Application of the ROSA Method for Evaluating Ergonomic Risk in University Students in Mexico During Remote Learning Due to COVID-19

Abstract

It is imperative that society becomes aware of ergonomic risks, not only in an occupational place but also in everyday contexts where they can go unnoticed, such as the educational sector, and in the specific case of students. To identify this risk, an ergonomic assessment was conducted on students in Mexico during remote learning due to COVID-19. To this end, a survey was applied, and the ROSA (Rapid Office Strain Assessment) method was used. According to the survey results, the students reported adopting inappropriate postures during online classes and suffering from musculoskeletal pains. Furthermore, they showed a strong interest in learning about ergonomics and improving their postures. In addition, the application of the ROSA method yielded a significant result 60% of the evaluated students are at high or very high ergonomic risk. Regardless of their profession, ergonomics should be integrated as part of educational programs. This measure would help prevent musculoskeletal disorders once students transition into their respective work environments.

1. Introduction

The COVID-19 pandemic forced university students to rapidly adapt to new educational initiatives, which have resulted in dramatic increases in occupational computer use. The proliferation of portable devices (i.e., laptops, tablets) and the maturation of conferencing software have made it a viable option to attend any class or activity [1]. This trend in computer usage has been associated with an increase in musculoskeletal disorders and other symptoms [2].

Related to ergonomic risk, “the occupational exposure to ergonomic risk factors is defined as occupational exposure to one or more of force exertion, demanding, posture, repetitive movement, hand-arm vibration, kneeling or squatting, lifting, and climbing” [3]. Additionally, musculoskeletal disorders are presented according to the workers’ postures and the movements they perform in their workplace [4].

In this context, the musculoskeletal system plays a relevant role in physiological health, as it supports the body’s movements and posture. However, as part of ergonomic risks, musculoskeletal disorders can be generated as a group of inflammatory or degenerative diseases affecting various parts of the body, such as the neck, back, arms, and legs [5].

The World Health Organization (WHO) and the International Labor Organization (ILO) attribute the burden of osteoarthritis and other musculoskeletal diseases to occupational exposure to ergonomic risk factors [6]. The use of computers, laptops, and tablets in the workspace has been documented since the 1980s, and with the COVID-19 pandemic, the number of people working from home has increased exponentially [7]. Risk factors of computer equipment use are: (1) hands and wrists [8,9,10], (2) head and neck, and (3) shoulder, elbow, and lower back [11].

During the COVID-19 pandemic, teachers and students started experimenting with virtual classes, and rapidly, this new virtual learning through videoconferencing operated entirely in every school environment. However, most students did not have adequate space, dedicated to an ideal home office [12]. Under these conditions, teachers and students are prone to a negative experience, such as neck pain, lower back pain, and shoulder pain, all ergonomic risk factors associated with musculoskeletal disorders [13].

The RULA method (Rapid Upper Limb Assessment) was created to evaluate ergonomic risk and identify postures that can lead to musculoskeletal disorders [14]. RULA evaluates neck, trunk, upper limb postures, muscle functions, and the loads experienced by the body [15]. However, the RULA method does not consider the quality of the workstation setup. In this context, the Rapid Office Strain Assessment (ROSA) method was developed specifically to evaluate office work and musculoskeletal disorder risk factors [16]. The ROSA method evaluates body positioning and considers how the individual interacts with their office equipment [16].

The ROSA method was selected for this study because it can make a rapid assessment with urgent action steps if necessary, and it can be applicable where people sit in a chair, at a desk, and operate a computer with a screen. These activities are closely related to the academic practices that the students perform. Additionally, the ROSA method has been used to evaluate ergonomic risk in the academic field [17,18,19,20].

In addition, several studies have been conducted worldwide evaluating ergonomic risk in universities, involving teachers and/or students who are exposed to ergonomic risks during their academic activities. Table 1. Summary of the literature review of ergonomic risk factors in the academic field, showing a recent increase in ergonomics research within the education sector.

Table 1. Summary of the literature found on ergonomic risk factors in the academic field.

Study	Method	Results
Determine the prevalence of musculoskeletal disorders in teachers [21]	Musculoskeletal fitness questionnaires and assessment. Sample 122.	Prevalence in 77.8% of teachers with musculoskeletal disorders, mainly affecting the lower back, neck, and fat percentage.
Mapping the evidence of burnout syndrome in teachers and its relationship with ergonomics and biopsychosocial aspects [22].	Review	Eighteen studies in 12 countries found that various ergonomic factors caused Burnout Syndrome, so the relationship between the syndrome and teachers’ activities should be studied to confirm the relationship.
To examine the prevalence of musculoskeletal disorders and gender differences among teachers [23].	Survey. Sample 460.	There was a prevalence of 61.7% of musculoskeletal disorders, and there is a gender difference in the prevalence of this disorder (men have a higher prevalence).
Estimate the prevalence and patterns of musculoskeletal disorders among female teachers and the sociodemographic and psychosocial factors that may affect them [24].	Questionnaire. Sample 240.	A prevalence of musculoskeletal discomfort is observed: 63.8% in the lower back, 45.4% in the shoulders, 42.1% in the neck, 40% in the legs, 16.2% in the wrists, and 10% in the elbow.
It was known that the health status of students with inadequate ergonomic conditions [25].	Questionnaire. Sample 2223.	Recommendations were developed to adjust classroom conditions, such as chair and desk conditions.
Evaluate the potential of classroom furniture in universities in Bangladesh [26].	Anthropometric measurements. Sample five hundred.	The chair and the desk do not meet the proper ergonomic conditions for students.
To investigate ergonomic factors associated with the work area in teachers and teaching assistants and to evaluate the correlation of musculoskeletal disorders [27].	Questionnaire. Sample 388.	Approximately 86% of teachers experience musculoskeletal disorders.
Develop a design of chairs for university students [28].	Anthropometric measurements. Sample 385.	The chair must be designed to meet the ergonomic conditions of students in order to produce healthy professionals.
Define a new method contributing to research feelings and discomfort in dynamic conditions [29].	Desk Mounted Pressure Data. Sample twenty-five.	It has been shown that performing many movements in a small space increases discomfort, but when changes in movements are made, the discomfort decreases.
Identify the most relevant ergonomic risk factors and their future implications [30].	Structural factor analysis and interview. Sample eighteen validated factors.	If students improve their ergonomic practices and become informed, ergonomic-related health problems can be minimized.
To assess ergonomic risk factors for musculoskeletal disorders in industrial engineering students during online classes [17].	ROSA method. Sample 152.	The students evaluated are prone to developing musculoskeletal disorders.
Design a program to give ergonomic risk prevention among teachers [31].	RULA, REBA, OWAS, and EPR. Sample twenty.	The most significant risk to teachers is to the spine due to improper posture.
Identify ergonomic risks [32].	Survey. Sample: 20 teachers and 60 students.	It was found that posture and environmental conditions, such as noise, lighting, and temperature, are associated with risks. The risk factors were also due to the fact that teachers did not have a space or adequate furniture to carry out their activities. Coupled with inadequate posture and long work periods, these factors generated discomfort mainly in the neck, shoulders, dorsal, and lumbar back.
Ergonomic assessment study on teachers with teleworking [19].	ROSA method and survey. Sample: 157 teachers.	Teachers present ergonomic problems due to the unfavorable conditions for teleworking activities. The neck, upper, and lower back were the body parts affected.
Ergonomic risk assessment in teachers during online courses [20].	ROSA method. Sample thirty teachers.	Inadequate and repetitive postures, visual fatigue, and musculoskeletal discomfort were observed.

In this study, we used a survey to evaluate ergonomic risk factors in university students exposed to virtual classes during the COVID-19 pandemic. The high frequency of ergonomic risk factors associated with the computer equipment during virtual classes indicates a need to propose a plan of recommendations to improve postures and provide strategies to improve and lower the intensity of symptoms and minimize disability during virtual scholar activities.

2. Materials and Methods

Study design: a quantitative study with an observational and cross-sectional design was conducted to assess ergonomic risk among university students in Mexico during the COVID-19 remote learning period. The analysis was primarily descriptive to identify baseline patterns and trends for future large-scale research. This methodological approach was necessitated by the logistical and financial constraints of the pandemic, which limited the sample size and precluded inferential analysis.

Data was collected through surveys and an evaluation of the risk assessment for the students. The research was divided into two stages: (1) apply an inquiry to the students, (2) perceive the main muscle discomfort in students (ROSA method).

Participants and sampling: the study was conducted by identifying all academic programs offered by the university. Subsequently, four programs were selected through a convenience sampling method to facilitate the application of data collection instruments and ensure operational feasibility, given the logistical constraints inherent to the study context. For stage 1, a statistically representative survey was applied with 95% reliability and a maximum allowed error (α) of 0.05. The calculation resulted in a required sample of 280 students. It is important to mention that in this study, 289 students were evaluated with the survey, and it was applied in order to assess the students’ opinion about the ergonomic risk they consider themselves exposed to during remote learning due to COVID-19.

For stage 2, a control group was selected in order to compare the data information obtained from the survey. In this case, 20 students of the academic program of environmental engineering were selected based on convenience for assessment. In addition, the COVID-19 pandemic complicated traditional ergonomic assessment; home visits were necessary to satisfy the ROSA method’s direct observation requirements for postural analysis during academic activities. The analysis was facilitated by the use of the Ergoniza software 3.5. All visits were conducted under strict safety protocols. Participant recruitment and data collection for the FTPs occurred between January and June 2021.

Inclusion criteria: (a) Academic criterion (belongs to the academic programs selected, bachelor’s degrees in ecology, environmental engineering, horticultural engineering and geoscience); (b) Geographical criterion, students must reside within the urban area of Hermosillo, Sonora, to ensure the viability and reduce the operational cost associated with in-home evaluation visits; (c) access criterion, students must provide their informed consent to participate and offer the opportunity to conduct in situ postural evaluation visits in accordance with the ROSA method.

Measures and Data Analysis. Once the data on ergonomic risks was collected, the Ergoniza software 3.5 (ROSA method) was applied for analysis. The data obtained from the surveys was automatically compiled into a Google spreadsheet linked to the form. The questions were multiple choice and were designed focus on identifying the conditions in which they attend their online courses.

3. Results

3.1. Stage 1

The main results obtained from the survey application are presented in stage 1. This data establishes the foundational context regarding students’ current knowledge and reported difficulties related to ergonomics. The results obtained from the application of the survey to the evaluated students are presented in the Supplementary Materials.

Considering the rapid change that occurred due to the COVID-19 pandemic, students had to address the change from face-to-face to virtual modality to attend their classes. This was difficult for the students since they had always been in a traditional learning system. Derived from the above, there were aspects that were left aside, such as ergonomics, which caused students to migrate to a 100% online activity. In addition to the above, the students were sitting in front of the monitor, considering the survey of the students evaluated, 49% indicated that they spent between 3 and 5 h in front of the monitor. Instead, the students were not provided with information about what actions they could carry out for correct ergonomics and to avoid musculoskeletal injuries. In fact, 92% of the students surveyed indicated that they would like to know how to improve their ergonomics.

Another important issue is the conditions in which students attend their online classes; according to the students surveyed, 83%, that is 239 students, indicated that they attended their classes from home, which, due to improvisation, did not give them the opportunity to have an adequate space to attend their classes and had to adapt the conditions of their home for their online classes. This finding is consistent with the students’ self-reports, in which 69% of the students indicated that they had experienced back, shoulder, and neck pain.

The results demonstrate a deficit in the student population’s knowledge regarding ergonomics principles and the correct postures required to mitigate associated risk. This evidence reflects a significant lack of specific information concerning several critical factors, including the necessity of break times, the optimal frequency for interrupting academic activities, and the appropriate type of chair for study. This collective unawareness directly contributes to a higher probability of ergonomic risk, primarily resulting in musculoskeletal problems due to the adoption of inadequate postures.

3.2. Stage 2

A value of one indicates that no risk is observed. Values between two and four indicate that the risk level is low, but that some aspects of the workstation are improvable. Values equal to or greater than five indicate that the risk level is high [33]. The ROSA method was applied to 20 students of environmental engineering. It can be observed that 5 of the 20 students (25%) are exposed to a very high ergonomic risk. Additionally, there were 7 students (35%) who were exposed to high ergonomic risk. Finally, there were 8 students (40%) at an improbable risk.

It is important to indicate that the results are because of the conditions in which the students are taking their online classes. The main problems were that their chairs do not have armrests. The seat height is not adjustable, which causes the screen height to be incorrect. On the other hand, the screen height is low, causing students to tilt their necks and backs. Considering keyboards are high, the wrists are not straight, and according to the mouse. Most of the students found themselves with their backs bowed and not fully supported by the backs of the chairs they used. It was observed that in several cases, the students were shrugging their shoulders to reach their keyboard or mouse. Additionally, there were students whose feet did not fully support them on the ground, either because their legs were crossed or bent, or because the height of the chair was incorrect.

4. Discussion

The education sector extends beyond traditional occupational contexts to include the education sector [21]. This contextually relevant observation is strongly supported by the present study’s findings. The results confirm a significant prevalence of ergonomics risk associated with musculoskeletal disorders, which correlated with their reports of muscular pain and the adoption of inadequate postures. This aligns with what has been consistently observed in ergonomic risk research within the educational sector [17,28,32].

Although issues related to musculoskeletal disorders caused by adopting inadequate postures exist, there is still no concerted effort to raise awareness about preventing these problems in the educational sector [20]. In the present study, it was observed how students improvised their study areas to attend online classes during the COVID-19 pandemic. Furthermore, each student conditioned their area according to their economic possibilities. This is important given that improvements to furniture and classrooms have been proposed for existing university facilities, implying that even these established settings fail to meet the necessary ergonomic standards to prevent musculoskeletal disorders [25].

The findings from the ROSA assessment align with the self-reported discomfort survey. For instance, according to ROSA risk scores, 60% of students are exposed to high or very high ergonomic risk, which corresponds with the survey results showing that 69% of the students reported experiencing back, shoulder, and neck pain. This integration suggests that the observed ergonomic deficiencies are directly reflected in the participant’s ergonomic symptoms.

The need for early intervention is paramount, “a sustainable work life is of importance in all age groups when working life will be extended to a higher age”; however, it is also important to add that since the workers are studying [34], it will improve a sustainable work-life. There are authors who conclude that there is a positive effect on students who are trained in ergonomics when they are in their work area, once they finish their studies. Regardless of the profession, ergonomics should be part of educational programs, and this will help prevent musculoskeletal disorders when students are already in their work areas [35].

5. Conclusions

The evidence shows that even with ongoing documentation of musculoskeletal problems due to inadequate postures, proactive steps to educate on prevention are still absent from the educational sector. This shows the importance of immediate attention to the ergonomic conditions of the students. Furthermore, the improvisation of the study space, compounded by the knowledge deficit and pre-existing ergonomic deficiencies on campus, created a high-risk environment for student musculoskeletal health. Considering that, it is completely necessary to train students on ergonomics issues and how to adapt to the conditions they have at home so that it becomes a suitable space to take online classes.

Limitations

The ROSA sample size was limited due to COVID-19-related restrictions and logistical constraints, as academic activities were conducted remotely and many students lived outside the city. Additionally, the study had no financial support, which further restricted on-site assessments and travel. Consequently, a smaller, accessible sample was selected to ensure feasibility and safety. While this limits generalizability and inferential analysis, the study provides valuable exploratory insights using the established ROSA method.