Office Ergonomics: Preventing Office-Related Injuries

Office Ergonomics:Preventing Office-RelatedInjuriesJames M. DeCarli, MPH, MPA, CHESResearch Analyst III/Behavioral SciencesInjury & Violence Prevention ProgramDepartment of Public Health, Los Angeles CountyApril 2008

Overview Background on ergonomics DefinitionStatisticsRegulatory Agencies & LawsTypes of work-related injuries Common Anatomical & Associated Risk Factors 6-Steps to Prevention work-related injuries Steps to take-if you experience work-related injury

At the conclusion of today’s trainingyou will be able to: Identify at least 3 risk factorsthat contribute to work relatedinjuries. Perform a self evaluation of yourown work environment. Describe at least 1 change ormodification that you intend tomake to your workstation, job orwork habits.

What is Ergonomics? ERGO WorkNOMICS “rules” or “laws”Ergonomics: Means “the laws of work”

What is Ergonomics? The science of “designing the job to fit the worker,rather than forcing the worker to fit the job” (OSHA) Ergonomic principles are used to improve the “fit”between the worker and the workplace. A practical approach to Ergonomics considers thematch between the person, the equipment they use,the work processes, and the work environment.

Outcome of ErgonomicsOverall, Ergonomic Interventions: Makes the job safer by preventing injury and illness Makes the job easier by adjusting the job to theworker Makes the job more pleasant by reducing physicaland mental stress Saves

Occupational Injury StatisticsErgonomic injuries accountfor one-third of all workplacerelated injuries 600,000 office workerseach year miss at leastone day of work due toergonomic injuries (U.S.Department of Labor (2005) Cost of ergonomicinjuries to employees,employers, and society asa whole: 50 billionannually (National ResearchCouncil/Institute of Medicine, 2001)

Regulatory AgenciesWork-Related Injury & PreventionOccupational Safety and Health Act of 1970National Institute for Occupational Safety andHealth (NIOSH) - U.S. Department ofHealth and Human Services Responsible for conducting research and making recommendations forthe prevention of work-related injury and illness.Occupational Safety and HealthAdministration (OSHA) in the U.S.Department of Labor Responsible for developing and enforcing workplace safety and health regulations.

Regulatory AgenciesWork -Related Injury & PreventionThe State of California Division ofOccupational Safety and Health(DOSH) - referred to as Cal/OSHAResponsible for enforcing California laws and regulationspertaining to workplace safety and health and for providingassistance to employers and workers about workplace safety andhealth issues.

Ergonomic Laws(National)OSHA Act of 1970, Section 5 (a) (1) An employer “ shall furnish a place of employment whichis free from recognized hazards that are likely to causedeath or serious physical harm to employees.”

Ergonomic Laws(California)California Code of Regulations, Section 5110(Repetitive Motion Injuries, 1997) Employers shall establish a program to reduce RMI’s Worksite evaluation Control of exposures that cause RMI’s throughengineering and administrative controls. Employee training RMI exposure Symptoms and consequences Reporting procedures Methods to reduce RMI’s

Ergonomic-Related InjuriesMay be called: CTD’s (cumulative trauma disorders) RSI’s (repetitive stress injuries) RMI’s (repetitive motion injuries)Which are all considered MSD’s (musculoskeletal disorders) MSD’s can affect muscles, tendons, nerves, joints andspinal disks.

Risk Factors and Causes of MSD’s Repetitive, frequent movementsExcessive force (pinch-grip of hands and fingers)Awkward Posture - deviation from the “neutral” body positionStatic Posture - posture occurs when one position is held for aprolonged period of time. The muscles will become fatigued from a lackof blood flow during a static postureContact Stress - Caused by repetitive motion that created localizedpressure point such as on finger tip or thumb. This irritates local tissuesand interfere with circulation and nerve function.Psycho Social - Stress, boredom, clutter, job dissatisfaction and anxietycan contribute to the possibility of developing a MSD. This stress alsocreates increased muscle tension and reduce a person’s awareness ofwork technique.

Common AnatomicalRisks of MSD’sEyesNeckShoulderElbowBackHand/Wrist

Back-Related MSD’sSymptoms MusculartensionLow back painReduced rangeof motionRisks Awkward sittingpositionStatic positionProlonged sittingLumbar notsupportedChair backrest notusedTwisting of torsoFeet dangling-notflat on floor

Shoulder-Related MSD’sSymptoms Musculartension Stiffness Reduced rangeof motionRisks Prolonged ShoulderAbduction (elbows restedoutward on arm rest) Elbows hanging (notusing arm rest) Prolong Raised ShoulderFlexion (elbows forward) Prolong ShoulderHunched position(shoulders up aroundears) Static position

Eye-Related MSD’sSymptoms Sore, tired, itchy,dry, or burningeyesHeadachesDifficulty focusingbetween monitorand documentsIncreasedsensitivity to lightColor fringes/afterimagesRisks Improper viewing,height, angle, anddistanceImproper lightingGlareUninterrupted focus onthe screenHard copy documentlocationDirty screenType of reading glassesScreen contrast betweenscreen and hard copydocument

Neck-Related MSD’sRisksSymptoms Twisting head fromside to side to readhard copy documents Head tilted slightlyback Neck severely flexeddownwardMusculartension Stiffness Reduced rangeof motion

Elbow-Related MSD’sRisksSymptoms Pain Swelling Stiffness Reduced gripstrength in hand Elbow or forearmresting for longperiods on hard orsharp work surface,chair armrests, etc. Elbow flexed for longperiod while usingmouse or keyboard Forceful Repetitivemovements of wristand arm Forceful Repetitivehand grip

Hand/wrist-Related MSD’sSymptoms PainSwelling in jointsStiffness in jointsNumbness orburning sensationin the hand orfingersReduced gripstrength in handRisks Rapid, sustained,or prolongedkeyingForceful keystrokes orexertionsProlonged mouseuseWrists bent back(extended) orforward (flexed)for prolongperiodsContinued

Hand/wrist-Related, continuedRisks Wrists angled to theside when usingside keysWrists or palmsresting for longperiods on hardsurfaceKeyboard andmouse notpositioned correctly

Types of Musculoskeletal Disorders(MSD’s) TendonitisBursitisTennis ElbowTrigger fingerThoracic Outlet Syndrome Carpal Tunnel Syndrome Other Types: Sprains & StrainsNeck & Back Injuries

Tendonitis Inflammation of tendon-thick cord that attaches bone to muscleCommon Office Related Anatomical Location: Elbow & ShoulderCause: Repetitive motion

Tendonitis-Shoulder

Bursitis Inflammation of one of bursa sacks (fluid filled sack-like structuresdiminish friction between two moving structures)Common Office Related Anatomical Location: Elbow & ShoulderCause: Repetitive motion & overuse

Bursitis-Shoulder

Tennis Elbow (lateral epicondylitis) Inflammation of the tendons outside (lateral side) of the elbowCause: Repetitive motion of wrists or repetitive gripping

Trigger Finger(Stenosing Flexor Tenosynovitis) Inflammation of A! pullyCause: Repetitive, forceful,and frequent squeezing orgripping

Trigger Finger(Stenosing Flexor Tenosynovitis)Cont’dNORMAL ANATOMYABNORMAL ANATOMY

Thoracic Outlet Syndrome Compression of the nervesand blood vessels in thethoracic outlet (spacebetween clavicle and firstrib).Symptoms: Pain in shoulders andneck Numbness in fingersCause: Repetitive motion &poor posture

Carpal Tunnel Syndrome

Carpal Tunnel: Narrow, C-shapedpassagewayMade of tiny bonesand ligamentsTendon and nerves Controlmovement tofingersPass through thecarpal tunnel

Symptoms:During repetitive movement:TheTendonsTendon: Irritated-causing Covered-fluid sheath Swelling Help glide during Inflammationmovement Numbness &tingling inthumb and firsttwo fingers. Pain increasesduring sleep &after work

Preventing MSD’sBy applying ergonomic principles to the office setting: Risk factors are minimized Productivity is increased and Workplace quality is improved

Preventing MSD’sErgonomic principles: 6-Steps to Preventing MSD’s: Adjust workstation to promote a neutral position that fits you andmakes you feel most comfortable.When adjusting your workstation-remember-All of the equipmentinteracts with your body and actions-making one adjustment mayalter another. Remember: THINK-type of adjustment to be made ADJUST-make adjustment FEEL-your body/if no improvement, then RE-ADJUST

STEP 1. Workstation Area Organize Desktop to keep frequentlyused items withineasy, limited reach Clear any clutter - tohave space whenworking Area under desk –clear of clutter toaccommodate legs &allow for stretching

STEP 2. Chair Adjustment-Posture Hands, wrists, and forearms are straight, in-line,parallel to the floor.Head is level, or bent slightly forward, forward facing,and balanced. Generally it is in-line with the torso.Shoulders are relaxed, upper arms hang normally atthe side of the body.Elbows stay in close to the body and bent between 90and 120 degrees, resting on armrest.Back is fully supported with lumbar when sittingvertical or leaning back.Thighs and hips are supported by well-padded seat,parallel to the floor.Knees are about the same height as the hips with feetslightly forward.Feet are fully supported by floor or footrest.

STEP 3. Monitor Adjustment Your eyes should be level withthe top of monitor Distance between the eyes andmonitor - not less than 20-inchesaway or not less than arm length The monitor should be tiltedupward slightly Reduce glare from lights orwindows Have document holder next tocomputer monitor

STEP 4. Keyboard/MouseKEYBOARD The keyboard should be directly in frontof you.Your shoulders should be relaxed andyour elbows close to your body.Your wrists should be straight and inline with your forearmsMOUSE Keep mouse close to keyboardAlternate hands with which you operatethe mouseLearn to use keyboard short cuts toreduce extended use

STEP 5. Workstation EnvironmentBe aware of, and try to limit: Glare from overhead lights, desk lamps, and windows Poor air circulation Air conditioning vents that "dump" air right on top ofyouConsider Ergonomic Products to help fit the workenvironment to you

Ergonomically Designed OfficeEquipment

Ergonomically Designed HouseholdTools and Products

STEP 6. Consider New ErgonomicFriendly Work Habits When working for long periods of time on thecomputer, very 20-30minutes take a short 1minute routine break:Remove eyes from screen (see handout in folder) Stretch hands, arms, and back (see handouts infolder) Get regular exercise outside the office. Increasephysical activities (walking, biking, social club) tohelp reduce stress

Ergonomic Assessment &MSD Symptoms?What to do if you need an ergonomic assessment orbegin to experience MSD symptoms: Ergonomic Self-Assessment MSD Symptoms http://www.lapublichealth.org/ivpp/injury topics/OccupationalInjury/OfficeInjury.htmSee your DoctorRequest formal ergonomic assessment (contact IVPP) Give “Ergonomic Assessment Request” to your supervisorSubmit to IVPP

SummaryRemember: THINK ADJUSTtype of adjustment to be made- make adjustment- your body/if no improvement,then RE-ADJUST FEEL

Summary6-Steps to Preventing MSD’s1.2.3.4.5.6.Keep frequently used items in easy reach & clear clutterAdjust chair for neutral posture-feet flat on floor,appropriate height, arm rests adjusted, lumbar supportAdjust top of monitor to eye level and not closer thanarms reachEnsure keyboard is in front of you, located so shouldersare relaxed and elbows close to body, and wrists straight inline with forearms. Ensure mouse is next to keyboardReduce glare & ensure proper lightingTake routine 1-minute eye and stretch breaks every 20-30minutes of computer work and increase physical activity tohelp reduce job stress

Contact InformationErgonomic decarli@ladhs.orgPhone:(213) 351-7888

Outcome of Ergonomics Overall, Ergonomic Interventions: Makes the job Makes the job safer by preventing injury and illnessby preventing injury and illness Makes the job Makes the job easier by adjusting the job to the by adjusting the job to the worker Makes the job Makes the job more pleasantmore p