Assessment of Manual Material Lifting and Comparison of Oral and Booklet Training Intervention for Improvement of Working Conditions in a Porcelain Production Industry: A Randomized Controlled Trial

alireza besharati, Ali Ghanbari, Alireza Choobineh, Seyed Hamidreza Tabatabaee, Hadi Daneshmandi


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.


Musculoskeletal diseases, Lifting, Oral, Booklet, Intervention

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Pinzke S. Automatic registration of OWAS postures

from video film. Proceeding of the Human Factors

and Ergonomics Society Annual Meeting, July 29-

August 4, 2000; California, USA. http://pro.sagepub.


Fredericks TK, Kumar AR, Karim S. An ergonomic

evaluation of a manual metal pouring operation. Int J Ind

Ergonom 2008; 38(2): 182-92. http://www.sciencedirect.


Kivi P, Mattila M. Analysis and improvement of work

postures in the building industry: application of the

computerized OWAS method. Appl Ergon 1991; 22(1):


Mattila M, Karwowski W, Vilkki M. Analysis of working

postures in hammering tasks on building construction

sites using the computerized OWAS method. Appl

Ergon 1993; 24(6): 405-12. http://www.sciencedirect.


Verbeek J, Martimo KP, Karppinen J, Kuijer PP, Takala

EP, Viikari-Juntura E. Manual material handling advice

and assistive devices for preventing and treating back

pain in workers. Occup Environ Med 2012; 69(1): 79-80.


Martimo KP1, Verbeek J, Karppinen J, Furlan AD,

Takala EP, Kuijer PP, et al. Effect of training and

lifting equipment for preventing back pain in lifting

and handling: systematic review. BMJ 2008; 336(7641):


Mc Neely A, Beauregard K, Geddie JE. A Guide to Manual Materials Handling and Back Safety.

Occupational Safety and Health Division, N.C.

Department of Labor, 2012.


Danziger J, Dunkle D. Methods of Training in the

Workplace. Center for Research on Information

Technology and Organizations, School of Social

Sciences. University of California, Irvine CA



Mohammadi Zeidi I, Morshedi H, Mohammadi Zeidi

B. Effectiveness of a Theory-Based Educational

Intervention on Modifying Body Posture of Computer

Users in Iran. JRUMS 2012; 11(2): 145-58. http://journal.

Kaur G. Study and Analysis of Lecture Model

of Teaching. IJEPA 2011; 1(1): 9-13. http://www.

Kuorinka I, Jonsson B, Kilbom A, Vinterberg

H, Biering-Sørensen F, Andersson G, et al.

Standardized Nordic Questionnaires for the analysis

of musculoskeletal symptoms. Appl Ergon 1987; 18:



Choobineh AR, Lahmi M, Shahnavaz H, Jazani RK,

Hosseini M. Musculoskeletal symptoms as related

to ergonomic factors in Iranian hand-woven carpet

industry and general guidelines for workstation design.

Int J Occup Saf Ergon 2004; 10(2): 157-68. http://www.

Choobineh A, Tabatabaee S, Behzadi M.

Musculoskeletal problems among workers of an Iranian

sugar - producing factory. Int J Occup Saf Ergon 2009;

(4): 419-27.


Jaap H. Van Dieen and Maury A. Nussbaum. In

Delleman NJ, Haslegrave CM, Chaffin DB, editor:

Working Postures and Movement: Tools for Evaluation

and Engineering. New York; CRC Press; 2004: p. 4, 109.

Waters TR, Putz-Anderson V, Garg A, Fine LJ. Revised

NIOSH equation for the design and evaluation of

manual lifting tasks. Ergonomics. 1993; 36(7): 749-76.

Solhi M, Saki M, Alimohammadi I, Haghani H. The

Effect of Health Education on the Use of Personal Respiratory Protective Equipments based on BASNEF

Model among Workers of Block Carbon Factory in

Ahwaz. IJAST 2013; 3(3): 122-8. http://www.ijastnet.


Sadeghi naeini H: The principles of ergonomics

in manual handling systems. 1st ed. Tehran, Asana

publication, 2000.

Habibi E, Gharib S, Shakerian M, Hasanzadeh A.

Musculoskeletal disorders and ergonomics of workers

involved with analyzing the situation manually

carrying goods in the dairy industry. JHSR 2010;

(4): 629-57.


Nasl Saraji J, Hajaghazadeh M, Hosseine S, Adl J.

Musculoskeletal Disorders Study in a Construction

Industry Workers. IOH 2007; 4(1): 15-19. http://sjsph.

Snook SH. A Study of Three Preventive Approaches

to Low Back Injury. Jom-J Occup Med 1978;

(17): 153-60.



Marras WS, Allread WG, Burr DL, Fathallah FA.

Prospective validation of a low-back disorder risk

model and assessment of ergonomic interventions

associated with manual materials handling tasks.

Ergonomics 2000; 43(11): 1866-86. http://www.ncbi.

van der Molen HF, Sluiter JK, Hulshof CT, Vink P,

Frings-Dresen MH. Effectiveness of measures and

implementation strategies in reducing physical work

demands due to manual handling at work. Scand J

Work Environ Health 2005; 31(2): 75-87. http://www.

Saremi M, Lahmi M, Faghihzadeh S. The survey

of effect of ergonomics intervention on dentist’s

musculoskeletal disorders. Daneshvar Medicine 2006;

(64): 55-62.


Mohammadi Zeidi I, Pakpour Hajiagha A, Mohammadi

Zeidi B. Evaluation of Educational Programs Based

on the Theory of Planned Behavior on Employees’

Safety Behaviors. J Mazandaran Univ Med Sci 2013;

(97): 166-77.



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