Minimize Ergonomic Risk Factors

The ergonomic risk factors that you should try to eliminate or minimize are as follows:

✓ Awkward postures
✓ Cold Temperatures
✓ Force
✓ Repetition
✓ Static Postures
✓ Contact Stress
✓ Vibrations

To minimize awkward postures:

  • Position your mouse next to your keyboard.
  • Keep your elbows close to your sides and your forearms parallel to the floor; adjust the height of your chair so that your arms are at a 90 degree angle.
  • When you adjust the height of the chair to put your arms in the proper position, if your feet are not flat on the floor, use a footrest (or a phonebook if needed).
  • Position materials you are referring to right next to your computer screen, so you don’t need to extend your head or neck.
  • Use a telephone headset if you can.
  • Put your feet flat on the floor.
  • Do not slouch.
  • Keep your wrists straight. Do not bend them forward or backward when typing. This pinches the median nerve, which can lead to carpal tunnel syndrome.
  • Minimize twisting your trunk from side to side; turn the whole chair with your legs instead.

To Minimize Force:

  •  Type with a light touch.
  • Pad hard surfaces. This will also reduce contact stress.
  • If your feet do not rest flatly on the floor, use a footrest. This will take the weight off the back of your thighs while sitting. It may also reduce the incidence of varicose veins.

To Minimize Repetition:

  • Break up long repetitious tasks, such as typing or computer work, with other tasks, such as phone work or errands.
  • Automate stapling, copying, and colating.

To Minimize Static Postures:

  • Try to change your position frequently throughout the day.
  • Take a break from intense work periodically; move around, or take a walk if you can.
  • If you cannot take a break, try to stretch your arms and/or put your hands at your sides and shake them out periodically to get the feeling back in your fingers; and try to stand up for 30 seconds every hour.

PREVENTION NEEDS RESOURCES

Textbook of Pain, 1998, “Prevention of Disability due to Chronic Musculoskeletal Pain,” written by Steven James Linton:

The above-mentioned chapter in the Textbook of Pain, “examines procedures designed for use in health-care settings to prevent disability due to musculoskeletal pain.”

The following statement is made:

“Because musculoskeletal pain is a major source of suffering, health care, and utilization of compensation, there is a definite need for prevention.  However, prevention is not an easy task because disability is related to a developmental process in which multidimensional factors operate over time to produce significant lifestyle changes.  Research on risk factors indicates that although medical and workplace factors are obvious, psychosocial variables are central to the transition from acute to chronic pain.  The early identification of ‘at-risk’ patients is a key to allocating resources and initiating secondary prevention.”

“Unfortunately, we do not yet understand the exact mechanisms that produce musculoskeletal pain.”

ACUTE PAIN

“Acute pain – Pain which is generally defined as pain up to about three weeks is characterized by temporary decreases in activity, reliance on medication, and help-seeking.  It is accompanied by psychological distress; for example, fear, anxiety and worry, in addition to beliefs that pain is controllable through medical and active coping…The patient may have organic findings as well as muscle spasms.

SUBACUTE PAIN

“Subacute pain – Pain which is considered to be between 3 and 12 weeks.  Patients may exhibit altering patterns of increasing and decreasing activity, and withdraw or become reliant on medication.”

PERSISTENT OR CHRONIC PAIN

“Persistent or chronic pain – Pain which is defined as more than 3 months’ duration, activities may have decreased sharply. . .The pain becomes more constant although patients may experience ‘good’ and ‘bad’ periods.”

RECURRENT MUSCULOSKELETAL PAIN

“Musculoskeletal pain is usually recurrent in nature.  While most episodes of back pain remit rather quickly and most people return to work within 6 weeks, (Reid, et al., 1997), the majority of sufferers will experience several episodes of pain during the course of a year, (Frymoyer, 1992; Nachemson, 1992; VonKorff, 1994; Linton & Hallden, 1997).”

50 % OF ACUTE BACK PAIN SUFFERERS HAVE PAIN 6 – 12 MONTHS LATER

“More than 50 percent of patients with acute back pain will experience another episode within a year (Nachemson, 1992), and prospective studies indicate that almost half will still have significant problems 6 – 12 months later, (Philips & Grant, 1991; VonKorff, 1994; Linton & Hallden, 1997).”

MUSCULOSKELETAL PAIN = LEADING CAUSE OF EARLY PENSIONS

“Firstly, a large number of people suffer from musculoskeletal pain, making it a leading health-care problem even though only a minority develop persistent dysfunction.  Musculoskeletal pain is a leading cause of health-care visits, particularly in primary care,  sick absenteeism, and early pensions, (Frymoyer, 1992; Nachemson, 1992; Skovron, 1992).  However, several studies indicate that over 90 percent of those off work with an acute episode of back pain will return within 3 months, (Waddell, 1996;  Reid, et al., 1997).”

“Secondly, as shown above, musculoskeletal pain is recurrent in nature even though most patients return to work rather quickly after an acute episode.  Although acute sufferers usually feel better and return to work within a few weeks, this does not mean that they have recovered fully or permanently.”

“Thirdly, while up to 85 percent of the population will suffer from musculoskeletal pain, only a small number will account for most of the costs, (Nachemson, 1992; Skovron, 1992; Waddell, 1996).  In general, less than 10 percent of the sufferers may consume up to 75 percent of the resources, (VonKorff, 1994; Reid, et al., 1997).  Thus preventing disability and high-cost cases may result in large economic savings, so that these people constitute a special target for prevention programs.”

MUSCULOSKELETAL PAIN IN SWEDEN & THE NETHERLANDS

“Further, most of the money at this time is spent on compensation, while relatively little is spent on treatment, and almost nothing is invested in prevention.  In Sweden, about 85 percent of the total resources for musculoskeletal pain are spent on compensation as compared to 15 percent for all treatments and drugs, a figure which has remained fairly constant over a 15-year period, (Linton, 1998).”

“Similarly, in The Netherlands, a recent study of all costs due to back pain showed that 93 percent involved compensation and only 7 percent involved treatment, (Van Tulder, et al., 1995).”

PREVENTION NEEDS RESOURCES

“Consequently, until prevention is granted more resources, programs need to be relatively cheap; and this suggests incorporating them into existing practice routines.”

ERGONOMIC RISK FACTORS TO PREVENT

“A host of ergonomic factors, for example, lifting, heavy work, twisting, bending, manual handling, and repetitive work have been found to be associated with musculoskeletal pain, (Pope, et al., 1991; Skovron, 1992).”

“A recent review of some 60 studies revealed a relationship between musculoskeletal pain problems and job demands, control, monotonous work, time pressure, and perceived workload, (Bongers, et al., 1993).”

“If the problem does not remit within 2 – 4 weeks, a formal screening procedure is suggested.”

ERGONOMICS

Ergonomics is the science of fitting jobs to people, including anatomy, physiology, and psychology. 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.
Up to 85 percent of the population will suffer from musculoskeletal pain. When workers sit incorrectly, specifically in a posture that is not ergonomically correct for the individual, they can experience musculoskeletal pain. Because musculoskeletal pain is a major source of suffering, health care, and utilization of compensation, there is a definite need for prevention (2).
A large number of people suffer from musculoskeletal pain, making it a leading health-care problem. . .Musculoskeletal pain is a leading cause of health-care visits, particularly in primary care, sick absenteeism, and early pensions. . .Thus preventing disability and high-cost cases may result in large economic savings (2).
Until prevention is granted more resources, programs need to be relatively cheap; and this suggests incorporating them into existing practice routines (2).
A host of ergonomic factors have been found to be associated with musculoskeletal pain, such as lifting, heavy work, twisting, bending, manual handling, and repetitive work.
Studies have shown that people with herniated inter-vertebral discs often have a history of an activity or occupation involving repetitive forward bending. Forward bending has been clearly recognized as a risk factor for low back pain (3).
The body posture of sedentary workers, especially in offices, and of school children has long been a concern of orthopedists and physiologists. The increasing number of office positions, of seated factory workers, of people sitting in cars and airplanes, even of seated soldiers, has augmented the concern about “unhealthful” sitting postures. Complaints about lower back pains are widespread among people who commonly work in the sitting position (4).
As a result of this very common pain and suffering, the Occupational Safety & Health Administration (OSHA) has created a standard, 29 CFR Part 1910, which was first published on February 8, 2000, to explain the benefits of prevention of musculoskeletal disorders to both employers and employees.
OSHA expects its workable, practical approach to prevent an average of 460,000 injuries annually and to save businesses $9.1 billion annually because of reduced workplace injuries and greater productivity, with a $27,700 savings in direct costs for each musculoskeletal disorder prevented (1).
OSHA estimates that the cost to an employer to implement the new ergonomics approach will be an average of $250 per work station per year, or a total of $4.5 billion to industry per year. This contrasts with business and industry groups that estimate it will cost U.S. businesses between $18 billion and $120 billion per year (1).

OSHA’s suggestions are as follows:

  • There should be management leadership and employee participation in your ergonomics program.
  • Management should identify and assess any hazards.
  • Employees should be trained to identify, prevent and control possible hazards through information and training. Any ergonomics program you set up should also be evaluated for effectiveness.

REFERENCES:

  1. CBA Report, Cincinnati Bar Association, March, 2001: “Is There Light at the End of the Carpal Tunnel?” written by Ann W. DeVoe, Esq.
  2.  Textbook of Pain, 1998, “Prevention of Disability due to Chronic Musculoskeletal Pain,” written by Steven James Litton.
  3.  Spine, Volume 21, Number 1, pp.71-78, 1996, “Analysis of Lumbar Spine and Hip Motion During Forward Bending in Subjects with and Without a History of Low Back Pain,” written by Marcia A. Esola, M.S., P.T.; Philip W. McClure, M.S., P.T.; G. Kelley Fitzgerald, M.S., P.T.; and Sorin Siegler, Ph.D., U.S.A.
  4. Industrial Medicine, Vol. 38, No. 4, April, 1969, Orthopedics, “Ergonomics in the Design of Office Furniture,” written by K. H. Eberhard Kroemer, Dr. Ing.; Joan C. Robinette, Aerospace Medical Research Laboratory, Aerospace Medical Division, Wright-Paterson Air Force Base, Ohio.

First blog post – ErgoNews

Following is an ErgoNews article I wrote on January 5, 2002:

A coalition of business groups and other employers sued the state of Washington over new ergonomic rules designed to protect workers from injury. (1)

“This is clearly a case of a state agency abusing its power and pushing through a rule based on political agendas,” said Tom McCabe, president of the Building Industry Association of Washington. (1)

“Musculoskeletal disorders are believed to be a major cause of time lost from work and long-term disability.  Payments for Workers’ Compensation claims for these disorders have risen rapidly.” (5)

“Because musculoskeletal pain is a major source of suffering, healthcare and utilization of compensation, there is a definite need for prevention.” (2)

“Research on risk factors indicates that although medical and workplace factors are obvious, psychosocial variables are central to the transition from acute to chronic pain.  The early identification of ‘at risk’ patients is a key to allocating resources and initiating secondary prevention.” (2)

“If only we could prevent disability due to chronic pain from occurring, tremendous suffering and monumental costs would be saved. . .Yet, while disability consumes huge amounts of resources, only a small fraction of the amount of these sums is available to prevent chronic pain problems.” (2)

State officials contend the regulations are long overdue and could prevent thousands of injuries per year.  The labor and industries department has no plans to rescind or revise the regulations, Director Gary Moore said.

One study done in April of 1969 by the Aerospace Medical Research Laboratory, Aerospace Medical Division, Air Force Systems Command, Wright-Patterson Air Force Base, Ohio, states:

“The body posture of sedentary workers, especially in offices, and of school children has long been a concern of orthopedists and physiologists.  The increasing number of office positions, of seated factory workers, of people sitting in cars and airplanes, even of seated soldiers, has augmented the concern about ‘unhealthful’ sitting postures.  Complaints about lower back pains are widespread among people who commonly work in the sitting position.  Medical treatment of ailments thought to be connected with the sitting posture, sick leave taken by employees, and reduced work output highlight some of the economic aspects.” (3)

Businesses in industries that report the highest number of injuries must take steps to lower the risks by buying new equipment, repositioning existing equipment, and providing training on how to avoid injury (OSHA).

Major employer groups say the rules will cost them $725 million a year.  The lawsuit also challenges the effectiveness of the ergonomic techniques spelled out in the rules.  (1)

The Occupational Safety & Health Administration expects its workable, practical approach to prevent an average of 460,000 injuries annually and to save businesses $9.1 billion annually because of reduced workplace injuries and greater productivity; with a $27,700 savings in direct costs for each MSD prevented . . .90 percent of American workers are covered by the new OSHA regulation. (4)

FYI:  Ergonomic regulations were passed during the Clinton Administration; but President Bush and Congress repealed them shortly thereafter.

Eugene Scalia, the Labor Department’s top lawyer, has called the regulations “quackery” and “junk science.”

According to  Richard Trumka, AFL-CIO secretary-treasurer:  “The most important question – how we can protect workers from these crippling injuries – is not even being asked.”

At a forum addressing workplace safety in July, 2001, Labor Secretary Chao stated: “We can choose to do one of two things starting today. . .We can play politics, or we can protect workers.  We can engage in sideshows, or we can pursue safety.”

REFERENCES:

  1. “Business Groups Sue Washington State, Say New Ergonomics Rules Place Burden on Employers,” written by Paul Queary.

  2. “Prevention of Disability Due to Chronic Musculoskeletal Pain,” written by Steven James Linton.

  3. “Ergonomics in the Design of Office Furniture,” written by E. H. Eberhard Kroemer, Dr. Ing., Joan C. Robinette, Aerospace Medical Research Laboratory, Wright-Patterson Air Force Base, Ohio.

  4. “Is there Light at the End of the Carpal Tunnel?” written by Ann W. DeVoe, Esq., CBA Report.

  5. American Journal of Industrial Medicine 19:87-107 (1991), “Workplace Ergonomic Factors and the Development of Musculoskeletal Disorders of the Neck and Upper Limbs:  A Meta-analysis,” written by Susan Stock, M.D.