A detailed presentation showing the risk factors of desk work, the cause for development of musculoskeletal disorders (MSDs) or Repetitive Stress Injuries (RSIs) and the role of ergonomics in prevention and management of the same. The rationale to inculcate office ergonomics to save the incidental and non incidental costs plus to improve efficiency. Desk work is the cause for most physical ailments experienced by the worker and it is beyond the physical aches and pains. The symptoms of indigestion, difficulty in breathing, obesity, cramps on and off, pelvic problems or any symptom than is not diagnosed can all be attributed to various dimensions of desk work and primarily sitting.

1. Office Ergonomics
Creating Education of the Aches and Pains
And Awareness Regarding Solutions
Dr. Utpal Sheth
Musculoskeletal Physiatrist and Orthopaedic Consultant

2. Optimum Way of Working

3. What does a office have?

4. The Best Available Ergonomic Chair

7. Survey!!!!!
• How many of you are using a desk top? Laptop?
• How many of you consciously make an effort to work in the optimal
posture as shown?
• How many of you have heard, read &/or are educated about
ergonomics and Repetitive Stress Injuries/Musculoskeletal Disorder’s?

9. Survey
• How many of you have ben diagnosed to be suffering from any of the
previously illustrated conditions?
• How many feel or are informed that this conditions are due to your
working/occupation?
• How many of you attribute the aches and pains to deficiencies or
disease/condition?

11. Why are we having this talk?

12. Musculoskeletal Disorders (MSD's)
• As the name suggests it primarily is a problem that involves the
muscles and there is a secondary influence of the affected muscles
(with its tendons) on the joints/nerves/vessels.
• Why muscles? All the actions performed by a human being is
undertaken at the joints BUT by the muscles.
• Fingers moving
• Holding the mouse
• Sitting upright (active sitting) or sitting cross-legged
• Walking/Running

13. • The muscles tend to become
stiffer (that is the flexibility
reduces). With reduction in
flexibility the available range of
movement of the concerned
joint/spinal segment
progressively reduces.
• Thus, when that joint/spinal
segment requires to move
beyond the available range, it
leads to injury, pain & reduction
in function.

14. Musculoskeletal Disorders
• Complaints: May involve one or more body parts
• discomfort
• pain
• fatigue
• swelling
• stiffness with reducing range of movement of corresponding joint
• numbness and tingling of the fingers (outer 3 or inner 2)
• NOT DUE TO DEFICIENCY OR DISEASE.

15. Musculoskeletal Disorders
• DUE TO MECHANICAL OVERLOAD i.e.
• REDUCTION IN TOLERANCE CAPACITY OF THE PART TO PERFORM THE
TASK THAT ONE WANTS IT TO PERFORM AND BODY’S WAY OF
INFORMING THE SAME BY GIVING ONE EXPERIENCE OF
DISCOMFORT/PAIN/STIFFNESS/SWELLING.
• THERE IS A COMPONENT OF MUSCULAR IMBALANCES ACROSS THAT
AREA WHERE THERE ARE PAIRS OF TIGHT/STRETCHED MUSCLES
WHICH ARE WEAKER IN BOTH THIS STATES.

16. What
influences
how does one
work
properly?
• User: height and body frame are
significant
• Chair: the height, depth, arm rests
height/width
• Working Table, Work Conditions
• Individual working habits & fitness
status
• Office environment

17. Risk Factors for MSD's
• Awkward postures
• Static loading
• Repetitive movements
• Pressure/Force applied
• Vibration
• In every individual there are
always more than one risk
factors functioning
simultaneously.

19. Awkward Postures

20. Awkward Postures

22. Static Loading

23. Repetitive Movements

24. Mechanical contact stress

26. Staging of Symptoms of MSD’s : EARLY
• The body part aches and one feels tired at work, but
symptoms disappear during the time away from work.
• The injury does not usually interfere with the ability to
work and will completely heal if dealt with properly at
this early stage.

27. Staging of Symptoms of MSD’s : Intermediate
• The injured area aches and feels weak soon after the
start of work, until well after work has ended.
• The injury will still heal completely if treated promptly

28. Staging of Symptoms of MSD’s : Advanced
• The injured area aches and feels weak even at rest.
• Sleep may be affected.
• Even light duties and everyday tasks become difficult
to perform.
• The extent of healing at this stage varies considerably.

29. The frequency of reported musculoskeletal symptoms in
different body regions among workers (n = 101).
The effect of musculoskeletal problems on fatigue and productivity of office personnel: a cross-
sectional study. Journal of Prev Med Hyg. 2017 Sep; 58(3): E252–E258.
Body region MSDs symptoms
No. %
Neck 42 41.6
Shoulders 41 40.6
Elbows 15 14.9
Wrists/hands 27 26.7
Upper back 31 30.7
Lower back 42 41.6
Thighs 13 12.9
Knees 36 35.6
Legs/feet 31 30.7

30. Common Sitting Habits

37. Upper and Lower Crossed Syndrome

50. Lower Limb in Desk Work
• MSD’s are believed to be affecting only the UL or Spine
• It is my strong belief and conviction (and studies to support) that
pains around the hip, legs, thighs, knee, ankle and feet in a desk
worker have their root in the way they sit.
• The adjustments that are done lead to muscular overload situations
creating a vulnerable environment which may trigger while
walking/running/sports.

54. Incidences across the world
• A study revealed that the 6-month prevalence of MSDs symptoms was 92.8% and
71.2% among Malaysian and Australian office workers, respectively [Maakip et
al.].
• A study in Iran found that the prevalence rates of MSDs symptoms in shoulders,
hands/wrists, and elbows of office workers were 18.1%, 13.9%, 5.3%,
respectively. Additionally, MSDs in shoulders, elbows, and hands/wrists were
associated with poor mental health (p < 0.001) [Alavi et al.].
• Choobineh et al. demonstrated that the prevalence rate of MSDs symptoms was
56.6% in the neck, 46.7% in wrists/hands, 44.6% in lower back, 39.2% in upper
back, 38.2% in shoulders, 34.4% in knees, 24.1% in legs/feet, 15.0% in elbows,
and 14.6% in thighs among Iranian office workers [18].

55. The Reason for MSD’s
• Mismatch between the user and the environment provided
• Lack of training to address the mismatch
• Lack of awareness on part of the employer and the employee
regarding the impact of this mismatch and the ensuing adjustments
• Lack of awareness in the healthcare regarding the impact and thus
lack of a uniform approach to the problem
• Lack of resources in the preventive health or wellness aspect. The HR
always looking out for “bakras” who would do everything for free or
subsidized as the management is not ready to spend.

57. Is providing an Ergonomic Chair enough?
• If we go and recollect all the images and if you recollect your working
habits, you will realize that you are hardly utilizing all the functions of
the chair, at most for height adjustments.
• The workstation is designed taking into consideration the average
dimensions of a user and the chair is adjusted to the same
• The height is adjusted either to match the screen or to support the
feet.

58. •Office Ergonomics is the branch of ergonomics
dealing specifically with the office environment.
•In recent years the main focus of office
ergonomics has been on computer work due
to the rapid increase in computer use in the
modern office and the associated increase in
injuries.

59. Why Ergonomics?
• Something that is ergonomic is designed for safe,
comfortable and efficient use.
• Principles of ergonomics have to be used for work and
leisure purposes as the aim is to maximize
productivity and reduce fatigue. A good design is
intuitive and easy to use.

60. Why Ergonomics?
• Factors that have an influence on the user while working:
• Design of workstation
• Design of Work
• Equipment design
• Work Organization
• Environment.
• USER: All people are different and the design of a workstation
should incorporate a high degree of adjustability such that the user
can adapt safely to it.

61. How it can be achieved?
•Work stations’ should be altered
safely and quickly as per the needs
of the anthropometry of the user.

62. How Ergonomics helps to an organization?
• Ergonomics reduces the risk of injury by adapting the work to fit the
person instead of forcing the person to adapt to the work.
• Ergonomics is also concerned with enhancing work performance, by
removing the barriers that exist in many work places that prevent
employees from performing to the best of their abilities.
• It helps people work more effectively, efficiently, and productively
at their jobs.

63. My Simple Principle
•The problem is because the users are
working by “going to the work”. The solution
is creating an environment where the “work
comes to the user”.
•Ergonomics and Discipline are the answer
for the same.

64. Benefits of Office Ergonomics
• Increased productivity
• Increased work quality
• Reduced turnover
• Reduced absenteeism
• Increased morale.
• Reduced direct and indirect medical expenses.

65. Applying Ergonomics To Your
Office Environment

66. Organization
Office
Individual
Workstation
The Individual
Worker
• Job design, Staffing
• Work Schedules
• Lighting, Noise
• Temperature, Office
design
• Furniture, Chairs,
Accessories
• Hardware, software
• UNIQUE
CHARACTERISTICS

67. The Individual Worker
• Focus of ergonomics must always be YOU, as you bring
unique characteristics with yourself for the job.
• Some of these characteristics, such as height, weight, body
structure (anthropometry) and age, cannot be changed,
while others, such as training and experience, can be
changed.

68. Worksite Analysis
• Worksite analysis is the first step in developing solutions to
potential causes of WMSD's. Causes of injury can come from
any of the different levels in your organization, and you
should therefore be as comprehensive as possible when
performing the analysis.
• There are a number of different types of analyses that you
can do as part of a worksite analysis.

69. Worksite Analysis - Task Analysis
• Look at how you are doing your job on a daily basis keeping
in mind the risk factors mentioned before.
• You are the best sources of information for your daily
activities.
• The application of ergonomic principles, workstation
equipment selection, lighting design and other worksite
elements depends on the nature of the task being done.

70. Worksite Analysis - Workstation Analysis
• Look at the physical components
of your workstation, such as
monitor and keyboard location,
work surfaces, and chair
adjustments.
• Arrange them and other
accessories such that there is
minimal exposure to risk factors.

71. Environmental Analysis
• Examine the area surrounding you, looking at factors which affect
your comfort and performance such as
• lighting and glare,
• temperature, humidity and
• noise
• Organizational Analysis
• outside your control
• can have the greatest impact on risk factors (repetition, static loading,
duration of exposure to all risk factors).

72. Setting A Ergonomic Workstation
Taking into account that
• the working table is of a fixed height,
• the ergonomic chair has height/depth/backrest/armrest
adjustments and
• a height adjustable footrest is available.

73. Chair Height
• Adjust the chair height such
that the keyboard is at the
level of the elbow.
• Keyboard on the table: chair
must slide under the table
• Keyboard tray: tray must be
pulled as near to the user so as
to type comfortably.
• The mouse must also be
accommodated in the tray.

74. Chair Depth
• Check the depth of the
seat after you are sitting
taking the back support of
the chair.
• There must be not more
or less than 2-3 finger
width between the edge
of the chair and the back
of your knee.

76. Feet Support
• After this chair height and depth
adjustment your feet must rest
horizontally in front such that
you can see your toes
• On the floor with the footwear
• Or fill the gap between the floor
and your feet kept horizontally
with a footrest.

78. Armrests
• Adjust the armrests height such
that the elbow is more or less at
a right angle and the shoulder
within 20 degrees of the body.
• The forearms must be
adequately supported
• If no armrest, then the chair
must go under the table

79. Monitor
• Adjust the screen height such that
the upper third of the screen is at
your eye level and the screen is
directly in front of you.
• The screen should be roughly at an
arm length distance of the user.
• If using two screens then the main
screen must be in front
• If both screens are main then they
must be kept in a V shape with the
apex in centre

81. Laptop Ergonomics

82. Simple ways to make a Laptop More Ergonomic.
The key is to separate the
keyboard/mouse and the
monitor so each can be
placed at the proper height

85. Implementing Solutions
Stretching and Rest Breaks

86. Change postures frequently
• Regardless of how good your posture may be, sitting
still for long periods of time isn't healthy. You should
make small adjustments to your posture about every 15
minutes, by changing the height of your chair slightly, or
leaning back a little further into the backrest.
• Larger changes in posture are also important; stand up
and stretch or walk around for one or two minutes
every hour.

87. Involuntary Stretches

88. Do simple stretching exercises at Regular
Intervals.
This will help prevent you from feeling stiff.

89. Do simple stretching exercises at Regular
Intervals.
This will help prevent you from feeling stiff.

90. Do simple stretching exercises at Regular
Intervals.
This will help prevent you from feeling stiff.

92. Stand up every half hour to walk around a bit
• This will ensure continuous blood
circulation in your arms and legs, and will
keep them from getting too strained.
• Take walks to the water station to refill
your glass
• If you can afford to take longer breaks,
take a short walk outside your building,
• Use the stairs instead of the elevator to
go down (if no knee pain).

93. How to prevent MSD’s?
• The key to MSD prevention is to systematically reduce
all risk factors that contribute to MSDs.
• A comprehensive approach that reduces ergonomic
risk factors and individual risk factors is required for a
prevention strategy that works.

94. Prevention Strategy for an Organization
1. An Ergonomics Improvement Process
2. Employee Education & Training
3. A Proactive Early Intervention Strategy
4. Regular Evaluation & Continuous Improvement
5. Establishing a Culture of Safety & Wellness for All People

96. Prevention Strategy - Early Intervention
• The employee will be consulted on the following injury prevention
tools and techniques:
• Preventive warm-up exercise
• Proper body mechanics & Proper lifting techniques
• Identification of ergonomics improvement opportunities
• Preventive counteractive stretching exercises
• Proper resting/sleeping posture
• Strengthening exercises
• Fatigue recovery and sleep
• Proper nutrition and hydration/Good health habits
• Personal fitness and wellness

97. Prevention Strategy - Early Intervention
• Early Reporting is Key
• The earlier an employee reports his or her fatigue and discomfort, the better
the chances are of reversing the causative risk factors and preventing the
injury by using the self-care tools and techniques listed above.
• Consultations must be done with a professional who is aware about
the risk factors of computer work, can identify the causes for the risk
factors and provide solutions.

98. The Way Ahead! Ergonomics Program
• Education of the employee & increasing awareness with
periodic analysis and evaluation
• Workshops and seminars on regular basis to inculcate
discipline and encourage early identification and reporting of
problems.
• Facilities for on-site consultation
• Continuous ergonomic improvement process

100. On Site Clinics
• Conducted by a consultant who can identify the early symptoms, correlate
to the work, identify the risk factors, the cause for risk factors, suggest
solutions and undertake regular evaluations.
• Weekly or Bimonthly depending on the number of employees in the
organization.
• Will encourage employees for early reporting of symptoms, thus
decreasing the risk of injury development and saving on expenses.
• Uniform treatment available to all employees, avoiding discrepancy in
symptom management and costs.

101. Benefits of an Ergonomic program

102. Importance of Employee Engagement

104. THANK YOU