WORK PHYSIOLOGY

     People perform widely different tasks in
daily work situations. These tasks must be
matched with human capabilities to avoid
“underloading”, in which human capacities are
not utilized properly, as well as “overloading”,
which may cause the employee to break down
and suffer reduced performance capability or
even permanent damage.
Work physiologists study the chanced
appearing in the functions of the main organs
and systems (cardiovascular and respiratory) of
workers at work and evaluate the capacities and
limitations of the worker for performing physical
work; they also determine human tolerance to
stresses produced by the physical environment.
Capacity for physical work
     An individual’s physical tolerance
to physical work is usually determined
by the capacity of his or her
cardiovascular and respiratory systems
to deliver oxygen to the working
muscles and to metabolize chemically
stored energy.
Maximum oxygen uptake is often
used to describe the upper limit of
            this capacity.
 If a person is pushed beyond this
  limit in an emergency situation,
  anaerobic processes provide the
     additional energy required.
The biochemical processes that
transform foodstuffs into energy available for
 work are quite complex; they involve series
        of aerobic and anaerobic steps.
        Nevertheless, measurement of the
    volume oxygen consumed provides a
  relatively simple overall index of energy
   consumption and hence of the energy
              demands of work.
       Utilization of 1 liter of oxygen yields
     approximately 5 kilocalories (kcal).
To put oxygen consumption and
energy demands into proper perspective,
 consider the abilities of trained athletes
who may reach maximal oxygen uptake
       capacity of up to 6 L/min.
    Aside from a person’s physique, age
and gender influence the oxygen uptake
                capacity.
Men who are 20 years of age have an
  average maximal capacity of 3-3.5
L/min; women of the same age have an
  average capacity of 2.3-2.8 l/min.

       At age of 60 the capacity is
diminished to about 2.2-2.5 L/min. for
  men and 1.8-2.0 L/min for women.
The ability to move oxygen from the
air to the active muscle can be improved
through physical training by up to 20 %.
     Of course, an individual’s capacity
also depends on other “central” functions
(e.g. of the circulatory of the cardiac
system) and on “local” capacities (e.g. of
muscles).
To determine the individual’s
 tolerance to physical work the
  following lung volumes and
  capacities can be measured:

- tidal volume (TV) – the volume
 of gas inspired or expired during
      each respiratory cycle;
- vital capacity (VC) – the maximum
amount of air that can be exhaled from the
lungs after a maximum inspiration. It is a very
sensitive index for estimation of work capacity

      - forced expiratory volume in one
second (FEV1) – the volume of air which can
be forcibly expelled during the first second of
expiration. Its reduction indicates reduction of
airflow rates and prolongation of expiration.
Energy cost of work
Totally, the heaviest work that a young, fit
 man can sustain for prolonged periods is
  about 500 kcal/hr. Among the general
population, this figure is somewhat lower:
             400-425 kcal/hr.
Industrial jobs seldom demand
such a high-energy expenditure
  over the course of a workday.
Rest pauses, providing tools, and
 receiving instruction all tend to
    reduce the average energy
    expenditure considerably.
When intermittent tasks are performed, the
average expenditure may be calculated using
          the following formula:

      M = (M1t1 + M2t2 + ………Mntn)t-1

 where M is the total energy cost; M1, M2 and
so on are the energy costs of individual tasks;
  t1, t2 and so on indicate the duration of the
individual task; and t is the total elapsed time.
                         
Heart rate at work
 There is a close interaction between
the human circulatory and metabolic
               systems.
    Nutrients and oxygen must be
 brought to the working muscles and
metabolic by-products removed from
 them to ensure proper functioning.
Therefore, heart rate (which is a
  primary indicator of circulatory
      functions) and oxygen
  consumption (representing the
metabolic processes taking place in
   the body) have a linear and
reliable relationship in the range
 between light and heavy work.
When very light work loads or very
heavy ones are being handled, the
 relationship may not be reliable.

It is also not reliable under severe
 environment conditions or when
 workers are under mental stress.
Given such a linear relationship,
 one can often simply substitute
  heart rate measurements for a
   measurement of a metabolic
     process such as oxygen
          consumption.
This is a very attractive shortcut,
 since heart rate measurements
 can be performed rather easily.
The simplest technique for heart rate
assessment is to palpate an artery, often
in the wrist, and to count the number of
heartbeats over a period of time such as
 15 seconds and calculate the average
         heart beat per minute.

 More refined methods utilize various
   plethysmographic techniques.
More expensive techniques rely on
   electric signals generated by the
  nervous system that control heart
                  rate.
 When using this technique, electrodes
   are usually placed on the patient’s
 chest. This allows recording of heart
rate when the worker is performing his
     typical working operations –
         “heart rate at work”.
Some of these instruments are computerized
 and have memory enough to record the heart
   rate up to 16 hours and to perform various
              analyses by software.
 It is quite important to record the basic, at
rest, values of heart rate, to have in mind the
individual (or due to other, even pathological
  conditions in the body) variability of heart
 rate, and to follow up its dynamical changes
              during the workday.
This is useful to provide a

proper work/rest regimen.
Use of heart rate measurements has
 one major advantage over oxygen
   measurement as an indicator of
        metabolic processes:
  heart rate reacts faster to work
demands and therefore more easily
  indicates quick changes in body
 functions due to changes in work
           requirements.
Work classification

  The work demands are usually rated
from light to extremely heavy in terms
                   of
 energy expenditure per minute, and
  the relative heart rate in beats peer
          minute is also given.
Classification of Light to Heavy work according to
           Energy expenditure and Heart rate

              Classification

              Total Energy expenditure    Heart Rate

                          (kcal/min)      (beats/min)
Light work                2.5 – 3         90 or less
Medium work               3–5             90 – 100
Heavy work                5 – 7.5         100 – 120
Very heavy work           7.5 – 10        120 – 140
Extremely heavy work      10 – 15         140 or more
When the work is light, the energy
   needs of the working muscles are
  supplied by oxygen available in the
blood and by glycogen in the muscles.

There is no building of lactic acid or
 other metabolic by-products that
  would limit a person’s ability to
         continue such work.
In heavy work, during which the heart
  rate is about 120 beats/min, the oxygen
  required is still supplied if the person is
  physically capable to do such work and
       specifically trained in this job.
   However, the lactic acid concentration
produced during the initial phase of work
 is not reduced but remains high until the
   end of the work period and returns to
normal level after cessation of the work.
In course of light, medium, and
even heavy (if the person is trained
 and capable) work, the metabolic
 and other physiological functions
     can attain a steady-state
condition during the work period.

   No steady-state exists in the
   course of very heavy work.
In this case, the oxygen deficit incurred
during the early phase of work increases
throughout the duration of the effort and
  metabolic by-products accumulate,
     making intermittent rest periods
 necessary or even forcing the person to
        stop this effort completely.
That is why it is not advisable to perform
    work tasks requiring such efforts,
 excluding very short periods of time.
Matching people and their work
Obviously, it is important to match human
 capabilities with the related requirement
 of a given job. If the job demands equal the
 worker’s capabilities or if they exceed them,
the person will be under much strain and may
          be not able to perform task.
Hence, various functional stress tests, which
  are administered by a physician, have been
developed to assess an individual’s capability
    to perform physically demanding work.
Bicycle ergometers, treadmills, or steps
 are used to simulate stressful demands.
  The reactions of individual in terms of
oxygen consumption, heart rate, or blood
 pressure are used to assess that person’s
    ability to withstand such demands.

 It is of big importance that the loading
dosage is exact considering the age, body
             weight and gender.
Example for such stress test is the
      Master’s step test.

  The initial values of the blood
 pressure and heart rate beats are
measured before loading and each
   minute after loading till the
  recovery to the initial values.
The worker’s reaction is estimated
   as good when the increasing of
 heart rate is accompanied with an
  increasing of the maximal blood
pressure with unchanged or slightly
  increased values of the minimal
           blood pressure.
The reaction is astenic when the
    heart rate is increased, the
   heartbeats are weak, and the
   minimal and maximal blood
  pressure - slightly increased.

Such reaction indicates insufficient
         heart function.
In case of disturbed elasticity of
  the blood vessels the reaction is
 hypertonic – the maximal blood
 pressure increases suddenly, with
the same tend for the minimal one;
    heart rate is also increased.
In case of disturbed balance of
  the autonomic nervous system
   and the tonus of the peripheral
   blood vessels is decreased, the
reaction is dystonic - the heart rate
is increased and the minimal blood
    pressure suddenly decreases.
Fatigue
 Fatigue is an overexertion phenomenon
  that leads to a temporary decrease in
    physical performance. It is often
associated with a buildup of lactic acid in
                 the body.
 Subjective feeling of fatigue is feeling
    tired and deteriorated mental and
  physical activities may result from it.
The sensation of fatigue has a
  protective function similar to
hunger; feeling fatigue forces one
to avoid further stress and allows
     recovery to take place.
      Fatigue-induced low
performance can be completely
restored to its full level by rest.
Many different factors can produce
 fatigue and the most important are:
- physical work intensity (static and
           dynamic work);
- lack of rest (sleep), and poor eating
              habits; and
   - psychological factors – worry,
                conflict,
- monotony – a sensation associated
       with the lack of stimuli.
Severe, continuous daily fatigue
     eventually leads to chronic
  fatigue. Not only is the feeling of
tiredness intensified and continuous
    after work, but occasionally a
 person feels tired before beginning
                work.

The following signs signal chronic
            fatigue:
- Increased irritability – intolerance,
antisocial behavior
 - Tendency to depression –unmotivated
worries
- General weakness and a dislike for
work
- Nonspecific physical complaints –
headaches, giddiness, palpitations, rapid
breathing, loss of appetite, indigestion, or
insomnia.
When physical complaints of this
kind appear, the condition can be
     called ‘clinical fatigue”.
    As a result of this condition
  absence from work increase in
 frequency and duration, workers
need longer rest periods, and they
may show increased susceptibility
              to illness.
It is often difficult to separate mental
  or emotional events from physical
 causes of fatigue. In clinical fatigue
 one is hardly to distinguish between
            cause and effect.
   A negative attitude toward one’s
work, superiors, or place of work can
   just as well be a cause of clinical
       fatigue as the result of it.
Work/rest cycles
 In order to avoid the fatigue and
especially the chronic fatigue, rest
      pauses must be taken.
   Frequent short rest periods
reduce cumulative fatigue better
     than a few long breaks.
 The worst procedure is to let the
worker go home early, exhausted.
A general principle for the
  schedule work/rest cycles is to
  break up excessively hard work
into bouts of work that are as short
as is practical for the task at hand,

or intermingling light tasks with
          heavy ones.
The light, secondary work task thus
actually constitutes rest time from
    the heavy, primary task.

Sharpening tools or walking to get
material and other interruptions can
 provide productive respites from
           heavy work.

Work physiology

  • 1.
    WORK PHYSIOLOGY People perform widely different tasks in daily work situations. These tasks must be matched with human capabilities to avoid “underloading”, in which human capacities are not utilized properly, as well as “overloading”, which may cause the employee to break down and suffer reduced performance capability or even permanent damage.
  • 2.
    Work physiologists studythe chanced appearing in the functions of the main organs and systems (cardiovascular and respiratory) of workers at work and evaluate the capacities and limitations of the worker for performing physical work; they also determine human tolerance to stresses produced by the physical environment.
  • 3.
    Capacity for physicalwork An individual’s physical tolerance to physical work is usually determined by the capacity of his or her cardiovascular and respiratory systems to deliver oxygen to the working muscles and to metabolize chemically stored energy.
  • 4.
    Maximum oxygen uptakeis often used to describe the upper limit of this capacity. If a person is pushed beyond this limit in an emergency situation, anaerobic processes provide the additional energy required.
  • 5.
    The biochemical processesthat transform foodstuffs into energy available for work are quite complex; they involve series of aerobic and anaerobic steps. Nevertheless, measurement of the volume oxygen consumed provides a relatively simple overall index of energy consumption and hence of the energy demands of work. Utilization of 1 liter of oxygen yields approximately 5 kilocalories (kcal).
  • 6.
    To put oxygenconsumption and energy demands into proper perspective, consider the abilities of trained athletes who may reach maximal oxygen uptake capacity of up to 6 L/min. Aside from a person’s physique, age and gender influence the oxygen uptake capacity.
  • 7.
    Men who are20 years of age have an average maximal capacity of 3-3.5 L/min; women of the same age have an average capacity of 2.3-2.8 l/min. At age of 60 the capacity is diminished to about 2.2-2.5 L/min. for men and 1.8-2.0 L/min for women.
  • 8.
    The ability tomove oxygen from the air to the active muscle can be improved through physical training by up to 20 %. Of course, an individual’s capacity also depends on other “central” functions (e.g. of the circulatory of the cardiac system) and on “local” capacities (e.g. of muscles).
  • 9.
    To determine theindividual’s tolerance to physical work the following lung volumes and capacities can be measured: - tidal volume (TV) – the volume of gas inspired or expired during each respiratory cycle;
  • 10.
    - vital capacity(VC) – the maximum amount of air that can be exhaled from the lungs after a maximum inspiration. It is a very sensitive index for estimation of work capacity - forced expiratory volume in one second (FEV1) – the volume of air which can be forcibly expelled during the first second of expiration. Its reduction indicates reduction of airflow rates and prolongation of expiration.
  • 11.
    Energy cost ofwork Totally, the heaviest work that a young, fit man can sustain for prolonged periods is about 500 kcal/hr. Among the general population, this figure is somewhat lower: 400-425 kcal/hr.
  • 12.
    Industrial jobs seldomdemand such a high-energy expenditure over the course of a workday. Rest pauses, providing tools, and receiving instruction all tend to reduce the average energy expenditure considerably.
  • 13.
    When intermittent tasksare performed, the average expenditure may be calculated using the following formula: M = (M1t1 + M2t2 + ………Mntn)t-1 where M is the total energy cost; M1, M2 and so on are the energy costs of individual tasks; t1, t2 and so on indicate the duration of the individual task; and t is the total elapsed time.  
  • 14.
    Heart rate atwork There is a close interaction between the human circulatory and metabolic systems. Nutrients and oxygen must be brought to the working muscles and metabolic by-products removed from them to ensure proper functioning.
  • 15.
    Therefore, heart rate(which is a primary indicator of circulatory functions) and oxygen consumption (representing the metabolic processes taking place in the body) have a linear and reliable relationship in the range between light and heavy work.
  • 16.
    When very lightwork loads or very heavy ones are being handled, the relationship may not be reliable. It is also not reliable under severe environment conditions or when workers are under mental stress.
  • 17.
    Given such alinear relationship, one can often simply substitute heart rate measurements for a measurement of a metabolic process such as oxygen consumption. This is a very attractive shortcut, since heart rate measurements can be performed rather easily.
  • 18.
    The simplest techniquefor heart rate assessment is to palpate an artery, often in the wrist, and to count the number of heartbeats over a period of time such as 15 seconds and calculate the average heart beat per minute. More refined methods utilize various plethysmographic techniques.
  • 19.
    More expensive techniquesrely on electric signals generated by the nervous system that control heart rate. When using this technique, electrodes are usually placed on the patient’s chest. This allows recording of heart rate when the worker is performing his typical working operations – “heart rate at work”.
  • 20.
    Some of theseinstruments are computerized and have memory enough to record the heart rate up to 16 hours and to perform various analyses by software. It is quite important to record the basic, at rest, values of heart rate, to have in mind the individual (or due to other, even pathological conditions in the body) variability of heart rate, and to follow up its dynamical changes during the workday.
  • 21.
    This is usefulto provide a proper work/rest regimen.
  • 22.
    Use of heartrate measurements has one major advantage over oxygen measurement as an indicator of metabolic processes: heart rate reacts faster to work demands and therefore more easily indicates quick changes in body functions due to changes in work requirements.
  • 23.
    Work classification The work demands are usually rated from light to extremely heavy in terms of energy expenditure per minute, and the relative heart rate in beats peer minute is also given.
  • 24.
    Classification of Lightto Heavy work according to Energy expenditure and Heart rate Classification Total Energy expenditure Heart Rate (kcal/min) (beats/min) Light work 2.5 – 3 90 or less Medium work 3–5 90 – 100 Heavy work 5 – 7.5 100 – 120 Very heavy work 7.5 – 10 120 – 140 Extremely heavy work 10 – 15 140 or more
  • 25.
    When the workis light, the energy needs of the working muscles are supplied by oxygen available in the blood and by glycogen in the muscles. There is no building of lactic acid or other metabolic by-products that would limit a person’s ability to continue such work.
  • 26.
    In heavy work,during which the heart rate is about 120 beats/min, the oxygen required is still supplied if the person is physically capable to do such work and specifically trained in this job. However, the lactic acid concentration produced during the initial phase of work is not reduced but remains high until the end of the work period and returns to normal level after cessation of the work.
  • 27.
    In course oflight, medium, and even heavy (if the person is trained and capable) work, the metabolic and other physiological functions can attain a steady-state condition during the work period. No steady-state exists in the course of very heavy work.
  • 28.
    In this case,the oxygen deficit incurred during the early phase of work increases throughout the duration of the effort and metabolic by-products accumulate, making intermittent rest periods necessary or even forcing the person to stop this effort completely. That is why it is not advisable to perform work tasks requiring such efforts, excluding very short periods of time.
  • 29.
    Matching people andtheir work Obviously, it is important to match human capabilities with the related requirement of a given job. If the job demands equal the worker’s capabilities or if they exceed them, the person will be under much strain and may be not able to perform task. Hence, various functional stress tests, which are administered by a physician, have been developed to assess an individual’s capability to perform physically demanding work.
  • 30.
    Bicycle ergometers, treadmills,or steps are used to simulate stressful demands. The reactions of individual in terms of oxygen consumption, heart rate, or blood pressure are used to assess that person’s ability to withstand such demands. It is of big importance that the loading dosage is exact considering the age, body weight and gender.
  • 31.
    Example for suchstress test is the Master’s step test. The initial values of the blood pressure and heart rate beats are measured before loading and each minute after loading till the recovery to the initial values.
  • 32.
    The worker’s reactionis estimated as good when the increasing of heart rate is accompanied with an increasing of the maximal blood pressure with unchanged or slightly increased values of the minimal blood pressure.
  • 33.
    The reaction isastenic when the heart rate is increased, the heartbeats are weak, and the minimal and maximal blood pressure - slightly increased. Such reaction indicates insufficient heart function.
  • 34.
    In case ofdisturbed elasticity of the blood vessels the reaction is hypertonic – the maximal blood pressure increases suddenly, with the same tend for the minimal one; heart rate is also increased.
  • 35.
    In case ofdisturbed balance of the autonomic nervous system and the tonus of the peripheral blood vessels is decreased, the reaction is dystonic - the heart rate is increased and the minimal blood pressure suddenly decreases.
  • 36.
    Fatigue Fatigue isan overexertion phenomenon that leads to a temporary decrease in physical performance. It is often associated with a buildup of lactic acid in the body. Subjective feeling of fatigue is feeling tired and deteriorated mental and physical activities may result from it.
  • 37.
    The sensation offatigue has a protective function similar to hunger; feeling fatigue forces one to avoid further stress and allows recovery to take place. Fatigue-induced low performance can be completely restored to its full level by rest.
  • 38.
    Many different factorscan produce fatigue and the most important are: - physical work intensity (static and dynamic work); - lack of rest (sleep), and poor eating habits; and - psychological factors – worry, conflict, - monotony – a sensation associated with the lack of stimuli.
  • 39.
    Severe, continuous dailyfatigue eventually leads to chronic fatigue. Not only is the feeling of tiredness intensified and continuous after work, but occasionally a person feels tired before beginning work. The following signs signal chronic fatigue:
  • 40.
    - Increased irritability– intolerance, antisocial behavior - Tendency to depression –unmotivated worries - General weakness and a dislike for work - Nonspecific physical complaints – headaches, giddiness, palpitations, rapid breathing, loss of appetite, indigestion, or insomnia.
  • 41.
    When physical complaintsof this kind appear, the condition can be called ‘clinical fatigue”. As a result of this condition absence from work increase in frequency and duration, workers need longer rest periods, and they may show increased susceptibility to illness.
  • 42.
    It is oftendifficult to separate mental or emotional events from physical causes of fatigue. In clinical fatigue one is hardly to distinguish between cause and effect. A negative attitude toward one’s work, superiors, or place of work can just as well be a cause of clinical fatigue as the result of it.
  • 43.
    Work/rest cycles Inorder to avoid the fatigue and especially the chronic fatigue, rest pauses must be taken. Frequent short rest periods reduce cumulative fatigue better than a few long breaks. The worst procedure is to let the worker go home early, exhausted.
  • 44.
    A general principlefor the schedule work/rest cycles is to break up excessively hard work into bouts of work that are as short as is practical for the task at hand, or intermingling light tasks with heavy ones.
  • 45.
    The light, secondarywork task thus actually constitutes rest time from the heavy, primary task. Sharpening tools or walking to get material and other interruptions can provide productive respites from heavy work.