Real, Not Voodoo Ergonomics
Real ergonomics, or in truth, ergonomics applications, transcends the computer workstation to the industrial workstations and anything in-between. In fact, this is an informal designation between a professional ergonomist and someone who has only had minimal training or limited experience. Real ergonomics is more than attending a couple of seminars or reading a few books. In point-of-fact, ergonomics can be a real and valuable tool in getting injured workers back to the job of injury or into jobs they otherwise couldn’t perform.
Marketers have brainwashed the masses into believing if it is labeled ergonomic it should be better. They espouse that if it feels better, it probably is better, however, just because it feels better doesn’t necessarily mean that it is applicable, meaningful or even practical. For the holidays, I saw a computer UPS (uninterrupted power supply) advertised as ergonomic, simply because the power LEDs were on the front, so they could be more easily seen. Where else would you put them, on the back? Truly, a misuse of the term, and supposed application of ergonomics and really missing the whole point. We call this Voodoo Ergonomics, more on that at another time.
Without getting into the boring (and almost meaningless) Webster’s definition, ergonomics relates to the performance of tasks, whether personal, recreational or occupational. Real and extreme ergonomics, as is applicable to the return to work profession, is the approach that considers the physical limitations of an injured worker and the appropriate application of modifying tools, equipment or workstations to get them back the ability to perform any work task while they heal up. Also in the mix is the prevention of additional/continued injury when they go back to work. Essentially, extreme ergonomics can return an injured worker to the job of injury without the specter of re-injury, enabling them to continue to work, supporting their families, staying off light duty, feeling better about themselves and making any VOC, OT, PT, MD, PA or other healthcare professional look like a real, well.…professional.
First, let’s talk about a case in general. Say for example, a worker has a soft tissue occupational injury, and cannot perform the job of injury because of continued pain triggers. What happens? They get shipped to various medical professionals, MDs, DOs, PTs, pain clinics, acupuncturists, etc. All of whom are expert at repairing and reconditioning a damaged anatomy. The worker heals and is given the green light to return to work, wherein by performing the same work tasks that caused the injury in the first place, they immediately flare up again to the point of a forced revisit to the medical professionals. Again, damaged anatomy is fixed and another green light is given. Upon returning to the job, the worker is reinjured, to no one’s surprise, and again revisits the medical practitioner, and the loop continues. This is known as the worker comp loop, costing much time, effort and with little to show, other than the fact that the worker cannot perform the job of injury with no end or solution is in sight. Light duty, time loss, lost time, change of job or vocation, disability, new hires, temporary replacements, are some of the answers. However, these are not always the best solution and can ultimately end up with spiraling costs often surpassing six figures per case. Unless something changes with the way the job tasks are performed, this loop like a Mobius strip is endless.
Proper applications of ergonomics can put an end to this spiraling “worker comp loop” by addressing and eliminating the specific injury or pain triggers inherent in the job tasks, or task performance. It is a relatively easy process to identify these at-risk conditions; it is quite another story to find a solution eliminating them. First of all, an analysis is required to determine the specific task, posture or effort that is the injury or pain trigger. Your best source is the worker, who will generally be enthusiastic in letting you know what the triggers or problems are. “It hurts when I do this” or “When I have to do that” are the primary lead-ins to the causal relationships. The on-site analysis is most important for identifying the issues and to initiate an effective work plan. Actually performing the work task by the analyst is also a good indicator as to how it affects the musculoskeletal system since most workers are not accustomed to making a detailed and accurate description of the injury site, the pain or of the kinetics involved. This actually allows the analyst to get a real feel (pun intended) for the at-risk condition and to fully understand the biomechanical process involved. Knowledge of biomechanics and anatomy on the analysts’ part is most important in developing a solution. Film and photos are also welcomed as valuable tools. A solution cannot be developed unless a full understanding of the kinetics, biomechanics and anatomical functions and especially the tasks are fully understood. This is where the professionals separate themselves from those with less experience or training.
Secondly, from the analysis, the ergonomics come into play. Herein lies one of the most creative parts of the return-to-work process. Return to the job of injury in an industrial setting from manufacture to service to any other sort of manual task, from an ergonomics standpoint requires figuring out a way to perform that certain task(s) and then modifying the method, process, tool or posture so the worker can perform the same task without injury or pain triggers. Sounds simple, and in reality, it is. The only requirements are a team of professionals with specialized skill sets (or an individual with a really extensive skill set and experience) that can design, prototype, install, modify and evaluate any workstation modification specific to the worker injury. Oftentimes, a full machine shop is necessary to actually fabricate specialized tools or equipment. A prototyping capability/shop is also handy to mock up work environments, testing different solutions and methods. This is a classical design process in that a solution is developed and then tested under controlled environment and refined until the design / return-to-work team is satisfied the solution is applicable. Sometimes the worker will actually try the modifications in the prototype shop to lend their input, and critique for refinement or to sign off for the installation to the actual workstation. The team often includes the medical practitioner, VOC, OT, claims manager and the worker for input and communication. After testing and evaluation in the shop, the solution is trialed in the actual workplace and further refined until the worker determines the effectiveness and “signs off” on the solution. Worker sign off is very important as they are the ones who must have the final critique as to the effectiveness of the solution in real time and under actual conditions.
Examples abound with return-to-work resulting from ergonomics applications. Some of our case files include aluminum smelters, where special power tools were adapted to replace the repetitive cleaning of casting tables. Prior cleaning tasks involved forceful and repetitive motions of wiping dozens of circular openings per cast resulting in worker injuries. In construction crews performing overhead chipping with 25# chipping hammers, shoulder injuries were commonplace. The solution was the development of a portable pneumatic stand which held up the chipping hammers allowing workers to chip for 8 hours per day without injury. In public utility crews, repetitive lifting of 100# manhole covers are known to cause back injuries, especially with the state-of-the-art inexpensive “J” hooks. A portable lifting device about the size of a shovel was developed to lift 200# lids without any strain on the back or without any lifting required. In 911 workstation that is occupied 24/7, workstations had to be developed enabling all operators varying in size from petite 4’-11” females to 6’-4” ex-linebackers to fully adjust seating, viewing angles to 4 different computer screens and 3 different emergency radios within seconds were developed.
Other examples involve specialized tools to be sourced enabling painters to mix paint without the repetitive lifting of the heavy 5 gallon paint cans. Specialized mats provided bank tellers who had wrist problems to spread out bills for customers without the typical grasping, holding and showing. In automotive assembly plants, special tools have been developed enabling assemblers to insert and seat door weather stripping without using the previous method of hammering the stripping with the palm of the hand resulting in hand injuries and big time quality problems (from leaks) ending up in recalls, of which you may have been an unwilling participant. Needless to say this was a really big money saver, both from a worker comp angle and in company operations. Maybe this would be a big selling point considering the current automaker financial situation.
More examples include developing special carts for librarians to move heavy loads of books between extremely tight aisles. Specialized drill stands allowed aerospace workers to drill extremely accurate holes in engine mounts and underwing assemblies without the need to hold drill motors overhead for extensive periods. Holders for expensive antique musical instruments were developed for professional musicians to transport these large and fragile instruments from backstage storage to center stage because injuries disallowed them to lift and carry large bulky items. With the proper application of high tech input devices, a mechanic who had two crushed hands and had zero flexion, extension, ulnar or radial deviation, and minimal grip capability, was able to enroll in tech school and learn CAD.
Ergonomics applications can be made in all professions and areas such as police officers, truck drivers, bus drivers, boat captains, mechanics, carpenters, utility workers, assemblers, janitors, surveyors, painters, groundskeepers, magicians, pet groomers, gardeners, construction workers, cabinet makers, locksmiths, oyster shuckers, and almost any other profession you can think of. The common theme and requirement is simply an industrial injury caused by performing a specific job or task(s).
The return-to-work arena abounds with cases that scream for ergonomic applications. To help you determine if a solution is apparent, don’t be afraid to hunt down a creative ergonomics professional to work with, who just might be able to aid you in closing that claim. And who knows, you just might finish a project that no one ever thought possible or even been able to accomplish before.
A Successful Project
Thus for a successful project, the entire work environment or all things which impact the worker’s ability to perform the identified work tasks must be analyzed and addressed. Breaking down each specific task to simplistic parts is the key. A creative approach and ability to implement that approach, no matter the complexity of the task, for addressing the identified issues is then required. Proper application and follow up evaluation is necessary to ensure the modifications are indeed effective or if they should be further refined. Remember how a small and minor issue in the ski boots didn’t seem like such a big deal in the sporting goods shop? After which became a really major pain on the slopes? In the same way, an initial solution may look like it will work, however, under “battle conditions” it may turn out that some minor tweaking or modifications are still needed to make it so the worker can easily use it effectively. This is another tool of the professional ergonomist
Ergonomics can address almost any type of repetitive motion injury or soft tissue injury, all it takes is a complete analysis with two other key elements. A creative attitude (design) and the ability to carry out that design by actually fabricating, prototyping, testing and evaluating any job mod. The work plan is an easy thing to implement, however it takes a real team to do it.
The whole point is to get an injured worker back to the job of injury performing the same tasks without further injury and healing up at the same time. If any return-to-work professional can do that, they can look like a hero, not only to the worker comp institutions, but also to the company by saving costs, reducing lost time and improving productivity, and most importantly, to the workers themselves.