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Work, health, military: is the augmented human revolution already here?

How to assist or augment workers

with Marina Julienne, Independent Journalist
On June 23rd, 2022 |
3min reading time
Jean-Jacques Atain Kouadio
Jean-Jacques Atain Kouadio
Assistance expert at the Ergonomics and Psychology Applied to Prevention (EPAP) laboratory at INRS
Key takeaways
  • Musculoskeletal disorders (MSDs) account for 88% of occupational illnesses in France and back pain accounts for 20% of work-related accidents.
  • In 2012, the INRS launched an initial prospective study entitled “Use of physical assistance robots by 2030 in France” to relieve workers.
  • For the shoulder, for example, the teams viewed the inter-bone and tendon spaces, using ultrasound, and compared the behaviour of this joint with and without assistance.
  • But exoskeletons are not an answer to all the physical constraints to which employees are exposed.

How long has INRS been interested in this subject?

In 2012, INRS launched an ini­tial pro­spect­ive study entitled “Use of phys­ic­al assist­ance robots by 2030 in France”. At the time, there were two exo­skel­et­ons in France that were being tested in com­pan­ies. Barely ten years later, there are some forty of them avail­able on the mar­ket! They range from pos­ture har­nesses that help relieve the back to robot­ic exo­skel­et­ons that com­pensate for effort. For us, it is excit­ing that research and inter­ven­tions in the field are in phase with the emer­gence of these phys­ic­al assist­ance technologies.

Why are companies using exoskeletons?

Mus­cu­lo­skelet­al dis­orders (MSDs) account for 87% of occu­pa­tion­al ill­nesses and back pain accounts for 20% of work-related acci­dents – a size­able num­ber! As well as the dam­age caused to employ­ees, MSDs have a high eco­nom­ic cost for com­pan­ies and social secur­ity (days off work). This is why mech­an­ic­al devices that help com­pensate for the phys­ic­al efforts of oper­at­ors or assist them in their move­ments are already employed or being stud­ied in all fields: from the auto­mot­ive to the nuc­le­ar industry, includ­ing con­struc­tion, mass retail­ing, the health-med­ic­al-social sec­tor, etc.

How do you study these devices?

The labor­at­ory stud­ies focus on hand­ling and hold­ing loads to observe the con­sequences on the activ­ity of the muscles that are assisted as well as those that aren’t, on pos­ture and on motor coordin­a­tion. For the shoulder, for example, our team has stud­ied the space between bone and between ten­don tis­sue using ultra­sound and com­pared the beha­viour of joints with and without exo­skelet­al assist­ance. We are also car­ry­ing out assist­ance in con­junc­tion with pre­ven­tion net­works in com­pan­ies to ana­lyse how exo­skel­et­ons are integ­rated and wheth­er or not they are being accep­ted by employ­ees. It is import­ant to under­stand that the dif­fer­ence between this tech­no­logy and “clas­sic” phys­ic­al assist­ance is that it is attached to the per­son’s body. This assist­ance, while help­ing to reduce effort, can, at the same time, be felt by the wear­er as a phys­ic­al and psy­cho­lo­gic­al restraint. 

Do these devices effectively relieve physical effort?

Exo­skel­et­ons can bring sig­ni­fic­ant bene­fits, but they offer very loc­al­ised assist­ance and do not address all the phys­ic­al con­straints to which employ­ees are exposed. Import­antly, they can them­selves cre­ate new bio­mech­an­ic­al con­straints: impact on the mus­cu­lar activ­ity of muscles not assisted by the exo­skel­et­on, impact on bal­ance, on motor coordin­a­tion, suit­ab­il­ity for high rates of work and high degrees of move­ment repet­it­ive­ness, trans­fer of bio­mech­an­ic­al demands to oth­er parts of the body, etc. The nature and extent of the bene­fits or lim­it­a­tions observed depend on the activ­ity per­formed (the work­ing pos­ture adop­ted, load handled, work rhythm, etc.), the tech­nic­al char­ac­ter­ist­ics of the exo­skel­et­on (con­tact points, weight, stiff­ness, etc.), and the tasks identified.

So, it’s not that simple for companies to adopt these exoskeletons?

They must think very care­fully before choos­ing equip­ment and con­sider the impact it will have on the whole work organ­isa­tion. We are pub­lish­ing guides to help them ask the right ques­tions. First, think­ing about pos­sibly mak­ing use of an exo­skel­et­on must be accom­pan­ied by a broad­er reflec­tion aimed at redu­cing the con­straints linked to phys­ic­al activ­ity through organ­isa­tion­al changes, train­ing, etc. The pre­cise nature of the phys­ic­al assist­ance required must then be defined (the body areas to be assisted, pos­tures usu­ally adop­ted, load weights handled, etc.)

If the exo­skel­et­on solu­tion is chosen, it is then cru­cial to ini­ti­ate a test pro­cess by address­ing pre­cise eval­u­ation cri­ter­ia: to what extent has the oper­at­or taken on the equip­ment? Is it easy to use? Is it really use­ful? What are the effects of using the exo­skel­et­on on the envir­on­ment and the work group? How many people in a team will be equipped with an exo­skel­et­on? How will oth­ers view those who wear it? The exo­skel­et­on must be included in work­sta­tion ana­lys­is risks, as it may, for example, lead to new col­li­sion risks for the per­son wear­ing the equipment.

Many com­pan­ies do not real­ise the extent to which exo­skel­et­ons can dis­rupt an entire work­ing environment.

What are the regulations on the subject?

We must remem­ber that exo­skel­et­ons are there to “assist” oper­at­ors and not to “enhance”. To put it plainly, in the future, oper­at­ors will not be car­ry­ing loads that they were not car­ry­ing before, but rather car­ry­ing loads that they were already car­ry­ing with less risk of impact on their health. In this respect, the stand­ards in force today con­cern­ing load and phys­ic­al stress lim­its for manu­al hand­ling tasks must con­tin­ue to be respected.

Exopush: a textbook case

In 2014, the com­pany Colas1 exper­i­mented with its first robot­ic exo­skel­et­on, “Exopush”, for road­works where work­ers had to spread and level asphalt on the road. A kind of robot­ic rake was developed. It con­sisted of a har­ness, a strut that trans­fers the weight of the load to the ground in order to reduce effort and improve the user­’s pos­ture and a tele­scop­ic handle that detects the user­’s inten­tion and extends his move­ment. This equip­ment was little used in the field, how­ever. A multi-dis­cip­lin­ary steer­ing com­mit­tee bring­ing togeth­er the com­pany’s intern­al and extern­al pre­ven­tion play­ers was then set up, with the par­ti­cip­a­tion of the INRS. Numer­ous meet­ings with the teams were organ­ised, the equip­ment was adap­ted, the work­ers were trained, and a ded­ic­ated deploy­ment man­ager was appoin­ted in 2019 to gen­er­al­ise the use of almost 90 Exopushes in the dif­fer­ent branches of Colas.

1INRS; deploy­ment of a robot­ic exo­skel­et­on, feed­back from the Colas com­pany. Sept 2021

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