# Skilled Workers' Perspectives on Utilizing a Passive Shoulder Exoskeleton in Construction
## 1 Introduction  
Canada's construction sector plays a vital role in our national and provincial economies; however, it faces record-high job vacancy rates that will impact its economic contribution and have made construction businesses less competitive. Typically, construction work exposes workers to numerous risk factors for the development of musculoskeletal disorders (MSD), including awkward postures, forceful exertions, contact stress, vibration, repetitive movements, overhead work, and low temperatures [1, 2, 3, 4]. Incidence rates of MSD (40%) are among the highest in construction compared to all other industries combined [5]. These disproportionately high MSD rates, in combination with the aging workforce and the lack of young workers pursuing careers in construction, prioritize sustainability as a major issue for this sector [6]. Without intervention, the construction trades in Ontario alone expect a significant shortage of skilled workers over the next decade: at least 170,000 workers will be needed to meet industry demands by 2027, as 13% of the current labor force is expected to retire within the next 3 years [7]. As such, there is an immediate need to prolong the healthy working life of the existing and aging construction workforce, reduce MSD risks, and attract younger workers. Adoption of industrial exoskeletons may contribute to better sustaining the construction industry (i.e., reducing MSD risks, enticing young workers to pursue a career in construction, and prolonging the working life of the aging construction workforce). Industrial exoskeletons are wearable, external mechanical structures designed to augment, amplify, or reinforce the performance of a worker's body part(s). They are often classified by type (i.e., active or passive) and by which body part they support (i.e., lower body, upper body, back, or full body) [8]. Active exoskeletons consist of external actuators, such as electric motors, hydraulic actuators, and pneumatic muscles, to augment the user's power and provide extra energy [8; 9]. In contrast, passive exoskeletons do not use any actuators. Instead, they rely on mechanisms such as springs and dampers to store and release energy generated by the user's movements [8; 9]. While several types of exoskeletons exist for various applications, this study focuses on applying a passive shoulder exoskeleton intended for construction work. With the emergence of commercially available passive shoulder exoskeletons, researchers and organizations have been trying to better understand the impacts of exoskeletons on workers' health, safety, performance, and the organization's economic viability [10]. Under controlled laboratory settings, passive shoulder exoskeletons have demonstrated their efficacy in decreasing muscle activity [11], increasing endurance [12], and improving work performance and productivity [12] for tasks across various industries. For example, using shoulder exoskeletons reduced shoulder discomfort and increased productivity and work quality in simulated painting and welding tasks [13]. Despite the demonstrated benefits of exoskeletons, some drawbacks have also been identified. For example, increased chest pressure and decreased mobility have been documented as a result of exoskeleton use [8; 12; 14]. Although exoskeletons have been implemented in other industries, such as automanufacturing and logistics [15; 16; 17], the integration of innovations aimed at reducing injury risks, such as exoskeletons, into the construction industry has been deemed challenging and 'lagging behind' [18; 19; 20; 21]. Several studies have sought to better understand the barriers and facilitators in the uptake of exoskeletons in construction. For example, construction industry representatives (i.e., vice presidents, project managers, health and safety managers/directors, and carpenters) were interviewed about their perspectives on adopting exoskeletons [20]. Many stakeholders expressed concerns regarding the ruggedness, effectiveness, versatility, and usability of exoskeletons.