RAMP (Risk Assessment and Management tool for manual handling – Proactively), is arisk management tool focusing on manual handling work. Since 2017 RAMP has beenspread to over 105 countries. More than other methods, RAMP supports the entire riskmanagement process. RAMP is based on risk factors documented in scientific literature,and it has been evaluated regarding usability and reliability. It is now used for MSDrisk management in many organisations. The feedback from RAMP users is positive,and there are indications of reductions in sick absence.The purpose of the ongoing project is to investigate a selection of effects thatimplementation entails and to examine the implementation of RAMP from a leadershipand system perspective. Specific questions are: What happens when a companyimplements RAMP? Are the risk factors reduced? What affects the change? Whatstrategies do companies use when implementing RAMP? Are the effects of whichstrategies companies apply when implementing affected? What are the facilitators andbarriers to the implementation of this risk management method?The project is carried out as an implementation study based on mixed methods incollaboration between researchers and four production companies and two FHV actors.The effects and implementation of RAMP will be evaluated by comparing risk levels,qualitative interviews, document analyses, questionnaires and structured observationsof work processes. For changes in risk factors, RAMP risk assessments, which includeobservations and objectivemeasurements of push-pull forces, carried out at baseline andat follow-up will be compared. If possible, in addition to the above data collection, thecompany's own data on sick leave, productivity and quality (eg quality deficiency data)will be included and monitored over time.Implementations and effects of RAMP will be summarized in so-called logicalmodels. These models will identify inputs (e.g. time and resources set aside forimplementation), activities (e.g. training and measures implemented), intermediate(short-term) outcomes (e.g. the extent to which RAMP is used in the systematic workenvironment work and in the entire process for risk management, how much of the highrisks have been reduced, what type of measures have been taken and how the riskawareness has developed among employees), long-term outcomes (e.g. employees'perception of the workload, perceived health and perceived problems), and possiblylong-term outcomes (e.g. changes in sick absence, quality and productivity as well assharing good examples within the organisation).157At this point in the project, the questionnaire has been designed, companies havebeen contacted, and data collection at the first company, that now has assigned animplementation strategy, is about to start.The project is expected to show what effects on the work environment (possibly alsohealth, quality and productivity) that systematic application of the RAMP method canhave, aswell aswhich of the studied factors affect the implementation and to what extentthey do so. The results are expected to lead to new knowledge in the area of systematicrisk management and implementation strategies.

Companies use risk observations and work environment (WE) deviations such as occupationalaccidents and occupational illnesses to prevent injuries. There is no standard for how risks andoccupational injuries are reported. Praktikertjänst's management requests a standard as ameasure that can be used to work more proactively with health and safety and supportsustainable business development. Therefore, the SRA method was developed for calculatingand visualizing a work environment KPI related to the severity of WE deviations, the SRA Index.(Sustainable Risk Awareness Index for management support). Existing data (risk observations,near misses, work-related accidents and work-related illnesses) are used for calculating the SRAIndex. In this study the usability of the SRA Index was evaluated with a questionnaire amongwork environment experts. They assessed the SRA method to be easy to understand, to havehigh usability and to be valuable for assessing an organisation’s risk awareness.

The objective with this project is to develop a key performance indicator (KPI) related to work environment deviations, such as risk observations, near misses and injuries. This as a support for managers decision making in steering companies towards higher risk awareness as well as to contribute to the development of safer and more sustainable work environments and jobs. In addition, the aim is to contribute to a work environment (WE) reporting standard with a KPI related to the severity of WE deviations. Based on a literature study an iterative development of such a KPI has resulted in the Sustainable Risk Awareness Index (the SRA Index) and a visualization of it and its components using the Risk Awareness Triangle, also developed in this project. The development of the SRA Index is described and the index is exemplified with data from the electrical installation sector, the healthcare industry and one of Sweden’s largest private health company. Also the Risk Triangle is exemplified. The need for and the advantages of standardized methods to report WE deviations in companies sustainability reports are discussed. It is concluded that initial use of this KPI, according to management, fills an identified gap, it provides the management with a usable tool for systematic work environment overview and it supports their informed decision-making.

The purpose of this study is to evaluate an updated beta version of Ergo-Index, a digital tool for ergonomic risk assessments. The evaluation was performed with 15 expert users who assessed type, distance, height and exposure time of certain work tasks, as well as the usability of the tool. In conclusion, the users find the present state of the Ergo-Index suitable as a first screening method. Assessments of lifting work have the greatest inter-rater reliability. Further development of the digitalized version of the tool is needed to improve accuracy assessing input regarding pushing and pulling work tasks, and to increase usability.

A recently developed model intended to be used by practitioners and ergonomists in themanufacturing and logistics industry for assessment of physical ergonomic risks related to manuallifting and lowering operations is presented. The model is constructed using the revised NIOSH liftingequation (RNLE) as a basis, but it has been modified to enhance its usability, regarding (1)simplifications of the existing factors in the RNLE, (2) adding new factors and (3) a more conservativejudgment of lifts performed at low and high vertical heights. In addition, a survey regarding theusability of the new lifting model including twenty-two ergonomists/physiotherapists is presented,

RAMP I is a screening tool developed to support practitioners in screening for work-related musculoskeletal disorder riskfactors related to manual handling. RAMP I, which is part of the RAMP tool, is based on research-based studies combinedwith expert group judgments. More than 80 practitioners participated in the development of RAMP I. The tool consistsof dichotomous assessment items grouped into seven categories. Acceptable reliability was found for a majority of theassessment items for 15 practitioners who were given 1 h of training. The usability evaluation points to RAMP I beingusable for screening for musculoskeletal disorder risk factors, i.e., usable for assessing risks, being usable as a decision base,having clear results and that the time needed for an assessment is acceptable. It is concluded that RAMP I is a usable toolfor practitioners.

RAMP I is a screening tool developed to support practitioners in screening for work-related musculoskeletal disorder risk factors related to manual handling. RAMP I, which is part of the RAMP tool, is based on research based studies combined with expert group judgments. More than 80 practitioners participated in the development of RAMP I. The tool constitutes of dichotomous assessment items grouped in seven categories. Acceptable reliability was found for a majority of the assessment items for 15 practitioners who were given 1h training. The usability evaluation points to RAMP I being usable for screening for musculoskeletal disorder risk factors, i.e., usable for assessing risks, usable as a decision base, has clear results, and the time needed for an assessment is acceptable. It is concluded that RAMP I is a valuable tool for practitioners.

RAMP II is an observation-based tool developed for assessing a wide range of musculoskeletal disorder risk factors related to industrial manual handling. RAMP II, which is part of the RAMP tool, is based on research studies and expert judgments. The assessment relies mainly on direct or video observations of the work being assessed, but additionally on measured push/pull forces and weights of handled objects, and on perceived workload and discomfort. Over 80 practitioners participated in the development of the tool. According to the evaluations, 73% of the assessment items evaluated had acceptable reliability, and the majority of the potential end-users reported that RAMP II is usable for assessing risks and as a decision base. It is concluded that this study provides support that RAMP II is usable for risk assessment of musculoskeletal disorder risk factors in industrial manual handling. Practitioner summary: RAMP II is an observation-based assessment tool for screening and assessing major musculoskeletal exposures in industrial manual handling jobs. Over 80 practitioners participated in the development of the tool. This study provides support that RAMP II is usable for risk assessment of musculoskeletal disorder risk factors in industrial manual handling. Abbreviations: CTS: carpal tunnel syndrome; HARM: the Hand Arm Risk Assessment method; IMP: intramuscular pressure; κw: linearly weighted kappa; LBD: lower back disorders; LBP: lower back pain; MAWL: maximum acceptable weight of lift; MHO: manual handling operations; MSD: musculoskeletal disorder; MNSD: neck-shoulder disorder; NSP: neck-shoulder pain; OCRA: the Occupational Repetitive Action methods; OHS: occupational health and safety; PABAK: prevalence and bias adjusted kappa; p0: proportion of agreement; RAMP: Risk Assessment and Management tool for manual handling Proactively; ROM: range of motion; RPL: risk and priority level; RSI: the Revised Strain Index; RULA: the Rapid Upper Limb Assessment; SWEA: Swedish Work Environment Authority; UEMSDs: upper-extremity work-related musculoskeletal disorders; WMSD: work-related musculoskeletal disorder; WRMSD: work-related musculoskeletal disorder; workday8h: eight hours workday.

Ergonomic risk factors are major contributors to work-related musculoskeletaldisorders and quality deficiencies in the manufacturing industry. Due to lack of tools or systemsthat can support a systematic risk management of these production and health related factors, anew risk management tool (RAMP) was developed. In this paper, the risk communication system(the Results module) of this tool is presented along with a description of its development. Anexample of how it can be used, based on assessments performed in industry, is given. Anevaluation of its usability, which included twenty practitioners active in the industry, givessupport to the notion that the system is usable both for risk communication and as a decision base.

Introduction

Manual Materials Handling (MMH) and working in awkward postures are still important causes of MSDs. Proper ergonomic conditions can contribute to reduce absence from work, and are important prerequisites to ensure high quality and productivity. Risk assessment can be used to improve the working conditions by identifying important risk factors and support communication between key stakeholders in order to improve the working conditions.

This paper presents an ongoing project called RAMP (Risk management Assessment tool for Manual handling Proactively), reported e.g. at NES 2011. The aim of the project is to develop a freely accessible load ergonomic risk assessment tool and to gain knowledge of contributing factors for implementation and usability of such a tool. The RAMP-tool is developed for assessing risk of MSDs, support communication of the main risk factors among stakeholders and support effective interventions. The project, mainly financed by AFA Insurance, is conducted in collaboration between KTH and companies in the manufacturing industry, mainly Arla Foods and Scania CV.

Methods

This far an overview of risk assessment tools which can be used to assess MMH activities and potentially be used by companies or OSH personnel has been performed including e.g. KIM, QEC, ART Tool, SES and Washington State Checklist. Interviews with companies in the manufacturing industry have been performed to gain insight of the companies’ use of risk assessment tools and their perception of their usability.

Results

The tool consists of two levels, RAMP I and RAMP II. The first level is intended for quick screening of work stations of occurrence (or not) of risk factors. If the screening indicates an occurrence of a risk factor, a more thorough analysis with the second level could be performed. RAMP II can be used for a more detailed analysis of the exposure to risk factors and point out the direction of possible improvements in order to reduce the exposure.

A first prototype of the RAMP I has been evaluated by users, including managers, health and safety representatives, OSH personnel and workers.The tool will be further evaluated and refined after feedback from users. A preliminary version of the RAMP I will be presented at the conference and also preliminary results from the user tests.

This paper presents an IT-based risk management tool called RAMP, risk assessment management tool for manual handling proactively. The tool consists of a checklist (RAMP I) and an assessment tool (RAMP II) which can be used to assess physicalrisk factors associated with manual handling activities in the production industry. The tool provides guidance for action plans and evaluations to promote improvement of occupational health and safety work at company level. Examples of the tool, its development and evaluation are presented.

Reaction forces from nutrunner tools constitute a risk of developing MSDs. However, recommendations for sustainable reaction force levels are lacking. The aim of this study was to inform recommendations regarding reaction load exposures from right-angle nutrunners. Through a psychophysics approach, experienced assembly workers subjectively assessed reaction loads when using a nutrunner in six combinations of tool tightening strategy, work-pace and screw-joint stiffness. Electromyography, tool and joint parameters were measured. Regardless of tightening strategy, joint stiffness and work-pace combinations, no large differences in acceptable tightening torque, peak reaction force, and handle displacement were observed. However, acceptable jerk and impulse differed substantially between the TurboTight (R) (high-acceleration) and QuickStep (R) (conventional) tightening strategies. Although the TurboTight (R) strategy overall showed reduced peak muscular activities compared to the QuickStep (R), the participant-rated acceptable torque levels were similar, plausibly due to TurboTights' high jerk levels. Jerk and impulse are hypothesized to influence the perception of reaction loads.

Assembly workers using handheld powered tightening tools are repetitively subjected to reaction loads resulting from the tool handle. Despite the vast amount of research, tool manufacturers and OSH practitioners still lack well-grounded recommendations and benchmarks for ergonomics evaluations of reaction loads. This review provides an overview of research investigating reaction loads and operator physical demand, and identifies gaps in current means of evaluating reaction load exposure from tightening tools. A scoping review was conducted, scanning for quantifications of reaction loads as well as reported indications of MSD risks following tightening tool use. Suggested maximum exposures for reaction loads were further identified. The most commonly investigated quantities among the 40 publications included, were peak reaction force/torque (70%) and handle displacement (70%), followed by impulse (23%). Pneumatic tools were studied at greater extent (65%) than electric tools (30%). Three studies presented a relationship between reaction load exposure and physiological changes, i.e. edema, tissue oxygenation and blood volume changes, indicating an elevated risk of developing MSDs. Four publications proposed values for maximum reaction load exposure, expressed as either reaction torque, handle displacement, or tightening torque. To conclude, strategies for developing recommendations for reaction load exposure are suggested. Less investigated reaction parameters, e.g. impulse, can carry additional relevant information regarding exposure. Exposure values should be expressed as physical quantities of the reaction load rather than tightening torque. Recommendations are further needed for various tool handle-configurations, emphasizing the increasingly used electric tools. Such recommendations can eventually contribute to reducing MSDs resulting from tightening tool use.

Background: The impact of physical reactions on human operators generated byhandheld powered tightening tools has been researched by evaluating variousparameters, here referred to as ‘reaction parameters’. The objective of this literaturereview is to investigate which reaction parameters commonly are assessed duringphysical load evaluations of tightening tools, as well as reported correlations betweenreaction parameters and risk of developing cumulative trauma disorders (CTDs). Anadditional aim is to map exposure limits established for reaction parameters and identifyknowledge gaps regarding tightening tool impact on operators, if any.Methods: A systematic approach was adopted to review relevant literature, followingthe PRISMA flow-diagram. Synonyms of defined keywords were combined for search in3 databases. 76 articles were read and evaluated against inclusion criteria, of which 47articles where included in a qualitative synthesis. An overview of the assessed reactionparameters was obtained, as well as suggested linkages between these parameters andrisk of injury development.Results: Main parameters studied in literature are reaction force/torque (79%) andhandle displacement (74%). Impulse and handle velocity are studied in 26% and 15% ofthe articles, respectively. 51% of the studies also report a correlation between assessedreaction parameters and risk of developing CTDs. Three studies present exposure limitsfor reaction parameters. 1/3 of the studies were conducted on electric tools, whereasapproximately 2/3 were performed on pneumatic tools.Conclusions: There is a knowledge gap concerning several reaction parametersand their implications for developing CTDs, especially regarding impulse, tool handlevelocity/acceleration and grip force. Their influence is suggested to be explored infurther studies. Establishing exposure limits related to the reaction parameters wouldtranslate the scientific knowledge into industrially applicable recommendations. Further,the need for studies on electric tools is evident, due to a shift in the industry frompneumatic to electric tools.

OCCUPATIONAL APPLICATIONS Designing sustainable cyclic work requires attention to both the workload amplitude as well as the duty cycle, the fraction of the work cycle with active workload, that therefore also defines the recovery phase of the cycle. A number of different approaches and models have been developed to calculate the required recovery time for a given load and duty cycle. We present a comparison of three types of models at the "breakpoint" that defines the boundary of load amplitude and duty cycle where fatigue begins to accumulate faster than recovery allows within the work cycle. This comparison shows considerable variation between models of the "allowable" load or duty cycle depending on the method used. Practitioners should thus be cautious applying these models indiscriminately in job design as their results can vary substantially. In particular, differences between the tasks used for model formulation and application may compromise validity, and model application in a given context should be verified before broad application. TECHNICAL ABSTRACT Rationale: There is a need for tools to help design sustainable work in which muscular capacity and other human resources can recover at least as quickly as they are used. Purpose: In this brief report, three different approaches presented in the literature to determining work-rest schedules in cyclic work are compared. Methods: First, a set of five different muscular endurance models coupled with a recovery time model were considered, both with and without a dynamic work correction factor. Second, we examined a model of "resumption time", and third a psychophysically-based model of maximum duty cycle was included. These models were compared using the concept of a "breakpoint" in fatigue accumulation-the point at which a given load amplitude and duty cycle combination begins to cause accumulation of fatigue in each cycle and from which there is inadequate time to recover. Results: While the five endurance time models all behaved similarly, both with and without the static-to-dynamic correction factor applied, the three different types of modeling approaches provided substantially different response patterns. The psychophysically based model provided the most protective guideline among the models compared. Conclusion: These models should be applied with caution to particular work scenarios. Further research is needed to test accuracy and effectiveness when applying such models to a range of task scenarios to establish safe workloads and loading times in the design of repetitive work.

Background and purpose

Our society is facing major demographic challenges in healthcare. The growing population of older people is outpacing the creation of residential care facilities like nursing homes, meaning that more and more people are ‘aging in place’. ‘Aging in place’ means continuing to reside in a private residence in the community even as care needs intensify. It is an economically efficient option and often preferred by aging people, but it also brings substantial challenges. Eventually people require support from home careworkers with the vital and personal tasks that take place in the bathroom: toileting and bathing. However, residential bathrooms are often small and not designed to accommodate a care recipient, care worker, and mobility aids such as a walker or wheelchair. There is a growing need to update residential bathrooms to meet the evolving needs of older residents. Although there exist several aids and assistive devices intended to facilitate bathroom tasks, this can be hard for users and caregivers to navigate. This project was undertaken as part of a larger study funded by AFA Försäkring. The goal of this portion was to develop an inventory of currently-available bathroom assistance devices for use by residents and their family members, health care organizations, insurance agencies, and other stakeholders. The primary research question was: What type of bathroom assistive devices are currently available, either commercially or in prototype form, intended to assist users with the tasks of toileting, bathing, and handwashing?

Methodology

The primary method was web search and document review across several domains: regulations, assistive devices, and residential bathroom renovation examples. The first set of searches investigated the legislation and guidelines on bathroom design both for residential and healthcare settings; consistent and conflicting specifications were noted. The second set of searches was for assistive devices that could be used to facilitate bathing and toileting tasks in residential bathrooms. Examples of renovated residential bathrooms were solicited through authors’ networks.

Results

When it came to guidelines and specifications for bathroom design, there was substantial tension between the regulations set out by the Swedish Work Environment Authority and the National Board of Housing, Building and Planning. The inventory includes images of assistive devices as well as their main features: target task (bathing, toileting, personal care, handwashing), dimensions, weight ratings, colors, materials, store, website address, accessibility, and price. Documented assistive device categories include shower benches, toilet aids, support handles, showers, washbasins, taps, alarm buttons, contrast marks, and others, with approximately 20 examples for each.

Conclusions

This project developed an inventory of currently-available bathroom assistance devices, intended to inform users’ selection of devices for growing care needs in realistic (i.e. nonideal) settings. However, it is not the intention for the inventory represent an assessmentof the quality, safety, effectiveness, or usability of the devices. While it is hoped this list will represent the variety of available devices, it is also not intended to be exhaustive. Together with an introduction that includes the examples of renovated bathrooms, the inventory will be disseminated as a searchable web-based resource.

The aim of this study was to investigate fatigue reactions in eye-level work with low loads. It consisted of two parts, each with eight men participating. A handle, placed at eye-level 0.5 m in front of the body, was pushed at three different loading levels, varying between 1 and 20 % of maximum voluntary contraction (MVC). Sustained contractions were performed a) until exhaustion at endurance time Tend during registra-tion of subjective ratings of discomfort/pain and resumption time Tres, and b) for two minutes during registration of mean power frequency, MPF, of the myoelectric signals (EMG) from the biceps brachii (BB), triceps brachii (TB), trapezius (TZ) and deltoideus (DD) muscles and subjective ratings of discomfort/pain. These parameters were also studied during the following recovery period.The higher the load, the shorter were the Tend and the following recovery period. Also, the Tres decreased with increasing load. The MPF increased in some cases and de-creased in others during the sustained contractions. The levels of decrease/increase in MPF differed for the different loading levels and the different muscles. The largest fa-tigue indications in MPF were in BB while the discomfort/pain originated from TB. TZ showed the smallest fatigue reactions.The results indicate that caution should be taken when developing and using models for estimating physical strain and fatigue based on EMG indications in low loading situations.

It can be challenging to motivate decision-makers to invest in work environmentimprovements (WEIs). One success factor is to use the same vocabulary as companymanagement and express suggested WEIs in a way that management can understand and usein their decision-making. This paper has two objectives, to present: 1) examples of realorganisations’ ergonomics problems, suggestions for improvements and financial estimationsof effects of the suggested interventions, carried out by students in a Master’s course; 2)course-design features evaluated as important for this type of course. Results from six studentprojects, using several financial methods, are presented. The discussion focuses on the valueof increasing the availability of such a course, as well as competencies needed to be successfulinWEIs. In conclusion: by applied training as in this course, non-economists can rather rapidlylearn to assess ergonomics problems, and to develop, present and argue for suggestedsolutions, also with financial effect estimations.

This study's objective was to develop models of endurance time (ET), as a function of load level (LL), and of resumption time (RT) after loading as a function of both LL and loading time (LT) for repeated loadings. Ten male participants with experience in construction work each performed 15 different one-handed repetaed pushing tasks at shoulder height with varied exerted force and duration. These data were used to create regression models predicting ET and RT. It is concluded that power law relationships are most appropriate to use when modelling ET and RT. While the data the equations are based on are limited regarding number of participants, gender, postures, magnitude and type of exerted force, the paper suggests how this kind of modelling can be used in job design and in further research.Practitioner Summary: Adequate muscular recovery during work-shifts is important to create sustainable jobs. This paper describes mathematical modelling and presents models for endurance times and resumption times (an aspect of recovery need), based on data from an empirical study. The models can be used to help manage fatigue levels in job design.

The objective of this paper is to describe the development, dissemination and preliminary effects of the use of a new musculoskeletal disorder (MSD) risk management tool for manual handling, RAMP (Risk Assessment and Management tool for manual handling Proactively). RAMP is research based and developed in close collaboration between researchers and practitioners with a participative iterative methodology. A broad strategy is used for the dissemination, including the use of professional networks, conferences, a specially developed homepage, and Massive Open Online Courses which also provide training on the tool use. The tool has been spread widely to about 45 countries since the release 2017. E.g. Scania CV uses RAMP as its global standard method for managing MSD risks at logistics and machining departments. Among the preliminary effects results show that at one department risk reduction measures had been taken for more than 2/3 of the work stations with assessments signalling elevated risk levels after 1.5 years. Further studies on RAMP are discussed. It is concluded that the development and the dissemination of RAMP can be seen as successful. Preliminary reports on the tool use effects indicate that the RAMP tool supports the MSD risk management process in the work to reduce MDS risks at workplaces.

In this paper the RAMP Package is presented with the objective to facilitate the application of the RAMP tool to systematically manage MSD risks. The package consists of the RAMP tool (Risk Assessment and Management tool for manual handling Proactively), the RAMP website, and free, globally available online, training courses (MOOCs). An Action module used for managing identified MSD risks is introduced. The tool, encompassing a wide range of risks, is applicable to the whole risk management process. Furthermore, RAMP is openly available for download, and free to use. The RAMP tool and training materials were developed using a participative iterative methodology including researchers and practitioners. RAMP was downloaded in 86 countries in the first 26 months since its' launch and over 2400 learners from high-, middle- and low-income countries have joined the MOOCs. The RAMP Package meets organisations’ needs for an accessible, comprehensive risk assessment and management tool.

In 2017 RAMP (Risk Assessment and Management tool for manual handling – Proactively), a risk management tool focusing on manual handling work, was launched with the objective to contribute to reducing musculoskeletal disorders (MSDs). RAMP has since then been spread to over 105 countries and is used as the standard method for MSD risk management in several organisations. Different usability, reliability and validity aspects of RAMP have been evaluated as being good. To enhance RAMP’s application range and to further increase its usability, the RAMP 2.0 project started in 2018. Results from this ongoing project have been reported at several conferences, e.g. IEA 2021.The objective of this conference-contribution is to provide an overview of the results of the project this far, whereas the objectives of the project are to: i) expand RAMP’s application range to include hand-intensive work, ii) in addition to the existing Excel-based version, provide RAMP in a system version, and iii) enable practitioners to use RAMP results in forming key performance indicators, KPIs, as a means to follow the results of systematic work environment progress at an organisation, and to provide managers with relevant data for informed decision making.The project is carried out with a participatory, iterative methodology. It is led by re-searchers at KTH, and carried out in a collaboration between researchers and practitioners from over a dozen organisations. Methods used include needs analyses, literature studies and iterative development of the three parts, where workshops with different types of experts are regarded as crucial.The results this far for each one of the three parts are: i) Enhanced application range. Based on a needs analysis among the participating organisations, the first version of RAMP’s “Hand model” has been developed. An evaluation study of this model in planned for the spring 2022 where usability and reliability are in focus; ii) Also a version of the RAMP system version has been developed, as well as iii) methods for forming KPIs, i.e. both KPIs formed by using only RAMP results data and KPIs formed by combining RAMP results and company data, as for example quality and sick-leave data.By the inclusion of hand intensive work in RAMP’s application range, a large part of commonly performed work tasks can be assessed and managed. However, limitations of the tool’s application range is discussed, as well as how adequate input data can and determined.

RAMP (Risk Assessment and Management tool for manual handling – Proactively), a freely accessible MSD risk management tool for manual handling work, was launched 2017 to contribute to the reduction of musculoskeletal disorder (MSD) risks for manual handling work-tasks. The tool is currently developed further, using an iterative participative methodology, to: i) enhance the RAMP tool’s application range, mainly to include hand-intensive work, ii) develop a system version of the tool, and iii) include key performance indicators (KPIs). A needs analysis resulted in 99 identified needs. Regarding i), six needs were assessed as “very important to include” to enhance the application range. A literature study focusing on relevant risk factors and how exposure to them is associated with MSD risks was carried out and first drafts of a model for assessing risks in hand-intensive work are iteratively developed, using feedback from intended users. Regarding ii), 50 needs and suggestions on what to consider when developing a databased system version of the RAMP tool were identified. Prototypes of parts of the system-version are iteratively developed, using intended users’ feedback. Regarding iii), the needs analysis resulted in 16 suggested KPIs, including KPIs based solely on RAMP results and KPIs which can be established combining RAMP results and company data. The project is ongoing. An enhanced RAMP tool, RAMP 2.0, with the abovementioned expansions could support MSD risk assessment and risk management in systematic MSD risks reduction work for a wide range of work tasks.

This paper describes an on-going project with the main objective to develop, implement, and disseminate a freely accessible computer-based assessment tool for physical ergonomics, the Risk Management Assessment Tool for Manual Handling Proactively, RAMP. The project is conducted in seven steps, in close co-operation between researchers and key company stakeholders, using an interactive research methodology. Results include a specification of requirements that the RAMP should meet. Difficulties of developing models of this kind and possible benefits of using such a tool are discussed.

Background:The RAMP package (Rose et al., 2018) consists of RAMP (RiskAssessment and Management tool for manual handling Proactively), a website (ramp.proj.kth.se) and a Professional Certificate Program consisting of three MOOCs (massive open online courses) on musculoskeletal disorders (MSDs) and the RAMPuse. RAMP, developed for managing risks in manual handling work, was launched 2017and has been disseminated to over 70 countries. In October 2018 the “RAMP 2.0”project started to meet requests from industries to i) expand the tools application range,ii) include key performance indicators (KPIs), and iii) provide a database version of the‘RAMP 2.0’. Here the current state of the project is presented.Methods:The project, using a participative, iterative methodology, is carried out in sevensteps ranging from a needs analysis and specification of requirements on the new toolto development and dissemination of a “RAMP 2.0”. The project is led by KTH andcarried out in cooperation between researchers and practitioners at companies.Results:This far eight organisations from five industrial branches (Manufacturing,Food, Dental Care Occupational Safety & Health, and Technical Installation industries)participated in a needs analysis, resulting in:i) a wish-list with additionally 20 types of work tasks to be included in the RAMP 2.0,e.g. electricians cable stripping and dentists’ drilling work,ii)suggestions of 16 KPIs, e.g. trends of Number of high risks, compared to Numberof low risks over several years andiii)15 characteristics considered important in the database-design and user interface,e.g. security and flexibility in results presentation.Conclusion: In conclusion, requirements on the RAMP 2.0 have been identified and willbe used as a basis in the development process.References:Rose, LM, Eklund, J & Nord Nilsson, L (2018) RAMP - A ComprehensiveMSD Risk Management Tool. In the Proceedings of the IEA Congress 2018, August 30,Florence, Italy.36.

This report describes the work with refinement of the Ergo-Index model, initially developed in the 1980’s by a group of researchers and practitioners. Ergo-Index is intended to enable comparison of different methods to perform a work task with the aim to support the choice of working methods to satisfy ergonomics requirements as well as requirements on time consumption and production economics. The outputs from the method are assessments of recovery need, production time and load level. The project has been carried out in two parts, of which this report deals with the second part.

The objective has been to gain relevant information and to develop the Ergo-Index model further, especially regarding recovery, based on a literature review and an experimental study.  In the experimental study maximum exerted forces as well as subjectively assessed Endurance and Resumption times for 15 different loading cases were determined with different load levels and loading times.

The results revealed a previously unknown fatigue-load phenomenon, namely that the recovery need was found to be shortest, expressed in relative loading time, for a medium load level (30 % of max), compared to low (10 % of max)  and high (50 % of max) load levels. This led to some unexpected difficulties in the project.

After several rounds of modeling relations for endurance and recovery need, the new Ergo-Index was developed. This, partly performed by deriving at mathematical relationships via regression analysis and partly by using results from other published studies and also Swedish physical ergonomics legislation recommendations, is described in the report. Seven examples of applications of the model are also given. These form a start of a planned database where applied examples are gathered to facilitate the use of the method.  These tasks were also evaluated with subjective methods by the participants, using Borg’s CR10 scale, a body map and interviews and photo- and video-documented. 

The new model should to be applied and evaluated more than has been done up until now, before it is spread to a large extent. Application and evaluation is planned with a couple of companies.

The experimental results have also been used for developing a prediction model of perceived fatigue. Further, also based on the experimental study, where the working task was carried out with one repetition in two subsequent trials, a model for accumulation of fatigue is presented. Both these parts have not been tested or evaluated, but it is suggested to evaluate them in studies with applied repetitive working tasks. These results may also be used to form an enhanced recovery assessment model on occupational tasks for selection of working methods and job design from ergonomics and time perspectives for repetitive work.

Issues regarding modeling, such as field of application and accuracy, are discussed. Dissemination of the results, to companies, in educations as well as in the research community, is also described.

As ergonomists, for many of us, a driving force is to improve work environments to “do good”:  to reduce risks for injury and human suffering, improve working conditions and support human well-being. This motivation is in accordance with the first of the two objectives of ergonomics as in the IEA definition – ‘…to optimize human well-being and overall system performance”. However, ‘doing good’ in this sense can be difficult. A challenging task we face as ergonomists is to motivate work site improvements within a business environment that is focused on the second objective of ergonomics, overall system performance. Thus, the art of ergonomics lies in balancing the two – in addressing individual wellbeing as well as the broader goals of system performance. As part of this balancing act, displaying financial impacts of ergonomics plays an important role and is therefore the focus of this key-note.

In all business activity decision makers have to choose between different investment options. For investments that can improve ergonomics, the full economic benefits are often difficult to quantify. Such benefits are associated with reduced costs related to non-optimal work environment. Visible costs, such as direct costs for absenteeism, are quite easily measured while hidden costs, related to business key parameters, such as productivity and quality issues, are often complex, contextually dependent and difficult to estimate. However, these issues are vital for organizations and such costs, which directly affect the company’s competitiveness, are often many times greater than the visible costs.  If decision makers only are aware of the direct financial impact of investments they may prioritize solutions that are not optimal neither for organizational performance and business results nor for the work environment and health of the employees. In extreme cases this can jeopardize the company’s future.

So, what is needed for informed decision-making?  First, awareness that ergonomics also influences core business parameters and organizational performance is needed. Second, there is a need for user-friendly assessment tools to estimate the financial effects associated with workplace ergonomics. In the presentation a survey of existing assessment tools and methods is presented. Reasons why these tools aren’t more widely used are discussed.

There is an increased call from companies for assessment tools that companies can use in their operational management to motivate and carry out ergonomic improvements. This is partly due to the need to form business cases to motivate investments. There is also an increased awareness from company management, who recognize that improved working environments also lead to other positive effects for the company. Increasingly managers seek knowledge for informed decision making, for example when prioritizing between work environment improvements and strategic corporate decisions.  The assessment tools can be used i) proactively in the design of production systems, which leads to advantages for the staff as well as for the company’s performance, ii) reactively to evaluate different scenarios to reduce work environment, productivity and quality problems and iii) strategically for promoting the company.

So, what actions are needed to improve these assessment tools, increase their use of and make them a natural part in the company operational processes? In this presentation some research and development suggestions are given. These involve tool as well as organizational and process development.

In summary, working towards improved tools and their usage in striving towards the twofold ergonomics objective involves many challenges, but strengthens the possibilities to be successful in “doing good”, for individuals and organizations, as well as for societies.

A poor working environment can result in negative consequences at the individual, organizational, as well as societal level, for instance as a negative financial consequence. The driving force for many who are working within the occupational safety and health (OSH) field is to achieve improvements in the working environment, but it can be challenging to motivate investments in this area.

It is fairly easy to calculate the direct, visible costs of a poor working environment, but difficult to estimate the hidden costs and the benefits of improvements. This presentation will give examples of visible and hidden effects and types of costs due to a poor working environment and will provide a survey of methods available for estimating financial effects.

The demographic changes societies face lead both to challenges and opportunities. One of the challenges is how to design jobs so that even an ageing population can remain healthy and productive at work. The presentation will also give some examples on the state of the art of what we know in the area of an ageing workforce and where some of the knowledge gaps are that require research and development to meet the two objectives of ergonomics: human well-being and overall system performance.

I denna rapport beskrivs riskhanteringsmetoden RAMP – Risk Assessment and Management tool for manual handling Proactively – och dess utveckling som gjorts i projektet ”Utveckling, implementering och spridning av belastningsergonomiskt bedömningsverktyg och åtgärds-process”. Projektets mål har varit att utveckla en fritt tillgänglig metod för riskhantering för arbete med manuell hantering. Metoden ska kunna användas för att bedöma risken att utveckla belastningsbesvär och stötta det systematiska arbetsmiljöarbetet genom att ge en struktur för förbättringsåtgärder och utarbetande av handlingsplaner. Syftet är att användningen av verktyget ska bidra att arbetsmiljöförbättrande åtgärder genomförs, vilket förväntas leda till positiva hälsoeffekter.

Projektet har genomförts som ett samarbetsprojekt med interaktiv metodologisk ansats mellan forskare vid KTH Skolan för Teknik och hälsa, Enheten för Ergonomi, och personer som aktivt deltagit i projektet i egenskap av professionella yrkesverksamma med olika roller på de medverkande företagen Arla Foods, Scania CV AB, Svenskt Butikskött AB och Mikael Loods Åkeri AB – exempelvis operatör, logistiker, chef, VD, skyddsombud, produktionstekniker, ergonom, och global arbetsmiljösmordnare. Till projektet har en referensgrupp och en expertgrupp varit knutna. Projektet har finansierats av i huvudsak Afa Försäkring och de medverkande företagen.

Bland metoderna om används i projektet finns litteraturgenomgång, iterativ prototyp-utveckling, användartester och utvärdering av prototyper, work-shops, intervjuer och enkäter. RAMP baseras på vetenskapliga studier, svensk arbetsmiljölagstiftning, ergonomistandarder, andra bedömningsmetoder, expertbedömningar av projektets expertgrupp, erfarenheter och expertbedömningar från personer verksamma i industrin inom bland annat företagshälsovård, ledning och produktion, användartester samt referensgruppens feed-back.

I rapporten presenteras RAMP-verktyget som består av fyra moduler: RAMP I - en checklista för screening av belastningsergonomiska riskfaktorer; RAMP II – som möjliggör en fördjupad analys; en Resultatmodul där resultatet kan presenteras på olika detaljnivå och med olika omfattning och en Åtgärdsmodul som ger stöd för det systematiska arbetsmiljöarbetet med bland annat åtgärdsförslag och en mall för att utforma handlingsplaner för att minska riskerna.

En prototyp av RAMP har utvärderades i ett examensarbete genom validitets- och reliabilitets- och användbarhetsstudier. Utvärderingen visar på hög repeterbarhet av bedömningar genomförda av icke-experter samt att överensstämmelsen var hög mellan experter och icke-experter. Användbarhetsstudien visade att RAMP uppleveds som ganska lätt att använda och tidseffektiv.

Digitaliseringen av RAMP förväntas bli klar under hösten 2014. RAMP kommer därefter att göras fritt tillgänglig via KTH STHs hemsida och en implementeringsstudie av metoden sker på de medverkande företagen. Metoden kommer att spridas enligt projektets kommunikationsplan som beskrivs i rapporten.

Introduction

Incomplete recovery is considered as one of the main causes for developing MSDs. This paper describes the further development and application of an assessment tool, Ergo-Index, which can be used to analyse different ways to perform a work task considering load ergonomics as well as time aspects. It can support decision making when choosing production methods and help reduce the physical load and the risk of MSDs in combination with good production economics.

Objectives

The objectives were to further develop the existing Ergo-Index by i) gaining data to understand how load level and loading time affect recovery need ii) modelling the recovery need, iii) refining the existing Ergo-Index model iv) testing and implementing the model and gathering examples in a database and v) disseminating the results.

Methods

An experimental study was carried out with 10 participants. over 16 sessions, each participant pushed a handle, in which static force and time were altered between the sessions. Subjectively rated Endurance time (ET) and Resumption time (T_res), defined as the time period needed after loading until the participant would resume the task if it was his job, was noted, as well as other parameters. Based on experimental data mathematical relationships were established, using regression analysis. A new version of the Ergo-Index was developed based on the results and results from literature. The new tool was coded as a simple Excel-program and applied to 10 typical work tasks in industry and evaluated using biomechanical and subjective methods.

Results

The main results were data for ET, T_res and Rating of perceived discomfort/fatigue and a new Ergo-Index model, which is described briefly in the conference paper. Some applied examples are illustrated in the presentation.

Discussion

Different types of fatigue and models are discussed, as well as issues when trying to model the complex phenomena of fatigue.

Conclusions

It is concluded that the recovery time can be modelled as a relationship between load level and loading time, and that the method has to be further used and validated.

This paper describes a project with the aim of reducing the risk of injury when using precast concrete shells in the Swedish construction industry by identifying injury risks, developing and implementing solutions. An interactive research approach was used. Three major injury risks were identified and a system consisting of three tools and a handbook was developed, evaluated, and implemented at one company and made available to the construction industry.