what are repetitive stress injuries?

Contents

Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

What Are Repetitive Stress Injuries? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6What are the risk factors for work-related RSIs? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Are RSIs a problem for education support professionals? . . . . . . . . . . . . . . . . . . . 7

Types of Repetitive Stress Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Hand and Arm Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Neck and Shoulder Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Back Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

What You Can Do to Prevent Injuries and Illnesses . . . . . . . . . . . . . . . . . . . . . . 11Avoid Repetitive Work. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Avoid Awkward and Static Postures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Avoid Standing for Long Periods of Time. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12Avoid Bending, Twisting, and Reaching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Be Careful How You Lift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Reduce the Amount of Force You Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Design Computer Workstations to Fit the User . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16Choose and Use Tools Carefully . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17Keep Workplace Conditions in Mind . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Job Risks for Clerical and Technical ESP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Job Risks for School Bus Drivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Job Risks for Skilled Trades Workers and Custodians . . . . . . . . . . . . . . . . . . . . 21

Job Risks for Food Service Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Health and Safety Committees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Your Legal Rights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25OSHA Standards and Inspections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25Workers’ Compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25Americans With Disabilities Act (ADA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27Internet Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

ESP REPETITIVE STRESS INJURIES HANDBOOK

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The National Education Association is the nation's largest professional employee organization,representing 2.7 million elementary and secondary teachers,

higher education faculty, education support professionals, school administrators,retired educators, and students preparing to become teachers.

NEA EXECUTIVE COMMITTEE MEMBERSReg Weaver, President

Dennis Van Roekel, Vice PresidentLily Eskelsen, Secretary-Treasurer

Michael (Mike) BillirakisMark Cebulski

Carolyn CrowderMichael Marks

Rebecca (Becky) PringleMarsha Smith

EDUCATION SUPPORT PROFESSIONALS QUALITYJohn I.Wilson, NEA Executive Director

Al Perez, DirectorLisa Connor, Organizational SpecialistCara Elmore, Organizational Specialist

Dominic Padilla, Organizational SpecialistRafael Rivera, Organizational SpecialistAgnes Smith, Organizational Specialist

Mareena Nephew, Senior Program Assistant

Editing and Design: American Labor Education Center

No part of this guide may be produced in any form without the permission from NEA Education Support Professionals Quality,

except by NEA affiliates or members. Any reproduction of the report material must include the usual credit line and the copyright notice.

Address communications to NEA ESP Quality, 1201 16th Street, N.W., Washington, DC 20036-3290, 202-822-7131.

E-mail directly to [email protected].

Published October 2004

If you answered “yes” to any of thesequestions, your work may be harmingyou. Education support professionals cansuffer from hand and wrist disorders, backand neck injuries, and muscle strains dueto repetitive motions or awkward workpositions. Poorly designed equipmentand chairs, forceful exertions, improperlifting and reaching, or vibrating handtools increase the chances of injury towrists, arms, back, or shoulders. Doing thesame motions over and over, hour afterhour, week after week, can make theseproblems even worse.

It’s now common knowledge that theseproblems are a result of repetitivestress injuries (RSIs), also known ascumulative trauma disorders (CTDs).Certain work activities that you do everyday can cause tiny injuries to yourshoulders, elbows, wrists, hands, fingers,knees, or back. Each trauma alone is sosmall that you don’t know it is happening. . . until all the small injuries add up andyou’re in pain. RSIs may take weeks,months, or even years to develop.That’swhy what you do now is important toyour health and your ability to work inthe future.


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Do you …

� Sit at a desk in front of a computer all day?

� Drive a bus or operate heavy equipment?

� Stretch your arms or twist your back to reach your work?

� Lift or carry materials?

� Spend most of the day on your feet?

� Use hand tools?

� Repeat the same motions over and over?

Introduction

The good news is, most of thesedisorders are preventable.Ergonomics—the study of the relationshipbetween work and the worker—can beused to make your work fit your bodyinstead of the other way around.

When you get in a car, you adjust theseat, mirrors, and steering wheel to drivecomfortably and safely. In the same way,your workstation may also take someadjusting to “fit” you. If you work in a

seated position, you may need to raiseor lower your chair. Computer operatorsusually are able to adjust the height oftheir keyboard, and the angles of theirmonitor and keyboard as well.

If you work in a standing position, youcan use anti-fatigue mats, change yourposture periodically, or alternately restone foot on a wooden or concrete blockto relieve the pressure of constantlystanding.


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LOOK ATTHE WHOLE

PICTURE:Designing

a safeworkplace

involves taking

multiplefactors into

account.

Tools, supplies, and parts can bemoved closer to you to avoid longreaches.Trays, cleaning supplies, andother materials can often be raised up offthe floor to avoid stooping and bending.Hand tools can be modified to avoidawkward arm or hand positions.

In many cases the problem isn’t the jobyou’re doing or the tool you’re using buthow you’re doing or using it. Overheadreaches, lots of lifting and bending, wristrotations—the things that you usually dowithout thinking can create a problem.The motion itself may be harmless, butwhen you do it many times a day, youcan hurt yourself.

Poorly designed or maintained workenvironments together with a poorlydesigned job or workstation can increasethe likelihood of repetitive stress injuriesor other adverse health effects.Environmental factors such as heat orcold, lack of ventilation, noise, vibration,too much or too little light can worsenergonomic problems.

This handbook is designed to helpyou recognize workplace stress andhazards and the methods that canbe used to correct them. Acting alone,with your co-workers, and with yourassociation representatives, you can applyergonomics in your workplace.You cancustomize your job, tools, and work-station, even the way you do your job,to some degree. However, your employerwill still have to approve purchases ofnew equipment or tools, and will usuallywant to approve any changes in workmethods or organization.

It’s the employer’s responsibility to makechanges in the workplace that willprotect your health and safety. Thishandbook should help you make the casethat the changes are necessary.


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A repetitive stress injury (RSI) is damage to bodytissues—muscles, tendons, spinal discs, blood vessels,and nerves—caused by repeated physical stresses.RSIs are produced by a gradual build-up of tinyamounts of damage caused by repetitive motionsinvolving the same few tendons or ligaments.Maintaining the same body posture for long periodsof time—as many jobs require—contributes todeveloping RSIs, because such postures decreaseblood supply to the working tissues, making itincreasingly difficult for your body to repair itself.

What Are Repetitive StressInjuries?

Symptoms can range from mild aching tosharp, crippling pain. Symptoms oftenbegin at work, then disappear duringperiods of rest. As the symptoms getworse, they begin to interfere with yourusual work activities and disturb yoursleep. Eventually, severe pain, limitedmobility, loss of sensation, or muscleweakness make it impossible to performkey job tasks.

The first symptoms of injury are weak-ness of the injured area, trembling, andaches and pains. In an isolated incident,

symptoms will disappear. If an RSI isdeveloping, the symptoms will notdisappear, even after you have stoppedperforming the task. At this point, youshould see a doctor, or talk to yoursupervisor about ways to change yourworkstation or work methods.

What are the risk factorsfor work-related RSIs?> Repetition: doing the same motionhundreds of times each day, never giving


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your body a chance to rest and recoverfrom the stress and strain

> Awkward or stressful posture:repeated overhead motions; reachingdown and behind your body; extremebending of the elbow and extremerotation of the lower arm; lifting, twisting,or bending your back or other parts ofyour body; holding a fixed position forlong time

> Forceful movements: using a lot ofeffort or strength to do the job, even insmall movements like pinching yourfingers or bending your wrist

> Frequent and difficult lifting: in abadly-designed job, even 25-pound loadscan cause injuries. Loads over 70 poundsare always dangerous for one person to lift.

> Poorly-designed tools: too muchvibration; handles that require stronggrips or bent wrists or arms; sharp edges

> Work organization/job design:the speed at which you work; the work-load; job security, and lack of control overwork can contribute to the developmentof RSIs.

Additional health symptoms anddisorders—including anxiousness, irrita-bility, high blood pressure, ulcers, andheadaches—can be caused by poor workorganization or job design.

There are also a number of non-workrelated risk factors, such as inherited

conditions, pregnancy, obesity, medi-cation, diseases, overall fitness levels, andothers.

Are RSIs a problem foreducation supportprofessionals?Workers in every ESP job category are atrisk of developing repetitive stressinjuries.

> Bus drivers repeatedly open andclose manually-operated doors, repeatedlydepress clutch and/or brake pedals,operate hand controls forcefully andquickly, and climb and descend bus stepshundreds of times a day.Women drivers’bodies especially are stressed when usingthis equipment, since buses and othervehicles originally were designed by menfor men. In addition, the job of safelytransporting children is psychologicallystressful.

> Food service workers repeatedlyreach above shoulder level and belowknee level, reach across deep counters,twist sideways to reach food items, liftheavy equipment and trays, repeatedlybend hands and wrists when preparingfood, and stand for long shifts.

> Technical service workers andclerical workers perform repetitivekeystroke motions on computers, workwith back, shoulders, arms or hands inawkward positions due to improperlyfitted work stations, and do continuouswork in one position without breaks.


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> Skilled trades workers andcustodians are subject to repeatedmuscle and skeletal stress from vibratingor badly designed tools, improper lifting,overhead work, prolonged kneeling, andbending and twisting.

> Health and student servicesworkers and security ESP are less atrisk from repetitive motions than from

psychological stress. Health workers aresubject to occupational hazards such asexposure to diseases and contact withblood and other body fluids. Securitystaff face psychological stress fromdealing with violent student and parentbehavior. Working at a stressful job or in a stressful environment can contributeto and exacerbate physical symptoms.

ERGONOMIC FACTS

� Musculo-skeletal disorders account for 35% of all workplaceinjuries.

� Nearly 1.8 million workers each year suffer from ergonomicinjuries.

� It is estimated that 50 cents of every dollar spent on medicalcosts will be for treating repetitive stress injuries.

� Workers’ compensation claims have nearly tripled in the last twodecades. An estimated 60% of this increase is attributed toinadequate ergonomic conditions in the workplace.

Source: OSHA


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Hand and Arm PainThe many bones of the hand and armsare joined together by a combination ofligaments, tendons, and muscles. Becauseof this delicate combination, your hands,wrists, and arms are easily damagedwhen stressful movements are repeatedfrequently over time. Repetitive stressinjuries of the hands and arms can bebroken down into disorders of thetendons, nerves, and neurovascular(nerves and blood vessels) system.

> Tendon disorders: Tendinitis resultsfrom overuse or stress on a tendon.Wristand arm tendons often are affected.Symptoms include pain, swelling, andweakness in the hand, elbow, or shoulder.The way to treat this inflammation is toprovide time for rest and recovery.

> Nerve disorders: Nerve disorders areassociated with the repeated exposure tocontact stressors, such as sharp edges oftools or work surfaces, or even of adjacentbones, ligaments, or tendons. Perhaps the

best known nerve disorder is carpaltunnel syndrome, which results when themedian nerve in the wrist is compressedbetween the tendon and the bone.Carpal tunnel syndrome victims mayexperience numbness, tingling and painin the thumb, index, middle finger andinner side of ring finger. Many of thesesymptoms will first occur away fromwork, often in bed. If untreated, it canresult in progressive loss of strength inthe hand and inability to grasp objects.

Clerical workers who rest their wrists onthe sharp edge of their desk or foodservice workers who perform repetitiouschopping or slicing motions riskdeveloping carpal tunnel syndrome.

> Neurovascular disorders: One ofthe most common neurovascular dis-orders is thoracic outlet syndrome. Thiscondition produces numbness in thefingers and a weakening of the pulse. Thecompression of blood vessels resultsfrom activities which pull the shoulders

Most work-related repetitive stress injuries affect theupper part of the body—the spinal column, neck,shoulders, arms and hands.

Types of Repetitive StressInjuries


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back and down, such as carrying a heavypack, and work that requires constantoverhead motions, like stacking dishes orsupplies.

Neck and Shoulder PainThe neck is frequently involved in work-related discomfort and pain. Prolongedbending of the muscles of the neck isprobably the most common cause ofdiscomfort.

Clerical workers often experience neckdiscomfort from bending the neck downto read documents, up to view thecomputer monitor, or sideways to holdthe telephone receiver between the headand the shoulder. Bus drivers report neckpain from craning to see their passengersin the mirror.

In addition, psychological stress, whichusually increases the muscular tensionthroughout the body, is particularlycritical to the muscles of the neck.

Work-related shoulder disorders are oftenassociated with job tasks where theelbow is kept in an elevated position. Ifyour job requires you to keep your handsabove your shoulder for significantperiods day in and day out, you mightdevelop a condition known as frozenshoulder.

Repeated motion of the arm away fromthe body can lead to a common shoulderdisorder known as rotator cuff tendinitis.Bus drivers who repeatedly operate

manual doors are prone to this condition,which is characterized by a persistent anddull pain in the shoulder region anddiscomfort in the arms.

Back PainBack injuries occur when people areforced to work for extended periods oftime in awkward positions—bent over,leaning forward or sideways—and whenthey use poor lifting techniques. Becauseback injuries are difficult to treat,attention should be directed towardsprevention, by designing the job andworkplace to fit the worker. Every cate-gory of education support professionalis at risk of back pain and injury because

of their work.

Kinds of Back Injuries:

� Back strains, caused when weak ortense muscles are stretched beyondtheir limit

� Back sprains, caused by a partial orcomplete tear of a back ligament

� Herniated discs, resulting whenstress, strain, or gradual deterioration on a disc causes it to stick outbetween the vertebrae

� Ruptured discs, caused when the wall of a disc breaks open


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Avoid Awkward and StaticPosturesA neutral body position is the mostcomfortable working posture.That’swhen your shoulders are down andrelaxed, your arms are close to your sides,your elbows are bent, and your wrists andhands are straight.When your posture is“out of neutral” you increase the stress on

your joints, muscles, tendons, nerves, andblood vessels.

If you work bent over, leaning forward, orwith your arms above shoulder height,you’re probably keeping your body in oneposition for a while.These “static” workactivities are very tiring and stress thelower back and shoulders.

The first step in preventing RSIs is to take a hard lookat your workplace and the way you do your job. Youmay be able to make changes in the physical set-upof your workstation or the position of your body asyou do your work, or both.The following are somesuggestions for how to protect yourself.

What You Can Do to PreventInjuries and Illnesses

MODIFY EQUIPMENT:Simple equipment changescan reduce the need to workin awkward positions.

� Move around and change yourposture often.Take a “micro”break.Try to split up yourwork. If you have beenbending or kneeling, switchto something else to restyour back and knees.

� Use the right tool for thejob.This can reduceawkward postures. Forexample, extensionpoles can be usedfor cleaning orpainting tools so thatcustodians don’t have to reach so faroverhead.

� Organize the work space so that there is enoughroom to move around andchange body position.

Avoid Standing for LongPeriods of TimeStanding in one position can also putstress on your spine and back muscles.Back and muscle stress on standing jobscan be reduced by the use of:

� Rubber or plastic anti-fatigue mats.

� Foot rests, to allow you to shift yourweight often.

� A “sit/stand” stool—and theopportunity to changepositions or move around.

� Rotation to another job.


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REDESIGN WORK AREA: Reaching likethis over deep counters can stress the

back, shoulders, and arms.

MODIFYTOOLS:Extensionpoles can be used forcleaning orpaintingtools so thatcustodiansdon’t have toreach so faroverhead.


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� Reach without stretching andstraining.

� Keep reaches below shoulder level.

� Avoid stacking materials aboveshoulder height.

� Keep your elbows at the height of thework counter.

� Support your forearms with armrestsor other padded surfaces.

� Have enough room in work area to useyour arms while keeping your wristsstraight.

Be Careful How You LiftLifting stresses your muscles, tendons,ligaments and spine.The key to properlifting is to keep the back in its naturalposition. Here are some steps that willhelp prevent back injuries:

Use safe lifting procedures

� Squat lifts put less stress on your back,but only if you can fit the objectbetween your knees.The best solutionis to reduce the size and weight of theload.

� Never pick up a load unless . . .

> Both feet are firmly on the ground.

> The load is no higher than yourshoulders.

� Stand close to load with feet apart.Minimize long reaches.The closer theload to the body, the less pressure itputs on your back.

REPOSITIONSUPPLIES:Stack materials so that you don’thave to liftabove shoulderheight.

Avoid Bending, Twisting,and Reaching� Tables, chairs, and countertops should

be designed to eliminate frequentbending and extended bending andleaning. Design work tables or countersso that materials are within easy reach.

� Keep arms and elbows low and closeto your body.


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� Face load directly. Do not twist yourshoulders to reach the load

.� When gripping the load, arch yourlower back inward by pulling

shoulders back and sticking out yourchest. Avoid fast, jerky movements.

Use safe carrying procedures

Another part of lifting is carrying.The bestposture for carrying a load is closest tonormal standing:

� Hold the load as close to your body aspossible. Objects should have handlesor hand-holds.

� Keep your elbows touching againstyour sides.

� Keep the weight of the load evenly balanced.

� When setting the load down, bend atyour knees, keeping your lower backarched.

Reduce the amount of liftingyou do:

� Let mechanical devices do the lifting.Use forklifts, jacks, cranes, and carts tolift or carry heavy loads.

� Lift lighter loads. Lift with a buddy.

Careful planning and improved layoutcan help to reduce the amount ofcarrying and climbing needed andreduce the distance that loads need to becarried.

AVOID TWISTING:Face the load square to yourshoulders rather than twistingto reach it. Twisting puts strainon your lower back.

REDUCE AWKWARDLIFTING AND CARRYING:Objects should have handles or hand-holds.


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Reduce the Amount ofForce You UseThe more force you use, the more youstress your body and the more you riskfatigue and injury.

Forceful movements such as pushing,pulling, tugging, and sliding objects putstrain on your lower back.They also stressthe muscles, tendons, and joints of yourshoulders, arms, upper back, and legs.

Use dollies, carts, hand trucks, or bins on wheels designed for pushing insteadof pulling. Pulling, which stresses yourshoulders and arms, is worse for yourbody than pushing. When you push,you use your own body weight toadvantage.

If you’re in an awkward posture whilepushing or pulling, you need to use moreforce to move the object. High friction

between the object and the surface alsoincreases the force you use.

Pushing or pulling an object aboveshoulder height or below waist heightrequires a lot of force because theposture is so awkward.

The amount of force you apply alsocan be affected by:

� The type of grip you use. Gripping withyour fingers (pinch grip) is tiring. A full-hand power grip uses the largermuscles of your arm and requires lessmuscle effort.

� The position of your hands and arms. Ifyour wrists are bent down, backwardor to one side, you will need to usemore force to do your work.

� Cold, slippery handles and gloves. Aslippery handle or one with a smalldiameter is hard to hold, so you tendto grip it more tightly.You also use

PUSH, DON’T PULL: Use carts on wheels designed for pushing ratherthan pulling, which stresses your shoulders and arms.


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INSIST ON AN ADJUSTABLE CHAIR:Chairs with adjustable features andproper back support are essentialto preventinjury.

more force when your hands or fingersare cold. Gloves which are too tight ortoo loose make you grip more tightly.

� The length of time you keep your bodyin one position.

� The amount of rest your muscles get. Ifyou’re tired, you use more force to getyour work done.

Design ComputerWorkstations to Fit The UserWorkstations must consider a worker’sability to comfortably see and handle the work. Chairs with adjustable featuresand proper back support are essentialto prevent injury and improve overall

comfort and work performance.

It’s important that “adjustable” chairs areeasily adjusted—by the workersthemselves. If someone else has to do theadjustment—like a mechanic orsupervisor—then the chair will probablycause injuries, not prevent them.

Chair heightDifferences in seat height can affect thewhole body.

If a chair is too high, it can

� Press thighs against table

� Press seat against back of the thigh

� Reduce blood to the feet

� Make wrists bend up

� Force head to lean forward and lookdown

If the chair is too low, it can

� Raise knees higher than hips andcreate balance problems

� Raise elbows away from the body

� Make wrists bend to the side

A good chair should have . . .

� Adjustable seat heights (between 16"and 21")

� A backrest that is adjustable up/downand forward/backward to help supportthe lower back


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� Cushioned/contoured seats (15"-17"long and 16"-19" wide) that arepadded but firm

� A five-foot base for maximum stability.

� Depending on the job, swivel seatsthat allow workers to turn their wholebodies and reduce twisting of the back

Avoid Repetitive WorkEvery time a muscle works—contractsand relaxes—the tendons are stretched.Repeated stretching and pulling cancause the tendon to swell and get sore. Ifthe tendons and muscles don’t getenough time for rest and recovery, therisk of injury is increased.

Repetitive work can also damage nervesand blood vessels if they are squeezedagainst a hard tool handle or againstmuscle or bone.

Repeated stresses on your back canspeed up normal wear and tear.As your muscles get tired from doing thesame motion over and over, you exertmore effort to do the job.

One way to prevent your muscles fromgetting tired is to rest the muscles doingmost of the work. A “micro”break, in whichyou use different muscles or pause foreven a few seconds, can help.This relievesyour muscles more effectively thanuninterrupted periods of work with onlyone or two longer rest breaks.

Choose and Use ToolsCarefully� Use tools or implements that allow

you to keep your wrist straight.Consider the requirements of the jobas well as the tool. A tool that allowsyou to keep your wrist straight to doone task may force you to bend yourwrist under different conditions.Toolswith bent handles can help you keepyour wrist straight. Swivels at theconnection of a tool and power hosemake it easier to manipulate the toolinstead of your wrist.

� Use well-balanced tools. Supporthandles allow you to support theweight with both hands.

� Make sure handles and grips are theright size, shape, and material. Usetools with strip triggers andcompressible covering. Handles andgrips should be oval or round.Youshould be able to wrap your handaround the handle in a power grip.Handles must be long enough for yourhand and all your fingers.

Try to avoid tools that:

� Make you bend or twist your wrist.

� Are heavy and/or unbalanced.

� Vibrate. Long-term use of vibratingtools can damage the blood vesselsand nerves in your hands and fingers.The risk of injury is increased if you arealso exposed to cold.


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� Dig into the palm of your hand or the sides of your fingers. Sharp edgesor tools that press into the soft tissuesof your hand can compress bloodvessels and nerves. Compressedblood vessels reduce the supply ofblood reaching the tissues. Squeezednerves can cause numbness andtingling.

� Need a lot of trigger pressure.

� Need repetitive triggering and useonly one trigger finger.

� Have finger grooves on the handle.

� Blow cold exhaust air onto your hands.

Keep WorkplaceConditions in Mind� Good planning, improved work layout,

and better work organization canreduce obstacles and slip/trip hazards.Proper storage can reduce the need tolift, move, or reach around objects lateron.

� Planks, sand, gravel, and walkways canbe used to reduce the hazards of mudand slippery surfaces for ESP workingoutside.

� In cold weather, warm-up exercisesmay help reduce the risk of musclestrain.

� When it’s hot, heavy physical work canquickly lead to fatigue. Set acomfortable work pace. Shortexertions with frequent “micro” breaksis better than extended work periodswith fewer but longer rests. Drinkplenty of fluids, especially water.

� If practical and safe, fans and heaterscan be used to moderate extremes intemperature.

� Be aware of your own level of fitness.The closer the match between yourstrength and fitness and the physicaldemands of your job, the better you’ll feel. But strength and fitnesscannot protect your spine from thecumulative traumas of lifting and otherrisk factors.


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Job Risks for Clerical and Technical ESP

Tendinitis,tenosynovitis,carpal tunnelsyndrome

Muscle soreness,cramping, andfatigue,particularly inshoulders, neck,and back

Pressure onthigh, legfatigue, andnumbness infeet

Wrist flexion

or extension,

repetitive

keying

Chair too

high or too

low, poorly

designed

seat, footrest

too low,

insufficient

back or arm

support

Detachable keyboards that can be moved around to a comfortable

position.The keyboard should be relatively flat in relation to the working

surface, and the angle should not be more than 15 degrees off horizontal.

The mouse should be designed to fit your hand.The mouse should be

within easy reach, located at the same height and angle as the keyboard

and situated next to the keyboard.

Keep your wrists in as neutral a posture as possible. Arm and wrist rests

may help you do this.The wrist rests should provide cushioned support

and be rounded on the front edge.

Adjustable chairs: Seats, backrests, and armrests should be adjustable to fit

the individual user. Seats should be at least 16 inches wide and 15-17

inches deep.They should be padded but firm, and should be tiltable

forward and back.The seat height should be raised so that the angle

between upper and lower leg is roughly perpendicular (about 90 degrees).

Back rest: The back rest should be height-adjustable as well as tiltable, so

you can recline backward or forward with adequate support for your lower

back.

Armrests: Cushioned armrests may be helpful to support your elbows and

upper and lower arms and maintain a neutral wrist posture.

Foot rest: A foot rest should be provided for operators who cannot securely

place their feet on the floor while seated.The foot rest should be

adjustable both in height and angle, and have a non-skid surface.

Document holder: When you work with hard copy, an adjustable (angle

and height) document holder should be provided.

Adequate workspace: You need enough tabletop space to be able to move

and properly position your keyboard, mouse, monitor, and document

holder.

Micro-breaks: You should take more frequent, short breaks in addition to

the regular scheduled breaks every two hours.

PROBLEM/HAZARD RISK FACTOR PREVENTIVE ACTION


20

Job Risks for School Bus Drivers

Tennis elbow,tendinitis,shoulder pain

Low back pain,pressure onthighs

Carpal tunnelsyndrome, handpain

Knee and footpain

Reaching and

twisting to open

and close

manual doors,

straining to see

in internal

and external

mirrors and

instruments,

manual shifting

Non-adjustable

drivers seats,

bumpy roads

Repetitive and

forceful hand

movements on

manual shifts or

manual doors

Repeatedly

depressing

clutch and/or

brake pedals

Automatic “power” doors

Adjustable seats and steering wheels

Improved placement of controls

Better mirror placement

Arm rests

Automatic transmissions

Adjustable seats

Air cushion seats


Power doors


Adjustable seats



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Job Risks for Skilled Trades Workers andCustodians

Fatigue andmuscle sorenessin arms andshoulders—tendinitis,bursitis, rotatorcuff syndrome

Elbow, wrist andhand pain—tendinitis,tenosynovitis,carpal tunnelsyndrome

Loss of feeling inhands, pain onside of the wristand base of thethumb

Tingling andnumbness inhands, followedby whitening ofthe fingertips

Back pain/strain,disc injury

Working with the

elbows elevated

or with hands

above the

shoulder, regularly

carrying loads on

the shoulder,

throwing objects

Repeated wrist

motions, forcefully

extending the

hand backward or

to the side

Palm and finger

pressure, repeated

wrist motions,

rapidly rotating

the hand

Using powered

hand tools that

cause vibration,

cut circulation

Improper lifting or

carrying, bending

and twisting,

lifting heavy or

awkward loads

Counterbalance tools

Reorient handles

Lower the work or raise the worker

“Micro” breaks

Use tools that allow work with straight wrist. Raise

or lower the work to put your wrist in a neutral

position

Avoid forcefully gripping or pinch-gripping the tool

“Micro” breaks

Reduce the gripping force, reduce trigger force,

lengthen the tool handle, eliminate single finger

triggers

Counterbalance or lighten tool, reduce the vibration

Use safe lifting and carrying procedures, break heavy

or bulky loads into smaller, more manageable loads,

get help

Use mechanical lifting devices



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Job Risks for Food Service Workers

Low back pain,numbness in legsor feet

Back pain/strain,disc injury

Fatigue andmuscle sorenessin arms andshoulders—tendinitis,bursitis, rotatorcuff syndrome

Elbow, wrist andhand pain—tendinitis,tenosynovitis,carpal tunnelsyndrome

Bending and

stretching to

reach across

counters,

prolonged

standing

Improper lifting or

carrying, bending

and twisting,

lifting heavy or

awkward bundles

or boxes

Overhead

work,elbows

elevated with

hands above the

shoulder

Repeated wrist

motions, forcefully

extending the

hand backward or

to the side

Height-adjustable sinks for dishwashers, tables for servers

Reposition supplies, dishes and implements to reduce reaching

Rotate positions at both the trayline and dishline on a daily basis,

ensuring that rotation from one side of the trayline to the other is

included

Anti-fatigue mats

Store food and supplies at work height to reduce bending. Reduce the

number of items handled at once to reduce force associated with lifting

and pushing

Use safe lifting and carrying procedures, break heavy or bulky loads into

smaller, more manageable loads, use carts to reduce carrying distances,

get help.Turn your feet towards work to avoid twisting your back

Lower dishwasher rinse nozzle to mid-body height to reduce reach

Store materials at waist height

Use implements that allow work with straight wrist

Use automatic can opener. Use shallow ladles to minimize wrist

movement

Raise or lower the work to put the wrist in a neutral position

Consider menu choices to reduce hand actions associated with

portioning, such as cutting, spooning and peeling

Avoid forcefully gripping or pinch-gripping the tools; flexing your wrists

when wrapping or stacking cutlery



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� worker training to promote earlyrecognition and quick reporting ofinjuries/illnesses to the administration.

� a system for collecting and reviewinginjury/illness reports

� careful check-up of injured workers bymedical personnel

� conservative treatment (ice, massage,splints, medication), instead of earlysurgery

� follow-up medical evaluation within aweek by specialist familiar with RSIs ifcondition does not improve

� conservative return to work, including:

> following all work restrictions fromdoctors

> adequate recovery time

> real work opportunities on jobs withno “risk factors” for the worker’sinjury

� staffing and adequate facilities,including medical personnel whoknow about job-related risk factors

Administrations must not discourageworkers from asking to see a doctor.Actions which discourage injury reportsinclude warnings, write-up or harassmentof injured workers, contests based ondays-without-injury reports, ordiscrimination against injured workers.

Association representatives who learn ofsuch actions should discuss alternativesand propose correct policies to theadministration.

Associations should consider forming Health andSafety Committees to monitor conditions in the workenvironment, negotiate or develop policies to addresshealth and safety language, and meet withsupervisors and administrations to have health andsafety issues taken seriously.The committee couldadvocate for:

Health and SafetyCommittees


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OSHA Standards andInspectionsOSHA (part of the U. S. Department ofLabor) sets minimum standardsgoverning workplace safety and healthconditions.These standards covermachine guarding, materials handling,noise, chemicals, exits, and other hazards,except for ergonomic hazards.To datethere is no standard that coversergonomic hazards.

But the Occupational Safety and HealthAct does give workers the right to aworkplace “free from recognized hazards.”Dangers not regulated by currentstandards are still covered by OSHA’s“general duty clause.” If you feel yourworkplace is unsafe, you can call for anOSHA inspection, and your employer maybe required to take corrective action. Askyour local Association or UniServrepresentative for guidance.

Workers’ CompensationHow does the workers’compensation system work?In most states, workers’ compensationlaws require employers to carry insurancethat pays full medical costs, and usually2/3 of lost wages, for workers with job-related injuries or illnesses.Workers’compensation laws usually also require

“rehabilitation” services for disabledworkers, and death benefits for fatalinjuries.

It is a “no-fault” system.This meansemployers cannot deny benefits byclaiming that the injury was caused bythe worker. Employers usually also cannot deny benefits because an oldinjury/illness may have contributed to anew injury.The employer takes anemployee “as is” and usually must paycompensation even if the job aggravatesa pre-existing injury or illness or ifworkers re-injure themselves.

What should you do if youdevelop injuries or illnesses onthe job?

1.Tell your supervisor as soon as possible.

2. Get medical attention immediately anddocument it.

3. Inform your employer in writing aboutthe injury or illness. (NOTE: There aredeadlines in each state for givingnotice to your employer.)

4. File a claim with the statecompensation agency.

5. Ask the state compensation agency fora hearing if the employer—or theemployer’s insurance company—refuses or fails to pay workers’ com-pensation that the state agency has

Your Legal Rights


25

determined you are owed. In compli-cated occupational illness cases, youmay need a lawyer to protect yourrights.

Who pays for workers’compensation?

The employer pays all the costs ofworkers’ compensation benefits. Some-times these costs are large—even greaterthan the costs for regular healthinsurance.

Association leaders and health and safetycommittees can show employers that thebest way to reduce workers’ compen-sation costs is to become aware of howemployee health can be affected byworking conditions or equipment. If the

administration cooperates, a jointESP/employer committee can make anergonomics program into a economic“win-win” for both the school district andthe Association, where the district savesmoney and the Association improvesmembers’ job safety and security.

Your Association can help

Use your state or local Association as aresource for questions about workers’compensation.Your Association shouldhave information about your state’scompensation laws and benefits, as wellas a list of telephone numbers for thenearest workers’ compensation office,union-friendly lawyers and doctors, andany other related information.


26

Internet ResourcesThere are thousands of ergonomics-related websites. NEA cannot vouch for the accuracyor completeness of the sites on this list, but they all have merit, and some are excellent.Those that are essentially ads for consulting services or products are included here ifthey also include basic information about repetitive stress injuries and/or ergonomicsolutions.

Ergowebwww.ergoweb.com/resources/casestudies/

Ergoweb is an online forum on ergonomics.The site includes Introduction toErgonomics, Frequently Asked Questions, Ergonomics Glossary, ErgonomicsConcepts, Case Studies, and Reference Materials. Case studies describe real lifeexamples in which ergonomics hazards have been addressed. Each case studyconsists of a task description, ergonomic risk factors, administrative or designsolutions, comments, and vendor information. Case studies currently on the sitecover school custodians and nutrition services, among other occupations.

Ohio Bureau of Workers’ Compensation www.ohiobwc.com/employer/programs/safety/ErgonomicLinks.asp

This agency has developed “Ergonomic Best Practices,” a series of industry-specificpublications that could help prevent cumulative trauma disorders (CTDs) in yourworkplace.“Ergonomics Best Practices for Public Employers” is full of usefulinformation about best practices for, among other worksites, VDT workstations,school buses, and custodial and maintenance work.

Canadian Centre for Occupational Health and Safetywww.ccohs.ca/products/subjects/ergonomic.html

Among their products and services are the following:

> Cold Weather Workers Safety Guide

> Food Service Workers Safety Guide

> Groundskeepers Safety Guide

> Health and Safety Guide for Libraries

Resources


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> Office Ergonomics Safety Guide

> Warehouse Workers Safety Guide

Workers Compensation Board of British Columbiawww.worksafebc.com

Publications include “Preventing Injuries to Dishwashers” and “Back Talk: An Owner’sManual for Backs.”

Labor Occupational Health Program, University of California at Berkeleyist-socrates.berkeley.edu/~lohp/

LOHP is a community outreach program at the University of California, Berkeleywhose work addresses today’s health and safety needs in nearly every industry,from healthcare to agriculture to construction. Among the current projects:

> Ergonomics

> Human factors

> Immigrant workers

> Union health and safety skills

> Workers’ compensation

> Workplace violence

The UCLA Labor Occupational Safety and Health (UCLA-LOSH) Programwww.losh.ucla.edu

UCLA-LOSH works with workers, unions, community-based organizations,academics and health professionals to improve environmental health and safetyconditions for workers, with a special emphasis on those in Southern California.

University of Victoria, British Columbiahttp://ohs.uvic.ca/ergonomics/index.html

The University of Victoria has various ergonomic programs and services focusing onthe prevention of work-related musculoskeletal injuries.

Massachusetts Coalition for Occupational Safety and Health (MassCOSH)www.MassCOSH.org

MassCOSH brings together workers, unions, community groups, and health, safetyand environmental activists to organize and advocate for safe, secure jobs andhealthy communities throughout eastern and central Massachusetts.Through


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training, technical assistance and building community/labor alliances, MassCOSHmobilizes its members and develops leaders in the movement to end unsafe workconditions. Sponsors RSI Action (www.rsiaction.org) an all-volunteerorganization,that advocates for the health, safety and rights of office workers,focusing on computer-related Repetitive Strain Injuries (RSIs).

Computer-Related Repetitive Strain Injury, by Paul Marxhauseneeshop.unl.edu/rsi.html

A very brief introduction to computer-related RSI with an extensive list of bookreferences and links to helpful Internet resources, including where to getinformation about workers’ compensation and legal help.

The CTD Resource Network, Inc.www.ctdrn.org/

The CTD Resource Network, Inc. (CTDRN) is a nonprofit organization that provideseducational material related to the prevention and treatment of cumulative traumadisorders (also known as repetitive stress injuries).

The Typing Injury FAQ www.tifaq.com

The Typing Injury FAQ (frequently asked questions) is an educational site, providedby the CTD Resource Network, Inc., containing a wide variety of information aboutrepetitive strain injuries (RSIs), resources for dealing with these ailments, and abroad description of assistive products to reduce injury risk and symptoms.

CTDNews www.ctdnews.com

CTDNews–Workplace Solutions for Repetitive Stress Injuries is aimed at employers.Includes ergonomics tips and solutions to improve workplace safety, preventemployee injuries, and keep workers’ compensation costs down.

American Society of Safety Engineers, Ergo Resources Projectwww.asse.org/govern_affair_ergo.htm

ASSE provides links to worldwide ergonomics resources, from governments, touniversities, to computer manufacturers.


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Humanics Ergosystemswww.humanics-es.com

Humanics Ergosystems is a consulting firm with original reports and articles and awealth of ergonomics resources including workplace ergonomics, ergonomics forchildren and people with disabilities as well as design of the built environment. Alsoextensive links to medical research and resources.

Government ResourcesU.S. Department of Labor, Occupational Safety & Health Administrationwww.osha.gov

Access to state ergonomics plans and many publications about ergonomic issues,especially RSI issues involving computers.

NIOSH (National Institute for Occupational Safety and Health)www.cdc.gov/niosh/topics/ergonomics/

Among the many resources offered are:

> NIOSH Musculoskeletal Documents on CD-ROM: Preventing Work-RelatedDisorders

> NIOSH FACTS: Carpal Tunnel Syndrome, Work-Related Musculoskeletal Disorders

> Cumulative Trauma Disorders in the Workplace Bibliography

> NIOSH: Elements of Ergonomics Programs. Provides basic information that will beuseful for employers, workers, and others in designing effective programs toprevent work-related musculoskeletal disorders.

California Division of Occupational Safety and Health (DOSH) www.dir.ca.gov/dosh/dosh

This page provides links to several online ergonomics-related publications providedby DOSH.

Americans with Disabilities Act (ADA)www.usdoj.gov/crt/ada

The ADA prohibits discrimination and ensures equal opportunity for persons withdisabilities in employment, State and local government services, publicaccommodations, commercial facilities, and transportation. Among the publicationson the website are ADA Questions and Answers, and lists of information andtechnical assistance sources.


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Printed Material

Ergonomics: A Common Sense Activity That Can Save Schools Money. Fleer, Paul;Gauthier-Green, Erin. School Business Affairs; v68 n6 , p24-30 ; Jun 2002.

Describes the use of ergonomics to reduce work-related musculoskeletaldisorders such as back pain, tendinitis, and carpal tunnel syndrome that ofteneffect custodians, food service workers, maintenance personnel, and computerusers. Describes ergonomics and how to identify ergonomic problems, conduct ajob hazard analysis, and develop solutions. Also lists common ergonomic errors inschools. Provides an ergonomic checklist for employees working on computers.

National Clearinghouse for Educational Facilities at the National Institute ofBuilding Sciences

1090 Vermont Ave., NW Suite 700, Washington, D.C. 20005Toll free: 888-552-0624 · 202-289-7800www.edfacilities.org

Extensive literature list of school-maintenance-related topics

“The Ergonomics of School Bus Driving and the Successful Campaign of theBoston School Bus Drivers’ Union to Redesign Their Buses to Reduce Injuries”

pha.confex.com/apha/128am/techprogram/paper_14509.htm

Susan Moir, Sandra Baldwin-Gonsalves, and Tolle Graham, MassCOSH.

Briefly describes “The School Bus Design Project,” a report that identified 9 specificergonomic design problems in school buses and proposed solutions. Several of thedesign solutions proposed by the Committee have been incorporated inspecifications for purchase of new buses by the city of Boston. As of September2000, all full size and half buses in Boston have ergonomically adjustable drivers’seats and automatic doors.

Dr. Pascarelli’s Complete Guide to Repetitive Strain Injury: What You Need toKnow About RSI and Carpal Tunnel Syndrome.

A 2004 update to his best-selling 1994 book “Repetitive Strain Injury: A ComputerUser’s Guide.” Emil Pascarelli, M.D., is one of the world’s leading experts on repetitivestrain injury. List Price: $17.95. Paperback: 272 pages. Publisher:Wiley, June 2004.ISBN: 0471388432


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It’s Not Carpal Tunnel Syndrome, by Suparna Damany and Jack Bellis.

Jack Bellis writes, on his website http://www.rsiprogram.com/ ‘When a physicaltherapist performed tests on me that my surgeon didn’t—before or after theoperation on my ulnar nerve—and my symptoms returned in a few weeks, Idecided that someone had to tell the story.With my therapist, Suparna Damany, I’vewritten a book on the subject, entitled “It’s Not Carpal Tunnel Syndrome: RSI Theory& Therapy for Computer Professionals.” In the book and on this web site is what Ilearned about RSI, without embellishment or false promises, and with harddetails—not just accolades—from other patients.” $19.95 list price. 234 pages.2000. ISBN 0965510999.

“Ergonomically Designed Tools: Selecting the Right Tool for the Job,” IndustrialEngineering, July 1993, p.27-29.

“Ergonomics is the science of optimizing the interaction between the person, thejob, and the environment.The primary goal of ergonomics is to create a safe,comfortable workplace that will reduce the potential for cumulative traumainjuries.” Although ergonomically correct work stations and tools may cost moreinitially than others, they are expected to save money in the long run becauseworkers will lose less work time, workers will not file workers’ compensation claims,and employers will not have to train new employees.

“The Comfort Zone,” by Steve Hirano, School Bus Fleet, December 1996.

Ironically, occupational injuries are driving school bus drivers out of driving at thevery time when there is a national driver shortage. Manual door levers are a majorcause of shoulder injury; bumpy roads can cause back problems.“Losing driverservices represents wasted recruitment and training efforts in addition to expensiveworkers’ comp claims.”

Better Work Environments. Murray, Chris. School Planning and Management; v41 n12 ,p22-23 ; Dec 2002.

Looks at equipment, process, and training aspects of backpack vacuum cleanersthat facilitate good ergonomics and high productivity levels, focusing on:designing new equipment for bodies and productivity; creating comfortablebackpack harnesses; improving the work process via team training; and providingergonomic training to ensure that backpack vacuums are worn and usedproperly.


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Glossary

Acute Trauma – an injury such as a bonefracture that has an immediate andeasily identified cause. Pain and/orother health effect is also immediate.

Artery – a blood vessel that carriesoxygen-rich blood from the heart tothe rest of the body.

Arthritis – inflammation of a joint (knee,

hip, shoulder, fingers are all joints

which can become arthritic).

Awkward Posture – body posture thatcan increase the risk of RepetitiveStress Injuries.

Blood Vessel – an artery, vein or capillarythrough which blood flows, eitherfrom the heart to the tissues (arteries)or from the tissues back to the heart(veins).

Brain – the main part of the nervoussystem (which also includes the spinalcord and nerves).The brain regulatesall of the body’s activities. (The brain isthe part of the body which when usedwill save wear and tear on the rest ofyour body.)

Capillary – a tiny blood vessel with thinwalls. Nutrients and oxygen leave theblood through the walls of capillariesto feed the body’s cells.

Cardiovascular System – the systemthat circulates blood through thebody; includes the heart and bloodvessels (arteries, veins, capillaries).

Carpal Tunnel Syndrome – painfulwrist/hand repetitive stress injury inwhich inflamed tendon squeezesnerve against bone in wrist. Symptomsinclude tingling and numbness inhand. If not treated, permanentdamage, including muscle weakness,can result.

Cartilage – tissue found betweenvertebrae and at the ends of bones atthe joints. Cartilage can withstand a lotof tension and pressure.

Chronic Low Back Pain – soreness,fatigue of the low back.

Compressive Force – pressure that actsto compact or squeeze together partsof the body. Even the body’s ownweight puts compressive force on thespine.

Constriction of Blood Vessels – bloodvessels can be squeezed, compressedor shrink so that it is hard for the bloodto flow through the vessels. Reducedblood flow means less nourishmentfor the cells past the constriction.


33

Contraction (muscle) – when a muscleis used, it shortens and thickens(contraction) then relaxes andbecomes longer and slimmer.

Degenerative Disc Disease –breakdown of the discs (which act asshock absorbers) that separate thevertebrae.

Disc – composed of cartilage with a gel-like center, discs separate onevertebrae from the next, and act asshock absorbers to help resistcompression of the spine.

Dynamic Work – involves movement ofthe muscles. For example, when youhammer, your biceps and triceps aredynamic. (See Static Work.)

Energy – the capacity to do a certainactivity. Some activities, such ascarrying, lifting, climbing require a lotof energy.

Engineering Control – redesigningequipment, tools, work organizationand workplaces to reduce workers’exposures to factors that cause harm.

Epicondylitis – inflammation of tendonsat the elbow (known as tennis orgolfer’s elbow).

Ergonomics – the study of how work,the workplace and the worker allrelate to each other.The goal ofergonomics is to fit the work andworkplace to the person.

External Contact Stress – directpressure from tools and sharp edgeson soft tissues (for example, palm ofthe hand) can damage blood vesselsand nerves.

Fatigue – tiredness that results whenthere is not enough rest and recoverytime for the body to recover fromwork. Depending upon the activity, thefatigue may be in a muscle or group ofmuscles (localized muscle fatigue) orthe whole body (whole body fatigue).

Force Requirements – the amount ofeffort needed to lift, push, pull, holdobjects or operate a tool.

Hand-Arm Vibration – vibration(generally from a hand tool) that goesthrough the hand, then travelsthrough the rest of the body.

Heavy Physical Work – work that uses ahigh level of energy. Lifting, carrying,pushing, pulling, climbing are allexamples of heavy physical work.

Inflammation – the body’s reaction toinjury. A repair process that producespain, swelling, redness.

Joint – the place where two bones meet— knee, elbow, fingers, etc.

Ligament – tough, strong tissue thatattaches one bone to the next across ajoint.

Localized Muscle Fatigue – occurs in aspecific muscle or muscle group orgroups.


34

Median Nerve – an important nervethat goes down the arm from the neckto the thumb, index and middlefingers and near side of ring finger. It isthe median nerve that gets squeezedin carpal tunnel syndrome.

Muscle Cramp – sudden painfulcontraction of a muscle; usually causedby overuse (without rest), strain, chill.

Muscle Force – the effort need to move,lift, hold an object or tool or keep aposture without moving much.

Musculoskeletal System – the skeleton(bones), cartilage, ligaments, tendonsand muscles that support us.

Nervous System – the brain, spinal cordand nerves — coordinates all bodyactivities.

NIOSH – National Institute forOccupational Safety and Health. Agovernment agency that researchesworkers’ health and safety issues.

Pinch Grip – gripping an objectbetween the fingertips. A pinch grip,which uses small muscles of handrequires much more strength than apower grip (see below).

Power Grip – gripping an object bywrapping the whole hand around it sothe thumb and finger tip are touchingeach other (for example, gripping ahammer). Uses large muscles of arm;has about four times the strength of apinch grip.

Repetitive Stress Injuries (RSIs) –disorders of the muscles, tendons,nerves and blood vessels caused byrepeated forceful exertions. It can takesome time before pain or dysfunctionappear. (Also called overuse orCumulative Trauma Disorder [CTD].)

Reynaud’s Phenomenon – also called“white fingers” or hand-arm vibrationsyndrome. Use of vibrating tools (forexample, a rotary hammer) constrictsblood vessels in hand, preventingtissues in fingertips from gettingenough blood, oxygen and nutrients.Fingertips turn white and painful,especially in the cold.

Risk Factor (work-related) – a part of ajob that increases the worker’s chanceof getting an illness or injury. Formusculoskeletal disorders risk factorsinclude forcefulness, awkwardpostures and repetitive motions.

Rotator Cuff Tendinitis – Inflammationof a tendon or tendons in theshoulder. Also called “Pitcher’sShoulder.”

Sheath – the covering around a tendon.Sometimes it is the sheath and not thetendon that gets inflamed (seetenosynovitis below).

Spinal Column – the channel made upof vertebrae held together byligaments and muscles. (See spinalcord below).


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Spinal Cord – the cord of nerve tissuethat comes from the base of the brain,through the spinal column down theback. Major nerves branch off thespinal cord.

Sprain – overstretching or tearing of aligament. Sprains are generally acutetraumas (for example, a “twisted”sprained ankle).

Static Work – In static work, the workerholds a body position (for example,working bent over) for long periods oftime without moving much. Staticwork is very tiring. (See DynamicWork.)

Strain – an injury, usually to the muscle,caused by too much force or overuse.

Strip Trigger – a trigger that can beused by two or more fingers at a time.Strip triggers are less stressful thansingle-finger triggers which can cause“trigger finger” (an inflammation offinger tendon or its covering).

Tendinitis – inflammation of a tendon.Tennis elbow is tendinitis of theelbow; pitcher’s shoulder is tendinitisof the shoulder.

Tendon – tough, rope-like tissue thatusually attaches muscles to bones.

Tenosynovitis – inflammation of thesheath (covering) of a tendon.Whenthe sheath is inflamed it becomesdifficult for the tendon to move.

Trigger Finger – tendinitis ortenosynovitis (see above) of a finger(or fingers or thumb) caused byrepeated triggering of a tool orforcefully holding fingers in oneposition. It becomes hard to straightenfinger.

Upper Extremity – entire area from theneck to the fingertips, includingshoulders, arms, elbows and hands.

Vein – blood vessel that carries bloodfrom the body cells back to the heartto pick up more oxygen.

Vertebra – one of the 33 bones thatform the spinal column.

Whole Body Fatigue – when physicaldemands on your body exceed yourcapacity your heart beats faster, youbreathe faster, you feel hot,uncomfortable and may sweat.

Whole Body Vibration – heavyequipment operators and bus driversare exposed to this. Over time, thevibration can cause small traumas tothe spine.

Workload – the physical effort neededto do a job.

2. Do you know any other workers whohave had any pain or discomfort duringthe past year which they feel mighthave been caused or made worse bytheir work ? Yes �� No ��

3. Have you had any pain or discomfortduring the past year which you feelmight have been caused or madeworse by your work ?Yes �� No ��

If NO, please stop here.

4.What part of your job do you thinkcaused your pain or discomfort?

5. Did this problem begin before or afteryou began your current job? Before �� After ��

6. If you think the problem was caused bya previous job, please describe.

7.Who has given you treatment for thisproblem? (check each that applies)

�� none

�� self-treatment (aspirin, Tylenol, etc.)

�� school nurse

�� doctor picked by administration

�� doctor I chose myself

�� occupational or physical therapist

�� chiropractor


36

Ergonomics Symptoms Survey ESP Healthand safetycommitteescan use thissurvey todocumentwork-relatedinjuries andillnesses.This type of record can be usedto helpconvince theemployer to makenecessarychanges in workequipmentor processes.

Name _______________________________________ Date _____/_____/____

�� Male �� Female �� Right-Handed �� Left-Handed

Current Job Title

1. Briefly describe your job duties. Focus on how you use your body.