BLR’s Training Presentations Ergonomics and the Computer Workstation I. Trainer Tips: This Training session includes a 29-slide PowerPoint session with speaker’s notes, a set of full-color employee booklets, reproducible employee handouts, and a customizable training completion certificate. See the Quick Guide that accompanies this product for information on how to access these features. Distribute booklets “Ergonomics and the Computer Workstation.” II. Speaker’s Notes: In this training session, you will be able to follow along in your booklets, “Ergonomics and the Computer Workstation.” Feel free to take notes or write down thoughts or comments in the booklet, because they are yours to keep and reference in the future. The order of this presentation will closely follow the order of the information presented in the booklet. There will, however, be additional information presented here that is not contained in the booklet. Today’s training and your booklet focuses on Ergonomics for the Office and presents a number of helpful tips. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Why Ergonomics? 1.8 million work-related MSDs each year 600,000 require time away from work to recover Ergonomics prevents MSDs I. Trainer Tips: Page 2 of booklet II. Speaker’s Notes: According to OSHA, 1.8 million workers in the United States report work-related musculoskeletal disorders (MSDs) each year. Of those injuries, about 600,000 require the worker to take time off of work to recover. According to OSHA, ergonomics is the solution to preventing these work-related MSD injuries and illnesses. 31508715/0103 ©2001 Business & Legal Reports, Inc.

What is Ergonomics? Science of fitting the job to the worker Reduces exposure to MSD risk factors Involves engineering and administrative controls I. Trainer Tips: Page 2 of booklet II. Speaker’s Notes: Ergonomics is the science of fitting the job to the worker doing that job. The goal of ergonomics is to reduce a worker’s exposure to MSD risk factors, which we will talk about later. Ergonomics may include engineering or designing the layout of a workstation, in our case the computer workstation, so that the worker’s exposure to MSD risk factors is reduced. The way or sequence in which a job is done may also be changed to help reduce MSD risk factors. Administrative controls include rotating employees through a job with higher MSD risk factors so that employees are only exposed for a short period each day. For example, a job with heavy data processing might be shared by four employees that perform other duties when not doing the data process. This prevents one person from being exposed to the heavy data processing for an entire day. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Musculoskeletal Disorder (MSD) Injury or disorder of the nervous system or soft tissue: Muscles Tendons Ligaments Joints Cartilage Blood vessels Nerves I. Trainer Tips: Page 3 of booklet II. Speaker’s Notes: What is a Musculoskeletal Disorder (MSD)? An MSD is an injury or disorder of the nervous system or soft tissue in your fingers, hands, wrists, elbows, shoulders, back, neck, etc., which includes: Muscles Tendons Ligaments Joints Cartilage Blood vessels Nerves 31508715/0103 ©2001 Business & Legal Reports, Inc.

Risk Factors Repetition Force Awkward postures Contact stress Vibration I. Trainer Tips: Page 3 of booklet II. Speaker’s Notes: These five MSD risk factors are the major contributors to MSD-related injuries and illness. Prolonged exposure to one or more of these risk factors in your job puts you at risk of an MSD. Repetition might include daily and lengthy use of a keyboard or mouse. Force might include constant lifting, pushing, or pulling. Awkward postures might including extending arms to type or sitting forward with hunched shoulders. Contact stress might include soft tissue damage by contact with a hard surface such as leaning against a counter or continual use of a stapler or hole punch. Vibration includes the use of vibrating tools or equipment such as powered saws (not typically an office concern). 31508715/0103 ©2001 Business & Legal Reports, Inc.

MSD Signs and Symptoms You will feel pain or swelling in your: Hands Wrists Fingers Forearms Joints Elbows I. Trainer Tips: Page 4 of booklet II. Speaker’s Notes: Understanding the first signs and symptoms of MSD-related illnesses will help in their prevention. An MSD can cause pain or swelling in a number of body parts, depending on the specific MSD that might be developing. The pain or swelling for office-work-related MSDs can occur in your: Hands Wrists Fingers Forearms Joints Elbows Pain may also occur in your back, neck, or even your legs. 31508715/0103 ©2001 Business & Legal Reports, Inc.

MSD-Related Pain Pain described as: Tightness Stiffness Discomfort Soreness Burning Tingling Coldness Numbness I. Trainer Tips: Page 4 of booklet II. Speaker’s Notes: The type of pain you experience will also vary depending on the type of MSD and the type of injuries you have suffered. Tightness might occur in muscles or tendons from overuse. Stiffness might occur from damaged joints or cartilage. Discomfort can occur from damage to any of the nerves or soft tissue. Soreness may occur from overused muscles or tendons. Burning may occur from damage to blood vessels or nerves. Tingling may occur from damage to nerves. Coldness may occur from damage to blood vessels. Numbness may occur from damage to nerves or blood vessels. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Outward Signs of MSDs Swelling or inflammation of joints Vigorously shaking hands Urge to massage hands, wrists, or arms Cradling arms I. Trainer Tips: Page 4 of booklet II. Speaker’s Notes: You might also note that a co-worker is experiencing some MSD symptoms by outward signs such as: They have joints that are swelled or inflamed. They vigorously shake hands their hands and wrists during work as if trying to regain the circulation. You see them almost unconsciously massaging their hands, wrists, or arms. They walk around or sit in meetings and cradle their arms as if giving it extra support or holding the arm in a position that reduces pain. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Common MSDs Carpal Tunnel Syndrome Tendinitis Tenosynovitis Thoracic Outlet Syndrome De Quervain’s Disease Trigger Finger I. Trainer Tips: Details of this slide are not found in the booklet. II. Speaker’s Notes: Carpal Tunnel Syndrome: Compression of the median nerve, which provides sense of touch for fingers, where it passes through the wrist and into the hand. Usually the result of repetitive motion such as typing. Tendinitis: Tendon inflammation that occurs when a muscle/tendon is repeatedly overused. Tenosynovitis: Inflammation or injury to the synovial sheath surrounding the tendon. Usually the result of excessive motion. Thoracic Outlet Syndrome: Compression of nerves and blood vessels as they travel from the neck, under the collar bone, through the armpit, and down into the arm. Often attributed to repetitive arm extension and slouching. De Quervain’s Disease: Inflammation of the tendon sheath of the thumb. Usually caused by forceful gripping or twisting motions of the hands. Trigger Finger: Tendon becomes locked in the sheath and attempts to move the finger cause snapping or jerking motions. Associated with using tools with hard handles. 31508715/0103 ©2001 Business & Legal Reports, Inc.

MSDs Related to Risk Factors Carpal Tunnel Syndrome—Repetition Thoracic Outlet Syndrome—Posture De Quervain’s Disease—Forceful grip Trigger Finger— Contact stress I. Trainer Tips: Details of this slide are not found in the booklet. II. Speaker’s Notes: Notice that these common MSDs usually result from repetitive motion, poor posture, forceful gripping, or contact stress, which are all MSD risk factors. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Report Symptoms Immediately Report any MSD signs or symptoms immediately Follow your company’s reporting procedures Begin medical treatment early Alert your company to risk factors I. Trainer Tips: Page 5 of booklet You may wish to customize the second bullet in this slide to indicate the exact person or job title that these symptoms should be reported to (e.g., HR manager, supervisor). II. Speaker’s Notes: If you notice any of the signs or symptoms of MSDs, you should report them immediately. Follow you company’s reporting procedures by reporting the symptoms to your supervisor, safety coordinator, or HR representative. Early reporting allows you to begin taking steps toward medical evaluation and treatment before your symptoms and illness get worse. Early reporting also permits your company to take steps toward reducing or even eliminating the risk factors that are causing your signs and symptoms. Eliminating these risk factors may even help you to continue working while your body heals. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Computer Workstation: Head and Shoulders Head vertical and facing forward Tilted head puts stress on neck and shoulders Minimize head rotation Shoulders not raised or hunched Arms tucked close to the body Avoid extended reaching I. Trainer Tips: Page 6 of booklet Consider demonstrating the proper computer workstation posture by having a computer workstation set-up in the classroom and go through the different concepts discussed in this and the following few slides. II. Speaker’s Notes: When working with a computer, keep your head vertical and facing forward. Holding your head off-balance (leaning it to the side) puts stress on the neck and shoulders. Put your work (e.g., notes, order forms, or other information that you are typing from) in front of you to minimize repetitive or lengthy head rotation. Shoulders should not be raised up or hunched for extended periods because this puts stress on your muscles, blood vessels, and nerves. Keep shoulders in a neutral position with arms and elbows tucked close to the body and hanging relaxed. Objects on the workstation such as staplers that are often used should be available without extended reaching. Repetitive or long periods of reaching with the arms or leaning forward to reach may contribute to an MSD. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Computer Workstation: Elbows and Wrists Elbows hanging comfortably below the shoulders Not extended outward from the body Not extended forward or backward of the shoulders Wrists in a straight line with the lower arms Hands not flexed up or down Hands not bent inward or outward I. Trainer Tips: Page 6 of booklet II. Speaker’s Notes: While working at a computer workstation, your elbows should be positioned comfortably, hanging below the shoulders and not extended outward from the body or forward or backward from the shoulders. Wrists must be in a straight line with the lower arms. Hands flexed down or up or bent towards the little finger or thumb will put pressure on nerves and soft tissue. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Computer Workstation: Legs and Feet Knees bent about 90 degrees Thighs parallel to the floor Chair at comfortable height Remove any obstructions to your legs and feet I. Trainer Tips: Page 7 of booklet II. Speaker’s Notes: Your knees should be comfortably bent at about 90 degrees. The angle does not have to be exact, as long as you are comfortable. Your thighs should be approximately parallel to the floor. Adjust your chair so that your feet can be flat, your thighs parallel to the floor, and your knees bent about 90 degrees. Also, make sure the chair has a curved front edge so that it does not put pressure on the back of your thighs. Remove any obstructions to your legs and feet so that you can maintain a comfortable working position. Your feet should be resting comfortably flat on the floor or a footrest. Although it is good to change the position of your feet on occasion, you do not want to be on your toes or heels for extended periods of time. Feet flat on floor or footrest 31508715/0103 ©2001 Business & Legal Reports, Inc.

Ergonomic Chair: Seat Surface Comfortable Slightly wider than hips/thighs Proper length Adjustable height Adjustable tilt I. Trainer Tips: Page 8 of booklet II. Speaker’s Notes: A comfortable and ergonomic chair is critical when working at a computer workstation for extended periods each day. First we will focus on the seat surface. The seat surface should be properly padded and comfortable, even after sitting for 30 to 60 minutes. The width of the seat should be at least an inch wider than your hips and thighs. To determine the appropriate length of the seat surface, sit with your back against the lumbar support. In this position, the front edge of seat should be about an inch from the back of your knee. Also, the front edge should be contoured so that you are not subjecting the back of your legs to contact stress of a hard corner of the front of the seat. The chair height must be adjustable so that your feet can rest on the floor. Some seat surfaces can also be tilted to help you maintain a balanced posture. You may prefer a seat that is tilted slightly forward so that you can easily reach the keyboard and supplies on the workstation; or, you may want the seat surface tilted back to help you stay seated against the back support. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Ergonomic Chair: Back and Armrest Backrest Angle adjustable Adjustable lumbar support Armrest Broad and cushioned Supports shoulders, elbows and wrists Adjustable height and side-to-side I. Trainer Tips: Page 8 of booklet II. Speaker’s Notes: The backrest of a chair is very important because you need adequate back support when working at a computer workstation for extended periods. You should be able to adjust the angle of the backrest relative to the seat surface so that you can lean back, forward, or sit straight up, depending on what is comfortable for you. The backrest must also have an adjustable lumbar support. Armrests must be broad, cushioned, and comfortable. However, they should not be too cushioned, because when working a mouse or keyboard, you want to keep your wrist straight and work the mouse with movement from your elbows. Therefore if your armrest is too cushioned, you will not be able to slide your elbow back and forth to move your mouse. The armrest should provide support for your shoulders, elbows, and wrists so that they can be maintained in the neutral position when working. The armrests should also be adjustable independently in both height and side to side so that they will fit the user of the chair properly. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Computer Monitor Directly in front of you Arm’s length away Proper height so that your head is level Documents placed close to monitor I. Trainer Tips: Page 9 of booklet II. Speaker’s Notes: Place your computer monitor directly in front of and facing you. Remember, you want to keep your head facing forward and straight or level. Do not put your monitor off to the side so that you have to turn your head to look at it. Your monitor should be about arm’s length away to prevent eye strain. Sit back in your chair as you would when working and reach toward the monitor—you should be able to touch it with your fingertips. Keep the text size large so that you do not strain your eyes to read the monitor. After being seated properly, the monitor should be placed such that your eyes are aligned with a point 2-3 inches below the top of the screen. Tilt the monitor back just slightly to help prevent glare. You should not have to tilt your head up or bend your neck down to see it. Place any documents that you are reading as close to the monitor as possible and at a similar angle as the monitor. Use a document holder. This will prevent unnecessary turning of your head to read or review documents related to your computer activity. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Neutral Keyboard Position Elbows close to the body Wrists flat and in line with the forearms Hands not angled up/down or turned in/out No wrist rests when typing I. Trainer Tips: Page 10 of booklet II. Speaker’s Notes: While using the keyboard, keep your elbows close to your body. Avoid reaching toward the keyboard or allowing your elbows to extend away from your body. Adjust the height of your keyboard so that your wrists are flat and in line with your forearms. Remember, your elbows should be bent about 90 degrees. Your hands and wrists must be in line with your forearms. Hands that are bent up or down or turned in or out will put stress on your nerves and blood vessels. Do not rest your wrists on a wrist rest when typing. This puts pressure on your carpal tunnel. You should only use the wrist rest during a typing pause. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Adjustable Keyboard Height adjustable In a tilting keyboard tray Detachable from the computer monitor Keystroke pressure comfortable for the user I. Trainer Tips: Page 10 of booklet II. Speaker’s Notes: To achieve the neutral typing position discussed in the last slide, the keyboard tray must be adjustable. Remember, you have already positioned your chair and monitor; now it is time to adjust your keyboard to fit your size and posture. The keyboard must be placed in a keyboard tray that is height-adjustable so that the user can maintain the neutral position. Placing the keyboard at a “negative tilt,” such that the back of the keyboard is lower than the front, will help you maintain a neutral hand/wrist position. The keyboard must also be detachable from the monitor. For example, a laptop does not allow for the proper neutral position because the monitor is attached to the keyboard. If your wrists have proper position, your neck is bent down to see the monitor, and if you place the monitor up high, your typing position is sacrificed. Finally, make sure the keystroke pressure is comfortable for the user. Today's keyboards typically have comfortable keystroke pressure. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Using a Mouse Control mouse movement from your elbow Wrist straight and neutral Locate mouse properly Use symmetrically shaped and flat mouse I. Trainer Tips: Page 11 of booklet II. Speaker’s Notes: Most people consider the keyboard to be the main contributor to computer workstation MSD injuries. However, the mouse, when used heavily and improperly, will also contribute to computer MSD injuries. Control the mouse movement from your elbow. Controlling the mouse with wrist movements will put a strain your nerves, blood vessels, and other soft tissue in your wrist. In addition, a neutral position cannot be maintained. Keep your wrist straight and neutral and move or turn at your elbow slightly to make mouse movements. Position your mouse properly: Sit back in your chair and relax your elbows Lift your mouse hand up, pivoting at your elbow, until your hand is just above elbow level This is where your mouse should be located. Use an adjustable mouse platform to obtain this position You should not have to reach or extend your arm or body to use the mouse Use a symmetrically shaped mouse that is flat and fits your hand comfortably. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Using a Laptop Computer Occasional users: Sit back in comfortable chair Sacrifice neck posture rather than wrist posture Full-time users: Position screen like a normal workstation monitor Use separate keyboard and mouse like a normal workstation I. Trainer Tips: Details of this slide are not found in the booklet II. Speaker’s Notes: The design of laptop computers violates basic ergonomic principles for a computer workstation because the keyboard and screen are not separated. The laptop can be positioned to provide either good neck/head posture or good hand/wrist posture, but not both. Occasional laptop users should sacrifice neck posture (larger muscles) rather than wrist posture. Sit back in a comfortable chair. Position the laptop so that you have a natural wrist position. Angle the screen to avoid neck strain as much as possible. Full-time users (laptop used as main computer): Position the laptop screen as you would a normal workstation monitor. Use a separate keyboard and mouse set up like a normal workstation. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Break Time Mini-break— Relax your hands Rest break— Do a different task Eye break— Look away and blink I. Trainer Tips: Page 12 of booklet II. Speaker’s Notes: Mini-break—Typing is typically done in short bursts. Between those bursts of activity allow your hands to relax in a flat and straight posture. At this time it would be acceptable to use a wrist-rest. A mini-break is not a break from work, rather it is a break from using the typing or “mousing” muscles. Use this time to make a phone call or file some documents. Rest breaks—Take a short rest break every 30–60 minutes. Get up from your computer workstation and get a drink of water, make some photocopies, or do a different work-related task. Eye breaks—Every 15 minutes look away from the monitor at something 20 feet away for a minute or so. This allows your eye muscles to relax. Also, blink rapidly for a few seconds to refresh the eyes’ surfaces. When typing, it is easy to become transfixed by the monitor so you don't blink as much as normal, which cleans your eyes’ surfaces. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Hand, Wrist, and Shoulder Stretches Hand—Finger extensions Wrist—Bend hands up and down Wrist—Backwards stretch Shoulder—Shrug and roll your shoulders Shoulder—Shoulder blade pinch Shoulder—Overhead reach I. Trainer Tips: Page 13 of booklet Demonstrate these exercises to the class and have them do the exercises and stretches with you. All of these exercises and stretches can be done while sitting in a chair. II. Speaker’s Notes: Exercises help strengthen muscles and allow overworked areas to stretch. Practice the following “workouts.” Hand—Finger extensions. Make a fist, then extend and spread your fingers. Wrist—Bend hands up and down. Hold arms out in front of your body and bend hands up and down Wrist—Backwards stretch. Palms together with fingers pointed upward and elbows pointed out, bring your hands down toward your waist until you feel the stretch. Shoulder—Shrug and roll your shoulders. Shrug your shoulder and then roll your shoulders forward and back. Shoulder—Shoulder blade pinch. With elbows out, move your arms back to bring your shoulder blades together. Shoulder—Overhead reach. Reach your arms overhead and stretch, bend from side to side. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Neck, Back, and Arm Stretches Neck—Nod head Neck—Turn head Neck—Tilt head Back/Arm—Hands behind head Back/Arm—Bend forward Back/Arm—Knee to chest Back/Arm—Back bend I. Trainer Tips: Page 13 of booklet Demonstrate these exercises to the class and have them do the exercises and stretches with you. Most of these exercises and stretches can be done while sitting in a chair. II. Speaker’s Notes: Neck—Nod head. Rotate your head up and down. Neck—Turn head. Turn your head from side to side. Neck—Tilt head. Tilt your head toward each shoulder. Back/Arm—Hands behind head. Put your hands behind your head and pinch your shoulder blades together. Back/Arm—Bend forward. Bend forward in your chair and try to touch the floor. Back/Arm—Knee to chest. Grasp you shin or knee and pull your knee toward your chest (do while sitting). Back/Arm—Back bend. Stand up, place your hands on your hips, and bend backwards. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Focus on Your Posture Elbows at your side, forearms parallel to floor Chair with good back support Close to keyboard, avoid extending Feet flat on floor or footrest Head and neck forward and straight Be comfortable and relaxed I. Trainer Tips: Page 14 of booklet II. Speaker’s Notes: Always focus on your posture because a good posture during work will go a long way in preventing MSDs. Keep your elbows at your side and forearms parallel to the floor or tilted slightly downward (wrist slightly lower than elbows) to prevent nerve compression at your elbow. Use an ergonomic chair that has good back support, and use the back support. Position yourself close to the keyboard so that you do not have to extend. Keep your feet flat on the floor or on a footrest. Keep your head and neck straight and facing forward. In general, your posture must be comfortable and relaxed! 31508715/0103 ©2001 Business & Legal Reports, Inc.

Quiz 1. T or F The neutral position for elbows is about 4 inches away from your body 2. T or F Resting your wrist on a wrist rest promotes good posture 3. T or F A short stretch break should be taken every 30–60 minutes 4. T or F Repetition and awkward posture are risk factors that contribute to MSDs 5. T or F In the neutral position, your feet should be tucked under your chair I. Trainer Tips: Back cover of booklet (page 16) You may elect to read questions aloud and answer them as a class or have each employee take the quiz individually and record their scores. 31508715/0103 ©2001 Business & Legal Reports, Inc.

Quiz (cont.) 6. T or F Ergonomics is the science of fitting the job to the worker 7. T or F Soreness, tingling, and numbness in your wrist or hands are all symptoms of an MSD 8. T or F Repetitive rotation of your head between your work and your computer results in good exercise and stretching 9. T or F Leaning forward to see the monitor contributes to poor posture 10. T or F A negative-tilt keyboard may help you maintain good wrist posture I. Trainer Tips: Back cover of booklet (page 16) 31508715/0103 ©2001 Business & Legal Reports, Inc.

Quiz Answers 1. False; the neutral position for your elbows is tucked close to your body 2. False; wrist rests often contribute to poor posture and put pressure on your carpal tunnel 3. True 4. True 5. False; your feet should be flat on the floor or on a footrest I. Trainer Tips: Back cover of booklet (page 16) 31508715/0103 ©2001 Business & Legal Reports, Inc.

Quiz Answers (cont.) 6. True 7. True 8. False; your work should be placed next to your monitor to prevent repetitive head rotation 9. True 10. True I. Trainer Tips: Back cover of booklet (page 16) 31508715/0103 ©2001 Business & Legal Reports, Inc.