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Ergonomics risk assessment methods for creating healthy work environments
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems, Ergonomics.ORCID iD: 0000-0002-5616-3568
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Risk assessments of ergonomic conditions in pre-production and in field are necessary to prevent work-related musculoskeletal disorders and to increase productivity and quality. Methods for such assessments include simulations, direct measurements and observations. In order to carry out correct ergonomic assessments, which is an important part in the work of creating healthy workplaces, it is vital that these methods are user-friendly, accurate and reliable. However, several methods are insufficiently tested with respect to these factors.

The aim of this thesis was to increase the knowledge of some relevant risk assessment methods for the prevention of musculoskeletal disorders. The methods include risk assessments in both planned and existing work environments.

A risk assessment approach for digital human modelling was developed. The approach included a reference database of epidemiological relationships between directly measured exposure and related musculoskeletal disorders. For illustration, a case in manual assembly was simulated; exposures were calculated and compared to the reference data to indicate the risk of work-related musculoskeletal disorders. The application and detailed assessment would be helpful to prioritise among different design solutions.

A 3D digital prototype of a laparoscopic robotic open console was ergonomically evaluated using the simulation tool Intelligently Moving MAnikins (IMMA); twelve manikins representing anthropometries of the Swedish and US populations were used. The work-ranges of the console and the manikins were calculated and compared. The ergonomics was evaluated using a US checklist and the Swedish standard for computer work. The assessment criteria, which are related to the adjustability of the screen, the armrests, and the pedals, were not fulfilled. The result showed that IMMA, with its built-in functions, provides the opportunity for risk assessment of planned static work tasks. With some improvements, tools like IMMA may increasingly be used efficiently for early assessments of planned products or work environments.

The inter- and intra-rater reliability and validity of six observation-based assessment methods, ART, HARM, SI, QEC, OCRA and SWEA, were studied through twelve ergonomists' and an expert group's repeated risk assessments of ten videotaped tasks. The results showed a low to moderate inter- and intra-rater reliability. Both the percent agreement and the reliability differed for the assessments of the methods' overall risk levels. Using a standardised task duration of 3.75 hours (rather than different durations for the different tasks) in the statistical calculations, the reliability of all methods decreased, except for OCRA. The decrease was most evident for HARM and ART, which was due to the fact that the duration of the task has a large impact in the methods' calculation of the total risk level. The validity was similar to the inter-rater reliability for each method.

This thesis emphasizes the importance of detailed quantification of exposure and reliable methods to draw accurate conclusions about the risk of musculoskeletal disorders, both in planned and existing work environments.

Today's technology, with small and wireless devices for direct measurements and methods for analysing physical exposure, provides opportunities to perform accurate and reliable ergonomic assessments. The possibility of using similar measurement strategies in digital human modelling, allows the discrimination of small differences in exposure which simplifies comparisons of different design solutions as well as between planned and existing work environment. Although the reliability of several observation-based methods was found to be low, observational methods are still important in the risk assessments of physical exposure, in order to include parts of the work environment that are not yet possible to measure. However, observational methods should preferably be used for screening and in combination with technical measurements.

Abstract [sv]

Riskbedömningar av ergonomiska förhållanden i förproduktion och i fält är nödvändiga för att förebygga arbetsrelaterade muskuloskeletala besvär och för att öka produktivitet och kvalitet. Metoder för sådana bedömningar inkluderar simuleringar, direkta mätningar och observationer. För att kunna genomföra korrekta ergonomiska bedömningar, vilket är en viktig del i arbetet med att skapa hälsosamma arbetsplatser, är det avgörande att dessa metoder är användarvänliga, noggranna och tillförlitliga. Flera metoder är dock otillräckligt testade när det gäller dessa faktorer. 

Syftet med den här avhandlingen var att öka kunskapen om några relevanta riskbedömningsmetoder för att förebygga muskuloskeletala besvär. Metoderna inkluderar riskbedömningar i både planerade och befintliga arbetsmiljöer. 

En riskbedömningsmetodik för digitala mänskliga modeller utvecklades. Metodiken inkluderade en referensdatabas över epidemiologiskt identifierade samband mellan direkt uppmätt exponering och relaterade muskuloskeletala besvär. Som illustration simulerades ett fall i manuell montering; exponeringar beräknades och jämfördes med referensdata för att påvisa risken för besvärsuppkomst. En sådan metodik kan komma att vara till hjälp för att prioritera bland olika designlösningar. 

Ergonomin vid arbete i en digital 3D-prototyp av en öppen robotisk konsol för laparoskopisk kirurgi studerades med hjälp av simuleringsverktyget Intelligently Moving MAnikins (IMMA); tolv digitala människomodeller (manikiner) med antropometriska mått från svensk och amerikansk befolkning användes. Arbetsområdena för konsolen och manikinerna beräknades och jämfördes. De ergonomiska kriterierna utvärderades med hjälp av en amerikansk checklista och den svenska standarden för datorarbete. Bedömningskriterierna, vilka är relaterade till justerbarheten av skärmen, armstödet och pedalerna, uppfylldes inte för samtliga manikiner. Resultatet visade att IMMA med sina inbyggda funktioner ger möjlighet till riskbedömning av planerat statiska arbete. Med några förbättringar kommer metoder som IMMA i allt högre grad kunna användas effektivt för tidiga bedömningar av planerade produkter och arbetsmiljöer. 

Inter- och intrabedömartillförlitligheten och validiteten hos sex observationsbaserade bedömningsmetoder, ART, HARM, SI, QEC, OCRA och SWEA, studerades genom tolv ergonomers, samt en expertgrupps, upprepade riskbedömningar av tio videoinspelade arbetsuppgifter. Resultaten visade en låg till måttlig inter- och intrabedömartillförlitlighet. Både procentuell överensstämmelsen och linjärt viktad kappa skilde sig åt med avseende på metodernas övergripande risknivåer. Med en standardiserad uppgiftslängd på 3,75 timmar (istället för olika tidslängder för de olika uppgifterna) i de statistiska beräkningarna, minskade tillförlitligheten hos alla metoder utom OCRA. Tillförlitligheten för HARM och ART minskade mest vilket berodde på att uppgiftens tidslängd har en stor inverkan i metodernas beräkning av den totala risknivån. Validiteten liknade interbedömartillförlitligheten för varje metod. 

Den här avhandlingen betonar att det är viktigt med detaljerad kvantifiering av exponering och tillförlitliga metoder för att dra korrekta slutsatser om risken för muskuloskeletala besvär, både i planerade och befintliga arbetsmiljöer.

Dagens teknik, med små och trådlösa enheter för direkta mätningar samt metoder för att analysera fysisk exponering, ger möjligheter att utföra noggranna och tillförlitliga bedömningar. Möjligheten att använda liknande mätstrategier för analys inom digital mänsklig modellering, medger identifiering av små skillnader i exponering, vilket förenklar jämförelser av olika designlösningar samt mellan planerade och befintliga arbetsmiljöer. Även om tillförlitligheten hos flera observationsbaserade metoder visade sig vara låg, är observationsmetoder fortfarande viktiga i riskbedömningarna av fysisk exponering, detta för att inkludera delar i arbetsmiljön som ännu inte är möjliga att mäta. Observationsmetoder ska dock helst användas för screening och gärna i kombination med tekniska mätningar.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2023. , p. 101
Series
TRITA-CBH-FOU ; 2023:22
Keywords [en]
Ergonomics, Risk assessment, Reliability, Validity, Systematic Observation, Direct measurement, Simulation, Digital Human Modelling, Workplace Design, Work-related Musculoskeletal Disorders, Biomechanical Exposure
National Category
Medical Modelling and Simulation
Research subject
Technology and Health
Identifiers
URN: urn:nbn:se:kth:diva-326816ISBN: 978-91-8040-590-4 (print)OAI: oai:DiVA.org:kth-326816DiVA, id: diva2:1756356
Public defence
2023-06-02, https://kth-se.zoom.us/j/62935040135, Emmy Rappnesalen (room T1), School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH, Hälsovägen 11C, Huddinge, 09:00 (English)
Opponent
Supervisors
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 1212-1202AFA Insurance, 180098, 180254Vinnova
Note

QC 20230511

Available from: 2023-05-11 Created: 2023-05-11 Last updated: 2025-02-09Bibliographically approved
List of papers
1. Reliability and Validity of Six Selected Observational Methods for Risk Assessment of Hand Intensive and Repetitive Work
Open this publication in new window or tab >>Reliability and Validity of Six Selected Observational Methods for Risk Assessment of Hand Intensive and Repetitive Work
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2023 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, no 8, p. 5505-5505Article in journal (Refereed) Published
Abstract [en]

Risk assessments of hand-intensive and repetitive work are commonly done using observational methods, and it is important that the methods are reliable and valid. However, comparisons of the reliability and validity of methods are hampered by differences in studies, e.g., regarding the background and competence of the observers, the complexity of the observed work tasks and the statistical methodology. The purpose of the present study was to evaluate six risk assessment methods, concerning inter- and intra-observer reliability and concurrent validity, using the same methodological design and statistical parameters in the analyses. Twelve experienced ergonomists were recruited to perform risk assessments of ten video-recorded work tasks twice, and consensus assessments for the concurrent validity were carried out by three experts. All methods’ total-risk linearly weighted kappa values for inter-observer reliability (when all tasks were set to the same duration) were lower than 0.5 (0.15–0.45). Moreover, the concurrent validity values were in the same range with regards to total-risk linearly weighted kappa (0.31–0.54). Although these levels are often considered as being fair to substantial, they denote agreements lower than 50% when the expected agreement by chance has been compensated for. Hence, the risk of misclassification is substantial. The intra-observer reliability was only somewhat higher (0.16–0.58). Regarding the methods ART (Assessment of repetitive tasks of the upper limbs) and HARM (Hand Arm Risk Assessment Method), it is worth noting that the work task duration has a high impact in the risk level calculation, which needs to be taken into account in studies of reliability. This study indicates that when experienced ergonomists use systematic methods, the reliability is low. As seen in other studies, especially assessments of hand/wrist postures were difficult to rate. In light of these results, complementing observational risk assessments with technical methods should be considered, especially when evaluating the effects of ergonomic interventions.

Place, publisher, year, edition, pages
MDPI AG, 2023
Keywords
ergonomics; repetitive work; hand intensive; risk assessment; observation; reliability
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:kth:diva-326815 (URN)10.3390/ijerph20085505 (DOI)2-s2.0-85153935302 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 1212-1202
Note

QC 20230516

Available from: 2023-05-11 Created: 2023-05-11 Last updated: 2024-03-18Bibliographically approved
2. A possible revival of population-representing digital human manikins in static work situations - exemplified through an evaluation of a prototype console for robotic surgery
Open this publication in new window or tab >>A possible revival of population-representing digital human manikins in static work situations - exemplified through an evaluation of a prototype console for robotic surgery
2021 (English)In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 70, no 3, p. 833-851Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In the 90s, digital human manikins (DHMs) were introduced in planning ofworkstations, by static or semi-static simulations. Modern DHMs can simulate dynamic work and offer a rapid way for a virtual pre-production ergonomic evaluation. Work-related musculoskeletal disorders may affect surgical performance and patient safety. A prototype of an open console, which is contrary to the conventional closed consoles and may be seen as a representative for a new generation, has been designed to reduce workload for robotic surgery surgeons. OBJECTIVE: The aim of this project was to test a new DHM tool with improved usability to evaluate the ergonomics of a console of a robotic surgical system in a pre-production stage. METHODS: The DHM tool IMMA was used together with a 3D model of the prototype console. Twelve manikins who represented females and males from two national populations were introduced. Manikin-console distances, after console adjustments per manikin, were compared with a US checklist and Swedish standard for VDU work. RESULTS: The DHM tool was useful for this case, but the distances of the checklist and the standard were needed to be obtained "manually". The automatic functions of the DHM worked smoothly but were not optimized for VDU work. The prototype fulfilled most, but not all, of the ergonomic criteria of the checklist and the standard. CONCLUSIONS: There is room for improvements of the adjustable ranges of the console prototype. DHMs may facilitate rapid pre-production evaluation of workstations for static work; if ergonomic assessment models for VDU work are built-in, there may be a revival of DHMs in static work situations.

Place, publisher, year, edition, pages
IOS Press, 2021
Keywords
Robotic surgery, digital human manikin, simulation, ergonomic assessment, occupational ergonomics
National Category
Production Engineering, Human Work Science and Ergonomics
Identifiers
urn:nbn:se:kth:diva-306570 (URN)10.3233/WOR-213604 (DOI)000724731100017 ()34719466 (PubMedID)2-s2.0-85122647567 (Scopus ID)
Note

QC 20211220

Available from: 2021-12-20 Created: 2021-12-20 Last updated: 2023-05-11Bibliographically approved
3. Inter- and intra-rater reliability of the OCRA checklist method in video-recorded manual work tasks
Open this publication in new window or tab >>Inter- and intra-rater reliability of the OCRA checklist method in video-recorded manual work tasks
2020 (English)In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 84, article id 103025Article in journal (Refereed) Published
Abstract [en]

Observation-based risk assessments are often used for evaluation of biomechanical workload and the condition of the workplace ergonomics. However, the inter- and intra-rater reliability of the methods used for the assessments are insufficiently studied. The OCRA checklist method, included as a reference method in the ISO and CEN standards regarding upper limb repetitive risk assessment, was in this study investigated regarding its reliability. Eleven ergonomists were educated within the method. Each ergonomist risk-assessed ten video-recorded manual work tasks, on two occasions. The average inter-rater agreement of the five overall risk levels was 39% and the linearly weighted kappa was 0.43, the intra-rater dittos were 45% and 0.52. Both indicating a moderate reliability, but lower than what could be expected. The levels might be sufficient for coarse surveys. However, for risk assessments before and after an intervention, complementing technical methods should be considered.

Place, publisher, year, edition, pages
Elsevier Ltd, 2020
Keywords
Inter-rater reliability, Intra-rater reliability, Observational methods, Risk assessment, Ergonomics, Reliability, Inter-rater agreements, Inter-rater reliabilities, Observational method, Overall risk level, Reference method, Upper limbs, Work task, article, checklist, interrater reliability, intrarater reliability, manual labor, upper limb, videorecording
National Category
Production Engineering, Human Work Science and Ergonomics
Identifiers
urn:nbn:se:kth:diva-267946 (URN)10.1016/j.apergo.2019.103025 (DOI)000512220600007 ()31987511 (PubMedID)2-s2.0-85075972830 (Scopus ID)
Note

QC 20200401

Available from: 2020-04-01 Created: 2020-04-01 Last updated: 2023-05-11Bibliographically approved
4. Ergonomic risk assessment in DHM tools employing motion data-exposure calculation and comparison to epidemiological reference data
Open this publication in new window or tab >>Ergonomic risk assessment in DHM tools employing motion data-exposure calculation and comparison to epidemiological reference data
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2018 (English)In: International Journal of Human Factors Modelling and Simulation, ISSN 1742-5549, Vol. 6, no 1, p. 31-64Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Inderscience Publishers (IEL), 2018
National Category
Production Engineering, Human Work Science and Ergonomics
Identifiers
urn:nbn:se:kth:diva-297181 (URN)
Note

QC 20210617

Available from: 2021-06-13 Created: 2021-06-13 Last updated: 2023-05-11Bibliographically approved

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