Intro slides

1. Intro to ErgonomicsIntro to Ergonomics
Instructor: Kelly Ingram Mitchell, MPTInstructor: Kelly Ingram Mitchell, MPT
CEASCEAS

2. ErgonomicsErgonomics
Used to design the job to theUsed to design the job to the
worker not the worker to theworker not the worker to the
job….job….

3. Defining ErgonomicsDefining Ergonomics
Official DefinitionOfficial Definition
ErgonomicsErgonomics is theis the
application ofapplication of
scientific informationscientific information
concerning humans toconcerning humans to
the design of objects,the design of objects,
systems andsystems and
environment forenvironment for
human use.human use.
Practical DefinitionPractical Definition
Study of workplaceStudy of workplace
design:design: the study ofthe study of
how a workplace andhow a workplace and
the equipment usedthe equipment used
there can best bethere can best be
designed for comfort,designed for comfort,
efficiency, safety, andefficiency, safety, and
productivity; withoutproductivity; without
sacrifice of quality.sacrifice of quality.

4. Today and ErgonomicsToday and Ergonomics

5. There are Many TypeThere are Many Type
Ergonomic Assessments are ?Ergonomic Assessments are ?
Primary Types are :Primary Types are :
AutoAuto
IndustrialIndustrial
OfficeOffice
Most Common in our Clinical Field :Most Common in our Clinical Field :
OfficeOffice

6. One Size Fits All ? NEVEROne Size Fits All ? NEVER
 National /InternationalNational /International
 MobileMobile
 Surge/Causals/TempsSurge/Causals/Temps
 Training /Roll-outTraining /Roll-out
 Generic Testing SystemsGeneric Testing Systems
verses customverses custom
 Multi-Service CompaniesMulti-Service Companies

7. History of ErgonomicsHistory of Ergonomics
 Earliest evidence of consideration toEarliest evidence of consideration to
occupational illness:occupational illness:
Hippocrates (c. 460-377 BC)Hippocrates (c. 460-377 BC)
 Father of Occupational Medicine:Father of Occupational Medicine:
Bernardino RamazziniBernardino Ramazzini (1633 – 1714)(1633 – 1714)

8. Who is Qualified to PerformWho is Qualified to Perform
Clinician with certificationClinician with certification
Engineer withEngineer with
education/certificationeducation/certification

9. Increased Illness and Injury Rates areIncreased Illness and Injury Rates are
Constant Drivers for :Constant Drivers for :
Safety AwarenessSafety Awareness
Prevention ProgramsPrevention Programs
Applied ErgonomicsApplied Ergonomics
Implementation of ComprehensiveImplementation of Comprehensive
Ergonomics ProgramErgonomics Program

10. The FactsThe Facts
 The Surgeon General reported 60% adults overweight & UnfitThe Surgeon General reported 60% adults overweight & Unfit
 Bureau of Labor Statistics(BLS) ½ WC $ to MSD ;600,000 perBureau of Labor Statistics(BLS) ½ WC $ to MSD ;600,000 per
yr OSHAyr OSHA
 $20billion of Direct Cost of WC ;$1 in Every $3 Spent$20billion of Direct Cost of WC ;$1 in Every $3 Spent
 5X Indirect Cost for Hiring/Training/Recruiting5X Indirect Cost for Hiring/Training/Recruiting
 MSD comprise 1/3 of Occupational inj.MSD comprise 1/3 of Occupational inj.
 Largest job related injury cost in USALargest job related injury cost in USA
 American Industries in 2014 spent over trillion dollars on HCAmerican Industries in 2014 spent over trillion dollars on HC
 151 million workers were covered for disability insurance151 million workers were covered for disability insurance
under the SSDI program at the conclusion of 2013, a 0.2under the SSDI program at the conclusion of 2013, a 0.2
percent increase annuallypercent increase annually

11. Therefore…..Therefore…..
Ergonomics can significantly impactErgonomics can significantly impact
an organizations cost byan organizations cost by
implementing pre and post injuryimplementing pre and post injury
assessments.assessments.

12. Primary Reason For ErgonomicPrimary Reason For Ergonomic
Prevention ProgramsPrevention Programs
 Improves MoraleImproves Morale
 Reduces Risk and Injury by 30%Reduces Risk and Injury by 30%
 Direct Impact is correlated withDirect Impact is correlated with
programprogram
 Decreases exposureDecreases exposure
 Decrease overall medical costDecrease overall medical cost
 Decreases absenteeismDecreases absenteeism

13. The New: PresentismThe New: Presentism
Working but less productive due to health but noWorking but less productive due to health but no
indicators appear because employee is not absentindicators appear because employee is not absent
Result of : Stress/Illness/Medications & NonResult of : Stress/Illness/Medications & Non
Compliance/AbuseCompliance/Abuse

14. 5 Generations at Work5 Generations at Work

15. Aging Work ForceAging Work Force
55 >= 25 % of WF by 202055 >= 25 % of WF by 2020
Lower rates of work-related injuriesLower rates of work-related injuries
Severity and fatalitySeverity and fatality
>65 4x rate fatal events ( 8,11, 18 days)>65 4x rate fatal events ( 8,11, 18 days)
ConsiderConsider
RTW additional instructionRTW additional instruction
Greater integration between recovery of function andGreater integration between recovery of function and
return-to-work medical care with work-based healthreturn-to-work medical care with work-based health
promotion programs ( Step up to RTW)promotion programs ( Step up to RTW)
Metrics of workers’ compensation, medical andMetrics of workers’ compensation, medical and
productivity metrics will facilitate analysis andproductivity metrics will facilitate analysis and
development of best practices.development of best practices.

16. Long Term Disability TrendsLong Term Disability Trends
Male 52%Male 52% Female 48%Female 48%
MSDs #1- DDD, LBP, Sciatica, TendonitisMSDs #1- DDD, LBP, Sciatica, Tendonitis
Age = Increase $Age = Increase $
( $400-$1400 per month SSDI Awards)( $400-$1400 per month SSDI Awards)

17. MSDs, WR-MSDs and ErgonomicsMSDs, WR-MSDs and Ergonomics
 MSD: Musculoskeletal disorders include aMSD: Musculoskeletal disorders include a
group of conditions that involve the nerves,group of conditions that involve the nerves,
tendons, muscles, and supporting structurestendons, muscles, and supporting structures
such as intervertebral discs. WR-MSD:such as intervertebral discs. WR-MSD:
Work-Related Musculoskeletal DisordersWork-Related Musculoskeletal Disorders
 Also called Cumulative Trauma DisordersAlso called Cumulative Trauma Disorders
(CTD), and Repetitive Strain Injuries (RSI),(CTD), and Repetitive Strain Injuries (RSI),
and Repetitive Motion Disorders (RMDs).and Repetitive Motion Disorders (RMDs).

18. What Causes MSDs?What Causes MSDs?
1.1. Restricted Blood FlowRestricted Blood Flow
2.2. Compensatory Muscle RecruitmentCompensatory Muscle Recruitment
3.3. Cellular DegenerationCellular Degeneration
4.4. Applied Pressure to Surrounding NervesApplied Pressure to Surrounding Nerves
General PrinciplesGeneral Principles……

19. Other Upper Extremity MSDsOther Upper Extremity MSDs
 TendonitisTendonitis
 EpicondylitisEpicondylitis
 Tenosynovitis (wrist tendonitis)Tenosynovitis (wrist tendonitis)
 BursitisBursitis
 DeQuervain’s diseaseDeQuervain’s disease
 Trigger FingerTrigger Finger
 Cervical radiculopathy (phone shoulderCervical radiculopathy (phone shoulder
syndrome)syndrome)
 Thoracic Outlet SyndromeThoracic Outlet Syndrome

20. The MarketThe Market
Remember TetrisRemember Tetris
ThumbThumb
““BlackBerry Thumb”BlackBerry Thumb”
““PlayStation Thumb”PlayStation Thumb”
““IPod Thumb”IPod Thumb”
IPad /Cell PhoneIPad /Cell Phone

21. Injury Containment StrategyInjury Containment Strategy
WristWrist
PainPain
CarpalCarpal
TunnelTunnel
SyndromeSyndrome
CarpalCarpal
TunnelTunnel
ReleaseRelease
$250,000$250,000
$14,000$14,000
$8,000$8,000

22. Work Factors Associated with OfficeWork Factors Associated with Office
WR-MSDsWR-MSDs
 High repetitionsHigh repetitions
 Awkward posturesAwkward postures
 Forceful grippingForceful gripping
 Contact stressesContact stresses
 Lifting, lowering, carryingLifting, lowering, carrying
 Pushing, pullingPushing, pulling
 Organizational work factorsOrganizational work factors
 Psychosocial factorsPsychosocial factors
 Cognitive demandsCognitive demands

23. Individual Factors Associated withIndividual Factors Associated with
MSDsMSDs
 AgeAge
 GenderGender
 SmokingSmoking
 Physical ActivityPhysical Activity
 Other Medical Conditions – arthritis, diabetes,Other Medical Conditions – arthritis, diabetes,
vascular disorders, thyroid conditions.vascular disorders, thyroid conditions.
 StrengthStrength
 AnthropometryAnthropometry
 PregnancyPregnancy
Mixed results ofMixed results of
studiesstudies

24. Psychosocial FactorsPsychosocial Factors
Perception of:Perception of:
 Intensified WorkloadIntensified Workload
 Monotonous WorkMonotonous Work
 Limited Job ControlLimited Job Control
 Low Job ClarityLow Job Clarity
 Low Social SupportLow Social Support
Job and WorkJob and Work
EnvironmentEnvironment
Extra WorkExtra Work
EnvironmentEnvironment
CharacteristicsCharacteristics
Of the WorkerOf the Worker
Psychosocial FactorsPsychosocial Factors

25. Non-Work-Related Activity FactorsNon-Work-Related Activity Factors
 At-home computer activitiesAt-home computer activities
 GamesGames
 Chores /HobbiesChores /Hobbies

26. Conceptual Model of Factors thatConceptual Model of Factors that
Potentially Contribute toPotentially Contribute to
Musculoskeletal DisordersMusculoskeletal Disorders
LoadLoad Tissue ResponseTissue Response  OutcomeOutcome
AdaptationAdaptation SymptomsSymptoms

ImpairmentImpairment

DisabilityDisability
Interventions can be implemented anywhere along this pathway.Interventions can be implemented anywhere along this pathway.

27. Ergonomic FactorsErgonomic Factors
Human FactorHuman Factor
Machine / Equipment DesignMachine / Equipment Design
Task DesignTask Design

29. Human FactorsHuman Factors
HFE (or human factors) is the scientific
discipline concerned with the understanding
of interactions among humans and other
elements of a system, and the profession that
applies theory, principles, data and methods
to design in order to optimize human well-
being and overall system performance.

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

31. Factors Leading to HEFactors Leading to HE
1)Skilled Based Behavior1)Skilled Based Behavior
2) Rule Behavior2) Rule Behavior
3) Knowledge Behavior3) Knowledge Behavior

33. Ergonomic GoalsErgonomic Goals
1.1. Prevent unnecessary muscular effort and toPrevent unnecessary muscular effort and to
avoid postures which put a strain on the body.avoid postures which put a strain on the body.
2.2. Reduce work-related musculoskeletal disordersReduce work-related musculoskeletal disorders
(WR-MSDs) by adapting the work to fit the(WR-MSDs) by adapting the work to fit the
person, instead of forcing the person to adapt toperson, instead of forcing the person to adapt to
the work or work station.the work or work station.
3.3. Recommend practical adjustments to theRecommend practical adjustments to the
workstation environment, based on the user’sworkstation environment, based on the user’s
comfort zone.comfort zone.
4.4. Instill trust to the user, so they ‘buy in’ to theInstill trust to the user, so they ‘buy in’ to the
recommendations.recommendations.

34. Principle of Good Ergonomic DesignPrinciple of Good Ergonomic Design
1.1. Human characteristics should be on theHuman characteristics should be on the
front and back end of the design process.front and back end of the design process.
2.2. One size does not fit all.One size does not fit all.
3.3. Consideration should be given to posture,Consideration should be given to posture,
behavior, placement, force, repetition andbehavior, placement, force, repetition and
frequency, and environmental andfrequency, and environmental and
psychosocial factors.psychosocial factors.

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

36. ““Conventional Wisdom”Conventional Wisdom”
vs. Current Ergonomicsvs. Current Ergonomics
DistanceDistance
PlacementPlacement
PosturePosture
SupportSupport
HeightHeight
AngleAngle
UseUse
TaskTask

37. Neutral Body PositionsNeutral Body Positions
 SpineSpine
 ShouldersShoulders
 Upper ArmsUpper Arms
 Forearms and WristForearms and Wrist
 FingersFingers
 HipsHips
 Knees and AnkleKnees and Ankless

38. Work StationWork Station
AssessmentAssessment

39. Job Characteristics are PredictorsJob Characteristics are Predictors
of Riskof Risk

40. Workstation ArrangementWorkstation Arrangement
The WhoThe Who
One – optimize toward the person’s shape,One – optimize toward the person’s shape,
size, and comfort preferencessize, and comfort preferences
Many – Then needs modifiable optionsMany – Then needs modifiable options
– Many – satisfy the extremes and in between.Many – satisfy the extremes and in between.
(95(95thth
% male; 5% male; 5thth
% female). The ability to make% female). The ability to make
daily and frequent adjustmentsdaily and frequent adjustments..

41. Tasks AssessmentTasks Assessment
What kind of work performed will influenceWhat kind of work performed will influence
the type of equipment used and the priority ofthe type of equipment used and the priority of
placement.placement.
– Word Processing – Keyboard and mouseWord Processing – Keyboard and mouse
– Net Surfing – MouseNet Surfing – Mouse
– Data Entry – keyboard bias for numeric keypadData Entry – keyboard bias for numeric keypad
– MachineryMachinery
– DrivingDriving
– LiftingLifting

42. Workstations SurfacesWorkstations Surfaces
 Surface AreaSurface Area
 Areas Under WorkAreas Under Work
SurfaceSurface
1. Desk surface should allow you
to place the monitor directly in
front of you, at least 20 inches
away.
2. Avoid storing items, such as a
CPU, under desks.
3. Desks should be able to
accommodate a variety of
working postures.

43. Work Surface /Station HazardsWork Surface /Station Hazards

44. Workstation SpaceWorkstation Space
Problem: Limited Workstation SpaceProblem: Limited Workstation Space
Hazard: Awkward postures to use equipmentHazard: Awkward postures to use equipment
Solution: Remove clutter, reposition items inSolution: Remove clutter, reposition items in
the proper work zones, removethe proper work zones, remove
unnecessary objectsunnecessary objects

45. Beneath the WorkstationBeneath the Workstation
Problem: Not enough clearance for lower extremitiesProblem: Not enough clearance for lower extremities
or hard surface for prolonged standing or movingor hard surface for prolonged standing or moving
belt for production linebelt for production line
Hazards:.Hazards:.
Solution:Solution:

46. Workstation HeightWorkstation Height
Problem: Too high or too lowProblem: Too high or too low
Hazard: Exposure to compensatory awkwardHazard: Exposure to compensatory awkward
postures, such as placing feet on the casters,postures, such as placing feet on the casters,
sitting on one leg.sitting on one leg.
Solutions:Solutions:

47. Work ZonesWork Zones

48. PosturesPostures
 ““75% of work in industrial countries is performed while75% of work in industrial countries is performed while
seated.”seated.”
 ““Males experience greater interface pressures thanMales experience greater interface pressures than
females.”females.”
 ““Increased (reclined) backrest angles (i.e. angles rangingIncreased (reclined) backrest angles (i.e. angles ranging
from 100 to 120 degrees from the horizontal) havefrom 100 to 120 degrees from the horizontal) have
associated with reduced spinal disc pressure.”associated with reduced spinal disc pressure.”
 ““Disc pressures at 120 degrees were at the lowest, beingDisc pressures at 120 degrees were at the lowest, being
only 50% of those observed at 90 degrees.”only 50% of those observed at 90 degrees.”
““Postural versus chair design impacts upon interface pressure”Postural versus chair design impacts upon interface pressure”; Vos, Congleton,; Vos, Congleton,
Moore, Amendola, and Ringer; Applied Ergonomics 37 (2006) 619-628’Moore, Amendola, and Ringer; Applied Ergonomics 37 (2006) 619-628’

49. Vertebral Compression FactorsVertebral Compression Factors
Four FactorsFour Factors
1.1. Weight of Upper BodyWeight of Upper Body
2.2. Deviation of an erectDeviation of an erect
posture stanceposture stance
3.3. Weight of the loadWeight of the load
4.4. Pull of the lower backPull of the lower back
musclesmuscles

50. Factors Affecting VisibilityFactors Affecting Visibility
 GlareGlare
 Luminance (brightness)Luminance (brightness)
 Amount of LightAmount of Light
 Distance of Eye from Document / MonitorDistance of Eye from Document / Monitor
 Readability of Document / MonitorReadability of Document / Monitor
 Personal VisionPersonal Vision

51. IlluminationIllumination
 Most office spaces rely on florescentMost office spaces rely on florescent
lighting. If approved, increase illuminationlighting. If approved, increase illumination
by using multiple light sources. Use full-by using multiple light sources. Use full-
spectrum light bulbs.spectrum light bulbs.
 Arial font, size 12, black on whiteArial font, size 12, black on white
 No naked light sources – including sunlightNo naked light sources – including sunlight

52. Ergonomic Tips for Vision DeficitsErgonomic Tips for Vision Deficits
 Increase illumination, text size (largerIncrease illumination, text size (larger
screens, bit size), and contrast (monitorscreens, bit size), and contrast (monitor
controls)controls)
 Reduce direct glare and indirect flare (shinyReduce direct glare and indirect flare (shiny
wall surfaces)wall surfaces)
 Avoid color-coding blue-greenAvoid color-coding blue-green
 Lower monitor or machinery if applicableLower monitor or machinery if applicable
height for bi/trifocalsheight for bi/trifocals

53. Who are the team players?Who are the team players?
 HRHR
 SafetySafety
 Partner- Medical/Clinical ConsultantPartner- Medical/Clinical Consultant
 Supervisors/ManagerSupervisors/Manager
 Employee LiaisonEmployee Liaison
 PhysicianPhysician
 Nurse Case ManagerNurse Case Manager
 AdjusterAdjuster
 TPATPA
 CarrierCarrier

54. Outline the Ergonomics Work FlowOutline the Ergonomics Work Flow
PossibilitiesPossibilities

55. Results of Good ErgonomicsResults of Good Ergonomics
  medical costsmedical costs
  compensation claimscompensation claims
  absenteeismabsenteeism
  productivityproductivity
  health and boost employee moralehealth and boost employee morale

56. QuestionsQuestions