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Productivity and disability: The need to modify work standards

Article  in  International Journal of Productivity and Quality Management · January 2009

DOI: 10.1504/IJPQM.2009.023188

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212 Int. J. Productivity and Quality Management, Vol. 4, No. 2, 2009

Productivity and disability: the need to modify work

standards

Anand Subramanian* and Anil Mital

Department of Industrial Engineering,
University of Cincinnati, Cincinnati,
OH 45221-0072, USA
E-mail: subramad@email.uc.edu
E-mail: anil.mital@uc.edu
*Corresponding author

Abstract: About 14% of the adult population in the USA is disabled (either
partially or totally). There is a continuous influx of partially disabled
population into the workforce. This results in a growing need to rehabilitate and
provide better working conditions for the disabled individuals at the work
place. This has not only necessitated a change in approach but also the need to
investigate and analyse the economic implications on the functioning of the
business model. Productivity measurement is a key element in understanding
the social and economic well-being. This paper reviews the need to understand
the relationship between productivity and the disabled individual. The goal here
is to understand how the disability has a direct impact on the productivity of the
organisation and the creation of accurate work standards can help determine
this productivity-disability relationship.

Keywords: productivity; disability; economic well-being; work standards; fair

day’s work.

Reference to this paper should be made as follows: Subramanian, A. and

Mital, A. (2009) ‘Productivity and disability: the need to modify work
standards’, Int. J. Productivity and Quality Management, Vol. 4, No. 2,
pp.212–227.

Biographical notes: Anand Subramanian is a graduate student in Industrial

Engineering at the University of Cincinnati. He holds his Masters in Industrial
Engineering from University of Cincinnati and his Bachelor in Production
Engineering from University of Bombay, India. He is a Doctoral candidate at
the University of Cincinnati and is currently working on creating/modifying
work standards for individuals with disabilities. He is also the Managing Editor
of the International Journal of Industrial Engineering Theory, Applications,
and Practice.

Anil Mital is a Professor and former Director of Industrial Engineering and a

Professor of Physical Medicine and Rehabilitation at the University of
Cincinnati. He holds his BE in Mechanical Engineering and an MS and PhD in
Industrial Engineering. He is the Editor-in-Chief of the International Journal of
Industrial Engineering-Theory, Applications and Practice. Professor Mital
heads the Ergonomics and Engineering Controls Research Laboratory at the
University of Cincinnati.

Copyright © 2009 Inderscience Enterprises Ltd.

 Productivity and disability: the need to modify work standards 213

1 Introduction

The purpose of any research is to develop test theories and thereby, advance knowledge,
stimulate product development, and promote technological advances that contribute in
the long-term to economic development and competitiveness in a market-based economy
(Kerlinger, 1986). The underlying fact is that any research undertaken must provide a
value to the society. As a societal goal, improving the quality of life for persons with
disabilities (i.e. physical, emotional, mental, and sensorial) rests on the development of
science knowledge that goes beyond discoveries of basic science but also addresses
disability with a broader socio-ecological context. As an area of research, the disability
rehabilitation field has made significant improvements over the past decade to provide
better accommodation to individuals with disabilities. The efforts on part of rehabilitation
researchers has also lead to a better understanding of the disabilities resulting from work
and the methods and process that are in place for ensuring a timely return to work
post-disability.
Disability and rehabilitation experts have conventionally focused on understanding
the method, extent, and cost of accommodations and adjustments that employers need to
provide. However, there are no studies that elicit the cost effectiveness studies for
employers providing work accommodations, the hidden costs due to the employers’
decision to hire. Due to lack of research, the general assumption is that the cost to employ
individuals with disabilities is high (Samorodov, 1996). Graffam et al. (2002) identified
advantages related to individual employee performance and general organisation
performance associated with employing a person with a disability. Although more
variable, the performance of employees with disability as a group was in certain respects
comparable to that of ‘average’ (non-disabled) employees. In general, employees with a
disability were rated lower than average employees on productivity factors (speed and
accuracy) and better than average employees on reliability factors (attendance and sick
leave) and employee maintenance factors (recruitment, safety, insurance costs). The
conventional studies have focused primarily on the performance of employees, the effects
of work place accommodations and adjustments, and/or the incentives and subsidies for
such population.
With disability and rehabilitation practitioners enjoying reasonable success, it is now
important that they renew their focus and emphasise on the socio-economic aspect of
disability. The economic well-being of any entity is directly relative to how productive its
operations are. The driver for any firm is its profit-oriented business model.
Consequently, it is very important to explore the issues relating to the economics of
disability. To understand the extent of the problem, we need to first look into the
prevalence of disability and what has been done to accommodate this population.

2 Disability prevalence

Work disability has never been a central concern of the public or of policymakers until its
increased prevalence towards the turn of the century. Academics traditionally neglected
work disability problem, considering it to be inherently simple process – an individual
contracts a chronic illness or suffers from injury and consequently stops working
(Yelin, 1992).
214 A. Subramanian and A. Mital

According to the US Census Bureau data, a narrow estimate of Americans (over five
years of age) with disabilities was around 37.5 million (US Bureau of Census, 2006).
This represents a staggering 14% of the total US population and does not include the
number of persons institutionalised and in healthcare and nursing homes. More than 42%
of the total disabled men between ages of 21 and 64 are employed in some form or the
other. A similar estimate for women gives 34% to be employed. Figure 1 shows the
prevalence of disability among adults between the age ranges of 18 and 64 from 1981 to
2004. In the year 2004, an estimated total of 7.9% of civilian non-institutionalised people
aged 18–64 in the USA reported a work limitation. An estimated 8.0% and 7.9% of
civilian non-institutionalised, men and women respectively, aged 18–64 in the USA
reported a work limitation. These estimated percentages are based on a sample of
127,071 persons who participated in the current population survey (CPS) (Houtenville,
2005). The long-term increase in disability rates from 1981 to 2004 is largely due to
demographic shifts. Also, the disability statistics presented above does on include the
disability among the children (< 18 years) and the elderly (> 65 years).

Figure 1 The percentage of men, women and the total, aged 18–64 who reported a work
limitation in the USA from 1981–2004
Total
Prevalence of Disability
Male
Female
10
9.5
9
8.5
8
Percent

7.5
7
6.5
6
5.5
5
19 1
19 2
83

19 4
85
86

19 7
88

19 9
90
91

19 2
93

19 4
19 5
96

19 7
19 8
99

20 0
01

20 2
03
04
8
8

9
9

9
9

0
19

19

19
19

19

19
19

19

19

20

20

20

Year

Figure 2 shows the employment rate of people with disabilities categorised by their
status. The overall employment rate of people with some kind of disability is significantly
lower (38.1%) than that of individuals with no disability (78.3%). Among the various
disabilities, more individuals (47.8%) with ‘sensory disabilities’ found it easier to be
employed. The lowest employment rate was for people with ‘go outside home
disabilities’, (16.7%).
 Productivity and disability: the need to modify work standards 215

Figure 2 % employment of working-age people (ages 21–64) categorised by the disability status
in US (see online version for colours)
Employment of working-age people (ages 21-64) by disability status

100.0
90.0 78.3
80.0
70.0
60.0 47.8
50.0 38.1 32.0
40.0 29.0
30.0 17.2 16.7 17.7
20.0
10.0
0.0
No Disability Disability Sensory Physical Mental Self-Care Go-Outside- Employment
Disability Disability Disability Disability Home Disability
Disability

Status

The improvements in science and technology have increased the life expectancy, but
associated with this is the increasing prevalence of disability and the associated costs
(Deleire, 1999). Clearly, the statistics above indicate the disparity that exists in
employment rates between the disabled and non-disabled and also within the various
groups among the disabled. The next question that arises is: ‘what is the extent of
government intervention to reduce this gap and why is it important to accommodate this
population into the workforce?’
Towards the later half of the century, employers started facing increasing pressure to
integrate disabled individuals into the work force and/or accommodate them, due to the
passage of the Americans with Disabilities Act. The Americans with Disabilities Act of
1990 provides guidelines that assure the provision of services to people with disabilities
and the protection of their legal rights.
Table 1 Laws affecting the employment of individuals with disabilities

Statute/law/act
Occupational Safety and
Health Act (OSHA) of 1970
National Labor Relations
Act (NLRA)
Rehabilitation Act of 1973,
Title V (as amended)
Americans with Disabilities
Act (ADA) of 1990, Title I
Purpose
Ensure safe and healthy working conditions for all working
people.
Protect rights of employees to form, join, or assist a labour
organisation and to bargain collectively through representatives
of their own choosing or to refrain from such activities.
Prevent/prohibit discrimination in employment by federal
agencies, programs receiving federal financial assistance, and
federal contractors.
Title I of ADA prohibits discrimination on the basis of
disability in employment and to provide disabled individuals
with accommodation to perform regular work
Title II prohibits discrimination by state and local governments
in several areas, including employment.
216 A. Subramanian and A. Mital

Table 1 Laws affecting the employment of individuals with disabilities (continued)

Statute/law/act Purpose
Family Medical Leave Require employers to provide unpaid leave (up to 12 weeks/year) for
Act (FMLA) of 1993 employees to care for newborn children, foster/adopted children, a
relative with a serious medical condition, of the employee’s own
serious medical condition.
Veterans Rehabilitation Grant rehabilitation services and preferential hiring status to disabled
legislation veterans of the US Armed Forces.
Workforce Investment Consolidate, coordinate, and improve employment, training, literacy,
Act (WIA) of 1998 and vocational rehabilitation programs in the USA.
Ticket to Work and Lower barriers to employment for individuals who receive
Work Incentives supplemental security income (SSI) and social security disability
Improvement Act of insurance (SSDI) and encourage beneficiaries and recipients to
1999 access vocational services to assist their return to work. Designed to
provide more vocational options for SSA beneficiaries.
State short-term Pay covered workers with disabilities or medical conditions benefits
disability laws for a relatively short period of time – typically less than 26 weeks.
State workers’ Designed to insure workers against possibility of lost income due to
compensation laws injuries on the job.

Table 1 shows a summary of the various laws affecting the employment of disabled
individuals at the workplace. Reasonable accommodation and rehabilitation can turn an
unqualified person with disability to a qualified person with disability by reducing the
effects of the individual’s functional limitations on the job by changing some features on
the job, without affecting the person’s disability status. Now that we have a framework
for the rehabilitation and accommodation of the disabled population, we need to look into
what are the costs associated with bringing the disabled individual back to work and also
how it affects work.

3 Economics of disability

The cost imposed by disability is typically made up of the cost of the accommodating
factors to rehabilitate the disabled at the work place, the cost of loss in productivity, the
cost of insurance etc. On a macro scale, to determine the cost of disability, we not only
require an accurate figure on the number of disabled but also a good approximation of the
average cost of disability. Narrowing the scope to a business’s point of view, the cost of
disability can be considered to be made up of two elements:
1 the costs that are associated with the industry/business
2 costs associated with the particular individual with disability.
The cost for the employer is the direct costs (medical insurance and disability
compensation costs, work-related rehabilitation costs, and the training costs) and the
indirect costs (loss in productivity and morale) associated with an individual’s disability.
From an individual’s point of view, there is a total or partial loss of ability to generate
income for the household due to reduced wage levels, reduced hours of work, reduced
skill levels, etc.
 Productivity and disability: the need to modify work standards 217

Also, there is another aspect of the economic implications disability which is more
often neglected. This is the cost of not working. When an individual is partially or totally
disabled, he/she is no longer contributing to the taxes. This has a direct implication on the
cost structure of the county, city, state, and federal levels. Not only is there reduced
inflow in terms of tax monies but there is an increased outflow from these units in terms
of welfare. This further increase the burden at all levels of the organisations. Also, there
is big void in terms of their contribution to the economic growth by means of spending.
As the earning potential goes down and as the medical expenditure of the household
increases, there is a drastic change in the spending habits of these households and
individuals. This has a direct implication on the economy.

3.1 Direct costs associated with disability

3.1.1 Disability compensation
Disability compensation benefits can be payments from public or private funds to a
disabled person who cannot work, such as social security or workers’ compensation
benefits, a company’s disability fund, etc. Basically, there are two types of disability
compensation benefits to which a person can be eligible viz., disability insurance benefits
and supplemental security income benefits. The disability insurance benefit pays benefits
to the ‘insured’, by the employer, state, or federal government. There are various
categories of disability insurance benefits:
1 employer disability insurance benefits
2 state disability insurance benefits
3 SSDI benefits
4 workers’ compensation disability insurance benefits
5 veterans’ disability insurance benefits
The SSI is a federal income supplement program funded by general tax revenues. The
SSI program provides cash assistance to individuals who have limited income and
resources and are either age 65 or older, or blind or disabled, including children. SSI is a
‘needs-based’ program, sometimes called a ‘welfare’ program.

3.1.2 Medicare costs

The traditional focus of disability research has been on the elderly. Chronic disability is
much more prevalent among the elderly, and it has a more direct impact on the demand
for medical care. It is also important to understand trends in disability among the young,
however, particularly if these trends diverge from those among the elderly. These trends
could have serious implications for future healthcare spending because more disability at
younger ages almost certainly translates into more disability among the elderly, and
disability is a key predictor of healthcare spending (Bhattacharya et al., 2004). People
with disabilities use more medical services than those without disabilities. Disability, and
the institutionalisation that often results from it, are very expensive. Only one third of the
years lived after the age of 70 are lived with a disability, but the costs for care in those
years account for two thirds of lifetime medical spending (Cutler, 2003). The use of
218 A. Subramanian and A. Mital

medical services by the disabled also varies greatly. Among persons with three or more
limitations in activities of daily living, for example, live more in the community than in
institutions (Manton and Gu, 2001).

3.1.3 Rehabilitation costs

Job accommodation refers to the degree of change to the work environment or work place
as a result of rehabilitating the disabled worker. Rehabilitation experts have been
addressing the problem of accommodating the disabled workers in the workplace for
many years. When a disabled worker is rehabilitated, accomplishing the tasks they
performed prior to disability can present a serious challenge. Even more challenging is
the task of fitting in a disabled worker to a job for which he has no prior experience.
Meeting this challenge successfully requires that the employers provide accommodations
and special allowances at the work place so that the disabled workers can continue to
contribute efficiently. 42% of the disabled people are part of the workforce. This does not
include the elderly and the morbidly obese individuals that also form an integral part of
the labour force. The influx of the disabled people into the workforce is also expected to
lead the existing workforce to find new employment opportunities, which have hitherto
been closed to them (Mital, 1999). In turn, the employers will have to rehabilitate this
workforce in accordance with the laws and statues and associated with this is the cost of
providing the necessary rehabilitation.

3.1.4 Training costs

A viable definition of training must include the following:
1 systematic processes that are concerned with some form of planned and controlled,
rather than random, learning experience
2 changing the behaviour, skills and attitudes of the people as individuals and as
members of social work groups
3 improvements of both the present and the following job performance and
enhancement of the effectiveness of the organisation in which the individual or
group works.
Accommodating a disabled individual to perform functions, which he/she is not skilled,
requires training. The costs associated with lack of a structured training program can be
divided into two groups (Mital et al., 2004):
1 tangible costs:
• costs associated with quality (poor product/service, increase scrap, and waste)
• costs associate with increase in throughput time
• costs associated with decreased flexibility to respond to unfamiliar situations
• reduced profit
2 intangible costs:
• costs associated with lower worker morale
• costs associated with loss of competitive edge
 Productivity and disability: the need to modify work standards 219

• costs associated with loss of market share

• costs associated with diminishing customer satisfaction and confidence.

3.2 Indirect costs associated with disability

1 Cost of lost productivity. As mentioned, the tangible costs of not training the disabled
individuals can lead to increase in throughput time. Research has shown that
disability is associated with diminished functional and range of motion capacity
depending on the nature and type of the disability. There is a tendency among the
disabled to become more cautious while performing job functions. This leads to an
increase in the work-cycle time (Mital and Mehta, 1988). The traditional rest
allowances are sufficient to recover from fatigue only to a certain extent.
Modification of the work-rest cycle hence increases the cycle time for producing the
same product or service.
2 Cost of loss in morale. It is widely recognised that human capital or the level of
knowledge and skills of the population has an important impact on productivity and
economic performance. Loss of skill – both job related and social, tends to reduce
the morale. A general feeling of dissatisfaction slowly but surely tends to build up
into the individuals’ psyche. This results in a general loss of interest on the job and
can result in poor on-the-job performance, which has a direct bearing on the quality
of the product/service, increase scrape rate, etc. (Mital et al., 2004).
3 Cost of loss in earning potential. The foregone output of disability is the partial or
total loss of the work-related earnings. Another foregone output is the partial or total
loss of earnings from family or household members due to their inability to earn
because of the time devoted to caring for the disabled person (Detmeter et al., 1996).
Hence, the loss of the primary caregiver of the household generally results in a
decrease in household earning. This not only has a direct impact on the spending
habits of the individuals and household but also to a great deal affect the economy of
the nation as a whole.
4 Cost of lost expertise. Work place injuries are common and occur all the time.
Injuries that lead to a disability can imply that an individual who was performing
the task over a period of time and had attained expertise in that particular operation
is no longer available. As a requirement, the employer is required to
accommodate/rehabilitate the individual depending on the extent of the disability. If
the individual cannot be accommodated to perform the same tasks, a void is created.
The operations would not be performed at the same level of expertise and efficiency.
To scrutinise how each of these cost impacts the organisation is beyond the scope of this
paper. We shall narrow our focus and analyse how disability affects productivity and
what could be done to determine the correct levels of productivity.

4 Fair day’s work and productivity

Work is a central aspect of human life. Not only is work a means by which individuals
define themselves in society, but it is also a part of the very fabric of societies
220 A. Subramanian and A. Mital

(Szymanski and Parker, 2003). Work has been defined as ‘a physical or mental effort
directed towards a goal.’ Performance of this work requires expenditure of metabolic
energy, substantial amounts in the event the task being performed is physical and highly
repetitive. Moreover, the physical work capacity (PWC) of a person decreases as the
workday progresses. This phenomenon is attributed largely to the continuous build up of
fatigue (Mital et al., 1991). The main aim of developing work standards is not only to
increase productivity but to alleviate the stress and fatigue of the workers (by application
of allowances to the standards). The onset of fatigue not only results in decline in
quantity of work (efficiency) but also the quality of work being performed
(Mital et al., 1991). Hence, any error in setting up of standards leads has a cascading
effect in the determination of levels of production and renders the business models and
plans inaccurate.
For a society or a nation to raise the standard of living, it must strive to maximise the
return from its resources or improve productivity. Productivity measurement, of which
the measurement of human work is an integral part, is a means to an end. Webster defines
productivity as ‘the quality or state of being productive’. Productivity and efficiency are
commonly used interchangeably, which is a misnomer. While productivity is the amount
of output produced relative to the amount of resources (time and money) that go into the
production, efficiency is the value of output relative to the cost of inputs used.
Productivity improves when the quantity of output increases relative to the quantity of
input. Efficiency improves, when the cost of inputs used is reduced relative the value of
output.
Figure 3 shows the cyclic effects of low productivity growth rate on the national
economy. The problems of inflation, international trade competition, and unemployment
are directly affected by the level of productivity growth and the quality of goods and
services produced. Hence, productivity needs to be measured dynamically in order to
appraise the socio-economic health of the nation. Measurement of productivity (be that of
labour, material, or capital) would provide an entity the necessary information to take
action to increase labour productivity in order to increase performance and attain
effective utilisation. It also serves as a tool to measure results of actions, set achievable
targets and goals, and establishes means whereby remuneration may be linked to
improvement.
Figure 4 shows the potential tools that could be used by organisations to improve
productivity. All these tools, when used in the right way, can lead not only to remarkable
improvements in productivity but also increases worker morale, efficiency, and their
overall standard of living. The well-being or quality of life of a population is an important
concern. It is measured by the social and economic environment. The quality of life
comprises of a number of components some quantifiable: e.g., the standard of living, the
amount of money and access to goods and services that a person has, etc.; and others
which cannot be measured directly: e.g., freedom, happiness, art, environmental health,
and innovation. Productivity and work can be tied together by the concept of fair day’s
work.
‘The fundamental principle of the work and wage relationship is that the employee is
entitled to a fair day’s pay in return for which the company is entitled to a fair day’s
work.’
 Productivity and disability: the need to modify work standards 221

Figure 3 The cyclic effects of low productivity growth

Higher prices for goods and

services

Higher unit labour Decline in sales volume

Higher machinery cost
Higher interest rate Low rate of
productivity
growth
Reduced plant capacity
More inflation
Reduced employment
Decline in capital investment
Reduced research and
Increased unemployment

Further decline in productivity

– loss of sales revenues, and
low output

Source: Edosomwan (1985)

Figure 4 Productivity tools for organisations

Improved material
handling
Improved Improved
layout Work
simplification workflow

Job Systems
enlargement analysis
PRODUCTIVITY
TOOLS
Incentive Attitude
plans surveys

Supervisory Job Suggestion

training programs
redesign
Cost-reduction
programs

Source: Hamlin (1978)

222 A. Subramanian and A. Mital

Thus, a fair day’s work can be defined as the amount of work that can be produced by a
qualified employee when working at a normal pace and effectively utilising the time
where work is not restricted by process limitations. The major source of confusion in the
above definition is the abundance and variability in defining who a qualified employee is
what is defined as normal pace is, and what is meant by effective utilisation. The fair
wage received by the worker depends on the effort he expends in excess of the work
rules, the work rules themselves, the wages of other workers, the benefits of unemployed
workers, as well as the number of such workers, and the worker’s wages received in
previous periods.

5 Productivity, work standards and disability

In the current cut-throat competitive business environment, there is a constant need for
innovation and establishment of improved methods to control costs. A work standard for
performance is one such cog in the wheel of cost control program for a business. Work
measurement is a means of establishing what a fair day’s work should be through
development of sound work standards. Establishing work standards is crucial for
establishing a fair relationship between the work performed and manpower utilised. This
necessitates that the standards are accurate and established economically.
Reid (2006), in his paper of framework for productivity and quality improvement,
outlined that organisations are far more likely to achieve their improvement goals when
they used a structured and repeatable method, rather than an ad hoc approach, for
continuous improvement (CI). Work standards permit management to streamline
productivity and also determine how well its employees are performance. This
performance may be productivity related such as assembly tasks, lifting, carrying, etc., or
non-productive operations such as engineering, administrative, managerial, etc. By
definition, work standards are the ‘standard time for a qualified worker working at a
normal pace under standard conditions of tools, equipments, work place, and/or layout
using a standard method to produce quality part or assembly’. Any variation in one or
more standard conditions renders the standard being biased.
Historically, all work standards have been established based on studies conducted on
healthy humans. The question at hand now is whether these existing standards can be
applied directly to disabled individuals performing the tasks and based on that calculate
the productivity and make planning, budgeting, costing, and control decisions? Would the
standards applied project an accurate picture of the reality? If the answer here were
affirmative, which means these are the correct basis for our decisions, there is a
fundamental flaw in our argument. Disability studies have time and again provided
validation that there is significant decrease in the disabled individual’s functional
capacity to do work. The capacity could be in the form of reduced grip strength of finger
or the hands, reduced range of motion, lifting capability, reduced mental capability, etc.
Also, studies have pointed out that there is significant increase in the time to perform
tasks for individuals with disability (Mital, 1999). This implies that any numbers, plans,
and/or budgets derived with these standard times would be incorrect. It is crucial not only
from the point of view of the employer, as it results in a sub-standard decision-making
process, but it is important that the standards be set right from the disabled individual’s
perspective. This is due to the reason that most of the wage, incentive, and remuneration
systems are arrived at based on these standards.
 Productivity and disability: the need to modify work standards 223

Table 2 Summary of some key studies on upper extremity disabilities and functional
capacities evaluation

Study/experiment title Type of upper Main inference/result on functional

Manual lifting: kinematics of a
disability
Strength and range of motion of
females with CTS
Acceptable work limits for the
upper extremities with
psychological approach
The effect of upper extremities
posture on maximum grip
strength
Comparison of functional
capabilities of individuals with
and without finger disabilities
Comparing severity of
impairment for different
permanent upper extremity
musculoskeletal injuries
Basis for an FCE methodology
for patients with work-related
upper limb disorders
extremity disability capacity
Finger Loss of one jaw (finger/thumb) leads
to reduced grip strength (Mital and
Mehta, 1988).
Hand Grip strength and range of motion
severely affected (Fernandez, 1991).
Hand Maximum acceptable frequency
(MAF) reduced, varies as the degree
of flexion/supination changed (Kim
et al., 1994).
Hand, lower arm, Reduced grip strength due to one or
upper arm and more disabilities of up to 42% of the
shoulder maximum (Kong et al., 1996).
Finger Performance adversely affected due
to disability, dexterity was affected
due to disability, lifting capability
declined, torque exertion capability
declined. Time to perform dexterity
tasks increased 3 folds due to
disability (Mital and Pennathur,
1999).
Hand, lower arm, Range of motion is severely reduced
upper arm and (Reville et al., 2002).
shoulder
Upper and lower Reduced handgrip strength, finger
arm strength, wrist positioning, hand
dexterity, and range of motion of
hand and arm reduced significantly
(Reneman et al., 2005).

Table 2 shows a summary of studies that were conducted pertaining to individuals with
upper extremity disabilities. Conclusion from all studies above point out that there were
significant decline in performances. Mital and Mehta (1988) and Mital and Pennathur
(1999) also evaluated the time it took for the individuals to perform tasks with and
without their disabilities. The tasks in the studies aimed at evaluating the dexterity and
the lifting time. Both the studies concluded that there was significant increase in the time
it took to perform the tasks with disability as compared to performing without the
disability. Hence, based on existing literature it could be concluded that the productivity
of the disabled individual is not the same at that of the individual without the disability.

5.1 Productivity study based on lifting task

Mital and Mehta (1988) conducted study simulating lifting tasks performed by
individuals with and without disabilities. Their primary hypothesis was to test whether
there were significant loses in the grip strength due to disability while performing lifting
224 A. Subramanian and A. Mital

tasks. The secondary premise was to examine whether the individuals with disability
performed tasks at a slower pace than without disability.
Eight subjects were used for the study and the tasks were performed under two
conditions:
1 as healthy individuals
2 as individuals with finger disabilities.
The disabilities were simulated by constraining the motion of the individual’s fingers
with tape. The nature of disability was specific and limited to loss of four fingers in the
primary (preferred) hand and the thumb in the weaker (non-preferred) hand. Under
normal conditions, a box is held in grip formed by two jaws of the hand; four fingers
together form one jaw and the thumb forms the other. Loss of either jaw results in weak
coupling and hence additional effort needs to be expended by the individual. Lifting of
two loads of different weights (25 lbs and 50 lbs) was simulated.
Table 3 Summary of time to perform experimental tasks for individuals without disability and
with simulated disability

Performance Task time Task time Difference % of age

measure (no disability) (disabled) difference
millisecs millisecs
25 lbs box-lift 1265 2590 1325 104.74%
50 lbs box-lift 1432 2655 1223 85.41%
Source: Mital and Metha (1988)
Table 3 summarises the results that were obtained from the study. It is evident that
disability causes individuals to perform tasks at a slower pace. The modifying factors for
the task times in these cases varied from 1.84 to 2.04. Consider the task of lifting and
placing the 25 lbs box. In one hour, the individual without disability would have
completed 2,846 cycles, while the disabled individual would have completed only 1,390
cycles. Clearly, the employer needs to make arrangements to cover this shortfall in
productivity. Table 4 shows the various alternatives along with their cost to the business.
Table 4 Various alternatives to regain productivity losses due to disability

Alternative Cost
Overtime Direct cost × (1.5–2.0)
Over employment Wage × number over-employed
Replacement (Wage + training + lowered quality/production) × number of
employment replacement employees
Increase work rate Reduced product/service quality
No action Reduced productivity
Source: Oxenburgh (1991)
The various alternatives mentioned above may or may not be feasible depending on the
nature of the task under analysis. The direct cost in the overtime option does not include
the administrative and personnel costs. In this alternative, the employer offers other
employees an increased pay for additional services over their regular work-hours. In case
of over employment, the employer would go and hire additional workers to make up for
 Productivity and disability: the need to modify work standards 225

the lost productivity. Of all the above, the overtime is the best option in terms of cost
benefits. However, the limitation is that it is effective only over a short period, e.g., cases
of absenteeism from work due to injury etc. Increase work rate can lead to loss of worker
morale and faster deterioration of the ability to perform work over longer durations. All
the alternatives mentioned above have a cost associated with them. This will be in
addition to the disability related costs and any other rehabilitation costs that the employer
might have to expend.

6 Discussions

Research and literature points out that while disability rehabilitation and accommodation
process has gained a lot of momentum over the past decade or so, there has been a lack of
continuing research to study the time constraints imposed by tasks. Further, a clear
taxonomy does not seem to exist for prescribing work and production standards for
individuals with disability. Task specific, disability specific and wide individual
differences due to disabilities imposed by tasks are some factors lacking proper taxonomy
Although disabilities studies in the past have quantified the loss in performance and
also to some extent the increase in time to perform tasks, there has been no dedicated
effort to review or modify the underlying time standards on which these cycle times are
derived from. All studies were based on standardised experimental tasks, which have
very limited application to the industry. The need is to develop modifiers for the existing
standards like the MTM and arrive at accurate standards for individuals with disabilities.
As these standards are used by business for their short-term and strategic planning, the
wage incentive plans, productivity levels, planning, budgeting, costing, pricing, and
control data arrived at based on these accurate standards would provide precise picture. A
good measure of the productivity would help the business in providing motivation for
better task performance, since it helps to identify on what basis the individual task,
project, product, or customer is to be measured. It provides the basis for planning the
profit level in a company. It provides key measures to planners within the company to
identify areas for potential improvement and do so in a timely manner to prevent
bottlenecking.

7 Conclusions

This paper has extended the literature on the factors affecting productivity metrics when
it concerns the disabled individuals. It has outlined the various disability related studies,
the key outcomes of these studies and how these studies and the disability research to
date can be utilised in furthering the process of continuous improvement. This in turn is
directly related to an organisation’s performance and productivity. It can be concluded
from the above discussion that there is a need to develop disability specific work
measurement data. This data needs to be developed in lines with the requirements for
standard data as defined by work measurement system. This data would be useful not
only to determine standard times for tasks but also help in determining wage
compensations and design incentive schemes, determine the levels of productivity,
determine insurance benefits, etc.
226 A. Subramanian and A. Mital

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