Work-Related Musculoskeletal Risk Assessment in Beedi Workers Using RULA and OCRA Checklist: A Cross Sectional Study

Abstract Background: Beedi rolling is a highly repetitive occupation characterized by prolonged static postures and forceful hand movements, making workers vulnerable to work-related musculoskeletal disorders (WRMSDs). The prevalence of musculoskeletal symptoms in beedi workers ranges from 34.6% to 87.0% across different populations. Objective: To assess occupational ergonomic risk factors in beedi workers using the Rapid Upper Limb Assessment (RULA) and Occupational Repetitive Action (OCRA) Checklist, and to identify the correlation between assessment methods and symptom prevalence. Methods: A cross-sectional observational study was conducted with 320 beedi workers (mean age 40.6 ± 12.29 years) from urban beedi rolling units. Ergonomic assessments were performed using RULA (scores 1–7) and OCRA Checklist (Green/Yellow/Red/Purple categories). Musculoskeletal symptom prevalence was assessed using a standardized questionnaire. Postural analysis was conducted through direct observation and video recording during work cycles. Statistical analysis included descriptive statistics, chi-square tests for categorical associations, and Pearson correlation for assessment method comparison. Results: RULA assessment identified 50% of workers in high-risk category (scores 5–7), 35% in medium-risk (scores 3–4), and 15% in low-risk (scores 1–2). OCRA Checklist revealed 65% of workers in red/purple risk categories combined (medium-to-high risk), indicating significant repetitive strain exposure. Overall musculoskeletal symptom prevalence was 63.4% (n=203), with lower back (60%) and knee (50%) regions most commonly affected. Strong correlation existed between RULA scores and symptom prevalence (r = 0.78, p < 0.001) and between OCRA risk categories and upper extremity symptoms (r = 0.71, p < 0.001). Occupational duration significantly influenced risk levels; workers with >25 years experience showed 42% symptom prevalence compared to 7% in those with <5 years (p < 0.01). Conclusion: Both RULA and OCRA Checklist demonstrated high sensitivity in detecting ergonomic risk factors in beedi workers. The combination of these assessment methods provided comprehensive evaluation of upper extremity and postural risks. Significant WRMSDs burden necessitates immediate implementation of ergonomic interventions including workstation modification, task rotation, and regular rest intervals to reduce occupational health hazards in this vulnerable population.