Ergonomic Interventions in Workstations of an Assembly Company
| Javad Torkaman *
|Department of Ergonomics, School of Health, Hamadan University of Medical Sciences Hamadan, Iran
|Keywords: Musculoskeletal disorders, Ergonomics, Methods, ART technique
Full-Text [PDF 750 kb]
| Abstract (HTML) (158 Views)
Type of Study: Original Article |
Received: 2022/01/1 | Accepted: 2022/02/9 | Published: 2022/10/2
Full-Text: (60 Views)
Manpower is regarded as the largest capital of a country; the role of manpower in the economic and social development of societies should be considered more than any other major factor, and supporting it should be one of the main concerns of the owners of industries. It is also the most important force for the increase or decrease in productivity .
Musculoskeletal disorders (MSDs) affect muscles, nerves, blood vessels, ligaments, and tendons in all parts of the body. Workers in different industries and occupations can be exposed to risk factors such as lifting heavy objects, bending, reaching, pushing and pulling heavy loads, working in awkward body postures, and performing repetition tasks repetitively. Exposure to these known risk factors for MSDs increases the risk of injury to workers .
Work-related MSDs are the most common occupational problems worldwide worsened by physical and psychological factors in different occupations. Further, they are the most economically costly diseases, and the individual has to carry the cost, resulting in income loss and increasing poverty. The global burden of MSDs constitutes the second most common cause of disability that most frequently appears in the form of back pain, measured by years lived with disability .
These disorders occur in the upper and lower extremities of the body. Upper limb disorders (ULDs) are aches, pains, tension, and disorders involving any part of the arm from fingers to the shoulder or neck; they include problems with the soft tissues, muscles, tendons, and ligaments, along with the circulatory and nerve supply to the limb, and are often caused or made worse by work [4-6]. Studies have reported that poor posture, repetitive work, high force (e.g., exposed to higher loads), vibration, manual material handling, bending and twisting, and extreme temperatures are associated with work-related MSDs in the upper limbs of people working in manufacturing units. In addition, causal relationships have been found between some physical risk factors (e.g., poor posture and repetitive tasks) and neck, knee, or wrist pain among workers in various industries .
Pain in the neck and lower back is the most prevalent MSD, often leading to disability and sick leave. It has
Ergonomic Interventions in Workstations of an Assembly Company
Department of Ergonomics, School of Health, Hamadan University of Medical Sciences Hamadan, Iran
*Corresponding Author: Javad Torkaman, Department of Ergonomics, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran. Email: firstname.lastname@example.org
Received: January 1, 2022, Accepted: February 9, 2022, ePublished: September 29, 2022
Vol. 11, No. 3, 2022, 189-197
190 Arch Hyg Sci. Volume 11, Number 3, 2022
been reported as one of the most costly health problems
in Western society. Previously, MSDs were defined as all
complaints related to muscles, joints, tendons, ligaments,
and bones .
The risk factors for MSDs are highly diverse, but
awkward posture is one of their most important causes.
These disorders will be reduced and eliminated by
improving the awkward posture [7,8].
The assembly industry is one of the occupations
that has risk factors such as frequent movements or
workstation design and awkward postures for a long
time, and workers’ exposure to these factors causes high
pressure on various organs and the possibility of MSDs
between them .
Examining the ergonomic risks of repetitive
movements in assemblers, Habibi et al reported high
pain in the wrist and fingers with frequencies of > 86%
and > 62%, respectively . In another study performed
by Choobineh et al on assemblers, the frequency of pain
in the shoulder, knee, and back areas was 73%, 67%, and
66% . Furthermore, the Malaysian Department of
Occupational Safety and Health conducted an ergonomic
risk assessment in the workplace of 86 medical equipment
assembly workers in a multinational company in Malaysia.
The results revealed that the lower back and shoulders
were the most commonly injured parts of the body with
the highest MSD severity. Also, the thumb, ring finger
and middle finger had the highest MSD severity score in
the right hand.
Management control, along with engineering control
can play an important role in reducing MSDs. Among the
management control methods are employee training, job
rotation, and management of work and rest time, which
is one of the most important intervention approaches for
reducing the exposure of people to MSDs .
Some studies have evaluated the positive effect of
educational interventions and proper adjustment of work
equipment and workstation of workers on alleviating
Several methods have been developed for the exposure
assessment of MSD risk factors, mainly for the assessment
of the upper limbs of the body, including the back, neck,
shoulder, arms, and wrists. The assessment of repetitive
tasks (ARTs) is one of the methods for investigating
MSDs. This method was presented by the UK Health and
Safety Committee. According to the above description
and considering the wide range of disorders in most
occupations, the use of appropriate methods and their
analyses, the identification of MSDs risk factors, as well
as the presentation and implementation of ergonomic
intervention strategies to reduce the risk factors of MSDs
are necessary [14-16].
The workstation has the most important role in
increasing productivity in various industries. However,
limited ergonomic studies have been performed in
relation to the repetition of tasks in the workplace
using the ART technique. Given the above-mentioned
explanations, the importance of the subject, and upper
extremity disorders, it is essential to study the risk factors
affecting MSDs related to repetitive activities and to
achieve corrective methods in this regard.
1. 1. Aims of the study
This study was performed to investigate the risk factors of
MSDs using the ART technique in 2016 and ergonomic
interventions, as well as the effect of ergonomic
interventions in a gas production company.
2. Materials and Methods
This study was an interventional and cross-sectional
study. Data were collected by simple random sampling
of active workers in the production hall. It is noteworthy
that workers in workstations performed their tasks
standing and mostly sitting. It should be noted that more
sitting positions were considered in this study. Data on
MSDs were collected from 60 workers, including 15
(25%) females and 45 (75%) males (considering SD of 2,
d of 0.7, the first type error of 5%, and the test power of
80%, and the number of samples was set to 60 people)
at workstations, using the ART method . The entry
criteria were having permanent employment or at least
3 years of experience in the company and residing in
Hamadan; because people at the beginning of work
experience are probably less exposed to factors affecting
MSDs (e.g., psychosocial factors and workload, and the
like). Further, the results demonstrate fewer points, and
the number of people at exposure levels will be less at risk.
On the other hand, people with a history of trauma or
fractures to the neck, elbows, back, and arms, a history of
rheumatoid arthritis, arthritis, diabetes, or thyroid disease
were excluded from the study because of the effects
of these diseases on the musculoskeletal system. After
coordination with the director of the occupational health
and safety department, a list of basic tasks and absences
from the musculoskeletal diseases of extremities limbs
was prepared according to the number and type of work.
The job assessment was concerned with the ergonomic
risk factors related to head/neck, back, shoulder/arm, and
wrist and hand/finger grip. The mentioned tasks were
filmed in each unit, and the time required to photograph
each task was at least 3 minutes. The captured videos for
each task were used by the evaluators for the qualification
and documentation of the tasks. The workers of the
production line with ergonomic risk factors such as
manual handling, pushing/pulling of the loads, force,
awkward, finger grip and repetitive movements of upper
limbs, and additional factors, including breaks, work
speed, vibration, need for the accurate movements of the
hand and feet, working time, and psychological factors
were observed carefully . Before the assessment,
Arch Hyg Sci. Volume 11, Number 3, 2022 191
Ergonomic Interventions in Workstations
related licenses were received from the company’s
manager. The consent form was distributed among the
workers, and they filled out the forms. Workers who were
unwilling to cooperate were excluded from the study.
Then, the samples were determined, and the study was
conducted in three phases as follows:
Stage I. Initial Assessment of the Environment and
1) Data collection using a demographic questionnaire
(including variables of occupation, age, gender, height,
weight, and work experience).
2) Assessment of the risk factors of MSDs:
The ART tool is used to identify, design, evaluate,
manage, and monitor common risk factors and those that
cause MSDs in the upper limbs [14,16].
After initially reviewing the documents of periodic
examinations, observing different workstations, and
interviewing workers and the person in charge of
safety and health, it was found that employees perform
additional tasks such as vibration exposure and use of
gloves while working, along with inappropriate postures.
MSDs in the upper limbs were assessed by the ART
The investigation represented that the ART tool has a
substantial agreement of the inter-rater reliability (Cohen’s
kappa) value of 0.725-1.000 (left side) and 0.649-1.000
(right side), as well as the re-evaluation of the reliability
of approved (Intra-class correlation coefficient) values of
0.741-1.000 (left side) and 0.651-1.000 (right side). The
ART tool meets the requirements of reliability .
2. 1. Required equipment
The ART instrument is designed to help assess tasks
that require the repetitive movement of the upper limbs
(arms and hands). It further helps in assessing some of
the common risk factors in repetitive work contributing
to the development of ULDs.
The ART targets those responsible for designing,
assessing, managing, and inspecting repetitive works. It
can help identify tasks that involve significant risks and
focus on risk-reduction measures.
Repetitive tasks are made up of a sequence of upper
limb actions, which have a fairly short duration, are
repeated many times and are almost always the same
(e.g., stitching a piece of cloth, manufacturing one part,
and packaging one item).
The ART is mostly suited for tasks that involve the
actions of the upper limbs, are repeated every few minutes
or even more frequently, and occur for at least 1-2 hours
per day or shift.
The tasks are typically found in assembly, production,
processing, packaging, packing, and sorting works, as
well as works involving the regular use of hand tools.
The ART method and a pen were required for recording
scores, observations, and employees’ descriptions or
opinions about their works, along with a watch or
stopwatch and a video camera. One of the strengths of the
ART method is that it provides a separate assessment for
each risk factor, a risk level that is defined by three colors
of green, yellow, and red for each score .
Stage I. Initial Assessment
The assessment ART is split into four stages as follows:
Stage A: Frequency and repetition of movements;
Stage B: Force;
Stage C: Awkward postures;
Stage D: Additional factors.
For each stage, the level of risk for each risk factor can
be determined by following the flow chart and/or the
assessment guide (Figure 1).
The task and exposure scores help prioritize the tasks
that need the most urgent attention and help check the
effect of any improvements. The colors assigned to the risk
factors will help identify where to focus on risk-reduction
measures. A system for interpreting the exposure score is
proposed in Table 1.
For each stage, the flow chart and/or assessment guide
should be followed for determining the level of risk for
each risk factor. Table 1 classifies the levels of risk.
Stage II. Implementation of Interventions:
The draft HFES 100 standard provides specifications
for the design of workstations. Previous research (Honan,
2015) suggests that desktop workstations remain a critical
component of the workplace . Due to the risk factors
of MSDs, engineering and managerial interventions were
performed in the workstations.
Stage III. Educational Interventions:
Training classes were held for the workers before the
interventions and during the work for three months. The
following items were taught to the participants.
Considering short-term and continuous break times
during work, stretching exercises and work-related
tasks were performed during long rest and even at
home. Workers became aware of work-related MSDs,
correct carrying and manual handling in the workplace,
ergonomic seat workstation adjustment before working
for proportion to the percentile of each person, how to
sit on the chair properly, and how to walk and stand in
accordance with ergonomic principles in the workplace,
and were introduced with the ergonomic risk factors of
the work environment .
Stage IV. Evaluating the Effectiveness of Interventions
To determine the effectiveness of the interventions,
the ART evaluation score before the interventions was
compared with the ART score after 3 months after the
Despite the permission of the company management
and coordination with the head of the unit, more
ergonomic interventions were not acceptable in the
workstations, and it took a long time to perform each
intervention. On the other hand, there was not enough
192 Arch Hyg Sci. Volume 11, Number 3, 2022
time for long-term interventions, and these factors
limited the work.
The demographic characteristics of the 60 workers who
completed the consent form to collaborate with the
research were the: mean and standard deviation (SD) of
work experience, height, weight, and age were 7.26 ± 5
years, 172 ± 0.086 cm, 67.13 ± 8.91 kg, and 31.37 ± 7.73
years, respectively. Additionally, 22, 34, and 4 workers
worked in the machine-building, assembly, and painting
In terms of education, there were 11 undergraduates,
and 45, 4, and 4 diploma, post-diploma, and higher
education, cases, respectively. In addition, 56 workers
(93.3%) worked with both hands, and the final score was
equal for both hands.
This method includes tasks that are suitable for carrying
light loads less than 8 kg, thus the mean (SD) of the weight
of the obtained objects was 3.6 (± 4.07) kg, respectively.
The results of the initial assessment among 60 workers
from different stations revealed that the exposure of 13
(21.7%) workers was at low risk. The frequency of people
was at the average risk level of 29 people (3.48%), which
is the highest number of exposed people at this level, and
18 people were at the high level of exposure (30%). Given
that the majority of workers evaluated in the first stage
were in the assembly department (39 people), the second
stage of assessment and interventions was also performed
in this unit. Some of interventions were removed from
the initial interventions due to the difference between
the workstations of the machining and painting units,
the large workload of workers in different stations, the
types of tools in the halls, and the seasonality of some
tasks and workers. Furthermore, most interventions
were performed on 39 people who mostly worked in the
assembly unit. Five of these workers in the machining unit
had joint tasks with the assembly unit, and their initial
assessment score was at the medium (3 people) and high
(2 people) risk levels. Thus, they only entered the next
stages of evaluation and intervention. The ART scores of
workers before intervention are presented in Table 2.
In the initial assessment of 60 people, 18% and 29%
were at high and moderate risk levels, respectively. To
Figure 1. Overview of the ART rapid assessment process flow chart. Note. ART: Assessment of repetitive task.
Table 1. Risk level boundaries used for the benchmarking of risk assessment
Risk levels Risk interpretation ART
1 Low 0-11
2 Medium 12-21
3 High + 22
Note. ART: Assessment of repetitive task.
Arch Hyg Sci. Volume 11, Number 3, 2022 193
Ergonomic Interventions in Workstations
determine the impact of the interventions, 34 people at
moderate to high (64.10%) and high (5.2%) risk levels
with similar workstations and equipment assembled the
gas regulators, along with 5 other individuals. Those who
had rotational work with the machining unit but mostly
worked shifts in the assembly unit were selected for this
purpose. The exposure levels of these people changed after
performing engineering and management interventions
in their workstations (Table 3).
The highest frequency after interventions is assigned to
risk level one, which includes 21 people (53.85%).
Due to the same ergonomic conditions of the
workstation, 12 out of 39 workers were at a low-risk
level before the evaluation; it is predicted that they
would be exposed to skeletal disorders in the future if
not correcting the ergonomics of the workstation (e.g.,
using inappropriate chairs and footrests, and the like).
In addition, they are likely to be exposed to MSDs in the
future; therefore, reforms affect all workers at risk.
3. 1. Engineering interventions in the workstation
3. 1. 1. Making a chair according to anthropometric
This study evaluated anthropometric characteristics
related to the chair of 39 working men and women who
were to undergo ergonomic interventions. Then, the chair
was designed according to the standard ANSI/HFES100-
2007  and workers’ anthropometry and ergonomic
criteria (i.e., armrest, lumbar support with detachable
seat, and adjustable seat height, design and construction
of adjustable footrest with each percentage used, and
design of desktop toolbox with workers’ access range).
Further, the ergonomic chair was made considering the
technical limitations. Next, this chair was compared with
the old chairs used in the workstation. The comparison of
the final assessment score of this chair using paired t-test
showed that there is a significant difference between the
new chair and the previous chair of the workers (P < 0.001,
The ART technique assesses a variety of risk factors,
the majority of which are related to the workstation; the
risk factor exposure would be eliminated or reduced to
a minimum if correcting these risk factors. Considering
that most of our risk factors were present in workstations,
engineering interventions (e.g., design and construction
of workstation equipment such as chairs, footrests,
toolboxes, and the like) were performed by the research
team in the workstation.
3. 1. 2. Footrest
The footrest was adjustable for short persons, who could
not fully fit their legs on the floor if they wanted to place
their legs on this footrest. Moreover, tall persons could
fully close it if they did not want to use the footrest.
This adjustable footrest helps increase your comfort
and productivity and keeps you in an ergonomic position
throughout the day. This is an affordable way to change
your workstation. By adjusting the height and angle at
any time, you can adjust your foot position in the most
comfortable position .
To build an ergonomically suitable footrest, several
items were considered by the workers and the research
team. They included product aesthetics (adaptation
to the background color of the work environment),
physical conditions of the work environment (possible
contamination), resistance to moisture in the work
environment (can be washed if the outer surface can
be washed), and the necessary strength against various
pressures on the workers’ feet (Figure 3).
3. 1. 3. Toolbox
The reach limit is the range determined from the tip of
the thumb during the circular motion of the arm on the
work surface (the table). During this movement, the arm
is in a relaxed and downward position. The maximum
access limit is linear in front of the work surface, and
the operator can access without bending the trunk. For
Table 2. Exposure risk level in workers before ergonomic interventions
Risk levels Assembly Machining Frequently Percentage
Low 13 10 13 21.7
Moderate 27 12 29 48.3
High 15 4 18 30
Total 34 26 60 100
Table 3. Results of the interventions performed and their comparison using
the ART technique among assembly workers
Before P value
Low 0-11 12 (30.70) 21 (53.85)
Moderate 12-21 25 (64.10) 17 (43.59) 0.003
High + 22 2 (5.2) 1 (2.56)
Training score 1.33 5.79
Total 39 (100) 39 (100)
Note. ART: Assessment of repetitive task. Paired t-test showed that there
was a significant difference in the risk score before and after ergonomic
interventions (P = 0.003). The average risk score decreased from 1.74 to 1.48. Figure 2. Interventions for chair design and construction.
194 Arch Hyg Sci. Volume 11, Number 3, 2022
repetitive tasks, hand movements should be in the normal
workspace. Although controls and less commonly used
devices can be located outside this space, they must be
within maximum accessibility.
The concept of a natural work area is the maximum
space in front of the worker at a horizontal level below
elbow height. This space is often the most used area
of the workstation, which must be within the normal
reach of the operator. Access requirements should not
exceed the maximum access to avoid bending forward
and improper posture. Anthropometric measurements
for arm length, shoulder height, and elbow height are
employed to calculate the arm radius in the 95th, 50th,
and 5th percentiles of women (Table 4).
Practical access restrictions determine the range of
motion of individuals so that the primary components
and parts are in the primary motion zone, and the
secondary components and components are in the
secondary motion zone. The location of the tools in the
workstation is chosen so that it can be used for all tasks.
A proper workstation design saves time and increases
productivity. In making this device, the proper location of
the hand tools, controls, and parts was considered based
on their degree of importance and priority according to
Figures 4a and b .
The standard height for this type of work is for the 5th,
84th, 89th, 50th, 90th, and 95th percentiles. The height of
the station desk for all percentiles set in the assembly unit
was 81 cm and 95 cm .
3. 2. Management interventions
3. 2. 1. Educational interventions
Educational interventions can help people gain
knowledge of lumbar anatomy, how to lift and carry
objects effectively, and potential risk factors for low back
pain [19, 22].
It is predicted that after designing engineering
interventions and implementing them in workstations,
workers with different percentages will benefit from
these interventions. The training program to work with
this equipment will require a variety of training topics.
Additionally, the results of the evaluation with the ART
technique demonstrated that the risk factors for upper
extremity disorders (i.e., posture, psychosocial factors,
load weight, sitting on a chair and access to equipment
at the workstation, and the like) created the need for
ergonomic training sessions.
During this study, the researcher and two occupational
health undergraduate students provided ergonomic
training to the participants, and the assessment results
with a paired t-test revealed that the comparison of the
ergonomics training scores of the participants before the
intervention and after the educational intervention (a
score of 20) was significant between the mean score of
pre- and post-test participants (P < 0.001, Table 3).
In this study, engineering controls reduced workers’
exposure levels (Table 3) because they eliminated harmful
factors at the source of production; however, they cannot
eliminate harmful factors alone, and management
interventions can complement them in recognizing
risk factors by workers and reduce their exposure. The
construction of an ergonomic chair and a tool holder and
the adjustment of the height of the work surface according
to the anthropometric work of the workers reduced the
risk score of posture factors (neck/head, back, arms, and
wrists), work speed, arm movements, and repetition. In
addition, adjusting the height of the local lighting of the
Figure 3. Interventions for footrest design and construction.
Table 4. Women’s anthropometric sizes and maximum access (cm)
Percentile Arm length
5th percentiles 60 128 99 53
50th percentiles 66 138 105 58
95th percentiles 72 147 111 63
Figure 4. (a) Schematic view of hand tools within the reach of workers.
Source. . (b) Interventions for toolbox construction .
Arch Hyg Sci. Volume 11, Number 3, 2022 195
Ergonomic Interventions in Workstations
workstation was effective in reducing the score of postures
and installing a pneumatic wrench at a standard height,
and hanging in a way that was effective in reducing the
force score and repetition of arm movements. Therefore,
the evaluation score after the intervention with the ART
technique showed that the engineering interventions
performed in the workstation were effective in reducing
the final ART score and thus reducing exposure levels
(Table 3). Thus, none of the mentioned interventions
alone can effectively reduce the risk of exposure to the
risk factor, and the role of each of these modifications in
reducing the risk is unknown. Furthermore, a separate
evaluation of training represented that training alone
has a slight effect on reducing exposure to all risk factors.
Performing other management interventions (e.g., job
rotation and work-rest program) and using personal
protective equipment (work gloves) to reduce fatigue,
psychological factors, or according to the workers, the
reduction of pressure on the evaluated organs were
effective, but the contribution of each of them to the risk
factor score is not certain.
The results of the assessment of workers in the production
unit by the ART method before the intervention
indicated that the levels of the risk of exposure in workers
are medium and high. To reduce the high level of risk
in workers’ workstations, engineering and management
reforms were carried out in workstations. Engineering
and management interventions including prolonged poor
posture and discomfort combined with the improper
design of chairs and tables used in the workstation are
important factors that may affect a person’s physical
performance and ability. Therefore, chairs should be
designed based on the anthropometric dimensions of
the users. Matching between the dimensions of the seats
and the anthropometric dimensions of the user and
the ergonomic indicators makes the consumers more
comfortable. The standard design of the chairs can
enhance various anatomical and comfortable positions,
leading to the prevention of inappropriate postures. It can
also reduce the risk of MSDs and increase the efficiency of
the individual and the system [23, 24].
The footrest of the designed chair was adjustable for
short persons, who cannot fully fit their legs on the floor if
they want to place their legs on this footrest. In addition,
tall persons can fully get it aside if they do not want to use
Toolbox design according to workers’ access and its
use on the workstation table, placement of the pneumatic
wrench hanging and accessible so as not to hinder the
work of workers, placement of the appropriate light
source at the right height at the workstation, rotation
of work shifts among workers, and stretching exercises
were performed during fatigue at the workstation and at
break times to reduce static posture. Results related to the
elimination of inappropriate postures caused by fatigue
and the overall assessment result after the intervention
showed that workers at moderate and high-risk levels
were exposed to low risk levels. The results of the present
study revealed that various factors cause assembly
workers in workstations to be at medium- and high-risk
levels. Some of the risk factors that cause inappropriate
posture and play a role in accelerating MSDs include
frequent activities and light problems , vibrating and
inactive devices , high workload , psychosocial
factors such as stress and job dissatisfaction , tools and
equipment , and proper ventilation and temperature
. If any of the non-standard work environment factors
are designed, they will cause physical discomfort to the
workstation operator, as well as psychological stress and
After designing all the interventions of the workstation,
they were placed in the workstation to observe the results of
the study. After 3 months of intervention (July-October),
the results of the risk assessment (Table 3) demonstrated
that the level of exposure risk after ergonomic
interventions decreased from level 2 (a medium risk
level) to level 1 (a safe risk level). Accordingly, the main
strategies for performing engineering and managerial
interventions in assemblers’ workstations are effective
in reducing MSDs or eliminating the risk . In the
study conducted in a car assembly hall that used RULA
and MFA methods for risk assessment, Motamedzade et
al found that many factors might cause musculoskeletal
injuries, and a significant portion of these disorders can
be reduced to an acceptable level by proper ergonomic
Numerous studies have been conducted on engineering
interventions in the workstation. In the study of Azizi et al,
the mirror control workstation was performed on a glass
production company. The RULA technique was used to
assess the physical condition of workers before and after
the intervention. The data analysis after the intervention
showed that 20% and 80% of the workstations were at
action levels 3 and 2, respectively, and the risk level was
reduced efficiently . A similar perception was also
discussed in the interventions implemented by Khan
Mohammadi et al .
Ergonomics workshops were held to prevent
musculoskeletal injuries, and there was a significant
difference between the mean scores of pre- and post-test
participants. In a study by Choobineh et al, educational
action was effective as part of ergonomic interventions .
This indicated that making a device is divided into
partitions according to the access of workers in the
sitting position. Commonly tools and controls should
be placed in the first access area and at elbow height,
the construction of ergonomic footrests should be
based on the anthropometric characteristics of users at
196 Arch Hyg Sci. Volume 11, Number 3, 2022
workstations, and install the (hydraulic) wrench from
the center of gravity in place. Workers workstations will
increase ease of use and efficiency of users.
Despite the permission of the company management
and coordination with the head of the unit, more
ergonomic interventions in the workstations were not
acceptable, and it took a long time to perform each
intervention. On the other hand, there was insufficient
time for long-term interventions, limiting the work.
This study showed that the use of ART technique is a
suitable method to identify and evaluate the risk factors
of repetitive tasks in the upper limbs.
Previous studies revealed that the implementation
of various ergonomic interventions in the workplace
has reduced exposure to ergonomic risk factors and
MSDs, and ergonomic standards in the workplace have
improved accordingly [11, 36]. However, current risk
management strategies to reduce MSDs alone do not
function properly. It has been proven that the focus is
not only on interventions such as exercise, work station,
and training of optimal methods to reduce ergonomic
risk, but also attention to all risks, especially psychosocial
factors and other factors that cause disorders such as
air pollution, lighting, weather conditions, vibration,
organizational, cognitive, psychological, and individual
factors are essential. Moreover, it is necessary to use a
comprehensive assessment technique that can assess
each of the risk factors for the role of organizational
ergonomics involved in the development of MSDs.
The authors deeply thank all who participated in the present study.
All stages of writing the article have been done by the author.
Conflict of Interests
The authors declare no conflict of interests.
In this research, all ethical principles were approved by the Ethics
Committee of Hamadan University of Medical Sciences (IR.
UMSHA.REC.1396.399), and participants were satisfied with the
study and signed the consent form before starting the study.
1. Azizi N, Akhavan P, Philsoophian M, Davison C, Haass
O, Saremi S. Exploring the factors affecting sustainable
human resource productivity in railway lines. Sustainability.
2021;14(1):225. doi: 10.3390/su14010225.
2. Shaikh S, Siddiqui AA, Alshammary F, Amin J, Agwan MA.
Musculoskeletal disorders among healthcare workers:
prevalence and risk factors in the Arab World. In: Laher I,
ed. Handbook of Healthcare in the Arab World. Berlin,
Heidelberg: Springer; 2021. p. 1-39. doi: 10.1007/978-3-
3. Oo TW, Taneepanichskul N. Work-related musculoskeletal
disorders, psychosocial factors, work productivity, and work
ability among garment factory workers in Myanmar. Int J
Multidiscip Res Publ. 2022;4(8):1-7.
4. Sauter S, Moon SD. Beyond Biomechanics: Psychosocial
Aspects of Musculoskeletal Disorders in Office Work.
London: CRC Press; 1996. doi: 10.1201/9781482272680.
5. Stjernbrandt A, Hoftun Farbu E. Occupational cold
exposure is associated with neck pain, low back pain,
and lumbar radiculopathy. Ergonomics. 2022:1-10. doi:
6. Anwer S, Li H, Antwi-Afari MF, Wong AYL. Associations
between physical or psychosocial risk factors and work-related
musculoskeletal disorders in construction workers based on
literature in the last 20 years: a systematic review. Int J Ind
Ergon. 2021;83:103113. doi: 10.1016/j.ergon.2021.103113.
7. Najafi-Dolatabadi SH, Ahmadi-Jahanabad F, Malekzadeh
J, Mohebi-Nobandegani Z. Patient satisfaction before and
after implementation of paying per case for employees. Iran
Journal of Nursing. 2011;23(68):39-46. [Persian].
8. Santos AC, Bredemeier M, Rosa KF, Amantéa VA, Xavier RM.
Impact on the quality of life of an educational program for
the prevention of work-related musculoskeletal disorders: a
randomized controlled trial. BMC Public Health. 2011;11:60.
9. Habibi EA, Karimi S, Hasanzadeh A. Evaluation of ergonomic
risk factors by OCRA method in assembly industry. Iran
Occup Health. 2008;5(1-2):70-6. [Persian].
10. Choobineh A, Tabatabaei SH, Tozihian M, Ghadami F.
Musculoskeletal problems among workers of an Iranian
communication company. Indian J Occup Environ Med.
2007;11(1):32-6. doi: 10.4103/0019-5278.32462.
11. Poosanthanasarn N, Lohachit C, Fungladda W, Sriboorapa S,
Pulkate C. An ergonomics intervention program to prevent
worker injuries in a metal autoparts factory. Southeast Asian J
Trop Med Public Health. 2005;36(2):512-22.
12. Dehghan N, Choobineh A, Hasanzadeh J. Interventional
ergonomic study to correct and improve working postures
and decrease discomfort in assembly workers of an electronic
industry. Iran Occup Health. 2013;9(4):71-9. [Persian].
13. Mesbah F, Choobineh A, Tozihian T, Jafari P, Naghibalhosseini
F, Shidmosavi M, et al. Ergonomic intervention
effect in reducing musculoskeletal disorders in staff of Shiraz
Medical School. Iran Occup Health. 2012;9(1):41-51.
14. Ferreira J, Gray M, Stanley L, Riley D. Development of an
inspectors’ assessment tool for repetitive tasks of the upper
limbs. In: Bust PD, ed. Contemporary Ergonomics 2008:
Proceedings of the International Conference on Contemporary
Ergonomics (CE2008), 1-3 April 2008. Nottingham, UK: CRC
Press; 2017. p. 459. doi: 10.1201/9780203883259.
15. Abbaszadeh M, Zokaei M, Zakerian SA, Hassani H. Using
assessment repetitive task (ART) tool in an assembly industry.
Iran Occup Health. 2013;10(6):1-15. [Persian ].
16. Abdol Rahman MN, Abd Razak NS. Review on pen and
paper based observational methods for assessing work-related
upper limb disorders. Indian J Sci Technol. 2016;9(S1):1-11.
17. Snell S, Morris S, Bohlander GW. Managing Human
Resources. Nelson Education; 2015.
18. Ahmad Zuhaidi MF, Abdol Rahman MN. A review on
methods for assessing risk factors of the upper limb disorders
among cashiers in grocery retail industries. MATEC Web Conf.
2017;135(6):00023. doi: 10.1051/matecconf/201713500023.
19. Salman M, Bettany-Saltikov J, Kandasamy G, Whittaker
V, Hogg J, Racero GA. Protocol: the effect of education
programmes for improving knowledge of back health,
ergonomics and postural behaviour in university students:
|Send email to the article author
|Add your comments about this article