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2549-5747 Ergonomic Analysis of Traditional Pine Oleoresin Tapping:
Musculoskeletal Disorders.
Cumulative Fatigue, and Job Satisfaction By:
Efi Yuliati Yovi*.
Nadya Amanda Department of Forest Management.
Faculty of Forestry and Environment.
IPB University.
Jl.
Raya Dramaga.
Bogor 16680.
West Java.
Indonesia E-mail: eyyovi@apps.
ABSTRACT
Pine oleoresin is a valuable non-timber forest product commodity in Indonesia.
A traditional tapping using small-sized hoes ("kadukul" in Sundanese or "pethel" in Javanes.
are widely Given the protection of occupational safety and health is a worker's right, various ergonomic issues were discussed in this study.
Musculoskeletal disorders (MSD.
was examined by using Standardized Nordic Questionnaire and Wong-Baker Pain Rating Scale instruments, physical-mental-social fatigue was measured by Cumulative Fatigue Symptoms Index (CFSI), and job satisfaction was tested from eight variables such as wage, employment status, accessibility, health service, living facilities, work equipment, training, and social This study revealed that most of the workers suffered from intense MSDs in the shoulder, arm, wrist, hand, thigh, calf, and foot .
ostly right body sid.
This finding was in line with the CFSI analysis.
The common fatigue symptoms suffered by the workers were in the category of the physical dimension, such as in sub-dimensions of general fatigue, chronics fatigue, and physical disorder.
The job satisfaction analysis confirmed that two variables, i.
wage and employment status, influenced job satisfaction significantly in a positive association.
Proper personal protective equipment and workaid, working techniques improvement that meets occupational safety and health standard, and safety behavior incentive should be considered as effective strategies in improving the worker's safety and health protection.
Keywords: forest harvesting, forestry worker, non-timber forest product, physical fatigue.
INTRODUCTION Forest product harvesting refers to extracting forest products from the forest to the market place for a benefit value.
Due to the type of commodity, resources, and social context, forest product harvesting activities in Indonesia are carried out at various levels of technological application, ranging from the conventional or manual system .
abor-intensiv.
to semimechanical system (Yovi and Andriyani 2.
Regardless of the level of technology used, this operation has a high-risk that may threaten the worker's occupational safety and health (Lindroos and Burstrym 2010.
Potosnik et al.
Tsioras et al.
Yovi 2019.
Yovi and Yamada 2.
Pine oleoresin extraction is one form of forest product harvesting, specifically from pine tree (Pine sp.
Pine oleoresin is a valuable non-timber forest product commodity in Indonesia.
The estimation of total pine stands was around 126,666 ha (BPS 2.
In 2017, pine oleoresin production reached 77,706 tons, 1.
7 times higher than 2010 production .
,689 tons onl.
(BPS 2011, 2.
Jurnal Sylva Lestari Vol.
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2549-5747 Despite the lack of accurate data, traditional tapping tools such as small-sized hoes ("kadukul" in Sundanese or "pethel" in Javanes.
has been widely applied for the tapping Body movements in this traditional oleoresin tapping technique are categorized as manual material handling activity (Kumar 2001.
Sakka et al.
Manual handling is closely associated with musculoskeletal disorders (MSD.
(Chaffin et al.
Yovi and Prajawati Musculoskeletal disorders (MSD.
are diseases or disorders of the soft tissues of the muscles, joints, ligaments, tendons, cartilage, and the nervous system (Chaffin et al.
America.
MSDs are better known as cumulative trauma disorders (CTD), while in the UK and Australia are called repetitive strain injuries (RSI).
Parts of the body that are usually affected by MSDs are the spine, legs, and shoulders (Huysamen et al.
Whereas, all of this is body segment mostly used for manual material handling work (Collins and OAoSullivan 2.
such as pine collecting work.
Reports of fatalities in the oleoresin extraction are rarely found.
Yovi and Yamada .
stated that the accident case with fatality in tapping activity was around 1 case per year from 2008Ae2015, which is the lowest below other forest management activities.
However, given the protection of occupational safety and health is a worker's right that must be fulfilled, an ergonomics study on oleoresin extraction is still needed.
In the long term, functional occupational safety and health protection of the workers is one crucial support for sustainable forest management.
Ergonomics evaluation in terms of workload and the appropriate duration and frequency of resting in the oleoresin extraction activities had been carried out by ( et al.
In extend, a comprehensive ergonomics evaluation on oleoresin is required to grab a complete picture of the ergonomics problems.
Therefore, this research explored ergonomic issues on MSDs, physical-mental-social fatigue, and job satisfaction in traditional tapping of pine oleoresin.
MATERIALS AND METHODS
This research was conducted in a plantation forest in Sukabumi.
West Java.
Indonesia, from February to March 2020.
Thirty respondents Aerandomly selected- participated in this study.
It should be noted that: .
the process and stages of the pine oleoresin extraction in this study represents the traditional extraction method carried out in Indonesia, and .
the characteristics of respondents involved in this study also represent the majority of pine oleoresin tapping workers in Indonesia.
Therefore, even though the number of respondents involved was only 30 people, the information captured from this study offered sufficient elements to grab a generic picture on ergonomics conditions of the pine oleoresin extraction from pine tree (Pinus merkusii Jungh.
& de Vries.
Musculoskeletal disorders (MSD.
MSDs issue was investigated by using the Standardized Nordic Questionnaire (SNQ) Different people may feel musculoskeletal pain in different parts of the body even though they perform similar physical activity.
However, the SNQ questionnaire has high accuracy in capturing MSDs complaints that are likely experienced by sedentary workers (Kuorinka et al.
This instrument has been widely applied in different discipline from human health and social assistance, agriculture, livestock, forestry, computer, teaching, commercial activities, and other (Lypez-Aragyn et al.
Since the musculoskeletal system in the human body works as a complex mechanism, a modification was performed on the SNQ, especially on the questions related to body parts and recall periods.
Most body postures are generated by a complex mechanism work of agonist, antagonist, and synergist muscles located differently in dorsal and ventral sections .
oronal Jurnal Sylva Lestari Vol.
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of the human body (Chen et al.
Therefore, we added the front and backside version in the SNQ questionnaire to differentiate the pain locations according to the coronal plane.
The SNQ data was taken through in-depth interviews by always ensuring that respondents only point to the pain caused by the tapping work, not from other physical activities.
In the term of recall period, the frequency of the symptoms was not asked to avoid complexity perception during data collection.
Instead, pain intensity data was taken.
The pain was measured based on selfreport using the Wong-Baker pain rating scale (WBS).
The WBS has been used for the children's population as it is easy to understand and has been widely used in the diverse adult population (Garra et al.
In this study, the respondent chose the face that best describes their level of pain.
We modified the scale into a 0Ae5 pain scale.
An explanation of each scale was given to the respondent before data collection to avoid misperceptions in the level selection.
The pain level 0 refers to "no hurts" in which respondents feel perfectly normal.
Pain level 5 refers to "hurts worst".
Cumulative fatigue Cumulative fatigue was measured by using the Cumulative Fatigue Symptoms Index (CFSI) (Kosugo et al.
CFSI is a questionnaire that contains "yes" or "no" answers reflecting three dimensions of fatigue .
hysical fatigue, mental fatigue, and social fatigu.
The three dimensions are classified into eight sub-dimensions with 75 questions (Table .
(Yoshimura and Acar 2.
The Indonesian version of the questionnaires is available in Yovi .
The equation for each question is:
yc yc= ycN where r indicates the complaint rate for each question, y indicates the total "yes" answer within each question, and T indicates the total number of respondents involved.
The equation for each group is:
ycU ycI= ycoycN where R indicates the complaint rate for each group.
Y indicates the total "yes" answer within each group.
T indicates the total number of respondents involved, and k indicates the number of questions in each group.
Table 1.
Description of the Cumulative Fatigue Symptom Index .
riginated from Kosugo and Fujii 1.
Number of Type of fatigue Scope of questions Physical fatigue The questions cover items on carelessness, feeling weak, dizzy, and tiring eyes.
Respondents were also questioned General fatigue whether they have a backache, shoulder stiffness, and tired legs.
Included in this question is whether respondents are slept well or not.
The questions cover symptoms related to tiredness such as too sleepy, feeling tired all the time so that they feel Chronic fatigue like lying down during work, lacking energy, and not recover from the previous fatigue.
The questions cover items on the common symptom of a physical disorder, such as loss of appetite, difficulty Physical disorders falling asleep, problem on the digestive system, diarrhea, heavy head, and excessive worry about their health.
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2549-5747 Number of Psychological fatigue Type of fatigue Depressive Feeling of anxiety Decrease in Scope of questions The questions cover items on the typical symptoms that reflecting a mental dimension of fatigue especially depressive feeling, e.
, feeling gloomy, hate their self, can enjoy nothing, no fun in their life, tend to be a loner .
r in contrar.
, and want to have a party and let loose.
The questions were given to measure the mental dimension of fatigue, especially those related to "feeling of anxiety" symptoms, e.
, feeling worried, uneasy, restless, difficulty in focusing or concentrating, and feeling inferior.
The questions measure fatigue's mental dimension, especially in the aspect of decrease of vitality cover items to reveal their impatience, laziness, and ability to give full attention to work.
The respondents also questioned whether they are feeling troublesome, lose vitality, and dull minds or not to measure the decrease vitality level.
Social fatigue Irritability Unwillingness to All the questions are about whether the respondents quickly get angry or not, feel tense or not, and feel irritated for no reason.
Including in the questions is whether respondents have a feeling to beat someone up or not.
The issues were given to measure the social dimension of fatigue, especially in "irritability" The questions cover items on the typical symptom of social dimension fatigue, especially unwillingness to work, e.
, feel unsatisfied with their work, feel their work is too monotonous, relationship with boss or Adopted from Yoshimura and Acar .
Job satisfaction Job satisfaction was analyzed through a questionnaire exploring potential variables that potentially affect job satisfaction.
Eight independent variables were tested in this study, i.
wage, employment status, accessibility, health service, living facility, work equipment, training, and social facility (Yovi and Yamada 2.
The attributes used in this study were binary .
atisfied = 1.
dissatisfied = .
Spearman Rank test was used to see the association of each dependent variable to job satisfaction.
RESULTS AND DISCUSSION
Respondents characteristics and the nature of oleoresin tapping work All respondents were married, with an average age of 46 years .
Ae75 year.
The average number of dependent family members is four people .
Ae8 family member.
Almost 83% of respondents had low levels of education .
lementary school graduate.
Their status is a Jurnal Sylva Lestari Vol.
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2549-5747 seasonal worker with pine tapping as their second job.
This work provides a stable additional income during the dry season.
On average, respondents have been in this job for more than 20 years.
Their other economic activities are farming .
, running a small grocery shop, or breeding farm The percentage of income contribution from oleoresin tapping to their monthly income is 50% (Figure .
The average monthly income from tapping activities is IDR 1,680,0000 (IDR 600,000Ae3,800,.
, make the average total monthly income is IDR 3,392,000 (IDR 1,683,677Ae6,509,.
As many as 73% of respondents have a total income above the Sukabumi DistrictAos minimum wage.
Monthly income (IDR) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Respondents Tapping Farming Figure 1.
Monthly income of pine oleoresin tapping versus other jobs.
The extraction of pine oleoresin consists of bark removal activity .
sually called as "refreshing") and oleoresin collecting activity.
Refreshing is carried out periodically .
sually once in three day.
to expose the resin canal in secondary xylem.
Oleoresin collecting is carried once in 10 days period.
In this study, a worker can do the refreshing activity to 100Ae120 trees per day .
ith two cut surfaces per tree.
it makes 200Ae240 bark removal replication.
Tapping usually started at 6:00 a.
and ended at around 2:00 p.
bout 6Ae7 hours There are various traditional extractions methods, i.
Chinese method .
he downward-pointing V-shape groov.
American method .
orizontal groov.
Hugues or French method .
n Indonesia usually called quar.
, and Mazek or rill method (V-shaped groov.
(Cunningham 2.
The Hugues/French method/quare is the most dominant extraction method in Indonesia (Figure 2.
In this technique, slices of around 10 cm wide are cut .
y using small hoe/kadukul/pethe.
into the trunk, reaching the secondary xylem.
Kadukul has a slightly curved sharp edge (Figure 2.
with a total length of about 18 cm, the width of the blade is 5.
cm and weight 0.
5 kg.
The cut surface/wound position varied considerably at the study site, ranging from 10 cm up to 3 m above the ground.
A stimulant .
sually strong acidic liquid, either organic or non-organi.
is applied in the freshly wounded exposed surface after a new wound is made.
This strong acidic liquid will provide a heating effect so that the oleoresin lasts in liquid condition.
This liquid can cause eye irritation if contact occurs.
Many of the stimulants are toxic that inhaling spray particles can cause respiratory problems (Guan et al.
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2549-5747 Based on the work's characteristics, personal protective equipment (PPE) such as safety shoes, gloves, safety helmets, safety glasses or visors, and masks, are needed.
Safety shoes will prevent direct contact with hazard sources such as slippery and uneven forest ground, venomous animals .
, snake.
, and slippery stairs.
Safety shoes should be light boots with anti-slip rubber sole.
Rubber grid gloves are needed for better hand coupling.
Gloves are also needed to prevent injured hands from touching the rough surface of the bark.
Safety helmets are mandatory PPE when working under forest stands because pine fruit or dried twigs can fall.
Although the size is quite small and light, falling from a height causes these light objects to posses significant kinetic energy due to its motion.
This kinetic energy can cause injury when falling on the bare head.
Safety glasses/visors are needed to protect the eyes against small pine bark flakes and splashes of strong acidic liquid.
The mask is used to avoid small chemical particles of strong acidic liquid being inhaled (Guan et al.
Figure 2.
The wound shape on the Hugue/French/quare technique and .
the traditional tapping tool .
adukul/pethe.
However, during the observation, most of the workers did not use proper and complete PPE.
None of the workers wore safety helmets, the majority .
%) only wore cloth hats that were considered a sufficient substitute for helmets, and the rest .
%) work bareheaded.
Masks were used by only 10% of workers, and gloves were used by 43% of workers for the reason of feeling discomfort.
No workers wore visor even though there were accidents causing eye injury due to bark flakes splitting.
Depth interview reveals there were seven accidents cases during 2006Ae2012: six cases were in the form of hit by the tip of the kadukul/pethel's blade .
ix cases, causing 148 lost workdays, ranged from 14Ae30 working days lost, parts of the body injured were the forearm, right thigh, right knee, and right foo.
and one case was in the form of a hit by a splinter of pine barks .
aused two working days los.
In the interview, the near-miss incidents were not being Work accidents will increase ineffective work time, which will reduce overall work Experienced injured respondents admitted that work accidents occurred because they were not careful and not wear proper PPE.
These statements indicate that unsafe actions .
, careless and inadvertent, disobey the rules, break the standard of work procedures, do not wear PPE, and keep working in unwell health condition.
mostly triggered the work accidents in oleoresin extraction, although indirectly, work equipment used and natural conditions also may contribute to the accidents (Wiegmann et al.
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MSDs distribution among the workers.
Right foot Left foot Right calf Left calf Right thigh Left thigh Right hand Right wrist Right lower arm Lower back Right upper arm Back Right shoulder Right foot Left foot Right calf Left calf Right hand Right lower arm Right upper arm Right shoulder % of respondent who complained Standardized Nordic Questionnaire In Indonesia, the issue of MSDs has not been taken seriously.
In Indonesia, data on economic losses due to MSDs are not yet available, but in America, the financial costs of MSDs reach USD 2.
6 billion per year (Bhattacharya 2.
MSDs may result in severe health problems that cost not only to economic distress due to medical expenses or low work productivity (Karwowski and Marras 2.
but also reduce the quality of life of the sufferers (Kahraman et al.
For seasonal workers with a straight work rate payment system, a decrease in workability will directly result in a reduction of income (Hrymak and Pyrezgonzylez In the end, this situation will ultimately harm the companyAos performance.
The SNQ shows that the parts of the body with the highest level of pain were the right shoulder and upper arm .
or dorsal dan ventral section.
and the right forearm and wrist .
entral sectio.
(Figure .
High intensity in using the right hand during refreshing, especially when the tapping height is above the worker's shoulder, was suspected to be the trigger.
Muscle work is getting heavier as workers also often using an awkward posture (Figure .
Field observations confirmed that this movement is carried out hundreds of times a day.
As a result, the right muscles receive more pressure due to the continuous workload, repetitive movements, and awkward posture that accelerates the decrease in muscular endurance (Chaffin et al.
Ferguson et al.
Hansen et al.
MSDs were also reported in the right and left legs .
highs, back of the knee, and calf.
Figure .
because the worker also works in a squatting position (Figure .
The WBS results (Figure .
also verified that squatting posture potentially triggers excessive pressure on the vertebrae, resulting in musculoskeletal injury and chronics low back pain (Kroemer and Grandjean 1997.
Kumar 2001.
Sakka et al.
Yovi and Andriyani 2.
The location of MSDs complaints in this study is very different from the results of a similar study in chainsaw-use logging activities (Yovi and Yamada 2.
Chainsaw operators mostly use the left hand for lifting and maneuvering chainsaw.
As a result, these movements affect the musculoskeletal system in the left upper arm, left forearm, and left hand.
Different work postures require the use of different parts of the body, and in the end, lead to different MSDs consequences.
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Several tapping postures.
Postures vary greatly depending on the height of the tapping location.
Sources: Modified from Kuorinka et al.
Figure 5.
Distribution of body pain among the workers.
Cumulative Fatigue Symptom Fatigue is a complex phenomenon and is a multidimensional concept.
Its triggers factors and effects overlap the areas of physical, physiology, cognitive, emotion, and even social.
Many studies have consistently shown that fatigue impairs cognitive functioning and behavioral motor performance (Neu et al.
, which lead to error and accidents.
Therefore, we consider that it is essential to understand the status of fatigue among Indonesian forestry workers.
Most of the workers experienced physical fatigue in all subdimensions: general fatigue .
%), chronic fatigue .
%), and physical disorders .
%) (Figure .
, and showed light mental and social fatigue.
The common symptoms for general fatigue syndrome were shoulder stiffness, backache, joint pain, and experiencing weakness .
The workers also stated they were too sleepy and feeling tired all the time, even after they take some rest, where all of these symptoms refers to chronic fatigue.
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terms of the mental dimension, the most dominant complaint is in the subdimension of depressive feelings, which is reflected in the great desire to do recreation to escape from their In general, the distribution of fatigue symptoms in the tapping workers is similar to that of chainsaw operators, helpers, logging truck drivers, and hauling workers (Yovi and Yamada 2.
These groups of workers are field workers who use the physical while doing their work.
It should be noted that different situations occurred in forest inventory workers who have a high anxiety disorder (Yovi 2.
The work location and work characteristics among inventory workers seem to be a determining factor for the occurrence of severe mental fatigue Irritability (%) 70 Depressive feeling Feeling of anxiety Decrease in fitality General Fatigue Physical disorders Chronic fatigue Unwillingness to Figure 6.
Cumulative fatigue symptoms experienced by the workers.
Job Satisfaction As is discussed in the previous segments, work in the forest brings significant pressures.
These job stressors relate negatively to job performance (Arshadi and Damiri 2.
and are detrimental not only to individual health and work productivity (Shobe 2.
but also to safety (Strahan et al.
On the other side, good job satisfaction associated with higher safety commitment (Barling et al.
Gyekye 2005.
Probst and Brubaker 2.
The reliability test showed a high Cronbach's .
and McDonald's O .
The data were normally distributed (Shapiro-Wilk p <0.
Associative tests (Rank Spearma.
that were carried out on each variable showed that among the variables, wages and contract status have a significant association .
with job satisfaction ( = 0.
Spearman's rho 390 and 0.
577, respectivel.
The test results indicate that in the context of wages, the higher the wage, the greater the job satisfaction level.
Interesting findings were found in the employment status variable.
Interview with workers indicates that seasonal work contracts give opportunities to do other economic activities, such as farming, raising livestock, and running small grocery stores.
The wage/income from this work is half of their monthly financial income.
This finding is contrary to the result of a similar study carried out to contract workers in the operator/equal level, i.
chainsaw operator, helper, logging truck drivers, manual hauling workers, nursery workers, and tractor operator (Yovi and Yamada 2.
This group of workers expects their contract status to become permanent employees.
The finding that being permanent workers is associated with high job satisfaction also has been verified in another study carried out to permanent workers.
This study confirmed that status as permanent workers related to a high level of job satisfaction (Yovi 2.
It seems that the level of dependency on forestry work to make a living, which is quite high in these two previous studies .
Ae100% of monthly income derived from forestry wor.
, is the reason behind different employment status preferences.
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2549-5747 Occupational Safety and Health (OSH) Protection Strategy This study offers a picture of the working conditions in pine oleoresin extraction activities from physical and cognitive ergonomics standpoints.
Improvement strategy should be put into serious consideration.
The improvement of OSH protection from technical aspects that need to be done is to complete PPE, improve working aids, and improve work techniques.
For nontechnical aspects, the improvement that needs to be done is to increase the wage of the workers.
PPE and workaid tools PPE is a hazard control technique having the lowest effectiveness (NIOSH 2.
, but it is the easiest and most likely to be done.
The provision of complete PPE needs to be done.
With a low level of income from manual tapping, employers should provide the required PPE.
The next challenge is the habituation in using the PPE, as it refers to behavior shifting.
Behavior shifting is a complex and not an instant process because it involves elements of capability .
hysical and psychologica.
, opportunity .
hysical and socia.
, and motivation .
utomatic and reflectiv.
(Michie et al.
To overcome this, a potential approach that can be put in the employerAos consideration is offering incentives in the form of financial rewards (Forsythe and Venter 2.
At the same time, the workers should acquire the safety aspect of pine tapping.
Because of the literacy limitation, learning can be done in game-based learning, which has proven to be very effective in increasing the level of knowledge for forestry workers (Yovi and Yamada 2.
In the context of workaid tools, the design of the kadukul should be improved, as the handle's design could not support a firm and strong handhold (Figure 1.
Therefore it is necessary to add rubber pads to the grip that will increase friction and increase the grip strength so that kadukul does not slip easily.
Working technique In working techniques, it is important to improve work instructions, especially the "may and may not be done.
" The tapping height should be set clearly and firmly.
Included in the improvement of work techniques is providing clear work technical guidelines governing PPE and workaid tools.
Wage Tapping work contributes 50% of the worker's total monthly income, while this work takes longer work time compared to farming, breeding livestock, or running a small grocery One cycle of pine oleoresin extraction consists of three times refreshing and one time collecting that go to this order: refreshing-refreshing-refreshing-collecting with three days intervals between each activity.
If a worker holds a tapping right for three different areas .
hich is quite commo.
, he will work almost every day, 6 hours per day .
, and allocate the remaining time for non-forestry works to make a living.
This work time allocation indicates that for almost the same amount of income, the workers spend a long time tapping than for the non-forestry work.
The fact that the resin extraction is stopped during the rainy season toughen worker's perception that tapping jobs are less economically promising than their other There is a strong need to raise the wage/income of the worker To increase safety in pine oleoresin extraction, as there is a positive and strong relationship between the amount of wage and job satisfaction.
Job satisfaction has been confirmed as an important element in the safety behavior (Barling et al.
Gyekye 2005.
Probst and Brubaker 2.
In this attempt, wage increases will satisfy the workers.
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2549-5747 The increment could be given in the form of safe behavior incentive, where a certain amount of money should be awarded to workers who keep the safety rule.
This way, the workers will be satisfied with the higher income, and on the other side, employers will achieve success in promoting safe work behavior in the workplace (Forsythe and Venter 2.
CONCLUSIONS
Even though reports of fatalities in oleoresin extraction is rarely found, this forestry work may threaten the worker's occupational safety and health.
The protection of occupational safety and health is one of the fundamental human rights and, at the same time, crucial in the issue of sustainable forest management.
This study focuses on ergonomics conditions on pine oleoresin extraction on physical and cognitive ergonomics, especially on MSDs, physical-mental-social fatigue, and job satisfaction.
As the traditional tapping technique -which is a typical manual handling activity- discussed in this study are widely applied, this study findings can also be seen as a representation of other similar operations carried out all over Indonesia.
This traditional oleoresin extraction caused MSDs on the upper limb's right side.
For the lower limb, the MSDs were reported in the right and left legs .
highs, back of the knee, and cal.
at various pain levels.
In terms of fatigue, most of the workers experienced general fatigue, chronic fatigue, and physical disorders.
Type of accidents ever occurred are hit by the tip of the kadukul/pethel's blade and hit by a splinter of pine barks.
The finding explicitly shows that OSH threats in this activity do exist.
Therefore, an OSH protection strategy is required.
A job satisfaction analysis indicates that increasing wages may increase job satisfaction, and in the end, will increase individual safety behavior.
REFERENCES