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Maine Safety Conference presentation 2011
This document discusses ergonomics and employee behavior change. It outlines 10 essential elements: understanding the 3 elements of ergonomics (work, worker, worksite); recognizing risk factors that can be changed; understanding the behavior change process; setting employees up for success through education and support; and teaching proper techniques like lifting, flexibility, exercises, workstation setup, pacing, and wellness. The goal is to help employees adopt new habits to prevent injuries through awareness, commitment to change, and consistent practice of safe behaviors.
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Maine Safety Conference presentation 2011
- 1. Denise Dumont- Bernier,PT, Director Workplace Health & MGMC Express Care Ergonomics & Employee Behavior Change How To Teach An “Old Dog” New Tricks
- 2. Today’s Objectives What arethe 3 essential ergonomics elements? Reducing risk factors- what can be changed? Understand behavior change process Set employees up for success Teaching the “old dogs” new tricks Summary
- 3. 3 Essential ErgonomicsElements Work Worker Worksite
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- 8. Stretching and Pacing at Work WorkerAttributes- Preferences
- 9. Reducing Risk Factors- WhatCan Be Changed? Fitness Extreme Temperatures Fitness
- 10. Heart Disease RiskFactors
- 11. What can bechanged to reduce risks? Work Worker Worksite
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- 13. Understand Readiness toChange
- 14. Personalized, Behavior Change Onesize does not fit all
- 15. Steps To Changing Awareness ●Recognizing the benefits and negative affects of not changing Wanting to Change ● Accepting that change is important Making a Commitment Consistent Actions (conscious effort) Perseverance (unconscious effort)
- 16. Setting Employees UpFor Success Helping them to take better care of themselves at work Whose responsibility is it?
- 17. Step 1: RaiseAwareness and Educate Define the problem: “WHAT?” ● Ergonomic injuries, safety, costs, pain, etc Answer the question of “WHY?” ● Personal well-being ● Business need Then define “How?” ● Safety training ● Policy ● Behavior Change “We’re going to help and support you”
- 18. Step 2: ResolveAmbivalence Specific Tools- MI Motivational interviewing (MI) ● Client-centered counseling that explores and resolves ambivalence Pros & cons exercise Assess importance and confidence ● Should I? and Could I? Looking back/looking forward Exploring goals “right sized steps”
- 19. Step 3: TakeAction Set clear expectations Emphasize “why” it’s important Begin practicing (conscious effort) Positive reinforcements- messaging ● If wrong behaviors are observed, just remind them that you liked what you saw earlier when they were doing__X___ ● Don’t say: “I need to STOP lifting with my back” ● Say: “ I need to START lifting with my legs” Work on consistency ● Consider carrots rather than sticks ● Provide prompts
- 20. Teaching The “OldDogs” Understanding of how ergonomic injuries occur How to prevent injuries Personal responsibility
- 21. Prevention of Ergonomic Injuries Posture/ Positions Prevention exercises Workstation set up ● Worker choices Pacing Listen to your body Practice
- 22. Respect Warning signs Fatigue or lack of endurance Weakness in hands or forearms Tingling, numbness, or lack of sensation Frequent self massage Clumsiness Stiffness Pain
- 23. Understanding FatigueFatigue Blood Flowto Tissues At Rest Dynamic Work Static Work Blood Flow Demands Blood Flow Supplied
- 24. Understanding the Mechanism ofInjury Ischemia of tissues (not enough blood) Microscopic disruption Inflammation Muscle spasm Pain
- 25. Localized Muscle Fatigue Intensity of effort Duration of exertion Rest intervals Concentric or static work
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- 27. Common Causes ofBack Injuries Heavy Lifting Sitting or Standing Awkward Postures Carrying & Lifting Twisting Reaching & Lifting Slips, Trips & Falls
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- 29. Stages Of DiscHerniation
- 30. The Nerve Roots/ The Spinal Cord
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- 35. First New Trick:Hamstring Flexibility
- 36. Common Causes ofBack Injuries Twisting
- 37. Common Causes ofBack Injuries Lifting or carrying awkward or odd shapes . . . .
- 38. Common Causes ofBack Injuries Reaching and lifting . . .
- 39. Common Causes ofBack Injuries Awkward, uncomfortable positions . . .
- 40. Common Causes ofBack Injuries Prolonged Sitting or Standing
- 41. Common Causes ofBack Injuries Tripping, slipping and Falling….
- 42. “New Trick #2: Proper Lifting
- 43. New Trick #3: Improve Flexibility Stretch Programs At Work
- 44. ● Wall Squats Stand with back leaning against wall Walk feet 12 inches in front of body. Keep abdominal muscles tight while slowly bending both knees 45 degrees. Hold 5 seconds. Slowly return to upright position. Repeat at least 5 to 10 times. New Trick # 4: Exercises To Help Strengthen Your Back and Legs
- 45. New Trick #5:VDT Checklists
- 46. Chair Height Low backflexion Normal Lordosis
- 47. Back Rest Adjustments NeckFlexion Balanced neck
- 48. Personal Choices ToPrevent Back Injuries Use proper lifting techniques Proper physical condition for work ● Flexibility, strength, endurance Workstation set up ● Chair height, standing foot rests Frequent change of positions ● From static work ● From awkward or confined spaces
- 49. Ergonomic Upper Extremity& Neck Injuries
- 50. Repetitive Motions CarpalTunnel Syndrome
- 51. Elbow Tendonitis Lateral Epicondylitis(Tennis Elbow)
- 52. Awkward Joint Positions andPostures Risk factors for Tendonitis and Carpal Tunnel Syndrome Pinch maneuvers Forceful grip Awkward wrist positions Repetitive finger movements
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- 55. New Trick #7:Reduce Excessive Forces Writing Mouse Keyboards
- 56. Neck & ShoulderStrain
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- 58. Strong Lower Traps& Good Posture! Upper and Lower Trapezius Muscles
- 59. Choice: Avoid Extended& Overhead Reach
- 60. New Trick #8:Learn To Use Lower Traps Proper Posture Strengthening
- 61. Awkward Joint Positions NeckStrain Document holders Phone Posture
- 62. # 9: PacingWork, Changing Positions Outlook Pop-up Reminders
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- 64. #10: Implement Wellness WhyWellness? ● Prevalence of chronic conditions is growing ● Inactivity and obesity contributes to chronic diseases ● Our workforce is aging ● Poor health costs more ● Employers can make a difference
- 65. The Real Problem: TheFull Cost of Employee Poor Health Personal care costs Medical Care Pharmacy 25% Productivity costs 75% STD LTD Overtime Turnover Temporary staffing Administrative costs Replacement training Off-site travel for care Customer dissatisfaction Variable product quality Absenteeism Presenteeism Medical & Pharmacy Costs $3,376 PEPY Health-related Productivity Costs $10,128 PEPY Total: $13, 504 PEPY Sources: Edington DW, Burton WN. Health and Productivity. In McCunney RJ, Editor. A Practical Approach to Occupational and Environmental Medicine. 3rd edition. Philadelphia, PA. Lippincott, Williams and Wilkens; 2003: 40-152. Loeppke, et.al., JOEM, 2003; 45:349-359 and Brady, et.al., JOEM, 1997; 39:224-231
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- 67. Ergonomics Is An InexactScience
- 68. In summary Work, worker,worksite Behavior change is not easy Get to the “why?” (education) Practice makes perfect (well almost) Include fitness and wellness Model and reward safe behaviors
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Editor's Notes
- #14 Pre- Who me? No intention of changing in foreseeable future Cont-Aware but not ready, weighing pro’s and cons Prep-intention to take action, sets a goal and plans Action-modifies behavior, experiences and environment to change problem Maintenance- relapse prevention, chooses effective support systems
- #28 Lifting: Lifting or carrying objects with awkward or odd shapes . . . In addition, Reaching and lifting . . . over your head, across a table, or out the back of a truck . . . Twisting: Twisting at the waist while lifting or holding a heavy load . . . This frequently happens when using a shovel. Carrying: Make sure you can see Take small, stable steps Do not twist your back
- #29 Discussion: Each disc is a circular pad filled with a gelatin type substance, that is under constant pressure. The disc acts like a shock absorber between the vertebrae and allows for the smooth segmental movement that occurs when you move. You may have a relative or you may have been told that you have arthritis, degenerative joint disease or a narrowing of the joint spaces in your spine, this is due to the compression of the discs over time and the loss of volume or fluid that they contain. You can see that as you bend and extend your back part of the disc is compressed while the other part is stretched. This is why therapists are always emphasizing the maintenance of your curves and keeping your back straight while you lift. You can see if you constantly bend and twist without maintaining a neutral spine, then the wear and tear on your disc becomes more and more of an issue and the joint spaces begin to approximate or touch one another, causing wear and tear on the joint surfaces.
- #37 Discussion: When you twist in the flexed position, you are essentially winding up your spine; (demonstrate with spine model or with a towel the compressive forces). In this position, compressive forces in the discs along with the stretching that occurs on the other structures is extremely dangerous. You need to look at your work station and assess how you can reduce or eliminate the need to twist during your day.
- #38 Discussion: Awkward or odd shaped objects are difficult to lift and carry typically because it is so hard to get close to them. Again, you must assess your situation, use assistive devices, like a cart or dolly or ask for help.
- #39 Discussion: What can you do to your work environment to eliminate or reduce excessive reaching. Ask yourself, do you really need to stack the objects that high? Should you use a step stool? How do you have the objects situated? Heaviest at waist level, lightest on top and those items not routinely moved down low.
- #40 Discussion: When I look at job during my onsite analysis, I ask myself, “would I do that job that way?”, and “how can I make that job more comfortable” These are the questions that you must ask yourself. Everyone has a comfort zone in which they should work, if you feel like you are moving outside of what is comfortable for you, you must stop and assess the situation, typically you can come up with a solution to improve the work postures. Go over the pictures with the audience, get their feedback; discuss the significance of the postures in terms of cervical compression and lumbar extension; weight bearing through the knee caps, etc.
- #41 Discussion: What position is harder on the spine? (discuss the difference in sitting and standing and the compressive spinal forces that occur in the spine). You need to try and alternate between the two positions if at all possible (this should be reviewed in terms of the work behaviors observed). If you have a job that requires you to sit most of the day, then you must make sure that the chair is fitting you correctly and that it is adjusted properly. In addition, you must make it a habit to get up out of your chair every 45 – 60 minutes and perform some type of stretching activity. Even if it is to just bend backwards a few times, do some laps of the cubicle and some shoulder rolls (demonstrate), this will improve the blood flow to the spine and lower extremities and ultimately change and improve the spinal compression. Typically, if you have a job that requires you to stand most of the day, you can change your position readily, by raising one foot onto a ledge/platform or leaning against a surface intermittently, all of which helps to maintain the vascular supply and reduce the compressive forces occurring in the spine. It is also important for those that stand for prolonged periods to stretch those muscles being used most often, like the calves and hamstrings.
- #42 Discussion: You’ve seen the saying, “Safety is No Accident”. You have to make yourself aware of your environment and the areas that may potentially impact your day. If you work in an environment that has wet, slippery floors, make sure that you have good rubber soled shoes that will grip to the floor. If you work in an environment that is cold, such as a freezer, make sure you take the time to put on the correct clothing and protective gear….do not be in such a hurry, take your time to assess the situation, use good work decisions and get the task done correctly and ultimately safely.
- #45 Discussion: When you are performing your exercises, you need to be able to breath with minimal effort throughout the routine. Do not hold your breath, you muscles need the oxygen that your lungs and heart are supplying. Each exercise should be demonstrated with group participation. Again, these exercises should be based on the jobs observed and should be changed in the presentation to match the appropriate muscle groups.