Ergonomic Considerations for Safe Job Placement

By: David Rodriguez, DPT, MS Doctorate in Physical Therapy and Masters in Risk Control (EH&S Affairs)

Presentation

• Introduction: Therapist, Instructor, Consultant• Where the Greatest Losses are Occurring• Job Analysis: Definition, Risk Mgt Approach• How to Identify Unsafe Exposures• Methods to Control Unsafe Exposures• Real Examples using Engineering Controls• Using Job Analysis with RTW• Discuss other Post-Loss Reduction Activities

Cost of Workplace Injuries

• LBP is the second leading cause of missed workdays (behind the common cold) and the second most common reason for doctor visits among US citizens

– The overall real (inflation-adjusted) direct costs of disabling workplace injuries decreased 4.6 percent between 1998 and 2009.

– According to the 2011 Liberty Mutual Workplace Safety Index, disabling workplace injuries in 2009 resulted in $50.1 billion in US workers compensation costs

Prevalence of Back Injury

• LBP is the most common work-related medical problem in the US.

• Leading cause of disability among people ages 19-45.How many of you have experienced LBP?

• 80% of Americans will experience a major episode of LBP at some point in their lives.

You may not know that you are developing disc problems

• Millions of people suffer from neck, shoulder, arm, low back, and leg pain ― common cause is a herniated disc

• Disc problems are like heart disease ― it usually takes years to develop and can go without early warning symptoms

• Risk factors that can contribute to development of disc herniations and other physical problems include:

Aging and age related changes History of major or minor trauma Lifestyle choices such as poor diet, tobacco use, and lack of exercise Poor posture habits Incorrect and/or repetitive lifting or twisting

Herniated Disc

• Excess spinal pressure can cause these discs to be compressed until they bulge or rupture and impress upon nerve roots.

• Disc herniation occurs when the annulus breaks open or cracks, allowing the nucleus to escape. This is called a Herniated Disc.

Aging WorkforceU.S. Bureau of Labor Market Statistics’ data

• Between 1977 and 2007 there was a 101% increase in the employment of workers aged 65 and above

• By 2016, it is estimated, the number of workers aged 55 to 65 will increase by 36.5%, while the number of workers aged 65 and over will increase by more than 80%

• Injury occurrences are 1/3 less, but more severe (disabling)

•Bone Mass Losses•Disc Dehydration, Spine Degen•Joints lose flexibility, lose fluid•Weight-bearing joint cartilage•Muscle mass loss, fibrosis•Balance decline•Cognitive functions, brain mass•Tremor, decreased reflexes

•Benefits of Exercise

How does Job Analysis fit in?• Definition

– Systematic processes for collecting information on the work related aspects of the job.

• Purpose – To identifying knowledge, skills, and abilities

(KSAs) for employee success on a job– To select or derive testing criteria or predictors

that measure likeliness of job applicant success– To develop standards of performance that

measure employee success on the job for HR selection

Benefits of Job Analysis (relative to our concerns for safe placement)

• Defining physical and environmental exposures that are applicable to all employees in the job

• Development of Pre-placement Physical Exams

• Job matching of employee physical abilities with workplace physical demands

• Provides standards for applying functional testing and assessing RTW abilities

• Provision of a basis for work conditioning programs for return to full-work capacity

• Proactive identification of ergonomic risk factors

• Job categorization for EH&S risk analysis

Functional Capacity Evaluation Forms

y Evaluation Forms

Physical Demands

mands

Workability Forms

Physical Demands

Proactive Environmental Health & Safety

Risk Analysis & Ergonomics

Foundation for HR Recruiting,

Selection, Placement, Training &

Development

Work Conditioning Program Forms

Quantitative Task

Descriptions

Pre-Placement Examination Forms

Quantitative Task

Descriptions

Physical Demands

Quantitative Task Descriptions

J ob Analysis Integrated System (POSSIBLE APPROACH)

JA Composition• Purpose• Job Objective• Critical Tasks (Essential Job Functions)• Significant Worksite Measurements• Demands (including physical, chemical, biological,

sensory and mental-emotional demands)• Tools, Equipment, and Clothing/PPE used • Environmental Conditions• Validation Process

JA Process (Task Analysis Approach)1. Identify the Job Title2. Develop a Job Objective Statement3. The Walkthrough: Scope of JA4. Review Relevant Literature:

• Previous JAs• Available Job Descriptions• DOT-SCO• ONET• Occupational Outlook Handbook• SME Interviews – Productivity Issues

5. Develop Task Statements

JA Process (Task Analysis Approach)

6. Validate tasks with the SMEs (UGESP Specifications)7. Assess the Physical & Environmental Demands and

exposures of each critical task in the field• Obtain Objective Measurements of the tasks in the field • These are Directly Observable and Measurable

Behaviors and Exposures• Document and/or Video step-by-step components to

complete a task• May be useful to establish written safe operational

procedures• Industrial Hygienist (CIH) may be recommended

Physical and Environmental Demands

Standing (Metric, Task 3)Walking SittingForward bendingSquattingCrawling KneelingStair climbingLadder climbingBalance Push/Pull Trunk rotation Lift floor to waistUnilateral Carry

Firm Grasping Finger Manipulating ReachingNeck Flexion Neck Extension Neck Rotation Color Vision Night VisionHearingOlfactory/SmellVibrationTemperatureAirborne ContaminantsChemical Contact

Ergonomic Risk Factor Assessment Toolshttp://www.lni.wa.gov/wisha/ergo

• Qualitative– OSHA VDT Checklist– WISHA rule 2000 Checklists

• WMSD Checklist• Lifting Checklist• Hand-Arm Vibration

– ACGIH TLV for Back

• Semi-Quantitative– REBA– RULA– Liberty Mutual

• MMH (Snook) Tables• Push-Pull Analysis Package• Carry Analysis Package• Lift-Lower Analysis Package

– ACGIH TLV for Hand

• Quantitative– ANSI Z-365– Rogers Muscle Fatigue

Assessment– NIOSH Lift Equation– Moore-Garg Strain Index – Static Work Analysis – Dynamic Work Analysis– Hand-Arm Vibration – Total Body Vibration

Proactive Ergonomics and Risk Control• By systematically breaking-down the step-by-

step operational components of tasks, we may identify and quantify existing or potential employee exposures to environmental, health, and safety (EH&S) hazards, and determine the best methods to control, reduce or eliminate these hazards.

• Ergonomic controls are used to help fit the workplace to the worker

Hierarchy of ControlsI. Engineering Controls

– Modifying, redesigning, replacing• Workstations, work areas• Materials, objects, containers design and handling• Hand tools and equipment used

II. Administrative Controls– Deal with how work is structured

• Proper maintenance and housekeeping• Job rotation• Job enlargement• Work schedule - shifts• Breaks – recovery time

Hierarchy of Controls

III. Safe Work-Methods Instruction– Education, training, and monitoring in safe

procedures and technique• Organization of workspace to reduce fatigue• Modifying procedures to ensure neutral postures• Gradual reintroduction to work for new hires and RTW• Worker controlled pace to reduce fatigue

IV. Personnel Protective Equipment– Reduces the amount of exposure by placing a

barrier between the hazard and the worker

Refinery Reactor 25 lb Drain Valve Removal & Installation

procedures resulting in a costly low back injury

Stressors were significantly reduced after sitting on a wooden plank placed across the scaffold supports

Right-hand dominant female sustaining costly work-related injuries and surgeries (ganglion cyst and carpal tunnel release) to the left-wrist began to develop problems with the right-wrist shortly after RTW. Job involves bench assembly work with pistol-grip style pneumatic impact-wrenches balanced and suspended overhead.

600 Flexion

Tools with straight handles are a good choice for tasks in which the force is exerted perpendicular to the straightened forearm and wrist

Right-hand dominant male sustained a left bicep tendon sprain and rotator cuff tear upon forcibly pulling on a computer cabinet

reportedly costing the company $150,000 in direct costs( measured a 52 lb breaking force to move cabinet)

• Post surgical continuing to work. Instructed in pushing and pulling technique by keeping elbows along-side body and weight-shifting whole body on feet to move the load

• Avoid pulling and always push when possible. Keep cabinets stored where pushing is possible

• Ask for assistance where needed

Injury Mechanism

Battery Operated Cart

Power Stackers, Pallet Jacks, Elevating Carts

Rollers Diverters

Adjustable Platforms

Using Job Analysis Info with RTW

• Effective Post-Injury Employer Loss Reduction Activities with Return-to-Work will require an understanding of combining 2 components:1. The Physical and Environmental Demands of the Target Job where

placement may occur• Job analysis to tease-out the demands and exposures

2. The injured and/or disabled Employee’s Safe Physical Tolerances and Capabilities

• Brief history and neuromusuloskeletal physical and objective functional testing should precede placement

Comparative Assessment of 1 & 2 above for successful placement

Other Employer Post-Loss Reduction Activities

• RTW Programs• Work Conditioning• Post-Offer Pre-Placement Testing• Rehabilitative Therapies• Adaptive Equipment and Special Tools• Functional Capacity Evaluation

• A Primer Based on Workplace Evaluations of Musculoskeletal Disorders – Describes the basic elements of a workplace program designed to

prevent WMSDs

– Management commitment, worker participation and trainingare addressed along with proceduresfor identifying, evaluating and controlling risk factors for WMSDs

– Performing job analyses and developing controls to abate Ergorisk factors are integral to this process

http://www.cdc.gov/niosh/docs/97-117/default.html

Contact Information:

David Rodriguez, DPT, MSOccupational Health & Safety Consultant

MSI Occupational Health & Safety, LLCP.O. Box 8134

Eau Claire, WI 54702Phone: (715) 495-0165

Fax: (877) 532-0334Website: http://www.healthyMSI.com

Email: Info@healthyMSI.com