Automation in Construction 44 (2014) 227233

Contents lists available at ScienceDirect

Automation in Construction
journal homepage: www.elsevier.com/locate/autcon

Physiological condition monitoring of construction workers

Umberto C. Gatti a,1, Suzanne Schneider b, Giovanni C. Migliaccio c,
a
b
c

Department of Civil Engineering, University of New Mexico, 210 University Blvd NE, Albuquerque, NM 87106, USA
Department of Health, Exercise and Sports Sciences, University of New Mexico, MSC04 2610, Albuquerque, NM 87131, USA
Department of Construction Management, College of Built Environments, University of Washington, 120 Architecture Hall, Box 351610, Seattle, WA 98195, USA

a r t i c l e

i n f o

Article history:
Received 13 August 2013
Revised 8 January 2014
Accepted 19 April 2014
Available online 10 May 2014
Keywords:
Construction worker
Physiological status monitoring technology
Work physiological demand
Work physiology
Productivity
Occupational health and safety
Construction management
Ergonomics

a b s t r a c t
Monitoring of workers' physiological conditions can potentially enhance construction workforce productivity,
safety, and well-being. Recently, Physiological Status Monitors (PSMs) were validated as an accurate technology
to assess physiological conditions during typical sport science and medicine testing procedures (e.g., treadmill
and cycle ergometer protocols). However, sport science and medicine testing procedures cannot simulate routine
construction worker movements in a comprehensive manner. Thus, this paper investigated the validity of two
PSMs by comparing their measurements with gold standard laboratory instruments' measurements at rest and
during dynamic activities resembling construction workforce's routine activities. Two physiological parameters
such as heart rate and breathing rate were considered. Ten apparently healthy subjects participated in the
study. One of the PSMs proved to be a viable technology in assessing construction workers' heart rate (correlation
coefcient 0.74; percentage of differences within 11 bpm 84.8%).
2014 Elsevier B.V. All rights reserved.

1. Introduction
Despite enhancements in construction equipment, methods, and
workplace safety and ergonomics, the construction industry is among
the most dangerous and physically demanding industries. For instance,
the US Bureau of Labor Statistics [1,2] indicate that in 2011 the US construction industry had over 180 thousand nonfatal occupational injuries
and 738 fatal occupational injuries accounting for over 5% and 15% of the
total recorded injuries, respectively. Further, as noted elsewhere [3], researches indicate that productivity in construction decreased in the
past decades while it generally increased in other industries [47].
Therefore, it is imperative to develop innovative tools, methods, and
techniques capable of improving productivity and safety in construction.
According to Strasser [8], the assessment of workers' physiological
conditions is a crucial prerequisite in every ergonomics study. Further,
several authors [921] suggest that excessive work physiological demands can negatively affect safety and productivity due to a decrease
in workers' well-being, attentiveness, motivation, and capacity to perform muscular work. Thus, devices capable of assessing worker's physiological conditions and, eventually, work physiological demands can
play a crucial role in supporting the development of the needed tools,
Corresponding author. Tel.: +1 206 685 1676.
E-mail address: gianciro@uw.edu (G.C. Migliaccio).
1
Present address: Department of Construction Management, University of Washington,
Box 351610, Seattle, WA 98195, USA.

http://dx.doi.org/10.1016/j.autcon.2014.04.013
0926-5805/ 2014 Elsevier B.V. All rights reserved.

methods, and techniques to enhance construction workforce productivity, safety, and well-being. In fact, few recent studies used one or more
workers' physiological parameters in developing tools to improve construction workforce performance. For instance, Hsie et al. [21] implemented workers' energy expenditure in developing a theoretical
model that can be used to generate efcient workrest schedules.
Cheng et al. [3,22] utilized workers' thoracic posture to develop an algorithm capable of characterizing worker's activity in terms of productivity and safety behavior.
Numerous techniques are available to assess work physiological demands through the assessment of physiological conditions, such as questionnaires (e.g., rating of perceived exertion), oxygen consumption,
motion sensors, and heart rate monitoring. Several authors applied one
or more of these techniques to monitor various workforces, such as construction workers [9,10,2325], manufacturing workers [2629], farmers
[3032], and nurses [3335]. These studies successfully assessed work
physiological demands. Nevertheless, most of these studies employed
monitoring tools and/or technologies that can be hardly employed on
construction sites. For example, some studies used monitoring tools
that could not continuously monitor the subjects. Other studies
employed cumbersome and/or uncomfortable monitoring devices that
would hinder construction workers during routine activities if used as
standard construction equipment. In addition, some monitoring
methods were suitable only for small groups in experimental settings.
Among the available physiological demand assessment techniques,
heart rate is very promising for daily and eld situations [13,36,37].

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U.C. Gatti et al. / Automation in Construction 44 (2014) 227233

Numerous portable, lightweight, unobtrusive, and comfortable heart

rate monitors are available on the market. In particular, innovative
devices called Physiological Status Monitors (PSMs) can monitor
heart rate and many other physiological parameters (e.g., breathing
rate, body acceleration, and skin temperature) simultaneously.
PSMs have already been implemented to monitor police ofcers,
re ghters, and soldiers; to test physical performance (e.g., professional American football and soccer athletes); and, in healthcare
(e.g., home/remote healthcare). Few studies analyzed PSM validity
in measuring heart rate and/or other physiological parameters
[3843]. These studies implemented exclusively typical sport science and medicine testing procedures such as treadmill, walkjog
run, and cycle ergometer protocols. Routine construction worker
movements include walking but also lifting and carrying, and repetitive motions, such as arm lifting and thoracic rotations [4446].
Therefore, sport science and medicine testing procedures can hardly
simulate routine construction worker movements in a comprehensive manner. Further, these studies demonstrated that PSM accuracy
in measuring heart and breathing rate depends on the subject movement intensity and characteristics. It is, therefore, necessary to implement testing procedures capable of simulating routine construction
worker movements to effectively investigate the PSM validity in monitoring construction workforce. Thus, the goal of this paper is to validate
two off-the-shelf PSMs in monitoring subjects performing static and dynamic tasks comparable to construction workforce's routine movements. The validation procedure is based on the analysis of the
agreement between PSM and gold standard laboratory instrument
measurements of Heart Rate (HR) and Breathing Rate (BR) during static
and dynamic activities [4750]. In the following sections an overview of
the selected PSMs is given. Then, the study protocol is presented and the
obtained results are discussed.

2. Materials and methods

2.1. Description of PSMs and their key features
PSMs are wearable telemetry systems that are capable of monitoring
numerous physiological parameters (Table 1) in a non-invasive, autonomous, and wireless manner. In fact, PSMs are designed to be comfortably and continuously worn for several hours and to not hamper any
type of movement. PSMs can include numerous elements, such as biosensors, wearable materials, smart textiles, actuators, power supplies,
wireless communication modules and links, control and processing
units, interface for the user, software, and advanced algorithms for
data extracting and decision making [51]. In particular, sensors can
be either located in a fabric chest belt/garments (e.g., a vest), or be implantable. Two off-the-shelf PSMs were selected for evaluation
(Table 2): BioHarness BT 1 (BH-BT) manufactured by Zephyr Technology Corporation (Annapolis, MD, USA); and, Equivital EQ-01 (EQ-01)
manufactured by Hidalgo Ltd (Swavesey, UK).

2.2. Participants
The participants of the study were ten apparently healthy participants (seven males and three females, age 23.8 2.9 years., body stature 179 8 cm, body mass 75.5 10.7 kg). All participants were
informed about the potential risks of the study and provided a written
informed consent. Further, the participants completed a physical activity
questionnaire based on the PAR-Q [54] and a health history questionnaire to verify that it was safe for them to perform moderate physical activity. The University of New Mexico's Human Research Policies and
Procedures Board (HRRC) granted the permission to perform the study.
2.3. Experimental design
Depending on the monitored physiological parameter, different experimental procedures were implemented. HR and BR were monitored
simultaneously at rest and during dynamic activities (n = ten subjects).
Experimental design detailed description is provided in the following
sections.
PSMs determine HR and BR by collecting the heart's electric signal
through electrocardiography leads embedded in the PSM chest belt
and by measuring chest belt expansions and contractions, respectively.
Thus, chest belt displacements due to movements during dynamic activities can affect HR and BR assessment [55,56]. Moreover, EMG activity
(i.e., electrical signals generated by skeletal muscle contractions) may
superimpose the heart's electric signal and, therefore, hinder HR assessment [57,58]. Thus, to assess PSM validity in monitoring construction
workers' HR and BR, a series of static and dynamic activities comparable
to construction workforce's routine movements were designed
(Table 3) to be performed by the study participants.
The participants were prepared according to the following procedure. First, the participants were prepared for EKG monitoring (CASE
Exercise Testing Electrocardiogram, GE Healthcare, Waukesha, WI,
USA) at 500 Hz using ve connections (V5, left arm, left leg, right arm,
and right leg) to avoid hindrances with PSM chest belts. The participants
were then asked to wear a nose clip and a mouthpiece connected to a
metabolic cart developed by the University of New Mexico Exercise Science Laboratory to collect the inspired and expired air and, therefore, to
determine BR. Finally, according to the manufacturer's instructions, the
PSM chest belts were placed just below the sternum after moistening
the skin electrodes. The participants accomplished the designed activities wearing one PSM at a time. First, the participants accomplished all
the activities by wearing the BH-BT device. Then, after resting for
20 min, the participants repeated the testing protocol wearing the EQ01 device.
2.4. Signal processing and data analysis
Signal processing and data analysis were accomplished ofine with
Matlab R2008a (The Mathworks, Natick, MA, USA) and Microsoft
Excel 2010 (Microsoft, Seattle, WA, USA). PSMs and lab instruments'

Table 1
Parameters that can be potentially monitored by PSMs.
Parameter

Type of sensor

Description of measured data

Electrocardiogram (EKG)
Heart rate
Breathing rate
Skin/body temperature
Body movement
Body orientation
Blood pressure
Oxygen saturation
Perspiration
Electromyogram (EMG)

Skin/chest electrodes
Skin/chest electrodes or pulse oximeter
Piezoelectric/piezoresistive sensor
Temperature skin patch/probe
Accelerometer
Accelerometer
Arm cuff-based monitor
Pulse oximeter
Galvanic skin response sensor
Skin electrodes

Electrical activity of the heart

Frequency of the cardiac cycle
Frequency of the breathing cycle (i.e., inspiration and expiration)
Skin surface/core body temperature
Accelerations due to body movements
Body orientation according to the gravity
Pressure exerted by circulating blood on the walls of blood vessels
Amount of oxygen carried in the blood
Electrical conductance of the skin associated with the activity of the sweat glands
Electrical activity of the skeletal muscles

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229

Table 2
Sample of BH-BT, EQ-01 technical specications [52,53].

Dimensions
Weight (without belt)
Adjustable shoulder strap
Standard monitored parameter
(sampling & reporting frequency; resolution)

Optional parameter
Wireless transmission
Internal memory
Viewing and analysis software

BH-BT

EQ-01

80 40 15 mm
35 g
Over both shoulders, removable
Heart rate (250 & 1 Hz; 1 bpm)
Breathing rate (18 & 1 Hz; 0.1 Bpm);
Skin temperature (1 & 1 Hz; 0.1 C);
3D accelerations (50 & 50 Hz; 0.1 m/s2)
Body orientation (50 & 1 Hz; 1)
Galvanic skin response;
oxygen saturation; and, core body temperature
Bluetooth
Fixed, 229 Mbyte
Proprietary software developed by Zephyr

123 74 14 mm
75 g
Over left shoulder, xed
Heart rate (256 & 0.07 Hz; 1 bpm)
Breathing rate (25.6 & 0.07 Hz; 1 Bpm);
Skin temperature (0.25 & 0.07 Hz; 0.1 C)
3D accelerations (25 & 25 Hz; 0.09 m/s2)
Body orientation (25 & 1 Hz; 1)
Galvanic skin response; oxygen s
aturation; and, core body temperature
Bluetooth
Removable, micro SD card
Proprietary software developed by Hidalgo

Unit of measurement: millimeter (mm); gram (g); Hertz (Hz); beat per minute (bpm); breath per minute (Bpm); Celsius scale (C); and, meter per second squared (m/s2).

HR and BR signals were re-sampled from the original reporting period

(i.e., BH-BT 1 s; EQ-01 15 s; lab EKG monitor 1/500 s; and, metabolic cart NA) to 15 s.
Data analysis was performed by calculating Pearson product
moment correlation coefcient (r), and by using the BlandAltman
technique [59] as done in many similar studies dealing with the
validation of a physiological monitoring device [3843,6065].
Fist, by considering previous validation studies indicating boundaries for the Pearson productmoment correlation coefcient [41,
42,55,66], the following boundaries were assumed:

r N 0.9 excellent correlation;

0.7 r 0.9 very large correlation;
0.5 r 0.7 moderate to good correlation; and,
r b 0.5 minor correlation.

Then, differences between the PSM- and lab-measurements were

analyzed by applying the BlandAltman technique. Thus, the mean difference between the two measurement methods (D), the standard deviation of the differences (s), the Limits of Agreement (LoA) equal to D
1.96s, and the percentage of differences within the LoA (%DLoA) were
calculated.
Studies analyzing the validity of instruments measuring HR and/or BR
are available in the medical literature. Some of these studies applied the
BlandAltman technique to validate innovative clinical monitoring instruments by suggesting maximum acceptable LoA and considering an innovative instrument valid if 95% of the differences were within the

Table 3
Description of the activities.
Activity

Duration

Description

1. Static
2. Thoracic rotation

5 min
5 min

3. Arm lifting

5 min

4. Batting

5 min

5. Weight moving

10 min

6. Walking

10 min

The participant sits without moving.

The participant rotates the torso either side
(average pace 20 movements per minute)
keeping his/her forearms horizontal and
raised at the device level (i.e., just below
the sternum).
The participant stands and raises his/her arms
simultaneously to vertical alongside his/her
ears position and lowers again
(average pace 30 movements per minute).
The participant repeats a combined movement
of the arms and the twisting of the torso to
either side (i.e., like a baseball batting; average
pace 12 movements per minute).
The participant repetitively moves a 5-kg weight
for a distance of 3 m. The weight is on the oor,
thus the participant bends down to pick it up,
walks 3 m, and sets it down.
The participant walks on a treadmill at two
different walking paces: 5 min at 4.8 km/h
(i.e., 3 mph), and 5 min at 6.4 km/h (i.e., 4 mph).

maximum acceptable LoA. In accordance with medical and sport science

studies, the maximum acceptable LoA selected for this study
were 11 beats per minute for HR [40,41,67,68] and 3 breaths per
minute for BR [40,41,60]. Therefore, the percentage of differences within
these LoA (%Dmv) was also calculated.
Previous studies assessing the validity of portable instruments measuring HR and/or BR removed data sets when measurements were evidently affected by technical issues affecting the reference and/or tested
instrument [41,42,55]. Therefore, before performing the data analysis,
the following data cleaning procedures were adopted for HR and BR
data. A HR data set was removed if the absolute mean of the differences
(i.e., absolute value of D) was higher than 20 beats per minute, and a BR
data set was removed if the absolute mean of the differences was higher
than 7 breaths per minute.
3. Results
All participants accomplished the testing procedure with no adverse
events. Nevertheless, one of the EQ-01 monitoring belts stopped working preventing the collection of BR data for two participants. Table 4
shows the maximum and minimum values measured by each device
(i.e., PSMs and lab instruments), the number of data pairs, and the
total testing time.
3.1. Heart rate
3.1.1. BioHarness BT 1
Validity statistics for BH-BT (unit of measurement beat per minute, bpm) are presented for every activity in Table 5. No data
cleaning was necessary for BH-BT data. BH-BT obtained excellent correlation (r 0.94), small D and s (0.78 D 0.22 bpm; s 4.05 bpm),
and validity (%Dmv 98.4%) for activity 1, 2, and 3. Decreased precision
is seen for activity 4, 5, and 6 with lower correlation, yet very large (0.74
r 0.78), larger D and s ( 4.81 D 1.68 bpm; 6.73 s
9.01 bpm), and %Dmv lower than 95% (84.8% %Dmv 90.3%).
3.1.2. Equivital EQ-01
Validity statistics for EQ-01 are presented for every activity in
Table 6. When considering all the data (i.e., 10 participants), EQ-01 obtained excellent correlation (r 0.92) for activity 1 and 5; very large
correlation (0.73 r 0.85) for activity 2, 3, and 6; and, moderate correlation (r = 0.52) for activity 4. In activity 1, relative small D and s
are seen (D = 2.29 bpm; s = 3.49 bpm), and validity is achieved
(%Dmv = 98.4%). In all the other activities, statistics presented reduced
precision with large D and s (D 4.83 bpm; s 5.17 bpm), and %Dmv
lower than 95%. After removing data with clear technical error in activity
3, 4, and 6 (i.e., a total of 3 data sets over 60 data sets were removed), results improved with higher correlation (0.68 r 0.89), and smaller
LoA though %Dmv remained lower than 95% (55.8% %Dmv 91.1%).

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U.C. Gatti et al. / Automation in Construction 44 (2014) 227233

Table 4
Minimum and maximum values, number of data pairs, and total testing time.
Parameter

Device

Minmax
value

Data
pairs

Total testing
time

HR

BH-BT
Lab paired with BH-BT
EQ-01
Lab paired with EQ-01
BH-BT
Lab paired with BH-BT
EQ-01
Lab paired with EQ-01

59165 bpm
59162 bpm
64150 bpm
47171 bpm
662 Bpm
665 Bpm
761 Bpm
791 Bpm

1504

6 h 16

1499

6 h 14 45

1567

6 h 31 45

1207

5 h 1 45

BR

to enhance construction workforce productivity, safety, and wellbeing. However, PSM validity in monitoring construction workforce's
physiological parameters has yet to be determined. Validity refers to
the soundness or appropriateness of the test (i.e., measuring instrument)
in measuring what it is designed to measure. Validity may be determined [] by a comparison to another test known to be valid [49]. In
the present study, the validity of two PSMs was evaluated by analyzing
the agreement between PSM and gold standard laboratory instrument
measurements during static and dynamic tasks comparable to construction workforce's routine movements. Two physiological parameters
were considered such as HR and BR.

Unit of measurement: beat per minute (bpm); breath per minute (Bpm).

4.1. Heart rate

3.2. Breathing rate
3.2.1. BioHarness BT 1
Validity statistics for BH-BT (unit of measurement breath per
minute, Bpm) are presented for every activity in Table 7. When considering all the data (i.e., 10 participants), BH-BT showed excellent correlation (r 0.91) for activity 1 and 6; very large correlation (0.73 r
0.83) for activity 3 and 4; and, minor correlation (0.16 r 0.44)
for activity 2 and 5. BR data produced low D and s (D = 0.19 Bpm;
s = 1.22 Bpm) and %Dmv was equal to 95% in activity 1. In all the
other activities, statistics presented reduced precision with large LoA
and %Dmv lower than 95%. After data cleaning (i.e., a total of 7 data
sets over 60 data sets were removed), results improved with higher correlation (0.54 r 0.93) and lower D and s (2.42 D 0.08 bpm;
3.01 D 4.83 Bpm) though %Dmv remained lower than 95%.
3.2.2. Equivital EQ-01
Validity statistics for EQ-01 are presented for every activity in
Table 8. When considering all the data (i.e., 8 participants), BH-BT
showed excellent correlation (r 0.91) for activity 3 and 6; very large
correlation (0.71 r 0.87) for activity 1, 2, and 5; and, moderate correlation (r = 0.55) for activity 4. EQ-01 obtained large D and s, and
%Dmv lower than 95% in all the activities. After data cleaning for activity
1 and 5 (i.e., a total of 2 data sets over 48 data sets were removed), results improved with excellent correlation (r = 0.97) and lower D and
s (D = 1.05 Bpm; s = 1.65 Bpm) though %Dmv remained lower
than 95% (%Dmv = 88.3%) for activity 1; and, correlation slightly worsened (r = 0.81), and D and s slightly improved (D = 3.05 Bpm; s =
4.26 Bpm) for activity 5.
4. Discussion
By assessing work physiological demands, PSMs can play a crucial
role in supporting the development of tools, methods, and techniques

BH-BT measurements were extremely accurate in activity 1, 2, and 3

(i.e., static, thoracic rotation, and arm lifting) with excellent correlation
and low LoA, and proved to be valid. For the other activities (i.e., batting,
weight moving, and walking), there was a general trend of decreased
accuracy. Nevertheless, correlation remained very large, LoA relatively
low, and more than 84.8% of the differences within the maximum acceptable LoA (i.e., 11 bpm). Thus, experiment outcomes suggest
that BH-BT is suitable for the monitoring HR during static and dynamic
activities. The obtained results are comparable to the results obtained in
three previous studies analyzing BH-BT performance in monitoring HR
at rest and during dynamic activities, such as incremental treadmill
and walkjogrun protocols [4042].
EQ-01 proved to be valid in activity 1 (i.e., static) with excellent and
low LoA. In activities 2, 5, and 6 (i.e., thoracic rotation, weight moving,
and walking), measurements were relatively accurate with very large
to excellent correlation, relatively low LoA, and more than 82.8% of the
differences within 11 bpm. Measurements in activity 3 and 4 (i.e.,
arm lifting and weight moving) presented the worst performance
with very large to moderate correlation, large LoA, and less than 75%
of the differences within 11 bpm. To remove the inuence of technical
issues, data cleaning procedures were applied to activity 3, 4, and 6 (i.e.,
3 data sets over 60 data sets were removed). Erroneous data were not
linked to any specic subject. It can be hypothesized that the need to
apply data cleaning procedures might be due to awed lab EKG patches
that lost contact with the skin after extended usage. After data cleaning,
measurement accuracy improved for all the activities but LoA remained
relatively large and validity was not attained. Thus, regardless of the use
of data cleaning procedures, EQ-01 was not valid during dynamic activities. Moreover, EQ-01 tended to underestimate HR since D was negative for all the activity (Table 6). Thus, the results suggest that EQ-01
is valid in monitoring subjects at rest but during dynamic activities its
performance is likely to worsen and, potentially, lose signicance. Although there are differences in the applied data analysis procedures,

Table 5
BH-BT heart rate validity statistics.
Activity

1 Static
2 Thoracic rotation
3 Arm lifting
4 Batting
5 Weight moving
6 Walking

Data pairs (data sets)

All
Clean
All
Clean
All
Clean
All
Clean
All
Clean
All
Clean

202 (10)

190 (10)

185 (10)

185 (10)

368 (10)

374 (10)

0.99

0.98

0.94

0.76

0.78

0.74

D s (bpm)

0.78 2.21

0.77 2.39

0.22 4.05

2.51 6.73

4.81 9.01

1.68 7.10

LoA (bpm)
D-1.96s

D + 1.96s

5.1

5.4

7.7

15.7

22.5

15.6

3.6

3.9

8.1

10.7

12.9

12.2

%DLoA

%Dmv

95.0%

92.1%

92.4%

93.5%

94.8%

92.2%

100.0%

99.5%

98.4%

90.3%

84.8%

87.7%

Unit of measurement: beat per minute (bpm).

Tabular report of validity statistics: Pearson productmoment correlation (r), mean difference (D), standard deviation of the differences (s), Limits of Agreement (LoA) equal to
D 1.96s, percentage of differences within the LoA (%DLoA), and percentage of differences (%Dmv) within 11 bpm.

U.C. Gatti et al. / Automation in Construction 44 (2014) 227233

231

Table 6
EQ-01 heart rate validity statistics.
Activity

1 Static
2 Thoracic rotation
3 Arm lifting
4 Batting
5 Weight moving
6 Walking

Data pairs (data sets)

All
Clean
All
Clean
All
Clean
All
Clean
All
Clean
All
Clean

185 (10)

183 (10)

183 (10)
163 (9)
186 (10)
167 (9)
372 (10)

390 (10)
350 (9)

0.95

0.85

0.79
0.86
0.52
0.68
0.92

0.73
0.89

D s (bpm)

2.29 3.49

4.90 5.17

11.79 8.66
10.35 7.14
7.20 8.69
5.49 7.09
4.83 5.55

5.44 8.65
3.51 5.44

LoA (bpm)
D-1.96s

D + 1.96s

9.1

15.0

28.8
24.3
24.2
19.4
15.7

22.4
14.2

4.5

5.2

5.2
3.6
9.8
8.4
6.0

11.5
7.2

%DLoA

%Dmv

92.4%

91.8%

95.6%
96.3%
93.5%
95.8%
94.1%

92.1%
95.7%

98.4%

84.7%

50.8%
55.8%
74.2%
82.6%
86.8%

82.8%
91.1%

Unit of measurement: beat per minute (bpm).

Tabular report of validity statistics: Pearson productmoment correlation (r), mean difference (D), standard deviation of the differences (s), Limits of Agreement (LoA) equal to D 1.96s,
percentage of differences within the LoA (%DLoA), and percentage of differences (%Dmv) within 11 bpm.

EQ-01 results are comparable to a recent study validating an Equivital

monitoring unit at rest and during walk at 3 km/h [38].
HR measurements indicate that PSMs perform best in monitoring
participants at rest. This nding supports the assumption that participant movements can affect PSM performance in monitoring HR. Similar
results were obtained in other studies analyzing HR monitor performance [41,42,64,65]. Visual analysis of the EKG vs. either BH-BT or
EQ-01 data plot over time does not allow for detecting any systematic
behavior (e.g., PSM loses the heart's electric signal) capable of
explaining performance worsening during dynamic activities.
4.2. Breathing rate
BH-BT results suggest that the device is valid at rest but its accuracy
can decrease during dynamic activities. BH-BT was extremely accurate
in monitoring BR at rest (i.e., activity 1) with excellent correlation and
low LoA. In all the other activities, overall performance decreased and
measurements lost any signicance in activity 2 and 5 (i.e., thoracic rotation and weight moving). Data sets of a specic male participant were
consistently removed when data cleaning procedures were applied. In
particular, four data sets out of the seven removed data sets belonged to
this participant. It is likely that the PSM chest belt was not properly tightened and, therefore, moved during the experiment. In fact, this issue did
not occur when data cleaning procedures were applied to his EQ-01 measurements. After assessing cleaned data, measurement accuracy improved but the agreement remained weak for activities 5 and 6 (i.e.,
weight movement and walking). Thus, regardless of the use of data
cleaning procedures, BH-BT was not valid during dynamic activities. The

results are similar to the results reported in previous studies assessing

BH-BT performance in monitoring BR at rest and during dynamic activities, such as incremental treadmill and walkjogrun protocols [3942].
Although EQ-01 correlation was either very large or excellent except
for activity 4 (i.e., batting), LoA were large for all the activities. Data
cleaning procedures did not improved measurement accuracy and
discarded data sets were not linked to any specic subject. Thus, the results suggest that EQ-01 measurements are invalid at rest and during
dynamic activities. Results collected in the present study are comparable, yet worse, to the results described in a previous study analyzing
an advanced version of the EQ-01 at rest and during walk at 3 km/h [38].
Collected data support the assumption that movements can affect
PSMs' measurements in monitoring BR. Faetti et al. [69] analyzed the performance of two BR measurement systems based on fabric strain gauges
and piezoelectric strain sensors during static and dynamic activities
reaching results comparable to the ones obtained in this study. Furthermore, PSM performance was better in monitoring HR than BR. This outcome was expected since speech, posture, and dynamic activities can
affect more BR monitoring devices than HR monitoring devices [69,70].
In fact, regardless of the several BR monitoring devices developed for
eld studies, Brookes et al. [60] noted that it is extremely problematic to
realize a BR monitoring device that is safe, reliable, robust, and noninvasive.
4.3. Limitation
The main limitation of the present study is the number of participants, which was limited to ten subjects. Although the sample size

Table 7
BH-BT breathing rate validity statistics.
Activity

1 Static
2 Thoracic rotation
3 Arm lifting
4 Batting
5 Weight moving
6 Walking

Data pairs (data sets)

All
Clean
All
Clean
All
Clean
All
Clean
All
Clean
All
Clean

200 (10)

195 (10)
155 (8)
194 (10)
153 (8)
187 (10)

397 (10)
316 (8)
394 (10)
356 (9)

0.98

0.44
0.84
0.73
0.91
0.83

0.16
0.54
0.91
0.93

D s (Bpm)

0.19 1.22

1.56 8.83
0.08 3.46
0.71 5.57
1.16 3.01
0.75 2.66

4.75 6.67
2.42 4.08
2.57 6.39
1.92 4.83

LoA (Bpm)
D-1.96s

D + 1.96s

2.58

18.87
6.69
11.63
7.06
5.95

17.99
10.42
15.10
11.39

2.20

15.75
6.86
10.20
4.73
4.46

8.50
5.57
9.97
7.55

%DLoA

%Dmv

93.5%

90.8%
91.6%
88.7%
95.4%
95.2%

94.9%
94.9%
92.9%
93.0%

95.0%

65.1%
81.3%
72.2%
84.3%
85.6%

49.4%
57.9%
64.0%
64.9%

Unit of measurement: breath per minute (Bpm).

Tabular report of validity statistics: Pearson productmoment correlation (r), mean difference (D), standard deviation of the differences (s), Limits of Agreement (LoA) equal to
D 1.96s, percentage of differences within the LoA (%DLoA), and percentage of differences (%Dmv) within 3 Bpm.

232

U.C. Gatti et al. / Automation in Construction 44 (2014) 227233

Table 8
EQ-01 breathing rate validity statistics.
Activity

1 Static
2 Thoracic rotation
3 Arm lifting
4 Batting
5 Weight moving
6 Walking

Data pairs (data sets)

All
Clean
All
Clean
All
Clean
All
Clean
All
Clean
All
Clean

147 (8)
128 (7)
148 (8)

150 (8)

148 (8)

303 (8)
264 (7)
311 (8)

0.71
0.97
0.87

0.92

0.55

0.82
0.81
0.91

D s (Bpm)

2.74
1.05
1.93

1.46

1.51

3.95
3.05
2.10

5.34
1.65
4.05
2.71
4.40
5.04
4.26
6.60

LoA (Bpm)
D-1.96s

D + 1.96s

13.21
4.29
9.87

6.77

10.12

13.84
11.40
15.04

7.73
2.20
6.00

3.85

7.11

5.94
5.30
10.85

%DLoA

%Dmv

91.8%
92.2%
93.2%

95.3%

96.6%

94.3%
94.3%
94.5%

78.2%
88.3%
66.2%

76.7%

70.3%

52.8%
58.3%
64.6%

Unit of measurement: breath per minute (Bpm).

Tabular report of validity statistics: Pearson productmoment correlation (r), mean difference (D), standard deviation of the differences (s), Limits of Agreement (LoA) equal to
D 1.96s, percentage of differences within the LoA (%DLoA), and percentage of differences (%Dmv) within 3 Bpm.

and/or the amount of the collected data were either comparable to or

larger than other similar research studies [3842,61,6265,71], such
limited sample size may not be sufcient to assess true differences between device measurements. Furthermore, the present study did not
consider the reliability of instrument performance on repeated measures. Although repeated measurements with the same subject are rarely performed in human subject testing [40], they can provide important
insight on the instrument reliability and precision [72]. Thus, further examination of PSMs reliability should be considered for future studies
that continue assessing the maturity of this technology.

5. Conclusions
This study has analyzed the validity of two PSMs in monitoring two
physiological parameters during dynamic activities resembling construction workforce's routine activities. First, general results across activities suggest that BH-BT is a suitable tool to assess HR at rest and
during dynamic activities. EQ-01 collected valid HR data at rest but during dynamic activities data quality worsened. Thus, EQ-01 cannot be
considered a suitable instrument for construction workforce HR monitoring. Then, both PSMs were proved not capable of effectively assessing
BR effectively except for BH-BT at rest.
In conclusion, the data suggest that, with prior understanding of
study limitations, BH-BT is a viable device in assessing HR and, therefore, can be implemented to measure work physiological demands on
construction sites in an unobtrusive and remote manner. Therefore,
the use of PSMs, coupled with work physiology and ergonomics concepts, could foster the creation of innovative workforce management
procedures allowing enhancements not only in productivity, but also
in workers' well-being and safety. In fact, PSMs were successfully implemented in analyzing the relationship between physical strain and task
level productivity [73], and performing automatic work sampling to facilitate real-time productivity assessment [3] and monitoring of ergonomically safe and unsafe behavior of construction workers [22].
Moreover, considering that the dynamic activities employed in the experiments can resemble many work activities (e.g., material handling),
this paper can be a valuable reference for industries other than
construction.

Acknowledgment
The authors would like to thank the Exercise Physiology Lab and the
Multi-Agent, Robotics, Hybrid, and Embedded Systems (MARHES) Lab
at the University of New Mexico for granting access to the necessary
lab equipment as well as the lab assistant Jeremy Clayton Fransen.

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