Staff
Report

Education Not Dollars

Comprehensive Ergonomics Program

California’s Ergonomics Standard

ELITE Services

Match the job station with the employee. Say it this way, and it is common sense. Say it another way, and it is a science—ergonomics. It is defined as "the study of the natural laws at work, in particular, the relationship between the worker and the work environment." There is no mystery in ergonomics. It’s just the notion that if you make a job less dangerous or difficult, your employees are less likely to hurt themselves.

Ergonomics has no boundaries. It is not restricted to a certain type of job or a particular sector of industry. Its domain is any physical activity. Nonetheless, the word "ergonomics" often conjures images of workers in factories, at construction sites, or on production lines. This is only an incomplete picture at best. As the scope of computers increases exponentially in America’s homes and offices, more of us are susceptible to injuries. As a nation, we are spending more time at work and for many of us it means more time in front of the computer. It is no longer just your assembly line worker at risk, but also your secretary down the hall.

The concept of automation has brought many conveniences and an enviable level of efficiency. But experts say that it has also brought undesirable and unforeseen consequences. For instance, workers used to walk down the hall to talk with their coworkers, giving them the opportunity to stretch their legs and break the repetitious patterns of their work. Now they simply send e-mail.

America has become far more sedentary, restricting workers to smaller and smaller work areas, even as those workers work longer and longer hours, surpassing even their Japanese counterparts. Since Americans mostly interact with their workstations, experts say, it is imperative that that space is suited or adapted to how the body acts, moves, and reacts. So, an ergonomics program should reduce "work-related musculoskeletal disorders (MSDs) developed by workers when a major part of their jobs involve reaching, bending over, lifting heavy objects, using continuous force, working with vibrating equipment, and doing repetitive motions."

The corporate world has been slow to adopt ergonomic measures, which, in part, has lead to over a decade of debate among business, industry, and OSHA on the need for a federally mandated ergonomics standard, despite the fact that "each year 1.8 million workers in the United States report work-related MSDs, such as carpal tunnel syndrome, tendonitis, and back injuries." Of these, it is estimated that "about 600,000 MSDs are serious enough to result in workers having to take time off work to recover."¹ These statistics do not include thousands of MSDs that go unreported each year.

It is no wonder then that the pioneers of ergonomics have been touting increased productivity, reduced turnover and related expenses, and higher rate of retention as measurable indicators of success. But an ergonomics program is only as good as its implementation. And so the question is: what makes a successful implementation? What does it include and how much does it cost?

The Tracker turned to Patti Flint, RN, Coordinator of Occupational Health Center and Nora Shippelhoute, EP, Ergonomics Specialist of Enloe Medical Center located in Chico, California, to answer some of these questions. Together, they manage the ELITE program—a comprehensive ergonomics program that aims to eliminate injuries through education.

"Many employers think that implementing an ergonomics program translates into money that they do not want to spend. They assume it entails buying more equipment for the workspace. The truth of the matter is that you can have the best equipment but if the employee does not know how to function with it, the investment is rendered useless. Education cannot be replaced," Ms. Shippelhoute emphasizes.

Education and not dollars is the focus of any good program. Ms. Flint points out that more often than not, it only takes an adjustment of the current workstation with no new or additional purchase. "We call it guerrilla ergonomics, where we go in and evaluate a desk and use a non-traditional item for a foot rest or adjust the height of the computer monitor with the help of yellow pages or a stack of paper," she explains. Both experts agree that if an employer is willing to invest in new equipment, it should take the form of a chair. "Usually, a desk can be adjusted to make a safe desk. But it is harder to transform an unsafe chair into a safe one," Ms. Shippelhoute explains.

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According to Ms. Shippelhoute and Ms. Flint, a successful ergonomics program is a comprehensive one, "which can be successfully integrated throughout an organization. A clearly defined policy will improve support at all levels and build a solid foundation for a successful program."

They explain that such a program benefits employers because it increases productivity, reduces injury, reduces absenteeism, and reduces turnover rate as well as other related expenses. It also benefits the employees because it improves their job satisfaction, reduces their risk of injury, and sends them the message that their employers care for their well-being.

"The first step in the implementation of a comprehensive program is to identify and incorporate customer needs. The second step is to provide a full service line to support the program, and the last component is outcomes analysis," Ms. Flint elucidates.

But what does a full service line mean? In the case of ELITE program it means offering several services, including Job Task Analysis, which documents the physical requirements and conditions of a position; Conditional Offer Exam, which is a post-offer exam for new employees to determine optimal placement in the prospective position; ErGO Series, which provides ergonomics education to the employees during orientation and more often as needed; Safety through Employee Participation, which is an employee safety suggestion program. 

Ms. Flint suggests that employee involvement at every level determines the success of a program. "Educating employees about basic ergonomics principles and employer policies, as well as teaching employees how to access the system, are key components. An employee who understands the company goals is the best resource for problem solving within the organization," she adds.

When evaluating your ergonomics program, the two experts advise to keep the process extremely simple. Compliance and follow through, they say, will be better if administration and staff clearly understand the process.

Part of ELITE’s success lies in the fact that California has adopted an Ergonomics Rule, which provides a guideline as to what a program should aim to achieve.

"In some ways a state mandate and guidelines mean that half the battle is won. It helps streamline the process quite a bit," admits Ms. Shippelhoute.

The standard that became effective on July 3, 1997, requires a three-fold ergonomics program, which includes worksite evaluation, control of exposures that cause RMIs (Repetitive Motion Injury), and training employees. The rule states, "any exposures that have caused RMIs shall, in a timely manner, be corrected, or if not capable of being corrected, have the exposures minimized to the extent feasible."² To accomplish this an employer can consider such engineering controls as workstation redesign, adjustable fixtures or tool redesign, and administrative controls, such as job rotation, work pacing or work breaks.

Employee training, the rule articulates, should include explanations of the employer’s program, the exposure associated with RMIs, the symptoms and consequences of injuries caused by repetitive motion, the importance of reporting symptoms and injuries to the employer and the methods used by the employer to minimize RMIs.

But most states do not have a clear mandate, or any mandate. What advice do Ms. Flint and Ms. Shippelhoute have for those starting an ergonomics program in a state with no mandate? "Stress the importance of employee education and that many ergonomics solutions can be practical and inexpensive. You have to increase awareness and make it easy for the employee to access the program in place. If an employee lifts, you have to teach the safest way to lift. If an employee types, you have to teach how to position his or her hands and wrists in relation to the keyboard. Also, employee input is invaluable to the success of a program," says Ms. Shippelhoute.

"Basically, it boils down to common sense, a lot of it. For instance, global purchasing of an item that improves a workstation may not be practical or even necessary. Look around and see what you can work with, " she adds.

Nora Shippelhoute is an Exercise Physiologist working as the Occupational Health Program Assistant at Enloe Medical Center. She has been providing occupational health services, ergonomic worksite evaluations and ergonomic education for ten years. She can be reached at 530.332.6858 or nora.shippelhoute@enloe.org.

Patti Flint, RN, has been Coordinator of the Occupational Health Center, Enloe Medical Center, since 1994. During this time the client base has grown significantly and the center has developed into a provider with the most comprehensive line of work-related services in northern California. She can be reached at 530.332.6833 or patti.flint@enloe.org. 

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ELITE Services: Occupational Health Center at Enloe Medical Center, Chico, California

Job Task Analysis
A report documenting the physical requirements and conditions of a position

Conditional Offer Exam (COE)
A post offer exam for employees

Elite Education Series
An ergonomic educational series provided to employees at orientation and as needed at the request of a department manager

Safety Through Employee Participation (STEP)
An employee safety suggestion program

Suggested Hospital Office Products (SHOP)
A purchasing guide to assist in the selection of appropriate furnishings and ergonomic accessories

Wellsource Lifestyle Challenge
An employee wellness program to educate employees in healthy lifestyle choices

Worksite Evaluation
An evaluation of a worksite performed by an Ergonomic Specialist

Work-Related Injury Policy
Policy and procedure for reporting on-the-job injuries; contained in the center’s safety manual

Focused Injury Review Safety Team
A task force that reviews appropriate work-related injuries

Job-Specific Ergonomics Training
Job-specific training required prior to return to full duty after a work-related injury

Supplemental Musculoskeletal and Repetitive Motion Injury Training (SMART)
An employee training program focused on safe work practices

Footnotes:

1. http://www.osha-slc.gov/SLTC/ergonomics/recognition.html

2. http://www.dir.ca.gov/title8/5110.html

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