safety of the environment. Management should review the employee’s job description. A well-written job description should describe the amount of weight that an employee would be required to lift, if any, as well as describe the expected job tasks required of the position. This information will assist the evaluator in focusing on the areas of risk. For instance, if an office employee’s job description states that 75 percent of the time the employee is expected to be on the phone, this tells the evaluator that risks are likely to relate to static posture. Therefore, interventions may need to focus on varying tasks during the other 25 percent of the day. 4. List, rank, and set priorities for hazardous jobs . Of highest priority are the jobs known to have severe hazards that are very likely to occur. The lowest priority are the jobs where hazards are less likely to occur, and the hazards involved are minor. Most jobs will fall somewhere in between. For example, suppose that during the ergonomics evaluation of a wood shop, an employee mentions that the guard on his table saw broke three months earlier. The employee describes several near misses in the last three months that almost caused the loss of a finger. This is a severe hazard (loss of a limb), with several near misses indicating that an injury is very likely to occur. Evaluators should address this Evaluation of risk factors Evaluators should look for the following risk factors during an evaluation: 1. Awkward postures : According to Yale health and safety, this is any posture that deviates significantly from neutral [4] . In a workstation, this can take many different forms. Ideally, a static workstation will be set up so that a person’s eyes look straight forward or slightly down, allowing the neck to rest in a neutral position. Arms should be supported so that shoulders can be relaxed, wrists are in a neutral position and elbows in 90 degrees of flexion. The back and hips should be in neutral if in standing, and the knees in full extension. If in a sitting position, the hips and knees should be supported in 90 degrees of flexion and ankles should be in neutral. If the job is more of a dynamic position, evaluators should watch the employee’s movement patterns closely. Look for more than 30 degrees of flexion and/or twisting and side bending in the neck or back on a frequent basis, reaching overhead, or reaching out front. Workstations that are set up for the majority of work to be completed in the “strike zone,” which is near mid-thigh to mid chest, which will minimize the awkward postures. 2. Contact stress : Contact stress can be either internal or external [5] . Typically during an ergonomics evaluation, external contact stress, or any part of the body rubbing against the workstation causes the highest concern. If this is not addressed it can cause nerve irritation. While completing the assessment, evaluators should look for any source of friction. Often in an office environment, this occurs at the wrists if an appropriate wrist rest is not used. Contact stress can also occur at the forearms if armrests are either not available or are set at the right height. Someone who writes much of the day can have contact stress on the fingers where the pen rests. In a manufacturing environment, evaluators should look for areas of contact stress on the hand where the employee is holding various tools, or if they use other parts of their body to push objects (like a hip or shoulder). 3. Lifting : According to OSHA, over 36 percent of workplace injuries are related to lifting [6] . When assessing risk of injury, evaluators should examine the amount of weight lifted, the frequency of the lifts, the placement of the weight, if adequate handholds are present, and any other environmental factors that can affect the safety of the employees. Ideally, weight will be placed in the “strike zone” and will be moved to another area within the strike zone. This is not always possible, so the goal of the ergonomics program will be to place weight on a raised surface instead of on the floor, or to limit how high weight is stacked.
situation immediately. In contrast, consider an employee who is required to reach overhead and stand on their tiptoes in an awkward posture to obtain textbooks that weigh seven pounds each. The employee does this about five times a day and describes no near misses. In this example, while reaching overhead and standing on tiptoes is not ideal, there have been no near misses, and any potential injury would likely not be severe. This situation also needs to be addressed, but it would be a lower priority than the first example. 5. Outline the steps or tasks . At this time, evaluators should observe the job and assess each job task. They should look for hazards in each step of the job. It may help to take video that they can review at a later time. For instance, the job of a certified nursing assistant, or can, in a nursing home could be broken down into the following steps: 1) bedding changes 2) assisting patient with bed mobility 3) assisting patient with transfers from bed to chair 4) assisting patient with wheelchair mobility 5) assisting patient with toilet transfers 6) assisting patient with feeding tasks. Evaluators should then analyze each of these individual tasks for possible risks. If necessary, they could break down each of these steps into smaller steps to further assess for risk. Evaluators can consider if it is possible to package weight in such a way to minimize the load, or if there is a way to lift large amounts of weight with a mechanical lift. In a medical environment like a nursing home or hospital, it is not possible to reduce the weight of the patients. Therefore, evaluators should encourage staff to make use of the equipment available as well as recommend appropriate lifts, train employees in proper lifting ergonomics (engage the core, use the legs, and pivot rather than twist) and make sure employees are raising or lowering the beds to appropriate heights. 4. Lighting : When considering appropriate lighting evaluators should look for the following lighting conditions: a. Glare. b. Insufficient light. c. Flickering. d. Poorly distributed light. Insufficient lighting can cause tripping, falling, and inaccuracies. If there is too much light, the glare can cause headaches. Typically the goal is to provide between twenty to fifty candles of illumination. A standard florescent light fixture on a nine-foot ceiling with four, 40-watt bulbs will produce approximately fifty foot-candles of light at the desktop level [7] . But windows can also cause glare, especially at the times of the day when sunlight will be direct. It is generally best to position the monitor perpendicular to the window, not directly facing the window or facing directly away. Utilize shades to reduce light coming from the window, and use anti-glare screens for monitors. 5. Repetitive motion : Put simply, this is performing the same motion several times in a day. This particularly becomes a risk when workers either perform them at high speed, with weight, or in an awkward posture. In an office environment, repetitive movements can occur most frequently with typing, but can also occur when reaching into drawers or shelves. This is a significant risk factor in factories where each employee may perform the same task repetitively all day long. It may not be feasible to change the task, but job rotation can allow for a decrease in the same movements for each employee. In a patient care environment that involves repetitive lifting, the best solution may be to divide the patients that require the most physical assistance between the nursing staff so that no one person is overloaded if mechanical lifts are not available. In an environment where none of these solutions are practical, for instance a UPS delivery driver, training in an exercise program to improve strength and flexibility as well as
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