Ergonomics in OT Practice
The Aging Worker
-10,000 people will turn 65 every day until 2030 (AARP) -79% of Baby Boomers do not plan to fully retire at age 65 (AARP) -17% of the labor force will be 65 or older by 2025 (BLS, 2015) -The average age of skilled manufacturing workers is 56 (BLS, 2015)
Basic Job Profile Information -Department of Labor Resources
-Because we will be interfacing with those in employment settings, we need to be aware of their terminology and available tools. -The DOL has offered some resources and they are used by industry. -Most useful tools: Occupation finder and Skills search a) The Dictionary of Occupational Titles (DOT) -In publication from 1939 - 1991 -Still referred to for SSI/SSD cases -Used by many employers still -The taxonomy of job classification that had evolved since the 1930s was abandoned and the Employment Service has adopted a modern empirically-based framework and methodology for obtaining and delivering occupational information known as O*Net. ---O*Net classifies jobs in job families, so it is less useful for determining disability eligibility or job-specific benefits analysis. b) O*Net -Current primary US source for occupational information -nCan provide a basis for our career exploration -http://online.onetcenter.org/ -While the Content Model defines the information structure for a single occupation, the O*NET-SOC taxonomy defines the set of occupations across the world of work. Based on the Standard Occupational Classification , the O*NET-SOC taxonomy currently includes 812 occupations which currently have, or are scheduled to have, data collected from job incumbents or occupation experts. -To keep up with the changing occupational landscape, the taxonomy is periodically revised; the last revision was in 2006, with additional new and emerging occupations coming in a future update.
What do we need to know as an OT? -worksite
-Design/Layout -Equipment used -Work flow
Who are some of the other players in ergonomics?
-Engineers -Safety Professionals -Industrial Psychologists -Other health professions
The Neck - Bad Postures
-Head forward -Twisted greater than 20º -Bent greater than 45º -Tilted greater than 30 º
The Nuts and Bolts of Workstation Layout -Monitor
-Head should be neutral when viewing with screen directly in front of viewer. -Correct focal distance is arms' length +3" for 14-17" and +9" for >18" VDTs. -Correct height is center of forehead to top of screen (non-bifocal user), and 5-6" lower for bifocals.
What's the benefit to an employer? a) Facilitates:
-Lowers costs a) Facilitates: -Maximum productivity -Consistent product quality -Improved employee engagement ---Less turnover, more consistent staffing -Better Safety Culture = Decreased WC premiums
Department of Labor Terminology
-Never = 0% -Occasional = (1-33% of the workday) -Frequently = (34-66% of the workday) -Constant = (67-100% of the workday) This is typically applied to physical activities but has been applied to cognitive and behavioral aspects of a job.
Organizational Ergonomics a) Areas
-Organizational ergo - concerned with the optimization of sociotechnical systems, including their organizational structures, policies, and processes. a) Areas: communication crew resource management work design design of working times teamwork participatory design community ergonomics cooperative work new work paradigms virtual organizations telework quality management
Current Trends in the Workplace with Regard to Ergonomics
-Participatory Ergonomics -Workplace Stretching Programs -Total Worker Health
Categories of robotics/ exoskeletons
-Power Assisted Devices -Power Suits -Power Armor -Powered Exoskeleton -Passive Exoskeletons -Exosuits -Ergosuits -Powered Orthotics
Change in load and its effect on the lumbar discs
-Relative change in pressure (or load) in the third lumbar disc in various positions in living subjects.
The Nuts and Bolts of Workstation Layout -Lighting/ Glare
-Screen should be neutral or tilted downward 10-15°. -Screen should be parallel to fluorescent light sources. -Close blinds if outdoor light is causing glare. -Use pastel background settings. -Keep screen clean. -Full spectrum lighting is best
The Nuts and Bolts of Workstation Layout -Chairs
-Seat height should allow for feet to rest firmly on a support surface. -Back of knee should be 1-2 inches from edge of seat -Back tilt should be 90-105° -Lumbar region should be supported between L3 and L5 -"Waterfall" edge on seat -Five caster base -Cushion should not bottom out when pushed on (dual density foam) -Arm rests are optional and should be adjustable
The Nuts and Bolts of Workstation Layout -Keyboards
-Shoulders should be relaxed, elbows at 90°, and wrists flat. -Wrist "rests" should only be used when resting. -Use a document holder when doing copy work.
Old School - Ergonomics Defined
Ergonomics is a body of knowledge about human abilities, limitations, and other characteristics that are relevant to design. The practice of ergonomics is the application of this knowledge to the design of tools, machines, systems, tasks, jobs, and work environments for safe, comfortable, and effective human use. Board of Certification in Professional Ergonomics, 1992
Visual Ergonomics
a) Viewing distances -lcd screens better; depends on size of the monitor; recommend arms length +/- 2-4 inches b) Monitor angle - screen face should be perpendicular to desktop surface c) Lighting - blue light
Is static standing any better?
a) We know from experience in manufacturing and service jobs that standing all day can: -Leg and foot pain -Low back pain -Fatigue -Varicose veins
When is the advice of an ergonomic specialist typically solicited?
a) When workers complain about discomfort or pain b) When worker performance declines c) When workers get sick or injured on the job d) When management wants design input (product, production, liability concerns)
BOS
a) When you lift, how you position your feet is important. -They should be approximately shoulder's width apart. -You can offset them (place one foot slightly more forward than the other) to add to your stability.
Participatory Ergonomics a) Why? b) Organizational Benefits
a) Why? -Workplace stressors are known to contribute to MSDs and chronic conditions -Employee decision making and problem solving facilitates a positive psychosocial environment b) Organizational benefits: -Workers define the primary issues and determine the root causes -Workers know the job and can propose realistic solutions -Worker ownership enhances the adoption of proposed solutions -Is sustainable because "in-house" expertise is developed
Cancer Risk and Sitting
a) Women who sit > 6 hours/day have a 34% increase mortality rate compared to those who sit <3 hours/day b) Risk increases for every 2 hours/day c) Risk is independent of physical activity -Journal of the National Cancer Institute. (2014), 106(7) ---https://academic.oup.com/jnci/article/doi/10.1093/jnci/dju206/1010488/Sedentary-behavior-increases-the-risk-of-certain
Ergonomic Analysis -Three level approach
a) Worker: Gender, age, size, strength, endurance, coordination, aerobic capacity, risk factors, etc. b) Work: Motions, repetitions, pace, coordination, rest breaks, forces, etc. c) Worksite: Seating, equipment, chairs, floor lighting, distances, tools, etc.
Quick Evaluation Form -Office Ergonomic Eval
a) You can design your own b) Can be performed on the spot by the evaluator c) Immediate feedback d) Can be used in conjunction with the OSHA Office Ergo Checklist -https://www.osha.gov/SLTC/etools/computerworkstations/checklist_evaluation.html
The sit/ stand computer workstation
a) adjustable height desk b) desktop conversion c) other options: -monitor arm conversion -Altwork Station
Breakdown of Ergonomics a) Ergos = b) Nomos = c) Ergonomics =
a) work b) natural law of system c) natural laws of work
Workstation Equipment
a) Universal design/ Anthropometrics b) Special accommodations c) Office standards
RULA Action Levels
-The RULA action levels give you the urgency about the need to change how a person is working as a function of the degree of injury risk. a) Action level 1 - RULA score 1-2 means that the person is working in the best posture with no risk of injury from their work posture b) Action level 2 - RULA score 3-4 means that the person is working in a posture that could present some risk of injury from their work posture, and this score most likely is the result of one part of the body being in a deviated and awkward position, so this should be investigated and corrected. c) Action level 3 - RULA score 5-6 means that the person is working in a poor posture with a risk of injury from their work posture, and the reasons for this need to be investigated and changed in the near future to prevent an injury d) Action level 4 - RULA score 7-8 means that the person is working in the worst posture with an immediate risk of injury from their work posture, and the reasons for this need to be investigated and changed immediately to prevent an injury
How to assess lifting risks?
-Use of the Washington State Lift Hazard Calculator
Common Solutions for Ergonomics
-Worker Education -Exercise Breaks -Administrative Controls -Mechanical Assists -Engineering Controls -Better Tools -Work-Site Redesign -Job Rotation
Ergonomic Solutions for Aging Workers
-Working in neutral postures -Allow for stretching and movement during activities -Work in the power and comfort zones - "The Handshake Zone" -Create tasks that require a power grip and not a pinch grip -Ensure adequate lighting
Cognitive Ergonomics a) areas
-concerned with mental processes, such as perception, memory, reasoning, and motor response, as they affect interactions among humans and other elements of a system. a) Areas: mental workload decision-making skilled performance human-computer interaction human reliability work stress training as these may relate to human-system design
Objective Ergonomic Tools Resources
-http://www.safetyawakenings.com/ergonomics/ -http://www.nexgenergo.com/ergonomics/ergointeluea.html#Sec1
Types of Ergonomics Practice (3)
1) Physical Ergonomics -workplace ergonomics: subset of physical ergonomics 2) Cognitive Ergonomics 3) Organizational Ergonomics
Work Zones (3)
1) Primary - Frequently used materials; use of only the lower arms to reach (15-20"). 2) Secondary - Materials that are occasionally used; involves upper & lower arm movements (20-28"). 3) Tertiary - Materials infrequently used that involve forward or side reach; may have to get up (>28"). n
10 Steps to Better Lifting -Steps 1-4
1. Size up the load. Test it to see if you can lift it safely. Can you grasp it securely? Good handholds (cut-outs, handles) will make the load easier to lift. Make sure the load is balanced in your hands. 2. Get as close to the load as possible before lifting it. If possible, slide the load towards you before picking it up. 3. Lift smoothly and slowly. Do not jerk the load. 4. Make sure your footing is secure. Do not lift objects that obscure vision and footing.
Participatory Ergo Program Steps
1. Training 2. Assess the extent of MSDs 3. Job hazard analysis 4. Develop & implement controls 5. Evaluate controls
10 Steps to Better Lifting -Steps 5-6
5. Organize the work so as to avoid lifting from the floor or above shoulder level. Items to be handled should be between knee and shoulder height. 6. Keep the load as close to your body as possible. If the load is large and cannot be placed between your knees as they are bent, bend at the hips and waist with your knees relaxed. It is more important to keep the load close than it is to bend your knees. One solution to lifting a larger load is to get another person to help you. A better solution is to use mechanical assistance (hand trucks, carts) to avoid lifting altogether.
10 Steps to Better Lifting -Steps 7-10
7. If you have a lot of lifting to do during the day, try not to do it all at once. Alternate lifting tasks with lighter work to give your body a chance to recover. Remember, mechanical assistance is just as important for repetitive lifting as it is for heavy lifting. 8. Use the same principles when lowering or placing the load after lifting. 9. Do not twist while lifting! Move your feet so that they point in the direction of the lift as you turn. 10. Try to avoid carrying the load more than 10 feet without getting mechanical assistance. Use a dolly or cart.
Lab: How can I measure if forces are harmful to a worker?
At home: a) Use the object that you chose to lift and perform a lift from one level or another. b) Measure: -The height of where the lift started -How far your hands were away from the tips of your toes when you started the lift c) Calculate the recommended lifting weight for your lift d) If your object weight is greater than what is recommended, how would you change the lift to make it safe?
BOM
Balance of Motion a) We have an opposite for every motion our body makes. b) Give muscles and joint motions that are constantly performed a "REST". c) Provide "EXERCISE" to muscles and joint motions that are not used in your work. d) 30/30 Rule
MSD Defined - Continued (2011)
a) "...Raynaud's syndrome or phenomenon; musculoskeletal system and connective tissue diseases and disorders, when the event or exposure leading to the injury or illness is overexertion and bodily reaction, unspecified; overexertion involving outside sources; repetitive motion involving microtasks; other and multiple exertions or bodily reactions; and rubbed, abraded, or jarred by vibration."
Today - Ergonomics Defined
a) "Ergonomics (or human factors) is the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance." b) International Ergonomics Association (IEA), 2020
Lower Extremities - Good Postures
a) 90/90/90 Rule? -At hips, knees, and ankles -Don't have to be all at 90 b) Hips higher than the knees -90 to 105 degrees for hips -Don't want knees higher than hips c) Firm base of support d) Anterior pelvic tilt
What is a task?
a) A set of specific cognitive & physical actions or work elements performed to achieve a 'functional objective' or goal (Drury et al 1987)
Job Demands Analysis
a) Activity analysis of a job b) Addresses the demands on the worker to perform the job -Physical -Cognitive -Behavioral -Emotional *Really a detailed job description
The "Ins and Outs" of a Stretching Program
a) Administration -Management must be committed to the lost work time and overhead of starting such a program -A schedule must be developed of when stretching breaks are to take place -The proposed stretches must be tailored to the job b) Program Development -Job analysis -Train instructors and monitor the classes -Stretch 2-3x/week at a minimum c) Program Essentials -Warm up for 5 minutes -Hold each stretch for 10-30 seconds -3-4 stretches for each focused muscle group -Static stretches only!! No bouncing Stretch to mild discomfort only d) example: A "Sweet" Program Sample
Ergonomic Solutions
a) Administrative Controls -Assessment for telecommuters -Postural education -Reduce exposure time b) Engineering Controls -Ergonomic Furniture for the home office -External accessories for mobile devices ---Headsets ---External keyboards/pointing devices ---Voice control
Ergonomics for Telecommuters
a) Administrative Controls -Virtual training program -In home evaluations -Participatory ergonomics -Lifestyle changes b) Engineering Controls -Standardized equipment and set up -https://benthamopen.com/contents/pdf/TOERGJ/TOERGJ-8-38.pdf -https://ergobuyer.com/blog/best-company-practices-for-home-office-ergonomics/
What are the solution for sitting?
a) Administrative Controls: -Lifestyle and work habit changes b) Engineering Controls: -Sit/Stand options
What you need to know: The Basics of robotics/ exoskeletons a) advantages b) some cons
a) Advantages: -They increase both capacity and capability -Reduce loads on the musculoskeletal system -Work well for very specific applications b) Some cons: -Issues with universal fit -Users complain of other issues (i.e., skin) -Nothing has the interface with objects like the hand
COG
a) All of us have a Center Of Gravity. It rests inside your pelvis at the same level a belt buckle would. This is where the 'core' of our power for movement and stability is generated from. b) The closer you keep your center of gravity to the center of gravity of an object you are lifting, the more power you can generate with less energy. Then your risk for back and neck injury is reduced. c) Close Open Gaps
Common Causes of MSDs
a) Angle/Twist -joint angles -don't twist while lifting b) Force c) Repetition d) Hold-Time Duration e) Impact f) Vibration g) Acceleration h) Cold i) Work-Time Duration j) Health Risk Factors
Keep it Simple -Ergonomics
a) BOS - Base of Support b) COG - Center of Gravity/Close Open Gaps c) BOM - Balance of Motion n
Objective Tools
a) Can act as a "scientific" guide b) Provides more than just an opinion c) Facilitates management "buy-in" d) Tools we will use: -Washington State tools (WISHA) ---Caution & Hazard Zone Checklists ****https://lni.wa.gov/safety-health/_docs/HazardZoneChecklist.pdf ****https://lni.wa.gov/safety-health/_docs/HazardZoneChecklist.pdf ---Lifting Hazard Calculator ****https://osha.oregon.gov/OSHAPubs/apps/liftcalc/lifting-calculator-app.html ****http://worksafebcmedia.com/misc/calculator/ppcc/?_ga=2.11973364.1398754961.1583429323-1295636603.1583429323 -Office Ergonomics ---https://www.osha.gov/SLTC/etools/computerworkstations/checklist_evaluation.html -BWC/OSU ---https://www.bwc.ohio.gov/employer/programs/safety/PushPullGuide/PushPullGuide.aspx
Workstation Settings and Tools
a) Chairs b) Monitors c) Desk d) Keyboards e) Mouse f) Lighting
Safe Lifting/ Handling
a) Close Open Gaps/Center of Gravity (COG) - Keep objects as close to your body as you can when lifting and carrying. -Holding objects at waist height brings the object closest to your Center of Gravity, which is located right where the buckle on a belt is, at your waist. b) Use the combination lift bend at the knees and hips when reaching for your load. c) Size up the load and determine if mechanical or other physical help is needed. d) Push, don't pull whenever necessary. -You decrease your chances of back and shoulder strain. DO NOT pull with only one hand and only pull if you are going no farther than 10-feet. e) Do not twist when you lift. -If you have to turn to place the object or patient where it/they are going, then turn with your feet. n
Why assess?
a) Determine if the task(s) are acceptable b) Identify issues to fix nProactively evaluate new jobs or workstations c) Prioritize risks to address d) Project the impact of ergonomic changes e) Evaluate if problem was resolved (Re-assess)
The Interventions Steps fo the Ergonomic Process (Kodak, 2004)
a) Develop strategies to address the root causes -Generate at least 3 solutions for each task of concern b) Choosing the best solution -Should substantially reduce risk -Should be cost effective
Office Ergonomics Checklist
a) Developed by OSHA for their ergonomic standard b) Checklist format c) Very easy to use -https://www.osha.gov/SLTC/etools/computerworkstations/checklist_evaluation.html
What are the risks? -workstations
a) Employer has less input into workstations. b) Mobile device ergonomic study is still in its initial stages c) Mobile devices are convenient but do not facilitate neutral postures -Higher risks with neck, wrist, and thumb d) Wait... There's more and it's worse than we thought. -Sleep deprivation & mental stress ---Blue light affects ability to sleep ---Late night/early morning check ins ---More usage equates to more mental stress -Just the tip of the iceberg... ´Car/pedestrian accidents •1/5 million accidents in U.S/year •8.5% of fatal crashes involve a cell phone •3-6000 deaths per year •5x higher incidence rate than DUI Pedestrian •11,000 injuries/year •5,400 deaths/year (2019) ´Speech delays •Kids 6-24 months For every 30-minutes increase in screen time = 49% increase in speech delay ´Adolescent deformities ´Migraines ´Social isolation
Participatory Ergonomics
a) Engages workers in the evaluation and proposal of solutions b) Workers are the experts in their jobs c) Team of workers & managers, ergo consultants d) Worker's input -Ensures most important problems will be addressed -Provides a reality check on suggestions e) Management's input -Shows visible commitment -Allows necessary resources to be allocated f) On company time
Where it applies in OT practice
a) Ergonomic-for-one -specific setting/ specific person -ex: mom with wrist pain due to car seat transfers b) Ergonomics for populations c) Prevention of musculoskeletal injuries d) Equipment design/application -be part of a design team e) Support for the ADA -primarily in employment but also in the community f) Everywhere!!
Balance of Motion (BOM)
a) For every motion our body makes we have an opposite motion. Most work activities require a person to stand straight or bend forward (over 80%). b) Rarely, in most jobs, do most people bend backward to perform work tasks. c) Not using all of your back movements may cause you to lose those movements over time. d) By performing regular backward bending (every 1-2 hours for 30 seconds) you decrease the backward pressure on the disc and help to maintain all of your spine's motion. -Pic: Example of a backward bend
Subjective Interviews
a) Get workers' perception of job duties b) Employee comfort surveys c) Determine other life roles d) Creates a collaborative relationship
Critical Factors That Affect Postural Risk Zones
a) Height of your hands b) Distance of your hands from your body c) Amount of weight and/or force d) Frequency of activity e) Duration spent in postural position f) Presence of signs and symptoms
Evidence-Based Practice for chair; computer programs; early training
a) Highly adjustable chairs decrease symptom occurrence -Chair training is a necessary component b) Computer programs facilitate ergonomic awareness c) Early training (school/college) facilitates life-long disability prevention
The Shoulder - Bad Postures
a) Holding your shoulders in a shrugged position b) Shoulders rolled forward c) Holding heavy objects away from your body d) Reaching behind for objects e) One-armed pull f) Constant reaching over your head g) Overreaching
The Steps to Ergonomic Assessment (Kodak, 2004)
a) Identifying the jobs with ergonomic opportunities b) Defining the job demands (Job task analysis) c) Identify risk by body part for each task of concern d) Ask why risk is present until a "dead end" is reached -Why, why, why? e) To be continued...
Research Sample (Kietrys, Gerg, Gold, & Dropkin, 2015)
a) Input device type, screen size and texting style affect ergonomic exposures in texting. b) Touch screen texting elicits lower muscle activity than a physical keypad. c) 2-handed texting confers more wrist extension and radial deviation than 1 thumb/hand. d) Upper extremity muscle activity and cervical flexion increase with screen size. e) Fewer choose to use the thumbs in texting with larger screen sizes.
What postures are important?
a) Legs - Hips/knees/ankles b) Spine c) Head/Neck d) Shoulders e) Elbows f) Wrist g) Visual posture
The Physiology of Stretching
a) Lengthen Tissues •Prevents tendon tightness •Prevents imbalance b) Circulation •More O2 to muscles •More energy •Productivity c) Joint •Absorb loads Prevents injury
EBP for Ergonomics
a) Lift programs should include training, early assessment and symptom notification, and early return to work b) Repetitive and frequent training improves worker lifting techniques -COG -Knee slide
Common Work Station Adaptations
a) Lumbar support b) Keyboard Trays c) Wrist rests d) Footrests e) Monitor risers
Injury Prevention Training
a) Must be applicable to job setting b) Address appropriate injury/risk areas c) Present from the standpoint of "prevention" (proactive NOT reactive) d) Repeat regularly e) Regular reinforcement
BWC/OSU Push/Pull Tool
a) Need a force gauge -https://www.bwc.ohio.gov/employer/programs/safety/PushPullGuide/PushPullGuide.aspx
The Neck - Good Ergonomics
a) Neutral -Head over shoulders -Minimal twist -Minimal flexion/extension
As OTs what do we already know for ergonomics?
a) Neutral posture b) Body mechanics c) Energy conservation d) Universal design
Types of Ergonomic Assessments
a) Observational/ Screening Assessments b) Subjective Assessments c) Checklists d) Objective/"Deep dive" Assessments
Why the big focus on MMH?
a) Occupationally-related low back and shoulder MSDs are a leading cause of lost workdays b) Low back pain costs over $50 billion/year in direct costs c ) Shoulder injuries alone cost over $7 billion/year
The Wrist - Bad Postures
a) Out of neutral b) Beyond 15° extension/flexion c) Forearm - constant pronation/supination
Direct Costs in the US a) Overexertion b) Repetitive Motions involving Microtasks
a) Overexertion -n23.4% -$13.7 Billions b) Repetitive Motions involving Microtasks -2.6% -$1.2 Billion
Videotape and photo analysis a) Photograph b) Video
a) Photograph: -Good for jobs that require static postures -Can do before and after b) Video: -Good for repetitive jobs -Videotape at least 6-8 cycles
Considerations for the Older Worker
a) Physical -Decreased strength, balance, and flexibility -Decreased hearing and vision -Decreased manual dexterity, reaction time, and speed -Decreased body fat b) Physiological -Decreased oxygen intake and endurance -Increased risk of higher blood pressure -More susceptible to temperature extremes c) Psychosocial -Different training and learning styles -Can tend to experience disenfranchisement with work and co-workers
a) Physical Ergonomics b) Workplace Ergonomics
a) Physical ergonomics is concerned with human anatomical, anthropometric (science or theory of design, physiological and biomechanical characteristics as they relate to physical activity. -This is the ergonomics domain we are most concerned with in the workplace, and most of the content on this site is very much focused on workplace ergonomics. b) Workplace ergo - The science of fitting workplace conditions and job demands to the capabilities of the working population. -Ergonomics is an approach or solution to deal with a number of problems—among them are work-related musculoskeletal disorders.
Physical Demands
a) Positional/Postural Requirements -sit, stand (dynamic vs. static), squat, kneel, stoop, crawl, etc. b) Forces -lift weight, push/pull, triggers and buttons, grip/pinch, pedaling c) Dexterity/Upper body requirements -Dexterity - grasp patterns, fine motor, keying, etc. -UE - reach, weight bearing, postures d) Hold-time durations e) Work-time duration
The Lumbar Spine
a) Posture b) Use of chair back for support c) Lumbar Roll - get a chair with this à has a curvature in the chair
Sitting: What we know
a) Premature death -Heart disease -Diabetes- higher blood sugar -Increased cancer risk ---Colon, lung, prostate, endometrial rates increased in those who sit the majority of time b) Obesity -Changes in fat metabolism c) Less oxygen to muscles d) Depression rates increased
NIOSH's Total Worker Health Program
a) Premise: -Risk factors in the workplace contribute to overall health -http://www.cdc.gov/niosh/twh/ b) Total Worker Health is a strategy that integrates occupational health and safety protection with health promotion to prevent worker injury and advance their wellbeing c) Benefits: -Better worker health improves productivity and reduces healthcare costs -Cost efficient use of resources -Uses common measures to monitor safety and health -Improves recruitment and retention
Why not exercise while you work? a) Pros b) Cons
a) Pro's -Increased heart rate and energy expenditure -Work is no longer sedentary b) Con's -Decreased productivity with typing and mousing activities -Fall risk -Very expensive
Successful Outcomes for Ergonomics
a) Research shows that simple behavior changes are more likely to facilitate successful outcomes than complex programs b) Make your solutions realistic c) Motivate!! d) Perform follow-up
Evidence-based practice for Ergonomics
a) Research supports ergonomic intervention -Simple changes are more successful than complex b) There is some evidence that stretching helps improve worker health and decrease overall severity and costs of MSDs c) Encouraging active lifestyle changes along with work habit changes appears more effective
The RULA
a) Screening tool b) Assesses biomechanical and postural loading on the whole body c) Pays particular attention to the neck, trunk and upper limbs
Upper Extremity - Good Postures
a) Shoulders neutral b) Arms at sides c) Elbows 80-100° d) Wrists neutral
Indirect Costs: What's Not Readily Apparent
a) Sick leave paid b) Wage costs for overtime or work stoppages c) Administrative time d) Employee training and replacement e) Decreased productivity f) Replacement of damaged machinery and/or property
RULA Steps
a) Step 1 Observe and select posture(s) to assess -Longest held posture -Worst posture(s) b) Step 2 Score & record the posture -See the evaluation nhttp://www.rula.co.uk/survey.html c) Step 3 Determine Action Level -Provide a guide for further action -Aid in efficient and effective control of any risks -May lead to a more detailed investigation.
Stretching Programs
a) Stretching: -Increases blood flow -Increases flexibility -Prevents injury -Decreases fatigue -Increases worker productivity -Improves morale
Evaluation Basics: Job Task Analysis
a) Subjective Interviews b) Still and Video Photography c) Objective Tools -Use of wearables in evaluation -Other technologies d) Solutions & Successful Outcomes
How do we evaluate the office setting?
a) Subjective interview b) Ergonomic checklist (appendix D-2) c) Customized quick eval form d) Rapid upper limb assessment (RULA) e) Resources: -OSHA website - E-tools f) Follow-up
The O*Net Model
a) The Content Model is the conceptual foundation of O*NET. -Within each Content Model domain, information is organized by different levels of description. -This hierarchical structure allows O*NET users to drill down to the level of specificity they need for their own purpose. -In essence, it creates a staircase that leads users step by step to the depth of information/detail they want. -The O*NET program publishes occupational data on 277 Content Model descriptors, with more data available from other federal agencies such as the Bureau of Labor Statistics.
MSD Defined (2011)
a) The U. S. Department of Labor defines a musculoskeletal disorder (MSD) as include cases where the nature of the injury or illness is pinched nerve; herniated disc; meniscus tear; sprains, strains, tears; hernia (traumatic and nontraumatic); pain, swelling, and numbness; carpal or tarsal tunnel syndrome; ...
Current Trends in the workplace & ergonomics
a) The aging of the U.S. work population -https://www.bls.gov/careeroutlook/2017/article/older-workers.htm b) We know a little more about the hazards of static postures. c) Work has become more mobile due to the changes in our technology d) U.S. businesses recognize the benefits of sound ergonomic practices e) Ergonomics expands beyond the realm of work -http://www.apa.org/about/gr/issues/workforce/ergonomics.aspx
What do we need to know as an OT?
a) The worker -Conditions/Physiology -Basic Biomechanics/Anatomy/Kinesiology -Cognitive Demands -Psychosocial issues b) The work -Physical job demands -Cognitive demands -Behavioral/ Emotional Demands