Interface (Vol 1 No 3)

1
Interface www.asse.org 2011
From Nothing to
Best PracticeEstablishment of an
Ergonomics Program for HTSI-COS
For a complete
Table of Contents
see page 3
A
fter retiring from the
Army after 25 years of
service, I was hired by
Honeywell Technology
Solutions Inc.-Colorado
Springs (HTSI-COS) and began
work in the facilities department.
When I first arrived in 2003, no
ergonomics program was available
to employees to assess or correct
deficiencies in their workstations
or in their processes. Over the next
few years, our company saw five
to seven complaints of potential
We have estab-
lished an ergo-
nomics/well-
ness lab in our
building, and
several safety
professionals
from around
the Colorado
Springs area
have toured
our facility.
workplace musculoskeletal disorders
(WMSDs) each month and no real
process to help lessen or eliminate
this trend.
This level continued through 2004
until HTSI-COS chose to become
an OSHA Voluntary Protection
Program (VPP) member. One of the
key elements of inclusion was an
ergonomics program with additional
emphasis on health and wellness
initiatives within the company. With
the support of our management team
continued on page 24
A Technical Publication of ASSE’s
Ergonomics Practice Specialty
D
PAGE 4
ASSE
The Next
100 Years
D
PAGE 8
TRAINING
Proper
Ergonomics
D
PAGE 10
ERGONOMICS
Integrating
Ergonomics &
Sustainability
D
PAGE 19
INJURIES
Patient Care
Ergonomics
Volume 1 Number 3
By Keith Osborne

A
s we recognize another National
Ergonomics Month, I find it hard to believe
that a year has gone by since we became
a practice specialty. The Ergonomics
Practice Specialty continues to grow slowly, and
we remain very active: we enhanced our newslet-
ter to meet standards as a practice specialty, rec-
ognized our first Safety Professional of the Year,
sponsored speakers for concurrent sessions at
Safety 2011 in Chicago, solicited several speakers
for Safety 2012 in Denver and launched fundrais-
ing efforts to offer a scholarship for our members.
It truly has been a remarkable year! I look forward
to another great year. x
Jeremy Harris
Ergonomics Practice Specialty
Officers
Administrator
Jeremy Harris
(847) 277-4385
jeremy.j.harris@ge.com
Assistant Administrator
David Brodie
(919) 368-1129
david_brodie@cargill.com
Publication Coordinator
Walt Rostykus
(503) 680-6521
wrostykus@humantech.com
ASSE STAFF
Staff Liaison
Krista Sonneson
(847) 768-3436
ksonneson@asse.org
Communications Specialist
Jolinda Cappello
jcappello@asse.org
Publication Design
Susan Carlson
scarlson@asse.org
Interface is a publication of ASSE’s
Ergonomics Practice Specialty, 1800 East
Oakton St., Des Plaines, IL 60018, and is dis-
tributed free of charge to members of the
Ergonomics Practice Specialty. The opinions
expressed in articles herein are those of the
author(s) and are not necessarily those of
ASSE. Technical accuracy is the responsibility
of the author(s). Send address changes to the
address above; fax to (847) 768-3434; or send
via e-mail to customerservice@asse.org.
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. . . Whereas there is evidence that products
used in safety and health programs, or by the
public in general, may in themselves present
hazards; and Whereas, commercial advertising
of products may not depict the procedures or
requirements for their safe use, or may depict
their use in some unsafe manner . . . the
Board of Directors of ASSE directs staff to see
that advertising in Society publications is war-
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publication, to assure that products show evi-
dence of having been reviewed or examined
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Another Great Year
administrator’s MESSAGE
2
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Ergonomics Practice Specialty Resources

PAGE 1 From Nothing to Best Practice
By Keith Osborne
The author explains how Honeywell Technology Solutions Inc.-
Colorado Springs improved not only its safety program, but also
its ergonomics program and health and wellness initiatives.
PAGE 7 Ergonomics for Selecting
Fleet & Service Vehicles
By Julia Brenner
Humantech management consultants Kent Hatcher and Deepesh
Desai have researched ways to improve the ergonomics of fleet
and service vehicles.
The Growing
Problem in
Ergonomics:
Obesity
By Winnie Ip
In traditional ergonomics programs, the
primary goal is to adapt the workplace
and tools to the capabilities of people.
This goal does not change when consid-
ering obese workers.
Patient Care
Ergonomics
By Mary Willa
Matz
Manual patient
handling is the
primary reason for
musculoskeletal
injuries in patient
care providers, and
the understanding
of the impact of
patient handling on the body leads to a
clear understanding why this is so.
PAGE 15
PAGE 19
Volume 1 • Number 3
CONNECTION KEY
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PAGE 8 Bend Me Shake Me:
Time to Teach Adults
Proper Ergonomics
By Cathy White
Training is an essential element to ergonomics program success.
The right training for the right people will ensure that your orga-
nization has the skills and methods to effectively carry out key
responsibilities and to achieve sustainable gains in the ergonomics
program.
PAGE 10 Integrating Ergonomics
& Sustainability
By Jessica Ellison & Danny Nou
Ergonomics initiatives have many parallels with sustainability
goals and can function effectively as an integrated program rather
than as two distinct programs.
contents
3

4
By George Pearson, CSP, ARMAnnouncements
A
s we now begin our second century, ASSE
still faces future challenges in improving the
safety community. However, coming out of our
100th-anniversary Professional Development
Conference, I see many positive signs that indicate we
have a very bright future. As the world’s oldest profes-
sional society dedicated to protecting people, property
and the environment, there are many heartening indica-
tors, many of which come from our Council. In fact,
I am very optimistic, as we are poised for the next
hundred years, that our ability to support our growing
membership is strong.
We are fortunate our Society is vital and growth
continues as we come out of the economic recession.
Even more encouraging is that membership retention
has increased 5 basis points from
87% last year to 92% this year. This
proves safety professionals realize
the value in ASSE membership, and
we are primed for greater progress.
As economic times improve, our
nation’s industry base expands and
the global economy gains momen-
tum. Being in a Society leadership
role, I look forward to the introduc-
tion of additional opportunities in
the areas of global growth, value of
the profession and fruition of our
Body of Knowledge (BOK) project.
Membership in the practice spe-
cialties and branches has grown
in parallel to the Society, and we
have every reason to believe that
we will continue to grow through
additional membership and partici-
pation opportunities. As of May 2011, we had 21,111
practice specialty members and 2,180 branch members.
The Health & Wellness Branch was approved at the
Council on Practices and Standards (COPS) meet-
ing held at Safety 2011 and should contribute to our
growth. The Health & Wellness Branch will create
awareness and will educate its members to help shape
attitudes and beliefs, thinking and behavior through a
proactive, holistic approach to employee well-being,
not just freedom from disease. This refers to an active
process that aims to build and enhance an organiza-
tion’s employee population, promoting habits and
behaviors that optimize health, social and emotional
well-being. Two things will contribute to the Branch’s
success: we are thinking outside the box by going
beyond traditional ASSE boundaries, and we can draw
new members not just from practice specialties and
branches, but also from
the Society at large.
There is also a value
proposition here in that
employers with effec-
tive health and well-
ness programs have
lower healthcare and
workers’ compensation
costs.
Growth in the
Common Interest
Groups (CIGs) has
been exceptional and beyond expectations. With 5,085
members belonging to one or more of our four com-
mon interest groups, our CIGs are among the most
active committees in the Society. Safety Professionals
and the Latino Workforce (SPALW) continues its
outreach into Latin America with activity in Mexico
and Ecuador and plans to expand that into Panama,
Columbia, Brazil and Argentina. Women in Safety
Engineering (WISE) is completing its publication
honoring 100 women in safety. Young Professionals
in SH&E (YP) has enjoyed additional memberships as
graduating student members become regular members.
Blacks in Safety Engineering (BISE) has continued to
grow and was able to award a scholarship at this year’s
conference.
The BOK project is on schedule. Keywords have
been finalized. More than 1,000 keywords have
been submitted for inclusion and more are to come.
Volunteer members and temporary workers assisted
with the BOK project this summer. With the growth
in membership, it is possible to accelerate the project
schedule and quantity of available content.
Looking forward to the next 100 years, I am posi-
tive about COPS’s and the Society’s future. Dr. Darryl
Hill, our departing Society president, reported in a
farewell message to the Board, “Keep your goals very
high, have a balance and enjoy your family. The future
is bright.” x
George W. Pearson, CSP, ARM
Vice President, ASSE Council on
Practices & Standards (COPS)
The Next 100 Years
Volunteer mem-
bers and temporary
workers assisted
with the BOK proj-
ect this summer.
With the growth in
membership, it is
possible to
accelerate the
project schedule
and quantity of
available content.

ASSE body of knowlEdgE
Get started today
visit www.safetybok.org
New
Member
benefit!
your source for sH&e answers and solutions

•Katery Alfaro
•Robert Allen, Walt Disney Co. Worldwide Safety
•Brent Altemose, Sabre Health & Safety
•Manny Alviso, United Stationers Inc.
•Joyce Anderson, Compliance Specialties Inc.
•Mary Anderson, Honeywell International
•Gwendolyn Arps, AON
•Susan Barriball
•Felicia Beaulieu, Marine Corps, Quantico MCB,
Safety Division
•Raymond Blanco
•Eric Blankenheim, Blankenheim Services
•Vickie Brewster, Mike Monroney
Aeronautical Center
•Raymond Brown, IESA LLC
•Cathy Burch, Frontier Pro Services
•Patrick Carley, American International College
•Allen Coppolo, Doncasters Inc.
•Keith Crumpton, Lone Peak Conservation Center
•Robert Debner
•Michael Domingo Cruz, Pride Industries
•Kelly Doughty, Chevron
•Sharon DuBois, Skagit County Risk Management
•Phan Duong-Ngo
•David Ewanick
•Suljo Fermic
•Lloyd Fischel
6
•Aleece Foxx
•Christopher Gates
•Maureen Gillis, Siemens Healthcare Diagnostics
•Christopher Gongora, Diagnostic Laboratory
Services Inc.
•George Gough, Occidental of Elk Hills Inc.
•George Gruetzmacher, Wisconsin State Laboratory
of Hygiene
•Alejo Habal, New Safety Index
•Jon Hamill, Oxy USA
•David Hanson
•Saundra Harris
•Henry Ho
•Richard Hofman
•Susan Holland
•Randy Huff, Ingersoll Rand
•Dana Hughes-Dawsey, Caterpillar Inc.
•Wael Jamaan, Saudi Aramco
•Miriam Joffe, Auburn Engineers
•Joseph Jones
•James Kennedy, Alaska Fisheries Science Center
•Deepa Kundadka
•Bruce Lambert, B.A. Lambert Workplace
Performance
•Diane Lancon, NW Natural Gas
•Melanie Langlais
•Michael Lim, Pacific Gas & Electric Co.
•Bernie Lynch
•Brian Manges
•Paul Marchand, APC by Schneider Electric
•Michael Mariscalco, QEI Engineers Inc.
•Jenna Marshall
•Etta Mason, Southern California Edison
•Dean Maudlin, Just Ergonomics LLC
•Ruth McCafferty
•Kellie McNeil
•Allison McPhee, Genzyme
•Danny Meekins, Ellwood Texas Forge Navasota
•Larry Mendoza, Howard Hughes Medical Institute
—JFRC
We want to thank everyone who has
remained a loyal member of the
Ergonomics Practice Specialty (EPS) and wel-
come the following members who recently
joined. We are currently at 438 members and
growing. If you have any colleagues who might
be interested in joining EPS, please contact
Krista Sonneson to request an information
packet. If you know anyone who might be
interested in joining ASSE, please contact
customer service.
Welcome New Members!

When your workplace is a vehicle, ergonomics matter most.
Humantech management consultants Kent Hatcher and
Deepesh Desai have researched ways to improve the ergo-
nomics of these atypical “offices” so that they do not get left
on the side of the road.
Anthropometry, or the measurement of the size, weight
and proportions of a human, is important to consider when
selecting fleet and service vehicles, Hatcher says. If a 4’11”
female and a 6’6” male do the same job, then the vehicle
must accommodate both body types. This requires adjust-
able features and designing for extremes. The general rule of
thumb, he says, is to design large for any clearances and small
for any reaches. When designing space for head room, for
example, design for the large male. When designing the verti-
cal reach to close the trunk, design for the small female.
The analysis of a vehicle should focus on manual material
handling and interior comfort and posture, Hatcher adds.
Manual material handling includes features like interior trunk
width, height and depth, loading service height and depth,
force required to open the trunk and the vertical reach to
close it. Hatcher offers his top five recommendations for sales
fleet vehicles:
1) Cargo deck (floor of trunk) height should be within rec-
ommended guidelines for manual material handling, 33 in. to
38 in. above the standing surface.
2) The cargo deck should be flush with the loading sill to
prevent the need to lift and clear products from the cargo
area. The total depth of the sill, or the horizontal reach,
should be 18 in.
3) A higher driver’s seat height can ease ingress/egress from
vehicle.
4) Check the quality of visibility to the vehicle’s exterior
when using mirrors (rearview and side) as well as when check-
ing blind spots.
5) Presence of full controls on the steering wheel optimizes
driver attentiveness on the road and reduces reaches to the
console.
To effectively retrofit vehicles, Desai suggests assessing the
risks already present and then developing viable and cost-
effective solutions to create a business case for implementing
them across all vehicles. Because thousands of vehicles are
already in circulation, a company should start by gaining sup-
port from top management and by establishing a loss preven-
tion plan and goals. From there, it can prioritize ergonomic
issues through workplace ergonomic risk assessments, develop
short-term and long-term improvement plans and then imple-
ment short-term improvements. “Test it and tweak it,” Desai
says. “You do not want to do it all and realize that you have
made a mistake.” Desai offers his top five recommendations
for field service and delivery vehicles:
1) Product storage: Position heavier, more frequently
handled items in the comfort zone, between 38 in. and 49 in.
above the standing surface.
2) Appropriate handholds: Retrofit grab handles with 30 in.
in length and 1.25 in. in diameter.
3) Entering/exiting cab—step height: Retrofit a retractable
supplementary step.
4) Lift gates: Provide a pendant control to operate the lift
gate.
5) Rear-view camera: Ensure that vehicles are fitted with a
rear-view camera. Make sure the camera monitor is placed in
an optimal viewing distance, preferably on the dashboard.
For more information, click here. x
Julia Brenner is a communications intern with ASSE. She holds a jour-
nalism degree from University of Wisconsin-Madison.
7
•Mark Mitchell, Alaska Railroad Corp.
•Lee Mooney, Amgen
•Brian Murphy, BRS Inc.
•Paul Myers
•James Newberry, Island Insurance Co. Ltd.
•Daniel O’Farrell, EA Engineering
Science & Technology
•Kay Parker Paul
•Robb Patterson, Pfizer
•Ellen Rader Smith, Ergo & Rehab Services
•Steven Ramiza, LAN Associates Inc.
•Charles Raymond, Gray Insurance Co.
•Deborah Read, ErgoFit Consulting Inc.
•Susan Reinhardt
•Ian Renteria, Avon
•June Robinson, Battelle Toxicology NW
•Peggy Ross
•Karri Russ, Florida Power & Light
•Eric Schultz
•Lawrence J. Schulze, University of Houston
•Judy Sehnal, Hartford
•Albert Shaw, Honeywell International
•Tom Stallings, ABB Power T&D
•Edmund Sullivan, Middlebury College
•Scott Swanson
•Linda Tapp
•Philip Taylor, Chevron Products Co.
•James Thatcher, EnCana Oil & Gas
•Robert Thomas, Auburn University
•Jimmie Tullis
•Walter Urbanski, Lafarge NA
•Alan Weikert
•Stephen Wolszczenski, Pepperidge Farms
•Pamela Yates
•Kristi Young, BP x
Ergonomics for Selecting Fleet & Service Vehicles
By Julia Brenner

E
rgonomics training takes many forms, from
teaching employees correct postures to instruct-
ing engineers about principles of design. While
each training effort has different objectives, it is
important to provide the right type of knowledge with
the desired impact for the intended
audience. Training is an essential
element to ergonomics program
success. The right training for the
right people will ensure that your
organization has the skills and
methods to effectively carry out
key responsibilities and to achieve
sustainable gains in the ergonomics
program.
Before providing employees
with ergonomics training, the orga-
nization must first define the ergo-
nomics program’s support infrastructure. Key roles to
define include the senior leaders of the organization,
the person or
team responsible
for managing
the ergonom-
ics program,
engineers who
design the work
environment and
the managers of
the workgroups
in the organi-
zation. Many
organizations
begin an ergo-
nomics program
by providing
general ergo-
nomics aware-
ness training to
their workgroup.
Although this
is simple to
implement, an
ergonomics pro-
gram based solely on awareness is not sustainable. The
order of ergonomics training that people in key roles
play has a major impact on the ergonomics program’s
success. Education and training should then follow a
logical sequence in order to implement a program from
the leaders down to the employees:
•Educate senior leaders with a business case for the
ergonomics process. The intent of this education is to
demonstrate the value of ergonomics for the organiza-
tion to gain their sponsorship and to establish the ergo-
nomics program’s goals.
•Train the person or team responsible for manag-
ing the ergonomics program. This group will need to
gain the knowledge and skills necessary to deploy and
sustain the ergonomics program. This group will need
to be able to address difficult ergonomic challenges
brought to them by employees and managers.
•Educate engineers on workplace design principles.
Principles of workplace design related to manual
materials handling, hand tools and seated and standing
workstations should be reviewed with guidelines for
appropriate heights, reaches and clearances.
•Provide training to managers who are the interface
between employees and ergonomics team members.
In their roles, they will be the most influential people
to impact employee safe work practices and behaviors
and to provide assistance with the implementation
of improvements identified by the ergonomics team.
Provide coaching to affect work practices and behav-
iors and to improve workplace conditions.
After all roles are trained, employees then need to
be provided with ergonomics training to prepare and
empower them to identify potential ergonomic issues
in their workplace and to adjust the workplace or their
work practices to control the issues. If unable to con-
trol the issues, they should be taught to escalate such
issues to their manager.
Effective employee training is essential to a sustain-
able ergonomics program. While computer-based train-
ing has its place in a learning environment, it has been
proven that interactive training based on adult learning
principles is effective in retaining knowledge. General
ergonomics awareness training can be complemented
with having all employees go through an ergonomics
By Cathy White, CPE
Bend Me Shake Me:
Time to Teach Adults
Proper Ergonomics
The order of ergo-
nomics training that
people in key
roles play has a
major impact on
the ergonomics
program’s success.
Training
Figure 1 A Working Height
That Is Too Low Will
Force Awkward Postures
to Handle the Load
on the Conveyor
8

assessment of their work area. This can be completed
as part of a team for shared work areas or by individual
for office workstations. This exercise facilitates a
deeper impression of ergonomics on each employee in
a hands-on format.
An administrative option often used by companies
to address an identified high-risk task is to train the
work group on the hazard of the task and to provide
training on the appropriate way to perform the task
with a reduced likelihood of injury. Training all by
itself, without making changes to the workplace, is
often not effective in preventing injuries. If employees
are taught “proper lifting techniques” and then sent
out to work under conditions that do not allow them to
use these techniques, the training is of no benefit. The
working area should be set up to allow for the proper
working height for the population with reach distances
minimized.
A working height that is too low will force awkward
postures to handle the load on the conveyor. Training
on proper lifting techniques will not alleviate the inher-
ent design flaw in this workplace.
However, training is an important part of imple-
menting changes. Showing employees how to use
new equipment and explaining why it is important to
use it properly to prevent injuries helps make sure the
equipment gets used. Workers need hands-on practice
with new tools, equipment or work practices to make
sure they have the skills necessary to work safely.
Training is most effective when it is interactive and
fully involves workers. This training needs to be based
on adult learning principles to retain the information
received. Some suggestions to achieve this include:
•Provide hands-on practice when new tools, equip-
ment or procedures are introduced to the workforce.
Being trained where they work, using the objects they
typically lift and the equipment they use on the job
helps employees relate to what they are being taught,
rather than showing them a generic lifting video.
•Use several types of visual aids
of actual tasks in your workplace.
Combine the use of pictures, hand-
outs, charts or videos. To supple-
ment the visual aids, you could
compile or purchase an ergonomic
brochure of handy tips that can be
posted at the office desk or in the
work area for employees to review
at their convenience. This increases
the likelihood that good ergonomic
practices will be adopted.
•Make sure that employees have
learned what you are trying to
teach them by having each one, or
all of them demonstrate the proper
operating techniques with the tools
before leaving the class.
•Follow up with learners after
the training to make sure they are
able to use the proper techniques on the job.
An ergonomics brochure can consist of a pictorial
representation of proper ergonomics design and can
be supplemental with a written description of ways
to control risk factors in that particular workplace.
For a computer workstation, information regarding
chair adjustments, proper working height and loca-
tion of items in the computer workstation environment
are typical items to include in a handout. These can
be posted at the computer workstation as a recurrent
reminder of proper work habits.
Organizations that establish clearly defined roles
and responsibilities and provide ergonomics training to
ensure the capability to meet these responsibilities cre-
ate a strong internal support infrastructure. The infra-
structure ensures that employees receive support when
they take responsibility for improving their workplace
and practices. By combining this infrastructure with
effective employee ergonomics training, the result is a
strong and sustainable ergonomics program. x
Cathy White, CPE, is an industrial hygiene and personal safety
specialist at the Dow Chemical Co. She holds a bachelor’s and
master’s degree in Industrial and Operations Engineering from
the University of Michigan. She has 11 years’ experience as an
ergonomics and safety professional in managing ergonomics
programs, conducting risk assessments and identifying controls
to manage the risks.
Figure 2: Example of Office
Ergonomics Brochure
An ergonomics bro-
chure can consist
of a pictorial repre-
sentation of proper
ergonomics design
and can be supple-
mental with a writ-
ten description of
ways to control risk
factors in that par-
ticular workplace.
9

10
workers’ compensation costs, improve morale and have
a variety of other positive impacts on the company’s bot-
tom line. However, challenges, such as a lack of fund-
ing, C-level (CEO, CFO, COO) attention and support
and overall government legislation have undermined the
effectiveness of ergonomic programs. By integrating
ergonomics into sustainability and repackaging successes
from ergonomic programs, there is a huge opportunity
for ergonomic professionals to capture attention in the
boardroom. This visibility will help get programs and
solutions funded and will bring ergonomics into strategic
boardroom discussions resulting in a more proactive pro-
gram that will benefit employees and also the company’s
triple bottom line.
Defining Sustainability
To understand ergonomics’ role in sustainability, it
is important to first understand the definition of sustain-
ability since it is often used as a catchall buzz word.
Sustainability has been defined by many people. James
Hagan, Ph.D., M.S., provided a concise definition at
the National Ergonomics Conference and Exposition in
2008 as “Allowing future generations to have the same
standard of living that we enjoy while improving the
condition of the current generation” (NECE, 2008).
The key concepts of sustainability revolve around the
3Ps: people, planet and profit. The first concept within
sustainability is people, which includes the ethics of
how workers and the community are treated. It includes
ideals, such as basic human rights and avoiding child
labor, and labor issues, such as providing a safe work-
place that minimizes safety and health hazards, valuing
By Jessica Ellison, M.S., CPE, CSP & Danny NouSustainability
R
ecent
trends
show
that more
companies are
focusing on sus-
tainability [also
known as the
corporate social
responsibility
(CSR) initiative,
3P (People,
Planet, Profit) Triple Bottom Line or 3E (Equity,
Environment, Economy)], which emphasizes a balance
between people, planet and profit. In addition, the work-
place has changed, in part due to sustainability, from
employees working from the office to working from
home or telecommuting and how buildings are designed
so companies can create Leadership in Energy and
Environmental Design (LEED)-certified buildings.
Ergonomics programs need to start thinking outside
of the box about their value so that they leverage the
momentum created by sustainability. Based on these
trends occurring in industry, it is evident that there is
tremendous global momentum in corporate sustainability
and that ergonomics fits right into the people aspects of
the people/planet/profit or triple bottom line.
Corporate ergonomists and ergonomic consultants
understand the value of the work they provide to a
company. They understand that they are helping reduce
injuries and decrease discomfort and in the process can
improve productivity, decrease lost work days, decrease
Integrating
Ergonomics &
Sustainability

11
diversity and philanthropy. On the planet portion, we see
businesses taking responsibility for the lifecycle of their
products, from the raw materials to stewardship in prod-
uct use to ultimate disposal. There is also an emphasis on
reducing externalities (unintended costs) and minimiz-
ing resource use (water, electricity, gas and packaging).
Finally, the profit section, which emphasizes jobs and
growth, cost reduction and green products, is shown to
be impacted in a positive way by using fewer resources
and by creating less waste.
Sustainability is Here to Stay
Why is sustainability such an important trend for
ergonomists? This huge and growing trend is predicted
to be here for a long time because the concept of creat-
ing economic value through environmental and social
impact has come to the forefront in businesses around
the world. The “green” label has captivated corporate
mindshare and corporate funding. On March 1, 2011,
Hedge Funds Review (2011) showed that more than
$13 trillion has been invested globally in socially respon-
sible companies that demonstrate strong sustainability
practices.
Investors are making an impact on the world by put-
ting money into investments listed on the Dow Jones
Sustainability Indexes or the FTSE4Good or by invest-
ing in socially responsible investment funds, like Calvert
and Domini, who will only buy shares in socially
responsible companies. This is impacting decisions in
boardrooms around the world and driving change with-
out having the stick of regulation.
Corporations are even restructuring to organize for
sustainability. Many Fortune 500 companies, such as
Google, Verizon and Ikea, have their own corporate sus-
tainability officers (CSOs) and/or vice president of sus-
tainability (Deutsch, 2007). The website, Green Business
Views, notes that President Obama issued Executive
Order 13514, which “provides guidance to how govern-
ment agencies are to go green…[and] the order calls for
the installation of sustainability officer or committee”
(2010). The fact that sustainability is being given as
much attention as the CEO, CFO or COO speaks to the
importance of this movement to companies and to the
likely longevity of this trend.
Benefits of Sustainability
Sustainability is not only socially responsible, it pro-
vides many benefits to companies that pursue and volun-
tarily commit to the movement. The first example is the
millions of dollars that have been saved from a variety of
sustainability efforts.
For example, Wal-Mart has shown that by improv-
ing the fuel efficiency of its fleet by one mile per gal-
lon, it hopes to save approximately $35 to $50 million
(MSNBC, 2007). Alcoa has implemented an energy
reduction strategy and has already realized $20 million
in savings (Alderton, 2008). The cost estimates saved
from this procedure have led to savings in the millions.
One more example is that the IRS reported real estate
savings of $585,000 for a pilot telecommuting program
of 150 participants (Telework Exchange, 2007).
Another benefit of sustainability is that companies
that practice the principles have a higher ability to recruit
and retain top-level talent for their companies. A survey
by MonsterTRAK.com shows that 92% of Generation
Y employees (people born between 1977 and 2002)
are more likely to work for environmentally friendly
company. Also, Adecco USA’s 2008 Workplace Insight
Survey showed that Generation Y workers are willing
to sacrifice about 6% of their salary to work for a green
company as opposed to a traditional one (Stika, 2010).
These are just a few of the benefits that compa-
nies practicing sustainability have reported, which has
increased the popularity of sustain-
ability among some of the strongest
and most successful companies
in the market today. Therefore,
programs that help fit within the
sustainability movement also have
the opportunity to grow and have a
wide-ranging impact not only on the
environment, but on their corporate
bottom line as well.
Ergonomics’ Role in
Sustainability
Ergonomics has the ability to
show value by having a direct and
positive financial impact on a com-
pany’s bottom line and to affect
the lives of people to create a more
sustainable work environment.
Ergonomists need to know how to
market their programs internally
and to take advantage of the sustain-
ability trend by making connec-
tions where they exist in both programs. Following is a
description of some of these links: people, CSR reports,
LEED certification and telecommuting programs with a
discussion around what future links may be possible.
Link 1: The People
The most obvious link is between ergonomics and
the sustainability component of people. Chris Patton,
a past ASSE president, has stated that, “Safety should
be viewed as the cornerstone of the people component.
In this context, sustainability means implementing and
maintaining programs that keep people safe, facilities
intact, communities protected, supply chains secure and
the organization’s mission uninterrupted. Sustainable
organizations are, by definition, safe organizations,
and we play a key role in ensuring that safety” (Patton,
2010).
Even the pure definition of ergonomics shows the
link between ergonomics and people. For example, the
International Ergonomics Association (IEA) defines
This huge and
growing trend is
predicted to be
here for a long
time because the
concept of creat-
ing economic value
through environ-
mental and social
impact has come
to the forefront in
businesses around
the world.

12
Interface www.asse.org
within an organization, and a few companies have
reported not only their energy efficiency and envi-
ronmental and philanthropy achievements, but also
their ergonomic and employee wellness programs to
increase corporate transparency and to show the link
between ergonomics and sustainability. CSR reporting
promotes socially responsible businesses to be con-
cerned about public interest by voluntarily eliminating
practices that harm human health and the environ-
ment, even when those practices are perfectly legal.
Nintendo of America reported in its CSR report
that it has an Ergonomic Task Force, which focuses
on annual training and assessment of fixed and non-
fixed workstations (Nintendo, 2010). Another com-
pany, Hormel Foods, reported in its CSR report that
injury prevention was a key focus in its ergonomic
programs and even went as far as to show the soft-
tissue incident rate and its steady decline year over
year (Hormel Foods, 2010). There are more examples,
but the clear message is that companies’ sustainabil-
ity program and ergonomic program both focus on
employees and their well-being.
Link 3: LEED Certifications
Currently, more than 40,000 projects currently par-
ticipate in commercial and institutional LEED rating
systems, which comprise all 50 states and 117 coun-
tries (USGBC, 2011). Dr. Alan Hedge, director of the
Human Factors and Ergonomics Laboratory at Cornell
University, is also an IEA representative for environ-
mental design and a Cornell Center for Sustainable
Futures Faculty Fellow. He has already outlined a way
to use ergonomics to get one point as an “Innovation in
Design” or “Innovation in Operations” credit.
A good ergonomic design is one that creates and
maintains a flexible ergonomic environment that prop-
erly accommodates building users and promotes healthy,
comfortable and productive work. The requirement for
this point involves the development and implementa-
tion of “a comprehensive ergonomics strategy that will
have a positive impact on human health and comfort
when performing daily activity for at least 75% of full-
time equivalent building users” (Cornell, 2011). In an
e-mail communication with Hedge in April 2011, he
noted in the next version of LEED due out at the end of
November 2012, that “office ergonomics is a separate
line item credit point in the indoor environment section
of the rating system.” What is great for companies that
already have an established ergonomic program is that
they simply need to document their efforts and possibly
make a few small changes in the program to be able
to qualify for this point. This is a great opportunity for
ergonomists to start getting involved in the design phase
and to become more strategic and proactive to prevent
injury rather than reactively dealing with employees
once injured, as outlined in Hedge’s article on “The
Sprouting of ‘Green’ Ergonomics” (Hedge, 2008). This
ergonomics (or human factors) as “the scientific disci-
pline 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 to optimize human well-being and
overall system performance. Ergonomists contribute to
the design and evaluation of tasks, jobs, products, envi-
ronments and systems in order to make them compatible
with the needs, abilities and limitations of people” (IEA
2000).
Some companies and organizations, such as Xerox
and Univar and many others, have listed safety on their
external websites stating their commitment to safety.
Xerox says, “Xerox creates safe and efficient prod-
ucts, maintains a safe workplace for our people, sup-
ports health and wellness programs and reduces injury
and exposure to hazardous materials” (Xerox, 2010).
People’s safety is on the forefront of any good sustain-
ability program protecting a company’s most valuable
asset. Ergonomics works directly with people to help
support a safe working environment that enables compa-
nies to reduce injuries.
Link 2: Corporate Sustainability
Responsibility (CSR) Reports
CSR reports show the results of sustainability efforts
Safety should be
viewed as the
cornerstone of the
people component.
In this context, sus-
tainability means
implementing and
maintaining pro-
grams that keep
people safe.

13
A possible link also exists between ergonomics and
“green” products for items purchased to achieve good
ergonomics. As ergonomists, we should be aware of the
company policy and expectations and be aware of the
environmental impact we make when recommending
products.
Another possible link is to lean manufacturing, ergo-
nomics and sustainability. Ergonomics can improve
cycle time and lean metrics, which in turn drives
improved safety and profit. Some great technologies are
also available on the market today to help streamline
the efficiency of ergonomic and sustainability programs,
such as Remedy Interactive and Hara. In the future, there
may be an opportunity to bring these two technologies
together into one platform for ease of use, reporting and
communication.
For example, the tool may be able to help home office
workers set up their workstation ergonomically and help
capture the true carbon footprint of
the company by collecting data on
the number of commute miles saved
and energy and water use and may
influence sustainable practices in the
home.
Conclusion
In summary, ergonomics initia-
tives have many parallels with sus-
tainability goals and can function
effectively as an integrated program
rather than two distinct programs.
Ergonomists should start by making
an effort to find out who leads sus-
tainability at their company. Start by
making an introduction, sharing this
article with them and discussing possible common goals.
You might find that some of these links will be intrigu-
ing to sustainability leaders, and they will be interested
in anything that will help support their goals as well. The
industry is changing to a “greener” world, and sustain-
ability offers a huge opportunity for ergonomists to assist
sustainability efforts and to reap the benefits of being
allied with such a strong and well-funded movement.
The authors would love to hear about further ideas
readers may have on future links and thoughts on this
article. Please feel free to contact them with any ques-
tions or comments. x
References
Alderton, M. (2008). The ROI of sustainability.
Retrieved May 31, 2011, from http://www.greenbiz.com/
blog/2008/08/24/roi-sustainability.
CNN Money. (2011). Best benefits: Telecommuting.
Retrieved May 13, 2011, from http://money.cnn.com/
magazines/fortune/bestcompanies/2011/benefits/telecom-
muting.html.
Cornell University Ergonomics Web. (2011). “Green”
ergonomics requirements worksheets and survey.
point further strengthens the role of ergonomics in sup-
porting sustainability initiatives and focusing on environ-
mental awareness.
Link 4: Telecommuting Programs
Telecommuting is often a centerpiece of corporate
sustainability programs. CNN Money’s report on “The
Best 100 Companies to Work for” showed that 82% of
these companies allow employees to telecommute at
least 20% of their time with the top 5 companies hav-
ing 80% to 86% regular telecommuters (CNN Money,
2011). These programs have shown to reduce the carbon
footprint of companies and to increase productivity at the
same time.
The disadvantage to telecommuting is that the ergo-
nomic risks for computer-based employees are the same
as the risks found when employees work from the cor-
porate office. Many companies have not established a
system to address ergonomic concerns or are struggling
with a cost-effective method to address ergonomics
in remote and home offices. However, workers’ com-
pensation and OSHA/European Union regulations still
apply when working outside of the corporate office so
it is important for companies to establish programs that
address ergonomics in telecommuting programs. Many
agencies and groups already recommend that ergonom-
ics be included in the telecommuting policy, such as
EPA, Telecommute Connecticut!, Microsoft Business,
City and County of San Francisco and many others.
Link 5: Ergonomic Associations
The last point is that ergonomic associations, such
as the Human Factors and Ergonomics Society (HFES)
and IEA already see the link between ergonomics and
sustainability and have established groups dedicated to
the integration of ergonomics into environmental design.
According to HFES’s website, the overall objective of
HFES’s Environmental Design Technical Group is “to
foster and encourage the integration of ergonomic prin-
ciples into the design of all built environments” (HFES,
2011). IEA’s Human Factors and Sustainable Develop
ment Technical Committee intends “to build a powerful
global network of experts in the fields of ergonomics/
human factors and sustainability” (IEA, 2011). The goal
is to again bring ergonomics out of the reactionary mode
and into the design stages of projects to reduce or elimi-
nate risk prior to construction.
Future Links
This seems to just be the beginning of the link
between ergonomics and sustainability. Other ideas
where the link could be made include employee recruit-
ment and retention. It seems like a clear connection
could be made with recruitment and retention if employ-
ees were offered comfortable workstations designed
with ergonomic principles in mind. Why not offer this
as a benefit and publish the information in the CSR
report and on the benefits page of the corporate website?
Ergonomics initia-
tives have many
parallels with sus-
tainability goals
and can function
effectively as an
integrated program
rather than two
distinct programs.

14
2011, from http://www.npr.org/templates/story/story.
php?storyId=129406588.
Nintendo. (2010). Nintendo corporate social responsi-
bility report. Retrieved May 13, 2011, from http://www.
nintendo.com/corp/csr/index.jsp.
Patton, C. (2010). ASSE president’s blog:
Sustainability and safety. Retrieved May 13, 2011, from
http://assepresident.blogspot.com/2009/12/sustainability-
safety.html.
Stika, N. (2010). Sustainability drives recruitment and
retention. Retrieved May 13, 2011, from http://www.
cosemindspring.com/Topics/Sustainability/Greening%20
Your%20Business/Sustainability%20Drives%20
Recruitment%20and%20Retention.aspx.
Telework Exchange. (2007). Resource center, success
stories. Retrieved May 13, 2011, from http://archive.tele-
workexchange.com/resource-center-case-studies.asp.
U.S. Green Building Council. (2011). List of top 10
states for LEED green buildings released. Retrieved
May 13, 2011, from http://www.usgbc.org/Docs/News/
List%20of%20Top%20Ten%20States%20for%20
LEED%202011.pdf.
Xerox. (2010). The 2010 report on global citizenship.
Retrieved May 13, 2011, from http://www.xerox.com/
about-xerox/citizenship/enus.html.
Jessica Ellison, M.S., CPE, CSP, is a member of ASSE’s San
Francisco Chapter and incoming chapter secretary. She is a
principal consultant at Environmental and Occupational Risk
Management, a consulting firm headquartered in San Jose, CA.
She holds an M.S. in Biomedical Engineering (Biomechanics)
from the University of California-Davis and has extensive experi-
ence in analyzing and implementing effective solutions for office,
laboratory and manufacturing environments.
Danny Nou is an Ergonomics Specialist for Environmental and
Occupational Risk Management in Laguna Hills, CA. He was
a lead biomechanics researcher in the biomedical engineering
department at Hokkaido University. Nou holds B.S. and M.S
degrees in Biological Systems Engineering from the University of
California-Davis.
Retrieved May 13, 2011, from http://ergo.human.cornell.
edu/cuergoUSGBC.html.
Deutsch, C.H. (2007, Jul. 3). Companies giving green
an office. Retrieved May 13, 2011, from http://www.
nytimes.com/2007/07/03/business/03sustain.html.
Green Business Views. (2010). The most secure
green job in America. Retrieved May 13, 2011, from
http://www.greenbusinessviews.com/?tag=corporate-
sustainability-officer.
Hedge Funds Review. (2011). Ethical investment
hits $11 trillion. Retrieved May 13, 2011, from http://
www.hedgefundsreview.com/hedge-funds-review/
news/2028493/ethical-investment-hits-usd11-trillion.
Hedge, A. (2008, Dec.). The sprouting of “green”
ergonomics. Retrieved May 13, 2011, from http://ergo.
human.cornell.edu/cuergoUSGBC.html.
Hormel Foods. (2010). 2010 Hormel Foods corporate
responsibility report. Retrieved May 13, 2011, from
http://2010csr.hormelfoods.com/.
Human Factors and Ergonomics Society (HFES).
(2011). Environmental design technical group.
Retrieved May 13, 2011, from http://www.hfes.org/web/
TechnicalGroups/EDTG.pdf.
International Ergonomics Association (IEA). (2000).
What is ergonomics? Retrieved May 13, 2011, from
http://www.iea.cc/01_what/What%20is%20Ergonomics.
html.
IEA. (2011). Human factors and sustainable develop-
ment. Retrieved May 13, 2011, from http://www.iea.cc/
browse.php?contID=hf_and_sustainable_dev.
MSNBC. (2007). Wal-Mart on track to cut truck fuel
use by 25%. Retrieved May 13, 2011, from http://www.
msnbc.msn.com/id/19810648/.
National Ergonomics Conference and Exposition.
(2008). The role of ergonomics in green design and sus-
tainability. Keynote speech delivered on Dec. 5, 2009.
National Public Radio. (2010). Outsourced call
centers return, to U.S. homes. Retrieved March 1,
ASSE and the Ergonomics Practice Specialty
(EPS) would like to thank the following mem-
bers who have volunteered to serve on the advi-
sory committee for 2011-12. We thank you all for
your time and dedication to EPS and to the safety
community.
•Administrator: Jeremy Harris
•Assistant Administrator: David Brodie
•Publication Coordinator: Walt Rostykus
•Awards & Honors: Pam Perrich
•Body of Knowledge: Cindy Roth
•Conferences & Seminars: Lawrence Schulze
& Ben Amick
•Membership
Development: Scott
Valorose
•Nominations: Open
•Web: Open
•Special Projects:
Open
If you would like to
get more involved and
work with this great
group of volunteers,
click here.
The Future of EPS

15
T
he prevalence of obesity in the U.S. continues
to climb, exceeding 30% in most gender and
age groups. Over the past decade, medical costs
associated with obesity have also sky-rocketed
and are now $147 billion annually, representing almost
10% of all medical spending (CDC, 2009).
Much of these costs are due to the fact that obesity
(defined as a body mass index (BMI) of greater than
30, CDC) is also a risk factor for a variety of chronic
conditions, including diabetes, hypertension, heart
disease and arthritis. So what does this mean from an
ergonomist’s perspective? It means we cannot continue
to ignore this issue and act like it is the “elephant in the
room.” Ergonomics can actually have a positive impact
on addressing issues that obese and bariatric individu-
als may face in the workplace, in addition to the grow-
ing number of injuries that healthcare providers face in
terms of safe patient handling with a larger population.
Body Mass Index (BMI)
BMI stems from the Quetelet Index, which was
originally developed between 1830 and 1850 by
Adolphe Quetelet, a Belgian mathematician/statistician.
BMI is calculated using the individual’s body weight
divided by the square of his or her height (unit of mea-
sure kg/m2). BMI can also be determined using a BMI
chart (Figure 1), which displays BMI as a function of
weight (horizontal axis) and height (vertical axis) using
contour lines for different values of BMI or colors for
different BMI categories.
Several government and health organizations use
BMI to classify individuals as “overweight” and
“obese” in adult populations (CDC, National Institutes
of Health, WHO). BMI categories can vary from coun-
try to country; however, in 1998, the U.S. National
Institutes of Health aligned BMI categories with those
defined by the World Health Organization (WHO).
The World Health Organization 2008 projections
indicate that globally:
•approximately 1.5 billion adults, over the age of 20,
were overweight;
•of these, more than 200 million men and nearly 300
million women were obese;
•WHO further projects that by 2015, approximately
2.3 billion adults will be overweight and more than 700
million will be obese.
During the past two decades, there has been a
marked increase in obesity in the U.S. In 2009,
only Colorado and the District of Columbia had a
By Winnie Ip, CPE
The Growing Problem
in Ergonomics: Obesity
Obesity
Figure 1 BMI Chart With
Classification Systems
prevalence of obesity less than 20% (CDC, 2009).
Thirty-three states had prevalence equal to or greater
than 25%; nine of these states (Alabama, Arkansas,
Kentucky, Louisiana, Mississippi, Missouri, Oklahoma,
Tennessee and West Virginia) had a prevalence of obe-
sity equal to or greater than 30% (CDC, 2009). Figure
2 shows the shift in U.S. obesity prevalence from 1985
to 2009.
BMI as an Indicator for Obesity:
A Good Measure?
The popularity of using BMI as an indicator for obe-
sity stems from research conducted in the 1970s. Keys,
et al. (1972) found BMI to be the “best proxy for body
fat percentage among ratios of weight and height”
and explicitly cited BMI as appropriate for popula-
tion studies and inappropriate for individual diagnosis.
However, due to the simplicity of the equation, BMI
has since become the “norm” to measure a person’s
“fatness” or “thinness” and has been widely adopted in
individual diagnoses.
Source: WHO, 2011

In more recent years, BMI has come under scru-
tiny and is a controversial topic among researchers
and health care professionals. Sample articles and key
points include:
•CNN Health: “Can Neck Measure Indicate Body
Fat Better Than BMI?” (2010)
—Article based on research by
Olubukola, et al. (2010) published
in the journal Pediatrics.
—A wide neck circumference
is associated with obesity-related
conditions, such as sleep apnea,
diabetes and hypertension. Neck
circumference has been explored
in studies for potential obesity and
heart problems in adults.
—One of BMI’s shortcomings is
that it “does not accurately define
central body fatness.”
—Studies have shown that
regional adiposity, fat collected
around the midsection, is often a
good indicator for obesity-related
complications, including hyperten-
sion, diabetes and heart disease.
The correlation between regional
adiposity and a high neck circum-
ference was found to be strong.
•National Public Radio: “Top 10
Reasons Why the BMI is Bogus” (2009.)
—Keith Devlin of Stanford University suggests any
obesity findings based on BMI should be taken with a
grain of salt.
—Quetelet said explicitly that it could not and
should not be used to indicate the level of fatness in an
individual.
—There is no physiological reason to square a per-
son’s height in BMI. Moreover, it ignores waist size,
16
which is a clear indicator of obesity
level.
—It makes no allowance for
the relative proportions of bone,
muscle and fat in the body.
—A high BMI does not mean
an individual is even overweight,
let alone obese. It could mean the
person is fit and healthy, with very
little fat.
•Science Daily: “BMI Not
Accurate Indicator of Body Fat,
New Research Suggests” (2007)
—Article based on research
published in the official journal of
the American College of Sports
Medicine.
—A research team from
Michigan State University and
Saginaw Valley State University
measured the BMI of more than 400 college students—
some of whom were athletes and some not—and found
that in most cases, the student’s BMI did not accurately
reflect his or her percentage of body fat.
—BMI does not distinguish between body fat and
muscle mass.
Causes Consequences
of Obesity
The primary cause of obesity and being overweight
is an imbalance between calories consumed and calo-
ries expended (WHO, 2009). According to WHO
(2009), global increases are attributable to many fac-
tors, including:
•a global shift in diet toward increased intake of
energy-dense foods that are high in fat and sugars, but
low in vitamins, minerals and other micronutrients; and
•a trend toward decreased physical activity due to
the increasingly sedentary nature of many forms of
work, changing modes of transportation and increasing
urbanization.
The environment may also have an impact on obe-
sity. People interact with several different environ-
ments. In the home, people may choose to do activities
that do not lead to caloric expenditure, such as watch-
ing television and other sedentary behaviors. Schools
also impact children; they dictate lunch menus and
how much physical activity children get throughout the
day. The type of work that a person does may affect
the amount of physical activity, for instance, sitting
expends less than 720 calories over 8 hours, whereas
heavy work, such as construction, can expend around
2,400 to 3,600 calories over 8 hours (Sanders, 1993).
Finally, the community may affect people’s choices
about exercise and food. The availability of nutritious
low-calorie food will influence the type of diet avail-
able for an individual.
The environment
may also have an
impact on obesity.
People interact with
several different
environments. In
the home, people
may choose to do
activities that do
not lead to caloric
expenditure, such
as watching televi-
sion and other sed-
entary behaviors.
Table 1
BMI Categories Sample Weights
Category
BMI Range
(kg/m2
)
Weight of a 5 ft 11 in Person With
This BMI
Severely
underweight
less than 16.0 Less than 118 lbs
Underweight from 16.0 to 18.5 Between 118 and 132 lbs
Normal from 18.5 to 25 Between 130 and 178 lbs
Overweight from 25 to 30 Between 180 and 214 lbs
Obese Class I from 30 to 35 Between 210 and 249 lbs
Obese Class II from 35 to 40 Between 250 and 286 lbs
Obese Class III over 40 Over 290 lbs
Source: WHO, 2011

Genes may also play a role in obesity. Some scien-
tific evidence indicates that people may have a higher
risk of becoming obese based on their family history
(CDC, 2009). Many studies have been done on obese
populations and obese families. In general, these
studies have shown that a sizable portion of weight
variation can be explained because of genetic factors.
Narrowing these factors is the current challenge for
researchers and scientists.
People classified as overweight or obese face many
health consequences. Scientists have produced the first
direct evidence that fat accelerates aging. Valdes, et al.
(2005) found that obesity (BMI 30) adds the equiva-
lent of nearly 9 years of age to a person’s body. This
can begin to explain why obese children are develop-
ing adult-onset Type 2 diabetes between ages 10 and
19 (as opposed to age 45 which has been the norm).
Other health consequences include:
•coronary heart disease;
•type 2 diabetes;
•certain cancers (endometrial, breast and colon);
•hypertension;
•dyslipidemia (high cholesterol, high triglycerides);
•stroke;
•liver and gallbladder disease;
•sleep apnea and respiratory problems;
•osteoarthritis;
•gynecological problems (abnormal menses,
infertility).
Physiological Effects of
Obe Range of Motion (ROM)
Obesity depending on the level and distribution of
adipose tissue can affect range of motion (Park, et al.,
2010). Overweight and obese individuals do not have
as much flexibility in their hips or in their back. This
means that obese individuals may have more trouble
reaching objects. Park, et al. (2010) found significant
differences between obese and non-obese groups;
decreased range of motion for shoulder extension (~20
to 22%), shoulder adduction (~36 to 39%), trunk exten-
sion (22%) and trunk lateral flexion (~18 to 20%).
A person’s abdomen may also be an obstruction,
thereby limiting the reach distance at a work surface.
This could also influence working postures. Because of
the limited reach envelope, the individual may need to
compensate with other parts of their body (e.g., shoul-
der abduction, trunk flexion). It is important to note
that these limitations exist for both seated and standing
workstations.
Physiology
Excess fat increases the oxygen requirements
for any given task performed (Wood, et al., 2010).
Therefore, there is a larger physiological deficit
for those who are overweight or obese. This may
reduce the endurance time for this segment of work-
ers. Fatigued workers may show increases in quality
defects or lower production rates. Resting heart rates
are also higher for obese individuals, which can affect
physical work capacity. It can also lead to adverse car-
diac outcomes in the long run, such as heart disease.
Key Workplace
Design Guidelines
We can take a proactive approach to address some
of the particular challenges obese workers face by
keeping in mind the following design guidelines:
•Keep things close. For obese individuals, keeping
things close (i.e., within arm’s reach) becomes even
more important since excess body weight can increase
the forces and loads placed on the spine. Design worksta-
tions and processes to ensure that items are placed within
16” from the edge of the work surface. If items must be
placed further than the recommended 16”, minimize the
time spent in sustained postures at this distance.
•Keep it in the comfort zone. Obese individuals are
more prone to back and knee injuries from excess body
weight so keeping all work tasks within the comfort
Figure 2
U.S. Obesity Prevalence in 1985 Versus 2009
17
Source:CDC,2009

18
(2009). U.S. obesity trends. Atlanta, GA: Author.
Retrieved March 9, 2011, from http://www.cdc.gov/
obesity/data/trends.html.
CDC. (2009). Obesity causes and consequences.
Atlanta, GA: Author. Retrieved March 10, 2011, from
CDC http://www.cdc.gov/obesity/causes/index.html.
Devlin, K. (2009, July). Top 10 reasons why the BMI
is bogus. Retrieved March 9, 2011, from http://www.
npr.org/templates/story/story.php?storyId=106268439.
Eknoyan, G. (2008, Jan.). Adolphe Quetelet (1796-
1874)—the average man and indices of obesity.
Nephrology Dialysis Transplantation, 23(1), 47-51.
Keys, A., Fidanza, F., Karvonen, M.J., Kimura, N.
Taylor, H.L. (1972, Jul.). Indices of relative weight
and obesity. Journal of Chronic Disability, 125(6),
329-43.
Michigan State University. (2007). BMI not accu-
rate indicator of body fat, new research suggests.
ScienceDaily. Retrieved March 9, 2011, from http://
www.sciencedaily.com/releases/2007/03/070305202535.
htm.
Nafiu, O.O., Burke, C., Lee, J., Voepel-Lewis, T.,
Malviya, S. Tremper, K.K. (2010, Aug.). Neck cir-
cumference as a screening measure for identifying chil-
dren with high body mass index. Pediatrics, 126(2),
e306-e310.
Park, W., Ramachandran, J., Weisman, P. Jung,
E.S. (2010, Jan.). Obesity effect on male active joint
range of motion. Ergonomics, 53(1), 102-108.
Sanders, M.S. McCormick, E.J. (1993). Human
factors in engineering and design. New York, NY:
McGraw Hill.
Valdes, A.M., Andrew, T., Gardner, J.P., Kimura,
M., Oelsner, E., Cherkas, L.F., Aviv, A. Spector,
T.D. (2005, June 14). Obesity, cigarette smoking and
telomere length in women. The Lancet, 366(9486),
662-664.
Wood, R.E., Hills, A.P., Hunter, G.R., King, N.A.
Byrne N.M. (2010, March). VO2 max in overweight
and obese adults: Do they meet the threshold criteria?
Medicine Science in Sports Exercise, 42(3), 470-
477.
World Health Organization (2011, Feb.). Obesity
and overweight factsheet. Geneva, Switzerland:
Author. Retrieved March 9, 2011, from http://www.
who.int/mediacentre/factsheets/fs311/en/index.html.
Winnie Ip, CPE, director of consulting and ergonomics engi-
neer for Humantech, manages and implements complex, large-
scale ergonomics programs in a variety of industries, from
automotive to petroleum to food and beverage and printing
industries. She provides technical services, delivers ergonomics
training, establishes management programs and conducts pro-
cess reviews of ergonomics and health and safety programs. Ip
holds a B.S. in Kinesiology from the University of Waterloo in
Waterloo, Ontario. She is also an ASSE member.
Reprinted with permission from the proceedings of ASSE’s
2011 Professional Development Conference.
zone (i.e., knees to shoulders) will help. Design work-
stations and processes to be height-adjustable and min-
imize storing items on the floor; keep all items between
38” and 47” above the standing surface.
•Provide appropriate equipment. Ensure that
equipment and furniture are purchased and/or designed
with expanded capacity in mind (e.g., office and indus-
trial chairs). Most standard chairs have a weight rat-
ing between 225 and 275 lbs. Chairs designed for the
obese individual are more involved than just changing
out the pneumatic cylinder with one rated for a higher
weight; they are also designed to accommodate a larger
profile (e.g., wider seat pan, swivel arm rests).
•Promote variety at the workstation. Standing
workstations have been shown to increase energy
expenditure by 40% versus seated
workstations. Standing just 2.5 hours
out of the day can result in 350 extra
calories burned. Standing worksta-
tions can also have an impact on
compressive force on intervertebral
discs, which can impact occurrence
of low back pain.
•Embrace 5S. This lean manufac-
turing concept has been adopted by
many companies and involves steps
to ensure that workspaces promote
efficiency and productivity (i.e., Sort,
Straighten, Shine, Standardize and
Sustain). Keeping the work area clean
and reducing/eliminating clutter wher-
ever possible will help obese individu-
als maneuver around their workstation
more easily.
Conclusion
In traditional ergonomics pro-
grams, the primary goal is to adapt
the workplace and tools to the capa-
bilities of people. This goal does not change when con-
sidering obese workers. You need only make a slight
shift to accommodate the limitations of obese individu-
als. Do exactly what you are doing today, just do it
better, with more knowledge of the key performance
differentiators within your workforce.
The obesity problem will not go away or resolve
itself anytime soon. Although obese individuals must
take ownership of their health and well-being, we as
professionals in the ergonomics, safety and engineer-
ing realms must also better understand the needs of this
growing population and find solutions so that we can
fit the job to all workers. x
References
Centers for Disease Control and Prevention (CDC).
In traditional ergo-
nomics programs,
the primary goal is
to adapt the work-
place and tools to
the capabilities of
people. This goal
does not change
when considering
obese workers. You
need only make
a slight shift to
accommodate the
limitations of
obese individuals.

19
M
anual patient handling is the primary rea-
son for musculoskeletal injuries in patient
care providers, and the understanding of
the impact of patient handling on the body
leads to a clear understanding why this is
so. When the biomechanical capabilities of the body
are exceeded, injury occurs. To set industry recommen-
dations that decrease the risk of injury to caregivers
from manual patient handling and moving, a patient
lifting weight limit was determined, algorithms and
guidelines for patient handling tasks were developed
and guidelines for the introduction of patient care ergo-
nomics in design and construction were instituted.
Ramifications of Exceeding the
Body’s Biomechanical Limits
Providing Patient Care is High-Risk
In 2007, nursing aides, orderlies and attendants suf-
fered 24,340 musculoskeletal disorders (MSDs) requir-
ing days away from work, the second highest number
in the country while registered nurses experienced
8,580 MSDs, the seventh highest number of MSDs.
The rate of injuries for nursing aides, orderlies and
attendants as a group (252 MSDs per 10,000 workers)
was the highest rate of MSDs for any occupation, more
than seven times the national MSD average (Facility
Guidelines Institute, 2010). However, many patient
handling injuries are not reported, so these numbers
may be misleading and not tell the true story of injuries
to caregivers (Siddharthan, et al., 2006). Some estimate
that caregiver injuries are underreported by at least
50% (Siddharthan, et al., 2006).
The 2003 OSHA Ergonomic Guidelines for Nursing
Homes directly related manual patient handling to the
high rate of injuries in healthcare providers (OSHA,
2003). And, manual patient handling has become even
more problematic over the years as patient acuity lev-
els and weights have increased. With the recognition
of the importance of patient mobilization in the heal-
ing process, these increasingly dependent and larger
patients are moved and handled more often.
For more than 30 years, caregivers were trained
in body mechanics and “proper” lifting techniques to
decrease injuries related to manual patient handling.
However, for those 30+ years, injuries from manual
patient handling continued to increase (BLS, 2001).
Today, evidence demonstrates that no amount of train-
ing in proper body mechanics and lifting techniques
will ever overcome the effects on the body when the
biomechanical limits are exceeded, and lifting patients
has been found to exceed caregivers’ biomechanical
limits (Owen, 2000; Owen
Garg, 1994; Garg Owen, 1994;
Rice, et al., 2009; Marras, et al.,
2009; Nelson, et al., 2003).
Why How
Caregivers Are Injured
When manual patient han-
dling or any other activity that
exceeds a person’s biomechani-
cal capabilities is performed, the
musculoskeletal system is dam-
aged (Waters, 2007). Any part
of the musculoskeletal system
can be affected—muscles, bones,
tendons, ligaments, joints, etc.
The majority of patient handling
injuries are located in the lower
back, but injuries also occur
in the middle and upper back,
shoulders, neck, arms, wrists, and
even the hands and knees.
Most musculoskeletal inju-
ries in caregivers are cumulative
trauma ones, though the majority
are recorded as and considered (incorrectly) acute inju-
ries. In acute injuries, one event results in damage. For
instance, an acute injury may occur when a caregiver is
providing ambulation rehabilitation for a large patient.
If the patient loses his or her balance and falls and the
caregiver attempts to prevent the fall, a muscle may be
torn or a shoulder dislocated.
Nearly all patient handing injuries are cumula-
tive trauma. A cumulative trauma injury results from
the accumulation of microinjuries over time. These
microtears in the muscles or microfractures to the end
plates of spinal vertebrae often progress until severe
damage occurs (Marras, 2000). Microtears to the
muscles result from muscle fatigue when the muscle
is no longer able to produce energy for contraction.
Overexertion for an extended period of time or too
often without adequate recovery will result in muscle
fatigue. Muscle fibers can also be damaged when
exposed to excessive loading or repetitive actions with-
out sufficient recovery periods (Waters, 2008).
Excessive spinal loading is a consequence of lift-
ing heavy loads and even light loads for a long period
of time and/or twisting, bending and other similar
actions. Lifting results in compressive forces on the
spine. Twisting, reaching, bending, pulling and such
motions produce shear forces on the spine. Together or
By Mary Willa Matz, MSPH, CPE
Patient Care Ergonomics
Biomechanical Drivers for Patient Handling Technology Design
musculoskeletal injuries

separately,
these result
in spinal load-
ing (Waters,
2008). When
spinal forces
exceed the
spinal load-
ing capacity,
microfractures
occur in the ver-
tebral endplates
and scar tissue
is formed. This
impacts the flow
of nutrients into
the intervertebral
discs of the spine.
In most tissues, the
body’s blood sup-
ply brings nutrients
to the tissues;
however, inter-
vertebral discs
receive nutrients
only by diffu-
sion through the
vertebral endplate. Nutrients will easily diffuse through
a healthy vertebral endplate into the adjacent disc,
but endplate scar tissue impedes this flow. Without
adequate nutrients, a disc degenerates, and without a
nerve supply to the discs as well as a blood supply,
disc degeneration continues unnoticed until nerve
impingement results in pain and decreased work capac-
ity (Waters, 2008).
Guidelines Algorithms to Decrease
Risk of Injury from Patient Handling
Patent Lifting Weight Limit
To have a quantitative value for understanding
risk from activities that exceed the safe load on the
musculoskeletal system, Thomas Waters, Ph.D., CPE,
adapted the revised NIOSH lifting equation (RNLE)
for patient handling tasks. His calculations led to a
maximum lifting limit of 35 pounds for caregivers lift-
ing patients under the best of circumstances and under
ideal conditions. The “best of circumstances” includes
no tubes, lines, contractures, combative behavior, etc.,
not often found in hospitals and nursing homes with
high-acuity patients (Waters, 2007). Ideal condi-
tions preclude lifting with arms extended, lifting
from near the floor, lifting while twisting or lifting
from the side of the body.
The RNLE is an ergonomic assessment tool that
is used to determine safe lifting weight limits for
two-handed manual lifting tasks. Through inclusion
of quantitative values for specific task variables, the
RNLE calculates a recommended weight limit (RWL).
The RWL is defined for a specific set of task condi-
tions in which the weight of the load could be lifted by
nearly all healthy workers for up to 8 hours without an
increased risk of developing low back pain. These cri-
teria include the load of the object, horizontal distance
of the load from the worker, vertical height of the lift,
vertical displacement during the lift, frequency, dura-
tion, hand-to-object coupling characteristics and angle
of asymmetry (NIOSH, 1994).
However, the RNLE specifically excluded patient
lifting (Waters, et al., 1993). Reasons included the
unpredictability of patients, leading to unexpect-
edly heavy loads when a patient has a muscle spasm,
is combative or resists care, as well as the common
occurrence of patient movement that increases forces
due to acceleration of the load beyond what it would be
when performing a slow, smooth lift of a stable object.
Additionally, estimating the weight lifted is difficult,
especially when more than one caregiver is lifting a
patient, or when a patient has partial weight-bearing
and/or assistance capabilities.
However, Waters determined that the RNLE could
be used to determine the RWL for patient lifting during
some tasks, such as those when the patient is coopera-
tive and can follow directions, the amount of weight
to lift can be estimated, the body and hand positions in
relation to the object lifted do not change, the weight
lifted does not change and the patient is not likely
to make sudden movements during the lift (Waters,
2007).
To modify the RNLE in order to calculate an RWL
for lifting patients, criteria used in the RNLE were
evaluated for how and if they pertained to patient
handling and assumptions were made. One critical
assumption was that, most likely, when lifting patients,
a caregiver is not able to get as close to the patient as
s/he would to a box—the standard NIOSH test item.
Lifting patients often involves reaching out for, as
well as lowering a load (e.g., lowering a patient into
a chair or onto a bed), so the horizontal distance vari-
able would be greater in patient lifting activities. In the
RNLE, the minimum horizontal reach for the RWL is
set at 10 in.; however, for patient lifting, Waters deter-
mined a more appropriate distance of 14.5 in. (Waters,
et al., 1993). Using this modified horizontal distance,
the recommended weight limit would then be 35
pounds for an ideal patient lift.
20
The majority of
patient handling
injuries are
located in the
lower back, but
injuries also occur
in the middle and
upper back,

•reposition in bed: side to side, up in bed;
•reposition in chair: wheelchair or dependency chair;
•transfer a patient up from the floor.
Later, the need for algorithms for bariatric patient
care was determined. These algorithms provide guid-
ance for the following high-risk tasks involving bariat-
ric patients (Nelson, 2001):
•transfer to and from: bed to chair, chair to toilet,
chair to chair or car to chair;
•lateral transfer to and from: bed to stretcher,
trolley;
•reposition in bed: side to side, up in bed;
•reposition in chair: wheelchair or dependency
chair;
•tasks requiring sustained hold-
ing of limbs or access to body parts;
•transporting (stretcher, wheel-
chair, walker);
•toileting;
•transfer patient up from floor.
Soon after release of these algo-
rithms, clinicians from specific
clinical settings recognized the need
for guidance specific to the high-
risk tasks performed as a result of
their special patient populations.
AORN was the first group to devel-
op such individualized guidelines.
The ergonomically high-risk tasks
in the perioperative environment
include both patient handling and
nonpatient care ergonomic guide-
lines (Association of periOpera-
tive Registered Nurses Workplace
Safety Taskforce, 2007):
•lateral transfer from stretcher to
OR bed;
•positioning/repositioning the
patient on the OR
bed to and from the supine position;
•lifting and holding legs, arms and heads for
prepping;
•prolonged standing;
•retraction;
•pushing, pulling and moving equipment on wheels.
NAON then developed guidelines specific to the
orthopaedic clinical environment. The high-risk tasks
found in this clinical setting include the following
(Sedlak, et al., 2009):
•turning patient in bed (side to side);
•vertical transfer of a post-operative total hip
replacement patient;
•vertical transfer of a patient with an extremity cast/
splint;
•ambulation;
•Lifting or holding legs or arms in an orthopaedic
setting.
21
Guidelines Algorithms
for Safe Patient Handling
Research has been conducted in various patient care
environments to identify manual patient handling tasks
that put caregivers at risk for injury, and findings con-
firm that these high-risk patient handling tasks place
excessive biomechanical and postural stress on the mus-
culoskeletal system of caregivers (Nelson, 1996; Nelson
Fragala, 2004; Owen Garg, 1990; Sedlak, et al.,
2009; Association of periOperative Registered Nurses
Workplace Safety Taskforce, 2007; Nelson, et al., 2003).
To give caregivers information to make ergonomi-
cally safe patient handling and movement decisions,
algorithms and guidelines were developed. After
identifying ergonomic hazards in specific clinical envi-
ronments, clinicians and ergonomists collaborated to
develop ergonomic guidelines and algorithms. Most
algorithms and guidelines reflect control measures
for high-risk patient handling tasks, such as patient
lifts and transfers, but some focus on other high-
risk activities found in clinical environments, such
as pushing/pulling beds/equipment. The Veterans
Health Administration (VHA), American periOp-
erative Registered Nurses Association, the National
Association of Orthopaedic Nurses (NAON), the
American Nurses Association and NIOSH were in the
forefront in the development of such guidelines.
The first algorithms for safe patient handling devel-
oped by VHA and the Department of Defense were
released in 2001. These algorithms were developed by
a national team of clinicians who trialed them in all
clinical settings prior to release. These algorithms, for
the first time in the U.S., standardized care in relation
to completion of high-risk patient handling and move-
ment tasks; however, it is important to understand that
the algorithms provide general direction. Caregivers
must use their professional judgment in applying algo-
rithms (Nelson, 2001).
As a first step in using these algorithms, a patient
assessment is completed that provides information on a
patient’s level of assistance, weight-bearing capability,
upper-body strength, level of cooperation and compre-
hension, weight, height and any medical or physical
factors affecting moving and handling. The information
from the assessment is then used to answer questions
found in the algorithms. Answering the algorithm ques-
tions leads a caregiver to find out the number of caregiv-
ers and patient handling equipment needed for a particu-
lar high-risk task based on the unique characteristics of
the patient assessed. The original algorithms were devel-
oped for these high-risk tasks (Nelson, et al., 2003):
•transfer to and from: bed to chair, chair to toilet,
chair to chair or car to chair;
•lateral transfer to and from: bed to stretcher,
trolley;
•transfer to and from: chair to stretcher, chair to
chair or chair to exam table;
After identifying
ergonomic hazards
in specific clinical
environments, clini-
cians and ergono-
mists collaborated
to develop ergo-
nomic guidelines
and algorithms.
Most algorithms
and guidelines
reflect control
measures for high-
risk patient han-
dling tasks.

22
•impact of aesthetics;
•infection control risk mitigation.
Conclusion
Solid science supports the need for biomechanical
control measures, a weight limit for patient lifts, use
of clinical guidelines and algorithms and the institu-
tion of a systematic assessment to ensure that building
design promotes safe patient handling and movement.
Together and separately, these provide critical guid-
ance to ensure safe patient handling, and movement
and the ergonomic safety of our caregivers. x
References
Association of periOperative Registered Nurses
(AORN) Workplace Safety Taskforce. (2007). Safe
patient handling and movement in the perioperative
setting. Denver, CO: AORN.
Bureau of Labor Statistics. (2001). Survey of occu-
pational inquiries and illnesses. Washington, DC:
Author.
Facility Guidelines Institute. (2010). Guidelines
for design and construction of healthcare facilities.
American Society for Healthcare Engineering.
Facility Guidelines Institute. (2010). Patient han-
dling and movement assessments: A white paper.
Retrieved Feb. 28, 2011, from http://www.fgiguide-
lines.org/interim_pubs.html.
Garg, A. Owen, B.D. (1994). Prevention of back
injuries in healthcare workers. International Journal of
Industrial Ergonomics, 14, 315-31.
Marras, W.S. (2000). Occupational low back disor-
der causation and control. Ergonomics, 43(7), 880-902.
Marras, W.S., Knapik, G.G. Ferguson, S.
(2009). Lumbar spine forces during maneuvering of
ceiling-based and floor-based patient transfer devices.
Ergonomics, 52(3), 384-97.
Nelson, A. (1996). Unpublished research data from
pilot study. Tampa, FL: James A. Haley VA Medical
Center.
Nelson, A. (2001). Patient care ergonomics resource
guide: Safe patient handling and movement. Tampa,
FL: Veterans Administration Patient Safety Center
of Inquiry. Retrieved March 1, 2011, from http://
www.visn8.va.gov/visn8/patientsafetycenter/resguide/
ErgoGuidePtOne.pdf.
Nelson, A., Lloyd, J., Menzel, N. Gross, C.
(2003). Preventing nursing back injuries: Redesigning
patient handling tasks. AAOHN Journal, 51(3), 126-
134. Retrieved March 1, 2011, from http://www.aaohn
journal.com/SHOWABST.asp?thing=34518.
Nelson, A.L. Fragala, G. (2004). Equipment
for safe patient handling and movement. Back injury
among healthcare workers. Washington, DC: Lewis
Publishers.
Nelson, A.L., Lloyd, J., Menzel, N. Gross, C.
(2003). Preventing nursing back injuries: Redesigning
patient handling tasks. AAOHN Journal, 51(3), 126-34.
Patient Care Ergonomic Guidelines in the
Design Construction of Healthcare Facilities
Patient care ergonomics, including basic ergonomic
assessment methodologies, institution of resultant
technology control measures and incorporation of
such technology into the design of new and existing
buildings has been found to decrease the incidence of
caregiver injuries, lost time and modified duty days,
while demonstrating a cost/benefit for an organiza-
tion. Patient benefits are also seen. For these reasons, a
patient handling and movement assessment (PHAMA)
was incorporated into the 2010 Guidelines for the
Design and Construction of Health
Care Facilities, and a comprehen-
sive white paper was written to
further explain and provide addi-
tional information for designers and
organizations (Facility Guidelines
Institute, 2010).
The main purpose of the white
paper is to relay information to
assist in ensuring that appropri-
ate patient handling equipment is
introduced and that other conditions
and building attributes support safe
patient handling and movement.
However, further information
needed to be relayed to designers,
building owners, administrators
and others. In addition to supply-
ing in-depth information related
to the PHAMA, the white paper
includes chapters on the rationale
for, and background of patient care
ergonomics, developing a business
case, safe patient handling program
implementation and resources
(Facility Guidelines Institute, 2010).
The PHAMA has two distinct yet interdependent
phases. The first phase includes a patient handling
needs assessment to identify appropriate patient
handling and patient movement equipment for each
clinical area in which patient handling and movement
occurs. The second phase includes definition of space
requirements, and structural and other design consid-
erations to accommodate incorporation of such patient
handling, and movement equipment. Phase 2 includes
the following design considerations:
•structural;
•electrical and mechanical;
•provision of adequate space;
•destination points;
•door openings (sizes and types);
•floor finishes, surfaces and transitions;
•installation coordination;
•storage space;
•impact on environment of care;
Solid science sup-
ports the need
for biomechanical
control measures,
a weight limit for
patient lifts, use of
clinical guidelines
and algorithms and
the institution of a
systematic assess-
ment to ensure that
building design
promotes safe
patient handling
and movement.

23
T.R. (2009). Development of the National Association
of Orthopaedic Nurses guidance statement on safe
patient handling and movement in the orthopaedic set-
ting. Orthopaedic Nursing, supplement to 28(25), 2-8.
Siddharthan, K., Hodgson, M., Rosenberg, D.,
Haiduven, D. Nelson, A. (2006). Underreporting of
work-related musculoskeletal disorders in the Veterans
Administration. International Journal of Health Care
Quality Assurance, 19(6-7), 463-76.
Waters, T.R. (2007). When is it safe to manually lift
a patient? American Journal of Nursing, 107(6), 40-45.
Waters, T.R. (2008, Mar.). Science to support spe-
cific limits on lifting, pushing and pulling, and static
postures. Presentation at the 8th Annual Safe Patient
Handling Conference, Lake Buena Vista, FL.
Waters, T.R., Putz-Anderson, V., Garg, A. Fine,
L.J. (1993). Revised NIOSH equation for the design
and evaluation of manual lifting tasks. Ergonomics,
36(7), 749-776.
Mary Matz, MSPH, CPE, is an internationally recognized
expert in patient care ergonomics. She provides patient care
ergonomic consultation related to ergonomic equipment and
design requirements and safe patient handling program imple-
mentation. She is an active member of the Health Guidelines
Revisions Committee and was the primary author of the patient
handling and movement assessment in the 2010 National
Guidelines for Design and Construction of Healthcare
Facilities.
Reprinted with permission from the proceedings of ASSE’s
2011 Professional Development Conference.
Nelson, A.L., Owen, B., Lloyd, J., Fragala, G.,
Matz, M., Amato, M., Bowers, J., Moss-Cureton,
S.,Ramsey, G., Lentz, K. (2003). Safe patient han-
dling and movement. American Journal of Nursing,
103(3), 32-43.
NIOSH. (1994). Applications manual for the
revised NIOSH lifting equation. Atlanta, GA: Author.
Retrieved March 1, 2011, from http://www.cdc.gov/
niosh/docs/94-110/.
OSHA. (2003). Ergonomic guidelines for nursing
homes. Washington, DC: Author. Retrieved Feb. 28,
2011, from http://www.osha.gov/ergonomics/guide-
lines/nursinghome/final_nh_guidelines.html.
Owen, B. Garg, A. (1990). Assistive devices for
use with patient handling tasks. Advances in industrial
ergonomics and safety. Philadelphia, PA: Taylor
Frances.
Owen, B.D. Garg, A. (1994). Reducing back
stress through an ergonomic approach: Weighing a
patient. International Journal of Nursing Studies,
31(6), 511-19.
Owen, B.D. (2000). Preventing injuries using an
ergonomic approach. Association of periOperative.
Registered Nurses Journal, 72(6), 1031-36.
Rice, M.S., Woolley, S.M. Waters, T.R. (2009).
Comparison of required operating forces between
floor-based and overhead-mounted patient lifting
devices. Ergonomics, 52(1), 112-20.
Sedlak, C.A., Doheny, M.O., Nelson, A. Waters,
Practice specialty members
are highly encouraged to
nominate peers for an award
to recognize their exceptional
work and service. Winners will
be acknowledged at the annual
conference, on the ASSE website
and in press releases. Awards
offered include:
•Council on Practices and
Standards (CoPS) Safety
Professional of the Year
•Ergonomics Practice Specialty
Safety Professional of the Year
To find out more about the
COPS awards program, click
here. x
Awards Honors
Nominations
Best of the Best
ASSE and the Ergonomics
Practice
Specialty would
like to con-
gratulate Jeremy
Harris for his
notable article,
“The Concept of
Universal Design.”
This article was
one of 17 articles selected for inclu-
sion in the 2010-11 Best of the Best
publication. Click here to view this
compilation of technical material.
Click here for more information
on the groups represented in this
publication or click here to add
another practice specialty to your
membership.

and all of the employees, we were able to attain a merit
status, but one of the mandates that came out of that
status was to continuously improve not only our whole
safety program, but our ergonomics program and the
health and wellness initiatives.
In early 2006, I asked my manager to allow me to
take over these programs, and I attended what was to
become more than 175 hours of training from various
organizations via seminars and con-
ferences. I also took advantage of
online offerings and used this training
to begin establishing a viable ergo-
nomics program at Honeywell. The
initial effort was slow to take hold as
there was hesitancy to begin a pro-
gram that had not yet proven itself.
The remainder of 2006 was spent gar-
nering support for the program and
securing equipment to assist in imple-
menting corrective actions found dur-
ing initial ergonomic assessments. At
this point, it required a doctor’s note
to procure equipment for someone
who was experiencing trouble.
In 2007, funding was established
and a sharp increase in the number
of formal assessments began. During
this period, the number of WMSDs
decreased, but the time to implement
corrective actions still was too long.
I was only able to order equipment
once an assessment was done. I had
no in-house stock from which to
pull. Also during this period, we had
OSHA back for our follow-up to gain
our Star status in the VPP, which we
were able to achieve. One thing noted
was the progress in ergonomics and
health and wellness areas. I knew we had a long way to
go to consider this program effective so I kept imple-
menting ideas and asking for more management buy-in
to the effort.
2008-09 were cornerstone years for the program,
as funding was firmly established and we were able to
maintain a limited supply of equipment on hand to make
ergonomic changes more quickly. In many instances, the
ergonomic process was down to a few hours instead of
a few days or weeks. The two key moments during this
period that were crucial in obtaining upper management
buy-in to the program, were assessments conducted on
our program manager and our chief financial manager.
One was experiencing elbow and hand discomfort while
the other had some lower back pain. Assessments were
conducted and changes were made immediately to their
office setups. Each felt relief in less than a week from
minor changes and from there, the program took off.
During this period, WMSDs dropped to one to two
each quarter, but none ever developed into lost time or
workers’ compensation due to the proactive nature of the
program and the corrective actions taken to resolve their
issues. In 2009, I was awarded the HTSI Health, Safety
and Environmental President’s Award for my work in
the areas of ergonomics, and health and wellness. This
award was due mainly to the support I received from my
management team in allowing me to run with this pro-
gram and allowing it to mature into what it is today.
So where are we now? In 2010, we recertified our
Star status in the OSHA VPP, and the ergonomics and
health and wellness programs were cited as best prac-
tices by OSHA and, at a corporate level, by Honeywell.
We have established an ergonomics/wellness lab in our
building, and several safety professionals from around
the Colorado Springs area have toured our facility to
gain insight into what the program entails and how to get
started. The ergonomics lab is set up with two different
adjustable tables (one is powered, the other is manual),
both of which allow me to be more precise in my assess-
ments and to give the customer the opportunity to see
how sit/stand stations could feel before actually reconfig-
uring their own workstation. I also have a large variety
of input devices for people to try out before we install
them.
In 2010 alone, we have saved Honeywell more than
$400,000 in potential direct and indirect costs due to the
program’s proactive nature. The cost to Honeywell for
the corrective actions was just under $5,000. This was
just further validation that the program has begun to real-
ly mature and shows the evolution of the program to one
of proactivity. Innovations, such as the lab and the newly
purchased ergonomic software, will help us dramatically
decrease potential hazards and workplace injuries by
assisting us in designing better layouts for warehouses,
and shipping and receiving areas as well as our office
environment. Our ergonomics/wellness lab now stocks
more than 20 different keyboards and mice, as well as an
assortment of other equipment, such as footrests, moni-
tor and laptop arms and several varieties of ergonomic
chairs. Having all these items readily available allows us
to be proactive and to correct deficiencies in hours.
How does an employee get an ergonomic assess-
ment? For newly hired personnel, it is part of their in-
processing checklist to complete the assessment. Once
they have established their e-mail, they submit a work
request for an ergonomic assessment. I then schedule
the assessment, which contains several steps. I first go
to their office/cube and take initial measurements to see
how they are in the workspace prior to the analysis in
the lab. I then take employees to the lab where we fine-
tune their seated posture and do adjustments to monitors,
surface heights and seat pan heights to get the employees
into a sound neutral position. From there, I have them try
24
From Nothing to Best Practice
continued from page 1
How does an
employee get an
ergonomic assess-
ment? For newly
hired personnel, it
is part of their in-
processing check-
list to complete the
assessment. Once
they have estab-
lished their e-mail,
they submit a
work request for
an ergonomic
assessment. I then
schedule the assess-
ment, which con-
tains several steps.

25
dor. This partnership has allowed me to expand the lab
to three separate setups to give our employees even more
options when they come for an assessment.
The evolution of this program has been remarkable,
and I look forward to growing the program and to shar-
ing this best practice with as many people as possible. I
would like to thank everyone in my management team
that has allowed me to take charge of this program and
grow it over the years from nothing to best practice. x
Keith Osborne retired from the U.S. Army in 2002 after 25 years
of service and currently works for Honeywell Technology Solut
ions Inc.-Colorado Springs (HTSI-COS) as a health, safety and
environmental (HSE) site specialist. His primary duties include
company ergonomic administrator, wellness program administra-
tor, lead emergency first responder and CPR/first-aid instructor/
trainer, personal fitness trainer and building continuity team
member. He is a certified master fitness trainer and has more
than 175 contact hours of ergonomics/biomechanics training. He
received the HTSI HSE President’s Award in 2009 for his work
in ergonomics and wellness, both programs being recognized as
OSHA and Honeywell best practices, and is currently a member
of HFES, AIHA and ASSE. Osborne holds two bachelor’s degrees
from National American University in Applied Management and
Business Administration.
out each input device to
fit them to a mouse and
keyboard. If employees
wish to take a couple
of them back to use for
a while to help narrow
down the best one, they
can do that. The final
step in the lab is to fit
employees to a chair.
We keep several differ-
ent models on hand so
chances are we have one
that will work for them.
If not, we can special-
order a chair if it can
solve a specific issue
and alleviate a potential
issue down the road.
After the lab session,
all data are compiled
and changes/adjustments
to the workstation are
done that day, or the following morning so the employee
can begin work in a station that fits him or her, not the
other way around. Follow-ups are done in 4 to 6 weeks
or sooner if an employee is not comfortable with what
was done.
We have also begun building sit/stand stations. I
began to introduce these to our employees in certain dis-
ciplines to help them be less sedentary in their work and
to improve their overall health. This year alone, 25 sit/
stand stations have been built, and I foresee many more
being completed. The success rate has been phenomenal,
and everyone who has had one built has talked about
their increased energy levels and how they feel more
alert during the day. The increased caloric burn the posi-
tion provides versus sitting all day is a nice benefit as
well.
We also do periodic reassessments based on changes
in a person’s health, reassignment, which causes a
change in location, or an individual’s desire to try a new
setup, such as a sit/stand station. On average, I conduct
35 assessments each month and have expanded the pro-
gram to include our personnel working at our remote site
locations and at our offices in El Segundo, CA.
With the addition of the ergonomic software, we
now have a sound tool in which to evaluate other areas
of our company to maximize worker productivity and
safety, and it is a tool I look forward to learning and
using to assist me in growing the program even further.
Other recent additions to the program include equipment
loaned to me from businesses that provide ergonomic
equipment. These companies have agreed to send equip-
ment for use in the lab where employees can try them
out. If they decide that they want to use them on a per-
manent basis, I order the product for them from the ven-
The evolution of this program
has been remarkable, and I
look forward to growing the
program and to sharing this
best practice with as many
people as possible.

26
Safety 2011 included record attendance
and special events to celebrate ASSE’s
100th anniversary. The Ergonomics Practice
Specialty (EPS) held its annual face-to-face
meeting and also sponsored three sessions.
EPS leadership attended the biannual
Council on Practices Standards meeting
where growth and technological engage-
ment were discussed and the Health
Wellness Branch was approved. EPS vol-
unteers also helped answer questions at
the Practice Specialties booth where free
practice specialties were raffled off, com-
plimentary newsletters were available for
all 28 groups and mouse pads were given
out. Click here for our blog recap of what
happened in Chicago at our biggest and
best conference yet! Click here to order
CD or MP3 audio recordings from Safety
2011 conference sessions. If you were
unable to make it to Safety 2011, please
mark your calendar now for Safety 2012 in
Denver, CO, June 3-6, 2012. x
Safety 2011
Recap

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January 29-February 4, 2012

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