Postural Analyses of Coal Mining in Low Working Heights:
Effect of Working Height and Job Type
Subject Code ___________
Date ___________
Time ___________
Height (feet +inches) ___________ (meters) ______
Weight (lbs) ___________ (kilograms) ______
Body Mass Index (kg/m2) ______
Age (years) ___________
Time in job (years) ___________
Time in low height mines (years) ___________
Type of knee pad used ___________
Side SCSR is worn on ___________
Side cap lamp battery is worn on ___________
How control is worn ___________
Weight of mining belt (lbs) ___________ (kilograms) ______
Items worn on mining belt: _________________________________________________
________________________________________________________________________
Least physically demanding task that you perform on a daily basis: _________________
________________________________________________________________________
Most physically demanding task that you perform on a daily basis: __________________ ________________________________________________________________________
Comments on knee pads used. _______________________________________________
________________________________________________________________________________________________________________________________________________
How often do you clean your knee pads? ______________________________________
How do you clean them? ___________________________________________________
Public reporting burden of this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintain the data needed, and completing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX).
Subjects will be asked the following questions by a NIOSH representative. This data will be used to determine whether or not an injury to the knee may have influenced the postures utilized by the subject.
Check all that apply:
____ Diagnosed knee injury:_________________________
____ Pain/Redness/Swelling in front of knee
____ Infection/ Hardening at the front of knee
____ Popping feeling in knee
____ Pain inside the knee
____ Catching/Locking of knee
____ Instability/Feeling like knee is going to give away
____ Knee stiffness after waking up
____ General knee weakness
Please check all tasks that you perform on a daily basis.
____ Building stoppings
____ Rock dusting
____ Scooping/clean up
____ Bolting where unfinished
____ Advancing power load center
____ Moving/advancing belt (where applicable)
____ Changing miner bits
____ Other (please explain) _____________________________________
________________________________________________________
Task:_____________________________________________
How many hours do you spend performing this task on a daily basis? ____
Which two postures from the above chart (1-16) do you use most often?
_____ b)_____
What percentage of your time is spent in each posture (a, b)?
_____ % b) _____ %
Did the subject indicate that they used an obscure posture (posture not on list)?
If so, please describe.__________________________________________
____________________________________________________________
Task:_____________________________________________
How many hours do you spend performing this task on a daily basis? ____
Which two postures from the above chart (1-16) do you use most often?
_____ b)_____
What percentage of your time is spent in each posture (a, b)?
_____ % b) _____ %
Did the subject indicate that they used an obscure posture (posture not on list)?
If so, please describe.__________________________________________
____________________________________________________________
Task:_____________________________________________
How many hours do you spend performing this task on a daily basis? ____
Which two postures from the above chart (1-16) do you use most often?
_____ b)_____
What percentage of your time is spent in each posture (a, b)?
_____ % b) _____ %
Did the subject indicate that they used an obscure posture (posture not on list)?
If so, please describe.__________________________________________
____________________________________________________________
Task:_____________________________________________
How many hours do you spend performing this task on a daily basis? ____
Which two postures from the above chart (1-16) do you use most often?
_____ b)_____
What percentage of your time is spent in each posture (a, b)?
_____ % b) _____ %
Did the subject indicate that they used an obscure posture (posture not on list)?
If so, please describe.__________________________________________
____________________________________________________________
Task:_____________________________________________
How many hours do you spend performing this task on a daily basis? ____
Which two postures from the above chart (1-16) do you use most often?
_____ b)_____
What percentage of your time is spent in each posture (a, b)?
_____ % b) _____ %
Did the subject indicate that they used an obscure posture (posture not on list)?
If so, please describe.__________________________________________
____________________________________________________________
Task:_____________________________________________
How many hours do you spend performing this task on a daily basis? ____
Which two postures from the above chart (1-16) do you use most often?
_____ b)_____
What percentage of your time is spent in each posture (a, b)?
_____ % b) _____ %
Did the subject indicate that they used an obscure posture (posture not on list)?
If so, please describe.__________________________________________
____________________________________________________________
Task:_____________________________________________
How many hours do you spend performing this task on a daily basis? ____
Which two postures from the above chart (1-16) do you use most often?
_____ b)_____
What percentage of your time is spent in each posture (a, b)?
_____ % b) _____ %
Did the subject indicate that they used an obscure posture (posture not on list)?
If so, please describe.__________________________________________
____________________________________________________________
Task:_____________________________________________
How many hours do you spend performing this task on a daily basis? ____
Which two postures from the above chart (1-16) do you use most often?
_____ b)_____
What percentage of your time is spent in each posture (a, b)?
_____ % b) _____ %
Did the subject indicate that they used an obscure posture (posture not on list)?
If so, please describe.__________________________________________
____________________________________________________________
Task:_____________________________________________
How many hours do you spend performing this task on a daily basis? ____
Which two postures from the above chart (1-16) do you use most often?
_____ b)_____
What percentage of your time is spent in each posture (a, b)?
_____ % b) _____ %
Did the subject indicate that they used an obscure posture (posture not on list)?
If so, please describe.__________________________________________
____________________________________________________________
File Type | application/msword |
File Title | Study: Postural Analyses of Coal Mining in Low Working Heights: Effect of Working Height and Job Type |
Author | jni3 |
Last Modified By | Nelda Robinson |
File Modified | 2009-06-30 |
File Created | 2009-05-29 |