Mdota 2010 intro to ergo

INTRODUCTION TO ERGONOMICS

Naomi Abrams, MOT, OTR/L

MDOTA November 2010

© Worksite Health & Safety Consultants, 2010

COURSE OBJECTIVES

Participants will leave this session with

An understanding of the contextual influences and

psychosocial demands of the work environment

An understanding of the connection of work

activities with repetitive strain disorders

Methods to identify and measure the hazards

commonly faced by workers

Methods to actively involve workers in addressing

worksite hazards

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Ergonomics is just another name

for joint protection….

We have been doing it for years.


HISTORY OF ERGONOMICS

1700 – Bernardino Ramazinni (1633-1714) wrote about

work-related injuries that he saw in his medical practice.

1857 – Wojciech Jastrzebowski first used the word to

describe the “Science of Work”.

However, good tool fit has been explored since people

started using tools!


Ergon (work) + Nomos (principle of law)

WHAT IS ERGONOMICS

OSHA 1999:

Ergonomics is the science of fitting jobs to people.

Ergonomics encompasses the body of knowledge about

physical abilities and limitations as well as other human

characteristics that are relevant to job design. Ergonomic

design is the application of this body of knowledge to the

design of the workplace (i.e., work tasks, equipment,

environment) for safe and efficient use by workers. Good

ergonomic design makes the most efficient use of worker

capabilities while ensuring the job demands do not

exceed those capabilities.

(Ergoweb, 2003)


OSHA

Osha.gov

NIOSH

Cdc.gov/niosh

Human Factors and Ergonomic Society

hfes.org

Board Certification of Professional Ergonomists

bcpe.org

American Industrial Hygiene Association

aiha.org

American Society of Safety Engineers

asse.org

International Ergonomics Association

iea.cc

Chesapeake Region Safety Council (local)

chesapeakesc.org

Business and Institutional Furniture Manufacturer’s Association

bifma.org


COMPONENTS OF WORK

Cognitive requirements

Psycho-social

requirements

Context/environment

influences

Physical requirements


ERGONOMIC RISK FACTORS Awkward postures

Static postures

Forceful exertions

Repetition

Vibration

Environment

Temperature

Lighting

Fumes/Smells

Recovery time

Precision/control required


TERMINOLOGY

Administrative control: procedures or methods that are

put in place to change how a task is done (i.e., employee

rotation, adjusting work pace, changing schedules)

Engineering control: changing the physical environment

of the job to decrease exposures (i.e. changing tools,

changing rigging, using adjustable chair)

Individual factors: a person’s physical, cognitive and

psychological characteristics


COMMON INJURIES

Low back strain or herniated disc

Rotator cuff syndrome

Carpal tunnel syndrome

Lateral/medial epichondylitis

Think -- cause and effect.

Think -- when do you do this?


LOW BACK STRAIN

AND “HERNIATED DISCS”

Common causes at work:

Improper

lifting/pushing/pulling

technique

Lifting too much

Sitting incorrectly

Sitting too long (even in the

correct position)

Reaching too far

Lifting “cold” (without

stretching)


ROTATOR CUFF SYNDROME

Common causes at

work:

Reaching behind to lift

Repeated reaching

overhead

Poor postural and

shoulder muscle strength


CARPAL TUNNEL SYNDROME

Common causes at

work:

Frequent gripping

Constant wrist bending

Direct pressure on the

wrist from straps or tools

Vibration


ELBOW PAIN (LATERAL AND MEDIAL)

Common causes at work:

Frequent gripping with

reaching or turning

Frequent hook grasp

Constant mouse use with

an extended arm


THE ERGONOMIC EVALUATION PROCESS Observation begins before you even enter the room.

Look around for how the hallways are arranged, the looks

on peoples’ faces, the temperature, the ambient sounds.

Interview:

What is the problem in their words.

How have they tried to fix it.

How would they fix it.

Psychosocial factors

Pain scale rating or pre-test: measure what you hope to

change (i.e., pain, efficiency, stress level).

Measurement and recording of the job requirements.


THE OFFICE ENVIRONMENT

ANSI/HFES 100-2007: Human Factors Engineering of

Computer Workstations

Designed mostly for furniture manufacturers, not as a guide for

ergonomic evaluations

Only applies to a standard computer used on a desk. Does not

take into account laptops or alternative computer set-ups.

Does not address the health of the operator or work practices.


RULES?

90-90-90


4 BASIC COMPUTING POSITIONS


The best

position is

one you

don’t stay

in for a

long time.

THE COMPUTER WORKSTATION ASSESSMENT

The “VDT” Checklists

There is no one standard checklist. You can find or make any

number of versions.

Only serves as a guide to be sure you look at all parts of

the workstation (equipment, environment, task, and

person)


FIRST: WHAT DO THEY DO AND WHY?

Assess what type of work the person does.

Constantly on e-mail = more mouse work

Editing from books = needs more space

Doing two things at once = may need hands-free devices

Why do they do what they do?

Habit versus job requirement

Time constrictions that are self-imposed versus demanded

Cognitive demands exceed ability


SECOND: WHERE DO THEY WORK?

Visual scan of the environment

Q&A about the environment

(temperature, noise, etc.)

Psychosocial demands: not

really a Q&A, more therapeutic

use of self


THIRD: WHY WERE YOU CONTACTED?

Where they hurt can give you great insight into what is

wrong.


“Mostly, my

neck hurts.”

ONLY NOW CAN YOU GET INTO EQUIPMENT.

Seating

Keyboard

Mouse

Monitor

Phone

Paperwork

Other


THE CHAIR: UPRIGHT OR RECLINED SITTING

Feet are placed firmly on the floor or slightly in

front for proper circulation and weight bearing.

Raise or lower the chair so that the knees are

approximately even with the hip joint.

The seat should be 3-4 finger widths from the

popliteal fold.

Adjust the seat tilt so that the seat pan (the part

you sit on) is level with the floor or tilted back

slightly.


THE BACKREST

Sit up tall with a neutral pelvis then rest back against the chair

Should be leaning backwards slightly (try for a 110-135° hip/trunk angle).

Feel the contour of the back and compare it to the contour of the chair especially at the small of the back. The chair should fully support the back’s natural curves*.

Back rest should support the body without blocking the movement of the shoulder blades.


“ERGONOMIC” CHAIRS



SUPPORTS MAY BE NEEDED


Use caution!

Too much

padding may

result in seat

depth problems.

http://www.healthyback.com/products/healthyback/healthy-back-sacro-seat-wedge/50

http://www.healthyback.com/products/healthyback/healthy-back-sacro-seat-wedge/50

http://www.healthyback.com/products/obus-forme/obusforme-high-back/81

http://www.healthyback.com/products/obus-forme/obusforme-high-back/81


KEYBOARD AND MOUSE

Rule: elbows down by the sides.

Rule: wrists straight.

Everything else is negotiable.


“ERGONOMIC” KEYBOARDS AND MICE


MONITOR(S) SHOULD BE

Front and center

Approximately 22-24 inches from the face depending

whether the user has glasses

Set so that the top portion of the screen that is used most

often is at eye level.

Positioned so that the zygomatic arch/maxilla are level.




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PHONE USE Use a hands-free device if required to type or write

while on the phone.

The phone should be on their non-dominant side.

The reach distance depends on use frequency.


THE REACH ENVELOPE


Sanders and McCormick, 1993, p

432

PAPERWORK AND LIGHTING

Assess focal length

For reading, it is typically 16-18 inches.

Assess glare versus illumination


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© W

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20

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© W

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BREAK


THE SCIENTIFIC METHOD OF ANALYZING

RISK… Ergonomic risk factors:

Awkward postures

Static postures

Forceful exertions

Repetition

Vibration

Environment

Temperature

Lighting

Fumes/Smells

Recovery time

Precision/control required


NIOSH

NIOSH LIFTING EQUATION

Yields a maximum safe lifting weight based on the

position of the object at the origin and the

destination, the distances of the lift, and the lifting

frequency

Can be used to analyze a single lift or multiple lifts

Cannot be used when there is a tool involved

(shovel, straps, lever)

Does not take into account what happens during a

lift (going over a barrier or through an access panel)


LIFT



Point of

Projection

V =

Mid-Point Between Inner Ankle Bones

H

From: Ergoweb Jet Toolbox


A =

Sagittal

Line

Sagittal

Plane

Frontal

Plane

Point of

Projection

A

degrees

Origin Destination


NIOSH LIFT ANALYSIS: LIFTING FROM CRIB

PART 1 (BED TO RAIL HEIGHT)

1:Record Object Weight:

Average 22 lb. Maximum 40 lb.

2: Record Origin Measurements:

Horizontal:12 in. Vertical: 33 in. Asymmetry: 30 deg.

3: Record Destination Measurements:

Horizontal: 8 in. Vertical: 54 in. Asymmetry: 0 deg.

4: Record Lifting Frequency (Repetition) Frequency 0.02

lifts/minute

5: Select Lifting Task Duration Select: Short

6: Select Coupling Classification Select: Poor


Data Form

Data form lifting from crib.pdf

Origin and Destination values are then referenced on a

NIOSH table to get the “multiplier.”

Example: Height multiplier: 10/Height at origin = 10/12=0.83;

Vertical multiplier: 1 - (.0075 |V-30|)


Multiplier Tables

Lift

Constant

(always

51)

Horizontal

Mult.

Vertical

Mult.

Distance

Mult.

Asymmetry

Mult.

Frequency

Mult.

Coupling

Mult.

Max

weight

Origin 51 X0.83 X0.98 X0.91 X0.9 X1 X0.9 =30.6

Dest. 51 X1 X0.82 X0.91 X1 X1 X0.9 =34.1

So, our mom:

Origin: weight max=30.6 lb

Destination: weight max=34.1 lb

Data form lifting from crib multiplier tables.pdf

CALCULATIONS AND MORE…

Max tested wt/max calculated wt =

lifting index

Origin lifting index: 40 lb./ 30.6 lb. =1.3

Destination lifting index: 40 lb. /34.1 lb. =1.2

Lifting index: <1 ok; 1-3 concern; >3 needs change


www. Ergoweb.com

JET Toolbox

The Ergoweb™ Online Toolbox.mht

CASE STUDIES

Group 1:

25 lb. box

From under the table

Put onto the table

Group 2:

50 lb. bag

From next chair over (2 chair widths away)

Put on table

Group 3

40 lb. box with two handles

From table on right of room

Put on table on left of room


SIMPLE CHANGES YIELD BETTER RESULTS

THAN COMPLEX CHANGES.

“This is your personal space. Keep everything in it” (horizontal distance)

Squaring off to item (asymmetry)

Taking one step forward towards item (horizontal distance)

Ask for help and accept it when offered (frequency)

Use everyday items to change surface heights

Use a step stool (vertical distance)

Put hard to handle items in a container or on a push cart (coupling and horizontal distance)

Use shelves instead of baskets/buckets on floor for items (vertical distance)



SIMPLE CHANGES – PROBLEM SOLVING WITH

THE CLIENT

Pacing, Prioritizing, Positioning

Using a dining room chair instead of the couch

Use a pillow under books when reading in bed or

on couch

Use a cookbook holder when reading at table

Keep frequently needed tools in multiple places

(such as scissors where the mail is opened)

Rearrange items and shelves – where are the

heavy items?


PATIENT DRIVEN GOALS

AOTA 1998 Standard V: “client centered goals that are

clear, measurable, behavioral, functional, contextually

relevant and appropriate to the client’s needs, desires,

and expected outcomes” (Sames, 2005)


SAMPLE GOALS In 3 weeks, the client will independently verbalize 3

methods of completing yard work using proper body mechanics.

In 3 weeks, the client will demonstrate through photographs appropriate changes to workstation for proper ergonomic set up.

In 6 weeks, the client will return to work as a parent, consistently using good body mechanics.

In 6 weeks, the client will carry 10 pounds of groceries from car to home (>150 ft.) using proper carrying techniques.

© Worksite Health & Safety Consultants,

2010

THE ERGONOMIC PROCESS

Observation

Measure/evaluate: homemade checklist or

standardized tools like the NIOSH

Justify need for correction

Goal setting

Change: administrative, engineering, or

individual/person

Re-measure/re-evaluate


Return on investment (ROI)

THANK YOU

Naomi Abrams, MOT, OTR/L, CEAS

240-912-9559

[email protected]


REFERENCES AND SUGGESTED READING

Anders, M. J., & Morse, T. (2005). The ergonomics of caring for children: An exploratory study. American Journal of Occupational Therapy, 59, 285-295.

Care for cargivers (2003). CareGuide@Home [on-line]. Available: http://www.eldercare.com/modules.php?op=modload&name=CG_Resources&file=article&sid=861.

Ergoweb (2003). Applied Workplace Ergonomics Manual. Ergoweb, Inc.

Ergoweb (2003). Fundamentals of Office Ergonomics. Ergoweb, Inc.

Franklin, B. A., Hogan, P., Bonzheim, K., Bakalyar, D., Terrien, E., Gordon, S., & Timmis, G. C. (1995). Cardiac demands of heavy snow shoveling. JAMA. 273 (11), 880-882.

Gauthier, A. H., Smeeding, T. M., & Furstnburg, F. F. (2004). Are parents investing more or less time in children. (Policy Brief) Canadian Research Institute for Social Policy. Available at www.unb.ca/crisp/pbrief.html.

Griffin, S. D., & Price, V. J. (2000). Living with lifting: Mothers’ perceptions of lifting and back strain in childcare. Occupational Therapy International, 7 (1), 1-20.

Gunn, S. M., van der Ploeg, G. E., Withers, R. T., Gore, C. J., Owen, N., Bauman, A. E., & Cormack, J. (2004). Measurement and prediction of energy expenditure in males during household and garden tasks. European Journal of Applied Physiology. 91(1), 61-70.

Herr, N. (2007). Television & health. Retrieved from http://www.csun.edu/science/health/docs/tv&health.html.

Hinojosa, J., Kramer, P., & Pratt, P. N. (1996). Foundations of practice: Developmental principles, theories, and frames of reference. In J. Case-Smith, A. S. Allen, & P. N. Pratt (Eds.), Occupational therapy for children (pp. 25-45). St. Louis, MO: Mosby.


Human Factors and Ergonomics Society (2007). ANSI/HFES 100-2007 Human Factors Engineering of Computer Workstations. HFES. http://hfes.org.

Iwakiri, K., Sotoyama, M., Mori, I., & Saito, S. (2007). Does leaning posture on the kitchen counter alleviate workload on the low back and legs during dishwashing? Industrial Health. 45, 535-545.

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Mdota 2010 intro to ergo