1. Ergonomics Assessment For The Workplace

2. Disclaimer This training material presents very important information.
Your organization must do an evaluation of all exposures, applicable codes and regulations, and establish proper controls, training, and protective measures to effectively control exposures and assure compliance.
This program is neither a determination that the conditions and practices of your organization are safe nor a warranty that reliance upon this program will prevent accidents and losses or satisfy local, state or federal regulations.
All procedures and training, whether required by law or not, should be implemented and reviewed by safety and risk management professionals, and legal counsel to ensure that all local, state and federal requirements are satisfied.

3. Course Outline – Ergonomics For The Workplace
1. What Is Ergonomics?
2. Work Related Musculoskeletal Disorders (WMSDs)
3. Types of WMSD Injuries
4. WMSDs Are Caused By…
What Factors Contribute to WMSDs?
Ergonomic Safety Programs
Evaluation and Analysis
Applying Ergonomic Controls
Administrative Controls
Work Practice Controls
Summary

4. Ergonomics is the science of fitting jobs to people:
What Is Ergonomics?
Ergonomics is the science of fitting jobs to people:
Ergonomics uses knowledge of physical abilities, limitations, and human characteristics that apply to job design, and “Anthropometrics,” or the study of human body measurement.
Workstations and tasks are then designed around the knowledge of those physical abilities and characteristics.
The goal: neutral posture.

5. What Is Ergonomics?
Old method: The worker had to fit the workstation.
Ergonomic Method: We fit the workstation to the worker.

6. Work Related Musculoskeletal Disorders (WMSDs)
Impact of WMSDs:
Work related musculoskeletal disorders or “WMSDs” can occur from ergonomically-related stressors.
The following slides will discuss these stressors in greater detail.

7. Work Related Musculoskeletal Disorders (WMSDs)
What are WMSDs?
Musculoskeletal disorders (WMSDs) are injuries to soft body tissues such as:
Muscles
Nerves
Tendons
Ligaments
Joints
Cartilage
Bursa
Spinal discs

8. Types/symptoms of WMSD injuries include:
Types of WMSD Injuries
Types/symptoms of WMSD injuries include:
Cumulative disorders, e.g., Carpal Tunnel Syndrome
Fatigue
Eye strain or blurriness
Headache
Strains and sprains
Soreness and/or pain
Connective tissue disorders
Pain, fatigue, and general soreness lead the MSD symptoms.

9. Carpal Tunnel Syndrome:
Types of WMSD Injuries
Carpal Tunnel Syndrome:
Carpal Tunnel Syndrome is characterized by compression to the median nerve within the carpal tunnel (wrist). The carpal tunnel is located in that area where a watchband would normally be worn.
Compression to the median nerve is a result of swelling of the tendons inside the carpal tunnel from repeated use and other stressors; including but not limited to repetitive motion, compression, physical fitness, etc.

10. Tendonitis and Tenosynovitis:
Types of WMSD Injuries
Tendonitis and Tenosynovitis:
Tendonitis is characterized by an inflammation of the tendons. The tendons in the wrists are covered with lubricating sheaths.
Tenosynovitis is characterized by an inflammation of sheaths covering the tendons.
Tendonitis and Tenosynovitis can occur when the demands of the task exceed the physical capabilities of the body.
Tendonitis usually results from overuse of the tendon in question.
Tenosynovitis also results from overuse of tendons but impacts the synovial sheath instead of the tendon. De Quervain’s Syndrome (aka, gamer’s thumb) is an example.

11. Types of WMSD Injuries Muscle Strains:
Muscle strains and pulls are the most common injuries in the workplace.
Contrary to popular belief, muscle strains and pulls are not always the result of lifting heavy objects.
Lifting below the knee and above the shoulder, as well as twisting while lifting, can increase the chance of a back injury %.

12. Types of WMSD Injuries Hidden lifting task:
Many stressful working positions are considered "hidden lifting tasks.”
A hidden lifting task occurs when no object is being lifted other than the weight of one’s own body, such as the torso when flexed forward, or the arms fully extended.
As the torso and arms move farther away from the center of the body, more force is applied to the back, and the person experiences greater back-related strain.

13. Overexertion and/or excessive extension:
WMSDs Are Caused By…
Overexertion and/or excessive extension:
Climbing
Bending
Crawling
Reaching
Repetition
Vibration
Twisting
Exposure to hard and/or abrupt contact points
Grip size
Force of grip
Force/Weight
Improper body positions

14. Causes and remedies: WMSDs Are Caused By…
Continuous and repetitive motions:
Use lightweight, balanced and sharpened tools to minimize force requirements.
Static body positioning:
Use things such as magnifiers and proper chair adjustments to eliminate the need for awkward body positioning.
Grasping small instruments:
Reduce force exertion and maintain the hand and wrist in a neutral position.
Prolonged use of vibrating hand tools:
Use vibration dampening devices to minimize exposure.
Improper lifting techniques:
Use proper lifting techniques.
Neutral positioning, routine breaks or built-in job rotations, physical fitness and personal health are most important. .

15. What Factors Contribute to WMSDs?
WMSDs are medical conditions:
They develop gradually over a period of time.
They do not typically result from a single, instantaneous event.

16. What Factors Contribute to WMSDs?
Factors that contribute to elbow injuries:
Sharp or hard contact points and repeated bumping or resting against these points.
Elbows that are held outstretched and far from the body.
Repetitious extending or retracting.

17. What Factors Contribute to WMSDs?
Factors that contribute to elbow injuries (continued):
Overexertion of the elbow, due to holding too much weight or holding things far away from the body.
Grip type – something slippery requires a stronger or more awkward grip, which can, in turn, hurt the elbow.
Static or awkwardly-leaning posture.
Awkward lifting angles with arm extension.

18. What Factors Contribute to WMSDs?
Video display terminal (VDT) workstation risk factors:
Hard contact surfaces.
Glare in the room.
Wrong desk, monitor, or keyboard height.
Improper chair adjustments.
Poor housekeeping.
Poor posture.

19. What Factors Contribute to WMSDs?
Other risk factors
Off-work activities
Sleeping
Diet/physical fitness
Pregnancy
Personal physiology/genetics
Acute injuries
Physical fitness is one of the leading causes of MSD illnesses; usually resulting from poor circulation.

20. Ergonomic Safety Program
Goals of an Ergonomic Safety Program:
Increase awareness of the risk factors.
Improve efficiency and productivity.
Decrease defects and musculoskeletal disorders, and the severity of each.
Reduced insurance costs.
Reduced absenteeism due to injury.
Increase comfort
Decrease risk factors

21. Ergonomic Safety Program
Why implement the program?
Improves efficiency and morale.
Increases production capability.
Reduces workplace injuries.
Lowers worker compensation costs.
Reduces absenteeism.
Improved work quality.
Bottomline, employer’s are obligated to provide a safe and healthful work environment. The cost of not doing so is too great.

22. Ergonomic Safety Program
Ergonomic Safety Programs
Ergonomic Safety Program
Accident triangle:
Ergonomic risk factors are at the bottom of the “accident triangle.”
The amount of serious injuries can be an indicator of how numerous the risk factors are.
To prevent injuries, reduce the number of ergo risk factors! 1
Permanent
Disability
10 Time Loss
100 Injuries
The results of discomfort surveys are a great way to begin focusing a company’s assessment efforts.
1000 Sore Workers
10,000 Ergo Risk Factors

23. Ergonomic Safety Program
Ergonomic Safety Programs
Developing a written Ergonomic Safety Program:
Develop an ergonomics team to assist in identifying caution jobs/tasks, risk factors.
Develop physical demands by task to assure capability of staff to perform duties.
Physical demands include such items as sitting, standing, lifting, pushing/pulling, climbing, etc.; specifically the time and weight involved.

24. Ergonomic Safety Program
Ergonomic Safety Programs
Elements of a successful Ergonomic Safety Program:
Management leadership
Employee participation
Hazard identification
Discomfort survey
Screening assessment
Application assessment tool (e.g., NIOSH Lifting Equation)
Hazard information
Medical management
Program evaluation
Record keeping
Hazard identification is multi-level, but must include the employee.
The level of discomfort will dictate further assessment.
The type of activity will dictate the necessity to evaluate using specific ergonomic evaluation tools.

25. Evaluation and Analysis
Objectives:
Define caution zone jobs and ergonomic risk factors and discuss how they affect the worker.
Review body parts and discuss the risk factors that affect each one.
Review and practice workstation assessment using the caution zone job approach.

26. Evaluation and Analysis
Use checklists to identify risk factors:
Identify “caution zone jobs” by performing:
General risk analysis
Task analysis
Workstation evaluation
Knowing the risk factors leads to the selection and implementation of proper controls.

27. Evaluation and Analysis
Use a checklist to evaluate:
Lifting
Leaning
Vibration
Work stations
Chairs

28. Evaluation and Analysis
Step 1 – Is the task a “Caution Zone Job?”
Does job qualify as a “caution zone job?”
A “caution zone job” is a job or task where an employee’s typical work includes any pre-determined physical risk factors such as:
Duration of exposure
Force requirements (weight)
Posture
Repetition
Injury data
Other
A Job Hazard Assessment is a great tool for identifying task/job risks and should include historical injury, observation and awareness information.

29. Evaluation and Analysis
Step 2 – Risk factor reduction:
Use a risk factor identification form to identify all high risk factors including any other possible risk factors.
Identify control approaches for reduction of risk factors.
Get input from the people doing the work.
Follow up to see that controls are effective.

30. Applying Ergonomic Controls
Engineering controls:
Method of controlling exposure by modifying the source of exposure.
Administrative controls:
Controlling exposure by job rotation, work assignment and time periods.
Work practice controls:
Applied work procedures that limit the exposure.

31. Applying Ergonomic Controls
In your daily routine:
Ergonomics principles can be applied to the worker’s experiences in the workplace:
Tools and instruments
Workstations
Work practices

32. Applying Ergonomic Controls
Tools and instrument design:
To reduce force exertion and maintain hands/wrists in neutral posture, one should look at the tools in regard to:
Overall shape/size
Handle shape/size
Weight
Balance
Maneuverability
Ease of operation
Ease of maintenance
Grip (hand to tool coupling) 19 20 20

33. Applying Ergonomic Controls
Under and over lighted areas cause:
Headaches
Improper body positions
Muscle strains
Fatigue
Eye strain
Glare
Shadows
Poorly lighted areas:
Can contribute to trip and fall hazards.
Many resources are available to assist with the proper lumen level.

34. Applying Ergonomic Controls
Magnification systems:
To improve neck posture and provide clearer vision consider these factors:
Working distance
Depth of field
Declination angle
Convergence angle
Magnification factor
Lighting needs
Remember, altering one of the above may result in creating a different ergonomic concern.
A holistic approach to the task assessment will more likely result in overall MSD stress reduction.

35. Applying Ergonomic Controls
Operator chair:
Assure it promotes mobility, access, and accommodates different body sizes.
The chair should be stable and have five legged base with casters.
Look for:
Lumbar support
Hands-free seat height adjustment
Adjustable foot rests
Adjustable, wrap-around body support
Seamless upholstery 20 21 21

36. Applying Ergonomic Controls
Posture and positioning:
Avoid static and/or awkward postures.
Good strategies:
Routinely alternate between standing and sitting.
Alternate tasks.
Take scheduled breaks.
Micro breaks (stand up, walk around, move)
HCP is responsible for ensuring that work-related illnesses are appropriately recorded and referred to PH for investigation. Should also be involved in efforts to monitor trends for WMSDs across base by participating in reviews of sign-in logs, OSHA 200 forms and individual employee medical records.
To facilitate early evaluation of WMSDs all employees must be educated on the causes and symptoms of WMSDs and encouraged to report symptoms to supervisors with subsequent referral to medical. Important to avoid potential disincentives to employee reporting.
Written health care management protocols should be established. One example is the Clinical Practice Guidelines developed for Acute Lob Back Problems by the USPHS, Agency for Health Care Policy and Research (attached to Gen Mabry’s policy letter). HCPs should also perform evaluations of employees with known ergonomic hazards. These should include medical/occupational history and a brief non-invasive physical exam. Not currently incorporated into AF Physical Exam protocols.
Conservative treatment deserves adequate trial before surgery is contemplated (at least 6 months). 22 23 23

37. Applying Ergonomic Controls
A helpful example:
Clinic case study - Naval Station Rota Spain:
A periodic industrial hygiene survey was completed.
Lab techs mentioned chronic back, shoulder, and neck discomfort and pain from working at a non-adjustable bench in obviously stressful static postures.
Also, there was no forearm support nor bench edge padding. 25 25

38. Applying Ergonomic Controls
A helpful example (continued):
Post intervention improvements:
Offered by Kavo ergonomic lab benches.
Providing ample forearm support and work-piece support centering prosthesis directly below technician which optimizes vertical alignment of the spine, neck, and head.
Lab techs affirm increased comfort and decrease in back, shoulder, and neck discomfort. 25 25

39. Applying Ergonomic Controls
A helpful example (continued):
Lab technicians now work in optimized ergonomic posture.
In addition to forearm supports and central work-piece support, the table also has much improved overhead lighting, a magnifying lens and a drill speed control operated by the tech’s right knee. 25 25

40. Applying Ergonomic Controls
It’s important to establish proper:
Desk height
Keyboard height/angle
Monitor height/angle
Chair adjustments (height/tilt/lumbar)
Foot and leg space
Angles
Remember, neutral posture is key to proper circulation and muscoskeletal strain reduction.

41. Applying Ergonomic Controls
Adjustment Controls
Chair and desk adjustments:
Chair adjustments:
Tilt lock
Lumbar height
Lumbar depth
Chair height
Seat pan tilt
Desk adjustments:
Drawer configuration
CPU placement
Height

42. Applying Ergonomic Controls
Adjustment Controls
Establish softeners and other ergonomic devices, such as:
Keyboard drawer
Wrist rest
Mouse wrist rest
Alternative mouse
Lumbar cushion
Seat pan extender
Monitor stand
Document holders
Task lighting
These devices can be used incorrectly, causing more issues than not having them.
Also, some devices are not “ergonomic”, regardless of the marketing claim.
Even those that are, may not be the correct solution for the employee in need.

43. Administrative Controls
Adjustment Controls
Administrative controls include:
Rotating body parts.
Employee job rotation.
Job task enlargement.
Adjustment of the work pace.
Redesigning work methods.
Doing alternative tasks.
Taking rest breaks and doing stretching exercises.
Task enlargement refers to providing additional tasks inside a production line type job. Rather than doing one repetitive task, allow the employee the repetitive task plus another task before returning to the repetitive task. This allows muscle recovery.

44. Work Practice Controls
Adjustment Controls
Work practice controls include:
Good work techniques and procedures.
A conditioning period.
Training on lifting techniques and workstation set-up.
Observation, coaching and resources.

45. Summary – Ergonomics Assessment For The Workplace
WMSDs: Disorders such as Carpal Tunnel Syndrome, tendonitis, and muscle strains can develop over time and impact the health and career longevity of people in many different industries.
Ergonomics: Implementing and following proper principles will help mitigate the effects of things like overextension, repetitive motion, static body position and prolonged use of vibrating hand tools.
Ergonomic program: Managers and employees must buy in and support the program so that hazards will be identified and corrective measures taken.
Engineering, administrative and work practice controls:
Workstation layout, both patient and operator chairs, tool design, magnification systems, syringe type etc.
Work methods, task management and physical discipline.

46. Ergonomics Assessment For The Workplace
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