EST 8003: Awareness Level Training for Small Business Owners and Managers on the Recognition

EST 8003: Awareness Level Training for Small Business Owners and Managers on the Recognition and Control of Work-related Musculoskeletal Disorders

Funding Provided by: DOL-OSHA and the Georgia Tech Research Institute’s OSHA Consultation Program

Consultation Staff: Paul Schlumper, CSP, PE, MSIE Damon Nix. BSIE Daniel Ortiz, CSP, MPH Purpose and Goals

The purpose of the training is to provide management and owners of small business in the state of Georgia working knowledge of workplace musculoskeletal disorders (MSDs), the risk factors and solutions, and some ready to use hazard recognition tools. This awareness level training will guide the management decision making process concerning the need for higher level task analysis and the use of additional resources outside or within the company to solve problems associated with MSDs.

At the conclusion of this training management will:

1. Be able to list the common Work-Related Musculoskeletal Disorders and Risk Factors.

2. Understand the importance of an ergonomic management system as part of their organizational culture and existing management systems.

3. Understand how to use Tier I assessment tools in their workplace.

4. Understand how to access and use ergonomic web applications.

5. Be able to make informed decisions concerning training and the need for outside help to solve their more involved problems that will require Tier II assessments.

Course Topics:

1. Introduction 2. Overview of the Basic Approaches to the Recognition, Measurement, and Control of WRMSDs 3. Analysis, Improvements, and Controls for Reducing Worker Exposure to Risk Factors Associated with WRMSDs of the back 4. Analysis, Improvements, and Controls for Reducing Worker Exposure to Risk Factors Associated with WRMSDs of the Upper Extremities 5. Ergonomic Management Systems Overview Loss Sources

Workers sprain or strain their back from over-exertion associated with lifting and pushing or pulling objects.

Workers develop Carpal Tunnel Syndrome from repeated use of their upper extremities during assembly operations. The incidence rate for Carpal Tunnel Syndrome is comparably low to back injuries. The severity is greater, however, taking an average of 28 days to recuperate.

Management Systems

An attempt was made to frame this course in well established management systems including DMAICS and 6 sigma, lean and modular manufacturing, and the more familiar safety and health management systems used by OSHA Consultation programs across the country. As part of the Consultation Annual Project Plan for FY 2011 we proposed taking a closer look at the impact of Lean Manufacturing, Continuous Improvement, and Six Sigma systems on the incidence of workplace injuries and illnesses. It is our view (or hypothesis) if safety and health concepts are not integral to the management system it might have a negative effect on the incidence of injuries and illnesses especially work related musculoskeletal disorders.

Management Systems Table

Six Sigma Safety and Health ISO 14001 Lean Georgia Tech Systems Management System OHSAS Engineering 18001

Define Hazard Recognition Plan Setting Limits Identify Team Define

Measure Hazard Control Do Identify Tasks Identify Problems

Analyze Planning Check Assessing Waste Develop Plan

Improve Administration Act Reducing Waste Prioritize Develop

Control Training Verifying Train Users

Sustain Leadership Finishing Implement

Employee Involvement Go Back To Plan Measure Deploy Control Go Back To Plan Or Proactive Surveillance Task Analysis Tools: Tier I and Tier II

There are many different approaches to task analysis for the detection of risk factors associated with musculoskeletal disorders. They range from computer models and posture tracking systems to simple job observation questionnaires and risk factor checklists.

Tier I quick assessment tools include checklists and questionnaires. Tier II assessment tools are more quantitative and involve more detailed calculations and/or computer applications as well as video registration and analysis (VIRA) of the jobs in question. VIRA provides a more detailed review of the job since the task can be observed in slow motion. High stress postures can be recorded and the amount of time and number of posture changes documented and categorized by the reviewer. With VIRA you get a more complete picture of the duration and frequency of exposure to risk factors.

A table that summarizes a literature search review of the literature on postural and task analysis techniques can be found in the last section. Jobs should be screened using Tier I assessment tools. The next level assessment should take place when:

 The problem is widespread involving different jobs and departments.  Establishing a rotation program where it is important to move between jobs that differ significantly in terms of force and body part activity (e.g., number of hand motions differ significantly).  Establishing a best practice where there are substantial methodological differences between workers performing the same task.  Establishing light duty programs as a medical intervention.  The solution is not readily apparent or effective.

Tier I Tools: Tier II Tools Checklists: Quantitative

Quick Exposure Checklist Job Safety Analysis Washington State Checklists NIOSH Work Practice Guide to Manual Lifting Stover Snook’s Psychophysical Tables for

Ovako Working Posture Analysis System (OWAS) Rapid Upper Limb Assessment (RULA) NIOSH Checklists (Publication 97-117) Rapid Entire Body Assessment (REBA) Job Strain Index

Occupational Repetitive Action Methods Video Registration and Analysis

Important Web Sites

Manual Material Handling and Upper Limb Assessment tools are available on the internet. A sample of these are listed as follows

Bureau of Labor Statistics Nonfatal Occupational Injuries and Illnesses Requiring Days Away From Work 2008 and 2009

 http://www.bls.gov/news.release/archives/osh2_12042009.pdf

 http://www.bls.gov/news.release/pdf/osh2.pdf

Musculoskeletal Disorders and Workplace Factors, NIOSH Publication No. 97-141, 1997

 http://www.cdc.gov/niosh/docs/97-141/

NIOSH Manual for the Revised Lifting Guide  http://www.cdc.gov/niosh/docs/94-110/

Rapid Entire Body Assessment (REBA) and Rapid Upper Limb Assessment (RULA) other ergonomic assessment tools:

 http://ergo.human.cornell.edu/cutools.html

 http://personal.health.usf.edu/tbernard/ergotools/index.html

Liberty Mutual psychophysical tables for assessing lift, lower, carry, push and pull tasks:

 http://libertymmhtables.libertymutual.com/CM_LMTablesWeb/pdf/LibertyMutualTables .pdf

Quick checklist assessment and other tools for the state of Washington

 http://www.lni.wa.gov/Safety/Topics/Ergonomics/ServicesResources/Tools/default.asp

The Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health Ergonomics web addresses:

 http://www.osha.gov/SLTC/ergonomics/index.html

 http://www.cdc.gov/niosh/topics/ergonomics/

Office Ergonomics  http://ergo.human.cornell.edu/CUVDTChecklist.html

 http://www.osha.gov/SLTC/etools/computerworkstations/index.html

 http://ergo.berkeley.edu/services/computer_use.php

Construction Ergonomics

 http://www.elcosh.org/

 http://www.elcosh.org/en/document/4/d000003/construction-ergonomics-checklist.html

 http://www.ohsu.edu/croetweb/links.cfm?subtopicID=350

 http://www.croetweb.com/links.cfm?subtopicID=350

 http://ergo.berkeley.edu

 http://www.dir.ca.gov/dosh/consultation.html

Vendors and Resources recommended by Ohio State

 http://ergonomics.osu.edu/resources_links.html#ergosites

References

a. Dan Petersen, “Techniques of Safety Management – A Systems Approach”, 4th Edition, ASSE Press, 2003, page 21.

b. ANSI/ISO 14001, “Environmental Management Systems”

c. Andrew P. Sage, “Introduction to Systems Engineering”. John Wiley & Sons, Inc. New York 2000.

d. ANSI B11.TR7-2007, “Designing for Safety and Lean Manufacturing”

e. American National Standards Institute. Human Factors Engineering of Computer Workstations.ANSI/HFES 100-2007. Human Factors and Ergonomic Society, Santa Monica, CA

f. Brammer A. J. and W. Taylor, eds. Vibration Effects on the Hand and Arm in Industry. New York: Wiley, 1982. g. Clarke, T. S. and E. M. Corlett. The Ergonomics of Workplace and Machines: A Design Manual. New York: Taylor & Francis, 1984. h. Eastman Kodak Company. Kodak’s Ergonomic Design for People at Work.2nd ed. Hoboken, NJ: John Wiley & Sons, Inc.2004. i. Grandjean, E., ed. Ergonomics of Computerized Offices. New York: Taylor & Francis, 1987. j. Grandjean, E. Fitting the Task to the Man: A Textbook of Occupational Ergonomics. 4th ed. New York: Taylor & Francis, 1988. k. Marras,W.S. and W. Karwowski, ed. Fundamentals and Assessment Tools for Occupational Ergonomics. 2nd ed. Boca Raton, Fl: Taylor and Francis, 2006. l. National Institute for Occupational Safety and Health. Application Manual for the Revised NIOSH Lifting Equation, NIOSH Publication Number 94-110. Cincinnati: U.S. Department of Health and Human Services, 1994. m. Musculoskeletal Disorders and Workplace Factors: A Critical Review of Epidemiologic Evidence for Work-Related Musculoskeletal Disorders of the Neck, Upper Extremity, and Low Back, NIOSH Publication No. 97-141. Cincinnati: National Institute for Occupational Safety and Health, 1997. n. Elements of Ergonomics Programs, NIOSH Publication No. 97-117. Cincinnati: National Institute for Occupational Safety and Health, 1997. o. Putz-Anderson, Vern, ed. Cumulative Trauma Disorders: A Manual for Musculoskeletal Diseases of the Upper Limbs. New York: Taylor & Francis, 1988. p. Systems For People. Bedford, MA: Digital Press, 1984. q. Salvendy, Gabriel, ed. Handbook of Human Factors. New York: Wiley, 1987. r. Stanton, N., A. Hedge, (et al.). Handbook of Human Factors and Ergonomic Methods. Boca Raton, Fl: CRC Press LLC, 2005. s. U. S. Department of Labor. NIOSH Technical Report 81-122, “Work Practices Guide for Manual Lifting.” Washington, DC: Government Printing Office, 1981. Task Analysis Risk Assessment Tools Literature Search Summary Tables Time Time Body parts Name of Expertise in Sensitivity/ Risk Factors required to required to included in Results Reliability/Validity Tool User Generality Evaluated learn administer assessment Good inter-rater Back, Load weight reliability, high intra- 15 to 20 10 minutes shoulder/arm Duration Scores based on risk QEC Inexperienced High/Low rater reliability, minutes per task , wrist/hand, Posture factors and exposure inconsistent validity neck Frequency findings Was Validity studies Inexperienced developed Upper limbs, Posture Action list with level showed scores were (minimal Moderate/ RULA 1 to 2 hours “to be wrist, neck, Muscle function of intervention related to training Moderate administered trunk, leg Muscle load required discomfort/pain, required) quickly” moderate reliability Wrists, Inexperienced forearms, Posture (although elbows, Force Good face validity, training in Moderate/ 2 minutes per Action levels (similar REBA 3 hours shoulders, Movement good interrater OWAS or Moderate posture to RULA) neck truck, Repetition reliability RULA back, legs, Coupling recommended) and knees Intensity & Duration of Score based on exertion product of 6 task High predictive Depends on Elbow, Job Strain Exertions per variables; gives a validity, good 1 day Experienced High/Low complexity, forearm, Index (JSI) minute dichotomous reliability (inter-rater, up to an hour wrist, hand Hand/wrist posture classification (cutoff) test-retest) Speed of work of hazardous or safe Duration per day A few Action categories Shown to predict back Back, arms, Frequency OWAS 5 days Inexperienced Low/High minutes per (based on pain, inter-rater legs Duration posture intervention) reliability is very high Can be High/Low or Low/High 20–30 Arms, neck, PEO Moderately depending on - Duration Description of High inter-rater Unknown minutes/ trunk, and Method Experienced how many - Number of events exposure reliability task knee categories are observed simultaneously - Repetitiveness Index of the ratio of Provides satisfactory 2 days w/ - Force the number of Up to 30-45 predictive performance follow up Elbows, - Awkward technical actions by OCRA Experienced High/High minutes/ of risks of WMSDs; training wrists, hands positions & the number of task reliability depends on recommended movements technical actions the expertise of analyst - Lack of recovery recommended Time Time Body parts Name of Expertise in Sensitivity/ Risk Factors required to required to included in Results Reliability/Validity Tool User Generality Evaluated learn administer assessment -Exposure -Duration Lower limb, Specific parts: back, neck, Scores that describe Reliability and validity ManTRA Unknown Unknown Unknown Unknown Cycle time shoulder/arm level of risk of injury unknown Force s, wrist/hand Speed Awkwardness

Time Time Body parts Name of Expertise in Sensitivity/ Risk Factors required to required to included in Results Reliability/Validity Tool User Generality Evaluated learn administer assessment -Exposure -Duration Lower limb, Specific parts: back, neck, Cycle time Scores that describe Reliability and validity ManTRA Unknown Unknown Unknown Unknown shoulder/arm Force level of risk of injury unknown s, wrist/hand Speed Awkwardness Vibration Posture Head – neck Dynamic muscle Depends on Shoulder/arm effort Ergonomic stress/time ARBAN Few Hours Inexperienced Low/High duration of Trunk Unknown Static muscle load curves work cycle Back Vibration Legs Shock Depends on the duration High inter-rater of the work Unknown (most Neck, Duration Scores of severity of reliability, high validity VIRA 30 minutes High/Low sequence, but likely moderate) shoulders Frequency anatomical disorders (can identify risk estimated to factors) be four times the duration.

Sensitivity – ability to identify change in exposure before and after an ergonomic intervention