本研究之目的試圖為KIM LHC檢核表補充一式靜態作業的調整評級點數，以修正KIM LHC檢核表對靜態作業評估的準確性。本研究的方法是以WISHA篩選工具（WISHA screening tool）為實驗條件，以實驗結果來修正KIM檢核表。KIM檢核表為近年來在EU-OSHA的主導下所推出的檢核表系列，KIM檢核表系列包含適用於全身性工作的LHC版本（lifting、holding和carrying）、推拉作業的PP版本（push、pull）和針對手部作業如產品組裝、食品生產等的MHO版本（manual handling operation），其中以KIM LHC在評估上最具簡潔性與準確性，且風險值的計算僅以時間評級與其他評級總和的乘積，無疑是一項快速上手的肌肉骨骼傷害評估利器。而WISHA篩選工具是美國華盛頓州所提出的人因工程準則，被視為肌肉骨骼傷害的基礎準則，多數肌肉骨骼危害檢核表以此準則做為檢核表參考標準。
雖然KIM LHC適用性非常高，但明顯沒有考慮動態與靜態作業之間的差異。學理上，動態作業的作業週期是由工作期間與休息期間所組成，在動態作業休息期間，工作期間所累積的氧不足所欠缺的能量會在此時回補，代謝產物亦在此時排出，因此疲勞感會在休息期間快速舒緩；而在靜態作業時，氧不足所欠缺的能量不斷增加，代謝產物因無法適時排出而不斷累積，因而導致疲勞痠痛的產生。事實上，專家普遍認為從事靜態作業遠比動態作業更加且更快勞累。因此，在時間評級尺度上補充靜態調整評級以修正KIM LHC相當有意義。
本實驗目的是來比較4組靜態實驗組與1組動態對照組，進而比較KIM LHC風險值與主觀疲勞感受之間的差異，而對照組的實驗條件是以WISHA 篩選工具的警告區域判斷條件為基礎，而4組靜態實驗組是以4種不同水準的工作-休息週期作為自變項，自變項水準分別為5-2.5、10-5、20-10和40-20分，為使靜態作業的危害更加敏感，因此設計手握持0.5kg的物體舉手過肩的不良姿勢為實驗姿勢。徵求10位年輕男子以上述實驗條件做實驗，最後依據實驗結果來比較KIM LHC風險值與主觀疲勞感受之間的差異，利用此差異來調整KIM LHC時間評級尺度。
最後根據修正後的KIM LHC再次評估既有的5個靜態作業案例，結果顯示，修正後KIM LHC具備微調靜態作業之風險值的功能，能使風險值更能符合主觀疲勞感受。

The purpose of this thesis is attempting to devise a static task adjustment rating point to KIM LHC checklist to improve accuracy in assessing static-related operations, the methodology is to conduct an experiment according to WISHA screening tool for devising an adjustment rating scale for the time rating of KIM LHC checklists. KIM checklist is one of newly developed checklists under EU-OSHA’s sponsorship. The KIM checklist consists of 3 versions：KIM LHC, KIM PP, KIM MHO. KIM LHC was designed for whole body tasks, including lifting、holding and carrying, KIM PP for pushing and pulling tasks, KIM MHO for manual hand operation tasks, such as product assembly, food processing. KIM LHC is especially easy-to-use and almost fit-all, risk score is the product of time rating and the summation of three other ratings. WISHA screening tool is an ergonomics guideline proposed by Washington State as a musculoskeletal hazard standard. It is considered as a major reference for assessing the goodness of checklists.
Although KIM LHC is very promising, it does not explicitly take into account the difference in fatigue between dynamic and static operations. In theory, dynamic task is interposed with work and rest durations, during rest durations, the O2 deficit occurring during work periods can be replenished, and metabolite wasted can be expelled. Therefore, fatigue can be lessened. On the other hand, for static tasks, O2 deficit is continuing increased and waste is accumulated, and fatigue and exhaustion are the inevitable outcome. In reality, it is generally agreed that static tasks is far more fatiguing than dynamic tasks. Therefore, it is wondered that a supplement adjustment rating for the time rating scale of KIM LHC can be devised.
The experiment is to compare the difference in KIM LHC risk score and subjective fatigue perception on 4 static experimental conditions against the dynamic control condition. The control condition is based on the caution zone of WISHA screening tool. These 4 dynamic static experimental conditions vary in various work-rest periods, such as 5-2.5, 10-5, 20-10, 40-20 min. To be sensitive, an awkward working posture of holding 0.5 kg weight over the shoulders was devised. Ten young men were recruited as subjects. Based on experimental results, the difference between risk scores and subjective fatigue perception are compared, the discrepancy serves as the adjustment for the time rating scale of KIM LHC.
According to this supplement, the risk scores of 5 old cases were re-assessed. The results show that the new supplement is able to fine-tune the risk score to match our subjective fatigue perception.

[1] Liang Hui-Wen, Labor investigate yearly report, A brief of WMSDs, Industrial safety scientific and technological quarterly, Council Of Labor Affairs Executive Yuan Taiwan 2003, Vol.50, P.2-6
[2] Nonfatal occupational injuries and illnesses requiring days away from work, U.S. Bureau of Labor Statistics 2005~2009
[3] Machi Suka, Katsumi Yoshida, Musculoskeletal pain in Japan：prevalence and interference with daily activities, Japan College of Rheumatology and Springer-Verlag Tokyo 2005
[4] Health and safety statistics 2004/05~2009/10, Health and Safety Executive
[5] Musculoskeletal disorders in Europe-Definitions and statistics, EUROGIP 2007
[6] W. Monroe Keyserling, Sheryl S. Ulin, 2004, Case Studies of Ergonomic Interventions in Automotive Parts Distribution Operations, Journal of Occupational Rehabilitation, Vol.14, No.4.
[7] E. N. Corlett, I. Manenica, 1980, The effects and measurement of working postures, Applied Ergonomics, Vol.11, No.1, 7-16
[8] Kermit G. Davis, William S. Marras, “Partitioning the contributing role of biomechanical, psychosocial, and individual risk factors in the development of spine loads”, The Spine Journal 2003, vol.3, pp.331-338
[9] Waters, T.R, Putz-Anderson V., Garg A., Fine L. J., 1993, Revised NIOSH equation for the design and evaluation of manual lifting tasks, Ergonomics, 36, 749-776.
[10] Waters, T.R, Baron, S.L., Kemmlert, K., 1998, Accuracy of measurements for the revised NIOSH lifting equation, 29, 433-438.
[11] Chung, M.K. and Kee, D., 2000, Evaluation of lifting tasks frequently performed during fire brick manufacturing processes using NIOSH lifting equations, International Journal of Industrial Ergonomics, 25, 423-433.
[12] Van der Beek, A.J., Mathiassen, S.E., Windhorst, J., Burdorf, A., 2005, An evaluation of methods assessing the physical demands of manual lifting in scaffolding, Applied Ergonomics, 36, 213-222.
[13] Ayoub, M. and Mital, A. 1989, Manual Materials Handling, London: Taylor & Francis
[14] Chaffin et al., Occupational biomechanics, John Wiley & Sons 1988, p.293
[15] Waters, T.R, Putz-Anderson V., Garg A., Fine L. J., 1993, Revised NIOSH equation for the design and evaluation of manual lifting tasks, Ergonomics, 36, 749-776.
[16] Waters, T.R, Baron, S.L., Kemmlert, K., 1998, Accuracy of measurements for the revised NIOSH lifting equation, 29, 433-438.
[17] Chung, M.K. and Kee, D., 2000, Evaluation of lifting tasks frequently performed during fire brick manufacturing processes using NIOSH lifting equations, International Journal of Industrial Ergonomics, 25, 423-433.
[18] Van der Beek, A.J., Mathiassen, S.E., Windhorst, J., Burdorf, A., 2005, An evaluation of methods assessing the physical demands of manual lifting in scaffolding, Applied Ergonomics, 36, 213-222.
[19] Ayoub, M. and Mital, A. 1989, Manual Materials Handling, London: Taylor & Francis
[20] Khalid El ahrache, Daniel Imbeau,2009,Comparison of rest allowance models for static muscular work, International Journal of Industrial Ergonomics,73-80
[21] Mary T. Moffroid, PhD, PT,1997,Endurance of trunk muscles in persons with chronic low back pain : Assessment, performance, training, Journal of Rehabilitation Research and Development Vol. 34 No . 4, 440-447
[22] Karhu, O., Kansi, P., and Kuorinka, I., 1977. “Correcting Working Postures in Industry: A Practical Method for Analysis”, Applied Ergonomics 1977, Vol.8, No.4, 199-201.
[23] Osmo Karhu, Reino Harkonen, Pentti Sorvali and Pentti Vepsalainen, “Observing working postures in industry : examples of OWAS application”, Applied Ergonomics 1981, Vol.12, No.1, 13-17
[24] Hamrick C.,“Overview of Ergonomic Assessment.” In W.S. Marras & W.Karwowski (eds), Fundamentals and Assessment Tools for Occupational Ergonomics,Taylor & Francis Group,Vol. 34,pp.1-11 (2006).
[25] Graham, B., Nicola, R., 1996. “Working Practices in a Perchery System, Using the Ovako Working Posture Analyzing System”, Applied Ergonomics 1996, Vol.27, No.4, 281-284.
[26] Khalid El ahrache, Daniel Imbeau, Bruno Farbos,2006,Percentile values for determining maximum endurance times for static muscular work,International Journal of Industrial Ergonomics 36, 99–108
[27] OHSCO’s Musculoskeletal Disorders Prevention Series Part 3: MSD Prevention Toolbox – Final Draft ,2007
[28] Lynn McAtamney and E.Nigel Corlett, 1993, “RULA: a survey method for the investigation of related upper limb disorders“ Applied Ergonomics 1993, Vol.24, No.2, 91-99.
[29] RULA - A RAPID UPPER LIMB ASSESSMENT TOOL, Lynn McAtamney and Nigel Corlett, http://www.rula.co.uk/brief.html 123

[30] McAtamney, L. & Corlett, E.N. , 2004, Rapid Upper Limb Assessment (RULA) In Stanton, N. et al. (eds.) Handbook of Human Factors and Ergonomics Methods, Chapter 7, Boca Raton, FL, pp. 7:1 - 7:11
[31] Sue Hignett,Lynn McAtamney,2000,Rapid Entire Body Assessment (REBA), Applied Ergonomics 31,201~205
[32] Mathilde C. Miedema , Marjolein Douwes, Jan Dul,1997,Recommended maximum holding times for prevention of discomfort of static standing postures, International Journal of Industrial Ergonomics 19, 9-18
[33] Hakan Sporrong, Leif SandsjoK , Roland Kadefors, Peter Herberts,1999, Assessment of workload and arm position during different work sequences: a study with portable devices on construction workers, Applied Ergonomics 30 , 495~503
[34] Arun Garga, Kurt Hegmannb, Jay Kapelluscha,2006, Short-cycle overhead work and shoulder girdle muscle fatigue, International Journal of Industrial Ergonomics 36 ,581–597
[35] Alireza,Choobineh,Abdolreza,Rajaeefard,Masoud,Neghab,2006, Association Between Perceived Demands and Musculoskeletal Disorders Among Hospital Nurses of Shiraz University of Medical Sciences: A Questionnaire Survey, International Journal of Occupational Safety and Ergonomics (JOSE) Vol. 12, No. 4, 409–416
[36] S Luoto BM’, M Heliijvaara MD’, H Hurri MD’, H Alaranta MD,1995, Static back endurance and the risk of low-back pain, Clinical Biomechanics Vol. 10, No. 6, pp. 323-324
[37] André Klussmann1, Ulf Steinberg, Falk Liebers, Hansjürgen Gebhardt1 and Monika A Rieger, 2010, The Key Indicator Method for Manual Handling Operations (KIM-MHO) - evaluation of a new method for the assessment of working conditions within a cross-sectional study, BMC Musculoskeletal Disorders, 11:272
[38] U. Steinberg, S. Behrendt, G. Caffier, K. Schultz, M. Jakob, 2008., Key indicator method manual handling operations- Design and testing of a practical aid for assessing working conditions, Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Project number: F 1994
[39] Lori L. Winnemuller,Peregrin O. Spielholz, William E. Daniell,
and Joel D. Kaufman1,2004,Comparison of Ergonomist, Supervisor, and Worker Assessments of Work-Related Musculoskeletal Risk Factors, Journal of Occupational and Environmental Hygiene, 1: 414–422
[40] Washington State Department of Labor and Industries, 2000, SAFETY BULLETIN 00-6：Ergonomics Rule
http://www.pmanet.org/?cmd=main.content&id_content=961783998
[41] Thomas E. Bernard,2010,Washington State WISHA Screening Tool (Modified) Version 2.0 , Washington State Department of Labor and Industries
[42] Council Of Labor Affairs Executive Yuan Taiwan, Human Factor Guide Book, Taipei 1995.
[43] Assessment of manual handling tasks based on key indicators,Version 2001
[44] Assessment of pulling and pushing based on key indicators ,Version 2002
[45] SHARP, Safety and Health Achievement Recognition Program, Retrieved from http://www.osha.gov/dcsp/smallbusiness/sharp.html
[46] OSHA, Ergonomics: The Study of Work, 2000, U.S. Department of Labor Occupational Safety and Health Administration
[47] Easy Ergonomics：A Practical Approach for Improving the Workplace”, Cal/OSHA Consultation Service, California Department of Industrial Relations 1999.
[48] Niklas Krause et al.,“Physical Workload Ergonomic Problems and Incidence of Low Back Injury: A 7.5-Year Prospective Study of SanFrancisco Transit Operators”, American Journal of Industrial Medicine 2004, vol.46, pp.570-585
[49] WORKING CONDITIONS : A QUARTER OF EU CITIZENS SUFFER FROM MUSCULOSKELETAL DISORDERS, European Social Policy
[50] Chapter9 Health Care Utilization and Economic Cost, The Burden of Musculoskeletal Diseases in the United States
[51] Health and Safety Executive, Manual handling assessment chart (MAC) tool,
http://www.hse.gov.uk/msd/mac/
http://www.hse.gov.uk/pubns/indg383.pdf
[52] Health and Safety Executive, Assessment of Repetitive Tasks (ART) tool,
http://www.hse.gov.uk/msd/uld/art/index.htm
http://www.hse.gov.uk/pubns/indg438.pdf

中文文獻

[53] 徐儆暉、李諭昇，「工作環境安全衛生狀況認知調查-2007 年」，行政院勞工委員會勞工安全衛生研究所，IOSH96-M319，台北(2008)
[54] 行政院勞工委員會勞工保險局,勞工保險統計年報民國94年~98年,
[55] 高雄榮民總醫院神經外科,腰椎椎間盤突出症手術後須知，http://www2.vghks.gov.tw/HE/pdf/7620002_1.pdf
[56] 陳協慶、杜宗禮、劉永平，「手腕部肌肉骨骼傷害危害因子暴露調查研究」，行政院勞工委員會勞工安全衛生研究所委託研究報告，IOSH95-H102，台北(2007)。
[57] Mark S. Sanders,Ernest J. McCormick, 譯者：吳水丕, 許勝雄, 彭游,人因工程-工程與設計之人性因素, 滄海書局
[58] 潘儀聰、游志雲，人因工程現場不良工作姿勢改善績效評估研究，行政院勞工委員會勞工安全衛生研究所，民國97年
[59] 潘儀聰、游志雲，工作場所人因工程危害預防效益研究，行政院勞工委員會勞工安全衛生研究所，民國98年
[60] 李正隆，人因工程常用的評估技術即案例探討，人因工程危害預防技術研討會，經濟部工業局主辦，中華民國工業安全衛生協會執行
[61] 行政院勞工委員會勞工安全衛生研究所，人因工程肌肉骨骼傷害預防指引,2001.12.02
[62] 陳協慶，人體衝擊性振動測定軟體編寫與現場測定，勞工安全衛生研究所，2007
[63] 職業相關肌肉骨骼疾病之流行病學, 工業安全科技 第五十期
[64] 江傳江, 肌肉骨骼評估基礎與技術, 2003, 合記書局, 台北