International Journal of Occupational Safety and

Ergonomics

ISSN: 1080-3548 (Print) 2376-9130 (Online) Journal homepage: https://www.tandfonline.com/loi/tose20

An empirical comparison of OWAS, RULA and REBA

based on self-reported discomfort

Dohyung Kee

To cite this article: Dohyung Kee (2020): An empirical comparison of OWAS, RULA and REBA
based on self-reported discomfort, International Journal of Occupational Safety and Ergonomics,
DOI: 10.1080/10803548.2019.1710933

To link to this article: https://doi.org/10.1080/10803548.2019.1710933

Accepted author version posted online: 16

Jan 2020.

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Publisher: Taylor & Francis & Central Institute for Labour Protection – National Research Institute (CIOP-PIB)

Journal: International Journal of Occupational Safety and Ergonomics

DOI: 10.1080/10803548.2019.1710933

An empirical comparison of OWAS, RULA and REBA based on self-reported discomfort

Dohyung Kee†

Department of Industrial Engineering, Keimyung University, Korea

†
Corresponding author

dhkee@kmu.ac.kr
Acknowledgement

This work was supported by the Ministry of Education of the Republic of Korea and the National
Research Foundation of Korea (NRF-2017R1D1A1B03028532).

Abstract

This study aimed to compare three observational techniques of Ovako Working posture Analysis
System (OWAS), Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA)
based on whole-body discomfort. Fifteen college students participated in the experiment measuring
discomfort. Hand height and distance, and external load were used as independent variables. The
results showed that while just two independent variables of the hand height and distance significantly
affected the OWAS action category, all three independent variables including external load were
significant on the discomfort, RULA grand, and REBA scores. The grand score was more linearly
correlated to the discomfort, compared to the OWAS action category and REBA score. RULA
generally assessed postural loads for the postures tested more highly than OWAS and REBA. Based
on these findings, it was concluded that of the three methods, RULA may be the best for estimating
postural stress under the conditions of this study.

Keywords: work-related musculoskeletal disorders; observation technique; discomfort; OWAS;

RULA; REBA

1. Introduction

In Korea, 5,195 cases of work-related musculoskeletal disorders (WMSDs) were reported in 2017,
accounting for about 57% of occupational diseases [1]. WMSDs are developed and aggravated by
varying risk factors, classified into three categories: physical, psychosocial and individual [2,3].
During the 1980s, the emphasis in ergonomic epidemiology was moved to the physical factors from
the individual factors [3]. Several epidemiological studies identified static posture, manual handling,
repetitive work, vibration, and others as physical risk factors [4,5,6]. A number of researchers have
pointed out that poor body posture is an important contributing factor to WMSDs [7-11].

Assessing exposure to these risk factors is essential in the management and prevention of WMSDs
[12]. A number of methods for quantifying exposure to the risk factors, especially postural loads, have
been developed and used, which are categorized into three: self-reports, observational methods and
direct measurements [12,13]. The precision of the data gathered from workers and the interference
with workers being assessed increased from the self-reports to the direct measurements [12]. The
observational techniques are more widespread in industry because (1) they do not interfere with job
processes; (2) do not require the use of expensive equipment for measuring the angular deviation of a
body segment from the neutral position; (3) are user-friendly, applicable and repeatable in various
conditions; and (4) have higher validity and lower subjectivity than the self-reports such as worker
diaries, interviews, and questionnaires [4,13,14].

A few studies summarized and simply compared the existing observation techniques in varying view
points including scales for posture classification, main functions, correspondence with valid reference,
association with WMSDs, repeatability between observers, potential users, ergonomic experts’
evaluation, exposure factors assessed such as postures or body regions, load/force, movement
frequency, duration, recovery, and vibration, etc. [4,12,13,15,16,17]. Burdorf et al. [18] compared
back bending movements collected by an Ovako Working posture Analysis System (OWAS) [19]
(>20o) to those by inclinometer recordings, and found a significant correlation between the two
methods in the time spent in forward flexion of the back, during both sedentary and dynamic work.
Burdof [20] showed that the average time spent working with a bent and/or twisted back position,
measured by the OWAS, contributed to the prevalence of back pain. Takala et al [21] evaluated
several observational methods for manual materials handling and assessing workload on the upper
limbs and whole body in terms of correspondence with valid reference, association with WMSDs,
repeatability between observers and potential users. Kong et al. [16] compared agricultural lower limb
assessment (ALLA) [22], OWAS, Rapid Upper Limb Assessment (RULA) [23] and Rapid Entire
Body Assessment (REBA) [24] on the basis of 16 ergonomic experts’ evaluation results. Yazdanirad
et al. [25] compared the effectiveness of three ergonomic risk observation techniques including
RULA, Loading on the Upper Body Assessment (LUBA) [26] and Novel ERgonomic Posture
Assessment (NERPA) [27] to predict upper extremity musculoskeletal disorders. The study reported
that of the three methods, RULA was the best for assessing WMSDs. Kee and Karwowski [28]
compared OWAS, RULA and REBA in terms of the distribution of postural loading scores by
techniques, and inter-technique reliability (coincidence rate), based on analyses of 301 postures taken
from varying industries. The comparison revealed that compared to RULA, OWAS and REBA
generally underestimated postural loads for the analyzed postures, irrespective of industry, work type,
and whether the body postures were in a balanced state.

For choosing a specific observation method and, in turn, precisely quantifying postural stress, a
comparative study for observation methods to investigate the relationship between physical exposures
and their corresponding scores measured by the observation techniques is needed. However, it is very
sparse as stated above. Of the studies mentioned above, the comparisons by Kong et al. [16], and Kee
and Karwowski [28] alone examined the relationship, but were confined to lower extremity postures
occurring in agricultural tasks or only based on relative distribution of postural scores assessed using
the three techniques without any comparison criterion. Therefore, this study aimed to compare and
evaluate three observation techniques of OWAS, RULA and REBA, based on a comparison criterion
of perceived whole-body discomfort. Of several observational methods, OWAS, RULA and REBA
were chosen for this study because they have been widely used in industry, applied to many case
studies, and cited more frequently in relevant studies [13,15,16,17,29-36]. For empirical comparison,
an experiment measuring perceived whole-body discomfort according to hand position and external
load was conducted.

1.1 OWAS, RULA and REBA

OWAS technique was developed by a Finnish steel company of Ovako Oy [19]. The method was
based on ratings of working postures taken in several divisions of the steel factory performed by 32
experienced steel workers and international ergonomists. OWAS identifies four work postures for the
back, three for the arms, seven for the lower limbs, and three categories for the weight of load handled
or amount of force used. The technique classifies combinations of these four categories by the degree
of their impact on the musculoskeletal system for all posture combinations. The degrees of the
assessed harmfulness of these posture–load combinations are grouped into four action categories,
which indicate the urgency for the required workplace interventions:

 action category 1: normal postures, which do not need any special attention;
 action category 2: postures must be considered during the next regular check of working
methods;
 action category 3: postures need consideration in the near future;
 action category 4: postures need immediate consideration.

RULA was proposed to provide a quick assessment of the loading on the musculoskeletal system due
to postures of the neck, trunk, and upper limbs, muscle function, and external loads exerted. Based on
the grand score of its coding system, four action levels, which indicate the level of intervention
required to reduce the risks of injury due to physical loading on the worker, were suggested [23]:

 action level 1: posture is acceptable;

 action level 2: further investigation is needed and changes may be needed;
 action level 3: investigation and changes are required soon;
 action level 4: investigation and changes are required immediately.

REBA is a postural analysis system sensitive to musculoskeletal risks in a variety of tasks, especially
for assessment of working postures found in health care and other service industries. The posture
classification system, which included the upper arms, lower arms, wrist, trunk, neck, and legs, was
based on the body part diagrams from RULA. The method reflected the extent of the external
load/forces exerted, muscle activity caused by static, dynamic, rapid changing or unstable postures,
and coupling effect. Unlike OWAS and RULA, this technique provided five action levels for
evaluating the level of corrective actions [24]:

 action level 0: corrective action including further assessment is not necessary;

 action level 1: corrective action including further assessment may be necessary;
 action level 2: corrective action including further assessment is necessary;
 action level 3: corrective action including further assessment is necessary soon;
 action level 4: corrective action including further assessment is necessary now.

2. Methods
2.1 Participants
Fifteen healthy male college students without a history of musculoskeletal disorders voluntarily
participated in the experiment, where the whole-body discomfort was measured depending upon hand
positions and external loads. Their demographic data are as follows: age – 21.3 ± 1.80 years; stature –
175.3 ± 5.88 cm; arm reach - 64.1 ± 3.70 cm; shoulder height - 145.5 ± 5.54 cm; and body weight –
75.5 ± 12.31 kg. All participants were right-handed and paid for participating.

2.2 Experimental design

Hand position and external load were adopted as independent variables. Hand position was
determined by two relative parameters as described by Miedema et al. [36]: percentage of arm reach
(i.e., hand distance) and percentage of shoulder height (i.e., hand height). Arm reach (AR) was
defined as the maximum horizontal distance from the tip of the middle finger to the wall when the
subject stood upright with his back against the wall. Shoulder height (SH) was defined as the vertical
distance from the floor to an acromion in the upright position (Figure 1).

In this study, three levels of the hand distance (AR 40%, AR 70%, and AR 100%) and four levels of
the hand height (SH 30%, SH 65%, SH 100%, and SH 120%) were chosen (Figure 1). These hand
positions were designed to include almost all of the work spaces found in real workshops. Four levels
of the external load weight (0.0kg, 1.0kg, 3.0kg, and 5.0kg) were employed. Three dumbbells (1.0kg,
3.0kg and 5.0kg) were used for the external load. The weight of the external load was chosen on the
basis of actual weights of the hand tools frequently used in industrial sites (<3.0kg) [38,39] and the
participants’ capabilities to endure the load in the experiment. Following the experimental design, a
total of 48 experimental treatments were conducted for every participant.
 120

100

% shoulder height
65

30

40 70 100
% arm reach

Figure 1. Experimental postures

The dependent variable was whole-body discomfort, measured by the Borg CR10 [39]. The scale was
taught to the participants before the experiment, and made available for reference whenever necessary
during the experiment.

2.3 Experimental procedures

Prior to the experiment, the participants were informed of its purpose, procedures and potential risks
involved in a 10 min training session, and an informed consent was obtained. Anthropometric
dimensions including stature, arm reach, shoulder height, and body weight were measured. The entire
experiment was conducted in the laboratory with good ventilation and light at around 20oC. The
experimental protocol was examined and approved by the Institutional Review Board of the author’s
university.

In the experiment, the participants were asked to assume and maintain the given experimental
postures for 60 s with the aid and instruction of the experimenter. The participants were allowed to
drop out at any time if they could not hold the given postures for 60 s or felt at risk of personal injury
during the experiment. After 60 s, the participants were required to rate their perceived whole-body
discomfort for the given experimental treatments with the Borg CR10. The pointer of the iron bar was
used to ensure that the participants put their right hand on the hand position designated according to
the experimental treatments. The experimental treatments were presented in a random order for each
participant. All postures were photographed for the following analyses, an example of which is
illustrated in Figure 2.

All participants were allowed enough rest periods of at least 2 min between the experimental trials,
which was based on the standardized procedures for measuring static strengths giving rest between
exertions from 30 s to 2 min [40]. During the rest periods, the participants took a rest in a comfortable
posture such as sitting on a chair. For reducing fatigue effect, each participant attended two
consecutive sessions on two separate days for a total of 3.5-4.0 h. Each experimental session consists
of 24 experimental treatments. Each session followed three or more warm-up tests for new postures
not used in the experimental conditions.

Figure 2. An example of experimental postures

2.4 Data analysis

Firstly, the author assessed postural loads for the 48 experimental postures on the pictures taken
during the experiment by using OWAS, RULA and REBA classification schemes, for producing
comparison criteria for the three schemes. This resulted in three postural load scores for each posture:
an action category for OWAS, a grand score for RULA and a REBA score. The OWAS action
category is basically an ordinal scale, but applied to quantitative statistical analysis assuming an
interval scale like the grand and REBA scores for comparing the three techniques.

Secondly, analysis of variance (ANOVA) was performed to investigate the statistical significance of
the independent variables on the whole-body discomfort measured with the Borg CR10 and three
postural load scores. Thirdly, the pairwise t-test was adopted for comparing the sizes of the RULA
grand and REBA scores. Fourthly, the relationship between three postural scores, discomfort and
biomechanical measures of the percent capables at the shoulder and trunk was analyzed by plotting
three postural load scores with respect to discomfort levels, the correlation and linear regression
analyses. The analysis was performed for investigating the relationship between three postural load
scores by the three techniques and other load scores including the whole-body discomfort and the
percent capables. The biomechanical measures were obtained by 3DSSPP version 4.2(University of
Michigan, USA) and used for showing that the subjective discomfort was correlated with the
objective biomechanical measures, i.e., discomfort can be used as a criterion for assessing postural
loads. The percent capable is the percentage of the population with the strength capability to generate
a moment at the corresponding joints larger than the resultant moment for a given posture and
external load, which is calculated by entering participant’s anthropometric data and body segment
angles for a posture into 3DSSPP.

Fifthly, the three observational techniques were compared using the scale of action levels or risk
categories by the techniques. Each technique has its own scale of action levels or risk categories that
guides the risk level and the urgency indication to enable more detailed assessments and
improvements [23,24]. OWAS and RULA classify postural loads for the urgency of corrective actions
into four action categories and action levels, respectively, the meanings of which are similar. REBA
groups postural loads into five action levels, which have slightly different meanings from the action
categories/levels of OWAS/RULA. To enable an effective comparison, the five REBA action levels
were regrouped into four categories with consideration of the meanings of the action categories/levels
for these three techniques. The four new REBA action levels were as follows: action level 1
(originally action level of 0), 2 (originally action levels of 1 and 2), 3 (originally action level of 3) and
4 (originally action level of 4). The comparison results were statistically tested by the Wilcoxon sign
test.
Finally, the three techniques were generically compared in terms of the assessment factors, body parts
evaluated and risk category, based on the literatures dealing with the techniques’ development
processes. The data analyses procedure and techniques are illustrated in Figure 3. All analyses were
conducted using SAS version 9.4(SAS Inc., USA) and Microsoft Excel 2010(Microsoft Co., USA).

Figure 3. Procedure for data analyses. Note: ANOVA = ANalysis Of VAriance.

3 Results

3.1 Significances of independent variables

ANOVA (analysis of variance) was performed separately for the whole-body discomfort and each
observational technique (Table 1). In the ANOVA, the action category, grand score, and REBA score
were used as dependent variables for OWAS, RULA and REBA, respectively. ANOVA of OWAS for
interaction effects could not be performed because the sum of squares for the model’s error and
external load were 0.0 in cases including the interactions in the ANOVA model. This was attributed to
the insensitivity of OWAS with respect to the external load (See Figure 3). The results showed that the
hand height, hand distance, external load, and two interactions of hand height and external load, and
of hand distance and external load affected significantly on the whole-body discomfort at α = 0.01,
while an interaction of hand height and hand distance did not. For OWAS, the hand height and hand
distance were significant on the action category at α = 0.01, whereas the external load was not.

For RULA, the simple effects of the hand height, hand distance and external load, and two
interactions of hand height and hand distance, and of hand height and external load were significant
on the grand score at α = 0.01, while an interaction of hand distance and external load was not
significant. In the ANOVA of REBA, three simple effects and two interactions of hand height and
hand distance, and of hand height and external load showed significant effects on the REBA score at α
= 0.01, while an interaction of hand distance and external load did not.

Table 1. Results of ANOVA

Dependent Source df MS F value p
variable
Discomfort Hand height(SH) 3 9.28 105.15 <0.01
Hand distance(AR) 2 11.55 130.84 <0.01
External load(L) 3 87.21 987.77 <0.01
SH x AR 6 0.20 2.27 0.08
SH x L 9 2.53 28.62 <0.01
AR x L 6 1.11 12.57 <0.01
OWAS action Hand height(SH) 3 11.00 214.50 <0.01
category Hand distance(AR) 2 0.33 6.50 <0.01
External load(L) 3 0.00 0.00 1.00
SH x AR 6 - - -
SH x L 9 - - -
AR x L 6 - - -
RULA grand Hand height(SH) 3 8.31 81.55 <0.01
score Hand distance(AR) 2 1.58 15.55 <0.01
External load(L) 3 17.36 170.45 <0.01
SH x AR 6 0.47 4.64 <0.01
SH x L 9 0.55 5.36 <0.01
AR x L 6 0.03 0.27 0.94
REBA score Hand height(SH) 3 5.41 260.00 <0.01
Hand distance(AR) 2 6.27 301.00 <0.01
External load(L) 3 1.27 61.00 <0.01
SH x AR 6 1.34 38.60 <0.01
SH x L 9 0.08 4.00 <0.01
AR x L 6 0.02 1.00 0.46
-: ANOVA is impossible.
Notes: ANOVA = analysis of variance; OWAS = Ovako Working posture Analysis System; REBA = Rapid
Entire Body Assessment; RULA = Rapid Upper Limb Assessment.
3.2 Effects of independent variables

The OWAS action category slightly decreased as the hand height increased (Figure 4 (a)). The RULA
grand and REBA scores showed very similar trends; they decreased from SH 30% to SH 65%, and
increased from SH 65%. The pairwise t-test revealed that the grand score was statistically larger than
the REBA score (p< 0.01). Like the grand and REBA scores, the whole-body discomfort also
decreased to SH 65%, and increased from the hand height of SH 65%.

The OWAS action categories were almost identical irrespective of the hand distance. The discomfort,
grand and REBA scores increased linearly with the hand distance (Figure 4 (b)).

The discomfort almost linearly increased with the external load. However, the OWAS action
categories were the same irrespective of the external load. RULA produced the same grand scores at
0.0 and 1.0kg, and at 3.0 and 5.0kg of the external load, respectively. The REBA scores were identical
at lighter external loads of ≤3kg (Figure 4 (c)).
(a)

7.0
Discomfort OWAS RULA REBA
Discomfort and postural

6.0

5.0

4.0
load

3.0

2.0

1.0

0.0
30 65 100 120
Hand height (%)

(b)

6.0
Discomfort OWAS RULA REBA
Discomfort and postural

5.0

4.0
load

3.0

2.0

1.0

0.0
40 70 100
Hand distance (%)
(c)

9.0
Discomfort OWAS RULA REBA
8.0
Discomfort and postural

7.0
6.0
5.0
load

4.0
3.0
2.0
1.0
0.0
0 1 3 5
External load (kg)

Figure 4. Relationships between discomfort and postural loads and independent variables: (a) Hand
height; (b) Hand distance; (b) External load. Notes: OWAS = Ovako Working posture Analysis
System; REBA = Rapid Entire Body Assessment; RULA = Rapid Upper Limb Assessment.

3.3 Relationships between discomfort and postural loads

The relationships between the whole-body discomfort and the three postural loads assessed by the
three observation techniques are illustrated in Figure 5. The Pearson correlation coefficients between
the discomfort, three postural loads and two objective biomechanical measures of the percent capables
at the shoulder and trunk are shown in Table 2. These suggested that while the action categories by
OWAS were negatively related to the discomfort (r = -0.151), the grand and REBA scores were a little
positively proportional to it (r = 0.554 and 0.379, respectively). The whole-body discomfort was
negatively linearly related to the objective measures of the percent capables at the shoulder and trunk
(r = -0.798 and -0.622, respectively).

The postural loads by OWAS, RULA and REBA were somewhat linearly correlated to each other with
correlation coefficients ranged from 0.415 to 0.482. The postural loads were lowly correlated with the
percent capable at the shoulder. Although the postural load should be negatively correlated to the
percent capable, the OWAS action category was positively related to the percent capable at the
shoulder. While RULA grand and REBA scores were a little highly correlated with the percent
capable at the trunk, the correlation coefficient between the OWAS action category and the percent
capable at the trunk was not high (r = -0.395).

The linear regression analyses also showed similar tendencies to the above (Table 3). The linear
model for OWAS was not significant, while four linear models for RULA, REBA and two percent
capables were highly significant (p<0.01). Of them, the model for the percent capable at the shoulder
had the largest R2 of 0.64, and compared to OWAS and REBA, the model for RULA showed larger R2
of 0.42.

8.0

7.0

6.0
Postural load

5.0
OWAS
4.0
RULA
3.0
REBA
2.0

1.0

0.0
0.0 2.0 4.0 6.0 8.0 10.0 12.0
Discomfort

Figure 5. Relationships between discomfort and postural loads. Notes: OWAS = Ovako Working posture
Analysis System; REBA = Rapid Entire Body Assessment; RULA = Rapid Upper Limb Assessment.

Table 2. Pearson correlation coefficients

Dependent OWAS action RULA grand REBA score Percent capable at
variable category score shoulder trunk
Discomfort -0.151 0.554* 0.379* -0.798* -0.622*
OWAS action - 0.482* 0.435* 0.289 -0.395*
category
RULA grand - - 0.415* -0.242 -0.591*
score
REBA score - - - -0.272 -0.609*
*: significant at α = 0.01.
Notes: OWAS = Ovako Working posture Analysis System; REBA = Rapid Entire Body Assessment; RULA =
Rapid Upper Limb Assessment.
 Table 3. Linear models for OWAS, RULA and REBA
Independent variable Equation R2
OWAS action category Discomfort = 5.122 – 0.470 x action category 0.02
RULA grand score Discomfort = -2.328 + 1.267 x grand score* 0.42
REBA score Discomfort = -0.085 + 1.260 x REBA score* 0.20
% capable at shoulder Discomfort = 184.47 - 1.817 x % capable* 0.64
trunk Discomfort = 105.63 - 1.035 x % capable* 0.39
*: significant at α = 0.01.
Notes: OWAS = Ovako Working posture Analysis System; REBA = Rapid Entire Body Assessment; RULA =
Rapid Upper Limb Assessment.

3.4 Comparisons by action level scales

The distribution of the action categories by OWAS with respect to the action levels by RULA is
presented in Figure 6 (a). The OWAS action categories were the same as the RULA action levels for
eight postures (two action categories/levels of 2 and six action categories/levels of 3), while the
categories for the remaining 40 postures were lower than the corresponding levels. The inter-
technique reliability (coincidence rate) was just 16.7%. The Wilcoxon sign test also showed that
OWAS significantly underestimated the postural loads compared to RULA (p<0.01).

REBA identically rated the loads for all 48 postures as the action level 2, while OWAS assessed the
loads for 32 postures as the action category 1, for four postures as the action category 2, and for 12
postures as the action category 3 (Figure 6 (b)). The coincidence ratio was just 8.3%. The Wilcoxon
sign test results suggested that OWAS relatively underestimated the postural risk levels compared to
REBA (p<0.01).

RULA assessed the postural stress for 18 postures as the action level of 2, for 22 postures as the action
level of 3, and for 8 postures as the action level of 4 (Figure 6 (c)). This revealed that compared to
RULA, REBA generally underestimated the postural loads for 30 postures used in the experiment,
which was statistically supported by the Wilcoxon sign test (p<0.01). The inter-technique reliability
was 33.3%.
(a)

18
Action category 1
16
Action category 2
14
Action category 3
12
Frequency

Action category 4
10
8
6
4
2
0
Action level 1 Action level 2 Action level 3 Action level 4
RULA

(b)

35
Action category 1
30
Action category 2
25 Action category 3
Frequency

20 Action category 4

15

10

0
Action level 1 Action level 2 Action level 3 Action level 4
REBA
(c)

25
REBA Action level 1
REBA Action level 2
20
REBA Action level 3
Frequency

REBA Action level 4

15

10

0
Action level 1 Action level 2 Action level 3 Action level 4
RULA

Figure 6. Distribution of action categories/levels by technique: (a) OWAs and RULA; (b) OWAS and
REBA; (c) RULA and REBA. Notes: OWAS = Ovako Working posture Analysis System; REBA
= Rapid Entire Body Assessment; RULA = Rapid Upper Limb Assessment.

3.5 Generic comparisons

The generic comparisons are summarized in Table 4. While OWAS has only two assessment factors of
the posture and force/external load, RULA and REBA evaluate the posture and force/external load as
well as the repeated and static posture effects. Furthermore, REBA reflects the coupling and dynamic
loading effects. OWAS does not specify the body parts assessed, but RULA and REBA evaluate only
the left or right side at a time. The three observational methods are equipped with the 4 or 5 action
categories or levels for deciding the risk category [19,23,24].

Table 4. Results of generic comparisons

Technique Assessment factor Body part Risk
Posture Force/ Repeti- Static Dyna- Coup- assessed cate-
External tion action mic ling gory
load loading
OWAS Back, 3 X X X X Not 4
arms, categorie specified action
legs s cate-
 gories
RULA Upper 4 O O X X Right or 4
arms, categorie left side action
lower s levels
arms,
wrist,
neck,
trunk, leg
REBA Upper 3 O O O O Right or 5
arms, categorie left side action
lower s(+ 1 levels
arms, adjusting
wrist, factor)
neck,
trunk, leg
O: included; X: not included.
Notes: OWAS = Ovako Working posture Analysis System; REBA = Rapid Entire Body Assessment; RULA =
Rapid Upper Limb Assessment.

4. Discussion

Although there is no generally accepted standard way to systematically compare or evaluate the
techniques [21], the observation techniques for assessing the postural workloads can be compared or
evaluated in varying view points, including epidemiological data of association with WMSDs,
repeatability between observers, subjective measure of discomfort, objective biomechanical measures
such as posture maximum holding time, torque at joints, etc. Of these, this study compared three
representative observation methods based on subjective discomfort rather than objective measures
such as biomechanical stress, epidemiological data, etc., but it is supported by the findings of previous
studies, which suggested that 1) discomfort is a valid measure of postural load [42,43]; 2) minimizing
of discomfort can contribute to reducing the risk of musculoskeletal disorders [44]; 3) discomfort can
be considered an independent evaluation criterion for static postures [44]; and 4) discomfort is easy to
use and versatile to assess the postural stresses [45]. This study also revealed that the subjective
discomfort used as a criterion for comparison was linearly related to the objective biomechanical
measures of the percent capables at the shoulder and trunk (Table 2 and 3). These may justify this
study to compare observational techniques mainly based on the subjective discomfort, not on the
objective biomechanical measures or epidemiological data. However, further comparative researches
based on objective measures are needed for obtaining more reliable comparison results.

This study showed that while the three independent variables including the hand height, hand distance,
and external load significantly affected the RULA grand and REBA scores, only two independent
variables of the hand height and distance were significant on the OWAS action category (Table 1).
The trend of the grand scores against the hand height was almost the same as that of the REBA scores
except for their sizes of postural loads, which was similar to that of discomfort. However, the OWAS
action categories decreased with the hand height, the trend of which was very different from the two
postural load scores by RULA and REBA, and discomfort. The trends of the grand and REBA scores
with respect to the hand distance were also similar to the trend of discomfort, but the trend of the
OWAS action category was slightly different from that of discomfort. In addition, the subjective
discomfort was linearly related to the objective biomechanical measures such as the percent capables
at the shoulder and trunk, which means that the discomfort can be used as a valid measure for postural
loads instead of biomechanical stress. The above implies that compared to OWAS, RULA and REBA
may reflect the effects of the hand height and distance more precisely in postural load assessments
under the conditions adopted in the experiment of this study. Furthermore, OWAS has some inherent
limitations that it does not consider the posture repetition, static or dynamic loading and coupling,
does not assess the joint motions of the neck, elbow and wrist, and does not separate the left or right
body parts being evaluated, and so on (Table 4).

While the external load was the most significant factor on the whole-body discomfort, it was not
significant on the OWAS action category (Table 1). This is not in agreement with the previous studies
[46,47], which showed that exertion or external load was the most significant factor on discomfort.
This may be attributed to the fact that OWAS crudely classifies external load into three categories:
<10kg, 10-20kg, and >20kg. The external loads of ≤5kg used in the experiment were classified into
the same group of <10kg, which resulted in the same OWAS force/external load code of 1.
Consequently, this produced the mean square of 0.0 for the external load in ANOVA; thus, performing
ANOVA that included external load and its interactions was impossible. Similarly, RULA and REBA
categorized the external load used in the experiment into two groups: 0.0, 1.0kg and 3.0, 5.0kg; and
0.0, 1.0, 3.0kg and 5.0kg, respectively. The categorization brought about two muscle use scores by
RULA of 0 and 2 (averaged RULA grand scores by external load of 4.25 and 6.33), and two
load/force scores by REBA of 0 and 1 (averaged REBA scores by external load of 3.33 and 4.17)
(Figure 4(c)). This led to the significance of the external load for RULA and REBA in ANOVA.

During the experiment, 11 participants gave up performing 36 trials for 10 experimental treatments
because they could not hold the given postures for 60 s or felt at risk of injury. The external loads for
the treatments were 3.0kg in three treatments and 5.0kg in seven treatments. The average discomfort
scores for the treatments ranged from 6.71 to 10.71 (very strong to extremely strong discomfort in
Borg CR10’s verbal anchor), and the grand scores were 6 or 7(action level of 4). On the other hand,
the OWAS action categories were 1 or 2 (nine had the action category of 1 and one had the action
category of 2), and the REBA scores were 3 to 5 (action level of 2). In other words, RULA estimated
the postural loads for all the 10 treatments with the action level of 4, indicating the highly strained
postures that investigation and changes are required immediately. On the contrary, OWAS and REBA
underestimated the treatments at the action category of 1 or 2, and the action level of 2, respectively,
which corresponds to the postures without high stress that any special attention or corrective actions
are not needed or must be considered during the next regular checks of the working methods.
Although it can be interpreted on the basis of participants’ giving up and the size of the whole-body
discomfort that the 10 treatments are too stressful for the participants to hold for 60 s, OWAS and
REBA did not estimate the postural stress for the treatments that highly. Accordingly, OWAS and
REBA may be problematic in this view point.

When transforming the REBA scores into the indices of acceptability or risk category, REBA
identically assessed the postural stresses for all 48 experimental treatments with the action level of 2.
This means that the risk level is so medium that any corrective actions are not necessary soon or
immediately. In other words, REBA has a tendency to underestimate the postural loads for the 48
experimental treatments irrespective of actual stress, compared to RULA. In addition, the pairwise t-
test and Wilcoxon sign test showed that RULA assessed the postural loads for the 48 experimental
treatments more highly than the other two methods. This agrees with the findings by Kee and
Karwowski [28], which reported that compared to RULA, OWAS and REBA generally
underestimated postural loads, irrespective of industry, work type and whether or not the body
postures were in a balanced state. In the safety field, it may be more desirable to estimate certain
postures or tasks in industry more stressful for preventing WMSDs, rather than to assess them less
stressful. Accordingly, it may be considered that RULA is better suited for assessing postural loads
under the experimental conditions of this study.

OWAS, RULA and REBA’s scoring or coding systems were not based on experimental results or
objective measures such as biomechanical stress, epidemiological data, etc., but rather relied on the
rankings provided by ergonomists, occupational therapists, occupational physiotherapists, etc., using
the biomechanical and muscle function criteria, or the subjective rankings assessed by the experienced
steel workers and international ergonomists [19,23,24]. This may result in lower correlation
coefficients of the postural loads by OWAS, RULA and REBA with the whole body discomfort as
well as the biomechanical measures of the percent capables (Table 2).

Although many participants including male and female should be involved in the experiment for more
reliable comparison results, just 15 male college students participated in the experiment. However, it
may be backed by a previous study. Kee [48] showed that while the discomfort levels of female
subjects for the joint motions were larger by about 28% than those of males (p<0.01), the two
discomfort levels were highly positively related (r = 0.908).

Of varying comparison criteria, this study was based on the subjective discomfort scores measured for
the 15 male participants, the symmetrical postures assumed in the sagittal plane with external load of
≤5kg, and the balanced postures where the body weight were evenly distributed on two legs and feet
in a laboratory. So, it should be noted that the results are used and interpreted with caution. Further
research for overcoming the problems may be required.

5. Conclusions

Though RULA had not very high correlation coefficients with the whole-body discomfort and percent
capables, and does not evaluate the risk factors of the dynamic loading, duration, coupling, vibration,
etc., RULA may be thought to be better for assessing the postural loads among the three methods
under the conditions of this study, because (1) the RULA grand score more closely reflected the
effects of three independent variables adopted in the experiment than the OWAS action category or
REBA score; (2) the grand score was more linearly proportional to the whole-body discomfort, which
was known to be a valid measure of postural loads and linearly correlated to the objective measures of
the percent capables; and (3) while OWAS and REBA tended to underestimate the postural loads for
the 48 treatments, particularly for even the 10 treatments that were too stressful for the participants to
complete during the experiment, RULA generally rated them highly. This agrees with Kong et al.’s
study [16] pointing out that compared to OWAS and REBA, RULA is superior on the basis of the hit
rate with ergonomic expert assessment and quadratic weighted κ analysis.

References

[1] Ministry of Employment and Labor. 산업재해현황분석[Industrial accidents status analysis].

Seoul( Korea): Ministry of Employment and Labor; 2018. Korean.

[2] van der Beek A, Frings-Dresen MHW. Assessment of mechanical exposure in ergonomic
epidemiology. Occupational Environment and Medicine. 1998; 55:291-299.
[3] Winkel J, Mathiassen SE. Assessment of physical work load in epidemiologic studies: concepts,
issues and operational considerations. Ergonomics. 1994; 37(6):979-988.
[4] Kilbom Å. Repetitive work of the upper extremity: Part II-The scientific basis (knowledge base)
for the guide. International Journal of Industrial Ergonomics. 1994; 14:59-86.
[5] Riihimäki H. Low back pain, its origin and risk indicators. Scandinavian Journal of Work,
Environment & Health. 1991;17: 81-90.
[6] Winkel J, Westgaard R. Occupational and individual risk factors for shoulder-neck complaints:
part II – The scientific basis (literature review) for the guide. International Journal of Industrial
Ergonomics. 1992;10:85-104.
[7] Aarås A, Westgaard RH, Stranden E. Postural angles as an indicator of postural load and muscular
injury in occupational work situations. Ergonomics. 1988; 31(6):915-933
[8] Genaidy A, Karwowski W. The Effects of body movements on perceived joint discomfort ratings
in sitting and standing postures. Ergonomics. 1993; 36:785–92.
[9] Keyserling WM, Punnett L, Fine LJ. Trunk posture and back pain: identification and control of
occupational risk factors. Applied Industrial Hygiene. 1988; 3:87–92.
[10] NIOSH (National Institute for Occupational Safety and Health). Musculoskeletal disorders and
workplace factors: A critical review of epidemiologic evidence for work-related musculoskeletal
disorders of the neck, upper extremity, low backs. DHHS (NIOSH) Publication No. 97-141,
Cincinnati(OH): US Department of Health and Human Services; 1997.
[11] Ryan GA. The prevalence of musculoskeletal symptoms in supermarket workers. Ergonomic.
1989;32:359–71.
[12] David GC. Ergonomic methods for assessing exposure to risk factors for work-related
musculoskeletal disorders. Occupational Medicine. 2005; 55:190-199.
[13] Genaidy AM, Al-Shedi AA, Karwowski W. Postural stress analysis in industry. Applied
Ergonomics. 1994; 25:77–87.
[14] Li G, Buckle P. Current techniques for assessing physical exposure to work-related
musculoskeletal risks, with emphasis on posture-based methods. Ergonomics. 1999;42(5):674-
695.
[15] Gómez-Galán N, Pérez-Alonso J, Callejón-Ferre Á-J, et al. Musculoskeletal disorders: OWAS
review. Industrial Health. 2017; 55:314-337.
[16] Kong Y-G, Lee S, Lee K-S, et al. Comparisons of ergonomic evaluation tools (ALLA, RULA,
REBA and OWAS) for farm work. International Journal of Occupational Safety and Ergonomics.
2017; 24(2):218-223.
[17] Sukadarin EH, Deros BM, Ghani J., et al. Postural assessment in pen-and-paper-based
observational methods and their associated health effects: a review. International Journal of
Occupational Safety and Ergonomics. 2016; 22(3):389-398.
[18] Burdof A, Derksen J, Naaktgeboren B, et al. Measurement of trunk bending during work by
direct observation and continuous measurement. Applied Ergonomics. 1992;23:263-267.
[19] Karhu O, Kansi P, Kuorinka I. Correcting working postures in industry: a practical method for
analysis. Applied Ergonomics. 1977; 8:199–201.
[20] Burdof A. Assessment of postural load on the back in occupational epidemiology. Dissertation,
Rotterdam(Netherlands): Erasmus University; 1992.
[21] Takala EP, Pehkonen I, Forsman M, et al. Systematic evaluation of observational methods
assessing biomechanical exposures at work. Scandinavian Journal of Work, Environment &
Health. 2010;36:3-24.
[22] Kong YK, Han JG, Kim DM. Development of an ergonomic checklist for the investigation of
work-related lower limb disorders in farming – ALLA: agricultural lower limb assessment.
Journal of Ergonomics of the Society of Korea. 2010;29(6):933-942.
[23] McAtamney L, Corlett EN. RULA: a survey method for the investigation of work-related upper
limb disorders. Applied Ergonomics. 1993; 24:91–99.
[24] Hignett S, McAtamney L. Rapid Entire Body Assessment (REBA). Applied Ergonomics. 2000;
31:201–205.
[25] Yazdanirad S, Khoshakhagh AH, Habib E. et al. Comparing the effectiveness of three ergonomic
risk assessment methods-RULA, LUBA, and NERPA-to predict the upper extremity
musculoskeletal disorders. Indian Journal of Occupational and Environmental Medicine. 2018;
22(1):17-21.
[26] Kee D, Karwowski W. LUBA: An assessment technique for postural loading on the upper body
based on joint motion discomfort and maximum holding time. Applied Ergonomics. 2001;
32:357-366.
[27] Sanchez-Lite A, Garcia M, Domingo R, et al. Novel ergonomic postural assessment method
(NERPA) using product-process computer aided engineering for ergonomic workplace design.
PLoS ONE. 2013;8: e72703.
[28] Kee D, Karwowski W. A comparison of three observational techniques for assessing postural
loads in industry. International Journal of Occupational Safety and Ergonomics. 2007; 1(1):3-14.
[29] Ansari NA, Sheikh MJ. Evaluation of work posture by RULA and REBA: A case study. Journal
of Mechanical and Civil Engineering. 2014;1(4):18-23.
[30] Choobineh A, Tosian R, Alhamdi Z, et al. Ergonomic intervention in carpet mending operation.
Applied Ergonomics. 2004; 35:493–496.
[31] Engels JA, Landeweerd JA, Kant Y. An OWAS-based analysis of nurses’ working postures.
Ergonomics. 1994; 37:909–19.
[32] Gonzalez BA, Adenso-Diaz B, Torre PG. Ergonomic performance and quality relationship: an
empirical evidence case. International Journal of Industrial Ergonomics. 2003; 31:33–40.
[33] Massaccesi M, Pagnotta A, Soccetti A, et al. Investigation of work-related disorders in trunk
drivers. Applied Ergonomics. 2003; 34;303–307.
[34] Mattila M, Karwowski W, Vilkki M. Analysis of working postures in hammering tasks on
building construction sites using the computerized OWAS method. Applied Ergonomics. 1993;
 24:405–412.
[35] Sane SM, Karandikar VN, Nandudikar SS, et al. Application of RULA and REBA for ergonomic
assessment in assembly workers. International Journal of Multidisciplinary Research and
Advances in Engineering. 2011; 3(4):23-28.
[36] Scott GB, Lambe NR. Working practices in a perchery system, using the OVAKO Working
Posture Analysing System (OWAS). Applied Ergonomics. 1996; 27:281–284.
[37] Miedema MC, Douwes M, Dul J. Recommended maximum holding times for prevention of
discomfort of static standing postures. International Journal of Industrial Ergonomics. 1998;19:9-
18.
[38] Armstrong T, Punnett L, Ketner P. Subjective worker assessment of hand tools used in
automobile assembly. American Industrial Hygiene Association Journal. 1989;50:639-645.
[39] Na S. An observation method for postural stress associated with an external load based on the
perceived discomfort. Unpublished Doctoral Dissertation, Pohang(Korea): POSTECH; 2006.
[40] Chaffin DB. Ergonomic guide for the assessment of human strength. American Industrial
Hygiene Association Journal. 1975;36:505-510.
[41] Borg G. Borg’s perceived exertion and pain scales. Champaign(IL, USA): Human Kinetics; 1998.
[42] Corlett EN, Bishop RP. A technique for assessing postural discomfort. Ergonomics. 1976;19
(2):175-182.
[43] Corlett EN, Manenica J. The effects and measurement of working postures. Applied Ergonomics.
1980; 11(1):7-16.
[44] Dul J, Douwes M, Smitt P. Ergonomic guidelines for the prevention of discomfort of static
postures can be based on endurance data. Ergonomics. 1994; 37:807-815.
[45] Kee D, Lee I. Relationships between subjective and objective measures in assessing postural
stresses. Applied Ergonomics. 2012; 43:277-282.
[46] Carey EJ, Gallwey TJ. Effects of wrist posture, pace and exertion on discomfort. International
Journal of Industrial Ergonomics. 2002; 29:85-94.
[47] Kee D, Na S, Chung MK. Effect of external load at varying hand positions on perceived
discomfort. International Journal of Occupational Safety and Ergonomics. 2013;19(3):397-408.
[48] Kee D. Gender differences in rankings of joint motion stressfulness based on psychophysical
scaling. International Journal of Industrial Ergonomics. 2005;35:461-469.