factors. Completion of the job analysis results in identification of

ergonomic stresses, design of interventions and follow-up evaluation of the

interventions.

There are two levels of job analysis. They are:

1. Surveys/Walkthroughs (Level 1) are a basic method of identifying risk

factors associated with the performance of work. Service unit ergonomics

teams, in consultation with health care and safety professionals, conduct

the surveys. Checklists are useful in completion of the

survey/walkthrough. Other resource material is available in Safety

Services.

2. Analysis (Level 2): Ergonomics team members conduct detailed job

analysis in work areas after determining and prioritizing those jobs that

warrant analysis. All personnel conducting ergonomic job analysis must

have received specific training in ergonomic job analysis and

intervention techniques. The job analysis process identifies and ranks

specific risk factors, documents job attributes, and assesses ergonomic

stress factors.

a. Documentation: The following constitute documentation of the job

analysis:

(1) Position description: The official position description

permits the analyst to compare job function to the intended goal/objective.

It is possible that the findings of the analysis may support changes in

position descriptions.

(2) Direct observation: Risk factors in a job or work area

studied can be determined by direct observation. The analysis includes, as

necessary, upper extremity repetitive measurements for total hand

manipulations per cycle, cycle time and total manipulations or cycles per

shift. Where appropriate force measurement determinations are needed these

can be estimated as an average effort or peak force. Force measurements

can be obtained using appropriate test equipment (if available).

(3) Supervisor/employee interviews: Staff, including labor

organization representatives, provide a broad knowledge base regarding job

history and problems. All job analysis includes on-site interviews with

employees, supervisors, and labor organization representatives.

(4) Videotaping is the preferred method of documenting a

specific job analysis, in most cases. It helps the analyst understand the

task demands on the worker, and how each worker accomplishes the task.

Videotaping requires the presence and activity of the worker. Use of a

checklist aids in accurate documentation of conditions present during the

analysis. Where videotape equipment is not available use of a checklist is

even more important.

b. Assessment of Ergonomic Stresses: During the detailed analysis,

some specific actions and/or potential stressors are evaluated for impact

on the worker. There are four specific stressors for which the analyst

should be alert. They are noted below.

(1) Repeated and sustained static exertions: Does the

performance of work, required in the position description, require these

exertions, or do they result from a work practice?

(2) Forceful exertions: Where forceful exertions are

identified in the analysis some specific steps may be required for

evaluation and intervention. It may be necessary to estimate loads and

friction resistance, make posture adjustments, determine need for

mechanical aids, consider use of gloves, and evaluate muscle use with tools

such as resistance meters and surface electromyography equipment.

(3) Localized mechanical stresses: Does the work require

specific forces and/or contact with areas of the worker's body?

(4) Posture stresses: Identification of posture stresses can

be accomplished through job analysis observation and/or video tape. The

analysis may be supplemented with instrumentation noted in (2) above,

analysis of orientation of the worker in relation to the work, review of

types of tools used, and use of anthropometric data.

Design of Jobs.

When considering design or redesign of jobs the objective is to

minimize ergonomic stresses present in the performance of the work.

Interventions considered must eliminate or reduce employee exposure to the

potential for suffering from CTDs and other back and upper extremity pain,

while allowing accomplishment of the organization's mission.

1. Propose interventions. A complete job analysis includes reporting

of the findings, recommendations for design of control measures, and

evaluation of actions taken. The report may be formal or less formal,

depending on the extent of recommendations for change. Intervention is

accomplished through the application of appropriate engineering changes,

and/or implementation of

administrative control for the work. Intervention is followed by

evaluation.

1.1 Engineering Changes include actual modifications to the physical

work site and any tools or equipment used in the work process.

Determination of needed changes may require assistance of medical, safety

and other recognized experts.

(1) Tools - Are power assists available? Can handles be

changed?

(2) Machines/Equipment - Are changes necessary to the

equipment? Economic impact may be a necessary consideration in some cases.

1.2 Administrative Controls are necessary as interim protective

measures, pending completion of required engineering changes. In some

situations administrative controls may be the only intervention needed.

(1) Work area - Can changes be made in the work/equipment

location and orientation? Are proper chairs used?

(2) Methods - Is there another way to do the work? Is job

rotation allowed?

(3) Standards - If standards are established for the

work, are they realistic, up-to-date?

(4) Schedules - Are schedules flexible enough to provide

periodic rest breaks and/or on-the-job exercises? Are work schedules

flexible?

(5) Education/Training - Are employees trained to recognize

problems and take proper action?

(6) Maintenance - Is equipment with moving parts, e.g.,

wheels, lifts, etc., properly inspected and maintained?

3. Evaluation. Each intervention action taken to prevent/reduce CTDs and

other related disorders requires follow-up evaluation to assess

effectiveness of the action. The evaluation can be accomplished through:

a. Job Analysis - using the methods described above,

and/or

b. Active/Passive Surveillance - methods described in

Surveillance.

c. Assessment - evaluation of information from a. and b. above

to determine whether the goal has been achieved

MEDICAL MANAGEMENT

The goal of medical management is to ensure evaluation, diagnosis and

treatment of repetitive strain disorders, and to provide avenues for

prevention. Integration of medical management is essential to the success

of the program. All medical evaluations, records, and data as well as

results of surveys etc. are handled in a manner which preserves the

anonymity of individual employees and maintains the confidentiality of

personal and medical information. The components of this program are:

Accessibility; Health Surveillance; Identification of Restricted-Duty Jobs;

Medical Intervention; and Record-keeping, Data Evaluation, and Action.

Employee investment in the problems, along with early medical

intervention and good open communications between Health Services and other

treating clinicians, are key to success.

Accessibility

The health care providers must be accessible to the employees to

facilitate treatment, surveillance activities, and recording of

information. This may be accomplished via walkthroughs and educational

initiatives. The walkthrough increases visibility and provides a forum for

interaction and exchange of information.

Health Services undertakes educational initiatives for different

types of cumulative trauma disorders (CTDs), their causes, prevention, etc.

These are carried out through new employee orientation, health forums,

_Gazette_ articles, brochures, posters, etc.

Health Surveillance.

The Health Services Office serves as a principal member of the

surveillance team assessing and analyzing symptoms surveys, and encouraging

and receiving early reports of symptoms. This role is more clearly

outlined under Surveillance.

Identification of Restricted-Duty Jobs

The objective of a restricted-duty assignment is to provide a chance

for healing or rehabilitation of an injured area by assigning the worker to

a position that does not involve the use of the injured muscle-tendon

group. This type of assignment is individualized to each worker. A list or

data base of jobs categorized according to ergonomic risk from high to low

is to be developed. The identification process requires job analysis (see

Analysis and Design of Jobs). As these job analyses are completed,

relevant information is added to the official position description.

Medical Intervention.

Appropriate medical evaluation and care is essential to prevent the

development of more serious medical problems. The main objective of

medical management is to identify and treat disorders at a very early

stage, and minimize progression or exacerbation. This includes health

interviews and examinations. These examinations are in the form of, a

baseline evaluation, a post conditioning period evaluation, and a periodic

assessment. The baseline or preplacement exam would determine capabilities

(as opposed to disabilities) and identify required job restrictions. The

examinations are job-specific, based on the official position description,

initiated by the supervisor or Human Resources, and administered by Health

Services. The post-conditioning evaluation is done no later than 1 month

after a new position is assumed to determine if there are symptoms

consistent with the breaking in of muscles as opposed to the onset of a

cumulative trauma disorder (CTD). The periodic assessment is oriented

towards early detection of health changes in at-risk workers

Responsibilities are outlined in Program Management.

Record-keeping, Data Evaluation, and Action.

It is important to maintain accurate records. OSHA logs, medical

records, compensation reports, and Safety Services injury reports, as well

as the results of symptoms surveillance, are the epidemiological tools in

assessing the workplace and employees and determining trends and costs.

Original sources, used in the work

1. gopher://marvel.loc.gov:70/00/employee/health/ergonomics/program3

2. www.ergosci.com

3. www.osha.com

4. http://www.ergonomics.org/

5. http://www.combo.com/ergo/atwork.htm

6. http://www.usernomics.com/hf.html

7. http://www.cordis.lu/src/g_001_en.htm#SEARCH

8. http://www.cdc.gov/niosh/jobstres.html

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