1. Ergonomic Considerations for Safe Job Placement
By: David Rodriguez, DPT, MS
Doctorate in Physical Therapy and Masters in Risk Control (EH&S Affairs)

2. Presentation Introduction: Therapist, Instructor, Consultant
Where the Greatest Losses are Occurring
Job Analysis: Definition, Risk Mgt Approach
How to Identify Unsafe Exposures
Methods to Control Unsafe Exposures
Real Examples using Engineering Controls
Using Job Analysis with RTW
Discuss other Post-Loss Reduction Activities

3. Cost of Workplace Injuries$
LBP is the second leading cause of missed workdays (behind the common cold) and the second most common reason for doctor visits among US citizens
The overall real (inflation-adjusted) direct costs of disabling workplace injuries decreased 4.6 percent between 1998 and 2009.
According to the 2011 Liberty Mutual Workplace Safety Index, disabling workplace injuries in 2009 resulted in $50.1 billion in US workers compensation costs

5. Prevalence of Back Injury
LBP is the most common work-related medical problem in the US.
Leading cause of disability among people ages
How many of you have experienced LBP?
80% of Americans will experience a major episode of LBP at some point in their lives.

6. You may not know that you are developing disc problems
Millions of people suffer from neck, shoulder, arm, low back, and leg pain ― common cause is a herniated disc
Disc problems are like heart disease ― it usually takes years to develop and can go without early warning symptoms
Risk factors that can contribute to development of disc herniations and other physical problems include:
Aging and age related changes
History of major or minor trauma
Lifestyle choices such as poor diet, tobacco use, and lack of exercise
Poor posture habits
Incorrect and/or repetitive lifting or twisting

7. Herniated Disc
Excess spinal pressure can cause these discs to be compressed until they bulge or rupture and impress upon nerve roots.
Disc herniation occurs when the annulus breaks open or cracks, allowing the nucleus to escape. This is called a Herniated Disc.

8. Aging Workforce U.S. Bureau of Labor Market Statistics’ data
Between 1977 and 2007 there was a 101% increase in the employment of workers aged 65 and above
By 2016, it is estimated, the number of workers aged 55 to 65 will increase by 36.5%, while the number of workers aged 65 and over will increase by more than 80%
Injury occurrences are 1/3 less, but more severe (disabling)
Bone Mass Losses
Disc Dehydration, Spine Degen
Joints lose flexibility, lose fluid
Weight-bearing joint cartilage
Muscle mass loss, fibrosis
Balance decline
Cognitive functions, brain mass
Tremor, decreased reflexes
Benefits of Exercise

9. How does Job Analysis fit in?
Definition
Systematic processes for collecting information on the work related aspects of the job.
Purpose
To identifying knowledge, skills, and abilities (KSAs) for employee success on a job
To select or derive testing criteria or predictors that measure likeliness of job applicant success
To develop standards of performance that measure employee success on the job for HR selection

10. Benefits of Job Analysis (relative to our concerns for safe placement)
Defining physical and environmental exposures that are applicable to all employees in the job
Development of Pre-placement Physical Exams
Job matching of employee physical abilities with workplace physical demands
Provides standards for applying functional testing and assessing RTW abilities
Provision of a basis for work conditioning programs for return to full-work capacity
Proactive identification of ergonomic risk factors
Job categorization for EH&S risk analysis

12. JA Composition Purpose Job Objective
Critical Tasks (Essential Job Functions)
Significant Worksite Measurements
Demands (including physical, chemical, biological, sensory and mental-emotional demands)
Tools, Equipment, and Clothing/PPE used
Environmental Conditions
Validation Process

13. JA Process (Task Analysis Approach)
Identify the Job Title
Develop a Job Objective Statement
The Walkthrough: Scope of JA
Review Relevant Literature:
Previous JAs
Available Job Descriptions
DOT-SCO
ONET
Occupational Outlook Handbook
SME Interviews – Productivity Issues
Develop Task Statements

14. JA Process (Task Analysis Approach)
Validate tasks with the SMEs (UGESP Specifications)
Assess the Physical & Environmental Demands and exposures of each critical task in the field
Obtain Objective Measurements of the tasks in the field
These are Directly Observable and Measurable Behaviors and Exposures
Document and/or Video step-by-step components to complete a task
May be useful to establish written safe operational procedures
Industrial Hygienist (CIH) may be recommended

15. Physical and Environmental Demands
Standing (Metric, Task 3)
Walking
Sitting
Forward bending
Squatting
Crawling
Kneeling
Stair climbing
Ladder climbing
Balance
Push/Pull
Trunk rotation
Lift floor to waist
Unilateral Carry
Firm Grasping Finger Manipulating Reaching Neck Flexion Neck Extension Neck Rotation Color Vision Night Vision Hearing Olfactory/Smell Vibration Temperature Airborne Contaminants Chemical Contact

16. Ergonomic Risk Factor Assessment Tools http://www. lni. wa
Qualitative
OSHA VDT Checklist
WISHA rule 2000 Checklists
WMSD Checklist
Lifting Checklist
Hand-Arm Vibration
ACGIH TLV for Back
Semi-Quantitative
REBA
RULA
Liberty Mutual
MMH (Snook) Tables
Push-Pull Analysis Package
Carry Analysis Package
Lift-Lower Analysis Package
ACGIH TLV for Hand
Quantitative
ANSI Z-365
Rogers Muscle Fatigue Assessment
NIOSH Lift Equation
Moore-Garg Strain Index
Static Work Analysis
Dynamic Work Analysis
Hand-Arm Vibration
Total Body Vibration

17. Proactive Ergonomics and Risk Control
By systematically breaking-down the step-by-step operational components of tasks, we may identify and quantify existing or potential employee exposures to environmental, health, and safety (EH&S) hazards, and determine the best methods to control, reduce or eliminate these hazards.
Ergonomic controls are used to help fit the workplace to the worker

18. Hierarchy of Controls Engineering Controls Administrative Controls
Modifying, redesigning, replacing
Workstations, work areas
Materials, objects, containers design and handling
Hand tools and equipment used
Administrative Controls
Deal with how work is structured
Proper maintenance and housekeeping
Job rotation
Job enlargement
Work schedule - shifts
Breaks – recovery time

19. Hierarchy of Controls Safe Work-Methods Instruction
Education, training, and monitoring in safe procedures and technique
Organization of workspace to reduce fatigue
Modifying procedures to ensure neutral postures
Gradual reintroduction to work for new hires and RTW
Worker controlled pace to reduce fatigue
Personnel Protective Equipment
Reduces the amount of exposure by placing a barrier between the hazard and the worker

20. Refinery Reactor 25 lb Drain Valve Removal & Installation procedures resulting in a costly low back injury
Stressors were significantly reduced after sitting on a wooden plank placed across the scaffold supports

21. Right-hand dominant female sustaining costly work-related injuries and surgeries (ganglion cyst and carpal tunnel release) to the left-wrist began to develop problems with the right-wrist shortly after RTW. Job involves bench assembly work with pistol-grip style pneumatic impact-wrenches balanced and suspended overhead.
600 Flexion
Tools with straight handles are a good choice for tasks in which the force is exerted perpendicular to the straightened forearm and wrist

22. Right-hand dominant male sustained a left bicep tendon sprain and rotator cuff tear upon forcibly pulling on a computer cabinet reportedly costing the company $150,000 in direct costs ( measured a 52 lb breaking force to move cabinet)
Post surgical continuing to work. Instructed in pushing and pulling technique by keeping elbows along-side body and weight-shifting whole body on feet to move the load
Avoid pulling and always push when possible. Keep cabinets stored where pushing is possible
Ask for assistance where needed
Injury Mechanism

23. Battery Operated Cart

24. Power Stackers, Pallet Jacks, Elevating Carts

25. Diverters
Rollers

26. Adjustable Platforms

27. Using Job Analysis Info with RTW
Effective Post-Injury Employer Loss Reduction Activities with Return-to-Work will require an understanding of combining 2 components:
The Physical and Environmental Demands of the Target Job where placement may occur
Job analysis to tease-out the demands and exposures
The injured and/or disabled Employee’s Safe Physical Tolerances and Capabilities
Brief history and neuromusuloskeletal physical and objective functional testing should precede placement
Comparative Assessment of 1 & 2 above for successful placement

28. Other Employer Post-Loss Reduction Activities
RTW Programs
Work Conditioning
Post-Offer Pre-Placement Testing
Rehabilitative Therapies
Adaptive Equipment and Special Tools
Functional Capacity Evaluation

29. A Primer Based on Workplace Evaluations of Musculoskeletal Disorders
Describes the basic elements of a workplace program designed to prevent WMSDs
Management commitment,
worker participation and training
are addressed along with procedures
for identifying, evaluating and
controlling risk factors for WMSDs
Performing job analyses and
developing controls to abate Ergo
risk factors are integral to this process

30. Contact Information:
David Rodriguez, DPT, MS
Occupational Health & Safety Consultant
MSI Occupational Health & Safety, LLC P.O. Box 8134 Eau Claire, WI Phone: (715) Fax: (877) Website: