Hand-intensive work significantly correlates with the increased risks of developing Distal upper-extremity (DUE) Work-related musculoskeletal disorders (WMSDs), such as carpal tunnel syndrome and tendinitis. Many studies have investigated the physical risk factors and their contribution to the occurrence of the DUE WMSDs. These factors include but are not limited to hand force, level of hand movement repetition, and non-neutral hand-wrist postures. Several observational-based risk assessment methods have emerged from these studies to control these risk factors and reduce the DUE WMSDs' development. In this regard, The RAMP Tool's Hand Model (RAMP's HM) has been developed recently by the Ergonomics Division at KTH Royal Institute of Technology as a new model within the RAMP Tool .The aim with RAMP's HM is to fulfill the need for an observational-based, preventive, research-oriented, and systematic method of risk management targeting the elevated risks of DUE occupational injuries associated with hand-intensive tasks. Moreover, the RAMP's HM seeks to investigate and combine a more significant number of ergonomic risk factors than those covered by existing DUE observational-based risk assessment methods. This master's thesis project evaluated the latest prototype of RAMP's HM for reliability, usability, and face validity. A group of ten ergonomists and ergonomics coordinators, all working at Scania AB, had volunteered to participate in this evaluation study. They assessed eight video records of hand-intensive work tasks across various industries using RAMP's HM. The raters assessed the model's inter-rater and intra-rater reliability by evaluating eight video records of hand-intensive work tasks in two assessment sessions, which were separated by a 21-day gap. The ergonomists also used the 2018 ACGIH® Hand Activity Level (HAL)– Threshold Limit Value (HAL Tool) to assess the same video-recorded tasks in the two sessions to evaluate the reliability of RAMP's HM in comparison (the inter-method reliability). Seven of the ten ergonomists volunteered to complete a quantitative questionnaire using a 5-Likert scale to assess the usability and face validity of the new RAMP model. The evaluation showed that the RAMP Tool's Hand Model has fair inter-rater and moderate intra-rater reliability. The reliability test also showed a similar level of reliability for the two methods, with no significant differences between the reliability results of RAMP's HM and HAL. The reliability results of the RAMP's HM may have been adversely influenced by statistical factors, and factors related to the observation process, raters' experience and background, and pre-test training. The categories of the resulting ratings for overall risk levels on the task level using RAMP's HM and the HAL Tool agreed in over 75% of ratings. According to the ergonomists, RAMP's HM is usable; it supports the systematic risk management approach, and their answers indicated that it has been designed in a user-centered way. Furthermore, the evaluation results indicated a strong face validity for RAMP's HM. Raters perceived the new model as a practical tool for systematically managing DUE WMSDs and the corresponding risk factors across various work environments and industries. Based on the results of this study, it is recommended that comprehensive education and practical training on RAMP's HM are provided before conducting further evaluations, i.e., on the complete RAMP 2.0 version. Furthermore, it is recommended to include more participants and tasks in such evaluations. Additionally, it may be valuable to consider using other reliability parameters besides the weighted Cohen's kappa.

In Sweden, all employers are obligated to provide occupational health services that prevent and eliminate health risks in the workplace. Risk assessment is one of the recommended procedures of systematic work environment management that employers shall conduct to investigate the occurrence of workplace risks. However, implementation of systematic risk management tools might be challenging for employers because it requires certain organizational preconditions such as enough OHS skills, resources, management commitment or a good workplace climate because these preconditions might facilitate or hinder the implementation. To support the implementation of risk management tools, the organizational readiness for change can be assessed. This master's thesis was written in collaboration with LKAB, the Swedish company operating in the mining industry. Specifically, the aim was to assess the organizational readiness of the worksite LKAB Malmberget for initiating the implementation of the RAMP risk assessment tool. The organizational readiness was evaluated based on the modified theoretical model which was created by combining existing theoretical concepts about organizational readiness for change together with the findings from the empirical pre-study conducted with two ergonomists who worked with the RAMP tool implementation in the Swedish company Scania. The research method was a case study, the data were collected by semi-structured interviews and analysed through directed qualitative content analysis. The evaluation resulted in the identification of facilitating and hindering aspects of organizational readiness. The organizational facilitating factors for RAMP tool implementation were identified as - sufficient organizational resources for work environment activities; high management commitment to improving work environment; good organizational climate for employees' participation in work environment routines; well-integrated technological system for risk reporting; and workers' positive experience with previously done work environment changes. The organizational hindering aspects for RAMP tool implementation were identified as - the prevalence of reactive approach in the systematic work environment management; lack of usage of standardized risk assessment tools, lack of OHS expertise in the execution of the work environment routines; ergonomics was not integrated into the work environment management; top management's tendency to support work environment interventions with clear benefits and timelines. Finally, the evaluation of organizational readiness resulted in the development of practical recommendations for the worksite which could be supported and initiated for the RAMP tool implementation.

Despite efforts of reducing harmful physical ergonomics exposures related to manual handling, the occurrence of heavy or repetitive manual handling, and non-neutral postures is high in many occupational sectors. To reduce these exposures, interventions and job design strategies can utilize risk assessment. A need was identified of an observation-based tool which supported occupational health and safety practitioners for assessments of risk factors related to manual handling. The aim of this thesis was to explore the use and important usability-related aspects of observation-based assessment tools among professional ergonomists, and to develop new research based assessment and screening tools, to present their scientific basis and to evaluate their reliability and usability. A web-based questionnaire was employed to gain knowledge on the use and usability aspects of risk assessment tools among ergonomists in Sweden. The assessment tools RAMP I and RAMP II were developed in an iterative process, including literature searches, expert group judgments, and with input from more than 80 practitioners. The reliability and usability evaluations included assessments and ratings by practitioners. The thesis points to a low use of several internationally spread assessment tools among Swedish ergonomists, and a relatively higher use of tools promoted by the Swedish Work Environment Authority. Several usability-related aspects were identified as important, such as being easy and quick to use, its ability to communicate and visualize the results, and its ability to facilitate improvement measures. The developed tools support assessment of a broad range of risk factors related to manual handling. The thesis supports that assessments with acceptable reliability can be achieved for the majority of items of the two developed tools. The thesis supports that the tools are usable in supporting risk assessments targeting risk factors related to industrial manual handling. / Trots ansträngningar för att minska belastningsergonomiska exponeringar relaterade till manuell hantering är förekomsten av exponering av riskkällor såsom tung eller repetitiv manuell hantering, obekväma arbetsställningar, hand–armvibrationer och helkroppsvibration omfattande inom flera sektorer. Dessa belastningsergonomiska exponeringar tros i betydande utsträckning bidra till en stor andel av arbetsrelaterade muskuloskeletala besvär och arbetssjukdomar inom flera sektorer som exempelvis tillverkningsindustrin. Riskbedömningar kan användas inom det förebyggande arbetet kopplat till interventioner eller arbetsutformning för att minska dessa skadliga exponeringar (risk faktorer), vilket även är ett krav om arbetet innefattar manuell hantering eller andra riskkällor. Trots det stora antalet observationsbaserade bedömningsverktyg utvecklade för att stödja riskbedömningar av arbete som innefattar manuell hantering identifierades ett behov av ett nytt observationsbaserat bedömningsverktyg som stödjer praktiker i utförliga bedömningar av flertalet riskfaktorer relaterade till manuell hantering och som ger stöd i det systematiska arbetsmiljöarbetet. Syftet med avhandlingen är att utforska användningen av, och viktiga användbarhetsrelaterade aspekter av observationsbaserade bedömningsverktyg bland professionella ergonomer som arbetar i Sverige. Dessutom är syftet även att utveckla nya forskningsbaserade screeningverktyg och bedömningsverktyg, presentera deras forskningsbas samt att utvärdera deras reliabilitet och användbarhet. En webbaserad enkät användes för att inhämta kunskap om i vilken omfattning dessa verktyg används av professionella ergonomer och vilka användbarhetsrelaterade aspekter som ansågs särskilt betydelsefulla för dessa verktyg. För att utveckla de nya verktygen (dvs. RAMP I och RAMP II) genomfördes litteratursökningar för att identifiera kvantitativt beskrivna riskfaktorer relaterade till manuell hantering och betydelsefulla faktorer som påverkar arbetstagares kapacitet vid manuell hantering. Verktygen utvecklades i en iterativ process med input från mer 80 praktiker, varav mer än 30 professionella ergonomer, samt expertgruppsbedömning. De två verktygen utvärderades med avseende deras interbedömarreliabilitet utifrån bedömningar genomförda av ergonomer och ingenjörer/tekniker utifrån videofilmade arbeten inom industriell manuell hantering. Verktygens användbarhet utvärderas av 20 praktiker med en pappersenkät och verktygens ’användarvänlighet’ av 22 ergonomer. Avhandlingen pekar på en relativt låg proportionell användning av flera internationellt spridda bedömningsverktyg bland professionella ergonomer som arbetar i Sverige, och en relativt hög proportionell användning av bedömningsverktyg som stöds av Arbetsmiljöverket. Flera användbarhetsrelaterade aspekter identifierades som betydelsefulla bland ergonomerna, i synnerhet betydelsen av att bedömningsverktygen är enkla och snabba att använda, deras förmåga att kommunicera och visualisera resultatet av bedömningar, och deras förmåga att stödja åtgärdsarbetet. Det utvecklade screeningverktyget och bedömningsverktyget stödjer bedömning av flertalet riskfaktorer relaterade till industriell manual hantering. Avhandling ger stöd att majoriteten av verktygens bedömningspunkter har acceptabel interbedömarreliabilitet och förbättringsområden för verktygen har identifierats. Avhandling ger stöd att de två utvecklade verktygen är användbara vid riskbedömningar av belastningsergonomiska riskfaktorer relaterade till industriell manual hantering. / <p>QC 20170510</p>