Intro to ErgonomicsIntro to ErgonomicsInstructor: Kelly Ingram Mitchell, MPTInstructor: Kelly Ingram Mitchell, MPT

CEASCEAS

Ergonomics Ergonomics

Used to design the job to the Used to design the job to the worker not the worker to the worker not the worker to the job…. job….

Defining ErgonomicsDefining Ergonomics

Official DefinitionOfficial Definition

ErgonomicsErgonomics is the is the application of application of scientific information scientific information concerning humans to concerning humans to the design of objects, the design of objects, systems and systems and environment for environment for human use. human use.

Practical DefinitionPractical Definition

Study of workplace Study of workplace design: design: the study of the study of how a workplace and how a workplace and the equipment used the equipment used there can best be there can best be designed for comfort, designed for comfort, efficiency, safety, and efficiency, safety, and productivity; without productivity; without sacrifice of quality. sacrifice of quality.

Today and Ergonomics Today and Ergonomics

There are Many Type There are Many Type Ergonomic Assessments are ?Ergonomic Assessments are ?

Primary Types are :Primary Types are :

AutoAuto

IndustrialIndustrial

Office Office

Most Common in our Clinical Field :Most Common in our Clinical Field :

Office Office

One Size Fits All ? NEVEROne Size Fits All ? NEVER

National /International National /International MobileMobile Surge/Causals/TempsSurge/Causals/Temps Training /Roll-out Training /Roll-out Generic Testing Systems Generic Testing Systems

verses customverses custom Multi-Service CompaniesMulti-Service Companies

History of Ergonomics History of Ergonomics

Earliest evidence of consideration to Earliest evidence of consideration to occupational illness: occupational illness:

Hippocrates (c. 460-377 BC) Hippocrates (c. 460-377 BC)

Father of Occupational Medicine:Father of Occupational Medicine:

Bernardino RamazziniBernardino Ramazzini (1633 – 1714) (1633 – 1714)

Who is Qualified to Perform Who is Qualified to Perform

Clinician with certification Clinician with certification

Engineer with Engineer with education/certificationeducation/certification

Increased Illness and Injury Rates are Increased Illness and Injury Rates are Constant Drivers for :Constant Drivers for :

Safety Awareness Safety Awareness Prevention Programs Prevention Programs Applied ErgonomicsApplied ErgonomicsImplementation of Comprehensive Implementation of Comprehensive Ergonomics ProgramErgonomics Program

The Facts The Facts The Surgeon General reported 60% adults overweight & Unfit The Surgeon General reported 60% adults overweight & Unfit Bureau of Labor Statistics(BLS) ½ WC $ to MSD ;600,000 per Bureau of Labor Statistics(BLS) ½ WC $ to MSD ;600,000 per

yr OSHAyr OSHA $20billion of Direct Cost of WC ;$1 in Every $3 Spent $20billion of Direct Cost of WC ;$1 in Every $3 Spent 5X Indirect Cost for Hiring/Training/Recruiting 5X Indirect Cost for Hiring/Training/Recruiting MSD comprise 1/3 of Occupational inj. MSD comprise 1/3 of Occupational inj. Largest job related injury cost in USALargest job related injury cost in USA American Industries in 2014 spent over trillion dollars on HCAmerican Industries in 2014 spent over trillion dollars on HC 151 million workers were covered for disability insurance 151 million workers were covered for disability insurance

under the SSDI program at the conclusion of 2013, a 0.2 under the SSDI program at the conclusion of 2013, a 0.2 percent increase annuallypercent increase annually

Therefore…..Therefore…..

Ergonomics can significantly impact Ergonomics can significantly impact an organizations cost by an organizations cost by implementing pre and post injury implementing pre and post injury assessments.assessments.

Primary Reason For Ergonomic Primary Reason For Ergonomic Prevention Programs Prevention Programs

Improves MoraleImproves Morale Reduces Risk and Injury by 30%Reduces Risk and Injury by 30% Direct Impact is correlated with Direct Impact is correlated with

programprogram Decreases exposureDecreases exposure Decrease overall medical costDecrease overall medical cost Decreases absenteeismDecreases absenteeism

The New: Presentism The New: Presentism

Working but less productive due to health but no indicators appear because employee is not Working but less productive due to health but no indicators appear because employee is not absentabsent

Result of : Stress/Illness/Medications & Non Compliance/AbuseResult of : Stress/Illness/Medications & Non Compliance/Abuse

5 Generations at Work 5 Generations at Work

Aging Work Force Aging Work Force 55 >= 25 % of WF by 202055 >= 25 % of WF by 2020Lower rates of work-related injuriesLower rates of work-related injuriesSeverity and fatality Severity and fatality >65 4x rate fatal events ( 8,11, 18 days)>65 4x rate fatal events ( 8,11, 18 days)

Consider Consider RTW additional instruction RTW additional instruction Greater integration between recovery of function and Greater integration between recovery of function and return-to-work medical care with work-based health return-to-work medical care with work-based health promotion programs ( Step up to RTW)promotion programs ( Step up to RTW)Metrics of workers’ compensation, medical and Metrics of workers’ compensation, medical and productivity metrics will facilitate analysis and productivity metrics will facilitate analysis and development of best practices.development of best practices.

Long Term Disability Trends Long Term Disability Trends

Male 52%Male 52% Female 48% Female 48%

MSDs #1- DDD, LBP, Sciatica, TendonitisMSDs #1- DDD, LBP, Sciatica, Tendonitis

Age = Increase $ Age = Increase $

( $400-$1400 per month SSDI Awards)( $400-$1400 per month SSDI Awards)

MSDs, WR-MSDs and ErgonomicsMSDs, WR-MSDs and Ergonomics

MSD: Musculoskeletal disorders include a MSD: Musculoskeletal disorders include a group of conditions that involve the nerves, group of conditions that involve the nerves, tendons, muscles, and supporting structures tendons, muscles, and supporting structures such as intervertebral discs. WR-MSD: such as intervertebral discs. WR-MSD: Work-Related Musculoskeletal DisordersWork-Related Musculoskeletal Disorders

Also called Cumulative Trauma Disorders Also called Cumulative Trauma Disorders (CTD), and Repetitive Strain Injuries (RSI), (CTD), and Repetitive Strain Injuries (RSI), and Repetitive Motion Disorders (RMDs). and Repetitive Motion Disorders (RMDs).

What Causes MSDs?What Causes MSDs?

1.1. Restricted Blood FlowRestricted Blood Flow

2.2. Compensatory Muscle RecruitmentCompensatory Muscle Recruitment

3.3. Cellular DegenerationCellular Degeneration

4.4. Applied Pressure to Surrounding NervesApplied Pressure to Surrounding Nerves

General PrinciplesGeneral Principles……

Other Upper Extremity MSDsOther Upper Extremity MSDs

TendonitisTendonitis EpicondylitisEpicondylitis Tenosynovitis (wrist tendonitis)Tenosynovitis (wrist tendonitis) BursitisBursitis DeQuervain’s diseaseDeQuervain’s disease Trigger FingerTrigger Finger Cervical radiculopathy (phone shoulder Cervical radiculopathy (phone shoulder

syndrome)syndrome) Thoracic Outlet SyndromeThoracic Outlet Syndrome

The MarketThe MarketRemember Tetris Remember Tetris

ThumbThumb

““BlackBerry Thumb”BlackBerry Thumb”

““PlayStation Thumb”PlayStation Thumb”

““IPod Thumb”IPod Thumb”

IPad /Cell Phone IPad /Cell Phone

Injury Containment StrategyInjury Containment Strategy

Wrist Wrist PainPain

Carpal Carpal Tunnel Tunnel

SyndromeSyndrome

Carpal Carpal Tunnel Tunnel ReleaseRelease

$250,000$250,000

$14,000$14,000

$8,000$8,000

Work Factors Associated with Office Work Factors Associated with Office WR-MSDsWR-MSDs

High repetitionsHigh repetitions Awkward posturesAwkward postures Forceful grippingForceful gripping Contact stressesContact stresses Lifting, lowering, carryingLifting, lowering, carrying Pushing, pullingPushing, pulling Organizational work factorsOrganizational work factors Psychosocial factorsPsychosocial factors Cognitive demandsCognitive demands

Individual Factors Associated with Individual Factors Associated with MSDsMSDs

AgeAge GenderGender SmokingSmoking Physical ActivityPhysical Activity Other Medical Conditions – arthritis, diabetes, Other Medical Conditions – arthritis, diabetes,

vascular disorders, thyroid conditions.vascular disorders, thyroid conditions. StrengthStrength AnthropometryAnthropometry PregnancyPregnancy

Mixed results Mixed results of studies of studies

Psychosocial FactorsPsychosocial Factors

Perception of:Perception of: Intensified WorkloadIntensified Workload Monotonous WorkMonotonous Work Limited Job ControlLimited Job Control Low Job ClarityLow Job Clarity Low Social SupportLow Social Support

Job and WorkJob and WorkEnvironmentEnvironment

Extra WorkExtra WorkEnvironmentEnvironment CharacteristicsCharacteristics

Of the WorkerOf the Worker

Psychosocial FactorsPsychosocial Factors

Non-Work-Related Activity FactorsNon-Work-Related Activity Factors

At-home computer activitiesAt-home computer activities Games Games Chores /HobbiesChores /Hobbies

Conceptual Model of Factors that Conceptual Model of Factors that Potentially Contribute to Potentially Contribute to

Musculoskeletal DisordersMusculoskeletal Disorders

Load Load Tissue Response Tissue Response Outcome Outcome

AdaptationAdaptation SymptomsSymptoms ImpairmentImpairment DisabilityDisability

Interventions can be implemented anywhere along this pathway.Interventions can be implemented anywhere along this pathway.

Ergonomic Factors Ergonomic Factors

Human FactorHuman Factor

Machine / Equipment Design Machine / Equipment Design

Task Design Task Design

Human Factors Human Factors

HFE (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.

Human Error Human Error Human Error cant be totally eliminated Human Error cant be totally eliminated but most of them can be prevented but most of them can be prevented this is a component in ergonomics and this is a component in ergonomics and assessment of risk and prevention assessment of risk and prevention thereof.thereof.

Factors Leading to HEFactors Leading to HE

1)Skilled Based Behavior1)Skilled Based Behavior

2) Rule Behavior 2) Rule Behavior

3) Knowledge Behavior3) Knowledge Behavior

Ergonomic GoalsErgonomic Goals

1.1. Prevent unnecessary muscular effort and to Prevent unnecessary muscular effort and to avoid postures which put a strain on the body. avoid postures which put a strain on the body.

2.2. Reduce work-related musculoskeletal disorders Reduce work-related musculoskeletal disorders (WR-MSDs) by adapting the work to fit the (WR-MSDs) by adapting the work to fit the person, instead of forcing the person to adapt to person, instead of forcing the person to adapt to the work or work station. the work or work station.

3.3. Recommend practical adjustments to the Recommend practical adjustments to the workstation environment, based on the user’s workstation environment, based on the user’s comfort zone. comfort zone.

4.4. Instill trust to the user, so they ‘buy in’ to the Instill trust to the user, so they ‘buy in’ to the recommendations. recommendations.

Principle of Good Ergonomic DesignPrinciple of Good Ergonomic Design

1.1. Human characteristics should be on the Human characteristics should be on the front and back end of the design process. front and back end of the design process.

2.2. One size does not fit all. One size does not fit all.

3.3. Consideration should be given to posture, Consideration should be given to posture, behavior, placement, force, repetition and behavior, placement, force, repetition and frequency, and environmental and frequency, and environmental and psychosocial factors. psychosocial factors.

K.I.S.S.K.I.S.S.

““Conventional Wisdom” Conventional Wisdom” vs. Current Ergonomicsvs. Current Ergonomics

DistanceDistancePlacementPlacementPosture Posture Support Support

HeightHeightAngleAngleUse Use Task Task

Neutral Body PositionsNeutral Body Positions

SpineSpine ShouldersShoulders Upper ArmsUpper Arms Forearms and WristForearms and Wrist FingersFingers HipsHips Knees and AnkleKnees and Ankless

Work Station Work Station Assessment Assessment

Job Characteristics are Predictors Job Characteristics are Predictors of Riskof Risk

Workstation ArrangementWorkstation Arrangement

The Who The Who

One – optimize toward the person’s shape, size, One – optimize toward the person’s shape, size, and comfort preferencesand comfort preferences

Many – Then needs modifiable options Many – Then needs modifiable options

– Many – satisfy the extremes and in between. (95Many – satisfy the extremes and in between. (95thth % male; 5% male; 5thth % female). The ability to make daily % female). The ability to make daily and frequent adjustmentsand frequent adjustments. .

Tasks Assessment Tasks Assessment What kind of work performed will influence What kind of work performed will influence the type of equipment used and the priority of the type of equipment used and the priority of placement. placement.

– Word Processing – Keyboard and mouse Word Processing – Keyboard and mouse – Net Surfing – Mouse Net Surfing – Mouse – Data Entry – keyboard bias for numeric keypadData Entry – keyboard bias for numeric keypad– Machinery Machinery – DrivingDriving– Lifting Lifting

Workstations Surfaces Workstations Surfaces

Surface AreaSurface Area Areas Under Work Areas Under Work

SurfaceSurface

1. Desk surface should allow you to place the monitor directly in front of you, at least 20 inches away.

2. Avoid storing items, such as a CPU, under desks.

3. Desks should be able to accommodate a variety of working postures.

Work Surface /Station Work Surface /Station HazardsHazards

Workstation SpaceWorkstation Space

Problem: Limited Workstation SpaceProblem: Limited Workstation Space

Hazard: Awkward postures to use equipmentHazard: Awkward postures to use equipment

Solution: Remove clutter, reposition items in Solution: Remove clutter, reposition items in the proper work zones, remove the proper work zones, remove unnecessary objects unnecessary objects

Beneath the WorkstationBeneath the Workstation

Problem: Not enough clearance for lower extremities Problem: Not enough clearance for lower extremities or hard surface for prolonged standing or moving or hard surface for prolonged standing or moving belt for production linebelt for production line

Hazards:. Hazards:.

Solution:Solution:

Workstation HeightWorkstation Height

Problem: Too high or too low Problem: Too high or too low

Hazard: Exposure to compensatory awkward Hazard: Exposure to compensatory awkward postures, such as placing feet on the casters, postures, such as placing feet on the casters, sitting on one leg.sitting on one leg.

Solutions:Solutions:

Work ZonesWork Zones

PosturesPostures ““75% of work in industrial countries is performed while 75% of work in industrial countries is performed while

seated.”seated.” ““Males experience greater interface pressures than Males experience greater interface pressures than

females.”females.” ““Increased (reclined) backrest angles (i.e. angles ranging Increased (reclined) backrest angles (i.e. angles ranging

from 100 to 120 degrees from the horizontal) have from 100 to 120 degrees from the horizontal) have associated with reduced spinal disc pressure.”associated with reduced spinal disc pressure.”

““Disc pressures at 120 degrees were at the lowest, being Disc pressures at 120 degrees were at the lowest, being only 50% of those observed at 90 degrees.”only 50% of those observed at 90 degrees.”

““Postural versus chair design impacts upon interface pressure”Postural versus chair design impacts upon interface pressure”; Vos, Congleton, ; Vos, Congleton, Moore, Amendola, and Ringer; Applied Ergonomics 37 (2006) 619-628’ Moore, Amendola, and Ringer; Applied Ergonomics 37 (2006) 619-628’

Vertebral Compression FactorsVertebral Compression Factors

Four FactorsFour Factors1.1. Weight of Upper BodyWeight of Upper Body

2.2. Deviation of an erect Deviation of an erect posture stanceposture stance

3.3. Weight of the loadWeight of the load

4.4. Pull of the lower back Pull of the lower back musclesmuscles

Factors Affecting VisibilityFactors Affecting Visibility

GlareGlare Luminance (brightness)Luminance (brightness) Amount of LightAmount of Light Distance of Eye from Document / MonitorDistance of Eye from Document / Monitor Readability of Document / MonitorReadability of Document / Monitor Personal VisionPersonal Vision

IlluminationIllumination

Most office spaces rely on florescent Most office spaces rely on florescent lighting. If approved, increase illumination lighting. If approved, increase illumination by using multiple light sources. Use full-by using multiple light sources. Use full-spectrum light bulbs. spectrum light bulbs.

Arial font, size 12, black on whiteArial font, size 12, black on white No naked light sources – including sunlightNo naked light sources – including sunlight

Ergonomic Tips for Vision DeficitsErgonomic Tips for Vision Deficits

Increase illumination, text size (larger Increase illumination, text size (larger screens, bit size), and contrast (monitor screens, bit size), and contrast (monitor controls)controls)

Reduce direct glare and indirect flare (shiny Reduce direct glare and indirect flare (shiny wall surfaces)wall surfaces)

Avoid color-coding blue-greenAvoid color-coding blue-green Lower monitor or machinery if applicable Lower monitor or machinery if applicable

height for bi/trifocals height for bi/trifocals

Who are the team players?Who are the team players?

HRHR SafetySafety Partner- Medical/Clinical ConsultantPartner- Medical/Clinical Consultant Supervisors/ManagerSupervisors/Manager Employee LiaisonEmployee Liaison PhysicianPhysician Nurse Case ManagerNurse Case Manager AdjusterAdjuster TPA TPA Carrier Carrier

Outline the Ergonomics Work Outline the Ergonomics Work Flow Possibilities Flow Possibilities

Results of Good ErgonomicsResults of Good Ergonomics medical costsmedical costs compensation claimscompensation claims absenteeismabsenteeism

productivityproductivity health and boost employee moralehealth and boost employee morale

Questions Questions