Work Related Upper Limb Disorders

by

Thomas J. Armstrong
The University of Michigan
Ann Arbor, MI 48109

Copyright © 2002, Thomas J. Armstrong


--- Contents ---

IV. Program for Control of Cumulative Trauma Disorders
4.1 Goals
4.2 The Process
4.3 Ergonomics Team
4.4 Health Surveillance
4.5 Analysis of Jobs:
4.6 Control Measures
V. References

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IV. Program for Control of Work Related Disorders

4.1 Goals

The goal of an ergonomics program is to establish an ongoing mechanism for systematically identifying affected workers and jobs, for implementation of medical and work interventions, and for evaluating the effectiveness of those interventions.

4.2 The Process

4.2.1 The Plan

Management commitment

Goals statement

Long term

Short term

Tasks necessary to attain goals

Identify people who will perform the necessary tasks

Schedule for completion of necessary tasks and goals

A written program description should be tailored to fit each organization

4.2.2 The Components (see Figure 5.1)


Figure 4.1: Organization chart of an ergonomic program for control of cumulative trauma disorders. (adapted from work by ANSI accredited Z365 Committee on Control of Work Related Cumulative Trauma Disorders)

4. 3 Ergonomics Team

The causes of cumulative trauma disorders can be attributed to many job design factors and management policies at most work sites. Therefore, an ergonomics program should enlist the support of management, engineering, faciliti es, safety, medical and labor. It is recommended that an ergonomics team be established to:

It may be desirable to establish teams in each production area of a work site. It is desirable to appoint a team coordinator to act as a liaison among team members.

Caution: Certain team functions may be a violation of the National Labor Relations Act (see: Bernstein 1993)

4. 4 Health Surveillance

4.4.1 Objectives

4.4.2 Passive surveillance

sources of information:

OSHA logs - see Section I.J.2 Compensation reports Medical visits Personal medical records

Limitations: reporting may be influenced by:

4.4.3 Active surveillance

a. Health surveys

b. Fatigue surveys

Comfort patterns (Scott and Huskisson 1976; Borg 1982; Price et al. 1983; Corlett & Bishop 1978; Habes 1984; Melzack 1975; Harms-Ringdahl 1986) --- See Appendix B

4.4.4 Statistics

a. Incidence rates

b. Prevalence

c. Identifying high risk groups

d. Limitations

Small sample sizes & unstable work patterns often make it difficult to statistically validate findings

e. Example:

Upper limb musculoskeletal case reports for 6 months at an instrument engineering and manufacturing plant

n

Cases

Incidence Rate1

Relative Risk2

Production Area

       

Dept. 1

13

0

0.0

0.0

Dept. 2

12

4

66.7

44.5

Dept. 3

23

0

0.0

0.0

Dept. 4

23

1

8.7

5.8

Dept. 5

39

4

20.5

13.7

Dept. 6

4

1

50.0

33.3

Total

114

10

17.5

11.7

Office -Hrs Keying

       

<4 hrs

133

1

1.5

1.0

4-6 hrs

253

2

1.6

1.1

>6 hrs

253

5

5.1

3.4

Total

581

8

2.8

2.8

1 - Cases per 100 workers per year
2 - Relative risk with respect to keying < 4 hours per day

f. References

4.5 Analysis of Jobs:

4.5.1 Objectives

Identify and rank specific risk factors for:

4.5.2 Methods

4.5.3 Analysis Procedures

a. Document job attributes

Information needed to characterize job:

Sources of information

b. Assess Ergonomic Stresses

See: Work Factors

4.6 Control Measures

4.6.1 Design

Possible areas for work improvement:

4.6.2 Evaluation

Often it is necessary to evaluate solutions to determine their effectiveness.

4.7 Training

4.8 Management of Restricted Workers