Prevalence of musculoskeletal disorders, ergonomics risk assessment and implementation of participatory ergonomics program for pistachio farm workers

Main Article Content

Naser Hasheminejad
Alireza Choobineh
Reza Mostafavi
Somayeh Tahernejad
Matin Rostami


Agriculture, Musculoskeletal disorders, Participatory ergonomics, Working posture, pistachio, farmer


Background and objectives: Pistachio farmers are exposed to a variety of risk factors for musculoskeletal disorders (MSDs). However, no study has been conducted to investigate MSDs in pistachio workers. Therefore, in the present study, besides investigating the prevalence of MSDs and their ergonomic risk factors, the participatory ergonomics (PE) method is used to provide an intervention program to reduce MSDs in this population in harvesting and processing pistachio. Methods: The present study was conducted in two phases. In the first phase 138 workers participated. The prevalence of MSDs was assessed with Nordic Musculoskeletal Questionnaire and the ergonomic risk factors was identified with ManTRA method. In the second phase PE was used to perform ergonomic interventions for reducing MSDs and the effect of the intervention was investigated. Sixty-four workers participated in the second phase (32 in the case group and 32 in the control group). Results: The highest prevalence of MSDs was in shoulders (63.7%), followed by the lower back (63%) and wrists/hands (52.1%). The comparison showed that after implementing the PE intervention program, the prevalence of MSDs in the intervention group was not significantly different from that in the control group. However, in the reassessment by the ManTRA method for five tasks that were identified as high risk in the first phase, a decrease in ManTRA final score was observed for all the five tasks. Conclusions: MSDs were prevalent in all body regions of workers. After implementing PE interventions exposure to ergonomic risk factors decreased.


Download data is not yet available.
Abstract 91 | PDF Downloads 48


1. Punnett L, Wegman DH. Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. Journal of electromyography and kinesiology. 2004;14(1):13-23.
2. Karimi A, Dianat I, Barkhordari A, Yusefzade I, Rohani-Rasaf M. A multicomponent ergonomic intervention involving individual and organisational changes for improving musculoskeletal outcomes and exposure risks among dairy workers. Applied Ergonomics. 2020;88:103159.
3. Houshyar E, Kim I-J. Understanding musculoskeletal disorders among Iranian apple harvesting laborers: Ergonomic and stop watch time studies. International Journal of Industrial Ergonomics. 2018;67:32-40.
4. Osborne A, Blake C, Fullen BM, Meredith D, Phelan J, McNamara J, et al. Prevalence of musculoskeletal disorders among farmers: a systematic review. American journal of industrial medicine. 2012;55(2):143-58.
5. Motabar H, Nimbarte AD, Raub E. Strength, endurance and fatigue response of rotator cuff muscles during isometric exertions. International Journal of Industrial Ergonomics. 2019;71:128-35.
6. Lewis RJ, Krawiec M, Confer E, Agopsowicz D, Crandall E. Musculoskeletal disorder worker compensation costs and injuries before and after an office ergonomics program. International Journal of Industrial Ergonomics. 2002;29(2):95-9.
7. Benos L, Tsaopoulos D, Bochtis D. A Review on Ergonomics in Agriculture. Part I: Manual Operations. Applied Sciences. 2020;10(6):1905.
8. Momeni Z, Choobineh A, Razeghi M, Ghaem H, Azadian F, Daneshmandi H. Work-related musculoskeletal symptoms among agricultural workers: a cross-sectional study in Iran. Journal of agromedicine. 2020:1-10.
9. mahmoodi a. Iranian pistachio export competitiveness in world markets. Journal of Economic Research (Tahghighat- E- Eghtesadi). 2016;51(4):951-76. doi: 10.22059/jte.2016.59464.
10. Palsson TS, Boudreau S, Høgh M, Herrero P, Bellosta-Lopez P, Domenech-Garcia V, et al. Education as a strategy for managing occupational-related musculoskeletal pain: a scoping review. BMJ open. 2020;10(2).
11. Kuorinka I. Tools and means of implementing participatory ergonomics. International Journal of Industrial Ergonomics. 1997;19(4):267-70.
12. Sarter NB, Woods DD, Billings CE. Automation surprises. Handbook of human factors and ergonomics. 1997;2:1926-43.
13. Hignett S, Wilson JR, Morris W. Finding ergonomic solutions—participatory approaches. Occupational Medicine. 2005;55(3):200-7.
14. Sarter N, Woods D, Billings C, Salvendy C. Automation surprises. Handbook of human factors and ergonomics. :: Wiley; 1997.
15. Van Eerd D, King T, Keown K, Slack T, Cole DC, Irvin E, et al. Dissemination and use of a participatory ergonomics guide for workplaces. Ergonomics. 2016;59(6):851-8.
16. Nejad NH, Choobineh A, Rahimifard H, Haidari HR, Reza Tabatabaei SH. Musculoskeletal risk assessment in small furniture manufacturing workshops. International journal of occupational safety and ergonomics. 2013;19(2):275-84.
17. Jahangiri M, Eskandari F, Karimi N, Hasanipour S, Shakerian M, Zare A. Self-reported, work-related injuries and illnesses among restaurant workers in Shiraz City, South of Iran. Annals of global health. 2019;85(1).
19. Choobineh A, Tabatabaei SH, Mokhtarzadeh A, Salehi M. Musculoskeletal problems among workers of an Iranian rubber factory. Journal of occupational health. 2007;49(5):418-23.
20. Stanton N, Salmon PM, Rafferty LA. Human factors methods: a practical guide for engineering and design: Ashgate Publishing, Ltd.; 2013.
21. Kurinka I, Jonsson B, Kilbom A. Vinter berg H, Biering-sorensen F, Anderon G and Jorgensen. Standardized Nordic Questionnaires for the analysis of musculoskeletal symptoms. Applied Ergonomics. 1987;18(3):233-7.
22. Choobineh A, Lahmi M, Shahnavaz H, Khani Jazani R, Hosseini M. Musculoskeletal symptoms as related to ergonomic factors in Iranian hand-woven carpet industry and general guidelines for workstation design. International journal of occupational safety and ergonomics. 2004;10(2):157-68.
23. Burgess-Limerick R. Issues associated with force and weight limits and associated threshold limit values in the physical handling work environment. Issues Paper. 2003;2.
24. Moussavi–Najarkola SA, Mirzaei R. ManTRA for the Assessment of Musculoskeletal Risk Factors Associated With Manual Tasks in an Electric Factory. Health Scope. 2012;1(3):132-9.
25. Carabalona R, Grossi F, Tessadri A, Castiglioni P, Caracciolo A, de Munari I. Light on! Real world evaluation of a P300-based brain–computer interface (BCI) for environment control in a smart home. Ergonomics. 2012;55(5):552-63.
26. Rasmussen CDN, Sørensen OH, van der Beek AJ, Holtermann A. The effect of training for a participatory ergonomic intervention on physical exertion and musculoskeletal pain among childcare workers (the TOY project)-a wait-list cluster-randomized controlled trial. Scandinavian Journal of Work, Environment & Health. 2020.
27. Haines H, Wilson JR, Vink P, Koningsveld E. Validating a framework for participatory ergonomics (the PEF). Ergonomics. 2002;45(4):309-27.
28. Miedema MC, Douwes M, Dul J. Recommended maximum holding times for prevention of discomfort of static standing postures. International Journal of Industrial Ergonomics. 1997;19(1):9-18.
29. Pinzke S, Lavesson L. Ergonomic conditions in manual harvesting in Swedish outdoor cultivation. Annals of agricultural and environmental medicine: AAEM. 2018;25(3):481-7.
30. Jain R, Meena ML, Dangayach GS, Bhardwaj AK. Risk factors for musculoskeletal disorders in manual harvesting farmers of Rajasthan. Industrial health. 2018;56(3):241-8.
31. Fulmer S, Punnett L, Tucker Slingerland D, Earle‐Richardson G. Ergonomic exposures in apple harvesting: Preliminary observations. American journal of industrial medicine. 2002;42(S2):3-9.
32. Besharati A, Daneshmandi H, Zareh K, Fakherpour A, Zoaktafi M. Work-related musculoskeletal problems and associated factors among office workers. International Journal of Occupational Safety and Ergonomics. 2020;26(3):632-8.
33. Abedini R, Choobineh A, Hasanzadeh J. Patient manual handling risk assessment among hospital nurses. Work. 2015;50(4):669-75.
34. Falahati M, Dehghani F, Malakoutikhah M, Karimi A, Zare A. Using fuzzy logic approach to predict work-related musculoskeletal disorders among automotive assembly workers. Medical Journal of the Islamic Republic of Iran. 2019;33:136.
35. Kim E, Freivalds A, Takeda F, Li C. Ergonomic evaluation of current advancements in blueberry harvesting. Agronomy. 2018;8(11):266.
36. Mulyati G, Maksum M, Purwantana B, Ainuri M, editors. Ergonomic risk identification for rice harvesting worker. IOP Conference Series: Earth and Environmental Science; 2019: IOP Publishing.
37. Capodaglio EM. Participatory ergonomics for the reduction of musculoskeletal exposure of maintenance workers. International Journal of Occupational Safety and Ergonomics. 2020(just-accepted):1-21.
38. Reiman A, Pekkala J, Väyrynen S, Putkonen A, Forsman M. Participatory video-assisted evaluation of truck drivers’ work outside cab: deliveries in two types of transport. International journal of occupational safety and ergonomics. 2014;20(3):477-89.
39. Shorthouse F, Roffi V, Tack C. Effectiveness of educational materials to prevent occupational low back pain. Occupational Medicine. 2016;66(8):623-9.
40. Ya’acob NA, Abidin EZ, Rasdi I, Rahman AA, Ismail S. Reducing work-related musculoskeletal symptoms through implementation of Kiken Yochi training intervention approach. Work. 2018;60(1):143-52.
41. Plantation A. Effectiveness of a participatory action oriented training intervention approach among harvesters in oil palm plantation. American Journal of Applied Sciences. 2014;11(4):681-93.
42. Ishkandar M, Shamsul B. Developing ergonomics intervention for improving safety & health among smallholders in melaka oil palm plantation: a participatory action oriented approach. Malays J Hum Factors Ergon. 2016;1(1):36-42.
43. Kristensen TS. Intervention studies in occupational epidemiology. Occupational and environmental medicine. 2005;62(3):205-10.
44. Jaegers L, Dale AM, Weaver N, Buchholz B, Welch L, Evanoff B. Development of a program logic model and evaluation plan for a participatory ergonomics intervention in construction. American journal of industrial medicine. 2014;57(3):351-61.
45. Bosch LM, van der Molen HF, Frings-Dresen MH. Optimizing implementation of interventions in agriculture for occupational upper extremity musculoskeletal disorders: results of an expert panel. Work. 2018;61(3):413-20.
46. Pranav P, Patel T. Impact of ergonomic intervention in manual orange harvester among the workers of hilly region in India. Work. 2016;54(1):179-87.
47. Mokarami H, Varmazyar S, Kazemi R, Taghavi SM, Stallones L, Marioryad H, et al. Low cost ergonomic interventions to reduce risk factors for work related musculoskeletal disorders during dairy farming. Work. 2019;64(2):195-201.
48. McAtamney L, Corlett EN. RULA: a survey method for the investigation of work-related upper limb disorders. Applied ergonomics. 1993;24(2):91-9.