Step 3 of an Ergonomics Program: Collect Health and Medical Evidence

Key points

• Collect records of work-related musculoskeletal disorders (WMSDs): OSHA logs, medical records, claims, absentee records and job transfer requests.
• Interview workers and survey symptoms to find when and how problems start.
• Offer periodic medical exams, designed and run by a health care provider.

This is the third step of NIOSH's guide to workplace ergonomics programs. Once you have learned the signs of WMSDs and trained workers, the next step is to measure how big the problem is and what it looks like.

Why it matters: follow up on anyone whose job causes undue fatigue, stress or discomfort. Symptoms reported early leave time to act before a disorder develops. If one department reports more problems than others, study its risk factors right away.

Calculate incidence and prevalence rates

Start your review from the date of your last equipment or process change, and gather data from:

• OSHA logs of work-related injuries and illnesses
• company medical records
• workers' compensation and insurance claims
• absentee records
• job transfer applications

Both rates are expressed per 100 full-time workers, which equals 200,000 work hours a year:

• Which cases: rates are usually computed for total recordable cases (TRC), with or without lost workdays. They can also be computed for DART cases — days away, restricted duty or transfer to another job.
• Partial years: use hours worked through the period in question.
• No hours data? Estimate 2,000 hours a year for each full-time worker.
• Compare your rates with other departments, industries, occupations or the nation using the Bureau of Labor Statistics injury and illness rate calculator.

Interview workers and survey symptoms

Interviews and surveys catch problems that might otherwise go unnoticed. Ask about:

• personal details: age, sex, work history, current job
• where symptoms are, when they occur, how long they last and how severe they are
• how difficult the job tasks are
• symptoms in previous jobs
• medical history

A body map lets workers mark where they hurt. It rank-orders how often and how badly each body part is affected, and results can be averaged by department or job.

• Keep surveys anonymous and voluntary, and have them completed on work time.
• Out of respect for workers' personal information, survey only if the company is ready to act on the results.

Offer periodic medical exams

A health care provider takes each worker's medical history and gives a physical exam, which may include range-of-motion and tenderness tests and questions about pain. The examiner should already know the worker's existing conditions and job title.

A disorder counts as work-related when problems in one part of the body go with a particular job function. Interviews, surveys and exams together confirm what the rates suggest.

Example: supermarket cashiers have more hand and wrist disorders than other supermarket workers — and those who do the most checkout work or the longest shifts have the most.

Analyze each job

A job analysis studies a job and all of its parts — tools, equipment, materials, workstation layout, physical environment, demands and organizational climate (a definition from Brannick, Levine and Morgeson, 2007). A human resources professional or other experienced person usually does it.

There is no standard protocol. Good practice:

1. Write a summary of each job, with the total time for each task.
2. Ask workers whether the way the job is done has changed.
3. Divide the job into separate tasks and actions.
4. Count and categorize the risk factors in each.
5. Find the underlying cause of each risk factor.
6. Record each factor's severity, frequency and duration.

Consider:

Assessment tools

It can be hard to know how much exposure is harmful. NIOSH suggests three approaches: the Revised NIOSH Lifting Equation for lifting and lowering; comparing the strength a task needs with the strength of the workers doing it; and asking workers what conditions they find acceptable.

Whole body and screening

Back

Upper body

Where to find them: Washington State Department of Labor & Industries, the Ohio Bureau of Workers' Compensation, Thomas E. Bernard's ergonomics tools (University of South Florida), Cornell University Ergonomics Web and the AIHA Ergonomic Assessment Toolkit.

NIOSH forms: WMSD hazard identification checklist · symptoms survey with a body map · measures of workstation layouts.

Sources

Based on "Step 3: Collect Health and Medical Evidence," National Institute for Occupational Safety and Health (NIOSH), CDC; its two formulas, published as images, are set here as text. A work of the United States government in the public domain.