covid-19 preparation fast hires or returning workers? · 4. adding a 25 lb. box of glue pellets 0-2...

White Paper

Making It Easy to Keep the Modern Workforce Healthy

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COVID-19 Preparation

Fast Hires or Returning Workers? How to Prevent Injuries with a Physical Readiness Plan


Overview

To deal with the business changes driven by COVID-19, your organization likely faced difficult workforce decisions. You may have scaled back hours or temporarily ceased production. If you’re in a high-demand industry, you had to hire and get people to the floor fast.

In both cases, the risk for injuries increases without the right preparation. In the new world of COVID and keeping employees healthy, multiple challenges have emerged:

Depending upon the amount of down time and the personal habits of each worker, furloughed or laid off workers may assume a relatively sedentary lifestyle during their enforced leave from work. When deconditioned workers return to physically-demanding jobs, the likelihood of increased discomfort complaints and possibly even workers’ compensation claims can result.

Having new workers start jobs rapidly creates a different scenario. This quick start creates challenges for workers who are not used to the level of physical demand required for their new job or may have previously worked in a more sedentary role. If not adequately prepared, these workers may be at risk for developing discomfort or becoming injured.

Then there’s the workers returning after recovering from COVID-19. These workers, likely deconditioned and with new or exacerbated comorbidities such as pulmonary or heart issues, may need extra time, assistance and support in safely returning to a previous job role. Or, if not yet able to fully return to a previous job, may need support in identifying transitional work duties to facilitate a safer return to work process.

The financial impact of slowdowns on organizations resulting from the COVID-19 disruption may be significant. Having a wave of workers’ compensation claims, reduced productivity and staffing issues can contribute to creating an even worse financial situation.

This white paper offers practical tips for how your organization needs to prepare for these scenarios.


The Key to Minimizing Injuries – Basic Fitness

Generally speaking, minimizing the likelihood of physical breakdowns involves maintaining some degree of basic fitness, including:

When employees are off work, providing fitness recommendations to help smooth resumption of work duties.

In the case of new hires, adopting processes to help transition employees successfully into physically demanding jobs can help.

In the case of workers recovering from COVID-19, modified or transitional work opportunities may increase the possibility of a successful return to work.

The strategies will differ, depending on the situation. The desired outcome, however, is the same – maintaining a safe and healthy workforce. Try these recommendations.


Staying Fit While Off Work

You can provide furloughed or laid off workers with suggestions for a basic fitness program. In addition to helping with fitness, it can be a way to keep employees engaged as part of the company. Participation with this program may be hit or miss, but any involvement puts employers ahead of the game. The fitness program needs to be:

Home-based, involving little to no equipment Simple and easy to follow Convenient and brief Perceived as valuable to the employee

Building Endurance

Workers who are required to manually lift, carry, push and pull need to have sufficient muscle strength to perform these tasks. They must also have the endurance to stand and walk for extended periods of time, typically the majority of a work shift. The ability to perform these two components can erode during prolonged absences from the worksite. Simply put, the workforce can get out of shape.

Maintaining endurance is relatively simple. Employees need to stay on their feet for several hours a day. Examples of how this might be achieved:

1. Walking allows employees a reason to get out of the house. Even in cities where “shelter in place” is in effect, going outside for exercise is allowed with social distancing. Walking can be tracked by time, such as walking for 30 minutes. Employees can use pedometers, measured walking courses (for example, in Chicago, eight full city blocks is one mile), Fitbits/smartwatches or even the health apps on their smartphones.

2. When watching television, alternate standing with sitting. Use commercial breaks as the break points. Stand from the beginning of a television show until the first commercial break. Then sit until the second break. Stand until the third break, etc. If watching programming without commercial breaks (such as movies or streaming shows), alternating 15-minute sitting and standing periods can be effective. Set a timer.

Workers who return to jobs where they will be on their feet all day should try to stand and walk for at least two hours per day to maintain tolerance. Studies show that walking has the added benefit of burning calories (and thereby combatting weight gain), improving mood and reducing stress.


Maintaining Muscular Strength

Muscular strength is a critical fitness category to address. Simply put, if you don’t use it, you lose it. That being said, very few employees are likely to spend hours in their houses doing exercises. Doing a few exercises three to five times a week to address core strength should help. This will only take two to five minutes a day to maintain and even build muscle tone.

There are numerous types of activities such as basic calisthenics and weight-training. Many employees may not have access to exercise equipment and may find extensive exercising at home difficult to accomplish. Keep it simple. A relatively small amount of exercise can be effective for maintaining basic strength.

One example of a minimal home strengthening exercise program:

1. Planks. Start with a time that can be held comfortably and increase by 5 seconds a week. These can be performed in traditional (on forearms and toes) or modified (on forearms and knees) positions. An individual starting with a 10 second hold the first week could progress to 15 seconds the second week, 20 seconds the third and so forth.

2. Push-ups. Everyone has done these. Push-ups can be performed from one of two positions (from the knees or from the toes). Start with 5-10 repetitions and increase by one repetition per week.

It is well-documented that even in “normal” times, people do not get a sufficient amount of exercise on a regular basis. In its 2019 2nd edition, the U.S. Department of Health & Human Services has established Physical Activity Guidelines for all Americans. Move Your Way is a specific campaign designed to promote these Physical Activity Guidelines. All movement and activity counts. These resources can help.

Helpful Resources

Move Your Way Campaign (https://health.gov/moveyourway ) includes an interactive tool to build a weekly activity plan, educational videos and guidance for adults and parents.

US Department of Health and Human Services - Physical Activity Guidelines, 2019 https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf

Mayo Clinic 12 Week Walking Program: https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/walking/art-20050972

Mayo Clinic Healthy Lifestyle Basic Fitness Resources: https://www.mayoclinic.org/healthy-lifestyle/fitness/basics/fitness-basics/hlv-20049447


Nutrition

Weight gain can be a major contributor to workforce deconditioning during lay-offs. While standing and walking will increase calorie burning, being at home is a major change for individuals who spend eight or more hours a day at work engaging in physical activity with limited eating time. When at home with less activity and snacks close at hand, it’s easy put on unwanted weight. Being overweight increases the likelihood of injuries such as plantar fasciitis in addition to reduced productivity resulting from loss of stamina.

Instead of encouraging workers to eat less, it’s best to encourage them to find healthy choices for snacking and meals. The United States Department of Agriculture (USDA) recommends consuming 2 ½ cups of vegetables and 2 cups of fruit each day. Since fruits and vegetables are usually high-fiber and low-fat (unless they are fried), just adhering to these USDA guidelines may help satisfy hunger, curtail weight gain and improve overall health.

USDA Dietary Guidelines: https://www.dietaryguidelines.gov/sites/default/files/2019-05/2015-2020_Dietary_Guidelines.pdf


Preparing Workers Who Had COVID-19

It is too soon to know the full impact of COVID-19 on workers after their recovery from the virus. It is known, however, that these workers may have unique issues and needs related to their illness. Some workers who become infected will have mild symptoms or even no symptoms. But for the workers who have more severe symptoms and complications with hospitalization, they are likely to require more extensive rehabilitation. You need to be aware of:

o Workers may be left with pulmonary or heart issues that they previously did not experience or which are worse than before. https://www.webmd.com/lung/coronavirus-complications#1

o Muscle weakness due to the immobility of being ill and hospitalized may delay return to work and recovery. Early rehabilitation (during and after hospitalization) can aid in the recovery of functional abilities, such as activities of daily living.

o Employees may develop Post Intensive Care Syndrome (PICS), a health condition that influences recovery from critical illnesses. It can include health problems unrelated to COVID, including muscle weakness, cognitive issues such as difficulty problem-solving or memory issues and post-traumatic stress disorder. The return to work process is likely to be more complex for these people. https://www.sccm.org/MyICUCare/THRIVE/Post-intensive-Care-Syndrome

People with severe cases of COVID-19 may face a complex return-to-work situation. The following strategies can help: Fitness for Duty Testing. This test makes sure the worker possesses the physical ability

to perform the essential functions of their job and can identify any work restrictions or effective transitional work plans.

Transitional Work Opportunities. It can help to prepare a set of safe transitional work duty tasks for individuals working at less than optimal capacity.

Job Coaching Worksite Check-ins. With a prepared list, an onsite therapist will check in with workers who have recently returned to work with no documented restrictions. Are they struggling? Are there modifications needed to decrease the difficulty? Is conditioning needed? This proactive outreach shows employees you care and is part of an effective early intervention program.

Coordinate return-to-work planning with a healthcare team. For the most complex cases, a plan that includes the employee’s healthcare team and even physical, occupational and/or speech therapists may lead to the greatest success.


Helping Workers Return to their Jobs

Workers returning to full duty after prolonged absence require extra diligence to address at-risk behaviors. Employers commonly have ongoing programs designed to address body mechanics, ergonomics and other aspects of safety and safe worker behavior. However, workers that have been away for a while may quickly adopt work practices that are physically unsound.

Several tools and techniques will help mitigate this risk:

Use short pre-shift safety reminders, such as 4-6 common precautions that are reinforced

repetitively. Examples may include proper pushing and pulling techniques, how to lift safely, when and how to perform team lifting/carrying or the importance of making eye contact with lift truck drivers before walking in the vicinity of forklifts or other rolling stock.

Set up pre-shift warm up routines. A handful of exercises will warm up workers before they begin duties.

Mini-breaks can also be helpful. Building in a short (3-5 minute) rest every hour for a week or two can allow some recovery and allow for a more gradual progression into full production.

Try modified frequency of job or task rotation. If job rotation or task rotation is part of a job, increasing the frequency of the rotation upon returning to work may distribute the workload among different muscle groups. There are many ways to accomplish this. If workers normally rotate every 4 hours, try rotating every 2 hours on week one, every 3 hours on week two and then return to rotating every 4 hours on week three.

Respond promptly to worker complaints of discomfort before an injury occurs: o Administer OSHA first aid to individuals with discomfort complaints. Be careful not to

perform a medical treatment that causes an OSHA recordable. Know the guidelines (www.osha.gov )!

o Provide job coaching. Watching a worker perform required job functions and making suggestions to address individualized sources of biomechanical stress can reduce discomfort and minimize the risk of injury development.

Using Onsite Physical Therapists

An onsite physical or occupational therapist (PT or OT) helps drive change for at-risk behaviors and becomes a welcome, trusted part of the team. A PT provides prevention, treatment and even advice on general wellness and other health-related items. Their expertise at your worksite can be a powerful asset in transitioning the workforce back to full operations. It also can positively impact the employee experience. Quick read: compare onsite vs. off-site care.

https://www.workwell.com/pdf/onsite-vs-off-site-employee-workplace-injury-prevention/


Job Coaching Example

The employees in a department operate box-makers (equipment that converts flattened cardboard boxes into assembled boxes ready to be filled with product). Work shifts are 10 hours, with two 15-minute breaks and a 30-minute lunch.

Job duties include:

1. Using a manual pallet jack to move pallets holding flattened boxes (flats) from a warehouse to the machine, 3-4 times per shift.

2. Using a safety knife to cut straps around the flats 3-4 times per shift. 3. Moving a minimal load of 10 flats from the pallet into the magazine of the box-maker

30-40 times an hour. A minimal load is 10 flats. Dimensions are 27 in. wide, 25 in. long, and 4 in. thick. Each load weighs 12 lbs. Flats are moved from a pallet at varying heights from 5-54 in. 3 feet horizontally, and placed in a standing-on-end position in a magazine at 35 in. height.

4. Adding a 25 lb. box of glue pellets 0-2 times a shift. Boxes are on the floor. Employees cut the boxes open with a safety knife and empty them into a reservoir at 36 in. height.

5. Cleaning the work area. Sweep and pick up debris (swept materials, pieces of plastic, cardboard, etc.).

Goal of intervention: minimize at-risk worker behaviors and address discomfort complaints to prevent escalation into discomfort and/or injuries.

Interventions in this example might include:

Reinforce proper body mechanics with workers. Are workers carrying too many flats at time when loading the magazine? Are they twisting when loading the magazine? Are workers lifting the boxes of glue pellets off the floor properly?

Suggest tools and techniques to improve at-risk behaviors (discuss with the employer, not the workers!)

o Use rubber-palmed gloves when moving bundles of flats to minimize gripping force required.

o Place pallet on an adjustable-height turntable to minimize vertical displacement of bundles of flats when loading the box-maker magazine.

o Position the boxes of glue pellets on a surface above the floor. o Implement micro-breaks/stretch breaks to address common areas of

biomechanical stress (wrist stretches, back extensions, etc.)


Preparing New Hires or Workers in New Roles

It is not uncommon for workers starting new, more physically demanding jobs to experience periods of general soreness as their body adapts to the new activity level. It is important for them to understand that general body soreness and fatigue may be expected, but also understand that this differs from an injury. Supporting new workers before and during the employment process can go a long way in helping equip them for success in their new job roles. There are several strategies that can be implemented during this stage to help reduce the risk of injury for these new workers.

Use Post Offer Employment Testing. Make sure the job candidates possess the physical ability to perform the job they are being hired to do.

Provide a detailed safety orientation. Reviewing safe work practices, safety rules and policies are all important aspects of promoting safety culture and reducing risk of injury due to unsafe work practices.

Encourage physical activity and preparation for an increase in activity. If the new job will involve a lot of standing and walking, provide the new worker with educational information about implementing a walking program to build tolerance prior to (or at the beginning) of employment.

Allow time for adaptation to increased physical demands. When possible, allow a gradual increase in exposure to the high physical demands, over the course of the first 2-3 weeks of employment.

Job conditioning movement routines. If the physical demands of the job are clearly understood and documented, consider developing job-specific movement routines that can be given to all new and existing workers in a specific job or department. The specific exercises should be selected to focus on flexibility and/or strengthening for the body areas most impacted by the work. Examples may include kneeling to standing exercises to prepare for positional changes; or step ups to prepare for stair climbing.


Don’t Forget Mental Health

In addition to the physical effects of not being at work and not engaging in routine activities, some people may experience significant amounts of psychosocial distress. Our world amidst the COVID-19 shelter-in-place restrictions is anything but normal. For everyone. And, as restrictions are gradually released, we will begin to move into what a new normal might look like. This transition period is likely to be long and arduous.

Employers will need to learn to recognize signs and symptoms of worker distress and be prepared to offer support and intervene in other ways, as necessary.

CDC Daily Life Stress and Coping: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html

WHO Mental Health and Psychosocial Considerations: https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf?sfvrsn=6d3578af_2

Resilience Skills: https://positivepsychology.com/resilience-skills/?fbclid=IwAR3RJ8xHk-nT9ouhKd22lpVCYkC2nBVMm3zmK6laPSRD91dkGGHGsE4w2Vo

Stay Ready

With a plan for physical readiness, you can help your employees and the company prepare for the challenges of COVID-19, right now with new hires and as your workforce returns. WorkWell Prevention & Care has been helping companies of all sizes meet these challenges for over 30 years through a proven approach, expertise in occupational and physical therapy and deep resources and data. Contact us today to learn more.

https://www.workwell.com/contact-us/

covid-19 preparation fast hires or returning workers? · 4. adding a 25 lb. box of glue pellets 0-2...

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