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Interface www.asse.org 2011
From Nothing to
Best PracticeEstablishment of an
Ergonomics Program for HTSI-COS
For a compl...
A
s we recognize another National
Ergonomics Month, I find it hard to believe
that a year has gone by since we became
a pr...
PAGE 1	 From Nothing to Best Practice
By Keith Osborne
The author explains how Honeywell Technology Solutions Inc.-
Colora...
4
Interface www.asse.org 2011
By George Pearson, CSP, ARMAnnouncements
A
s we now begin our second century, ASSE
still fac...
ASSE body of knowlEdgE
Get started today
visit www.safetybok.org
New
Member
benefit!
your source for sH&e answers and solu...
•Katery Alfaro	
•Robert Allen, Walt Disney Co. Worldwide Safety
•Brent Altemose, Sabre Health & Safety
•Manny Alviso, Unit...
When your workplace is a vehicle, ergonomics matter most.
Humantech management consultants Kent Hatcher and
Deepesh Desai ...
E
rgonomics training takes many forms, from
teaching employees correct postures to instruct-
ing engineers about principle...
assessment of their work area. This can be completed
as part of a team for shared work areas or by individual
for office w...
10
Interface www.asse.org 2011
workers’ compensation costs, improve morale and have
a variety of other positive impacts on...
11
Interface www.asse.org 2011
diversity and philanthropy. On the planet portion, we see
businesses taking responsibility ...
12
Interface www.asse.org
within an organization, and a few companies have
reported not only their energy efficiency and e...
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Interface www.asse.org
A possible link also exists between ergonomics and
“green” products for items purchased to achie...
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Interface www.asse.org
2011, from http://www.npr.org/templates/story/story.
php?storyId=129406588.
Nintendo. (2010). Ni...
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T
he prevalence of obesity in the U.S. continues
to climb, exceeding 30% in most gender and...
In more recent years, BMI has come under scru-
tiny and is a controversial topic among researchers
and health care profess...
Genes may also play a role in obesity. Some scien-
tific evidence indicates that people may have a higher
risk of becoming...
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Interface www.asse.org 2011
(2009). U.S. obesity trends. Atlanta, GA: Author.
Retrieved March 9, 2011, from http://www....
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Interface www.asse.org 2011
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anual patient handling is the primary rea-
son for musculoskeletal injuries in patient
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separately,
these result
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Interface www.asse.org 2011
•impact of aesthetics;
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Conclusion
Solid science support...
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Interface www.asse.org 2011
T.R. (2009). Development of the National Association
of Orthopaedic Nurses guidance stateme...
and all of the employees, we were able to attain a merit
status, but one of the mandates that came out of that
status was ...
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Interface www.asse.org 2011
dor. This partnership has allowed me to expand the lab
to three separate setups to give our...
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Interface www.asse.org 2011
Safety 2011 included record attendance
and special events to celebrate ASSE’s
100th anniver...
P
R E S E N
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LAS VEGAS, NEVADA60 seminars and workshops on essential SHE topics
Earn up to 5.0 CEUs in on...
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Interface (Vol 1 No 3)

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Within this edition of Interface I was able to author an article discussing the development of my Best Practice Ergonomics Program while at Honeywell- Colorado Springs

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Interface (Vol 1 No 3)

  1. 1. 1 Interface www.asse.org 2011 From Nothing to Best PracticeEstablishment of an Ergonomics Program for HTSI-COS For a complete Table of Contents see page 3 A fter retiring from the Army after 25 years of service, I was hired by Honeywell Tech­nology Solutions Inc.-Colorado Springs (HTSI-COS) and began work in the facilities department. When I first arrived in 2003, no ergonomics program was available to employees to assess or correct deficiencies in their workstations or in their processes. Over the next few years, our company saw five to seven complaints of potential We have estab- lished an ergo- nomics/well- ness lab in our building, and several safety professionals from around the Colorado Springs area have toured our facility. workplace musculoskeletal disorders (WMSDs) each month and no real process to help lessen or eliminate this trend. This level continued through 2004 until HTSI-COS chose to become an OSHA Voluntary Protection Program (VPP) member. One of the key elements of inclusion was an ergonomics program with additional emphasis on health and wellness initiatives within the company. With the support of our management team continued on page 24 A Technical Publication of ASSE’s Ergonomics Practice Specialty D PAGE 4 ASSE The Next 100 Years D PAGE 8 TRAINING Proper Ergonomics D PAGE 10 ERGONOMICS Integrating Ergonomics & Sustainability D PAGE 19 INJURIES Patient Care Ergonomics Volume 1 Number 3 By Keith Osborne
  2. 2. A s we recognize another National Ergonomics Month, I find it hard to believe that a year has gone by since we became a practice specialty. The Ergonomics Practice Specialty continues to grow slowly, and we remain very active: we enhanced our newslet- ter to meet standards as a practice specialty, rec- ognized our first Safety Professional of the Year, sponsored speakers for concurrent sessions at Safety 2011 in Chicago, solicited several speakers for Safety 2012 in Denver and launched fundrais- ing efforts to offer a scholarship for our members. It truly has been a remarkable year! I look forward to another great year. x Jeremy Harris Ergonomics Practice Specialty Officers Administrator Jeremy Harris (847) 277-4385 jeremy.j.harris@ge.com Assistant Administrator David Brodie (919) 368-1129 david_brodie@cargill.com Publication Coordinator Walt Rostykus (503) 680-6521 wrostykus@humantech.com ASSE STAFF Staff Liaison Krista Sonneson (847) 768-3436 ksonneson@asse.org Communications Specialist Jolinda Cappello jcappello@asse.org Publication Design Susan Carlson scarlson@asse.org Interface is a publication of ASSE’s Ergonomics Practice Specialty, 1800 East Oakton St., Des Plaines, IL 60018, and is dis- tributed free of charge to members of the Ergonomics Practice Specialty. The opinions expressed in articles herein are those of the author(s) and are not necessarily those of ASSE. Technical accuracy is the responsibility of the author(s). Send address changes to the address above; fax to (847) 768-3434; or send via e-mail to customerservice@asse.org. Advertising policy . . . Whereas there is evidence that products used in safety and health programs, or by the public in general, may in themselves present hazards; and Whereas, commercial advertising of products may not depict the procedures or requirements for their safe use, or may depict their use in some unsafe manner . . . the Board of Directors of ASSE directs staff to see that advertising in Society publications is war- ranted and certified by the advertiser prior to publication, to assure that products show evi- dence of having been reviewed or examined for safety and health problems, and that no unsafe use and/or procedures are shown and/ or described in the addvertising. Such require- ments and acceptance of advertising by ASSE shall not be considered an endorsement or approval in any way of such products for any purpose. ASSE may reject or refuse any adver- tisement for any reason ASSE deems proper. Another Great Year administrator’s MESSAGE 2 Interface www.asse.org 2011 Mentoring Services •Members Only (click Mentor Contacts) •ASSE staff Job Search Assistance •Nexsteps •Local ASSE chapter Career Resources •ASSE’s Career Resources LinkedIn site •Career Resource Center Networking •LinkedIn •Facebook •ASSE’s social media sites Technical Questions/Advice •24/7 online question submission form •Ergonomics Practice Specialty’s (EPS) Volunteer Advisory Committee Publication Opportunities •Article submissions (earn COCs and win a cash prize if you are the top article) •Topic suggestions and interview requests Educational Resources •EPS website •SH&E Standards Digest •Special Issues & Best of the Best Publication •Key Issues publication •Interviews •Business of Safety Committee •Nanotechnology Support Site •Webinars Standards •ANSI/ASSE SH&E Standards Informa- tion Center •New standards •ASSE’s Standards Development Committee *Click any of the bulleted items to access linked content. Ergonomics Practice Specialty Resources
  3. 3. PAGE 1 From Nothing to Best Practice By Keith Osborne The author explains how Honeywell Technology Solutions Inc.- Colorado Springs improved not only its safety program, but also its ergonomics program and health and wellness initiatives. PAGE 7 Ergonomics for Selecting Fleet & Service Vehicles By Julia Brenner Humantech management consultants Kent Hatcher and Deepesh Desai have researched ways to improve the ergonomics of fleet and service vehicles. The Growing Problem in Ergonomics: Obesity By Winnie Ip In traditional ergonomics programs, the primary goal is to adapt the workplace and tools to the capabilities of people. This goal does not change when consid- ering obese workers. Patient Care Ergonomics By Mary Willa Matz Manual patient handling is the primary reason for musculoskeletal injuries in patient care providers, and the understanding of the impact of patient handling on the body leads to a clear understanding why this is so. PAGE 15 PAGE 19 Volume 1 • Number 3 CONNECTION KEY V W P L Ad D D D Video Website PDF Hot Link Ad Link Direct Link Click on these icons for immediate access or bonus information PAGE 8 Bend Me Shake Me: Time to Teach Adults Proper Ergonomics By Cathy White Training is an essential element to ergonomics program success. The right training for the right people will ensure that your orga- nization has the skills and methods to effectively carry out key responsibilities and to achieve sustainable gains in the ergonomics program. PAGE 10 Integrating Ergonomics & Sustainability By Jessica Ellison & Danny Nou Ergonomics initiatives have many parallels with sustainability goals and can function effectively as an integrated program rather than as two distinct programs. contents 3 Interface www.asse.org 2011
  4. 4. 4 Interface www.asse.org 2011 By George Pearson, CSP, ARMAnnouncements A s we now begin our second century, ASSE still faces future challenges in improving the safety community. However, coming out of our 100th-anniversary Professional Development Conference, I see many positive signs that indicate we have a very bright future. As the world’s oldest profes- sional society dedicated to protecting people, property and the environment, there are many heartening indica- tors, many of which come from our Council. In fact, I am very optimistic, as we are poised for the next hundred years, that our ability to support our growing membership is strong. We are fortunate our Society is vital and growth continues as we come out of the economic recession. Even more encouraging is that membership retention has increased 5 basis points from 87% last year to 92% this year. This proves safety professionals realize the value in ASSE membership, and we are primed for greater progress. As economic times improve, our nation’s industry base expands and the global economy gains momen- tum. Being in a Society leadership role, I look forward to the introduc- tion of additional opportunities in the areas of global growth, value of the profession and fruition of our Body of Knowledge (BOK) project. Membership in the practice spe- cialties and branches has grown in parallel to the Society, and we have every reason to believe that we will continue to grow through additional membership and partici- pation opportunities. As of May 2011, we had 21,111 practice specialty members and 2,180 branch members. The Health & Wellness Branch was approved at the Council on Practices and Standards (COPS) meet- ing held at Safety 2011 and should contribute to our growth. The Health & Wellness Branch will create awareness and will educate its members to help shape attitudes and beliefs, thinking and behavior through a proactive, holistic approach to employee well-being, not just freedom from disease. This refers to an active process that aims to build and enhance an organiza- tion’s employee population, promoting habits and behaviors that optimize health, social and emotional well-being. Two things will contribute to the Branch’s success: we are thinking outside the box by going beyond traditional ASSE boundaries, and we can draw new members not just from practice specialties and branches, but also from the Society at large. There is also a value proposition here in that employers with effec- tive health and well- ness programs have lower healthcare and workers’ compensation costs. Growth in the Common Interest Groups (CIGs) has been exceptional and beyond expectations. With 5,085 members belonging to one or more of our four com- mon interest groups, our CIGs are among the most active committees in the Society. Safety Professionals and the Latino Workforce (SPALW) continues its outreach into Latin America with activity in Mexico and Ecuador and plans to expand that into Panama, Columbia, Brazil and Argentina. Women in Safety Engineering (WISE) is completing its publication honoring 100 women in safety. Young Professionals in SH&E (YP) has enjoyed additional memberships as graduating student members become regular members. Blacks in Safety Engineering (BISE) has continued to grow and was able to award a scholarship at this year’s conference. The BOK project is on schedule. Keywords have been finalized. More than 1,000 keywords have been submitted for inclusion and more are to come. Volunteer members and temporary workers assisted with the BOK project this summer. With the growth in membership, it is possible to accelerate the project schedule and quantity of available content. Looking forward to the next 100 years, I am posi- tive about COPS’s and the Society’s future. Dr. Darryl Hill, our departing Society president, reported in a farewell message to the Board, “Keep your goals very high, have a balance and enjoy your family. The future is bright.” x George W. Pearson, CSP, ARM Vice President, ASSE Council on Practices & Standards (COPS) The Next 100 Years Volunteer mem- bers and temporary workers assisted with the BOK proj- ect this summer. With the growth in membership, it is possible to accelerate the project schedule and quantity of available content.
  5. 5. ASSE body of knowlEdgE Get started today visit www.safetybok.org New Member benefit! your source for sH&e answers and solutions
  6. 6. •Katery Alfaro •Robert Allen, Walt Disney Co. Worldwide Safety •Brent Altemose, Sabre Health & Safety •Manny Alviso, United Stationers Inc. •Joyce Anderson, Compliance Specialties Inc. •Mary Anderson, Honeywell International •Gwendolyn Arps, AON •Susan Barriball •Felicia Beaulieu, Marine Corps, Quantico MCB, Safety Division •Raymond Blanco •Eric Blankenheim, Blankenheim Services •Vickie Brewster, Mike Monroney Aeronautical Center •Raymond Brown, IESA LLC •Cathy Burch, Frontier Pro Services •Patrick Carley, American International College •Allen Coppolo, Doncasters Inc. •Keith Crumpton, Lone Peak Conservation Center •Robert Debner •Michael Domingo Cruz, Pride Industries •Kelly Doughty, Chevron •Sharon DuBois, Skagit County Risk Management •Phan Duong-Ngo •David Ewanick •Suljo Fermic •Lloyd Fischel 6 Interface www.asse.org 2011 •Aleece Foxx •Christopher Gates •Maureen Gillis, Siemens Healthcare Diagnostics •Christopher Gongora, Diagnostic Laboratory Services Inc. •George Gough, Occidental of Elk Hills Inc. •George Gruetzmacher, Wisconsin State Laboratory of Hygiene •Alejo Habal, New Safety Index •Jon Hamill, Oxy USA •David Hanson •Saundra Harris •Henry Ho •Richard Hofman •Susan Holland •Randy Huff, Ingersoll Rand •Dana Hughes-Dawsey, Caterpillar Inc. •Wael Jamaan, Saudi Aramco •Miriam Joffe, Auburn Engineers •Joseph Jones •James Kennedy, Alaska Fisheries Science Center •Deepa Kundadka •Bruce Lambert, B.A. Lambert Workplace Performance •Diane Lancon, NW Natural Gas •Melanie Langlais •Michael Lim, Pacific Gas & Electric Co. •Bernie Lynch •Brian Manges •Paul Marchand, APC by Schneider Electric •Michael Mariscalco, QEI Engineers Inc. •Jenna Marshall •Etta Mason, Southern California Edison •Dean Maudlin, Just Ergonomics LLC •Ruth McCafferty •Kellie McNeil •Allison McPhee, Genzyme •Danny Meekins, Ellwood Texas Forge Navasota •Larry Mendoza, Howard Hughes Medical Institute —JFRC We want to thank everyone who has remained a loyal member of the Ergonomics Practice Specialty (EPS) and wel- come the following members who recently joined. We are currently at 438 members and growing. If you have any colleagues who might be interested in joining EPS, please contact Krista Sonneson to request an information packet. If you know anyone who might be interested in joining ASSE, please contact customer service. Welcome New Members!
  7. 7. When your workplace is a vehicle, ergonomics matter most. Humantech management consultants Kent Hatcher and Deepesh Desai have researched ways to improve the ergo- nomics of these atypical “offices” so that they do not get left on the side of the road. Anthropometry, or the measurement of the size, weight and proportions of a human, is important to consider when selecting fleet and service vehicles, Hatcher says. If a 4’11” female and a 6’6” male do the same job, then the vehicle must accommodate both body types. This requires adjust- able features and designing for extremes. The general rule of thumb, he says, is to design large for any clearances and small for any reaches. When designing space for head room, for example, design for the large male. When designing the verti- cal reach to close the trunk, design for the small female. The analysis of a vehicle should focus on manual material handling and interior comfort and posture, Hatcher adds. Manual material handling includes features like interior trunk width, height and depth, loading service height and depth, force required to open the trunk and the vertical reach to close it. Hatcher offers his top five recommendations for sales fleet vehicles: 1) Cargo deck (floor of trunk) height should be within rec- ommended guidelines for manual material handling, 33 in. to 38 in. above the standing surface. 2) The cargo deck should be flush with the loading sill to prevent the need to lift and clear products from the cargo area. The total depth of the sill, or the horizontal reach, should be 18 in. 3) A higher driver’s seat height can ease ingress/egress from vehicle. 4) Check the quality of visibility to the vehicle’s exterior when using mirrors (rearview and side) as well as when check- ing blind spots. 5) Presence of full controls on the steering wheel optimizes driver attentiveness on the road and reduces reaches to the console. To effectively retrofit vehicles, Desai suggests assessing the risks already present and then developing viable and cost- effective solutions to create a business case for implementing them across all vehicles. Because thousands of vehicles are already in circulation, a company should start by gaining sup- port from top management and by establishing a loss preven- tion plan and goals. From there, it can prioritize ergonomic issues through workplace ergonomic risk assessments, develop short-term and long-term improvement plans and then imple- ment short-term improvements. “Test it and tweak it,” Desai says. “You do not want to do it all and realize that you have made a mistake.” Desai offers his top five recommendations for field service and delivery vehicles: 1) Product storage: Position heavier, more frequently handled items in the comfort zone, between 38 in. and 49 in. above the standing surface. 2) Appropriate handholds: Retrofit grab handles with 30 in. in length and 1.25 in. in diameter. 3) Entering/exiting cab—step height: Retrofit a retractable supplementary step. 4) Lift gates: Provide a pendant control to operate the lift gate. 5) Rear-view camera: Ensure that vehicles are fitted with a rear-view camera. Make sure the camera monitor is placed in an optimal viewing distance, preferably on the dashboard. For more information, click here. x Julia Brenner is a communications intern with ASSE. She holds a jour- nalism degree from University of Wisconsin-Madison. 7 Interface www.asse.org 2011 •Mark Mitchell, Alaska Railroad Corp. •Lee Mooney, Amgen •Brian Murphy, BRS Inc. •Paul Myers •James Newberry, Island Insurance Co. Ltd. •Daniel O’Farrell, EA Engineering Science & Technology •Kay Parker Paul •Robb Patterson, Pfizer •Ellen Rader Smith, Ergo & Rehab Services •Steven Ramiza, LAN Associates Inc. •Charles Raymond, Gray Insurance Co. •Deborah Read, ErgoFit Consulting Inc. •Susan Reinhardt •Ian Renteria, Avon •June Robinson, Battelle Toxicology NW •Peggy Ross •Karri Russ, Florida Power & Light •Eric Schultz •Lawrence J. Schulze, University of Houston •Judy Sehnal, Hartford •Albert Shaw, Honeywell International •Tom Stallings, ABB Power T&D •Edmund Sullivan, Middlebury College •Scott Swanson •Linda Tapp •Philip Taylor, Chevron Products Co. •James Thatcher, EnCana Oil & Gas •Robert Thomas, Auburn University •Jimmie Tullis •Walter Urbanski, Lafarge NA •Alan Weikert •Stephen Wolszczenski, Pepperidge Farms •Pamela Yates •Kristi Young, BP x Ergonomics for Selecting Fleet & Service Vehicles By Julia Brenner
  8. 8. E rgonomics training takes many forms, from teaching employees correct postures to instruct- ing engineers about principles of design. While each training effort has different objectives, it is important to provide the right type of knowledge with the desired impact for the intended audience. Training is an essential element to ergonomics program success. The right training for the right people will ensure that your organization has the skills and methods to effectively carry out key responsibilities and to achieve sustainable gains in the ergonomics program. Before providing employees with ergonomics training, the orga- nization must first define the ergo- nomics program’s support infrastructure. Key roles to define include the senior leaders of the organization, the person or team responsible for managing the ergonom- ics program, engineers who design the work environment and the managers of the workgroups in the organi- zation. Many organizations begin an ergo- nomics program by providing general ergo- nomics aware- ness training to their workgroup. Although this is simple to implement, an ergonomics pro- gram based solely on awareness is not sustainable. The order of ergonomics training that people in key roles play has a major impact on the ergonomics program’s success. Education and training should then follow a logical sequence in order to implement a program from the leaders down to the employees: •Educate senior leaders with a business case for the ergonomics process. The intent of this education is to demonstrate the value of ergonomics for the organiza- tion to gain their sponsorship and to establish the ergo- nomics program’s goals. •Train the person or team responsible for manag- ing the ergonomics program. This group will need to gain the knowledge and skills necessary to deploy and sustain the ergonomics program. This group will need to be able to address difficult ergonomic challenges brought to them by employees and managers. •Educate engineers on workplace design principles. Principles of workplace design related to manual materials handling, hand tools and seated and standing workstations should be reviewed with guidelines for appropriate heights, reaches and clearances. •Provide training to managers who are the interface between employees and ergonomics team members. In their roles, they will be the most influential people to impact employee safe work practices and behaviors and to provide assistance with the implementation of improvements identified by the ergonomics team. Provide coaching to affect work practices and behav- iors and to improve workplace conditions. After all roles are trained, employees then need to be provided with ergonomics training to prepare and empower them to identify potential ergonomic issues in their workplace and to adjust the workplace or their work practices to control the issues. If unable to con- trol the issues, they should be taught to escalate such issues to their manager. Effective employee training is essential to a sustain- able ergonomics program. While computer-based train- ing has its place in a learning environment, it has been proven that interactive training based on adult learning principles is effective in retaining knowledge. General ergonomics awareness training can be complemented with having all employees go through an ergonomics By Cathy White, CPE Bend Me Shake Me: Time to Teach Adults Proper Ergonomics The order of ergo- nomics training that people in key roles play has a major impact on the ergonomics program’s success. Training Figure 1 A Working Height That Is Too Low Will Force Awkward Postures to Handle the Load on the Conveyor 8 Interface www.asse.org 2011
  9. 9. assessment of their work area. This can be completed as part of a team for shared work areas or by individual for office workstations. This exercise facilitates a deeper impression of ergonomics on each employee in a hands-on format. An administrative option often used by companies to address an identified high-risk task is to train the work group on the hazard of the task and to provide training on the appropriate way to perform the task with a reduced likelihood of injury. Training all by itself, without making changes to the workplace, is often not effective in preventing injuries. If employees are taught “proper lifting techniques” and then sent out to work under conditions that do not allow them to use these techniques, the training is of no benefit. The working area should be set up to allow for the proper working height for the population with reach distances minimized. A working height that is too low will force awkward postures to handle the load on the conveyor. Training on proper lifting techniques will not alleviate the inher- ent design flaw in this workplace. However, training is an important part of imple- menting changes. Showing employees how to use new equipment and explaining why it is important to use it properly to prevent injuries helps make sure the equipment gets used. Workers need hands-on practice with new tools, equipment or work practices to make sure they have the skills necessary to work safely. Training is most effective when it is interactive and fully involves workers. This training needs to be based on adult learning principles to retain the information received. Some suggestions to achieve this include: •Provide hands-on practice when new tools, equip- ment or procedures are introduced to the workforce. Being trained where they work, using the objects they typically lift and the equipment they use on the job helps employees relate to what they are being taught, rather than showing them a generic lifting video. •Use several types of visual aids of actual tasks in your workplace. Combine the use of pictures, hand- outs, charts or videos. To supple- ment the visual aids, you could compile or purchase an ergonomic brochure of handy tips that can be posted at the office desk or in the work area for employees to review at their convenience. This increases the likelihood that good ergonomic practices will be adopted. •Make sure that employees have learned what you are trying to teach them by having each one, or all of them demonstrate the proper operating techniques with the tools before leaving the class. •Follow up with learners after the training to make sure they are able to use the proper techniques on the job. An ergonomics brochure can consist of a pictorial representation of proper ergonomics design and can be supplemental with a written description of ways to control risk factors in that particular workplace. For a computer workstation, information regarding chair adjustments, proper working height and loca- tion of items in the computer workstation environment are typical items to include in a handout. These can be posted at the computer workstation as a recurrent reminder of proper work habits. Organizations that establish clearly defined roles and responsibilities and provide ergonomics training to ensure the capability to meet these responsibilities cre- ate a strong internal support infrastructure. The infra- structure ensures that employees receive support when they take responsibility for improving their workplace and practices. By combining this infrastructure with effective employee ergonomics training, the result is a strong and sustainable ergonomics program. x Cathy White, CPE, is an industrial hygiene and personal safety specialist at the Dow Chemical Co. She holds a bachelor’s and master’s degree in Industrial and Operations Engineering from the University of Michigan. She has 11 years’ experience as an ergonomics and safety professional in managing ergonomics programs, conducting risk assessments and identifying controls to manage the risks. Figure 2: Example of Office Ergonomics Brochure An ergonomics bro- chure can consist of a pictorial repre- sentation of proper ergonomics design and can be supple- mental with a writ- ten description of ways to control risk factors in that par- ticular workplace. 9 Interface www.asse.org 2011
  10. 10. 10 Interface www.asse.org 2011 workers’ compensation costs, improve morale and have a variety of other positive impacts on the company’s bot- tom line. However, challenges, such as a lack of fund- ing, C-level (CEO, CFO, COO) attention and support and overall government legislation have undermined the effectiveness of ergonomic programs. By integrating ergonomics into sustainability and repackaging successes from ergonomic programs, there is a huge opportunity for ergonomic professionals to capture attention in the boardroom. This visibility will help get programs and solutions funded and will bring ergonomics into strategic boardroom discussions resulting in a more proactive pro- gram that will benefit employees and also the company’s triple bottom line. Defining Sustainability To understand ergonomics’ role in sustainability, it is important to first understand the definition of sustain- ability since it is often used as a catchall buzz word. Sus­tainability has been defined by many people. James Hagan, Ph.D., M.S., provided a concise definition at the National Ergonomics Conference and Exposition in 2008 as “Allowing future generations to have the same standard of living that we enjoy while improving the condition of the current generation” (NECE, 2008). The key concepts of sustainability revolve around the 3Ps: people, planet and profit. The first concept within sustainability is people, which includes the ethics of how workers and the community are treated. It includes ideals, such as basic human rights and avoiding child labor, and labor issues, such as providing a safe work- place that minimizes safety and health hazards, valuing By Jessica Ellison, M.S., CPE, CSP & Danny NouSustainability R ecent trends show that more companies are focusing on sus- tainability [also known as the corporate social responsibility (CSR) initiative, 3P (People, Planet, Profit) Triple Bottom Line or 3E (Equity, Environment, Economy)], which emphasizes a balance between people, planet and profit. In addition, the work- place has changed, in part due to sustainability, from employees working from the office to working from home or telecommuting and how buildings are designed so companies can create Leadership in Energy and Environmental Design (LEED)-certified buildings. Ergonomics programs need to start thinking outside of the box about their value so that they leverage the momentum created by sustainability. Based on these trends occurring in industry, it is evident that there is tremendous global momentum in corporate sustainability and that ergonomics fits right into the people aspects of the people/planet/profit or triple bottom line. Corporate ergonomists and ergonomic consultants understand the value of the work they provide to a company. They understand that they are helping reduce injuries and decrease discomfort and in the process can improve productivity, decrease lost work days, decrease Integrating Ergonomics & Sustainability
  11. 11. 11 Interface www.asse.org 2011 diversity and philanthropy. On the planet portion, we see businesses taking responsibility for the lifecycle of their products, from the raw materials to stewardship in prod- uct use to ultimate disposal. There is also an emphasis on reducing externalities (unintended costs) and minimiz- ing resource use (water, electricity, gas and packaging). Finally, the profit section, which emphasizes jobs and growth, cost reduction and green products, is shown to be impacted in a positive way by using fewer resources and by creating less waste. Sustainability is Here to Stay Why is sustainability such an important trend for ergonomists? This huge and growing trend is predicted to be here for a long time because the concept of creat- ing economic value through environmental and social impact has come to the forefront in businesses around the world. The “green” label has captivated corporate mindshare and corporate funding. On March 1, 2011, Hedge Funds Review (2011) showed that more than $13 trillion has been invested globally in socially respon- sible companies that demonstrate strong sustainability practices. Investors are making an impact on the world by put- ting money into investments listed on the Dow Jones Sustainability Indexes or the FTSE4Good or by invest- ing in socially responsible investment funds, like Calvert and Domini, who will only buy shares in socially responsible companies. This is impacting decisions in boardrooms around the world and driving change with- out having the stick of regulation. Corporations are even restructuring to organize for sustainability. Many Fortune 500 companies, such as Google, Verizon and Ikea, have their own corporate sus- tainability officers (CSOs) and/or vice president of sus- tainability (Deutsch, 2007). The website, Green Business Views, notes that President Obama issued Executive Order 13514, which “provides guidance to how govern- ment agencies are to go green…[and] the order calls for the installation of sustainability officer or committee” (2010). The fact that sustainability is being given as much attention as the CEO, CFO or COO speaks to the importance of this movement to companies and to the likely longevity of this trend. Benefits of Sustainability Sustainability is not only socially responsible, it pro- vides many benefits to companies that pursue and volun- tarily commit to the movement. The first example is the millions of dollars that have been saved from a variety of sustainability efforts. For example, Wal-Mart has shown that by improv- ing the fuel efficiency of its fleet by one mile per gal- lon, it hopes to save approximately $35 to $50 million (MSNBC, 2007). Alcoa has implemented an energy reduction strategy and has already realized $20 million in savings (Alderton, 2008). The cost estimates saved from this procedure have led to savings in the millions. One more example is that the IRS reported real estate savings of $585,000 for a pilot telecommuting program of 150 participants (Telework Exchange, 2007). Another benefit of sustainability is that companies that practice the principles have a higher ability to recruit and retain top-level talent for their companies. A survey by MonsterTRAK.com shows that 92% of Generation Y employees (people born between 1977 and 2002) are more likely to work for environmentally friendly company. Also, Adecco USA’s 2008 Workplace Insight Survey showed that Generation Y workers are willing to sacrifice about 6% of their salary to work for a green company as opposed to a traditional one (Stika, 2010). These are just a few of the benefits that compa- nies practicing sustainability have reported, which has increased the popularity of sustain- ability among some of the strongest and most successful companies in the market today. Therefore, programs that help fit within the sustainability movement also have the opportunity to grow and have a wide-ranging impact not only on the environment, but on their corporate bottom line as well. Ergonomics’ Role in Sustainability Ergonomics has the ability to show value by having a direct and positive financial impact on a com- pany’s bottom line and to affect the lives of people to create a more sustainable work environment. Ergonomists need to know how to market their programs internally and to take advantage of the sustain- ability trend by making connec- tions where they exist in both programs. Following is a description of some of these links: people, CSR reports, LEED certification and telecommuting programs with a discussion around what future links may be possible. Link 1: The People The most obvious link is between ergonomics and the sustainability component of people. Chris Patton, a past ASSE president, has stated that, “Safety should be viewed as the cornerstone of the people component. In this context, sustainability means implementing and maintaining programs that keep people safe, facilities intact, communities protected, supply chains secure and the organization’s mission uninterrupted. Sustainable organizations are, by definition, safe organizations, and we play a key role in ensuring that safety” (Patton, 2010). Even the pure definition of ergonomics shows the link between ergonomics and people. For example, the International Ergonomics Association (IEA) defines This huge and growing trend is predicted to be here for a long time because the concept of creat- ing economic value through environ- mental and social impact has come to the forefront in businesses around the world.
  12. 12. 12 Interface www.asse.org within an organization, and a few companies have reported not only their energy efficiency and envi- ronmental and philanthropy achievements, but also their ergonomic and employee wellness programs to increase corporate transparency and to show the link between ergonomics and sustainability. CSR reporting promotes socially responsible businesses to be con- cerned about public interest by voluntarily eliminating practices that harm human health and the environ- ment, even when those practices are perfectly legal. Nintendo of America reported in its CSR report that it has an Ergonomic Task Force, which focuses on annual training and assessment of fixed and non- fixed workstations (Nintendo, 2010). Another com- pany, Hormel Foods, reported in its CSR report that injury prevention was a key focus in its ergonomic programs and even went as far as to show the soft- tissue incident rate and its steady decline year over year (Hormel Foods, 2010). There are more examples, but the clear message is that companies’ sustainabil- ity program and ergonomic program both focus on employees and their well-being. Link 3: LEED Certifications Currently, more than 40,000 projects currently par- ticipate in commercial and institutional LEED rating systems, which comprise all 50 states and 117 coun- tries (USGBC, 2011). Dr. Alan Hedge, director of the Human Factors and Ergonomics Laboratory at Cornell University, is also an IEA representative for environ- mental design and a Cornell Center for Sustainable Futures Faculty Fellow. He has already outlined a way to use ergonomics to get one point as an “Innovation in Design” or “Innovation in Operations” credit. A good ergonomic design is one that creates and maintains a flexible ergonomic environment that prop- erly accommodates building users and promotes healthy, comfortable and productive work. The requirement for this point involves the development and implementa- tion of “a comprehensive ergonomics strategy that will have a positive impact on human health and comfort when performing daily activity for at least 75% of full- time equivalent building users” (Cornell, 2011). In an e-mail communication with Hedge in April 2011, he noted in the next version of LEED due out at the end of November 2012, that “office ergonomics is a separate line item credit point in the indoor environment section of the rating system.” What is great for companies that already have an established ergonomic program is that they simply need to document their efforts and possibly make a few small changes in the program to be able to qualify for this point. This is a great opportunity for ergonomists to start getting involved in the design phase and to become more strategic and proactive to prevent injury rather than reactively dealing with employees once injured, as outlined in Hedge’s article on “The Sprouting of ‘Green’ Ergonomics” (Hedge, 2008). This ergonomics (or human factors) as “the scientific disci- pline concerned with the understanding of interactions among humans and other elements of a system and the profession that applies theory, principles, data and methods to design to optimize human well-being and overall system performance. Ergonomists contribute to the design and evaluation of tasks, jobs, products, envi- ronments and systems in order to make them compatible with the needs, abilities and limitations of people” (IEA 2000). Some companies and organizations, such as Xerox and Univar and many others, have listed safety on their external websites stating their commitment to safety. Xerox says, “Xerox creates safe and efficient prod- ucts, maintains a safe workplace for our people, sup- ports health and wellness programs and reduces injury and exposure to hazardous materials” (Xerox, 2010). People’s safety is on the forefront of any good sustain- ability program protecting a company’s most valuable asset. Ergonomics works directly with people to help support a safe working environment that enables compa- nies to reduce injuries. Link 2: Corporate Sustainability Responsibility (CSR) Reports CSR reports show the results of sustainability efforts Safety should be viewed as the cornerstone of the people component. In this context, sus- tainability means implementing and maintaining pro- grams that keep people safe.
  13. 13. 13 Interface www.asse.org A possible link also exists between ergonomics and “green” products for items purchased to achieve good ergonomics. As ergonomists, we should be aware of the company policy and expectations and be aware of the environmental impact we make when recommending products. Another possible link is to lean manufacturing, ergo- nomics and sustainability. Ergonomics can improve cycle time and lean metrics, which in turn drives im­proved safety and profit. Some great technologies are also available on the market today to help streamline the efficiency of ergonomic and sustainability programs, such as Remedy Interactive and Hara. In the future, there may be an opportunity to bring these two technologies together into one platform for ease of use, reporting and communication. For example, the tool may be able to help home office workers set up their workstation ergonomically and help capture the true carbon footprint of the company by collecting data on the number of commute miles saved and energy and water use and may influence sustainable practices in the home. Conclusion In summary, ergonomics initia- tives have many parallels with sus- tainability goals and can function effectively as an integrated program rather than two distinct programs. Ergonomists should start by making an effort to find out who leads sus- tainability at their company. Start by making an introduction, sharing this article with them and discussing possible common goals. You might find that some of these links will be intrigu- ing to sustainability leaders, and they will be interested in anything that will help support their goals as well. The industry is changing to a “greener” world, and sustain- ability offers a huge opportunity for ergonomists to assist sustainability efforts and to reap the benefits of being allied with such a strong and well-funded movement. The authors would love to hear about further ideas readers may have on future links and thoughts on this article. Please feel free to contact them with any ques- tions or comments. x References Alderton, M. (2008). The ROI of sustainability. Retrieved May 31, 2011, from http://www.greenbiz.com/ blog/2008/08/24/roi-sustainability. CNN Money. (2011). Best benefits: Telecommuting. Retrieved May 13, 2011, from http://money.cnn.com/ magazines/fortune/bestcompanies/2011/benefits/telecom- muting.html. Cornell University Ergonomics Web. (2011). “Green” ergonomics requirements worksheets and survey. point further strengthens the role of ergonomics in sup- porting sustainability initiatives and focusing on environ- mental awareness. Link 4: Telecommuting Programs Telecommuting is often a centerpiece of corporate sustainability programs. CNN Money’s report on “The Best 100 Companies to Work for” showed that 82% of these companies allow employees to telecommute at least 20% of their time with the top 5 companies hav- ing 80% to 86% regular telecommuters (CNN Money, 2011). These programs have shown to reduce the carbon footprint of companies and to increase productivity at the same time. The disadvantage to telecommuting is that the ergo- nomic risks for computer-based employees are the same as the risks found when employees work from the cor- porate office. Many companies have not established a system to address ergonomic concerns or are struggling with a cost-effective method to address ergonomics in remote and home offices. However, workers’ com- pensation and OSHA/European Union regulations still apply when working outside of the corporate office so it is important for companies to establish programs that address ergonomics in telecommuting programs. Many agencies and groups already recommend that ergonom- ics be included in the telecommuting policy, such as EPA, Telecommute Connecticut!, Microsoft Business, City and County of San Francisco and many others. Link 5: Ergonomic Associations The last point is that ergonomic associations, such as the Human Factors and Ergonomics Society (HFES) and IEA already see the link between ergonomics and sustainability and have established groups dedicated to the integration of ergonomics into environmental design. According to HFES’s website, the overall objective of HFES’s Environmental Design Technical Group is “to foster and encourage the integration of ergonomic prin- ciples into the design of all built environments” (HFES, 2011). IEA’s Human Factors and Sustainable Develop­ ment Technical Committee intends “to build a powerful global network of experts in the fields of ergonomics/ human factors and sustainability” (IEA, 2011). The goal is to again bring ergonomics out of the reactionary mode and into the design stages of projects to reduce or elimi- nate risk prior to construction. Future Links This seems to just be the beginning of the link between ergonomics and sustainability. Other ideas where the link could be made include employee recruit- ment and retention. It seems like a clear connection could be made with recruitment and retention if employ- ees were offered comfortable workstations designed with ergonomic principles in mind. Why not offer this as a benefit and publish the information in the CSR report and on the benefits page of the corporate website? Ergonomics initia- tives have many parallels with sus- tainability goals and can function effectively as an integrated program rather than two distinct programs.
  14. 14. 14 Interface www.asse.org 2011, from http://www.npr.org/templates/story/story. php?storyId=129406588. Nintendo. (2010). Nintendo corporate social responsi- bility report. Retrieved May 13, 2011, from http://www. nintendo.com/corp/csr/index.jsp. Patton, C. (2010). ASSE president’s blog: Sustainability and safety. Retrieved May 13, 2011, from http://assepresident.blogspot.com/2009/12/sustainability- safety.html. Stika, N. (2010). Sustainability drives recruitment and retention. Retrieved May 13, 2011, from http://www. cosemindspring.com/Topics/Sustainability/Greening%20 Your%20Business/Sustainability%20Drives%20 Recruitment%20and%20Retention.aspx. Telework Exchange. (2007). Resource center, success stories. Retrieved May 13, 2011, from http://archive.tele- workexchange.com/resource-center-case-studies.asp. U.S. Green Building Council. (2011). List of top 10 states for LEED green buildings released. Retrieved May 13, 2011, from http://www.usgbc.org/Docs/News/ List%20of%20Top%20Ten%20States%20for%20 LEED%202011.pdf. Xerox. (2010). The 2010 report on global citizenship. Retrieved May 13, 2011, from http://www.xerox.com/ about-xerox/citizenship/enus.html. Jessica Ellison, M.S., CPE, CSP, is a member of ASSE’s San Francisco Chapter and incoming chapter secretary. She is a principal consultant at Environmental and Occupational Risk Management, a consulting firm headquartered in San Jose, CA. She holds an M.S. in Biomedical Engineering (Biomechanics) from the University of California-Davis and has extensive experi- ence in analyzing and implementing effective solutions for office, laboratory and manufacturing environments. Danny Nou is an Ergonomics Specialist for Environmental and Occupational Risk Management in Laguna Hills, CA. He was a lead biomechanics researcher in the biomedical engineering department at Hokkaido University. Nou holds B.S. and M.S degrees in Biological Systems Engineering from the University of California-Davis. Retrieved May 13, 2011, from http://ergo.human.cornell. edu/cuergoUSGBC.html. Deutsch, C.H. (2007, Jul. 3). Companies giving green an office. Retrieved May 13, 2011, from http://www. nytimes.com/2007/07/03/business/03sustain.html. Green Business Views. (2010). The most secure green job in America. Retrieved May 13, 2011, from http://www.greenbusinessviews.com/?tag=corporate- sustainability-officer. Hedge Funds Review. (2011). Ethical investment hits $11 trillion. Retrieved May 13, 2011, from http:// www.hedgefundsreview.com/hedge-funds-review/ news/2028493/ethical-investment-hits-usd11-trillion. Hedge, A. (2008, Dec.). The sprouting of “green” ergonomics. Retrieved May 13, 2011, from http://ergo. human.cornell.edu/cuergoUSGBC.html. Hormel Foods. (2010). 2010 Hormel Foods corporate responsibility report. Retrieved May 13, 2011, from http://2010csr.hormelfoods.com/. Human Factors and Ergonomics Society (HFES). (2011). Environmental design technical group. Retrieved May 13, 2011, from http://www.hfes.org/web/ TechnicalGroups/EDTG.pdf. International Ergonomics Association (IEA). (2000). What is ergonomics? Retrieved May 13, 2011, from http://www.iea.cc/01_what/What%20is%20Ergonomics. html. IEA. (2011). Human factors and sustainable develop- ment. Retrieved May 13, 2011, from http://www.iea.cc/ browse.php?contID=hf_and_sustainable_dev. MSNBC. (2007). Wal-Mart on track to cut truck fuel use by 25%. Retrieved May 13, 2011, from http://www. msnbc.msn.com/id/19810648/. National Ergonomics Conference and Exposition. (2008). The role of ergonomics in green design and sus- tainability. Keynote speech delivered on Dec. 5, 2009. National Public Radio. (2010). Outsourced call centers return, to U.S. homes. Retrieved March 1, ASSE and the Ergonomics Practice Specialty (EPS) would like to thank the following mem- bers who have volunteered to serve on the advi- sory committee for 2011-12. We thank you all for your time and dedication to EPS and to the safety community. •Administrator: Jeremy Harris •Assistant Administrator: David Brodie •Publication Coordinator: Walt Rostykus •Awards & Honors: Pam Perrich •Body of Knowledge: Cindy Roth •Conferences & Seminars: Lawrence Schulze & Ben Amick •Membership Development: Scott Valorose •Nominations: Open •Web: Open •Special Projects: Open If you would like to get more involved and work with this great group of volunteers, click here. The Future of EPS
  15. 15. 15 Interface www.asse.org 2011 T he prevalence of obesity in the U.S. continues to climb, exceeding 30% in most gender and age groups. Over the past decade, medical costs associated with obesity have also sky-rocketed and are now $147 billion annually, representing almost 10% of all medical spending (CDC, 2009). Much of these costs are due to the fact that obesity (defined as a body mass index (BMI) of greater than 30, CDC) is also a risk factor for a variety of chronic conditions, including diabetes, hypertension, heart disease and arthritis. So what does this mean from an ergonomist’s perspective? It means we cannot continue to ignore this issue and act like it is the “elephant in the room.” Ergonomics can actually have a positive impact on addressing issues that obese and bariatric individu- als may face in the workplace, in addition to the grow- ing number of injuries that healthcare providers face in terms of safe patient handling with a larger population. Body Mass Index (BMI) BMI stems from the Quetelet Index, which was originally developed between 1830 and 1850 by Adolphe Quetelet, a Belgian mathematician/statistician. BMI is calculated using the individual’s body weight divided by the square of his or her height (unit of mea- sure kg/m2). BMI can also be determined using a BMI chart (Figure 1), which displays BMI as a function of weight (horizontal axis) and height (vertical axis) using contour lines for different values of BMI or colors for different BMI categories. Several government and health organizations use BMI to classify individuals as “overweight” and “obese” in adult populations (CDC, National Institutes of Health, WHO). BMI categories can vary from coun- try to country; however, in 1998, the U.S. National Institutes of Health aligned BMI categories with those defined by the World Health Organization (WHO). The World Health Organization 2008 projections indicate that globally: •approximately 1.5 billion adults, over the age of 20, were overweight; •of these, more than 200 million men and nearly 300 million women were obese; •WHO further projects that by 2015, approximately 2.3 billion adults will be overweight and more than 700 million will be obese. During the past two decades, there has been a marked increase in obesity in the U.S. In 2009, only Colorado and the District of Columbia had a By Winnie Ip, CPE The Growing Problem in Ergonomics: Obesity Obesity Figure 1 BMI Chart With Classification Systems prevalence of obesity less than 20% (CDC, 2009). Thirty-three states had prevalence equal to or greater than 25%; nine of these states (Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee and West Virginia) had a prevalence of obe- sity equal to or greater than 30% (CDC, 2009). Figure 2 shows the shift in U.S. obesity prevalence from 1985 to 2009. BMI as an Indicator for Obesity: A Good Measure? The popularity of using BMI as an indicator for obe- sity stems from research conducted in the 1970s. Keys, et al. (1972) found BMI to be the “best proxy for body fat percentage among ratios of weight and height” and explicitly cited BMI as appropriate for popula- tion studies and inappropriate for individual diagnosis. However, due to the simplicity of the equation, BMI has since become the “norm” to measure a person’s “fatness” or “thinness” and has been widely adopted in individual diagnoses. Source: WHO, 2011
  16. 16. In more recent years, BMI has come under scru- tiny and is a controversial topic among researchers and health care professionals. Sample articles and key points include: •CNN Health: “Can Neck Measure Indicate Body Fat Better Than BMI?” (2010) —Article based on research by Olubukola, et al. (2010) published in the journal Pediatrics. —A wide neck circumference is associated with obesity-related conditions, such as sleep apnea, diabetes and hypertension. Neck circumference has been explored in studies for potential obesity and heart problems in adults. —One of BMI’s shortcomings is that it “does not accurately define central body fatness.” —Studies have shown that regional adiposity, fat collected around the midsection, is often a good indicator for obesity-related complications, including hyperten- sion, diabetes and heart disease. The correlation between regional adiposity and a high neck circum- ference was found to be strong. •National Public Radio: “Top 10 Reasons Why the BMI is Bogus” (2009.) —Keith Devlin of Stanford University suggests any obesity findings based on BMI should be taken with a grain of salt. —Quetelet said explicitly that it could not and should not be used to indicate the level of fatness in an individual. —There is no physiological reason to square a per- son’s height in BMI. Moreover, it ignores waist size, 16 Interface www.asse.org 2011 which is a clear indicator of obesity level. —It makes no allowance for the relative proportions of bone, muscle and fat in the body. —A high BMI does not mean an individual is even overweight, let alone obese. It could mean the person is fit and healthy, with very little fat. •Science Daily: “BMI Not Accurate Indicator of Body Fat, New Research Suggests” (2007) —Article based on research published in the official journal of the American College of Sports Medicine. —A research team from Michigan State University and Saginaw Valley State University measured the BMI of more than 400 college students— some of whom were athletes and some not—and found that in most cases, the student’s BMI did not accurately reflect his or her percentage of body fat. —BMI does not distinguish between body fat and muscle mass. Causes Consequences of Obesity The primary cause of obesity and being overweight is an imbalance between calories consumed and calo- ries expended (WHO, 2009). According to WHO (2009), global increases are attributable to many fac- tors, including: •a global shift in diet toward increased intake of energy-dense foods that are high in fat and sugars, but low in vitamins, minerals and other micronutrients; and •a trend toward decreased physical activity due to the increasingly sedentary nature of many forms of work, changing modes of transportation and increasing urbanization. The environment may also have an impact on obe- sity. People interact with several different environ- ments. In the home, people may choose to do activities that do not lead to caloric expenditure, such as watch- ing television and other sedentary behaviors. Schools also impact children; they dictate lunch menus and how much physical activity children get throughout the day. The type of work that a person does may affect the amount of physical activity, for instance, sitting expends less than 720 calories over 8 hours, whereas heavy work, such as construction, can expend around 2,400 to 3,600 calories over 8 hours (Sanders, 1993). Finally, the community may affect people’s choices about exercise and food. The availability of nutritious low-calorie food will influence the type of diet avail- able for an individual. The environment may also have an impact on obesity. People interact with several different environments. In the home, people may choose to do activities that do not lead to caloric expenditure, such as watching televi- sion and other sed- entary behaviors. Table 1 BMI Categories Sample Weights Category BMI Range (kg/m2 ) Weight of a 5 ft 11 in Person With This BMI Severely underweight less than 16.0 Less than 118 lbs Underweight from 16.0 to 18.5 Between 118 and 132 lbs Normal from 18.5 to 25 Between 130 and 178 lbs Overweight from 25 to 30 Between 180 and 214 lbs Obese Class I from 30 to 35 Between 210 and 249 lbs Obese Class II from 35 to 40 Between 250 and 286 lbs Obese Class III over 40 Over 290 lbs Source: WHO, 2011
  17. 17. Genes may also play a role in obesity. Some scien- tific evidence indicates that people may have a higher risk of becoming obese based on their family history (CDC, 2009). Many studies have been done on obese populations and obese families. In general, these studies have shown that a sizable portion of weight variation can be explained because of genetic factors. Narrowing these factors is the current challenge for researchers and scientists. People classified as overweight or obese face many health consequences. Scientists have produced the first direct evidence that fat accelerates aging. Valdes, et al. (2005) found that obesity (BMI 30) adds the equiva- lent of nearly 9 years of age to a person’s body. This can begin to explain why obese children are develop- ing adult-onset Type 2 diabetes between ages 10 and 19 (as opposed to age 45 which has been the norm). Other health consequences include: •coronary heart disease; •type 2 diabetes; •certain cancers (endometrial, breast and colon); •hypertension; •dyslipidemia (high cholesterol, high triglycerides); •stroke; •liver and gallbladder disease; •sleep apnea and respiratory problems; •osteoarthritis; •gynecological problems (abnormal menses, infertility). Physiological Effects of Obe Range of Motion (ROM) Obesity depending on the level and distribution of adipose tissue can affect range of motion (Park, et al., 2010). Overweight and obese individuals do not have as much flexibility in their hips or in their back. This means that obese individuals may have more trouble reaching objects. Park, et al. (2010) found significant differences between obese and non-obese groups; decreased range of motion for shoulder extension (~20 to 22%), shoulder adduction (~36 to 39%), trunk exten- sion (22%) and trunk lateral flexion (~18 to 20%). A person’s abdomen may also be an obstruction, thereby limiting the reach distance at a work surface. This could also influence working postures. Because of the limited reach envelope, the individual may need to compensate with other parts of their body (e.g., shoul- der abduction, trunk flexion). It is important to note that these limitations exist for both seated and standing workstations. Physiology Excess fat increases the oxygen requirements for any given task performed (Wood, et al., 2010). Therefore, there is a larger physiological deficit for those who are overweight or obese. This may reduce the endurance time for this segment of work- ers. Fatigued workers may show increases in quality defects or lower production rates. Resting heart rates are also higher for obese individuals, which can affect physical work capacity. It can also lead to adverse car- diac outcomes in the long run, such as heart disease. Key Workplace Design Guidelines We can take a proactive approach to address some of the particular challenges obese workers face by keeping in mind the following design guidelines: •Keep things close. For obese individuals, keeping things close (i.e., within arm’s reach) becomes even more important since excess body weight can increase the forces and loads placed on the spine. Design worksta- tions and processes to ensure that items are placed within 16” from the edge of the work surface. If items must be placed further than the recommended 16”, minimize the time spent in sustained postures at this distance. •Keep it in the comfort zone. Obese individuals are more prone to back and knee injuries from excess body weight so keeping all work tasks within the comfort Figure 2 U.S. Obesity Prevalence in 1985 Versus 2009 17 Interface www.asse.org 2011 Source:CDC,2009
  18. 18. 18 Interface www.asse.org 2011 (2009). U.S. obesity trends. Atlanta, GA: Author. Retrieved March 9, 2011, from http://www.cdc.gov/ obesity/data/trends.html. CDC. (2009). Obesity causes and consequences. Atlanta, GA: Author. Retrieved March 10, 2011, from CDC http://www.cdc.gov/obesity/causes/index.html. Devlin, K. (2009, July). Top 10 reasons why the BMI is bogus. Retrieved March 9, 2011, from http://www. npr.org/templates/story/story.php?storyId=106268439. Eknoyan, G. (2008, Jan.). Adolphe Quetelet (1796- 1874)—the average man and indices of obesity. Nephrology Dialysis Transplantation, 23(1), 47-51. Keys, A., Fidanza, F., Karvonen, M.J., Kimura, N. Taylor, H.L. (1972, Jul.). Indices of relative weight and obesity. Journal of Chronic Disability, 125(6), 329-43. Michigan State University. (2007). BMI not accu- rate indicator of body fat, new research suggests. ScienceDaily. Retrieved March 9, 2011, from http:// www.sciencedaily.com/releases/2007/03/070305202535. htm. Nafiu, O.O., Burke, C., Lee, J., Voepel-Lewis, T., Malviya, S. Tremper, K.K. (2010, Aug.). Neck cir- cumference as a screening measure for identifying chil- dren with high body mass index. Pediatrics, 126(2), e306-e310. Park, W., Ramachandran, J., Weisman, P. Jung, E.S. (2010, Jan.). Obesity effect on male active joint range of motion. Ergonomics, 53(1), 102-108. Sanders, M.S. McCormick, E.J. (1993). Human factors in engineering and design. New York, NY: McGraw Hill. Valdes, A.M., Andrew, T., Gardner, J.P., Kimura, M., Oelsner, E., Cherkas, L.F., Aviv, A. Spector, T.D. (2005, June 14). Obesity, cigarette smoking and telomere length in women. The Lancet, 366(9486), 662-664. Wood, R.E., Hills, A.P., Hunter, G.R., King, N.A. Byrne N.M. (2010, March). VO2 max in overweight and obese adults: Do they meet the threshold criteria? Medicine Science in Sports Exercise, 42(3), 470- 477. World Health Organization (2011, Feb.). Obesity and overweight factsheet. Geneva, Switzerland: Author. Retrieved March 9, 2011, from http://www. who.int/mediacentre/factsheets/fs311/en/index.html. Winnie Ip, CPE, director of consulting and ergonomics engi- neer for Humantech, manages and implements complex, large- scale ergonomics programs in a variety of industries, from automotive to petroleum to food and beverage and printing industries. She provides technical services, delivers ergonomics training, establishes management programs and conducts pro- cess reviews of ergonomics and health and safety programs. Ip holds a B.S. in Kinesiology from the University of Waterloo in Waterloo, Ontario. She is also an ASSE member. Reprinted with permission from the proceedings of ASSE’s 2011 Professional Development Conference. zone (i.e., knees to shoulders) will help. Design work- stations and processes to be height-adjustable and min- imize storing items on the floor; keep all items between 38” and 47” above the standing surface. •Provide appropriate equipment. Ensure that equipment and furniture are purchased and/or designed with expanded capacity in mind (e.g., office and indus- trial chairs). Most standard chairs have a weight rat- ing between 225 and 275 lbs. Chairs designed for the obese individual are more involved than just changing out the pneumatic cylinder with one rated for a higher weight; they are also designed to accommodate a larger profile (e.g., wider seat pan, swivel arm rests). •Promote variety at the workstation. Standing workstations have been shown to increase energy expenditure by 40% versus seated workstations. Standing just 2.5 hours out of the day can result in 350 extra calories burned. Standing worksta- tions can also have an impact on compressive force on intervertebral discs, which can impact occurrence of low back pain. •Embrace 5S. This lean manufac- turing concept has been adopted by many companies and involves steps to ensure that workspaces promote efficiency and productivity (i.e., Sort, Straighten, Shine, Standardize and Sustain). Keeping the work area clean and reducing/eliminating clutter wher- ever possible will help obese individu- als maneuver around their workstation more easily. Conclusion In traditional ergonomics pro- grams, the primary goal is to adapt the workplace and tools to the capa- bilities of people. This goal does not change when con- sidering obese workers. You need only make a slight shift to accommodate the limitations of obese individu- als. Do exactly what you are doing today, just do it better, with more knowledge of the key performance differentiators within your workforce. The obesity problem will not go away or resolve itself anytime soon. Although obese individuals must take ownership of their health and well-being, we as professionals in the ergonomics, safety and engineer- ing realms must also better understand the needs of this growing population and find solutions so that we can fit the job to all workers. x References Centers for Disease Control and Prevention (CDC). In traditional ergo- nomics programs, the primary goal is to adapt the work- place and tools to the capabilities of people. This goal does not change when considering obese workers. You need only make a slight shift to accommodate the limitations of obese individuals.
  19. 19. 19 Interface www.asse.org 2011 M anual patient handling is the primary rea- son for musculoskeletal injuries in patient care providers, and the understanding of the impact of patient handling on the body leads to a clear understanding why this is so. When the biomechanical capabilities of the body are exceeded, injury occurs. To set industry recommen- dations that decrease the risk of injury to caregivers from manual patient handling and moving, a patient lifting weight limit was determined, algorithms and guidelines for patient handling tasks were developed and guidelines for the introduction of patient care ergo- nomics in design and construction were instituted. Ramifications of Exceeding the Body’s Biomechanical Limits Providing Patient Care is High-Risk In 2007, nursing aides, orderlies and attendants suf- fered 24,340 musculoskeletal disorders (MSDs) requir- ing days away from work, the second highest number in the country while registered nurses experienced 8,580 MSDs, the seventh highest number of MSDs. The rate of injuries for nursing aides, orderlies and attendants as a group (252 MSDs per 10,000 workers) was the highest rate of MSDs for any occupation, more than seven times the national MSD average (Facility Guidelines Institute, 2010). However, many patient handling injuries are not reported, so these numbers may be misleading and not tell the true story of injuries to caregivers (Siddharthan, et al., 2006). Some estimate that caregiver injuries are underreported by at least 50% (Siddharthan, et al., 2006). The 2003 OSHA Ergonomic Guidelines for Nursing Homes directly related manual patient handling to the high rate of injuries in healthcare providers (OSHA, 2003). And, manual patient handling has become even more problematic over the years as patient acuity lev- els and weights have increased. With the recognition of the importance of patient mobilization in the heal- ing process, these increasingly dependent and larger patients are moved and handled more often. For more than 30 years, caregivers were trained in body mechanics and “proper” lifting techniques to decrease injuries related to manual patient handling. However, for those 30+ years, injuries from manual patient handling continued to increase (BLS, 2001). Today, evidence demonstrates that no amount of train- ing in proper body mechanics and lifting techniques will ever overcome the effects on the body when the biomechanical limits are exceeded, and lifting patients has been found to exceed caregivers’ biomechanical limits (Owen, 2000; Owen Garg, 1994; Garg Owen, 1994; Rice, et al., 2009; Marras, et al., 2009; Nelson, et al., 2003). Why How Caregivers Are Injured When manual patient han- dling or any other activity that exceeds a person’s biomechani- cal capabilities is performed, the musculoskeletal system is dam- aged (Waters, 2007). Any part of the musculoskeletal system can be affected—muscles, bones, tendons, ligaments, joints, etc. The majority of patient handling injuries are located in the lower back, but injuries also occur in the middle and upper back, shoulders, neck, arms, wrists, and even the hands and knees. Most musculoskeletal inju- ries in caregivers are cumulative trauma ones, though the majority are recorded as and considered (incorrectly) acute inju- ries. In acute injuries, one event results in damage. For instance, an acute injury may occur when a caregiver is providing ambulation rehabilitation for a large patient. If the patient loses his or her balance and falls and the caregiver attempts to prevent the fall, a muscle may be torn or a shoulder dislocated. Nearly all patient handing injuries are cumula- tive trauma. A cumulative trauma injury results from the accumulation of microinjuries over time. These microtears in the muscles or microfractures to the end plates of spinal vertebrae often progress until severe damage occurs (Marras, 2000). Microtears to the muscles result from muscle fatigue when the muscle is no longer able to produce energy for contraction. Overexertion for an extended period of time or too often without adequate recovery will result in muscle fatigue. Muscle fibers can also be damaged when exposed to excessive loading or repetitive actions with- out sufficient recovery periods (Waters, 2008). Excessive spinal loading is a consequence of lift- ing heavy loads and even light loads for a long period of time and/or twisting, bending and other similar actions. Lifting results in compressive forces on the spine. Twisting, reaching, bending, pulling and such motions produce shear forces on the spine. Together or By Mary Willa Matz, MSPH, CPE Patient Care Ergonomics Biomechanical Drivers for Patient Handling Technology Design musculoskeletal injuries
  20. 20. separately, these result in spinal load- ing (Waters, 2008). When spinal forces exceed the spinal load- ing capacity, microfractures occur in the ver- tebral endplates and scar tissue is formed. This impacts the flow of nutrients into the intervertebral discs of the spine. In most tissues, the body’s blood sup- ply brings nutrients to the tissues; however, inter- vertebral discs receive nutrients only by diffu- sion through the vertebral endplate. Nutrients will easily diffuse through a healthy vertebral endplate into the adjacent disc, but endplate scar tissue impedes this flow. Without adequate nutrients, a disc degenerates, and without a nerve supply to the discs as well as a blood supply, disc degeneration continues unnoticed until nerve impingement results in pain and decreased work capac- ity (Waters, 2008). Guidelines Algorithms to Decrease Risk of Injury from Patient Handling Patent Lifting Weight Limit To have a quantitative value for understanding risk from activities that exceed the safe load on the musculoskeletal system, Thomas Waters, Ph.D., CPE, adapted the revised NIOSH lifting equation (RNLE) for patient handling tasks. His calculations led to a maximum lifting limit of 35 pounds for caregivers lift- ing patients under the best of circumstances and under ideal conditions. The “best of circumstances” includes no tubes, lines, contractures, combative behavior, etc., not often found in hospitals and nursing homes with high-acuity patients (Waters, 2007). Ideal condi- tions preclude lifting with arms extended, lifting from near the floor, lifting while twisting or lifting from the side of the body. The RNLE is an ergonomic assessment tool that is used to determine safe lifting weight limits for two-handed manual lifting tasks. Through inclusion of quantitative values for specific task variables, the RNLE calculates a recommended weight limit (RWL). The RWL is defined for a specific set of task condi- tions in which the weight of the load could be lifted by nearly all healthy workers for up to 8 hours without an increased risk of developing low back pain. These cri- teria include the load of the object, horizontal distance of the load from the worker, vertical height of the lift, vertical displacement during the lift, frequency, dura- tion, hand-to-object coupling characteristics and angle of asymmetry (NIOSH, 1994). However, the RNLE specifically excluded patient lifting (Waters, et al., 1993). Reasons included the unpredictability of patients, leading to unexpect- edly heavy loads when a patient has a muscle spasm, is combative or resists care, as well as the common occurrence of patient movement that increases forces due to acceleration of the load beyond what it would be when performing a slow, smooth lift of a stable object. Additionally, estimating the weight lifted is difficult, especially when more than one caregiver is lifting a patient, or when a patient has partial weight-bearing and/or assistance capabilities. However, Waters determined that the RNLE could be used to determine the RWL for patient lifting during some tasks, such as those when the patient is coopera- tive and can follow directions, the amount of weight to lift can be estimated, the body and hand positions in relation to the object lifted do not change, the weight lifted does not change and the patient is not likely to make sudden movements during the lift (Waters, 2007). To modify the RNLE in order to calculate an RWL for lifting patients, criteria used in the RNLE were evaluated for how and if they pertained to patient handling and assumptions were made. One critical assumption was that, most likely, when lifting patients, a caregiver is not able to get as close to the patient as s/he would to a box—the standard NIOSH test item. Lifting patients often involves reaching out for, as well as lowering a load (e.g., lowering a patient into a chair or onto a bed), so the horizontal distance vari- able would be greater in patient lifting activities. In the RNLE, the minimum horizontal reach for the RWL is set at 10 in.; however, for patient lifting, Waters deter- mined a more appropriate distance of 14.5 in. (Waters, et al., 1993). Using this modified horizontal distance, the recommended weight limit would then be 35 pounds for an ideal patient lift. 20 Interface www.asse.org 2011 The majority of patient handling injuries are located in the lower back, but injuries also occur in the middle and upper back,
  21. 21. •reposition in bed: side to side, up in bed; •reposition in chair: wheelchair or dependency chair; •transfer a patient up from the floor. Later, the need for algorithms for bariatric patient care was determined. These algorithms provide guid- ance for the following high-risk tasks involving bariat- ric patients (Nelson, 2001): •transfer to and from: bed to chair, chair to toilet, chair to chair or car to chair; •lateral transfer to and from: bed to stretcher, trolley; •reposition in bed: side to side, up in bed; •reposition in chair: wheelchair or dependency chair; •tasks requiring sustained hold- ing of limbs or access to body parts; •transporting (stretcher, wheel- chair, walker); •toileting; •transfer patient up from floor. Soon after release of these algo- rithms, clinicians from specific clinical settings recognized the need for guidance specific to the high- risk tasks performed as a result of their special patient populations. AORN was the first group to devel- op such individualized guidelines. The ergonomically high-risk tasks in the perioperative environment include both patient handling and nonpatient care ergonomic guide- lines (Association of periOpera- tive Registered Nurses Workplace Safety Taskforce, 2007): •lateral transfer from stretcher to OR bed; •positioning/repositioning the patient on the OR bed to and from the supine position; •lifting and holding legs, arms and heads for prepping; •prolonged standing; •retraction; •pushing, pulling and moving equipment on wheels. NAON then developed guidelines specific to the orthopaedic clinical environment. The high-risk tasks found in this clinical setting include the following (Sedlak, et al., 2009): •turning patient in bed (side to side); •vertical transfer of a post-operative total hip replacement patient; •vertical transfer of a patient with an extremity cast/ splint; •ambulation; •Lifting or holding legs or arms in an orthopaedic setting. 21 Interface www.asse.org 2011 Guidelines Algorithms for Safe Patient Handling Research has been conducted in various patient care environments to identify manual patient handling tasks that put caregivers at risk for injury, and findings con- firm that these high-risk patient handling tasks place excessive biomechanical and postural stress on the mus- culoskeletal system of caregivers (Nelson, 1996; Nelson Fragala, 2004; Owen Garg, 1990; Sedlak, et al., 2009; Association of periOperative Registered Nurses Workplace Safety Taskforce, 2007; Nelson, et al., 2003). To give caregivers information to make ergonomi- cally safe patient handling and movement decisions, algorithms and guidelines were developed. After identifying ergonomic hazards in specific clinical envi- ronments, clinicians and ergonomists collaborated to develop ergonomic guidelines and algorithms. Most algorithms and guidelines reflect control measures for high-risk patient handling tasks, such as patient lifts and transfers, but some focus on other high- risk activities found in clinical environments, such as pushing/pulling beds/equipment. The Veterans Health Administration (VHA), American periOp- erative Registered Nurses Association, the National Association of Orthopaedic Nurses (NAON), the American Nurses Association and NIOSH were in the forefront in the development of such guidelines. The first algorithms for safe patient handling devel- oped by VHA and the Department of Defense were released in 2001. These algorithms were developed by a national team of clinicians who trialed them in all clinical settings prior to release. These algorithms, for the first time in the U.S., standardized care in relation to completion of high-risk patient handling and move- ment tasks; however, it is important to understand that the algorithms provide general direction. Caregivers must use their professional judgment in applying algo- rithms (Nelson, 2001). As a first step in using these algorithms, a patient assessment is completed that provides information on a patient’s level of assistance, weight-bearing capability, upper-body strength, level of cooperation and compre- hension, weight, height and any medical or physical factors affecting moving and handling. The information from the assessment is then used to answer questions found in the algorithms. Answering the algorithm ques- tions leads a caregiver to find out the number of caregiv- ers and patient handling equipment needed for a particu- lar high-risk task based on the unique characteristics of the patient assessed. The original algorithms were devel- oped for these high-risk tasks (Nelson, et al., 2003): •transfer to and from: bed to chair, chair to toilet, chair to chair or car to chair; •lateral transfer to and from: bed to stretcher, trolley; •transfer to and from: chair to stretcher, chair to chair or chair to exam table; After identifying ergonomic hazards in specific clinical environments, clini- cians and ergono- mists collaborated to develop ergo- nomic guidelines and algorithms. Most algorithms and guidelines reflect control measures for high- risk patient han- dling tasks.
  22. 22. 22 Interface www.asse.org 2011 •impact of aesthetics; •infection control risk mitigation. Conclusion Solid science supports the need for biomechanical control measures, a weight limit for patient lifts, use of clinical guidelines and algorithms and the institu- tion of a systematic assessment to ensure that building design promotes safe patient handling and movement. Together and separately, these provide critical guid- ance to ensure safe patient handling, and movement and the ergonomic safety of our caregivers. x References Association of periOperative Registered Nurses (AORN) Workplace Safety Taskforce. (2007). Safe patient handling and movement in the perioperative setting. Denver, CO: AORN. Bureau of Labor Statistics. (2001). Survey of occu- pational inquiries and illnesses. Washington, DC: Author. Facility Guidelines Institute. (2010). Guidelines for design and construction of healthcare facilities. American Society for Healthcare Engineering. Facility Guidelines Institute. (2010). Patient han- dling and movement assessments: A white paper. Retrieved Feb. 28, 2011, from http://www.fgiguide- lines.org/interim_pubs.html. Garg, A. Owen, B.D. (1994). Prevention of back injuries in healthcare workers. International Journal of Industrial Ergonomics, 14, 315-31. Marras, W.S. (2000). Occupational low back disor- der causation and control. Ergonomics, 43(7), 880-902. Marras, W.S., Knapik, G.G. Ferguson, S. (2009). Lumbar spine forces during maneuvering of ceiling-based and floor-based patient transfer devices. Ergonomics, 52(3), 384-97. Nelson, A. (1996). Unpublished research data from pilot study. Tampa, FL: James A. Haley VA Medical Center. Nelson, A. (2001). Patient care ergonomics resource guide: Safe patient handling and movement. Tampa, FL: Veterans Administration Patient Safety Center of Inquiry. Retrieved March 1, 2011, from http:// www.visn8.va.gov/visn8/patientsafetycenter/resguide/ ErgoGuidePtOne.pdf. Nelson, A., Lloyd, J., Menzel, N. Gross, C. (2003). Preventing nursing back injuries: Redesigning patient handling tasks. AAOHN Journal, 51(3), 126- 134. Retrieved March 1, 2011, from http://www.aaohn journal.com/SHOWABST.asp?thing=34518. Nelson, A.L. Fragala, G. (2004). Equipment for safe patient handling and movement. Back injury among healthcare workers. Washington, DC: Lewis Publishers. Nelson, A.L., Lloyd, J., Menzel, N. Gross, C. (2003). Preventing nursing back injuries: Redesigning patient handling tasks. AAOHN Journal, 51(3), 126-34. Patient Care Ergonomic Guidelines in the Design Construction of Healthcare Facilities Patient care ergonomics, including basic ergonomic assessment methodologies, institution of resultant technology control measures and incorporation of such technology into the design of new and existing buildings has been found to decrease the incidence of caregiver injuries, lost time and modified duty days, while demonstrating a cost/benefit for an organiza- tion. Patient benefits are also seen. For these reasons, a patient handling and movement assessment (PHAMA) was incorporated into the 2010 Guidelines for the Design and Construc­tion of Health Care Facilities, and a comprehen- sive white paper was written to further explain and provide addi- tional information for designers and organizations (Facility Guidelines Institute, 2010). The main purpose of the white paper is to relay information to assist in ensuring that appropri- ate patient handling equipment is introduced and that other conditions and building attributes support safe patient handling and movement. However, further information needed to be relayed to designers, building owners, administrators and others. In addition to supply- ing in-depth information related to the PHAMA, the white paper includes chapters on the rationale for, and background of patient care ergonomics, developing a business case, safe patient handling program implementation and resources (Facility Guidelines Institute, 2010). The PHAMA has two distinct yet interdependent phases. The first phase includes a patient handling needs assessment to identify appropriate patient handling and patient movement equipment for each clinical area in which patient handling and movement occurs. The second phase includes definition of space requirements, and structural and other design consid- erations to accommodate incorporation of such patient handling, and movement equipment. Phase 2 includes the following design considerations: •structural; •electrical and mechanical; •provision of adequate space; •destination points; •door openings (sizes and types); •floor finishes, surfaces and transitions; •installation coordination; •storage space; •impact on environment of care; Solid science sup- ports the need for biomechanical control measures, a weight limit for patient lifts, use of clinical guidelines and algorithms and the institution of a systematic assess- ment to ensure that building design promotes safe patient handling and movement.
  23. 23. 23 Interface www.asse.org 2011 T.R. (2009). Development of the National Association of Orthopaedic Nurses guidance statement on safe patient handling and movement in the orthopaedic set- ting. Orthopaedic Nursing, supplement to 28(25), 2-8. Siddharthan, K., Hodgson, M., Rosenberg, D., Haiduven, D. Nelson, A. (2006). Underreporting of work-related musculoskeletal disorders in the Veterans Administration. International Journal of Health Care Quality Assurance, 19(6-7), 463-76. Waters, T.R. (2007). When is it safe to manually lift a patient? American Journal of Nursing, 107(6), 40-45. Waters, T.R. (2008, Mar.). Science to support spe- cific limits on lifting, pushing and pulling, and static postures. Presentation at the 8th Annual Safe Patient Handling Conference, Lake Buena Vista, FL. Waters, T.R., Putz-Anderson, V., Garg, A. Fine, L.J. (1993). Revised NIOSH equation for the design and evaluation of manual lifting tasks. Ergonomics, 36(7), 749-776. Mary Matz, MSPH, CPE, is an internationally recognized expert in patient care ergonomics. She provides patient care ergonomic consultation related to ergonomic equipment and design requirements and safe patient handling program imple- mentation. She is an active member of the Health Guidelines Revisions Committee and was the primary author of the patient handling and movement assessment in the 2010 National Guidelines for Design and Construction of  Healthcare Facilities. Reprinted with permission from the proceedings of ASSE’s 2011 Professional Development Conference. Nelson, A.L., Owen, B., Lloyd, J., Fragala, G., Matz, M., Amato, M., Bowers, J., Moss-Cureton, S.,Ramsey, G., Lentz, K. (2003). Safe patient han- dling and movement. American Journal of Nursing, 103(3), 32-43. NIOSH. (1994). Applications manual for the revised NIOSH lifting equation. Atlanta, GA: Author. Retrieved March 1, 2011, from http://www.cdc.gov/ niosh/docs/94-110/. OSHA. (2003). Ergonomic guidelines for nursing homes. Washington, DC: Author. Retrieved Feb. 28, 2011, from http://www.osha.gov/ergonomics/guide- lines/nursinghome/final_nh_guidelines.html. Owen, B. Garg, A. (1990). Assistive devices for use with patient handling tasks. Advances in industrial ergonomics and safety. Philadelphia, PA: Taylor Frances. Owen, B.D. Garg, A. (1994). Reducing back stress through an ergonomic approach: Weighing a patient. International Journal of Nursing Studies, 31(6), 511-19. Owen, B.D. (2000). Preventing injuries using an ergonomic approach. Association of periOperative. Registered Nurses Journal, 72(6), 1031-36. Rice, M.S., Woolley, S.M. Waters, T.R. (2009). Comparison of required operating forces between floor-based and overhead-mounted patient lifting devices. Ergonomics, 52(1), 112-20. Sedlak, C.A., Doheny, M.O., Nelson, A. Waters, Practice specialty members are highly encouraged to nominate peers for an award to recognize their exceptional work and service. Winners will be acknowledged at the annual conference, on the ASSE website and in press releases. Awards offered include: •Council on Practices and Standards (CoPS) Safety Professional of the Year •Ergonomics Practice Specialty Safety Professional of the Year To find out more about the COPS awards program, click here. x Awards Honors Nominations Best of the Best ASSE and the Ergonomics Practice Special­ty would like to con- gratulate Jeremy Harris for his notable article, “The Concept of Universal Design.” This article was one of 17 articles selected for inclu- sion in the 2010-11 Best of the Best publication. Click here to view this compilation of technical material. Click here for more information on the groups represented in this publication or click here to add another practice specialty to your membership.
  24. 24. and all of the employees, we were able to attain a merit status, but one of the mandates that came out of that status was to continuously improve not only our whole safety program, but our ergonomics program and the health and wellness initiatives. In early 2006, I asked my manager to allow me to take over these programs, and I attended what was to become more than 175 hours of training from various organizations via seminars and con- ferences. I also took advantage of online offerings and used this training to begin establishing a viable ergo- nomics program at Honeywell. The initial effort was slow to take hold as there was hesitancy to begin a pro- gram that had not yet proven itself. The remainder of 2006 was spent gar- nering support for the program and securing equipment to assist in imple- menting corrective actions found dur- ing initial ergonomic assessments. At this point, it required a doctor’s note to procure equipment for someone who was experiencing trouble. In 2007, funding was established and a sharp increase in the number of formal assessments began. During this period, the number of WMSDs decreased, but the time to implement corrective actions still was too long. I was only able to order equipment once an assessment was done. I had no in-house stock from which to pull. Also during this period, we had OSHA back for our follow-up to gain our Star status in the VPP, which we were able to achieve. One thing noted was the progress in ergonomics and health and wellness areas. I knew we had a long way to go to consider this program effective so I kept imple- menting ideas and asking for more management buy-in to the effort. 2008-09 were cornerstone years for the program, as funding was firmly established and we were able to maintain a limited supply of equipment on hand to make ergonomic changes more quickly. In many instances, the ergonomic process was down to a few hours instead of a few days or weeks. The two key moments during this period that were crucial in obtaining upper management buy-in to the program, were assessments conducted on our program manager and our chief financial manager. One was experiencing elbow and hand discomfort while the other had some lower back pain. Assessments were conducted and changes were made immediately to their office setups. Each felt relief in less than a week from minor changes and from there, the program took off. During this period, WMSDs dropped to one to two each quarter, but none ever developed into lost time or workers’ compensation due to the proactive nature of the program and the corrective actions taken to resolve their issues. In 2009, I was awarded the HTSI Health, Safety and Environmental President’s Award for my work in the areas of ergonomics, and health and wellness. This award was due mainly to the support I received from my management team in allowing me to run with this pro- gram and allowing it to mature into what it is today. So where are we now? In 2010, we recertified our Star status in the OSHA VPP, and the ergonomics and health and wellness programs were cited as best prac- tices by OSHA and, at a corporate level, by Honeywell. We have established an ergonomics/wellness lab in our building, and several safety professionals from around the Colorado Springs area have toured our facility to gain insight into what the program entails and how to get started. The ergonomics lab is set up with two different adjustable tables (one is powered, the other is manual), both of which allow me to be more precise in my assess- ments and to give the customer the opportunity to see how sit/stand stations could feel before actually reconfig- uring their own workstation. I also have a large variety of input devices for people to try out before we install them. In 2010 alone, we have saved Honeywell more than $400,000 in potential direct and indirect costs due to the program’s proactive nature. The cost to Honeywell for the corrective actions was just under $5,000. This was just further validation that the program has begun to real- ly mature and shows the evolution of the program to one of proactivity. Innovations, such as the lab and the newly purchased ergonomic software, will help us dramatically decrease potential hazards and workplace injuries by assisting us in designing better layouts for warehouses, and shipping and receiving areas as well as our office environment. Our ergonomics/wellness lab now stocks more than 20 different keyboards and mice, as well as an assortment of other equipment, such as footrests, moni- tor and laptop arms and several varieties of ergonomic chairs. Having all these items readily available allows us to be proactive and to correct deficiencies in hours. How does an employee get an ergonomic assess- ment? For newly hired personnel, it is part of their in- processing checklist to complete the assessment. Once they have established their e-mail, they submit a work request for an ergonomic assessment. I then schedule the assessment, which contains several steps. I first go to their office/cube and take initial measurements to see how they are in the workspace prior to the analysis in the lab. I then take employees to the lab where we fine- tune their seated posture and do adjustments to monitors, surface heights and seat pan heights to get the employees into a sound neutral position. From there, I have them try 24 Interface www.asse.org 2011 From Nothing to Best Practice continued from page 1 How does an employee get an ergonomic assess- ment? For newly hired personnel, it is part of their in- processing check- list to complete the assessment. Once they have estab- lished their e-mail, they submit a work request for an ergonomic assessment. I then schedule the assess- ment, which con- tains several steps.
  25. 25. 25 Interface www.asse.org 2011 dor. This partnership has allowed me to expand the lab to three separate setups to give our employees even more options when they come for an assessment. The evolution of this program has been remarkable, and I look forward to growing the program and to shar- ing this best practice with as many people as possible. I would like to thank everyone in my management team that has allowed me to take charge of this program and grow it over the years from nothing to best practice. x Keith Osborne retired from the U.S. Army in 2002 after 25 years of service and currently works for Honeywell Technology Solut­ ions Inc.-Colorado Springs (HTSI-COS) as a health, safety and environmental (HSE) site specialist. His primary duties include company ergonomic administrator, wellness program administra- tor, lead emergency first responder and CPR/first-aid instructor/ trainer, personal fitness trainer and building continuity team member. He is a certified master fitness trainer and has more than 175 contact hours of ergonomics/biomechanics training. He received the HTSI HSE President’s Award in 2009 for his work in ergonomics and wellness, both programs being recognized as OSHA and Honeywell best practices, and is currently a member of HFES, AIHA and ASSE. Osborne holds two bachelor’s degrees from National American University in Applied Management and Business Administration. out each input device to fit them to a mouse and keyboard. If employees wish to take a couple of them back to use for a while to help narrow down the best one, they can do that. The final step in the lab is to fit employees to a chair. We keep several differ- ent models on hand so chances are we have one that will work for them. If not, we can special- order a chair if it can solve a specific issue and alleviate a potential issue down the road. After the lab session, all data are compiled and changes/adjustments to the workstation are done that day, or the following morning so the employee can begin work in a station that fits him or her, not the other way around. Follow-ups are done in 4 to 6 weeks or sooner if an employee is not comfortable with what was done. We have also begun building sit/stand stations. I began to introduce these to our employees in certain dis- ciplines to help them be less sedentary in their work and to improve their overall health. This year alone, 25 sit/ stand stations have been built, and I foresee many more being completed. The success rate has been phenomenal, and everyone who has had one built has talked about their increased energy levels and how they feel more alert during the day. The increased caloric burn the posi- tion provides versus sitting all day is a nice benefit as well. We also do periodic reassessments based on changes in a person’s health, reassignment, which causes a change in location, or an individual’s desire to try a new setup, such as a sit/stand station. On average, I conduct 35 assessments each month and have expanded the pro- gram to include our personnel working at our remote site locations and at our offices in El Segundo, CA. With the addition of the ergonomic software, we now have a sound tool in which to evaluate other areas of our company to maximize worker productivity and safety, and it is a tool I look forward to learning and using to assist me in growing the program even further. Other recent additions to the program include equipment loaned to me from businesses that provide ergonomic equipment. These companies have agreed to send equip- ment for use in the lab where employees can try them out. If they decide that they want to use them on a per- manent basis, I order the product for them from the ven- The evolution of this program has been remarkable, and I look forward to growing the program and to sharing this best practice with as many people as possible.
  26. 26. 26 Interface www.asse.org 2011 Safety 2011 included record attendance and special events to celebrate ASSE’s 100th anniversary. The Ergonomics Practice Specialty (EPS) held its annual face-to-face meeting and also sponsored three sessions. EPS leadership attended the biannual Council on Practices Standards meeting where growth and technological engage- ment were discussed and the Health Wellness Branch was approved. EPS vol- unteers also helped answer questions at the Practice Specialties booth where free practice specialties were raffled off, com- plimentary newsletters were available for all 28 groups and mouse pads were given out. Click here for our blog recap of what happened in Chicago at our biggest and best conference yet! Click here to order CD or MP3 audio recordings from Safety 2011 conference sessions. If you were unable to make it to Safety 2011, please mark your calendar now for Safety 2012 in Denver, CO, June 3-6, 2012. x Safety 2011 Recap
  27. 27. P R E S E N SP R E S E N S TT LAS VEGAS, NEVADA60 seminars and workshops on essential SHE topics Earn up to 5.0 CEUs in one week Network with experts and peers Sponsored by www.SeminarFest.org January 29-February 4, 2012

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