Scoop Operator Form

Postural Analysis in Low-Seam Mines

Attachment 10 - Scoop Operator Form

Scoop Operator Form

OMB: 0920-0829

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Postural Analyses of Coal Mining in Low Working Heights:

Effect of Working Height and Job Type

  1. Subject Code ___________

  2. Date ___________

  3. Time ___________

  4. Height (feet +inches) ___________ (meters) ______

  5. Weight (lbs) ___________ (kilograms) ______

Body Mass Index (kg/m2) ______

  1. Age (years) ___________

  2. Time in job (years) ___________

  3. Time in low height mines (years) ___________

  4. Type of Knee pad used ___________

  5. Side SCSR is worn on ___________

  6. Side cap lamp battery is worn on ___________

  7. 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? ___________________________________________________

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


______ Scoop faces

______ Load and unload supplies

______ Rock dust

______ Building stoppings

______ Advancing power load center

______ Hanging cable

______ Hanging curtain

______ Extending tubing

______ 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?

  1. _____ b)_____


What percentage of your time is spent in each posture (a, b)?

  1. _____ % 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?

  1. _____ b)_____


What percentage of your time is spent in each posture (a, b)?

  1. _____ % 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?

  1. _____ b)_____


What percentage of your time is spent in each posture (a, b)?

  1. _____ % 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?

  1. _____ b)_____


What percentage of your time is spent in each posture (a, b)?

  1. _____ % 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?

  1. _____ b)_____


What percentage of your time is spent in each posture (a, b)?

  1. _____ % 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?

  1. _____ b)_____


What percentage of your time is spent in each posture (a, b)?

  1. _____ % b) _____ %


Did the subject indicate that they used an obscure posture (posture not on list)?

If so, please describe.__________________________________________

____________________________________________________________


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File Typeapplication/msword
File TitleScoop Operator
Authorjni3
Last Modified ByNelda Robinson
File Modified2009-05-29
File Created2009-05-29

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