Ergonomics involves designing workplaces and work tools to be used easily, efficiently and effectively by people. The overall goal is to promote health and productivity in the workplace. Where ergonomic principles are not applied, chronic musculoskeletal disorders such as tendinitis of the arm and hand, eyestrain injury and back injuries may be common.<br><br>Most people are concerned when they cannot use parts of the body like they know they should be able to use them. People are often unaware of ways to prevent injury, and ergonomics will introduce methods that will help reduce those injuries. Chiropractors recommend using ergonomics in a professional environment as well as at home. Following simple guidelines can help prevent injury to the arms and hands, eyes, and back. Everyday activities at work, home, or play can cause wear and tear on muscles, joints, tendons, and nerves. Problems can be a direct result of poor posture, repetitive motion, and excessive force or pressure to any part of the body.<br><br>Occupational Safety and Health Administration (OSHA) provides ergonomic consulting services to companies, labor organizations and government agencies. In an environment where Repetitive Strain Injury (RSI) and the associated workers' compensation costs continue to increase, these services are directed to identifying the risk factors to such disorders and assisting clients in reducing the hazards created by these factors.<br><br><b>INTRODUCTION</b><br>Increased or constant productivity is a concern of every employer. Employers want to know that their employees are doing their best. Therefore, employers should strive to make the work environment suitable for productivity. The ergonomics program is designed to do just that. In most cases, a happy employer leads to happy employees.<br><br><I>Purpose</I><br>The purpose of the ergonomic program is to make employers aware of injury prevention. Such awareness can to increased productivity, a decrease in the number of worker's compensation cases, and a decrease in number of lower back injuries.<br><br>The information provided to you in this proposal will make you, as an employer, see the necessity of applying ergonomics to your working environment. Studies have shown that with increased computer use, the numbers of Repetitive Motion Disorders has tripled since 1979.<br><br><I>Scope</I><br>These ergonomic consulting serves are provided by trained and experienced industrial engineers and health professionals. The range of services include:<br>Workstation evaluation and modification;<br><li>Job evaluations combined with recommendations for modifications;<br><li>Tool design to reduce hand and forearm fatigue;<br><li>Training of employees and supervisors in ergonomic concepts, proper work break patterns and exercises;<br><li>Assistance with the evaluation and selection of furniture and hand tools;<br><li>Review of medical management protocol for employees with cumulative trauma disorders;<br><li>Design of an effective Ergonomics Program to meet in-house needs and satisfy pending OSHA Ergonomic regulations.<br><li>Definitions and Symptoms <br><li>RSI (also known as RMI, repetitive movement injury, OOS, occupational overuse syndrome, and CTD, cumulative trauma disorder) is a description, and not a diagnosis. It is a term which has many causes and many manifestations. <li>Carpal tunnel syndrome, CTS, is a specific condition, and therefore a diagnosis. It is this sort of confusion which leads to many arguments that "RSI does not exist."<br><br>The many diagnosable disorders that RSI encompasses include carpal tunnel syndrome, ulnar nerve entrapment, tennis elbow, and tendinitis. These disorders can develop gradually and affect many parts of the body as a result of repetitive action over time. Many symptoms may come and go before settling in: aching, tenderness, swelling, pain, cracking, tingling, numbness, loss of strength, loss of joint movement, and diminishing coordination of the injured area. These symptoms can then lead to the disorders listed above. Although the causes of RSI are controversial, most sufferers will agree that a stressful day will worsen their symptoms, simply by increasing muscle tension and thereby pain. RSI is caused by many shared and individual factors, including physical fitness, muscle tension, individual work habits, stress, long hours, lack of breaks, bad ergonomics, and poor, static posture. In the office environment, the most common reported injuries were eyestrain, lower back pain, and pain in the arms and hands.<br><br><I>Eyestrain Basics</I><br>Reflective glare, such as on computer screens, sometimes causes eyestrain. But its worse effect may be causing you to change your posture to an uncomfortable position in order to see well. The most overlooked cause of eyestrain in offices is contrast -- usually, a dark screen surrounded by a bright background such as a window or a lit wall. Eyes are strained more by close viewing than by distant viewing. <br> <br>If you gaze at something too long, your eyes can tire. Eyes need to focus at different distances from time to time. It is a good idea to follow the "20/20 rule" --- every twenty minutes, look twenty feet away for twenty seconds. Computer work rarely causes nearsightedness; it more likely makes you realize that you need glasses.<br><br><I>Low Back Pain</I><br>Back pain is as mystifying today as it was decades ago. Despite excellent tests and procedures, modern back specialists admit that up to eighty percent of all cases have no clear physiological cause. In fact, many pain-free people show bulging or herniated discs in x-rays. Job characteristics are predictors of back pain. Jobs with heavy or frequent lifting are high risks, as are jobs involving prolonged standing or sitting. People who sit for long periods are at risk for back disorders. The two greatest problems seem to be 1) sitting upright or forward, and 2) not changing position. An upright posture with a ninety-degree hip position is actually unhealthy. For a number of reasons, the discs experience more pressure ---- and the pressure is more lopsided --- than while standing.<br><br>Upper back and neck discomfort is often related to upward viewing angles (for example, monitors above eye height) or leaning, twisting, or reaching (for example, looking down and sideways at a document on the desk, or reaching for a mouse). Signs and symptoms include pain when attempting to assume normal posture, decreased mobility, and pain when standing or rising from a seated position.<br><br>Although back injuries account for no work-related deaths, they do account for a significant amount of human suffering, loss of productivity, and economic burden on compensations systems. Back disorders are one of the leading cause of disability for people in their working years. <br><br><I>Arms and Hands</I><br>There are many kinds of Cumulative Trauma Disorder (CTD) medical conditions that have ergonomic causes among office workers, including carpal tunnel syndrome and various kinds of tendon inflammation. Because of the complexity and subtle differences between disorders, physicians do not always diagnose CTDs correctly or easily. CTDs can happen when there is very little repetitious work. Besides repetition, other possible causes include:<br><li>Holding one position. Muscles that hold a body part in position for long periods are more prone to fatigue than muscles that move a body part around.<br><li>Non-neutral positions. In this context, "posture" is the position of an individual joint, not overall body posture. Any posture significantly different from "neutral" is considered to be at risk for musculoskeletal distress.<br><li>Localized pressure. Direct pressure on nerves or tendons can cause damage in the long run. The wrist is one location of concern. The elbow (the funny-bone or crazy-bone nerve) is another.<br><li>Use of force. Even small exertions can cause stress if small muscles are involved. Sudden, fast motions involving a jerk or a snap.<br>Cold temperatures.<br><li>Vibration, as with hand-help power tools or whole-body vibration as caused by driving heavy equipment.<br><br><b>CHECKLIST FOR SOLUTIONS</b><br>Solutions the common problems of eyestrain, back pain, and arm and hand pain, are relatively easy. Simple changes to one's everyday routine and surroundings can help lower work- related injuries. When one decides to change his or her office habits, there are a few things in one's surroundings that can be changed. RSI and associated poor ergonomics not only affect the health of computer users --- they hit the finances of their employers as well. One direct cost is a productivity loss of 20 percent , according to one study. The following remedies will not cure already existing problems, but are designed to prevent further distress. Simply changing work habits and at home can help reduce the cost of sick leave and staff turnover.<br><br><I>Armrests</I><br>The use of armrests on chairs is a controversial subject in the ergonomic community. Ulnar nerve entrapment can result from resting forearms and elbows against hard surfaces, like some armrests. However, an armrest can provide some support if you are already injured, as long as the armrest is well-padded, and it is not forcing your shoulders up and preventing you from relaxing your upper body.<br><br><I>Monitor Placement</I><br>The distance for computer monitors and documents depends entirely on how clearly they can be read at a given distance. The general rule is to keep viewed material as far away as possible if it can be easily read. For distance from your monitor, you should be between 18 and 28 inches away from your screen. Your screen should be adjusted so that it is between 15 and 30 degrees below your straight-ahead line of sight. If the screen is much lower than that, you can possibly end up slouching. The use of glare screens can reduce bright spots caused by light reflecting on monitor screens.<br><br><I>Alternative Input Devices</I><br>Look into alternative input methods that will reduce strain on your hands and wrists. Many heavy keyboard users have found the split and adjustable keyboards to be more comfortable. The most popular alternative input device is the trackball, but the new "trackpad" is generating a lot of interest. <br><br><I>Wrist Pads</I><br>Wrist pads/rests are usually the neoprene pads that many people put in front of their keyboards. The wrist pads help in two ways. First, the wrist pad is designed to remind you to lift up your wrist slightly so that your hands don't rest on any surface as you type, because that angle can compress the carpal tunnel. Secondly, when you pause in your typing, you probably put your hands down, and it's better to rest then on a soft pad than on the hard corner of a desk. This can cut off circulation and compress the carpal tunnel. When wearing wrist braces, the main rule of thumb is to pay close attention to how your hand and wrist feels. If you catch yourself working against the brace instead of with it, don't wear it. Most experts agree it is a better idea to wear braces when your hands and wrists are passive, such as while asleep.<br><br><i>The Chair</i><br>The chair is probably the most important piece of ergonomic furniture. The following are the basics:<br><li>Tilt the seat pan to get your thighs slightly higher than your knees. This straightens the spine and helps support your head and arms.<br><li>Check that your chair has a tiltable back. Ergonomic wisdom says that you should not sit bolt-straight, but a little back (no more than 10 degrees). <br><li>If using armrests, make sure they are not too wide apart. Too wide leads to more ulnar deviation at the wrist.<br><li>If using armrests, make sure they are not too close together. Too close together interferes with your arms during typing.<br><li>If using armrests, make sure that they are not too high. This will force your shoulders upward and will lead to neck and shoulder tightness.<br><li>If using armrests, make sure they are not too low. Too low leads to rounding of the spine, contraction of the chest, and restricted breathing.<br><li>If using armrests, make sure they are not too hard. If it is too hard, it puts pressure on ulnar nerve at the cubital tunnel at the elbow.<br><br><br><b>STRATEGY</b><br>Over the next four years, OSHA is committed to reducing workplace injuries and illnesses in three target groups: in the 100,000 workplaces where we conduct major interventions; in five hazard industries --- food processing, nursing homes, shipyards, logging and construction; and in three serious safety and health problems --- silicosis, amputations and lead poisoning. OSHA is planning extensive outreach to assist employers in developing safety and health programs and addressing ergonomic hazards. The agency also is working to improve training for inspectors to help them learn to evaluate workplace safety and health programs.<br><br><b>PROMOTING HEALTH</b><br>Conventional medicine mostly addresses treating the symptoms. We need to focus on the causes and view the whole body as a complete system. One will have to go through trial-and-error to find a specialist that practices a skill that works for each individual since each repetitive injury case is different.<br>Promoting habits for healing and health is a matter of personal taste. Investigate and learn what works for you. Good methods to try are the following:<br><li>For stretching and gentle body movement: Try Yoga, Chi Kung, or Tai Chi.<br><li>For reducing stress: Try meditation, visualization exercises, taking deep breaths, or going for a walk<br><li>For working through sore, stiff, or sensitive muscles: Try massage, physiotherapy, trigger point therapy, acupressure or shiatsu<br><li>For reducing inflammation and pain: Try ice or a package of frozen vegetables on the affected area.<br><li>For relieving neck strain after sleeping: Use a cervical roll or a "contour pillow" and don't sleep on your stomach.<br><li>For general well-being: Take frequent rest breaks (recommended is 5 minute rests every 20 minutes and get out of your chair at least once an hour), drink lots of water, exercise, stretch, and move around often.<br><br><b>CONCLUSIONS</b><br>Those are the basics. The most important thing to ask yourself is: Are you comfortable throughout a day's work? If it feels good and you tend not to shift trying to get comfortable, then you are probably less at risk of injury or possible reinjury. Remember, people are not robots. Move around. Get up. A good chair lets you have a little room to move so you can stay loose. Leaning and slumping is fine once in a while, just don't make that your continual working position.
