Abstract Types of low-cost improvements that could reduce work-related musculoskeletal disorders were reviewed by examining simple improvements in materials handling and workstations undertaken within a Work Improvement in Small Enterprises (WISE) project in the Philippines. Serial WISE action-training courses in four regions of the Philippines yielded many improvements relying on local resources. Over 2000 improvements resulted from participatory activities in small groups, and many of them were found to relate to actual reduction of musculoskeletal loads. Typically, these improvements, mostly implemented at low cost during the course period of about 2 weeks, concerned the use of push carts or lifting devices, better worksite layout, worktables and chairs of appropriate height, fixing handtools, better lighting, job rotation and inserting breaks. The effects of such improvements on reducing workloads were investigated by case study measurements applying electromyography, heart rate recording and posture study methods. Reduced muscular activities were found after work changes associated with improved materials transport, avoiding deep bending postures, fixing handtools or better work organization. Productivity increase was also confirmed in some cases. There was thus a variety of work improvements undertaken by managers and workers of small enterprises through voluntary training steps, often with combined effects on reducing musculoskeletal loads and improving other aspects of working conditions. This flexibility in work re-design seemed necessary in promoting multiple changes linked with a reduced musculoskeletal risk. Such examples collected from WISE training courses proved useful for various training programmes and advisory inspections. These results demonstrated the importance of undertaking multiple work improvements on voluntary basis in reducing the risk of musculoskeletal disorders in a large number of small enterprises. Relevance to industry There is a perception in industry that improvements to reduce the risk of musculoskeletal disorders are too costly. This paper demonstrates that a participatory approach can be successful in making work improvements with very little cost. Further, the work improvements reduced the risk of musculoskeletal disorder and increase productivity.
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