Fatigue during prolonged intermittent overhead work: reliability of measures and effects of working height.

Shoulder pain is prevalent among industrial workers and existing evidence supports that overhead work is an important specific risk factor. Existing guidelines are limited, with overhead work typically recommended to be avoided, and research on overhead work has been mixed in terms of the effects of increasing arm reach. A laboratory-based simulation of overhead work was conducted, at three working heights, in order to facilitate improved guidelines and to identify potential non-linear effects of overhead work height. Several indicators of shoulder fatigue served as outcome measures and a preliminary study was performed to assess the reliability of several of these measures. Fatigue measures based on electromyography (EMG) generally had low reliability, whereas excellent reliability was exhibited for ratings of perceived discomfort (RPD). Consistent with this, no effects of overhead work height were found on EMG-based measures, yet clear non-linear effects were found on RPD and task performance. The source of the effects of work height appeared to be related to a combination of muscle activation levels and demands on precision/control at the highest location. These results support the utility of subjective measures for relatively low-level intermittent exertions and demonstrate increasingly detrimental fatigue and performance effects at extremes in reach during overhead work.