DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention 

National Institute for Occupational Safety and Health

Summary

Baggage screeners and handlers 

at airports are exposed to manual 

baggage lifting and handling that are 

associated with work-related musculoskeletal disorders (WMSDs). 

The National Institute for Occupational Safety and Health (NIOSH) 

evaluated two mechanical lift aids 

to determine if they could reduce 

the risk of WMSDs. The two mechanical lift aids reduced some 

physical WMSD risk factors such 

as hand loading and spinal compression force. 

Reducing Musculoskeletal Disorders among 

Airport Baggage Screeners and Handlers 

Description of 

the Problem

Approximately 45,000 baggage screeners and 173,700 baggage handlers are 

employed in U.S. airports by the Transportation Security Administration 

(TSA) and airline carriers, respectively. 

Manual lifting and materials handling 

have been shown as main risk factors for 

WMSDs [NIOSH 1997]. The average 

weight of checked bags is about 32 lbs, 

and the maximum baggage weight can 

reach up to 70 lbs or more [NIOSH 

2014]. Manual baggage lifting and handling are therefore considered the main 

risk factors for WMSDs among baggage screeners and handlers. A portion 

of the checked bags are manually handled by baggage screeners, while every 

checked bag is required to be manually 

transferred to airplanes by carrier baggage handlers. 

In most airports, checked bags are 

screened by screening machines. If machine screening cannot be completed, 

manual screening is required to clear 

bags in a baggage screening area. To 

perform manual screening tasks, a bag 

is typically lifted or pulled by a baggage 

screener from the inbound conveyor. 

Once manual screening is completed, the 

bags are lifted to an outbound conveyor 

that is separate from the inbound conveyor, requiring lifting and carrying. If 

screening machines are located in the 

airport lobby area, baggage screeners 

may be required to manually lift each 

checked bag twice—transporting the 

bag from the floor to the machine and 

from the machine to the conveyor connected to the baggage make-up area 

for airline carriers. Therefore, baggage 

screeners working in checked baggage 

screening areas may be involved in intensive baggage lifting in some settings, particularly during rush hours. 

Once checked bags are cleared by 

baggage screeners, they typically are 

transported on a conveyor to the baggage make-up area where the checked 

bags are manually transported to baggage carts and then airplanes by carrier baggage handlers. Carrier baggage handlers who work in the ramp 

area (i.e., the area where airplanes are 

parked for departure and arrival) lift 

bags onto a belt loader from a cart, 

handle bags at the airplane cargo compartment doors, and stack bags inside 

cargo compartments. They reverse the 

operations when bags are unloaded 

from the cargo compartments. Carrier baggage handlers typically lift 

5−10 bags per minute during loading/

unloading to the airplane [Oxley et al. 

2009]. Risk factors for WMSDs associated with these tasks include heavy lifting, awkward and restricted postures 

(in the small cargo areas), and time 

pressure [Tapley and Riley 2005; Tapley et al. 2007]. The problem is more 

acute when handlers load narrowbodied airplanes with a cargo ceiling 

ranging from 46−55 inches. Automatic container systems for loading 

and unloading checked baggage have 

been used in larger airplanes, but are 

not available for narrow-bodied airplanes. 
NIOSH Case Studies

NIOSH evaluated the effect of two ergonomic interventions 

on the risk of WMSDs among baggage screeners [NIOSH, 

2014]. The main findings are summarized below: 

Vacuum Lifting Assist Device

Operation of the vacuum lifting assist system (Figure 1) 

involves pushing and pulling the controller as the vacuum 

power lifts the bag. Three bag weights (25, 40, and 50 lbs) were 

tested in the study. When the system was used, the average 

minimal pushing/pulling force was reduced to 2.7, 4.0, and 

4.2 lbs, respectively. Compared to the hand forces measured 

during lifting, this was approximately a 90% reduction when 

using the vacuum system. In addition, the vacuum lifting 

assist system resulted in improved postures (near neutral 

trunk flexion angles) because of the adjustable controller 

that can keep the bag at the optimal height for lifting. The 

reduced hand force and improved posture resulted in a 63% 

measured reduction of the compressive force in the lower 

back [NIOSH 2014]. 

pushing force is about 80% of the force required for manual 

lifting of a 25- or 50-lb bag. The posture and force involved 

in using the system resulted in a 44% reduction in the 

compressive force in the lower back [NIOSH 2014]. 

Table 1 summarizes the features of the vacuum lifting assist 

and the automatic baggage moving systems.

Other Risk Control Methods

Mechanical lift aids are recommended to be used as the 

primary risk reduction method for baggage handling [Tapley 

and Riley 2005; Tapley et al. 2007]. For baggage handling in 

the airplane cargo space, certain methods of loading and 

stacking bags may also help reduce strain on the back [VatanKorkmaz et al. 2006]. These may include marking heavy bags 

so they can be slid into the cargo and lighter bags lifted on 

top [Vatan-Korkmaz et al. 2006]. Job rotation, short breaks, 

and training on proper lifting procedures (lifting above the 

knees, below the shoulder, and close to the body) are other 

administrative controls that may help reduce the risk of 

injury [Dell 1998; NIOSH et al. 2007]. Baggage-handling jobs 

are associated with low levels of employee control over tasks, 

time pressure, and low social support [Rosskam 2007]. These 

workplace factors may also play a role in the development 

of WMSDs, although they are not as evident as the physical 

job demands [NIOSH 1997; da Costa 2010]. Reductions in 

the workplace stressors in the work environment may help 

prevent WMSDs [Hauke et al. 2011]. 

Acknowledgments

This document was prepared by Ming-Lun Lu, Susan Afanuh, 

Robert Dick, Dwight Werren, and Thomas Waters of the 

National Institute for Occupational Safety and Health. The 

authors would like to thank Brian Lowe, Tarah Cole, Jessica 

Burkhart, and the TSA for their support in data collection 

and analysis. Mention of any company or product does not 

constitute endorsement by NIOSH. 

Automatic Baggage Moving System

The automatic baggage moving system (Figure 2) is a 

conveyor that helps move the bags from the screening area 

to the outbound conveyor. Unlike the traditional conveyor 

systems, this system does not connect the two ends of the 

working area. It connects to one end at a time, then moves 

itself automatically to the other end as it senses the bag that 

is loaded to the moving system. This system might be shared 

between two work stations connected by a roller bed. This 

intervention eliminates lifting entirely, but requires manual 

pushing to load the bag from the screening table through 

the roller bed to the baggage moving system. The average 

Figure 1. A baggage handler lifts a bag with a vacuum 

lifting assist device

Figure 2. An automatic baggage moving system

Photo by NIOSH

Photo by NIOSH
References

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http://www.bls.gov/iif/oshwc/osh/case/ostb2924.pdf 

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screening processes. By Lu M, Dick R, Werren D, Lowe B. 

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risks for airport baggage handlers. London: Health and Safety Executive. http://www.hse.gov.uk/research/rrpdf/rr675.pdf 

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changing the workplace. Amityville, NY: Baywood Publishing Company Inc. 

Tapley S, Riley D [2005]. Baggage handling in narrowbodied aircraft: identification and assessment of musculoskeletal injury risk factors. London: Health and Safety Executive. http://www.hse.gov.uk/airtransport/docs/baggage.pdf 

Table 1. Features of ergonomic interventions for baggage screening and handling

Vacuum lifting assist device

Automatic baggage

moving system

Hand force reduction* 90% 20%

Reduction of spinal compressive 

force in the lower back†

63% 44%

Cost ~$10−30K per unit, depending on 

configuration. Additional costs may 

be incurred when taller ceilings are 

required.

$50K per unit

Noise Potential for noise exposure from 

vacuum pump motor due to improper housing

Minimal noise

Sharing capability Overhead trailing system allows for 

sharing between multiple work stations

Limited sharing capability

(1−2 workstations)

Configuration constraint Required taller ceiling to accommodate the long vacuum hose

Potential egress/ingress concerns 

because of railing system on the 

ground/floor

Bag transfer Potential inability to pick up bags 

with uneven surfaces

Capable of transferring all bags,

including very heavy ones

Work cycle Adjustable, and shorter cycle time 

determined by user

Longer cycle time because of slower 

operating speed

*Hand force is pushing/pulling force. The reduction is compared with manual lifting force.

†

Data is compared with that for manual lifting.
Tapley S, Riley D, Oxley L [2007]. Baggage handling in narrow-bodied aircraft: further risk identification. London: 

Health and Safety Executive. http://www.crcnetbase.com/

doi/abs/10.1201/9780203883259.ch74 

Vatan-Korkmaz S, et al. [2006]. Baggage handling in an airplane cargo hold: an ergonomic intervention study. Int J Ind 

Ergonomics 36:301−312. http://biodynamics.osu.edu/publication%20pdf/2006/Baggage%20Korkmaz%202006.pdf 

Suggested Citation

NIOSH [2015]. Reducing musculoskeletal disorders among airport baggage screeners and handlers. By Lu M, Afanuh S, Dick 

R, Werren D, Waters T. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. DHHS (NIOSH) Publication No. 2015-201.

For More Information For more information about work-related musculoskeletal 

For more information about work-related musculoskeletal 

disorders, visit the NIOSH website: 

http://www.cdc.gov/niosh/topics/ergonomics/ 

To obtain information about other occupational safety and 

health topics, contact NIOSH at 

Telephone: 1–800–CDC–INFO (1–800–232–4636)

TTY: 1–888–232–6348 ■ E-mail: cdcinfo@cdc.gov

or visit the NIOSH website at www.cdc.gov/niosh

For a monthly update on news at NIOSH, subscribe to 

NIOSH eNews by visiting www.cdc.gov/niosh/eNews 

Mention of any company or product does not constitute 

endorsement by NIOSH. In addition, citations to websites 

external to NIOSH do not constitute NIOSH endorsement 

of the sponsoring organizations or their programs or products. Furthermore, NIOSH is not responsible for the content of these websites.

This document is in the public domain and may be freely 

copied or reprinted. NIOSH encourages all readers of the 

Workplace Solutions to make them available to all interested employers and workers.

As part of the Centers for Disease Control and Prevention, NIOSH is the Federal agency responsible for conducting research and making recommendations to prevent 

work-related illness and injuries. All Workplace Solutions

are based on research studies that show how worker exposures to hazardous agents or activities can be significantly reduced.

DHHS (NIOSH) Publication No. 2015-201

Reducing Musculoskeletal Disorders among Airport 

Baggage Screeners and Handlers 

SAFER • HEALTH • PEOPLETM August 2015