"The Proceedings of the 2018 Ergo-X Symposium: Exoskeletons in the Workplace have been assembled to disseminate the speakers' presentations and to summarize the question and answer/discussion periods that followed the presentations within each session. The proceedings appear by session and include summary points with links to presentation slides from speakers who agreed to provide them. The Ergo-X Proceedings Editors identified and documented the summary points and gave presenters of specific content (such as keynote presentations) an opportunity to review, edit, and approve the content. Here are some of the key summary points from the 2018 Ergo-X Symposium: 1. Metabolic demand may be a predictor of fatigue onset

however, we need a better understanding of how the positive or negative effect of an exoskeleton on metabolic demand affects injury prevention/risk. 2. The fit of the exoskeleton system is complex. Static assessments of fit that do not consider task dynamics are insufficient

multivariate anthropometric data are critical to fit. 3. Simulation and digital human modeling technologies have potential use in (1) assessing the interface between the user and exoskeleton and (2) reducing the test and evaluation burden of using human subjects. 4. Existing exoskeleton systems require a period of adaptation by the end user. For a new user, task performance is not likely to reach a steady state immediately. We need to establish acceptable test durations for exoskeleton trials. 5. Cognitive and psychomotor effects of exoskeleton use have been observed and are likely task dependent. 6. Industrial exoskeleton designs should be compatible with off-the-shelf tools, equipment, and personal protective equipment, rather than relying on specialty tools and custom interfaces. 7. Although industry speakers presented examples of wider-scale deployment of overhead support exoskeletons, overhead work with tool support appears to be the most mature industrial-use case at present. 8. The FDA oversees devices marketed/prescribed for medical use. Early adoption of medical exoskeletons may be more promising among individuals who are less adapted to other mobility-assistive technologies for their disabilities. 9. In the rehabilitation domain, clinics can utilize exoskeletons to assist therapists in delivering appropriate therapeutic doses. 10. ASTM Committee F48 on Exoskeletons and Exosuits and other standards organizations offer a forum for sharing exoskeleton knowledge. Feedback gathered from attendees and participants revealed 19 different topics (see the word cloud) that were issues or concerns for exoskeleton developers, researchers, and end users in 2018 and moving forward. The top four topics were (1) return on investment (ROI) considerations

(2) size, shape, and fit of exoskeletons on users

(3) longitudinal effects of exoskeleton usage

and (4) “What metrics are right?” for measuring safe, effective, or reliable system design and integration for users or patients." - NIOSHTIC-2

NIOSHTIC no. 20057456

Suggested citation: NIOSH [2019] Proceedings of the 2018 Ergo-X Symposium: Exoskeletons in the Workplace — Assessing Safety, Usability, and Productivity. By Lowe B, Billotte W, Brogmus G, McDowell T, Reid C, Rempel D, Srinivasan D (Editors). Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2020-102, https://doi.org/10.26616/NIOSHPUB2020102

2020-102.pdf?id=10.26616/NIOSHPUB2020102