# A Review on Ergonomics in Agriculture. Part I: Manual Operations
## 4 Discussion  
In the present analysis, a systematic review was performed regarding the identification of the key risk factors associated with MSDs coming from manual agricultural operations. Furthermore, the main root causes were determined along with the evaluation of the current ergonomic interventions. As a consequence, the entire range of ergonomics was captured pertaining to agriculture, which is an industry that occupies the majority of workers worldwide and is notorious for subjecting them to arduous working conditions. For this purpose, 27 papers were selected according to stated exclusive criteria that assured the uniqueness of the present bibliographic review as well as the validity and up-to-date record in this field. The systematic survey led to the classification of the papers into subcategories, which represent the ordinary manual tasks.  
The manual agricultural tasks are usually carried out under adverse weather and ground conditions. The most highly investigated rural activity during the last decade was harvesting, followed by load carrying, pruning, planting, digging, peeling (of pineapple), sorting, and weeding. Studies dealing with multiple agricultural activities were also detected. Interestingly, low-growing crops were investigated in the majority of the articles. This fact is related to the relatively low height, in terms of human body configuration, of the crops and the consequent stooping and kneeling positions that workers must maintain. Both stooping and kneeling, along with heavy carrying and lifting, were identified as potential risk factors for pathogenesis of MSDs. The repetitive nature of these actions deteriorates the pain and accelerates the onset of tissue injuries. Especially repetitive stooping seems to be responsible for the low back injuries, which are of epidemic proportion among agricultural workers. Personal characteristics, such as age, gender, and BMI, were also identified as potential risk factors. In addition, pesticide poisoning and inappropriate tools contribute to the development of MSDs. Finally, frequent rest breaks were suggested by a number of researchers, as well as frequent maintenance of the agricultural tools. The ergonomically designed tools along with special load transfer devices (in the form of suits) were observed to lessen MSDs. Finally, even relatively \"small changes\" in the design of common equipment, have been observed to make a \"big difference\" in the reported comfort of workers [20].  
Overall, more targeted research efforts are required based on the anthropometric characteristics and social policy and culture of each nation. For example, an ergonomic intervention may be beneficial in a specific country, while the same intervention can cause additional MSDs to workers due to the different anthropometric characteristics in another country. Although some risk factors are similar among several agricultural activities and commodities, each kind has its own ergonomic dangers and musculoskeletal injury complications. This means that although most ergonomic interventions are based on proven strategies, every task should be separately addressed.  
Definitely, automation is expected to replace most of the demanding agricultural manual operations and duplicate the adaptability of human beings in the near future. However, a number of barriers, ranging from social [3] and ethical [93] aspects, to technological [94] and monetary [95] aspects, still prevent a wide assimilation of robotic technologies in agricultural production systems. In any case, occupational health problems and safety is a major scientific discipline either for improving current operational systems or for designing human-centered future-envisioned robotized systems.