Safety in the Office

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					Safety in the Office

   Sit up pay attention
And Look at your Ergo Mr.!



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                    Definition
• Webster:
   – er·go·nom·ics (ûr'gə-nŏm'ĭks): 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”

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                           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 people’s 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


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                                                   People
                                                 physical size
                                                 work habits
                                              physical condition
                                             individual attributes




Environment
   lighting
  air quality                                                                              Tasks
 temperature                                                                       tools and equipment
     space                                                                               work pace
     noise                                                                           job requirements




             Psychosocial                                                 Furniture
        administration philosophy                                        work surfaces
         employee responsibility                                     technology/equipment
            job satisfaction                                                 chairs
                  stress                                                  adjustability
              incentive pay
                 quotas
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              Components of a Work Station
                 Fitting all the pieces together!



•   Chair
•   Work surface
•   Keyboard/Mouse
•   Monitor
•   Telephone
•   Environment
•   Accessories
                               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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                 Work Surface
• What can be adjusted?

  – Height
     • Should be adjusted to the proper chair position.
     • Allows for ergonomic positioning.


  – Arrangement
     • Primary, secondary, reference zone



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                   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 arm’s reach


•   Reference Zone
     –   Outside of arm’s reach
           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.




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                                           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.
                 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.




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


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             Accessories
• Document Holders
• Footrests
• Glare Screens




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       Assessment Process
1. Gather information.
2. Evaluate how the existing set-up looks.
3. Adjust what is already there.
4. Make your adjustments/recommendations.
5. Follow up/Re-evaluate (2 weeks).
6. If still deficient…try new adjustments and
   consider introducing equipment.
7. TRAIN how to use!
8. Follow up as needed.
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                  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 most…end 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?

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             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.


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              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 so…is there anything else already present that can be adjusted?
   – May need to look at introducing some type of ergonomic equipment.
       • Explain why…train how to use…use it yourself




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              “Ergonomic” Equipment
           Gadgets, 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



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• 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

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• 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

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Do we need an ergo intervention?




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                Trouble Shooting
                  Why 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 70:30
     • 60 second break every hour




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                     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
     –   Lack of breaks


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                    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


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               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

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       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

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             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

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               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


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           Common Themes??

• Poor Posture

• Failure to take breaks

  – We need to continuously stress the importance of
    each employee taking a personal responsibility for
    themselves.

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        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

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    Common repetitive-type injuries found in the office
                        setting

•   Lateral Epicondylitis
•   Medial Epicondylitis
•   Tendonitis
•   Carpal Tunnel Syndrome
•   Ulnar Nerve Impingement
•   DeQuervain’s Tendonitis
•   Shoulder Tendonitis, Bursitis, Impingement
•   Rotator Cuff Tear
•   Thoracic Outlet Syndrome

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                    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

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               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.
              Medial Epicondylitis
• Also known as “Golfer’s
  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.
      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
        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
          DeQuervain’s 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.
       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.
                  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.
        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.
            Personal factors/habits
•   Posture
•   Attitude
•   Sleep Postures
•   Hobbies/Sports
•   Age
•   Gender
•   Driving
•   Psychological Impact
•   Obesity/Exercise & Fitness
•   Smoking
•   Personal Habits

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Posture and neutral position gets the
             first look




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Not so innocent victims




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And so on….




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And so on….




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       P from Chaffin &
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What was always Mother’s Advice???
• Sit up straight!!!
• Guess what…she 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

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     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.


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What is Proper Posture?

            • Head, trunk, arms and legs
              are aligned with one
              another

            • Look around, how many
              people demonstrate good
              posture?
                             At what age do you think kids
                                 start to develop poor
                                        posture?



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       Try breathing with head down and hunched
       shoulders compared to head up in proper
       alignment. Which gives you better breathing
       capacity?




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         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

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

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              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?)




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      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

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    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

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      Buy-in from the top down
• If your CEO, Director, etc. does not believe in
  establishing a program…IT WILL FAIL!

• Need to allocate resources

• Delineate authority



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  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?




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        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



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        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?



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                  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.



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         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.




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       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

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       Expectations/Requirements
• What do you expect/require from your upper
  level management? (Supervisors, managers,
  directors, etc.)
  1.   Conduct initial work station assessments within the first week of a
       new employee’s start date.

  2.   Document all ergo visits. Include date, symptoms, observations and
       any recommendations given.

  3.   Address your employees ergo needs in a timely manner.

  4.   Discuss safety/ergonomics regularly at your dept. meetings


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

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    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?



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   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

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Before & After Look at Ergonomics




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                  Hands-on
• We’ll head upstairs at this point to conduct
  assessments of actual workstations.




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           Conclusion
• Don’t be afraid to try something.
• Communication is key!
  – It is no longer acceptable to be hurting while at
    work
  – Talk about safety often…bring 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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