JRHS 2011; 11(1): 26-32

JRHS
Journal of Research in Health Sciences
journal homepage: www.umsha.ac.ir/jrhs

Original Article

Comparison of Ergonomic Risk Assessment Outputs from
Rapid Entire Body Assessment and Quick Exposure Check in
an Engine Oil Company

Majid Motamedzade (PhD)
a
*, Mohammad Reza Ashuri (MSc)
b
, Rostam Golmohammadi
(PhD)
c
, Hossein Mahjub (PhD)
d


a
Ergonomics Department, School of Public Health and Research Centre for Health Sciences,Hamadan University of
Medical Sciences, Hamadan, Iran
b
Department of Occupational Health, School of Public Health, Hamadan University of Medical Sciences, Iran
c
Department of Occupational Health, School of Public Health and Research Center for Health Sciences, Hamadan Uni-
versity of Medical Sciences, Hamadan, Iran
d
Department of Biostatistics & Epidemiology, School of Public Health and Center for Health Research, Hamadan
University of Medical Sciences, Iran

ARTICLE INFORMATION ABSTRACT
Article history:
Received: 4 April 2011
Revised: 2 June 2011
Accepted: 7 June 2011
Available online: 12 June 2011
Background: During the last decades, to assess the risk factors of work-related
musculoskeletal disorders (WMSDs), enormous observational methods have
been developed. Rapid Entire Body Assessment (REBA) and Quick Exposure
Check (QEC) are two general methods in this field. This study aimed to compare
ergonomic risk assessment outputs from QEC and REBA in terms of agreement
in distribution of postural loading scores based on analysis of working postures.
Methods: This cross-sectional study was conducted in an engine oil company in
which 40 jobs were studied. All jobs were observed by a trained occupational
health practitioner. Job information was collected to ensure the completion of
ergonomic risk assessment tools, including QEC, and REBA.
Results: The result revealed that there was a significant correlation between
final scores (r=0.731) and the action levels (r =0.893) of two applied methods.
Comparison between the action levels and final scores of two methods showed
that there was no significant difference among working departments. Most of
studied postures acquired low and moderate risk level in QEC assessment (low
risk=20%, moderate risk=50% and High risk=30%) and in REBA assessment
(low risk=15%, moderate risk=60% and high risk=25%).
Conclusion: There is a significant correlation between two methods. They have
a strong correlation in identifying risky jobs, and determining the potential risk for
incidence of WMSDs. Therefore, there is possibility for researchers to apply in-
terchangeably both methods, for postural risk assessment in appropriate working
environments.
Keywords:
Musculoskeletal Disorders
Ergonomics
Observational method
QEC
REBA
* Correspondence
Majid Motamedzade (PhD)
Tel: +98 811 8255963
Fax: +98 811 8255301
E-mail: motamedzade@yahoo.com

Citation: Motamedzade M, Ashuri MR, Golmohammadi R, Mahjub M. Comparison of ergonomic risk assessment outputs from rapid
entire body assessment and quick exposure check in an engine oil company. JRHS. 2011;11(1):26-32.
Introduction

ork-related musculoskeletal disord-
ers (WMSDs) are responsible for
morbidity in many working popula-
tions and are known as an important occupa-
tional problem with increasing compensation
and health costs, reduced productivity, and
lower quality of life
1
. In recent years, many
studies are conducted to provide basis for the
risk assessment of the development of WMSDs
2
. WMSDs are characterized as multi factorial
3
.
Quantifying mechanical loads on muscu-
loskeletal system in occupational activities
W
27
Majid Motamedzade et al

JRHS 2011; 11(1): 26-32
have many methodological difficulties and li-
mitations
4
. Therefore, alternative approaches
based on simplified methods to file ergonomic
exposures are required. Quantification of ergo-
nomic exposures, based on comprehensive in-
formation on the frequency and duration of par-
ticular postures and movements, is now com-
mon. During the last decades, numerous ergo-
nomic risk assessment methods have been de-
veloped for assessing exposure to risk factors
for WMSDs, most of them assess the risk of the
various regions of the body such as the back,
neck, shoulder, arms and the wrists
3, 5-7
.
The origins of ergonomic risk factors in-
clude the workstations, tools, equipments, work
methods, work environment, worker personal
characteristics, metabolic demands, physical
stress, and emotional stress. Professionals from
mechanical engineering, industrial engineering,
occupational hygiene, occupational medicine,
occupational therapy, kinesiology, psychology,
and many other fields, provide unique insights
into the relationship between worker/workplace
and WMSDs. Understanding ergonomic risk
factors are essential because there is indication
that ergonomic risk factors are causally related
to musculoskeletal disorders of the upper ex-
tremities and the low back
8
.
There are abundant ergonomic risk assess-
ment tools that attempt to evaluate the ergo-
nomic risk of a task or job. For example, the
Rapid Entire Body Assessment (REBA) and
Quick Exposure Check (QEC) are more holistic
ergonomic risk assessment tools that measure
the ergonomic risks to the both upper and lower
parts of the musculoskeletal system. Biome-
chanical assessments can be done for all the
regions of the musculoskeletal system especial-
ly shoulder moments and moments about the
low back. Evaluations of several ergonomic
observational methods revealed that these me-
thods had been developed based on special ra-
tionale, and as a result were applicable under
various workplace conditions
5-7
. Each method
has its own posture classification scheme,
which is different from other methods and
therefore may lead to assign different postural
scores for a given posture, depending on par-
ticular methods used.
Since the time of introduction of QEC and
REBA, studies showed their value for postural
assessments of jobs in several occupational set-
tings, including construction
9-10
, supermarket
workers
11
, clothing manufacturing
12
, assembly
13
, rubber and sugar industry
14-15
, firefighters
and emergency medical technicians
16
, sawmill
17
and hospital
18
.
The present study aimed to compare ergo-
nomic risk assessment observational methods,
namely, QEC and REBA, in terms of agree-
ment in distribution of postural loading scores
based on analysis of working postures taken
from an engine oil company.
Methods
This cross-sectional study was conducted in
order to investigate correlation between risk
assessment results of REBA and QEC in an
engine oil company in which 40 jobs were stu-
died. The company did not allow us to state its
name and characteristic in details.
All jobs were observed by a trained occupa-
tional health practitioner. Job information was
collected to ensure the completion of ergonom-
ic risk assessment tools, including the QEC,
and REBA. It should be noted that REBA and
QEC are applied at task level of the jobs.
The REBA (Rapid Entire Body Assessment)
is a posture-based analysis system responsive
to musculoskeletal risks in various tasks, in
particular for assessment of working postures
that are present in health care sector and other
service industries
19
. The classification of post-
ures is derived from body part diagrams. The
REBA is a method for estimating the risks of
entire body WMSDs, gives a quick and logical
assessment of the complete body postural risks
to a worker, and is appropriate for evaluating
tasks where postures are dynamic, static, or
where gross changes in position take place. The
design of REBA is very similar to that of RU-
LA method
20
and special attention is devoted
to the external load acting on trunk, neck, and
legs and to the workerload coupling using the
upper limbs. Postures of individual body parts
are observed and postural scores increase when
postures diverge from the neutral position.
Group A includes trunk, neck, and legs, while
group B includes upper and lower arms and
28
Comparison of Assessment Outputs from REBA and QEC

JRHS 2011; 11(1): 26-32
wrists. Other items including the load handled,
couplings with the load, and physical activity
are specifically scored and then processed into
a single combined risk score using a table pro-
vided. These scores are summed up to give one
score for each observation, which can then be
compared to tables stating risk at five levels,
leading to the necessity of actions. Unlike
OWAS
21
and RULA
20
, REBA provides five
action levels for estimating the risk level.
These risk levels starting from 0 to 4 are cor-
responding to negligible, low, moderate, high
and very high risk level respectively
20
.
Quick Exposure Check (QEC) is an observa-
tional method that developed firstly by Li and
Buckle in 1998
22
and enhanced by David et al.
in 2003
23
. As other ergonomic risk assessment
tools, QEC is applied to assess the level of ex-
posure to ergonomic risks. QEC analysis pro-
duces scores to the back, shoulder/arm,
wrist/hand, and neck. One of the unique fea-
tures of QEC is that the observed worker
should rate the weights handled, time spent on
observed task, level of hand force, visual de-
mands, application of vibrating tools, and diffi-
culties to sustain with the work as well as the
stressfulness of the work. The ratings are
weighted into scores and added up to summary
scores for different body parts and other items
driving, vibration, work pace, and stress). In
QEC to achieve an overall score, total scores
obtained from four body parts are added and
the product is divided by the maximum possi-
ble score, i.e., 176 for manual material handling
tasks and 162 for others. Low scores (<40%)
indicate satisfactory loading (low risk). For
41% to 50%, further investigation is needed
and changes may be required (moderate risk).
Timely investigation and changes are required
soon for scores of 51% to 70% (high risk); and
urgent investigation and changes are required
for scores over 70% (very high risk). Finally,
QEC provides 4 categories for estimating the
risk level. These risk levels named from 1 to 4
are corresponding to low, moderate, high and
very high risk level respectively
24-26
.
In the study of oil company, every job is
made up of a variety of tasks. The first aspect
of the job evaluation was to break down each
job into tasks. The job break down was consis-
tent for each QEC and REBA analysis. There
were 40 jobs with 123 tasks. From each studied
job one task was selected for risk analysis by
QEC and REBA methods based on 1) posture
held for the greatest amount of the work cycle
or 2) where highest loads occur. After the ergo-
nomic data were completed, the ergonomic risk
for each tool was quantified using REBA and
the QEC. Using each method authors guide
19,
25
, the tool output for each task computed and
the final risk level identified. Accordingly,
QEC and REBA outputs for each task were ob-
tained respectively.
Statistical analysis was conducted using
SPSS Version 13.0. Spearman correlation coef-
ficient, Wilcoxon signed-rank test and Kruskal-
Wallis test was done for comparing the risk as-
sessment outputs of applied methods. P values
<0.05 were considered statistically significant.
Results
Percentages of action levels of QEC and
REBA for 40 studied jobs are presented in Ta-
ble 1. According to this table, most of studied
postures classified as low and moderate risk
level in QEC assessment (low risk=20%, mod-
erate risk=50% and High risk=30%) and also in
REBA assessment (low risk=15%, moderate
risk=60% and high risk=25%).
Table 1: Percentage of action levels of QEC
and REBA outputs from 40 posture analyses
The Wilcoxon signed-rank test showed that
REBA and QEC action levels generally have
no significant differences in 40 studied jobs.
Further analysis using Wilcoxon signed-rank
test in various working departments was done
and no significant differences was found be-
tween REBA and QEC action levels among
different working departments (Table 2). Table
3 shows the Kruskal-Wallis test results for
REBA and QEC action levels between working
departments. Similar to Wilcoxon signed-rank
test results (Table 2), Kruskal-Wallis test
showed no significant differences between
REBA and QEC action levels among various
working departments. Further analysis using
Action levels QEC REBA
Low risk 20 15
Moderate risk 50 60
High risk 30 25
29
Majid Motamedzade et al

JRHS 2011; 11(1): 26-32
Kruskal-Wallis test was done on final scores of
QEC and REBA among various working de-
partments. As it may seen in Table 4, the test
showed no significant differences between
REBA and QEC final scores in different work-
ing departments. Correlation coefficients for
final scores and action levels between QEC and
REBA were r=0.73 and r=0.89, respectively
(Figure 1).
Table 2: Wilcoxon signed-rank test results for REBA and QEC action levels (N=40) in working de-
partments
Working departments
REBA Action Levels QEC Action Levels
P value
Mean 95% CI Mean 95% CI
Production 2.10 0.67, 3.53 2.10 0.67, 3.53 0.800
Packing 2.30 1.12, 3.48 2.37 1.17, 3.57 0.317
Labeling 2.00 0.41, 3.59 2.25 0.39, 4.11 0.317
Warehouse 1.66 0.54, 2.78 1.66 0.54, 2.78 0.800
Quality control 2.00 2.00, 2.00 1.00 1.00, 1.00 0.157
Engineering 2.00 2.00, 2.00 2.00 2.00, 2.00 0.800
Office 1.66 0.54, 2.78 1.66 0.54, 2.78 0.800

Table 3: Kruskal-Wallis test results for REBA and QEC action levels (N=40) in working departments
Working departments
REBA Action Levels QEC Action Levels
Mean 95% CI Mean 95% CI
Production 2.10 0.67, 3.53 2.10 0.67, 3.53
Packing 2.30 1.12, 3.48 2.37 1.17, 3.57
Labeling 2.00 0.41, 3.59 2.25 0.39, 4.11
Warehouse 1.66 0.54, 2.78 1.66 0.54, 2.78
Quality control 2.00 2.00, 2.00 1.00 1.00, 1.00
Engineering 2.00 2.00, 2.00 2.00 2.00, 2.00
Office 1.66 0.54, 2.78 1.66 0.54, 2.78
P value P=0.562 P=0.151

Table 4: Kruskal-Wallis test results for REBA and QEC final scores (N=40) in working departments
Working departments
REBA Final Scores QEC Final Scores
Mean 95% CI Mean 95% CI
Production 3.80 -0.90, 8.16 46.00 25.42, 58.46
Packing 6.00 1.88, 10.06 48.00 33.30, 57.46
Labeling 5.50 -0.14, 10.34 50.75 36.05, 60.21
Warehouse 5.33 1.25, 9.37 44.66 33.35, 52.39
Quality control 7.00 7.00, 8.96 32.50 31.13, 35.16
Engineering 5.00 5.00, 6.96 47.00 44.24, 50.37
Office 4.00 2.04, 6.96 36.33 17.00, 48.15
P value P=0.147 P=0.673

Discussion
The key finding of present study is the pres-
ence of significant correlation between two me-
thods. QEC and REBA methods have a strong
correlation in identifying risky jobs and deter-
mining the potential risk for incidence of
WMSDs.
Due to absence of very high risk category
and limited high risk category in outputs of
REBA and QEC, the potential risk for inci-
dence of WMSDs in most of studied working
postures was low to moderate, therefore fur-
ther investigation is needed and administrative
and engineering controls may be required in
some workstations. Recent studies that applied
30
Comparison of Assessment Outputs from REBA and QEC

JRHS 2011; 11(1): 26-32
REBA and QEC in their ergonomic risk as-
sessment have reported, to some extent, similar
outputs
9-18
. The absence of high-risk category
in current study may be justified somewhat by
smallness of analyzed postures (40 selected
tasks). It should be noted that the aim of this
study firstly was to compare ergonomic risk
assessment outputs in two observational me-
thods i.e. REBA and QEC.

Figure 1: Scatter plot of QEC and REBA final scores
Up to now there is no research finding about
comparison of risk assessment outputs from
QEC and REBA. However, there are several
researches about comparison between other er-
gonomics risk assessment observational me-
thods
8, 11,

27-30
. In this study, we compared two
different methods for the assessment of postur-
al load in a population of an engine oil compa-
ny workers. The applied methods of QEC and
REBA were compared based on the results for
40 different working postures. The results
showed that regardless of task type, QEC and
REBA estimations for posture-related risk were
similar. According to Figure 1, and computed
correlation coefficients for QEC and REBA
outputs including final scores (r=0.73) and ac-
tion levels (r=0.89), there was a considerable
agreement between the assessment outputs de-
rived from two methods. In addition, according
to Table 2, 3 and 4, Wilcoxon signed-rank and
Kruskal-Wallis tests showed no significant dif-
ferences between REBA and QEC assessment
outputs in different working departments and
confirm the association between the outputs of
two applied methods. Therefore, there is possi-
bility for researchers to apply interchangeably
both used methods i.e. REBA and QEC, for
postural risk assessment in appropriate working
environments.
The most important limitation to the present
study was that the relationships between each
evaluation method and the injury data were un-
known. Unfortunately, the injury data were not
available from the plant.
Conclusion
Based on our findings, there is a significant
correlation between two applied methods. They
have a strong correlation in identifying risky
jobs and determining the potential risk for inci-
dence of WMSDs. Therefore, QEC and REBA
methods are recommended for evaluation of
work-related musculoskeletal disorders risk
factors in similar industries.
Acknowledgments
The authors wish to extend their gratitude to
all who helped make this work possible, espe-
cially all the workers, supervisors and the man-
agers who participated in this study. We also
thank to Dr. Jalal Poorolajal for his comments
about data analysis and presentation.
31
Majid Motamedzade et al

JRHS 2011; 11(1): 26-32
Conflict of interest statement
The authors declare that they have no con-
flicts of interest.
Funding
This study was funded by the Deputy of Re-
search and Technology of Hamadan University
of Medical Sciences.
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