|Year : 2017 | Volume
| Issue : 3 | Page : 589-594
|REBA method for the ergonomic risk assessment of auto mechanics postural stress caused by working conditions in Kermanshah (Iran)
Meisam Moradi1, Mohsen Poursadeghiyan2, Alireza Khammar3, Mahsa Hami4, Afshin Darsnj1, Hamed Yarmohammadi1
1 Department of Occupational Health Engineering, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
2 Research Center in Emergency and Disaster Health, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
3 Department of Occupational Health Engineering, School of Health, Zabol University of Medical Sciences, Zabol, Iran
4 Master of Economic Development and Planning, University of Firoozkooh Branch, Islamic Azad University, Firoozkooh, Iran
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|Date of Web Publication||21-Aug-2017|
| Abstract|| |
Background: Work-related musculoskeletal disorders (WMSDs) are among the leading causes of occupational injuries and disabilities in industrialized and developing countries. Objective: This study was aimed at evaluating the ergonomic risk assessment of auto mechanic postural stress due to their working conditions in the city of Kermanshah (Iran) using the Rapid Entire Body Assessment (REBA) method. Materials and Methods: This descriptive–analytical study of cross-sectional type was carried out on 99 auto mechanics in the city of Kermanshah (Iran). In order to determine the prevalence of WMSDs and evaluate the risk of developing WMSDs, the Nordic Body Map questionnaires and REBA method were applied. The data were analyzed by SPSS-16 software. Results: The results showed that the highest prevalence of WMSDs was associated with the back (62.6%) and waist (64.6%). Also, the final obtained score from auto mechanics by the REBA posture assessment method showed that 55.5% are at high and very high risk level. Conclusion: The findings of this study showed that the prevalence of WMSDs in the back and the waist was high. It is, therefore, recommended to improve the working conditions and prevent these disorders by controlling the risk factors related to these areas and removing them from the workplace by taking effective measures. Any prevention programs should focus on risk factors related to these areas.
Keywords: Auto mechanic, Iran, Kermanshah, postural stress, rapid entire body assessment
|How to cite this article:|
Moradi M, Poursadeghiyan M, Khammar A, Hami M, Darsnj A, Yarmohammadi H. REBA method for the ergonomic risk assessment of auto mechanics postural stress caused by working conditions in Kermanshah (Iran). Ann Trop Med Public Health 2017;10:589-94
|How to cite this URL:|
Moradi M, Poursadeghiyan M, Khammar A, Hami M, Darsnj A, Yarmohammadi H. REBA method for the ergonomic risk assessment of auto mechanics postural stress caused by working conditions in Kermanshah (Iran). Ann Trop Med Public Health [serial online] 2017 [cited 2020 Apr 1];10:589-94. Available from: http://www.atmph.org/text.asp?2017/10/3/589/213116
| Introduction|| |
Work-related musculoskeletal disorders (WMSDs) are one of the leading causes of occupational injuries and disability in industrialized and developing countries. These disorders constitute nearly half of all work-related diseases and are a major cause of working time loss, increasing labor costs, and workers' injuries.,
According to the World Health Organization, the musculoskeletal disorders are the impairment of muscles, tendons, nerves, or vascular system that does not directly result from an incident or accident but is chronic and progressive in nature.,, Research has shown that pain and discomfort in various parts of the musculoskeletal system is a major problem in the workplaces causing more than half of the absences at workplace.,
Work-related musculoskeletal disorders not only affect the workers' quality of life but also causes a lot of direct costs mainly related to diagnosis and treatment and indirect costs due to the work absenteeism, loss of working time, and professional workers. It is one of the biggest occupational health problems in industrialized countries., It is also one of the most important issues that ergonomists face worldwide. When handling heavy objects and performing activities such as lifting, holding, displacement, and lowering the load, the risk of injury to the musculoskeletal system, especially lumbar spine, is highly increased. These disorders are the most common type of occupational injuries and diseases and the main cause of workers' disability.
Several risk factors play a significant role in developing musculoskeletal disorders such as unfavorable conditions in the workplace in terms of ergonomics, crafts, lifting heavy objects, and repetitive and heavy tasks. According to the estimates of International Labor Organization among 160 million work-related diseases that occur annually, the highest number of recorded ailments are WMSDs. In addition, each year 2.3 million workers lose their lives due to occupational accidents and diseases. Each year more than a million workers experience a variety of injuries mainly because of repetitive motion, awkward posture, and excessive strain.
Work-related musculoskeletal injuries impose large costs on the health care system of every country [Table 1]. Direct costs include the cost of payments to doctors and hospitals, rehabilitation, and insurance, whereas indirect costs include disability, losing job by the worker, losing the wages, costs incurred by the employer to employ and train the new workers to replace the one who is injured, administrative costs including costs related to get the compensation, and costs associated with quality of life, which is related to the pains and suffering of the victims and their family.,
|Table 1: The level of risk and prioritized corrective actions in REBA method|
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In a meta-analysis study conducted by Parno et al., the prevalence of musculoskeletal disorders in the neck was 31.8%, shoulders 36.8%, elbows 17.4%, wrist 34.6%, and upper back 38.1%. In a study conducted by Eskandari et al. with the aim of determining the prevalence of musculoskeletal disorders in the automobile industry, it was reported that the most common symptoms of musculoskeletal disorders were respectively related to the tasks of tire (92.8%) and exhaust silencer installation (88.4%) and the least prevalence was associated to car doors installation unit (43.7%). Also, awkward postures during operation, lifting and manual handling, and back bending and twisting were the most important risk factors for developing WMSDs in the back area. The results from another study conducted by Eskandari et al. in the automobile industry showed that the most common symptoms of musculoskeletal disorders among occupational groups have been reported in the back and upper back (92%). Based on the results obtained from the key indicator method, those who performed the tasks of manually carrying and installing tires, installing the seats, and carrying the engine by the shuttle had the risk scores of 66, 52, and 52, respectively, and were exposed to the highest levels of risk. Several studies in this field have shown that risk factors for WMSDs are very diverse but it is assumed that the most predominant one is adopting poor working postures. Therefore, the reduction and elimination of such awkward postures will contribute to the prevention of WMSDs.
Due to the fact that no study had been performed on auto mechanic musculoskeletal disorders, using the Rapid Entire Body Assessment (REBA) method, this study aimed to assess the ergonomic risk assessment of auto mechanic postural stress because of the working conditions in the city of Kermanshah (Iran) [Table 2] and [Table 3].
|Table 2: Mean and standard deviation of demographic characteristics of auto mechanics (n: 99)|
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|Table 3: The frequency of demographic and occupational characteristics of auto mechanics (n: 99)|
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| Materials and Methods|| |
This cross-sectional, descriptive analytical study was carried out randomly on 99 auto mechanics in the city of Kermanshah in the west of Iran. The data were collected via a demographic questionnaire and two WMSDs screening questionnaires. This demographic questionnaire contained topics related to job and personal characteristics such as age, weight, height, wearing glasses, and job authentication information such as hours of operation. To determine the prevalence of WMSDs, Nordic standardized questionnaire and Body map were used. This questionnaire is the most comprehensive tool for diagnosing WMSDs. The questionnaire was devised in 1987 by Kuorinka et al as a simple standard questionnaire to be used in WMSDs screening as part of ergonomic programs and epidemiological studies. To assess the risk of musculoskeletal disorders, the REBA method was used. REBA is a novel method for the analysis of workers' body during work and is based on the likelihood of musculoskeletal risks. Accordingly, the body organs are classified into two groups (A: trunk, neck, and legs) and (B: shoulders, elbows, and wrists). Based on the factors such as the range and direction of joints motion, the amount of force exerted, the condition of load grip, and the activity, a score for each body part was calculated. In the next phase, using the special tables, the final score is estimated. The obtained final score represents the risk potential for the development of WMSDs.
Eventually, after collecting data through observation and interviewing, the collected data were analyzed by SPSS 16 software using Spearman's t-test and descriptive statistical tests.
| Results|| |
A total of 99 auto mechanics were randomly selected as the participants of the study. The mean and standard deviation of participants' age and job experience were 10.96 ± 37.24 and 9.6 ± 16.06, respectively. Of all the participants, 37.4% had primary education, 36.4% had ninth grade, and 26.3% had high school diploma.
Spearman's t-test results
There was a statistically significant relationship between the age and the neck pain (P = 0.035) and the right (P = 0.046) and the left forearm pains (P = 0.01). Hence, older patients feel more pain. Also, the results indicate that the right (0.008) and left (0.023) forearm pains had an inverse significant correlation with working hours. There was a statistically significant relationship between the pain in the right hand and BMI (P = 0.03), between the age and the back pain (P = 0.016) and between the back pain and working hours (P = 0.04). There was a statistically significant relationship between hip pain with age (P = 0.21) and hip pain with BMI (P = 0.031). Also, there was a statistically significant relationship between the right ankle pain (P = 0.03) and left wing (P = 0.012) with age.
The results of t-test
The participants who wore glasses felt more pain in their right shoulder (P = 0.032), right wrist (P = 0.041), and left wrist (P = 0.032). There was a statistically significant reverse relationship between the pain in the left calf and the REBA score (P = 0.032).
| Discussion|| |
The results of this study showed that the prevalence of WMSDs among the auto mechanics is considerably high as almost all the participants had pain and disorders in one of their nine anatomic areas of their bodies. Such finding is consistence with the results obtained in studies conducted by Eskandari et al. in the automotive industry in Tehran and Kashan where the majority of participants had pain in their anatomic areas.,,,
Based on the results presented in [Table 4] and [Table 5], 39.4% of the auto mechanics were suffering from the neck pain, 42.5% had pain in their shoulders, 16.2% in their elbows, 54.5% in their wrist and hand, 62.6% in the back, 64.6% in the waist, 17.2% in thighs and buttocks, 49.5% in their knees, and 27.3% in their leg and ankle within the previous 12 months. Therefore, the highest prevalence of musculoskeletal disorders among the participants occurred in the back and the waist. This is again consistent with the results obtained in studies conducted by Eskandari et al. who determined the prevalence of musculoskeletal disorders in the automotive industry in Kashan Saipa (Iran) car manufacturing industry. In a study by Eskandari et al. that aimed to assess the prevalence of WMSDs in Tehran automotive industry, it was reported that 82.3% of the surveyed workers in the past 12 months were suffering from musculoskeletal disorders at least in one of their nine body organs.
|Table 4:The percent and the frequency of musculoskeletal disorders in the lower extremities of auto mechanics (n: 99)|
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|Table 5: Percent and the frequency of musculoskeletal disorders in the upper extremities auto mechanic (n: 99)|
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The results of this study is consistent with the results of the study conducted by Ghasemkhani et al. in the automotive industry who reported that 79% of prevalence of musculoskeletal disorders is in the waist region.
In this study, the highest prevalence of WMSDs was in the back, lower back, neck, and knee. According to Salehi et al., the most common prevalence of WMSDs was seen at the neck, shoulders, waist, and back that is consistent with the results obtained from our evaluation in this study where the waist, back, and shoulders had the highest prevalence. A study conducted by Soori et al. showed that low-back disorders were the most frequent ailment in automobile industry which is consistent with the results of this study. Dehghan et al.,in a study conducted in the assembly industry, showed that the highest prevalence of WMSDs was in the neck, back, shoulders, and arms that is consistent with the findings of our study [Table 6].
|Table 6: Frequency of risk levels for auto mechanic musculoskeletal disorders by REBA method (n: 99)|
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The final obtained scores of REBA revealed that 55.5% of auto mechanics were at high and very high levels of risk. Manual handling and carrying heavy objects and loads, inappropriate working condition in terms of work ergonomics concerns, and prolonged sedentary and standing positions are among the major causes of high incidence of WMSDs in this group of workers. Motamedi et al. conducted a study at the battery manufacturing company using the RULA method; they showed that 31.25% of evaluated postures had corrective actions level 4. Although in assembly line, mechanical means such as manual forklifts, cranes, lifting pallet, and movable tables are used to facilitate the transport and material handling, such measures did not effectively improve the situation and lots of work stations and postures needed to be improved. In a study by Azizi et al., 60% of assembly workstations were at 3 and 4 action levels. They recommended the posture training and exercise programs for the staff.
In this study, there was a statistically significant relationship between the age and the neck pain, elbow, forearm, hand, thigh, and ankle. Similar results were also obtained by Choobineh et al. in the metal industry where there was a significant relationship between the prevalence of symptoms with aging of all nine body parts except ankle. Therefore, the increase in age is associated with the prevalence of symptoms. Similar results have been reported in the other previous studies; however, some researchers have presented different results.
In the present study, there was a statistically significant relationship between the pain in the right hand and BMI (sig: 0.003). Mostaghaci et al. reported that the highest prevalence of WMSDs was seen among the participants with BMI less than 25.
According to the cross-sectional nature of this study and the method of data collection which was conducted via self-reporting, the findings should cautiously be interpreted and analyzed as in this case the self-reported method have some weakness such as participants' difficulty in remembering the history of their WMSDs.
However, in this study, by limiting the remembering period to 12 months, such problem was partly removed. Moreover, because of the fact that we only focused on participants who were actively working during the period, this study was conducted and those who had temporarily or permanently left their jobs due to WMSDs were not taken into account as the potential participants of the study; there might be an underestimation in number of workers suffering from WMSDs.
| Conclusion|| |
According to assessments conducted, unfavorable body condition, repetitive movements, lifting and carrying the load, work with no ergonomically designed tools, lack of sufficient breaks to rest, and standing for long periods of time are among the risk factors for musculoskeletal disorders which are frequently and abundantly seen in this job. Therefore, to prevent the development of WMSDs, auto mechanics should be provided with proper trainings about the body positioning and posture during performing their tasks work and the use of the suitable and ergonomic equipment and manual tools. Mechanization and automation are two other techniques to minimize the risk of developing WMSDs in such workplaces.
It is also concluded that with regard to the excessive prevalence of musculoskeletal disorders in the back and the waist, removing the possible risk factors related to disorders and eliminating them in the workplace can be an effective measure to improve working conditions and prevent such disorders. Therefore, any prevention programs should focus on the risk factors related to these areas.
The authors thank all those who have helped them in conducting this study Kermanshah University of Medical Sciences, Kermanshah, Iran.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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Department of Occupational Health Engineering, Kermanshah University of Medical Sciences, Kermanshah
Source of Support: None, Conflict of Interest: None
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]
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