1.

INTRODUCTION

Work-related musculoskeletal disorders have been found to be associated with

numerous occupational ‘risk factors’, including physical work load factors such as force,
posture, movement and vibration, psychosocial stressors, and individual factors. The
level of exposure to physical workload can be normally assessed with respect to intensity
(or magnitude),repetitiveness and duration. Various methods are now available for
assessing exposure to the risks associated with work-related musculoskeletal disorders, or
identifying potentially hazardous jobs or risk factors within a job. These include
observational methods, instrumental or direct methods, self-reports and other
psychophysiological methods. (Mali & Vyavahare, 2015).

75-80% of the population is at some time affected by back pain, and back pain is
the most frequent cause of activity limitation in persons less than 45 years old. Low back
pain claims account for 40-50% of all workers compensation claims in health care, iron
and steel production, timber processing, and rubber and tire-manufacturing industries.
Despite confounders, there appears to be an association between these disorders and 1)
heavy physical work, including lifting, bending, and twisting; 2) static work posture,
including long-term sitting; 3) vibration; and 4) psychological work factors such as work
dissatisfaction. Work-related carpal tunnel syndrome has been associated with high
repetitive forces, awkward wrist postures, and segmental vibration. Construction and
food processing were among the industries with the highest rates of distal upper-
extremity disorders. Work-related low back disorders (WLBD) are frequent in the steel
industry. It is reported that about 70% of the workers of the maintenance division of a
steel mill had back pain during life (Ning, et. al., 2015). studied WLBD in two steel
companies using checklist. The prevalence of low back pain was 66% for lifetime, 53%
during previous year, and 25% during the previous week. Similarly, Hildebrandt et al.
(1996) found a prevalence of low back symptoms in steel workers of 53%after 1 year of
work. WLBD control is an important issue in occupational health. Several
epidemiological studies have demonstrated evidence that musculoskeletal disorders and

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workload are related (López et. al., 2015). Bending, twisting, lifting heavy weights, and
making forceful movements were shown to be related to WLBD (Zhao et. al., 2014).

The International Labor Organization first defined the limits for manual lifting in
1962, as reported (Mital, 2017). These limits were established based on the opinions of
medical experts. Such limits were defined without taking into account the size of the
objects being lifted and the lifting frequency. The adoption of these recommended limits
failed to reduce the occurrence of musculoskeletal injuries and work-related disorders.
Hence, in 1981, the National Institute for Occupational Safety and Health (NIOSH), a US
federal agency, recognized the problem linked to lower back injuries and published the
Work Practices Guide for Manual Lifting (Dick et. al., 2016).

1.1 LITERATURE REVIEW

(Mustafa et. al., 2009) evaluate the level of ergonomics awareness in Malaysian
manufacturing industries and to determine the best practices of ergonomics program
using Quality Function Deployment (QFD) among the manufacturing industries with the
highest awareness of ergonomics. A questionnaire was developed and distributed to 200
manufacturing industries where the respond rate was only 22.5%. The evaluation showed
that 35.6% of the industries were classified as having high level of ergonomics
awareness, 51.1% with moderate levels and 13.3% having low level of ergonomics
awareness. The results from the Ergonomics House of Quality (EHOQ) analysis showed
that the orientation program (124 point) was the best practice in helping to increase the
awareness of ergonomics amongst the employees. Besides, ergonomics need to be
formalized via the creation of ergonomics team within the organization. This is based on
the results where, 62.2% of the respondents agreed that organized ergonomics team will
help to improve the awareness of ergonomics.

(Hu & Ning, 2015) studied about the ergonomics interventions of steel
manufacturing workers. In this study, they concluded that introducing a ground pit to the
regular tractor maintenance task could significantly reduce workers’ neck stress.
Adjusting the height of a coil to workers’ shoulder level could reduce whole body muscle
stress and generate more neutral trunk and lower extremity postures. Moreover, when

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performing the steel sample-cutting task, the apparatus proposed in this study may reduce
the required hand force and consequently reduce upper extremity and lower back muscle
stress. Finally, the use of anti-slip gloves could decrease the risks of MSDs to the neck,
lower back, shoulder and arm during task performance. In conclusion, the proposed
ergonomic interventions tested in this study all showed potential of reducing MSD risk
for steel manufacturing workers.

(Munir et. al., 2012) study was conducted in Sugar industry of Pakistan to analyze
the ergonomics and occupational health status. Sugar industry is one of the majors agro
based industries in Pakistan. There were frequent injuries and accidents in sugar
industries but a little work had been done on ergonomics and occupational health of
workers. For this purpose, questionnaires were prepared and surveys of different sugar
industries were conducted to gather both qualitative and quantitative data. The
modification in the existing design is also suggested in order to work at safe working
level. The results showed that 15 to 20% workers were injured during the season in sugar
industry of Pakistan. It is also observed that 40% of the total working staff was equipped
with safety equipment. On an average, 85 to 112 dB noise levels were recorded in the
sugar industry that affects human health very badly. It was found that about 50% of the
workers were not equipped with safety measures. The results showed that working
conditions existed in the sugar mills were not satisfactory regarding ergonomics and
occupational health. The study suggests that there is need to recruit the skilled manpower
to minimize the injuries in sugar industry of Pakistan.

(Boyi et al., 2013) studied that lifting tasks performed on uneven ground surfaces
are common in outdoor industries. In this study, the effect of laterally slanted ground
surfaces on the lumbar muscle flexion–relaxation responses was investigated. Fourteen
participants performed sagittal plane, trunk flexion–extension tasks on three laterally
slanted ground surfaces (0° (flat ground), 15° and 30°), while lumbar muscle activities
and trunk kinematics were recorded. Results showed that flexion–relaxation occurred up
to 6.2° earlier among ipsilateral lumbar muscles with an increase in laterally slanted
ground angle; however, the contralateral side was not affected as much. Our findings
suggest that uneven ground alters the lumbar tissue load-sharing mechanism and creates

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unbalanced lumbar muscle activity, which may increase the risk of low back pain with
repeated exposure to lifting on variable surfaces.

(Hussain & Javed, 2016)studied that Pakistan is the eighth largest exporter of
textiles, and this sector contributes 8.7% to the country’s GDP. The garment industry
contribution to the total textile-based exports from the country is 47%. Skilled labour is
available at relatively cheap rates. Work-related musculoskeletal disorders (WMSDs) are
prevalent in this sector and this research is aimed at finding the levels of risk attached to
working activities and to gain knowledge of the major causes of musculoskeletal
disorders. The Rapid Entire Body Assessment (REBA) method was used for this purpose.
It was found that postures related to the wrist (0-150 or >150 flexion or extension with
twist or deviation), lower arm (1000 flexion) and neck (extension and flexion with twist
or side flexed) are the major causes of musculoskeletal disorders. These findings will
help in the design of workplaces and working strategies to minimize risk and so increase
satisfaction, productivity and overall well-being at the workplace.

2. OBJECTIVES
1. To identify manual work related hazards in steel goods manufacturing
industry.
2. To determine unsafe works or work conditions using standard ergonomic
assessment tools.
3. To assess risks associated with manual works and vibrations at work.

3. STUDY AREA

The area of study is a hub for many bus transportation companies and various
steel goods production small, medium and large size workshops alongside IJP road
Rawalpindi. The Rawalpindi Development Authority (RDA) is managing the study area.
Manual works including production of boring machines, concrete mixer machine, block
making machines, wheelbarrows, numerous HVAC items including grills etc. are
included.

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 4. METHODOLOGY
4.1 SAMPLING
4.1.1 SAMPLE SIZE

Total of hundred (100) samples will be collected from 10 different steel goods
manufacturing processes i.e. 10 samples from each process. Sampling will be based on
number of works which includes welding, cutting, rolling, twisting, bending, molding,
grinding, lifting weights, hammering.

4.2 INCLUSION CRITERIA

1. Manual works done repeatedly.

2. Workers exposed to vibration.

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 3. Works that are performed for 1 year or more in study that are part of
samples.

4.2.3 EXCLUSION CRITERIA

All the works that are performed mechanically are excluded from study.

4.2.4 SAMPLE TYPE

For REBA For NIOSH For HAV Calculator

Data on works causing Horizontal location of the Vibration magnitude
stress on Neck, Trunk and object relative to the body m/s2 r.m.s
Legs and injury data
Data on works causing Vertical location of the Exposure Duration
stress on Arm and Wrist object relative to the floor
and related injuries
Distance the object is
moved vertically
Asymmetry angle or
twisting requirement
Frequency and duration of
lifting activity
Coupling or quality of the
workers grip on the object

5. DATA ANALYSIS
Samples will be analyzed for risk assessment using Rapid Entire Body
Assessment (REBA) and Hand-Arm Vibration Calculator for vibration effect and
National Institute for Occupational Safety and Health (NIOSH) lifting equation to find
out WLBD.

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 5.1 Rapid Entire Body Assessment (REBA)

Rapid Entire Body Assessment (REBA) has been developed to fill a perceived need
for a practitioner's field tool, precisely designed to be sensitive to the type of
unpredictable working postures found in health care and other service industries. REBA
is a Rapid Entire Body Assessment tool which is being developed to investigate dynamic
activities where there is a risk of work related musculoskeletal disorders. It is to be used
to investigate tasks for which RULA (Rapid Upper Limb Assessment) was not designed.
RULA is a survey method which was developed to be used in ergonomics investigations
of inactive tasks where work related upper limb and neck disorders. REBA uses the
RULA posture scoring criteria as a basis and is being designed to additionally record
risks associated with the knee positions, the loads or forces being exerted, the coupling
and whole body activities . Data are collected about the body posture, forces used, type
of movement or action, repetition, and coupling. A final REBA score is generated to give
an indication of the level of risk and exigency with which action should be taken. REBA
may be more useful if specific ergonomic or biomechanical changes are being
implemented to reduce risk of work-related injury particularly if an objective numeric
score is required for re-assessment following modifications, to determine their
effectiveness. REBA directs the user toward implementing controls, which are thorough,
multi-factorial and useful to control hazards relating to several other areas, including task,
load, environment, people and management factors. REBA was used as a code with other
ergonomic methodology (Al Madani & Dababneh, 2016).

In the spectrum of postural analysis tools, REBA lies between the detailed event
driven systems and time-driven tools. REBA was designed to be used as an event driven
tool due the complexity of data collection. However it has lately been computerized for
field use on a Palm PC and it can now be used as a time-driven tool. The initial
development was based on the ranges of limb positions using concepts from RULA
(rapid upper limb assessment), OWAS (Ovako Working posture Analysis System) and
NIOSH (National Institute for Occupational Safety and Health). The baseline posture is
the functional anatomically neutral posture. As the posture moves away from the neutral
position, the risk scores increases. Tables are available to convert the 144 posture

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combinations into a single score that represents the level of musculoskeletal risk. These
scores are then banded into three action levels that advise on the exigency of avoiding or
reducing the risk of the assessed posture (Mendiratta, 2015).

5.2 HAND-ARM VIBRATION CALCULATOR

Depending upon the nature of their work, workers can be exposed to either of two
types of vibration hazard. The first is from whole-body vibration (WBV) (Duarte & de
Melo, 2018). This being vibration transmitted into the body resulting from operating
machinery (Duarte & de Melo, 2018). such as rollers, dump trucks or excavators. The
second, with which this research is concerned, is hand-arm vibration (HAV) (Roseiro, et.
al., 2016) – this being vibration transmitted into the hand(s) of operatives (HSE, 2003a).
HAV emanates from: (i) the use of hand-held power tools; (ii) the use of hand-guided
mechanical equipment; and (iii) the holding of materials against a mechanical process
(Roseiro et al., 2016).

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 Hand-arm vibration (HAV) is vibration transmitted from a work process into
workers’ hands and arms. It can be caused by operating hand-held power tools, hand-
guided equipment, or by holding materials being processed by machines. The Hand-Arm
Vibration Exposure Calculator pictured below (adapted HSE Health & Safety Executive
HAV Calculator) is a very effective tool for the objective ergonomic evaluation of HAV
in the workplace.

The final product of the HAV Exposure Calculator is Total Exposure Points for
the entire job, which is calculated from partial exposure values from all tools used to
perform the job. The Exposure Action Value (EAV) is equivalent to 100 points and the
Exposure Limit Value (ELV) is equivalent to 400 points.

5.3 NIOSH LIFTING EQUATION

The NIOSH Lifting Equation is a tool used by occupational health and safety
professionals to assess the manual material handling risks associated with lifting and
lowering tasks in the workplace. This equation considers job task variables to determine
safe lifting practices and guidelines. The primary product of the NIOSH lifting equation
is the Recommended Weight Limit (RWL), which defines the maximum acceptable

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weight (load) that nearly all healthy employees could lift over the course of an 8 hour
shift without increasing the risk of musculoskeletal disorders (MSD) to the lower back. In
addition, a Lifting Index (LI) is calculated to provide a relative estimate of the level of
physical stress and MSD risk associated with the manual lifting tasks evaluated.

The NIOSH lifting equation always uses a load constant (LC) of 51 pounds,
which represents the maximum recommended load weight to be lifted under ideal
conditions. From that starting point, the equation uses several task variables expressed as
coefficients or multipliers (In the equation, M = multiplier) that serve to decrease the load
constant and calculate the RWL for that particular lifting task.

NIOSH Lifting Equation: LC (51) x HM x VM x DM x AM x FM x CM =

RWL

Task variables needed to calculate the RWL:

 H = Horizontal location of the object relative to the body

 V = Vertical location of the object relative to the floor

 D = Distance the object is moved vertically

 A = Asymmetry angle or twisting requirement

 F = Frequency and duration of lifting activity

 C = Coupling or quality of the workers grip on the object.

5.3 RISK ASSESSMENT

Questionnaire are designed to direct interview for risk assessment

including

1) Anthropometric information,

2) Health information,

3) Awareness information. Are attached as Annexure A

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 6. PROJECT OUTCOMES
1. Baseline will be determined for ergonomic management of industry.
2. Risk & Hazard level will be identified.
3. Awareness will be increased.

RESEARCH PLAN

Activities Year 2018-19

Months

Time Sep- Oct- Nov- Dec- Jan- Feb- Mar- April- May-
2018 2018 2018 2018 2019 2019 2019 2019 2019

Proposal writing

Approval of
study

Data collection

Data analysis

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Report writing

1st Draft

Final report

REFERENCES
Al Madani, D., & Dababneh, A. (2016). Rapid entire body assessment: a literature review.
American Journal of Engineering and Applied Sciences, 9(1), 107-118.
Dick, R. B., Hudock, S. D., Lu, M. L., Waters, T. R., & Putz‐Anderson, V. (2016). Manual
materials handling. Physical and Biological Hazards of the Workplace, 33-52.
Duarte, M. L. M., & de Melo, G. C. (2018). Influence of pavement type and speed on
whole body vibration (WBV) levels measured on passenger vehicles. Journal
of the Brazilian Society of Mechanical Sciences and Engineering, 40(3), 150.
López-Arquillos, A., Rubio-Romero, J. C., Súarez-Cebador, M., & del Carmen
Pardo-Ferreira, M. (2015). Comparative risk assessment of vehicle
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Mendiratta, M. (2015). Comparison Of Different Ergonomic Risk Assessment Tools
In A Repetitive High Risk Metal Works Industry. MNIT Jaipur.

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Mital, A. (2017). Guide to manual materials handling: CRC Press.
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