2017 gosh - ergonomics - keeping the worker on the job ... · keeping the worker on the job david...
TRANSCRIPT
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Ergonomics Keeping the Worker on the Job
David Raptosh, MA, OTR/L
Regional Director of WorkStrategies
Job Site Analysis
� WorkRisk Analysis
� WorkTask Analysis
� WorkStation Analysis
Job Site Analysis - Identify Risk
� WorkRisk Analysis
� Analyze Job Functions and
Determine Risk Factors
� Establish a plan of action
� Implement the proposed
recommendation, modification or
reasonable accommodation
� Educate the employee to prevent in
juries and minimize symptoms
� Identify equipment and ergonomic
solutions
Job Site Analysis – Evaluate Job
Functions
� WorkTask Analysis
� Narrative report describing each
essential functions performed
� Physical and postural demands
quantified
� Frequency of each function listed
� Describe how the function is
performed
� List and description of tools used.
� Valuable tool for return to work
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Job Site Analysis – Ergonomics
� WorkStation Analysis
� Analyze computer workstation according to accepted ergonomic principles.
� Make adjustments to existing equipment.
� Educate regarding use of existing equipment.
� Make recommendations for possible equipment modifications
Ergonomics
� A discipline that involves arranging the
environment to fit the person in it.
� Following ergonomic principles helps reduce stress and
eliminate many potential injuries and disorders associated with
the overuse of muscles, bad posture, and repeated tasks.
� This is accomplished by designing tasks, work spaces, controls,
displays, tools, lighting, and equipment to fit the employee’s
physical capabilities and limitations.
» Center for Disease Control
» www.cdc.gov/od/ohs/Ergonomics/ergodef.htm
Ergonomics Benefits / Features
� Reduces lost time from work (Average Carpal Tunnel Syndrome lost work time is 30 days)
� Reduces worker’s compensation costs and claims
� Reduces human errors
� Reduces absenteeism and turnover
� Demonstrates proactive work environment
� Provides primary and preferred method of controlling
Cumulative Trauma Disorders
� Improves employees’ health and safety
� Improves production, quality, and efficiency
� Improves job satisfaction
� Boosts employee morale
Perspectives
Single-segment dynamic coplanar analysis at elbow
of forearm-hand flexion motion.
It doesn’t have to be hard or complicated
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Digital Neuritis
Trigger Finger
Radial Tunnel Syndrome
DeQuervain’s
Disease
Tendonitis
Thoracic Outlet Syndrome
Cervical Strain
Rotator Cuff Tendonitis
Mechanical Back Syndrome
Muscle Strain
Carpal Tunnel Syndrome
Guyon Tunnel Syndrome
Epicondylitis
Sub-Patellar Bursitis
Shin Splints
Plantar Fasciitis
Ligament Sprain
Herniated Disc
Degenerative Disc Disease
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CTDs
� Two main categories
� Tendonitis
• Lateral epicondylitis
• DeQuarvain’s Stenosising Tenosynovitis
• Post Tibials Syndrome
� Nerve compression
• Carpal Tunnel Syndrome
• Cubital Tunnel Syndrome
• Tarsal Tunnel Sydrome
• Radiculopathy
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Carpal Tunnel Syndrome
� Evidence of highly repetitive work alone or combined with other factors and CTS
� Evidence of forceful work and CTS
� Insufficient evidence of awkward postures and CTS
� Evidence of vibration and CTS
� Think for a moment about incidence and cost as related to risk factors and their reduction:
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Neck MSD
� Evidence for causal relationship between highly repetitive work and neck & neck/shoulder MSD
� Repetitive work was those with continuous arm or hand movements which loaded neck & shldr
� Evidence for forceful exertion & neck MSD
� Strong evidence for high levels of static contraction, prolonged static loads or extreme posture & neck/shoulder MSD.
� Insufficient evidence for vibration and neck/shoulder MSD.
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Shoulder MSD
� Evidence for highly repetitive work & shoulder MSD.
� Insufficient evidence for Force and shoulder MSD
� Evidence for repeated or sustained shoulder postures
and shoulder MSD
� Insufficient evidence for vibration and MSD
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Elbow MSD
� Insufficient evidence for repetitive work and elbow
MSD
� Evidence for forceful work and elbow MSD
� Insufficient evidence for posture alone and elbow MSD
� Strong evidence for exposure to combination of risk
factors and elbow MSD
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Hand/Wrist Tendonitis
� Evidence of Repetitions and hand/wrist tendonitis.
� Evidence of Force and hand/wrist tendonitis.
� Evidence of Posture and hand/wrist tendonitis.
� Evidence of Vibrations and hand/wrist tendonitis.
� STRONG evidence of combination of risk factors and
hand/wrist tendonitis.
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Hand-Arm Vibration Syndrome
� Strong evidence of high level of hand-arm vibration
and vascular symptoms of hand-arm vibration
syndrome (HAVS) – Shocker!!
� Greater the intensity and duration of vibration, greater
the HAVS incidence risk.
� Greater vibration intensity, greater HAVS severity.
� With increased intensity and duration, quicker onset of
symptoms.
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Low Back Disorders
� Evidence for back disorder and heavy work
� Strong evidence for LB disorder and force
� Evidence for awkward posture and LB disorders
� Strong evidence of whole body vibration and low back
disorder
� Insufficient evidence of LB disorder and static work
posture. (but few studies)
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Overview of Risk Factors and MSDs
Reps Force Posture Vibration
Neck + + ++ No
Shoulder + No + No
Elbow No + No All RF: +++
CTS + + No +
Hand/wrist
tendonitis
+ + + +
All RF: +++
Low Back Not studied ++ Awkward +
Static No
++
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Perspectives
� It Doesn’t Have to be Expensive
Bucket Analogy
Wear & Tear
���� Cumulative
Trauma: Wear
& Tear Exceeds
Healing
Healing
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Activity Factors� Activity Duration
� Repetitive Motions
� Awkward Postures
� High Forces
� Environmental� Vibration
� Cold
� Stress
Duration
� Eight hour day?
� Continuous activity?
� Breaks?
� Overtime?
Repetition Wrist CTDs - Reps & Force
Silverstein 1985
Low Force/
Low Reps
Hi Force/
Low Reps
Low Force/
Hi Reps
Hi Force/
Hi Reps
Odds
Ratio
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Force Awkward Postures
Vibration
Pressure
Points
Pressure
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Temperature Extremes Stressful Conditions
High Compression/Forces Vibration
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What are the Ergonomic Hazard(s) in
this office?Ergonomic Solution
Identify the Ergonomic Hazard(s) in
this office?Is there any Ergonomic Hazard here?
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Lathe Operator
Normal guy
Perfect Lathe Operator
Work in Neutral Postures
� Neck Straight
� Shoulders Relaxed
� Elbows at your side
� Wrists Straight
� Three Curves in the Back
Neutral Postures – Before & After
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Reduce Excessive Force Reduce Repetitions – Before & After
Keep Everything within Easy Reach Work at Proper Heights
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Minimize Fatigue & Static Load Minimize Pressure Points
Provide Clearance Move, Exercise, Stretch
� No one best posture
� Alternate sitting and standing
� Compensate for sustained postures
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10. Maintain a Comfortable
Environment
� Lighting
� Temperature
� Vibration
� Noise
� Stress
Work Environment
When To Recommend a Job Analysis
or an Ergonomic Evaluation
� Client with CTD, especially surgical case
� Recurrent injuries
� Method of injury – routine work activities & symptoms
developed over time
� Multiple injuries from same area of company
Questions?
David Raptosh, MA, OTR/L
Select Physical Therapy / NovaCare Rehabilitation
Regional Director of Work Strategies
2015 Technology Parkway
Mechanicsburg, PA 17050
Phone: 717-580-8749
Email: [email protected]