title: Postural assessment in pen-and-paper-based observational methods and their associated health effects: a review.
abstract: BACKGROUND
  This review describes standardized ergonomics assessment based on pen-and-paper observational methods for assessing ergonomics risk factors.
  
  
  OBJECTIVE
  The three main objectives are to analyze published pen-and-paper observational methods, to extract and understand the risk levels of each method and to identify their associated health effects.
  
  
  METHODS
  The authors searched scientific databases and the Internet for materials from 1970 to 2013 using the following keywords: ergo, posture, method, observational, postural angle, health effects, pain and diseases. Postural assessments of upper arms, lower arms, wrists, neck, back and legs in six pen-and-paper-based observational methods are highlighted, extracted in groups and linked with associated adverse health effects.
  
  
  RESULTS
  The literature reviewed showed strengths and limitations of published pen-and-paper-based observational methods in determining the work activities, risk levels and related postural angles to adverse health effects. This provided a better understanding of unsafe work postures and how to improve these postures.
  
  
  CONCLUSIONS
  Many pen-and-paper-based observational methods have been developed. However, there are still many limitations of these methods. There is, therefore, a need to develop a new pen-and-paper-based observational method for assessing postural problems.
authors.affiliation: a Universiti Kebangsaan Malaysia , Malaysia.
authors.forename: Ezrin Hani
authors.initials: EH
authors.lastname: Sukadarin
authors.affiliation: a Universiti Kebangsaan Malaysia , Malaysia.
authors.forename: Baba Md
authors.initials: BM
authors.lastname: Deros
authors.affiliation: a Universiti Kebangsaan Malaysia , Malaysia.
authors.forename: Jaharah A
authors.initials: JA
authors.lastname: Ghani
authors.affiliation: a Universiti Kebangsaan Malaysia , Malaysia.
authors.forename: Nur Syazwani
authors.initials: NS
authors.lastname: Mohd Nawi
authors.affiliation: b Universiti Malaysia Kelantan.
authors.forename: Ahmad Rasdan
authors.initials: AR
authors.lastname: Ismail
mesh_terms: D006804:Ergonomics / Q000379:methods*; D006801:Humans; D009140:Musculoskeletal Diseases / Q000517:prevention & control; D009784:Occupational Diseases / Q000517:prevention & control; D011187:Posture; D012307:Risk Factors
keywords: health effects; observational method; posture; risk factors