Will The Real Relationship Between Lean and Safety - Ergonomics Please Stand Up
Will The Real Relationship Between Lean and Safety - Ergonomics Please Stand Up
Applied Ergonomics
journal homepage: www.elsevier.com/locate/apergo
A R T I C L E I N F O A B S T R A C T
Keywords: This paper provides a review of studies containing safety and ergonomic outcomes in lean manufacturing (LM)
Toyota production system environments over the past 40 years. The aim is to identify effects from specific LM methods on specific safety/
Occupational safety ergonomic outcomes, to understand the relationship in greater detail. One hundred and one studies containing
one hundred and seventy outcomes were identified. Thirty-seven outcomes pertained to just-in-time (JIT) pro
duction, which contained twenty-three negative, eleven neutral, and three positive safety/ergonomic outcomes.
Conversely, twenty-six outcomes pertained to 5S and consisted of twenty-four positive, two negative, and no
neutral outcomes. The most common negative JIT outcome was stress and mental strain, while the most common
positive 5S outcome was a tie between safety performance and hazard exposure. Studies containing other
methods were fewer in number with more mixed outcomes. These findings suggest that individual LM methods,
especially JIT and 5S, uniquely contribute to the safety/ergonomic outcomes attributed to LM.
Practitioner summary (Gronning, 1997). Standardized work, which established written pro
cedures for each job and promoted worker interchangeability, came
A systematic review of the scientific literature over the past forty about in 1951; as did an employee suggestion system that would evolve
years (1980–2020) regarding the relationship between lean into the Kaizen method (Gronning, 1997). The most significant Toyota
manufacturing (LM) methods and occupational safety and ergonomics innovations of this post-WWII period were the concepts of just-in-time
(OSE). The purpose is to conduct a complete historical analysis of safety (JIT) production and Kanban “pull” supply systems, the operational
and ergonomic outcomes from LM systems and methods. Areas for control system for JIT (Sugimori et al., 1977). Several other TPS
future research are identified and discussed. methods evolved over time, such as Total productive maintenance
(TPM), an employee-involved method of improving machine perfor
1. Introduction mance (Suryaprakash et al., 2020), and 5S, a method to create a cleaner
and more efficient workspace (Goswami et al., 2019).
The Toyota Production System (TPS) originated in post-World War II In 1973, a dispute between the Organization of Petroleum Exporting
(WWII) Japan, as the Toyota Motor Company had to overcome such Countries (OPEC) and multinational oil companies resulted in massive
challenges as a 10 to 1 productivity gap with American manufacturers, a increases on the price of oil (Fattouh, 2007). Referred to as the “1973 oil
small domestic market, American intervention in labor disputes, and crisis”, this event was followed by a recession where Japan’s economy
eagerness of outside car manufacturers to establish operations in Japan fell to a state of zero growth; but Toyota gained the attention of Japanese
(Womack et al., 1990). To withstand these adverse economic conditions, industry by posting higher earnings than other companies in the years
Toyota began innovating manufacturing methods that would evolve into that followed (Ohno, 1988). Toyota disseminated its JIT production
the Toyota Production System (TPS). In 1946, what would later be management technology to other Japanese automakers in the late
known as the “lean factory layout” was born, where the factory floor was 1970s, and by the end of the decade all Japanese automakers had
altered so that workers could operate multiple machines simultaneously; adopted JIT (Nakamura et al., 1998). By 1980, Toyota and other Japa
and by 1947, each worker was operating an average of two machines nese auto manufacturers had become so competitive using the TPS
* Corresponding author. Auburn University Department of Industrial and Systems Engineering, 3301 Shelby Center for Engineering Technology Auburn, AL,
36849-5346, USA.
E-mail addresses: [email protected] (J.G. Brawner), [email protected] (G.A. Harris), [email protected] (G.A. Davis).
https://doi.org/10.1016/j.apergo.2021.103673
Received 6 July 2021; Received in revised form 2 November 2021; Accepted 15 December 2021
Available online 20 December 2021
0003-6870/© 2021 Elsevier Ltd. All rights reserved.
J.G. Brawner et al. Applied Ergonomics 100 (2022) 103673
system that they had gained a 22.2% market share in US passenger car outcomes (outputs), by synthesizing literature containing safety and
sales (Holweg, 2007). Japan was importing cars into the US at lower cost ergonomic outcomes associated with LM. The hypothesis is that LM
and higher quality than domestic cars, due mainly to this difference in methods, when considered individually, each have a unique influence
production control systems (National Research Council, 1982). In on the safety and ergonomic outcomes resulting from the use of LM. This
response to the loss of market share, American industry became focused higher level of detail might explain the contradictory outcomes found in
on how Japanese manufacturing methods could be adopted in the US. the literature, as the safety/ergonomic outcomes from an LM imple
However, the TPS concept entered North America through Japanese mentation could depend on the methods that are emphasized in that
“transplant” companies rather than through adoption by American car system.
companies (Robertson et al., 1992), and these transplant companies
outperformed American car companies in both quality and productivity, 2. Literature review method
just as with native Japanese car companies (Womack et al., 1990;
Krafcik, 1988). To understand the effect of LM on occupational safety and ergo
Evaluating the reasons for the disparity, John Krafcik (1988) coined nomics, a review was conducted with the goal of capturing, summari
the term “lean” in his 1988 thesis at the Massachusetts Institute of zing, and examining all safety and ergonomic outcomes related to the
Technology (MIT) to describe the TPS philosophy that was responsible use of LM methods found in the literature. The research referred back to
for the superior performance. Description of the “lean” production 1980, prior to worldwide adoption and 8 years before the term “lean”
process was then referenced in the books, “The Machine that Changed was introduced by Krafcik, attempting to gather all available literature
the World” (Womack et al., 1990) and “Lean Thinking” (Womack and on the topic. A systematic search and review was conducted based on the
Jones, 1996), which led to the mainstream establishment of “lean” as a method proposed by Grant and Booth (2009) which consists of separate
manufacturing model (Liker and Hoseus, 2010; Alkhoraif et al., 2019). phases for search, appraisal, and synthesis; and is designed for exhaus
As with the TPS, the key feature of lean manufacturing (LM) is to in tive and comprehensive searching. Relevant articles from 1980 to 2020
crease business performance through the elimination of seven wastes: were identified from five databases: Science Direct, Web of Science,
defects, overproduction, waiting, unnecessary transportation, excess Ergonomics Abstracts, PubMed, and Google Scholar. In addition, rele
inventory, motion, and over-processing (Ohno, 1988; Liker and Hoseus, vant articles cited in the identified manuscripts were also considered.
2010; Monden, 2011; Shingo and Dillon, 1989; Godinho Filho et al., Table 1 lists the search strings used in the article investigation. The
2017; Deshkar et al., 2018). Despite being essentially a re-branding of search string “(1 AND 2 AND 3)” was disallowed by Science Direct due to
TPS, LM is the system that would gain worldwide adoption (Nunes et al., limitations on the number of Boolean connectors used and was searched
2017). therefore using only strings “(1 AND 2)”. Similarly, Google Scholar was
Although LM is designed to be a worker-empowering system also searched using only strings “(1 AND 2)” as this unexpectedly yiel
(Demeter and Matyusz, 2011), waste reduction efforts sometimes lead to ded fewer results than “(1 AND 2 AND 3)”. For the remaining databases,
shortened cycle times, which have the drawback of intensifying all three search strings were used.
employee workload (Longoni et al., 2013). Evidence to the claims that Sources not found in scholarly journals, conference papers/pro
LM was harmful to workers began to emerge. A landmark case would ceedings, and book chapters were excluded as part of the search setting.
occur at the New United Motors Manufacturing, Inc. (NUMMI), a joint The focus of our research is on the worker in a manufacturing envi
venture between General Motors and Toyota located in California. While ronment, not manufacturing support or other industries. Therefore, only
NUMMI was lauded for achieving performance based on the high LM implementations in a manufacturing setting were considered, which
employee involvement afforded by LM, it was also cited in 1993 by excluded industries such as healthcare, warehousing, and trans
California’s Occupational Safety and Health Administration (Cal-OSHA) portation. Studies containing implementations that combine safety and
for high ergonomic injury rates (Adler, Goldoftas and Levine, 1997). The ergonomic improvement measures alongside LM were excluded, as the
same authors published a study the following year attributing a poorly outcome would not be purely a result of lean.
planned new model launch to the ergonomic hazards (Adler et al., The initial article search identified 72,815 documents. Titles and
1998). However, the perception that LM increases efficiency at the abstracts of these documents were screened according to the following
expense of employee well-being would persist, as literature critical to criteria: 1) Relevance of the article to the topic of interest; 2) Full text
LM continued to emerge (Landsbergis et al., 1999; Shoaf et al., 2004; papers published in peer-reviewed journals; and 3) Written in or trans
Arezes et al., 2015). lated into English. An irrelevant article was defined as any article clearly
Amid increasing concerns about safety and ergonomics, the National unrelated to manufacturing. For example, several articles concerning
Institute for Occupational Safety and Health (NIOSH) released the report lean healthcare were found using the search terms, which were thus
“The Changing Organization of Work and the Safety and Health of removed. Based on these criteria, 70,474 records were excluded. A full
Working People” in 2002, stating that the effect lean and other new article screening (n = 2341) eliminated 1760 articles that lacked a stated
organizations of work on employee health was an area where future safety or ergonomic outcome, and 131 duplicates were removed. The
research is urgently needed (Sauter et al., 2002). The body of scientific remaining articles (n = 349) were thoroughly reviewed in their entire
literature that grew after NUMMI and the NIOSH report was both critical content, and 248 were excluded where a cause-and-effect relationship
and complimentary of the effect of LM on occupational safety and er was not established between LM and the safety/ergonomic outcome(s).
gonomics (Arezes et al., 2015; Hasle et al., 2012; Hamja et al., 2017), The remaining articles (N = 101) are summarized in Table 2.
and the topic continues to be studied and debated to this day (Hamja
et al., 2019).
To further understand this contested topic, this paper aims to
examine the relationship between LM methods and safety/ergonomic
outcomes for workers in a manufacturing environment. Koukoulaki Table 1
(2014) found that lean methods such as JIT and standardized work cause Search strings used to identify articles.
intensification of work and are strongly associated with both mechanical Search Search Terms
and psychosocial exposure. Likewise Arezes, Dinis-Carvalho, and Alves String
(Arezes et al., 2015) identified associations between LM and several 1 “lean manufacturing” OR “lean production” OR “Toyota production"
safety and ergonomic dimensions. Building on the existing works, the 2 “ergonomic” OR “stress” OR “health” OR “safety” OR “OSH”
objective of this review is to investigate to a higher level of detail as to 3 “study” OR “experiment” OR “sectional” OR “longitudinal” OR “case
study”
which LM methods (inputs) lead to which safety and ergonomic
2
J.G. Brawner et al. Applied Ergonomics 100 (2022) 103673
Table 2
Details from safety and ergonomic outcomes found in literature.
Article Industry Location Meas. Method Sample Study Type Lean Method ↑↓ Safety and Ergonomic
Outcome
Babson (1993) Automobile assembly Michigan, Survey & 2380 workers Cross- Just-in-time (JIT) ↓ Increased intensity,
USA worker’s sectional and Kaizen high workers’
compensation compensation claims
claims
Rinehart et al. (1994) Automobile assembly Ontario, Survey 2300 workers Longitudinal Unspecified lean ↓ Workers viewed lean
Canada methods or as “competitive and
systems stressful” 83% of the
time, “cooperative and
helpful” 17% of the
time. Pre-lean, these
views were 43% and
57% respectively.
Mullarkey et al. Electronics United Survey 32 workers Longitudinal JIT ↑↓ No effect on stress or
(1995) manufacturing Kingdom work intensification.
Parker et al. (1995) Car seat manufacturing New Zealand Questionnaires 38 workers Longitudinal General TPS ↑↓ Neutral to positive
implementation health effects for
workers participating
in change, workload
and strain increase for
uninvolved workers.
Stewart and Garrahan Automobile USA and Questionnaires 372 workers in Case study Unspecified lean ↓ Workers perceived
(1995) manufacturing United 4 factories methods or lean to be more
Kingdom systems demanding, both
physically and
mentally.
Jackson and Martin Electronics United Survey 44 workers Longitudinal JIT ↑↓ JIT had no effect on
(1996) manufacturing Kingdom psychological well-
being.
Adler, Goldoftas, and Automobile assembly California, Cal-OSHA 4000 workers Longitudinal JIT and Kaizen ↓ Increase in ergonomic
Levine (1997) USA citations (est.) injuries, Cal-OSHA
citations
Lewchuk and Automobile assembly Canada Survey 2424 workers Cross- JIT and Kaizen ↑↓ Of two lean plants, one
Robertson (1997) sectional had higher work
intensity than
traditional plants, one
had lower
Parker and Sprigg Truck chassis assembly Great Britain Survey 38 workers Longitudinal Moving assembly ↓ Increased stress,
(1998) (automotive) line, work-in- decreased perception
process (WIP) of well-being
reduction
Lewchuk and Automotive Canada Survey 1670 workers, Cross- Unspecified lean ↓ Workers reported
Robertson (1999) components 16 workplaces sectional methods or faster pace and heavier
systems workload in lean
factories, compared to
traditional factories
Yildirim (1999) Tyre manufacturing Turkey Interviews and 147 workers Case study Total quality ↑ Improvement in safety
surveys management perception and
(TQM) accident rate after
TQM implementation
Jackson and Garment United Survey 556 workers Cross- JIT ↑↓ No overall effect on
Mullarkey (2000) manufacturing Kingdom sectional mental job strain,
balanced effect on job-
related strain.
Godard (2001) Multiple industries Canada Telephone survey 508 workers Cross- JIT ↓ Negative effect on
sectional worker stress
Hunter (2001) Machining and South 3D simulation, 1 work cell Cross- Lean work cell ↑ The lean work cell
metalworking Carolina, RULA, REBA simulation sectional presented less
USA ergonomic risk
compared to the job
shop configuration.
Lewchuk et al. (2001) Automobile United Survey 2639 workers Cross- WIP reduction, ↓ Excessive workload,
manufacturing Kingdom and sectional pull systems, JIT increased stress
Canada
Anderson-Connolly Anonymous company USA Survey 1000 workers Longitudinal Unspecified lean ↓ Increased stress and
et al. (2002) methods or higher work intensity
systems
Bruno and Jordan Automobile assembly Illinois, USA Survey 1000 workers Longitudinal Kaizen ↓ Job eliminations from
(2002) Kaizen results
intensified workload
Harenstam, Rydbeck, Multiple industries Sweden Interviews 208 workers Case study General lean ↓ Increased workload
Johansson, reported in lean
Karlqvist, and organizations.
Wiklund (2002)
(continued on next page)
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J.G. Brawner et al. Applied Ergonomics 100 (2022) 103673
Table 2 (continued )
Article Industry Location Meas. Method Sample Study Type Lean Method ↑↓ Safety and Ergonomic
Outcome
Parker (2003) Automobile assembly United Survey 368 workers Longitudinal WIP reduction, ↓ Negative stress and
Kingdom pull system psychological
outcomes
Brenner et al. (2004) Multiple industries USA Survey 1848 workers Cross- Quality circles ↓ Negative effect on
sectional and JIT cumulative trauma
disorders
Schouteten and Bicycle manufacturing Netherlands Survey 63 workers Case study JIT and ↑↓ Neutral findings on
Benders (2004) standardized stress and general
work health, although
increase in exhaustion
was reported
Seppala and Klemola Multiple industries Finland Interviews and 525 workers Cross- JIT ↓ Increase in stress,
(2004) questionnaires sectional particularly for white-
collar, maintenance,
and material workers
Cochrane et al. Dairy products New Zealand Postal survey 106 workers Case study Lean-based high- ↑ 52.8% of survey
(2005) performance respondents agreed
work practices that the work
(HPWP) environment was safer,
32.0% disagreed
Conti et al. (2006) Multiple industries United Interviews and 1391 workers Cross- Total productive ↓ Negative ergonomic
Kingdom questionnaires sectional maintenance effects from JIT,
(TPM), JIT, and negative stress effects
Kaizen from TPM, positive
stress effects from
Kaizen
Leroyer et al. (2006) Automobile assembly France Questionnaire 80 workers Longitudinal TQM ↓ Negative effect on
injury rate, strain, and
stress
Mehri (2006) Automobile assembly Japan Interviews and 75 affiliated Case study Unspecified lean ↓ High work intensity
direct people methods or and injury rates, along
observations systems with accident
misreporting by the
company
Velazquez, Munguia, Various industries; Mexico OSHA program 50 workers Case study Unspecified lean ↓ Multiple negative
de los Angeles maquiladora evaluation profile methods or effects from lean
Navarrete, and manufacturing (PEP) systems production, including
Zavala (2006) musculoskeletal
symptoms.
Brown and O’Rourke Shoe manufacturing Guangdong, Surveys, direct 1 company Case study Lean work-cell ↓ Observation of
(2007) China measurements, analyzed; 27 configuration increased worker
and observations workers exposure to heat,
surveyed noise, chemicals, and
moving machine parts.
Surveyed workers
reported higher stress.
Eklund and Berglund Turbine and lift truck Sweden Interviews 19 workers Case study Kaizen, TPM, and ↓ Increase in worker
(2007) manufacturing kanban stress and a higher
work pace.
Grunberg et al. Advanced technology USA Questionnaires 525 workers, Longitudinal Unspecified lean ↓ Increase in reported
(2008) products and interviews white & blue methods or health problems after
collar systems lean implementation
Hunter (2008) Furniture Mississippi, General shop 8 workers Case study Lean work-cell ↑ Positive effect on
manufacturing USA floor observations configuration ergonomics and
general worker health
Mothersell et al. Automobile Antwerp, Company 1 Company, Longitudinal Unspecified lean ↑ Reduction in minor
(2008) manufacturing Belgium documentation >1000 workers methods or (first aid) accidents
and interviews est. systems after lean
implementation,
despite doubling of car
output per worker
Lu (2009) Garment and Philippines Questionnaire 630 workers Cross- Unspecified lean ↓ Intensification of work
electronics sectional methods or resulted in stress, new
manufacturing systems forms of hazard, and
occupational illnesses.
Nikolou-Walker and Engineering Ireland Observations, 250 workers Cross- Unspecified lean ↑↓ Lean improved overall
Lavery (2009) interviews, & sectional methods or safety, but a minority
statistical analysis systems of workers experienced
increased workload
and stress
Saurin and Ferreira Farm equipment Brazil Survey 67 workers Case study Housekeeping ↑ Improvement in
(2009) manufacturing (5S) perceived safety
Womack et al. (2009) Automobile USA HAL and ACGIH 112 jobs (56 Cross- JIT, increased ↑↓ Workers in lean plant
manufacturing TLV® lean and 56 sectional work frequency had higher HAL scores
assessments traditional) but lower ACGIH TLV
(continued on next page)
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J.G. Brawner et al. Applied Ergonomics 100 (2022) 103673
Table 2 (continued )
Article Industry Location Meas. Method Sample Study Type Lean Method ↑↓ Safety and Ergonomic
Outcome
5
J.G. Brawner et al. Applied Ergonomics 100 (2022) 103673
Table 2 (continued )
Article Industry Location Meas. Method Sample Study Type Lean Method ↑↓ Safety and Ergonomic
Outcome
Pagell et al. (2014) Multiple industries Oregon, USA Surveys, phone 153 facilities Cross- JIT ↓ JIT was a significant
questionnaires, sectional and negative predictor
and government of safety.
safety date.
Shanmuganathan Textile manufacturing India Surveys and 150 workers Case study 5S ↑ Health and safety
et al. (2014)) interviews standards were
improved after the
introduction of 5S.
Singh and Ahuja Boiler manufacturing India Company records 1 company Case study 5S ↑ Decrease in accident
(2014) severity after 5S
implementation.
Hernández Lamprea Automotive Colombia Surveys and 1 company Case study 5S ↑ Ergonomic, physical,
et al. (2015) components direct and other hazards
assessments were greatly reduced
after 5S
implementation.
Kumar and Kumar Multiple industries India Survey 59 industries Case study Unspecified lean ↑↓ Reportable accidents,
(2015) methods or unsafe practices, and
systems behavioral safety were
not improved after
lean implementation.
Mohiuddin et al. Automotive Malaysia Company safety 1 company Longitudinal Unspecified lean ↑ Company experienced
(2015) manufacturing data methods or a sharp drop in
systems accident rate after lean
implementation
Wan Mahmood et al. Multiple industries Malaysia Questionnaire 40 managers Case study Unspecified lean ↑ Lean production has a
(2015) and staff methods or positive correlation
systems with sustainability
components, including
safety.
Zhang (2015) Automobile China Ethnographic 7 factories Case study Unspecified lean ↓ Lean systems resulted
manufacturing research methods or in intense work pace
systems and high stress.
Abeysekera and Garment Sri Lanka Survey 118 workers Case study 5S, Kaizen ↑↓ Positive worker
Illankoon (2016) manufacturing across 3 perception of
companies workplace
ergonomics, but
negative perception of
heat and noise
hazards.
Alhuraish et al. Multiple industries France Survey 33 (est.) lean Case study Unspecified lean ↑↓ Hypothesis that lean
(2016) experts methods or had positive safety
systems effects was rejected.
Baoet al. (2016) Multiple industries USA SI, HAL, TLV®, 1834 workers Cross- Single-piece flow ↑↓ Workers using single-
assessments sectional piece flow had higher
perception of H&S and
lower force
requirements, but
higher repetition of
forceful exertions.
Hussain et al. (2016) Textile manufacturing Pakistan Questionnaire 326 employees Case study Standardized ↑↓ Standardized work
work created more stress for
blue-collar workers,
less for white-collar
workers.
Kumar and Kumar Multiple industries India Survey 62 companies Case study Unspecified lean ↑ Lean has a positive
(2016) methods or impact on employee
systems safety participation.
Manfredsson (2016) Textile manufacturing Sweden Interviews, 2 teams, 11 total Case study Unspecified lean ↑↓ Lean was found to
observations, & workers methods or have increased stress
group systems in one company, but
discussions. reduced stress in
another.
Ramesh and Ravi Cutting tool India Questionnaire 75 workers Case study 5S ↑ Significant
(2016) manufacturing relationship between
5S implementation
and improved safety
performance.
Resta et al. (2016) Multiple industries Italy Interviews, direct Unknown Case study JIT, TQM and ↑↓ JIT implementation
observations, sample from TPM resulted in higher
company >300,000 safety and ergonomics,
documentation workers but higher stress. TQM
resulted in reduced
risks. TPM resulted in
(continued on next page)
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J.G. Brawner et al. Applied Ergonomics 100 (2022) 103673
Table 2 (continued )
Article Industry Location Meas. Method Sample Study Type Lean Method ↑↓ Safety and Ergonomic
Outcome
7
J.G. Brawner et al. Applied Ergonomics 100 (2022) 103673
Table 2 (continued )
Article Industry Location Meas. Method Sample Study Type Lean Method ↑↓ Safety and Ergonomic
Outcome
further through
Kaizen.
Ratnayake and Apparel manufacturing Sri Lanka Surveys 84 workers Cross- Lean work cell ↑ Workers found the lean
Dinosha (2018) sectional (U-shaped) layout to be safer and
more ergonomic than
traditional layouts.
Singh and Deokar Multiple industries India Questionnaire 100 companies Case study 5S ↑ Workplace safety was
(2018) viewed as “highly
improved” after 5S
implementation.
Adzrie et al. (2019) Metal Malaysia Survey 30 workers Longitudinal 5S ↑ Safety initially
fabrication—stainless improved after 5S
steel tables introduction and
continued to improve
over time.
Beraldin et al. (2019) Appliance Italy Job demands 138 workers Case study JIT ↓ JIT has a negative
manufacturing research model effect on exhaustion,
(JDRM) but effect can be
reduced by soft lean
practices (SLPs).
Bocquet et al. (2019) Multiple industries 2 European, Employee 24 employees Case studies Multiple lean ↓ Lean implementation
1 unknown interviews practices negatively affected
worker stress. High
involvement practices
(HIP) can mitigate if
fully integrated into
the lean
implementation.
de Negreiros et al. Automotive Brazil Direct evaluation 120 workers Cross- Lean work-cell ↑↓ Neutral effect on stress
(2019) component (QEC, WAI, NFR, sectional configuration and other health
manufacturing JSS) factors.
Huo et al. (2019) Consumer goods China Survey 315 workers Longitudinal JIT, ↓ Negative effects on
manufacturing intensification of emotional stress and
work physical health,
mediated by
supervisory support
Seddik (2019) Garment industry Egypt Safety climate 1 company Cross- 5S ↑ 5S had a positive
survey sectional impact on safety
climate in 7 of 8
categories, neutral in 1
of 8.
Tortorella et al. Multiple industries Brazil Survey 144 companies Cross- JIT ↑↓ Neutral effect on
(2019) sectional worker health
Ulewicz and Lazar Metal manufacturing Poland and Surveys and 20 companies Cross- Unspecified lean ↑ Companies using lean
(2019) Romania public company sectional methods or tools reported fewer
safety data systems critical incidents than
industry average and
improved further with
time.
Annamalai et al. Garment Tamilnadu, Questionnaires 80 workers Case study Lean production ↑ Positive correlation
(2020) manufacturing India layout between lean
production layout and
safety/ergonomics
Cierniak-Emerych Multiple industries Lower Silesia Direct 3 companies Case study 5S ↑↓ 5S improved physical
and Golej (2020) (Poland) observations and working conditions but
interviews increased stress and
anxiety
Dieste et al. (2020) Metal casting Italy General 600 workers Case study 5S, TPM, and ↑ Multiple risks and
(foundry) observation, Kaizen hazards were
OCRA evaluation mitigated by
eliminating wasteful
activities.
Mousavi et al. (2020) Multiple industries Worldwide Survey 112 workers Cross- Multiple lean ↑↓ Lean implementation
and sectional practices influences OHS
professionals performance, with
several mediating
factors
Sakthi Nagaraj and Multiple industries India and Sri Survey 168 workers Cross- General lean ↑ Positive human factors
Jeyapaul (2020) Lanka and sectional outcomes are
professionals associated with
successful lean
implementation
Stimec (2020) Multiple industries France Surveys and 9 companies, Case studies General lean ↓ Negative perceived
interviews 380 workers transformation health effect,
mitigated by team
learning.
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J.G. Brawner et al. Applied Ergonomics 100 (2022) 103673
3. Article search results human factors (4), hazard exposure (6), and safety performance (6) were
the most common categories benefiting from 5S. Only two negative
The search and screening process produced 101 articles that con outcomes were found, where one was due to the inadvertent introduc
tained a safety and ergonomic outcome resulting from LM or related tion of noise and heat hazards from the implementation (Abeysekera and
methods. Most articles (n = 54) pertained to unspecified lean methods or Illankoon, 2016); and the other was due to worker stress resulting from
systems. The most prevalent safety and ergonomic outcome contained in fear of change (Cierniak-Emerych and Golej, 2020).
the literature was stress and mental strain (n = 36). Table 3 summarizes
the LM methods and safety/ergonomic outcomes found in the articles. 3.3. Kaizen outcomes
Some articles contain multiple lean methods or safety and ergonomic
outcomes and therefore appear in the results multiple times. The literature contains safety outcomes from both kaizen related
activities and their resulting changes in working conditions. Kaizen
3.1. Safety and ergonomic outcome categories outcomes were evenly split between positive and negative at nine each,
with one neutral outcome (Table 3). Negative outcomes from kaizen
The safety outcomes found in the literature have been sorted into 10 include higher work intensity (3) and stress (2) resulting from the
categories which includes some overlapping dimensions due to the lack changes in the workplace or work methods. Positive outcomes include
of detail found in many articles. For example, when a specific outcome human factors and ergonomic improvements (2) and hazard mitigation
such as physical strain was identified, it was categorized as such, even (2).
though a physical strain outcome can also be associated with a broader
outcome such as general health and safety. Hazard exposure refers to the 3.4. Just-in-time (JIT), Chaku-Chaku, and work pacing outcomes
introduction of sources of harm with the potential to cause injury or
death to the worker, such as mechanical energy, temperature extremes, In the literature, safety and ergonomic outcomes from JIT related
and noise. Workload, work intensity, and exhaustive work is the one methods were the most prominent among individual LM methods and
category that is not a direct safety and ergonomic outcome. However, had the most proportionately negative results. Twenty-three of the
items in this category are associated with a reduction or elimination of thirty-seven safety and ergonomic outcomes found in the literature were
non-value added time, which reduces recovery time for the worker and negative, while only three were positive and eleven had a neutral or
may increase the risk for work-related musculoskeletal disorders offsetting effect (Table 3). These negative outcomes occurred in the
(WMSD) (Winkel and Westgaard, 2008) and stress (van Eijnatten, 2000). categories of human factors and ergonomics (4), stress and mental strain
(9), psychological and psychosocial well-being (1), workload and work
3.2. 5S outcomes intensity (3), safety performance/accident rates (4), and general health
and well-being (2). Two of the three positive outcomes were found in
Of the outcomes pertaining to 5S, twenty-four of twenty-six con one multi-case study that also listed stress as a negative outcome (Resta
tained a positive safety and ergonomic effect (Table 3). Improvements in et al., 2016). Chaku-Chaku methods were included in these totals,
Table 3
Outcome summary with symbols for negative (●), neutral/offsetting (◐), and positive (○) safety/ergonomic outcomes.
JIT, Work Pacing, Slack Kanban 5S Standardized TPM Kaizen, Problem Lean Work TQM HPWP HIM Unspecified Lean
Reduction, Chaku-Chaku Work Solving, Cell, Lean Methods or Systems
Continuous Factory
Improvement Layout
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J.G. Brawner et al. Applied Ergonomics 100 (2022) 103673
contributing two negative outcomes, stress and work intensification, LM is a safe and worker-empowering system. Babson (1993) reported
both from the same longitudinal study (Enríquez-Díaz et al., 2012). that Ohno’s original purpose for Kaizen was for workers to figure out
how to return to normal production levels after he removed 10 percent
3.5. Outcomes from other methods of the workforce; a process that was repeated each time equilibrium was
reached. And, according to Alcaraz (2014), JIT waste reduction efforts
Only one article containing two negative outcomes from Kanban was have evolved to include increasing worker capacity, while Weingarten
found in the literature. Eklund et al. (2007) reported negative outcomes (2017) associated a 1% decrease in worker slack (increase in worker
in stress and work intensity in a multiple-method LM system that capacity) with a 0.69% increase in workplace injuries.
emphasized Kanban. Only five safety and ergonomic related outcomes Therefore, the objective of this review was to determine whether
from TPM were found in the literature, (3) positive and (2) negative specific LM methods uniquely contributed to safety and ergonomic
(Table 3). Positive outcomes were due to hazard mitigation and stress outcomes, thus adding detail to this complex topic. As hypothesized,
reduction from the simplification of work (Resta et al., 2016; Dieste some LM methods uniquely contributed to safety and ergonomic out
et al., 2020). Negative outcomes were due to work intensification and comes, as the two most prominently mentioned methods in the literature
resulting increase in stress, however both outcomes were from a single contained biased and opposing outcomes. Some explanation as to why
study involving a multiple-method lean implementation (Eklund and contradicting viewpoints exist concerning the relationship between LM
Berglund, 2007). Only three studies containing five TQM outcomes were and safety/ergonomics might be found by determining whether a LM
found in the literature. Leroyer et al. (2006) listed physical strain, stress implementation has a disproportionate focus on one of these impactful
and mental strain, and safety performance as negative outcomes. Resta methods.
et al. (2016) lists hazard mitigation as a positive outcome, and Yildirim It is not surprising that some methods resulted in positive safety and
(1999) found safety climate to be a positive safety and ergonomic ergonomic outcomes. 5S lends itself well to safety improvement, so
outcome. Both positive and negative safety and ergonomic outcomes much so that safety is often considered as a direct benefit of 5S imple
from lean factory layouts are found in the literature. Positive effects in mentation (Veres et al., 2018; Mutaza et al., 2020). Likewise, a typical
human factors and ergonomics (4), and overall safety and health (3), goal of a kaizen event is the enhancement of safety in a particular area
were found. Negative effects on human factors/ergonomics (1), stress (Vieira et al., 2012), often implementing 5S methods in this effort (Zocca
and mental strain (1), and increased hazard exposure (1) were also et al., 2018). Also, the employee-involvement aspect of kaizen tends to
found. Neutral or offsetting effects (2) were also reported. Only three have a positive impact on worker stress by giving workers more job
articles and four outcomes were found in the literature from standard control (Conti et al., 2006). A lean factory layout is composed of a group
ized work, all of which were neutral to safety and ergonomics. of dissimilar processes operated by multifunctional workers, thus re
High-performance work practices (HPWP) and high-involvement man petitive motion is reduced, along with ergonomic risk (Hunter, 2001).
agement (HIM) yielded positive outcomes in safety perception (2), HPWP and HIM are both worker-focused methods of increasing per
safety performance (2), and overall safety and health (1) were found in formance through employee involvement and engagement (Böckerman
three articles. No negative or neutral outcomes associated with HPWP or et al., 2012; Tregaskis et al., 2013), so positive outcomes from these
HIM were found in the literature (Table 3). methods could also be expected.
Few safety and ergonomic outcomes were found that resulted from
3.6. Unspecified lean and TPS methods or systems TPM and TQM, and those results were evenly positive and negative.
TPM and TQM are not methods that directly affect the workplace like 5S,
The largest number of safety and ergonomic outcomes found in the or that change worker motion characteristics like the lean factory
literature were resulting from unspecified lean methods or systems. The layout, thus a small number of outcomes and mixed results associated
literature contains fifty-five outcomes, most of which are negative with these methods is unsurprising. Likewise, standardized work is
(Table 3). These negative outcomes are in the categories of human concerned with publishing a standardized sequence of operations
factors and ergonomics (2), physical strain (3), stress and mental strain (Hussain et al., 2016) rather than changing how the work is performed,
(8), psychological and psychosocial well-being (1), workload and work so a small number of outcomes, all with neutral safety and ergonomic
intensity (11), hazard exposure (2), safety perception and climate (2), effects, was a plausible finding in the literature.
overall safety and health (3), and safety performance (1). Positive out Only two outcomes were associated with Kanban, negative effects on
comes were in the categories of human factors and ergonomics (2), stress and work intensity, both from the same study that examined a
hazard exposure (1), safety perception and safety climate (1), safety newly introduced LM system. It is possible that the change itself was the
behavior and participation (1), overall safety and health (4), and safety source of the stress outcome, as newly employed persons without ex
performance (4). Several neutral or offsetting outcomes (9) were also periences of the previous system accepted the new system better (Eklund
found in the literature. and Berglund, 2007). Kanban is a material flow system, so the work
Outcomes from unspecified lean methods or systems in the cate intensity outcome might be attributed to the removal of slack from the
gories of physical strain and stress/mental strain were numerous and overall LM system, rather than the Kanban method itself.
mostly negative (11) or neutral (2), with no positive outcomes. The large number of negative results from JIT and related methods
Conversely, safety performance, which includes accident and severity are understandable given that JIT attempts to remove slack and there
rates, was mostly positive (4) or neutral (3) and rarely reported as fore increases work intensity. In a Chaku-Chaku system, the cycle time of
negative (1). the machine(s), and the possibility that the load-unload rate may be
machine controlled, can create ergonomic problems through work in
4. Discussion tensity and a set frequency of motion for the worker. Other methods to
enhance JIT through work pacing, such as piece-rate policies that base
In his book “Toyota Production System: An Integrated Approach to worker wages on quantity of pieces produced, may have a likewise effect
Just-in-Time”, Monden (2011) states that one goal of the TPS is “respect on work intensity.
for humanity, or morale, which must be cultivated while the system
utilizes human resources to attain its cost objectives.” Womack et al. 4.1. Review summary
(1990) describes LM as “humanly fulfilling.” And Liker (2004), quoting
Ohno, stated that “safety is the foundation of all our activities” in Just as with the contradicting claims about the design intent of LM
reference to the TPS. concerning worker well-being, the LM related safety and ergonomic
However, some literary claims exist that challenge the assertion that outcomes found in the literature are also contradictory. Our research
10
J.G. Brawner et al. Applied Ergonomics 100 (2022) 103673
found 101 articles containing safety and ergonomic outcomes from LM, A national or regional cross-sectional study could be used to
in which 37 had positive outcomes, 39 had negative outcomes, and 25 demonstrate associations between several of these factors within rela
contained neutral or offsetting outcomes. However, some clarity can be tionship between LM and safety and ergonomics. Effects from factors
found by examining details of the LM methods used, the specific safety such as culture, industry type, LM methods used, LM maturity, employee
and ergonomic outcomes resulting from these methods, along with other demographics, union status, and company size could be determined
details from these studies. from such a large sample size. An employee-perceived safety climate
This review found that use of JIT resulted in negative safety/ergo survey, which has been demonstrated to have association with safety
nomic outcomes in 62% of occurrences found in the literature, most behavior and injury data (Zohar, 2000; Zohar and Luria, 2005), could be
commonly in the category of stress and mental strain. On the other hand, used to determine safety outcome (dependent variable) if actual injury
the use of 5S resulted in a positive outcome in 92% of cases, impacting data cannot be obtained. If the other factors (independent variables) can
several safety and ergonomic dimensions. Such a wide disparity of also be defined with survey questions, such a large cross-sectional study
outcomes in the two most common methods found in the literature is a might be feasible.
matter to consider when examining the unclear relationship between LM The aptitude of the LM systems and methods is generally unstated in
and safety/ergonomics. the literature. However, if the safety and ergonomic outcomes occurred
in an incomplete or poorly designed LM method or system, then these
4.2. Areas for future research outcomes might be attributed to a poorly functioning system. The use of
a survey to assess the state of a lean implementation, such as the survey
Krafcik (1988) noted that cultural differences between native Japa by Huang, Harris, and Loyd (Huang et al., 2021), could be compared to
nese TPS and transplanted TPS affected efficiency outcomes. Likewise, safety data to determine if lean aptitude has any bearing on safety and
there is an indication that the country and/or culture where LM practice ergonomic outcomes. Company incident rates are publicly available
occurs influences the relationship between LM and safety and ergo from the Occupational Safety and Health Administration (OSHA) and
nomics. Brown and O’Rourke (2007) established that obstacles to NIOSH, which could be used to define the safety and ergonomic
effective worker participation in China must be overcome to realize component of the study.
safety under LM, whereas Kumar and Kumar (2016) found that Indian While most of the literature search results pertained to front-line
culture embraces the idea that worker participation is a necessary manufacturing workers, two studies contained outcomes for managers.
component of LM. Our research harmonizes with this view, as all out Hussain, Rehman, Case, Masood, and Habib (Hussain et al., 2016) found
comes in this review that took place in China, along with France, had that standardized work created less stress for white-collar workers in a
exclusively negative outcomes; while outcomes that occurred in India case study in Pakistan. Conversely, Huo and Boxall (2017) found role
were entirely positive. Scientific confirmation of this notion, along with overload to be a risk in a case study of 226 front-line LM managers in
how these cultural differences manifest into variations in safety and China. The effect of LM on supervisors and managers is another op
ergonomic outcomes, would be a meaningful contribution to the LM and portunity for meaningful research.
Safety/Ergonomic communities.
There are signs that unionized companies experience dispropor
tionately negative safety and ergonomic outcomes (Kaminski, 2001). Declaration of competing interest
This outcome might be attributed to automobile manufacturing com
panies, as they have a high propensity for both unionization and LM The authors declare that they have no known competing financial
adoption. Regardless, a determination of what effect unionization has on interests or personal relationships that could have appeared to influence
the relationship between LM and safety and ergonomics would also be a the work reported in this paper.
meaningful contribution to the literature.
Ergonomic assessment methods such as OCRA (Occupational Re Acknowledgement
petitive Actions), RULA (Rapid Upper Limb Assessment), and REBA
(Rapid Entire Body Assessment) are designed to determine safety and This research was partially supported by the Deep South Center for
ergonomic risk in work activities. An increase in work intensity is a Occupational Health and Safety, a National Institute for Occupational
common outcome from LM systems and methods, especially JIT. Safety and Health (NIOSH) Education and Research Center (Grant
Therefore, a derivative method of determining a work frequency limit, #5T42 OH008436-16). The contents are solely the viewpoint of the
based on the movement details of a particular job, would benefit man authors and do not necessarily represent the official views of the Deep
agers and engineers in the design and implementation of a JIT system. South Center or NIOSH.
The review findings also indicate that different industries experience
different results from LM implementation and methods. For example, References
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