Document Type: Original Articles


1 Department of Ergonomics, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran;

2 Department of Ergonomics, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran;

3 Research Center for Health Science, Shiraz University of Medical Sciences, Shiraz, Iran;

4 Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran;

5 Research Center for Health Sciences, Shiraz University of Medical Sciences, Shiraz, Iran


Background: Proper training on how to correctly handle loads is one key point for prevention of low back disorders. This study was conducted with the objectives of assessing manual material lifting activities and comparing two methods of training intervention in a porcelain company. Methods: In this randomized controlled trial which was conducted in a porcelain company, all male employees with lifting activities (n=204) participated. The data were collected using Nordic Musculoskeletal Disorders Questionnaire and Lift/ Lower Force Risk Assessment software for assessing manual material lifting. Intervention methods included booklet and oral training. Data were analyzed using Mann-Whitney U and Chisquare tests using SPSS software (Version 17.0). Results: The most prevalent musculoskeletal disorders symptoms were reported in the knee (52.5%), feet (45.1%), and lower back (43.6%). Risk assessment before intervention showed that in 62.7% of the workers studied, the level of exposure to musculoskeletal risks was in Action Level (AL) 1, 31.9% in AL 2 and 5.4% in AL 3. The risk assessment after intervention showed that in 77.5% of the workers studied, the level of exposure to musculoskeletal risks was in Action Level (AL) 1, 20.6% in AL 2 and 2% in AL 3 (P<0.001). Also, statistical analysis revealed that oral training (24.5%) was more effective than the booklet training (11.8%) (P=0.018). Conclusion: This study showed that training intervention could be effective in correction of methods of manual material lifting of workers. It seems oral training for workers of porcelain industry is more effective than the booklet training. Trial registration number: IRCT2015050322071N1.


  1. Pinzke S. Automatic registration of OWAS postures
  2. from video film. Proceeding of the Human Factors
  3. and Ergonomics Society Annual Meeting, July 29-
  4. August 4, 2000; California, USA. http://pro.sagepub.
  5. com/content/44/36/529.abstract
  6. Fredericks TK, Kumar AR, Karim S. An ergonomic
  7. evaluation of a manual metal pouring operation. Int J Ind
  8. Ergonom 2008; 38(2): 182-92. http://www.sciencedirect.
  9. com/science/article/pii/S0169814107000388
  10. Kivi P, Mattila M. Analysis and improvement of work
  11. postures in the building industry: application of the
  12. computerized OWAS method. Appl Ergon 1991; 22(1):
  13. -8.
  14. Mattila M, Karwowski W, Vilkki M. Analysis of working
  15. postures in hammering tasks on building construction
  16. sites using the computerized OWAS method. Appl
  17. Ergon 1993; 24(6): 405-12. http://www.sciencedirect.
  18. com/science/article/pii/0003687093901726
  19. Verbeek J, Martimo KP, Karppinen J, Kuijer PP, Takala
  20. EP, Viikari-Juntura E. Manual material handling advice
  21. and assistive devices for preventing and treating back
  22. pain in workers. Occup Environ Med 2012; 69(1): 79-80.
  24. CD005958.pub2/abstract
  25. Martimo KP1, Verbeek J, Karppinen J, Furlan AD,
  26. Takala EP, Kuijer PP, et al. Effect of training and
  27. lifting equipment for preventing back pain in lifting
  28. and handling: systematic review. BMJ 2008; 336(7641):
  29. -31.
  30. Mc Neely A, Beauregard K, Geddie JE. A Guide to Manual Materials Handling and Back Safety.
  31. Occupational Safety and Health Division, N.C.
  32. Department of Labor, 2012.
  33. osha/etta/indguide/ig26.pdf
  34. Danziger J, Dunkle D. Methods of Training in the
  35. Workplace. Center for Research on Information
  36. Technology and Organizations, School of Social
  37. Sciences. University of California, Irvine CA
  38. -4650.
  39. DanzigerDunkle.pdf
  40. Mohammadi Zeidi I, Morshedi H, Mohammadi Zeidi
  41. B. Effectiveness of a Theory-Based Educational
  42. Intervention on Modifying Body Posture of Computer
  43. Users in Iran. JRUMS 2012; 11(2): 145-58. http://journal.
  45. Kaur G. Study and Analysis of Lecture Model
  46. of Teaching. IJEPA 2011; 1(1): 9-13. http://www.
  48. Kuorinka I, Jonsson B, Kilbom A, Vinterberg
  49. H, Biering-Sørensen F, Andersson G, et al.
  50. Standardized Nordic Questionnaires for the analysis
  51. of musculoskeletal symptoms. Appl Ergon 1987; 18:
  52. -7.
  53. pii/000368708790010X
  54. Choobineh AR, Lahmi M, Shahnavaz H, Jazani RK,
  55. Hosseini M. Musculoskeletal symptoms as related
  56. to ergonomic factors in Iranian hand-woven carpet
  57. industry and general guidelines for workstation design.
  58. Int J Occup Saf Ergon 2004; 10(2): 157-68. http://www.
  60. Choobineh A, Tabatabaee S, Behzadi M.
  61. Musculoskeletal problems among workers of an Iranian
  62. sugar - producing factory. Int J Occup Saf Ergon 2009;
  63. (4): 419-27.
  64. /10803548.2009.11076820#.VO9pphCCQTg
  65. Jaap H. Van Dieen and Maury A. Nussbaum. In
  66. Delleman NJ, Haslegrave CM, Chaffin DB, editor:
  67. Working Postures and Movement: Tools for Evaluation
  68. and Engineering. New York; CRC Press; 2004: p. 4, 109.
  69. Waters TR, Putz-Anderson V, Garg A, Fine LJ. Revised
  70. NIOSH equation for the design and evaluation of
  71. manual lifting tasks. Ergonomics. 1993; 36(7): 749-76.
  73. Solhi M, Saki M, Alimohammadi I, Haghani H. The
  74. Effect of Health Education on the Use of Personal Respiratory Protective Equipments based on BASNEF
  75. Model among Workers of Block Carbon Factory in
  76. Ahwaz. IJAST 2013; 3(3): 122-8. http://www.ijastnet.
  77. com/journals/Vol_3_No_3_March_2013/15.pdf
  78. Sadeghi naeini H: The principles of ergonomics
  79. in manual handling systems. 1st ed. Tehran, Asana
  80. publication, 2000.
  81. Habibi E, Gharib S, Shakerian M, Hasanzadeh A.
  82. Musculoskeletal disorders and ergonomics of workers
  83. involved with analyzing the situation manually
  84. carrying goods in the dairy industry. JHSR 2010;
  85. (4): 629-57.
  86. pdf/3001013890406.pdf
  87. Nasl Saraji J, Hajaghazadeh M, Hosseine S, Adl J.
  88. Musculoskeletal Disorders Study in a Construction
  89. Industry Workers. IOH 2007; 4(1): 15-19. http://sjsph.
  91. Snook SH. A Study of Three Preventive Approaches
  92. to Low Back Injury. Jom-J Occup Med 1978;
  93. (17): 153-60.
  94. abstract/1978/07000/a_study_of_three_preventive_
  95. approaches_to_low_back.9.aspx
  96. Marras WS, Allread WG, Burr DL, Fathallah FA.
  97. Prospective validation of a low-back disorder risk
  98. model and assessment of ergonomic interventions
  99. associated with manual materials handling tasks.
  100. Ergonomics 2000; 43(11): 1866-86. http://www.ncbi.
  102. van der Molen HF, Sluiter JK, Hulshof CT, Vink P,
  103. Frings-Dresen MH. Effectiveness of measures and
  104. implementation strategies in reducing physical work
  105. demands due to manual handling at work. Scand J
  106. Work Environ Health 2005; 31(2): 75-87. http://www.
  108. Saremi M, Lahmi M, Faghihzadeh S. The survey
  109. of effect of ergonomics intervention on dentist’s
  110. musculoskeletal disorders. Daneshvar Medicine 2006;
  111. (64): 55-62.
  112. pdf/59513925810.pdf
  113. Mohammadi Zeidi I, Pakpour Hajiagha A, Mohammadi
  114. Zeidi B. Evaluation of Educational Programs Based
  115. on the Theory of Planned Behavior on Employees’
  116. Safety Behaviors. J Mazandaran Univ Med Sci 2013;
  117. (97): 166-77.
  118. php?a_id=1775&sid=1&slc_lang=en