Wearable System for the evaluation of Well-Being in the Workplace
Authors: Paradiso Rita , Krijnen Eefke , Vannetti FEderica 
Published: June 2024

Healthcare workers experience physically, emotionally stressful situations, are exposed to human suffering, experience pressure from interactions with patients and family members, and are under constant threat of infection, injury and stress. Healthcare workers are at greater risk of developing stress-related mental disorders, such as depression or post-traumatic stress disorder (Braquehais et al., 2023, doi:10.1016/j.mcna.2022.04.004). The COVID-19 pandemic has highlighted the need for healthcare organizations to ensure the well-being of healthcare workers. Indeed, more stressful working hours, the fear of being infected and the need to ensure immediate decision-making have significantly increased the risk of burnout, depression, anxiety and insomnia. In the USA and Europe, a series of regulations have been issued to preserve the health of workers, specific to the workload linked to the various tasks and in the literature work-related stress indices have been evaluated in the healthcare sector, linked to muscle disorders skeletal injuries due to patient handling, for nurses and personal care/assistance workers. However, biomechanical overload and the risk of damage to the musculoskeletal system are only one aspect linked to the health of the worker: the dimension of work stress has a significant role in the general well-being of the worker during his activities and a methodology for the objective assessment of mental and physical workload in work environments.In this study we propose the use of a wearable system (WWS by Smartex) compatible with work activity, to monitor and extract significant information on the workload, due to the physical demand and the physiological response to stress, on a sample of physiotherapists. The system consists of a t-shirt for the continuous detection of a cluster of physiological parameters, that can be stored and processed during work. The system detects an ECG lead via integrated textile electrodes, the respiratory signal through the measurement of thoracic movement, posture, and physical activity recognition, via an Inertial and Magnetic Measurement Unit (IMMU), integrated into the RUSA device, a portable data logger dedicated to the acquisition, processing, storage and/or transmission of data.The RUSA is connected to the garment through a simple plug and can be easily unplugged when necessary. The T-shirt is absolutely similar to a common underwear. The base yarn is composed by antibacterial materials to guarantee a safe and prolonged use. The sensors are made of fibers that are directly woven during the production process to be fully integrated in the garment without discontinuity. The shirts come in male and female version and in several sizes to fit the largest number of users. The data acquired by the RUSA are processed on board to extract the following parameters: Hearth Rate (HR), HR Variability, RR interval, signal quality, Breathing rate, activity classification, activity intensity. The RUSA can save data on a Flash Memory (microSD), transmit data via Bluetooth® 2.1), save and transmit them simultaneously, without losing information in case of interruption of wireless transmission.A pilot study has been performed on 11 physiotherapists, engaged in XX sessions. During the study, the cluster of physiological data have been combined with a set of meta-data related to the work session such as the type of intervention (i.e. neurological rehabilitation, orthopaedic rehabilitation, etc), the level of physical impairment of the patient (according to modified Rankin score and Communicative disability scale), the working place etc.). As well as to the results of NASA questionnaire that has been administrated after each acquisition section to the physiotherapists. Preliminary results on the stress level will be presented, in parallel to evaluate the use of the IMMU platform for the overload of the musculoskeletal system, research on the posture evaluation in the rehabilitation workplace has been performed. The accuracy of a single IMMU to retrieve trunk angles was assessed by comparison with stereophotogrammetry. The results revealed that the IMMU is adequately effective in determining sagittal angles but has limitations in assessing lateral and transverse angles in a natural and uncontrolled environment.