Upper Limb Assessment – Table B DRAFT 6 1

ManTRA OCRA OWAS QEC REBA

Title
Manual Tasks Risk Ovako Working Posture Analysis
Concise Exposure Index Quick Exposure Checklist Rapid Entire Body Assessment
Assessment Tool V2.0 System

Manual task assessment tool. Upper limb assessment tool. Entire body assessment tool. Upper limb assessment checklist Entire body assessment checklist
Overview Intervention information Intervention information included. tool. Useful for comparison before tool. Intervention information
included. and after an intervention. included.

Type Risk Assessment Risk Assessment Risk Assessment Checklist Risk Assessment

• To assess exposure to • The purpose of this index is to • A practical method for • User-friendly tool designed to • REBA was specifically designed
musculoskeletal risk classify diverse occupational identifying and evaluating poor assess worker exposure to risks to assess various unpredictable
factors associated with scenarios according to their working posture. for work-related working postures found in
manual tasks in workplace. exposure to WMSDs. musculoskeletal disorders of the health care and other service
• To prioritize tasks that upper limbs. industries. The Rapid Entire
must be changed due to a • Useful for comparison before Body Assessment (REBA) is
high risk. and after an intervention. similar to RULA, but it has been
• Incorporates assessment of modified to be more useful for
manual task risk levels, working postures found in the
related safety activity, health care and other service
organizational industries.
environment. • A postural analysis system that
is sensitive to musculoskeletal
Stated Purpose
Straker et al. Ergonomics
2004. risks in a variety of tasks.
• To assist inspectors in • The purpose of this index is to • To determine the loads caused • “Front line” assessment as part
auditing workplaces across quantify worker exposure to by the most common postures of of a broader ergonomic
all industries for tasks involving repetitive the back, arms and legs in assessment.
compliance with the movements of the upper limbs. different jobs.
Queensland Manual Tasks Grieco, Ergonomics, 1998. • Useful for directing
Advisory Standard. improvements in the working
ManTRA, V2.0 Cornell methods.
University Ergonomics Karwowski, W., and Marras,
Web. W. 1999. OWAS Methods in
The Occupational Ergonomics
Handbook. pp 447-459.
Upper Limb Assessment – Table B
ManTRA
Body Parts Arm/wrist/hand, lower limbs,
Elbows, wrists, hands
Assessed back, neck/shoulder
• Determine the maximum • Force required is considered by • The load or use of force is
force exerted within each
region during the task
relative to the maximal
force which can be
Force
exerted.
Measurement of Risk Factors
• Posture is measured by • The posture of each part of the • Back posture is identified by a
considering deviations
from the mid range.
• Postures combinations
such as twisting and
bending are also
considered.
Posture
• Total time for which a • The duration of the task is
person performs the task in
a typical day (exposure).
Time
• Total cycle time for each
region of the body is
measured.
• The typical time which the
task is performed without
break is measured
DRAFT 6
OCRA OWAS
Back, arms, legs
determining the perceived effort characterized by the mass
of maintaining a posture using involved.
the Borg scale.
body is assessed by considering number indicating whether the
the angle of flexion/extension of back is straight, bent or bent
each segment. and twisted.
• Arm posture is identified by a
number indicating whether one
or both arms are at or below
shoulder level.
• Leg posture is identified by a
number indicating that the
worker is sitting, standing on
one or two legs, squatting on
one or two bent legs, kneeling
or walking.
• Observations are made at time
considered as well as the intervals of 30 or 60 seconds
number of recommended during field work. Using video
actions and the total number of tape, smaller intervals of 40
actions for repetitive tasks. The seconds are possible.
recovery time is also considered
as well as the number of tasks
per minute.
2
QEC REBA
Wrists, forearms, elbows, shoulders,
Back, shoulder/arm, wrist/hand
neck, trunk, back, legs and knees
• The measurement of force • Force measurement is divided
considers the maximum weight into different categories. The
handled in the task. This ranges different categories range from
from a light load of 5kg to a loads less than 5kg to loads
very heavy load of 20kg or greater than 10kg. The risk
more. associated with shock or a rapid
• The measurement of hand force build up of force are also
exertion ranges from low values considered.
of less than 1kg to high values
of more than 4kg.
• Back posture is considered by • The posture is evaluated by
determining if it is neutral, measuring joint angle are wrist,
moderately or excessively lower arm, upper arm, leg, neck
flexed or twisted. and trunk posture.
• Shoulder/arm posture is
considered by determining
movement frequency. This
assessment should be done
when the shoulder/arm is most
heavily loaded, not necessarily
at the same time the back is
assessed.
• Wrist/hand posture is considered
at the most awkward point of a
task. Movement is regarded as
almost straight if it is limited
within a small angular range
(eg. <15ºC). Otherwise, it is
deviated or bent.
• Neck posture is considered by
determining the angle of
bending and twisting.
• The number of times a task is • Repetition – e.g., repeating same
performed is considered. motions every few seconds for 2
• The duration of a task is hours at a time, or using a
measured. It is rated depending device (such as a keyboard
on repetition time. and/or mouse) steadily for more
than 4 hours daily.
Upper Limb Assessment – Table B
ManTRA
• Vibration is measured.
Other
• Maximum force score
corresponds to the
Evaluation of Single
maximum force possible.
Scoring scale ranges from
minimal to maximal force.
Risk Factors
Force
OCRA
• The length of time that a risky
posture is maintained is
considered.
Grieco, Ergonomics, 1998.
• Vibration, recovery time,
exposure to low temperatures,
use of gloves, effect of high
precision work, intensity of
exertion are considered.
Grieco, Ergonomics, 1998.
• Reference lifting score = 1. This • A value of 1 is given to tasks
is largely acceptable conditions
for the majority of healthy adult
working population. As this
values changes, exposure is
more dangerous, different
interventions can be identified.
Strong propensity towards
preventative actions.
• Required force is evaluated by
rating the perceived effort using
the Borg scale and the percent
effort required with respect to
the MVC. These values are
combined in a multiplying
factor.
Grieco, Ergonomics, 1998.
DRAFT 6 3
OWAS QEC REBA
• Other task components are • Hand hold on a tool or handle is
characterized. They include, rated.
vibration, visual demand of the • Activity level is rated including
work, the difficulty a worker has the size of the action and
keeping up with the work, and whether it affects a small part of
the workers opinion of how the body or causes a large
stressful they find their job. posture change.
• The assessment is completed by
an observer regarding posture
and repetition of movements.
The worker completes the
assessment regarding the weight
lifted, the time spend doing this
task, the vibration experienced,
the visual demand, the difficulty
keeping up with a task and the
stress of the work.
Li et al. Proceedings of the
Human Factors and
Ergonomics Society, 1998.
• Force/load handled by the body • Assessment done by observer
involving less than 10kg, a and hands is rated. and by worker.
value of 2 is given to tasks • Also rated is the force due to a
involving from 10 to 20 kg and load, the coupling of a hand and
a value of 3 is given to tasks object and the activity level.
involving more than 20kg.
Upper Limb Assessment – Table B DRAFT 6 4

ManTRA OCRA OWAS QEC REBA

• Awkwardness rating is low • The amount of time that each • Postures are classified based on • Shoulder/arm posture and • The posture of the trunk, neck,
for postures close to segment spends in a risky a risk assessment of movement are rated. legs, upper arm, lower arm and
neutral, and greater for posture is determined. The musculoskeletal disorders and • Wrist/hand posture and wrist are given a score.
tasks near the end of the riskiest posture maintained for physical load. movement are rated.
range of motion in more the longest time is used to • Each classified posture is • The neck posture is rated
Posture
than one direction. determine a postural recognized by a 4-digit code according to the degree of
• Higher risk occurs when involvement index score that that indicates the back, arm and bending and twisting.
the deviation of the upper corresponds to a multiplying leg posture and the load or use
limb occur in factor. of force.
combinations. For Grieco, Ergonomics, 1998. • A fifth digit is used to indicate
example, wrist extension the work phase or task that the
combined with ulnar worker is working on.
deviation. • Back posture and movement
score determined.
• Cycle time (exposure), • The frequency of task repetition • Multiply the reference
time that a person typically is evaluated as well as the frequency (30 actions/min) by
performs the task during an duration of repetitive tasks and number of repetitions actually
entire day. recovery time. done (after altering this value to
• Cycle duration, typical Grieco, Ergonomics, 1998. take into account the force,
time that task is performed posture, recovery time etc.)
without a break.
Time

• Task speed was assessed.

Slow to moderate
movements have the least
risk. Static application of
force to a particular region
has greater risk. Tasks with
fast movement, quick
accelerations and
decelerations have the
greatest risk.
• Vibration rating ranges • Vibration, recovery time, • Vibration, visual demand, task
from a low value for no exposure to low temperatures, duration, vibration, difficulty
vibration to a higher value use of gloves, and the effect of keeping up, stress level.
for severe amplitudes. high precision work was also • Back movement is rated by
considered. Depending on the determining how often person
amount of time spend working bends or twists within one task
Other

in such conditions, a cycle.

corresponding multiplier is • Shoulder/arm movement
assigned. determined by how often the
• The preexisting disorders that motion of a task is repeated.
workers were affected by • Wrist/hand movement does not
(Carpal Tunnel Syndrome, include movement of the
epicondylitis etc,) are also fingers. One motion is counted
considered in a concise damage each time the same or similar
index. motion or pattern is repeated
Grieco, Ergonomics, 1998. over a set period of time.
Upper Limb Assessment – Table B DRAFT 6 5

ManTRA OCRA OWAS QEC REBA

• Assess cycle time and task • Combined the value determined • Postural data is combined with • The assessment performed by • Upper, lower arm, wrist and
Evaluation of Combined Risk
duration independently by the exposure index (OCRA) the proportion of time that a the observer and the worker are wrist twist posture are combined
then give a combined score and the damage index to worker spends in a particular combined with the exposure into one score and muscle use
for the repetition risk determine degree of association. position. This is used to scores to come up with an and force are added to this.
factor. Grieco, Ergonomics, 1998. determine the class of the job. exposure score for the back, Neck, Trunk and Leg posture
• The force and speed scores Based on this class, action may shoulder/arm, wrist/hand and scores are combined into one
are independently assessed • Each task is classified based on or may not be required. neck. posture based added to muscle
and combined to generate exposure to WMSDs related. • A similar analysis is done for use and force scores.
an exertion risk factor. This is translated into a rating the amount of time that each • Individual scores are combined
Factors

• Cumulative risk score
combines the scores of
each individual part. Yields
values between 5 and 25.
• Further action is required
no matter what the
combined risk score is the
exertion factor is greater
than 5, the sum of exertion
and awkwardness is
greater than 8 and the
cumulative risk score is 15
or greater.
• Simple linear regression model • Based on the study by Burdorf, • Assessment validity was
Validity
• Preliminary validation of the
by comparing the number daily
number of actions performed by
the upper limbs during
repetitive tasks and the number
of recommended actions.
provided a ‘satisfactory
predictive performance’ of the
risk of WMSDs based on index.
degree of association of the
index (OCRA) and the WMSDs
detected.
Grieco, Ergonomics, 1998.
body part spends in a particular
position. The results of this
determination are also used to
determine the class of the job.
This class may or may not
require action depending on the
value.
Karwowski, W., and Marras,
W. 1999. OWAS Methods in
The Occupational Ergonomics
Handbook. pp 447-459.
the OWAS system predicts back
pain based on the amount of
time spent working in a harmful
posture.
Burdorf et al Ergonomics,
1991.
to determine the overall REBA
score.
moderate due to a low level of
agreement on back posture
classifications.
• The relationship between
exposure and work-related
musculoskeletal disorders was
not made.
• Improvements to aid with
assessing frequent body
movements is required.
Li et al. Proceedings of the
Human Factors and
Ergonomics Society, 1998.

• Suggested thresholds help • The score is calculated and • Posture combinations and the • Risk factor values are combined • The final REBA score provides
to make judgments about classified as red, green or proportion of time spent in that to give overall exposure scores. an action level with an
Limit or the safety of the task. amber. Green indicates and posture are classified into 4 These scores are used to indication of urgency of
• Action is recommended if : acceptable frequency of motion. action categories indicating the compare tasks before and after intervention.
Guideline Level o The exertion score Amber indicates an area of urgency and priority for an intervention to determine the • Scores range from 1-15 and are
was 5 or greater for uncertainty, close monitoring is corrective measures. change in risk. grouped into 5 action
Proposed? any body region required. Red indicates a high • An action class of 1 indicates categories. These categories
o The sum of exertion risk of injury, the task must be that no action in required, 4 range from ‘no action
improved.
Upper Limb Assessment – Table B DRAFT 6 6

ManTRA OCRA OWAS QEC REBA

and awkwardness • An exposure index (OCRA) of indicates that corrective necessary’ to ‘action necessary
was eight or greater 4 or more predicts a high measures are needed now’.
for any region of occurrence of disorders. An immediately.
the body exposure index of 0.8 to 4 is an • A second classification is based
o The cumulative risk intermediate value that does not on the amount of time each
score (total of time, necessarily mean a disorder will body part spends in each
exertion, occur but does not completely posture. The relative proportion
awkwardness, rule out the possibility. of time spent in a position
vibration and Grieco, Ergonomics, 1998. determines the action class
repetition) was 15 (same as above).
or greater. Karwowski, W., and Marras,
W. 1999. OWAS Methods in
The Occupational Ergonomics
Handbook. pp 447-459.
• 48 workplaces with 30-100 • 462 workers exposed to • Developed for Finnish steel • Participatory approach • Reliability tested using 600
employees in the food, WMSDs and 749 workers not industry. involving 150 practitioners. examples of postures from
construction and health exposed to any specific • 680 jobs in the steel mill were • Manual laborers, laboratory electricity, health care,
industries occupational risk were studied to define the various workers, office workers, manufacturing industries and 14
Straker et al. Ergonomics examined. Total of 8 different postures. These jobs were warehouse workers, experts to perform the
2004 tasks in eight manufacturing representative of all steel mill supermarket workers. assessment/.
Study Base/ industries. Finishing ceramic
ornaments, auto body sanding,
jobs at the time.
Karwowski, W., and Marras,
• Inter-rater reliability of 62-85%.

Generalizability door and window sanding, W. 1999. OWAS Methods in

supermarket check out,
Used in: vegetable packing, meat
processing, etc.
Developed in:
• Reference group of workers
who were not exposed to the
repetitive tasks.
Grieco, Ergonomics, 1998.
The Occupational Ergonomics
Handbook. pp 447-459.
• 120 workers from a factory that
makes prefabricated concrete
elements.
Burdorf et al, Ergonomics,
1991.

• No equipment required • Stopwatch • Video tape is useful to replay • Stopwatch • Camera, weight scale,

Equipment
beyond the assessment the task and increases the stopwatch useful but not
sheet. frequency of postural necessary
Required
observations that can be made.
Computer aided applications
increase the ease of assessment.
• Inter-observer reliability has • Inter-observer reliability: Most
been tested in many different agreement between observers
job industries. The reported for wrist/hand posture,
inter-observer reliability is high, wrist/hand movement, back
Measurement
averaging over 90%. Back posture, shoulder/arm posture,
posture is most difficult to shoulder/arm movement. Least
Characteristics distinguish.
Karwowski, W., and Marras,
agreement between back
movement.
W. 1999. OWAS Methods in • Increased reliability when
The Occupational Ergonomics assessment done by practitioners
Handbook. pp 447-459. with work experience.
Upper Limb Assessment – Table B DRAFT 6 7

ManTRA OCRA OWAS QEC REBA

• Procedures are randomly
observed and recorded for a few
seconds. This results in a
summary description of the job.
Li and Buckle, Ergonomics,
1999.
• Action is recommended if : • If the number of actions in a • Two classes of action are
o The exertion score day performed by the upper determined based on postural
was 5 or greater for limbs exceeds the calculated data. The class of action
any body region recommended limit, determined will indicate
o The sum of exertion intervention is required. whether an intervention is
and awkwardness required or not. An action class
• Intra-observer reliability:
Assessment repeated by same
practitioner after 3 weeks. High
reliability in assessing back
posture, back movement,
shoulder/arm movement,
wrist/hand posture. Lower
reliability for wrist/hand
movement, neck posture,
shoulder/arm postures.
Reliability did not change when
assessments done by
practitioners with more
experience.
• The calculated REBA score
corresponds to an action level.
The recommended action may
include ‘action necessary now’.

Information for
was eight or greater of 1 indicates that no
for any region of intervention is required. An
Intervention? the body
o The cumulative risk
action class of 4 indicates
corrective action is needed
score (total of time, immediately.
exertion, Karwowski, W., and Marras,
awkwardness, W. 1999. OWAS Methods in
vibration and The Occupational Ergonomics
repetition) was 15 Handbook. pp 447-459.
or greater.
• Does not propose threshold • This method does not consider • The hand force exertion value is • Heavy focus on posture.
value as a standard. the proportion of time spent somewhat difficult to • No emphasis on the effect of
• Meant to identify jobs that using force or handling a load. determine. frequency and cumulative
require different levels of action Karwowski, W., and Marras, • No limit or guideline is loading.
W. 1999. OWAS Methods in proposed and there are no • Forces evaluator to use
The Occupational Ergonomics intervention instructions. This professional judgment to choose
Handbook. pp 447-459. method is generally used to a representative ‘snapshot’ of
compare before and after. the job

Limitations • It also does not consider

movement frequency or
• The ‘score system’ has not been • This method does not consider
validated through the duration of activity, the
duration, recovery time or epidemiological studies. recovery period or vibration.
vibration. Li and Buckle, Ergonomics, David et al. Occupational
David, Occupational 1999. Medicine, 2005.
Medicine, 2005.
• Posture categories are too broad
to accurately describe all
postures
Li and Buckle, Ergonomics,
1999.
Upper Limb Assessment – Table B
ManTRA
Burgess-Limerich, L.,
Straker, L., Pollock, C.,
Egeskov, R. 2004. Manual
Risk Assessment Tool
(ManTRA) V2.0. School of Ergonomics. 41(9): pp 1290-1311
Human Movement Studies,
The University of Queensland,
Australia. Accessed May
Core Reference 2006.
http://ergonomics.uq.edu.au/
download/mantra2.pdf
OCRA
Occipinti, E. 1998. OCRA: a
concise index for the assessment
of exposure to repetitive
movements of the upper limbs.
DRAFT 6 8
OWAS QEC REBA
Karhu, O., Kansi, P., Kuorinka, I. Guangyan, L., Buckle, P., 1999. Hignett S, and McAtamney L.
1977. Correcting working Evaluating change in exposure to 2000. Rapid Entire Body
postures in industry: A practical risk for musculoskeletal disorders Assessment (REBA). Applied
method for analysis. Applied ~ a practical tool. Prepared by the Ergonomics. 31(1): 201-205.
Ergonomics. 8(4): pp 199 to 201. Robens Centre for Health
Ergonomics, University of Surrey,
for the Health and Safety
Executive.
QEC – Quick Exposure Check on
risks for work-related
musculoskeletal disorders.
Maintained by G. Li in association
with Human Engineering Inc.,
Bristol, UK Accessed May 3, 2006.
http://www.sunderland.ac.uk/~ts0
gli/QEC.html
Upper Limb Assessment – Table B DRAFT 6 9

ManTRA OCRA OWAS QEC REBA

Manual Task Risk Grieco, A. 1998. Application of Burdorf, A., Govaert, G., Elders, Li, G. and Buckle, P., 1998, A David, G. 2005. Ergonomic
Assessment Tool (ManTRA) the concise exposure index L. 1991. Postural load and back practical method for the methods for assessing exposure to
V2.0. Cornell University (OCRA) to tasks involving pain of workers in the assessment of work-related risk factors for work-related
Ergonomics Web. Accessed repetitive movements of the upper manufacturing of prefabricated musculoskeletal risks - Quick musculoskeletal disorders.
May 3, 2006. limbs in a variety of concrete elements. Ergonomics. Exposure Check (QEC). In the Occupational Medicine. 55: pp
http://ergo.human.cornell.edmanufacturing industries: 34(7): 909 to 918. Proceedings of the Human 190-199.
u/cumantra2.htm preliminary validations, Factors and Ergonomics Society
Ergonomics, 41(9): pp 1347-1356. David, G. 2005. Ergonomic 42nd Annual Meeting, October 5-
Straker, L., Burgess- methods for assessing exposure to 9, Chicago, Human Factors and
Limerick, R., et al 2004. A risk factors for work-related Ergonomics Society: 1351-1355.
randomized and controlled musculoskeletal disorders.
trial of a participative Occupational Medicine. 55: pp 190 Li, G., Buckle, P. 1999. Current
ergonomics intervention to to 199. techniques for assessing physical
reduce injuries associated exposure to work-related
with manual tasks: physical Karhu, O. et al. 1981. Observing musculoskeletal risks, with
risk and legislative working postures in industry: emphasis on posture-based
compliance. Ergonomics. Examples of OWAS application. methods. Ergonomics, 42(5): pp
47(2). pp 166-188. Applied Ergonomics. 12(1): pp 13 674 to 695.
to 17.

Hassanzadeh, M., et al. 2003.

Evaluation of Musculoskeletal

Other
Disorders risk factors among the
crew of the ports and shipping
References organization’s vessels. IEA
Ergonomics in the Digital Age,
Seoul Korea.

Karwowski, W., and Marras, W.

1999. OWAS Methods in The
Occupational Ergonomics
Handbook. pp 447 to 459.

Kivi, P., Mattilal, M. 1991.

Analysis and improvement of
work postures in the building
industry: application of the
computerized OWAS method.
Applied Ergonomics. 22(1): pp 43
to 48.

Li, G., Buckle, P. 1999. Current

techniques for assessing physical
exposure to work-related
musculoskeletal risks, with
emphasis on posture-based
methods. Ergonomics, 42(5): pp
674 to 695.
Upper Limb Assessment – Table B DRAFT 6 10

ManTRA OCRA OWAS QEC REBA

Example
Worksheet Worksheet Worksheet
Worksheet Worksheet and Computer Program

Worksheet ManTRA, V2.0 Cornell

University Ergonomics Web.
Occipinti, Ergonomics, 1998. David, Occupational Medicine,
QEC – Quick Exposure Check on Hignett et al. Applied
risks for work-related Ergonomics, 2000.
2005.
musculoskeletal disorders. 2006

Comments