Course 202 ERGONOMICS PROGRAM MANAGEMENT For Training Purposes Only © OSTN Introduction to Ergonomics Program Management 2 For Training Purposes Only Welcome Proactive ergonomics emphasize efforts at the design stage of work processes to recognize the hazardous conditions and unsafe behaviors that may lead to musculoskeletal disorders (MSDs). The goal is to design operations that ensure proper selection and use of tools, job methods, workstation layouts, and materials that impose no undue stress and strain on the worker. Ergonomics programs should not be regarded as separate from those intended to address other workplace hazards. Aspects of hazard identification, case documentation, assessment of control options, and health care management techniques that are used to address ergonomic problems use the same approaches directed toward other workplace risks of injury or disease. Although many of the technical approaches described in this course are specific to ergonomic risk factors and MSDs, the core principles are the same as efforts to control other workplace hazards. This presentation will help you and your safety staff develop an effective ergonomics program for your company. The benefits to your organization’s corporate culture will be significant and long term. As with any learning experience, the more involved you are, the more you’ll get out of the material. So, raise your hand...offer your opinion, ideas, feelings...speak your mind! Workshop goal: Identify the primary components of an effective ergonomics program. © 2000-2006 OSTN. All rights reserved. This material, or any other material used to inform employers of compliance requirements of OSHA standards through simplification of the regulations should not be considered a substitute for any provisions of the Occupational Safety and Health Act of 1970 or for any standards issued by OSHA. The information in this publication is intended for training purposes only. © OSTN Introduction to Ergonomics Program Management For Training Purposes Only The Safety Management System “Every system is designed perfectly to produce what it’s producing” Inputs - Resources from other systems Tools Facilities Equipment People Machinery Time Materials Money Processes - Using available resources Planning and designing safety plans Leading and managing Educating and training Identifying, measuring, and analyzing data Recognizing and rewarding desired performance Suggesting, and recommending improvements Participating in safety committees, teams, projects Correcting hazards Improving system weaknesses Evaluating conditions, behaviors, systems, results The Seven Elements 1. Management Commitment 2. Accountability 3. Employee Involvement 4. Hazard Identification/Control 5. Incident/Accident Investigation 6. Education and Training 7. Periodic Evaluation Outputs - Conditions, Behaviors, Results Safe/Unsafe conditions Many/Few accidents High/Low morale, trust Safe/Unsafe behaviors High/Low costs/savings High/Low productivity What might be the result if an ergonomics plan is poorly written? _______________________________________________________________ _______________________________________________________________ Where do we look for clues that the ergonomics program design and/or implementation are flawed? _______________________________________________________________ _______________________________________________________________ © OSTN Introduction to Ergonomics Program Management 4 For Training Purposes Only What does a successful ergonomics program look like? The plan should address a core set of elements. • Management commitment • Identification of problem jobs • Training and education for employees • Evaluation of the program • Employee involvement • Solutions (controls) for problem jobs • Appropriate medical management Although most ergonomics programs display each of these elements, there is often significant variety in how they are implemented. Implementation strategies vary due to: • The facilities’ industries and product line, • Corporate culture, and • Experiences during the programs’ evolution. The processes used to identify and control problem jobs in successful ergonomics programs were typically: • Informal and simple • Generally involved a lower level of effort • Did not typically require significant investment or resources and did not drastically change the job or operation. Successful ergonomics programs yield real long-term benefits, including: • Reductions in workers’ compensation costs associated with MSDs. • Reductions in overall injuries and illnesses. • Reductions in the number of days injured employees were out of work, however, the number of restricted workdays may increase as a result of an increased emphasis on bringing employees back to work. • Improved worker morale, productivity, and product quality. © OSTN Introduction to Ergonomics Program Management 5 For Training Purposes Only Element 1: TOP MANAGEMENT COMMITMENT Attributes of “Proactive Ergonomics” Essential considerations An effective ergonomics program requires tough-caring leadership, diligent management, and sound engineering. Ergonomics issues should be identified and resolved in well-planned responsive process. In addition, general knowledge of ergonomic principles, learned from an ongoing ergonomics program, can be used to build a more proactive (prevention-oriented) approach. I. “Tough-caring” Safety Leadership Tough-caring leaders are tough precisely because they care about the welfare of their employees. Management commitment and employee involvement in the planning activity are essential. For example, management can set policy to require ergonomic considerations for any equipment to be purchased, and production employees can offer ideas on the basis of their past experiences for alleviating potential problems. How does management demonstrate leadership in ergonomics? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ What is the test for commitment? T ______________________________________ M ______________________________________ C ______________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ © OSTN Introduction to Ergonomics Program Management 6 For Training Purposes Only II. Supportive cultural values W. Edwards Deming has stated that the first priority in developing a successful corporate (safety) culture is to eliminate fear in the workplace. With that important principle in mind, assuring employees feel comfortable reporting symptoms of physical stress as early as possible must be a key element of a successful ergonomics program. What must we do to assure employees feel comfortable reporting symptoms? ________________________________________________________________________ ________________________________________________________________________ How does early reporting benefit the employee and the company? ________________________________________________________________________ ________________________________________________________________________ II. Diligent safety management Developing and implementing an ergonomics program is only half the battle. To be effective, the program must be effectively managed every day. Who might be best suited to “work” the ergonomics program daily? _________________________________________________________________________________ _________________________________________________________________________________ Who might best monitor, evaluate and improve the program? _________________________________________________________________________________ _________________________________________________________________________________ IV. Sound safety engineering Planners of new work processes involved in the design of job tasks, equipment, and workplace layout, must become more aware of ergonomic factors and principles. Why are engineering controls desired over work practice or administrative controls? _______________________________________________________________ _________________________________________________________________________________ © OSTN Introduction to Ergonomics Program Management 7 For Training Purposes Only What are the consequences of an accident? Direct Insured Costs 1.Workers’ compensation premiums 2. Some medical expenses “Just the tip of the iceberg” Indirect - Uninsured, hidden Costs - Out of pocket 1. Time lost from work by injured employee. 2. Lost time by fellow employees. 3. Loss of efficiency due to break-up of crew. 4. Lost time by supervisor. 5. Training costs for new/replacement workers. 6. Damage to tools and equipment. 7. Time damaged equipment is out of service. 8. Loss of production for remainder of the day. 9. Damage from accident: fire, water, chemical, explosives, etc. 10. Failure to fill orders/meet deadlines. 11. Overhead costs while work was disrupted. 12. Other miscellaneous costs (over 100 other items may impact the employer). 13. Others? ____________________________________________ 14. ___________________________________________________ 15. ___________________________________________________ Unknown Costs - © OSTN Introduction to Ergonomics Program Management 1. Human Tragedy 2. Morale 3. Reputation 8 For Training Purposes Only $ A F E T Y P A Y S ! OSHA Advisor @ www.osha.gov Estimated Costs of Ergonomics Injuries and Estimated Impact on a Company's Profitability Report for Year: 2000 Employer: Ergonot Inc. Prepared by: I. B. Safe, Safety Coordinator, on January 28, 2000 The injury or illness selected: Strain Average Direct Cost: Average Indirect Cost: Estimated Total Cost: The net profit margin for this company is The ADDITIONAL sales necessary - to cover Indirect Costs are: - to cover Total Costs are: The injury or illness selected: $178,350 $326,975 Carpal Tunnel Syndrome Average Direct Cost: Average Indirect Cost: Estimated Total Cost: The net profit margin for this company is The ADDITIONAL sales necessary - to cover Indirect Costs are: - to cover Total Costs are: The injury or illness selected: $5,945 $7,134 $13,079 4% $AFETY PAYS is a tool developed by OSHA to assist employers in assessing the impact of occupational injuries and illnesses on their profitability. It uses a company's profit margin, the AVERAGE costs of an injury or illness, and an indirect cost multiplier to project the amount of sales a company would need to generate in order to cover those costs. Since AVERAGES are used, the actual costs may be higher or lower. Costs used here do not reflect the pain and suffering of injuries and illnesses. The cost of injury and illness data were provided to OSHA by Argonaut Insurance Company and based on 53,000 claims for 1992-94. $8,305 $9,966 $18,271 4% $249,150 $456,775 Other Cumulative Trauma Average Direct Cost: Average Indirect Cost: Estimated Total Cost: The net profit margin for this company is The ADDITIONAL sales necessary - to cover Indirect Costs are: - to cover Total Costs are: $9,667 $11,600 $21,267 4% $290,000 $531,675 The TOTAL ADDITIONAL SALES required by these 3 incidents is estimated to be between: $717,500 and $1,315,425 The extent to which the employer ultimately pays the direct costs depends on the nature of the employer's workers‘ compensation insurance policy. The employer always pays the indirect costs. © OSTN Introduction to Ergonomics Program Management 9 For Training Purposes Only 2. Labor & Management Accountability An effective ergonomics program depends on accountability just like any other program. Without a culture of consequences, an ergonomics program is not likely to succeed. Let's take a look at the six basic elements of an effective accountability system. Six essential elements of an effective accountability system 1. Established formal standards of behavior and performance. • Programs, Policies, Plans, Processes, Procedures, Practices (the Six P's) 2. Resources provided to meet those standards. • Physical = tools, equipment, materials, workstations, facilities • Psychosocial = education, training, scheduling, culture 3. An effective system of measurement. • Recording/tracking employee behaviors • Performance appraisals 4. Application of effective consequences. • Soon - certain - significant - sincere • Must change behavior in the desired behavior 5. Appropriate application of consequences. • Justified - fair, consistent, goal is to help not hurt • Considered only after obligations have been met 6. Continual evaluation of the system. • Analysis/evaluation headed up by Safety committee, safety coordinator • Improvements headed up by line management © OSTN Introduction to Ergonomics Program Management 10 For Training Purposes Only Management/Employee Accountability Managers and employees are responsible and accountable for key behaviors and performance. Manager Employee When is a supervisor justified in disciplining for substandard behavior? Before you finger of blame, ask the following questions: provided leadership by complying myself Have I _______________________________________________? provided resources for a safety and healthful workplace Have I _______________________________________________? provided effective safety education and training Have I _______________________________________________? provided adequate supervision Have I _______________________________________________? provided positive and negative consequences Have I _______________________________________________? Management must fulfill its own accountabilities FIRST! © OSTN Introduction to Ergonomics Program Management 11 For Training Purposes Only XYZ Incorporated Ergonomics Program Responsibilities Injured Employee • Report symptoms immediately to the Occupational Health Nurse (OHN) and your Supervisor. • Follow all OHN and Physician treatment and any written instructions. • Attend all appointments with OHN, Physician, Physical Therapist, and person performing Ergonomics Evaluation. • Notify OH or Physician if pain does not subside. • Own behaving safely in the workplace. Supervisor • Complete factory SAR/SIR reports according to factory guidelines. • Follow up with Employee, OHN, and ergonomist in case management meetings as needed. • Ensure that Employee attends all OH Nurse, Physician, Physical Therapy and Ergonomics Evaluation appointments. • Communicate clearly that adhering to treatment is a top priority. • Follow up with Employee regarding injury I illness for 3 months minimum or as needed. One follow up per month is a minimum recommendation. • Ensure that all employees in the area are aware of risk factors that could lead to injury I illness. • Roll model safe behaviors Occupational Health Nurse (OHN) • Treat injured employees according to CTD Medical Management Guidelines and I or Medical Directive. • Determine the classification & recordability of injuries. • Coordinate communication of changes in treatment and instructions to employee and management. • Follow up with ergonomist as needed. • Share Ergonomics Evaluation and Supervisor Report with physician. Ergonomics Engineer • Follow up as needed with the injured employee, supervisor, OH Nurse, and Safety Engineering. • Document and communicate any needed workplace or procedural fixes and ensure that a roadmap with owners is established. Physician • Diagnose injury/illness and assess work relationship. • Prescribe treatment as needed for employee recovery. © OSTN Introduction to Ergonomics Program Management 12 For Training Purposes Only 3. Employee Involvement Ergonomic problems typically require a response that cuts across a number of organizational units. Hazard identification through job task analyses and review of injury records or symptom surveys, as well as the development and implementation of control measures, may require input from a number of groups and departments. How can each of the following help ensure an effective ergonomics program? Safety Staff ________________________________________________________ Engineering ________________________________________________________ HR ________________________________________________________ Maintenance ________________________________________________________ Supervisors ________________________________________________________ Management ________________________________________________________ Ergonomists ________________________________________________________ HCP ________________________________________________________ Why is it important for employers to encourage employees to report symptoms and signs of MSDs early? ________________________________________________________________________ ________________________________________________________________________ What message does management send to employees when it sets up conflicting pressures between working safely and production? _________________________________________________________________________ _________________________________________________________________________ © OSTN Introduction to Ergonomics Program Management 13 For Training Purposes Only Three categories of consequences Positive reinforcement - Must always increase desired behavior. • • • • • • Worker performs to receive the consequence Worker may perform far beyond minimum standards The only strategy that works to increase discretionary effort Focus is on excellence - success based “If you report a hazard, I will make sure you’re recognized.” “If you prevent an injury or save money, you will be rewarded.” Negative reinforcement - Intent is to increase desired behavior. • • • • • Worker performs to avoid the consequence - fear based Worker performs to minimum standard - just enough to get by Can work well if the focus is on compliance “If you wear that eye protection, you won’t get injured.” “If you comply with safety rules, you won’t be disciplined.” Extinction - Withdrawal of positive reinforcement. • • • • • Worker eventually performs without expectation of consequences (other than wages) Person is ignored - no relationship with management Is epidemic in organizations “It doesn’t matter how hard I work around here.” “Apathy is rampant, but who cares.” If people are taking shortcuts in areas such as safety and quality, the naturally occurring positive consequences associated with doing the job with less effort will cause the undesirable behaviors to continue. Aubrey, C. Daniels, Bringing Out the Best in People, p. 29 © OSTN Introduction to Ergonomics Program Management 14 For Training Purposes Only To be effective, consequences should be… Soon - occurs immediately after the behavior/performance. “Thanks, but I when did I go this?” _______________________________________________________________ _______________________________________________________________ Sure - employees know (1) they will be recognized, and (2) why they’re being recognized. “Guess I was just lucky.” _______________________________________________________________ _______________________________________________________________ Significant - perceived as more than an entitlement. Significance is defined by the receiver. Recognize and possibly reward when (1) employees meet or exceed expectations, and (2) save lives or money. “We don’t have to recognize them…that’s what they get paid to do.” _______________________________________________________________ _______________________________________________________________ Sincere - genuine appreciation or disapproval. You really mean it. Motives for recognizing are not questioned. “Recognize in public, reprimand in private!”… Any problems with this principle? _______________________________________________________________ _______________________________________________________________ © OSTN Introduction to Ergonomics Program Management 15 For Training Purposes Only 4. Hazard Identification & Control Four elements in the ergonomics program support this element of the safety and health system. Identifying risk factors, controlling risk factors, implementing control measures, medical management. All of these processes are critical in identifying, controlling and correct risk factors, and making long-term improvements to system components of the ergonomics program. Identifying risk factors Once a decision has been made to initiate an ergonomics program, a necessary step is to gather information to determine the scope and characteristics of the problem or potential problem. What are some methods to gather information and analyze ergonomics hazards in your workplace? ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ Some signs of potential risk factors and problem jobs. • OSHA 300 logs or workers compensation claims show cases of MSDs such as carpal tunnel syndrome, tendinitis, tenosynovitis, epicondylitis, and low back pain. Sometimes these records contain nonspecific entries like "hand pain," which may be an indicator of a significant health problem if severe or persistent. • Certain jobs or work conditions cause worker complaints of undue strain, localized fatigue, discomfort, or pain that does not go away after overnight rest. • Workers visiting the clinic make frequent references to physical aches and pains related to certain types of work assignments. • Job tasks involve at risk activities such as repetitive and forceful exertions; frequent, heavy, or overhead lifts; awkward work positions; or use of vibrating equipment. © OSTN Introduction to Ergonomics Program Management 16 For Training Purposes Only Other sources that could alert employers to potential problems include the following: • Trade publications, insurer newsletters, or references in popular literature indicating risks of MSDs • Cases of MSDs found among competitors or in similar businesses • Proposals for increasing line speed, retooling, or modifying jobs to increase individual worker output and overall productivity Following up on Worker Reports Criteria for an effective reporting system include: • Identification of at least one person to receive and respond to employee reports, and to take the action this standard requires. • Prompt response to employee reports of MSD signs or symptoms. Screening for Risk Factors Screening jobs for physical and psychological risk factors is very proactive, and should involve one or more of the following: • Walk-through observational surveys of the work facilities to detect obvious risk factors • Interviews with workers and supervisors to obtain the above information and other data not apparent in walk-through observations, such as time and workload pressures, length of rest breaks, etc. • Checklists for scoring job features against a list of risk factors. Physical risk factors include: Awkward postures Duration of exposure Vibration Forceful exertions Frequency of exposure Other conditions © OSTN Introduction to Ergonomics Program Management Repetitive motions Contact stresses 17 For Training Purposes Only Physical Risk factors Awkward postures. Body postures determine which joints and muscles are used in an activity and the amount of force or stresses that are generated or tolerated. For example, more stress is placed on the spinal discs when lifting, lowering, or handling objects with the back bent or twisted, compared with when the back is straight. Manipulative or other tasks requiring repeated or sustained bending or twisting of the wrists, knees, hips, or shoulders also impose increased stresses on these joints. Activities requiring frequent or prolonged work over shoulder height can be particularly stressful. Forceful exertions (including lifting, pushing, and pulling). Tasks that require forceful exertions place higher loads on the muscles, tendons, ligaments, and joints. Increasing force means increasing body demands such as greater muscle exertion along with other physiological changes necessary to sustain an increased effort. Prolonged or recurrent experiences of this type can give rise to not only feelings of fatigue but may also lead to musculoskeletal problems when there is inadequate time for rest or recovery. Force requirements may increase with: • increased weight of a load handled or lifted, • increased bulkiness of the load handled or lifted, • use of an awkward posture, • the speeding up of movements, • increased slipperiness of the objects handled (requiring increased grip force), • the presence of vibration (e.g., localized vibration from power handtools leads to use of an increased grip force), • forceful pinch grip compared with gripping the object with your whole hand), and • use of small or narrow tool handles that lessen grip capacity. © OSTN Introduction to Ergonomics Program Management 18 For Training Purposes Only Repetitive motions. If motions are repeated frequently (e.g., every few seconds) and for prolonged periods such as an 8-hour shift, fatigue and muscle-tendon strain can accumulate. Tendons and muscles can often recover from the effects of stretching or forceful exertions if sufficient time is allotted between exertions. Effects of repetitive motions from performing the same work activities are increased when awkward postures and forceful exertions are involved. Repetitive actions as a risk factor can also depend on the body area and specific act being performed. Duration. Duration refers to the amount of time a person is continually exposed to a risk factor. Job tasks that require use of the same muscles or motions for long durations increase the likelihood of both localized and general fatigue. In general, the longer the period of continuous work (e.g., tasks requiring sustained muscle contraction), the longer the recovery or rest time required. Frequency. Frequency refers to how many times a person repeats a given exertion within a given period of time. Of course, the more often the exertion is repeated, the greater the speed of movement of the body part being exerted. Also, recovery time decreases the more frequently an exertion is completed. And, as with duration, this increases the likelihood of both localized and general fatigue. Contact stresses. Repeated or continuous contact with hard or sharp objects such as non-rounded desk edges or unpadded, narrow tool handles may create pressure over one area of the body (e.g., the forearm or sides of the fingers) that can inhibit nerve function and blood flow. Vibration. Exposure to local vibration occurs when a specific part of the body comes in contact with a vibrating object, such as a power handtool. Exposure to whole-body vibration can occur while standing or sitting in vibrating environments or objects, such as when operating heavy-duty vehicles or large machinery. Other conditions. Workplace conditions that can influence the presence and magnitude of the risk factors for MSDs can include: • cold temperatures, • insufficient pauses and rest breaks for recovery, • machine paced work, and • unfamiliar or unaccustomed work © OSTN Introduction to Ergonomics Program Management 19 For Training Purposes Only Psychosocial Risk Factors In addition to the above conditions, other aspects of work may not only contribute to physical stress but psychological stress as well. As long as we believe we have adequate control over all aspects of our job, we may experience normal (positive) stress. However, if we believe we have little control over job demands, we may suffer from abnormal (negative) distress with accompanying ill health and possible irrational behaviors. Under distress, the probability of an accident increases greatly. Examples of psychosocial risk factors: : Lack of time Unreasonable workload Long work shifts Micro-management Poor communications Poor relationships _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ The object of the research is to determine whether these factors have a negative effect on the musculoskeletal system. Another related area of research is to determine which personal, work, or societal factors contribute to acute musculoskeletal disorders developing into chronic or disabling problems. What policies or expectations might cause distress in each of the three areas above? _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ © OSTN Introduction to Ergonomics Program Management 20 For Training Purposes Only Using a checklist The checklist procedure provides the most formal and orderly procedure for screening jobs. Numerous versions of checklists exist in ergonomics manuals. When checklist data are gathered by persons familiar with the job, task, or processes involved, the quality of the data is generally better. Using the checklist below, identify the general risk factors associated with the job you currently perform. Summarize your findings in the window below the checklist. General Ergonomic Risk Analysis Checklist Manual Material Handling ____ Is there lifting of loads, tools, or parts? ____ Is there lowering of tools, loads, or parts? ____ Is there overhead reaching for tools, loads, or parts? ____ Is there bending at the waist to handle tools, loads, or parts? ____ Is there twisting at the waist to handle tools, loads, or parts? Physical Energy Demands ____ Do tools and parts weigh more than 10 lb? ____ Is reaching greater than 20 in.? ____ Is bending, stooping, or squatting a primary task activity? ____ Is lifting or lowering loads a primary task activity? ____ Is walking or carrying loads a primary task activity? ____ Is stair or ladder climbing with loads a primary task activity? ____ Is pushing or pulling loads a primary task activity? ____ Is reaching overhead a primary task activity? ____ Do any of the above tasks require five or more complete work cycles to be done within a minute? ____ Do workers complain that rest breaks and fatigue allowances are insufficient? © OSTN Introduction to Ergonomics Program Management 21 For Training Purposes Only Other Musculoskeletal Demands ____ Do manual jobs require frequent, repetitive motions? ____ Do work postures require frequent bending of the neck, shoulder, elbow, wrist, or finger joints? ____ For seated work, do reaches for tools and materials exceed 15 in. from the worker's position? ____ Is the worker unable to change his or her position often? ____ Does the work involve forceful, quick, or sudden motions? ____ Does the work involve shock or rapid buildup of forces? ____ Is finger-pinch gripping used? ____ Do job postures involve sustained muscle contraction of any limb? Computer Workstation ____ Do operators use computer workstations for more than 4 hours a day? ____ Are there complaints of discomfort from those working at these stations? ____ Is the chair or desk nonadjustable? ____ Is the display monitor, keyboard, or document holder nonadjustable? ____ Does lighting cause glare or make the monitor screen hard to read? ____ Is the room temperature too hot or too cold? ____ Is there irritating vibration or noise? Environment ____ Is the temperature too hot or too cold? ____ Are the worker's hands exposed to temperatures less than 70 degrees Fahrenheit? ____ Is the workplace poorly lit? ____ Is there glare? ____ Is there excessive noise that is annoying, distracting, or producing hearing loss? ____ Is there upper extremity or whole body vibration? ____ Is air circulation too high or too low? © OSTN Introduction to Ergonomics Program Management 22 For Training Purposes Only General Workplace ____ Are walkways uneven, slippery, or obstructed? ____ Is housekeeping poor? ____ Is there inadequate clearance or accessibility for performing tasks? ____ Are stairs cluttered or lacking railings? ____ Is proper footwear worn? Tools ____ Is the handle too small or too large? ____ Does the handle shape cause the operator to bend the wrist in order to use the tool? ____ Is the tool hard to access? ____ Does the tool weigh more than 9 lb? ____ Does the tool vibrate excessively? ____ Does the tool cause excessive kickback to the operator? ____ Does the tool become too hot or too cold? Gloves ____ Do the gloves require the worker to use more force when performing job tasks? ____ Do the gloves provide inadequate protection? ____ Do the gloves present a hazard of catch points on the tool or in the workplace? Administration ____ Is there little worker control over the work process? ____ Is the task highly repetitive and monotonous? ____ Does the job involve critical tasks with high accountability and little or no tolerance for error? ____ Are work hours and breaks poorly organized? © OSTN Introduction to Ergonomics Program Management 23 For Training Purposes Only Medical Management Company health care management strategies and policies and health care providers is an important part of the overall ergonomics program. In general, medical management emphasizes the prevention of impairment and disability through early detection, prompt treatment, and timely recovery. Medical management responsibilities fall on employers, employees, and health care providers. What effective MSD management looks like: • Prompt response to employees with MSDs to prevent their condition from getting worse. It is available promptly whenever a MSD occurs at no cost to employees. • Prompt determination whether temporary work restrictions or other measures are necessary. Employees are provided temporary light duty/early return to work program jobs. Provide temporary work restrictions, where necessary, to employees with MSDs. When you have referred the employee to a HCP, follow the temporary work restriction recommendations in the HCP's written opinion. Make sure appropriate follow-up is provided during the recovery period. The employee should remain on restricted duty until it is determined he or she is able to return to the job; • Prompt access to a health care professional (HCP) for evaluation, management and follow-up. Provide the HCP with: A description of the employee's job and information about the MSD hazards in it. A description of available work restrictions that are reasonably likely to fit the employee's capabilities during the recovery period. A copy of the your company’s MSD management plan. Opportunities to conduct workplace walkthroughs. © OSTN Introduction to Ergonomics Program Management 24 For Training Purposes Only • Prompt application of recommended HCP corrective actions to eliminate or reduce the risk factors that cause MSDs. You implement measures that eliminate the MSD hazards or materially reduce them to the extent that the job does not pose a risk of harm to the injured employee during the recovery period. Obtain the HCP's written opinion so that appropriate corrective actions can be promptly applied. It’s important to know that any findings, diagnoses or information not related to workplace exposure to MSD hazards must remain confidential and must not be put in the written opinion or communicated to you. To the extent permitted and required by law, ensure employee privacy and confidentiality regarding medical conditions related to workplace exposure to MSD hazards that are identified during the MSD management process. The HCP should also provide recommended temporary work restrictions and followup; a statement that the HCP informed the employee about the results of the evaluation and any medical conditions resulting from exposure to MSD hazards that require further evaluation or treatment; and a statement that the HCP informed the employee about other physical activities that could aggravate the covered MSD during the recovery period. Job Familiarity and Job Placement Evaluations Health care providers who evaluate employees, determine their functional capabilities, and prepare opinions regarding work relatedness should be familiar with employee jobs and job tasks. With specific knowledge of the physical demands involved in various jobs and the physical capabilities or limitations of employees, the health care provider can match the employees capabilities with appropriate jobs. Being familiar with employee jobs not only assists the health care provider in making informed case management decisions but also assists with the identification of ergonomic hazards and alternative job tasks. One of the best ways for a health care provider to become familiar with jobs and job tasks is by periodic plant walk-throughs. Once familiar with plant operations and job tasks, the health care provider should periodically revisit the facility to remain knowledgeable about changing working conditions. Other approaches that may help the health care provider to become familiar with jobs and job tasks include reviewing job analysis reports, detailed job descriptions, job safety analyses, and photographs or videotapes that are accompanied by narrative or written descriptions of the jobs. © OSTN Introduction to Ergonomics Program Management 25 For Training Purposes Only Controlling Risk Factors It’s important that identified risk factors be eliminated or reduced, if possible, and controlled so that they do not resurface. Some important recommendations for controlling risk factors include: • Ask employees in the problem job for recommendations about eliminating or materially reducing the MSD hazards; • Identify, assess and implement feasible controls (interim and/or permanent) to eliminate or materially reduce the MSD hazards. This includes prioritizing the control of hazards, where necessary; • Track your progress in eliminating or materially reducing the MSD hazards. This includes consulting with employees in problem jobs about whether the implemented controls have eliminated or materially reduced the hazards; and • Identify and evaluate MSD hazards when you change, design or purchase equipment or processes in problem jobs. Hierarchy of Hazard Control Strategies Control strategies…to immediately correct hazardous conditions and unsafe behaviors. • Engineering controls. Eliminates/reduces hazards that existed, through equipment redesign, replacement, substitution. Most effective strategy. The preferred approach to prevent and control MSDs. Engineering control strategies to reduce ergonomic risk factors include the following: Changing the way materials, parts, and products can be transported . For example, using mechanical assist devices to relieve heavy load lifting and carrying tasks or using handles or slotted hand holes in packages requiring manual handling Changing the process or product to reduce worker exposures to risk factors. Examples include maintaining the fit of plastic molds to reduce the need for manual removal of flashing, or using easy-connect electrical terminals to reduce manual forces Modifying containers and parts presentation, such as height-adjustable material bins. Changing workstation layout. Examples might include using height-adjustable workbenches or locating tools and materials within short reaching distances. © OSTN Introduction to Ergonomics Program Management 26 For Training Purposes Only Changing the way parts, tools, machinery and materials are to be manipulated. Examples include using fixtures (clamps, vise-grips, etc.) to hold work pieces to relieve the need for awkward hand and arm positions or suspending tools to reduce weight and allow easier access. Changing tool designs. For example, pistol handle grips for knives to reduce wrist bending postures required by straight-handle knives or squeeze-grip-actuated screwdrivers to replace finger-trigger-actuated screwdrivers. Changes in materials and fasteners. For example, lighter-weight packaging materials to reduce lifting loads. Changing assembly access and sequence. For example, removing physical and visual obstructions when assembling components to reduce awkward postures or static exertions. • Management controls. These controls attempt to reduce exposure to the hazard by controlling behaviors through design of safe work practices, and procedures. They also reduce the frequency and duration of exposure to the hazards through scheduling strategies. These control strategies work as long as employees comply with the controls. Examples include: Broadening or varying the job content to offset certain risk factors (e.g., repetitive motions, static and awkward postures) Training in the recognition of risk factors for MSDs and instruction in work practices that can ease the task demands or burden Adjusting the work pace to relieve repetitive motion risks and give the worker more control of the work process Reducing shift length or curtailing the amount of overtime Rotating workers through several jobs with different physical demands to reduce the stress on limbs and body regions Scheduling more breaks to allow for rest and recovery • Interim Measures. These controls attempt to reduce exposure on a temporary basis through the use of engineering and management controls as well as warning devices, signage, etc. © OSTN Introduction to Ergonomics Program Management 27 For Training Purposes Only • Personal Protective Equipment (PPE). In conjunction with engineering and administrative controls, consider personal protective equipment. Back belts/braces and wrist braces/splints should not be considered PPE. In the field of occupational safety and health, PPE generally provides a barrier between the worker and the hazard source. Respirators, ear plugs, safety goggles, chemical aprons, safety shoes, and hard hats are all examples of PPE. Whether braces, wrist splints, back belts, and similar devices can be regarded as offering personal protection against ergonomic hazards remains open to question. Less controversial types of personal equipment are vibration attenuation gloves and knee pads for carpet layers. But even here, there can be concerns. For example, do the design and fit of the gloves make it harder to grip tools? What control measures might work to correct the hazard in the photo below? Engineering control ________________________________ __________________________________________________ Work practice control ______________________________ __________________________________________________ Administrative control ______________________________ __________________________________________________ PPE ______________________________________________ __________________________________________________ © OSTN Introduction to Ergonomics Program Management 28 For Training Purposes Only Implementing Control Strategies The process of implementing controls normally consists of: • Trials or tests of the selected solutions • Making modifications or revisions • Full-scale implementation • Follow up on evaluating control effectiveness Testing and evaluation Testing and evaluation verify that the proposed solution actually works and identifies any additional enhancements or modifications that may be needed. Employees who perform the job can provide valuable input into the testing and evaluation process. Worker acceptance of the changes put into place is important to the success of the intervention. It’s important that control strategies be implemented effectively to assure permanent improvement in conditions and behaviors. Use the following recommended strategies to help make sure your implementation process is effective. • Limit the variables. Implement one control at a time, to minimize the number of variables in the change. Implementing many controls may result in new problems. How will you determine which control is the cause? • Abandon, revise, add controls. If continued exposure to MSD hazards in the job prevents the injured employee's condition from improving or another covered MSD occurs in that job, you implement abandon the current control, revise the current control, or implement an additional control. Making modifications or revisions After the initial testing period, the proposed solution may need to be modified. If so, further testing should be conducted to ensure that the correct changes have been made, followed by full-scale implementation. Designating the personnel responsible, creating a timetable, and considering the logistics necessary for implementation are elements of the planning needed to ensure the timely implementation of controls. © OSTN Introduction to Ergonomics Program Management 29 For Training Purposes Only 5. Incident/Accident Analysis Be ready when accidents happen When a serious accident occurs in the workplace, everyone will be too busy dealing with the emergency at hand to worry about putting together an investigation plan, so now... before the accident occurs... is the time to develop effective accident investigation procedures. They should include as a minimum procedures that: 1. Write a clear policy statement. 2. Identify those authorized to notify outside agencies (fire, police, etc.) 3. Designate those responsible to investigate accidents. 4. Train all accident investigators. 5. Establish timetables for conducting the investigation and taking corrective action. 6. Identify those who will receive the report and take corrective action. Why do we “investigate” incidents/accidents? _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ Why are some incident/accident reports ineffective? _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ © OSTN Introduction to Ergonomics Program Management 30 For Training Purposes Only The Accident Weed Injury or Illness Direct Cause of Injury Strains • Harmful Energy Transfer • Kinetic, thermal, chemical, etc. Burns Cuts Un gu ar de d m ac sep hi ne H or Bro ken too ls Chem ical s p Defe ctive Untrained te Crea Ignore ill • • • • • • Directly cause of the injury event Unique hazardous condition(s) Individual unsafe behavior(s) Controllable or uncontrollable factors Events occur close to the injury event Failure to perform safety practices, procedures, processes • Involves the victim, others lay a h az ard rd a haza s to Fail PPE Primary Surface Causes rt repo r inju Secondary Surface Causes y Fails to inspect worker Fails to enforce Lack of time • • • • • • Indirectly cause the injury event Specific hazardous condition(s) Individual unsafe behavior(s) Controllable and uncontrollable factors Events occur distant from the injury event Failure to perform safety practices, procedures, processes • Co-workers, supervisors, anytime, anywhere Implementation Root Causes Inadequate training No discipline procedures No orientation process Inadequate training plan No accountability policy ain Lack of vision No mission statement T Fails to tr ork o much w No recognition Inadequate labeling Outdated hazcom program No recognition plan No inspection policy © OSTN Introduction to Ergonomics Program Management • Common conditions and behaviors • Inadequate implementation of safety policies, programs, plans • Inadequate design of processes, procedures • Pre-exist surface causes • Controllable • Middle management, anytime, anywhere System Design Root Causes • Inadequate design of safety system policies, programs, plans • Pre-exist all other causes • Controllable • CEO, top management, anytime, anywhere External Environmental Causes • • • • • Government regulation Physical resources Human resources Capital Society For Training Purposes Only XYZ Inc. Ergonomics Incident/Accident Analysis Plan 1. Actual/Potential musculoskeletal or ergonomics injury/illness complaint reported to OHN 2. Supervisor or OHN conducts an initial analysis of the employee, task, and work environment using the Corporate Ergonomics Questionnaire, if appropriate. 3. The employee's supervisor is notified according to factory policy. 4. If the injury/illness symptoms are severe, the OHN will refer the employee to the appropriate Physician immediately. 5. Where evidence of an occupational injury/illness exists, the OHN will request the supervisor to complete a Supervisor Incident/Accident Report. 6. A full workplace assessment is conducted to determine contributing factors of the injury / illness. a. The supervisor will conduct an analysis of the work area using the Workstation Analysis Worksheet. b. The workplace analysis should thoroughly examine all surface and root cause contributors. c. A complete supervisor report is prepared & sent to the factory superintendent, shift OHN, safety coordinator and other key players according to factory policy. 7. The OHN will refer the employee to the appropriate physician based on the symptoms and nature of the injury / illness. a. The Physician will perform an initial assessment of the employee. On completion of the examination, the Physician will make a diagnosis of the injury/illness. The OHN will provide all necessary information to the physician. b. The OHN will work with the Physician (if possible) to communicate the XYZ Inc. program for management of MSD’s (Early RTW, Modified Work, Wellness referrals, Physical Therapy). 8. The Physician will be fully briefed on the workplace Ergonomics evaluation by the OHN before making a determination if the injury/illness is occupational in nature. 9. All cases should be followed for one quarter by the supervisor and OHN to prevent potential recurrences of the injury I illness. © OSTN Introduction to Ergonomics Program Management 32 For Training Purposes Only 6. Education and Training Education explains why…training shows how Identifying and solving workplace MSD problems require some level of ergonomic knowledge and skills. Recognizing and filling different training needs is an important step in building an effective program. Education tells Why • Builds the philosophical foundation • Transfers general knowledge • Shapes attitudes Training shows How • • • • One form of education Builds the specific knowledge base Transfers initial skills Shapes attitudes Experience improves skills • Increases insight, understanding • Further develops expert skills • Shapes attitudes What are some different methods for conducting ergonomics safety education and training? ___________________________ ___________________________ ___________________________ ___________________________ Accountability sustains behaviors • Natural consequences - injury illness • System consequences - discipline, recognition, reward What does an effective ergonomics safety training program look like? _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ “Safety training is worthless without accountability.” © OSTN Introduction to Ergonomics Program Management 33 For Training Purposes Only What are the objectives of ergonomics education and training? The objectives for ergonomics awareness training are as follows: • Recognize workplace risk factors for MSDs. • Understand general methods for controlling MSDs. • Identify the signs and symptoms of MSDs that may result from exposure to such risk factors. • Be familiar with the company's health care procedures. • Know the process to address and control risk factors. • Know the the employee's role and accountabilities in the process. • Know the ways employees can actively participate in the ergonomics program. • Know the procedures for reporting risk factors and MSDs, including the names of designated persons who should receive the reports. How do we know ergonomics education and training is successful? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ How do we make sure it’s successful? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ © OSTN Introduction to Ergonomics Program Management 34 For Training Purposes Only Training in job analyses and control measures The objectives for training in job analyses and control measures are as follows: • Demonstrate the way to do a job analysis for identifying risk factors for musculoskeletal disorders • Select ways to implement and evaluate control measures Training in problem solving The objectives for training in problem solving are as follows: • Identify the departments, areas, and jobs with risk factors through a review of company reports, records, walk-through observations, and special surveys. • Identify tools and techniques that can be used to conduct job analyses and serve as a basis for recommendations. • Develop skills in team building, consensus development, and problem solving. • Recommend ways to control ergonomic hazards based on job analyses and pooling ideas from employees, management, and other affected and interested parties. Special considerations and precautions Training objectives are not intended to have workers, supervisors, or managers diagnose or treat MSDs. Rather, the purpose is to instill an understanding of what type of health problems may be work related and when to refer employees for medical evaluation. The training should include what is known about work and non-work causes of musculoskeletal disorders and the current limitations of scientific knowledge. Training should be understandable to the target audience. Training materials used should consider the participants educational levels, literacy abilities, and language skills. This may mean, for example, providing materials, instruction, or assistance in Spanish rather than English. © OSTN Introduction to Ergonomics Program Management 35 For Training Purposes Only 7. Periodic Evaluation • Last and first phase of planning cycle • Identify, analyze, evaluate, both labor and management Identify - “Is it present?” Yes/No. Inspect. Analyze - “What does the policy, plan, procedure look like?” Evaluate - “Is it effective?” Judgement call. • Use outside experts - /Insurer ergonomists • One of the safety committee’s primary responsibilities is to evaluate accountability. 437-001-0765(6)(d) Hazard assessment and control. (A) The safety committee shall assist the employer in evaluating the employer's accident and illness prevention program, and shall make written recommendations to improve the program where applicable. • Establish procedures for change - an action plan • Measure activity and results • Supervisor, manager behaviors, performance • Employee behaviors, performance • Make effective recommendations • Use facts and figures • Contrast benefits of investment with high costs if nothing is done © OSTN Introduction to Ergonomics Program Management 36 For Training Purposes Only © OSTN Introduction to Ergonomics Program Management 37 For Training Purposes Only Appendix © OSTN Introduction to Ergonomics Program Management 38 For Training Purposes Only Sample Ergonomics Plan I. Purpose of the program A. The Ergonomics Program is established to prevent the occurrence of work-related musculoskeletal disorders, primarily those in the back, upper and lower extremities. To do this the program employs various strategies: 1. Informs employees about musculoskeletal disorders and the risk factors that can cause or aggravate them. 2. Promotes continuous improvement in workplace ergonomic protection. 3. Encourages new technology and innovation in ergonomic protection. 4. Identifies design principles that prevent exposure to risk factors. 5. Ensures ongoing and consistent management leadership and employee involvement. B. ________________________ (person and position) is responsible for managing the Ergonomic Protection Plan. The ergonomic program health care provider, supervisors and the safety committee will assist in monitoring the effectiveness of the program. II. Worksite analysis A. Supervisor, with assistance from the program manager or a consultant, will conduct an ergonomic hazard analysis for each task in his or her area of responsibility. The purpose of worksite analysis is to recognize and identify existing ergonomic risk factors in the workplace. The analysis will include the use of an ergonomic checklist and employee questionnaire. Periodic surveys of the workplace will be conducted at appropriate intervals to evaluate changes in risk factors and effectiveness of work practices and engineering controls. B. The OSHA 300 log will be reviewed to determine whether any musculoskeletal disorders have occurred during the last two years. If musculoskeletal disorders have occurred in the past two years, the supervisor will further analyze and evaluate the associated "at risk" work areas for ergonomic hazards C. Each "at risk" task will be videotaped for the purpose of documenting work procedures, tools and materials used, and hazardous conditions encountered. The supervisor will analyze the task for ergonomic related hazard that could result in injury or illness. (See program description for instructions on videotaping) 1. The following risk factors should be considered in your analysis: a. Performance of the same motions or motion pattern every few seconds for more than two hours at a time. Questions to ask: • What is the task or cycle frequency per shift? • Is the task continuous or sporadic? • Does the worker perform the task for the entire shift or rotate with other workers? b. Fixed or awkward work postures for more than a total of two hours: for example, overhead work, twisted or bent back, bent wrist, kneeling, stooping, or squatting. Questions to ask: • What is the height of the workbench? • What is the maximum reach to parts bins, etc.? • What is the chair height? • Is movement restricted due to confined workspace? c. Use of hand tools. Questions to ask: • What is the weight of tool being used? • Are vibrating or impact tools or equipment used for more than a total of two hours? • Is there air exhaust onto the worker’s hand? © OSTN Introduction to Ergonomics Program Management 39 For Training Purposes Only d. Manual handling of objects more than 25 pounds more than once each workshift. e. The type of handwear being used. Questions to ask: • Is handwear slippery? • Do the gloves fit properly? f. No worker control over work pace (e.g., work is mechanically or electronically paced) for more than four hours at a time (exclusive of regular breaks.) g. Work performed in cold environment. D. The use of outside ergonomics consultants to evaluate areas identified is encouraged. Their assistance may be extremely valuable in conducting the initial analysis. Coordinate with the program manager to request assistance. III. Corrective Actions A. The supervisor with assistance from the program manager will determine the surface and root causes for all hazards (ergonomic and general) related to a task being analyzed. The following control strategies will be used to reduce or eliminate those hazards: Engineering controls - Engineering techniques, where feasible, are the preferred method of control. The focus of our ergonomics program is to make the job fit the person, not to force the person to fit the job. This can be accomplished by designing or modifying the work station, work methods, and tools to eliminate excessive exertion and awkward postures and to reduce repetitive motion. a. Work station design. • Work stations will be designed to accommodate the persons who actually work a given job; it is not adequate to design for the “average” or typical worker. • Work stations will be easily adjustable and either designed or selected to fit a specific task, so they are comfortable for the workers using them. • The work space will be large enough to allow for the full range of required movements, especially where knives, saws, hooks, and similar tools are used. b. Design of work methods. Work methods will be designed to reduce static, extreme, and awkward postures; repetitive motion; and excessive force. Work method design addresses the content of tasks performed by the workers. It requires analysis of the production system to design or modify tasks to eliminate stressors. c. Tool and Handle Design. Tools and handles, if well-designed, reduce the risk of MSDs. For any tool, a variety of sizes will be available to achieve a proper fit and reduce ergonomic risk. The appropriate tool should be used to do a specific job. Tools and handles should be selected to eliminate or minimize the following stressors: • Chronic muscle contraction or steady force. • Extreme or awkward finger/hand/arm positions. • Repetitive forceful motions. • Tool vibration. • Excessive gripping, pinching, pressing with the hand and fingers. © OSTN Introduction to Ergonomics Program Management 40 For Training Purposes Only Management controls - An effective program for hazard prevention and control also includes procedures for safe and proper work that are understood and followed by managers, supervisors, and workers. Key elements of an effective program for ergonomics include proper work techniques, employee conditioning, scheduling, regular monitoring, feedback, maintenance, adjustments and modifications, and enforcement. a. Proper work techniques include: • Proper cutting techniques, including work methods that improve posture and reduce stress and strain on extremities. • Good knife care, including steeling, and regular sharpening or steeling of knives. • Correct lifting techniques (proper body mechanics) • Correct use to ergonomically designed work stations and fixtures. • Reducing the total number of repetitions per employee by decreasing production rates and limiting overtime work. • Providing rest periods to relieve fatigued muscle-tendon groups. The length of time needed depends on the task’s overall effort and total cycle time. • Increasing the number of employees assigned to a task to alleviate severe conditions, especially in lifting heavy objects. • Using job rotation, used with caused as a preventive measure, not as a response to symptoms. The principle of job rotation is to alleviate physical fatigue and stress of a particular set of muscles and tendons by rotating employees among other jobs that use different muscle-tendon groups. If rotation is used, the job analyses must be reviewed by a qualified person to make sure the same muscle-tendon groups are not used. • Providing enough standby/relief workers to compensate for foreseeable upset conditions on the line (e.g., loss of workers). • Job enlargement -- see the guidance on “Design of Work Methods” b New Employee Conditioning Period. Some of our jobs may require regular condition, or break-in periods which may last several weeks. New and returning employees will be gradually integrated into a full workload as appropriate for specific jobs and individuals. Employees will be assigned to an experienced trainer for job training and evaluation during the break-in period. Employees reassigned to new jobs should also have a break-in period. c. Monitoring. Regular monitoring at all levels of operation will help to ensure that employees continue to use proper work practices. Monitoring will include a periodic review of the techniques in use and their effectiveness, including a determination of whether the procedures in use are those specified; if not, then we will determined why changes have occurred and whether corrective action is necessary. d. Adjustments and modifications. We will modify work practice controls when the dynamics of the workplace change. Such adjustments include changes in the following: • Line speeds • Staffing at position • Type, size, weight, or temperature of the product handled e. Enforcement. Supervisors will insist that all employees: • comply with ergonomics policies and rules, • report hazards as soon as possible, • report any sign, symptom or injury immediately, • use best practices in work behaviors. If supervisor accountabilities are fulfilled; e.g., resources, training, oversight, enforcement, progressive disciplinary procedures will be administered for non-compliance with the above behaviors. © OSTN Introduction to Ergonomics Program Management 41 For Training Purposes Only Personal Protective Equipment (PPE) - PPE will be selected with ergonomic stressors in mind. Appropriate PPE should be provided in a variety of sizes, should accommodate the physical requirements of workers and the job, and should not contribute to extreme postures and excessive forces. The following factors need to be considered when selecting PPE: a. Proper fit is essential. For example, gloves that are too thick or that fit improperly can reduce blood circulation and sensory feedback, contribute to slippage, and may require excessive grip strength. b. Protection against extreme cold (less than 40 degrees F.) is necessary to reduce stress on joints. c. Braces, splints, back belts, and other similar devices are not PPE. D. Other types of PPE that may be selected for use (e.g. arm guards) should not increase ergonomic stressors. Where feasible, engineering controls will be the preferred method for eliminating or reducing MSD hazards. However, administrative and work practice controls also may be important in addressing MSD hazards. • If continued exposure to MSD hazards in the job prevents the injured employee's condition from improving or another MSD occurs in that job, we will implement additional feasible controls to reduce the hazard further. • If the injured employee's condition improves and no additional covered MSD occurs in the job, we will not in further controls. However, if the employee's condition does not improve or another MSD occurs, we will continue incremental corrective actions if other feasible controls are available. • Personal protective equipment (PPE) may be used to supplement engineering, work practice and administrative controls, but will only be used alone where other controls are not feasible. Where PPE is used, we will provide it at no cost to employees. • NOTE: Back belts/braces and wrist braces/splints are not considered PPE for the purposes of this plan. • Periodic surveys of the workplace will be conducted at appropriate intervals to evaluate changes in risk factors and effectiveness of engineering, work practice, and administrative controls. IV. Employee involvement and training A. Management will be involved in all stages of identifying, assessing, and controlling ergonomics hazards. Managers and supervisors will work closely with employees to determine hazards. Training in ergonomic awareness and safe work practices will be key in ultimately reducing injuries and illnesses, and involving employees in this training will improve the interest and quality of the training B. All supervisors and employees will be educated on the early signs and symptoms of ergonomic injury and illness.. C. Further ergonomics training will be conducted for all "at risk" employees and supervisors, and will include specific information on the hazards associated with their jobs, reporting procedures, the risks of developing cumulative trauma disorders, symptoms of exposure, and how to prevent the occurrence of cumulative trauma disorders. The supervisor’s training program will also be implemented to allow recognition of the signs of cumulative trauma disorders and to reinforce the ergonomics program. After training is completed, supervisors will provide regular feedback on work practices to their employees. D. The training program will be conducted by a qualified health care provider. © OSTN Introduction to Ergonomics Program Management 42 For Training Purposes Only V. Medical management A. A medical management program will be established under the guidance of an appropriately qualified health professional. Appropriately trained health care providers will be available at all times, and on an ongoing basis as required. They will be knowledgeable in the prevention, early recognition, evaluation, treatment and rehabilitation of CTDs, and in the principles of ergonomics, physical assessment of employees, and OSHA recordkeeping requirements. B. Program health care providers will conduct monthly, systematic workplace walk-through to remain knowledgeable about operations and work practices, identify risk factors for CTDs in the workplace, identify potential light duty jobs, and maintain close contact with employees. Findings and recommendations will be documented and reported to the safety committee as soon as possible after the walk-through is completed. C. Program managers will develop a symptoms survey to measure the extent of symptoms of work-related disorders for each area of the plant, to determine which jobs are exhibiting problems and to measure progress of the ergonomic program. Body diagrams should be used to facilitate the gathering of this information. Employees identities and medical records, including surveys will remain confidential. D. All employees who report pain or other symptoms possibly related to musculoskeletal disorders will be promptly evaluated by a health care provider, and appropriate treatment and follow-up will be provided. E. Where an employee states that the injury or illness is work-related, and the case otherwise meets the criteria for recording, the case will be entered on the OSHA log pending final determination of the cause. E. The employee will be monitored until he or she is able to perform work without restrictions. The idea is to detect any problem as early as possible to reduce the severity of the injury and associated costs. F. The program health care provider will compile a list of light duty jobs with the lowest ergonomic risk. For such jobs, ergonomic risk(s) will be described. G. New and current employees who are assigned to at risk jobs or tasks will be given a baseline survey by the health care provider to establish a base against which changes in health status can be evaluated. The baseline survey is not for the purpose of precluding people from performing particular jobs. VI. Program Evaluation A. The Ergonomics Protection Program will be evaluated by the program manager and safety committee annually for its ability to identify, assess, and eliminate ergonomic hazards in the workplace. Reductions in ergonomics related injuries and illness should ideally be experienced soon after the program is implemented. B. Findings of the evaluation will be reported directly to the CEO. Certification _____________________________ ______________________ Reviewed by (Signature) Date _______________________________ ______________________ Approved by (Signature) Date © OSTN Introduction to Ergonomics Program Management 43 For Training Purposes Only Workstation Ergonomic Hazard Analysis Yes No 1. ____ ____ Does the working space allow for a full range of movement? 2. ____ ____ Are mechanical aids and equipment available? 3. ____ ____ Is the height of the work surface adjustable? 4. ____ ____ Can the work surface be tilted or angled? 5. Is the workstation designed to reduce or eliminate: ____ ____ Bending or twisting at the waist? ____ ____ Reaching above the shoulder? ____ ____ Static muscle loading? ____ ____ Extending the arms? ____ ____ Bending or twisting the wrists? ____ ____ Raised elbows? 6. ____ ____ Is the employee able to vary posture? 7. ____ ____ Are hands and arms free from pressure from sharp edges on work surfaces? 8. ____ ____ Is an armrest provided where needed? 9. ____ ____ Is the floor surface flat? 10. ____ ____ Are cushioned floor mats provided when workers stand for long periods? 11. ____ ____ Is the chair or stool easily adjustable and suited to the task? 12. ____ ____ Are all task requirements visible from comfortable positions? 13. ____ ____ Is there a preventive maintenance program for tools and equipment? © OSTN Introduction to Ergonomics Program Management 44 For Training Purposes Only Ergonomic Task Analysis Worksheet Yes No 1. Does the design of the task reduce or eliminate: ____ ____ Bending or twisting? ____ ____ Crouching? ____ ____ Bending or twisting the wrists? ____ ____ Extending the arms? ____ ____ Raising elbows? ____ ____ Static muscle loading? ____ ____ Clothes-wringing motions? ____ ____ Finger pinch grip? 2. ____ ____ Are mechanical devices used when necessary? 3. ____ ____ Can the task be done with either hand? 4. ____ ____ Can the task be done with two hands? 5. ____ ____ Are pushing and pulling forces reduced or eliminated? 6. ____ ____ Are the required forces acceptable? 7. ____ ____ Are the materials able to be held without slipping? 8. ____ ____ Are the materials easy to grasp? 9. ____ ____ Are the materials free from sharp edges or corners? 10. ____ ____ Do containers have good handholds? 11. ____ ____ Are jigs, fixtures and vises used where needed? 12. ____ ____ Do gloves fit properly, and are they made of the proper fabric? 13. ____ ____ Does the task avoid contact with sharp edges? 14. ____ ____ When needed, are push buttons designed properly? 15. ____ ____ Does personal protective equipment keep from getting in the way of the task? 16. Are high rates of repetitive motion avoided by: ____ ____ Job rotation? ____ ____ Self pacing? ____ ____ Sufficient rest pauses? ____ ____ Adjusting the job to the skill level of the worker? 17. Is the employee trained in: ____ ____ Proper work practices? ____ ____ When and how to make adjustments? ____ ____ Signs and symptoms of potential physical problems? © OSTN Introduction to Ergonomics Program Management 45 For Training Purposes Only Hand tool analysis checklist Yes No 1. Are tools selected to avoid: ____ ____ excessive vibration? ____ ____ excessive force? ____ ____ Bending or twisting the wrists? ____ ____ finger pinch grip? ____ ____ Raising elbows? ____ ____ problems associated with trigger finger? 2. ____ ____ Are tools powered where necessary and feasible? 3. ____ ____ Are tools evenly balanced? 4. ____ ____ Are heavy tools counterbalanced? 5. ____ ____ Does the tool allow adequate visibility of the work? 6. ____ ____ Does the tool grip/handle prevent slipping during use? 7. Are tools equipped with handles: ____ ____ of proper diameter? ____ ____ that do not end in the palm area? ____ ____ of textured non-conductive material? 8. ____ ____ Are different handle sizes available to fit a wide range of hand sizes? 9. ____ ____ Is the tool handle designed to not dig into the palm of the hand? 10. ____ ____ Can the tool be used safely with gloves? 11. ____ ____ Can the tool be used by either hand? 12. ____ ____ Is there a preventive maintenance program to keep tools operating as designed? 13. Have employees been trained: ____ ____ in the proper use of tools? ____ ____ when and how to report problems with tools? ____ ____ in proper tool maintenance? © OSTN Introduction to Ergonomics Program Management 46 For Training Purposes Only Materials handling checklist Yes No 1. ____ ____ Has excessive weight lifting been reduced? 2. ____ ____ Are materials moved over minimum distances? 3. ____ ____ Is the distance between the object and the body minimized? 4. Are walking surfaces: ____ ____ level? ____ ____ wide enough? ____ ____ clean and dry? ____ ____ well lit? 5. Are objects: ____ ____ easy to grasp? ____ ____ stable? ____ ____ able to be held without slipping? 6. ____ ____ Are there handholds on these objects? 7. ____ ____ When required, do gloves fit properly? 8. ____ ____ Is the proper footwear worn? 9. ____ ____ Is there enough room to maneuver? 10. ____ ____ Are mechanical aids easily available and used whenever possible? 11. ____ ____ Are working surfaces adjustable to the best handling heights? 12. Does material handling avoid: ____ ____ movements below knuckle height and above shoulder height? ____ ____ static muscle loading? ____ ____ sudden movements during handling? ____ ____ twisting at the waist? ____ ____ excessive reaching? 13. ____ ____ Is help available for heavy or awkward lifts? 14. Are high rates of repetition avoided by: ____ ____ job rotation? ____ ____ self pacing? ____ ____ sufficient rest pauses? 15. ____ ____ Are pushing and pulling forces reduced or eliminated? 16. ____ ____ Does the employee have an unobstructed view of the handling task? 17. ____ ____ Is there a preventive maintenance program for equipment? 18. ____ ____ Are workers trained in correct handling and lifting procedures? © OSTN Introduction to Ergonomics Program Management 47 For Training Purposes Only Computer workstation checklist Yes No 1. Is the chair adjusted to ensure proper posture, such as: ____ ____ knees and hips bent at approximately 90 degrees? ____ ____ feet flat on floor or footrest? ____ ____ arms comfortably at sides with elbows at 90-degree angle? ____ ____ straight wrists at keyboard? 2. Does the chair: ____ ____ adjust easily from the seated position? ____ ____ have a padded seat that is adjustable for height and angle? ____ ____ have an adjustable backrest? ____ ____ provide lumbar support? ____ ____ have a stable caster base? 3. ____ ____ Is there sufficient space for knees and feet? 4. ____ ____ Are the height and tilt of the keyboard work surface adjustable? 5. ____ ____ Is the keyboard prevented from slipping when in use? 6. ____ ____ Is the mouse or pointing device at the same level as the keyboard? 7. ____ ____ Does keying require minimal force? 8. ____ ____ Is there an adjustable document holder? 9. ____ ____ Are arm rests provided where needed? 10. ____ ____ Is the screen clean and free of flickering? 11. ____ ____ Is the top line of the screen slightly below eye level? 12. ____ ____ Does the monitor have brightness and contrast controls? 13. ____ ____ Is the monitor 18-30 inches from the worker for viewing? 14. ____ ____ Is there sufficient lighting without causing glare? 15. ____ ____ Is an anti-glare screen used if necessary? 16. ____ ____ Are adequate rest breaks provided for task demands? 17. Are high stroke rates avoided by: ____ ____ job rotation? ____ ____ self pacing? ____ ____ adjusting the job to the skill of the worker? ____ ____ adequate rest pauses? 18. Are employees trained in: ____ ____ proper postures? ____ ____ proper work methods? ____ ____ when and how to adjust their workstations? ____ ____ how to seek assistance with concerns? © OSTN Introduction to Ergonomics Program Management 48 For Training Purposes Only Symptoms Survey Name _______________________________________ Date ___________________________ (Optional) Work Location ____________________________________ Job _________________________ Shift _____________ Supervisor ________________________ (Optional) Time on this job: ____ Less than 3 months ____ 5 years to 10 years ____ 3 months to 1 year ____ 1 year to 5 years ____ Over 10 years Have you had any pain or discomfort during the last year? ____ Yes ____ No If you answered “Yes” to the above question, carefully shade in the area of the drawings below which indicate the location of the pain which bothers you the most. Front © OSTN Introduction to Ergonomics Program Management Back 49 For Training Purposes Only Symptoms Survey Name (Optional) _________________________________________________________ Please complete a separate page for each area that bothers you. Check area __ Neck __ Shoulder __ Elbow __ Forearm __ Hand/Wrist __ Fingers __ Upper back __ Low back __ Thigh __ Low leg __ Knee __ Ankle/foot 1. Please put a check by the word(s) that best describe your problem. __ Aching __ Cramp __ Numbness __ Tingling __ Stiffness __ Burning __ Pain __ Weakness __ Swelling __ Color Loss __ Other (Specify) ________________ 2. When did you first notice the problem? __ recently ___ number of months ago __ years ago 3. How long does each episode last? ____________________________________________ 4. How many separate episodes have you had in the last year? ________________________ 5. What do you think caused the problem? _________________________________________ _____________________________________________________________________________ 6. Have you had this problem in the last 7 days? __ Yes __ No 7. (optional) How would you rate the level of pain you experience related to this problem? Mark an “X” on the line. Right now: None ----------------------------------------------------------------------------Unbearable At its worst: None ----------------------------------------------------------------------------Unbearable 8. Have you had medical treatment for this problem? __ Yes __ No If yes, what was the diagnosis? ________________________________________________ 9. How many days have you lost from work in the last year because of this problem? _____ 10. How many days in the last year were you on modified duty because of this problem? ______ 11. Have you changed jobs because of this problem? __ Yes __ No 12. Please comment on what you think would improve your symptoms: _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ © OSTN Introduction to Ergonomics Program Management 50 Department of Consumer and Business Services Occupational Safety and Health Division () Workshop Evaluation How did we do? Developing an Effective Ergonomics Program Date: __________ Instructor: __________________________________________________________ WE VALUE YOUR COMMENTS I supervise others and/or manage programs: Yes No Yes No 1. The course information easy to understand and useable. 2. The course information was helpful in improving workplace safety and health. 3. The course materials (workbooks, overheads, slides, etc.) were helpful. 4. Please rate the overall effectiveness of course information. (circle a number) ... Effective... 10 9 ...Not Effective... 8 7 6 5 4 3 2 1 Comments: Please take the time to explain all “No” or “Not Effective” responses. Yes 1. The instructor provided a quality presentation (relevant, interesting, applicable). 2. The instructor answered questions adequately and/or made appropriate referrals. 3. The instructor encouraged student participation. 4. Please rate the overall effectiveness of the instructor. (circle a number) ...Effective... 10 9 ...Not Effective... 8 7 6 5 4 3 2 Comments: Please take the time to explain all “No” or “Not Effective” responses. 1 No For Training Purposes Only Don’t write on this page. You’ll be detaching it from the workbook at the end of the workshop. © OSTN Introduction to Ergonomics Program Management 52