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February 06, 2015
Worker discomfort: More than a pain in the neck

At your next safety meeting, ask how many employees are experiencing some sort of back pain or muscle ache at the moment. If your business is like most, expect to see plenty of hands in the air. According to the Institute of Medicine, more than half of Americans live with pain. The annual value of lost productivity is around $300 billion.

This Compliance Report meets worker discomfort head-on with important information, including facts about backs and the risks of excessive sitting and standing. The focus is on practical solutions and recommendations by safety professionals, consultants, and risk management experts who know what works.

Back basics

Back pain costs employers and society billions of dollars each year. Like other types of worker discomfort, it is distracting and annoying. Back pain can make people depressed, angry, grumpy, and less likely to work safely.
 
According to the Texas Division of Workers’ Compensation, backs are not all that resilient. Once the back has been injured, it will never be strong as it had been. For employers and safety professionals, the goal is to prevent injuries from occurring, not only among those who do heavy lifting, pushing, and pulling but also for desk jockeys and other more sedentary employees.

The key to avoiding injury is to maintain the body’s neutral position, which is an S-shaped curve. The ideal posture is a straight line from the midline of the ears down to the shoulders, to the midline of the hips, knees, and ankles. This posture should be maintained while sitting, standing, reaching, pushing, and even sleeping.

For many workers, keeping that neutral posture while sitting is a real challenge. Sitting increases weight on the spine, and slouching places additional pressure on the back. Here are a few tips for encouraging proper postures:

  • Provide chairs with maximum adjustability.
  • Encourage frequent microbreaks. For example, deliver a message in person rather than by text or e-mail, stretch at the desk, or walk up and down a flight of stairs.
  • Provide adjustable work surfaces, especially if two or more employees share a workstation.
  • Train your personnel to use their chairs and other equipment to their benefit. The most adjustable chair is of little use if it’s not used properly.
  • Encourage employees to arrange their work areas to avoid excessive reaching overhead or bending over. Place heavy, frequently used objects near waist height to reduce bending and twisting to reach them.

Make sure everyone at your site, including the office staff, knows the basics of smart lifting. Avoid common mistakes like bending forward at the waist with legs straight and keeping the load too far from the body.

Like any worker protection initiative, a back safety program requires support from the top and a comprehensive plan. The following are some key elements you’ll want to include:

  • Management commitment. Managers play a role by leading training; addressing back safety in blogs, newsletters, and at meetings; and staying informed about any incidents or new initiatives. Another sign of commitment is a budget that adequately supports the back safety program.
  • Employee engagement, including identifying risks and solutions, selecting equipment, and investigating incidents.
  • Policy statement that describes the objectives and intentions of the program. This should be clearly conveyed during new hire orientation.
  • Defined safety duties that extend to personnel at all levels. Your employees need to know what you expect of them, such as following safe lifting rules and the consequences of noncompliance.
  • Goals and objectives. Be clear about what you want the program to achieve in the short and long term. Then develop tactics to support those goals and objectives.
  • Incident investigation and incorporating lessons learned.
  • Ongoing program improvement. Pay attention to incident trends and employee suggestions for improvement.

Standing: Problems and solutions

Employees who work on their feet all day (such as chefs, hairdressers, surgeons, and warehouse employees) know how exhausting and even painful it can be. Although excessive sitting has been receiving media attention as a significant health risk, standing for long periods is its own hazard.

Problems can include sore feet, swelling of the legs, varicose veins, muscle fatigue, low back pain, and neck and shoulder stiffness, among others. When standing, workers have fewer positions to choose from. They’re limited by the layout of the workstation and the placement of keys, controls, and displays. The result is more rigid postures and fewer choices for moving around and resting working muscles.

According to the Canadian Center for Occupational Health and Safety, “Keeping the body in an upright position requires considerable muscular effort that is particularly unhealthy even while standing motionless.” It reduces blood supply to muscles, which can cause fatigue and pain in the muscles of the back and neck.

Prolonged, frequent standing without the relief of walking can cause blood to pool in the legs and feet and inflammation of the veins. Excessive standing also results in immobility (“locking”) of the joints in the spine, hips, knees, and feet, which can lead to degenerative damage to the tendons and ligaments that bind muscle to bone.

Changing job design and providing seating to give workers some relief from standing can mitigate the risks. Other ideas:

  • Change positions frequently.
  • Make sure the workstation fits variously sized and shaped employees and provides adequate support.
  • Provide a foot rail or portable footrest to shift body weight from leg to leg.
  • Avoid extreme bending, stretching, and twisting.
  • Allow rest and exercise periods for workers.
  • Provide instruction in proper work practices.
  • Allow an adjustment period for workers when they return after being away for vacation, etc.

Sitting: Problems and solutions

Sitting has gotten a “bum rap” in recent years. One of the most frequently cited studies comes from the Mayo Clinic. Researcher James Levine found a link between sitting for long periods of time and health concerns like obesity and metabolic syndrome, which causes symptoms such as increased blood pressure, high blood sugar, excess waist-area fat, and abnormal cholesterol levels.

Levine concluded, “Too much sitting also seems to increase the risk of death from cardiovascular disease and cancer.” Some have gone so far as to call sitting “the new smoking” as a way to describe the dangers.

7 STEPS TO SMARTER LIFTING

Your employees have heard the basics of safe lifting. What’s difficult is to get them to heed the warnings and do the right thing consistently. If it’s been a while since you’ve gone over this essential safety information, consider a toolbox talk or safety quiz to get your staff engaged.

  1. Size up the load. Make sure it’s balanced and stable. Test the weight by moving it with your foot. If you cannot move it, you probably need help.
  2. Plan the lift. Make sure the path is clear. Look for possible traffic, trip hazards, or doorways. When lifting to another level, use the elevator, not the stairs.
  3. Support the load. Use a wide, balanced stance with one foot in front of the other. Make sure your footing is solid, with feet staggered, approximately shoulder-width apart for stability.
  4. Lift with the knees, not with the back. As you lift, bend the knees, keeping heels off the floor and getting as close to the load as possible.
  5. Get a grip. Grip the object with the palms, and make sure you can maintain the hold without having to adjust the grip.
  6. Keep the load close to the body to prevent arching the lower back. Tighten the stomach muscles and keep the head and shoulders up.
  7. Pivot, don’t twist. Moving the feet in the direction of the lift will eliminate the need to twist at the waist.

Jim Kidd, product manager for Humanscale, a maker of ergonomic chairs and other equipment, thinks that’s not an accurate description. The problem isn’t so much sitting, he says, as lack of movement, especially related to the rise in computer-related technology.

“Sitting isn’t bad, but sitting for long periods of time is bad.” According to Humanscale, integrating 2 hours of standing work into an 8-hour workday (15 minutes per hour) appears to be linked to improvements in weight control, cardiovascular health, and worker performance.

The company is among manufacturers of sit-stand workstations. Float is a full-functioning sit-stand desk, and QuickStand is a movable worktop mounted on a desk or other surface. Another product not yet available is Office IQ, which integrates sensors into a sit-stand desk to remind users when it’s time to take a break.

If sit-stand or treadmill workstations are not likely to appear at your business, it’s still possible to introduce motion into the workday. Levin, suggests walking with colleagues rather than gathering in a conference room for meetings. Levine says the impact of even leisurely movement can be significant. You burn more calories, which can lead to weight loss and increased energy. “Even better, the muscle activity needed for standing and other movement seems to trigger important processes related to the breakdown off fats and sugars within the body,” adds Levine. Sitting slows these processes, increasing health risks. Standing or actively moving kicks them back into action.

Blake McGowan is a managing consultant with the ergonomics consulting company Humantech. He agrees that when it comes to sitting and standing, it’s important to strike a balance. “There’s a little bit of misinformation in the general media but [I agree that] there are some potential health consequences of sitting—or standing—too long.” He says safety experts and others are finally realizing that excessive sitting or standing is where the problems arise.

“You don’t need to do a triathlon or CrossFit at work. You need some level of variation in your day to encourage movement, which promotes blood flow and the flow of nutrients and the removal of metabolic by-products.”  For example, McGowan says standing is worse for doctors and surgical nurses who work in a static position for long periods than for assembly-line workers who walk from the line to the parts bin and other locations throughout the shift.

Try this, not that

McGowan is not a fan of tactics like job rotation and pop-up screen messages that remind workers when to get up and move around. He sees them as disruptive and annoying to many people, who simply turn them off, ignoring the warning. McGowan also doubts the benefits of prework stretching, which he says “does very little to address the root cause of the problem” and only nominally alters the potential for injury. It can even worsen things for older workers who may injure themselves performing a stretch.

What he does favor are solutions that reduce forces and improve postures and that have a secondary benefit beyond improving worker comfort. An example is providing a printer in a central location rather than on every floor. This not only encourages people to move around but also lowers printing costs because fewer are in use.

The same approach works for coffee or beverage stations; having food in fewer locations throughout the workplace reduces the chance for ants, mold, etc. Similarly, says McGowan, offering garbage and recycling in one location motivates people to get up and walk there. It also eases the garbage-collection duties of maintenance personnel.

The best return on investment, according to McGowan, is from efforts to reduce forceful exertions and awkward postures by finding “things you can do today to make tomorrow better.” For example, a contractor whose workers are carrying around an average of 20 pounds (lbs) of tools could reduce that exposure by 5 percent, or 1 lb per employee.

Another example is a beverage delivery driver who off-loads thousands of pounds of sodas to stores every day. “You may not be able to provide a $300 lifting device for every driver. But think about how you could differently organize the product on the trip to avoid double handling,” he recommends.

Ideas at work

For additional perspective on successful techniques to reduce discomfort, we turned to Bruce Lyon, director of risk control, and Melissa Henrich, wellness consultant for the Hays Companies. Hays is a nationwide property casualty and employee benefits brokerage firm. Lyon confirms that back problems, strains, and sprains are among the leading disorders at client companies.

“In some cases, people just don’t know how to move or they are too much in a hurry due to productivity pressures.” He also observes that in many cases, today’s younger workers are less fit than prior generations.

Adds Henrich, “We’re seeing a huge rise in our neck and back claims, not just in manufacturing, warehousing, and transportation, but in white-collar jobs.” She faults increasing use of devices, physical inactivity, and failure to sit and lift properly.

Another problem is the tendency for manufacturers to think about employees as fairly generic in size and shape. If shelves are built for “average” employees, a lot of taller and shorter people are going to have to reach high and low to use them. Lifting and handling of materials should be done from the middle of the body, which is quite different for a worker who is barely 5 feet (ft) tall than for one who tops 6 ft.

“We try to engage at the design level with engineering people to look at ergonomic principles as well as safety to design in adjustability,” says Lyon. Considerations include everything from the location of control panels and staging areas to the adjustability of parts bins, placement of task lighting, etc.

While it can be challenging for safety people to convince upper management of the need for training, ergonomic equipment, and lifting devices, the cost of injuries provides a pretty impressive rationale. Musculoskeletal injuries account for about a third of all disabling injuries, and a single carpal tunnel surgery costs about $30,000. “Use those numbers to help articulate a cost benefit analysis,” Lyon suggests.

Henrich has seen many successful ergonomic interventions at workplaces where leadership understands the problem and employees are engaged in solutions. At one manufacturing facility, some employees on a government contract were required to participate in a preshift stretching program, while other teams in the same building did not stretch. When it was determined that the stretching group had fewer injuries, the program was expanded to everyone at the facility.

Some Hays client sites use a team-based approach to solve ergonomic problems. Employees, engineers, and others work together to prioritize risk and come up with solutions.

Notes Lyon, “It’s important that ergonomics and wellness are not treated as separate entities, but should be part of an organization’s overall way of doing business.”

Built to move

The human body was meant to move. For many reasons—including how cities are built, the nature of work, and the impact of technology—people move less than ever. We’ve invented the idea of “exercise” as a way to build back motion into our existence. But for many, perhaps including your employees, getting to the gym three times a week or even outside for a walk just isn’t happening.

Identify opportunities to reduce static sitting and standing, awkward postures, and repetitive motion, while increasing movement on the job. Find ways to help employees avoid the discomfort that often leads to injury, absence, and lost productivity.

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