2012 Symposium on Human Factors and Ergonomics in Health Care


Survey of Anthropometric data collection methods of Indian population for design of proportional medical devices
Meera Ramachandran(1), Sashidharan Komandur(2), Clemson University, Clemson, SC, USA (1), Aalesund University College, Norway (2)

India is a developing country with a growing population of 1.155 billion with 668,131 registered medical practitioners. Owing to the large size of the population it is important to capture sufficient yet quality anthropometric data so that it is valid for use to design ergonomic medical devices suitable for the Indian population. In this paper, various databases were searched to compare data quality for Indian population versus others as captured in Caesar, ANSUR etc. A significantly less level of detail in anthropometric data for Indian population was observed although some of the Indian survey methodologies maybe cost effective. Greater levels of details and accuracy were exhibited by both CAESAR and ANSUR databases. This research proposes that the advantages from these two data bases should be combined to develop an efficient methodology for survey of anthropometric data for large populations such as in India. INTRODUCTION India is a developing country with a growing population of 1.155 billion (Population Reference Bureau [PRB], 2011). For designing devices proportional to the size and capabilities of the population that will use them, relevant anthropometric data need to be considered. Hearne (2004) suggests anthropometrics could be effectively applied to develop ergonomically sound medical devices. There were about 668,131 registered practitioners and about 73,271 dental surgeons in 2007 in India.
Copyright 2012 Human Factors and Ergonomics Society. All rights reserved. 10.1518/HCS-2012.945289401.036

generally employed in studies from India with the sophistication and accuracy of approaches as in Civilian American and European Surface Anthropometry Resource Project (CAESAR) and Anthropometric Survey of U.S. Army Personnel (ANSUR) 1988. BACKGROUND Studies indicate that Indian population is different in different regions (Majumdar, 1951). Stature of Indian population is smaller than other populations (Dewangan et al., 2005). Current status of medical device design for the Indian population is not known in detail (Karan & Mahal, 2009). According to the most recent data from the Annual Survey of Industries, there are more than 972 producers of medical devices in India. Increasing imports of medical devices (Karan & Mahal, 2009) suggests greater need for proportionally designed devices. This is possible only with data from the relevant population. METHOD The anthropometric data collection methods were obtained by searching through various databases like: Google scholar, EBSCOhost, Science Direct, Informa Health, Ingenta Connect, Taylor and Francis, Academic Search Premiere. The selection criteria were: literature published after the year 1989, details about survey methodology, and data from various regions of India. Eleven studies that matched the selection criteria and their aspects compared with CAESAR and ANSUR are tabulated in Figure 1 and Figure 2. It is seen that the number of subjects and number of dimensions measured is very low when compared to CAESAR and ANSUR. The 3-D Scanner can also be used to measure finer measurements. There is a possibility to generalize data from a

There are ergonomically designed dental and laparoscopic devices (Ferranti, 2002) and many studies have proposed a new standard for ergonomic design (Sawyer & Aziz, 1996). Studies have collected a wide variety of anthropometric data, including finer measures such as finger length. However, the applicability of the same raw data for designing medical devices (e.g., hand held devices) for the Indian population is not justifiable. This is mainly because of the inherent differences among the Indian population (Dewangan et al., 2005). The European Commission of Medical Device Design (MDD 93/42/EEC) stipulates that: “Devices must be designed and manufactured in such a way as to remove or minimize as far as is possible the risk of injury, in connection with their physical features, including the volume / pressure ratio, dimensional and where appropriate ergonomic features” (Martin et al., 2005). For example, repetitive stress injuries to the hands, wrists and elbows have become an increasing problem in dental practice (Martin et al., 2008) and have resulted in development of ergonomic dental grip (Ferranti M., 2002). Thus, our study attempts to catalogue various characteristics and tools used to collect data from Indian population and compares it with CAESAR 1999 and ANSUR 1988. The goal is to create a road map to collect a wide variety of anthropometric data to coalesce the low cost approaches

2012 Symposium on Human Factors and Ergonomics in Health Care


specific population to model the entire population optimally by combining the cost effective measures of the techniques used to analyze Indian Population with those of the other populations. RESULTS Figure 1 and Figure 2 indicate the variation of the number of subjects and the number of dimensions, respectively, for both Indian population studies and CAESAR and ANSUR database. Table 1 shows the various aspects of both populations along with the tools used. Also, factors like age with upper and lower limits and gender were taken into account for comparing the studies. Two out of ten studies did not mention the tools used to measure the anthropometric data. The majority of the studies used average accuracy of 0.75mm whereas CAESAR and ANSUR used an accuracy of length measurements to be 0.01mm. Out of ten studies published, only two studies had considered measurements of both genders.

Figure 2: Number of dimensions with studies Table 1: Aspects of Indian anthropometric studies, contrasting CAESAR and ANSUR
S.No 1 2
Studies R. Yadav et al. M.Dwivedi et al. Males 134 N/S Females 0 N/S Year Age lower limit Age Upper limit 1995 2009 3 N/S 60 Tools N/S Anthropometric Device (accuracy =1 mm) Height: Portable studiometer by Nivotise Brivete Depose , France (accuracy = 1 mm) Calibrated digital weighing scale by Soehnle Digital S, Germany (accuracy = 0.1 kg), Fore-arm circumference: flexible plastic tape, Handgrip dynamometers N/S Layout measuring device and ergonomic rig that records which can measure radial, vertical and horizontal coordinates. Also subjective feedback on ease of operation is recorded. Integrated Composite anthropometer (accuracy = 1 mm) and anthropometric scale from SiberHegner & Co., Switzerland Anthropometer (accuracy = 0.25 mm) Integrated composite anthropometer (accuracy = 1mm), grip size measuring device, sliding calipers Anthropometric sliding and spreading calipers, measuring tape, hand grip dynamometer Anthropometer (accuracy = 1mm) ,sliding compass, rod compass Vitus 3-D 1600 whole body scanning system 2-D Templates and 3-D manikins (accuracy= 0.01mm)

3 4 5 6 7 8 9 10

M.Vaz et al. L.P. Gite, B.G. Yadav

613 N/S

411 N/S

2002 2003

5 N/S


Patel et al. K.N. Dewangan et al. Victor et al. Dewangan et al.



2000 2010 2002 2005 18 21 20

N/S 60 48 30

Nag et al. Krishnan et al. CAESAR ANSUR88 N/S= Not specified

0 123 2400 1777

95 123 2400 2221

2003 2007 N/S 1988

N/S 17 18 17 20 65 51

Figure 1: Number of Subjects with number of studies

1 2

DISCUSSION Firstly, while there was much literature available on the survey of anthropometric data for agricultural purposes, studies measuring finer anthropometric details of medical practitioners were not found in significant numbers. Even with the existing literature, accuracy or sophistication levels are known with less certainty and it cannot be concluded whether the data is applicable for the use of medical practitioners. Moreover, there is much less variety in the number of body dimensions measured and number of subjects used when compared to CAESAR and ANSUR data bases. However, one major factor to consider is that there may be tremendous cost advantage in the methods used in the studies to collect anthropometric data. For instance, it is a

2012 Symposium on Human Factors and Ergonomics in Health Care


reasonable conclusion from the description of equipment(s) that studies on Indian population generally used much cheaper equipment - only for an accuracy difference of 0.1 on an average. In order to address the need to be more applicable to a large population, standard sizes from different dimensions could be arrived at by best-fit linear regression, during planning stage of the design. In order to address the need to be more applicable to a large population, standard sizes from different dimensions could be arrived at by best- fit linear regression, during planning stage of the design. The use of the Integrated Composite Anthropometer (ICA) (Dewangan, Owary, & Datta, 2010) is more cost effective than the 3-D scanner used in CAESAR and ANSUR if its accuracy is matched to 1mm. A varied population could be extrapolated by using factor analysis as mentioned in one of the literature (Dwivedi, Shetty, & Nath, 2009). The use of the Integrated Composite Anthropometer (Dewangan, Owary, & Datta, 2010) is more cost effective than the 3-D scanner used in CAESAR and ANSUR if its accuracy is matched to 1mm. Thus, it could be supplemented by the 3-D scanner for a certain sample of the population whose average size is extrapolated from the aforesaid procedure. On the whole, principles like these could be integrated with the techniques like the 3-D Scanning systems to obtain economic and accurate data for any given large population. CONCLUSION There is an urgent need to capture finer details of Indian anthropometric data in order to design ergonomic medical tools for the growing Indian population. Also, for any population, a mix and match approach can be used, where, a small portion of the population data can be captured using low cost equipments (that has been used for Indian population) in combination with the 3D scanning systems (E.g. Body metrics, LLC). As a next step, this could be validated by fitting a regression model between these two data capturing techniques. Finally, by employing these models on data captured from much larger sample sizes- using the low cost equipments, we can simulate the same accuracy at a much lower cost. FUTURE WORK Our primary goal is to predict the dimensions of Indian population from a relationship between existing minimal set of dimensions. By using the techniques mentioned below, the long term goal is to develop a population survey methodology that will not only be accurate but also cost effective. Some of the techniques in which this could be done are: 1. By fitting a regression model for the raw data and predicting dimensions (like stature, determination of sex and other classifications like regions, etc.) by using factor analysis (Dwivedi, Shetty, & Nath, 2009). 2. Fit a regression model between accuracy of measurements and the type of data capturing technique (like an accuracy of the measurement of raw data points using 3-D scanning

techniques, with the accuracy of Integrated Composite Anthropometer, etc). 3. Make an optimal use of 3-D scanning technique in combination with the other techniques in capturing the data for a smaller subset of population to predict the data of a larger subset of population. This could be tested for accuracy and then be extended to other populations if proved to be accurate for Indian population. REFERENCES
Dewangan, K. N., Owary, C., & Datta, R. K. (2010). Anthropometry of male agricultural workers of north-eastern India and its use in design of agricultural tools and equipment. International Journal of Industrial Ergonomics, 40(5), 560-573. doi:10.1016/j.ergon.2010.05.006 Dewangan, K. N., Prasanna Kumar, G. V., Suja, P. L., & Choudhury, M. D. (2005). Anthropometric dimensions of farm youth of the north eastern region of India. International Journal of Industrial Ergonomics, 35(11), 979-989. doi:10.1016/j.ergon.2005.04.003 Dwivedi, M., Shetty, K. D., Dwivedi, M., Shetty, K. D., & Nath, L. N. (2009). Design and development of anthropometric device for the standardization of sizes of knee-ankle-foot orthoses. J Med Eng Technol, 33(1), 87-94. doi:10.1080/03091900701860335 Gite, L. P., & Yadav, B. G. (1989).Anthropometric survey for agricultural machinery design: An Indian case study. Applied Ergonomics, 20(3), 191-196. doi:10.1016/0003-6870(89)90076-8 Hearne, D. (2004). Ergonomically sound medical devices. Medical Device Technology, 15(4), 32-33. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=buh&AN=1358 7889&site=ehost-live Karan, A. K., & Mahal, A. (2009). Diffusion of medical technology: Medical devices in India. Expert Review of Medical Devices, 6, 197+. Retrieved from http://go.galegroup.com/ps/i.do?&id=GALE%7CA223911616&v=2.1& u=clemson_itweb&it=r&p=AONE&sw=w Majumdar, D. N. (1951). Races & cultures of India. Lucknow, U.P.: Universal Publishers. Martin, J. L., Norris, B. J., Murphy, E., & Crowe, J. A. (2008). Medical device development: The challenge for ergonomics. Applied Ergonomics, 39(3), 271-283. doi:10.1016/j.apergo.2007.10.002 Patel, R., Kumar, A., & Mohan, D. (2000). Development of an ergonomic evaluation facility for Indian tractors. Applied Ergonomics, 31(3), 311316. doi:10.1016/S0003-6870(99)00060-5 Sawyer, D., Aziz, K. J., CDRH Work Group (U.S.), & Center for Devices and Radiological Health (U.S.). (1996). Do it by design : An introduction to human factors in medical devices. [Rockville, Md.]: U.S. Dept. of Health and Human Services, Public Health Service, Food and Drug Administration, Center for Devices and Radiological Health. Vaz, M., Hunsberger, S., & Diffey, B. (2002). Prediction equations for handgrip strength in healthy Indian male and female subjects encompassing a wide age range. Annals of Human Biology, 29(2), 131141. doi:10.1080/03014460110058962 Victor, V. M., Nath, S., & Verma, A. (2002). Anthropometric survey of Indian farm workers to approach ergonomics in agricultural machinery design. Applied Ergonomics, 33(6), 579-581. doi:10.1016/S00036870(02)00044-3 Yadav, R., Tewari, V. K., & Prasad, N. (1997). Anthropometric data of Indian farm workers — a module analysis. Applied Ergonomics, 28(1), 69-71. doi:10.1016/S0003-6870(96)00022-1 http://www.rediff.com/money/2008/apr/07panel.htm (Copyright2008 PTI) Annual Survey of Industries (ASI), Government of India http://mospi.nic.in/asi_result_2007_08_tab2_1june10.pdf Ferranti, M. (2002) , U.S. Patent Number : 6,390,818B2, Hampstead, NH (US)

2012 Symposium on Human Factors and Ergonomics in Health Care


CAESAR™- Executive Summary , ©2011 SAE International http://www.sae.org/standardsdev/tsb/cooperative/caesumm.htm The Defense Technical Information Center (DTIC®) –Anthropometric data Sets (Last modified: 06/21/11) http://www.dtic.mil/dticasd/docs-a/anthro_military.html Population Reference Bureau. (2011). Retrieved from http://www.prb.org/pdf11/2011population-data-sheet_eng.pdf

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