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Ergonomics: Train the Trainer

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Good rule of thumb is approx. an arms length away (18-30 in.). Height ... Pain over the thumb side of the wrist is the main symptom. ... – PowerPoint PPT presentation

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Title: Ergonomics: Train the Trainer


1
ErgonomicsTrain the Trainer
  • Randy Wegge

2
Definition
  • Webster
  • ergonomics (ûr'g?-nom'iks) an applied science
    concerned with designing and arranging things
    people use so that the people and things interact
    most efficiently and safely.
  • Literal definition
  • Ergon work
  • Nomos rules
  • The rules of work

3
Ergonomics
  • Ergonomics the engineering science concerned
    with the physical and psychological relationship
    between machines and the people who use them.
  • The practice of adapting products and processes
    to human characteristics and capabilities in
    order to improve peoples well-being and optimize
    productivity.
  • Fitting the job to the worker
  • We must understand
  • What tasks are being performed
  • Who is performing the tasks
  • What is being used to perform the tasks

4
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6
Components of a Work Station Fitting all the
pieces together!
  • Chair
  • Work surface
  • Keyboard/Mouse
  • Monitor
  • Telephone
  • Environment
  • Accessories

7
Chair
  • Seat Height
  • Able to reach the floor comfortable with both
    feet flat on the floor
  • Seat Angle
  • Slightly forward tilt
  • Seat Depth
  • Allow a width of three fingers between calf and
    seat pan
  • Backrest Height
  • Back support hits the lumbar region
  • Backrest Angle
  • Allows for 90 - 120 hip flexion
  • Armrests
  • Must be used correctly or should not be used at
    all

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9
Adjusting Your Chair - Video
  • Watch Video
  • Lets give it a try!

10
Work Surface
  • What can be adjusted?
  • Height
  • Should be adjusted to the proper chair position.
  • Allows for ergonomic positioning.
  • Arrangement
  • Primary, secondary, reference zone

11
Workstation Set-up
  • Primary Work Zone
  • The distance from elbow to hand
  • Able to reach these items without reaching for
    them.
  • Secondary Work Zone
  • Within arms reach
  • Reference Zone
  • Outside of arms reach

12
Keyboard/Mouse
  • For most employees these should be situated in
    the primary work space.
  • Arrange directly in front of monitor.
  • Demonstrate how to correctly use the mouse and
    keyboard.

13
Monitor
  • Distance
  • Good rule of thumb is approx. an arms length away
    (18-30 in.).
  • Height
  • Eye level should be at the top 1/3 of monitor.
  • Bifocals need to have monitor as low as you
    can.
  • Location
  • Directly in front of the keyboard.
  • Angle
  • Approx. 10-20
  • Font
  • Size
  • Clarity/Resolution
  • Color Schemes
  • Light colored font on dark background.

14
Telephone
  • Depending on employee, the phone will normally be
    placed either in the primary or secondary work
    space.
  • Headsets
  • More than 2 hrs of use per day Mandatory?
  • Built-up hand set attachments do not do enough.

15
Environment Every day nuisances
  • Lighting
  • Air Quality
  • Temperature
  • Space
  • Noise
  • Neighbors
  • Fax, Copier, Telephone, etc.

16
Accessories
  • Document Holders
  • Footrests
  • Glare Screens

17
Assessment Process
  • Gather information.
  • Evaluate how the existing set-up looks.
  • Adjust what is already there.
  • Make your adjustments/recommendations.
  • Follow up/Re-evaluate (2 weeks).
  • If still deficienttry new adjustments and
    consider introducing equipment.
  • TRAIN how to use!
  • Follow up as needed.

18
Gather Information
  • Interview the employee
  • What are your job tasks?
  • How often do you do these tasks each day?
  • How long have you noticed this pain?
  • When does it hurt mostend of day, busier days,
    towards the end of the week, etc.?
  • Do you take regular breaks?
  • What irritates it the most?
  • What specifically hurts?
  • What do you think the issue is?
  • What do you think will help?
  • Observe the employee
  • Watch them work for awhile.
  • Encourage them to work as they normally would.
  • How do they interact with their environment?

19
Assessment Process
  • Evaluate the existing set-up
  • Use checklists if available (initial
    assessments)
  • What is already present and what can we adjust?
  • The workstation components
  • The process
  • The worker
  • Look for postural issues and bad habits
  • Adjust what is adjustable
  • Who will be responsible for making adjustments?
  • Make your recommendations
  • Document
  • Stick only to the facts. What was said, what was
    observed, measurements.
  • Name, date, specific report of discomfort,
    observations, recommendations, plan of action,
    and follow up needs.

20
Sample documentation
  • ____ contacted me yesterday after seeing ____., a
    hand therapist at _________ . ____ has been
    having difficulty bilaterally with tendonitis in
    her wrists every since being pregnant. In
    looking at her workstation, I noted that her
    mouse is positioned in a way that causes her to
    reach forward with her shoulder and she is also
    anchoring her wrist down causing her to remain in
    a static wrist extension for prolonged periods of
    time. I moved her mouse so it is at the edged of
    her desk, reducing/eliminating shoulder flexion
    and I placed a piece of dycem underneath her
    mouse pad to eliminate any sliding. I also
    demonstrated the proper way to hold and use the
    mouse so that it involves the entire arm movement
    and keeps her wrist in a neutral position vs.
    anchoring at the wrist. I replaced her split
    keyboard with a regular one because her keyboard
    seemed too large for her. She still needs to
    reach laterally a good distance to get to her
    mouse so I ordered a keyboard with the number pad
    on the left side which will allow her to keep her
    mouse much closer to her side, reducing her
    lateral reach. I will follow up with ____ in one
    week and install the keyboard as soon as it
    arrives. rw

21
Assessment Process
  • Follow up
  • When? Varies depending on the situation.
  • Has there been any improvement?
  • Have conditions worsened?
  • Re-evaluate
  • Do you still note some areas of concerns?
  • If sois there anything else already present that
    can be adjusted?
  • May need to look at introducing some type of
    ergonomic equipment.
  • Explain whytrain how to useuse it yourself

22
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23
Ergonomic EquipmentGadgets, Gizmos, and Other
Stuff
  • Wrist Rests
  • Pros
  • Maintain neutral wrist positioning
  • Reduce weight throughout shoulders
  • Softens the surface under the wrists
  • Cons
  • Promotes anchoring at the wrist
  • Contact point on the wrist

24
  • Keyboard Trays
  • Pros
  • May adjust the keyboard height and angle to
    custom fit the users needs
  • Allows for more posture changes
  • Cons
  • May decrease knee clearance
  • May force longer reaches for other things
  • If adjusted incorrectly, may exaggerate problems

25
  • Alternative ergo Mice/Keyboards
  • Pros
  • Allows you to use different muscle groups
  • Reduce/Eliminate awkward postures of the arms or
    wrists
  • Reduce/Eliminate movement at the wrist
  • Cons
  • Difficulty adapting, leading to reduced
    production
  • May be using more/different/smaller muscle
    groups
  • No evidence that trackballs help/hinder

26
Do we need an ergo intervention?
27
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28
Trouble ShootingWhy do we hurt???
  • Poor posture
  • Lack of movement
  • Frequent micro breaks
  • Prolonged poor posture can decrease productivity
    by as much as 50
  • Stand to sit ratio of 7030
  • 60 second break every hour

29
Troubleshooting
  • Headaches
  • Muscle tension
  • Stress
  • Irritated/Dry Eyes
  • Monitor glare
  • Distance of monitor
  • Prolonged computer use/Lack of breaks
  • Font selection
  • Poor vision
  • Neck Pain
  • Poor head postures
  • Monitor height
  • Monitor location
  • Document viewing
  • Arms extended
  • Cradling the phone
  • Armrests

30
Troubleshooting
  • Shoulder Pain
  • Poor conditioning
  • Forward head posture
  • Mouse/keyboard too high or off to the side
  • Arms extended
  • Overhead reaching/lifting
  • Overuse/Lack of breaks
  • Elbow Pain
  • Keyboard too high
  • Leaning on elbows
  • Repetitive squeezing/pinching
  • Striking keys too hard
  • Reaching for mouse
  • Overuse/Lack of breaks

31
Troubleshooting
  • Wrist/Forearm Pain
  • Keyboard/mouse positioning
  • Contact forces
  • Striking keys too hard
  • Wrist alignment
  • Wrist deviation
  • Resting on elbows
  • Gripping too tight
  • Type of mouse
  • Overuse/Lack of breaks

32
Troubleshooting
  • Hand/Finger Pain
  • Excessive force on mouse/keyboard
  • Holding static positions
  • Contact points at wrists
  • Type of mouse
  • Wrist alignment
  • Gripping pen too tightly
  • Keyboard/mouse positioning
  • Overuse/Lack of breaks

33
Troubleshooting
  • Upper Back Pain
  • Poor conditioning
  • Elevated shoulders (armrests)
  • Extended arms
  • Forward head
  • Muscle tension
  • Mouse/keyboard is too high/low
  • Seating
  • Lack of breaks

34
Troubleshooting
  • Low Back Pain
  • Poor posture
  • One foot under buttocks
  • Arms extended
  • Twisting
  • Seating
  • Feet do not touch floor
  • Lack of breaks
  • Leg/Feet Pain
  • Seating
  • Feet dangling
  • Seat pan depth
  • Posture
  • Lack of breaks

35
Common Themes??
  • Poor Posture
  • Failure to take breaks
  • We need to continuously stress the importance of
    each employee taking a personal responsibility
    for themselves.

36
Upper Extremity Musculoskeletal Disorders
  • What are they?
  • Soft tissue ailments to the upper extremities,
    most commonly caused by overuse.
  • Soft tissue refers to any tissue that connects,
    supports, or surrounds other structures (bones,
    joints) and organs.
  • Examples muscles, tendons, cartilage,
    ligaments, nerves, fat cells, blood vessels
  • Also referred to as
  • CTD (Cumulative Trauma Disorder)
  • RSI (Repetitive Stress Injury)
  • Overuse Syndrome
  • Musculoskeletal Injuries

37
Common repetitive-type injuries found in the
office setting
  • Lateral Epicondylitis
  • Medial Epicondylitis
  • Tendonitis
  • Carpal Tunnel Syndrome
  • Ulnar Nerve Impingement
  • DeQuervains Tendonitis
  • Shoulder Tendonitis, Bursitis, Impingement
  • Rotator Cuff Tear
  • Thoracic Outlet Syndrome

38
Tendonitis
  • Literally means inflammation of the tendon.
  • Tendons connect your muscles to your bone.
  • Common cause is overuse, when muscles are being
    asked to do higher levels of activity they are
    not accustomed to doing.
  • Treatments
  • Icing the affected area
  • Rest
  • Brace protects the tendon
  • Anti-inflammatory medication

39
Lateral Epicondylitis
  • More commonly known as Tennis Elbow
  • Pain in the lateral aspect of the elbow where the
    muscles connect to the bone.
  • Treatment
  • Stop or limit activity
  • Anti-inflammatory medication
  • Brace may be worn
  • Stretching and strengthening.

40
Medial Epicondylitis
  • Also known as Golfers Elbow
  • Similar condition as Lat. Epi., only the pain in
    on the inside of the elbow around the boney
    prominence.
  • Treatment is the same as with Lat.
    Epicondylitis.

41
Carpal Tunnel Syndrome
  • A disorder in which the median nerve is
    compressed at the wrist
  • Causes numbness and tingling. Usually on the
    thumb side fingers.
  • Treatment
  • Wear brace at night or during activities
  • Limit activities that aggravate condition
  • Surgical intervention

42
Ulnar Nerve Impingement
  • Occurs when the Ulnar Nerve becomes compressed
    and cannot function properly
  • Numbness and tingling in the ring finger and
    little finger.
  • Causes
  • Overuse with the elbow in a bent position
  • Direct blow to the elbow
  • Sleep habits

43
DeQuervains Tendonitis
  • A condition caused by irritation or swelling of
    the tendons found along the thumb side of the
    wrist.
  • Pain over the thumb side of the wrist is the main
    symptom. Usually described as sharp, stabbing
    pain.

44
Shoulder Tendonitis, Bursitis, Impingement
  • Tendons of the rotator cuff make contact with the
    acromion and they become swollen.
  • The swollen tendon can get trapped and pinched
    under the acromion. This is known as an
    impingement.
  • Bursitis fluid-filled sacs called bursa become
    inflamed.

45
Rotator Cuff Tear
  • A tear in the tendon
  • Chronic over time, RC tenditis eventually wears
    a hole through the tendon.
  • Acute a sudden motion or lift causing a pop in
    the shoulder. Usually experience an immediate
    onset of pain.

46
Thoracic Outlet Syndrome
  • Your thoracic outlet is the small space between
    your collarbone (clavicle) and your first rib.
  • Caused by pressure on the nerves and/or blood
    vessels that pass through the thoracic outlet.
  • Symptoms can include pain, numbness, tingling,
    weakness, or coldness in the upper extremity.

47
Personal factors/habits
  • Posture
  • Attitude
  • Sleep Postures
  • Hobbies/Sports
  • Age
  • Gender
  • Driving
  • Psychological Impact
  • Obesity/Exercise Fitness
  • Smoking
  • Personal Habits

48
Posture and neutral position gets the first look
49
Not so innocent victims
50
And so on.
51
And so on.
52
Modified from Chaffin Anderson
53
What was always Mothers Advice???
  • Sit up straight!!!
  • Guess whatshe was absolutely right!
  • Decreases the load on your spine
  • Helps the organs of your body function more
    efficiently
  • It promotes movement efficiency and endurance and
    contributes to an overall feeling of well-being
  • Helps you look confident

54
Lifelong misuse of our bodies
  • We trick our bodies into thinking we are
    comfortable.
  • No longer using our core muscle groups.
  • Results in muscles weakening (atrophy)
  • May lead to
  • Fatigue
  • Muscle strain
  • Pain
  • Dr. Wilfred Barlow, a well known physician, has
    found that misuse is usually a major factor in
    both causing and perpetuating rheumatism,
    backache, arthritis, breathing disorders,
    hypertension, fatigue, gastro-intestinal
    conditions, headaches and certain sexual
    problems.

55
What is Proper Posture?
  • Head, trunk, arms and legs are aligned with one
    another
  • Look around, how many people demonstrate good
    posture?

56
At what age do you think kids start to develop
poor posture?
57
Try breathing with head down and hunched
shoulders compared to head up in proper
alignment. Which gives you better breathing
capacity?
58
Attitude of employees
  • Interactions with co-workers
  • Job Satisfaction
  • Unhappy attitude causes discomfort
  • Work Culture
  • Time Pressures (Stress)
  • No time for stretching, breaks, lunch
  • Performance Measures

59
What are other factors?
  • v Posture
  • v Attitude
  • Sleep Postures
  • Hobbies/Sports
  • Age
  • Gender
  • Driving
  • Psychological Impact
  • Obesity/Exercise Fitness
  • Smoking
  • Personal Habits

60
Things to consider
  • Longer work hours (is it really 40 hour work
    weeks?)
  • Smaller workstations
  • Productivity
  • Technology - faxing from desks, emailing, etc.
  • Aging Workforce (people working later in life)
  • Disabilities
  • Obesity (excuse of no time to exercise)
  • Sedentary lifestyles (workstations too
    efficient?)

61
Other things you can do
  • Watch your weight
  • Try to maintain an adequate body weight
  • Excess weight exaggerates poor postures
  • Stop Smoking
  • Constricted Blood Vessels
  • Reduced Oxygen
  • Coughing (mechanical strain)
  • Harder to recover from injury and illness

62
Key Components to a successful injury prevention
program
  • Buy-in from the top down
  • Define a purpose/Set goals
  • Employee involvement
  • Track statistics
  • Training
  • Have expectations/consequences/accountability
  • Be clear and consistent

63
Buy-in from the top down
  • If your CEO, Director, etc. does not believe in
    establishing a programIT WILL FAIL!
  • Need to allocate resources
  • Delineate authority

64
Define a purpose and set goals
  • Ask yourself
  • Why are we establishing a program?
  • What is it you are trying to achieve?
  • Are the employees ready to change?

65
Employee involvement
  • Involve them in all aspects of the program
  • Recognize employees for positive behavior
  • Recognize and analyze problem area
  • Survey the employees to find hot spots
  • Follow through after analyzing the surveys

66
Track injury statistics
  • This is a good starting point
  • Look at your loss runs, claims filed, near miss
    reports
  • Are there trends with injuries types, location
    where injuries occur, jobs with most instances?

67
Training
  • Train all employees on ergonomics, as well as
    your policies for managing injuries.
  • Employees must be informed of the expectations
    you have for them.
  • Employees must be informed of consequences.

68
Expectations/Requirements
  • What do you expect/require from your employees?
  • 1. Attend training, learn the basic principles of
    ergonomics and apply them to your daily tasks.
  • 2. Learn what you can do to decrease your chances
    of being hurt at work.
  • 3. Immediately report any signs of discomfort to
    your supervisor.
  • 4. Follow through with ergonomic
    recommendations.

69
Employee Responsibilities
  • Report any signs of discomfort immediately
  • Take breaks
  • Be willing to try recommendations
  • Do your part to stay healthy
  • Muscles that are well toned are less likely to be
    injured recover faster from injury.
  • Develop a personal lifelong fitness plan to
    include
  • stretching
  • strengthening
  • endurance

70
Expectations/Requirements
  • What do you expect/require from your upper level
    management? (Supervisors, managers, directors,
    etc.)
  • Conduct initial work station assessments within
    the first week of a new employees start date.
  • Document all ergo visits. Include date,
    symptoms, observations and any recommendations
    given.
  • Address your employees ergo needs in a timely
    manner.
  • Discuss safety/ergonomics regularly at your dept.
    meetings

71
Supervisor Responsibilities
  • COMMUNICATION!!
  • Address employee concerns in a timely manner
  • Encourage functional and effective work
    environments
  • Learn and use adjustment features
  • Organize workflow
  • Rotate job tasks
  • Promote positive employee, supervisor relations
  • Demonstrate self responsibility and healthy
    lifestyles
  • Perform a self evaluation and modify workstation,
    job or habits

72
Clear and consistent
  • Does your work environment reflect what you are
    telling your employees?
  • Do you follow the policies when corrective
    actions need to be taken?
  • Does everyone fully understand their role and
    responsibilities?

73
Other things that can be done
  • Know the basic principles and use them throughout
    the day.
  • Apply intervention methods at work and at home
  • Set the example adjust chair, stretch, take
    breaks, etc.
  • Talk ergonomics and safety with employees often

74
Before After Look at Ergonomics
75
Hands-on
  • Well head upstairs at this point to conduct
    assessments of actual workstations.

76
Conclusion
  • Dont be afraid to try something.
  • Communication is key!
  • It is no longer acceptable to be hurting while at
    work
  • Talk about safety oftenbring your ideas to the
    table
  • Ergonomics is not rocket science, once you learn
    the basic principles most of this is common
    sense.
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