training measures and knowledge on
how to best strike a balance of training enough for extreme events, that seldomly happen,
while remaining the ability to cope with complexity and variability in everyday
operations. To start to fill these research gaps, there is therefore a need for empirical
studies that explore what constitutes resilience and preparedness in everyday operations
and maritime training practices. Further, as the body of literature explores different
training approaches, empirical studies that focus on the short-term and long-term
training effects, as well as on potential gains for operational safety should be considered.
There is currently a lack of research-based findings that can be used to provide advice
and recommendations to different maritime stakeholders, such as training centers,
shipping companies and regulatory bodies.
Keywords. Resilience, Preparedness, Maritime, Training, Literature review.

232
Objective risk assessment of glare and subjective
rating of the frequency of glare – a visual ergonomics
risk assessment, VERAM
Hillevi Hemphälä (1), Susanne Glimne (2), Marina Heiden (3), Camilla Zetterberg (3),
Per Lindberg (3), Johannes Lindén (1), Per Nylén (4)
(1) Lund University, Division of Ergonomics and Aerosol Technology, Design Sciences,
Lund University, Lund, SWEDEN, hillevi.hemphala@design.lth.se;
(2) Karolinska Institute, Department of Clinical Neuroscience, Division of Eye and
Vision, St. Erik Eye Hospital, Stockholm, SWEDEN;
(3) University of Gävle, Centre for Musculoskeletal Research, Department of
Occupational and Public Health Sciences, Gävle, SWEDEN;
(4) Swedish Work Environment Authority, Stockholm, SWEDEN
Insufficient lighting conditions and glare from luminaires in the visual environment
can affect our visual ability and cause eyestrain, headache, and musculoskeletal strain.
Knave et al. found that the frequency of reported glare was associated with more
eyestrain. In this study a subjectively rated frequency of glare was compared to an
objectively rated risk for glare made by trained assessors.
A visual ergonomics risk assessment method (VERAM) was used to gather data
at workplaces, mainly computer workstations (n=420). Trained assessors (ergonomists)
measured the luminance ratio and assessed the risk for glare (objective risk for glare)
divided into three categories high risk (red), low risk (yellow) and no risk (green).
Workers rated the frequency of experienced glare at their workplaces (subjective
assessment of glare) via questionnaires. The frequency of subjective strain was divided
into three categories; no, never; occasionally; a few times a week/almost always.
Workers rated the frequency of glare present more seldom than the trained
assessors rated the presence for risk for glare, at the same workplaces. One factor
behind this might be individuals’ ability to evaluate the visual environment such as
risk for glare. A trained assessor can easier evaluate any risks in the visual
environment.
When the objective risk for glare was assessed to be high (red) or low (yellow)
the percentage of individuals reporting strain, such as eyestrain and musculoskeletal
strain, increased for most symptoms compared to when there was no risk (green). An
objective risk assessment for glare needs to be performed together with a subjective
rating of the frequency of glare to find the individuals with problems.
Keywords. discomfort glare, asthenopia, neck pain

233
Headaches in combination with visual ability, eye- and
musculoskeletal strain in connection with visually
demanding work tasks
Susanne Glimnea*, Hillevi Hemphäläb, Marina Heidenc, Camilla Zetterbergc,
Per Lindbergc, Johannes Lindénb and Per Nylénd
a Karolinska Institute, Department of Clinical Neuroscience, Division of Eye and
Vision, St. Erik Eye Hospital, Stockholm, SWEDEN
b Lund University, Division of Ergonomics and Aerosol Technology, Design Sciences,
Lund University, Lund, SWEDEN
c University of Gävle, Centre for Musculoskeletal Research, Department of
Occupational and Public Health Sciences, Gävle, SWEDEN
d Swedish Work Environment Authority, Stockholm, SWEDEN
Author for correspondence: susanne.glimne@ki.se
Keywords: High luminance levels, headache, photophobia, eye pain, arm pain, field study.
Suboptimal visual ergonomics (i.e., the interaction between our vision, the light, the visual
object, and the influence of other factors which impairs visibility) in work environment such
as glare can cause headache in combination with eyestrain, visual ability, and
musculoskeletal strain. Symptoms constituted to the syndrome of eyestrain has been well
described among computer workers (see for example Han et al., 2013; Portello et al., 2012;
Bhanderi et al., 2008; Mocci et al., 2001; Sanchez-Roman et al., 1996). However, research has
not focused on investigating the presence of headaches associated with eye-related and
musculoskeletal disorders among employees and visual related environmental factors.
The purpose of presented research was to study the presence of headaches in combination
with visual ability, eye- and musculoskeletal strain, and work ability in connection with
visually demanding work. Trained assessors recruited study participants primarily from
their regular clients in the OHS field. Evaluators were instructed to recruit participants with
a variety of characteristics to ensure highly variable data, such as different work tasks, age,
and gender. The participants mean age was 48.3 years (±10.3); 66% were women.
A visual ergonomics risk assessment method (VERAM, Heiden et al. 2019; Zetterberg et al.
2017) was used to compile the participated workers subjective grading of headache, eye- and
musculoskeletal strain using a questionnaire (n=430). At the same time, an evaluation of the
visual environment was carried out, which established if there was a risk of glare associated
with the implementation of work task (e.g., computer work and other related work such as
industry, healthcare, and shipping industry). The frequency of headaches was divided into
three categories; (1) no headache, (2) headache occasionally, and (3) headache a few times
per week/almost every day.

234
The measurements regarding evaluation of the visual environment used a photometer, an
instrument which was available and that the assessors could use, usually a Hagner
ScreenMaster or Hagner S1 / S2 / S3.
About 65% of the workers reported headaches occasionally, a few times/week or almost
every day. Among the workers with headaches reported about 29% of them that they
experienced the headaches a few times/week or almost every day.
Out of the workers with headaches reported 37% a severity of the headaches of more than 3
(on a scale of 1-10) and 5 % reported a severity of more than 6. About 40% of the workers
also stated that the headaches affected their working ability. The headaches were mainly
located around the eyes, forehead, or temples (70%) and came in the afternoon (69%). About
75% of the workers also reported that the headache disappeared or were reduced when they
were off work for one night or over the weekend. The data collection showed that visual-
related symptoms increased the higher the estimated headaches was.
The musculoskeletal strain increased when the headache increased. When workers reported
a high frequency of headaches 95% of them reported neck strain, 86% shoulder strain, 73%
upper back strain, and 61% were reported arm strain.
Moreover, only 8.2% of the workers rated their visual ability as bad or very bad, but at the
same time, about 60% reported dim vision, 14% diplopia, and 59% problems changing focus
at some time.
Dividing the data into workers with experienced or unexperienced headaches this study has
shown that there was a significant presence of headaches in combination with visual related
symptoms regarding experienced photophobia (p=0.011), eye pain (p=0.015), diplopia
(p=0.029), and arm strain (p=0.006). Further, the statistical analysis showed that there was a
tendency of combination regarding headaches and visual ability (p=0.070).
Dividing the data into workers with experienced or unexperienced headaches, our study
showed that the frequency of headache increased due to high luminance levels within the
visual field (p=0.044).
This study concludes presence of headaches in combination with eye- and musculoskeletal
strain performing work task such as computer work. Further, the presence of headaches is
due to visual ability induced by high luminance levels within the visual field.

51st Nordic Ergonomics and Human Factors Society Conference 2022
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Financial effects of suggested work environment improvements
– Examples from applied Masters students’ projects
Linda ROSE
KTH Royal Institute of Technology, CBE School, Division of Ergonomics, Hälsovägen 11C, 141 57
Huddinge, Sweden
lrose@kth.se
Abstract: It can be challenging to motivate decision-makers to invest in work environment
improvements (WEIs). One success factor is to use the same vocabulary as company
management and express suggested WEIs in a way that management can understand and use
in their decision-making. This paper has two objectives, to present: 1) examples of real
organisations’ ergonomics problems, suggestions for improvements and financial estimations
of effects of the suggested interventions, carried out by students in a Master’s course; 2)
course-design features evaluated as important for this type of course. Results from six student
projects, using several financial methods, are presented. The discussion focuses on the value
of increasing the availability of such a course, as well as competencies needed to be successful
in WEIs. In conclusion: by applied training as in this course, non-economists can rather rapidly
learn to assess ergonomics problems, and to develop, present and argue for suggested
solutions, also with financial effect estimations.
Keywords: Ergonomics; Investment analysis, Management
1. Introduction
Work environment improvements (WEIs) are one of the most common activities aimed at
reaching the dual ergonomics’ objectives: “to optimize human well-being and overall system
performance.” (IEA 2022), WEIs are also seen as means to contribute to sustainable jobs. To be
able to identify the need for, suggest and motivate WEIs, several types of competencies are
essential, in line with the United Nations Educational, Scientific and Cultural Organization’s
(UNESCO’s) learning objectives for education for the United Nations Sustainable Development
Goals, SDGs, (UN2015). They include Systems thinking competency, “the ability to recognize
and understand relationships; to analyse complex systems; to think of how systems are embedded
within different domains and different scales; and to deal with uncertainty” (UNESCO 2017).
The increasingly complex technology systems necessitate for ergonomics experts to have new
competencies and skills, as well as new methods to be developed and used to meet the new
challenges. To support Human Factors and Ergonomics (HFE) practitioners, the International
Ergonomics Association (IEA), presented HFE strategies for developing the discipline and
profession a decade ago (Dul et al. 2012).
For many professionals in ergonomics, it has been, and still is, challenging to motivate or
“convince” decision-makers to invest in WEIs. This has been discussed at several conferences
lately, e.g. at PREMUS 2019’s symposium “Evidence-based, sustainable interventions: Do

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research and practice meet” (PREMUS 2019). Many professionals in the ergonomics domain feel
uncertain or lack confidence and competence to speak “the language of management”. An
example of this is a study from 2014 where the board members of the five national Nordic
Ergonomics Society (NES) organisations participated in a project aimed at mapping practitioner
awareness, knowledge and strategies regarding how HFE can be used in optimizing system
performance. An additional aim was to investigate how and to what extent such strategies were
applied in organisations (Rose and Jonsson 2014). It became obvious that the participants felt
uncomfortable even contacting key professionals in decision-making roles; as a result, fewer than
a dozen interviews (out of over a suggested 100) were carried out in the study. One success factor
in motivating WEIs is to use the same vocabulary as company management and express suggested
WEIs in a way that management can understand and use in their decision-making, comparing the
suggestion to several other investment alternatives.
There is an increasing awareness among company management that a poor work environment
(WE), which for example also can be interpreted as fatigue (Village et al. 2016), has negative
effects on a company’s performance and bottom line (Rose et al. 2013). However, few companies
systematically estimate the costs and benefits of suggested WEIs as business cases, as they do
with other investment options (Rose et al. 2013). Although several methods exist, including The
ProductAbility Tool (Oxenburgh et al. 2004), The Balloon Model (Johanson and Johrén 2001),
and the SCA and MAWRIC methods (Rose and Örtengren, 2000), they are not generally
implemented as part of the management tools used in companies to assess the monetary effects
of WEIs (Rose et al. 2013). Suggested reasons for this include that managers have no knowledge
of models, that company information systems are insufficient to produce relevant information,
and there is no demand from top management for these kinds of analyses (Johansson 2017).
Costs of WE investments are usually rather easy to measure, while monetary effects of the
interventions often are difficult to even estimate. Further, not all WEI benefits can be assessed
easily in monetary terms (Abrahamsson 2000), in part due to the fact that many of the revenues
are hidden effects, not showing up in accounting systems (Rose et al. 2013). The estimated effects
of poor WE and WEIs have been found to be considerable in several studies (e.g. Goggins et al.
2008, Dul and Neumann 2009).
The topic of the financial effects of the WE has been increasingly highlighted lately, and there is
an increased call for usable methods, examples and skills on how to estimate the effects of WEIs.
The author of this paper has noticed an increasing need and pronounced wish to acquire increased
knowledge of how to estimate the costs and benefits of WEIs to motivate such improvements by
supporting management in informed decision-making. This observation comes from different
fora, at conferences and seminars, such as the EU Network of economists on the improvement of
working environment, and the Expert Group of Ergonomics Documentation in Sweden.
In 2018 a new international two-year Masters of Science in Engineering Programme was started
at KTH Royal Institute of Technology (Rose and Österman 2018), including the course “Work
Environment Economics” (7.5 ECTS). In this course (very similar to a course in a previous one-
year Masters Programme), students acquire applied knowledge on the relationship between a good
WE and an organisation's operational and financial performance. They do this by working with
real company case studies, defining and analysing an ergonomics problem, suggesting solutions
and estimating effects, including in monetary terms if the solution is implemented in comparison
to if no action is taken. Students use different methods to estimate the monetary effects, including
Return on Investment time (ROI) and sensitivity analyses. They also train argumentation skills
in workshops with role-playing, acting in different professional company

51st Nordic Ergonomics and Human Factors Society Conference 2022
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roles, such as acting CEO, human resources and financial managers, as well as ergonomics experts
and engineers. These and other workshops and an array of training in communication (different
types of oral presentations and in writing (reports and poster), peer-feedback, individual reflective
assignments, as well as seminars on relevant research publications are all in the course design to
support the students’ acquirement of relevant skills and competences.
2. Objective
The objective of this paper is twofold: 1) to present examples of real organisations’ ergonomics
problems, suggestions for improvements and financial estimations of the effects of the suggested
interventions, as carried out by master students in the abovementioned course. This is to
contribute to increased awareness and knowledge on how WEIs can be motivated from financial
perspectives; and 2) to present course-design features evaluated by the students as important for
this type of course. This includes features evaluated as important for acquiring competencies
needed to be able to carry out projects including identifying ergonomics problems, suggest ways
to reduce them and estimating financial effects of these, as well as being able to communicate the
results and motivating the suggested interventions.
3. Methods
Here results from six student projects are compiled. These examples were selected to illustrate
the range of different ergonomics problems, suggested solutions and industrial branches. The
results from the students’ projects with identified ergonomics problems, type of industries,
suggested interventions, parameters studied, estimated effects, also in monetary terms, ROI, and
financial methods used, were compiled. Course evaluations and other student feedback were used
to compile course design features and contents students evaluated as important for their learning
and in acquiring skills and competencies needed to be able to perform these types of projects.
4. Results
Relating to the first objective in this study, Table 1 provides a summary of some characteristics
of the six student case study projects and their results. As seen in the table, the projects covered a
wide range of WE problems, including insufficient ventilation and chemical substances, noise, air
quality problems and insufficient visual conditions, as well as stress and physically strenuous and
adverse work. The suggested changes, therefore, also had a wide range, from simpler, rather
inexpensive solutions like installing a “soundproof” door for a meeting room at a medical clinic
(project No. 1, with approximately 2500 Euro as estimated investment cost) to more advanced
and costly solutions including automation, like an elevator storage system at a mining company’s
central storage facility (project No. 5, with approximately 325 000 Euro as investment cost). Also
the anticipated effects had a wide range. During the 10 years that either the current or the former,
similar courses have been running, the vast majority of projects have resulted in positive estimated
financial effects of suggested WEIs. In this time period, some of the suggested interventions have
been implemented at the involved companies. Further, in almost all projects both visible and
hidden effects have been estimated.
Sensitivity analyses and ROI calculations show that in the projects, the estimated payback time
varied between less than one month to up to seven years. Typically, the payback time was less
than half of the investments’ technical and economic lifetime, entailing that after that time the
investment would contribute positively to the company’s bottom line. Further, this estimated gain

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(or profit) from the investments after the payback time for the rest of the investments’ lifetime
varied between a few thousand Euros per year and approximately 100 000 Euros per year.
Table 1: Examples of WEI analysis: type of organisations, ergonomics problems, suggested
interventions, parameters studied, estimated effects, ROI, and financial methods used.
No.
Industry
Ergonomics problem
Suggeted changes
Parameters studied
Estimated effects
ROI
Methods used
Authors
†
1
Advanced
Meeting room has improper
Installing
Investment costs,
Reduced noise
< 1 month
Pay-back
Coutinho &
radiotherapy
ventilation and high noise.
soundproof door,
machine
levels, fatigue &
method, ROI,
Obeid
clinic
installing proper
usage/year,
stress, improved air
Ballon model,
(2021)
ventilation.
Number of
quality, higher
Abrahamson's
treatments/year.
productivity,
matrix.
efficiency, higher
machine usage.
2
Municipal
Adverse postures, heavy force
Relpace petrol
Investment costs,
Elimintaed chemical
< 3 years
Cost-Benefit
Morin &
wood cutting
exertion, repetiative manual
driven chain saws
training costs,
exposure from
(Economic &
analysis,
Newaz
learning
handling movements, poor
with electric driven
adminsitration
petrol, reduce heavy
technical life
Balloon model,
Chowdhury
center
grip, uneven surfaces,
chain saws.
costs, sick leave
lifting and MSDs,
is 6 years)
Sensitivity
, 2021
outdoor temperature, visual
costs, improved
noise levels and
analysis,
conditions, high noise levels,
operational cost.
vibration levels,
Abrahamson's
CO gas emitation.
reduced sick-leave.
matrix.
3
Animal clinic
Heavy manual handling,
Installing lifting
Investment costs,
Decreased adverse
3 - 11 months
Balloon model,
Tabakov, A,
prolongued uncomfortable
equipment,
employee turnover
physical ergonomics
Economic
Kruse, J,
postures, crowded
educational course
rate, replacement
load, Improved
Effect Matrix,
Abou Jeb
areas/narrow space,
in lifting
employee cost, lean
efficiency (3%),
Abrahamson's
(2021)
unorganized wires, cluttered
techniques,
implementation
reduced turnover
matrix.
floors and storage units,
Surgeon (prismatic)
cost, education
(66%) and cost
ventilation and lighting.
glasses, lean
cost, equipment
related to turnover,
improvement (5 S).
cost, efficiency
increased job
change.
attractiveness.
4
Paper
Adverse physical ergonomics
Implementing
Investment costs,
Reduced risk of
19-47 months
Balloon model,
Abaid,
machine
conditions regarding the
containers with
time saved, sick-
injury, decreased
Hierarchical
Honeth &
foundry
logistics in th foundry.
built-in tipping
leave,
number of incidents
Task Analysis,
Olsson
mecanism
rehabilitation costs,
and accidents, time
Cost Benefit
(2019)
material & repair
saving, increased
Analysis,
costs.
efficiency, reduced
Sensitivity
annual costs for
Analysis, Net
tires, quality
Present Value
deficiencies
Method, etc.
5
Mining
Work environment problems
Implementing a
Investment costs,
Reduced risk of
7 years
Balloon Model,
Fagerlönn
company
using a shelf storage system.
elevator storage
time saved, salary
accidents,
(Economic &
Net Present
(2020)
system
costs.
overexertion
technical life
Value method,
injuries and material
is 15 years)
Payback
damages, time
Method,
saved
Sensitivity
Analysis.
6
Paper Mill
Poor air quality in the paper
Investment in air
Exposure to
Reduced sick-leave,
2-18 months
Balloon Model,
Berglund
mill.
cleaning
chemicals; Sick-
Reduced use of
Net Present
Christians
technology.
leave; Efficiency;
cemicls, time
Value Method,
et al.
Education costs;
savings.
ROI, Sensitivity
(2014)
Service; Investment
Analysis.
costs.
† The 10 results from the student projects in the Masters’ Programme course were presented in course reports
and are therefore not publically available.
Relating to the second objective of this study, Table 2 shows a compilation of course design
features and course content evaluated by the students as important in acquiring the skills and
competencies needed for carrying out these types of projects. Figure 1 shows one example of
students’ reflective map on the eight key competencies according to UNESCO (UNESCO 2017).
There the students evaluated that they acquired these competencies in the course, at least in part.
The reflective course activities, as well as the students’ performance in the course, clearly display
that the students acquire skills and competencies to perform these types of projects: from problem
identification to suggesting and calculating the financial effect of intervention suggestions and
feeling confident in how to argue for and motivate WEIs.

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Table 2: Course design features and course content evaluated by the students as important
of acquiring the skills and competencies needed for carrying out these types of projects.
Figure 1: An example of a student reflective map on key competencies according to
UNESCO (UNESCO 2017) – on acquiring them in the course. (Activities in the course lead
to (At the left) Collaboration, Self-awareness and Normative competencies, which also support
the System thinking competency. These, in combination with the course activities influence (In
the middle) Integrated problem-solving competency, which in turn also has an influence on
acquiring Critical thinking and Anticipatory competencies. The course activities and the other
competencies support acquiring (At the right) Strategic competency.)
5. Discussion
5.1 Discussion of results
As Table 1 shows, several different WE problems were analysed and an array of different effects
was estimated, using several different methods. The students, almost without exception being
non-economists, rather rapidly acquired competencies and skills in assessing WEI financial
effects, and in presenting and arguing for suggested solutions.
While feedback from students has clarified parts in the course they evaluate as adding to their
skills and competence in this field, it also clearly has shown that the students would like to see
even more “calculation examples”, especially regarding how to calculate costs and benefits under
the guidance of teachers. Recent course rounds have therefore focussed on having at least one
“applied calculation session” each course day on campus.
argumenting and motivating work environment related investments
industry
reserch community
Working with project son "real cases" from:
industry
society (e.g. municipalities, care givers, schools)
Course activities led by engaged, knowledgeable lecturers from different, relevant contexts:
Peer review activities:
give feedback
receive feedback
financial calculation, with focus on financial effects of the work environment
communication (oral and written), presenting own results
Reflective training (workshops and individual assignment) on:
sustainability and the UN SDGs
key competences according to UNESCO
own learning process
Theoretical base regarding:
economics and financing
financial effects of the work environment
Applied training (e.g. in work shops) on:

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In the beginning of the course students generally find it challenging to estimate visible costs and
very challenging to estimate hidden costs (Rose et al. 2013). However, starting out with a
theoretical basis, followed by teacher-led walk-throughs of examples and thereafter calculation
sessions with the teacher and peer support on real examples, it is notable that the students rapidly
gain competence and skills in estimating the monetary effects of WEIs. Rather soon thereafter,
they gain the skills to apply these techniques increasingly independently, in line with the
Taxonomy on Learning, Teaching, and Assessing (Anderson and Krathwohl 2001). In fact, the
course’s design was substantially inspired by this taxonomy (sometimes also called “the Revised
Bloom’s Taxonomy”).
5.2 Discussion of methods
The number of projects included in this study is small and the summary is rather simplistic with
only six out of dozens of projects included. This can be viewed as a weakness. On the other hand,
one of the intentions of this paper is to provide examples of what is possible to achieve in a course
with an applied project, not to present a thorough analysis of all projects that have been carried
out in the current and in the previous similar course.
However, the results of the included six projects, as well as the projects in this and the previous
course were all the results of work by Masters’ students, who in the vast majority were non-
economists, not by thorough financial analysis by economists. This may also be viewed as a
weakness. From another perspective though, we align with the view of Abrahamsson’s statement
that “Routine accepted calculations in companies include several estimated values, rules of thumb
and subjective guesses.” (Abrahamsson, 2000). As mentioned at the end of the Results section in
this paper, it is clear that the students have acquired considerable skills and competencies needed
for the types of projects in focus in this paper.
5.3 Practical implications
The course has been assessed as very valuable by the participants (e.g. in course evaluations) and
the author of this paper, who developed the course and is one of the main teachers in it, often
receives requests for education on this topic from ergonomics practitioners and companies. It is
argued that the course design and the course content both play relevant parts in the students’
success in the course regarding acquiring relevant skills and competencies. One question then is
how to meet the increasing call for this type of course. How could a course or other learning
activities be developed and disseminated to make it available on a larger scale and in different
contexts while opting for safeguarding good quality course outcomes? Educational and training
material could be “packaged” for example as Massive Open Online Courses (MOOCs), which
would allow for scalable courses where participants could follow the course at their own pace.
An alternative could be to develop courses within the (Swedish) Lifelong Learning context, where
the idea is to provide applied courses for people active on the working market to improve their
skills, competencies and employability. Such courses grant university credits, but would exclude
many practitioners not eligible to participate. Also more traditional ways of disseminating the
content could be of interest, including a seminar-series design, where the course teachers could,
at least in part, hold intensive courses or course activities in different locations. It is suggested
that future work explores and develops different training “packages“ in the WE and economics
field to meet the demand for skills in estimating financial effects of WE at companies and motivate
WEIs.

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Another relevant topic is what competencies are needed in the whole WEI process within
organisations to be successful in WEIs. Competencies viewed as important are, besides traditional
ergonomics competencies, being able to estimate the financial effects of WEI, being able to
motivate the WEIs, and have efficient skills in communicating with company decision-makers in
a way they can use for informed decision-making. Here both theoretical knowledge and practical
training are viewed as crucial. In addition to the key competencies defined by UNESCO as crucial
to work with in education (UNSECO 2017), it can be argued that having acquired competencies
in project teams to be able to perform the different steps in the systematic risk management
process (ISO 2009) also are essential.
In numerous reports, including course project reports in this course, it has been stated that WEIs
can contribute to achieving several of the United Nations’ Sustainable Development Goals, SDGs
(UN 2015). Possible contributions of the WEIs in this course include several SDGs. One example
is SDG No. 3, “Good health and well-being”, specifically SDG 3d on strengthening the capacity
for risk reduction and management of national and global health risks, since e.g. MSDs constitute
one of the more severe health risks. Another example is SDG No. 8: “Decent work and economic
growth”, and especially SDG 8.5 on achieving decent work for all women and men, since most
of the suggested interventions are assessed as improving the WE for employees.
6. Conclusion
It is concluded that by applied training, as provided in this course, non-economists rather rapidly
can learn to assess and investigate ergonomics problems, present and argue for suggested
solutions, and make financial effect estimations. Further, different types of knowledge and skills
are needed for being able to carry out the types of projects in focus in this study, i.e. projects
spanning from identifying and assessing a work environment problem to developing suggestions
for improving the work environment, estimate the financial effects of the suggestions, were they
to be implemented, and being able to motivate the investments. Course features evaluated by
students as contributing to acquiring the skills and competencies are also compiled and presented.
References
Abaid, M. A. Honeth, I. and Olsson, J. (2019) A case of when investing in safety is a safe
investment. Project report in the course HN2020, KTH Royal Institute of Technology.
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Hands-on training to use smart work clothes
Eklund, Jörgen; Forsman, Mikael
KTH Royal Institute of Technology
jorekl@kth.se; miforsm@kth.se
WORKSHOP: Hands-on training to use smart work clothes
Smart work clothes have been developed to measure work postures. Based on these
measurements an automatic risk assessment for MSDs can be obtained. Also, this
system can be used for self-training of work technique.
The participants in the workshop will get an opportunity to practice the use of smart
work clothes for risk assessment and work technique training. They will start up the
system, perform simulated work sessions, get the automated result analysis and
discuss the findings.
The workshop will partly be a demonstration and partly an applied hands-on training
session.
Keywords. Smart work clothes, work posture, automatic risk assessment

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Crisis Information Design with a Human
Factors/Ergonomics Perspective
Aryana, Bijan; Osvalder, Anna-Lisa
Chalmers University of Technology
bijan@chalmers.se
Workshop: The unexpected events of the past few years highlighted certain shortcomings
in the way societies response to crisis. In addition to disease, natural disasters and wars,
the world is also facing new challenges that have not been much experienced in the past,
such as climate change and cyberwarfare. The way that information is communicated
with the society before, during, and after a crisis is critical to any crisis management plan.
The information gap due to age, language, trust, and cognitive abilities poses threats to
such communication. As a result, an inclusive and universal crisis information design is
a vital part of crisis planning in any country, especially those with aging population, and
those with residents from various cultural and lingual backgrounds.
Existing universal design methodologies often focus on how disabilities hinder physical
and cognitive activities of people. In a crisis, there are also other subjective factors that
could contribute to exclusion from information flow, such as trust, everyday life habits,
technology acceptance, and temporary lapse of judgment. Each vulnerable group might
be impacted by such factors in a unique way. Crisis information design requires
development and adaptations of existing tools and methods, as well as informed and
active participation of vulnerable groups.
The focus of the workshop will be on tools and methods for crisis information design
from a human factors/ergonomics (HF/E) perspective. The main steps of the workshop
are as follows: (1) the session starts with an introduction to HF/E design for crisis, and
reflection on an ongoing research project on active participation of citizens in crisis
management; (2) an ideation activity by HF/E specialists around the role of HF/E in crisis
management; (3) exploration of a range of existing HF/E tools, methods and approaches,
and matching them to a number of critical scenarios before, during, and after crisis. (4)
reflection on possible adaptation of HE/F tools for crisis information design.
The result of the workshop is an elaboration on how existing HF/E tools, methods and
approaches can contribute to information design for crisis. Also, how these can show
possible gaps, or needs, for adaptation in HF/E tools, methods, and approaches within
the context of crisis information design.
The findings can be used in an ongoing research project entitled “User Participation in
Crisis and Contingency Work" financed by the Swedish Civil Contingencies Agency

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(MSB) and run by Design and Human Factors researchers at Chalmers, Lund University
and Linnaeus University. The overall aim of this project is to develop methods,
strategies, and guidelines for how groups with varying needs can be involved as active
resources in the society's crisis management. Knowledge and experience of people with
different types of disabilities can thus be utilized to prevent, manage, and recover from
serious events and crises.

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The human variable in societal resiliency to disasters:
the perspective of CORE project
Gabriella, Duca
Consuelo, Agnesi
Giovanni, Gugg
Elisabetta, Schiavone
Institute for Sustainable Society and Innovation
duca@issnova.eu
arch.consuelo.agnesi@gmail.com
gugg@issnova.eu
elisabettaschiavone@live.it
Raffaella, Russo
Università degli Studi di Salerno
rarusso@unisa.it
Stefano Zanut
Corpo Nazionale dei Vigili del Fuoco
stefano.zanut@vigilfuoco.it
Background and purpose
A relevant component of complexity in disaster preparedness and response relies
on the wide diversity in levels of vulnerability, risk awareness, safety culture, social and
science trust among interested populations either at regional or at European scale. A
lesson learned by the recent COVID 19 crisis is that risk is systemic, and crises are
cascading; even if everyone can be affected by a crisis, not everyone is equally impacted:
elderly, people with disabilities, poorly educated and low income are most vulnerable
categories.
The European research project CORE (sCience& human factOr for Resilient
sociEty) is working on a crisis modelling framework able to describe disaster scenarios
and dynamics according to human, social and societal variables and organizational
aspects under cascading effects. CORE project aims at evaluating and reviewing inherent
and structural vulnerabilities, as well as behaviours and responses to crises in order to
propose new collaborative approaches and strategies for community awareness,
leadership, and crisis readiness and management.
Methodology
In order to understand the role of human variability in vulnerability and social
resiliency, CORE project relies on two specific building blocks: the “Safety Culture in
European population” and the “Human vulnerability taxonomy”.
CORE project is transferring current safety culture concepts and practices from
safety critical industries to the field of DRR, developing appropriate indicators to

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measure and explain the shaping factors and aspects of the safety culture among
European population with respect to natural and man-made risks.
Case studies of past disasters provide a valuable framework for assessing human
behaviour and disasters’ impact in all its diverse forms, including psychological,
sociological and socio-economic perspectives. CORE is considering scenarios relating to
the following past events: wildland fire, earthquakes, terrorist attacks, industrial
accidents, flash floods, tsunami and COVID-19 pandemics in several countries. Analysis
of pitfalls involving vulnerable categories is under development, and the risk perception
of those categories and their level of preparedness will be investigated.
Results
CORE is building the methodological framework to understand risks awareness
in Europe in relation to diversity at individual and societal levels, among EU regions and
outside EU as well as among social and institutional groups at regional or local level. This
will result in novel and specific Safety Culture and vulnerability indicators for the six
project disaster scenarios, targeting separately: citizens and civil society associations,
public officers, first responders, governmental agencies, other indirect institutional
actors in disaster scenarios. Furthermore, a framework for mapping vulnerable social
groups will be delivered, to support involved institutions and rescuers when a crisis
scenario occurs.
Conclusions
Scientific advances under development in CORE will finally result in the definition
of a set of indicators to assess preparedness, reaction, overcoming and learning of local
actions (in terms of plans and actual operations), serving as solid basis for further
recommendations/advises to policy making, decision making, resources allocation
within EU countries and between countries.
Acknowledgement: This paper presents contents produced within CORE project, which
has received funding from the European Union’s Horizon 2020 research and innovation
program under grant agreement No 101021746.
Keywords. Disaster Resilient Society, Human Variability, Safety Culture, Vulnerability

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Visual ergonomics and lightning
Hemphälä,Hillevi; and Österman,Cecilia
Ergonomics and Aerosol Technologies, Design Sciences, Lund University,
Sweden
hillevi.hemphala@design.lth.se
PROPOSED FORMAT OF SPECIAL 90-MINUTE SESSION:
A workshop with three parts:
• An introductory lecture about visual ergonomics and lighting (30-45 minutes)
• An interactive workshop with educational stations demonstrating how to
measure light and other relevant visual ergonomics factors (20-30 minutes)
•A concluding question and answer session (10-15 minutes)
DESCRIPTIVE STATEMENT:
Good lighting is important for visual comfort, safety and productivity in workplaces.
What is good lighting? How do we start to question if a lighting solution is good? Glare
from wrongly placed luminaire can often cause strain and headaches.
This workshop will introduce some of the issues that should be considered when
evaluating the visual environment of a workplace. These include the lighting conditions
(illuminance and luminance), glare, types of light sources, as well as the use of spectacle
lenses and the visual conditions of the work task.
A brief review will be given of lighting recommendations and standards for the visual
environment and how these can be sourced. A short Visual Ergonomics checklist will
also be presented with instructions on how to use the checklist. It includes two parts:
subjective factors (such as headache, eyestrain and musculoskeletal strain) and objective
factors (such as illuminance and luminance measurement, type of light sources, colour
rendering, colour temperature, direction of the light, glare, and flicker (temporal light
modulation)). There will be an opportunity for discussion about topical issues for
lighting workplaces such as LED lighting systems, manipulating light to improve
performance and well-being (sometimes referred to as circadian/integrative lighting or
human-centric lighting) and concerns about eye safety and blue light exposure.
This workshop includes a lecture and practical demonstrations. It is suitable for those
wishing to gain an understanding of lighting and visual ergonomics for workplaces e.g.
workplace ergonomists, and work health safety officers. To ensure maximum
opportunity for participation, it will be limited to a maximum of 30 participants.
Keywords: Lighting, illuminance, eyestrain, musculoskeletal strain, visual environment,