title: Workers' assessments of manual lifting tasks: cognitive strategies and validation with respect to objective indices and musculoskeletal symptoms.
abstract: OBJECTIVE
  To determine the different cognitive strategies adopted by workers in assessing the effects of lifting-task parameters on effort, and to validate workers' assessments.
  
  
  METHODS
  Questionnaires were administered to 217 male workers with varied levels of experience in manual handling. Workers were asked to assess the effects of lifting on perceived effort, using linguistic descriptors (e.g., light, heavy), and to determine the physical meaning of such descriptors. In addition, each worker assessed on-the-job effort, perceived risk of injury and work dissatisfaction, and musculoskeletal outcomes in a cross-sectional design.
  
  
  RESULTS
  Perceived physical effort was significantly associated with lifting variables. Results indicated that the three-cluster strategy is the best performer. Weight of load emerged as the most influential factor that impacted on effort in the most dominant cluster (close to 50% of the observations). The second cluster (25% of the observations) demonstrated that weight, horizontal distance, and twisting angle, contributed equally to effort, and the third cluster had weight and vertical travel distance as the most important variables (with travel distance being more important). Perceived effort was significantly associated with objective indices (i.e., biomechanical lifting equivalent and NIOSH lifting index), and musculoskeletal symptoms in eight body parts.
  
  
  CONCLUSIONS
  Cognitive reasoning of experienced workers may be used as an active device for the evaluation of strenuous physical activities such as lifting tasks. Lifting activities are significantly associated with musculoskeletal symptoms, not only in the lower-back region, but also in seven other body parts; and effort may integrate the effects of both physical (lifting tasks) and non-physical (i.e., work dissatisfaction) factors, as well as perception of risk.
authors.affiliation: Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong. simon.yeung@polyu.edu.hk
authors.forename: Simon S
authors.initials: SS
authors.lastname: Yeung
authors.forename: Ash
authors.initials: A
authors.lastname: Genaidy
authors.forename: James
authors.initials: J
authors.lastname: Deddens
authors.forename: P C
authors.initials: PC
authors.lastname: Leung
mesh_terms: D003071:Cognition; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017770:Lifting; D017116:Low Back Pain; D008297:Male; D009048:Motor Skills; D009141:Musculoskeletal System; D009784:Occupational Diseases; D012647:Self-Assessment; D011795:Surveys and Questionnaires