Ergonomics: “Train the Trainer”

Ergonomics:Ergonomics:

“Train the Trainer”“Train the Trainer”

Daniel CohenGreater Valley Safety Consulting

Definition

Webster: er·go·nom·ics (ûr'gə-nŏm'ĭks): an applied

science concerned with designing and arranging things people use so that the people and things interact most efficiently and safely.

Literal definition: Ergon = work Nomos = rules “The rules of work”

Ergonomics

Ergonomics : the engineering science concerned with the physical and psychological relationship between machines and the people who use them.

The practice of adapting products and processes to human characteristics and capabilities in order to improve people’s well-being and optimize productivity.

“Fitting the job to the worker”

We must understand: What tasks are being performed Who is performing the tasks What is being used to perform the tasks

Environmentlighting

air qualitytemperature

spacenoise

Peoplephysical sizework habits

physical conditionindividual attributes

 Tasks

tools and equipmentwork pace

job requirements

Psychosocialadministration philosophyemployee responsibility

job satisfactionstress

incentive payquotas

Furniturework surfaces

technology/equipmentchairs

adjustability

Components of a Work Station Fitting all the pieces together!

Chair Work surface Keyboard/Mouse Monitor Telephone Environment Accessories

Chair

Seat Height Able to reach the floor comfortable with both feet flat on the

floor Seat Angle

Slightly forward tilt Seat Depth

Allow a width of three fingers between calf and seat pan Backrest Height

Back support hits the lumbar region Backrest Angle

Allows for 90° - 120° hip flexion Armrests

Must be used correctly or should not be used at all

Adjusting Your Chair - Video

Watch Video

Let’s give it a try!

Work Surface

What can be adjusted?

Height Should be adjusted to the proper chair position. Allows for ergonomic positioning.

Arrangement Primary, secondary, reference zone

Workstation Set-up Primary Work Zone

The distance from elbow to hand Able to reach these items without

reaching for them.

Secondary Work Zone Within arm’s reach

Reference Zone Outside of arm’s reach

Keyboard/Mouse

For most employees these should be situated in the primary work space.

Arrange directly in front of monitor. Demonstrate how to correctly use the

mouse and keyboard.

Monitor

Distance Good rule of thumb is approx.

an arms length away (18-30 in.). Height

Eye level should be at the top 1/3 of monitor.

Bifocals – need to have monitor as low as you can.

Location Directly in front of the

keyboard. Angle

Approx. 10°-20° Font

Size Clarity/Resolution Color Schemes

Light colored font on dark background.

Telephone

Depending on employee, the phone will normally be placed either in the primary or secondary work space.

Headsets: More than 2 hrs of use per day = Mandatory? Built-up hand set attachments do not do

enough.

Environment – Every day nuisances

Lighting Air Quality Temperature Space Noise

Neighbors Fax, Copier, Telephone, etc.

Accessories

Document Holders Footrests Glare Screens

Assessment Process

1. Gather information. 2. Evaluate how the existing set-up looks.3. Adjust what is already there.4. Make your

adjustments/recommendations.5. Follow up/Re-evaluate (2 weeks).6. If still deficient…try new adjustments and

consider introducing equipment.7. TRAIN how to use!8. Follow up as needed.

Gather Information

Interview the employee: What are your job tasks? How often do you do these tasks each day? How long have you noticed this pain? When does it hurt most…end of day, busier days, towards the

end of the week, etc.? Do you take regular breaks? What irritates it the most? What specifically hurts? What do you think the issue is? What do you think will help?

Observe the employee: Watch them work for awhile. Encourage them to work as they “normally” would. How do they interact with their environment?

Assessment Process…

Evaluate the existing set-up Use checklists if available (initial assessments) What is already present and what can we adjust?

The workstation components The process The worker

– Look for postural issues and bad habits Adjust what is adjustable

Who will be responsible for making adjustments? Make your recommendations Document

Stick only to the facts. What was said, what was observed, measurements.

Name, date, specific report of discomfort, observations, recommendations, plan of action, and follow up needs.

Sample documentation

____ contacted me yesterday after seeing ____., a hand therapist at _________ . ____ has been having difficulty bilaterally with tendonitis in her wrists every since being pregnant. In looking at her workstation, I noted that her mouse is positioned in a way that causes her to reach forward with her shoulder and she is also anchoring her wrist down causing her to remain in a static wrist extension for prolonged periods of time. I moved her mouse so it is at the edged of her desk, reducing/eliminating shoulder flexion and I placed a piece of dycem underneath her mouse pad to eliminate any sliding. I also demonstrated the proper way to hold and use the mouse so that it involves the entire arm movement and keeps her wrist in a neutral position vs. anchoring at the wrist. I replaced her split keyboard with a regular one because her keyboard seemed too large for her. She still needs to reach laterally a good distance to get to her mouse so I ordered a keyboard with the number pad on the left side which will allow her to keep her mouse much closer to her side, reducing her lateral reach. I will follow up with ____ in one week and install the keyboard as soon as it arrives. rw

Assessment Process…

Follow up When? Varies depending on the situation. Has there been any improvement? Have conditions worsened?

Re-evaluate Do you still note some areas of concerns? If so…is there anything else already present that can

be adjusted? May need to look at introducing some type of

ergonomic equipment. Explain why…train how to use…use it yourself

“Ergonomic” EquipmentGadgets, Gizmos, and Other Stuff

Wrist Rests Pros

Maintain neutral wrist positioning Reduce weight throughout shoulders Softens the surface under the wrists

Cons Promotes anchoring at the wrist Contact point on the wrist

Keyboard Trays Pros

May adjust the keyboard height and angle to custom fit the users needs

Allows for more posture changes

Cons May decrease knee clearance May force longer reaches for other things If adjusted incorrectly, may exaggerate problems

Alternative “ergo” Mice/Keyboards Pros

Allows you to use different muscle groups Reduce/Eliminate awkward postures of the arms or

wrists Reduce/Eliminate movement at the wrist

Cons Difficulty adapting, leading to reduced production May be using more/different/smaller muscle groups No evidence that trackballs help/hinder

Do we need an ergo intervention?

Trouble ShootingWhy do we hurt???

Poor posture Lack of movement

Frequent “micro” breaks Prolonged poor posture can decrease

productivity by as much as 50% Stand to sit ratio of 70:30

60 second break every hour

Troubleshooting

Headaches Muscle tension Stress

Irritated/Dry Eyes Monitor glare Distance of monitor Prolonged computer use/Lack of breaks Font selection Poor vision

Neck Pain Poor head postures Monitor height Monitor location Document viewing Arms extended Cradling the phone Armrests Lack of breaks

Troubleshooting

Shoulder Pain Poor conditioning Forward head posture Mouse/keyboard too high or off to the side Arms extended Overhead reaching/lifting Overuse/Lack of breaks

Elbow Pain Keyboard too high Leaning on elbows Repetitive squeezing/pinching Striking keys too hard Reaching for mouse Overuse/Lack of breaks

Troubleshooting

Wrist/Forearm Pain Keyboard/mouse positioning Contact forces Striking keys too hard Wrist alignment Wrist deviation Resting on elbows Gripping too tight Type of mouse Overuse/Lack of breaks

Troubleshooting

Hand/Finger Pain Excessive force on mouse/keyboard Holding static positions Contact points at wrists Type of mouse Wrist alignment Gripping pen too tightly Keyboard/mouse positioning Overuse/Lack of breaks

Troubleshooting

Upper Back Pain Poor conditioning Elevated shoulders (armrests) Extended arms Forward head Muscle tension Mouse/keyboard is too high/low Seating Lack of breaks

Troubleshooting

Low Back Pain Poor posture

One foot under buttocks Arms extended Twisting Seating

Feet do not touch floor Lack of breaks

Leg/Feet Pain Seating

Feet dangling Seat pan depth Posture

Lack of breaks

Common Themes??

Poor Posture

Failure to take breaks

We need to continuously stress the importance of each employee taking a personal responsibility for themselves.

Upper Extremity Musculoskeletal Disorders

What are they? Soft tissue ailments to the upper extremities,

most commonly caused by overuse. Soft tissue: refers to any tissue that connects,

supports, or surrounds other structures (bones, joints) and organs.

Examples: muscles, tendons, cartilage, ligaments, nerves, fat cells, blood vessels

Also referred to as: CTD (Cumulative Trauma Disorder) RSI (Repetitive Stress Injury) Overuse Syndrome Musculoskeletal Injuries

Common repetitive-type injuries found in the office setting

Lateral Epicondylitis Medial Epicondylitis Tendonitis Carpal Tunnel Syndrome Ulnar Nerve Impingement DeQuervain’s Tendonitis Shoulder Tendonitis, Bursitis, Impingement Rotator Cuff Tear Thoracic Outlet Syndrome

Tendonitis

Literally means inflammation of the tendon. Tendons connect your muscles to your bone. Common cause is overuse, when muscles are

being asked to do higher levels of activity they are not accustomed to doing.

Treatments: Icing the affected area Rest Brace – protects the tendon Anti-inflammatory medication

Lateral Epicondylitis

More commonly known as “Tennis Elbow”

Pain in the lateral aspect of the elbow where the muscles connect to the bone.

Treatment: Stop or limit activity Anti-inflammatory

medication Brace may be worn Stretching and

strengthening.

Medial Epicondylitis

Also known as “Golfer’s Elbow”

Similar condition as Lat. Epi., only the pain in on the inside of the elbow around the boney prominence.

Treatment is the same as with Lat. Epicondylitis.

Carpal Tunnel Syndrome

A disorder in which the median nerve is compressed at the wrist

Causes numbness and tingling. Usually on the thumb side fingers.

Treatment: Wear brace at night or

during activities Limit activities that

aggravate condition Surgical intervention

Ulnar Nerve Impingement

Occurs when the Ulnar Nerve becomes compressed and cannot function properly

Numbness and tingling in the ring finger and little finger.

Causes: Overuse with the elbow

in a bent position Direct blow to the elbow Sleep habits

DeQuervain’s Tendonitis

A condition caused by irritation or swelling of the tendons found along the thumb side of the wrist.

Pain over the thumb side of the wrist is the main symptom. Usually described as sharp, stabbing pain.

Shoulder Tendonitis, Bursitis, Impingement

Tendons of the rotator cuff make contact with the acromion and they become swollen.

The swollen tendon can get trapped and pinched under the acromion. This is known as an impingement.

Bursitis: fluid-filled sacs called “bursa” become inflamed.

Rotator Cuff Tear

A tear in the tendon Chronic: over time, RC

tenditis eventually wears a hole through the tendon.

Acute: a sudden motion or lift causing a “pop” in the shoulder. Usually experience an immediate onset of pain.

Thoracic Outlet Syndrome

Your thoracic outlet is the small space between your collarbone (clavicle) and your first rib.

Caused by pressure on the nerves and/or blood vessels that pass through the thoracic outlet.

Symptoms can include: pain, numbness, tingling, weakness, or coldness in the upper extremity.

Personal factors/habits

Posture Attitude Sleep Postures Hobbies/Sports Age Gender Driving Psychological Impact Obesity/Exercise & Fitness Smoking Personal Habits

Posture and neutral position gets the first look

Not so innocent victims

And so on….

And so on….

Modified from Chaffin & Anderson

What was always Mother’s Advice???

Sit up straight!!! Guess what…she was absolutely right!

Decreases the load on your spine Helps the organs of your body function more

efficiently It promotes movement efficiency and

endurance and contributes to an overall feeling of well-being

Helps you look confident

Lifelong misuse of our bodies

We trick our bodies into thinking we are comfortable.

No longer using our core muscle groups. Results in muscles weakening (atrophy)

May lead to: Fatigue Muscle strain Pain

Dr. Wilfred Barlow, a well known physician, has found that misuse is usually a major factor in both causing and perpetuating rheumatism, backache, arthritis, breathing disorders, hypertension, fatigue, gastro-intestinal conditions, headaches and certain sexual problems.

What is Proper Posture?

Head, trunk, arms and legs are aligned with one another

Look around, how many people demonstrate good posture?

At what age do you think kids start to

develop poor posture?

Try breathing with head down and hunched shoulders compared to head up in proper alignment. Which gives you better breathing capacity?

Attitude of employees

Interactions with co-workers Job Satisfaction

Unhappy attitude causes discomfort Work Culture Time Pressures (Stress)

No time for stretching, breaks, lunch Performance Measures

What are other factors?

√ Posture√ Attitude Sleep Postures Hobbies/Sports Age Gender Driving Psychological Impact Obesity/Exercise & Fitness Smoking Personal Habits

Things to consider

Longer work hours (is it really 40 hour work weeks?)

Smaller workstations Productivity Technology - faxing from desks, emailing, etc. Aging Workforce (people working later in life) Disabilities Obesity (excuse of no time to exercise) Sedentary lifestyles (workstations too

efficient?)

Other things you can do…

Watch your weight Try to maintain an adequate body weight

Excess weight exaggerates poor postures Stop Smoking

Constricted Blood Vessels Reduced Oxygen Coughing (mechanical strain) Harder to recover from injury and illness

Key Components to a successful injury prevention program:

Buy-in from the top down Define a purpose/Set goals Employee involvement Track statistics Training Have

expectations/consequences/accountability Be clear and consistent

Buy-in from the top down

If your CEO, Director, etc. does not believe in establishing a program…IT WILL FAIL!

Need to allocate resources

Delineate authority

Define a purpose and set goals

Ask yourself… Why are we establishing a program? What is it you are trying to achieve? Are the employees ready to change?

Employee involvement

Involve them in all aspects of the program Recognize employees for positive behavior

Recognize and analyze problem area

Survey the employees to find “hot spots” Follow through after analyzing the surveys

Track injury statistics

This is a good starting point Look at your loss runs, claims filed, near

miss reports Are there trends with injuries types,

location where injuries occur, jobs with most instances?

Training

Train all employees on ergonomics, as well as your policies for managing injuries.

Employees must be informed of the expectations you have for them.

Employees must be informed of consequences.

Expectations/Requirements

What do you expect/require from your employees?

1. Attend training, learn the basic principles of ergonomics and apply them to your daily tasks.

2. Learn what you can do to decrease your chances of being hurt at work.

3. Immediately report any signs of discomfort to your supervisor.

4. Follow through with ergonomic recommendations.

Employee Responsibilities

Report any signs of discomfort immediately Take breaks Be willing to try recommendations Do your part to stay healthy

Muscles that are well toned are less likely to be injured & recover faster from injury.

Develop a personal lifelong fitness plan to include:

stretching strengthening endurance

Expectations/Requirements

What do you expect/require from your upper level management? (Supervisors, managers, directors, etc.)

1. Conduct initial work station assessments within the first week of a new employee’s start date.

2. Document all ergo visits. Include date, symptoms, observations and any recommendations given.

3. Address your employees ergo needs in a timely manner.

4. Discuss safety/ergonomics regularly at your dept. meetings

Supervisor Responsibilities

COMMUNICATION!! Address employee

concerns in a timely manner

Encourage functional and effective work environments

Learn and use adjustment features

Organize workflow Rotate job tasks

Promote positive employee, supervisor relations

Demonstrate self responsibility and healthy lifestyles

Perform a self evaluation and modify workstation, job or habits

Clear and consistent

Does your work environment reflect what you are telling your employees?

Do you follow the policies when corrective actions need to be taken?

Does everyone fully understand their role and responsibilities?

Other things that can be done

Know the basic principles and use them throughout the day.

Apply intervention methods at work and at home

Set the example: adjust chair, stretch, take breaks, etc.

Talk ergonomics and safety with employees often

Before & After Look at Ergonomics

Hands-on

We’ll head upstairs at this point to conduct assessments of actual workstations.

Conclusion

Don’t be afraid to try something. Communication is key!

It is no longer acceptable to be hurting while at work

Talk about safety often…bring your ideas to the table

Ergonomics is not rocket science, once you learn the basic principles most of this is common sense.