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11 ERGONOMICS IN OSH The history of workplace development in the industrial world is characterised by jobs and technologies designed to improve processes and productivity. All too often in the past, little or no concern was given to the impact of the job process or technology on workers. As a result, work processes and machines have sometimes been unnecessarily dangerous. Another result has been that new technologies have sometimes failed to live up to expectations. This is because, even in the age of high technology, human involvement in work processes is still the key to the most significant and enduring productivity improvements. If a machine or system is uncomfortable, difficult, overly complicated, or dangerous to use, human workers will not be able to derive its full benefit. The proliferation of uncomfortable and dangerous workplace conditions, whether created by job design or unfriendly technologies, is now widely recognised as a harmful to productivity, quality, and worker safety and health. The advent of the science of ergonomics is making the workplace more physically friendly. This, in turn, is making the workplace a safer and healthier place.
Safety fact*

Pain, discomfort, and loss of function in the back, neck, and extremities are common among working people. Within 27 countries of the European Union, about 25% of workers complain of backache and about 23% report muscular pain. Available cost estimates of these disorders put the cost at 0,5% to 2% of GDP. * EASHW (2007)

11.1 THE SCIENCE OF ERGONOMICS Briefly, ergonomics is defined as the science of fitting the job to the worker (Hammer and Price 2001: 145). Minimising the amount of physical stress in the workplace requires continuous study of the ways in which people and technology interact. The insight learned from this study must then be used to improve the interaction. This is a wider description of the science of ergonomics. Thus ergonomics is a multidisciplinary science that seeks to conform the workplace and all of its physiological aspects to the worker. Ergonomics involves the following (Goetsch 2002: 147): Using special design and evaluation techniques to make tasks, objects, and environments more compatible with human abilities and limitations; Seeking to improve productivity and quality by reducing workplace stressors, reducing the risk of injuries and illnesses and increasing efficiency. The field of ergonomics is also called human engineering and human factors. The word ergonomics is derived from the Greek language. Ergon is Greek for work; nomos means laws. Therefore, in a literal sense, ergonomics means work of laws. In practice, it consists of the scientific principles (laws) applied in minimising the physical stress associated with the workplace (work). The widely accepted benefits of ergonomics are: Improved health and safety for workers, Higher morale throughout the workplace, Improved quality, Improved productivity, Improved competitiveness, Decreased absenteeism, Fewer workplace injuries/health problems. There are benefits to be derived from ergonomics. There are also problems, both financial and health-related, that can result from giving too little attention to ergonomics. The matter is complicated further because health problems tend to multiply companys financial problems. Common indicators of the existence of ergonomic problems include the following: Occupational health problems collectively known as musculoskeletal disorders,
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Trends in accidents and injuries, Absenteeism, High turnover rates, Employee complaints, Employee generated changes, Poor quality, and High incidence of manual material handling. 11.2 DOMAINS OF ERGONOMICS The International Ergonomics Association (IEA1) divides ergonomics broadly into three domains: Physical ergonomics. It is concerned with human anatomical, anthropometric, physiological and biomechanical characteristics as they relate to physical activity (Relevant topics include working postures, materials handling, repetitive movements, work related musculoskeletal disorders, workplace layout, safety and health). Cognitive ergonomis. It is concerned with mental processes, such as perception, memory, reasoning, and motor response, as they affect interactions among humans and other elements of a system (Relevant topics include mental workload, decision-making, skilled performance, human-computer interaction, human reliability, work stress and training as these may relate to human-system design). Organizational ergonomics. It is concerned with the optimization of sociotechnical systems, including their organizational structures, policies, and processes(Relevant topics include communication, crew resource management, work design, design of working times, teamwork, participatory design, community ergonomics, cooperative work, new work paradigms, virtual organizations, telework, and quality management). 11.3 MUSCULOSKELETAL DISORDERS Musculoskeletal disorders cause more than 30% of all occupational injuries and diseases in the United States (Goetsch 2002: 150). In the European Union, musculoskeletal disorders are the cause of about 50% of workrelated health problems (Figure 11.1) (European Social Statistics 2002: 104). Musculoskeletal disorder (MSD) is an umbrella term that covers a number of injuries caused by awkward movements repeated frequently over time. Other aggravating factors include poor posture, an improperly designed workstation, poor tool design, and work stress. MSDs occur to the muscles, nerves, and tendons of the hands, arms, shoulders, and neck. Box 11.1 shows a classification of musculoskeletal disorder. MSDs are also called by names such as occupational overuse disorders, cumulative trauma disorders, and repetitive stress injuries. Muscle and tendon disorders Tendons connect muscles to bones. They can accommodate very little in the way of stretching and are prone to injury when overused. Overworking a tendon can cause small tears in it. These tears can become inflamed and cause intense pain. This condition is known as tenditis. Shoulder tenditis occurs in the muscles of a shoulder. Forearm tenditis causes pain in fingers, wrist, and muscles in the top of the hand. Overexertion can cause myofacial muscle damage. The symptom of this disorder is soreness that persists even when resting. Muscles may burn and be sensitive to the touch. When the muscles become inflamed and swell, the symptoms are aggravated even further by nerve compression.

See URL http://www.iea.cc

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Musculoskeletal disorders, 52% Stress depression, anxiety, 18% Lung disorders, 8% Cardiovascular disorders, 4% Headaches, visual fatigue, 3% Hearing disorders, 3% Infectious diseases, 3% Skin problems, 3% Other, 6% 0 5 10 15 20 25 30 35 40 45 50 55

Percentage

Figure 11.1 Work-related health problems by diagnosis group (the old 15 countries of the European Union, 1999; serious health problem only, with or without days absence from work, %, source European Social Statistics (2002: 108)) Box 11.1: classification of musculoskeletal disorders (MSDs)* Muscle and tendon disorders

Tendinitis: Shoulder tendinitis, Bicipital tendinitis, Rotator cuff tendinitis, Muscle damage, Tenosynovitis, Stenosing tenosynovitis: DeQuervains disease, Trigger finger (flexor tenosynovitis), Forearm tendinitis: Flexor carpi radials tendinitis, Extensor tendinitis, Flexor tendinitis, Epicondylitis, Ganglion cysts.
Cervical Radiculopathy Tunnel syndromes

Carpal tunnel syndrome, Radial tunnel syndrome, Sulcus ulnaris syndrome, Cubital tunnel syndrome, Guyons canal syndrome.
Nerve and circulation disorders

Thoracic outlet syndrome, Raynauds disease, * Goetsch (2002: 175)

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Tendons which curve around bones are encased in protective coverings called sheaths. Sheaths contain a lubricated substance known as synovial fluid. When tendons rub against the sheath too frequently, friction is produced. The body responds by producing additional synovial fluid. Excess build-up of this fluid can cause swelling which, in turn, causes pressure on the surrounding nerves. This condition is known as tenosynovitis. Chronic tenosynovitis is known as stenosing tenosynovitis. Epicondilitis and ganglion cysts are two muscle and tendon disorders. Epicondilitis affects an elbow. The common term for this disorder is tennis elbow. Ganglion cysts grow on the tendon, tendon sheath, or synovial lining, typically on the top of the hand, on the nail bed, above the wrist, or on the inside of the wrist. Cervical radiculopathy This disorder is most commonly associated with holding a telephone receiver on an upraised shoulder when typing. This widely practised act can cause compression of the cervical discs in the neck making it painful to turn the head. Putting the body in an unnatural posture while using the hands is always dangerous. Tunnel syndromes Tunnels are conduits for nerves that are formed by ligaments and other soft tissues. Damage to the soft tissues can cause swelling that compresses the nerves that pass through the tunnel. These nerves are the medial, radial, and ulnar nerves that pass through the tunnel in the forearm and wrist. Pain experienced with tunnel injuries can be constant and intense. In addition to pain, people with a tunnel injury might experience numbness, tingling, and a loss of gripping power. Nerve and circulation disorders When friction or inflammation cause swelling, both nerves and arteries can be compressed and so restrict the flow of blood to muscles. This can cause a disorder known as thoracic outlet syndrome. The symptoms of this disorder are pain in the entire arm, numbness, coldness, and weakness in the arm, hand, and fingers. If the blood vessels in the hands are restricted, Raynauds disease can result. Symptoms include painful sensitivity, tingling, numbness, coldness, and paleness in the fingers. It can affect one or both hands. This disorder is also known as vibration syndrome because it is associated with vibrating tools. 11.4 RISK FACTORS FOR MSDS Identification of ergonomic hazards is based on ergonomic risk factors: conditions of the work process, workstations, or work method which contribute to the likelihood of developing MSDs. Not all of these risk factors will be present in every MSD probe occupational activity, nor is the existence of one of these factors necessarily sufficient to cause a MSD. Some of the risk factors for MSDs of the upper extremities include the following: Repetitive and/or prolonged activities; Forceful exertions usually with the hands (including pinch grips); Prolonged static pressures; Awkward postures of the upper body, including reaching above the shoulders or behind the back and twisting the wrists and other joints to perform tasks; Continued physical contact with work surfaces (soft tissue compression); Excessive vibration from the power tools; Cool temperatures; Inappropriate or inadequate tool design; High wrist acceleration; Fatigue (inadequate recovery time); Use of gloves. Risk factors for back disorders include items such as the following: Bad body mechanics such as continued bending over the waist, continued lifting from below the knees or above the shoulders, and twisting at the waist, especially while lifting (see Figure 11.2); Lifting or moving objects of excessive weight or asymmetric size; Prolonged sitting, especially with poor posture; Lack of adjustable chairs, footrests, body supports, and work surfaces at workstations; Poor grips on handles;
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Slippery footing.
Safety fact*

Almost all of us will experience back pain at sometime in our life. It is normal and a fact of life. All epidemiology studies indicate that up to 90% of persons between the ages of 18-55 years (i.e., of working age) will recall an episode of low back pain that interfered with their ability to function for at least 24 hours at some time. All social and occupational groups are the same. Approximately 40% of us will experience recurring problems with our backs. Most primary care patients who seek treatment for back pain will improve considerably over the first 4 weeks, but only 30% will be pain free. At one year 70-80% will still report some recurring back symptoms; one third will have intermittent or persistent pain of at least moderate intensity, and about 15-20% will have a poor functional outcome. The period prevalence of neck and arm pain in the population is similar to low back pain but not as frequently disabling. * Gardiner and Harrington (2005: 42)

Works, operations, or workstations that have multiple risk factors have a higher probability of MSDs. The combined effect of several risk factors in the development of MSD is sometimes referred to as multiple causation.

Figure 11.2 Workstation in a pharmaceutical plant: before and after adjustments were made to the workstation (EASHW 2007)

11.5 PREVENTION OF MSDS MSDs can occur across all types of jobs and work sectors. However, some types of employment groups seem to be particularly at risk. Specific industries (occupations) with high exposures and groups at high risk include (EASHW 2008: 17): Agriculture, forestry and fisheries; Manufacturing, mining; Machine operators; Craft workers, tailors; Construction; Wholesale, retail and repairs; Hotels, restaurants and catering; Secretaries, typists; Loaders and unloaders. Evidence suggests that MSDs affect women more than men largely because of the type of work they do than because of any gender or other personal factors. Physical causes of MSD include manual handling, loads, poor posture and awkward movements, highly repetitive movements, forceful hand applications, direct mechanical pressure on body tissues, vibrations, and cold work environments. Causes in the organisation of work include pace of work, repetitive work, time pat E. R. Vaidogas, Lecture Notes on OSH, VGTU, 2009

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terns, payment systems, monotonous work, and also psychosocial work factors. Some types of disorders are associated with particular tasks or occupations. To prevent musculoskeletal disorders effectively, the risk factors in the workplace must be identified and then practical measures taken to prevent or reduce the risks. Eight variables that can influence the amount of physical stress experienced on the job are as follows (Goetsch 2002: 147): Sitting versus standing. Stationary versus movable/mobile. Large demand for strength/power versus small demand for strength/power. Good horizontal work area versus bad horizontal work area. Good vertical work area versus bad vertical work area. Non-repetitive motion versus repetitive motion. Low surface versus high surface. No negative environmental factors versus negative environmental factors. For the prevention of MSDs, attention needs to be paid to: risk assessment; health surveillance; training; employee information and consultation; ergonomic work systems (i.e., looking at the effect of the whole workplace, equipment, work methods, and work organisation, etc. to identify problems and solutions); and prevention of fatigue. These components of MSD prevention are already recognised in the European practice (EASHW 2008). Solutions of the MSD problem include: 1 Administrative solutions: A reduction in daily working hours, modification of work, and job rotation may reduce MSDs; The introduction of additional breaks into repetitive work may be achievable without the loss of productivity. 2 Engineering solutions: Technical ergonomic measures can reduce the workload on the back and upper limbs (e.g., in the case of ergonomic hand tools), and thus the occurrence of MSDs, without the loss of productivity; Technical interventions may also include redesign of physical environment, introduction of lifting and transfer aids, etc. (Figure 11.3). 3 Behavioural modification: Training on working methods in manual handling is not effective if it is used as the only measure to prevent low back pain; Physical training can reduce the recurrence of back pain and neck-shoulder pain. But to be effective, the training should include vigorous exercise and be repeated at least three times a week. 4 Implementation strategies: A combination of several kinds of interventions (multidisciplinary approach) including organisational, technical and personal measures is needed to prevent MSDs. Interventions based on single measures are unlikely to prevent MSDs; A participative approach that includes the workers in the process of change may have a positive effect on the success of an intervention.

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Figure 11.3 Hand-guided pneumatic balancer and folding trolley used as lifting and transfer aids

11.6 THE ROLE OF ERGONOMICS IN ACCIDENT PREVENTION Besides improving the ease with which workers can undertake tasks such as reading dials, good ergonomics will reduce fatigue, erroneous actions, and wrong decisions (Figure 11.4). Ergonomics has resulted in the design of better tools, controls for equipment, seats and chairs, and many other items that affect comfort and safety. Investigation of the accident in the nuclear power plant at Three Mile Island cited two principal causes: human error and bad ergonomics. Much of the operator error occurred in making decisions and responses required because of inadequate designs.
Ergonomics

Better workplaces and workprocesses

Minimizing the work-related stress and fatigue

Reduces the possibility of human error and wrong decisions Contributes to the prevention of workplace accidents and industrial accidents

Prevents occupational diseases, first of all, muscular-skeletal disorders (MSDs)

Figure 11.4 The role of ergonomics in prevention of accidents and occupational diseases

Ergonomics attempts to obtain maximum effectiveness in any human-machine operation by integrating the best capabilities of both. It is concerned with the design of equipment so that it can be operated easily and rapidly with a minimum of undue effort or strain. A control panel designed for operation by a single person can overwhelm the workers mental and physical capabilities, if an overabundance of data from instruments must be monitored or its controls operated at one time. Should the instruments on a panel be widely separated, an operator would either quickly be exhausted trying to perform an almost impossible task, make errors or ignore some of the instruments, possibly leading to an accident. Much work has been done in the previous decades in the development of ergonomics. An ergonomic analysis of a very common operation is given in Table 11.1.

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Safety fact*

It often takes a major accident to get the attention of management and the engineering community regarding the lack of good ergonomics. Such an event occurred on 28 March 1979 at the Three Mile Island nuclear plant in Pennsylvania. Accident investigations disclosed that this catastrophe was due to a variety of factors: inadequate training, a control room poorly designed for people, questionable emergency operating procedures, and inadequate provisions for the monitoring of the basic parameters of plant functioning. The event was a turning point for the nuclear power industry because it emphasized the central importance of ergonomics to safe plant operation. The Presidents Commission on the Accident at Three-Mile Island stated that: There are many examples in our report that indicate the lack of attention to the ergonomics in nuclear safety. The control room, through which the operation of the Three Mile Island plant is carried out, is lacking in many ways. The control panel is huge, with hundreds of alarms, and there are some key indicators placed in locations where the operators cannot see them. There is little evidence of the impact of modern information technology within the control room it is seriously deficient under accident conditions. * with modifications from Korwowski (2001: 76)

Table 11.1 Ergonomic analysis of a straight ladder (Hammer and Price 2001:147) Misuse mode User sets ladder at angle too near vertical so that it tips backward as he ascends or gets near top Behavioural factors Lack of experience, user doesnt know proper erection-angle limits; doesnt know or realise his body needs to remain close to rungs; not familiar with centre of gravity factor Same as above Design consideration Warning-use instruction label conspicuously located (consider use of alternate orientation of ladder); built-in safe-angle indicator; design instruction with pictures Same as above; over design structurally; minimise bending characteristics Warning - use instruction

User sets ladder at shallow angle so that ladder bends or bounces when he is near centre of span Ladder is too short for situation so user stands on upper rungs with no hard support Due to uneven surface, ladder is not set up properly (e.g., it lists right or left causing ladder to twist, shift c.g.(1), or introduce structural stress); feet of ladder slip or penetrate surface unevenly User doesnt pick ladder up at c.g.(1) for carrying, causing him to drop it or dig one end into ground User injuries himself picking up ladder which is too heavy to carry User foot slips off rung or misses and slips between rungs Metal ladder comes in contact with

Doesnt think ahead or recognise potential hazards; tries to make do takes a chance Not conscious of support surface condition; poor judge of verticality; too lazy or too much in a hurry to prepare surface; willing to take chance due to inexperience; doesnt consider which end of ladder should be down or up Lack of experience; doesnt know where c.g. is Doesnt know ladder too heavy; doesnt think about it before he tries to pick up; doesnt pick up properly Climbs without looking at feet; puts them where he thinks rungs should be Unaware of hazard

Self-levelling, broad-footprint foot design; conspicuous warning; builtin vertical level indication

Warning; mark pick up point

Warning indicate weight

Use non-skid surface; use standard rung spacing and vertical separation User materials which will not carry

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Occupational Safety Management and Engineering: Ergonomics in OSH high-tension electrical wire or component; may cause shock or burn as user touches ladder In backing off roof or high place, misses rung with foot; may kick ladder and change its orientation, causing it to be unsteady (1) c.g. = centre of gravity electrical current

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Cant see where he is putting foot; unsteady; preoccupied with holding on to structure; in awkward position for determining orientation

Maximise ladder width; point out hazard in operation instruction

References
EASHW (2007) Prevention of Work-Related MSDs in Practice. Bilbao: European Agency for Safety and Health at Work. EASHW (2008) Work-related musculoskeletal disorders: Prevention report, EN 4. Bilbao: European Agency for Safety and Health at Work. European social statistics (2002) Accidents at work and work related health problems. Data 1994-2000. European Communities, 2002. Retrieved October, 2007, from http://epp.eurostat.cec.eu.int/cache/ITY_OFFPUB/KS-BP-02002-3A/EN/KS-BP-02-002-3A-EN.PDFGardiner, K.; Harrington, J. M. (Eds.) (2005) Occupational Hygiene. 3rd ed. Malden: Blackwell Publishing. Goetsch, D. L. (2002) Occupational Safety and Health for Technologists, Engineers, and Managers. 4th ed. Upper Side River, New Jersey: Prentice Hall. Hammer, W. & Proce, D. (2001) Occupational Safety Management and Engineering. 5th Ed., New Jersy: Prentice Hall. Korwowski, W. (2001) International Encyclopedia on Ergonomics and Human Factors. Vol. I. London and New York: Taylor and Francis.

Examination questions 1 2 3 4 5 6 Define the term ergonomics. Explain benefits of ergonomics. What is the main cause of occupational injuries and diseases in the European Union? What is the approximate percentage of MSDs among serious work-related health problems? List five risk factors associated with MSDs. Which industries and occupations have an increased risk of MSDs? Explain four possible solutions of the MSD problem. Provide one or two examples of each solution.

E. R. Vaidogas, Lecture Notes on OSH, VGTU, 2009