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Procedia CIRP 40 (2016) 91 – 96

13th Global Conference on Sustainable Manufacturing - Decoupling Growth from Resource Use

Adapting ergonomic assessments to Social Life Cycle Assessment

Ya-Ju Changa*, The Duy Nguyenb, Matthias Finkbeinera, Jörg Krügerb
a
Chair of Sustainable Engineering, Department of Environmental Technology, Technische Universität Berlin, Straße des 17. Juni 135, 10623 Berlin, Germany
b
Chair of Industrial Automation Technology, Institute of Machine Tools and Factory Management, Technische Universität Berlin, Pascalstr. 8-9, 10587 Berlin,
Germany
* Corresponding author. Tel.: +49-30-314-79564; fax: +49-30-314-25944. E-mail address: ya-ju.chang@tu-berlin.de

Abstract

In Social Life Cycle Assessment (SLCA), the health and safety aspect of workers is usually evaluated by considering the numbers of injuries
and accidents; however, the work related musculoskeletal disorders (MSDs), which dominate occupational diseases, are often neglected in
SLCA since the effects do not occur immediately. Thus, the MSDs lead to increased working absences and compensation costs, and also
reduced productivity of workers. To address the gap, applying ergonomic assessment is proposed since it identifies and quantifies the health
risks at work based on a set of pre-defined criteria e.g. force, posture, repetition and duration, and provides the numeric results analyzing the
physical load and their sources. In the study, the application of ergonomic assessment and its indicators in SLCA is displayed to screen risks
and to further improve working place design.
© 2016 The Authors. Published by Elsevier
Elsevier B.V.
B.V. This is an open access article under the CC BY-NC-ND license
Peer-review under responsibility of the International Scientific Committee of the 13th Global Conference on Sustainable Manufacturing.
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
Peer-review under responsibility of the International Scientific Committee of the 13th Global Conference on Sustainable Manufacturing
Keywords: Ergonomic assessment; Health and safety; Musculoskeletal disorders (MSDs); Social Life Cycle Assessment (SLCA)

1. Introduction protective gear required in all applicable situations. These

indicators reflect only the present existence of injuries or
Nowadays, sustainability has become an important goal for death from a result-based perspective. That means the
global governments and industries to pursue. Sustainability reduction of injuries may not fully represent the improvement
considers the environmental, economic and social dimensions of health and safety since it ignores some chronic or
as triple bottom line theory. Apart from focusing on the accumulative health impacts which can be predicted, such as
mitigation of environmental impacts, the concerns on social Musculoskeletal disorders (MSDs).
aspects, especially in improving working conditions, have MSDs denote health problems of the locomotor apparatus,
been increased. According to the Guidelines for Social Life i.e. muscles, tendons, the skeleton, cartilage, the vascular
Cycle Assessment of Products, SLCA is defined as a system, ligaments and nerves [1]. The physical characters
methodology that aims at assessing the potential positive and frequently cited as risk factors for MSDs are rapid work pace
negative social impacts related to human beings affected by and repetitive motion patterns, insufficient recovery time,
products/services throughout the life cycle, such as health and heavy lifting and forceful manual exertions, non-neutral body
labor rights of workers, etc. Based on the guidelines, ‘health postures, mechanical pressure concentrations, and body
and safety’ is one of the most widely-considered aspects to vibration [5]. Due to its symptoms occur in chronic and
evaluate the health condition or potential health risks of accumulated way, MSDs is often neglected and hard to
workers while working. estimate in existing injury measurements of SLCA. It was
However, how to consider the health condition or potential indicated as a major occupational diseases, bringing about
health risks from mid- and long-term, and even a preventive significant loss, for example increased working absences and
perspective is a challenge in SLCA. The current dominant compensation costs, and also reduced productivity of workers.
measurements of the health and safety aspect are e.g. MSDs including carpal tunnel syndrome represented 59% of
inventorying the numbers of injuries and accidents occurred in all recognized diseases covered by the European Occupational
working place and identifying the existence of appropriate Diseases Statistics in 2005. In 2009, the World Health

2212-8271 © 2016 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
Peer-review under responsibility of the International Scientific Committee of the 13th Global Conference on Sustainable Manufacturing
doi:10.1016/j.procir.2016.01.064
92 Ya-Ju Chang et al. / Procedia CIRP 40 (2016) 91 – 96

Organization (WHO) reported that MSDs accounted for more repeated movements at work. Finally, an analysis scheme is
than 10% of all years lost to disability [2]. These results provided to accumulate the single criteria into a final result.
indicate that considering MSDs issues in health and safety Ergonomics assessment methods differ in the level of
aspect is a key factor to improve workers’ well-being. detail they provide and are designed for different target
To address the challenge, engaging ergonomic assessment groups. Coarse screening methods, such as MSI Risk Factor
in SLCA is proposed due to it identifies and quantifies the Identification [8–10] can provide a rough overview for
health risks at work based on a set of pre-defined criteria and identifying potential risks of workplaces. Their biggest
provides the numeric results analyzing the physical load and advantage is their simplicity, such that even non-experts can
their sources. The results of ergonomic assessments can be use them after short training. These methods suit for a pre-
treated as a health condition from mid- and long-term, or selection of work places and processes for further
preventive perspective, supplementary to the current injury investigation [7]. Screening methods, such as RULA [11] and
measurements in SLCA. REBA [12] contain a more complex set of criteria and allow a
Despite the direct effects on health and safety of workers, more detailed analysis. Hence, measurements to improve
the contribution of ergonomics to sustainable development is working conditions can be better derived from the outputs.
also acknowledged [3,4]. Radjiyev et al. [4] concluded that Screening methods often provide numerical values for the
ergonomics influence on sustainable development by risk, which allows a more nuanced comparison between
improving occupational health and work design. In the different workplace designs. Detailed screening methods or
context, ergonomics contribute to sustainable development expert screening methods provide additional information to
with three different ways: achieving positive benefits for screening methods. The transition between these two groups
workers’ well-being, enhancing the performance of is merely continuous, such that a clear distinction is often not
organizations, and applying corporate social responsibility possible. Similar to screening methods, expert methods
policies [3]. However, the studies only outline that ergonomic provide point scales for a sophisticated comparison. Examples
can significantly support sustainable development. Currently, are EAWS [13], NIOSH [14] and OCRA [15]. Due to their
there are no available suggestions related to adopting complexity they are often only properly usable by experts.
ergonomic assessment into sustainability assessment methods. Finally, methods based on physical measuring can be used to
In this paper, the aims are to underline the existing gap of determine ergonomic variables based on biomechanical
considering health conditions (such as MSDs) from mid- and variables. An example is CUELA [16], which measures the
long-term perspective in SLCA and other sustainability tilt angle of the back using a set of acceleration sensors and
assessment methods, and hence to propose integrating gyroscopes. Measuring methods do not directly suit a high-
ergonomic assessment as a tool in SLCA to address the level assessment, but can provide data for advanced
challenge. The state-of-art studies related to ergonomic biomechanical analyses. Their disadvantage compared to the
intervention and health impacts are also reviewed and methods mentioned before is that they require high
summarized to show the relevance of ergonomics to MSDs, investments in expensive sensory equipment.
and to provide an overview about ergonomic interventions and Looking at the set of criteria and the scores assigned for
assessments. The results can encourage the industry to apply different kinds of physical load, one might ask whether they
ergonomics in working place, and provoke researchers to take are able to reliably predict risks based on complex
ergonomic assessment into one of the key topics in the SLCA. biomechanical processes. Therefore, there have been various
studies to investigate the validity of results of ergonomics
2. Ergonomics assessment assessment trying to find correlations between scores and
injury rates or musculoskeletal complaints. Examples are
Ergonomics assessment methods are employed to detect Window [17], Coyle [18], and Pascual and Naqvi [19].
and quantify health risks at work. Basically, these tools Having derived scores from assessment methods, they can
consist of a set of pre-defined criteria which are examined on be applied for different fields. The applications can be divided
the basis of a manual process. The process can either be into two groups. Firstly, ergonomics assessment has become a
performed and recorded by a camera or modeled in simulation vital part in factory process planning tools, such as
tools, such as ”Jack & Process Simulate Human” from Tecnomatix, where workplace and process designs can be
Siemens [6]. The criteria have been ordered into four simulated and evaluated. A human biomechanical model
categories indirectly related to the common causes of MSDs performs the actions a regular worker would do providing
described before: material handling, action forces, working data for the assessment methods. Therefore, risks can be
posture and repetitive movements [7]. Material handling revealed before the physical workplace has been set up.
criteria consider the forces the worker is exposed to when Secondly, ergonomics assessment results represent the basis
lifting, carrying, pushing or pulling loads. Action forces are for measurements for existing workplaces and processes. The
forces emerging through the worker’s actions. The working next section will give an overview over different ergonomic
posture criteria consider the pose of the limbs of the worker interventions performed in different fields and their impacts.
without forces from material or tool usage. Criteria on
repetitions analyze the physical load from monotonous and
 Ya-Ju Chang et al. / Procedia CIRP 40 (2016) 91 – 96 93

3. Ergonomic intervention and health impacts The results of empirical studies generally stated the positive
contribution of ergonomic interventions to workers’ health.
In the section, the relationship between ergonomic The summary of these studies is described in the
intervention and health impacts is investigated by carrying out following:
literature review. In this paper, the literature was collected • Areas of application: The areas are involved in service
from international peer-reviewed journals. The searching (nursing, kitchen, and post office) and manufacturing
keywords were ergonomic intervention, health, (material handling, carpet mending, printed circuit
musculoskeletal disorder and workplace. In total 15 journal assembly, automotive industry, clothing and furniture
articles were chosen due to their high correspondence with the production). Especially, one third of the collected studies
keywords. Among the selected articles, three are review are related to nursing. That shows the MSDs issues
papers, and the others are empirical studies of the contribution occurred in nursing workers have been greatly concerned.
of ergonomic intervention to MSDs. • Intervention methods: In the studies, we have found the
The three review papers examined the effectiveness of following intervention methods: PE, workshops,
workplace ergonomic interventions to control MSDs [20–22]. ergonomic (re-) design of workplaces, rearranging
Karsh et al. [20] reviewed 101 studies prior to 1999, and working flow, adding assistive equipment. Five studies
found out that 84% of the studies showing the positive results [26,30,31,34,35] adopted PE methods to carry out the
of ergonomic interventions. Among these 101 reviewed interventions. In those studies, the participant ergonomic
studies, 21.4% of the studies involved ergonomic and/or teams were trained and thus developed strategies and
lifting training as the only or primary intervention, and 48% adjustments to improve their working environment. Other
engaged multiple intervention components [20]. Following interventions were exercised based on the expertise of
Karsh et al [20], Silverstein and Clark [21] inspected the ergonomists. In the context, the ergonomists set up the
studies of ergonomic interventions between 1999-2003. The measurement according to the professional experiences
results supported that demonstrating combinations of and the results of interviewing workers, and visiting
intervention measures appear to have the greatest effect in working sites.
reducing MSDs. In addition, the paper also suggested that • Assessment methods: Most of the studies used
ergonomic interventions can be coupled with other questionnaires to collect and to evaluate the feedback from
epidemiological and laboratory studies to increase the participant workers. The subjective judgement of
precision in estimates of exposure-load relationships [21]. effectiveness of ergonomic intervention, physical and
Furthermore, the effectiveness of participatory ergonomic psychological health conditions, and improvement of
(PE) interventions was specifically investigated by Rivilis et working environment were usually adopted as criteria in
al. [22]. PE is defined as ‘the involvement of people in the questionnaires. Data of injuries, absences days,
planning and controlling a significant amount of their own indemnity claims, MSDs related complaints (like shoulder
work activities, with sufficient knowledge and power to and low-back disorder (LBD), etc.), and productivity
influence both processes and outcomes in order to achieve between pre- and post-intervention were also collected. In
desirable goals’ [22,23]. In PE interventions, an ergonomics the context, statistic methods were used to evaluate if the
team consisting of employees or their representatives, results of intervention were significant from statistic point
managers, ergonomists, health and safety personnel, and of view. RULA technique was used in one study [27] to
research experts will undergo training by experts to obtain calculate the ergonomic risk scores of workers to
ergonomic principles. With the fundamental knowledge of determine if the ergonomics improve between pre- and
ergonomic concepts and methods, the group can newly post-intervention. Moreover, four studies [26,28,31,34]
develop solutions and adjustments to improve their workplace carried out economic analysis to estimate the benefit-to-
[22]. Half of its collected studies in the article provided partial cost ratio and the recovered years of implementing
to moderate evidence that PE interventions have positive ergonomic intervention.
impacts on MSDs, reducing injuries and workers’ • Outcome: Generally, all the selected empirical studies
compensation claims, and a reduction in lost days from work stated that considering ergonomics brought about
or sickness absence [22]. Though all the three review papers moderate or significant positive contribution to addressing
conclude that ergonomic interventions lead to positive MSDs and working condition issues. Injuries, lost working
influence to worker’s health and safety; however, the intensity days (LWD), indemnity claims were reduced by and large;
of the effect demands more precise definition. meanwhile, the productivity and quality of
Apart from the chosen review papers, 12 empirical studies processes/products benefited from the improved working
[24–35] were investigated to identify the effects on workers’ environment, flows, and worker’s health. Especially, the
health contributed by ergonomic intervention in practical case close relationship between MSDs and eyestrain of workers
studies. The overview of the selected empirical studies is was highlighted [32]. For economic analysis, the results
provided (see Table 1). As shown in Table 1, the applications showed the benefit-to-cost ratios were estimated between
covered service and manufacturing sectors in developed (US, 5 and 11 [31,34]; and the cost savings from reduced
Finland, Canada and Sweden) and developing countries defective products were also a crucial impact [26] .
(Malaysia, Iran, Brazil, and Hong Kong district of China).
94 Ya-Ju Chang et al. / Procedia CIRP 40 (2016) 91 – 96

To sum up, the studies showed that ergonomics supported individual differences between workers, such as muscle
worker’s well-being by controlling MSDs and improving their strength, gender, body shape, and other chronic diseases,
working environment. Correspondingly, the organization’s which may influence the ergonomic assessments but usually,
performance improved since the productivity and quality rose. are neglected in the assessments.
The cost and benefit analysis also clearly indicated the Another topic shall be underlined is promoting ergonomics
ergonomic interventions obtained economic benefits. It in global value chain, especially small and medium-sized
pointed out considering ergonomics contribute to both enterprises (SME) in developing countries. The SME in
economic and social aspects of sustainability. developing countries mainly act as main upstream suppliers of
the products sold in developed countries, involving in millions
4. Discussion of workers. However, the harsh working condition is still
under debate and the health and safety issues are often
In the previous section, the overview of literature remarks insufficiently considered in developing countries. The
the effectiveness of ergonomic intervention on addressing situation is critical in developing countries where only cases
MSDs and working environment. Not only health and safety that cause workers’ disability are recorded [36]. Applying
perspective, but also the productivity and quality of products ergonomic assessment in SME in developing countries is
are consequently improved due to enhancing ergonomics of necessary to reduce the costly impact on productivity and to
workers. The advantages on supporting social and economic increase workers’ well-being [36].
sustainability shall be noticed. Additionally, ergonomics should not only be considered in
Since playing as the key role to bridge work and working place design, but also further in product design for
sustainable development, ergonomics should be considered in improving consumers’ comfort and safety.
SLCA and other related sustainability assessment methods,
especially to address the gap in the health and safety aspect. 5. Conlusion
As a first step, basic screening methods, for instance, MSI
Risk Factor Identification [8–10], which can provide a general This paper highlights the lack of considering mid- and
overview for identifying potential risks of workplaces, are long-term health and safety issues, especially MSDs of
recommended to integrate into SLCA. These techniques are workers, in SLCA. Adopting ergonomic assessments to SLCA
easily applied in industry since non-experts can use them after is suggested as a solution to address the challenge. Through
short training. The estimated scores can be treated as a the overview of the selected literature, ergonomic
potential health risk indicator to judge the risk level of MSDs, interventions are approved with positive contribution in
to identify the existing risk factors, and to provide information reducing MSDs, increasing workers’ well-being, enhancing
to decision makers for further working place improvement. productivity and quality in working tasks and products. The
Apart from using the estimated ergonomic scores, adopting results also acknowledge that ergonomics can support social
tailored questionnaires to summarize workers’ feedback in and economic sustainability in global value chain, especially
qualitative and/or quantitative values is an alternative. A critical for developing countries.
combination of the aforementioned standardized ergonomic As a first step, coarse screening methods which can
assessment methods and questionnaires is also recommended. provide an overview for identifying potential risks of
By adopting the values and ergonomics scores in SLCA, the workplaces are recommended to integrate into SLCA. The
mid- and long-term consideration of the MSDs can be estimated scores can be treated as a potential health risk
achieved. indicator to judge the risk level of MSDs for further working
However, implementing ergonomics assessments in place improvement. Despite the estimated scores,
practical may encounter some challenges. Each assessment summarizing workers’ feedback in qualitative or quantitative
method owns its benefits and drawbacks. Trade-off between values by using questionnaires is also recommended as an
effort and level of detail usually exits. Effort includes time, additional subjective indicator in SLCA.
equipment cost and required expertise. Level of detail decides
the measurement alternatives. There are no standardized Acknowledgements
criteria for selecting an appropriate one. The selection usually
depends on the complexity of working tasks, the need of The authors gratefully acknowledge that the study is
managers, and the time or financial budgets. Furthermore, the funded by the German Research Foundation DFG (SFB
evaluation may be carried out by examiners or ergonomists 1026/1 2012), Collaborative Research Center CRC1026
based on their experiences without investigating bio-mechanic (Sonderforschungsbereich SFB1026).
models deeply. That means the examiners or ergonomists
could fail to distinguish the ergonomic scores between
different working task, postures, and other ergonomic risk
factors in some specific working situations. In addition, the
dynamic and changing work environments, especially where
lengthy follow-up times required also limit the
implementation of ergonomic assessment. Furthermore, the
 Ya-Ju Chang et al. / Procedia CIRP 40 (2016) 91 – 96 95

Table 1. Overview of the selected ergonomic intervention studies

Literature Application Background Intervention & assessment Outcome

Materials Staffs with no low-back pain The interventions lead to mean reductions of
Marras et 19-month intervention: the addition of
handling tasks were fitted with the lumbar 7.42 LBD and 6.18 injuries per 100 full-time
al. [24] lift tables, the installation of lift aids.
(US) motion monitor. employees per year.

Staffs were trained in 2.5 h to use the

Stressful patient handling The injuries decreased to 40%, the LWDs
Owen et al. Nursing in five devices. The injury data were
tasks: transferring, lifting up, decreased from 64 down to 3, and restricted
[25] hospitals (US) collected for the 18 months pre- and
and toileting patients in bed. days decreased to 20%.
post- intervention.

PE intervention: Workstation with space Arm and trapezius muscles static work
Poor workstation design,
Printed circuit for resting arms and the oscilloscope; fatigue were dropped. Average savings in
Yeow & mix-up of (un)tested boards,
assembly clear segregation of boards; retraining of annual rejection cost (US$574,560), increase
Sen [26] incorrect test steps, and
(Malaysia) operators; and color reference for in monthly revenue and productivity were
unclear color inspection.
effective recognition. shown.

RULA technique was used to calculate

72 menders were questioned RULA scores showed improvement in
scores for the posture of body parts in
Choobineh Carpet mending regarding MSDs. Knees, ergonomics. 57% of the menders found
the operation of the tasks pre- and post-
et al. [27] (Iran) back and shoulders problems working on the table better than working in
intervention. The mending table with an
were more prevalent. the traditional conditions.
attached seat was redesigned.

Patient handling assessment, new Significant decrease in musculoskeletal

Nurses have one of the
equipment, and after action reviews, etc. injuries rate as well as the number of
Nelson et Nursing highest rates of work-related
Injury rates, lost work days, modified modified duty days taken per injury (from
al. [28] facilities (US) musculoskeletal injury of any
work days and other criteria were 1,777 to 539 days). Initial investment for the
profession.
compared over two nine-month periods. equipment was recovered in 3.75 years

Statewide program provided ergonomic

Fujishiro et Healthcare The high incidence of MSDs Median MSD rate decreased from 12.32 to
consultation and financial support for
al. [29] facilities (US) among healthcare workers. 6.64 per 200,000 employee-hours.
purchasing ergonomic devices.

Municipal Over the last 3 months, 87% The 11–14-month PE intervention: Workers estimated the effects of the
Pehkonen
kitchens of workers had reported pain workshops to train staffs to plan the intervention on musculoskeletal load and
et al. [30]
(Finland) related to MSDs. targets and implementation. disorders positively.

Automotive Few studies investigate the 11-month PE intervention: The staffs

Tompa et Weekly indemnity claims was reduced by
industry cost and consequences of received training, identified and
al. [31] 52%. The benefit-to-cost ratio was 10.6.
(Canada) participatory ergonomics implemented change projects.

Visual ergonomics intervention: new The subjective experience of the general

Hemphälä lighting systems were developed to lighting and sorting time improved. Close
Post offices The lighting systems were
& Eklund provide uniform light. The labelling relationship between eyestrain and MSDs
(Sweden) old and insufficient. strip lettering was enlarged; and the exist: Those with eyestrain had three times
[32]
angle of racks was adjusted. as much MSDs.

8-week intervention program:

community High physical demands at
Szeto et al. Ergonomic training, daily exercise Significant improvement in musculoskeletal
nursing (Hong work result in MSDs to the
[33] program, equipment modification, symptoms and functional outcomes.
Kong) nurses.
computer workstation assessment.

2-year PE intervention: The ergonomist First aid incidents, modified duty episodes,
Clothing Few studies investigate the
Tompa et trained the members to assess the casual absences, long term sickness absences
manufacturing cost and consequences of
al. [34] ergonomic risk factors of the identified and product quality were greatly affected.
(Canada) participatory ergonomics.
jobs, and develop solutions. The benefit-to-cost ratio was 5.5.

Body pain of workers was 4-month PE intervention: richer

Furniture
Guimarães associated with repetitive teamwork, adoption of safe motion and Workload was reduced by 42% and
manufacturing
et al. [35] work, inappropriate postures postures, reduced load handling and productivity increased by 46%.
(Brazil)
and materials handling. elimination of manual transportation.
96 Ya-Ju Chang et al. / Procedia CIRP 40 (2016) 91 – 96

[19] Pascual SA, Naqvi S. An investigation of ergonomics analysis tools used

References in industry in the identification of work-related musculoskeletal disorders.
Int J Occup Saf Ergon 2008;14:237–45.
[1] Schneider E, Irastorza X, Copsey S. OSH in figures: Work-related [20] Karsh B, Moro FBP, Michael J. The efficacy of workplace ergonomic
musculoskeletal disorders in the EU-Facts and figures. 2010. interventions to control musculoskeletal disorders : A critical analysis of
doi:10.2802/10952. the peer-reviewed literature. Theor Issues Ergon Sci 2011:37–41.
[2] International Labour Organization. The Prevention of Accupational doi:10.1080/14639220152644533.
Diseases. Geneva: 2013. [21] Silverstein B, Clark R. Interventions to reduce work-related
[3] Bolis I, Brunoro CM, Sznelwar LI. Mapping the relationships between musculoskeletal disorders. J Electromyogr Kinesiol 2004;14:135–52.
work and sustainability and the opportunities for ergonomic action. Appl doi:10.1016/j.jelekin.2003.09.023.
Ergon 2014;45:1225–39. doi:10.1016/j.apergo.2014.02.011. [22] Rivilis I, Van Eerd D, Cullen K, Cole DC, Irvin E, Tyson J, et al.
[4] Radjiyev A, Qiu H, Xiong S, Nam K. Ergonomics and sustainable Effectiveness of participatory ergonomic interventions on health
development in the past two decades (1992-2011): Research trends and outcomes: A systematic review. Appl Ergon 2008;39:342–58.
how ergonomics can contribute to sustainable development. Appl Ergon doi:10.1016/j.apergo.2007.08.006.
2014;46:67–75. doi:10.1016/j.apergo.2014.07.006. [23] Wilson JR. Ergonomics and participation. In: Corlett EN, Wilson JR,
[5] Punnett L, Wegman DH. Work-related musculoskeletal disorders: The Corlett N, editors. Eval. Hum. Work A Pract. Ergon. Methodol. 2nd ed.,
epidemiologic evidence and the debate. J Electromyogr Kinesiol London: Taylor and Francis; 1995, p. 1071–96.
2004;14:13–23. doi:10.1016/j.jelekin.2003.09.015. [24] Marras WS, Allread WG, Burr DL, Fathallah F a. Prospective validation
[6] Siemens Product Lifecycle Management Software Inc. Jack and Process of a low-back disorder risk model and assessment of ergonomic
Simulate Human 2015. interventions associated with manual materials handling tasks.
http://www.plm.automation.siemens.com/en_us/products/tecnomatix/man Ergonomics 2000;43:1866–86. doi:10.1080/00140130050174518.
ufacturing-simulation/human-ergonomics/jack.shtml (accessed May 19, [25] Owen BD, Keene K, Olson S. An ergonomic approach to reducing
2015). back/shoulder stress in hospital nursing personnel: A five year follow up.
[7] Kugler M, Bierwirth M, Schaub K, Feith A, Ghezel-Ahmadi K, Bruder R. Int J Nurs Stud 2002;39:295–302. doi:10.1016/S0020-7489(01)00023-2.
KoBRA - Kooperationsprogramm zu normativem Management von [26] Yeow PHP, Nath Sen R. Quality, productivity, occupational health and
Belastungen und Risiken bei körperlicher Arbeit Ergonomie in der safety and cost effectiveness of ergonomic improvements in the test
Industrie – aber wie? Handlungshilfe für den schrittweisen Aufbau eines workstations of an electronic factory. Int J Ind Ergon 2003;32:147–63.
einfachen Ergonomiemanagements. Munich: 2007. doi:10.1016/S0169-8141(03)00051-9.
[8] Workers’ Compensation Board of British Columbia Canada. Safety at [27] Choobineh A, Tosian R, Alhamdi Z, Davarzanie M. Ergonomic
work - ergonomics assessment tools 2015. intervention in carpet mending operation. Appl Ergon 2004;35:493–6.
http://www2.worksafebc.com/topics/ergonomics/AssessmentTools.asp doi:10.1016/j.apergo.2004.01.008.
(accessed May 19, 2015). [28] Nelson A, Matz M, Chen F, Siddharthan K, Lloyd J, Fragala G.
[9] Workers’ Compensation Board of British Columbia Canada. Worksheet A Development and evaluation of a multifaceted ergonomics program to
- MSI Risk Factor Identification 2013. prevent injuries associated with patient handling tasks. Int J Nurs Stud
[10] Workers’ Compensation Board of British Columbia Canada. Worksheet 2006;43:717–33. doi:10.1016/j.ijnurstu.2005.09.004.
B - MSI Risk Factor Assessment 2013. [29] Fujishiro K, Weaver JL, Heaney C a., Hamrick C a., Marras WS. The
[11] McAtamney L, Nigel Corlett E. RULA: a survey method for the effect of ergonomic interventions in healthcare facilities on
investigation of work-related upper limb disorders. Appl Ergon musculoskeletal disorders. Am J Ind Med 2005;48:338–47.
1993;24:91–9. doi:10.1002/ajim.20225.
[12] Hignett S, McAtamney L. Rapid Entire Body Assessment (REBA). Appl [30] Pehkonen I, Takala EP, Ketola R, Viikari-Juntura E, Leino-Arjas P,
Ergon 2000;31:201–5. doi:10.1016/S0003-6870(99)00039-3. Hopsu L, et al. Evaluation of a participatory ergonomic intervention
[13] Schaub K, Caragnano G, Britzke B, Bruder R. The European assembly process in kitchen work. Appl Ergon 2009;40:115–23.
worksheet. Theor Issues Ergon Sci 2013;14:616–39. doi:10.1016/j.apergo.2008.01.006.
doi:10.1080/1463922X.2012.678283. [31] Tompa E, Dolinschi R, Laing A. An economic evaluation of a
[14] Waters TR, Putz-Anderson V, Garg A, Safety NI for O, Health. participatory ergonomics process in an auto parts manufacturer. J Safety
Applications Manual for the Revised NIOSH Lifting Equation. Res 2009;40:41–7. doi:10.1016/j.jsr.2008.12.003.
Cincinnati: The National Institute for Occupational Safety and Health [32] Hemphälä H, Eklund J. A visual ergonomics intervention in mail sorting
(NIOSH); 1994. facilities: Effects on eyes, muscles and productivity. Appl Ergon
[15] Colombini D, Occhipinti E, Montomoli L, Cerbai M, Fantid M, 2012;43:217–29. doi:10.1016/j.apergo.2011.05.006.
Ardissone S, et al. Repetitive movements of upper limbs in agriculture: [33] Szeto GPY, Wong TKT, Law RKY, Lee EWC, Lau T, So BCL, et al.
set up of annual exposure level assessment models starting from OCRA The impact of a multifaceted ergonomic intervention program on
checklist via simple and practical tools. Int. Conf. Agric. Ergon. Dev. promoting occupational health in community nurses. Appl Ergon
Countries, AEDeC, 2007, p. 26–9. 2013;44:414–22. doi:10.1016/j.apergo.2012.10.004.
[16] Ellegast R, Hermanns I, Schiefer C. Workload assessment in field using [34] Tompa E, Dolinschi R, Natale J. Economic evaluation of a participatory
the ambulatory CUELA system. In: Duffy VG, editor. Digit. Hum. ergonomics intervention in a textile plant. Appl Ergon 2013;44:480–7.
Model., Springer; 2009, p. 221–6. doi:10.1007/978-3-642-02809-0_24. doi:10.1016/j.apergo.2012.10.019.
[17] Window JJ. The validity of using quick ergonomics assessment tools in [35] Guimarães LBDM, Anzanello MJ, Ribeiro JLD, Saurin TA.
the prediction of developing workplace musculoskeletal disorders. 42nd Participatory ergonomics intervention for improving human and
Annu. Hum. Factors Ergon. Soc. Aust. Conf. 2006, Sydney: Human production outcomes of a Brazilian furniture company. Int J Ind Ergon
Factors and Ergonomics Society of Australia ( HFESA ); 2006. 2015:1–11. doi:10.1016/j.ergon.2015.02.002.
[18] Coyle A. Comparison of the Rapid Entire Body Assessment and the New [36] Piedrahita H. Costs of work-related musculoskeletal disorders (MSDs) in
Zealand Manual Handling “Hazard Control Record”, for assessment of developing countries: Colombia case. Int J Occup Saf Ergon
manual handling hazards in the supermarket industry. Work 2005;24:111– 2006;12:379–86. doi:10.1080/10803548.2006.11076696.
6.