Author ORCID Identifier

https://orcid.org/0009-0004-6076-5141

Semester

Summer

Date of Graduation

2024

Document Type

Dissertation

Degree Type

PhD

College

Statler College of Engineering and Mineral Resources

Department

Industrial and Managements Systems Engineering

Committee Chair

Ashish Nimbarte

Committee Co-Chair

Avishek Choudhury

Committee Member

JuHyeong Ryu

Committee Member

Imtiaz Ahmed

Committee Member

Christopher Moore

Abstract

Work-related injuries, illnesses, and musculoskeletal disorders (MSDs) significantly impact the U.S. healthcare industry, leading to lost working days, high medical costs, and increased turnover rates among healthcare workers (HCWs). Increased physical and mental health risks due to the handling of deceased during COVID-19 pandemic has exacerbated these issues. While the ergonomic risks of patient handling are well-studied, limited research exists on the ergonomic risks of manual handling of the deceased. Therefore, the primary objective of this study was to explore the challenges associated with decedent handling so that effective safety interventions to reduce the risk of injury and mental distress among decedent handlers can be developed.

This study used an exploratory sequential mixed-methods research approach, combining both qualitative and quantitative data, to evaluate/assess and model the risks of mass decedent handling. A total of 206 decedent handlers participated in a cross-sectional survey study designed to explore the challenges of mass decedent handling during the COVID-19 pandemic. The most common safety concerns reported by HCWs included no access to PPE, inadequate PPE, physical overexertion, exposure to COVID-19, unclear guidelines, and mental distress from working in mass fatality environments. The second phase of the study investigated the impact of decedent handlers' subjective (rating of) workload on their mental health and willingness to continue in the healthcare industry. The modeling results showed that increased perceived workload among HCWs led to worsening mental health and reduced willingness to continue in the healthcare profession. One of the key takeaways from the survey study was that HCWs experienced elevated physical overexertion when performing decedent handling tasks, many attributing that to the poor designs of the body bags. These findings led to the development of the second study, a biomechanical lab-based experiment where 24 participants performed simulated decedent-handling tasks with 2 types of body bags. Results showed that differences in body bag grasp points (i.e., handle position) significantly affected peak joint angles (twisting, flexion/extension, and adduction/abduction) at the hips, shoulders, chest, elbows, and knees. Additionally, the handler's relative position with respect to the deceased (i.e., standing at the head or foot of the body) significantly affected different body joints (left and right sides of the body, along the sagittal plane). The body joints located closer to the goal-forward direction of the transfer task were more affected, resulting in peak joint angles being observed on opposite sides for participants performing the two-person task at the head and foot of the mannequin.

Overall, the study findings provide a holistic perspective on the challenges and risks of handling deceased during mass fatalities. The survey study provides the foundation for developing robust emergency response plans to address the multifaceted challenges of mass decedent handling. The biomechanical study results have implications for body bag design recommendations and task rotation strategies. Overall, this study provides equipment and task design recommendations to reduce the risk of injury and create a safer and healthier work environment for healthcare workers.

Embargo Reason

Publication Pending

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Available for download on Wednesday, June 25, 2025

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