OH 201 Principles and Methods of
Occupational Health
ERGONOMIC STRESSES AND
RISK FACTORS
VIVIEN FE F. FADRILAN-CAMACHO, MD, MPH, FPAFP
Associate Professor
Department of Environmental and Occupational Health
College of Public Health
1
Objectives
At the end of the session, the students should be able to
answer the following:
• What is Ergonomics and its origin?
• What is the magnitude of problems related to
ergonomic issues?
• What are the goals and benefits of Ergonomics?
• What are the potential risk factors for adverse health
effects?
• What are the basic control measures against
ergonomic risk factors?
2
Objectives
At the end of the session, the participants should be able
to answer the following:
• What is Ergonomics and its origin?
• What is the magnitude of problems related to
ergonomic issues?
• What are the goals and benefits of Ergonomics?
• What are the potential ergonomic risk factors for
adverse health effects such as musculoskeletal
disorders?
• What are the basic control measures against
ergonomic risk factors?
3
Let’s start with a case…….
• MC with no co-morbidities, 36yo/F with a complaint
of right shoulder and neck pain
• 1 year PTC - transient, minor pain and discomfort
while working with the visual display terminal (VDT)
• 3 weeks PTC – progressive and more frequent pain
described as dull and throbbing at rest and sharp
upon movements of the neck causing limitation in
movement
• Pain score was worst at 8/10 and 0/10 at night after
work
• Relieved by rest, Ibuprofen and self-massage
4
What other questions do we need
to ask?
What is the assessment?
How do we manage this patient?
5
BRIEF HISTORY
Stone Age
• Earliest steps toward a science of ergonomics
• Stone tools progressively shaped over
centuries to be easier to use and fit the hand
better
Ancient Greece
• Ergo (work)
• Nomos (laws)
6
BRIEF HISTORY
• Ergonomics actually
originated in Poland in 1857
• Term used by Wojciech
Jastrzebowski for the first
time 1857
• derived from the Greek
words:
– ergon/ergos (work) • Ergonomics is the “science of
work”
– nomikos/nomos (law - • ‘Science of Work’ in the
control and orderly comprehensive and integral
assignment sense
7
ORIGINS OF ERGONOMICS
• Ergonomics in the UK arose out
of World War 2 when scientists
were asked to determine the
capabilities of the soldier in
order to maximize efficiency of
the fighting man.
• In the US, ergonomics arose out
of psychology and cognitive
function in the aviation industry
and was termed “human
factors.”
8
ERGONOMICS
• Scientific discipline concerned with the understanding of
interactions among humans and the other elements of
a system, and the profession that applies theory,
principles, data and methods to design in order to
optimise human well-being and overall system
performance.”
• “Ergonomists contribute to the design and evaluation of
tasks, jobs, products, environments and systems in
order to make them compatible with the needs, abilities
and limitations of people.”
-International Ergonomics Association, 2000
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ERGONOMICS
Scientific study
• Effective interaction of people interact with
elements at work and in everyday living (tools,
workstation, physical environment, etc.)
Goals
• To match design of equipment, workstation,
procedure, tasks with the capabilities, limitations
and needs of individuals
•To optimize worker comfort, health and productivity
“Ergonomics” = “Human Factors”
à user-centered design
10
APPLIED ERGONOMICS
• Physical–human anatomy, anthropometrical,
physiological, biomechanical characteristics as they
relate to the physical activity/work
• Cognitive–mental processes eg perception, memory,
reasoning, motor response as they affect interactions
between man and work systems
• Organizational–optimization of socio-technical work eg
organisational structure, policies, processes
11
PROFESSIONAL BACKGROUNDS
• Psychology
• Anthropology
• Industrial
Engineering
• Computer Science
• Industrial Hygiene
• Safety
• Health
12
• Muscular work • Occupational stress
• Nervous control of • Boredom
movements • Job design to avoid
• Work efficiency monotonous tasks
• Body size • Working hours and eating
• Design of workstation habit
• Heavy work • Night and Shift work
• Handling loads • Vision
• Skilled work • Lighting
• Human-machine systems • Noise and vibration
• Mental activity • Indoor climate
• Fatigue • Pleasant work environment
THE SCOPE OF ERGONOMICS
‘FITTING THE TASK TO THE HUMAN – A Textbook of Occupational Ergonomics’
5th edition, E. Grandjean, Taylor & Francis 1998
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ERGONOMIC CONSIDERATIONS
• Physical factors
– ambient conditions; objects (tools, furniture, etc.)
• Biological factors
– body dimensions, body capabilities, physiological
processes
• Psychological factors
– mental workload, information processing, training,
motivation
• Work factors
– job demands (time, rate, etc.), job design
• Organizational factors
– organization type/climate, management regimes
14
RELEVANCE OF ERGONOMICS
• New, complex and ever changing
technology
• Mobile workforce
• Elastic contract workforce
• Changing demographics
15
FITTING THE JOB TO THE PERSON AND
PERSON TO THE JOB
When analyzing work and how it can be improved from an
ergonomics point of view, there are five elements that need to be
addressed:
1. Worker: the human element of the workplace; physical and
cognitive capacities; experience and skills; education and
training; age; sex; personality; health; residual disabilities.
2. Job/task design: what the employee is required to do and what
they actually do. It includes job content; work demands;
restrictions and time requirements such as deadlines; decision
latitude, working with other employees; and responsibilities of
the job.
16
FITTING THE JOB TO THE PERSON AND
PERSON TO THE JOB
3. Work environment: the buildings, work areas and spaces;
lighting, noise, the thermal environment.
4. Equipment design: the hardware of the workplace. It is
part of ergonomics that most people recognize and
includes electronic and mobile equipment, protective
clothing, furniture and tools.
5. Work organization: shiftwork; consultation; inefficiencies
or organizational difficulties; rest and work breaks;
teamwork; how the work is organized and why; the
workplace culture; as well as the broader economic and
social influences.
17
Figure 2. Five Elements to Consider in Ergonomic Analysis of Work
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EFFECTS ON
PERFORMANCE
low product quality
high rate or errors
material wastage
equipment damage • absenteeism
Ergonomic
imbalance • accidents
in the • compensation
work system costs
musculoskeletal
vascular
visual/ ocular
hearing
skin
Psychological
EFFECTS ON HEALTH
Compensated Cost of occupational injuries
and diseases (ILO, 2010)
Cost s b y disease
3% 3% 8%
9%
40%
14%
7%
16%
Tu m o r s Central Ner vous Sy st e m
Respiratory Di seases Accidents
Mental Disorders Heart Di seases
Musculoskeletal Diseases Skin Di seases
20
OCCUPATIONAL DISEASES All Industries (Establishments employing 20 and over)
Source of data: 2011/2012 BLES Integrated Survey (BITS)
Musculoskeletal disorders and days away from work in 2006
Nursing aides, orderlies, and attendants had a MSD rate of 252 cases per 10,000
workers, a rate more than seven times the national MSD average for all occupations. 22
BENEFITS OF ERGONOMICS
• Greater efficiency
• More productivity
• Fewer acute injuries
• Fewer musculoskeletal problems among
workers
• Less fatigue among workers
• Less spoilage of work and higher-quality
products or levels of service
• More satisfied workers
23
WORK-RELATED MUSCULOSKELETAL
DISORDERS
• these disorders are
multifactorial in nature
• partially caused,
• personal characteristics and aggravated,
psychosocial risk factors accelerated or
may contribute to WMSDs exacerbated by
• development requires adverse working
weeks, months or years of conditions
exposure to ergonomic risk
factors
• recovery is likewise
prolonged
24
RISK FACTORS
• Force
• Posture
• Vibration
• Repetition
25
Generic Ergonomic Risk Factors at Work
• Repetitive exertions • Extreme temperature, noise
• Lighting (e.g. glare)
• Posture stresses
• Vibration
(including awkward
• Job design – overtime, shiftwork,
static posture)
manually-operated, monotonous,
• Forceful exertions increased workload, “too many
• Contact stresses hats to wear,” tight deadlines
• Work organization - problematic
relationship with boss and peers,
lack OHS policies, programs and
services
http://www.measurabilities.com/Disability-and-Work-
Interruption-Prevention/blog/?Tag=Return-to-Work 26
27
AWKWARD POSTURES
Elbows above Bent Back Squatting or Bent Wrists
shoulders or Neck Kneeling
28
Summary of evidence linking risk factors and WMSDs
(Source: A critical review of epidemiologic evidence for work-related musculoskeletal disorders of the
neck, upper extremity, and low back, 1997, Cincinnati, OH: US DHHS publication (NIOSH) 97-141
Body Part Strength of
Risk factor Evidence
Neck and neck/
shoulder ++
Repetition ++
Force +++
Posture +/0
Vibration
Shoulder
Posture ++
Force +/0
Repetition ++
Vibration +/0 29
Summary of evidence linking risk factors and WMSDs
(Source: A critical review of epidemiologic evidence for work-related musculoskeletal disorders of the
neck, upper extremity, and low back, 1997, Cincinnati, OH: US DHHS publication (NIOSH) 97-141
Body Part Strength of Evidence
Risk factor
Elbow
Repetition +/0
Force ++
Posture +/0
Combination +++
HAND/WRIST
Carpal Tunnel Syndrome
Repetition ++
Force ++
Posture +/0
Vibration ++
Combination +++ 30
Summary of evidence linking risk factors and WMSDs
(Source: A critical review of epidemiologic evidence for work-related musculoskeletal disorders of the
neck, upper extremity, and low back, 1997, Cincinnati, OH: US DHHS publication (NIOSH) 97-141
Body Part Strength of Evidence
Risk factor
BACK
Lifting / forceful movement +++
Awkward posture ++
Heavy physical work ++
Whole body vibration +++
Static work posture +/0
31
High risk repetition rates by body parts (Kilbom 1994)
Body Part Repetitions per minute
Shoulder More than 2 ½
Upper arm/elbow More than 10
Forearm/wrist More than 10
Finger More than 200
32
33
EVALUATION OF
ERGONOMIC RISK FACTORS
• Characterize hazards
– Duration of exposure
– Magnitude of exposure
– Recovery time
http://www.eatprayandblog.info/making-money-online/computer-back-
pains/attachment/bad-posture-cartoon/
34
Methods to Evaluate Ergonomic Stresses
Measuring Method Advantages Disadvantages
Observation (checklist; No equipment Observer training; not
job analysis) needed; nominal to possible to observe all
ordinal measures; aspects of work
minimum time
Calculation Minimum Requires simplifying
equipment; absolute assumptions; requires
measures considerable knowledge
Instrumentation Absolute measures Requires equipment and
intensive training
Psychophysical No equipment Requires study of several
(Comfort/discomfort needed workers doing the same
rating) job
35
COMMON BASIC APPROACHES
• Changes to make the machine/workplace more
easily adjustable
• Design it to fit the reach, height or other dimension
of worker
• Make meters and gauges easier to read
• Reduce the force required to move a lever or operate
a tool
• Make fit of a tool in hand more comfortable
• Lower how high the worker must lift materials
• Reduce number of steps or movements worker must
make
36
SELECT INTERVENTION
OBJECTIVES
•reduce magnitude of risk factors
•reduce duration of exposure
– lengthen recovery time
– use other muscle groups and joints
– improve posture
37
SELECT INTERVENTION
• Look at available scientific information
• Learn from similar companies or companies
with similar processes
• Look at available guidelines, laws, standards
http://mpatkin.org/
38
SELECT INTERVENTION
Administrative control
• management or personnel
methods
– job rotation
– work enlargement
– rest breaks
– motion economy
– training and education
http://www.palmerchiropracticcenter.com/low_back_treatment3.html
39
SELECT INTERVENTION
Engineering control
– workplace modification
• work location and
dimensions
• tool design
• mechanical aids
http://zrhbzeds.homeip.net/funny-office-
cartoon-images.html
40
INTERVENTION
Ergo Knife
Electric deli slicer
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INTERVENTIONS
42
WORKSTATION DESIGN
avoiding tasks that require
excessive reach
Canadian Standards Association
43
44
45
ERGONOMICS PROGRAM
Identify ergonomic risk factors
Evaluate risk factors
Select intervention
Implement intervention
Monitor effectiveness
of intervention
46
Here is the link to the video that I showed you in class:
Office Ergonomics: Simple solutions for comfort and
safety
Identify ergonomic risk factors that will predispose
him to WRMSDs. Give ergonomic recommendations.
