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ERGONOMICS

For Partial Fulfillment of Degree Masters of Business Administration (MBA)

Submitted By: HEENA TALWAR M. B. A. 4 TH SEM ROLL NO - 201011018

Project Guide: MRS. JYOTI P SRIVASTAVA

AMRAPALI INSTITUTE OF MANAGEMENT AND APPLIED SCIENCES SHIKSHA NAGAR, LAMACHAUR, HALDWANI (AFFILIATED TO UTTRAKHAND TECHNICAL UNIVERSITY, DEHRADUN)

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(05946) 238201, 238202 (05946) 238205 aimca@vsnl.com

Shiksha Nagar, Lamachaur, Haldwani 263 139 (Nainital) Uttarakhand

TO WHOM SO EVER IT MAY CONCERN

This

is

to

certify

that

this

project

work

titled

. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Submitted by . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. .of MBA IV Semester for partial fulfillment of award of the degree of Master of Business Administration was carried out by him/her under my guidance. He/She was sincere in putting efforts to present this project report.

(Name of Project Guide).. . . . . . . . . . . . . . . . . . . . . Designation________________________________ Department of Management Studies.

STUDENT DECLARATION

I HEENA TALWAR student of MBA IV sem. of AMRAPALI INSTITUTE hereby declare that this project report ERGONOMICS is written and submitted by me under the guidance of MRS. JYOTI P SRIVASTAVA is my original work. The entire analysis and conclusion of this report are based on the information which is collected by me during the training period. The empirical finding in the report are based on the data collected myself while preparing this project. I have not copied any thing from any source or other project submitted for the similar purpose, if any. Name HEENA TALWAR

ACKNOWLEDGEMENT

I readily acknowledge my indebtness to my parents whose support, dedication and honest efforts have given me an immense help in doing this project. I take the opportunity to thank to Mrs. Jyoti p srivastava for motivating, encouraging, guiding and supporting at every step and sparing her valuable time for me. Last but not the least I express my sincere thanks to all beloved and respectable persons who helped me and could find any separate mention. Above all I praise GOD the most beneficial, the most merciful that I have been able to complete my training project successfully.

PREFACE

The Human Factors and Ergonomics Society (HFES) is now rapidly approaching its fiftieth year of existence. At the time of its founding, human beings had not yet ventured into space and computers were large, room-sized entities requiring squads of people to program, operate, and maintain. The world was just recovering from a disastrous global war, and farsighted scientists were beginning to explore the opportunities for peaceful exploitation of the technologies that had been developed in the heat of battle (Bush, 1945). Into this flux came the birth of a new professional organization made up largely of those who sought to create a better postwar world by matching technology to humans rather than the other way around. Reading the classics of that era, such as Chapanis, Garner, and Morgan (1949); Craik (1947, 1948); and Licklider (1960), one can sense the atmosphere of excitement, the air of opportunity, and the burgeoning of hope. In particular, Taylor (1957) proposed that the marriage of engineering and psychology could be more than simply a meeting of different disciplines. He speculated, "in starting to contribute to the design of machines, psychologists have begun theoretically and pragmatically to pull together the psychological and physical sciences. Just how far they can be moved toward one another at the concept level has yet to be seen."

CONTENTS

Certificate Declaration Acknowledgement Preface CHAPTER I Introduction Objectives of study Methodology Chapter arrangements CHAPTER 2: Introduction Definition What is Ergonomics? History Using Ergonomics CHAPTER 3 : Basic Ergonomics Principles A. Workstation B. Sitting and Chair design C. Standing workstation D. Hand tool and control E. Heavy physical work F. Job design G. Ergonomic accessories 30-33 33-36 37-39 39-43 44-46 46 47
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9 10 11 12

15 15-18 19-20 21-28

CHAPTER 4 : Disorders and Its Preventions

Common injuries / diseases Type of MSDs Role of health and safety representatives. Ergonomics risk factors Hazard control strategies Suggestions for small amenities CHAPTER 5 :

49-52 53-57 58-60 61-64 64-66 67-68

Conclusions Recommendations Limitation Bibliography CHAPTER 6 : Appendix

70 71-80 81 82

Appendix I: Job design checklist Appendix II: What do you think if you think you have a cumulative trauma disorder? Appendix III: Evaluate your job for risk factors Appendix IV: Controlling vibration hazards, health surveys: whole body vibration and hand - arm vibration. EXERCISE :

83-84

85 86 87 88-91

Identifying problems and developing solutions to ergonomic problems.

92-96

CHAPTER-1

Introduction Objectives of study Methodology Limitations of the study Chapter arrangements

INTRODUCTION At its simplest definition ergonomics literally means the science of work. So ergonomists, i.e. the practitioners of ergonomics, study work, how work is done and how to work better.It is the attempt to make work better that ergonomics becomes so useful. And that is also where making things comfortable and efficient comes into play. Ergonomics is commonly thought of in terms of products. But it can be equally useful in the design of services or processes I used the methodology of collecting secondary data through the books and internet. At the completion of the project work, I have made my best efforts to summarize the same in the report so that my report may act as imparting proper understanding, knowledge & detail for all readers.

OBJECTIVE

Objectives of my dissertation project are: (1) To explain what ergonomics means; (2) To explain some of the ways ergonomics can be used to improve working environment; (3) To state some common health problems that can result from poor ergonomic environment in the workplace; (4) To describe some basic ergonomic principles of work which involves sitting, standing, or using tools; (5) To describe some basic ergonomic principles for heavy manual work; (6) To state several recommended principles of job design.

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RESEARCH METHODOLOGY

Research Objective Type of Research Type of Data :

: To learn various techniques of ergonomics : Exploratory research

Secondary Data: E-books, company website, etc. Source Of Data SECONDARY DATA: Sources of information are attained indirectly. Such data are attained

generally published and unpublished documents like personal documents and the records available with HRD Department. And some data I collected from the Internet

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Chapter arrangement

CHAPTER-1 This chapter of the project report includes the introduction, objective, and sample size, period of study, methodology, and limitation of the study. CHAPTER-2 This chapter of the project includes the definition of ergonomics, its use and its CHAPTER-3 This part of project report includes the basic ergonomics principles, which includes work station, sitting and chair design, standing work station, hand tool and control etc.

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CHAPTER 4 In this part of the project report I included some disorders and its preventions CHAPTER- 5 This part of the chapter includes conclusion, recommendations, limitations and bibliography

ERGONOMICS: An Emerging Science To Enhance Working Environment Of Indian Corporate Houses

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CHAPTER 2: Introduction

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Definition What is Ergonomics? History Using Ergonomics

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INTRODUCTION:

Ergonomics is sometimes referred to as human factors. Not everyone really understands what ergonomics is, what it does, or how it affects people. It is aimed at anyone who has a duty to maintain and improve health and safety and who wants to gain insight into ergonomics. DEFINITION According to International Labour Organization, ergonomics is the application of the human biological sciences in conjunction with engineering sciences to the worker and his working environment, so as to obtain maximum satisfaction for the worker and at the same time enhance productivity.

WHAT IS ERGONOMICS? Ergonomics is a science concerned with the fit between people and their work. It puts people first, taking account of their capabilities and limitations. Ergonomics aims to make sure that tasks, equipment, information and the environment suit each worker.

To assess the fit between a person and their work, ergonomists have to consider many aspects. These include: the job being done and the demands on the worker; the equipment used (its size, shape, and how appropriate it is for the task); the information used (how it is presented, accessed, and changed); the physical environment (temperature, humidity, lighting, noise, vibration); and the social environment (such as teamwork and supportive management).

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Ergonomists consider all the physical aspects of a person, such as: body size and shape; fitness and strength; posture; the senses, especially vision, hearing and touch; and the stresses and strains on muscles, joints, nerves.

Ergonomists also consider the psychological aspects of a person, such as: mental abilities; personality; knowledge; and experience

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By assessing these aspects of people, their jobs, equipment, and working environment and the interaction between them, ergonomists are able to design safe, effective and productive work systems. More and more work today is being done by machines. This increase in mechanization and automation often speeds up the pace of work and at times can make work less interesting. On the other hand, there are still many jobs that must be done manually, involving heavy physical strain. One of the results of manual work, as well as the increase in mechanization, is that more and more workers are suffering from backaches, neckaches, sore wrists, arms and legs, and eyestrain. Ergonomics is the study of work in relation to the environment in which it is performed (the workplace) and those who perform it (workers). It is used to determine how the workplace can be designed or adapted to the worker in order to prevent a variety of health problems and to increase efficiency; in other words, to make the job fit the worker, instead of forcing the worker to conform to the job. One simple example is raising the height of a work table so that the worker does not have to bend down unnecessarily to reach his or her work. A specialist in ergonomics, called an ergonomist, studies the relation between the worker, the workplace and the job design. There are many obvious benefits of applying ergonomics in the workplace. For the worker, the benefits are healthier and safer working conditions. For the employer, the most obvious benefit is increased productivity. Ergonomics is a broad science encompassing the wide variety of working conditions that can affect worker comfort and health, including factors such as lighting, noise, temperature, vibration, workstation design, tool design, machine design, chair design and footwear, and job design, including factors such as shift work, breaks, and meal schedules. The information in this Module will be limited to basic ergonomic principles for sitting and standing work, tools, heavy physical work and job design.

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For many workers in developing countries, ergonomic problems may not be high on the list of priority health and safety problems they face. However, the large and increasing numbers of workers affected by poor work design make ergonomic issues important. As a result of the importance and prevalence of health problems related to a lack of ergonomics at work, these issues have become points of negotiation for many unions. Ergonomics applies principles of biology, psychology, anatomy and physiology to remove from the work environment the conditions that may cause workers to experience discomfort, fatigue or poor health. Ergonomics can be used to prevent bad design from being built into a job if applied when a job, tools or workstations are being set up. For example, a worker's risk of developing musculoskeletal injuries can be greatly reduced, or even eliminated completely, if he or she is provided with properly designed hand tools from the time he or she begins a job requiring the use of hand tools. It is only in recent years that some workers, trade unions, employers, manufacturers, and researchers have begun to give attention to how workplace design can affect the health of workers. Without the application of ergonomic principles, tools, machines, equipment and workstations are often designed without much consideration of the fact that people are of all different heights, shapes and sizes, and have different levels of strength. It is important to consider these differences in order to protect worker health and comfort. Without the application of ergonomic principles, workers are often forced to adapt themselves to poor working conditions.
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HISTORY OF ERGONOMICS As all sciences, the root of the study of ergonomics is also believed to have started with the process of human evolution itself. The quest to search for the natural fit between the humans and their tools is assumed to have started in the early stages of the development of the human species. Pre-historic men discovered and engineered many different tools to fit their needs of bare necessities like hunting and eating. The study of creation of everyday instruments like hammers and axes followed as we developed from century to century. With time the tools were engineered with understanding and study to make them work better for us. Later in the industrial age, people invented more sophisticated machines and equipment to improve working mechanism to yield better product output. The relationship between the factors of human occupational injuries and engineering of work tools is found to have been documented long time ago. It proves that work in the field of ergonomics had been started centuries ago. The term ergonomics however, came up in 1857 in a philosophical writings of Wojciech Jastrzebowski. In 19th century, Fredric Winslow Taylor introduced 'Scientific Management' proposing ways to improve productivity in factories. Frank and Lilian Gilberth built on that principal to develop 'Time and Motion Studies' theory in the 1900s. The theory deals with ways to improve performance by cutting down unnecessarily steps and improving tools in a factory production line. World War II is said to be an important catalyst in the rapid growth of the study of ergonomics. It incited greater interest in human-machine interest. The period saw the development of complex machinery and weaponry. People understood more clearly the importance of the role played by factors like decision making, situational awareness and hand-eye coordination of the workers or machine operators, for the successful conclusion of a given job. A lieutenant in the US army, Alphonse Chapanis, found out in 1943, that human error in air traffic accidents could be reduced to a great extent by changing the control panel design to make it simple, logical and hence, easy to operate. With that started the research on relationship between muscle force and manual task, cardiovascular reaction in heavy work performance, maximum work load that can be carried out etc. The field of study grew further in later centuries to encompass human attributes like decision making process, design of the organization, design-perception relation and human behavior.
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These came to be known as the human factor, or cognitive ergonomics. Industrial ergonomics was coined to refer to the field of study involving physical aspect of the work space. As we reach this day and age, ergonomics is a complex science of a combination of physics, biology, psychology, engineering, design, management etc. Experts working in the further development of the subject are the student of all these different field of studies. It involves understanding ways to provide greater safety, health and comfort in the work space. The discipline works to study and improve the techniques in making human performance better and yielding optimum output by re-structuring and rearranging of office equipment, furniture, process, management style etc When we began writing about Ergonomics more than 30 years ago, we were simply attempting to bring more scientific perspective to a common sense issue. If you consider the capabilities and limitations of the worker in the design of the workplace, the worker will be more productive and that productivity contributes to profit. At the time we had no idea that the topic of ergonomics would become so widely discussed, by so many people, in so many professions, with so many agendas. Despite all of the politics and hoopla, our view today is the same as it was 30 years ago. The practical application of ergonomic principles is core business proposition. Yes, it is about reducing worker fatigue and the risk of worker injury, which are very worthwhile objectives. However, the real desired benefit driving factory or warehouse investment is increased productivity and an improved bottom line. That's what investment in practical ergonomics produces and that is the point we have been making for decades. Improvement in productivity from the use of ergonomic equipment is easier to achieve and more important than ever. Lean manufacturing requires minimizing material handling and any approach to the products described in this website can do just that. In an effort to demonstrate that ergonomic equipment will "pay for itself" we have developed a simple cost justification wheel. It shows how percentage gains in productivity can usually provide full payback of equipment costs in just a few months. If you would like a ROI wheel, just give us a call and we'll be happy to send you one.

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USING ERGONOMICS How do we use ergonomics? Ergonomics incorporates elements from many subjects including anatomy, physiology, psychology and design. Agronomists apply their diverse knowledge to ensure that products and environments are comfortable, safe and efficient for people to use. Ergonomics can be used in every possible sphere of our lives. But we have tried to focus on some of the important aspects, where ergonomics should not be ignored.

For that purpose we have divided the usability of ergonomics into the following sections:

Ergonomics and the Computer User

Why is it Important? The personal computer is rapidly becoming a common household item and is now a necessary tool for all small businesses. There is a growing segment of the population that uses the computer exclusively for its vocation and it is in this group that we have begun to see the physical effects of spending long hours day after day at the computer. With improvements in technology the computer users are positioned to perform more and more functions without leaving their workstation. Here are some of the ergonomic ways to ensure that the using of the computer doesnt prove fatal to your health. Machine Set-up

Visibility:-

You must be able to see what you are doing easily to avoid eye strain

and neck pain. Have adequate amounts of light. Florescent lights are not very good, natural (sun) light is best. Reduce glare as much as possible, not only on your screen but also on the rest of your work areas including the keyboard. Hoods, drapes, glare screens and changing the lights can do wonders. Rearrange things until you can see well and it feels comfortable for you.
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Chairs:-

As with visibility factors, experiment with chair height and/or tilt. Try

different chairs. Keep trying until you get it the way your body likes. Keyboards:Be sure to get the height right to prevent too much bend at the wrist

and allow the forearm to have some support. The arms should hang loose to prevent the shoulder muscles from cramping. Many keyboards can tilt; unfortunately, most of them tilt the wrong way. Mouse:The continual clicking and small, precise motions involved in mouse use

are a repetitive action that can be a health hazard. A few basic rules can help make handling this convenient input devise safer and more comfortable: Hold the mouse loosely. "White knuckling" the mouse creates too much tension. Use a light touch when you click. Use you whole arm and shoulder to move the mouse, not just your wrist. Don't rest your forearm on the desk while you move the mouse. Keep your wrist relaxed and neutral, not bent. The click button should be about the same height as your keyboard.

Desks:

Make enough space so that you have room to work, especially if your

pushing your mouse around. Use a paper holder to keep letters or books semi-vertical and at eye level. Your work space should be set up so that you need not twist your neck. HUMAN SET-UP

Posture:-

No one posture is perfect. You do not have to be "military" but getting

comfortable is essential. The most important rule is to avoid prolonged positions. Shake your hands and shoulders now and then. Keep lose. Eyes:After good lighting and avoiding glare, the most important eye

consideration is to look away from the screen occasionally. It really helps. Also, don't forget to blink. Blinking moistens the eyes to prevent burning from dryness.

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Warm up:-

Just as an athlete prepares for the game by stretching and loosening

the joints and muscles to prevent injury and enhance performance, you too should prepare for a marathon session surfing the Net. Prevention is better than repair.

Ergonomics and driving

Why is it important? As our reliance on the automobile increases due to long distance job commutes driving has become a significant part of our daily routine. By spending more and more time in cars our driving can now be considered a major source of physical and psychological stress in day-today living. Stressors of Driving The challenge of the manufacturer is to strike a balance between safety and comfort. With the prime ergonomic elements being posture, force and repetition it is posture that is most important to the driver. Any deficiencies in postural design of the car seat contribute to tension and fatigue on the part of the driver and subsequently detract from performance. There are portable support systems/commuter supports designed to be added to the existing car seating. These compensate for ineffective car seat design. Neck and Shoulder Pain With long distance driving aches and pains in the legs, low back, mid, upper back and neck are experienced. With our hands on the steering wheel and the forward posture of the shoulders there is added stress on the shoulders and upper back. To prevent rounding of the shoulders the driver must have easy access to the steering wheel without having to fully extend the arms and at the same time comfortably reach the foot pedals without having to stretch the legs. Compact vehicles are notorious for poorly accommodating tall individuals. If the ceiling is too low for an erect seated position the driver is forced to crunch down in the seat with a forward head posture. Short drivers must be able
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to slide the seat forward to the extent that they do not have to lean forward and place the head in a forward position. Low Back Pain Several studies have shown a relationship between driving and low back pain. Risks of both low back and neck pain tend to increase as daily driving time increases For people with a history of low back problems it is recommended that they choose a vehicle with a higher curb height so they are not traumatized when getting in and out of the car. The driver should enter the car first by sitting down and then swinging the legs under the wheel. Features that are included in most modern vehicles include automatic transmissions and power steering. These features lessen any twisting of the spine and strain to the low back. Ergonomics at home

Why is it important? The opportunity we have in our home that we do not always have in our work area is the ability to create a user-friendly environment. As each room in the house serves a specific function we need to come up with ideas on how we can set up the room to best suit our needs so there is more efficiency and less stress in the activities of the house. The Living Room The next room we enter is the living room. This is the room in which we usually do most of our relaxing in the form of reading, socializing or watching TV. These activities require ergonomically designed couches, recliners and chairs. Watching television is best done from an easy chair or recliner. Directional light should be used while reading that will only illuminate a specific target area. The Kitchen The kitchen is where we store, cook and prepare food. It is most practical to use a refrigerator that has a freezer on the bottom with the most commonly used foods on the top or shelf that has the easiest access. Most people have refrigerators that are set up in such a way that they are forced to bend over at the waist to access the much frequently used foods. The most commonly used utensils should be within easy reach. Special kitchen tool designs make
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chores easier as in opening jars. Professional cooks like professional wood workers know the importance of using only sharp knives. When used skillfully, it is more dangerous to use a dull knife than a sharp one. Using a utensil that is not suited for the task (improvising) is a sure invitation to an accident.

The bathroom This is where most accidents in the house occur, usually from slipping. Bath and floor mats that provide good traction are essential for the purpose of preventing slips and falls. Hand bars are also crucial to prevent falls. Common flaws in bathroom design are low bathroom sinks and showerheads. These will tend precipitate low back and neck injuries respectively. All faucets in the house should be fitted with a user-friendly variety in which low force is necessary to turn the water on and off. Turning knobs that are poorly designed can put unnatural stress on the wrists thereby causing injury to wrist tendons. Ergonomics and kids

Why is it important? If we provide for their ergonomic needs we can increase childrens involvement in their environment and thereby cultivate mastery, productivity and independence. A Place for Toys Children work at play and toys are their tools. They should have their toys and things stored in such a way that they are readily accessible. If their toys are organized in open shelves or in transparent bins children are visually reminded of what they have and as a result will stay involved and interact more with their physical surroundings The area of play is close to the ground and it should be safe from hazards and easy to clean. Since young children spend most of their time close to the ground they should have their own throw rug to protect the knees and provide a cushion from falls. Kids and Backpacks

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Research is significant in view of the fact that school children are being burdened with heavier backpacks than ever before. Health care professionals are reporting increases in visits by children for various musculoskeletal complaints such as neck, back and shoulder pain, fatigue, muscle pain and numbness. Bags that are carried in one hand also put an uneven burden on the body. The pack should rest against the body naturally and the straps should be padded and as wide as possible.

Furniture for Children Chairs and tables must be proportionate to their size and the feet should be firmly planted on the ground or at least on a footrest. It is most practical to have furniture that can grow with the child. These include tables that have adjustable legs and chairs that have adjustable seats and footrest height. Ergonomics and the office

Why is it important? By incorporating ergonomic principles into the functional design of a contemporary office, the workers become more productive and efficient. Each worker's tasks center around a workstation and the configuration of the workstation depends on the performance duties of each worker. Workstation The goal for each worker should be to maximize productivity and efficiency with minimal stress and injury. In a modern day office the centre of the worker's activity revolves around a computer, desk and chair. The application of ergonomics is most important to the activities that make up the bulk of the workers time. To prevent the worker from wasting energy by moving in and out of a chair, space must be used efficiently. The working area can be divided into zones. Zone 1 is the area containing materials most frequently accessed and therefore within a 12-inch reach. Those materials less frequently used are in zone 2 or within a 20-inch reach. Those materials that are seldom used are in Zone 3 or greater than 20 inches away from the worker. The idea is to use shelving and cubicles that are compactly designed to organized things into respective zones. Sometimes it
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is necessary to organize shelving into portable units such as carts with casters. For ease of operation these casters should have low rolling resistance and a centralized locking system. Unnecessary motions interrupt a smooth workflow and expend wasted energy. They also cause cumulative trauma to the back, neck and shoulders. Stretches and exercises can be performed at the workstation without disrupting the work routine. By taking a proactive role in initiating ergonomic programs the business bottom line is enhanced through worker productivity and decreased healthcare costs.

Ergonomics and factory/assembly work Factory and assembly line type work is a carryover from the industrial revolution and has evolved over the years as a result of our increasing knowledge of ergonomics. The requirements of the work are extremely varied and the resulting consequences on human health can range from repetitive or cumulative trauma disorders to death. For this reason it is essential for companies to establish ergonomic programs for ensuring the safety, efficiency, and productivity of various jobs. It is a natural goal of these companies to minimize job related health costs and personnel turnover and to maximize productivity by workers. To this end it is important for companies to develop an overall ergonomic strategy as an integral part of their business strategy. Specifically these companies must come to understand how human performance issues contribute to production bottlenecks, problems in quality control, injury and turnover rates and how they can find solutions through production layout and tool design. Work Surfaces A worker is certain to get neck, upper back and shoulder pain if neck flexion exceeds 20 degrees for prolonged periods of time. The optimal viewing range is between horizontal and 45 degrees. Work surfaces should be round and padded where elbows, forearms and wrists can be rested. Certain work stations aids include ladders, stools and carts with casters ergonomically designed with low rolling resistance which have shock absorbing and noise free characteristics. They should have central locking systems and be equipped with proper push/pull assists.

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Ergonomics and Automotive Mechanics

Why is it Important? The work of auto mechanics is particularly awkward and demanding and frequently results in abuse to the wrists, elbows, and spine in general. The workers body is forced to conform to the various engine configurations and auto design. Automobiles have evolved over the last few years toward smaller and more compact machines and as a result the mechanics tools have had to undergo a refinement in ergonomic design to function in very confined space. Working under the Hood In applying ergonomics to work we normally think of fitting the task to the human but unfortunately in mechanic work we tend to fit the human to the task. The result is cumulative trauma from long hours of awkward static postures. The mechanic is forced to lean forward while working under the hood of the vehicle and this leads to low back strain. One way to work on engine parts under the hood that are particularly difficult to reach is by utilizing a special overhead creeper which consists of a padded chest board that is supported on top of a ladder-like apparatus. The Mechanic Workstation The mechanics job is facilitated by setting up the workstation in a way that tools can be accessed quickly and without an unnecessary expenditure of energy. To minimize the low back strain that results from manual lifting and carrying heavy engine parts and tools, sturdy utility carts with casters should be used as a means of transport. The casters should have low rolling resistance with shock dampening and noise free characteristics. Tool carts with trays should be organized into a system which arranges the most frequently used tools within easy reach. The tools should be easily modified and portable depending on the nature of the job at hand.

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CHAPTER 3

: Basic Ergonomics Principles H. Workstation I. Sitting and Chair design J. Standing workstation K. Hand tool and control L. Heavy physical work M. Job design N. Ergonomic accessories

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BASIC ERGONOMIC PRINCIPLES

It is generally most effective to examine work conditions on a case-by-case basis when applying ergonomic principles to solve or prevent problems. Sometimes even minor ergonomic changes in the design of equipment, workstations or job tasks can make significant improvements in worker comfort, health, safety and productivity. The following are a few examples of ergonomic changes which, if implemented, can result in significant improvements:

For assembly jobs, material should be placed in a position such that the worker's strongest muscles do most of the work. For detailed work which involves close inspection of the materials, the workbench should be lower than for work which is heavy.

Hand tools that cause discomfort or injury should be modified or replaced. Workers are often the best source of ideas on ways to improve a tool to make using it more comfortable. For example, pliers can be either straight or bent, depending on the need.

A task should not require workers to stay in awkward positions, such as reaching, bending, or hunching over for long periods of time.

Workers need to be trained in proper lifting techniques. A well designed job should minimize how far and how often workers have to lift.

Standing work should be minimized, since it is often less tiring to do a job sitting than standing.
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Job assignments should be rotated to minimize the amount of time a worker spends doing a highly repetitive task, since repetitive work requires using the same muscles again and again and is usually very boring.

Workers and equipment should be positioned so that workers can perform their jobs with their upper arms at their sides and with their wrists straight.

A. Workstation A workstation is the place a worker occupies when performing a job. The workstation may be occupied all the time or it may be one of several places where work is done. Some examples of workstations are work stands or work tables for machine operation, assembly or inspection; a work table where a computer is operated; a control console; etc.

A well designed workstation is important for preventing diseases related to poor working conditions, as well as for ensuring that work is productive. Every workstation should be designed with both the worker and the task in mind so that work can be performed comfortably, smoothly and efficiently. If the workstation is properly designed, the worker should be able to maintain a correct and comfortable body posture. This is important because an uncomfortable work posture can cause a variety of problems, such as:

back injury; development or aggravation of RSIs; circulatory problems in the legs.

The main causes of these problems are:


poorly designed seating; standing for long periods; reaching too far; inadequate lighting forcing the worker to get too close to the work.

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The following are some basic ergonomic principles for workstation design. A general rule of thumb is to consider body size information, such as height, when choosing and adjusting workstations. Above all, workstations must be adjusted so that the worker is comfortable.

Workstation

Head height

Allow adequate space for the tallest possible worker. Position displays at or below eye level because people naturally look slightly downward.

Shoulder height

Control panels should be placed between shoulder and waist height. Avoid placing above shoulder height objects or controls that are used often.

Arm reach

Place items within the shortest arm reach to avoid over-stretching while reaching up or outward.
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Position items needed for work so that the tallest worker does not need to bend while reaching down.

Keep frequently used materials and tools close to and in front of the body.

Elbow height

Adjust work surface height so that it is at or below elbow height for most job tasks.

Hand height

Make sure that items that have to be lifted are kept between hand and shoulder height.

Leg length

Adjust chair height according to leg length and the height of the work surface. Allow space so that legs can be outstretched, with enough space for long legs. Provide an adjustable footrest so that legs are not dangling and to help the worker change body position.

Hand size

Hand grips should fit the hands. Small hand grips are needed for small hands, larger grips for bigger hands. Allow enough work space for the largest hands.

Body size

Allow enough space at the workstation for the largest worker.

B. Sitting and chair design Sitting

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If a job does not require a great deal of physical strength and can be done in a limited space,then the work should be done in a sitting position. The following are some ergonomic guidelines for sitting work:

The worker needs to be able to reach the entire work area without stretching or twisting unnecessarily. A good sitting position means that the individual is sitting straight in front of and close to the work.

The work table and the chair should be designed so that the work surface is approximately at the same level as the elbows.

The back should be straight and the shoulders relaxed. If possible, there should be some form of adjustable support for the elbows, forearms or hands.

The working position should be as comfortable as possible. The arrows indicate areas that need to be improved to prevent potential injuries from developing. To improve the sitting position for the worker on the right, the chair height should be lowered, tilted slightly forward and the worker should be provided with a footrest.

The work chair A proper work chair needs to satisfy certain ergonomic requirements. Use the following guidelines when choosing a chair:
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The work chair should be appropriate for the job being performed and for the height of the work table or workbench. Ideally the seat height and the backrest height should be adjustable separately. The backrest tilt should also be adjustable.

The chair should allow the worker to lean forward or backward easily. The worker should have adequate leg room under the work table and should be able to change the position of the legs easily.

The feet should be flat on the floor. When this is not possible, the worker should be provided with a footrest. A footrest will also help to eliminate pressure from the back of the thighs and knees.

The chair should have a backrest which supports the lower back. The seat should curve slightly downward at the front edge. Ideally, the chair should have five legs for stability. It is preferable if arm rests are removable since some workers do not find them comfortable. In any case, arm rests should not prevent the worker from getting close senough to the work table.

The chair should be covered with a breathable fabric to prevent slipping off the chair.

On some jobs arm supports and rests may reduce arm fatigue.

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Much of the above information may be somewhat idealistic for most workers, particularly workers in developing countries. However, it is essential that workers and their representatives understand that many health and safety problems are related to the nonapplication of ergonomic principles in the workplace. By understanding the importance of ergonomics, workers can start to improve their work situation, especially if management understands the relationship between productivity and good ergonomic conditions.

Two examples of good workstations

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Here are some general suggestions for an ergonomic workstation:

Accommodate both right- and left-handed workers by providing a good work layout and tools which suit their needs. Provide each workstation with a chair even if the work is done standing up. Periodic rests and changes in body position reduce the problems of standing for too long.

Eliminate glare and shadows. Good lighting is essential.

When you think about how to improve a workstation, remember this rule: If it feels right, it probably is right. If it feels uncomfortable, there is probably something wrong with the design, not the worker. Things that should be kept in mind while using a work chair: 1. If a job does not require a great deal of physical strength and can be done in a limited space, then the work should be done in a sitting position. 2. Sitting all day, however, is not good for the body. Therefore, there should be some variety in the job tasks performed. 3. A good chair is essential for sitting work. 4. A sitting job should be designed so that the worker does not have to stretch or twist unnecessarily to reach the work area. There are a number of ergonomic factors to consider when designing sitting work and when selecting a chair for the worker who will perform the tasks. C. Standing workstation Standing for long periods of time to perform a job should be avoided whenever possible. Long periods of standing work can cause back pain, leg swelling, problems with blood circulation, sore feet and tired muscles. Here are some guidelines to follow when standing work cannot be avoided:

If a job must be done in a standing position, a chair or stool should be provided for the worker and he or she should be able to sit down at regular intervals.
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Workers should be able to work with their upper arms at their sides and without excessive bending or twisting of the back.

The work surface should be adjustable for workers of different heights and for different job tasks.

If the work surface is not adjustable, then provide a pedestal to raise the work surface for taller workers. For shorter workers, provide a platform to raise their working height.

A footrest should be provided to help reduce the strain on the back and to allow the worker to change positions. Shifting weight from time to time reduces the strain on the legs and back.

There should be a mat on the floor so the worker does not have to stand on a hard surface. A concrete or metal floor can be covered to absorb shock. The floor should be clean, level and not slippery.

Workers should wear shoes with arch support and low heels when performing standing work.

There should be adequate space and knee room to allow the worker to change body position while working.

The worker should not have to reach to do the job tasks. Therefore the work should be performed 8 to 12 inches (20 to 30 centimetres) in front of the body.

When determining the appropriate height of the work surface, it is important to consider the following factors:

the elbow height of the worker; the type of work being performed; the size of the product being worked on; the tools and equipment being used.

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A chair, footrest, a mat to stand on, and an adjustable work surface are essential components for a standing workstation.

The job should be designed to allow the worker to keep the arms low and the elbows close to the body.

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Follow these guidelines to ensure a good body position for standing work:

Face the work. Keep the body close to the work. Move the feet to face in a new direction instead of twisting your back or shoulders.

Following things should be kept in mind while working: 1. Standing for long periods of time to perform a job should be avoided whenever possible. 2. Long periods of standing work can cause health problems. 3. There are a number of ergonomic factors to consider when designing or redesigning a standing workstation. There are also important factors for the worker to consider to ensure a good body position for standing work. D. Hand tools and controls Hand tools Hand tools should be designed according to ergonomic requirements. Poorly designed hand tools, or tools that do not fit the individual worker or the task can cause negative health effects and decrease a worker's productivity. In order to prevent health problems, as well as to maintain the worker's productivity, hand tools should be designed so that they fit both the individual and the task. Well designed tools can contribute to good body positions and movements and can increase productivity. Use the following guidelines when selecting hand tools:

Avoid poor quality hand tools. Choose tools that allow the worker to use the larger muscles in the shoulders, arms and legs, rather than the smaller muscles in the wrists and fingers.

Avoid holding a tool continuously in a raised position or gripping a heavy tool. Properly designed tools allow the worker to keep the elbows next to the body to prevent damage to the shoulder or arm. Additionally, properly designed tools do not require the worker to bend the wrists, stoop or twist.
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Choose handles that are long enough to fit the whole hand. This will help to reduce uncomfortable pressure on the palm of the hand or on the joints of the fingers and hand.

Do not use tools with spaces where fingers and skin can get caught. Choose double-handled tools, such as scissors, pliers or clippers. These should have a span that does not overstretch the hand.

Do not select tools with contoured handles; they fit only one size of hand and put pressure on hands they do not fit.

Make tool handles easy to grip. Handles should also have good electrical insulation and they should not have any sharp edges or sharp corners. Put soft plastic covers on handgrips to reduce slipperiness.

Avoid using tools that force the wrist to bend or to be in an awkward position. Redesign tools so that the tool bends and not the wrist.

Choose tools with an evenly balanced weight and make sure they are used in the proper position.

Make sure tools are properly maintained. Tools should be appropriate for right- or left-handed workers.

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These pictures illustrate how tool design can prevent you having to work with a bent wrist.

Do not use tools with spaces that can catch fingers or flesh.

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Controls Control switches, levers, and knobs also need to be designed with the worker and the task in mind. Here are some guidelines for the design of controls:

Control switches, levers and knobs should be within easy reach of the machine operator from a normal standing or sitting position. This is particularly important for frequently used controls.

Select controls that are appropriate for the job task. For example, choose hand controls for precision of high-speed operation and foot controls, such as pedals, for operations that require more force. Two or more pedals should not be used per operator.

Design or redesign controls for two-handed operation. Triggers should be operated by several fingers, not just one. It is important to show a clear distinction between emergency controls and those which are used in normal operations. Such distinctions can be marked by physical separation, colour coding, clear labelling or machine guarding.

Design controls to prevent accidental activation. This can be done by proper spacing, adequate resistance, recesses or shields.

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It is important that operating procedures for controls are easy to understand using common sense. Common sense reactions may differ among countries and these differences should be taken into consideration, especially with imported equipment

Following points should be kept in mind while using tools: 1. Hand tools should be designed according to ergonomic requirements. Poorly designed hand tools, or tools which do not fit the individual worker or the task can cause negative health effects and decrease a worker's productivity. In order to prevent health problems, as well as to maintain the worker's productivity, hand tools should be designed so that they fit both the individual and the task. 2. There are a number of ergonomic factors to consider when designing or redesigning hand tools. Control switches, levers, and knobs also need to be designed with the worker and the task in mind.

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E. Heavy physical work Manual work must be designed properly so that workers will not overexert themselves and develop muscle strain, especially in the back. Performing heavy physical work for long periods causes the rate of breathing and the heart beat to increase. If a worker is not in good physical condition, he or she is likely to get tired easily while doing heavy physical work. Whenever possible, it is helpful to use mechanical power to do the heavy work. This does not mean that employers should replace workers with machines, rather, that workers can use machines to perform the most arduous tasks. Mechanical power reduces the risks to the worker and at the same time provides more work opportunities for people with less physical strength. Use the following guidelines for designing jobs that require heavy physical work:

Heavy work should not exceed the capacity of the individual worker. Heavy physical work should be varied throughout the day at regular intervals with lighter work.

Rest periods must be included in the day's work.

To design a heavy physical job appropriately, it is important to consider the following factors:

the weight of the load; how often the worker must lift the load; the distance of the load from the worker lifting it; the shape of the load; the length of time required to do the task.

The following are more detailed recommendations for heavy work, especially work that involves lifting. Reduce the weight of the load:
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repackage to reduce the size; reduce the number of objects carried at one time; assign more people to lift extra heavy loads.

Make the load easier to handle:

change the size and shape of the load so that the centre of gravity is closer to the person lifting; store the load at or above hip height to avoid the need to bend; use mechanical means to raise the load to at least hip height; use more than one person or a mechanical device to move the load; drag or roll the load with handling aids such as carts, ropes, or slings; transfer the weight of the load to stronger parts of the body using handgrips, straps or belts.

Use storage techniques to make handling materials easier:


use wall brackets, shelving or pallet stands of appropriate height; load pallets so that heavy articles are around the edges of the pallet and not in the centre. This will help to distribute weight evenly on the pallet. You must ensure, however, that articles do not easily fall off the pallet and injure someone.

Minimize the distance a load must be carried:


improve the layout of the work area; relocate production or storage areas.

Minimize the number of lifts required:


assign more people to the task; use mechanical aids; rearrange the storage or work area.

Minimize twisting of the body:

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keep all loads in front of the body; allow enough space for the whole body to turn; turn by moving the feet rather than twisting the body.

Points to be kept in mind while doing heavy physical work: 1. Whenever possible, use mechanical power in place of heavy work. Machines can be used by workers to perform the most arduous tasks, not to replace workers. 2. Heavy work should be varied with lighter work throughout the day. 3. Rest periods must be included in the job. 4. Consider ergonomic factors, such as the weight and shape of the load and how often a worker must lift the load, when designing heavy physical job tasks. Other ergonomic recommendations include: reducing the weight of the load; making the load easier to handle; using storage techniques to make handling easier; minimizing the distance a load must be carried; minimizing the number of lifts; and minimizing twisting of the body. F. Job design It is important to design jobs taking into consideration human factors. Well designed jobs consider the worker's mental and physical characteristics as well as health and safety conditions. The way a job is designed determines whether it is varied or repetitive, whether it allows the worker to be comfortable or forces him or her into awkward positions, and whether it involves interesting/stimulating tasks or boring monotonous ones. The following are some ergonomic factors that should be considered when designing or redesigning jobs:

the types of tasks that need to be done; how tasks need to be performed; how many tasks need to be performed; the order in which tasks need to be completed; the type of equipment needed to complete tasks.

Additionally, a well designed job should do the following:

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allow the worker to vary the position of the body; include a variety of mentally stimulating tasks; allow the worker some decision-making latitude so he or she can vary the work activities according to personal needs, work habits and the workplace environment;

give the worker a sense of accomplishment; provide adequate training to teach the worker what tasks are required and how to perform them;

provide adequate work/rest schedules which allow the worker enough time to complete tasks and to get sufficient rest;

allow an adjustment period for new job tasks, especially when they are physically demanding, so that the worker can gradually become accustomed to the work Things to be kept in mind about work design: 1. Well designed jobs consider the worker's mental and physical characteristics as well as health and safety conditions. 2. Job design determines whether the work is varied or repetitive, whether it allows the worker to be comfortable or forces him or her into awkward positions, and whether it involves interesting/stimulating tasks or boring/monotonous ones. G .Ergonomic Accessories Document Holder Position document holder at the same distance and same height as the monitor. Position the document holder on the same side as the dominant eye. To determine your dominant eye: 1. Make a triangle your fingers. 2. Focus on an object in the distance. 3. Close the right eye, then the left without moving your hands. 4. The eye that keeps the object centered is your dominant eye

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Footrest Use a footrest if your feet cannot touch the floor. Palm/Wrist Support Avoid resting your hands on the support while actively using the keyboard or mouse. Use during rest periods only. Telephone Use a headset if you frequently use the phone (for long and/or frequent calls). Hold the telephone with one hand, do not cradle it between your ear and shoulder if you do not use a

CHAPTER 4 : Disorders and Its Preventions

Common injuries / diseases Type of MSDs Role of health and safety representatives Ergonomics risk factors Hazard control strategies Suggestions for small amenities

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COMMON INJURIES/DISEASES Often workers are given little choice and are forced to adapt to poorly designed work conditions, which can lead to serious injury to the hands, wrists, joints, back or other parts of the body. In particular, injuries can result from:

repeated use over time of vibrating tools and equipment, such as a jackhammer; tools and tasks which require twisting hand or joint movements, such as the work many mechanics perform;

applying force in an awkward position; applying excessive pressure on parts of the hand, back, wrists or joints; working with the arms outstretched or over the head; working with a bent back; lifting or pushing heavy loads.

Injuries usually develop slowly

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The injuries and diseases caused by poorly designed or unsuitable tools and workstations often develop slowly over a period of months or years. However, a worker will usually have some signs and symptoms for a long period of time indicating that something is wrong. For example, the worker may be uncomfortable while doing his or her job, or feel aches in the muscles or joints after going home from work. Additionally, he or she may have many minor muscle strains over a period of time. It is important to investigate these kinds of problems because what may begin as discomfort may lead in some cases to serious disabling injury or disease. Table 1 This table describes some of the most common injuries and diseases caused by repetitive or poorly designed work. Workers need to be provided with information on injuries and diseases associated with the non-application of ergonomic principles so they will know what symptoms to look for and that such symptoms can be work-related.

Table 1. INJURY Bursitis: inflammation of the bursa (sack-like cavity) between skin and bone, or bone and tendon. Can occur at the knee, elbow, shoulder. Called beat knee, beat elbow or frozen shoulder at these locations. Tingling, pain and Carpal tunnel syndrome: pressure on the nerves which pass up the wrist. Repetitive work with a bent numbness in the thumb wrist. Use of vibrating and fingers, especially at tools. Sometimes follows night. hand following repeated bruising, palm. tenosynovitis (see below). hammers and shovels,
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SYMPTOMS

TYPICAL CAUSES

Pain and swelling at the site of the injury.

Kneeling, pressure at the elbow, repetitive shoulder movements.

Cellulitis: infection of the palm of the Pain and swelling of the Use of hand tools, like

called beat hand. Epicondylitis: inflammation of the area where bone and tendon are occurs at the elbow. Ganglion: a cyst at a joint or in a the hand or wrist. Osteo-arthritis: damage to the joints resulting in scarring at the joint and the growth of excess bone. Hard, small, round tendon-sheath. Usually on the back of swelling, usually painless. Stiffness and aching in the spine and neck, and other joints. Pain, swelling, Tendonitis: inflammation of the area where muscle and tendon are joined. tenderness and redness of hand, wrist, and/or forearm. Difficulty in using the hand. Pain and swelling at the joined. Called tennis elbow when it site of the injury.

coupled with abrasion from dust and dirt. Repetitive work, often from strenuous jobs like joinery, plastering, bricklaying.

Repetitive hand movement.

Long-term overloading of the spine and other joints.

Repetitive movements.

Repetitive movements, Aching, tenderness, Tenosynovitis: inflammation of tendons and/or tendon sheaths. difficulty in using the hand. Tension neck or shoulder: inflammation of the neck and shoulder muscles and tendons. Trigger finger: inflammation of tendons and/or tendon sheaths of the fingers. often non-strenuous. Can be increases in workload or by introduction of new processes. Localized pain in the neck or shoulders. Having to maintain a rigid posture. swelling, extreme pain, brought on by sudden

Inability to move fingers Repetitive movements. smoothly, with or without pain. Having to grip too long, too tightly, or too frequently.

Repetitive work is a common cause of musculoskeletal (and stress-related) injuries and diseases. Injuries caused by repetitive work are generally called repetitive strain injuries (RSIs). RSIs are very painful and can become permanently crippling. In the early stages of RSI, a worker may only feel aching and fatigue at the end of the work shift. However, as the
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condition gets worse, there can be extreme pain and weakness in the affected area of the body. This condition can become permanent and can progress to a point where the worker cannot do his or her job any longer. Permanent RSI can be prevented by:

eliminating the risk factors from the job; reducing the pace of work; moving the worker to other work, or by alternating repetitive tasks with non-repetitive tasks at regular intervals;

increasing the number of breaks from repetitive work.

In some industrialized countries, RSI is often treated with surgery. However, it is important to remember that treating a problem is not the same as preventing it in the first place. Prevention should be the first goal, especially since surgery for RSI often has poor results and, if the worker returns to the same job that caused the problem in the first place, in many cases the symptoms may return even after surgery.

Injuries are costly Injuries to workers caused by poorly designed tools or workstations can be very costly in terms of pain and suffering, not to mention the financial loss to workers and their families. Injuries are costly to employers as well. Carefully designing a job from the beginning, or redesigning it may cost an employer some money initially. However, in the long term the employer usually benefits financially. The quality and efficiency of the work being done may improve. Health care costs may be reduced, and worker morale may improve. For workers, the benefits are obvious. Applying ergonomic principles can prevent painful and potentially crippling injuries or illness and make work more comfortable and therefore easier to perform. Following are the things which should be kept in mind about common injuries and diseases: 1. Forcing a worker to adapt to poorly designed work conditions can lead to serious injury to the hands, wrists, joints, back or other parts of the body. 2. Vibration, repetitive work, twisting, awkward work positions, excessive force or pressure, lifting or pushing can all cause injuries and diseases to develop.

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3. Injuries and diseases caused by poorly designed or unsuitable tools and workstations often develop over time. 4. Workers should be provided with information on ergonomics-related injuries and diseases, including what the common symptoms are and what work-related conditions are known to cause them. 5. Injuries and diseases caused by repetitive work are generally called repetitive strain injuries (RSIs). Applying a number of recommended measures can prevent RSIs from developing. 6. Injuries associated with the non-application of ergonomic principles are costly to both workers and employers, both in terms of pain and suffering and financially. 7. Applying ergonomic principles in the workplace benefits both workers and employers.

TYPES OF MSDs Back Problems Lower back pain. Ninety per cent of people will have back pain at some point in their lives.2 Low back pain is second only to the common cold as the main reason for seeking medical attention.3 Low back pain (LBP) has been, and continues to be, an epidemic in the United States. It has been estimated that the annual incidence (number of persons who will have back pain this year) is 5% of the population. Understanding the natural history of LBP can be confusing as one looks at the medical literature. Reports show that 90% of back pain resolves within 6-12 weeks.4 The problem

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most people have is that there is a high rate of recidivism. Between 70% and 90% of people have recurrent episodes of pain, and one third of patients continue to have persistent, recurrent or intermittent pain after their first episode.5,6 In addition to the difficulty with healing certain tissue types (such as with spondylolisthesis), the degenerative process is ongoing with age, and many patients do not minimize potential risk factors. All of this can contribute to continued episodes of LBP. The cause of LBP is often multifactorial. While a full description of the anatomy of the lumbosacral spine is beyond the scope of this paper, any tissue or structure innervated with afferent nerve fibers has the potential to be a pain generator. That includes muscles, ligaments, facet and sacroiliac joints, intervertebral discs, nerve roots, and bony periosteum. However, this only addresses the end organ cause of pain. There can be many other biomechanical and functional deficits that might lead to tissue pain. In addition, the degenerative cascade affects multiple areas of the lumbar spine, including potentially, all of the pain generators.7 A separate but related issue with regard to back pain is back injury. These are usually acute, sudden episodes of back pain or sciatica related to a specific event. (Such injuries are typically not considered to be MSDs attributed to repetitive motions. Nevertheless, such injuries may render certain repetitive motions painful.) A fall, sudden jarring, or lifting incident can initiate the onset of pain in all of the tissues previously listed. However, certain persons are at increased risk of injury. Disc herniation occurs more frequently in middle age, usually due to early effects of degeneration of the outer disc annulus, combined with increased disc swelling pressure of the inner nucleus. It has also been described that combined motions of lumbar flexion with rotation increase risk to the lumbar disc. This is further exacerbated by inflexibilities around the hips and pelvis, as well as relative weakness of the stabilizers of the lumbar spine including the abdominal and gluteal muscles. Furthermore, back pain can exist due to underlying normal age related processes, become exacerbated by abnormal postures, relative weakness and decreased endurance, and then exacerbated by a specific injury. The treatment of low back pain has to be individualized for each patient. While there is little hard scientific evidence to support one specific intervention over all others, postural correction, proper patient positioning, general exercise, and possibly specific physical
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therapy techniques and/or manipulation may be beneficial. Upper back pain. While not as common as lower back pain, some individuals report extensive pain in the mid and upper back (thoracic area). The thoracic spine is designed for support in standing and for caging the vital organs, and is quite strong. It only rarely experiences symptoms of degeneration since there is little movement and great stability. Of course trauma or injury from strain could cause pain. Although the spinal structures (bones, discs, nerves) are less commonly injured, some conditions such as osteoporosis can predispose one to specific conditions such as compression fractures. Also, the thoracic spine is frequently involved in idiopathic scoliosis (side to side curve) or kyphosis (excessive forward curve). These can later develop into painful conditions, although the exact source and cause is often unclear. Probably a more frequent cause of mid back pain, but again difficult to precisely diagnose, is muscular pain from the postural muscles and scapular muscles. The contributions of abnormal posture, static postures, poor strength and endurance, and overall individual conditioning need to be taken into account. Some rehabilitation efforts, because of the large muscles involved, include stretching, strengthening exercises, which mimic functional activities, and attention to posture Hand and Wrist Problems MSDs of the hand and wrist can take a variety of forms, such as, cumulative trauma disorder, repetitive strain injury, occupational repetitive micro-trauma, repetitive motion injury, overuse syndrome, carpal tunnel syndrome and repetitive stress disorder.1 A predominant cause of repetitive motion hand disorders is constant flexion and extension motions of the wrist and fingers. Chronic, repetitive movements of the hand and wrist, especially with the hand in pinch position, seem to be the most detrimental.2 Other common contributing factors to hand and wrist injuries include movements in which the wrist is deviated from neutral posture into an abnormal or awkward position; working for too long a period without allowing rest or alternation of hand and forearm muscles; mechanical stresses to digital nerves from sustained grasps to sharp edges on instrument handles; forceful work; and extended use of vibratory instruments. Some of the specific hand and wrist conditions are discussed below.

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Tendinitis/Tenosynovitis. Tendinitis and tenosynovitis refers to inflammation of the tendon and tendon sheath, respectively. Both are associated with the occurrence of pain during physical movement that places the tendons in tension. Inflammation can occur in any of the tendons of muscles that control the movement of the fingers, wrist and forearm. The most common types of tenosynovitis of the hand and wrist are those involved with the muscles of the thumb and index finger. DeQuervains Disease. DeQuervains disease is an inflammation of the common tendon sheath of two muscles to the thumb abductor pollicis longus and extensor pollicis brevis. Predisposing activities include postures that maintain the thumb in abduction and extension, forceful gripping, and thumb flexion combined with wrist ulnar deviation.10 Symptoms include sharp pain and swelling over the radial sytloid process of the wrist, the bony prominence just proximal to the wrist joint. The pain may radiate up the forearm or down into the thumb. Muscle weakness and decreased ability to grip with the thumb will result. Trigger Finger. Tenosynovitis can progress causing a narrowing of the inflamed tendon sheath preventing the smooth movement of the tendon through the digital pulley system. A nodule will form on the tendon creating a clicking or triggering movement. Tenosynovitis of the finger is due to sustained, forceful power grip and/or repetitive motion. Symptoms include pain during physical movements that place the tendons in tension; and the presence of warmth, swelling and tenderness of the tendon on palpation. Carpal Tunnel Syndrome. Cumulative trauma disorder, repetitive strain injury and repetitive stress disorder are terms often used to describe the condition when the nerves innervating the hands are compressed. Any of the three nerves of the hand medial, radial, or ulnar may be affected.3 The most common of these nerve compressions for dentistry, as well as for the general population, is carpal tunnel syndrome. There has been a tremendous increase during the last 20 years in the number of reported cases of carpal tunnel syndrome.3 Carpal tunnel syndrome is difficult to deal with in the occupational setting because so many non-work factors may be involved. Numerous studies confirm that patients diagnosed with work-related carpal tunnel syndrome have a high prevalence of concurrent medical conditions that are capable of causing carpal tunnel syndrome without respect to
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any particular occupation.5-8 These medical factors include a genetic predisposition; obesity; metabolic or inflammatory diseases (i.e., arthritis, diabetes, hypothyroidism, neoplasms, gout, myxedema, amyloidosis, multiple myeloma); and hormonal factors (i.e., pregnancy, oral contraceptives, hormone replacement, menopause). Statistics reveal that carpal tunnel syndrome is at least three times more common in women than in men.6 Typically, carpal tunnel syndrome manifests during middle age. Carpel tunnel syndrome is a peripheral neuropathy caused by compression of the median nerve as it passes through the bony landmark in the wrist known as the carpal tunnel. The carpal tunnel is bordered on three sides by carpal bones. The fourth side is formed by the transverse carpal ligament; a thick, dense, fibrous band. The carpal tunnel is a rigid structure through which nine flexor tendons, blood vessels, and the median nerve pass. Tenosynovitis, an inflammation or swelling of the synovium around the tendons, may occur with repetitive, forceful exertion of the fingers, particularly with the wrist in a deviated position. The increased swelling cannot be accommodated in the limited space of the carpel tunnel, resulting in compression of the median nerve and its blood supply. It is either the compression of the median nerve, or the metabolic dysfunction of the median nerve due to obstruction of its vascular supply, or both, that results in a myriad of symptoms.

Symptoms of carpal tunnel syndrome include: Tingling or numbness in the hand Shooting pain from the hand up the arm A swollen feeling in the hand without visible swelling Hand weakness and clumsiness of the hands especially in the morning Stiffness and numbness in the thumb, index finger, middle finger and radial side of the ring finger Difficulty grasping and pinching Frequently dropping objects due to reduced sensation to touch Symptoms are worse at night Occurs most often in the dominant hand but is frequently bilateral Carpel tunnel syndrome is accurately diagnosed by the presence of any two of three criteria: 1) clinical symptoms; 2) physical tests (i.e., Phalens test, Tindels sign); and 3) electrodiagnostic
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Guyons Syndrome. Guyons syndrome, or ulnar neuropathy most commonly occurs secondary to compression or injury at the elbow as the ulnar nerve passes through the cubital tunnel. In addition to compression at the elbow, the ulnar nerve can also be compressed at the base of the palm as it passes through Guyons Canal. The contents of Guyons Canal are the ulnar nerve and artery and fatty tissue. No flexor tendons pass through the canal. Compression of the ulnar nerve can occur just proximal to Guyons canal or at the distal end where the motor branch of the ulnar nerve enters an arcade of ligaments and tendons.9 Symptoms of ulnar neuropathy generally include pain, numbness and/or tingling in the distribution of the ulnar nerve in the ring finger and the small finger; and a shooting electrical sensation down the ulnar aspect of the arm. Motor symptoms are less common, but may include loss of control of the small finger, weakness and clumsiness of the hand. 9 Diagnosis of Guyons syndrome is accomplished using clinical symptoms, physical examination and electro-diagnostic studies.

ROLE OF THE HEALTH AND SAFETY REPRESENTATIVE As the health and safety representative you can play an important role in ensuring that ergonomics is used in the workplace. Your efforts to ensure that equipment and jobs are designed or adapted to fit workers will help to prevent a variety of health problems caused by poor working conditions.

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Health and safety representative

Remember: the goal of ergonomics is to look for ways to make the job fit the worker, instead of forcing the worker to conform to the job.

When trying to eliminate or prevent problems that may exist owing to the nonapplication of ergonomic principles, asking the following questions may help you to identify the cause of the problem: (a) How well suited is the operator to his or her job, tools and workstation? (b) How much time and effort does the worker spend on a particular task? (c) How repetitive is the task?

Try to work together with the union, management and workers to implement ergonomic changes in the workplace. Use the health surveys and check-lists in the Appendices at the back of this Module to help you identify problem areas in your workplace. Then you can begin to establish priorities and work with the different groups to develop solutions. In many cases, you may have to think of ways to improve on an existing situation, since you may not, for example, have the luxury of getting new equipment which is designed according to ergonomic factors.

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Remember: it is vital that the workers who will be affected by ergonomic changes minor or major are involved in discussions before changes are implemented. Their input can be very helpful in determining necessary and appropriate changes. They know their job better than anyone else does.

The following six points are a strategy which you as the health and safety representative can use to help workers win ergonomic improvements in the workplace.

Six-point strategy for winning ergonomic improvements in the workplace 1. Reach out to other workers a. Distribute copies of information factsheets or leaflets at work. b. Listen to what others have to say about ergonomics-related issues. c. Write down the names and work areas of people who are experiencing symptoms which you suspect may be caused by the non-application of ergonomic principles. 2. Collect information to identify problem areas 3. Study the areas you suspect are a problem a. Walk through any problem areas and review the work tasks. b. Start thinking of solutions, such as raising tables, rotating work, etc. 4. Gather recommendations from: a. the workers who are affected; b. maintenance and repair workers; c. the union health and safety department (if one exists); d. other health and safety specialists. 5. Push for necessary changes

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Worker support (plus documentation) will give you the necessary encouragement for winning health and safety contract language, grievances, or other agreements with management. 6. Communicate with workers Two-way communication is important in building and maintaining solidarity within the union.

ERGONOMICS RISK FACTORS IN GENERAL


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Although the causes of any particular case of a MSD are exceedingly difficult to identify with complete accuracy, certain risk factors are typically discussed in the field of ergonomic studies. The primary occupational risk factors for MSDs includes: repetition force mechanical stresses posture vibration cold temperature extrinsic stress

It is essential to understand just what a risk factor is, or rather is not. A risk factor itself is not necessarily a causation factor for any particular MSD. Many times it is not simply the presence of a risk factor, but the degree to which the risk factor is expressed that may lead to MSDs. Similarly, to the extent a MSD case is attributable to a risk factor, often it will be a combination of multiple risk factors, rather than any single factor, which contributes to or causes an MSD.

It is also important to note, in evaluating any particular case of a MSD, that risk factors may be experienced by the affected individual during non-occupational activities. In addressing any ergonomic issue, it would be a mistake to focus solely on the workplace. Further, not every person exposed to any or all of these risk factors will develop a MSD. Nor, for that matter, will any two people who are exposed to the same combination of risk factors and in the same degree, respond to them in the same way. Nevertheless, because these are common factors that may give rise to a MSD in some combination and in some people, these seven risk factors are discussed in greater detail below.

Each of these work factors is discussed in more detail below.


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Repetitions. Repetition rate is defined as the average number of movements or exertions performed by a joint or a body link within a unit of time. Repeated identical or similar motions performed over a period of time could cause over-extension and overuse of certain muscle groups, which could lead to muscular fatigue. Interestingly, symptoms often relate not to the tendon and muscle groups involved in repetitive motions, but to the stabilizing or antagonistic tendon and muscle groups used to position and stabilize the extremity in space. Sometimes, by varying tasks, muscle groups have periods of activity alternated with periods of rest, which may be beneficial in reducing the possibility of injury. Force. Force is the mechanical or physical effort to accomplish a specific movement or exertion.5 For example, using the hands instead of a clamp to hold an object while performing a task such as placing an interproximal composite restoration. The amount of force required by an activity can sometimes be magnified causing even more muscular fatigue. If for example, in the just described dental procedure the arms are also elevated at the time. Mechanical Stresses. Mechanical stresses are defined as impingement or injury by hard, sharp objects, equipment or instruments when grasping, balancing or manipulating. Mechanical stresses are encountered when working with forearms or wrists against the edge of a desk or work counter. The muscles and tendons are impinged when pressed into the sharp edge. Using the hand as a hammer to close a lid securely also creates mechanical stresses, especially if the lid has raised surfaces or sharp edges. Posture. Posture is the position of a part of the body relative to an adjacent part as measured by the angle of the joint connecting them. Postural stress is assuming an extreme posture at or near the normal range of motion. Posture is one of the most frequently cited occupational risk factors. There is a neutral zone of movement for every articulating joint in the body. For each joint the range of motion is defined by movements that do not require high muscular force or cause undue discomfort. Injury risks increase whenever work requires a person to perform tasks with body segments outside their neutral range in a deviated posture. For the upper arm and shoulder area neutral posture is relaxed with the shoulders down and on the same plane, with arms at the side. Working with the arms abducted away from the
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body, overextended and shoulders hunched places these joints at the end of their normal range of motion, requires higher muscular force and greatly increases the risk for injury. Strained sitting positions, such as tilting sideways, twisting the vertebral column, bending forward or slumping begin in response to compensation for specific work relationships but can become habit over time. Posture and positioning profile factors such as torso twist, tipped shoulders, head tilt/rotation, raised elbows (either dominant , non-dominant, or both) and operating with hands close to the face are associated with increased risk of musculoskeletal symptoms. Vibration. Vibration has been found to be an etiological factor in work environments utilizing tools vibrating in the frequency band of 20 to 80 hz.1 Dental handpieces and powered automatic instruments operate at higher frequencies in the 5000 to 10,000 hz range, and duration of exposure to vibratory force during dental procedures is relatively short. Thus, it would appear that the exposure to this risk factor in dentistry is relatively small. The vibratory peaks experienced using dental handpieces is in the frequency range similar to driving a car. However, certain non-occupational activities of a practitioner may involve this risk factor. For example, use of a chain saw or powered wood working tools for extended periods of time. Cold Temperature. Low temperatures reduce manual dexterity and accentuate the symptoms of nerve-end impairment. Extrinsic Stress. Extrinsic stress, or sometimes called organizational factors, can be defined as the way in which work is structured, supervised and processed. Extrinsic stress reflects the objective nature of the work process. It may include such variables as job variety, job control, workload, time pressure, and financial constraints. In general manufacturing, some studies show a relationship between extrinsic stress factors and a higher incidence of MSDs. Of course, risk factors are only part of the story. As was noted above, two individuals exposed to the same combination of risk factors and to the same degree will respond differently. One worker may not experience any discomfort, while another might develop a MSD. Why this is so is not fully understood. Nevertheless, studies have identified some
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worker predisposing factors. Those factors might increase a persons probability of developing an MSD. Some predisposing factors (i.e., age, rheumatoid arthritis, renal disease, hormonal imbalances, diabetes, hypothyroidism) are biological mechanisms that could account for an increased occurrence of tissue damage and MSDs. For other factors (i.e., weight, wrist dimension) there is epidemiological evidence but the mechanism is less clear. Still other factors are even less well established (i.e. genetics, general conditioning). In addition, there are a host of non-work risk factors inherent to the hobbies and other activities a person engages in when away from work (i.e., knitting, crocheting, bowling, computer use, excessive driving). Hazard Control Strategies Control strategiesto immediately correct hazardous conditions and unsafe behaviors. Engineering controls. Eliminates/reduces hazards that existed, through equipment redesign, replacement, or substitution. This is the most effective strategy. The preferred approach to prevent and control MSDs. Engineering control strategies to reduce ergonomic risk factors include the following: Changing the way materials, parts, and products can be transported . For example, using mechanical assist devices to relieve heavy load lifting and carrying tasks or using handles or slotted hand holes in packages requiring manual handling Changing the process or product to reduce worker exposures to risk factors. Examples include maintaining the fit of plastic molds to reduce the need for manual removal of flashing, or using easy-connect electrical terminals to reduce manual forces or modifying containers and parts presentation, such as height-adjustable material bins. OR-OSHA 201 Introduction to Ergonomics This material is for training use onl Changing workstation layout. Examples might include using height-adjustable workbenches or locating tools and materials within short reaching distances. Changing the way parts, tools, machinery and materials are to be manipulated. Examples include using fixtures (clamps, vise-grips, etc.) to hold work pieces to relieve
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the need for awkward hand and arm positions or suspending tools to reduce weight and allow easier access. Changing tool designs. For example, pistol handle grips for knives to reduce wrist bending postures required by straight-handle knives or squeeze-grip-actuated screwdrivers to replace finger-trigger-actuated screwdrivers. Changes in materials and fasteners. For example, lighter-weight packaging materials to reduce lifting loads. Changing assembly access and sequence. For example, removing physical and visual obstructions when assembling components to reduce awkward postures or static exertions.

Management controls. If you can't eliminate or adequately reduce exposure through engineering controls (our first priority), then take a look at management controls. Reduce exposure to the hazard by controlling behaviors through design of safety rules and safe work practices and procedures. These control strategies work as long as employees comply with the controls. Examples include: Broadening or varying the job content to offset certain risk factors (e.g., repetitive motions, static and awkward postures) Training in the recognition of risk factors for MSDs and instruction in work practices that can ease the task demands or burden Adjusting the work pace to relieve repetitive motion risks and give the worker more control of the work process Reducing shift length or curtailing the amount of overtime Rotating workers through several jobs with different physical demands to reduce the stress on limbs and body regions Scheduling more breaks to allow for rest and recovery
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Bottom-line, in making any ergonomic changes you'll most likely use both engineering and management controls to lower the risk of ergonomics-related injuries. OR-OSHA 201 Introduction to Ergonomics This material is for training use onl Personal Protective Equipment (PPE). In conjunction with engineering and management controls, consider personal protective equipment to reduce exposure to a hazard by placing a barrier between the hazard and employee. The object of the barrier is to reduce harmful levels of energy transfer (direct cause of injury). Back belts/braces and wrist braces/splints should not be considered PPE. In the field of occupational safety and health, PPE generally provides a barrier between the worker and the hazard source. Respirators, ear plugs, safety goggles, chemical aprons, safety shoes, and hard hats are all examples of PPE. Results based on these multiple NIOSH-sponsored analyses of data all converge to a common conclusion: back-belt use is not associated with reduced incidence of back injury claims or low back pain in material handlers. Whether braces, wrist splints, back belts, and similar devices can be regarded as offering personal protection against ergonomic hazards remains open to question. Bottomline the jury is still out. Less controversial types of personal equipment are vibration attenuation gloves and knee pads for carpet layers. But even here, there can be concerns. For example, do the design and fit of the gloves make it harder to grip tools?

Suggestions for small amenities


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Here are some suggestions of small amenities you can provide your employees to keep them healthy, happy and productive: Provide massage tools. There are a surprising variety of self-massage tools available that people can use to rub out sore spots in the back, neck and shoulders. You can supply a few of these for each department and encourage people to use them if theyre tense, or to help each other by exchanging massages at stressful times. Supply stress balls or Chinese medicine balls. People develop injuries in their hands if they continually use the small, sensitive muscles in only one way. Providing stress balls and Chinese medicine balls will help staff exercise their hands in new ways, rather than just typing. Traditionally, Chinese medicine balls were used to help increase flexibility and control in the fingers, and their weight applies pressure to pressure points in the palm, helping to relieve tension and increase circulation. Keep ice packs in the freezer. Additionally, its important to always keep first aid kits and ice packs around, in case of an acute injury. Ice packs can be useful if an employee is suffering from pain from too much typing or mouse clicks. Tell employees they can avoid pain by warming up their arms in the morning (running them under hot water), and using the ice packs for 10 to 20 minutes at the end of the day. Provide ergonomic workstation equipment. Make sure that you have extra office tools that employees can use such as document holders, phone headsets, ergonomic mice, keyboard trays and so on. Then, if an employee comes in complaining about work-related pain, you can invite them to test drive some of your equipment. Make sure the employee gets an ergonomic evaluation by a qualified ergonomist as well. Provide information resources. You can hand out fliers about stretching, proper workstation set-up, and healthy living. Or, keep a small bookshelf in the break room with some resources for employees. Supply books about stretching, fitness or even healthy cooking.

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Design an inviting break room. People are more likely to spend lunch time in the break room instead of at their desks if its an inviting and comfortable space. Consider adding a fish tank, potted plants, free tea or other small luxuries to make it inviting. Make the room feel attractive, welcoming and comfortable. Provide a stretching or exercise room. Google might have its own gym, but most companies dont even have a quiet room where employees can stretch. You can easily provide a small, quiet office with a few yoga mats and maybe an exercise ball, where employees can go to stretch and let their cares float away. Ideally, provide a shower nearby too, and encourage staff to use the stretch room to warm up before a lunch time run. Use ergonomics software. Some large companies use rest-break software that makes their employees pause for a small break every few minutes, and perform a few stretches once an hour. This helps employees maintain healthy work habits instead of overdoing it. Many free programs are available also, such as Work Rave for PCs or anti RSI for Macs. For employees having a very difficult time typing, consider buying voice recognition software too, such as Dragon NaturallySpeaking for PCs or Dictate (formerly iListen) for Macs. (Both use the same linguistic speech engine.) Organize people power. If you have an organization with talented staff, they can surely come up with ideas about how to improve the workspace, too. Invite their input and elicit help in organizing fun staff events, sports teams and more.

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CHAPTER 5

Conclusions Recommendations Limitation Bibliography

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CONCLUSION The initial results from this new field study of ergonomics, health, and productivity appear to confirm that ergonomic interventions can lead to lower pain levels and increased productivity among office workers. These results are of interest to lawmakers considering the social costs and benefits of ergonomic work standards, to Occupational Safety and Health Agency regulators considering what type of work standards might be most appropriate in an office setting, to business managers seeking to improve the performance of their employees, and to economists interested in the relationship between health and economic outcomes. The net impact of the chair and training intervention is not only statistically significant, it is large enough to cover its costs within days. The impact of training alone, however, is less certain at this time. While point estimates of the impact of training alone on pain and production are all in the expected direction, none of the impacts are statistically significant. This may change as more participants from the next two firms are added to the study. Furthermore, the results presented here suggest that ergonomic interventions have a substantial impact on production per unit of time worked, and that an economic analysis of ergonomics on MSDs should not be confined to lost workdays alone. This additional economic channel may be empirically important because an ergonomic intervention that has a large effect on production per effective workday may have no corresponding effect on lost work time. Thus, past research on the benefits of ergonomic interventions that focuses solely on lost workdays may substantially underestimate the total benefits of such programs, or the costs of MSDs (musculoskeletal disorders).

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RECOMMENDATIONS Use a good chair with a dynamic chair back. Top of monitor casing 2-3" (5-8 cm) above eye level No glare on screen, use an optical glass anti-glare filter where needed Sit at arms length from monitor Feet on floor or stable footrest Use a document holder, preferably in-line with the computer screen

Wrists flat and straight in relation to forearms to use keyboard/mouse/input device Arms and elbows relaxed close to body Center monitor and keyboard in front of you Use a negative tilt keyboard tray with an upper mouse platform or downward able platform adjacent to keyboard tilt

Use a stable work surface and stable (no bounce) keyboard tray Take frequent short breaks (microbreaks) Most comfortable head tilt ( Ear Eye Line ) will be 7.7 above the horizontal. Most comfortable head/neck angle will be 43.7

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Stand with weight evenly distributed between feet. When standing for long periods of time, rest one foot on a sturdy object above floor height and switch legs periodically Keep elbows close to the body. Reduce the need for outstretched arms. Use a higher work surface.

Avoid bending over your work. Avoid overhead work. Use a ladder. Test every load before you lift by pushing the object lightly with your hands or feet to see how easily it moves. This tells you about how heavy it is.

Make sure the weight is balanced and packed so it won't move around. Loose pieces inside a box can cause accidents if the box becomes unbalanced. Be sure you have a tight grip on the object before you lift it.

Handles applied to the object may help you lift it safely. Pace yourself. Take many small breaks between lifts if you are lifting a number of things.

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Lift and carry properly Lifting and carrying are physically strenuous, and there is always a risk of accidents and in particular of injury to the back and arms. To avoid this it is important to be able to estimate the weight of a load, the effect of the handling level and the lifting environment. You must also know how to choose a safe working method and how to use devices and equipment that make your work lighter.

Position of the back and legs

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Lift the object close to your body, otherwise the muscles of the back and the ligaments stretch and the pressure in the intervertebral discs increases. Tense your stomach and back muscles so that your back stays in the same position all the time you are lifting. Position of the legs

Stand close to the object. The closer you can get to the object, the safer it is to lift. Keep your feet apart to maintain your balance well.

Position of the arms and grip

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Try to grasp the object firmly using your whole hands at right angles to your shoulder. You cannot get a firm grip using only your fingers. Lift with both hands if possible.

Lifting to the side

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Lifting a weight and twisting the body at the same time increases the risk of back injury. Place your feet in a walking position, one foot pointing slightly in the direction of the lift. Lift the object and then shift the weight of the body onto the foot in the turning direction.

Lifting upwards

If you have to lift something above shoulder level, place your feet in a walking position. First raise the object to chest level. Then begin pushing upwards by moving your feet out in order to get the object moving and shift the weight of your body onto the front foot. For many people a suitable lifting height level is 70 to 80 centimetres. Lifting something off the floor can be three times as strenuous.

Lifting with others

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People who often lift things together should be more or less equally strong and they should practise lifting things together. The lifting movements must be made at the same time and at the same speed. The maximum weights recommended by the International Labour Organization are: Men: . . . . . . . . . . . . . . . . . . . . . occasionally 55 kg., repeatedly 35 kg. Women: . . . . . . . . . . . . . . . . . . occasionally 30 kg., repeatedly 20 kg. Do not lift anything if you have backache. Once the pain has gone, start lifting with caution and gradually practise.

Carrying

Carrying places most strain on the back of the neck and the upper limbs, the heart and the circulation. Carry objects close to your body. Minimum effort is then required to keep your balance and to carry the object. A round object is difficult to carry because the weight is far from the body. Good handles or grips make the work easier and bring additional safety. Spread the weight evenly over both hands. Carrying is always strenuous. Check whether the object can be shifted on a conveyor belt, wheels or a trolley. Make sure you do not try to shift an object that is too heavy on your own, that there are proper hand grips, that the hand grips are at a suitable distance, that there is room to lift and carry the object, that the floor is not slippery, that there are no obstacles in your way and that there is sufficient lighting. Unless well designed, steps, doors and ramps are dangerous.

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Clothing

Your clothing should regulate the temperature between the air and the heat generated by you body. Clothes must not be so loose, or so long or flapping as to be dangerous. Gloves should protect your hands and help you to get a good grip. Footwear should be sturdy, non-slippery and have broad soles. The uppers should protect your feet from falling objects. A helmet is essential for mechanical lifting. The helmet must be firmly fastened so that it cannot fall off at the vital moment or obstruct your view. A wide belt giving the back support (a weightlifter's belt) may be useful.

Auxiliary devices

Devices used to make your work easier must be light and easy to use, in order to reduce exertion and the risk of accidents. For example, magnets, eccentric and lever grabs, suction
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cups, carrying frames, such as yokes and backpacks, give you a good grip on the load and improve your working position. Trolleys, lifting tables, roller and disc conveyors and conveyor belts reduce shifting work. OFFICE EXERCISE Shoulder/Arm Stretch Reach arm across chest, grasping opposite shoulder with the opposite hand. Gently pull the elbow across the chest and towards the body. Hold position for 6-10 seconds when stretch is felt in shoulder.

Shake Your Arms Wrist/Forearm Stretches a) - Drop your arms and hands to your sides. - Shake them out gently for a few seconds. b) - Sitting with elbows on table and palms together, slowly lower wrists to table until you feel a stretch. Be sure to keep palms together throughout the stretch. c) - Keeping elbow straight, grasp involved hand and slowly bend wrist down until you feel a stretch.

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Neck Stretch With an erect posture, draw chin in gently. Bend head to the right so the right ear moves to the right shoulder. Hold for 5 seconds. Repeat for opposite side.

Palming Your Eyes Cup your hands.


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While resting your elbows on the desk, cover your eyes without direct pressure on the eyes. Hold position for 30 seconds ensuring all light is blocked. Breathe naturally. Remove hands and open eyes slowly.

LIMITATIONS . Production of industry is still largely dependent on human power/motion and ergonomic concepts are developing to improve worker productivity. Scientific Management, a method that improved worker efficiency by improving the job process, became popular. Lack of awareness among the organizations as well as employees decreases the productivity of an organization. Ergonomics is cost effective to those in the profession, actual proof is hard to come by. Having said that, the number of cases showing financial benefits of ergonomics is growing.

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BIBLIOGRAPHY

Books

1- Handbook of Human Factors and Ergonomics- GAVRIEL SALVENDY

2- Ergonomics: How to Design for Ease and Efficiency- K. H. E. Kroemer, H. B.

Kroemer, Katrin E. Kroemer-Elbert

3- The Ergonomics Edge: Improving Safety, Quality, and Productivity- Dan MacLeod

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4- Safety Managers Guide to Office Ergonomics- Craig Chasen

5- Ergonomics: Man In His Working Environment- Hywel Murrell

APPENDIX Appendix I. Job design check-list

Difficult work positions Can the time spent in one position (sitting, standing, bending, twisting) be reduced by

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redesigning the job, providing rest breaks, rotating workers, or providing chairs or stools? Can the work height be adjusted? For example, can an adjustable table or counter be provided so that each worker can adjust it for his or her height and for sitting or standing? Can adjustable chairs be provided? Can machine controls or materials be placed so workers can reach them more easily?

Mental stress Can workers who must maintain close concentration be given extra breaks? Can employees who work alone be rotated to other jobs for part of the shift to alleviate feelings of isolation? Can workers who deal with the public spend part of their day doing other kinds of work? Can workers have more control over the pace of work? For example, could custodians be told what needs to be done during a given week and then be allowed to determine how and when the work is performed? Can the quota of work for each person be adjusted to a more realistic level?

Stress from the work environment Can sources of noise and vibration be removed or controlled? For example, a noisy motor or generator which causes stress for nearby workers might be enclosed or moved to a remote location. Can chemical hazards that cause headaches or minor irritations be controlled? Can lighting be improved? Can workers be given control over the temperature in their work environment?

Tools and machinery design Can tools be designed to eliminate twisting of the hand or wrist? Can trucks or other machinery be designed so the driver or operator has a clearer view? Can gauges be made easier to read?
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Can machinery be used to lift heavy loads instead of moving them by hand? For example, in hospitals, slings and other equipment can be used to help lift patients.

Appendix II. What do you do if you think you have a cumulative trauma disorder? Notify your employer Do this with a witness or in writing and keep a copy for yourself. See a doctor as soon as possible Because cumulative trauma injuries develop slowly, workers often ignore the symptoms until they become severe. By that time, the injury may be permanent. Make sure you explain to your doctor the type of work you do. Document Keep notes of the events related to this injury, including whom you spoke to and when, as well as all medical expenses related to the injury and any conversations with or correspondence from your employer. These notes could be invaluable if a dispute arises regarding your injury. Contact your union for assistance

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Appendix III. Evaluate your job for risk factors

Does your job require you to:


Repeatedly bend and twist your wrists? Repeatedly twist your arms? Repeatedly hold your elbows away from your body? Repeatedly use a pinch grip? Repeatedly reach or lift things above shoulder level? Repeatedly use a tool that vibrates? Repeatedly use your hand to apply force? Repeatedly twist or flex your back? Repeatedly lift objects from below knee level? Repeatedly work with your neck bent?

All of the above are risky positions that can lead to the development of repetitive strain injuries. If you answer yes to any of the questions above, tell your union and your employer.

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Appendix IV. Controlling vibration hazards; health survey: whole-body vibration and hand-arm vibration

Fit the job to the worker Controlling vibrating hazards

Eliminate the need to use vibrating machinery. Example: improved mould-making techniques in foundries have reduced the need to fettle castings. Substitute a different process. Example: air-arc gouging is a vibration-free way of removing metal.

Automate. Example: using robots to bring workpieces into contact with a grinding wheel.

Find a vibration-reduced tool. Example: some modern pneumatic tools have been specially designed to produce less vibration than their predecessors...

Fit vibration-isolating handles. Example: some modern chain-saws. Provide adequate maintenance. Examples:

correct dressing of wheels; regular renewal of vibration-isolators; regular tuning of engines; frequent sharpening of cutters;

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regular general maintenance.

Support the tool or workpiece. Examples:


resting posts at grinding wheels; suspension systems for left-hand tools.

Warm the tool or workpiece. Examples:


chain-saws with heated handles; pneumatic tools with plastic covers; pre-heating castings prior to fettling; air exhausts piped away from the operator's hands.

Warm the workplace by providing adequate heating and warm rest areas. Reduce time on the job by job rotation, cutting output, or regular breaks.

Health survey: whole-body vibration Personal description (if you want to give it) Name .................................................................................................................................... Age ....................................................................................................................................... Male ........................................................ Female ................................................................ Job description Present job title....................................................................................................................... When did you start on this job?............................................................................................... What vibrating equipment do you use?.....................................................................................

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For how long each day? ........................................................................................................... Past jobs where vibration was a factor: ....................................................................................... Length of time employed ......................................................................................................... Machines or tools used .............................................................................................................. Health description If you are exposed to mainly whole-body vibration (near machines, concrete vibrators, buses, trucks, tractors, etc.) do you or have you suffered from: back pain arthritis varicose veins piles groin trouble indigestion high blood pressure heart trouble Sleeplessness Irritability Giddiness blurred eyesight Fatigue Impotence difficulty breathing aching muscles

For each problem ticked indicate: A for All the time R for Regularly O for Occasionally Did you suffer from any of these complaints before you started your present job? If yes, please give

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details: .......................................................................................................................... .............................................................................................................................................. Any other comments? ........................................................................................................... ...............................................................................................................................................

Health survey: hand-arm vibration Personal description (if you want to give it) Name .................................................................................................................................... Age ....................................................................................................................................... Male ........................................................ Female ................................................................ Job description Present job title....................................................................................................................... When did you start on this job?............................................................................................... What vibrating equipment do you use?..................................................................................... For how long each day? ........................................................................................................... Past jobs where vibration was a factor: ....................................................................................... Length of time employed ......................................................................................................... Machines or tools used .............................................................................................................. Health description If you are exposed mainly to hand-arm vibration (from pneumatic tools, chain-saws, grinders,

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etc.) do you or have you suffered from: tingling in fingers or hands; numbness of fingers or hands; whiteness of fingers; whiteness of several fingers or hands; in winter only; at any season; cramping or pain in arms or shoulders; numbness of arms; drooping wrists;

For each problem ticked indicate: A for All the time R for Regularly O for Occasionally Did you suffer from any of these complaints before you started your present job? If yes, please give details: .......................................................................................................................... ........................................................................................................................ EXERCISE Identifying problems and developing solutions to ergonomic problems Note to the instructor For this exercise, you will need a flipchart (or large pieces of paper taped to the walls) and
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markers, or a chalkboard and chalks. Give each trainee a copy of the action plan form. If you cannot make copies, then trainees can make their own action plans on a plain piece of paper. Put a copy of the six-point strategy for winning ergonomic improvements in the workplace on the wall where everyone can see it. You may also want to give each participant a copy of the strategy. Instructions The first part of this exercise should be done in plenary or with the group as a whole. The second part will be a small group activity. 1. Ask members of the group to think of one or two important problems at their workplaces which they think may be related to the non-application of ergonomic principles. Trainees should explain the characteristics of the problem which are related to ergonomic principles and state what kinds of health problems result from the existing situation. If at first trainees cannot think of any problems in their workplaces related to ergonomics, then you may be able to use the building where your training group is located to provide examples. For example, look around your training room. How are the chairs designed? Are trainees required to sit for more than two hours at a time (which is not healthy for your musculoskeletal system)? You may be able to arrange to take the trainees to visit other worksites in the building, if they exist. Is there an office in the building? Discuss with the participants whether ergonomic principles have been applied for the secretaries. Is there a kitchen in the building? Does the cook have to stand on a hard floor all day? Does he or she have to do a lot of lifting? Ask trainees to think of other ergonomic issues. 2. Make three columns on the flipchart labelled as follows and write in the trainees' responses. You can put several responses on one paper. Problems What are the ergonomic characteristics of this problem Resulting health problems 1 2 3 3. After you have written down as many problems as you have time for, divide the
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trainees into small groups of three to five people. If the group of trainees is composed of workers from different workplaces, ask the groups to mix, so that there are people from different workplaces in each group. 4. Next, assign one problem from the flipchart to each working group. If there are not enough stated problems to go around, you can give the same problem to two different groups, or you can ask a couple of groups to come up with their own problems. 5. The members of each group should propose as many equipment design and/or organizational solutions to their problem as they can. One person in each group should volunteer to write on a piece of paper the solutions the group proposes. 6. From the list of proposed solutions, each group should identify three to four solutions that it selects as priorities. The priorities may be identified as such because they may seem to be the easiest and cheapest to implement (these are important considerations from management's point of view), or because they have the greatest potential for impact. The group must consider actions management can take to solve the problem, things the union can do, as well as things the worker(s) can do to improve the situation. 7. Review the six-point strategy with the plenary. When used effectively, it can help to win ergonomic improvements in the workplace. Each working group should fill in an Action Plan form with its priority solutions. While completing the form, the group should discuss and develop an actual strategy for action for solving the problem. 8. Each group should also discuss potential barriers to change which they might face when attempting to implement its strategy for action. What strategies can the group think of for overcoming these potential barriers? 9. Once the groups have completed their Action Plan forms, the plenary should reconvene. Each working group should identify a spokesperson who will state the following to the plenary: (a) the problem it was assigned; (b) the priority solutions it proposed; (c)why it chose those solutions as priorities;

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(d) the potential barriers to change it anticipated; (e) strategies it developed for overcoming those barriers. Try to plan enough time so that each group can present its Action Plan to the plenary. 10. After every group has made its presentation, collect all the Action Plan forms. Return the forms to the trainees, giving each trainee the Action Plan form(that attempt to solve the problem that the trainee identified in his or her own workplace (step 1 of this exercise). 11. Ask if there are any questions. Action plan for solving ergonomic problems in the workplace 1. The problem: 2. Priority solutions: Equipment Design (a) (b) (c) 3. What are some of the potential barriers you may encounter when trying to implement solutions to this problem? (a) (b) (c) 4. What strategies can you think of for overcoming those barriers? (a) (b)
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Organizational

(c) Symptoms Survey Name _______________________________________ Date ___________________________ (Optional) Work Location ____________________________________ Job _________________________ Shift _____________ Supervisor ________________________ (Optional) Time on this job: ____ Less than 3 months ____ 3 months to 1 year ____ 1 year to 5 years ____ 5 years to 10 years ____ Over 10 years Have you had any pain or discomfort during the last year? ____ Yes ____ No If you answered Yes to the above question, carefully shade in the area of the drawings below which indicate the location of the pain which bothers you the most.

OR-OSHA 201 Ergonomics This material is

Introduction to for training use only

Symptoms

Survey

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Name (Optional) _________________________________________________________ Please complete a separate page for each area that bothers you. Check area __ Neck __ Shoulder __ Elbow __ Forearm __ Hand/Wrist __ Fingers __ Upper back __ Low back __ Thigh __ Knee __ Low leg __ Ankle/foot 1. Please put a check by the word(s) that best describes your problem. __ Aching __ Cramp __ Numbness __ Tingling __ Stiffness __ Burning __ Pain __ Weakness __ Swelling __ Color Loss __ Other (Specify) ________________ 2. When did you first notice the problem? __ recently ___ number of months ago __ years ago 3. How long does each episode last? ____________________________________________ 4. How many separate episodes have you had in the last year? ________________________ 5. What do you think caused the problem? _________________________________________ ___________________________________________________________________________ __ 6. Have you had this problem in the last 7 days? __ Yes __ No 7. (optional) How would you rate the level of pain you experience related to this problem? Mark an X on the line. Right now: None ----------------------------------------------------------------------------Unbearable At its worst: None ----------------------------------------------------------------------------Unbearable 8. Have you had medical treatment for this problem? __ Yes __ No If yes, what was the diagnosis? ________________________________________________ 9. How many days have you lost from work in the last year because of this problem? _____ 10. How many days in the last year were you on modified duty because of this problem? ______ 11. Have you changed jobs because of this problem? __ Yes __ No

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