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OCRA (The Occupational Repetitive Actions)

methods: OCRA Index and OCRA Checklist
General description and development of the method
OCRA is a synthetic index describing risk factors of repetitive actions at work with one figure. The
OCRA index quantifies the relationship between the daily number of actually performed by the upper
limbs in repetitive tasks, and corresponding number of recommend actions:
OCRA = (total number of technical actions actually performed during the shift) /
(total number of recommended technical actions during the shift).
The number of recommended actions is counted from observed actions multiplied by weights due to
the following conditions: muscle force, posture of the parts of the upper limb, "additional factors",
lack of recovery periods, and the daily duration of the repetitive actions.
A simplified OCRA checklist is aimed to be used as a preliminary screening tool. (Occhipinti 2005)
OCRA methods have been developed in Italy to analyze worker's exposure to tasks featuring various
upper-limb injury risk factors. They are based on a consensus document of the International
Ergonomics Association (IEA) technical committee on musculoskeletal disorders and on the
procedure recommended by the NIOSH for calculating Lifting Index (Occhipinti 2005) (Occhipinti
1998). Method was described first time in literature in 1996 (Occhipinti 1996). OCRA checklist is
simpler and not so accurate than OCRA index. It can be used in risk evaluation to produce the fist
"map of risks".

Exposure descriptors

Description of exposure














(external) force

Muscular effort assessed by

CR-10 Borg scale



Use of vibrating tools

contact forces

Localized compressions on
anatomical structures of the
hand or forearm

Others: exposure to cold, slippery surfaces of objects. Lack of proper recovery periods. Other
"additional factors" are also considered e.g the requirement for extreme precision, the use of
inadequate gloves, required use of rapid or sudden wrenching movements.

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Resource demands and usability

OCRA checlists and OCRA index softwares:
Equipment needed
"Both methods can be carried out using just a pen and paper. The OCRA index method, however,
often requires the use of a video camera that allows films to be viewed in slow motion. Both methods
have specialized software available for loading and processing the data and results" (Occhipinti 2005)

Process of coding and analysis

General approach:
1. Pinpointing the repetitive tasks characterized by those cycles with significant durations
2. Finding the sequence of technical actions in a representative cycle of each task
3. Describing and classifying the risk factors within each cycle
4. Assembly of the data concerning the cycles in each task during the whole work shift,
taking into consideration the duration and sequences of the different tasks and of the
recovery periods

Brief and structured assessment of the risk factors for the job as a whole (exposure or risk

Computing of OCRA index:

Suitable weighting factors are selected for force, postures, "additional factors", and duration.
The factors are multiplied with frequency and duration of each task and summed up to
describe the whole job/task.
Output type/level (risk assessment)
OCRA index

Criteria to help the evaluator to make decision

The method provides an OCRA risk index score which can be compared to three action levels: red (=
risk), yellow (= very low risk), and green (= no risk). (Colombini 2006). New critical values of the
OCRA index were documented in Italian in 2004 and in English 2007 (Occhipinti 2004, Occhipinti

Fields of the working life where the method has been used
Ceramic ornament finishing, auto body sanding, door and window sanding, supermarket check-out,
preserved vegetables packing, auto seta assembly & sewing, meat processing, manual feeding in
ceramic line (Grieco 1998); manufacturing industry (Occhipinti 2007); ironwork industry (Najarkola
2006); toll collectors (Capodaglio 1998); pottery manufacturing (Clerici 2005); industry workers and
cleaners (Colombini 2004); industry workers (d'Angelo 2006, Spigno 2003, Zecchi 1998);
construction workers (Filosa 2005);

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Face validity / Contents validity
Does the method seem to be valid for the aimed purpose?

1. The contents of the method is such that a relevant assessment

can be expected


Comments: Common risk factors for upper limb disorders included

2. Items to be observed have a sound basis

3. Sound operationalization of the items to be observed

Comments: Description of the criteria not very clear


4. Sound process to collect data

Comments: The Index is more complicated and more time
consuming than the Checklist.

5. Sound process to get the output of the collected data

Comments: Multipliers are hypothetical and therefore can include
bias. Counting of index is complex.
6. Output can help in decision making

Concurrent validity
How well does the method correspond with more valid method/s?
1) Comparison of the checklists OCRA, OREGE, Strain Index, ACGIH
(Apostoli 2004) (Italian, English summary)
12 workstations assessed from video
" The comparison revealed variability between the methods in situations of middle risk, while the
methods substantially gave similar results in situations without any risk or with high risk. Methods
could not reveal every component of the risk in a reproducible and univocal way also when the risk
assessment was accordant. It is necessary a following analytical evaluation of each risk factor
contributing to define the sintetic index."
2) Strain Index vs. RULA, REBA, ACGIH TLV, and OCRA (Jones 2007)

NOTE! Estimations of risk level based on data of technical measurements

Comments: It is hard to see the reference methods as more valid method

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"Predictive validity"
How well has the risk-estimation of the method been shown to be associated
with or predicting musculoskeletal disorders (MSDs)?
Prevalence of upper limb disorders compared with OCRA (Occhipinti
2007); (Occhipinti 2004)
There is a high degree of association between OCRA Index and Prevalence of workers with one or
more UL-WMSDs.

Intra-observer repeatability (within observers)

No formal studies

Inter-observer repeatability (between observers)

No formal studies

Strengths of the method
Takes into account recovery periods. Gives an accurate (?) output
OCRA makes it possible to compare different work contexts.
Seems to be a useful tool to design or redesign of the workplace as well as job rotation and
Estimates the workers risk level by considering all the repetitive tasks in a complex job.
The OCRA Checklist is easy and quick to use.
Describes the risks related to exposure in terms of green-yellow-red (easy to understand).

Limitations in the use of the method

Multipliers are hypothetical; description of the criteria unclear; validity and repeatability not
studiedthe user have to assign variable scores for "additional" factors.
The use is time consuming.
The method does not consider psychosocial factors.
OCRA Checklist allows only an estimation of exposures, not a precise risk evaluation.
It needs a well trained observer. The training may take 2-3 days and some talent.

To whom can this method be recommended?

Occupational safety/health practitioners, ergonomists

Apostoli P &al. [Comparative analysis of the use of 4 methods in the evaluation of the biomechanical
risk to the upper limb]. G Ital Med Lav Ergon. 2004;26(3):223-41.
Capodaglio EM &al. [An ergonomic study of postures of toll collectors]. G Ital Med Lav Ergon.
Clerici P &al. [An example of the evaluation of risks of repeated movements in pottery plants located
in western Liguria]. G Ital Med Lav Ergon. 2005;27(2):213-9.

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Colombini D & Occhipinti E. [Results of risk and impairment assessment in groups of workers
exposed to repetitive strain and movement of the upper limbs in various sectors of industry]. Med Lav.
Colombini D & Occhipinti E. Preventing upper limb work-related musculoskeletal disorders (ULWMSDS): new approaches in job (re)design and current trends in standardization. Appl Ergon.
d'Angelo R &al. [Musculo-skeletal disorders and diseases in the complex metal-mechanical industry].
G Ital Med Lav Ergon. 2006;28(2):182-4.
Filosa L &al. [Risks for construction workers: analysis of the upper limb posture]. G Ital Med Lav
Ergon. 2005;27(2):220-34.
Grieco A. Application of the concise exposure index (OCRA) to tasks involving repetitive movements
of the upper limbs in a variety of manufacturing industries: preliminary validations. Ergonomics.
Jones T & Kumar S. Comparison of ergonomic risk assessments in a repetitive high-risk sawmill
occupation: Saw-filer. International Journal of Industrial Ergonomics. 2007;37(9-10):744-53.
Najarkola M. Assessment of risk factors of upper extremity musculoskeletal disorders (UEMSDS) by
OCRA method in repetitive tasks. Iranian J Publ Health. 2006;35(1):68-74.
Occhipinti E. OCRA: a concise index for the assessment of exposure to repetitive movements of the
upper limbs. Ergonomics. 1998;41(9):1290-311.
Occhipinti E & Colombini D. [Proposal of a concise index for the evaluation of the exposure to
repetitive movements of the upper extremity (OCRA index)]. Med Lav. 1996;87(6):526-48.
Occhipinti E & Colombini D. [The OCRA method: updating of reference values and prediction
models of occurrence of work-related musculo-skeletal diseases of the upper limbs (UL-WMSDs) in
working populations exposed to repetitive movements and exertions of the upper limbs]. Med Lav.
Occhipinti E & Colombini D. The occupational repetitive action (OCRA) methods: OCRA index and
OCRA checklis. In: Stanton N, Brookhuis K, Hedge A, Salas E, Hendrick HW, eds. Handbook of
human factors and ergonomics methods. Boca Raton, Florida: CRC Press 2005: 15:1-14.
Occhipinti E & Colombini D. Updating reference values and predictive models of the OCRA method
in the risk assessment of work-related musculoskeletal disorders of the upper limbs. Ergonomics.
Spigno F &al. [Biomechanical risk for the upper limbs: experience at a factory of feeding electric
cables]. G Ital Med Lav Ergon. 2003;25 Suppl(3):159-60.
Zecchi G & Venturi G. [Repetitive movements of the upper extremities: the results of assessing
exposure to biomechanical overload and of a clinical study in a group of workers employed in the
production of plywood and veneer panels]. Med Lav. 1998;89(5):412-23.

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