On August 10, 1998, the National Institute for Occupational Safety and Health (NIOSH) received a Health Hazard Evaluation (HHE) request from the International Union of Bricklayers and Allied Craftworkers (IUBAC) of Washington, DC. The requester was concerned that many of their members must kneel to perform their work (such as laying tiles on the floor) at a variety of construction sites but was not sure whether or not the workers were provided with adequate knee protection to perform their tasks safely. If such were provided, the requester was also concerned about the usage of the knee pad among workers and the protective quality thereof. A self-administered questionnaire survey was conducted among the members who were systematically selected, inquiring about their work history, history of knee problems, use of knee pads, and evaluation of the knee pad. The results indicated, among other things, that the amount of work time kneeling is closely associated with the use of knee pads

the median percentage of kneeling time at work was 50% for knee pad users and 8% for non-pad users. The knee pad users wore the pad 5 days per week, 6 hours per day (both medians). About 18% of the respondents reported that they had experienced a work-related knee problem. Among those who had a knee disorder, 33% lost one or more days of work due to that disorder. The average number of workdays lost for job-related knee disorder (22 days) was significantly more than those for non-job-related knee disorders (3.5 days). (However, whether or not the disorder was due to chronic kneeling or acute injury was not determined.) When various attributes of currently used knee pads were rated on a scale of 1 (worst) to 4 (best), 'ease of putting on/off' and 'protection against sharp objects' received median rating of 4

and 'durability' and 'comfort of padding' were rated 3, while 'comfort of support' and 'resistance to moisture' were rated 2, suggesting the need for improvement in these attributes. The median useful life of the padding was 16 weeks, and a pair was replaced at a median interval of 7 months. The median cost of a pair was $20. Only 8% of the knee pad users reported that their pads were provided by their employer

91% bought them on their own. Two-thirds of the pad users felt that the employer had a responsibility for providing them. Possible consequences of working without the knee pads were reported to be knee pain and/or inflammation or slowing down of the work to avoid such pain and inflammation, suggesting that this PPE is good for productivity. Currently, Occupational Safety and Health Administration (OSHA) regulations on personal protective equipment (PPE) do not include a specific requirement for knee protection. Members of IUBAC who must work kneeling mostly wear the knee pads for protection of their knees and to avoid knee pain. While it is very difficult to perform kneeling tasks without the knee protection, currently most of survey respondents who use knee pads must purchase this protection on their own. Survey respondents also indicated that improvements are needed in various components of knee pads, for example, the straps need to be made more supporting and comfortable, or the pads made more resistant to moisture.