PHOTO CAPTION: When you visit a company’s facility, you can witness firsthand the actions required of workers to perform their jobs. This on-site analysis allows you to properly evaluate how ergonomics could be improved to prevent strain and injury.

A perspective on on-site analysis of worker ergonomics in the COVID-19 environment.

by Virginia Halling, PT

As the Delta variant of COVID-19 surges and the economy continues to ramp up (albeit a little more slowly now), many companies across the country are struggling to hire, rebuild, and retain their workforces. Keeping workers healthy and uninjured as demand falls to those who remain in the workplace and new workers are hired is as important now as it has ever been. Employers are under considerable stress when it comes to these factors, and have limited time and resources as they struggle to meet customer demand. As if that is not enough, many are facing other challenges such as materials shortages.

With this as the backdrop, let’s take a look at the opportunities rehab professionals have to help employers and their workers. The key component here being the willingness of certain members of the rehab practice to step outside of the four walls of the clinic, enter the workplace, and apply their professional skills to analyzing jobs. Our professions are under stress as well, to be sure. However, it is imperative that we make sure that the practices we work for and with are reaching out to support the companies and employees of the communities we serve.

Analyze the Job

A physical demands analysis leads to a document that defines the physical nature of a job. This step is critical to applying any level of ergonomic intervention and also serves a broader range of value. Although the focus of this article is on ergonomics, it is important to keep in mind that a well-designed, function-based job analysis can and should serve within the scope of ergonomics (designing work to fit the worker better), but also can and should go further.

Humanomics is a term historically used to describe the interface of humans and economics. It could also be used to describe the matching of the worker to the work—the reverse of the common definition of ergonomics—which is also important. With this borrowed interpretation, humanomics would include job-based physical demands testing, targeted education initiatives, customized new employee training, initiatives to condition employees for their new jobs, and more.

Whether discussing ergonomics or the concepts of humanomics as defined above, it begins with a structured evaluation of the key critical functions of a job, otherwise defined as essential functions, primary tasks, or job functions. As each is explored and the associated physical demands are identified, measured, and documented, an understanding of the physical nature of the job is conveyed.

Testing

Physical demands tests designed to reflect the nature of the job can reveal how new-hires “fit” the job in question. It is often the case that certain of the physical demands prove to be the most challenging. These should become the focus for ergonomic and humanomic interventions. In this way the job analysis and the post-offer employment test can reveal to a company what needs to be addressed to improve the retention of newly hired employees. Beyond improving retention, this can substantially reduce first-year injuries.

There are a number of articles on the topic of post-offer employment testing that show a correlation between hiring and placing employees who are a good “fit” for the job and reduced injuries, workers’ compensation costs, and turnover. At this moment in time, however, many companies don’t see themselves as having the option of being selective. They need employees to fill empty positions. They need to get workers in the door. So now the job analysis that served as the base for testing and to rescind offers of employment needs to serve differently. The results of testing need to be used to identify ergonomic and humanomic stressors that should be addressed as soon as possible to retain workers.

Professional Qualifications

Most rehab professionals who participate in ergonomics are not board certified. Some certainly are, but the majority who have obtained advanced education have done so through workshops that certify the completion of coursework and a specified number of projects and reports. These professionals go forward to make a significant impact on work injury reduction and improved production and quality in the workplace. It is because of their advanced skill set that therapists, for example, bring to the coursework and subsequently to the workplace that the results of their interventions are so impactful.

For instance, physical and occupational therapists have a significant background in biomechanics, which positions them well to evaluate the impact of forces acting on the human body. Members of both fields also have extensive background in injury, illness, and disease and are accomplished evaluators. These professionals are actively sought out by employers, insurance companies, and even state entities such as North Dakota Workforce Safety & Insurance and JobsOhio for skills related to both humanomics and ergonomics.

Rehab professionals bring their unique body of knowledge to ergonomics by engaging with employer representatives at every level. Improving the fit of the work to the worker can take place at the individual worker level, group level, maintenance level, and engineering level. Employers can be quite good at problem-solving ergonomic issues once they know what to focus on. Even at the level of physical demands analysis (pre-ergonomic study), the more visible issues can be pointed out and addressed.

Rehab professionals who are not at the board certification level are more likely to be found working closely with a company’s internal resource personnel to solve the more obvious physical demand issues. Often, these interventions are cost-efficient and can be implemented quickly. Although longer-term solutions likely involve engineering changes, these early interventions produce results almost immediately if implemented and monitored correctly.

Case Examples

To demonstrate the ways in which rehab professionals can provide intervention to improve worker ergonomics on a production line, here are two examples.

Case 1: Machine Operators

Machine operators at two different but adjacent machines were loading 50 lbs of product at a time into hoppers and then unloading the machined product and placing it on a cart to transfer it to the next machine station. The height and angle of the hopper where product was loaded forced the workers on both machines to lift a heavy weight of 50 lbs (force) at a height and angle that required the shoulders, elbows, and wrists to be in an awkward and elevated position (posture), and this was repeated approximately every 10 minutes (repetition).

Short-Term Intervention: Maintenance was able to add a platform, effectively lowering the height of the hopper, and also change the angle (tilt modestly toward the worker). This improved worker posture. Force and repetition were unchanged, but workers reported less discomfort and fatigue overall with the improved positioning of the hopper.

Long-Term Intervention: Engineering was assigned the task of designing a conveyor system to load the hopper at machine 1 and then transfer product directly into the hopper of machine 2, essentially eliminating the need to load the hopper manually.

This is a good example of how short-term interventions can be implemented quickly with rehab professional interaction while longer-term solutions (often 1 to 2 years in the making) are ergonomically studied in more depth, designed, constructed, studied, and implemented.

Case 2: Packers

Packers on nine separate lines packed empty bottles into cartons for transfer to the filling department. The pace was very fast: two bottles, one in each hand, every 10 seconds (repetition). The cartons were tall and upright, requiring workers to reach up and over the top repetitively, with shoulders and elbows well out of neutral (posture). The bottle weight was negligible.

The rehab evaluator readily identified the posture influence and was able to correlate it to worker complaints of neck and shoulder discomfort and fatigue. Several workers had been off work with shoulder strains, and there was a history of several workers having rotator cuff surgeries. The rehab professional was invited to discuss the findings and help identify potential solutions.

With the input of workers, safety, and engineering, a new feature was added to the conveyor line. As the cartons entered the loading area, they were now tilted toward the worker, effectively reducing the height of the box and allowing the worker to load the box without raising the elbows. Workers reported less fatigue and discomfort even though the pace was unchanged.

Rehab professionals possess the necessary skills to work closely with companies, ergonomists, and engineers to implement ergonomic initiatives for employees at their place of work. They can take advantage of such opportunities if they are willing to venture on-site. The key word is on-site. RM

Virginia Halling, PT, is CEO of DSI Work Solutions. For more information, contact RehabEditor@medqor.com.