BACKGROUND: Several observation-based risk-assessment tools have been developed in recent decades. Studies reporting their use often focus only on the user, the ergonomist. The influence of context and the attributes of the tools may also affect the use but are factors that are seldom considered. OBJECTIVE: The aim of the present study was to explore the process of risk-assessment assignments and to identify factors influencing the use of research-based observation-based risk-assessment tools among Swedish ergonomists, with a background as reg. physiotherapists, employed in Occupational Health Services (OHS). METHODS: A web-based questionnaire (n = 70) was combined with semi-structured interviews (n = 12). RESULTS: There was limited use of several observation-based risk-assessment tools. Furthermore, the results showed that ergonomics risk-assessment assignments are most commonly initiated reactively and that interventions were seldom evaluated. Factors that influence use are related both to the ergonomist and to the attributes of the tools as well as to contextual factors assigned to authorities, and internal organisations both within occupational health service companies and client companies. CONCLUSION: There was a lack of systematic approaches in ergonomics risks assessment and low use and knowledge of risk-assessment tools. This indicates that there is a need to support OHS companies in implementing systematic tools in their practice.

Ergonomic interventions have often been studied with focus on the client company in which the intervention has been implemented and not from the perspective of the Occupational Health Service (OHS) company providing the expertise knowledge. The aim of the study was to explore factors within OHS companies which facilitate ergonomic interventions. Semi-structured interviews with twelve ergonomists employed at eight different OHS-companies in Sweden, were performed. Five main facilitators were identified as important for ergonomic interventions; having close relationships with the client, clients’ awareness of the wide-ranging competence of the ergonomist, utilization of standardized methods, specialization/industry knowledge and internal knowledge sharing.

Accelerometer-based inclinometers have dominated kinematic measurements in previous field studies, while the use of inertial measurement units that additionally include gyroscopes is rapidly increasing. Recent laboratory studies suggest that these two sensor types and the two commonly used angular velocity computational methods may produce substantially different results. The aim of this study was, therefore, to evaluate the effects of sensor types and angular velocity computational methods on the measures of work postures and movements in a real occupational setting. Half-workday recordings of arm and trunk postures, and movements from 38 warehouse workers were compared using two sensor types: accelerometers versus accelerometers with gyroscopes-and using two angular velocity computational methods, i.e., inclination velocity versus generalized velocity. The results showed an overall small difference (<2 degrees and value independent) for posture percentiles between the two sensor types, but substantial differences in movement percentiles both between the sensor types and between the angular computational methods. For example, the group mean of the 50th percentiles were for accelerometers: 71 degrees/s (generalized velocity) and 33 degrees/s (inclination velocity)-and for accelerometers with gyroscopes: 31 degrees/s (generalized velocity) and 16 degrees/s (inclination velocity). The significant effects of sensor types and angular computational methods on angular velocity measures in field work are important in inter-study comparisons and in comparisons to recommended threshold limit values.

Although work-life is changing, and production is modernized, workrelated musculoskeletal disorders (WMSDs) are still frequent, inducing very large costs for companies and societies all over the world. Ergonomists and other work health consultants work to make organizations sustainable. In their work to prevent WMSDs it is important to identify risks in a reliable way, to prioritize risks, and then to perform interventions (participatory interventions have shown to more often be successful), so that the risks and the disorders may be reduced. Most interventions concerns the environment and work methods, but also individual work technique, e.g. lifting technique and habitual work postures may be in focus. Today, risks are most often assessed by observation. However, observational methods generally have low reliability, i.e. low agreement between different observers for the same job task. There is also a low inter-method reliability, i.e. when the same work is assessed with different methods different risk levels are often obtained. There are now validated technical methods that may be used by practitioners. But, user-interfaces needs to be improved, and today's inexpensive electronic devices should be utilized to a higher degree, in the development of tools, in collaboration with practitioners. New methods should be attractive, easy and time efficient to use. The results of these methods will be objective and should increase the reliability in risk assessments of work tasks and jobs.

A tool has been developed for supporting practitioners when assessing manual pushing and pulling operations based onan initiative by two global companies in the manufacturing industry. The aim of the tool is to support occupational healthand safety practitioners in risk assessment and risk management of pushing and pulling operations in the manufacturingand logistics industries. The tool is based on a nine-multiplier equation that includes a wide range of factors affecting anoperator’s health risk and capacity in pushing and pulling. These multipliers are based on psychophysical, physiological andbiomechanical studies in combination with judgments from an expert group consisting of senior researchers and ergonomists.In order to consider usability, more than 50 occupational health and safety practitioners (e.g., ergonomists, managers, safetyrepresentatives and production personnel) participated in the development of the tool. An evaluation by 22 ergonomistssupports that the push/pull tool is user friendly in general.

Work-related musculoskeletal disorders are a major concern globally affecting societies, companies, and individuals. To address this, a new sensor-based system is presented: the Smart Workwear System, aimed at facilitating preventive measures by supporting risk assessments, work design, and work technique training. The system has a module-based platform that enables flexibility of sensor-type utilization, depending on the specific application. A module of the Smart Workwear System that utilizes haptic feedback for work technique training is further presented and evaluated in simulated mail sorting on sixteen novice participants for its potential to reduce adverse arm movements and postures in repetitive manual handling. Upper-arm postures were recorded, using an inertial measurement unit (IMU), perceived pain/discomfort with the Borg CR10-scale, and user experience with a semi-structured interview. This study shows that the use of haptic feedback for work technique training has the potential to significantly reduce the time in adverse upper-arm postures after short periods of training. The haptic feedback was experienced positive and usable by the participants and was effective in supporting learning of how to improve postures and movements. It is concluded that this type of sensorized system, using haptic feedback training, is promising for the future, especially when organizations are introducing newly employed staff, when teaching ergonomics to employees in physically demanding jobs, and when performing ergonomics interventions.

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,

This paper presents an evaluation of a feasible inclinometer system, for measurement of static and dynamic body postures, which can be used by practitioners. The system, an inclinometer based on a triaxial USB-accelerometer and an analysis program (Excel Macro), was compared with measurements obtained with a gold standard, i.e. an optical 3D motion capture system. The angles obtained with the inclinometer, had a high correlation with the corresponding angles of the optical motion capture system, for static upper arm postures above 0.997 for both abduction and flexion. At fast arm movements, the absolute difference in angles between the two systems was low, 4.1°, 5.4° and 3.6° at the 10th, 50th and 90th percentile respectively. This study indicates that this feasible and inexpensive ($140) inclinometer system (USB-accelerometer and Excel Macro), can be used to obtain upper arm inclination data of quality comparable to that of many research studies where direct measurements have been used.

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.

This paper presents strategies targeting prevention of work-related ill-health, and how the use of smart workwear (wearables) can facilitate these strategies

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.

Adverse work-related physical exposures such as repetitive movements and awkward postures have negative health effects and lead to large financial costs. To address these problems, a multi-disciplinary consortium was formed with the aim of developing an ambulatory system for recording and analyzing risks for musculoskeletal disorders utilizing textile integrated sensors as part of the regular workwear. This paper presents the consortium, the Smart Workwear System, and a case study illustrating its potential to decrease adverse biomechanical exposure by promoting improved work technique.

Vibrotactile feedback training may be one possible method for interventions that target at learning better work technique and improving postures in manual handling. The aim of this study was to evaluate the effect of real-time vibrotactile feedback using a smart workwear system for work postures intervention in industrial order picking. Fifteen workers at an industrial manufacturing plant performed order-picking tasks, in which the vibrotactile feedback was used for postural training at work. The trunk and upper arm postures were recorded by the system. Questionnaires and semi-structured interviews were conducted about the users’ experience of the system. The results showed reduced time in adverse postures for the trunk and upper arms when the workers received feedback, and for trunk postures also after feedback withdrawal. The workers perceived the system as usable, comfortable and supportive for learning.

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.

Vibrotactile feedback training may be one possible method for interventions that target at learning better work techniques and improving postures in manual handling. This study aimed to evaluate the short term effect of real-time vibrotactile feedback on postural exposure using a smart workwear system for work postures intervention in simulated industrial order picking. Fifteen workers at an industrial manufacturing plant performed order-picking tasks, in which the vibrotactile feedback was used for postural training at work. The system recorded the trunk and upper arm postures. Questionnaires and semi-structured interviews were conducted about the users’ experience of the system. The results showed reduced time in trunk inclination ≥20°, ≥30° and ≥45° and dominant upper arm elevation ≥30° and ≥45° when the workers received feedback, and for trunk inclination ≥20°, ≥30° and ≥45° and dominant upper arm elevation ≥30°, after feedback withdrawal. The workers perceived the system as useable, comfortable, and supportive for learning. The system has the potential of contributing to improved postures in order picking through an automated short-term training program.

Recent demographic developments in Europe have increased the demand for home care. Working in other people’s home environment is challenging. Home care personnel’s musculoskeletal disorders are common, and care personnel overall often have sleep disturbances. In this study, associations between occupational physical and psychosocial factors and possible sleep-related problems among home care personnel were explored using a questionnaire. The questionnaire was distributed to 19 workplaces in Stockholm County in 2017–2019, and 665 home care personnel answered. Several factors, including job contentment, physical burden of care, client-related burnout, quantitative demands, and pain, were significantly associated with sleep-related problems. The results highlight the need for implementing measures to improve psychosocial and organizational working conditions in home care service.

Working postures and movements affect work efficiency and musculoskeletal health. To reduce the biomechanical exposure in physically demanding settings, working techniques may be improved by giving instant ergonomic feedback to the operator. This study investigates if feedback can be used to decrease adverse postures and movements in assembly work. A prototype solution of a smart textile workwear was used on a trainee assembly line. Posture and movement signals of 24 trainee operators were sampled via the workwear, transferred to a tablet for analyses and used to provide feedback suggesting improvements of work technique. Two modes of feedback were tested. Every participant’s work technique was measured before and after receiving the feedback and the results were compared. For upper arm elevation angle ≥60°, behaviour change is indicated, supporting a positive work technique change, and indicated a future usefulness of technical automatic feedback for operators.

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.

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.