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Feature Articles

Looking into the Eye of the Reform (SB899)

 

In this issue, we will discuss the numerous reforms passed this April regarding workers’ compensation and the impact it will have on your business.

In a historical move this past April 19, 2004, Governor Arnold Schwarzenegger achieved bipartisan agreement on workers’ compensation reform measures to help the state’s ailing system. The comprehensive reform package was developed behind closed door sessions primarily between labor and management teams, leaving out the special interests of insurers and attorneys. The result was a reform package that is likely to respond to the concerns of the California employer and offer a number of concessions to injured workers in the coming months and years. The framework has been developed but in many of the reforms, details still need to be worked out over the next year.

The reform package contained in SB899 by Senator Poochigan features changes to numerous areas and also repeals a number of past legislations that were designed to save money but back fired after they were implemented. Not all areas of the reform will be discussed in detail.

Indemnity Payments and Statewide Fixes:

●Creation of fair and impartial treatment under the law for employers by refining the “Liberal Construction Statute”.

● Further the definition of “Cure and Relieve” by conforming to medical treatment based on guidelines in the American College of Occupational and Environmental Medicine’s (ACOEM) Occupational Medicine Practice Guidelines.

●Elimination of subjective “work capacity guidelines” and replacement with objective earning capacity ratings as it pertains to permanent disability awards using the AMA guidelines for objective impairment descriptions and the Rand report.

●Prohibit multiple permanent disability awards for the same injury by assigning liability for only that portion caused directly by the current work place injury.

●Prohibit against workers receiving disability payments for injuries or portions of injuries occurring outside of work. Physicians will need to determine the percentage of permanent disability that was caused by the present work-related injury and the portion caused by the non-work related activity/injury.

●Caps temporary disability payments after 2 years (with some exceptions for severe injuries).

●Eliminates the onerous penalty provision so that penalties are assessed on the actual late payment rather than the entire claim.

●Insurers must inspect the safety program for high hazard workplaces with an experience modification factor of 2.0 or >.

MEDICAL TREATMENT:

●Provisions that require workers to use Employer specified network physicians for the entire duration of their treatment to allow for near 100% total medical control of the injured workers claim.

●Establishment of an independent medical review process so that doctors make treatment decisions, not lawyers. Allows injured worker to seek alternative opinion regarding a disputed treatment outside of network.

●Provisions of objective AMA guidelines on evaluating impairment ratings to improve the consistency of disability awards.

●Permanent and total repeal of the primary treating physician presumption.

●Requires that workers seek immediate medical treatment, reducing the potential for expensive litigation in the system. Requires employers and insurers to immediately pay for medical treatment up to a maximum of $10,000 once an injured workers has filed a claim.

●Shifts in benefits from minor to more severe injuries resulting in reduced permanent partial disability for less severe injuries and an increase in benefits for those with more severe injuries.

This list highlights the most significant reforms contained in SB899. Many of these go into effect immediately, while others begin in 2005. Understanding the impact of the reforms on your organization’s workers’ compensation policies and procedures are essential. Employers’ are encouraged to update their workers’ compensation management programs to reflect these changes. For additional information, contact any of the following:

Alison Heller-Ono MSPT, CIE, CDA, CMC; 888-288-4463

California Coalition on Workers’ Compensation; 916-441-4111

Administrative Director, Division of Workers’ Compensation, Sacramento, CA.

Forming Medical Networks:

Beginning in January 2005, employers may establish networks composed of both occupational and non-occupational treating doctors (25%). This applies mostly to self-insured entities. Employers with workers’ comp. insurance should rely on their insurer to form the appropriate network. The network should provide a sufficient number of physicians and other health care providers (HCPs) to provide timely treatment. The employer or insurer have the exclusive right to decide which providers are in the network. Furthermore, compensation to HCPs will not be based on reducing, delaying or denying treatment. The medical network (MN) will use treatment protocols in accordance with the ACOEM guidelines or other accepted guidelines developed by the Admin. Director. Only the licensed physician in the appropriate scope of practice can modify, delay or deny a request for authorization for treatment.

What all this means for employers is more control over the care of your injured employees. The formation of MN will allow the employer to select the physicians and other providers including PTs, OTs, etc. who are qualified and can demonstrate the expertise, experience and knowledge needed to medically manage workers’ comp. claims. Employers are encouraged to seek out providers that understand work injuries, ergonomics and return to work.

Return to Work Incentives

SB899 has included some additional incentives for those employers who actively seek to return injured workers back to work. For those employers with 50 or fewer full time employees, the law provides for reimbursement for worksite modifications to accommodate the employee’s RTW. The program will reimburse up to $1250 of expenses to accommodate a TD worker or $2500 for a PD worker. Another incentive for employers who return PD employees back to work is a 15% reduction in the weekly rate of the payments of the PD award. If no RTW is offered, the PD award is increased by 15%. This adjustment only applies to >50 employees. Further details will be forthcoming from the Admin Director as to how small employers can apply for the refund.

 

 

MOUSING AROUND THE KEYBOARD: Part II

In our last issue (Spring/Fall 2003) we explored the hazards of pointing of pointing device use while keyboarding . This included a variety of common postures and habits users perform that could lead to injury while using these devices. In this issue, we identify a variety of alternative solutions to reduce and or eliminate pointing device use or increase the overall comfort of the user with the device.

There are an endless variety of pointing devices on the market today for computer users to select from making the choice a difficult one. However, when pain develops in the upper extremity and hands from use of these hand tools, the choice becomes even more difficult. An ergonomic analysis of the situation is strongly advised to determine whether the problem is a result of placement of the tool, the work surface, the tool itself or the user’s body mechanics with the tool. If the situation warrants a change in the tool, the end user should be aware of the variety of options in the marketplace today. Below is a list of just a few options to assist in making the change to healthier pointing and clicking.

 

In some cases it is necessary to completely eliminate the need to grasp and click the mouse. One such product is RSIGuard (www.rsiguard.com) which is an integrated approach that is designed to reduce repetitive computer activity. A unique feature is the AutoClick which eliminates the need to do two of the most demanding activities of grasping and clicking the mouse. Autoclick’s automatic clicking option simulates a mouse click whenever you stop moving the mouse. The feature allows the user to also assign hotkeys on the keyboard that allow the user to perform single clicks, double clicks, triple clicks, right/left click and right drag lock with simple key presses further reducing the repetitive nature of mousing.

Another option is voice activation or recognition software which has become increasingly advanced over the years to assist hand injured users.

This option works to eliminate mouse use to the extent feasible. Products available today include Dragon Naturally Speaking Voice Dictation Software and the Qpointer. These programs require time to establish voice recognition and often after use begins, the work product requires editing via the keyboard and mouse. None-the-less with a little patience time and a private area, this option can be a livelihood saver.

If the tool is identified as the problem, then seeking out an alternative mouse might be the right solution. There are now dozens of alternative shapes to support the hand more effectively. These options include the following:

The Perfit Mouse by Contour Designs offers a variety of sizes from x-small to x-large and right/left hand. use.

The 3M Renaissance mouse is an upright “handshake” design.

The Goldtouch mouse fits in the palm of the right hand with a curved design, easy grip ridges and scroll button.

The Whale mouse by Humanscale fits any size hand, left or right and offers a low profile.

Optical and cordless mice may help to ease the function of pushing and moving the mouse and allow more convenient placement of the tool.

Trackballs are entirely different in that the user no longer pushes or grasps the tool. However moving the ball with the fingers and hands, while offering different mechanics can sometimes lead to aggravation of the hand if safe practices are not observed.

An entirely different line of products is now available which avoids the traditional  hand use associated with mousing. This includes the Rollermouse by Contour Designs which centers the pointing device under the space bar and eliminates the need to reach left or right. Other options include touch pads, optical pens and pads for CAD use, foot pedal pointing devices and the HeadMouse

. The Contour Rollermouse

Whichever product you choose, keep in mind the need for proper placement, a “warming up” period to get used to the alternative design and safe work practices. In many cases, users may need to try more than one device. Also, keyboard shortcuts are a great way to reduce mousing effort.

To request a free copy of the complete 4 page newsletter, email alisonh@worksiteinternational.com and we will put you on our mailing list and send you our most recent copy.

MOUSING AROUND THE KEYBOARD: Part 1

Part I: This article explores the hazards of pointing device use while keyboarding and identifies a number of habits, postures and positional causes that contribute to the onset of right upper extremity RMIs.

OSHA statistics indicate most work injuries are related to high risk activities such as those that require forceful or heavy exertions. These overexertions are the leading cause of back injury today, especially in manufacturing and heavy industry. However, running closely behind is the trauma associated with manual tasks that require repetitive motion. OSHA statistics

indicate a significant level of RMIs associated with sedentary to light tasks such as keyboarding and mouse use. One might ask how can such a simple task lead to injury and cost so much?

First, it is important to understand physically what occurs with an overuse injury, especially one related to mouse use. The most common injuries are

Trigger Finger

Wrist Extensor Tendinitis

Elbow Extensor Tendinitis

Rotator Cuff Tendinitis

Tension Neck Syndrome

There are others that may result, including various nerve compressions. All of these are significant injuries that can result from repeated biomechanical stress over an extended period of time resulting from pointing device use.

Quantifying the amount of exposure such as how long and how often the tool is used is important. Users exceeding 2-4 hours cumulative daily use are likely more vulnerable to these injuries. The software format is also important.

Many soft wares rely highly on pointing device use such as database programs, customer service software, graphic design programs and internet searching.

Using the pointing device has significant biomechanical forces requiring sustained grip along with repeated finger motion when using the traditional mouse. Trackball mechanics vary based on the position of the roller ball, either top mounted or thumb driven. None-the-less, both tools drive repeated finger and thumb motions. The primary difference is the traditional mouse requires a firm grip to stabilize the mouse or to move and drag it effectively.

Perhaps the most significant stressors come from the postures assumed while mousing around the keyboard. Below is a series of metaphors for typical mousing postures:

The Mouse Chaser: Typically the mouse is used on the work surface along with the keyboard. The user drives the mouse forward on the desk until it is at a maximum full arm reach, often resulting in forward trunk inclination and poor back support.

The Rotating Mouse: Typically the mouse is placed on a keyboard tray that is >26” long and often set too low. The mouse is placed to the far right beyond the 10 key of the keyboard. The resulting posture is an open elbow angle with significant right shoulder external rotation creating fatigue to the entire upper extremity including the neck.

The High Mouse: This posture results when the mouse is placed on the desk about 4-6” higher than the keyboard on the keyboard tray resulting in an extended arm reach.

The Anchored Mouse: This often occurs simultaneously with the other mousing postures identified. This occurs when the arm is fully extended or the elbow is at an open angle and the user loads on the wrist, anchoring it on the mouse pad, palmrest or work surface. This results in contact stress to the wrist and creates a fulcrum of motion from the wrist forward allowing only the hand to move. The wrist is essentially locked in extension, limiting any upper extremity motion at the elbow or shoulder. This results in static muscle fatigue which ultimately can invoke the numerous injuries described earlier, including carpal tunnel syndrome.

DEVELOPING A QUALITY-DRIVEN ERGONOMICS PURCHASING PROCESS

This article is the last in a series on Quality.

Ergonomically designed products are regularly seen on T.V. and in the news these days. The term “ergonomic” is used in advertising daily to promote products that consumers use. From cars to refrigerators to pens to hair dryers to chairs, advertisers are defining products as “ergonomic” whether they are or not. When it comes to office furniture, accessories and supplies, just open any catalogue or walk down the aisle at Office Depot and any buyer is overwhelmed with “ergonomically-designed” products.

The trouble comes in not knowing which of these products are truly ergonomic. To really be able to identify an ergonomic product it should meet the following criteria:

It is comfortable to use.

It is easy to use and understand.

It’s use is practical.

It’s adjustable or can fit many different users.

It requires low force and encourages good postures when used.

So who is to decide whether a product is ergonomic or not? In most organizations, the decision comes directly from the Purchasing manager or supervisor. The challenge comes in selecting the right product for an employee (with a work injury) or even for a department or the entire organization.

Unfortunately, without the right training or knowledge regarding how to select an “ergonomic” product correctly, many Purchasing managers and supervisors make the wrong choice. In an effort to buy the right product for an injured worker, sometimes the wrong item is selected that doesn’t fit or in some circumstances, may even worsen the employees symptoms. Selecting the wrong product can often result in substantially more expense for the employer and frustration for the employee who usually must continue to use a product that is not quite meeting their needs.

Creating a quality-driven ergonomics purchasing process is one approach that should be considered. Such a program can help improve the success of selecting the right ergonomic product for the situation at hand.

In addition, it can help in a variety of other ways:

1. Assists in the budget management of purchases by controlling dollars spent and help obtain quantity discounts for multiple product purchases.

2. Provides quality control of products selected.

3. Offers consistency in product implementation throughout the organization so that each employee uses the same product.

4. Allows for better relationship development with vendors for improved customer service, quality control and maintenance.

5. Reduces errors in purchasing the wrong items when the organization allows purchasing at multiple levels.

Employers who rely on a Purchasing manager or supervisor to select and purchase ergonomic products are encouraged to send them to an Ergonomics training that offers education and information on how to identify and select the right ergonomic product for the right situation. Buyers should be aware of existing standards and guidelines that define quality furniture and other products for office or industrial use. The Human Factors and Ergonomics Society has recently released its draft standard on Human Factors Engineering of Computer Workstations which eventually will be submitted to the American National Standards Institute (ANSI) to become an official standard. This document is a revision of the previous ANSI/HFS 100 published in 1988. Another guideline for Visual Display Terminal furniture used in office work spaces is the guide put out recently by the Business and International Furniture Manufacturers Association or BIFMA. Both of these guides help the buyer to identify the criteria necessary to make the right selection. Having a good knowledge base and understanding of why products are designed the way they are will ultimately assure the proper selection and implementation of the selected product. By doing so, this further helps to define a quality ergonomics purchasing program.

Furthermore, employers are encouraged to develop an in-house guide for the selection and purchase of the most common ergonomic products used by the company. Experience in using the products successfully, receiving positive feedback from employees who use the products and appreciate the value of the product will help to identify which products are most appropriate for the guide. By creating an in-house selection guide, it can act as a standard for all those in the organization who must select and purchase product. This will enhance the quality of the ergonomics purchasing program by instilling consistency in the products used within the organization.

A good example is derived from a client who had established a furniture standards program that identified only certain manufacturers and work surface furniture that could be purchased. However, the standard was missing guidelines to select ergonomic chairs, articulating keyboard trays, telephone headsets, document supports, alternative keyboards and pointing devices, task lighting and other essential tools. The result was the organization had a multitude of poorly designed ergonomic chairs and keyboard trays that were not comfortable, useful or easy to operate based on the guidelines provided above. The employer took the time to create a quality-driven ergonomics purchasing process when they realized how much money had been spent on inferior product and how dissatisfied employees were with the existing equipment. Today, the employer has a comprehensive custom ergonomics purchasing guide that is available for product selection by purchasing, supervisors and others who make buying decisions driving quality deeper into the organizational process.

Finally, developing a quality-driven purchasing process that includes an in-house ergonomics purchasing guide will help to create a healthy and safe working environment for all employees. In addition, the guide should be considered a “work in progress” to be updated regularly to reflect changes in national furniture standards and ergonomic guidelines as well as changes to each vendor’s product line. By following through with a quality driven ergonomics purchasing process, the employer is guaranteed to save money, improve quality in product selection and increase employee satisfaction.

To learn more about how to create a quality driven ergonomics purchasing process, contact Worksite International for a complimentary onsite consultation and discussion of your current program. Call 888-288-4463.

Quality in Workers' Compensation Management

This article is the second in a series on Quality.

When it comes to managing a work injury at your workplace, how do supervisors know what to do? Does your organization offer a detailed quality oriented procedure of how supervisors should respond to employees concerns? Have supervisors undergone specific training identifying their role and responsibilities in the work injury process?

Often times, there are no written procedures or training to follow so supervisors respond based on their experience level or how they think they should handle the matter based on implied or unwritten policies at the workplace. Such accepted unwritten practices include," The worker must be 100% before returning to work” or “ We don’t provide modified duty”. Such practices are often biased, impractical and inappropriate. A worker is never able to give 100%, especially in a constrained system, which is likely how they were injured in the first place. People working in the system can only produce at the level inherent to the system. If there are internal problems with the work process, tools and materials or management, these will be exaggerated in the work injury process that does not offer quality integration.  

A supervisor’s response during the first minutes of the injury reporting process could be the difference between a successful outcome and a lawsuit. An approach that does not include quality management practices could lead to excessive claim costs, increased liability, reduced productivity, failed return to work and even a discrimination suit by the injured worker against the organization and the supervisor.

For the most part, employers have accepted work injury claims and costs as a part of doing business. This assumption has caused significant harm to employers impacting employee morale, production, medical expenses, increased liability and the bottom line. In fact, for every dollar spent on a work injury, employers spend an additional $2 to $5 on indirect costs according to Liberty Mutual, BLS and the National Academy of Social Insurance. An employer is advised to consider implementing a quality driven management program as it applies to work injury prevention and management. Management policies can limit quality or encourage improvement. This quality guideline or policy and procedure will help managers to realize the importance of responding appropriately to reduce the impact on the organization’s bottom line.

By implementing a workers’ compensation management policy based on quality, employers will assure reliability in the process, reduce failure and errors (lawsuits and failed RTW), save money and assure ease of implementation because of uniformity to the process. The “Fourteen Points to Quality Workers’ Compensation Management” is found below.

FOURTEEN POINTS TO

QUALITY WORKERS’ COMPENSATION MANAGEMENT

The “Fourteen Points” identified below are a derivative of Dr. W. Edwards Deming's, “14 Points for Management” from his book, Out of the Crisis published in 1982. The original 14 points served as the basis for transformation of American industry. It was meant to help solve big and small problems. Adoption and action of the 14 points signaled that management intended to stay in business with an aim to protect investors and jobs. Such a system formed the basis for lessons for top management in Japan in 1950 and in subsequent years. The 14 points listed below apply to large and small organizations, to service industry, manufacturing, private and public employers. As well, they apply to individuals, management, departments and divisions within a company. Implementation of the “Fourteen Points” below will drive quality change in your workers’ compensation process resulting in significant improvement in bottom line savings and organizational benefits.

1.Establish constancy of purpose towards managing work injuries with the aim of keeping the employee at work. Define in operational terms how managers should respond to employees who report work injury. Specify the standards and accepted practices.

2.Adopt the new philosophy. Unwritten rules and practices are no longer acceptable.

3.Don’t assume managers will do the right thing or will know what to do each time. Provide a support person or team to assure quality in the early stages. Use metrics to maintain quality standards.

4.Establish a long term relationship with a medical group that will support your quality workers’ compensation management process. Request the medical group show outcomes of medical care given to show healthcare cost management especially by supporting modified duty and return to work.

5.Improve safety on an ongoing basis to positively impact quality and employee productivity to decrease the cost of work injury.

6.Institute employee and manager training on the purpose and process of work injury management should one occur. Establish clear expectations up front to minimize inconsistency.

7.Institute leadership by improving supervision which ultimately is management’s responsibility.

8.Drive out fear so that employees report symptoms early, receive medical care promptly, are not demeaned by modified work activities and feel the need to file lawsuits resulting from inappropriate supervisor behaviors.

9.Break down barriers between departments so that Purchasing, Facilities, Information Systems and Human Resources all participate in the workers’ compensation process by addressing employee needs promptly. Use metrics to define expectations for each department.

10.Note accomplishments for employees and management for following safe work practices and implementing positive change in the workplace that drive health and safety initiatives.

11.Emphasize quality through the work injury process. Assure the injured worker and other workers understand the workers’ compensation management process by providing information in a variety of formats I.e. written, verbal, intranet.

12.Integrate the concept of pride of workmanship even in modified duty tasks by explaining to the employee the impact the task has on the organization.

13.Institute a vigorous program for (re)training people in new skills to facilitate job security and enhance employee value.

14.Create a structure in top management that will push every day on the above 13 points. Organize a task force with authority and obligation to act. Work with an experienced consultant for guidance. I.e. Ergonomics Task Force or Disability Management Team.

Quality and Ergonomics

 

This article is the first in a series on Quality and Ergonomics.

In a well organized system, all components work together to support each other. In a system that is well managed, everybody wins. According to Dr. W. Edwards Deming, the father of quality, as quality improves costs go down and productivity increases. Quality and productivity can be continually improved for better profitability. With this in mind, these are the same drivers that steer a company towards improving their workers’ compensation management and ergonomics process.

Many companies put the emphasis on employees to drive the change in safety behaviors and productivity improvements. For example, employers will provide employees with back safety belts to protect them from low back injuries. The reality is that some of the responsibility may come from the employee’s poor work practices of lifting, but it is more likely the set up of the task and how the work activity, tools and materials, and the layout were created by management that are likely driving the risk. Workers’ don’t determine the layout of the plant, the room temperature, the amount invested in research, development and training. They don’t buy the equipment, tools and materials or design products. They don’t determine 90% of things responsible for quality. Why then does management want to hold them responsible?

While workers play a critical roll in safety and ergonomics, it is management’s responsibility to change the system so that quality and productivity can improve and workers can experience pride of workmanship along with reduced risk of injury. In this way worker input becomes part of the process which in turn helps to drive quality.

What exactly is quality? According to Deming, quality is made in the boardroom. Quality is pride of workmanship. If quality is integral to the product or service, than quality is a function of management. As quality improves, costs go down and productivity increases. Quality and productivity can be continually improved.

With this in mind:

Quality= Pride of Workmanship.

Workmanship=the art or skill of a work man.

Ergonomics = the interrelationship of man and work (tools, materials handled, tasks performed).

Therefore…..Quality = Ergonomics.

It is management’s policies that can limit quality or encourage improvement. Most managers are in need of profound knowledge to maximize quality through workers’ compensation management and ergonomics. This knowledge can only be improved through training. Training will lower costs, reduce risk and improve the dollars saved in these areas. It is a critical part of improvement and is management’s responsibility, no other. Management training in these areas must be done right the first time or if learned incorrectly, economic hardships will follow further diminishing quality.

New Fed-OSHA Recordkeeping Rule

January 1, 2002 launches OSHA’s new injury/illness Recordkeeping rule which was revised to increase employee involvement, simplify forms and clarify regulatory requirements for reporting. The changes also enable employers to use computers to meet the written requirements. To summarize, Fed-OSHA has modified the following areas:

Simplification of forms 300 (Log), 300A (Incidence Report) and 301 (Summary)

Employee Privacy

Pre-existing Conditions        

Lost Workdays

Reporting of MSDs

The new forms 300, 300A and 301 are mandatory in recording injury/illnesses. Businesses are required to keep the old 200 forms for five years but do not need to update them. The new forms include information about how the injury occurred as well as new definitions for first aid, medical treatment, and restricted work.

Employees have access to form 301 to review their own injury/illness records. Privacy rights are extended to HIV,TB, sexual assaults or mental illness where employees can request their name not be used.

Pre-existing injury/illnesses require a “significant degree” of exacerbation in order for it to become work-related. “Significant

aggravation” of a pre-existing condition is considered work-related when it results in death, loss of consciousness, one or more days away from work, restricted work, job transfer or when medical treatment is required where none had been required previously.

The term “Lost Work Days” will now be replaced with “Days away from work, restricted work or job transfer”. There are also new rules for counting these days based on calendar days rather than work days. The day the injury or illness occurs is not counted as a day away from work and counting can stop after a maximum of 180 days away has been reached.

Another important change is expected to occur in January 2003 regarding the recording of Musculoskeletal Disorders (MSDs) as well as how Fed-OSHA will define MSDs. Work-related hearing loss will also be delayed until then as well. For now MSDs should be classified along side all other injuries, not segregated out.

In general, the new Recordkeeping rule was established to make the process of recording injuries and illnesses easier and more efficient. Data comparisons of past years to future years will be hampered because of the changes. However, incidence rates will be easier to calculate with the form 300A. There are a number of other changes as well. Additional information is found at www.osha.gov.

 

The 21st Century Tailor: The Ergonomist

Goodness of fit can be described as the closest match between worker and workplace to yield best practices and maximum productivity. It is something we knew very little about until recently. The birth of ergonomics and human factors in the modern world has brought the concept of “goodness of fit” to light. Since the late 40’s, ergonomics and human factors have woven their way into the fabric of our society without our awareness, a silent partner in the design of everyday things.

More likely by accident however, ergonomics has become the focus of attention, especially as it relates to Musculoskeletal disorders. The root cause of these injuries often reveal the engineering error that failed to recognize the human factor. The pain felt by a worker in his or her hands and wrists, elbows, neck or back from repetitive tasks, forceful exertions or awkward postures will often drive the pursuit of a solution for a better fit. The chaotic flow of people and papers in a busy work place built without consideration to tasks is in need of organization to maximize productivity and reduce stress. These areas all benefit from ergonomics.

It is the ergonomist that can resolve these issues; who can recognize their root cause and enhance the fit between the worker and machine, the tools and materials used, the tasks performed and the surrounding environment’s impact on the human. The “21st century tailor”, fitting the task to the human with camera and tape measure in hand, sizing up the user for the best fit possible to yield maximum comfort and productivity. The ergonomist is prepared to custom design the workstation to the worker, the hand tool to the hand, fit the chair to the office worker and reduce the extra unnecessary motions in a tedious process.

The ergonomist could be touted as the efficiency expert helping organizations to maximize human potential while minimizing the expense of error, pain, lost time and lost thought due to distraction and poor work design. In today’s world, we need to maximize our fit and performance. To do so, look for the 21st century tailor, today’s ergonomist… fitting the task to the worker one good fit at a time.

Worksite International is now providing expert chair fittings to assist employer clients with finding the right ergonomic chair for employees in need of a better fit. We provide the fit and the referral to the vendor for your convenience. Visit our vendor showroom featuring over 10 different USA and European designs at 2560 Garden Rd, Ste 101 Monterey, CA. To set-up an appointment with one of our 21st century tailors, call 831-648-8724 or visit www.worksiteinternational.com.

The 5th Percentile Employee

Ergonomics is the science of work or the relationship between humans and the workplace including the tools and materials handled, tasks performed and the environment in which it is performed. When humans are creating a place to perform work, it would make sense to consider the physical and mental characteristics of the human users. In essence, the design should match the capacities of the user to allow for:

  • Functional efficiency in productivity

  • Ease of use

  • Comfort

  • Health and Safety

  • Quality of work life

In order to achieve the best match possible in considering the human/machine interface, anthropometrics is important. Anthropometry, or “the measure of man” literally, is the branch of ergonomics that deals with body dimensions such as body size, shape, strength and work capacity. It is that part of ergonomics which is often poorly considered in the design and installation of new facilities and furniture which will be used by humans. An easy example to discuss is the relationship between the computer user and the ergonomic chair.

Many employers believe that one size fits all, at least it appears so as most all furniture and equipment is the same throughout the workplace. However, if we were to apply the concepts of Anthropometry, it would be wise to consider those individuals that don’t quite fit into the average population. Most furniture is designed to fit between the 5th percentile and 90th percentile human. For women, that would be 4’11-5’8 and for men, 5’4” to 6’1”. The 5th percentile employee is that employee which is less than or greater than the range or the remaining 10%. These small or tall stature individuals will not benefit from the ergonomic features and design of most chairs today. The chair simply will not provide the fit and comfort it was meant to provide for all the others. The armrests won’t go up high enough to support the forearms, the chair won’t go low enough for the feet to rest on the floor, etc. By the same token, those individuals that weigh less than the 5th percentile or greater than the 95th percentile will have the same issues, often impacting the safety of the chair as well. Most chair pedestals are not designed to support more than 250 lbs. By exceeding the weight capacity, the warranty in essence is violated and failure of the pedestal could occur, creating a significant liability for you and your employee.

With this in mind, how can an employer be better prepared to accommodate the 5th percentile employee. When buying and selecting furniture including chairs and work surfaces, assess the range of adjustability and ask the product vendor how much of the population will the product support. If the vendor replies all, be skeptical. Features such as height and width adjustable armrests that exceed ANSI 100 standards are helpful, pedestals that go as low as 15”-21”, seat depth adjustments are just a few features that would help. Anticipate that 10% of your workforce will need accommodating and reflect that in your purchase. Your employees and you will benefit from the comfort, quality and productivity achieved. Do you have a 5th percentile employee? We can help you find the right product. 888-288-4463.

Middle Management: Are They Your Weakest Link

In the course of providing ergonomic services and other strategies to business and industry, time and again I have seen clients struggle with gaining the support of its most critical link, supervisors and middle managers. This management entity is often the make or break component of your safety and ergonomics program success or failure and the driving force behind some of your workers’ compensation claims.

Employee relationships with supervisors provide an important social consideration in the causation of WMSD (Work Related Musculoskeletal Disorders). Work environments where supervisors aggressively pursue production, are non-supportive of employee’s and monitor employee’s performance closely cause substantial psychological stress as well as musculoskeletal health complaints (Smith et al, 1992). With increased psychosocial stress, employees are more likely to report symptoms associated with WMSDs. In turn, this dysfunctional relationship drives your claim frequency, occurrence and costs.

Why are supervisors and middle managers unknowingly the weakest link in your safety/ergonomics program? I believe it is a combination of many factors including the following:

  • Priorities are not toward safety.

  • Poor time management in handling safety responsibility.

  • Not tied to performance or accountability.

  • Lack of supportive feedback.

  • No training on the subject.

  • Do not see the value.

  • Lack of upper management support.

  • Do not understand the organization’s program.

  • Lack clear role and responsibilities in the process.

  • Do not trust leadership, employees or each other.

  • Fear of losing power.

  • Lack of self-interest.

So what can be done to strengthen the weakest link in your safety/ergonomics program? Middle managers must have a rational self-interest in such programs if they are expected to support them.

As a result, the following strategies will help to change or strengthen middle management participation in your corporate safety culture.

  • Share with supervisors/managers the overall corporate mission of the program frequently.

  • Align operating beliefs with corporate beliefs.

  • Create a participative management style.

  • Focus on results and rewarding results.

  • Encourage supervisor/employee teams to set standards and goals.

  • Appeal to self-interest to enhance motivation.

  • Maintain program values in concise, simple terms.
  • Assess how people are investing their time, energy and reputations.
  • Engage managers and supervisors in trainings that pertain to safety/ergonomics and gear the instruction specifically to desired outcomes the organization needs from them. (See article “Management Training Strategies for a Stronger Link”.)

By focusing specifically on the supervisor/middle management culture and its impact on the overall organizational culture as it pertains to safety and workplace health, you can expect to see dramatic changes in the perceived value of your safety and health program. These changes will positively impact improved employee/management relationships affecting your workers’ compensation claims and costs as well as productivity and morale.

Reference: Weiss, Alan “Managing for Peak Performance” Las Brisas Research Press, 1994. “Work Related Musculoskeletal Disorders”, Taylor & Frances, 1995

Management Strategies Training For A Stronger Link

In order to enhance middle management participation in your safety/ergonomics program, consider customizing training that addresses pertinent issues for these groups.

Executive training should include:

Supervisors:
  • Ergonomics training.
  • Basic structure and function of the human body at work.
  • Work methods to control/prevent occupational WMSDs.
  • Early recognition signs of WMSDs.
  • Information on medical referral and obtaining ergonomic worksite analysis.
  • Roles and responsibilities in return to work procedures, restricted duty and accommodating injured workers.
  • Understanding and managing the change process, including their role.

Managers:
  • Need for management commitment to reduce or prevent WMSDs and supporting injured workers.
  • Support training of supervisors and workers, set-up of WMSD prevention programs, recognition of work relatedness of WMSD and reinforcement of health and safety rules and principles.
  • Overview of ergonomics and WMSDs within the context of the company’s organization’s goals, polices and procedures.
  • Understand work related injury compensation, experience and cost.
  • Understand accepted standards, guidelines and regulations.
  • Macro ergonomics and system issues.
  • Management of change.
  • Cost expectations of process.
  • If you are interested in strengthening your management link, contact

Worksite International to learn more about our Executive Training Seminars specifically geared towards supervisors and managers. (888) 288-4463 or visit our Services section.

 
THE CUMULATIVE TIME BOMB OF RSI

Just as back pain often goes unreported as a work injury and instead is reported as a regular absence, so are repetitive strain injuries. Recent studies by the U. of Connecticut found that a random sampling of workers with self-reported discomfort to the neck and upper extremities far exceeded the number of reported claims. Of 292 workers, only 10% actually reported claims. More than half sought treatment, but only 20% were covered by workers’ compensation. 70% used their own insurance and a small percentage paid for care on their own.

Many employers don’t have any reported RSI claims and are therefore not motivated to implement prevention programs. However, the reality is that if employees are working aggressively at computers exceeding 4 hours or more per day and don’t fit quite right in their workstations, they are likely to be experiencing symptoms. As a result, the employer may be facing a cumulative time bomb which could easily result in unwanted RMIs that are severe and costly as employees failed to report early or only reported absent as a result.

The best solution is to encourage employees to come forward with their concerns so that an employer can respond proactively. Preventing the onset saves you 10-20 times the actual cost of an RSI and keeps the bomb squad away!

PRODUCT FEATURE: ERGONOMICS STRETCHING SOFTWARE

Looking for interruption software for your chronic computer users? These tools help to remind you to take frequent computer breaks. Check out the following:

STRETCH BREAK: designed by Paratechnologies, www.paratec.com, 714-546-8619. This program reminds you to take a short stretch break while working at your computer.

CYBERSTRETCH: designed by Jazzercise, www.cyberstretch.com, 760-434-2101. Modeled after “Jazzercise”, this program is an easy-to-use interactive screen saver for the reduction of muscle tension and RSIs.

Call the vendor or Worksite International for a preview of these programs.

 

  WWW.INSITEPT.COM 2000

Websites are useful tools for customers these days and Worksite International’s website is no different. Our site is modified quarterly for our visitors and has recently undergone a full renovation. Our new web design has been modified to reflect your needs. It’s an easy to use format and has the following contents for your convenience.

Our ABOUT Worksite International page introduces you to us, our consultants, our core concepts and practices, some of our customers and frequently asked questions (FAQ). We have a self-viewing presentation available for you as well.

Our PRODUCTS section allows you the convenience of ordering our book and software selections easily by offering you a downloadable order form with a description of our exclusive line of “Your Guide” books. We are now able to accept Visa and MasterCard for your convenience.

In our new SERVICES section, we offer a convenient table for you to point and click on the service description you are most interested in. Our service line offers 12 options for you to choose from as well as customizing your own programs.

In our PUBLICATIONS section, you’ll find our most current newsletter, a list of other published articles written by Alison Heller-Ono and our books for sale. We’ve also archived archived past newsletters as well for your review.

The NEWS AND EVENTS section provides you with a convenient calendar of events associated with Worksite International, ergonomics and workers’ compensation. In addition, our newsletter can be obtained here as well.

The SPEAKING OPPORTUNITIES page offers a comprehensive list of speaking topics available for your group luncheon or conference. Ms. Heller is able to customize a program based on your group’s interest.

Our last section, called

RESOURCES is full of downloadable forms for your convenience. We offer an easy Workstation Evaluation Model for you to use. Our Ergonomic Worksite Analysis Request Form is available to complete and fax to us to request a site visit. Our popular Ergonomic Certification Table is available along with our Product Order Form. We have also provided informative links for you to easily learn more about ergonomics and related issues.

Building and keeping up our website is important to us. We hope you’ll take the time to visit us online and let us know what you think. Send your reply to alisonh@insitept.com. And thank you for stopping by www.insitept.com.

 
 
RERS: REPETITIVE E-MAIL RESPONSE SYNDROME

Your familiar with CTS and RMIs, well know there is “RERS”, Repetitive 

E-mail Response Syndrome, a term coined here at Worksite International. Silicon 

Valley workers and many others around the world are experiencing a 

substantial increase in mousing and word processing demands in response to

co-workers’ emails. Some receive as many as 600/day. The visual and 

manual effort to view, scroll, sort, point, click, double click and click-delete 

alone increase pointing device use time by up to or exceeding 30% above 

daily task demands for many users. Instead of email, go back to nature. 

Use the telephone, fax, write a note and mail it, or take a walk. It’s likely 

the employee you are trying to reach is just a few cubicles away!

 

 

The Next Disability: Work Related Stress

Fall/Winter 1999

This past decade has been characterized by an increase in such musculo-

skeletal injuries as Repetitive Motion , Carpal Tunnel Syndrome (CTS) and 

back injuries. Employers have had to become more in tune with the physical 

demands of work as it relates to an employee’s functional abilities in 

performing the essential work tasks. With the ADA further supporting end 

stage workers’ compensation injuries that impact the worker’s ability to 

perform major life activities, employers have been faced with increasing 

demands to provide reasonable accommodations to these injuries.

 

In the 90’s we saw “bad backs” and CTS fill the #1 and #2 spot on the 

ADA’s most popular reasons for Title 1 discrimination complaints. But 

now, these physical impairments are being replaced by something even 

more elusive. If employers felt difficulty in accommodating employees 

with physical limitations, the challenge to accommodate for mental stress 

and other more severe psychiatric and emotional disabilities is about to 

begin. Move over bad backs, cause here comes work-related stress in the 

21st century. What are some of the drivers behind work-related stress? 

There are many that exist in the work and home. Here are just a few 

to consider:

DRIVERS OF WORK-RELATED STRESS

     Pressure and demands of restructuring and consolidation of 

        resources in business takeovers.

     Fear of termination

     Burn-out as the result of over-working in a “right-sized” company.

     The “Cellular Syndrome” of being available to your employer round 

        the clock or for extended hours beyond the usual 40.

     Increasing episodes of workplace violence, assault, rape and 

        murder in the workplace creating additional anxiety.

     Managing the home and family in the 2 working parent or one 

        parent household.

     Financial demands to earn more money to save for future 

        healthcare, retirement and your child’s education.

     If your organization is rapidly becoming a “stress bucket” of 

        over-worked employees, you can expect your workers’ compensation 

        claims for physical impairments to go up as well as mental.

Here are some tips to help minimize work place stress:

     Network with mental health professionals to better understand 

        the needs of individuals with stress related illnesses.

     Develop reasonable accommodation guidelines and strategies to accommodate.

     Use Employee Assistance Programs

     Develop flexible work schedules

     Train supervisors to be sensitive to stress

 

The ADA and Ergonomics Making Work-Life 
Easier 

(Winter 99)

 

Often workers’ compensation cases move into the realm of the ADA 

because an individual’s work injury impairment is significant enough 

to qualify as a disability. In order for an employee to prove that he/she 

is substantially limited in his/her ability to work, the employee must 

be restricted in his/her ability to perform a class of jobs or a broad 

range of jobs in various classes. If the individual qualifies under the 

ADA, the employer is required to look for reasonable accommodations 

to assist the individual in performing the essential functions of the job.

What exactly is a reasonable accommodation? A reasonable accommodation

(R.A.) assists the disabled worker in completing the work obligations of the 

essential functions of the job. According to the EEOC, the following are 

considered the most common types of accommodations:

  • Making all facilities accessible

  • Providing or modifying equipment

  • Job Restructuring

  • Auxiliary aids: voice activation, TDD

  • Support services

  • Modified work schedules

  • Reassignment to vacant position (if qualified)

Being reasonable implies that it meets the expectations of both the 

employer and the employee and at the same time allows the employee 

to accomplish the essential functions and the purpose

Determining R.A. is perhaps one of the most important tasks an employer 

can do to minimize liability and the threat of an EEOC lawsuit. 

Ergonomics can help in the R.A. process. Ergonomics is about 

matching the abilities and limitations of the worker to what is required 

on the job. By performing an Ergonomic analysis of the work area, 

the employer obtains critical information regarding the physical and 

mental demands of the job. Both the employer and employee can 

then see where the discrepancies are within the job by comparing the 

critical postures and work demands with the workers’ abilities and 

limitations. From this point, the appropriate R.A. can be determined 

and implemented in a timely manner creating a win-win situation for 

all involved parties.

 

If you are concerned about a workers’ compensation case going into 

a charge of ADA discrimination or have a disabled employee who 

requires reasonable accommodation, contact the Job Accommodation 

Network at 1-800-526-7234 or Worksite International for a Reasonable 

Accommodation Assessment at 1-888-288-4463.

 

Back to Table Of Contents

 

 

Developing An Ergonomics Process  

(Fall 98)

 

It’s over a year now since the Cal-OSHA regulation on RMI prevention was 

passed. If you are like most employers that meet the scope of the regulation, 

you are in the throws of developing your compliance strategy. Your 

obligation requires you to perform ergonomic worksite analysis on high 

risk tasks, develop hazard prevention and control measures and train those 

employees exposed to the ergonomic risk factors. There are many options

for employers today to achieve compliance. Anywhere from outside 

consulting assistance to in-house program development. There is a 

variety of interactive software programs, video programs and written 

manuals to assist you in your pursuit of compliance. Worksite International is 

proud to announce the release of a comprehensive, written process 

guide entitled, "Your Guide to Developing an Ergonomics

Process" that can be implemented by your in-house staff or with 

consulting assistance. Since 1993, we have followed Cal-OSHA’s 

pursuit of an ergonomics regulation and have created a start-up kit to 

meet the needs of today’s (California) employer seeking not only 

(Cal-OSHA) compliance, but workers’ compensation cost and claim 

reduction as well as productivity improvements. that can be implemented 

by your in-house staff or with consulting assistance. Since 1993, we have 

followed Cal-OSHA’s pursuit of an ergonomics regulation and have 

created a start-up kit to meet the needs of today’s (California) 

employer seeking not only (Cal-OSHA) compliance, but workers’ 

compensation cost and claim reduction as well as productivity 

improvements.

FEATURES

 

     The ergonomics process kit includes a 370 page primary manual, 7 

        team  workbooks to form an Ergonomics Task Force  and 

        a CD ROM of an impressive array of analysis forms and other  

        documents to assist in  implementation of your ergonomics process.

 

     Office ergonomics, assembly/material handling or laboratory 

        ergonomics, this process kit includes continuous improvement 

        measuring systems for analysis of your ergonomic concerns.

 

    The guide includes 3 overhead training kits on Participatory 

        Ergonomics, How to Develop an Ergonomics Task Force and 

        a comprehensive basic training course on CTD/RMI prevention 

        for employees and supervisors.

 

    A comprehensive list of strategies to address engineering issues, 

        administrative ideas, purchases and employee work practices is 

        included.

 

     A CTD medical management program that has form letters, symptom 

        screens and medical personnel procedures already designed for you 

        to use  with your healthcare providers.

 

     Critical ideas on how to gain administrative management buy-in to 

        your process.

 

    Monitor cost-benefit of the process with key indicators.

 

    Develop an in-house Ergonomics Task Force including roles 

       and responsibilities.

 

Alison Heller-Ono, M.S.P.T., CIE has spent 4 years of research and consultation

developing this guide for today’s employer. Outcomes show $4.50 Return 

on Investment for each $1.00 invested in implementing an Ergonomics 

process. The Guide is available for review at your worksite or at 

Worksite International. To arrange for an appointment, call (888) 288-4463. 

The Kit is published by Lewis Publishers and can be ordered on-line at

 www.crcpress.com (orders@crcpress.com) or through Worksite International.

Back to Table Of Contents

Safety Training Is Serious Business

Spring 1999

 

The Bureau of Labor Statistics reports that safety instruction is the single 

highest percentage of training activity per employee in the nation. 84% of 

employers with >50 employees provided OSHA training last year.

Developing an effective safety and health program requires essential 

training and education for employees to understand the requirements. 

Virtually all of OSHA’s safety regulations require some sort of employee 

training. The Fed-OSHA guidelines support 4 primary elements that 

include (1) management commitment and employee involvement, 

(2) worksite analysis (3) hazard prevention and control measures & (4) 

safety and health training. The primary reason for employers to provide 

training is so that employees understand the hazards they are exposed to 

and how to prevent harm to themselves and others due to exposure as 

well as assure accountability. Supervisors must be trained to carry out 

their safety and health responsibilities too. Supervisors should be able 

to analyze the work under their supervision to identify certain minimum 

standards have been set that require the employer to cover hazard 

communication and accident prevention. These include the following 

elements:

 

     Designate a responsible person(s) for the Safety and Health 

        Administration.

     Implement task specific hazard control measures which apply to 

        employees being trained. Include recognition of hazards, signs and 

        symptoms and employer protection measures.

     Include employee communication such as postings, newsletters, 

        handouts and safety meetings or committees, and supervisor/

        employee interactions.

     Set minimum safe work practice procedures and expectations 

        for employee compliance and as a condition of employment that 

        could result in disciplinary action.

     Provide reminder and training updates at least annually for new 

        employees and for employees who have violated safe work practices 

        or sustained injuries as a result of unsafe acts.

 

Training should include tests or exercises that facilitate adult learning. 

Employers should document in writing the content of training, dates 

occurring, the instructor, employee attendance and evidence that 

employees understand the training. Worksite International has consistently 

provided OSHA compliant training in ergonomics since 1993. 

 

Back to Table Of Contents

 
Worksite International Celebrates it’s Sixth Anniversary

Spring 1999

 

1999 began our 6th year in business already! Since we opened our doors in

1993, we’ve been able to positively impact over 100 companies and 

at least 1000 employees injury prevention and management. 

Not to shabby for a small start-up!

 

Back to Table Of Contents

  

SAFE COMPUTING WITH LAPTOPS

Summer  1999

 

Remember when you used a computer for the very first time? I was writing 

my master’s thesis and it was 1986. The program was Word Perfect. How 

strange that all felt then. Now computers are ubiquitous today compared 

to those days 13 years ago. Almost every electronic product we use has a 

computer in it. If your like me, you have at least 1-3 computers available to 

use at any time with at least one of them being a laptop computer. I find 

it confusing sometimes to decide where to put my information. I ponder 

when, if at all to carry the laptop with me. After all, I am already carrying 

a briefcase full of files throughout the day. Isn’t the pen still mightier 

than the sword if not the computer?

 

Since we are using computers more and more, laptop use is also becoming 

more common. As a global economy, we pack our computers like we 

pack our toothbrush. So, it’s important we use them as naturally as 

possible. By naturally I mean work as close to neutral as possible as the 

same basic ergonomic principles in the office apply with the laptop. 

It is sometimes more challenging as we don’t always have the room we 

need to set up properly for use. In addition, carrying the little gray box 

comfortably can also pose significant hazards to the neck and upper 

extremities. So here are some safety tips for computing with your laptop:

 

     Minimize eye fatigue and strain by taking "mini breaks" by focusing 

        on a distant object for a few seconds before continuing to work.

     Adjust the angle of the monitor screen to reduce direct light 

        sources and glare.

     Keep your head in a comfortable position, not overly turned or 

        tilted. Angle the screen so that it is perpendicular to your line of sight. 

        If you raise your laptop, make sure you can still keep your wrists in 

        neutral.

     Change positions often to avoid discomfort and muscle fatigue. 

        If you feel soreness, take your hands away and stop a