appendix vi-b. summary of case studies demonstrating

Appendix VI-B. Summary of Case Studies Demonstrating Effectiveness of Ergonomic Programs/ Interventions

Reported Reduction in Injury Rates

Job Title orActivity

SICCode Ergonomic Solutions Lost Workday MSDs Total MSDs Sources

Food Packing 20 Implemented full program on packing line,including job task analysis, employeeinvolvement in identifying problems andsolutions, worker training, and medicalmanagement. Job analysis resulted in 56proposals for changes in equipment and workenvironment, half of which were implemented insix months.

In 1976, prior toimplementing theprogram, there were 51hand MSDs identifiedamong 200 packingworkers. Hand MSDswere eliminated by1980, four years afterprogramimplementation. Otherupper extremity illnessesdeclined by about 47%in this same time period.

Luopajarvi et al. (1982)(Ex. 26-1042);Luopajarvi et al.(Undated) (Ex. 26-1090)

Meatpacker 2011 Training efforts included awareness training ofcorporate and plant managers and technicaltraining of safety and medical personnel. Ergonomic task forces were established atindividual plants to identify problem jobs andimplement exposure controls. Controls includeduse of anti-fatigue mats and manual handlingassists such as conveyors and trucks. Jobrotation and cross-training of rotated workerswas also employed.

Not Reported Cumulative traumainjuries reduced fromfour in one month tonone reported during a6-month period.

McCasland (1992) (Ex.26-1043)

Meatpacker- porkdeboning

2011 Introduction of automated system fordeboning/skinning and a pneumatic lifter toautomate hanging of large sausage casings ontoprocessing racks.

Lost time due to injurydropped from 30% oftotal work hours to lessthan 2%.

CTDs have declinedfrom 84 cases to 9 casesover a 6-year period

Murphy (1992) (Ex. 26-1103)

Meatpacker 2011 Implementation of an ergonomics program,including engineering controls, work hardeningprogram, training, and medical management.

Not Reported CTDs decreased from47.8 per 100 workers(1987) to 17.2/100workers (1990) and17.7/100 workers(1991).

OSHA Site VisitCase Study No. 2 (26-1175)





Meat preparation 2011 Introduction of engineering controls: redesignedworkstation by sloping the work surface towardthe meatcutter; introduced rotary cutter and singlehooks.

Not Reported 80% reduction inmusculoskeletal injuriesin the first year.

Oxenburgh (1994) (Ex.26-1041), Case 45

Poultry processing 2015 Implementation of an ergonomics program,including redesign of processing lines, use ofrubber-matted stools and platforms of varyingheights to eliminate awkward reaches, workertraining, and job reassignment for injuredworkers.

Not Reported Decline in upper-extremity andneck/shoulder injuriesfrom about 32 permonth to 0.

Farr (1991) (Ex. 26-1044)

Poultry processing 2015 Introduction of workstation analysis andredesign, including altering heights of products,providing workstands, and installing tank tiltersto reduce manual handling. Program alsoincluded worker training and development of anintegrated medical management/surveillance-analysis system.

Not Reported Carpal tunnel incidencerates decreased from 7.8per 200,000 hours tobetween 2.4 and 3.7 per200,000 hours. Backinjury rates declinedfrom 4.4 per 200,000hours to 3.0 per 200,000hours.

Stuart-Buttle(1994) (Ex. 26-1045)

Poultry processing 2015 Introduction of engineering controls: tool/handleredesign; work practice controls; administrativecontrols.

Not Reported Recordable injuries andillnesses decreased from10-14/100 workers(1988-89) to 7/100workers (1991).

OSHA Site VisitCase Study No. 1 (Ex.26-1174)





Ice creammanufacture,various jobs

2024 Performed job hazard analysis, implementedseveral controls including use of non-skidelevating platforms for shorter workers; modifiedworkspace layout to permit workers to movewithout being hindered; replaced sharp edges ofewuipment with sloping angles or padding;replace hygienic thin-filmed gloves with warm,flexible gloves; modified way employeesperformed lifting and carrying tasks.

In 1985, beforeimplementing theprogram, there were 4compensation claimsand absenteeismequalled 10 % of thenumber of shiftsworked. In 1897, therewere no compensationclaims and absenteeismwas reduced to 4% ofshifts worked.

Elie (OH&S Canada,Vol. 4, No. 7) (Ex. 26-1100)

Cattle feedprocessingoperation

2048 Provided a forklift and a bobcat to eliminatemanual lifting and relocated the feed mixer inorder to install chutes and augers to permitmechanical loading of feed. Installed bulkstorage containers so that additives could begravity-fed to the mixer. Constructed a platform under the auger equal inheight to the truck platform, which allowed feedbags to be filled without manual lifting.Program also included providing lifting andhandling training to workers.

Not Reported The company eliminatedmanual handlinginjuries.

Teleki (1995) (Ex. 26-1046)

Bakery 205 Engineering controls: workstation redesign, toolmodifications; improved work practices;formation of labor-management CTD committee.

Absenteeism related tocarpal tunnel syndromedecreased from 731 lostwork days(1987) to 8lost work days (Jan.-Aug., 1991).

Carpal tunnel casesdecreased from 34(1987) to 13 (1990).

Robinson (1993) (Ex.26-1102)





Packaging sugarcubes

206 Cubes were packed tightly using a hand tool thatrequired worker to exert considerable pressure ona sharp corner edge. Company changesmarketing strategy that permitted cubes to bepacked loosely, avoiding use of excessive handforce.

Considerable reductionin sickness absence andworkers compensationclaims.

Serious strain injuries tohands was “virtually”eliminated.


Mattressmanufacturer,material handling

2515 Introduction of hand trucks and lift systems toaid in manual handling. Job hazard analysisinvolving the employees in identification ofproblem areas and solutions to problems.

53.5% reduction inworkers compensationreports in one year(1991).

Not Reported Bedtimes (1992) (Ex.26-1047)

Mattressmanufacturer,material handling

2515 Job hazard analysis of all job functions to resolveergonomic problems. Modified workstations,tools, and manufacturing procedures. Modified equipment to reduce need to lift itemsabove shoulder height or below knee level.

Lost time reduced 1/4 to1/3 in 3 years.

Not Reported Bedtimes (1992) (Ex.26-1047)

Mattressmanufacturer,warehousing

2515 Added conveyor, increased fork truck use,reduced stacking heights, and revised handlingprocedures. Production process changed toeliminate material handling and loading ontotruck.

Not Reported Decreased injuries from9 to 1 in one year.

Marcotte (undated) (Ex.26-1048)

Office furnituremanufacturing,various jobs

252 Introduction of a plant ergonomics programemploying engineering controls, work practicecontrols, administrative controls, medicalmanagement, and education and training.

Restricted workdaysdecreased from 301/100employees to 221/100employees.

Decreased rate of MSDsfrom 21/100 employees(1989) to 19/100employees (1991-1992).

Robinson (1993) (Ex.26-1102)

Office furnituremanufacturing,various jobs

252 Installed scissor lifts to aid in packaging filecabinets of different sizes. Small-assemblyworkstations were altered to eliminate twistingand bending during lifting.

Not Reported Back injuries have beencut by 50 percent.

LaBar (1991) (Ex. 26-1078)





Pulp and papermill workers

2611 &2621

Conducted training sessions covering CTDissues and hazardous postures at the workplace. Job analysis included interviews of employees. Program included strengthening exercises andfitness initiatives.

The following engineering controls wereimplemented:

• reduced the number of wires per bale to reduceweight,

• use of padded bolt cutter handles,

Not Reported In a six-month follow-up to the interventions,the CTD rate had beendiminished to zero andthere were no wrist andelbow problems.

“Avenor’s fitness awarm-up toergonomics.” CTDNews (1996) (Ex. 26-1050)

• provided better lifting devices.Printing, gluemachine operators

27 Installed partial mechanical aid for off loading ofcartons.

Not Reported No injuries reported in 2yrs since changes.

Shinnick (1985) (Ex.26-1049)

Book bindingoperator

278 Introduced industrial load leveler (a spring loadedtable) for loading/unloading pockets, binders,stitchers, and off-line mailers.

Lost workdays fell from413 to 112.

Not Reported Ferris (1992) (Ex. 26-1051)

Organic chemicalmanufacture,manual handling

283 Analysis of injury data, observation of materialhandling tasks. Installed materials handlingequipment, automated container-packaging andinspection equipment. Reduced weight of bagsand drums. Worker training program.

Severe back injuriesresulting in lostworkdays wereeliminated (1979-1989).

62% reduction in theincidence of totaloverexertion backinjuries.

Ridyard (1990) (Ex. 26-1052)

Paintmanufacturing,manual handling

2851 Installation of material handling equipment. Medical management of injuries.

From 1990-1993, losttime injury ratedecreased byapproximately 63%.

Total OSHArecordables reduced by40% from 1990-1993.

Akzo Coatings, Inc.Louisville, KY. correspondence withOSHA (1994) (Ex. 26-1054)





Oil refinery,handling hoses andvalves, manualhandling

2911 Added platforms that make valve access easier,added extensions to valve stems to eliminatebending to turn valves, installed hoists over worktables to eliminate lifting and bending, purchasedadjustable height carts, upgraded lighting, andconducted back injury training.

Not Reported Injury rates dropped by90%.

Bone (1993) (Ex. 26-1055)

Rubber hosemanufacturing

3052 A new hand tool was designed (an air gun) thatis counterbalanced to reduce the amount ofweight supported. This tool also has betterhandles.

No lost time incidentsfrom repetitive traumasince the new tool wasintroduced.

Not Reported Oxenburgh (1994) (Ex.26-1041), Case 7

Shoe/luggagemanufacturing,various jobs

31 Instituted a comprehensive ergonomics programas part of a total quality management initiative. Program included elements of workerparticipation, medical management, job analysisand control of exposures to risk factors, andemployee education and training. Exposurecontrols included installation of adjustableworkstations; new jig fixtures to hold workpieces at proper angles; partial automation ofprocesses; and use of anti-skid surfaces on tools,fixtures, and handles.

Reduced lost time upperextremity and backdisorders by 79%.

Rooney and Morency(1992) (Ex. 26-1056)





Shoemanufacturer,various jobs

314 Several programs implemented that includedexercise and conditioning, stretching, andergonomics awareness training.

Conducted special training on ergonomics forindustrial engineers and maintenance workers.

Continuous flow manufacturing including groupworking, cross training, and job rotation wasinstituted.

Engineering controls implemented included::

• Purchase of new adjustable chairs;

• Use of anti-fatigue mats for all employeeswhose jobs involved prolonged standing;

• The cast iron base on heavy equipment was cutoff and refitted with an adjustable base;

• Electric or pneumatic foot pedals were usedinstead of non-adjustable mechanical ones;

• Prepackaged shoe laces were purchased toeliminate hand-tying repetition; and

• Sewing machines were tilted toward the workerto eliminate awkward posture.

Not Reported Repetitive motioninjuries in two problemareas were reduced from70 percent to between25 and 30 percent of thetotal OSHA recordableincidents in three years.

“Red Wing Shoes’ earlywarning system.” CTDNews (1995) (Ex. 26-1057)





Shoe manufacture,pneumatic pressoperator

314 Workstation design improvements included useof adjustable chairs and footrests, providingarmrests, changing angle of the presses,providing parts bins to reduce extreme wristflexion, and redesigning shoe ornaments soprongs were angled for easier insertion andpressing.

No injuries reported for2 years since changeswere implemented.

Wick (1987) (Ex. 26-1058)

Footwearassembly andfabrication

3149 Extensive ergonomic training program. Lost-time injuriesdropped 67% in 2 years.

Total number of CTDsdropped by 62% in 2years.

Holland (1991) (Ex. 26-1059)

Sewing and cuttingoperations

3199 Introduction of ergonomics program, includingmedical program to detect and treat CTDs early. Workplace modifications included use ofadjustable workstations, footrests, and anti-fatigue mats; installing larger handles on hotirons to improve grip; installing proximityswitches on presses; adjusting glue stations toprevent awkward upper-extremity postures; andautomating some processes.

Not Reported CTD incidence fell from14.6% in 1990 to 11%in 1992

Nickasch (1994) (Ex.26-1060)

Encapsulatingautomotive glasswindows

3229 Ergonomics program and control measures,including installation of adjustable workstations,job rotation, and anti-fatigue matting; medicalmanagement program and an employee trainingprogram.

Incidence of lost-work-day injuries declinedfrom 8.6% to 0.2% in 2years. Rate of lostworkdays declined from1,615/100 workers(1990) to 0.9/100workers (1992).

Not Reported OSHA Site VisitCase Study No. 12 (Ex.26-1182)





Packagers 3231 Workplace improvements included:

Reduced all material handling to less than 50pounds;

Purchased different sizes of gloves, cuffs, andsleeves to reduce additional stress and energyexpenditure;

Designed a device that allows employees to rollthe glass onto the line instead of lifting it;

Raised the racks to knuckle height to avoidbending while lifting the windshields; and

Altered the racks to allow workers to step intothem and load them from back to front in order toeliminate stressful forward reaches.

Not Reported Injury incidence ratedropped from 14 per100 workers in 1987 to3.3 in 1996.

Reduced severity andfrequency of injuries.

“PPG learned toovercome ergoinnocence.” CTD News(1996) (Ex. 26-1061)

Ceramic tilemanufacturing,various jobs

3253 Implementation of an ergonomics programincluding engineering controls (workstationredesign), job rotation, changes in workpractices, and an ergonomic training program foremployees.

Lost-time injury rate forrepetitive motion injuriesdecreased from 1.6 in1988/1989 to 0 in 1993.

Not Reported Stuart-Buttle (1994)(Ex. 26-1045)

Fiber-cementboard manufacture,manual handling

3272 Install on-loader at from of conveyor to permitworkers to load boards at their own pace. Automate process for separating boards andtransferring them to the on-loader. Automatestacking of final product.

Eliminated lost-timeMSDs in 2 years afterimprovements weremade.






Metal castings,unpackingoperation

33 Frequent, excessive reach was required to unpack15- to 18-pound casting from crates. Createswere modified by adding drop gates at each endof the crates and installing a scissor lift to liftcrates. In addition, changes were made in theway the castings were stacked in the crates topermit the workers’ arms to remain close to thebody while unpacking.

Not Reported Eliminated back injuriesassociated with thisoperation.


Palletizingoperation

33 Scissor lift tables with turntable tops wereinstalled alongside each packing station.

Not Reported Five out of six backinjuries were eliminated.

Benson, (1987) (Ex. 26-1062)

Aluminummanufacturer,materials handling

3350 Establishment of an ergonomics program,including of introduction lift tables, cranes, andmechanical assists in overhead lifting,rearrangement of work to allow use of cranes inlifting.

Not Reported Reduced overexertioninjuries of the back by40% to 60%.

Mandelker (1993) (Ex.26-1063)

De-burring andfinishing cast metalparts

34 Parts were held still by hand during finishingoperations. Work bench was replaced by apotter’s wheel to hold the part and rotate it asnecessary. Finishing tools were redesigned.

Not Reported Upper-extremitydisorders wereeliminated.


Welding 34 Manual welding of a 5-meter weld requiredwelder to work in a prolonged static posture. This process was replaced by a semi-automaticpowder welding process, permitting welder towork from a standing position.

Not Reported All knee, neck, andshoulder injuries fromthis operation have beeneliminated.


Materials handling,hardwaremanufacture

3411 Use of adjustable lift tables/ transporterscompletely eliminated manual lifting from the job.

Not Reported Back injuries reduced by90%.

“Put ergonomics topractical use.” MaterialHandling Engineering(1988) (Ex. 26-1064)





Packager 3452 Packaging area was redesigned; raised the level atwhich boxes are lifted, installed semi-automaticsealing machines and adjustable chairs, andeliminated loading of pallets; training introduced.

Nearly a five-folddecrease inmusculoskeletal injuriesbased on days lost.(equivalent to 5% of thedepartment's total wagecosts).


Manufacturingautomotive cables

3496 Introduction of ergonomics program utilizingengineering controls, work practice training, andmedical management.

Lost workday casesdecreased from 48(1991) to 27 (1993).Number of lostworkdays decreasedfrom 1,287 days (1991)to 275 days (1993).

Decreased illnessesfrom 47 (1991) to 17(1993)


Steel furnituremanufacturing,various jobs

3499 Employee involvement in identifying hazards anddeveloping interventions. Engineeringapproaches included the following:

• An enclosed shotblaster machine has been usedto automate polishing of the steel.

• An automatic washing system has beenprovided.

• Lighting placement and brightness have beenimproved to reduce the awkward posture requiredto inspect and brush the products.

• Many of the jigs were improved to beadjustable.

Lost days from carpaltunnel syndrome, backstrain and other CTDsdropped to zero in 1996,down from 176 lostworkdays in 1991.

Not Reported “Charleston Forgewelds homemadeapproach.” CTD News(1996) (Ex. 26-1065)

• And other engineering controls.





Farm equipmentmanufacture,assembly andmaterials handling

3523 Initiated an eight-hour engineer ergonomicstraining program.

Appointed ergonomics coordinators in all U.S.and Canadian factories, foundries and distributioncenters chosen from the industrial engineeringand safety departments.

Conducted training through attendingprofessional courses and conferences,memberships in professional organizations,subscriptions to ergonomics publications andtracking the latest ergonomics research.

Conducted ergonomic review of new officefurniture purchases.

Conducted VDT ergonomics awareness trainingfor video display operators.

Engineering Controls included:

• Limiting manual lifting to 40 pounds or less;

• Redesigning the assembling operations so thatassemblers worked in an upright position;

• Altered hand tools for better fit; and

• Installed hoists and lift tables.

83 percent reduction ofback injuries thatresulted in lost time.

Not Reported “An ergo process thatruns like a Deere.” CTDNews (1995) (Ex. 26-1101)

Welding, vehiclemanufacture

3531 Ergonomic training program implemented, seatheight adjustments installed, and work stationheight adjusted.

Not Reported Back injury rate wentdown by 27%.

“Caterpilar, Inc.”Welding Journal (1992)(Ex. 26-1066)





Chain sawassembly

3546 Introduction of new tools and modifiedproduction methods, and employee training.

The sick-leave ratedecreased from 17.0 to13.7 on an averageannual basis.

Not Reported Parenmark et al. (1993)(Ex. 26-1067)

Computermanufacturer

3571 The company engaged in several training andeducation initiatives, including:

• Mandated ergonomics training classes for highrisk groups;

• Created and distributed a 16-page ergonomicsbrochure; and

• Created an "ERGO Hotline" to scheduleergonomics evaluations, report problems, andseek information;

Exposure control approaches included:

• Limiting manual lifting to 40 pounds or less;educated the employees via a brief program onthe basic ergonomics fundamentals;

• Purchased new office sit-stand workstations;

• Adjusted the workstation surface height toaccommodate each worker; and

Not Reported • 41 percent drop inreportable upper limbdisorders from 1994 to1995 which addressedabout 70 percent of thecompany's upper-limbreportable injuries.

• Further 50 percentdecrease in reportableCTD cases from 1995 to1996.

• Reportable cases ofCTDs decreased to 25through November of1996 compared to 70cases in 1994.

“Silicon Graphics meldshigh- and low-tech.”CTD News (1997) (Ex.26-1068)

• Attached a wider, adjustable keyboard andmouse platform to the standard desk.





Computermainframeassembly

3571 Training had been provided for proper liftingtechniques, general safety and use of specialtools. Extensive office workstation ergonomicstraining was provided.

Engineering controls included:

• Providing new workbenches to accommodateworkers' shorter reaches;

• Adding roller-ball conveyor belts and liftingdevices were added to raise the units onto theconveyor belt.;

• Replacing pneumatic drivers with lighter electricunits which had much less vibration and weighedabout one pound;

• Installing lift platforms that would raise thecabinets and 3 feet off the floor;

• Providing seated and standing workstations soone employee could build the entire cabinetinstead of working on an assembly line in orderto reduce the static fatigue; and

• Modifying scissor lifts to rise up to 4 feet offthe floor.

There are no lost daysdue to CTDs in theoffice workplace.

CTD related injurieswere eliminated inproduction.

“AT&T uses cost-conscious program tofight CTDs.” CTDNews (1995) (Ex. 26-1069)

Copying machinecontrol systemassembly

3579 Assembly of the systems was performed on aworkbench and required frequent lifting andturning of the part. The bench was replaced byan adjustable stand designed to take the weight ofthe part being assembled.

Not Reported MSD rate declined by50% in the first year. Inthe second year, theMSD rate declined toone-third.






Hand tooloperation, tele-communicationsmanufacturing

36 Safety and health committee implementedprogram that included creation of task force,worker training, improvements in workstationdesign and tooling, and medical management ofworkers on restricted duty.

Plant-wide incidence ofrepetitive traumadisorders was 2.2 casesper 200,000 workhours, reduced to 0.53cases per 200,000workhours in 1 yearafter programimplementation.

McKenzie et al. (1985)(Ex. 26-1070)

Electronicsmanufacture

36 Controls: workstation redesign and job rotation. Not Reported CTDs reduced by 46%in one year.

Robinson (1993) (Ex.26-1102)

Electricalequipmentmanufacture, pressoperator

36 Automated handling and grinding of resistanceelements. Eliminated possibility for hazardousexposures.

Not Reported Eliminated MSDs Oxenburgh (1994) (Ex.26-1041), Case 16

Press operator,small electronicparts manufacture

36 Press operation caused excessive wrist flexionand palm compression. The press was modifiedby adding switches that either eliminated handcontact or only involved contact with parts of thehand that do not have nerves close to the skinsurface.

Not Reported 29% reduction inmusculoskeletal injuryincidence.


Lampmanufacturing,materials handling

3641 Added a vacuum hoist, reduced equipmentheight, reduced box size and weight, andintroduced a back awareness program foremployees.

Not Reported Eliminated back andupper extremitydisorders in the last fouryears.

Carreau and Bessett(1991) (Ex. 26-1071)

Telephone systemsassembly

3661 Implemented an ergonomics program for theassembly line. Elements included an employeeawareness program, disorder treatment protocols,job task analyses, job redesign, and cost savingsanalysis.

Lost-time repetitivestrain injuries droppedfrom 20 to 4 over 1.5years.

Darcangelo (1989) (Ex.26-1072)





Tele-communicationsequipmentassembly

3661 Introduced a training program, job hazardanalysis, and an engineering program to abateergonomic hazards. Medical management ofinjured employees on restricted jobs.

Rate of repetitive traumadisorders dropped from1.1 per 100,000 hours to0.26 per 100,000 hoursin 1 year.

Pope (1987) (Ex. 26-1073)

Tele-communicationsequipmentassembly

3661 Workstation redesign (adjustable tables,illumination), ergonomically designed chairs, andtool redesign.

Musculoskeletal injurysick leave in 1978=5.0,in 1982=2.9.

Not Reported Westgaard and Aaras(1984) (Ex. 26-1026)

Electronicsassembly

367 Job rotation, new assembly line procedures, andergonomic line balancing.

Not Reported No new cases ofcumulative trauma werereported.

Townes and Imrhan(1991) (Ex. 26-1074)

Electronicsmanufacturing,various jobs

3674 Redesigned workstations; introduced powered-screwdrivers; job rotation.

Not Reported Reduced injuries (notquantified).

Burri and Helander(undated) (Ex. 26-1075)

Vehicle seatassembly

371 Ergonomics training was provided.


• Redesigning seat covers in order to decrease thenumber of fasteners by more than 50 percent;

• Provided a compression tool to clamp the foampadding to the seat;

• Installed adjustable workstations;

• Provide electric torque guns.

In addition, a program of job rotation wasintroduced.

Tendinitis cases fell by93% and carpal tunnelcases fell by 96 percentin the year followingprogramimplementation.

“Problem-solving bycommittee at GeneralSeating.” CTD News(1995) (Ex. 26-1076)





Unpacking autoparts

371 A plywood sheet end board had to be removed tounpack crates, requiring excessive force andawkward postures. Plywood sheets weremodified to reduce their weight and permit themto slide more easily in the grooves.

Not Reported Back and shoulderinjuries associated withthis operation wereeliminated.


Motor vehicleassembly, variousjobs

371 Introduction of an ergonomics program,including engineering controls, work practicecontrols, job rotation/job enlargement, medicalmanagement, education, and training. Controlsimplemented included counterbalanced tools, lifttables, and workstation redesign to preventawkward postures and excessive reaches.

Lost-time workday ratedecreased 65%, and thelost-time case ratedecreased 48%.

Over a 3 year period, theinjury and illness ratedecreased 11% and theseverity rate decreased39%.


Truckmanufacturing,various jobs

3711 Introduction of company ergonomics program in1990. Engineering controls: substituted machineriveting for manual riveting, introduced raisedwork heights, and installed lifting devices. Introduction of job rotation for 85% of theworkforce.

• Lost-time injuries fellfrom 80 to 28 in 2 years.

• Lost workdays fellfrom 1,402 to 193.

CTD cases fell from 105to 54 in 2 years.

Mandelker (1993) (Ex.26-1063)

Auto assembly 3711 Introduced variable height car conveyer belt,articulating arms to move large parts, likedashboards, into place. Also redesigned tools.

Not Reported 50% decline inergonomic relatedinjuries in the first year.35% decline in secondand third years.

LaBar (1992) (Ex. 26-1053)

Auto assembly lineworker

3711 28 projects were redesigned to change specificjobs, making them ergonomically lesstroublesome.

Reduced from 3,134 lostdays per year to 1,355lost days per year afterproject completion.

Not Reported Brandon (1992)

Auto bodyassembly, fixingside mouldings tobody

3711 Replaced pneumatic nut runner with a lightermodel. Used a stepped ramp that allowedworkers to select an appropriate position relativeto the work piece.

Not Reported Upper-body MSDswere eliminated.

Oxenburgh (1994)(Ex.26-1041), Case 50





Spot welding ontoauto frame

3711 Fixed a large-diameter circular handle to thewelding frame, which allowed the frame to bemoved into any position while keeping the wristin a straight posture.

Not Reported Wrist injuries wereeliminated.


Spray paintingauto bodies

3711 Lengthened spray gun trigger to increase gun’sgrip diameter and allow the trigger to be operatedwith three fingers.

Not Reported Cases of hand tendinitiswere eliminated.


Auto instrumentpanel assembly,manual handling

3714 Installed a hoist system to remove panels fromconveyor and transport them to shippingcontainers.

Lost-time back injuriesassociated with thisoperation wereeliminated.

Not reported Oxenburgh (1994) (Ex.26-1041), Case 40

Pneumatic screwfeeder operation,auto instrumentpanel assembly

3714 Installed a counter-balanced articulated arm toreduce the weight of the tool.

Not Reported Upper-body MSDswere eliminated.


Computer operator 3714 The company instituted a biannual trainingprogram to emphasize good lifting and pushingtechniques as well as good posture. Alsoinstituted a stretching exercise program andencouraged the CAD operators to take frequentshort breaks.


• Purchased 27 back cushions, 71 lumbarsupports in three different sizes, 24keyboard/mouse rests, and 12 document holdersin the past five years;

• Provided adjustable chairs; and

• Provided foot rests for shorter workers.

Saved 20,000 hours losttime per year sinceeliminating CTD-relatedcomplaints.

Not Reported “Communication drivesprocess at Siemens.”CTD News, (1997) (Ex.26-1077)





Manufacturing ofelectroniccomponents,various jobs

3714 Introduction of an in-plant ergonomics program,engineering controls including hand tool andworkstation redesign, and lift devices. Jobrotation and other administrative controls, workpractice controls, medical management, andtraining also implemented.

Decrease of 50% from116 lost-time days/100workers (1990) to58/100 workers (1991)for MSDS. Additional50% decrease in 1992 to 29 lost-time days/100workers.

The incidence rate ofergonomic disordersdecreased by 67% from37/100 workers (1990)to 12/100 workers(1992).


Automotive engineassembly

3714 A hoist was replaced by a conveyer belt set atwaist height and part of the assembly processwas automated.

70 days lost time andover 1,000 days onrestricted duty werereduced to no lost daysand no personnel onrestricted duties.


Small partsassembly machineoperation

3714 Jammed machine required operator to climb a barladder while carrying a heavy load. A correctlydesigned ladder and catwalk were installed alongwith a chute to dispose of damaged parts withoutthe need for carrying them.

Not Reported. Foot and ankle MSDsassociated with theoperation wereeliminated.


Automotive airconditionermanufacture,material handling

3714 Installed overhead conveyor belt that moves thecondenser cores through the various procedures,minimizing manual handling. Also installed boxtilers to assist in packaging and scissor lift forstacking.

.Prior to program, plantaveraged 50 lost-timeinjuries per year, manyof those back injuries. After programimplementation, 2 backinjuries have beenrecorded over a 4-yearperiod.

LaBar (1991) (Ex. 26-1078)

Auto instrumentpanel sub-assembly

3714 Spring clips were pushed into position using ahand tool that required excessive force to operate. New tool was designed to reduce force andawkward positioning of the hand and wrist.

Not Reported Wrist and hand injurieswere eliminated.






Trimmingmouldings withhand cutter

3714 Hand cutters were replaced with automated orair-powered cutters.

Not Reported Hand and wrist injuriesassociated with thisoperation wereeliminated.


Manufacture of jetaircraft engineparts, various jobs

372 Implementation of ergonomics program,including engineering control measures, workpractice controls, medical management,education, and training. Controls implementedincluded redesigning workstations to provideemployees with more room to perform tasks,adding anti-fatigue mats and adjustable footrests,removed or padded tables and shelves to reducecontact stress, and installed vibration-absorbingpads onto grinding wheels.

Not Reported Decrease in carpaltunnel syndrome casesfrom 26 in 1988, 11 ofwhich required surgery,to 1 case in 1992 whichdid not require surgery.


Shipbuilder 3731 Initiated training classes covering the nature ofCTDs, anthropometry, work physiology, backand wrist anatomy and proper work techniques, In-depth training course covered tool selection,work habits, alternating trigger fingers and hands

Workers participated in evaluating anddeveloping interventions for the weldingdepartment, and selecting pistol grip and in-linebased tools so as to keep the wrists in a neutralposture.

Installed scaffolding at the right height anddistance from the work, and used ladders orinstalled scaffolding to higher positions for thework above shoulder height.

Decreased to only 6lost-time ergonomicswrist injuries throughNovember 1996, sincetraining completed inJune 1995.

Eliminated lost timeback injuries since July1995.

Eliminated wrist injuryin the weldingdepartment until March1996.

Reduced ergonomicscase rates about 30percent during 1996.

Training a ‘limbsaver’ atNewport News.” CTDNews (1997) (Ex. 26-1079)





Motorcyclemanufacturing,flywheel millingoperations

3751 Introduction of lighter flywheel castings and anoverhead lift; introduction of a customizeddeburring machine eliminating vibrationexposures; introduction of a customized 40-tonpress eliminating the use of the brass hammer.

MSDs involving lost orrestricted workdaysdropped from 27.6 per100 workers in 1989 to12.5 per 100 workers in1993. The severity rateof MSDs dropped from610 lost or restrictedworkdays per 100workers in 1989 to 190days in 1993.

Not Reported McGlothlin and Baron(1991) (Ex. 26-1080)

Assembly ofpressure-sensinginstruments

3823 Forceful turning actions were required to fit anO-ring in place. Cordless screwdrivers wereused with a custom attachment to bring wristsinto stronger position and allow hand to employ apower grip.

Not Reported Wrist and arm MSDswere eliminated.


Medical needlemanufacture,inspection station

384 Used task forces to identify jobs involvingworker exposures to risk factors. Identifiedproblems on quality control line and implementeddesign changes to the workstations.

. Achieved 75% reductionin upper extremity MSDcases

Benden (1994) (Ex. 26-1081)

Manufacture ofsuction canistersused in surgicalprocedures

3841 Introduction of an ergonomics program utilizing amedical management program, employee trainingprogram, job rotation, and engineering controls. Controls implemented include replacing oldwooden supply stations with ergonomicallydesigned stations, and automating variousprocesses.

Not Reported Decrease in theergonomic injury ratefrom 5.2/100 workers(1989) to 2.8/100workers (1993).

OSHA Site Visit No. 16(Ex. 26-1183)





Manual handlingof bulk paper

386 Two operators manually lifted large wads ofpaper from a trolley. Manual lifting waseliminated by installing a scissor lift. In addition,the trolley’s runners were replaced by rollerbearings that enabled the paper to be loaded ontothe scissor lift without manual lifting.

Not Reported There were 18 backinjuries in one year priorto implementingchanges. There havebeen no back injuries inthe 3 years sincemdifications were made.


Manufacturingboard games,inspection andpacking

3944 Job analysis and problem solving involvingemployees to redesign packing workstations. Design changes included raising the height of conveyors, slowing conveyor speed (no effect onthroughput), placing roller conveyors on anincline to facilitate carton removal, and changes inwork procedures.

Eliminated allcumulative traumainjuries associated withjob.

Cook and Marcotte(1990) (Ex. 26-1082)

Railroad repairmen 40 Introduced storage of tools and materials off theground between knee and shoulder height;devised winches to lift and handle heavyequipment; and redesigned work tables, dollies,and carts to more easily handle train car parts.

Lost-work days reducedto zero for back injuries.

Low-back injuries reduced to zero.

McMahan (1991) (Ex.26-1083)

VDT operator,package deliveryservice

42 Introduced sit-stand workstations that permitworkers to adjust workstation to meet specificneeds.

Reduced MSD cases byhalf in 12 months.

Nerhood and Thompson(1994) (Ex. 26-1084)

Freight truckterminal operations

4213 Established ergonomics program in esponse torising number of back injuries. Programelements include analysis of injury records toidentify hazardous operations, extensive use oflifting and carrying devices, providing extrapersonnel to handle heavy or awkward freight,employee training, and medical management ofinjured workers.

There were 7 lost-timeinjuries in 1989,followed by 4 in 1990and 5 in 1991.

Total number of MSDcases decline from 13 in1989 to 7 in 1990.

OSHA Site Visit No. 5(Ex. 26-1177)





VDT operation,tele-communicationsestablishment

481 Retrospective study of the impacts of anergonomics program on 500 VDT operators. Program included job task analyses, workstationredesign, and worker education and training.

. Number of upperextremity disorders overthe 6 months prior toimplementation of theprogram was 52; thiswas reduced to 29 forthe 6 months followingintervention

Tadano (1990)

Materials handling,electrical utility

4911 Redesigned equipment:

• Weight of the water coolers reduced from 10lbs to 5 lbs.

• Rotating platform for transformers. Step andgrab handles added to trucks.

• New shovel handle and new pry bars.

• Position of the kegs on trucks was lowered tominimize twisting of the back.

Lost time injuriesreduced to 0.42 per 100employees in 1989.

Injuries due to getting inand out of trucksreduced from 9 to 0 inyear following redesign. No injuries from liftingthe water kegs since thechanges.

“Foiling field injurieswith ergonomics.” Electrical World (1990) (Ex. 26-1085)

Data entryoperator, gas andelectric utility

4932 • Engineering controls: workstation design.

• Administrative controls implemented.

Lost time due to work-related injuriesdecreased from 1,008hours/month to 584hours one year later.

Not Reported Couch (1990) (Ex. 26-1086)

Sewing machineoperator

5137 Installed padded, swivel chairs with adjustablebacks and improved materials handling methods.Also instituted an exercise program.

Not Reported Incidence rate oftendinitis decreasedfrom 12% to less than1% in some plants.

Hammond-Smith (1990)(Ex. 26-1087)





Material handling,grocerydistribution center

514 Implemented comprehensive program thatincluded hazard identification and job hazardanalysis, medical management and reassignmentof injured employees, worker training, andimplementation of engineering and work practicecontrols. Controls included making minormodifications to some forklift equipment,replacing other equipment, and providingergonomically designed workstations for dataentry personnel.

Number of MSDworkers compensationclaims decline from 14in 1989 to 8 in 1991.

Not Reported OSHA Site Visit No. 4(Ex. 26-1176)

Restaurant worker 5812 Reduced the amount of food served by theworkers, and heavy porcelain crockery wasreplaced with plastic.

Not Reported Reported injuriesdecreased 40%.

Oxenbrugh (1994) (Ex.26-1041), Case 17

Pricer- clothingstore

5932 Staples were reduced to one per tag and jobrotation was introduced so that no one personstapled for more than 45 minutes at a time.

Not Reported In 1994-1995, 23% of pricers had CTDs; 2 had bilateral carpaltunnel releases and wereunable to return to work.In 1996-1997, 10% ofpricers were affected,but all have returned totheir jobs withoutsurgery or impairment.

“ARC takes thriftyapproach toergonomics.” CTDNews (1998) (Ex. 26-1089)

Data entry 6021 Adjusted workstations and lighting. Not Reported Reduced neck tensionsyndrome from 54% to16%.

Luopajarvi et al.(Undated) (Ex. 26-1090)





Nursing assistants,nursing home

805 Implemented program to determine patient liftingtasks that were the most stressful; evaluatealternative devices for acceptability amongassistants; train assistants in use of devices; andmodifying shower rooms and patient caretechniques to facilitate patient handling. Usedwalking belts and mechanical hoists for liftingaids.

Decrease of 634 lostworkdays/100 FTEsbefore intervention to317 lost workdays/100FTEs post intervention.

Incidence for backinjuries decreased from83 to 47 per 200,000work-hours.

Garg and Owen(undated) (Ex. 26-1093)

Nursing aides,nursing home

805 Committee of employees determined the types ofmechanical devices that were needed, installed in1993. Implemented employee training andmodified duty programs.

Decrease in lost workdays 38 in 1991 to 4 in1994 (as of Nov), islargely attributed to theimplementation of a nolifting greater than 50pounds policy.

Not Reported Comments to OSHAfrom Kennebec,(undated) (Ex. 26-1094)

Nurse, hospital 8062 Professional lifting team of 2 performs 95% ofall patient lifts; nurses freed to do more nursingactivities.

Not Reported Back injuries reduced94% first year afterteams were implemented

Charney et al (1991)(Ex. 26-1091)

Nursing andlaundry workers,hospital

8062 Worker education and training were provided. Employees were encouraged to take breaks.

A regular maintenance program for equipmentwas initiated. New hand tools and liftingequipment were provided. Handles wereinstalled onto tool carts. X-Ray cassettes werereorganized to avoid repetitive bending and backproblems.

Lost-time hours innursing ward fell 83percent in 4 years.

Lost-time hours amonglaundry workers fell 83percent in 2 years.

Back injury rates innursing wards fell 39percent in 4 years.

Back injury rates among laundry workers fell 71percent in 2 years.

“Giving health-careworkers a helping,mechanical hand.” CTDNews (1995) (Ex. 26-1092)





Nursing, hospital 8062 Ergonomic assessment of 14-room surgical suite,implemented changes in procedures for movingpatients, maneuvering carts and equipement,using gall bladder boards, walking on wet floors,and accessing power outlets. Workers areperiodically retrained in procedures to maintainawareness.

Not Reported Back injury ratesreduced by 25% in 18months since programwas implemented.

Garb and Dockery(1995) (Ex. 26-1095)

Prescription fillingusing a syringe,hospital

8062 A manual assist for syringe actuation wasdeveloped to reduce the thumb and pinch graspforces required while using a standard syringe.The system, about the size of a hot dog bun,accommodates standard syringe sizes from 10ccto 60cc.

Not Reported Upper extremity CTDcases were reduced fromsix to one.

“Case study 60:Hospital pharmacyliquid IV prescriptionfilling using a syringe.”ErgoWeb Inc., 1998(Ex. 26-1096)

Hospital workers 8062 Patient Air Lift Systems introduced. Not Reported Reduced injuries atsecond hospital by 94%.

Brigham (1994) (Ex.26-1097)

Nursing, hospital 8062 Redesigned work process: Mechanical liftingequipment, slide boards, and patient transferbelts.

Lost-time injuriesreduced to 49 (down35%), with 426 lostdays (a 57%decrease),and 1,851restricted days (a 54%decrease).

In 1994 total backinjuries decreased to 85(a 43% reduction)

Hospital EmployeeHealth (1995) (Ex. 26-1098)

Governmentemployees

91 Introduction of program of ergonomicimprovements, education, training, and physicalfitness activities.

Not Reported 1-year prevalence ofback pain fell from 65 to53 percent.

Shi (1993) (Ex. 26-1099)

appendix vi-b. summary of case studies demonstrating

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