Alain Piette

Bio: Alain Piette is an academic researcher from Université catholique de Louvain. The author has contributed to research in topics: Vibration perception & Purdue Pegboard Test. The author has an hindex of 15, co-authored 25 publications receiving 801 citations. Previous affiliations of Alain Piette include Catholic University of Leuven.

Development and validation of the predicted heat strain model

Abstract: Eight laboratories participated in a concerted research project on the assessment of hot working conditions. The objectives were, among others, to co-ordinate the work of the main European research teams in the field of thermal factors and to improve the methods available to assess the risks of heat disorders at the workplace, and in particular the "Required Sweat Rate" model as presented in International Standard ISO 7933 Standard (1989). The scientific bases of this standard were thoroughly reviewed and a revised model, called "Predicted Heat Strain" (PHS), was developed. This model was then used to predict the minute by minute sweat rates and rectal temperatures during 909 laboratory and field experiments collected from the partners. The Pearson correlation coefficients between observed and predicted values were equal to 0.76 and 0.66 for laboratory experiments and 0.74 and 0.59 for field experiments, respectively, for the sweat rates and the rectal temperatures. The change in sweat rate with time was predicted more accurately by the PHS model than by the required sweat rate model. This suggests that the PHS model would provide an improved basis upon which to determine allowable exposure times from the predicted heat strain in terms of dehydration and increased core temperature.

Strategy for evaluation and prevention of risk due to work in thermal environments.

Abstract: A strategy in four successive stages is described and justified for the prevention and control of thermal problems in the workplace. This should allow these problems to be approached and solved progressively in small as well as large companies by relying successively, when necessary, on the complementary competencies of the workers themselves, their technical assistance, the occupational health specialists and the experts. The criteria to fulfil at each stage are described and discussed. Appendix 1 describes in detail the methods to be used at stages 2, "Observation" by the workers and their assistance; at stage 3, "Analysis" with the help of specialists; and outlines the stage 4, "Expertise".

Musculoskeletal complaints, functional capacity, personality and psychosocial factors

Abstract: Objectives: The aim of the research was to study the association between psychosocial and personality factors, and neck and wrist-hand musculoskeletal complaints, taking account of the occupational factors of force, posture and repetitiveness, and non-occupational risk factors such as sport, hobbies, medical history. Methods: During personal interviews 133 women from seven different companies, working at constraining workplaces (very repetitive work), answered several questionnaires. These concerned: personal characteristics and history; work characteristics; psychosocial factors (perception and appreciation of the work situation, satisfaction at work, stress symptoms, Karasek questionnaire) and personality factors (neuroticism, conscientiousness, type-A behavior). They also undertook functional and psychomotor tests (wrist angles, grip strength and a dexterity test). Logistic regression models were calculated. Results: Wrist-hand complaints appear to be associated with some personal characteristics (smoking habits, fewer hobbies), work constraints (fewer breaks, heavy lifting efforts) and some personality (introversion) and psychosocial factors (worse appreciation of work). Neck complaints are also associated with some personal characteristics (young people, small, bad health, hormonal problems, fewer hobbies), some personality (urgency of time) and psychosocial factors (constraints as seen by the supervisor). Conclusion: The study confirms the multifactorial character of the musculoskeletal disorders and underlines the need for a global ergonomic approach to work situations, taking into account all their physical, psychological and social components.

Prediction of the average skin temperature in warm and hot environments

Abstract: The prediction of the mean skin temperature used for the Required Sweat Rate index was criticised for not being valid in conditions with high radiation and high humidity. Based on a large database provided by 9 institutes, 1999 data points obtained using steady-state conditions, from 1399 experiments and involving 377 male subjects, were used for the development of a new prediction model. The observed mean skin temperatures ranged from 30.7 degrees C to 38.6 degrees C. Experimental conditions included air temperatures (Ta) between 20 and 55 degrees C, mean radiant temperatures (Tr) up to 145 degrees C, partial vapour pressures (Pa) from 0.2 to 5.3 kPa, air velocities (v(a)) between 0.1 and 2 m/s, and metabolic rates (M) from 102 to 620 W. Rectal temperature (T(re)) was included in the models to increase the accuracy of prediction. Separate models were derived for nude (clothing insulation, I(cl), < or = 0.2 clo, where 1 clo = 0.155 m2 x degrees C x W(-1), which is equivalent to the thermal insulation of clothing necessary to maintain a resting subject in comfort in a normally ventilated room, air movement = 10 cm/s, at a temperature of 21 degrees C and a humidity of less than 50%) and clothed (0.6 < or = I(cl) < or = 1.0 clo) subjects using a multiple linear regression technique with re-sampling (non-parametric bootstrap). The following expressions were obtained for nude and clothed subjects, respectively: T(sk) = 7.19 + 0.064Ta + 0.061Tr + 0.198Pa - 0.348v(a) + 0.616T(re) and T(sk) = 12.17 + 0.020Ta + 0.044Tr + 0.194Pa - 0.253v(a) + 0.0029M + 0.513T(re). For the nude and clothed subjects, 83.3% and 81.8%, respectively, of the predicted skin temperatures were within the range of +/- 1 degree C of the observed skin temperatures. It is concluded that the proposed models for the prediction of the mean skin temperature are valid for a wide range of warm and hot ambient conditions in steady-state conditions, including those of high radiation and high humidity.

Vibration exposure on fork-lift trucks

Abstract: This study investigates the effects of the main characteristics of the working condition on the vibration exposure on fork-lift trucks. Four hundred and eighty recordings were made on five trucks equipped with four different types of tyres and a 'normal' or an 'anti-vibration' seat, driven while empty or loaded, on a smooth or a rough track by three workers. An analysis of variance was performed to study the main effects and the significant interactions between these factors. A mathematical model is proposed for the weighted acceleration on the floor and on the seat in the vertical axis. This shows quantitatively that the vibration exposure is mainly influenced by the roughness of the track, the speed and the quality of the seat. Inflated tyres are preferable when an anti-vibration seat with a very low resonance frequency is used. In other cases, cushion tyres are more indicated.

Risk factors for work-related musculoskeletal disorders: a systematic review of recent longitudinal studies

Abstract: Objective This systematic review was designed and conducted in an effort to evaluate the evidence currently available for the many suggested risk factors for work-related musculoskeletal disorders. Methods To identify pertinent literature we searched four electronic databases (Cinahl, Embase, Medline, and The Cochrane Library). The search strategies combined terms for musculoskeletal disorders, work, and risk factors. Only case–control or cohort studies were included. Results A total of 1,761 non-duplicated articles were identified and screened, and 63 studies were reviewed and integrated in this article. The risk factors identified for the development of work-related musculoskeletal disorders were divided and organized according to the affected body part, type of risk factor (biomechanical, psychosocial, or individual) and level of evidence (strong, reasonable, or insufficient evidence). Conclusions Risk factors with at least reasonable evidence of a causal relationship for the development of work-related musculoskeletal disorders include: heavy physical work, smoking, high body mass index, high psychosocial work demands, and the presence of co-morbidities. The most commonly reported biomechanical risk factors with at least reasonable evidence for causing WMSD include excessive repetition, awkward postures, and heavy lifting. Additional high methodological quality studies are needed to further understand and provide stronger evidence of the causal relationship between risk factors and work-related musculoskeletal disorders. The information provided in this article may be useful to healthcare providers, researchers, and ergonomists interested on risk identification and design of interventions to reduce the rates of work-related musculoskeletal disorders. Am. J. Ind. Med. 2009. 2009 Wiley-Liss, Inc.

An adaptability limit to climate change due to heat stress

Abstract: Despite the uncertainty in future climate-change impacts, it is often assumed that humans would be able to adapt to any possible warming. Here we argue that heat stress imposes a robust upper limit to such adaptation. Peak heat stress, quantified by the wet-bulb temperature TW, is surprisingly similar across diverse climates today. TW never exceeds 31 °C. Any exceedence of 35 °C for extended periods should induce hyperthermia in humans and other mammals, as dissipation of metabolic heat becomes impossible. While this never happens now, it would begin to occur with global-mean warming of about 7 °C, calling the habitability of some regions into question. With 11–12 °C warming, such regions would spread to encompass the majority of the human population as currently distributed. Eventual warmings of 12 °C are possible from fossil fuel burning. One implication is that recent estimates of the costs of unmitigated climate change are too low unless the range of possible warming can somehow be narrowed. Heat stress also may help explain trends in the mammalian fossil record.

Pain assessment

Abstract: Pain usually is the major complaint of patients with problems of the back, thus making pain evaluation a fundamental requisite in the outcome assessment in spinal surgery. Pain intensity, pain-related disability, pain duration and pain affect are the aspects that define pain and its effects. For each of these aspects, different assessment instruments exist and are discussed in terms of advantages and disadvantages. Risk factors for the development of chronic pain have been a major topic in pain research in the past two decades. Now, it has been realised that psychological and psychosocial factors may substantially influence pain perception in patients with chronic pain and thus may influence the surgical outcome. With this background, pain acceptance, pain tolerance and pain-related anxiety as factors influencing coping strategies are discussed. Finally, a recommendation for a minimum as well as for a more comprehensive pain assessment is given.

Workplace heat stress, health and productivity - an increasing challenge for low and middle-income countries during climate change.

Abstract: Background: Global climate change is already increasing the average temperature and direct heat exposure in many places around the world. Objectives: To assess the potential impact on occupational health and work capacity for people exposed at work to increasing heat due to climate change. Design: A brief review of basic thermal physiology mechanisms, occupational heat exposure guidelines and heat exposure changes in selected cities. Results: In countries with very hot seasons, workers are already affected by working environments hotter than that with which human physiological mechanisms can cope. To protect workers from excessive heat, a number of heat exposure indices have been developed. One that is commonly used in occupational health is the Wet Bulb Globe Temperature (WBGT). We use WBGT to illustrate assessing the proportion of a working hour during which a worker can sustain work and the proportion of that same working hour that (s)he needs to rest to cool the body down and maintain core body temperature below 38°C. Using this proportion a ‘work capacity’ estimate was calculated for selected heat exposure levels and work intensity levels. The work capacity rapidly reduces as the WBGT exceeds 26-30°C and this can be used to estimate the impact of increasing heat exposure as a result of climate change in tropical countries. Conclusions: One result of climate change is a reduced work capacity in heat-exposed jobs and greater difficulty in achieving economic and social development in the countries affected by this somewhat neglected impact of climate change. Keywords: climate change; work; heat; occupational health; productivity (Published: 11 November 2009) Citation: Global Health Action 2009. DOI: 10.3402/gha.v2i0.2047

Occupational health guidelines for the management of low back pain at work – evidence review

Abstract: Study design: A systematic review of the literature to inform the development of occupational health guidelines for the management of low back pain at work. Objectives: To evaluate the evidence from occupational health settings or concerning occupational outcomes. Summary of background: Clinical guidelines for the management of low back pain (LBP) provide only limited guidance on the occupational aspects. Thus the Faculty of Occupational Medicine requested this review in order that a multi-disciplinary working group could develop the first evidence-based UK guidelines for management of LBP at work. Methods: A systematic literature search was followed by rating of the strength of the evidence plus a narrative review, by agreement between two experienced and independently-minded reviewers. There was no attempt at blinded double review or quality scoring. The final version followed peer-review by four international experts. Results: More than 2000 titles were considered. 34 systematic reviews, 28 narrative reviews, 52 additional scientific studies, 22 less rigorous scientific studies and 17 previous guidelines were identified and included. The evidence statements (rated for strength) were presented under headings that reflect a logical sequence of occupational health situations (Background, Pre-placement assessment, Prevention, Assessment of the worker presenting with back pain, Management principles for the worker presenting with back pain, Management of the worker having difficulty returning to normal occupational duties at 4–12 weeks). Some important areas were given additional narrative evidence-linked discussion (High risk patients/physically demanding jobs, Return to work with back pain, Rehabilitation programmes). Thirty six evidence-linked statements were developed to inform the guidelines group. The strongest evidence suggests that: generally the physical demands at work have only a modest influence on the incidence of LBP or permanent spinal damage; a history of LBP is not a reason to deny employment; preventive strategies based on the injury model do not reduce LBP or work loss; individual and work-related psychosocial factors play an important role in persisting symptoms and work loss; the management approach should be ‘active’ (including early work return); the combination of clinical, rehabilitation and organisational interventions designed to assist work return is more effective than single elements. However, further research is needed to identify the optimal roles of all stakeholders (clinicians, employers and workers) in case management. Conclusions: This review consolidates the emerging focus on active management of LBP at work, and indicates that approaches addressing obstacles to recovery will provide greater benefits than attempts at primary prevention. The outcome of the review has resulted in what we believe are the first truly evidence-linked occupational health guidelines for back pain in the world (www.facoccmed.ac.uk).