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Ergonomics in the office.

IN SOME WAYS, CONTEMPORARY OFFICES are no different from those of years gone by. Secretaries still type, but today's technology allows them to type more data - and faster than ever before. However, in today's offices secretaries are not the only ones typing: Over the last decade, the increase in the use of computers has turned many office workers into frequent typists. According to the U.S. Census Bureau, computer sales increased more than 1,100 percent between 1981 and 1987. The National Association of Working Women, quoted b), the Bureau of National Affairs, reports that there were only two computers for every 100 workers in 1980, compared with two computers for every three workers in 1991.

Computers have produced many benefits in the office, including increases in productivity and a reduction in the amount of time needed to perform certain jobs. However, the growing demand for computers has resulted in ergonomic stressors that can be directly linked to the increase in cumulative trauma disorders (CTDs), which include injuries such as carpal tunnel syndrome, tendinitis and some forms of back pain.

This rise in the incidence of work-related injuries has resulted in human suffering and increased compensation claims, hospitalization costs and absenteeism. Because of these ill effects, risk managers must act to reduce these injuries, and thus their companies' potential liability. Applying the same basic ergonomics principles in the office that are applied in the industrial workplace is the primary step in accomplishing this goal. By becoming aware of how ergonomic office workstations can prevent workplace injuries, risk managers can help their companies design the most effective ergonomics program for their needs.

Other Stressors

DESPITE THE TRANSITION from typewriter to computer, many offices have not altered their furniture or other equipment. This results in awkward postures caused by workstations that were designed for typewriters. These postures lead to the repetitive motions that are linked to CTDs such as tendinitis and carpal tunnel syndrome.

Today's specialized job tasks are another culprit in the increase of CTD-type injuries. In the past, many office jobs involved a wide range of tasks. By contrast, contemporary offices feature a number of specialized job functions such as the tasks involved in word processing; employees who work in centralized word processing departments may sit in the same chair all day, typing in data. Today's technology even Kathleen A. Rickerr is a health and ergonomics consultant with National Loss Control Service Corp. in Long Grove, IL. allows computer users to communicate with each other via the computer screen, so they never even need to leave their seats. Such advances mean that some workers sit in the same positions for long periods of time. And since sitting is the most stressful posture to the back, it is therefore not surprising that complaints about back pain from office workers are on the rise.

Although computers make certain workers' jobs easier to perform, computereation has resulted in an increase in job demands and responsibilities for others. Additionally, the rise in electronic monitoring has led some workers to feel powerless and frustrated, with little control over their jobs. Workers in this situation often experience an increase in mental stress, which can be associated with the muscle tension and physical strain that can eventually lead to a CTD complaint.

Perhaps not surprisingly, the basic principles behind the reduction of CTDs in the office are the same as those used to reduce the incidence of similar injuries in the plant, factory or warehouse. The first step, prevention, is achieved through the purchase and use of ergonomically correct equipment and training and ergonomic design of the workstation. These redesigns are more easily accomplished in the office than in an industrial setting because ergonomically designed equipment is readily available. Rehabilitation, which involves properly treating and managing injuries after they occur, is the second step.

Equipment Design

RISK MANAGERS who wish to implement ergonomically correct equipment into the office environment should first consult authoritative guidelines on how this can be accomplished. Agood resource is the "American National Standard for Human Factors Engineering of Visual Display Terminal Workstations," published by the Human Factors Society (HFS). This report provides detailed guidelines for setting up an ergonomically correct computereed office. Many office furniture and equipment manufacturers follow these guidelines when designing their products. Since ergonomically correct equipment exists, the risk manager's challenge is to ensure that the right equipment and furniture are chosen, and that they are suitable for each worker's unique job duties.

Among all the equipment in an office workstation, the most important piece is the chair. A well-designed chair will greatly enhance the worker's comfort and allow an ergonomically correct position for all work tasks. It will reduce back stress, eliminate pressure or pinch points to the legs, and allow for optimal arm and hand positioning.

Even those chairs advertised as ergonomically designed should be evaluated closely before purchase. The HFS guidelines can be used as a standard against which to measure the chair's features. In addition, risk managers should solicit the opinion of supervisors and employees familiar with jobs and workstations where the chairs are to be used. Risk managers should also ensure that each individual's needs - and not just his or her job title - are taken into consideration when issuing the chairs. For example, executive chairs with armrests and larger seats may be appropriate for some nonmanagement level personnel due to their job tasks or body see.

Each worker's duties should be considered carefully when selecting new equipment. For example, equipment needed by a word processor who is primarily responsible for data entry is different from what is needed by an accounts receivable clerk who uses the computer less frequently, and often while using the phone or referring to documents. The word processor will probably need a document holder and an adjustable keyboard and monitor. However, the accounts receivable clerk may need more space, with the computer placed in a corner to provide a work surface for writing; the clerk's job tasks can also be made easier through the use of a phone headset, which would free the hands for writing and keying in data.

Training also plays an essential role in the prevention of CTDs. Companies must oversee the training of all workers, such as managers, supervisors and production employees, in the application of basic ergonomic principles, as well as in the early identification of and remedies for CTDs. However, problems can still occur. Despite state-of-the-art, ergonomic office equipment and basic training, some companies still suffer from climbing CTD rates. In many cases, this rate is due to the inappropriate use of the new equipment. For example, an employee may not know how to adjust a new, ergonomically correct chair in order to achieve the proper sitting posture. In addition, experts recommend that workers make occasional changes in posture in order to minimize the adverse effects of prolonged sitting. As a result, risk managers need to ensure that all equipment is being used appropriately.

Medical Management

DESPITE THESE preventive measures, today's fast-paced offices with increasingly specialized duties, combined with the different capacities, ages and health levels of office workers, make it impossible to implement a universally successful ergonomics program. As a result, CTDs will probably never be totally eliminated. In addition, due to previous years of cumulative stress, some workers will report CTDs even after a complete and effective prevention program has been put into place. Therefore, medical management or rehabilitation programs are vital to reduce the cost and severity of those cases of CTDs that do occur.

Recognition and Rehabilitation

THE FIRST STEP in medical management is early recognition. Training programs should provide information about CTD symptoms to those workers who are most susceptible; this step will help a company recognize CTDs when they are in the early stages. Often, the early symptoms of CTDs manifest themselves when the worker is at home; for example, a worker may put pressure on an injured nerve while sleeping. Without appropriate training, the worker may not realize that these early symptoms are linked to work activities. As a result, the CTD may develop to an advanced stage that requires surgery or extensive and costly rehabilitation. By recognizing early symptoms, workers can either adjust their own equipment or get the necessary help to reduce or eliminate ergonomic stressors. Consequently, early intervention can reduce a worker's injuries and prevent the need for drastic medical treatment such as surgery.

Once a CTD has occurred, and the employee has been on disability for a period of time, a return to work program must be developed and implemented. First, tasks that led to the injury must be analyzed and modified to reduce or eliminate any stressors that may have contributed to the CTD. Sometimes, this process will result in an immediate solution to the problem, thus allowing the worker to return directly to his or her regular job. Often, however, the employee can return to work only on restricted duty; this means providing the worker with different tasks or reduced work hours. In most cases, restricted duty allows the injured worker to build up a tolerance for work activities, thus reducing the chance that the CTD will reoccur.

Since most office jobs involve the same types of work- typically sedentary tasks such as typing and keying in data - alternate job tasks can sometimes be difficult to find. This lack of alternative job assignments can force companies to place injured employees on disability. Therefore, the importance of CTD prevention and early recognition is obvious; by effectively accomplishing these goals a company can eliminate human anguish and company cost.

Government Regulations

IN RESPONSE TO the escalation in the number of CTD complaints, office worker advocacy groups, unions and other organizations have pushed for legislation to force employers to take steps to control the problem. For example, in 1990 San Francisco passed comprehensive legislation regulating computer, or visual display terminal (VDT), usage. Though this legislation has since been repealed, some states have modeled proposed bills on those of San Francisco. Generally, these bills would aim to provide VDT users with user-friendly, ergonomic equipment, train workers to recognize and prevent the conditions leading to CTDs, and provide workers with regular work breaks.

The Occupational Safety and Health Administration (OSHA) is also responding to the increase in CTDs. OSHA published ergonomic guidelines covering the red meat industry in 1990 and is now considering standards for general industry. With potential fines recently increased from $10,000 to $70,000 per willful violation, risk managers have even more reason to try to decrease the number of CTDs by developing and implementing an ergonomics program.

Though not directly related to office ergonomic issues, Title I of the Americans with Disabilities Act of 1990 (ADA), which became effective in July of this year, provides further motivation for companies to address ergonomics issues. The ultimate purpose of the ADA is to eliminate discrimination against individuals with physical and mental disabilities. Among other provisions, the ADA mandates that medical status, including past workers' compensation history, cannot be considered prior to offering an applicant a job, and that reasonable accommodations must be made to allow disabled employees the opportunity to work.

The ADA can have relevance for companies that have workers suffering from CTDs; for example, an employee with a CDT-related back problem would have to be offered an ergonomically correct chair as a reasonable accommodation. And in general, ergonomic job design will allow more people, with and without disabilities, to do their jobs more efficiently and safely, and while greatly reducing the risk of future injury.
COPYRIGHT 1992 Risk Management Society Publishing, Inc.
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1992 Gale, Cengage Learning. All rights reserved.

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Author:Rickert, Kathleen A.
Publication:Risk Management
Date:Aug 1, 1992
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