Comparison of self-report, video observation and direct measurement methods for upper extremity musculoskeletal disorder physical risk factors

The prevention of work-related musculoskeletal disorders has become a national priority in many countries. Increasingly, attempts are made to quantify those exposures that increase risk in order to set exposure limit values. This study used commonly employed field measurement methods and tools in order to perform an inter-method comparison between three primary methods of risk factor exposure assessment: self-report questionnaires, observational video analysis and direct measurement. Extreme posture duration, repetition, hand force (estimated from electromyography) and movement velocity were assessed for 18 subjects while performing each of three jobs processing tree seedlings. Results indicated that self-reports were the least precise assessment method, which consistently overestimated exposures for each of the measured risk factors. However, adjustment of the reports as psychophysical scales may increase agreement on a group level. Wrist flexion/extension duration and repetition were best measured by electrogoniometer. Electrogoniometric measures of wrist deviation duration and frequency were less precise than video analysis. Forearm rotation duration and repetition, grip force and velocity appeared to be best quantified by direct measurement as measured by electrogoniometer and electromyography (EMG) (as root-mean-square amplitude). The results highlight the fact that it is as important to consider and report estimated measurement error in order to reduce potential exposure misclassification in epidemiologic studies.     

Reproducibility of a self-report questionnaire for upper extremity musculoskeletal disorder risk factors.

A self-report questionnaire was developed to evaluate the potential for assessment of possible risk factors for musculoskeletal disorders. Visual-analog and categorical scales were designed to represent responses relating to primary work as well as a second job and hobbies or non-work activities. 71 tree nursery workers completed the scales twice in consecutive weeks. Agreement between means of the two questionnaire administrations was 0.80 or higher for all scales. Intraclass correlation coefficients ranged between 0.59 and 0.69 for the primary job hand/wrist responses and between 0.49 and 0.82 for non-work/hobby neck and upper arm scales. These results show potential for future application of similar scales in industry or temporary and seasonal work to evaluate exposure to upper extremity risk factors.     

Assessing exposure to risk factors for work-related musculoskeletal disorders using Quick Exposure Check (QEC) in taxi drivers

Work-related musculoskeletal disorders (WMSDs) are a common health problem throughout the world. This study aimed to examine the risk factors that are involved in the development of WMSDs in taxi drivers. In total 382 taxi drivers were observed using Quick Exposure Check (QEC) observational tool, which allows practitioners and workers to assess four key areas of the body. Results of the QEC scores were found to be very high for the shoulder/arm, wrist/hand and neck, whereas the scores for the back were found to be high for static use and moderate for moving. The results also showed that the occupational risk factors for WMSDs were associated with restricted postures, repetitive movements, vibration, work related stress. Essential ergonomic interventions are needed to eliminate risk of exposures to WMSDs in taxi drivers.Relevance to industryThe study results have relevance for ergonomists, health and safety practitioners as well as the drivers themselves, and helpful for estimating the main physical risk factors for WMDSs before choosing a method prior to an ergonomic intervention in industry.     

The development of the Quick Exposure Check (QEC) for assessing exposure to risk factors for work-related musculoskeletal disorders

This paper describes the development and evaluation of the Quick Exposure Check (QEC), which is an observational tool developed for Occupational Safety and Health (OSH) practitioners to assess exposure to risks for work-related musculoskeletal disorders and provide a basis for ergonomic interventions. The tool is based on epidemiological evidence and investigations of OSH practitioners' aptitudes for undertaking assessments. It has been tested, modified and validated using simulated and workplace tasks, in two phases of development, with participation of 206 practitioners. The QEC allows the four main body areas to be assessed and involves practitioners and workers in the assessment. Trials have determined its usability, intra- and inter-observer reliability, and validity which show it is applicable to a wide range of working activities. The tool focuses primarily on physical workplace factors, but also includes the evaluation of psychosocial factors. Tasks can normally be assessed within 10min. It has a scoring system, and exposure levels have been proposed to guide priorities for intervention. Subsequently it should be used to evaluate the effectiveness of any interventions made. The QEC can contribute to a holistic assessment of all the elements of a work system.     

Comparison of concepts in easy-to-use methods for MSD risk assessment

This article presents a comparative analysis of easy-to-use methods for assessing musculoskeletal load and the risk for developing musculoskeletal disorders. In all such methods, assessment of load consists in defining input data, the procedure and the system of assessment. This article shows what assessment steps the methods have in common; it also shows how those methods differ in each step. In addition, the methods are grouped according to their characteristic features. The conclusion is that the concepts of assessing risk in different methods can be used to develop solutions leading to a comprehensive method appropriate for all work tasks and all parts of the body. However, studies are necessary to verify the accepted premises and to introduce some standardization that would make consolidation possible.     

Comparison of self-assessment and partnered-assessment as cost-effective alternative methods for office workstation evaluation

A study was conducted in order to determine if anthropometric and office workstation measurements could be accurately collected individually by the employees who worked as those stations, or alternatively by two-person teams consisting of the employee and a co-worker. An iterative process was used to develop a method that would: (1) require a minimum number of measurements to be made by the employees, (2) produce an acceptable level of accuracy, and (3) provide useful information for analyzing employee–workstation fit. Results of the study showed acceptable accuracy when using a combined assisted and unassisted data collection approach.

Relevance to industry

Office workstation assessment can be a challenge for companies with large numbers of employees working in office settings, particularly if those settings are distributed across a country or the globe. Developing a formulaic method for accurately measuring those workstations by someone other than the company's expert (ergonomist or other) has several benefits, including: (1) ability to measure more workstations in the same time period; (2) freeing the expert to perform tasks and analyses that require his/her expertise; and (3) inducing active involvement of employees in the company's health and safety (or ergonomics) efforts.     

Effects of psychosocial and individual factors on physiological risk factors for upper extremity musculoskeletal disorders while typing

Psychosocial factors are hypothesized to contribute to work-related musculoskeletal disorder (WMSD) development, although previous research has been largely epidemiological or has focused primarily on the shoulders, back and neck. The objective of this study was to quantify the effects of mental workload and time pressure on perceived workload and physiological responses of the distal upper extremity. A total of 18 typists completed nine 5-min typing sessions representing three levels of time pressure and mental workload. Levels were manipulated by adjusting typing speed and by requiring participants to perform arithmetic tasks while typing. Outcomes were measured in muscle activation levels, wrist postures and movements, key strike force and subjective assessments of workload. In general, increased time pressure increased muscle activation, key strike force and wrist deviations; and increased mental workload increased key strike force. Mental workload and time pressure mediated physical risk factors during typing to increase WMSD risk for the distal upper extremity.     

Effects of psychosocial and individual factors on physiological risk factors for upper extremity musculoskeletal disorders while typing

Psychosocial factors are hypothesized to contribute to work-related musculoskeletal disorder (WMSD) development, although previous research has been largely epidemiological or has focused primarily on the shoulders, back and neck. The objective of this study was to quantify the effects of mental workload and time pressure on perceived workload and physiological responses of the distal upper extremity. A total of 18 typists completed nine 5-min typing sessions representing three levels of time pressure and mental workload. Levels were manipulated by adjusting typing speed and by requiring participants to perform arithmetic tasks while typing. Outcomes were measured in muscle activation levels, wrist postures and movements, key strike force and subjective assessments of workload. In general, increased time pressure increased muscle activation, key strike force and wrist deviations; and increased mental workload increased key strike force. Mental workload and time pressure mediated physical risk factors during typing to increase WMSD risk for the distal upper extremity.     

Ergonomic risk factors in glass artware industries and prevalence of musculoskeletal disorder

Glass artware manufacturing activities are highly repetitive, labor-intensive, and demand prolonged standing during the working shift. This leads to the development of musculoskeletal disorders (MSDs) symptoms among the workers. However, there is a scarce of study on the prevalence of MSDs symptoms and their associated risk factors among the glass artware workers. To address this research gap, this study aims to evaluate the prevalence of MSDs and working conditions among Indian glass artware workers. Discomfort data is collected using Cornell Musculoskeletal Discomfort Questionnaire and working posture data is collected through direct observations using Rapid Entire Body Assessment (REBA). Multiple logistic regression model is developed for each body region to study the relationship between the associated risk factors and MSDs symptoms with the help of collected data. The findings of this study are first, MSDs symptoms are highly prevalent and severe, particularly in the lower back, thigh, and foot. Second, the average REBA grand score is 7.22, which reveals the high-risk level of worker's posture while performing the task. Third, Job characteristics and individual factors are associated with MSD symptoms in multiple logistic regression models. The results highlight the prevalence and severity level of MSDs and illustrate the demand for ergonomic interventions to alleviate musculoskeletal symptoms among these working groups.Relevance to industryThis study draws attention to work-related and other associated risk factors, which would help the researchers and managers to understand the working environment of glass artware industry. These risk factors should be considered for designing and implementing ergonomic interventions to prevent and alleviate musculoskeletal discomfort among the glass artware workers.     

Self-administered questionnaire and direct observation by checklist: comparing two methods for physical exposure surveillance in a highly repetitive tasks plant

Background

We evaluated the agreement between a questionnaire and an observational checklist for exposure assessment in the setting of an upper-limb work-related musculoskeletal disorders (UWMSD) surveillance program in a population with a high level of physical exposures.

Methods

A surveillance program was implemented in a large shoe factory. Physical exposures were assessed in 1996 by a self-administered questionnaire and by the direct observation of work tasks assessed using a checklist filled out by trained assessors. Items were summed into a “questionnaire” score and an “observational” score. These scores were compared by Pearson's correlation. The association between exposure assessment by each method and UWMSD incidence between 1996 and 1997, defined by a standardized examination, was also studied.

Results

Correlation between the “questionnaire” score and the “observational” score was low among the 196 workers (77%) who received both evaluations (rho=0.06, p>0.05). Only exposure assessed by the questionnaire method was significantly associated with high incidence of UWMSD between 1996 and 1997, with good sensitivity (97%) and poor specificity (27%).

Conclusion

In this surveillance program, self-reported physical exposures assessed by questionnaire and by direct observation did not evaluate same dimensions of high physical exposures. In this sample, exposures assessed by questionnaire identified workers at high risk of incident UWMSD more precisely than exposures identified by direct observation.     

Effects of negatively sloped keyboard wedges on risk factors for upper extremity work-related musculoskeletal disorders and user performance

Several changes to computer peripherals have been developed to reduce exposure to identified risk factors for musculoskeletal injury, notably in keyboard designs. Negative keyboard angles and their resulting effects on objective physiological measures, subjective measures and performance have been studied, although few angles have been investigated despite the benefits associated with their use. The objective of this study was to quantify the effects of negative keyboard angles on forearm muscle activity, wrist posture, key strike force, perceived discomfort and performance and to identify a negative keyboard angle or range of keyboard angles that minimizes exposure to risk factors for hand/wrist injuries. Ten experienced typists (four males and six females) participated in a laboratory study to compare keyboard angles ranging from 0° to ?30°, at 10° increments, and a keyboard with a 7° slope, using a wedge designed for use with standard QWERTY keyboards. Repeatability of exposures was examined by requiring participants to complete two test sessions 1 week apart. Dependent variable data were collected during 10 min basic data entry tasks. Wrist posture data favoured negative keyboard angles of 0° (horizontal) or greater, compared to a positive keyboard angle of 7°, especially for the flexion/extension direction. In general, the percentage of wrist movements within a neutral zone and the percentages of wrist movements within ±5° and ±10° increased as keyboard angle became more negative. Electromyography results were mixed, with some variables supporting negative keyboard angles whilst other results favoured the standard keyboard configuration. Net typing speed supported the ?10° keyboard angle, whilst other negative typing angles were comparable, if not better than, with the standard keyboard. Therefore, angles ranging from 0° to ?30° in general provide significant reductions in exposure to deviated wrist postures and muscle activity and comparable performance.     

Effects of negatively sloped keyboard wedges on risk factors for upper extremity work-related musculoskeletal disorders and user performance

Several changes to computer peripherals have been developed to reduce exposure to identified risk factors for musculoskeletal injury, notably in keyboard designs. Negative keyboard angles and their resulting effects on objective physiological measures, subjective measures and performance have been studied, although few angles have been investigated despite the benefits associated with their use. The objective of this study was to quantify the effects of negative keyboard angles on forearm muscle activity, wrist posture, key strike force, perceived discomfort and performance and to identify a negative keyboard angle or range of keyboard angles that minimizes exposure to risk factors for hand/wrist injuries. Ten experienced typists (four males and six females) participated in a laboratory study to compare keyboard angles ranging from 0 degrees to -30 degrees , at 10 degrees increments, and a keyboard with a 7 degrees slope, using a wedge designed for use with standard QWERTY keyboards. Repeatability of exposures was examined by requiring participants to complete two test sessions 1 week apart. Dependent variable data were collected during 10 min basic data entry tasks. Wrist posture data favoured negative keyboard angles of 0 degrees (horizontal) or greater, compared to a positive keyboard angle of 7 degrees , especially for the flexion/extension direction. In general, the percentage of wrist movements within a neutral zone and the percentages of wrist movements within +/-5 degrees and +/-10 degrees increased as keyboard angle became more negative. Electromyography results were mixed, with some variables supporting negative keyboard angles whilst other results favoured the standard keyboard configuration. Net typing speed supported the -10 degrees keyboard angle, whilst other negative typing angles were comparable, if not better than, with the standard keyboard. Therefore, angles ranging from 0 degrees to -30 degrees in general provide significant reductions in exposure to deviated wrist postures and muscle activity and comparable performance.     

Study protocol and baseline results for a quasi-randomized control trial: An investigation on the effects of ergonomic interventions on work-related musculoskeletal disorders,quality of work-life and productivity in knowledge-based companies

IntroductionWork-related musculoskeletal disorders (WMSDs) are the major causes of lost workdays, increased costs, and occupational diseases in all countries. The prevalence of WMSDs among the workers in small and medium-sized enterprises in Iran was reported as 73%. This paper aimed to describe the design of an interventional study to investigate the effects of ergonomic interventions on work-related musculoskeletal disorders, quality of work-life, and productivity among office workers of knowledge-based companies and introduce the results obtained from the baseline survey.Methods/designIt was a quasi-randomized control trial study on 313 participants with four parallel groups including ergonomic training intervention; management training and work changes intervention; ergonomic training, management training and work changes intervention; and non-interventional control group. The primary outcome was WMSDs, and the secondary outcomes were occupational stress factors, quality of work-life, and productivity. All primary and secondary outcomes were measured before the interventions, one, three, and six months after the interventions.ResultsAt this phase of study only baseline results were reported. 328 participants, with a mean age of 31.97 years (SD = 5.39), completed the baseline survey and entered the study. The highest prevalence of musculoskeletal disorders was found in neck (52.13%), right shoulder (41.16%) and right forearm (37.2%), respectively.ConclusionErgonomic interventions were conducted based on baseline data of the participants at individual and management levels. The focus of training program interventions was to reduce musculoskeletal disorders in upper limbs; in management training and work changes program, the focus was to increase social support.Trial registrationIRCT registration number: IRCT20181204041840N1 (date of registration: 2019-02-05).     

Heavy load carrying and musculoskeletal health: An exploratory study of biomechanical risk factors among sand miners in Pokhara,Kaski District,Nepal

BackgroundTrends in urbanization contribute to the growing global demand for raw construction materials. The health effects of load carrying among occupational groups that mine and carry sand and stone used for construction of roads and buildings remains poorly understood.MethodsWe conducted an exploratory cross-sectional study among a convenience sample of sand miners working at an excavation site on the Seti River in Pokhara, Nepal. Load carrying weight, duration, and frequency were used to categorize miners as having “low” or “high” load-carrying exposures. Musculoskeletal disorders (MSDs) were identified using self-reported symptoms of moderate to severe musculoskeletal pain, as well as physical examinations.ResultsThe average loads carried by female and male sand miners weighed 66 kg and 87 kg, respectively. Among all participants (N = 42), 45% reported moderate to severe musculoskeletal pain in at least one body region and 16 (38%) had MSDs identified using specified case criteria. The prevalence of MSDs was lower among miners carrying, on average, heavier loads compared to those carrying lighter loads (OR = 0.18; 95% CI: 0.04, 0.7), possibly indicative of the healthy worker survival effect. Miners carrying loads for longer durations had higher odds of MSDs compared with those carrying for shorter durations.ConclusionThis study has provided data on the extraordinary loads carried by sand miners in Nepal and preliminary evidence of health impacts associated with these loads. However, larger epidemiologic studies are needed to justify action to protect the health and safety of these unrecognized and understudied groups.     

Comparison of FFT,direct inversion,and conjugate gradient methods for use in pseudo-spectral methods

Direct matrix inversion methods and the conjugate gradient method are compared with the FFT for speed when used in pseudo-spectral calculations. It is demonstrated that in some cases either of these methods is competitive with an FFT. This is especially true when using direct methods in two dimensions.     

Multifactor association of job,individual and psychosocial factors in prevalence of distal upper extremity disorders and quantification of job physical exposure

The objective of this study was to develop a multifactor model of job, individual and psychosocial factors in prevalence of distal upper extremity musculoskeletal disorders (DUE MSDs); and quantify job physical exposure to establish safe exposure limits. The study sample comprised of 525 workers who were part of a large prospective cohort study and represented a broad array of industrial practices and a wide range of job physical exposure. Only baseline data was considered for the analysis in the study. Workers underwent laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current DUE MSDs. All workers' jobs were individually measured for job physical exposure factors and videotaped. Binomial logistic regression was used to develop and test the multifactor association and quantification of job physical exposure for safe exposure limits. Results indicated that work-related DUE MSDs are multifactor in nature and are significantly affected by specific factors of (1) job physical exposure - percentage duration of exertion (PDOE), workers' subjective ratings of perceived effort or intensity of exertion (IOE) (using Borg CR-10), hand activity level measured by the American conference of Governmental Industrial Hygienists (ACGIH) threshold limit value for hand activity level (TLV for HAL), and presence of 2-point pinch grasps; (2) individual factors - female gender, diabetes, higher body mass index (BMI), and past and current smokers; (3) psychosocial factors - neither likely/unlikely or very unlikely to take up the current job again, divorced/separated, and presence of family problems. Quantification of job physical exposure indicated that prevalence of work-related DUE MSDs significantly increases with efforts per minute (Eff/min) >8 (OR = 1.69, p = 0.006) and woker's perceived effort based on Borg rating for IOE at the end of the shift >3 (OR = 2.46, p < 0.001). Further studies should be conducted to validate these safe exposure limit criteria.     

Comparison of OWAS,RULA and REBA for assessing potential work-related musculoskeletal disorders

This study compared three representative observational methods for assessing musculoskeletal loadings: Ovako Working Posture Analysis System (OWAS), Rapid Upper Limb Assessment (RULA), and Rapid Entire Body Assessment (REBA). The comparison was based on 209 cases of upper-body musculoskeletal disorders (MSDs) diagnosed by medical doctors. The most awkward/stressful posture in each participant's tasks was assessed using these techniques. Postural loadings were rated more highly by the RULA than by the OWAS and REBA (p < 0.01). The chi-square test and logistic regression analysis showed that only RULA grand score and action level, and REBA action level were associated with MSD work-relatedness (p < 0.01, p < 0.05, and p < 0.05, respectively). The percentage concordant values of the logistic model for the RULA grand score and action level were 52.4% and 44.8%, respectively, while the percentage concordant value for the REBA action level was 22.1%. Therefore, the RULA may be the best system for estimating the postural loads and work-relatedness of MSDs.Relevance to industryWork-related musculoskeletal disorders are the leading cause of workplace disability in the developed countries. For preventing the disorders, quantification of musculoskeletal loads is required.     

The combined effect of physical,psychosocial/organisational and/or environmental risk factors on the presence of work-related musculoskeletal symptoms and its consequences

This study assessed the combined effect of physical and psychosocial/organisational and/or environmental factors on the presence of musculoskeletal symptoms (MSS) and its consequences (reduced activities and absenteeism due to MSS) in a random sample of 3003 workers in New Zealand. By telephone interview, participants reported their current workplace exposures and MSS (neck/shoulder, arm/elbow, wrist and low back) and its consequences. Data were analysed using multivariable logistic regression. Combined exposure to physical and psychosocial/organisational and/or environmental factors increased the odds of MSS in the neck/shoulder (OR 3.14, 95% CI 1.79–5.52), arms/elbow regions (OR 4.14, 95% CI 2.21–7.76) and low back (OR 1.74, 95% CI 1.28–2.37) and its consequences, i.e. reduced activities due to neck/shoulder symptoms (OR 5.45, 95% CI 2.28–13.00), absenteeism due to neck/shoulder symptoms (OR 5.19, 95% CI 2.24–12.01) and absenteeism due to low back symptoms (OR 4.37, 95% CI 2.92–6.53). In contrast, favourable psychosocial/organisational work conditions reduced the odds of wrist symptoms due to poor physical work conditions (OR 2.19, 95% CI 1.44–3.34). We conclude that to reduce MSS and its consequences, employers need to adopt a multifaceted approach: concentrate on improving physical conditions as well as the psychosocial/organisational and environmental aspects of the working environment.