1. Upper Extremity Musculoskeletal Disorders Recognition and Control

2. Work Related Upper Extremity Musculoskeletal Disorders Repetitive Motion Disorders (Exposure) Highest median days away from work (18) Carpal Tunnel Syndrome (Nature of injury/illness) H ighest median days from work (28) Tendinitis (Nature of Injury/Illness) Median 11 days from work

3. Evidence for Causal Relationship Between Physical Work Factors and MSDs StrongInsufficient Body PartEvidenceEvidenceEvidence Risk Factor(+++)(++)(+/0) Neck/Shoulder RepetitionX ForceX PostureX VibrationX Combination

4. Evidence for Causal Relationship Between Physical Work Factors and MSDs StrongInsufficient Body PartEvidenceEvidenceEvidence Risk Factor(+++)(++)(+/0) Shoulder RepetitionX ForceX PostureX VibrationX Combination

5. Evidence for Causal Relationship Between Physical Work Factors and MSDs 5 StrongInsufficient Body PartEvidenceEvidenceEvidence Risk Factor(+++)(++)(+/0) Elbow RepetitionX ForceX PostureX CombinationX Hand Wrist Tendinitis RepetitionX ForceX PostureX CombinationX

6. Evidence for Causal Relationship Between Physical Work Factors and MSDs 6 StrongInsufficient Body PartEvidenceEvidenceEvidence Risk Factor(+++)(++)(+/0) Hand/Wrist Carpal tunnel syndrome RepetitionX ForceX PostureX VibrationX CombinationX Hand-Arm Vibration Syndrome VibrationX

7. Common Risk Factors Force and Repetition Force Repetition Posture

8. WRUEMD Risk Factor Examples

9. Risk Factor Examples

10. Look for Clues- Checklist

11. Look for Clues Checklist

12. Look for Clues-Quick Assessment Tools Washington State Hazard Zone and Caution Zone Checklist  http://www.lni.wa.gov/wisha/ergo/evaltools/CautionZones2.pdf http://www.lni.wa.gov/wisha/ergo/evaltools/CautionZones2.pdf  http://www.lni.wa.gov/wisha/ergo/evaltools/HazardZoneChecklist.PDF http://www.lni.wa.gov/wisha/ergo/evaltools/HazardZoneChecklist.PDF Computer User Checklist Construction Ergonomic Checklist  http://www.elcosh.org/en/document/4/d000003/construction-ergonomics-checklist.html http://www.elcosh.org/en/document/4/d000003/construction-ergonomics-checklist.html  http://www.elcosh.org/ http://www.elcosh.org/

13. Risk Factor Examples

14. Look for Clues Risk Factor Checklist

18. Prioritize Jobs for Improvement The frequency and severity of the risk factors you have identified that may lead to injuries The frequency and severity of complaints, symptoms, and/or injuries Technical and financial resources at your disposal Ideas of workers for making improvements Difficulty in implementing various improvements Timeframe for making improvements

19. Questions for selecting improvement options: o Reduce or eliminate most or all of the identified risk factors? o Add any new risk factors that have not been previously identified? o Be affordable for our organization (e.g., is there a simpler, less expensive alternative that could be equally effective)? o Affect productivity, efficiency, or product quality? o Provide a temporary or permanent “fix”? o Be accepted by employees…will it affect employee morale? o Be able to be fully implemented (including training) in a reasonable amount of time? Make Improvements

20. Follow Up Questions for evaluating improvements: o Reduced or eliminated fatigue, discomfort, symptoms, and/or injuries? o Been accepted by workers? o Reduced or eliminated most or all of the risk factors? o Caused any new risk factors, hazards, or other problems? o Caused a decrease in productivity and efficiency? o Caused a decrease in product and service quality? o Been supported with the training needed to make it effective?

21. CONTROL TECHNOLOGY Tool redesign Workstation redesign Job methods Job rotation Rest Breaks Machine pacing Medical surveillance  Early detection

22. Right Tool For The Job

23. REDUCTION OF REPETITION Task Enlargement Mechanization Automation

24. REDUCTION OF EXTREME JOINT MOVEMENT (EASIEST) Altering tool or controls Workstation Design Moving the Worker

25. REDUCTION OF FORCE Reducing the force Spreading the force Better mechanical advantage

26. REMEMBER WORKSTATION DESIGN GUIDELINES Design where hands spend most of time Normal reach envelope Elbow height Edge compression Limit forward reaches to 16!

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31. Industry and Job Specific Guidelines http://www.osha.gov/SLTC/ergonomics/index.html http://www.cdc.gov/niosh/topics/ergonomics/ http://www.elcosh.org/ http://www.oshainfo.gatech.edu http://www.osha.gov/SLTC/etools/computerworkstations/index.html