The impact of the work place on health


Before furnishing the work place, it is recommended employers consult an ergonomist who can advise on the best options to reduce the risk of repetitive strain injury and other cumulative trauma disorders of the work place. Occupational Therapist Maher Kharma provides some insight into the all-important, but often overlooked, discipline of ergonomics.

It may not be difficult for an employer to sympathise with employees who call to let the employer know that they will not be able to make it to work due to a sudden episode of severe back pain.

This sympathy may not be the same if an employee calls up to let the employer know that they will not make it to work that day due to the fact that working on the computer has resulted in the employee developing aching and burning feeling in the shoulder or in the hand. While the employer may find these claims difficult to believe, research demonstrates that these injuries do exist and are resulting in interruption of an employees’ ability to perform their jobs at the required productivity level.

Aside from worker traumatic injuries, The Occupational Safety & Health Agency (OSHA) has identified five factors that have been leading the rising numbers of cumulative trauma disorders (CTDs) in the United States.

These factors are 1) repetitive work (e.g., data processing), 2) working in awkward positions (e.g., overhead work); 3) employing force to complete the task (e.g., using a hammer); 4) vibration (e.g., operating a forklift), and 5) contact stress (e.g., resting forearms against sharp edges). It is not uncommon to find that many of the daily jobs completed by various groups of workers involve one or more of these risk factors. Those workers who are at higher risk of developing CTDs include data processors, warehouse and construction workers, dentists, musicians, as well lab and pharmacy technicians.

While these slow developing injuries may become more evident over time, they eventually impact and interrupt an individual’s ability to perform non-work related tasks, with a direct influence on work performance and attendance. Cumulative trauma disorders (CTDs) spare no joint or muscle in the body, can affect soft tissue (muscles, ligaments, etc.) in the body, and may include one or more of the known CTDs (such as carpal tunnel syndrome, tendonitis, rotator cuff injuries, ganglion cyst, etc.).

Cost & Prevalence

At the time when OSHA reported that CTDs affects some 1.8 million workers in the U.S. every year, the U.S. Bureau of Labor and Statistics (BLS) estimates that nearly 700,000 workdays are lost annually because of such workrelated disorders, costing employers $15-$20 billion in workers’ compensation annually. While common musculoskeletal conditions (such as carpal tunnel syndrome) can be managed with minimum cost when addressed early on, the average lifetime cost for the same condition including medical bills and lost time from work, is estimated to be $30,000 for each injured worker.

Multiple studies concluded that overuse of soft tissue during repetitive work leads to injury as it causes decreased blood flow, tiny muscle tears and scarring that results in inflammation and muscle stiffness. As workers focus on meeting productivity expectations, they will attempt to work faster and may adopt awkward positions, both which result in elevating their stress level, and consequently increasing chances of a musculoskeletal injury. As the worker’s body goes through multiple adjustments, through out the day, to cope with environmental factors (such as noise level, temperature, air quality, colour, glare, etc), he/she may be too occupied to deal with those workstation adjustable elements (wrist support, seat depth, keyboard, foot rest, knee space, back support, monitor, etc.) that one should be paying attention to in order to prevent development of musculoskeletal injuries.

Workstation adjustments, is one measure that contributes to eliminating cumulative trauma disorders, are intended to provide best fit of the workstation to the worker’s physical dimensions (heights, arm length, size, etc). This intervention falls within the scope of a science known today as “ergonomics”, a concept that was first coined in 1857, which assesses the person-environment- job interaction, and proposes solutions that are meant to eliminate chances of injury through creating an employee-friendly working environment.

How does ergonomics work?

Based on an understanding of human body, joint protection concepts, normal joint stressors, impact of loading, and other variables, an ergonomist is able to provide workstation solutions utilising one or more of the three types of controls available to eliminate risk factors. The first being engineering controls, which involves applying measurements such as re-designing workstation or of used equipment, and the introducing of powered, or alternative types of equipment. Once applied, these types of controls will eliminate the aches that may have resulted from inappropriate workstation height or depth. In this scenario for example, the distance and height of a computer monitor would be adjusted to prevent sustained contraction of the neck muscles, a problem that frequently leads to developing end of day shoulder and upper neck pain. This control may be of tremendous impact in eliminating CTDs among assembly line workers who are subject to overusing same muscle groups thousands of times on a daily basis within an eight hour shift. Through building tool handles, changing assembly access and sequence, and changing method of transporting products, workers will complete their jobs in neutral positions, maintain proper postures, and consequently, eliminate over stressing their muscles, leading to better job performance.

The second hazard control measure is the implementation of “administrative controls”. Through the utilisation of this type of controls, an ergonomist would assess potential for employee’s job enlargement (adding additional tasks that require alternative positions and different muscle groups to the employee’s daily jobs). As well, the ergonomist would assess opportunities for a job rotation (rotating workers through several jobs), provide worker education and training regarding potential hazards, besides reallocating of rest breaks to enhance work performance throughout the working day. In addition to the injury prevention benefit following the implementation of administrative controls, while employee burn out can be decreased, a higher level of job satisfaction is created among employees who perceive such gesture as an employer’s appreciation, with employee cross-training leading to reducing the impact of an employee’s absenteeism on the flow of the job completion.

Finally, the ergonomist would asses the need for using personal protective equipment (e.g., back belts, gloves, masks, goggles, earplugs, etc) to determine if employing these gadgets will eliminate exposure to hazards or will reduce risk for injury.

For a fraction of the company’s workman’s compensation costs, employers are able to save their company’s assets through utilising the services of a consultant who will assess potential hazards for employees, and will assist employers in correcting these hazards before the damage is done. There is no need for employers to wait for a worker injury law suite such as the Edwards vs. Pepsi Cola that cost Pepsi Cola $1, 500,000 in settlement in 2005, when the cost could have been $250 if the latter would have applied safety recommendations. Not only would such a step have eliminated the cost so funds could have been used to generate more revenue, but the company would not have had to deal with unnecessary legal liabilities and expense.

As an effective ergonomics program can save a company $4 - $6 for every $1 invested, employing ergonomics would help reduce unnecessary medical expenses by decreasing rate of work-related injuries, reduce chances of citations and fines, decrease work errors, and improve productivity.

When two manufacturers in the State of Maine overhauled their factory by improving ergonomics, eliminating piecework, and rotating work activities, they cut their workers compensation costs from $1.2 million to $89,000 a year. Equally dramatic, the number of lost and restricted workdays dropped from 11,000 to 539, according to OSHA (Bierma & Hembree, 2008, Consumer Health Interactive).

While the introduction of ergonomics may appear to be somewhat intimidating, ergonomics and economics actually are true friends they come into place early on to alert the employer of the big and hidden financial road bumps ahead. In addition, while not all “ergonomically designed” labels are credible, only trained professionals will be able to provide advice regarding effective workstation solutions. Therefore, before you go out on a shopping spree for ergonomic office chairs, computer-based exercise programme, or ineffective wrist braces, you might want to invest in consulting with an ergonomist who can apply least expensive and most effective risk elimination measures. As a result, next time an employee approaches you to discuss the aches and pains in his arms, you may need to rethink your management strategies, and keep in mind that when business may experience an increase in cost of operation, and a need rises to hire more employees to do the work, implementing ergonomics will only lead to an increase in productivity, with reduction in injuries, reduction in absenteeism, and reduction in employee turnover.

● Maher Kharma MHS, OTR/L, CEAS, is an Occupational Therapist and Certified Ergonomic Assessment Specialist at Doctors Community Hospital, Lanham, Maryland, United States.

ate of upload: 25th January 2009

                                               Copyright © 2009 All Rights Reserved.