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TO AVOiD FINES mum on or bdom duo duo. DATE DUE DATE DUE DATE DUE f—Ji—T MSU Is An Affirmative Actionfiquol Opportunity Inflation m1 AN ASSESSMENT OF ERGONOMIC INTERVENTIONS AND POLICY DECISIONS AT A LARGE PUBLIC UNIVERSITY By Anne M Kosinski A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of MASTER OF ART Department of Human Environment and Design 1995 ABSTRACT AN ASSESSMENT OF ERGONOMIC INTERVENTIONS AND POLICY DECISIONS AT A LARGE PUBLIC UNIVERSITY By Anne M Kosinski This study was conducted to examine the effectiveness of reducing Cumulative Trauma Disorders (CTDS) after the establishment and implementation of an ergonomics policy at a large public university. Worker compensation data was obtained from the Occupational Health and Safety Administration 200 Log. The frequency and severity of CTD claims were examined and compared between established pre and post intervention groups. Policy effectiveness was judged by the reduction of CTD claims, reduction of CTD claims associated with days away from work, and days restricted from work, reduction of the number of days away from work and the reduction of the number of days restricted. The results suggest that the ergonomics policy had an effect on reducing CTDS in the workplace after it's official announcement/implementation. Limitations of the study include the inherent characteristics of the workers' compensation systems in tracking of CTD cases, time frame of the study, and limited evaluation Anne M Kosinski of the policy goals. Recommendations for further study include a more descriptive analysis of the worker, job task, workstation design and ergonomic knowledge. ACKNOWLEDGEMENTS I want to extend my sincere gratitude to Dr. Timothy Springer for his support, insight, and guidance, throughout this research project and my graduate study. Thank you for being a wonderful friend and mentor. Appreciation is expressed to Dr. Ann Slocum and Dr. Alison Barber, members of my committee, for their recommendations and expertise. I also want to thank Kristina Seppala Whitaker in Human Resources for her continued commitment. As always, a special thanks is extended to my family, friends, and fellow colleagues for their encouragement and understanding. TABLE OF CONTENTS Chapter VI. VII. VIII. INTRODUCTION Problem Statement Purpose of Research Research Objectives REVIEW OF LITERATURE Cumulative Trauma Disorders and Worker Compensation Costs Ergonomics and Ergonomic Strategies to Reduce CTDS Standards and Regulations Research Literature ERGONOMICS POLICY AT MICHIGAN STATE UNIVERSITY HYPOTHESES METHODOLOGY AND PROCEDURES Source of Data Procedure RESULTS AND DISCUSSION CONCLUSIONS AND RECOMMENDATIONS Page 11 13 17 21 23 23 25 3O 53 REFERENCES APPENDIX A: University Committee on Research Involving Human Subjects Approval APPENDIX B: 1993-1994 Healthy U Survey: Summary of Findings, Work Related Health Issues APPENDIX C: Ergonomics Policy APPENDIX D: Cumulative Trauma Disorder Statistic - December 1994 Report APPENDIX E: Olin Health Center Ergonomic Activity APPENDIX F: Computing and Technology Training Program APPENDIX G: Administrative Information Services Ergonomic Activity APPENDIX H: OSHA 200 Log APPENDIX I: Number of Academic and Support Staff 1990-1994 APPENDIX J: Mean Number of Days Away/Restricted From Work by Three Month Time Frames vi 58 61 62 67 73 74 84 87 98 99 100 APPENDIX K: 102 Central Matching Funds for Ergonomics Improvement Memo vii Table 1: Table 2: Table 3: Table 4: Table 5: Table 6: Table 7: Table 8: Table 9: Table 10: Table 11: Table 12: LIST OF TABLES Three Month Interval Groupings for Pre and Post Intervention Classifications of Groups of Severity Based on Days Away/ Restricted From Work Days Away/Restricted From Work By Quartile Total Number of Claims, Pre and Post Intervention Total Number of Claims, Pre and Post Intervention Days Away From Work Total Number of Claims, Pre and Post Intervention Days Restricted From Work ANOVA: Days Away From Work by Pre and Post Intervention ANOVA: Days Restricted From Work by Pre and Post Intervention Chi-square Summary Statistics for Days Away/Restricted From Work - July 1, 1991 - December 31, 1994 Chi-square Test of Independence Days Away/Restricted From Work, Pre and Post Intervention Crosstabulation with Chi-square Test of Independence Days Away from Work, Pre and Post Intervention Groups 0 - 6 Crosstabulation with Chi-square Test of Independence Days Restricted from Work, Pre and Post Intervention Groups 0 - 6 viii 26 29 31 32 33 35 36 38 39 41 42 Table 13: Table 14: Table 15: Table 16: Table 17: Table 18: Table 19: Table 20: Table 21: Crosstabulation with Chi-square Test of Independence Days Away from Work, Pre and Post Intervention Groups 1 - 6 Crosstabulation with Chi-square Test of Independence Days Away from Work, Pre and Post Intervention Groups 1 - 6 Frequency Matrix for Days Away From Work by Quartile Pre and Post Intervention Frequency Matrix for Days Restricted From Work by Quartile Pre and Post Intervention Crosstabulation with Chi-square for Days Away From Work, Pre and Post Intervention by Combined Quartile Groups Crosstabulation with Chi-square for Days Restricted From Work, Pre and Post Intervention by Combined Quartile Groups Frequency of Occupation Classification Frequency of Department Classification Frequency of Body Part Classification 43 44 47 47 48 48 51 51 52 LIST OF FIGURES Figure 1: Average Days Away From Work by Three Month Time 35 Frames, July 1, 1991 to December 31, 1994 Figure 2: Average Days Restricted From Work by Three Month Time 37 Frames, July 1, 1991 to December 31, 1994 CHAPTER I: INTRODUCTION Over the past decade, informational demands, the personal computer, and increased growth in related new technologies have made remarkable changes in business and in personal lives. Technological advances such as the installation of the computer and more powerful word processing equipment have increased worker productivity. The amount of text being processed and data being entered in data base/computer systems continues to grow (US. Department of Labor, May 1992). AS we continue to advance into the information age, the use of computers is increasing. It is estimated that approximately half of America's workforce uses video display terminals (VDTS) daily (Roughton, 1993). "According to the U. S. Census Bureau, computer sales increased more than 1,100 percent between 1981 - 1987. The National Association of Working Women, quoted by the Bureau of National Affairs, reports that there were only two computers for every 100 workers in 1980, compared with two computers for every three workers in 1991" (Rickert, 1992, p. 18). According to the U. S. Department of Commerce, the United States computer market has been steadily increasing Since 1991 (estimated through 1994) (U. S. Department of Commerce, 1994, p. 26-2). Also, an estimated 60 million computers are in use today (Banham, 1994). At a 1 2 large public university, more than three-quarters of the academic and support staff claim to use computers in their work. Of that group, 88% said they use their computers at least five days a week (Appendix B). In conjunction with the increased use in the VDT, user injury has also increased. The National Institute of Occupational Safety and Health (NIOSH) estimates that one in every 100 workers, across all industries, will develop CTD symptoms (U. S. Department of Labor Statistics, 1992). The most costly and severe disorders occurring in the VDT workplace are cumulative trauma disorders (Roughton, 1993). According to the U. S. Department of Labor Statistics, cumulative trauma disorders are the number one cause of workers' compensation losses in both time and money in the U. S. (Springer, 1994). "OSHA reports that by the end of the century 50 cents of each dollar paid as workers' compensation will go toward musculoskeletal injuries" (Banham, 1994, p. 26). These costs also put a burden on businesses to find ways to decrease such repetitive stress injuries. Although there are several methods to reduce CTDS in the workplace, the most effective way to reduce injury is a proactive approach by incorporating a comprehensive ergonomics policy. "If properly applied, ergonomics can make a great impact on reducing workers' compensation costs by removing the injurious relationship between the anatomy, the task and the work station" (Chong, 1993, p. 31). A comprehensive ergonomics solution targets the root causes of such 3 workplace problems by focusing on a fundamental, holistic approach. Incentives for businesses to establish an ergonomics programs are as follows : - Saving attributed to preventable injuries ° Reduction in extent of disability - Productivity and quality benefits - Avoidance of OSHA citations (Braun, 1994) This study will stress the importance of applied ergonomics and will examine the effectiveness of an ergonomics policy at a large university in reducing CTDS in the workplace. P l m n To reduce the risk of cumulative trauma disorders and related workers' compensation claims, an Ergonomics Policy was put in place at a large public university on April 1, 1993 (Appendix C). The policy is proactive and encourages units to address ergonomic issues before they reach a problem status. The policy requires that work stations and job flow be reviewed and supervisors are required to take the appropriate actions to reduce their employees' exposure to CTDS by educating, evaluating, and remediating. This study will examine the frequency and severity of workstation ergonomic related claims before and after the implementation of the Ergonomics Policy. Related interventions concerning the policy by participating units will also be examined. P r s r It is important to review University policies in order to see if they are meeting their intended goals. Policies are generally formed to give direction or clarification on various topics. Depending on the nature of the policy, some issues are more critical than others and review of such policies are needed to insure relevance and proper compliance. The Ergonomics Policy can be considered a critical policy due to the need to reduce health risks and control worker compensation costs. Increases in the use of computer technology, and the risk of VDT office related health hazards on campus require review of this policy as a timely and important step to reduce injuries and minimize costs both to the employee and the university. Re ' iv One objective of this study is to compare one of the university's ergonomic policy goals, to reduce the risk of cumulative trauma disorders, with workers' compensation data from the OSHA 200 log. For comparison, the data will be Split into two groups representing before and after the implementation of the Ergonomics Policy. Other policy goals such as containing and reducing workers' compensation costs and compliance to anticipated ergonomic standards will not be examined in this study. 5 The second objective of this study is to review the progress of implementation strategies for the policy such as training and ergonomic workSite evaluations. CHAPTER II: REVIEW OF LITERATURE This chapter gives background information on Cumulative Trauma Disorders and worker compensation costs, ergonomics and ergonomic strategies to reduce CTDS, and related standards and regulations. A review of research literature concerning ergonomic intervention program evaluations is also included. i Tr i r W rker m n 'on t Cumulative Trauma Disorders or CTDS are a type of injury to the musculoskeletal system usually stemming from repeated motion or stress. It is important to note that CTDS are developed gradually over time. "Because of the slow onset and often innocuous character of the microtrauma, the condition is often ignored until the symptoms become chronic and permanent injury occurs" (Putz-Anderson, 1988, p. 6). Although CTDS are not easy to diagnose, early detection and prevention are key in reducing such injuries (Putz-Anderson, 1988). In reviewing the literature on CTDS, the terms injury and illness are both commonly used to describe Cumulative Trauma Disorders. Although either term can be used depending on context and usage, CTDS are better associated with 7 the term illness, due to the chronic nature of these injuries from repetitive stress, rather than term injury which usually defines a single act (Putz-Anderson, 1988). Cumulative trauma injuries are generally caused by one or a combination of the following conditions: - High rates of manual repetition - Excessive force - Awkward postures - Excessive vibration - Warm or cold temperatures (Putz-Anderson, 1988) A common type of CTD is Carpal Tunnel Syndrome. Carpal Tunnel Syndrome is relatively common in professions such as musicians, sculptors, gardeners, and other manually intensive jobs. However, VDT operators and people who spend their time working at a computer are the largest and fastest growing population to develop CTDS. "The increase in CTD cases can largely be attributed to the widespread shift by industry to faster forms of automation" (Roughton, 1993, p. 29) which includes computer use. Claims for CTDS are the leading cause of work-related illness in the United States (Mahone, 1993) and can be considered one of the most serious occupational health hazards. The increase in workers' compensations claims related to CTDS are staggering. CTDS account for over half of all workplace illness and approximately thirty-three percent of workers' compensation costs 8 (Montante, 1994). AS an example, the Chubb Corporation in Warren, New Jersey estimates a claim for Carpal Tunnel on the East and West coast can range from $35,000 to $75,000 and $12,000 to $20,000 in the Mid-West (Marley, 1994). Even minor cases of CTDS can range from $5,000 to $10,000 (Springer, 1994). At Michigan State University, the average workers' compensation CTD expenditure ranged from $505 - $2,365 per claim although the average total expense for CTD illnesses per claim ranged from $1,042 - $12,938 (fiscal years 1989-1990 to 1993-1994) (Appendix D). Although one objective of 3 workers' compensation system is to help injured employees return to work, it is not without costs. Increases in medical care, increasing indemnity benefits, administrative costs for claims and costs associated with injured workers are all factors which contribute (besides increase in claims) to rising workers' compensations costs (Roughton, 1993). "The only effective way to control workers' compensation costs is to prevent worker injuries and illnesses from occurring. Significant gains can be made in workers' compensation cost control through the application of ergonomic principals and practices" (Manuele, 1991, p. 27). r n ' Er ' i Ergonomics can be defined as the study of people at work. "Applied to business, it means creating or designing a work environment that accommodates the needs, limitations, sizes, strengths and weaknesses of a wide range of 9 people" (Manning, 1994). In the past, ergonomics has generally been associated and applied with mass-production, industry and blue collar work. Vlfith the electronic age and increase of computerized "white-collar" work, ergonomics is becoming more identifiable with the office. The design of the computerized workstation, furniture and equipment in the workplace have a direct impact on the worker. These environments and tools support the workers and related job tasks and may also effect worker satisfaction, productivity and comfort. Poorly designed workstations, equipment, or job design can create fatigue, discomfort and/or mental stress (Braganza, 1994). Other possible symptoms include pain, low production and low morale. These symptoms can be attributed to an ergonomic problem or workplace deficiency (Polakoff, 1992). Although other environmental factors can contribute to discomfort such as illumination, glare (VDT), noise, and temperature, the more serious symptoms arise from improper use or design of the computerized workstation. For example, poor posture can result, in part, from poor workstation layout, improper worksurface and chair height, and lack of lumbar support (Braganza, 1994). "Ergonomic-related problems often indicate some inadequacy in the work design system. Often, the inadequacy involves interface design - the physical aspects of the worksite with which employees interact" (Mahone, 1993, p.17). Incorporating ergonomics in the office has far reaching benefits. First, properly applied ergonomic principals maximize employee performance while 10 minimizing stress, strain and injury. This approach can successfully reduce injury while in the long run contain workers' compensation costs. "Ergonomics, which incorporates an understanding of human capabilities, can be used to design equipment and environments to improve efficiency, alleviate physical stress and reduce the potential for injury" (Braganza, 1994, p. 22). There are many possible solutions to reduce CTDS in the workplace. They range from "quick-fixes" to more elaborate ergonomic-medical management solutions. "Quick-fix" solutions are usually easily identifiable. They include modifications to the existing worksite or adding "ergonomic" equipment. They are relatively low cost and easy to implement. Examples of quick-fix solutions are wrist wraps/splints, chair supports or cushions. Even ergonomic office products need to be used with caution. Quick- Ix solutions generally seem to solve the problem temporarily (employees seem initially satisfied) but the hazards still exist and the problem will resurface. "Treating symptoms by dealing with the proximate cause may not lead to lasting or even significant improvements" (Ayoub, 1990, p. 455). These types of solutions cannot solve fundamental job design inadequacies such as improper workload, inappropriate task allocation, improper scheduling or major interface deficiencies (Mahone, 1993). Conservative treatments or reactive measures for CTDS can include; rest, anti-inflammatory medication, wrist splints, physical therapy, job rotation, job retraining and surgery as a last resort (Roughton, 1993). Although these treatments can be successful, avoiding the need for treatment through 11 preventative measures is far more appealing. Successful CTD prevention strategies include proactive measures: workstation ergonomic assessment, education/training, job rotation, tool redesign, early diagnosis, employee involvement, medical/health management, top management support and a well defined program (Roughton, 1993; Henderson and Cernohous, 1994). A comprehensive ergonomics program "begins with an understanding of the worker, the nature of the work, and the expected outcome" (Springer, 1994, p. 19). An example of a successful ergonomic corporation-wide program is at IBM. Key elements of the program include corporation-wide participation, proactive measures, education, work place assessment, incorporation of field research and implementation of appropriate changes. Ergonomics is thought of as a long-term strategy and is incorporated into every facet of the job (Kukla, 1992). Because of the multidimensional nature of acquiring CTDS, (repetition, force, posture, vibration, temperature) a multidimensional solution can be an effective method to reduce such injuries. r R I There have been several ergonomic standards and regulations proposed or put into legislation which stress the importance of implementing such programs to insure employees' health and safety. 12 In late 1993, the Occupational Safety and Health Administration (OSHA) took action in developing a national ergonomic standard. Although the official ruling was set for late 1994, OSHA has yet to implement such a standard. Regardless of the status of the official standard, OSHA recommends that companies write an ergonomic plan. The plan Should incorporate worksite analysis, hazard prevention and control, medical management, and training and education. Businesses should note, "OSHA is conducting inspections for CTDS and assessing fines against employers without an active ergonomics program" (Roughton, 1993). The American National Standards Institute (ANSI) enacted a voluntary standard for computer work stations known as ANSI/HFS 100-1988 "American National Standard for Human Factors Engineering of Video Display Terminal Work Stations" (ANSI/HFS 1988). This standard lists recommended ergonomically-correct Specification for chairs and computer work stations. This standard is meant to assist business in selecting ergonomically correct furniture for their employees. The voluntary standard ANSI Z-365 or "Control of Cumulative Trauma Disorders", compliments ANSI/HFS 100. The ANSI Z-365 recommends an approach to CTD prevention including monitoring of symptoms, work site analysis and intervention, and medical management protocols. The final standards for both the ANSI/HFS 100 and ANSI Z—365 are expected in 1995 (Haworth Inc., 1994). 13 California has proposed a statewide ergonomic program scheduled for adoption in early 1995. Many states have VDT or ergonomic legislation or are in the process of developing legislation. Other countries including Canada and the European Community have developed ergonomic standards for VDT workstations and furniture (Haworth Inc., 1994). The National Safety Council also offers an on-site course "Joint Safety and Health Committee Training" and guide books for companies that are interested in developing safety programs (Etter, 1994). Research Literature A field methodology for the control of musculoskeletal injuries was developed by Reynolds and her colleagues (1994) for jobs prone to cumulative trauma disorders and manual material handling injuries. The systematic methodology is based upon the collection of quantitative data used to evaluate ergonomic changes with respect to biomechanical risk, perceived comfort, productivity and quality. This multi-step procedure allows for control measures to be implemented and evaluated within a short time frame. The methodology was judged to be successful in recognizing, diagnosing and controlling musculoskeletal injuries in manufacturing but can be applied throughout all work settings. The ten-step methodology includes: review of musculoskeletal injury data, ergonomic review, task and operator selection, data collection and analysis, design requirements, alternative solutions, selection and prioritization of 14 alternatives (cost-benefit analysis), fitting trails, re-analysis and evaluation and implementation. A case study in which this methodology was incorporated into an ergonomics program at a large apparel manufacturer is briefly summarized with encouraging results. Westlander and his associates (1995) evaluated a participatory ergonomics intervention program of video display terminal operators with routine data-entry and data-dialogue tasks. The researchers were interested in identifying work conditions and strategies for improvement of the worklife of these operators. The study included 68 computer operators at a post office and 21 switchboard operators at a trading company where the majority of operators suffered from musculoskeletal complains of the neck and/or shoulders and back. The intervention program was evaluated in two follow-up studies. Stages of the intervention included a pre-intervention phase (surveys of work conditions, work loads, and job-related health issues; development of the intervention program), an implementation phase and a follow-up of work conditions to control for possible changes. The program included informational workshops on VDT work, research-based proposals for ergonomic improvement via participatory steps by employees, and cost analysis for implementation. The research team strived to empower employees to improve their work Situation and foster collaboration among employees and management. In each workplace, the program received positive reception but due to organizational changes, economic depression and a shift in values in the management staff, many of the 15 improvement changes offered through each intervention program were not fully implemented. Keyserling and his colleagues (1993) developed a checklist for evaluating ergonomic risk factors associated with upper extremity cumulative trauma disorders. Questions were grouped into five major sections corresponding to the following categories of exposure; repetitiveness, local mechanical contract stress, forceful manual exertions, awkward upper extremity posture, and hand tool usage. The checklist was developed and evaluated at a large automotive corporation as part of a joint labor-management ergonomics intervention program to reduce injuries and disorders caused by poor ergonomic work conditions. Three hundred and thirty five manufacturing and warehouse jobs were surveyed with the checklist by plant personnel at four automotive work Sites. An additional analysis was conducted with a subset of 51 jobs by researchers with occupational ergonomics education. Most of the 335 jobs were associated with moderate or substantial exposures to upper extremity risk factors based on the criteria established by the checklist. Approximately 81% of the jobs were found to excessively 'repetitive'. Exertion of high hand forces and awkward work postures were common. Results generated by the ergonomic analysts and results generated by the checklist were generally in agreement, however, the checklist seemed to be more sensitive in identifying the presence of risk factors. The checklist proves to be an effective screening tool for identifying jobs that expose workers to potentially harmful ergonomic stresses. It is important to note 16 that the checklist methodology did not fully explore the correlation of work methods and Specific job attributes associated with these risk exposures. The research literature includes examples of models for evaluating and implementing ergonomic programs where the predominant goal is to reduce and/or contain worker injury. These methodologies may be useful if a formal evaluation of the entire range of ergonomic activities at the university is to be implemented. Worksite assessments and ergonomic training at the university currently incorporate some principals of the formal methodologies such as an ergonomic audit, workplace solutions, and necessary follow-up. CHAPTER III: ERGONOMICS POLICY AT MICHIGAN STATE UNIVERSITY The formation of the Ergonomics Policy was an effort to reduce the risk of cumulative trauma disorders, contain/reduce worker compensation costs and meet compliance to anticipated ergonomic standards. "Michigan State University strives to maintain a safe and healthy workplace for all University employees. Workplace ergonomics is of increasing importance to employees health and safety. This policy is established to promote and protect employee health through ergonomically sound practices." The policy is intended to be a shared responsibility of administrative units and all university employees. The history of the policy dates back to the early 1990's when there were discussions held on campus in an effort to reduce CTDS and workers' compensation costs. At this time, there were limited ergonomic related activity by various units but these interventions were not coordinated nor structured. Non-structured interventions include: worksite analyses by both outside and campus consultants, informal informational programs, seminars and workshops. The Ergonomics Policy was officially announced on April 1, 1993. From this point forward, there was a coordinated effort by various units on campus to provide ergonomic support, training and workplace assessment. Along with campus notification about the policy, numerous informational campaigns were 17 18 launched to inform employees about CTDS and how to obtain help. A complete ergonomics policy informational seminar was held in the fall of 1993 for all administrators and supervisors with attendance of approximately 1,000 people. The policy embodies a proactive university-wide approach to ergonomics, encouraging action before a problem is manifest. Implementation of the policy includes; ergonomic training, workstation design and evaluation, job design, and medical management. When the policy was enacted, resources to support the policy were fully implemented although some were implemented prior to an official policy. Listed below are the main ergonomic resources on campus in support of the policy. A brief overview of their involvement is summarized with more detailed information located in the appendices. MSU Occupational Health Services (Olin Health Center): - Offers individual or group workstation analysis and recommendations, training and distribution of general information and limited consultation concerning ergonomic furniture. Components of Olin Health Center's Ergonomic Training and Development Program (Working Smarter, Not Harder) include an initial meeting, video tape walk through (reviews job demands/environment, analysis of tape), workforce training, and follow-ups. Worksite evaluations started 11/91 but the majority of sessions fall into the 1994-5 years. (Appendix E). Human Environment and Design: - Offers ergonomic expertise and academic curriculum on ergonomics 19 Computing and Technology: - Offers “Ergonomic Basics and the Computer” course devoted entirely to ergonomics basics, guidelines and suggestions as they related to the use of computers. Course is generally offered every month (Appendix F). - Brief introduction to ergonomics included in existing entry level CTI'P (computer and technology training program) computer courses. - Ergonomic computer items available for purchase through MSU computer store. - Periodical and publication available for review from Commuter Resource Center MSU Purchasing: - Brochures on ergonomically designed furniture and accessories and chair loaner program available. - Broad knowledge base on ergonomic equipment. Healthy U: - Provides communication and education materials for the MSU community about ergonomics. Workers’ Compensation Division: - Administers workers' compensation benefits. Housing Construction and Design: - Offers work station design, space planning and interior design services. 20 Department of Public Safety: - Forwards ergonomics issues discovered during inspections to appropriate campus resource for follow-up. Administrative Information Services: - Participated in Healthy U pilot initiative on workplace ergonomics (Appendix G). Creation of Non-official Ergonomic Task Force: - Made up of administrators, faculty and staff members that are interested on ergonomic related activities on campus in support of the policy. CHAPTER IV: HYPOTHESES The primary goal of this research is to discover if there are relationships between the establishment of an ergonomics policy/program and the reduction of CTDS in the workplace. Listed below are research hypotheses which examines the relationship between the impact of the university's Ergonomics Policy and the frequency and severity of CTDS. H 1: The university's Ergonomics Policy has made no impact on reducing the frequency of CTDS in the workplace. H 2: The university's Ergonomics Policy has made no impact on reducing the frequency of CTDS associated with days away from work in the workplace. H 3: The university's Ergonomics Policy has made no impact on reducing the frequency of CTDS associated with days restricted from work in the workplace. H 4: The university's Ergonomics Policy has made no impact on reducing the severity of CTDS associated with days away from work in the workplace. 21 22 H 5: The university's Ergonomics Policy has made no impact on reducing the severity of CTDS associated with days restricted from work in the workplace. CHAPTER VI: METHODOLOGY AND PROCEDURES Seuree ef Dete Data for analysis was retrieved from the OSHA 200 log in the university's Human Resources Insurance Software Package (claims management system). The OSHA (Occupational Safety and Health Administration) 200 log is a summary statement of occupational injuries and illness for a given employer. A sample copy is shown in Appendix H. Names and case numbers have been altered to preserve confidentially. The entire database includes 5188 worker compensation claims dated from February 14, 1963 - March 15, 1995. Seven hundred and fifty three (14.5%) were described under the classification CTD (Cumulative Trauma Disorder) with dates from November 1988 through February 1995. Six percent of the employee base filed CTD claims, which is similar to the national average. This study will focus on CTD claims. Data retrieved from the OSHA 200 log used in this study consists of: - The Date of Illness or Injury (B). This is the date the injured worker listed as the start of the injury/illness or if that information was unobtainable, the date when the claim was filed. 23 24 - Occupation (D). The occupation classification used by the university. Includes all employees. - Department (E). The department of employment at the university. - Description Illnesses (F). General description of illness. In this log, CTD claims are classified under illness. Body part is also specified such as, hand (right, left, or both), wrist (right, left, or both), arm (right, left, or both), shoulder (right, left, or both), neck, or body. A body classification (minimal, moderate, or severe) could represent injuries to separate body parts (i.e., the arm and Shoulder) which occurred together under one claim but do not specifically list each body part effected. - Disorders Associated WIth Repeated Trauma (71). All should be a CTD claim. - Number of Days Away From Work (Illness) (11). A physician determines the number of days the employee is away from work. - Number of Days Restricted From Work (Illness) (12). A physician determines the number of days the employee is restricted at work but Human Resources decides how to limit a particular part of the job or and at what duration for each day. After an initial review of the data, the researcher noticed several CTD claims were listed separately under either the injury or illness classifications in the OSHA report. To verify the appropriate category, the researcher confirmed the suspected mistake with a manager in the Human Resources Department. In the OSHA report, CTD claims should be classified as an illness. To compensate 25 for this error, those CTD claims that were miS-coded as an injury were added to the claims under the illness classification in order to accurately account for all CTD claims in this study. OSHA requires that all claims must be logged in the system (to appear on the summary report) including claimants that do not miss days and/or not restricted from work (no loss of time) as they may have medical bills. First aid claims with no medical bills do not have to be logged. Each case number represents one separate claim. Claims represent full-time and part-time employees. Item To create comparison groups for study, the data were divided into 2 major subsets where the time interval is equal. April 1, 1993 was chosen as the intervention point because that is the date when the Ergonomics Policy was officially implemented. "Pre-intervention" is the time preceding April 1, 1993 and "post-intervention" is the time interval following April 1, 1993. The total population of this data subset is 572 (pre and post intervention). WIthin these two groupings, the data will be broken into 3 month intervals ranging from July 1, 1991 - December 31, 1994; intervals 1 - 7 will be considered the "pre- intervention" group and intervals 8 - 14 Will be the "post-intervention" group (see Table 1). The three month interval was chosen because it broke the year into quarters - a reasonable time interval to represent the smaller time frames which 26 also allows for short, intermediate and long term measures. There has been minimal variance in employee base at the university during the time frame this study (Appendix I) which makes the equal time measures for comparison groups methodologically sound. Table 1: Three Month Interval Groupings for Pre and Post Intervention Pre-intervention Months from Interval n Time Frame Intervention 1 36 July 1, 1991 - September 30, 1991 21 2 46 October 1, 1991 - December 31, 1991 18 3 42 January 1, 1992 - March 31,1992 15 4 44 April 1, 1992 - June 30, 1992 12 5 39 July 1, 1992 - September 30, 1992 9 6 42 October 1, 1992 - December 31, 1992 6 7 32 January 1, 1993 - March 31, 1993 3 Post-intervention Months from Interval n Time Frame Intervention 8 52 April 1, 1993 - June 30, 1993 3 9 43 July 1, 1993 - September 30, 1993 6 10 42 October 1, 1993 - December 31, 1993 9 11 51 January 1, 1994 - March 31, 1994 12 12 39 April 1, 1994 - June 30, 1994 15 13 35 July 1, 1994 - September 30, 1994 18 14 29 October 1, 1994 - December 31, 1994 21 To test the first hypothesis, a t test for differences between sample proportions (comparison of percents drawn from two samples) was performed to determine if the frequencies associated between pre-intervention (n=281) and 27 post-intervention (n=291) were statistically different for the total number of CTD claims (n=572). To test the second hypothesis, a t test for differences between sample proportions (comparison of percents drawn from two samples) was performed to determine if the frequencies associated between pre-intervention (n=30) and post-intervention (n=18) were statistically different for the total number of CTD claims associated with days away from work (n=48). To test the third hypothesis, a t test for differences between sample proportions (comparison of percents drawn from two samples) was performed to determine if the frequencies associated between pre-intervention (n=48) and post-intervention (n=19) were statistically different for the total number of CTD claims associated with days restricted from work (n=67). In order to determine the severity of the illness (CTD), the researcher examined the variables, "days away from work" and "days restricted from work". Because these variables represent loss of time from work or restricted time at work they can be considered indicators of severity of the CTD illness. The U. S. Department of Labor, Bureau of Labor Statistics uses these same measures when they report on occupational injuries and illnesses. To test hypothesis 4 and 5, an analysis of variance test was performed separately for the variables "days away from work" and "days restricted from work" for the pre and post intervention groups. The mean value of each variable can be compared in the pre-intervention and post-intervention groups for 28 significant differences. The mean value represents the average number of days away or restricted from work and is a measure of severity of the CTD illness. To further explore the variables "days away from work" and "days restricted from work" a chi-square was calculated to determine any association between the nominal values. There variables were spilt into two groups based on length of days away/restricted from work and frequency (quartiles) to examine the distribution for these claims for pre and post intervention. A crosstabulation with a chi-square test of independence was calculated to determine any association between the groups. Table 2 illustrates the groups formed on the basis of time and Table 3 illustrates the quartile groups based on frequency for the variables "days away/restricted from work". The Pearson chi-square is commonly used to test independence between row and column variables in a crosstabulation. The likelihood-ratio chi-square is alternative to the Pearson chi- square test and is often used in the analysis of categorical data. 29 Table 2: Classifications of Groups of Severity Based on Days Away/Restricted From Work. Group Severity Range of Time Away/Restricted From Work 0 None No time loss 1 Very mild Less than one week 2 Mild One - two weeks 3 Mild-moderate Two - four weeks 4 Moderate 1 - 3 months 5 Severe 3 - 12 months 6 Very severe Over one year Table 3: Days Away/Restricted From Work by Quartile Group Days Frequency Percent Days Away 1 1 - 8 11 22.9 2 9 - 17 11 22.9 3 21 - 48 13 27.1 4 56 - 698 13 27.1 Days Restricted 1 1 - 5 17 25.4 2 7 - 13 14 20.9 3 14 - 26 19 28.3 4 27 - 365 17 25.4 CHAPTER VII: RESULTS AND DISCUSSION The results for each test will be summarized followed by a brief discussion. General conclusions will be discussed in the next section. To test hypothesis 1 (The university's Ergonomics Policy has made no impact on reducing the frequency of CTDS in the workplace), a comparison of percents drawn from two samples was performed to determine significance (p= .05) for number of CTD claims between the pre-intervention and post- intervention groups. Table 4 reveals the frequencies for the pre-intervention group (f=281) and the post-intervention group (f=291) are not statistically significant (p=.669) although there was a slight increase of claims after the intervention. In this case, the first null hypothesis is not rejected, the university's Ergonomics Policy appears to have made little impact on reducing the frequency of CTDS in the workplace. This is not surprising due to ergonomic training and awareness of CTDS in the workplace by the university and mass media. Employees may now recognize their symptoms and consequently seek medical attention. 30 31 Table 4: Total Number of Claims, Pre and Post Intervention Group n Percent Pre-intervention 281 49.1 Post-intervention 291 50.9 t=0.4306 d. f.=570 p=.669 To test hypothesis 2 (The university's Ergonomics Policy has made no impact on reducing the frequency of CTDS associated with days away from work in the workplace), a t test for differences between proportions (comparison of percents drawn from two samples) was performed to determine significance (p= .05) for CTD claims associated with days away from work between the pre— intervention and post-intervention groups. Listed in Table 5, the frequencies for claims associated with days away from work are greater in pre-intervention group (n=30) than the post-intervention group (n=18) although these differences are not statistically significant (p=.09). The second hypothesis is not rejected, the university's Ergonomics Policy appears to have made little impact on reducing the frequency of CTDS associated with days away from work in the workplace. Although there are no significant differences, there are fewer claims in the post-intervention group which may represent a trend and possible significant differences with a larger sample size. 32 Table 5: Total Number of Claims, Pre and Post Intervention, Days Away From Work Group n Percent Pre-intervention 30 62.5 Post-intervention 18 37.5 t=1.7321 d. f.=46 p=.09 To test hypothesis 3 (The university's Ergonomics Policy has made no impact on reducing the frequency of CTDS associated with days restricted from work in the workplace), a t test for differences between proportions (comparison of percents drawn from two samples) was performed to determine significance (p=.05) for CTD claims associated with "days restricted from work" between the pre-intervention and post-intervention groups. Table 6 reveals the total number of claims associated with "days restricted from work" are greater in the pre- intervention group (n=48) than the post-intervention group (n=19) and this difference is statistically significant (p=.0008). The third hypothesis can be rejected, the university's Ergonomics Policy appears to have made an impact on reducing the frequency of CTDS associated with days restricted from work after policy implementation. 33 Table 6: Total Number of Claims, Pre and Post Intervention, Days Restricted From Work Group n Percent Pre-intervention 48 71 .6 Post-Intervention 19 28.4 t=3.5345 d. f.=65 p=.0008 In determining if frequency of claims have any significant differences between the pre and post intervention groups, the variable "days restricted from work" showed a significance difference. Because the number of claims are significantly lower in the post intervention group, it appears that the Ergonomics Policy is on the road to meeting its goals. Although there is no significant difference between group size in total number of claims pre and post intervention, this is not uncommon given the impact of training and CTD awareness and education on campus. It is important to note that the claims associated with "days away from work" and "days restricted from work" only account for 8% (n=48) and 12% (n=67). respectively, of the total number of claims in both the pre and post intervention groups (n=572). The remaining 457 claims (80%) have CTD symptoms and possible associated medical costs but were not as severe to be classified away or restricted from work. To test hypothesis 4 (The university's Ergonomics Policy has made no impact on reducing the severity of CTDs associate with days away from work in 34 the workplace), an analysis of variance test was performed for the variable "days away from work" for the pre and post intervention groups to determine significant mean differences between the groups (p=.05). Table 7 illustrates the pre- intervention group has a greater mean number of days (95.9) than the post- intervention group (1994) and these differences are significant (p=.0403). Hypothesis 4 can be rejected, the university's Ergonomics Policy appears to have made an impact on reducing the severity of CTDs associated with days away from work after the policy intervention in the workplace. Less time away from work means less stress and strain on the employee plus generally lower workers' compensation costs. The post-intervention mean of 20 days away from work is encouraging considering the median days away from work for carpal tunnel syndrome is 32 days as reported by the U. S. Department of Labor (Bureau of Labor Statistics, 1992). Figure 1 shows the distribution of mean values of "days away from work" by the three month time frames in graphical form. This graph clearly illustrates the lower mean of the post-intervention group which suggests a possible correlation to the Ergonomics Policy. It is interesting to note, lower means start with period 4 which may suggest a possible impact from ergonomic related activity before the official announcement of the policy. A table listing the intervals and associated mean value is located in Appendix J. 35 Table 7: ANOVA - Days Away From Work by Pre and Post Intervention Group Mean S. D. Error Cases Pre-intervention 95.9 151 .07 27.58 30 Post-intervention 19.94 22.62 5.33 18 d. f.=1 F=4.4523 Sig. of F=.0403 p<.05 Figure 1: Average Days Away From Work by Three Month Time Frame July 1, 1991 to December 31, 1994 zoo -— )—__.__—_—— p—_—-—.—_— 1oo~ ~ __.___ - —_——___—_——__—__—__.—_—_——_______——__——_—— Mean Number of Days Away From Work Pre-Intervention (1-7) Post-Intervention (3'14) 36 To test hypothesis 5 (The university's Ergonomics Policy has made no impact on reducing the severity of CTDs associated with days restricted from work in the workplace), an analysis of variance test was performed for the variable "days restricted from work" for the pre and post intervention groups to determine significant mean differences between the groups (p=.05). Table 8 shows the pre-intervention group has a mean number of days value of 31.21 and the post-intervention group a mean number of days value of 22.63. This difference is not significant (p=.53) and hypothesis 5 is not rejected, the university's Ergonomics Policy appears to have made little impact on reducing the severity of CTDs associated with days restricted from work in the workplace. Table 8: ANOVA - Days Restricted from Work by Pre and Post Intervention Group Mean S. D. Error Cases Pre-intervention 31.21 58.06 8.38 48 Post-intervention 22.63 21.86 5.01 19 d. f.=1 F=.3896 Sig. of F=.5347 p<.05 Figure 2 shows the distribution of mean values of "days restricted from work" by the three month time frames in graphical form. Note in this graph, the intervals 12, 13 and 14 have mean values of zero which may be a positive correlation with the Ergonomics Policy. It appears this graph suggests cyclical 37 trends which may be due to seasonal trends in the academic year and possible workload. A table listing the intervals and associated mean value is located in Appendix J. Figure 2: Average Days Restricted From Work by Three Month Time Frames July 1, 1991 to December 31, 1994 Mean Number of Days Restricted From Work Pre-Intervention (1-7) Post-Intervention (8-14) A chi-square test of independence was calculated separately for the variables "days away from work" and "days restricted from work". Zero or missing values were excluded due to the small sample size. In both cases, the 38 variables had such a wide range of values including many observations with a frequency of one, the chi-square statistic is questionable therefore no conclusions will be drawn. The variable "days away from work" contained 34 categories ranging from 1 - 698 days (n=48). The variable "days restricted from work" contained 36 categories ranging from 1 - 365 days (n=67). Table 9 lists the summary findings. Table 9: Chi-square Summary Statistics for Days Away/Restricted From Work - July 1, 1991 - December 31, 1994 Days Away/Restricted From Work (July 1, 1991 - December 31, 1994) Chi-Square D. F. p Range of Days Away 11.50 33 .9998 1 - 698 Restricted 48.52 35 .0639 1 - 365 A crosstabulation with a chi-square test of independence was performed separately for the variables "days away from work" and "days restricted from work" by pre and post intervention. Once again, in both cases, the variables had such a wide range of values plus many observations with a frequency of one, the chi-square statistic is questionable with this crosstabulation. Summary statistics are listed in Table 10. 39 Table 10: Chi-Square Test of independence Days Away/Restricted From Work, Pre and Post Intervention Days Away/Restricted From Work Pre and Post Intervention Days Away Value D. F. p Range of Days Pearson Chi-Square 34.49 33 .40 1 - 698 Likelihood Ratio 45.83 33 .07 1 - 698 Days Restricted Value D. F. p Range of Days Pearson Chi-Square 38.84 35 .30 1 - 365 Likelihood Ratio 47.08 35 .08 1 - 365 Due to the fact the above analysis yielded questionable results because the composition of the raw data set (many single frequency categories, small sample size), the data (days away/restricted from work) was categorized into quartiles where the frequencies are similar and into units of time based on days away/restricted from work in effort to decrease variance. To examine the distribution of the variables "days away from work" and "days restricted from work" separately by pre and post intervention, the frequency distribution was split into separate groups where the amount of time (days away/days restricted from work) was the basis of the classification. These groups can be considered to represent levels of severity: very mild, mild, mild- moderate, moderate, severe and very severe, with groups ranging from 0 - 6. Groups are listed in Table 2. A crosstabulation with a chi-square test for independence was calculated to determine any difference in distribution between 40 the groups for both variables separately for the time intervals 1 - 6, and time intervals 0 - 6. The time interval "0" represents claims without days away/restricted from work which aid in tracking frequency as well as severity in these analysis. Table 11 illustrates the crosstabulation with results from the chi-square test for "days away from work", pre and post intervention for time interval groups 0 - 6. This test shows moderately significant results (p=.7626). Table 12 illustrates the crosstabulation with results from the Chi-square test for "days restricted from work", pre and post intervention for time interval groups 0 - 6. This test shows significant results (p=.00423). Table 13 illustrates the crosstabulation with results from the chi-square test for "days away from work", pre and post intervention for time interval groups 1 - 6. No significant results (p=.14671) were noted. Table 14 illustrates the crosstabulation with results from the Chi-square test for "days restricted from work", pre and post intervention for time interval groups 1 - 6. This test also reveals no significant results (p=.49542). In reviewing these analysis together for the two time interval groups (0 - 6 and 1 - 6) possible conclusions can be drawn. Because significant results were calculated for both variables when the "0" category was included and no significant results were calculated without this variable, it appears these differences may be attributed to frequency of claims. A possible reason for not getting any significant results for the time periods (1-6) may be an indicator of 41 small sample sizes (days away/restricted) with large ranges of categories. Another possible explanation may be due to the possible lack of sensitivity of tracking severity in the OSHA 200 log. Table 11: Crosstabulation with Chi-Square Test of Independence, Days Away From Work, Pre and Post Intervention, Groups 0 - 6 Pre-intervention Group 0 1 2 3 4 5 6 Row total Count 251 4 4 2 10 6 4 281 Exp. Val. 257.4 3.4 3.9 3.4 7.4 3.4 2.0 Col. % 47.9 51.7 50.0 28.6 66.7 85.7 100 Row % 89.3 1.4 1.4 .7 3.6 2.1 1.4 Total % 43.9 .7 .7 .3 1.7 1.0 .7 49.1 Post-intervention Group 0 1 2 3 4 5 6 Row total Count 273 3 4 5 5 1 0 291 Exp. Val. 266.6 3.6 4.1 3.6 7.6 3.6 2 Col. % 52.1 42.9 50.0 71.4 33.3 14.3 0 Row % 93.8 1.0 1.4 1.7 1.7 .3 0 Total % 47.7 .5 .7 .9 .9 .2 0 50.9 Column 524 7 8 7 15 7 4 572 Total % 91.6 1.2 1.4 1.2 2.6 1.2 .7 100 Value D. F. Significance Pearson Chi-Square 11.42 6 .07626 Likelihood Ratio 13.43 6 .03673 42 Table 12: Crosstabulation with Chi-Square Test of Independence, Days Restricted From Work, Pre and Post Intervention, Groups 0 - 6 Pre-intervention Group 0 1 2 3 4 5 6 Row total Count 233 12 7 15 8 5 1 281 Exp. Val. 248.1 8.4 3.9 9.8 7.4 2.9 .5 Col. % 41.6 70.6 87.5 75.0 53.3 83.3 100 Row % 82.9 4.3 2.5 5.3 2.8 1.8 .4 Total % 40.7 2.1 1.2 2.6 1.4 .9 2 49.1 Post-intervention Group 0 1 2 3 4 5 6 Row total Count 272 5 1 5 7 1 0 291 Exp. Val. 256.9 8.6 4.1 10.2 7.6 3.1 .5 Col. % 53.9 29.4 12.5 25.0 46.7 16.7 0 Row % 93.5 1.7 .3 1.7 2.4 .3 0 Total % 47.6 .9 .2 .9 1.2 .2 0 50.9 Column 505 17 8 20 15 6 1 572 Total % 88.3 3.0 1.4 3.5 2.6 1.0 .2 100 Value D. F. Significance Pearson Chi-Square 18.96 6 .00423 Likelihood Ratio 20.47 6 .00228 Table 13: Crosstabulation with Chi-Square Test of Independence, Days Away 43 From Work, Pre and Post Intervention, Groups 1 - 6 Pre-intervention Group 1 2 3 4 5 6 Row total Count 4 4 2 10 6 4 30 Exp. Val. 4.4 5.0 4.4 9.4 4.4 2.5 Col. % 57.1 50.0 28.6 66.7 85.7 100 Row % 13.3 13.3 6.7 33.3 20.0 13.3 Total % 8.3 8.3 4.2 20.8 12.5 8.3 62.5 Post-intervention Group 1 2 3 4 5 6 Row total Count 3 4 5 5 1 0 18 Exp. Val. 2.6 3.0 2.6 5.6 2.6 1.5 Col. % 42.9 50.0 71.4 33.3 14.3 0 Row "/0 16.7 22.2 27.8 27.8 5.6 0 Total % 6.3 8.3 10.4 10.4 2.1 0 37.5 Column 7 8 7 15 7 4 48 Total % 14.6 16.7 14.6 31.3 14.6 8.3 100 Value D. F. Significance Pearson Chi-Square 8.18 5 .14671 Likelihood Ratio 9.64 5 .08590 44 Table 14: Crosstabulation with Chi-Square Test of Independence, Days Restricted From Work Pre and Post Intervention, Groups 1 - 6 Pre-intervention Group 1 2 3 4 5 6 Row total Count 12 7 15 8 5 1 48 Exp. Val. 12.5 5.7 14.3 10.7 4.3 .7 Col. % 70.6 87.5 75.0 53.3 83.3 100 Row % 25 14.6 31.3 16.7 10.4 2.1 Total % 17.9 10.4 22.4 11.9 7.5 1.5 71.6 Post-intervention Group 1 2 3 4 5 6 Row total Count 5 1 5 7 1 0 19 Exp. Val. 4.8 2.3 5.7 4.3 1.7 .3 Col. % 29.4 12.5 25.5 46.7 16.7 0 Row % 26.3 5.3 26.3 36.8 5.3 0 Total % 7.5 1.5 7.5 10.4 1.5 0 28.4 Column 17 8 20 15 6 1 67 Total % 25.4 11.9 29.9 22.4 9.0 1.5 100 Value D. F. Significance Pearson Chi-Square 4.38 5 .49542 Likelihood Ratio 4.65 5 .45987 To examine the distribution of the variables "days away from work" and "days restricted from work", a crosstabulation with chi-square analysis was constructed to examine the distribution of the claims for the pre and post intervention. These variables were split into quartiles where frequencies are similar in order to compare the similar variable groups (Table 3) for differences in distribution, pre and post intervention. For example, in Table 3, group 1 for "days away from work", has 11 people who were away from work between 1 - 8 45 days. (Groups could not be split equally due to the distribution of each variable). A Pearson's chi-square was calculated to determine any statistically significance difference in distribution between the groups. Table 15 shows frequencies for the variable "days away from work", pre and post intervention groups by quartiles. Quartile 1 represents 1-8 days away from work, quartile 2, 9-17 days, quartile 3, 21-48 days and quartile 4, 56-698 days. Table 16 presents frequencies for the variable "days restricted from work", pre and post intervention groups by quartiles. Quartile 1 represents 1-5 days away from work, quartile 2, 7-13 days, quartile 3, 14—26 days and quartile 4, 27- 365 days. In both cases, the test for significance could not accurately predict an accurate distribution for these classifications due to limited sample size and variance of ranges. To re-test this data, the quartiles 1 & 2, and 3 & 4, respectively, were combined for both variables. New crosstabulations were constructed with the new classification in relation to the pre and post intervention groups (Table 17 & 18). Table 17 illustrates the distribution of "days away from work" for the combined quartile groups 1 & 2 (1 - 17 days) and 3 & 4 (21 - 698 days) for the pre and post intervention groups. This test reveals observed versus predicted distribution patterns for the groups and there was a significant difference (p=.02484). In the pre-intervention group, "1 8 2" had a frequency of 10 and "3 & 4" a frequency of 20. In the post-intervention group, "1 & 2" had a frequency of 12 and "3 & 4" had a frequency of 6 - a actual decrease from the expected 46 value. In this case, the post-intervention group experienced fewer claims that can be considered more severe (i.e. more days away from work). This supports the claims that the Ergonomics Policy appears to be reducing the risk of severity CTD claims in the workplace. Table 18 illustrates the distribution of days restricted from work for the combined quartile groups 1 & 2 (1 - 13 days) and 3 & 4 (14 - 365 days) for the pre and post intervention groups. This test reveals observed versus predicted distribution patterns for the groups and there was no significant difference (p=.66718). The distributions are similar for the pre and post intervention groups. In the pre-intervention group, "1 & 2" had a frequency of 23 and "3 & 4" a frequency of 25 In the post-intervention group, "1 & 2" had a frequency of 8 and "3 & 4" had a frequency of 11. When splitting the data in quartiles, only with the variable "days away from work" any significant differences were found. This finding is encouraging that the frequency associated with claims that can be considered more severe dropped in the post intervention group. This is not surprising because the mean number of days away was significantly lower for the post intervention group as well. 47 Table 15: Frequency Matrix for Days Away From Work by Quartile, Pre and Post Intervention Pre-intervention Quartile 1 2 3 4 Row total Count 6 4 8 12 30 Row % 20.0 13.3 26.7 40.0 62.5 Col. % 54.5 36.4 61.5 92.3 Total % 12.5 8.3 16.7 25.0 Post-intervention Quartile 1 2 3 4 Row total Count 5 7 5 1 18 Row % 27.8 38.9 27.8 5.6 37.5 Col. % 45.5 63.6 38.5 7.7 Total % 10.4 14.6 10.4 2.1 Column 11 11 13 13 48 Total 22.9 22.9 27.1 27.1 100 Table 16: Frequency Matrix for Days Restricted From Work, Pre and Post Intervention Groups by Quartile Pre-intervention Quartile 1 2 3 4 row total Count 12 11 14 11 48 Row % 25.0 22.9 29.2 22.9 71.6 Col. % 70.6 78.6 73.7 64.7 Total % 17.9 16.4 20.9 16.4 Post-intervention Quartile 1 2 3 4 row total Count 5 3 5 6 19 Row % 26.3 15.8 26.3 31.6 28.4 Col. % 29.4 21.4 26.3 35.3 Total % 7.5 4.5 7.5 9.0 Column 17 14 19 17 67 Total 25.4 20.9 28.4 25.4 100 48 Table 17: Crosstabulation with Chi-square for Days Away From Work, Pre and Post Intervention by Combined Quartile Groups Group Quartile 1 - 2 3 - 4 Row total Pre-intervention Count 10 20 30 Row % 33.3 66.7 62.5 Col. % 45.5 76.9 Total % 20.8 41.7 Post—intervention Count 12 6 1 8 Row % 66.7 33.3 37.5 Col. % 54.4 23.1 Total % 25.0 12.5 Column 22 26 48 Total 45.8 54.2 100 Value D. F. Significance Pearson Chi-square 5.03497 1 .02484 Likelihood Ratio 5.10305 1 .02388 Table 18: Crosstabulation with Chi-square for Days Restricted From Work, Pre and Post Intervention Groups by Combined Quartile Groups Group Quartile 1 — 2 3 - 4 Row total Pre-intervention Count 23 25 48 Row °/o 47.9 52.1 71.6 Col. % 74.2 69.4 Total % 34.3 37.3 Post- Intervention Count 8 1 1 1 9 Row % 42.1 57.9 28.4 Col. °/o 25.8 30.6 Total % 11.9 16.4 Column 31 36 67 Total 46.3 53.7 100 Value D. F. Significance Pearson Chi-square .18491 1 .66718 Likelihood Ratio .18555 1 .66665 49 Listed below in Table 19, Table 20 and Table 21 are summary statistics for rates CTD occurrence in occupation classification, department and body part code for the combined time frames of both the pre and post intervention as a whole (n=572). It was not the intent of the researcher to examine these variables in depth, only to highlight insights of overview of findings, concerns and suggestions for further study. All information was retrieved from the OSHA 200 log. Table 19 represents selected administrative and academic positions. Approximately 75% of positions listed with CTDs fall into either category. The remaining 25%, of which are not listed, are mostly general labor such as kitchen positions, building services, custodial and maintenance. Because most of these positions are administrative in nature and most likely utilize the computer, a detailed task analysis would be recommended to study the occupations and risk of exposure to cumulative trauma disorders in more detail. Many of these positions vary their tasks/duties among the various departments which make it important to conduct a detailed task survey. Table 20 lists departments with the highest rates of occurrence (frequency) between July 1, 1991 - December 31, 1994 (pre and post intervention). The majority of departments, which are not listed, had fewer than 10 incidents during this time frame. The number of employees in each department (ee's) is an average value from employee data as provided by the department of Data Resources Services of Human Resources lnforrnation 50 Systems. Because the percentage of incidents per number of employees in the Libraries and Labor and Industrial Relations is noticeably higher than the other departments, a further analysis of job duties, and workstation design is warranted and may prove beneficial in helping to contain CTDs in these particular areas. Table 21 lists the body part associated with CTD illness between July 1, 1991 - December 31, 1994 (pre and post intervention). Specific body parts (left, right or both) were combined into general categories for this brief overview of the data. Although the "arm(s)", "body", and "wrists(s)" classifications are relatively high and may lead to plausible conclusions about body parts affected, a more detailed analysis should be conducted. The "body" classification does not specifically list each body part affected. This classification needs further breakdown to accurately account for body parts effected in CTDs. Although the separate classification of left limb, right limb or both limbs are specific, information on job task analysis and characteristics of users as right or left handed may aid in the understanding of injuries. 51 Table 19: Frequency of Occupation Classification Occupation classification Frequency Percent Secretary 145 33.6 Accounting clerk 21 4.9 Administrative assistant 13 3 Academic position 12 2.8 Office assistant 75 17.4 Typist 14 3.2 Librarian 22 5.1 Library assistant 50 11.6 Clerk/receptionist 12 2.8 Data entry operator 4 .9 Programmer/analyst 30 6.9 Editor 5 1.2 Heath care assistant 9 2.1 Medical billing 7 1.6 Office supervisor/supervisor 11 2.5 Animal care 2 .5 total 432 100 Table 20: Frequency of Department Classification Department Classification Code Ee's Freq. Percent Labor and Industrial Relations 38508 15 1 1 73 Administrative Info. Service 47220 123 18 15 Libraries 50536 (56536) 121 85 70 Admissions 51016 86 17 20 Clinical Center 55153 63 13 21 Health Ctr. MSU Student 55392 (90392) 133 10 8 Extension 4-H Office 58302 58 15 26 Student Affairs Financial Aid 66804 (65804) 66 10 15 As. VP Human Resources 70642 73 10 14 Comptroller 76200 269 10 4 total 199 52 Table 21: Frequency of Body Part Classification Body Part Classification Frequency Percent Arm(s) 157 27.8 Back 5 .9 Body 175 31 Elbow(s) 10 1 .8 Hand(s) 86 1 5.2 Finger(s) 13 2.3 Shoulder(s) 12 2.1 Wrist(s) 106 18.8 total 564 100 CHAPTER VIII: CONCLUSIONS AND RECOMMENDATIONS Based on the results of this study, the ergonomics policy might have had an effect in reducing the risk of CTDs in the workplace after it's official announcement. Significant differences are found between the pre and post intervention groups. There are fewer CTD claims associated with days restricted from work in the post intervention group. The post-intervention group for the variable "days away from work" experienced fewer claims that can be considered more severe (more days away from work). The average number of days away from work is significantly lower in the post-intervention group. Although these results are encouraging, these conclusions are conservative due to the indicators used and the presence of intervening variables through the various implementation strategies. Although the intent of this study was not to fully document the implementation strategies of various units that aid in support of the policy, general conclusions can be made. Through discussions and conversations with units that participate in supporting the policy, there is a genuine interested in the importance of ergonomics, the philosophy behind the policy and it's impact on the employees in the workplace. This policy is supported from top management 53 54 by providing funding to assist MSU academic and support units with ergonomic improvements (Appendix K). Summary CTD claim expenditures, although not fully analyzed, support the positive impact of the Ergonomics Policy. Total expenses and expenses paid out of workers' compensation for CTD claims are declining (Appendix D). Although this study focuses on data through 1994, a recent interview with a manager in Human Resources confirms the assumptions about the impact of the policy with current 1995 data. Through the 3rd quarter of 1995 there are fewer than half as many CTD claims when compared to the previous year totals for the same period (1995:48; 1995:119). Expenditures continue to be less and may be attributed to employees' earlier recognition of symptoms. imi i n ' f h r This study is limited to the data set of the OSHA 200 log. The log itself contains basic information about workers' compensation claims. The only indicator of severity is in the variables "days away from work" and "days restricted from work". Workers' compensation data may also underestimate CTDs. In order to be counted in the system, the worker must file a claim which is generally associated with the event of an injury or chronic pain. CTDs, on the other hand, develop over time, are associated with mild to severe symptoms, and are not associated with a single event. Thus, CTDs that appear in the OSHA log may represent only these more serious cases. Many people may 55 experience milder CTD symptoms and feel there is no need to file unless the symptoms turn chronic. Also, it is human nature to tolerate the symptoms of mild pain associated with the early stages of CTDs rather than file for workers' compensation. Other possible explanations for avoiding the workers' compensation system could include lack of awareness or perceived job threat (although illegal). A more comprehensive review of medical records/visits is recommended. Also urging employees to file a claim or seek medical attention with milder symptoms. The medical records, although this information may be difficult to obtain, may contain more sensitive information about measures of severity and length of illness (symptoms to treatment to recovery). Additional information such as habits, job task analysis and workstation design, demographic data (gender, age), employee knowledge of ergonomics and training program participation should be sought for further study to give insight in tests and measures used in analysis. This study is also limited to the time frame of data collection. Because of the nature of CTDs (which developed gradually over time) and of the long term impact of training, a better evaluation of the policy may lie in examining data several years from the implementation of the policy and also providing a longer time lapse from the official implementation of the policy to examine pre and post intervention groups. This study was only based on evaluating one goal (reduce to risk of cumulative trauma disorders) through data contained in the OSHA 200 log. A 56 more throughout examination of the policy goals and strategies is needed to accurately assess the strengths and weaknesses. Reynolds ten step methodology to evaluate for risk assessment and control of CTDs (Reynolds, J., et al, 1994) can be further explored. This study incorporated only one of the steps - the review of musculoskeletal injury data (OSHA 200 log). However, it appears that the activity at Olin is mirroring some of the principals behind the other steps such as conducting an ergonomic audit, formulating alternative and implementing workplace solutions, and necessary follow-up. Training, workstation design, job design and medical management need to be examined individually to assess their impact in the relationship of the goals of the policy. Also, a systematic procedure to track any type of ergonomic activity from purchase records of furniture to requests for ergonomic consultation might be valuable in tracking certain items for evaluation. Because this study was based on historical data, there was no opportunity to form a control group to validate results. Difficulty also arises in tracking the current status of particular units that provide ergonomic support for the policy - some information in not complete due to limited records plus a handful of units provided "ergonomic support" prior to the official implementation with questionable start dates. This study did not account for seasonal trends in data, although a trend seems likely due to the nature of the university and potential work patterns associated with the academic year. 57 Im f 'n' On-going training for ergonomic interventions is essential for success of a program. "Training, education, and information programs helped raise awareness and reduce the severity of CTDs, since people seek assistance earlier and those cases requiring therapy or treatment are less severe and more easier to remedied" (Springer, 1994, p. 24). Training is critical to form and reinforce good work habits by changes in work behavior. 'While poor job site design causes the most serious injuries, 80 percent of injuries are caused by damaging work behaviors" (Strakal, 1994, p. 45). Although the Ergonomics Policy states that work station and job flow be reviewed this responsibility falls on the supervisors to take appropriate action in minimizing employee's exposure to CTDs. The policy offers resources but utilizing these resources is not mandatory. University wide mandatory training may provide the avenue for truly minimizing risk of CTDs and workers' compensation costs. The literature provides many suggestion for ergonomic related training for the computerized office. Although particular methods vary, a generalization can be made. Successful programs should include a assessment of the workplace, equipment and facility characteristics, employee capabilities and job demands. A review of injury reports/medical logs may spot sources of problems. Ergonomic alternatives must be generated for the workplace and the employee with implementation and follow-up with training throughout the whole process. REFERENCES Ayoub, Mahmoud. (1990, May). Ergonomic Deficiencies: lll. Root Causes and Their Correction. W 455-460. ANSI/HFS Standard. 100-1988. Am ri F 'ne 'n fV' ual i l T ' I 'on. Human Factors Society. Santa Monica, CA. Banham, Russ. (1994, May). The New Risk in Ergonomic Solutions. Riek Management, 41 22-23, 26-28, 30. Braganza, Barry. (1994, August). Ergonomics in the Office. Emfeesjoflal w 22-27. Braun, Theodore. (1994, October). Ergonomics: The Safety Science of the 1990's. Risk Management, 54-56, 58, 60. Chong, Ian. (1993, July). Ergonomic Solutions Stop the "Loop" Encountered in Workers' Comp Costs. geeupatjgaaLfleafiLandfiafetyjz 31- 32, 53. Etter, Irvin. (1995, January). What Happened to OSHA Reform? Safety 801026110. 64. Haworth, Inc. (1994). .mmmmmmmmm Melee; Haworth, lnc.: Holland, MI. Henderson, Chris and Cernohous, Cindy. (1994, January). Ergonomics: A Business Approach MW 27- 31 Keyserling, W. M., Stetson, D. S., Silverstein, B. A., and Brouwer, M. L. (1993, July). A Checklist for Evaluating Ergonomic Risk Factors Associated with Upper Extremity Cumulative Trauma Disorders. M 807-827. 58 59 Kukla, VWliam. (1992, January) Long-Term, Corporation-Wide Program Makes Ergonomics a Part of Job. W 45-47. Mahone, David. (1993, September). Evaluation of Quick-Fix Solutions to Cumulative Trauma Hazards. flojessioaatfiafemglfi, 16-20. Mahone, David. (1994, January) Job Re—Design, Not "Quick Fixes", Thwarts Many Back Injury Hazards. WMJB; 51 -54. Manning, Harlan T. (1994, February). Ergonomics: The Science of Profitability Wiza- 37 Manuele, Fred. (1991, December). Workers' Compensation Cost Control Through Ergonomics. Prefessienal Safety, 55, 27-32. Marley, Sara. (1994, February, 14). Repetitive Motion Claims Increase. W228. 3.19. Montante, Vlfilliam. (1994, January). Avoiding Confrontation with OSHA on Ergonomics. An Attorney's Advice. W 37. Polakoff, Philip. (1992, October). Ergonomics: Diagnosis and Treatment For Ailing Workplace Performance. W 64-66. Putz—Anderson Vern (1988) W W National Institute for Occupational Safety and Health. Taylor & Francis: London. Reynolds, J. Drury, C. and Broderick, R. (1994, January). A Field Methodology for the Control of Musculoskeletal Injuries. W 25, 3- 16. Rickert, Kathleen. (1992, August). Ergonomics in the Office. Risk W 18-20. Roughton, Jim. (1993, July). Cumulative Trauma Disorders: The Newest Business Liability. W 29-35. Springer, Timothy. (1994, March) Managing Office Ergonomics. W19 24 Strakal, Michael. (1994, December). Prevention Pays Costs of Cumulative Trauma Disorders. O i l I f 43-48. 60 US. Department of Commerce, (1994). 26-2. US. Department of Labor. (1992, May). U. S. Department of Labor, Bureau of Labor Statistics (1992). Survey of Occupational Illness and Injury, Cases Involving Days Away From Work. Westlander, G., Viitasara, E., Johansson, A., and Shahnavaz, H. (1995, April). Evaluation of an Ergonomics Intervention Programme in VDT Workplaces. W 83-92. APPENDIX A University Committee on Research Involving Human Subjects Approval 61 APPENDIX A MICHIGAN STATE u N l v E R s l T Y April 17. 1995 to: Anne M. Kosinski 3316 Biber Street East Lansing, HI 48823 as: IRBI: 95-105 TITLE: AN Assassurur or racououxc xurrnvrurxous AND ponxcx DECISIONS A1 A LARGE PUBLIC uuxvrnsxrx arvzsxou aroursrro: N/A CATEGORY: -n APPROVAL oArr: 04/14/95 The University Committee on Research Involving Human Subjects'(ucnIHS) review of this project is complete. I am pleased to adv so that the rights and welfare of the human subjects appear to be adequately protected and methods to obtain informed consent are appropriate. lhegzgorgé the UCRIHS approved this project including any revision s a ve. RENEWAL: UCRIHS approval is valid for one calendar year, beginning with the approval date shown above. Investigators planning to continue a project be and one year must use the green renewal form (enclosed with t e original :Sproval letter or when a pro eat is renewed) to seek u at certification. there is a max um of four such expedite renewals ssible. Investigators wishing to continue a roject beyond the time need to submit it again or complete rev ew. REVISIONS: UCRIHS must review any changes in rocedures involving hu-an subjects, rior to in tiation of t e change. If this is done at the time o renewal, please use the green renewal form. To revise an ap roved protocol at any 0 her time during the year send your wr tten request to the CRIHS Chair, requesting revised approval and referencin the project's IRB I and title. Include in your request a descr ption of the change and any revised ins ruments, consent forms or advertisements that are applicable. PROBLEMS CIAIG£8:, Should either of the followin arise during the course of the work, investigators must noti y UCRIHS romptly: ll) problems (unexpected side effects comp aints, e c.) involv ng uman subjects or 2 changes in the research environment or new information n icating greater risk to the human sub ects than existed when the protocol was previously reviewed an approved. If we can be of any future helg lease do not hesitate to contact us at (517)355-2180 or rAx (517,3 5- 171. . Lt‘ avid !. Wrightq,Ph. UCRIHS Chair Dtflspjm cc: Timothy J. Springer Sincerely, flflfififlfll PM 517/4941" lauumuaeumne mammal-m. we“: talcum-sin. mas-m APPENDIX B 1993-1994 Healthy U Survey: Summary of Findings Work Related Health Issues APPENDIX B 1993-94 Healthy U Survey: Summary of Fmdings Larry Hombmfl‘, PhD and Ya-Li Huang January, 1995 Conducted for the MSU '5 Healthy U Program by: the Survey Research Division of IPPSR Institute for Public Policy and Social Research ' . DIichigan State University MSU i: m Affirmative Adieu/qud Opportunity Employer — 63 Wont-Related Health harm Intarmofthccostsofn'tcdicalcareand imurancc, the Universityhasavectod irttcrmtintrying to help individuals make lifestyle choices or to change their behaviors to adopt behaviors that are likely to promote health and, consequently, to reduce costs. But the health care costs to the employer who provides imurancc or who loses productivity because of injury or ill-health are still costs “bother the injury or ill-health resulted fiom choices within the control cfthc individual or not. Previom Healthy U Surveys have focused almost entirely on lifestyle: and habits which impact individuals' health and mil-being, most of which represent dccisiom over which individuals have control for themselves. While the evidence ts clear that many of thcsc dccisiom and behaviors do, tn fact, have serious, Sigtificant effects on individuals' mortility and morbidity, fincamodnrfadasthnUywidfindnwnholofhflMdmbMfidralsohflmdfir health. Amongflmcodtcrfactorsartalnstofuorkandmkqtlatcdcondifions whichmay adversely impact individuals' health. 11:1993-94HcalfltyUSmwyhnltdcdasccfimofqmdaSMuuchuaflcdmdaamhm hownmryMSUarpbjccsatggchtduldndsofmkamkmdadnldrdsofcmdifim thatartassociatcdwiththcmostcommonwork-relatcdinjmies. 'Ihcthrccmostcommontypcs ofworkrtlatcdinjmicshawtodocomtxrtcrusc,liflingandwithrcpctitivcmotion. Manyofthc cornprrtattscmlatcdhrjmicsarqthcmsclvcs, ocamplcs ofrcpcfifiwnnfiminjmiabutmt omitsiytly. Wtyart related to the ergonomics ofthc individtnl's wulcstaticn - it, the position offlremfitamlafivctoflchrdividml‘slmddtchcigmofdtcdtair,thcamourttofsaccnglarc, CtC. thfimsrtgmdingcomno'mcmaskcdbcforcthcoduhmtopics. Hom,forcach, Wmasbdwmamdnirmkhwlwddcaaifityhmmfimmoflmt forhowlmgmdvmdlumrxxuwymmaiamddiscomfatasamdtofdnacfivity. Ifso flwyvvueadmdmidafifyflnamsofdnirbodimmfindbcanfmmlnwofimam howsevcrc. 'IharcerltsfcrtlmcqrMonsareprwartcdinTabchZ. Ergonorm’cs andamtterUsc. TableZZ indicatcsthatnxxcthanthrccquartcrs (78.3%) of the famitymdstafi‘unploycdatdtcmfivusitydaimoddnylmtmusccmmm inthcirwrxlr. Ofthcsc, rmrlynincoutoftcn(87.9%) saidtltcymcacomncr'atlcast fivcdaysawcck. The averagcmnnbcrofhotnsspcmcadtdaymddngonacomputo'ms3.77withamcdianof3.00, indicatingthatafcwindividualsspartcomidcrablymoretimeonthccormrtcrcachdaythanis typical. Ofthoscwhomccomputcrsinthcirwodgsixoutoftcn(60.4%)indicatcdtlmdtcyoqacriatcc sornctypcofdiscomfcrtwlmthcytscthccorrputcr. Oftlmcwhooqao‘icrtccdiscomfcrtthc mostcormnonformisvisualfatigucorcycstrainvhidtmclaimcdtobcaproblcmfcrnflfi ofthoscwhooqaaricnccdsomcformofdiscomfort. 'Ihcsccondmostcommonlycitcdarcacf thcbodywhcrcdiscmnfortocansmthcuppo'orlowcrbadtao.4%),followcdbythcwrists (Z3.0°/o)artdthcncck(22.0%). Sirtccthcscarcthcpcrcantagcsaqicricncing discomfortin partiatlarpartsofthcbodyofthoscwhocaqnicnccanydiscomfcrtitmaytcndtooraggcratc thcappmmtprtvalcnccoftlmcdiscomforts. FormerrpletltcBOA'Mtwhosaidthcymmcriatcc discomfortinthciruppcrcrlombackactmllyrcpwattsonly18.4%ofallcrrployccswhousc connrtcrsandl44%ofallcmployccs. 64 Table 22. Distribution of Activity and Discomfort Associated with Using Conquers, lifting Objects, and Repetitive Motion in “brk Among All NSU Meyers: 1994 Use Conputr h’l‘t navy (lijecs Repetitive Motion TOTAL 783% 19.9% 37.5% W < 1 DayMeek 0.8% 3.4% 0.6% 1-4 DaysIchk ' 11.3 43.7 28.1 5-7 Days/Wed: 87.9 52.9 71.3 (N) (625) (161) (298) DURA‘HWI‘IMES Average 3.77 hrs/day 7.48 times/day 4.20 hrs/day Median 3.00 hrs/day 3.00 times/day 4.00 hrs/day W DW 60.4% 47.4% 60.2% (N) (625) (159) (297) 100th Eyes 72.6%' 0.0% 0.0% Neck 22.0 15.7 20.2 Upper/bows Back 30.4 85.3 22.5 Shoulders 16.7 8.2 17.3 , Uppafbower Ame 13.0 8.2 27.6 Wrists 23.0 9.5 53.9 Hands 11.6 8.8 32.1 Legs ' 3.2 2.5 2.6 Thigls 0.0 0.0 1.6 (N) (378) (74) (178) HOWOFIE‘! (All) . (All) (All) Almost Daily 33.2% (11.1) 17.2% (1.6) ' 33.6% (7.4) 2 - 5 Days/Wk. 25.3 21.6 (2.0) 37.6 (8.3) 2 - 4 Days/Mo. 31.8 (10.7) 15.1 (7.0) 19.2 (4.3) Few Tunes/Year 9.8 (3.2) 50.6 (4.7) 9.6 (7.1) WWW) (665) (90.6) (77.7) HOW MUCH . Only a Little 31.4% (10.4) 20.1% (1.8) 30.2% (6.7) Moderate Amount 52.0 (17.4) 43.8 (4.0) 55.9 (12.5) Quite a Bit 13.9 (4.1) 20.1 (1.8) 10.7 (2.4) A Great Deal 2.6 (0.9) 16.1 (1.5) 3.2 (0.7) (Not Applicable) (665) (90-6) (77.7) 65 Table 22 also indieates that those who experience discomfort do so quite otten. A third ofthose experiencing discomfort (33.2%) do so almost daily while an additional 25.3% do so 2-5 days per week. About a third of those experiencing discomfort indieatcd that theytypieally experience only a little discomfort (31.4%), but roughly half (52.0%) said they etqierience a moderate amount, while 13.9% and 2.6% indieatcd they experimce quite a bit or a great deal of discomfort respccu'vely. 'Ihose irxiieatingtheyeaqaerience quitea hit our greatdeal ofdiscomfort represent 4.7% and 0.9% of all MSU employees. knuviewusaskcdallrespmdmmmtsemmpmasmwumrkifunyhadbemgivm instnmionorinformtion about ways toreduoediscomfortwhenusingacorrputer. Overall, 68.2%oftheseemployeessaidthattlnyhadand803%oftheseindieatedthattheinfonnation hadbcenprovidedbytheuniversity. 'Iimewhoreportedhavingbeengivenarhinfonmtion meachnflysonanmelikdymreponoqniafingdiswmfonfiommmgamnmdnn wuedmeMnsaidunyhadmtbcmgivmmishtfmfimuinmfitishnpmmmtomte Mdnsemindmtrmdvcdmdtktfomnfimtmdedmmednmmpnafewudayspaweek andfeweriurrsperdaywhentinydiduseit. Woreitmightbemoreinformativeto examine the utilityofhaving received information about how to reduce computer-related discomfatbyconpadngtinsomoesofdnhtfmunfionannngflnsemmoeivedit nnseMnmcdveddnhtfmmfimfiomsonnsumodnrdmdnUmvusitywuemelflcely mrepmtdiswmfatm.6%)flmnmednsewinmcdveddninfmnnfimfiomdnUnivusity (63.9%). This may indieate something about the quality of the information provided. Knowingwhattodo,however,withotnhavingeithertinproperequipnnrttorworkflean’bilityto implementwhatsinuldbedornmaystiflresrdtinhealdtpoblars. Interviewersaskcd Mnhadmoeivedinfonmfionabmflnwmmdtnecomptnaaelateddisoomfortslnw oftentinywereableto follcwthe guidelines given. Overall, 373% oftimeresmndents indicated tinttheycouldfollowtheguidelinesallornearlyalltlntinnandanadditional 36.5%reported theycouldfollowtin guidelines nurhofthetinn. Onlyoneinten(10.3%)saidtlnycouldcnly rarely follow the guidelines, while 15.8% said theycould doso only oceasionally. More than thrc'equartersm.9%)oftheseemployees midthattheyhadbeenprovidcdtinequipmentor finnitureneededtofollowtlngttidelinesoradvice,artd903°oreportedhavingtinfleqdbilityin tinirvmrktaslrstofollowtinguidelinesandadvice. InguuaLdmeMnrepmtedbeutgmeoflmablemfollowdnadfimmgtddelmmm inddnrmmufledcmfipnufimfinfihmeuddmemlnddnmkflmbflitymedeiwue alsolees filoelymrqntoqnaianingdisoomfonasarendtoftsingacmmnerinfinirmk This,flnvaltnofbeingabletoconplywidtmwmnatdafianregardmgflnagunmiesof useseemstohavebeenarbstantiatcd. flncostirnplieationsmealsoindieatcd. govern“, 22.8%ofthosewhousedcompr1ersand35.7%ofthosewhosaidtheyexperienced quhtcddiswnfmtrepmwdhafinghadmseeknndimlmbemmeofphysimla visualproblemstinyassociatedwithusingtincorrqxrter. IngmeraLthoseMtoweremoreofien able to follow ergonomic guidelines, had proper equipment or firrniture, and had flexibility in their mkmflsmlemfikdymrepmtinvinglndmsedrnndimleamfamnaahmdimlm problemscrtomissdays ofwork. 66 lifting. Intaviewers asked a similar, although less detailed, set of questions regarding lilting heavyobjcctsasapartofone‘s work. Theresults forthesequestiom arealso presented in'l‘able 22. The table indicates that one in five employees (19.9%) reported having to lift heavy objects. Of those wiro mtnt do so, over haif(52.9%) said they lift heavy objects daily, while only 3.4% saidtireydoso less thanonceaweek. 'Iheseemployees reportcdhavingto lift heavyobjcctsan average ofsevenarrdahalftirnesaday,althoughtln mediannumberoftimrs perdaywas only 3. Theseanpioyeesreponedthattintypiealweightoftindtingsdnyhaveto liitatmrkwas, onaverage,47pornkanddnweightoftinheaviestthingstinyhadto lift was,onavaage, 70 pounds; horsever,the\\eights forbotirrang’ed fiomorriyoneortwopounds to 150 pounds. Intaviewasaskedtheseemployees iftinyeaqraiarceddisoomfortasaresultofthe liftingthey have to do in tinir work. Almost halfofthese anployees (47.4% or 9.4% of all employees) reported experiarcing discomfort, nrost ofwhom experienced badr poblems (85.3%). The table indieatesthatthesedisoomfortsoccurrcdonlyafewtinrespayearfor50.6%ofthose eaqaaiarcing discomfort (or 4.7%) ofall anployees, while 17.2% of these ernpioyees experienced discomfort ainrostdaiiyarrd21.6%eaq3aiarced discomfortsevaaidaysaweek. Ova'athirdofthosewlnreportcd experiarcingdiscomfort(36.2%)reportedtirattheyhadeitha quiteabit (20.1%)oragreatdealofdrsoomfort (16.1%). Onetnfiveoftheseemployees (20.1%) saidtheyerqaaiaroedonlyaiittlediscomfort. 'Ihosewhoreportederqraiarcingdiscomfortwere sonnuhatmefikelymseedndoaameofimbceueeofainaidrprobianardtonfiasmore days ofmkthanwaeotha'anployees. Repetitive Motion. Interviewers asked anployces if tireir work required doing things regularly witharepetitivenntionforextardcdpaiodsoftime. 'Ihoseerrployeeswhoseworkinvolved anhmslswaedmaskedasaiesofqtesfianmgardingdnfieqtnrnyarfldmafimofanh tasks,andwhetiraornottinyeaqaaiarocddisoomfortfiomtinmk. 'lheresultsarepresartcd inTable22aswe11. The table indieates that more than a third ofMSUenpioyees°(37.$%) worked irrjobs with repetitivemotionmks. Oftirese, 71.3%atgagedinrepetitive motiontasks'fiveormoredays meirweek. Onmraagefireseanpioyeesatgagedinrepefidvennfimmslafamugiflyfominns eacir day. Sixout of tar of these employees (60.2%) reported expaiareing discomfort associated witirtireirwork. Iinanployeesudnrepateddiscomfatindieatcdaqraianingdisoomfatsin leescornaruatedareascfthebodythanmstnnregrdingdisoomforts fromcomputauseor lifting. Neva‘dniessdndisoomfortsmegaraaflyconfirndmdnuppabodyandtmpa extremities. About halfoftime workers (53.9%) had discomfort in their wrists, 321% in their lends,27.6%intireiramrs,22.5%intheirbaeks,arrd20.2%intinirnecks.'Athirdofthese individuals said they expaiarce the discomfort almost daily wirile 37.6% mm: employees said theyexpaiaroe discomfort several days eachvreek. Only 13.9% of these anployces (3.1% ofaii - amioyees) reported erqreriareing quite a bit (24%) or a great deal (0.7%) of discomfort. Dosemrepatedamaiafingdismmfatgaaaflymmmefikdyfimnodraamloyees toseethedoetcrbecauseofhealthrroblansortomissdaysofwork However,those oqraiardnggeataunmmofdismmfatuaenmlflrdymbeabsaufiomwakardmsee tiredoctorrnoreoflat. APPENDIX C Ergonomics Policy 67 APPENDIX C MICHIGAN STATE UNIVERSITY omce or me movosr £16? UNSWG - MICHIGAN - 488244046 vrce mesroem son FNANCE mo opcmnous mo measuncn April 1, 1993 MEMORANDUM To: Vice Presidents, Deans, Directors, Chairpersons, Heads of Administrative Units and Supervisors From: Lou Anna Kimsey Simon, Interim Provost w Roger Wilkinson, Vice resident- for Finance and Operations and Treasurer Subject : Ergonomics Policy Since 1990, Michigan State University has experienced an increase in cumulative trauma disorders (CTD) . Worker's Compensation costs related to CTD's increased significantly in fiscal year 1991-92. In an effort to reduce the risk of these illnesses, the attached policy and procedure is to be implemented immediately. This policy will ensure that all departments and employees work cooperatively to reduce the risk of CTD illnesses. The policy requires that work statiOns and job flow be reviewed. Supervisors are to take appropriate corrective measures to minimize exposure to C'I‘D's. The procedure offers resources for training and support services. A supervisory training program on Ergonomics is being developed for presentation during the fall of 1993. Your immediate attention to the implementation of this policy is appreciated. Attachment 68 ERGONOM 1C5 POLICY March. 1993 Michigan State University strives to maintain a safe and healthy workplace for all University employees. Workplace ergonomics is of increasing importance to employee health and safety. This policy is established to promote and protect employee health through ergonomically sound practices. Several general principles guide MSU efforts in the ergonomics area, including the following: 0 Immediately after hiring a new employee or making significant changes in assigned responsibilities of an employee in place. supervisors should determine the adequacy of the employee’s familiarity with ergonomic principles and practices applicable to the new job responsibilities and locale. When needed. training should be provided. 0 Employees receiving ergonomics training should be encouraged to consider the applieability of training content to activities undertaken outside of the workplace. 0 When employees are provided unfamiliar or significantly changed new tools, equipment, or work stations, the training in the use of the tool, equipment. or work station should routinely address ergonomics issues. 0 Ergonomic features of equipment. tools. and work stations (whether existing or under consideration for acquisition, construction or renovations) should be evaluated. The employce(s) who will be working with the aforementioned should participate in the evaluation. 0 Ergonomics training and improvement efforts by administrative units should receive appropriate programmatic and budgetary priority. The efforts should be continuous, to ensure periodic reconsideration of ergonomic issues in light of environmental change and recent research. As with all such unit-level activities, a unit‘s intentions, priorities, and results achieved are properly discussed within the context of the annual APP&R or SSPP&R process. which permits MAUolevel review and reinforcement. In short, routine and widespread consideration of ergonomic issues should be institutionalized as a natural component in the conduct of University affairs. 69 implementation of this policy is a shared responsibility of various administrative units and of all University employees. in particular: 1. Training - Departments/MAUs are responsible for ensuring provision of ergonomic education in their units. For example, employees working with video display terminals or highly repetitive last: should have training in the fundamentals of ergonomics and cunruImiue trauma disorders (CID) risk factors. Supervisors should have training in how they ean work with employees to reduce the risk of injuries and illnesses. Units that provide primary training in the use of tools or equipment (such as MSU Computer Laboratory and Administrative Information Systems in the case of terminals and personal computers) are responsible for routinely incorporating ergonomics concepts within such training. 2. Work Station Design - incorporation of ergonomics principles in work site construction "or renovation planning, is a shared responsibility of all participating units, including the University Architect, Physical Plant, and Facilities Planning & Space Management. For this purpose, the work station should be considered to include furniture, electronic and other tools, lighting, and other environmental features. Departments/MAUs are responsible for individual work stations, once established. Each job-site should provide an appropriate fit between the worker, the technology, and the working environment. Employees should be empowered to share in the responsibility for the safety of their workplace with their supervisor or appropriate others. 3. Job Design - With leadership from'de’p’artments and MAUs, supervisors are responsible for ensuring appropriate work methods. When considering an employee‘s regular job assignment, both pace of work and job flow should be reviewed to avoid excessively repetitive work for any one employee and his/her specific position. 4. Medieal Management - Employees suffering from job-related cumulative trauma disorders will have access to medieal treatment and rehabilitative processes through the Workers‘ Compensation Program. In these cases, ergonomic accommodations or improvements may be coordinated by the Workers‘ Compensation Division. However, work station modifieations and equipment cost decisions are line responsibility, both financially, and administratively. 5. individual Compliance - Employees are responsible to follow ergonomic policies and to follow work practices directed or recommended for ergonomic purposes. Policy applies to: All University employees Refer questions to: Assistant Vice President for Human Resources 355—0290, or Assistant Provost and Assistant Vice President for Academic Human Resources 353-5300. 70 ERGONOMICS PROCEDURE March, I993 The following procedures are to be followed by departments to ensure ergonomically sound practices. Compliance: if a MlOSHA compliance of freer notifies your area of an impending inspection or simply visits your Department/MAU, immediately contact the MS U Occupational Safety Of freer at 355-5360. The Safety Of freer should be present for all investigations and will assist departments with all responses to cited violations, and/or citations. it is important to act immediately if notified by MlOSHA: severe penalties could arise if prompt action is not taken. Training: Once a department identifies a need for CT D and/or ergonomics training it may obtained from: MSU Occupational Health Services (Olin) at 353-9137, MSU Computer Laboratory at 355-4500, Administrative information Services at 353—4420, and/or MSU Health Promotion Programs (Healthy-U) at 353-2596. .infornration and Support Sources: Information on VDT and computer related ergonomics and CT D topics can be accessed through use of several electronic data resources including the following: 0 “Computer-Selects“ CD ROM periodical bibliography available in the Computer Lab, 0 'Magic' catalog available at the MSU Libraries, 0 “Gopher“ a eampus information server. in addition, a number of academic units on campus offer courses and programs on the subject of ergonomics in the workplace. Many of these units are also involved in research projects on various ergonomic issues. These units include the following: 0 Human Environment and Design at 355-77l2 0 Biomechanics at 353-9110 0 Building Construction Management at 353-0862 Finally, support for employees who have experienced a CT D illness is available through the Employee Assistance Program (BAP) at 355-4506. 71 \Vork Station Evaluation: Once departments identify work stations needing attention, assistance with work station evaluations can be obtained from MSU Occupational Health Center (Olin) at 353-9317, and lngham Medical Occupational Health Center at 334-2300. Other providers may be approved by Human Resources. Such evaluations typically entail a fee, and can include recommendations for work station design modifications. Similarly, for a fee, Housing Construction and Design at 355-7476 offers assistance with designing new work stations, or reorganizing existing work stations. Departments are responsible for reviewing the results of work station evaluations, and taking necessary action to implement all reasonable and necessary modifications in a timely manner. Job Design: When departments review the job design of particular positions, they should: 0 identify types of repetitive tasks performed in an individual‘s position. 0 Recommend a'job flow allowing on average a ten to fifteen minute alternative task break from repetitive tasks. As a general rule, time on repetitive task should not exceed two hours. 0 Communicate an approved, appropriate job flow to the employee, to be maintained as part of the regular job assignment. Questions regarding job design may be referred.,to MSU Occupational Health Services (Olin) at 353-9l37 or lngham Medieal Occupational Health Center at 334-2300 Medical Management: if an employee complains of a CT D or other work related injury/illness, departments should: i. Direct the employee to the appropriate medical facility designated by the Workers‘ Compensation Division (see workers‘ compensation policy and procedure). 2. Complete the following: An Authorization to invoice MSU (MO-2665) Report of Claimed Occupational injury or illness (MO-2592) if the employee is losing time, the injury Absence Report (l40-25i3) Request a job site evaluation, if one has not been done, through MSU Occupational Health Services (Olin) at 353-9l37, or lngham Medieal Occupational Health Center at 334-2300. 3. Follow all medieaily prescribed work restrictions if the employee is on the job. 4. Ensure that reasonable and necessary'work site modifications have been implemented. 72 Questions regarding medical management may he directed to Workers‘ Compensation at 353-5394. Questions on reasonable accommodation required under the Americans with Disabilities Act may be directed to the Coordinator of Handicapper Operations and Services at 355-2270. APPENDIX Definitions: Ergonomics: Referred to as human factors, or human engineering, ergonomics is concerned with understanding the basic physical and psychological attributes of people as these relate to the things that peeple use (tools, machines, environments). The goal of ergonomic design is to optimize the person-thing relationship, that is, the fit. (Dainoff and Dainoff, I986) Repetitive Tacks: Activities involving sustained or repetitive musculoskeletal exertion with no opportunity for rest or recovery. Examples of repetitive tasks are, chopping by hand various food items, working with tools in a twisting motion, bending, lifting, data entry work. Cumdative Trauma Disorders (CID): Injuries developed gradually over periods of weeks, months, or even years as a result of repeated stresses on a particular body part as a result of mechanieal stresses. (Putz-Anderson, l988) APPENDIX D Cumulative Trauma Disorder Statistics - December 1994 Report 73 APPENDIX D Cumulative Trauma Disorder Statistics - December 1994 Report This table reports the number of CTD cases workers' compensation expenditures were paid on in each fiscal year. Claims paid reflect expenses paid each fiscal year. The claim may have been incurred in a previous year. CUMULATIVE TRAUMA DISORDER (CTD) EXPENDITURES Year Claims Paid Expense FY 1989—90 22 $ 11,123 FY 1990-91 141 $292,813 FY 1991-92 266 $540,907 FY 1992-93 226 $534,603 FY 1993-94 276 $459,526 FY 1994 -95* 128 $258,414 This table reports all expenses attributed to CTD illnesses reported each fiscal year. Total expenses reports the total paid on a claim by the fiscal year the illness began. Claims reported reflects the number of new cases reported each FY. CUMULATIVE TRAUMA DISORDER (CTD) EXPENDITURES Year Claims Paid Expense FY 1989-90 24 $310,526 FY 1990-91 137 $600.1 14 FY 1991-92 175 $693,966 FY 1992-93 157 $227,195 FY 1993-94 186 $193,965 FY 1994 -95* 57 $ 25,799 * Through 11-30-94 Average cost per claim 1991-92: $3,965 Average cost per claim 1993-94: $1 ,042 NOTE: Eighteen individual cases account for a total of $1,008,000 of total expenses (to date) for CTD workers' compensation claims. APPENDIX E Olin Health Center Ergonomic Activity 74 APPENDIX E MSU Occupational Health Service - Group Assessments/Presentations Department Attendance Session Date MSU Development Fund 20 * 11/91 - 6l93* Controller's Office 100 total in 4 sessions 11/91-6/93 Sociology 5 * 1 1/91-6/93 Olin Health Center 13 21* 11l91-6/93 Food Science 4 * 11l91-6/93 University Printing 4 1 October 1993 Dept. of Communications 4 1 October 1993 College of Nursing 17 2 (same people)November 1993 Animal Health Diagnostic Lab 7 2 11/93 12 4 11l91 -6/93 Arts and Letters 8 * January 1994 Admissions Office 46 * January 1994 Romance & Classical Languages 3 1 February 1994 Packaging 8 1 February 1994 4-H Extension 21 * February 1994 surveyed 48 Dept. of History 6 1 March 1994 Registrar's Office 65 1 March 1993 Pesticide Research Center 3 * April 94 Human Medicine Dean 12 * April 94 Philosophy 3 * June 94 Student Life 14 * June 94 Veterinary Medicine 18 2 August 1994 Alumni Association 25 1 August 1994 Teachers Education 15 1 September 1994 Counseling Center 12 1 September 1994 Chemistry 13 1 September 1994 English Research 10 1 November 1994 lntemational Center 7 1 March 1995 * Insufficient data Projected: July - December 1994 - group assessments tripled 75 MSU Occupational Health Service - Individual Assessments/Presentations Fiscal Year July 1 - June 30 Individual Evaluations 1991 - 1992 15 1992 - 1993 37 1993 - 1994 33 1994 - 1995 74 (projected through May) CAMPUS Dear Thank you for your interest in our ergonomic services. We offer two types of programs: the individual job analysis and the group presentation 'Worla’ng Smarter, Nor Harder". The individual job analysis focuses on a particular individual at his/her workstation. An ergonomic specialist will observe the employee for possible risk factors. During the observation the specialist will make recommendations regarding work habits as well as possible equipment changes and use of existing equipment. The employee will also be videotaped while at the workstation for the specialist to review. A detailed report describing the results of the assessment and the recommendations will be sent to the supervisor and the employee. The cost for this service is SISO. The observation takes approximately one hour. The ergonomic group presentation 'Worla'ng Smarter, Abt Harder" is a comprehensive program designed to educate employees about the risk factors associated with cumulative trauma disorders. Larry Rush, P.T. and David Whitney, 0.0. are co-presenters of this program. We have enclosed the following information for your review: D Individual ergonomic request form and survey [:1 'librla'ng Smarter, Ab! Harder“ group presentation booklet if you would like the individual job analysis, please fill out the request form and the survey. Return them together to: Physical Therapy Clinic Olin Health Center After receiving the completed forms we will call the employee to schedule a mutually convenient meeting time. if you are interested in the group presentation, please call us for further information. Our phone number is 3-5008. Sincerely, Olin Health Center Physical Therapy 76 MSU Occupational Health - Ergonomics Survey In order to improve the MSU Occupational Health Service, we depend on feedback from our clients. We value your comments and suggestions and would greatly appreciate your taking a few minutes to complete this survey. Please return the survey through campus mail to: MSU Occupational Iiealth Olin Health Center Rm 253 Did you feel that the ergonomics program provided an adequate assessment of your work area? D Yes, comment: D No, comment: Did you make the suggested changes to improve your work habits (posture, positioning, etc.)? D Yes, I made most or all of the suggested changes Yes, i try but sometimes forget to use the new behaviors Yes, I made changes but discontinued them because: No, I didn't think the changes were necessary No, the changes were too disruptive/dif f icult Other i was not given suggested changes DDDDDD Were the suggested changes to improve your work station (change desk, chair, monitor, temperature, etc.) implemented? D Yes, most or all of the changes have been or will be made D Yes, some changes have been or will be made, however D No, changes have not been made because: C] i was not given suggested changes Were the suggested exercises for you to do in your work area implemented? CI Yes, and I continue to do them D Yes, but i stopped doing them because: 0 No, because: CI i was not given exercise suggestions Additional Comments: Please tell us which department you are employed by: Thank you for taking the time to complete our survey. 77 OLIN HEALTH CENTER OLIN HEALTH CENTER lDt NAME MICHIGAN STATE UNIVERSITY Birthdate Date ERGONONHCS SURVEY Campus Phone Job Title Rate your comfort for each region (A-J) by writing a number (0 to 10) in the box provided. (Make no distinction between right and left.) DISCOMFORT RATING Very Very Comfortable Uncomfortable A) Head/neckleyes O ........... [j ........... IO 8) Upper/mid back 0 ........... [:1 ........... 10 C) Low back/pelvis 0 ........... E] ........... 10 D) Shoulder/upper arm 0 ........... E] ........... IO E) Elbow/mid arm 0 ........... D ........... 10 F) Forearm/wrist 0 ........... D ........... 10 G) Hand 0 ........... E] ........... 10 H) Upper leg/hip 0 ........... E] ........... IO I) Mid leg/knee 0 ........... [:1 ........... 10 I) Lower leg/foot 0 ........... D ........... IO 78 ERGONOMICS SURVEY tor NAME Please respond to each of these questions in the boxes provided. How well are your needs being met at work? How hard is your work? How much energy do you have left after work? How often is there a great deal of work to be done? How often does your job require you to work fast? How often does your job leave you with little time to get things done? How much influence do you have over the variety of taslcs you perform? Very link How much influence do you have over the pace of your work? How often does there seem to be a sense of urgency about everything? V“! “"‘Y How often is there a significant increase in your workload (i.e., projects/proposals)? To what extent can you do your work ahead and take a short rest break during working hours? Very rarely In general, how much influence do you have ever work and work-related factors? Very little In the past week or two, how would you describe how you have been feeling? Very fatigued 79 Ergonomics Follow up Survey In November, 1993 a survey was sent to those who participated in an ergonomic group training or an individual work site assessment before June, I993. The purpose of the survey was to assess the service provided by MSU Occupational Health Service and to determine if recommended changes were implemented. See attached sample. One hundred seventy-six surveys were sent to those who participated in group training. 'i‘wcnty-six surveys were returned for a response rate was 15%. Of those who responded 73% indicated that most or all of the suggested changes had been made to their work station, 12% indicated that some of the changes had been made, 8% indicated that none of the changes had been made, 4% indicated that there were no suggestions made and 4% did not respond to the question. Thirty-eight surveys were sent to those who had individual work site assessments. Eighteen surveys were returned for a response rate of 47%. Of those who responded 72% indicated that most or all of the suggested changes had been made to their work station and 28% indicated that some of the changes had been made. The plan is to send a similar survey in November, 1994 to those who participated in an ergonomic group training or an individual work site assessment from July, 1993 to June, 1994. Reported Ergonomic Changes Group Pernod Reperted Ergonomic Changes Individual m .o. W ......... 40"" so-' 0‘ / u / / v Mills-t 8m None New \-~.- , ”om 'x‘l‘rz . -., - its .1 \ (\ \\~Av,~>\t~')' .~ ( N \\ h‘v $3) I ~\\\¢ ' Earn-:2 . . .. ,. In the period from July 1, 1994 to November 30, I994, Olin Health Center Physical Therapy performed forty-one individual worksite assessments. At the end of November, thirteen follow-up visits were made. These thirteen cases represented ten different departments. The initial assessments on these cases had been completed from four weeks to twenty weeks prior to the follow-up visit. A period of at least four weeks between initial and follow-up visits was provided to allow time for changes to be initiated. On follow-up visits, compliance with recommended interventions was assessed along with reasons for lack of change. Additional suggestions and review of the original recommendations were also provided as needed during follow-up visits. Results were as follows: Cassi w I 60f7 2 7of8 3 IOofll 4 50f? 5 6of6 6 9of9 7 50f6 8 7of8 9 4of4 IO 50f5 11 4of7 12 30f5 4of5 .— w 81 WWW Case #1 - Management decision not to implement job rotation Case #2 - Task lighting order pending Case #3 - Tried foam grip on pen but felt it was uncomfortable Case #4 - Did not feel that document holder would work for her situation Casefl- Didnotfeelthatstretcheswerenecessary Casel‘8- Hadnotobtainedachair from Purchasing fortn'aluse Cases Ill & 12 - Equipment changes not yet made as the department hadjust recently approved anamounttobespentperworkstation Case #13 - Had not 'gotten around' to ordering louvers for lights Overall compliance with suggested interventions in the cases reviewed was 85%. In all but one case, general satisfaction with department/supervisor support for changes was reported. 82 MICHIGAN STATE UNIVERSITY ERGONOMICS 0N MSU CAMPUS Through August 13, 1992 Ergonomics by definition is adapting the job to the employee. Under the umbrella of ergonomics, a variety of activities were initiated on the MSU campus which led to duplications with no coordination of efforts on campus. MSU Occupational Health began individual and group workstation analysis in October of 1990. Larry Rush, Physical Therapist, provided the first group analysis. This gave the group of five employees information to assess their individual work stations and make modifications that were ergonomically sound. In February, 1991, L. Rush evaluated a work station at the MSU Development Fund and three at University Services. Workstation analysis was underway when the Health and Safety Operations Committee appointed a task force to facilitate the coordination of efforts regarding ergonomics. The task force was composed of representatives from the Department of Safety, Human Resources and MSU Occupational Health Service. MSU Occupational Health Service chaired this task force. The task force engaged the expertise of Dr. Timothy Springer, department chair of Human Environment and Design, to assist in needs identification and planning. The task force also reviewed the HIOSHA log compiled by Worker’ 8 Compensation to determine what are the primary job related injuries or illnesses. Arm, shoulder, wrist, neck and back complaints were identified as the major problems. Decreasing the number of worker's compensation ammonites” claims for cumulative trauma disorders became the task EastCitcle one force's goal. East Lansing. um , “82"“, To accomplish this goal, the employees would need to 5‘7/355‘510 decrease their risks. The task force identified two “5‘7“”‘53‘ areas of focus. First the supervisors needed a better understanding of ergonomics in order to help them support their employees in making necessary changes. Secondly, the employees needed information and resources to make changes. To finance the educational process, a proposal was submitted to Healthy U for a seed grant. The supervisors would receive general education on ergonomics in lecture format and pilot behavior change groups would be established for specific employees. rain-W 83 ERGONOMICS ON MSU CAMPUS Page 2 July 1992 Healthy U funded a portion of the proposal. Olin Health Center with Human Resources funded the rest. During the planning phase, Marti Ricks B.S.N., M.A., Manager of MSU Occupational.Health.Services, and.Paula Lux:R.N.,B.S., Occupational Health Nurse, completed "Occupational Ergonomics" and “Ergonomics: Job Analysis 5 Field Studies" at the University of Michigan. The education and behavior change programs began in February 1992. The supervisor education sessions were presented once a month for four months and the behavior change programs met weekly for sixteen weeks. The behavior change pilot programs, patterned after the Worksite Wellness template, were at AIS, Human Resources, the Library and Olin Health Centemu Members of MSU’Occupational Health Service attended all the supervisor education sessions and the behavior change program at Olin. The behavior change programs had varying degrees of success. Each area had different concerns and availability of resources. Olin Health Center was the only site that completed the sixteen week behavior change program with minimal modifications. The success of Olin's behavior change program was due in part to qualified staff from MSU Occupational Health Service. They served as a resource and followed up throughout the week on concerns addressed by the participants. For more detailed information on the behavior change program see attached graphs. Prior to the implementation of the behavior change program, MSU Occupational Health Service developed a survey to evaluate a variety of chairs that were identified by the manufacturer as "ergonomic”. In addition, an ergonomic and a pain survey were developed. The ergonomic survey is given to individuals requesting an ergonomic assessment. It is to be completed and returned to MSU Occupational Health Service prior to the site visit. The pain survey was designed to identify particular areas and types of pain. Along with the survey information, an on site workstation analysis specifically looks at job design, body postures and potential behavior changes the employees could accomplish and equipment necessary to adapt the workstation to the employee. APPENDIX F Computing and Technology Training Program 84 APPENDIX F Agenda for AIS Ergonomics Basics and the Computer Computing and Technology Training Program (CTTP) .U‘PSPN.‘ 9’ 909°.“ 10. 11. Introduction/Welcome Purpose of the class Why is ergonomics important? Show 10 minute video "User Friendly, The Guide to VDT Safety" The importance of stretching, take a stretch break ** 5 minute break ** Workstation setup guidelines, practical hands on experiences using the computer workstations in the training room Ergonomic accessories, wrist rests, keyboard trays and more Ergonomic resources and expertise available on campus Computer demonstrations: A. Demo AIS.ERGO.NEWS (over 200 items or ergo information selected from the internet) B. Demo EXERCISE BREAK (software reminds you to stretch and leads you through the exercise pre-elected by you) Summary Evaluation and distribution of handouts 1993 Ergonomic Course Statistics Date # Enrollees Public/Special Notesfi _ Nov. 9 3 (1.5 hrs.) Special PILOT run of Ergo Class (lntemal) Nov. 13 5 Public First class Nov. 19 1 Public Dec. 3 8 Special Session for ICTC Dec. 16 4 Public Total sessions: 5 2 Special, 3 Public (completed) Total attendees: 21 11 Special, 10 Public 85 1994 Ergonomic Training Statistics Date # Enrollees Public/Special Notes Jan. 25 6 (2 hrs.) Public Changed from 1.5 hours to 2 hours Feb. 22 0 Public Cancelled/low enrollment March 22 3 Public April 12 2 Public May 23 8 Special Session for OFA June 14 O (2.5 hrs.) 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The goal of the initiative was to use the Healthy-U behavior modification model to improve awareness of ergonomic considerations among staff and to improve the personal ergonomically-related behaviors of staff members. After the team's first meeting. it was determined that the goal set by Healthy U did not fit the needs of the pilot team very well. Dr. Tim Springer was asked to worked'with the team to help tailor the goal better; The new goal of the team was to build.a sound understanding of the concepts and principles of ergonomics, the benefits which could result from their proper application in the workplace, and the consequences which could result from ignoring ergonomic considerations. Dr. Springer was asked to deliver a series of four presentations on ergonomics to the pilot team. 'This was the same series he offered campus-wide to University managers and supervisors during the same period. It was well received by the team and thus the beginning of our education and training program within A.I.S. The pilot team felt that more needed to be done beyond the Healthy-U’pilot if the full benefits of an ergonomically sound workplace was to be realized. A task force was developed to look at how we could best apply the knowledge gained by the group to the benefit of staff within the department. This group's mission was to act as an A.I.S. contact point on ergonomic issues with other campus ergonomic groups, act in an advocacy and advisory capacity on ergonomics issues to the Director of A.I.S. and educate and support A.I.S. staff on ergonomic issues. The team developed a general overview program for all staff members that included the following things: 1. Raise the level of awareness about CTD's. identify early warning signs and teach self help precautions such as stretching exercises and the importance of early detection and treatment. 2. Teach staff the importance of ergonomic workstation setup and show them how to adjust their workstation accordingly. The A.I.S. Ergonomic Task Force has initiated and carried out a number of specific activities in support of its mission since its beginning. Below is a list of some of these activities. Identifies and provides specialized office equipment: * Identifies modestly priced office equipment (e.g.. wrist rests, glare screens. foot rests) that could reduce the physical stress on people who sit at computer workstations. * Seeks and receives, umnagement support for acquisition of these items. * Orders variations of each type of equipment to accommodate a range of needs and circumstances. Staff are encouraged to evaluate more than one type of glare screen. or which ever item they have selected. Items are then ordered for the individual once they have determined which design works best for them. 88 Evaluates and Recommends purchase of ergonomic video: * Evaluated a series of general ergonomic videos that would teach the basics of sound ergonomic arrangement of furniture and equipment for a computer workstation. Upon approval. purchased video for department.Effective Fall Semester 1992. the showing of the video will be incorporated in all the Introductory computer classes taught to our customers by A.I.S. staff. This video will also be incorporated into the standard orientation of new A.I.S employees. General Ergonomic Information Sessions for staff: * Hold general sessions within the department to review and update staff on ergonomic issues. Activities include: showing the ergonomic video tape; display various office equipment items available for trial; review recommended stretching exercises. See Attachment A for handouts for general ergonomics session for staff. Adjusts/reconfigures workstations based upon ergonomic guidelines: Reviews, recommends. adjusts and aligns staff workstations. He have developed an “ergo checkup'I program that evaluates each staff 's workstation and equipment. This is completely voluntary but to date we have had more than 60! our staff participate in it. All staff have follow-up visits to ensure that the adjustments are working and that equipment is being used correctly. This is an ongoing activity for all staff members. See Attachment B for ergonomic checkup sheet. Liaison with campus ergonomics groups: * A.I.S. has representation on an ad hoc committee to review and recommend coordination of campus ergonomics activities. This is coordinated by the Human Resources Department. A.I.S. has representation on an ad hoc committee to review and recommend details for a University useability lab. A.I.S. has informal information sharing relationships with the internal ergonomics support groups: - MSU Libraries - Human Resources - Olin Health Center - Computer Lab See Attachment C for list of ergonomic resources at MSU 89 In November of 1993, another ergonomics program was developed. This program has been developed into a class that is offered through our Computing and.Technology Training Program (CTTP) which is available to any one on or off campus. A.I.S's goal. in offering this class. was to support the University's Ergonomics Policy by offering training suitable for individual staff members as well as whole departments. Our goal was that departments would take advantage of the class as a component of meeting their obligations under the University policy, and that we would reach many staff members with preventive information before cumulative stress disorders (CSDs) began to develop. Attendance Statistics for 1994 are as follows: Number of Public Sessions: 13 Number of Special Sessions: 17 Total Number of Sessions: 30 Attendance/Public Sessions: 28 Attendance/Special Sessions: 148 Total Attendance: 176 A copy of the course outline is attached for your information. (see Attachment D) Host class participants seem to attend because of personal interest, rather than at departmental initiative. Regrettably, participants' interest seems most often to have been triggered by existing cumulative stress disorder symptoms. Host participants have been staff, rather than students or faculty. A few participants have attended from professional interest. It is our hope that in 1995 we can broaden class participation and get more departments to integrate this program into their department in support of the University Ergonomics Policy. 90 ERGONONIICS AND THE COMPUTER: A PRACTICAL APPROACH R. Kelly Fairbanks Senior Systems Analyst Michigan State University Administrative Information Services Room 7., Administration Building East Lansing, MI 48824 (517)353-4420, ext 240 lnternet: ADP2C@MSU.EDU Michigan State University East Lansing, Michigan Enrollment: 40,000 Public 4-year institution This paper presents the major components of an ergonomic program Administrative Information Services (AIS) is deveIOping to provide its staff with a general knowledge of sound ergonomic principles as they relate to the use of computers. Our efforts to date have been geared toward increasing the awareness and understanding of the need to follow sound ergonomic guidelines during computer use. The goals of our ergonomic efforts are to increase the individual’s comfort level and reduce the severity of Cumulative Trauma Disorders. This results in a decrease in both human suffering and health care costs while it actually increases productivity. This classic win-win duration also addresses management’s responsibility to provide a work environment that is as productive and healthy as possible. Aspects of the program developed at AIS will be helpful to others desiring to achieve the same goals. 91 ERGONOMICS AND THE COMPUTER: A PRACTICAL APPROACH INTRODUCTION This paper presents the major components of an ergonomic program Administrative Information Services (A18) is developing to combat Repetitive Stress Injuries by providing its staff with a general knowledge of sound ergonomic principles as they relate to the use of computers. Our efforts to date have been geared toward increasing the awareness and understanding of the need to follow sound ergonomic guidelines during computer use. The goal of our ergonomic effort is to increase the individual’s comfort level and reduce the severity of Cumulative Trauma Disorders. This results in a decrease in both human suffering and health care costs while it actually increases productivity. This classic m’n-win situation also addresses management’s responsibility to provide a work environment that is as productive and healthy as possible. BACKGROUND As the nation's first land grant institution, Michigan State University (MSU) continually strives to improve the lives of all it serves. Toward this end, MSU has assembled a committee consisting of representatives from across the campus to address ergonomic issues that affect those within the campus community. Our department, Administrative Information Services (which reports organizationally to the Vice Provost for Computing and Technology), plays a key role in this effort. A campus-wide ergonomics policy was established, and areas of responsibility were outlined. In support of the spirit of this policy, AIS has worked internally to develop an ergonomic program for the 120 employees within its own departmental jurisdiction. This paper limits its discussion to the ergonomic efforts of AIS. AIS' ergonomic efforts have proven beneficial not only for our departmental employees, but also for the campus at large. We share our knowledge through a class we designed and teach about ergonomics and the computer workstation, and have been invited by several divisions to participate in their ergonomic efforts as well. This sharing of information and expertise supports the mission of A18 to provide leadership in the use of information tedmology as well as contributing to the University‘s overall mission of teaching research and servrce. THE NEED FOR ERGONOMICS Each of A18' 120 employees uses a computer workstation of some sort in their daily work. Because of a growing number of physical ailments experienced with the continual use of these workstations, the need for ergonomic information became apparent. This initially served as the motivation for AIS' ergonomic efforts. There is increasing speculation that impending legislation will soon mandate that employers provide employees with both an ergonomically sound work environment and ergonomic training. This has motivated a growing number of businesses throughout the country to begin offering ergonomic programs for their employees. An increasing number of workers compensation claims and disabilities associated with long-term computer use was also a great motivator to address these problems. 92 COMPONENTS OF AIS’ ERGONOMICS EFFORT To date, the approach AIS has taken in its ergonomics program includes many elements. The key components are: 1. Training via 'Ergonomic Basics and the Computer' Course 2. Ergonomic Equipment 3. Equipment Loaner Program 4. Ergonomic Workstation Check-Up 5. Electronic Resources and Communications The following sections elaborate on the specifies of these components and the importance each one plays in the total ergonomic effort. COMPONENT ONE: TRAINING VIA 'ERGONOMIC BASICS AND THE COMPUTER' COURSE AIS designed a two and one-half hour course entitled 'Ergonomic Basics and the Computer' that builds a foundation of ergonomic information. The course offers a forward-thinking, practical introduction to the principles and 'do’s and don’ts" of ergonomics, and increases awareness of ergonomic guidelines as they apply to the computer workstation. Each individual uses ergonomic guidelines to adjust their classroom workstation with the assistance of the instructor. Each attendee is given several handouts including a flyer listing ergonomic resources on campus, along with a synopsis of their services and their contact numbers. Additionally, students are introduced to some of the ergonomic equipment and software available in the marketplace today. We take great care to set a positive, upbeat tone to the content and delivery. This helps encourage the attendees to view the class as a positive opportunity to improve their personal workstation instead of just complaining. In an effort to ensure correctness and timeliness of the material included in the course, AIS invited several members of the MSU community with ergonomic expertise to critique the material. The course is intended to be a starting point in one’s ergonomic education, upon which the other MSU ergonomic services can easily build. The course, which debuted in November 1993, has received excellent feedback from those who have attended. In particular, clients who are currently experiencing some type of Cumulative Trauma Disorder (CTD) are especially appreciative of the course material and positive approach. Clients who are not currently suffering with symptoms of (.7le are not always enlightened as to the importance of preventive measures to ward off potential problems. In reality, the aspect of human nature that allows some to say 'I am not in pain today so I do not need to worry about ergonomics" is really a large contributor to the problem. The continuing challenge AIS faces is to encourage all clients to recognize the importance of education and awareness of proper ergonomic principles. While getting the word out to individuals around the MSU campus continues to be a challenge, some MSU departments-the Office of Admissions, for example-have been very forward-thinking in their ergonomic efforts. Admissions has taken the initiative to work with AIS to facilitate ergonomic training for all of their support staff (approximately seventy people). Working together with the management team from Admissions, AIS customized the basic ergonomics course to best meet the needs of the department and staff. These sessions 93 were deemed a great success, and many staff members expressed their appreciation to their management for caring enough to have them attend the class. AIS is currently customizing and teaching the ergonomics course for another large MSU department, in support of their pro-active approach toward ergonomic awareness. COMPONENT TWO: ERGONOMIC EQUIPMENT A computer workstation still has limitations on how effectively and easily it can present, and accept, information from a human being. It is the challenge of ergonomics to make the machine/human interface as effective and painlcss as possible. Several pieces of equipment have come out in the recent past to try to improve this process. Some of it makes a meaningful contribution while others are marketing gimmicks only intended to make a buck. The equipment that we have found, to date, to be most beneficial to our employees is as follows: 0 Anti-glare screens The most common visual problem among our department’s workforce today is too much light coming from the wrong direction. This light can easily create glare on the computer screen. The purpose of the anti-glare screen is to reduce as much unwanted light as possible. . Adjustable ergonomically dcsigned chairs Although replacing all the chairs in our department with new ergonomic chairs is not part of our program, we support the replacement of an individual's chair when the situation warrants it. We feel that a well-adjusted chair is the basis of comfort at the workstation. Significant improvements in chair dcsign have been made in the last few years. 0 Keyboard trays The keyboard tray has two main functions in our environment, they are; first to allow the keyboard to be placed directly in front of the monitor (most worksurfaws are only 24' deep), and second to lower the keyboard to the recommended height for keying while leaving the main surface at the correct height for writing. . Document stand or holder It is important for people who spend significant amounts of time entering information from a source document, to have the source document at the same height and distance as the monitor screen. The document stand or holder addresses this need. 0 Wrist Rests Wrist rcsts have also been found to be helpful to many peeple within our department. The purpose of the wrist rest is to provide a comfortable surface on which the heel of the hand can be rested when EQI typing. . Footrests A footrest is a device to provide a solid foundation for a person’s feet when they would otherwise not touch the floor. This product has proven to be beneficial for some employees within our department. 94 o Pointing Devices (mouse, trackball, etc.) It is becoming more and more necessary to use a pointing device with today‘s software. The problem is that the two most popular pointing devices--the mouse and the trackballucontinue to cause significant physical discomfort for some of our employees. We are currently testing a new pointing device that combines the best features of the mouse and the trackball, while eliminating both of their shortcomings. Although our analysis is not yet complete, we feel this product holds great promise for our employees. 0 CPU Floor Stand A large clamp (usually plastic) that allows the main processor to be stood on end and held stable. While not ergonomic in nature itself it promotes keeping the monitor at a lower level and removes clutter from the worksurface supporting correa ergonomic placement of other equipment. 0 CRT Stand This device allows the Monitor to be placed at the correct height for the individual. The kind we prefer so far is designed like twelve inch square interlocking 'LEGGO' blocks that are one inch thick so the monitor height can be fine tuned inch by inch if necessary. COMPONENT THREE: EQUIPMENT LOANER PROGRAM Because of the variety of equipment available in the marketplace today, we have developed an 'equipment loaner program' whereby ergonomic equipment described above is loaned to individuals for trial use as part of their workstation. This not only reduces equipment costs making sure the person likes the itemhejgfl we order it but it aLso eliminates the stigma of returning items that just didn’t work out. Ultimately each person selects the brand of equipment best suited to their particular needs. We have found that personal preference plays an important role in use and acceptance of the equipment. All the above Ergonomic Equipment is in our loaner progam plus a couple additional items listed below. One of the things that makes the loaner program necessary is the need to have several design variations of some items, for example: 0 wrist rests (currently offering four different types) keyboard trays (currently four types, some of which accommodate the mouse) 0 document stands (currently two types) . anti-glare screen a padded desk pad (for people who spend a lot of time with their elbows on the desk) . footrests (currently available in two different heights) We are currently testing various pointing devices and ergonomic keyboards, which may be included in our loaner program if deemed appropriate. When the situation warrants, we also participate in the ergonomic 95 chair loaner program sponsored by MSU's Purchasing Department. Currently, they have at least six different versions of adjustable chairs for trial by university employees. Our department’s loaner program has been very successful for several reasons. It helps us save money by making sure that the person likes the item before purchase, and it allows us to offer various options of a particular item to allow for personal preference. This program has been a real boost to morale by helping staff members feel that management understands their needs and is willing to work with them to find the best solution possible for their particular situation. Some funding has been specifically allocated for the purpose of purchasing ergonomic equipment. COMPONENT FOUR: TIIE ERGONOMIC WORKSTATION CHECK-UP In order to help our employees customize their workstation to fit them, we have developed what we call the 'ergonomic checkup' which is based upon ergonomic guidelines. Any individual can request that an ergonomic checkup be performed on their workstation. In order to be successful, the ergonomic checkup must be both non-judgmental and positive in its approach. Included in the checkup are such things as: o establishing correct chair height, keyboard height, and monitor height. 0 a discussion of the role played by posture and the benefits of appropriate stretching exercises. 0 various ergonomic equipment is discussed and recommendations are made (reference the section below entitled 'COMPONENT FOUR: EQUIPMENT LOANER PROGRAM). 0 documentation of all the necessary heights and distances within an individual’s workstation setup, as well as any changes that have been made. Because one of the most important things in an ergonomic program of this nature is follow up with the individual after changes have been made, this documcntation helps us fine tune later adjustments. It is very important to conduct followup visits to learn how the adjustments are working. Our ergonomic checkup effort calls for both a 60-day and 6—month follow-up visit. When each checkup is completed, the employee and their manager receive a copy of our ergonomic checkup worksheet which contains findings and recommendations. In our experience, an ergonomic checkup can take from twenty minutes (for a follow-up visit) to two days (conducted for a person just returning from carpal tunnel surgery who needed a complete redesign and onsite training). COMPONENT FIVE: ELECTRONIC RESOURCES AND COMMUNICATIONS The networking of individual computer workstations and the Information Highway (INTERNET) have given us some powerful took to assist in our ergonomic effort. The mediums we make use of currently are: 0 Monitor Internet resources In an effort to provide the most current information in the area of computer-related ergonomics, we monitor the Internet listserve called Computers Plus Health (listserve name is “Cd-HEALTH“). This 96 is a large international group of people interested in ergonomics as it applies to the computer. Many are professionals and practitioners in the field of ergonomics, medicine, or occupational health. This represents an amazing resource of current and emerging information. Anyone can submit a question that is then discussed and input provided by all interested members of the group. On a daily basis, we monitor this listserve and select all items considered worthwhile and appropriate to our audience. These selected items are then posted to an electronic mail bulletin board that is available to everyone in the department and elsewhere on campus. We currently have several hundred documents divided into different categories (e.g., exercise, cumulative trauma disorders, hardware, office equipment, general health, software, office environment) that have been established for the convenience of our audience. 0 Maintain alumni mailing list and communicate electronically We maintain an electronic mailing list of all alumni of our 'Ergonomic Basics and the Computer' class. As particularly interesting or important items or announcements come to our attention, they are distributed to all of the alumni to keep them abreast of ergonomic developments. This is important for two reasons: it keeps them up to date, and it also keeps them thinking about ergonomics and the role it plays in their worklife. 0 Send ergonomic tips electronically The electronic mail system is used to keep the employees of our department thinking about ergonomics by sharing late breaking news items and information of general interest. This avenue of communication is excellent for reinforcing the development of positive ergonomic work habits. For example, a recent ergonomic tip was sent to remind employees of the importance of lifting one’s hands off the wrist rest while keyingo-a habit that can be difficult to break. a Participate in Internet forum for ergonomics We also recently joined 'ErgoNet' an on-line, computer based, discussion forum for ergonomic practitioners and researchers sponsored by the University Of Michigan. Communications are organized by discussion topic, and are stored chronologically for ease of reference. We expect ERGONET will make a significant contribution to our knowledge of workstation ergonomics. . Ergonomic software It is very common-but unhealthy-40 spend hours at a time without a break at one’s workstation. One interesting, effective and relatively inexpensive solution is the use of exercise software that can be loaded on one’s computer. The software can be set to aaivate periodically to remind the Operator to do stretching and relaxation exercises. Some products then lead the Operator through a set of stretches that they have selected, illustrating the stretching and counting down the appropriate time interval. We are currently evaluating several of these products to identify the one most appropriate for our department. CONCLUSIONS It is the objective of all our ergonomic efforts to increase an individual's comfort and significantly reduce the seriousness of any Cumulative Trauma Disorders. Early detection of a problem, identification of the causes, and ongoing monitoring of the situation can lead to complete elimination of discomfort. Without exception, the earlier a problem is identified and resolved (including medical treatment when necessary) the less it costs in both 97 human suffering as well as lost time and dollars. The support of upper management is critical to the success of an ergonomic program. We are fortunate at MSU that the university has adopted a progressive ergonomic policy. Recently our Vice Provost for Computing and Technology announced a matching funds program that will encourage and enable many university departments to pursue ergonomic efforts and purchase equipment directly related to computer workstation ergonomics. Additionally, the Vice Provost has taken an active and supportive role in Sponsoring on-going, leading edge ergonomic training for those of us directly involved in our ergonomic effort. This vote of confidence and support is critical to the continued success of our ergonomic efforts. We are on the way toward achieving our objectives and have established credibility with MSU administrators and staff. It is rewarding to be involved with a program that is not only concerned about productivity but equally concerned about providing a safe and healthy environment where people perform their daily work. 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