Musculoskeletal disorders among hospital staff

1. Work Station Evaluation And Proper
Ergonomics
Dr. Kanagalakshmi, MD (Com. Medicine)
Staff Student Health Services
Christian Medical College, Vellore

2. Outline
• Ergonomics
• Components of ergonomics
• Good working posture
• Evaluation of workstation
• Our experience
• Summary

3. Ergonomics
• Ergonomics is the science of designing a safe, comfortable
and productive workplace
• Matching the job to the worker and the product to the
user.

4. Components Of Ergonomics
• Physical ergonomics
• Cognitive ergonomics
• Organizational ergonomics

5. Physical Ergonomics
• Physical ergonomics is the
human body’s responses to
physical and physiological
work loads.
• Includes repetitive strain
injuries from repetition,
vibration, force, and posture

6. Cognitive Ergonomics
• Cognitive ergonomics deals
with the mental processes
and human capacities when
at work.
• The application
of psycology to work.
• Includes mental strain from
workload, decision making,
human error, and training.

7. Organizational Ergonomics
• Organizational ergonomics
deals with the organizational
structures, policies and
processes in the work
environment
• Includes team work,
motivation, job satisfaction,
shift work, scheduling and
ethics

8. Benefits of Ergonomics
• Decreased injury risk
• Decreased mistakes
• Decreased lost work day
• Increased productivity
• Increased efficiency
• Improved morale

9. Ergonomic Risk Factors
• Forceful exertions
• Awkward work postures
• Repetitive motions
• Prolonged activities
• Localized contact stresses
• Segmental vibration
• Temperature extremes.

10. Principles Of Ergonomics
• Maintain the ‘S’ curve

11. Principles Of Ergonomics
• Keep everything in easy reach

12. Principles Of Ergonomics
• Work at proper heights

13. Principles Of Ergonomics
• Reduce excessive force

14. Principles Of Ergonomics
• Minimize static and fatigue load

15. Principles Of Ergonomics
• Minimize pressure points

16. Principles Of Ergonomics
• Reduce excessive motion

17. Principles Of Ergonomics
• Provide clearance

18. Principles Of Ergonomics
• Move, stretch and exercise

19. Posture

20. Seating

21. Monitor And Keyboard

22. Accessories at workstation

23. Bad Posture

24. Good Posture In Laboratory

25. Ergonomics In Pipette
• Maintain straight wrists
• Always have a relaxed but firm grip on the pipette
• Keep elbows and your body close to your work
• For every 15 minutes of pipette work, take a 2 minute
break

26. Evaluation Methods
Observation and scoring
• Rapid Entire Body Assessment (REBA)
• HSE upper limb risk assessment (posture, repetition, vibration,
force)
• NIOSH lifting equation - Risk of low back disorders with repeated
lifting
• PLIBEL- A method assigned for identification of ergonomic hazard
• Quick Exposure Check (QEC)
• Occupation safety and health administration(OSHA ) computer
workstation checklist
Computerised software analysis
• Ovako Working posture Assessment System(OWAS) posture, load
and force
• PATH (Posture, Activity, Tool and Handling)
• Ergonomic analysis (ERGAN) only posture

27. Our Experience
• Study was conducted to find the prevalence of neck pain
and potential risk factors associated with severe work
related neck pain.
• Study was done among the permanent staff in the support
services including technicians in all the departments,
pharmacist, medical records and computer terminal
operators, clerical and administrative staff.

28. Methodology
• 600 staff were selected randomly and screened for neck
pain using self administered questionnaire
• 206 staff who reported to have neck pain within the last
3 months were invited to participate in evaluation of
neck pain in detail addressing the duration, etiology and
severity of neck pain.

29. Study Tools
Case control:
- Questionnaire
- OSHA checklist for work station
- ICMR psychosocial stress scale

30. Prevalence Of Neck Pain
Neck pain –
350, 63%
162, 29 %
44, 8%
Neck pain +
206, 37%
Work Related Neck Pain
n=558
Neck pain in last 3
months
Severe work related neck
pain

31. Characteristics Of Pain
n=206
168
81.6%
61
29.6%
147
71.4%
152
72.8%
169
82%
178
86.4%
38 37 28
59 54
145
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Attributed
pain due to
work
No pain at
start of
work
Pain at end
of work
No neck
pain when
out of work
Relieved on
rest for 48
hrs
Leave on
account of
neck pain
No
Yes

32. Risk Factors
• 44 (7.8 %) met the criteria set in this study for
severe work related neck pain.
• 43 staff with severe work related neck pain and
124 staff with no neck pain were selected for
case control study.

33. Significant Risk Factors For Severe
Work Related Neck Pain
• Female gender
• Being overweight or obese
• Working for more than 3 hours a day with
computer
• Lacking job control (control over how a job is
performed)
• Job demand (Perceived increased workload)
• Uncomfortable physical work environment
• Job requiring repetitive movements
• Bad work posture

34. Significant Risk Factors For Severe
Work Related Neck Pain
• Being overweight or obese
• Working for more than 3 hours a day with
computer
• Lacking job control (control over how a job is
performed)
• Job demand (Perceived increased workload)
• Uncomfortable physical work environment
• Job requiring repetitive movements
• Bad work posture

35. Prevention Program
• Preventive program for work related neck pain will be
focused on training on good work posture and serial
monitoring on posture.
• Frequent micro breaks in between the work time.
• Efforts to increase job control to the staff in planning their
work.
• Motivation program to maintain normal BMI

36. To summarise….

37. References
• Office ergonomics. A practical solution for a safer workplace. WISHA
Services Division, Washington State Department of Labor and
Industries
• Geoffrey David, Ergonomic methods for assessing exposure to risk
factors for work-related musculoskeletal disorders, Occupational
Medicine 2005;55:190–199
• OSHA Ergonomic Solutions: Computer Workstations e-Tool -
Workstation Environment

38. Thank You