1. Ergonomics— The Case of the Ruptured Tendon
P O W E R P O I N T ® T R A I N I N G
Background for the Trainer:
This case and its training message primarily have to do with implementing ergonomic practices to avoid musculoskeletal disorders. Therefore it is most appropriate for workers exposed to ergonomic risk factors in an industrial setting. This session is probably not appropriate for office workers that may be exposed to ergonomic risk factors.
This training session presents a case study of an actual accident, which was inspected and documented by the Occupational Safety and Health Administration (OSHA). The case presented in this training session is:
Accident:
Report ID:
Inspection:
You may choose to present this training information in a lecture format, or make the training presentation interactive by engaging your class in discussions that will help them identify facts of the case, potential causes of the accident, and future accident prevention measures. In either case, students will benefit by learning from a real-life scenario.
Before beginning your training session, print and make copies of the one-page Case Study Student Handout, which is provided on the disc. The Case Study Student Handout can be used as a worksheet during the training session or as a take-away reminder once the training session is complete.
Also, print and make copies of the Case Study Quiz, which is provided on the disc as a fully customizable Word document. The students can take the quiz at the end of the training session in order to help reinforce the information presented. Note that the same quiz is included at the end of this PowerPoint presentation as actual slides to review in class.
Consider taking pictures of a worker lifting safely, using mechanical lifting aids, or using material handling aids in your workplace. You can add these pictures to the presentation by inserting them into existing slides or creating new slides.
Make sure the trainees understand the message as you go along. Periodically ask questions to test their understanding.
Speaker’s Notes:
Welcome everyone. Today we will conduct a case study of an actual accident, which was investigated by the Occupational Safety and Health Administration (OSHA). This is an actual, tragic, workplace accident that had real-life implications for the worker, the worker’s family, co-workers, and the employer.
The purpose of this training session is to teach and reinforce the importance of reducing exposure to ergonomic risk factors in our workplace in order to prevent tragic accidents. In particular it deals with exposure to lifting-related ergonomic hazards. The intention is to learn from the accident and to take steps to prevent a similar accident from occurring at our facility.
Ergonomics— The Case of the Ruptured Tendon
©2003

2. Ergonomics and MSDs 1.8 million work-related MSDs each year
Ergonomics—science of fitting job to the worker
MSD—injury of the nerve system or tissue
Carpal tunnel syndrome, tendinitis, etc.
Shooting pain, stiffness, swelling, numbness
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 from work to recover. According to OSHA, ergonomics is the solution to preventing these work-related MSD injuries and illnesses.
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 by changing the design of a workstation or the way a job is performed, allowing workers to rotate through different jobs, or providing personal protective equipment (PPE).
An MSD is an injury or disorder of the nervous system or soft tissue in your fingers, hands, wrists, elbows, shoulders, back, neck, legs, etc., which includes muscles, tendons, ligaments, joints, cartilage, blood vessels, or nerves.
Common MSDs include carpal tunnel syndrome, tendinitis, thoracic outlet syndrome, De Quervain’s disease, trigger finger, Raynaud's syndrome, rotator cuff syndrome, sciatica, epicondylitis, etc.
An MSD can cause pain or swelling in a number of body parts, depending on the specific MSD that might be developing. The type of pain you experience will also vary depending on the type of MSD and the type of injury you have suffered. Some typical signs or symptoms of an MSD include shooting pain, prolonged stiffness, loss of mobility, numbness, swelling, soreness, tingling, coldness, burning sensation, loss of strength, etc.

3. Take a Look at the Facts
Employee is working at a manufacturing facility moving wood from shelving to pallet lift
Shelving is waist high
Pallet lift is slightly higher than shelving
Background for the Trainer:
Training Option: Pass out the Case Study Student Handout. You may have the students read the accident description to themselves before discussing it in the class, or you may use the bullet points on the slide and the speaker notes below to describe the accident.
Speaker’s Notes:
An employee, a laborer/crew member at a manufacturing facility is moving lengths of wood.
This requires lifting 84-inch-long 2 by 4 stock two at a time from the shelving.
The shelving is waist high.
The wood stock is then placed onto a pallet lift, which is slightly higher than the shelving.

4. Take a Look at the Facts (cont.)
Employee lifts wood stock off shelving
Wood stock is placed onto pallet lift
Employee ruptures tendon near bicep
Employee says he did nothing out of the ordinary
Speaker’s Notes:
Employee lifts wood stock off shelving.
Wood stock is placed onto pallet lift.
The employee suffers a ruptured tendon in the area of his left biceps.
He states that he was not rushed at the time and was doing nothing out of the ordinary. The cause of the injury was undetermined.

5. What Do You Think Went Wrong?
Do you think job repetition had something to do with this injury?
Do you think the weight of the wood stock contributed to the injury?
Do you think the worker was able to use correct lifting techniques?
How does the proper use of a lift reduce the potential for injury?
Background for the Trainer:
Use the questions on this slide to elicit discussion.
Training options: After reviewing this slide and the accident description, give the class 5-10 minutes to discuss the accident description in small groups; or, ask the students to try to determine some of the facts, potential causes, and possible prevention measures. In either case, use the Case Study Student Handout as a way to encourage discussion as you go through this presentation.
Speaker’s Notes:
Let’s take a few minutes and, using the Case Study Student Handout, work in groups to try to determine the facts of the accident, potential causes of the accident, and possible prevention measures. Then we will review the Case Study together in class.
Consider some of the questions on this slide when discussing the Case Study in your groups.

6. Let’s Review the Causes
Worker was:
Lifting with an awkward posture
Lifting two pieces at a time
Not using the pallet lift effectively
Exposed to repetitive motion
Background for the Trainer:
Try to get the trainees to put themselves in the place of the person in the Case Study. What would they have done in this case? Point out how a near miss can turn into a catastrophe in the presence of emergencies. In this case, the worker was exposed to ergonomic risk factors that may have contributed to this injury.
Speaker’s Notes:
In addition to the repetition, the worker was likely in an awkward posture when lifting and moving the long pieces of wood stock. Although we do not know for sure, the worker could have been twisting his back when transferring the wood stock, holding the wood awkwardly so that it put strain on the tendons near his biceps, or stooping over to grab the wood stock.
Based on the size of the wood stock, it is not likely that they were very heavy; however, the worker could have cut the weight in half by only lifting one at a time instead of two.
The employer provided a pallet lift so that the worker could load the material at a comfortable height, rather than stoop down or lift the material up above his shoulder. However, maybe the worker was not using the pallet lift effectively to keep the loading operation at a comfortable height.
This worker is exposed to repetition when doing this job. The worker stated that he was doing nothing out of the ordinary, which indicates he does the job almost every day. The repetition of moving wood stock from the shelving to the pallet lift over time can wear on tendons, muscles, and other soft tissue and potentially result in a musculoskeletal disorder.
Can you think of any other causes that may have contributed to this accident?

7. Ergonomic Risk Factors
Repetition
Force
Awkward postures
Contact stress
Vibration
Speaker’s Notes:
The five MSD risk factors listed on this slide 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—Doing the same motion over and over for long periods each day.
Force—Constant lifting or pushing and pulling of heavy objects.
Awkward postures—Working with your back or neck bent down or twisted, or working with your hands above your head.
Contact stress—Using your hand or knee as a hammer.
Vibration—Using vibrating tools or equipment.
Have the employees give examples of what they do in their current job that might have one or more of these risk factors.

8. Keys to Ergonomic Lifting
Use correct lifting techniques
Items between knee and shoulder height
Decrease weight of objects or distance carried
Use material-handling aids
Do not exceed your lifting limits
Background for the Trainer:
Bring any written procedures your company has for lifting or material handling.
Show pictures of workers lifting correctly, using material-handling aids, etc.
Speaker’s Notes:
Lifting, carrying, pushing, and pulling put strain on the back, arms, knees, and shoulders.
Always use correct lifting techniques and maintain proper back posture. Take breaks for stretching when tasks require frequent lifting.
Position items to be lifted between knee and shoulder height. Lifting items off the floor or from above your shoulders puts an additional strain on your muscles and prevents you from always having correct back posture.
Reduce material-handling strain by either decreasing the weight of objects or decreasing the distance or height over which objects must be moved.
Use material-handling aids such as hand trucks, carts, conveyors, forklifts, or cranes whenever possible.
Remember, do not exceed your strength and lifting limits, because extreme muscular exertions can cause injuries.

9. Don’t Let It Happen to You
Change positions, take stretch breaks
Maintain good posture
Identify and eliminate ergonomic risk factors
Use material-handling aids
Speaker’s Notes:
Let’s take a look at what we can do to prevent a similar incident from happening at our facility.
To avoid exposure to repetition, change the way you perform your job, take stretch breaks, or do another task that requires the use of different muscle groups.
Avoid awkward postures in all of your job functions. Stand with your back straight, avoid bending forward or stooping, limit squatting and kneeling, keep your head straight and facing forward, avoid raising or hunching your shoulders, etc. Always use proper lifting techniques and posture.
Evaluate your job and associated tasks for exposure to ergonomic risk factors. Inform your supervisor of the risk factors and work to make changes that will help reduce or eliminate exposure to those risk factors.
Use material-handling aids to reduce exposure to the ergonomic risk factor of force, which includes lifting heavy objects.
Tell your supervisor if you have any early signs or symptoms of MSDs.
Are there any questions?
Thanks for your attention.
Report MSD symptoms

10. Quiz 1. What is a musculoskeletal disorder?
2. Ergonomics is the science of what?
3. What are the three ergonomic risk factors of lifting?
4. Describe a couple of engineering controls that can reduce exposure to lifting hazards.
5. Name some examples of MSD symptoms.
Background for the Trainer:
Remind employees that the quiz is used to encourage further discussion and to help you, the trainer, be sure that everyone understands what was discussed.
Print copies of the quiz for participants to take on their own, or go over the questions as part of the training session.

11. Quiz (cont.)
6. Name an administrative control that can reduce exposure to repetition.
7. What can you do to improve posture when lifting?
8. Name some examples of common MSDs.

12. Quiz Answers 1. Q. What is a musculoskeletal disorder?
A. Injury to soft tissue or nervous system.
2. Q. Ergonomics is the science of what?
A. Science of fitting the job to the worker.
3. Q. What are the three ergonomic risk factors of lifting?
A. Force, posture, repetition.

13. Quiz Answers (cont.)
4. Q. Describe a couple of engineering controls that can reduce exposure to lifting hazards.
A. Mechanical lifts, conveyors, material-handling aids, etc.
5. Q. Name some examples of MSD symptoms.
A. Shooting pain, numbness, tingling, stiffness, etc.
6. Q. Name an administrative control that can reduce exposure to repetition.
A. Job rotation.

14. Quiz Answers (cont.)
7. Q. What can you do to improve posture when lifting?
A. Lifting techniques, lift between knee and shoulder, reduce weight of object.
8. Q. Name some examples of common MSDs.
A. Carpal tunnel syndrome, tendinitis, sciatica.