Ergonomics Keeping the Worker on the Job Job Site Analysis WorkRisk Analysis WorkTask Analysis WorkStation Analysis David Raptosh, MA, OTR/L Regional Director of WorkStrategies Job Site Analysis - Identify Risk WorkRisk Analysis Analyze Job Functions and Determine Risk Factors Establish a plan of action Implement the proposed recommendation, modification or reasonable accommodation Educate the employee to prevent in juries and minimize symptoms Identify equipment and ergonomic solutions Job Site Analysis Evaluate Job Functions WorkTask Analysis Narrative report describing each essential functions performed Physical and postural demands quantified Frequency of each function listed Describe how the function is performed List and description of tools used. Valuable tool for return to work 1
Job Site Analysis Ergonomics Ergonomics WorkStation Analysis Analyze computer workstation according to accepted ergonomic principles. Make adjustments to existing equipment. Educate regarding use of existing equipment. Make recommendations for possible equipment modifications A discipline that involves arranging the environment to fit the person in it. Following ergonomic principles helps reduce stress and eliminate many potential injuries and disorders associated with the overuse of muscles, bad posture, and repeated tasks. This is accomplished by designing tasks, work spaces, controls, displays, tools, lighting, and equipment to fit the employee s physical capabilities and limitations.» Center for Disease Control» www.cdc.gov/od/ohs/ergonomics/ergodef.htm Ergonomics Benefits / Features Reduces lost time from work (Average Carpal Tunnel Syndrome lost work time is 30 days) Reduces worker s compensation costs and claims Reduces human errors Reduces absenteeism and turnover Demonstrates proactive work environment Provides primary and preferred method of controlling Cumulative Trauma Disorders Improves employees health and safety Improves production, quality, and efficiency Improves job satisfaction Boosts employee morale Perspectives It doesn t have to be hard or complicated Single-segment dynamic coplanar analysis at elbow of forearm-hand flexion motion. 2
Mechanical Back Syndrome Degenerative Disc Disease Herniated Disc Ligament Sprain Muscle Strain Cervical Strain Epicondylitis Radial Tunnel Syndrome Tendonitis Carpal Tunnel Syndrome Guyon Tunnel Syndrome Sub-Patellar Bursitis Shin Splints Plantar Fasciitis Thoracic Outlet Syndrome Rotator Cuff Tendonitis Digital Neuritis Trigger Finger DeQuervain s Disease CTDs Two main categories Tendonitis Lateral epicondylitis DeQuarvain s Stenosising Tenosynovitis Post Tibials Syndrome Nerve compression Carpal Tunnel Syndrome Cubital Tunnel Syndrome Tarsal Tunnel Sydrome Radiculopathy 9 10 Carpal Tunnel Syndrome Evidence of highly repetitive work alone or combined with other factors and CTS Evidence of forceful work and CTS Insufficient evidence of awkward postures and CTS Evidence of vibration and CTS Think for a moment about incidence and cost as related to risk factors and their reduction: Neck MSD Evidence for causal relationship between highly repetitive work and neck & neck/shoulder MSD Repetitive work was those with continuous arm or hand movements which loaded neck & shldr Evidence for forceful exertion & neck MSD Strong evidence for high levels of static contraction, prolonged static loads or extreme posture & neck/shoulder MSD. Insufficient evidence for vibration and neck/shoulder MSD. 11 12 3
Shoulder MSD Elbow MSD Evidence for highly repetitive work & shoulder MSD. Insufficient evidence for Force and shoulder MSD Evidence for repeated or sustained shoulder postures and shoulder MSD Insufficient evidence for vibration and MSD Insufficient evidence for repetitive work and elbow MSD Evidence for forceful work and elbow MSD Insufficient evidence for posture alone and elbow MSD Strong evidence for exposure to combination of risk factors and elbow MSD 13 14 Hand/Wrist Tendonitis Hand-Arm Vibration Syndrome Evidence of Repetitions and hand/wrist tendonitis. Evidence of Force and hand/wrist tendonitis. Evidence of Posture and hand/wrist tendonitis. Evidence of Vibrations and hand/wrist tendonitis. STRONG evidence of combination of risk factors and hand/wrist tendonitis. Strong evidence of high level of hand-arm vibration and vascular symptoms of hand-arm vibration syndrome (HAVS) Shocker!! Greater the intensity and duration of vibration, greater the HAVS incidence risk. Greater vibration intensity, greater HAVS severity. With increased intensity and duration, quicker onset of symptoms. 15 16 4
Low Back Disorders Evidence for back disorder and heavy work Strong evidence for LB disorder and force Evidence for awkward posture and LB disorders Strong evidence of whole body vibration and low back disorder Insufficient evidence of LB disorder and static work posture. (but few studies) Overview of Risk Factors and MSDs Reps Force Posture Vibration Neck + + ++ No Shoulder + No + No Elbow No + No All RF: +++ CTS + + No + Hand/wrist tendonitis + + + + All RF: +++ Low Back Not studied ++ Awkward + Static No ++ 17 18 Perspectives Bucket Analogy It Doesn t Have to be Expensive Wear & Tear Cumulative Trauma: Wear & Tear Exceeds Healing Healing 5
Activity Factors Activity Duration Repetitive Motions Awkward Postures High Forces Environmental Vibration Cold Stress Duration Eight hour day? Continuous activity? Breaks? Overtime? Repetition Wrist CTDs - Reps & Force Odds Ratio Low Force/ Low Reps Hi Force/ Low Reps Low Force/ Hi Reps Hi Force/ Hi Reps Silverstein 1985 6
Force Awkward Postures Vibration Pressure Pressure Points 7
9/28/2017 Temperature Extremes Stressful Conditions High Compression/Forces Vibration 8
What are the Ergonomic Hazard(s) in this office? Ergonomic Solution Identify the Ergonomic Hazard(s) in this office? Is there any Ergonomic Hazard here? 9
Lathe Operator Perfect Lathe Operator Normal guy Work in Neutral Postures Neutral Postures Before & After Neck Straight Shoulders Relaxed Elbows at your side Wrists Straight Three Curves in the Back 10
Reduce Excessive Force Reduce Repetitions Before & After Keep Everything within Easy Reach Work at Proper Heights 11
Minimize Fatigue & Static Load Minimize Pressure Points Provide Clearance Move, Exercise, Stretch No one best posture Alternate sitting and standing Compensate for sustained postures 12
10. Maintain a Comfortable Environment Work Environment Lighting Temperature Vibration Noise Stress When To Recommend a Job Analysis or an Ergonomic Evaluation Client with CTD, especially surgical case Recurrent injuries Method of injury routine work activities & symptoms developed over time Multiple injuries from same area of company Questions? David Raptosh, MA, OTR/L Select Physical Therapy / NovaCare Rehabilitation Regional Director of Work Strategies 2015 Technology Parkway Mechanicsburg, PA 17050 Phone: 717-580-8749 Email: draptosh@selectmedical.com 13