Each year, employees
miss work and potential wages due to work-related musculoskeletal disorders (MSDs).
According to the Bureau of Labor Statistic (BLS), 335,390 American workers
experienced MSDs serious enough to require time off work in 2007.
In fact, injuries to
the muscles and skeleton are among the most common lost time illnesses and
injuries in virtually every industry.
Musculoskeletal disorders
occur when there is a mismatch between what your job requires you to do and
what your body is capable of doing. MSDs can affect worker in job activities
across many diverse workplaces and tasks.
The Institute of
Medicine estimates that the economic burden of MSDs in the workplace, as
measured by compensation costs, lost wages, and lost productivity, are between
$45 and $54 billion annually. Historically, overexertion, one form of MSDs, is
the number one cause of workplace injury.
In 2007, there were 1,2
million MSD cases requiring days away from work in private industry out of 4
million total recordable cases. Of these, 335, 390 cases required an average of
nine days away from work, two more days than the average for all days away from
work cases.
Because of statistics like
these, ergonomics has become an important and serious issue for industry.
The term “ergonomic” is
derived from two Greek words: “erg” meaning work and “nomas” meaning natural
laws.
Basically, ergonomics
is the science of adjusting job conditions, equipment, and tasks to match the
body’s natural ways of functioning.
The goal of ergonomics
is to prevent illness and injury, assure high productivity, and promote
satisfaction in the workplace.
In the absence of a
federal ergonomics standard, the Occupational Safety and Health Administration
(OSHA) has addressed ergonomics in the workplace under the authority of section
5 (a)(1) of the Occupational Safety and Health Act.
This section is
referred to as the General Duty Clause and requires employers to provide work
and a work environment free from recognized hazards.
Many employers have
realized that the implementation of an ergonomics program is in their best
interest for the reduction of injuries and illnesses.
An ergonomics program
addresses some basic elements such as employers and employee responsibilities,
hazards identification and information, job hazard analysis and control, training,
medical management, records, and programs evaluation.
Your company’s
ergonomics programs is designed to help keep you healthy, productive and
motivated while making your working life as enjoyable as possible.
Your company can
express its commitment in a variety of ways. These include holding employee
meeting to discuss ergonomics operational goals and priorities that are firm,
achievable, and in line with cost reduction, productivity, and quality
initiatives.
In addition, your
employer may commit resources to training, administrative needs, expertise, and
ergonomics improvements or issue policy statements that define support and cooperation
from management, supervision, and employees.
Musculoskeletal Disorders
(MSDs) definitions: Are disorders of the muscles, ligaments, tendons,
cartilage, joints, nerves, or spinal discs that have been diagnosed by physical
exam, medical history, or specific medical test.
They typically result
from gradual or chronic development, as opposed to an acute event or injury
caused by, for example, a slip or fall. MSDs like carpal tunnel syndrome have
very distinct signs and symptoms. Other disorders, such as lower back pain, are
simply defined by the location of the pain.
To better understand
ergonomics, you should be familiar with the major parts of the musculoskeletal
system:
Ø Bones:
Provide structural support and are connected to one another at joints, which
allow movement between body segments.
Ø Muscles:
Contract and shorten, causing movement, just contract to provide stability. The
respiratory and circulatory systems supply nutrients and oxygen necessary for movement
of muscles.
Ø Ligaments
and tendons: ligaments connect bone to bone and provide stability at the
joints, while tendons attach muscle to the bone.
Ø Cartilage:
Provides the joints with low friction surface that help with movement.
Ergonomics Awareness
Recognizing the early
signs and symptoms of injuries to the muscles and skeleton and reporting them
as soon as possible is very important. A health care provider (HCP) can observe
the signs. Symptoms, however, are subjective and a patient needs to report them
to HCP.
Signs of injury to the
muscles and skeleton include redness or loss of color, swelling, loss of
function, deformity such as a lump, decreased range of motion, and decreased
grip strength.
Symptoms are your body’s
way of warning you that you may be developing an injury. Symptoms of injury to
the muscles and skeleton can vary in severity, depending on the amount of your
exposure.
Eventually the symptoms
become more severe as exposure continues and will appear even after rest. The pain
may increase to a point where it becomes difficult to perform your work or even
to a point where you are unable to perform any physical work activities.
Examples of symptoms of
injury to the muscles and skeleton include numbness, burning, tingling, aching,
pain or soreness, stiffness, and cramping.
Early reporting is
vital in preventing or minimizing injury to the muscles and skeleton. As an
employee, you must feel free to report any signs or symptoms of physical discomfort
as soon as possible to your supervisor or other personnel, such as a plant
nurse or HCP.
Employers can also
gather information by conducting symptoms surveys and interviews.
Risk Factors
The OSHA has identified
a high rate of injury among workers in various industries. It is impossible to
determine the exact weight lifted or the number of repetition that will either
cause or prevent injury.
However, establishing a
systematic approach to address such issues as repetition, excessive force,
awkward posture, and heavy lifting reduces the chance that you may ne injured.
Identifying risk
factors in the workplace, before injuries to the muscle and skeleton are
discovered, is an important step in keeping you healthy.
Your employer can use
several methods to detect risk factors, such as interviews with workers and
supervisors, and walk-through observations of the workplace.
A more formal approach
would be to use a standardized checklist to evaluate job tasks against risk
factors.
There are many
different types of risk factors for injuries to the muscle and skeleton, some
of which are not entirely work-related.
Risk factors for
work-related musculoskeletal disorders are cumulative and can include off-work
activities as well. Physical limitations, previous injuries, or existing health
problems can contribute to increased risk.
It is often difficult
to determine the impact that work activities versus non-work activities (sport
or medical conditions such as rheumatoid arthritis, diabetes, and thyroid
conditions) have on the disorder.
For example, in the
general population, non-work causes of lower back pain are probably more common
than workplace causes.
When jobs have risk
factors in combinations and high levels, the risk of developing a
musculoskeletal disorder will increase. The level of risk also depends on the
intensity, frequency, and duration of exposure. Examples of risk factors
include repetitive, forceful, or prolonged exertion and pushing, pulling, or
carrying heavy objects.
Risk factors (Actions)
·
Repetitive, forceful, or prolonged
exertion
·
Frequent or heavy lifting
·
Pushing, pulling, or carrying of heavy
objects
·
Prolonged awkward postures
·
Work in the cold
·
Insufficient pauses and rest breaks for
recovery
Risk factors
(Conditions)
·
Contact stresses
·
Machine-paced work
·
Stress
·
Unfamiliar or unaccustomed work
·
Vibration
Gathering data is a
vital step toward the identification of a problem. Checklists can be used to
provide the initial identification of a job or task which may put a worker at
risk for developing an injury to the muscles or skeleton.
It is important to
understand that the checklist findings must be viewed as a whole to determine
if the individual problems suggest the same underlying root cause.
Control Methods
Many employers provide
engineering controls, such as lift-assist equipment, that go unused or
under-used as the employees hurry to complete their tasks.
Engineering controls
reduce or eliminate the condition by modifying or redesigning workstations,
environmental conditions, tools and equipment, processes, or materials.
For instance, a
situation was reviewed in the electrical industry, where tasks included
hammering, crimping, wrapping, winding, soldering, painting, and various
electric motor assemble operations.
Problem: risk factor
involved in these types of tasks included repetitive and forceful exertions,
awkward postures, and contact stress. Workers were found to suffer from upper
limb and neck illnesses and injuries.
Solutions: included raised
standing surfaces, a modified mallet handle, and low force clamps. Job rotation,
training programs, and early reporting were also needed.
Workstation should be
adjustable to fit your body. Furniture and equipment should be positioned to
prevent excessive twisting, reaching, and leaning.
Eyes: Computer monitors
should be placed so that the top of the screen is just below eye level.
Arms and back: Chair
should have adjustable armrests to take the load off your neck and shoulders.
Chair should have back rests that fit your back.
Knees and feet: Chair
should ne adjustable to allow your knees to be bent at a right angle. Chair should
be adjustable to allow your feet to rest flat on the floor. Footrest may be
used.
When your finger are on
the keyboard, your wrist should be straight in a neutral position with the
upper arm vertical and the forearm at a 90 degree angle to the upper arm.
Your shoulders should
be relaxed and your elbows close to your sides. Reclining and reaching should
also be avoided.
When using the mouse,
you should be able to maintain the correct arm and wrist position. The mouse
should be at the same levels as the keyboard and the same distance from your
body as the keyboard.
Administrative controls
are changes in the workplace that adjust work practices, procedures, and
management policies.
Specific examples
include rest breaks, alternative tasks, slower work pace, redesign of work
methods, and employee rotation.
Consider his example of
an office work setting. Management reviewed an office environment that involved
primarily data entry and tasks involving video display units.
Problems: risk factors
identified from these tasks included repetitive exertions, awkward postures,
glare, and poor illumination. Personnel experienced problems with upper limbs,
neck, back, and eyestrain.
Solutions: included
reduction glare and improving workstation design. A vision test program and a
rest break schedule where also suggested.
You would use personal
protective equipment (PPE), such as gloves, to reduce vibration and prevent
injury.
Always use engineering
control s first if possible, followed by administrative controls. Use PPE only
as a last resort.
Studies show that
wearing a back belt does not reduce injury rates or the number of lost work
days. However, wearing a back belt and having training on lifting techniques
may reduce lost work days for people who have had lower back pain in the past.
Because musculoskeletal
disorders involving the back are among the most costly occupational injuries,
it is important to review back safety and some basic techniques for prevention
of back injuries.
These techniques
include good posture, proper lifting, and the practice of basic exercises, such
as stretching.
To evaluate your
posture, stand with your back against a doorframe and slip your hand between
the doorframe and the small of your back. Your hand should slide in easily and
slightly touch your back and the doorframe.
When possible, plan
jobs to avoid unnecessary lifting. Improper lifting, especially when combined
with twisting, is the most common way to injure your back.
Correct posture: Place
feet firmly apart with one foot forward for stability. Bend at the knees (not
at the waist) and keep your back as close to vertical as possible.
Incorrect posture: two
of the most common mistake made when lifting are bending at the waist instead
of the knees and holding the load too far out in front of you.
When lifting, tighten
your stomach muscle as soon as you lift to support your spine, breathing out as
you lift. Do not hold your breath.
Remember t use your leg
muscles instead of your back muscle to lift the load. Do not twist your body
while lifting and keep the load close to your body as you lift.
The best path to a
healthy back is to control your weight, exercise, and reduce back stress caused
by lifting or poor posture.
Excessive upper body
weight such as potbelly contributes to poor back posture and back pain because
of the added stress placed on the components of the back.
A regular exercise
program that includes flexibility and strengthening exercises can help prevent
injury or re-injury to your back. Consult your healthcare provider before
beginning an exercise program.
Remember to report
signs, symptoms, and hazards of MSDs and make recommendations on appropriate
ways to control them. Ways to make these recommendations include e-mail,
letters, and notes to your supervisor.
Recommendations can
also be made verbally through an employee representative or by serving on health
and safety committees. Always follow applicable workplace procedures and safety
and health rule.
Summary:
Employers are not the
only ones with specific responsibilities. You, as an employee, have an
important role also.
Your responsibilities include:
v Recognizing
the signs and symptoms of MSDs and the value of reporting them early
v Identifying
MSD hazards in your job
v Knowing
how to use and evaluate the control measures your employers implements, and
v Working
in ways that will reduce the risks in your job
Por Verónica Franco 
