Assessing the effects of lean on occupational health and safety in the Ready-Made Garment industry

1 Introduction

In the manufacturing sector, the focus has been on operational outcomes such as cost, quality, delivery, dependability, and flexibility [1]. Occupational health and safety (OHS) has traditionally not been high on the priority list of performance outcomes. One of the main reasons may be the difficulty in determining the financial consequences of improving OHS conditions, and thereby showing a quantitative relationship between OHS and productivity. The consequence of the exclusive focus on operational priorities is often that organizations push for performance increases in operations even at the cost of the health and safety of the workers [2].

In the last 30 years, companies from various sectors and geographies have used lean manufacturing principles (colloquially known as ‘lean’) as a framework to improve operational performance. Lean has also reached the ready-made garment (RMG) industry due to tough price competition, increased quality requirements, and the frequent changes of business requirements. The international fashion industry now requires smaller lots, increased variety of products, and shorter lead-time for delivery [3, 4]. The core feature of lean is elimination of waste, which has been applied more frequently in the production domain. However, there are indications in the literature that elimination of waste and streamlining the processes in a company can have adverse effects on the health and safety of workers [5]. These adverse effects are often reported in a repetitive assembly context where lean tends to have a negative effect on workers’ physical health [6]. The effects of lean on OHS seem to depend extensively on the content, context, and the process of lean implementation [7, 8].

In general, the relationship between lean and OHS is not completely understood, and that is particularly the case for the ready-made garment (RMG) industry. The garment industry fits the characteristics of a labour intensive and manual assembly of work well, where the literature suggest both physical and mental health risks for the workers. To date, knowledge about the consequences for OHS of lean application in RMG is very limited and inconclusive [9–11]. There is on the one hand a possibility of intensifying work with a risk of long-term repetitive strain injuries, and on the other hand possibilities for improving workstation design, which may improve workers’ health. However, a recent review concludes that more research is needed, but also point out that although there are examples of studies with negative effects, few studies point towards possibilities for positive effects of lean [12].

The aim of this paper is to narrow this gap in the literature by investigating the effects of lean implementation on OHS in the garment industry in Bangladesh. An action research project was used to introduce lean and integrated OHS elements into six RMG factories and measure before and after results. The findings of this study contributes to the literature by showing that - contrary to the expectations reported in the literature – lean can have positive effects on productivity and OHS outcomes in the garment industry, depending on the content and process of lean implementation. Our results thereby support the literature suggesting [13, 14] that by improving efficiency and simultaneously taking consideration OHS into consideration, then lean implementation is more likely to create synergies between productivity and OHS conditions. However, the physical health effects of long term exposure to sewing work organized based on lean principles still need to be further investigated.

2 Background

RMG is one of the most labor-intensive manufacturing industries, which has motivated international garment manufacturers and brands to outsource their production in countries where cheap labor is available in abundance. Nowadays, China is the largest supplier of RMG followed by other Asian countries such as Bangladesh, India, Laos, Vietnam, Indonesia, and Sri-Lanka. These countries share some common characteristics including cheap labor availability, a growing economy, and poor working conditions [15, 16].

In recent years, the garment sector has focused on competitive dimensions such as productivity and quality in order to attract international buyers [17]. For this reason, most of the garment manufacturers have adopted different strategies to improve productivity, with varying degrees of success [18, 19]. In particular, garment suppliers have frequently adopted lean manufacturing tools and practices to improve productivity and quality, and reduce costs [3, 21]. However, OHS has gained importance in the wake of deadly accidents in the garment industry, including the Rana Plaza tragedy in Bangladesh. As a consequence, the pressure on garment manufacturers has intensified as international buyers have demanded acceptable OHS conditions for workers as pre-requisite before placing orders [22, 23]. As such, lower cost alone is no longer a sustainable strategy for garment suppliers, who also have to invest in the improvement of OHS conditions in order to attract international brands.

Since the mid-2000 s, the garment manufacturers in several countries like China, Bangladesh, Sri Lanka, India, Pakistan in Asia started to implement lean tools for increasing efficiency and reducing costs. The experiences from introducing lean practices, in most cases, suggest improved productivity [3, 24–27], but there are also studies showing constraints and more limited effects [12, 28].

The literature about lean and OHS reports mixed results [6, 30]. For work that is complex and requires higher skills, the evidence suggests that lean can improve OHS; whereas the opposite is the case for manual assembly work with a tendency for adverse musculoskeletal health effects reported. The theory is that lean can intensify work by increasing work speed and removing micro breaks that are necessary for muscle recovery [5, 31]. It is well established that repetitive work is a risk factor for development of repetitive strain injuries (RSI) [32, 33], and the repetitive tasks of RMG sewing machine operators carry a high risk for RSI [34–36]. Arguably, the risk of RSI increases as a consequence of lean application; however, lean may also improve the ergonomic arrangement of workstations, reduce the load of equipment and materials, and remove obstacles for causing muscular strain [3, 37] such as excess inventory between the workstation causing unnecessary stretching and bending during frequent pickup.

Lean manufacturing consists of a wide range of tools [38] such as value stream mapping, 5 S, SMED and Kaizen, which may have varying effects on OHS and productivity. It is not expected that lean has one general effect on OHS. The effect on OHS outcomes will probably depend on both context and the mix of lean tools as suggested in the literature [8].

This study was designed as an action research project with interventions to introduce change in real life situations [39, 40]. Action research methodologies have also been widely used in OHS [41, 42] intervention research. Action research is especially relevant to study real life changes, which are highly context dependent. Susman and Evered [43] have developed an often used five step model for action research: 1) diagnosing, 2) action planning, 3) action taking, 4) evaluation, and 5) specifying learning. In this study, action research was used to introduce and test lean implementation with integration of OHS consideration. The target group was garment factories in Bangladesh and the effects of the integrated lean implementation on productivity and OHS were measured and assessed. The first and the final steps were carried out by the researchers. Before the intervention, the researchers developed an intervention manual [44], corresponding to the diagnosing in action research, which outlined the methodology to introduce change based on integrated lean in the garment companies. The development of the manual was based on a review of the literature related to study of productivity and OHS improvement [12].

4 Results of intervention

The aim of the study was to assess the effects of lean manufacturing processes on OHS outcomes in the garment industry in Bangladesh. We discussed the assessment from two different perspectives. The first one is related to the changes in the experience of musculoskeletal pain and fatigue, and the second is related to changes in work design associated with lean implementation.

For musculoskeletal pain and fatigue, workers have generally experienced reduction in pain intensity. This quick reduction in pain, after only few months of intervention, may be surprising. There can be several explanations. One explanation can be supported by the young age of workers and the short exposure time. It can therefore be expected that most musculoskeletal pain has an acute character and changes can appear after relatively short time; but it is important to emphasize that the result do not provide information about chronic pain and thereby long-term exposure to work organized after lean methodologies.

Another explanation can be the so-called “Hawthorne effect” [47], which may have contributed to the improvement. This effect indicates that social attention is a positive experience for workers, which by itself may improve well-being. In this case the workers experienced for the first-time extensive attention from both management and researchers, and this attention may have positively affected the outcome. Yet, perhaps the most important interpretation of this result is that the lack of any tendency of adverse health effects of lean does not support the literature suggesting adverse effects in manual assembly work [7]. Furthermore, the results thereby indicate that the application of basic lean tools such as TMS, 5 S, and VSM might have a positive effect on the acute experience of musculoskeletal pain and fatigue. It is still a question, however, whether the different tools as well as the different tangible changes of the work had different effects on OHS.

The other part of the assessment is a comparison of the most used improvement actions associated with the specific lean tool(s) and the likely impact on OHS for each of the actions (see Table 9).

The assessment indicates that most of the tangible changes are likely to have either a positive or a neutral effect on OHS. Some changes may not only have a positive ergonomic effect but also reduce other risk factors such as accidents and dust. As for VSM and 5 S, they do not seem to have indications of adverse effects, whereas for time and motion studies the effects can be more ambiguous. TMS has roots back to basic industrial engineering [48] and has usually been associated with repetitive strain injuries [35]. But TMS is at the same time a basic key tool for standardization and removal of waste, which is a key element of lean. Some related changes have a relatively straightforward potential for reducing risks such as training operators and adding quality control. Other actions may depend on the specific design of the changes, such as reducing/adding a helper and removing unnecessary activities.

In the evaluation of the consequences of lean in this study, the integration of with OHS must also be taken into consideration. Both management, operational team and workers were trained in OHS with a special focus on ergonomics, and it is therefore likely that lean implementation without explicit consideration of OHS might have less positive outcomes.

It is furthermore important to consider the total results of the changes. Although the acute musculoskeletal pain and fatigue seem to be reduced as an indication of the overall effect, there may be effects of long term exposure related to the so-called “the ergonomic trap” [49]. This concept is especially relevant for repetitive manual work such as sewing, and points to possibility of ergonomic improvements making the work easier, and thereby opening the possibility for increasing speed and intensity of the work. Increasing intensity of work might in turn result in long-term exposure and chronical health problems. This is particularly valid when plant management increases production targets as consequence of increased workers’ capacity. Worker involvement can be a tool to control this problem, but it is in particular difficult in a country like Bangladesh where the unions are weak.

One consequence of this possible health risk is the need for further research. Research in the relations between lean and health does at the move not provide any information about the health effects of long-term exposure to lean. Therefore, it is pertinent to carry out studies of the consequences of long-term exposure to lean in RMG, especially studies related to chronical repetitive strain injuries. Such studies need to go hand in hand with in-depth studies on the use of the different lean tools and the resultant design of the work. This study has started disentangling the effects and found that there is not one uniform effect of lean. Rather, the effects of lean implementation are embedded in many small specific changes, which may have different effects on workers’ health and well-being. It therefore needs to be tested in new studies whether the assessment of the specific changes can be repeated in other factories and in other countries.

Contrary to some expectations in the literature, our results do not indicate any overall negative OHS effects of application of basic lean tools in the six RMG factories. Rather, the tendency is towards improved health for the workers. However, it is important for the interpretation of this finding that OHS was given an explicit priority during lean implementation.

More research is needed to confirm these results and to learn about the possible health effects for workers after long term exposure to work organized after lean methodologies. For practitioners, the findings imply that implementation of basic lean tools with careful consideration of OHS can be a way forward to increase productivity competitiveness without jeopardizing compliance demands from buyers, but also that worker involvement is important to protect the workers from a potential health risk.

Conflict of interest

None to report.