AAFA-OSHA Alliance Volume 2:

A Guide to Implementing an
Ergonomics Process

WORK GROUP PARTICIPANTS

Gloria Carter
TC, Cary, North Carolina
Michael Della Mea
HANESbrandsINC., Winston-Salem, North Carolina
John Eapen
American & Efird, Inc., Mount Holly, North Carolina
Roger Hopkins
Carhartt, Madisonville, Kentucky
Carey Schuster
American Apparel & Footwear Association, Arlington, Virginia
Greg Murphy
Kellwood Company, Anniston, Alabama
Don Roberson
Maidenform Inc., Fayetteville, North Carolina
Michael Scott
American & Efird, Inc., Mount Holly, North Carolina

REVIEWED BY:
Kathy Parker, CPE
Consultant in Ergonomics, Chapel Hill, North Carolina
Brett Besser
Occupational Safety & Health Administration, Sandy, Utah
Dr. Gary Mirka
North Carolina State University, Raleigh, North Carolina
Eric Kennedy, MSIE, CPE
MARSH, Charlotte, North Carolina
Joanna Sznajder
Occupational Safety & Health Administration, Washington, DC

Special Thanks to Lucy Lapidus and Lindsay Masters for editing and proofreading.

TABLE OF CONTENTS:
SECTIONS:

PAGE

I.

Do we need an ergonomics process?

II.

Making a business case for an ergonomics process

III.

Developing and implementing an ergonomics process

IV.

Apparel / Footwear focused process

19

V.

Conclusions and Resources

33

APPENDICES:
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
L.

OSHA Cost Calculation

Ergonomics process Charter
Injury Prevention Exercise Program
Early Reporting Form
Ergonomics Process Audit
Job Safety Hazard Analysis
NIOSH Caution Zone Checklist
Ergonomic Examples
Post Offer Screening
Cut/Sew Toolbox
Warehouse Toolbox
Office Toolbox

35
36
39
45
46
49
50
58
79
84
88
92

This guideline is advisory in nature and informational in content. This document

does not represent a new regulatory standard and imposes no new legal
requirement. An employers failure to implement this guideline is not in violation of
the Occupational Safety and Health Act of 1970.

SECTION I:
DO WE NEED AN ERGONOMIC
PROCESS?
In todays corporate environment, any responsible manager will want to know if any
practice, activity, or program adds value to the bottom line.
As the person responsible for your companys safety and health program you will want to
establish a proactive leadership for presenting the business case for developing an
ergonomics process. You must be able to define the financial and operational importance
of an ergonomics effort so as to gain full management commitment. This will be
necessary to assure total management team involvement and successful execution of the
ergonomics process. (A financial impact analysis can be found in Appendix A.)
Most company managers have a general understanding of ergonomics. They have heard
the word ergonomics in reference to floor mats, adjustable workstations, automobiles and
recreational equipment. Their experience and understanding is limited to the basics so
you must be prepared to answer their questions and show them how ergonomics adds
value to the existing operation.
There are two primary areas of focus that you should evaluate to build your presentation.
The first is determining the extent of the problem in your operational setting. This is
related to employee complaints about pain and discomfort from strains and sprains that
are termed musculoskeletal disorders (MSDs) and affect joints and soft tissues of the
body. In other words, is there documented evidence that your company has an injury
experience based on MSDs?
The second important focus is improving the process of work so that the job is physically
and mentally easier. This adds efficiency, which in turn improves productivity and
favorably impacts the cost of work. This also produces a benefit of lessening the stress
on your employees. In other words, is there documented evidence that the physical or
mental nature of your companys jobs increases the cost of work?
In addition, you may want to emphasize that having an ergonomics process can have a
positive impact on hiring and retaining a workforce in a competitive market by reducing
barriers to job placement, reducing the cost of turnover and constant retraining, and
improving morale. This will demonstrate that your company should be the employer of
choice. The level of management commitment that you obtain will be directly related to
the data that you collect and present to support your intended action.
This manual has been developed to provide you with an understanding of the key data
that will support your effort in developing an effective ergonomics process for the work
environment. The subsequent chapters will guide you in a step-by-step way to
accomplish this goal.

SECTION II:
MAKING A BUSINESS CASE FOR AN
ERGONOMICS PROCESS
Developing an ergonomics process for your company should begin with your analyses of
the extent of the problem mentioned in the introduction of this manual. You have many
sources for gathering data about the types of injury and illness losses experienced by your
company. Some of this data will be available in-house and accessible through risk
management and insurance, safety and health, operations, and/or the medical department.
Outside sources of injury and illness data may come from your workers compensation
insurance company. Regardless of the source of the data (you should use all of them),
they will involve the injury and illness loss experience for your company. Lets take a
look at each source and see how it can benefit you in determining your companys need
for an ergonomics process.
OSHA Injury and Illness Log 300
The OSHA Injury and Illness Log 300 is the logical place to start in determining if a
companys employees have experienced exposures in the workplace that have given rise
to an OSHArecordable musculoskeletal disorder (MSD). Each company location is
required to have a log of its workplace injuries and illnesses. This is usually maintained
by the safety and health department. To be recordable on the OSHA Log 300, these
injuries and/or illnesses must meet the criteria defined by the OSHA Recordkeeping
Standard.
Obtain a copy of your companys OSHA Injury and Illness Log 300 for the past three
years. This provides you with a larger data set and assures more validity in the results.
Once you have the OSHA 300 Logs, formulate a table that allows you to record the
number and types of injuries/illnesses, the job function, and the body part. Be sure to
note any areas where processes have changed dramatically and look for any related
changes in the data. If there have been process changes, you may need to reference
earlier records.
Now you can identify which job(s) have experienced recorded strains. For example, are
there recordings of shoulder or lower back strains in jobs involving material handling?
Identifying the jobs and types of MSDs that have occurred will enable you to determine
the frequency and severity of these types of injuries/illnesses in your work site. The
frequency refers to the number of times that they have occurred and the severity refers to
the level of the injury/illness. This information can be coupled with additional
information from productivity, attendance, quality, turnover, and workers compensation
data to provide a complete picture for management about the effect of MSDs on the
business.

Risk Management and Insurance

The risk management and insurance department is usually responsible for procuring the
workers compensation insurance coverage used to financially cover workplace injuries
and illnesses. Work-related MSDs may contribute to a portion of the workers
compensation claims filed in your company. In order to determine whether or not MSDs
are part of the workers compensation loss experience picture, an analysis of the loss data
must be done.
The intent of this analysis is to determine the number and type of injuries/illnesses, the
job function, the body part, and the claim cost. Claim cost can be obtained as Total
Incurred Dollars or Reserved Dollars and Paid Dollars. Total Incurred Dollars refers to
the entire cost of the claim, Reserved Dollars is indicative of the amount of money set
aside to pay towards the claim, and Paid Dollars is the amount actually paid towards
medical treatment bills and wages due to lost time. The Paid Dollars are known as the
direct cost of a claim. The direct costs are the costs that can be accounted for directly
through invoices received and usually include medical, indemnity, and legal costs.
An important figure to add to your research is the indirect costs associated with MSDs.
Indirect costs refer to the costs that do not have hard evidence documentation. An
example of an indirect cost is all the production time lost by other employees standing
around after an employee is hurt. This lost production affects a companys efficiency.
Other indirect costs associated with injuries/illnesses are: 1) time lost by supervisors
investigating a claim, 2) time spent training a new employee filling in for the injured one,
3) production time lost for a machine that is idle due to an employee missing work, 4)
lower employee morale, 5) increased workers compensation premiums, 6) poor company
image due to frequency of claims, and 7) affected attitudes of employees.
Once you have determined the direct costs associated with your MSD claims, you should
be able to conservatively estimate the amount of indirect losses. The insurance industry
typically asserts that indirect costs are 3 to 4 times those of direct costs. By multiplying
the direct costs of your MSD claims by 3 or 4, you will have determined the amount of
money that these claims are costing your company. The significance of the direct and
indirect costs of MSD claims is that it is money that comes from the profit margin. The
profit margin provides your wages, benefits, and wage increases. Preventing MSDs and
their associated costs is not only the right thing to do, it is good business practice.
Note: Please make sure to contact legal counsel to ensure compliance with any
federal or state privacy laws.
Operational Records
Your human resource professional is another source of data. Attendance records can be
used to identify the jobs that have a high absentee rate or turnover. Training records can
be referenced as well as records of jobs that have been filled by a temp agency or contract
employees. These jobs can be compared to the other information that you have already
obtained to see if there is a correlation with the high absentee rate, perhaps offering a clue
as to why employees are absent.

Another record that can offer some perspective to ergonomics stressors in a job is the
production and quality metrics. Poor productivity and quality could be the result of
difficulty in performing the job or task. This could be associated with biomechanical
factors or mental stressors. When this data parallels the attendance data, there might be a
relevant correlation showing that the employees find this to be a difficult job to perform.

Summary
Once you have woven all the data into a fabric that clearly presents a relationship
between injuries/illnesses, cost of injuries/illnesses, effects on production, quality and
attendance all for which the common denominator is MSDs you are ready to Make
the Business Case for an Ergonomics Process to your companys management.
Note: The Occupational Safety and Health Administration (OSHA) has not issued a
formal Ergonomics Standard mandating that a company must implement an ergonomics
process. OSHA does have a directive to all its compliance officers that states: OSHA
will conduct inspections for ergonomic hazards and issue citations under the General
Duty Clause and issue ergonomic hazard alert letters where appropriate.
OSHA is interested in fostering a growing participation in the application of ergonomic
principles and ergonomics processes in all industries. OSHA has entered into alliance
agreements with many companies, associations, and professional organizations for this
purpose.
As a product of one of these alliances, the Occupational Safety and Health
Administration and the American Apparel & Footwear Association have formed an
Ergonomics Alliance to inspire and provide leadership to companies to address MSDs in
their workplaces.
It is in your companys best interest to take advantage of the information in this manual
and in the OSHA website www.osha.gov to design, implement, and maintain an active
ergonomics process that raises employee awareness, eliminates workplace exposure, and
reduces the costs associated with injury/illness claims.

SECTION III: DEVELOPING AND

IMPLEMENTING AN ERGONOMICS
PROCESS
Initiating the Process
This section is entitled Developing and Implementing an Ergonomics Process and is
written from the standpoint of the early stages of initiating a process. The procedure
begins with someone identifying the need and approaching management for support we
will call this person the champion. Typically, the champion should gather data to provide
management with justification for the project. Some of these topics were addressed in
Section II but are reiterated here to provide an overview of the entire strategy or plan of
implementing a process.
Once management has agreed to support the project, a sponsor is selected from upper
management. The corporate office sponsor is responsible for writing a project charter
that recognizes the business need for implementing an ergonomics process (See
Appendix B). The charter will provide written documentation of managements
commitment to the project, stating that safety and health (including ergonomics) is as
important as production.
Management should identify the appropriate cost account for the project and give an
estimated budget for implementation. Management should also choose or recruit the
project manager early in these stages so he or she may participate in the planning process.
The champion may be assigned the position of project manager or another candidate may
be recruited to fill the position. Depending on the organizational structure there may also
be facility project managers. The charter should also provide for the formation of a
multi-functional ergonomics team. Depending on the size of the company, there may be
a committee at each facility. Management should provide documented authority to the
manager and should authorize time and money expenditures for the committee. It is the
responsibility of the project manager to assign and communicate responsibilities to the
project team(s).
The ergonomics initiative is typically part of the health and safety department or the
engineering department. In addition to the creation of the committee, management
should outline its position on ergonomics in other areas. For example, ergonomics
should be a consideration for all new product designs, tools, new facilities, new
processes, etc.
Communication systems should be defined, as well as the required reports and their
distribution. The corporate office sponsor should serve as the management liaison to the
ergonomic project manager.

Outline of Process Components

The main components of the planned ergonomics process are outlined in the initial
charter provided by management. (Please refer to the first AAFA Manual Ergonomics
for Supervisors, Volume I An Introductory Manual for the Apparel and Footwear
Industries for a more in-depth coverage of these topics.) The main components are
Employee Involvement, Worksite Analysis, Hazard Prevention and Control, Medical
Management, and Training and Education.
The project must ensure that the employees are involved in the development,
implementation, and evaluation of the process. Employees should be represented on all
committees as well as the ergonomics team. An anonymous complaint or suggestion
system should be made available so that employees can give input without fear of
reprisal. Company policy should also dictate that employees are encouraged to report
signs and symptoms of musculoskeletal disorders as early as possible.
A worksite analysis component recognizes and identifies musculoskeletal hazards so that
they may be corrected. The procedures described in Section II: Making a Business Case,
are considered part of this component. In addition, the jobs identified in the datagathering process should be analyzed for the presence of risk factors. (Ergonomics for
Supervisors: Volume I deals specifically with recognizing the primary risk factors.)
Worksite analysis uses checklists and other forms to evaluate individual jobs in order to
determine the level of risk present that may need to be controlled, as well as to identify
opportunities for improvements.
Hazard prevention and control addresses multiple areas. Engineering controls should be
the preferred method of resolving ergonomic issues. The goal is to engineer problems
out of a job by redesigning work stations, work methods, equipment, or tools. An
example of redesigning work stations may be to change the height of the work surface.
Redesigning a method may involve reducing the size and weight of loads handled.
Equipment may be changed to provide automatic thread trimmers to eliminate the need
for palming scissors, or changing the scissors/tool to an ergonomic design which
improves hand posture and reduces contact force. If engineering controls are unavailable
or insufficient to eliminate the hazard, then work practice controls, administrative
controls, and personal protective equipment should play a part in controlling hazards.
Work practice controls could include training in safe lifting procedures or keeping tools
sharp and in good condition. Administrative controls could include more frequent rest
breaks, stretching/exercising, job enlargement, and job rotation.
Having the involvement and oversight from a Professional Occupational Therapist,
Physical Therapist, and/or Health Care Professional goes a long way in support of an
exercise program. These educators can help describe the benefits related to the particular
exercise. If an exercise program is implemented, management and employee
involvement must be mandatory. A voluntary process will usually not last long enough.
for the program to take a firm hold and be beneficial. A sample Injury Prevention
Exercise Program is included in Appendix C.

If the above controls do not completely address the hazard, the use of personal protective
equipment may be evaluated. An example would be the use of gloves to reduce the
transmission of vibration. In addition to implementing the various controls, management
should be prepared to commit to using outside consultants when in-house analysis or
expertise is shown to be insufficient.
A Medical Management component ensures health care services are available to all
employees. This may or may not involve on-site health care professionals, but emphasis
should be placed on the importance of early reporting and appropriate treatment of signs
and symptoms of musculoskeletal disorders. An example of an early reporting form can
be found in Appendix D.
Training and Education applies to all stakeholders in the process from upper
management to direct labor employees. The detail level of the training is a function of
the role that person will play in the process.
Each company should develop a method by which to measure the success and
effectiveness of their process. This method should allow a facility to track and measure
each ergonomic process element and to make adjustments as necessary. There are many
ways to measure the effectiveness of an ergonomics process. You begin by establishing a
procedure that everyone can be familiar with and relate to using easy, understandable
issues, and items. Your process objectives should be to reduce and/or eliminate the risk
of injury/illness, enhance worker productivity, and improve quality of work life. Typical
methods of evaluation include a qualitative method (questions/answer type responses), as
well as a quantitative one (compiling numbers and measurements from various sources).
The frequency of the evaluation varies for each element, but generally the overall process
evaluation should occur on an annual basis.
It is important to establish measures and evaluation criteria pertinent to your specific
process element and facility. A sample plant audit is included in Appendix E . Some
companies use quarterly reports to document and detail their activities, i.e. identify
problems, cases, solutions, improvements, follow-up responsibilities, and training. A
sample plant report is included in the Schedule Process Review element of this section.
Improvements in productivity, worker efficiency, quality standards, and employee morale
can be experienced and measured as well in conjunction with reductions in employee
complaints and discomfort.
The process and its results should be reviewed at least annually and a process of
continual improvement implemented.

Project Manager and Ergonomics Team

Earlier in this manual, the area of initiating the process was discussed which included the
assignment of a project manager. The project manager outlines the tasks to be completed
and is responsible for creating the multi-discipline ergonomics team. The following areas
should be represented: engineering, health and safety, supervision, health care provider,

management, maintenance, and employees. This diversity should provide insight from a
wide variety of experience areas. The team along with the project manager should
participate in the rest of the planning process.
An implementation plan should be designed, assigning dates to specific milestones such
as management overviews, data collection and prioritization, training, and meeting
schedules for the project team. The following is an example of a responsibility
assignment matrix that can be used by the project manager to document and ensure that
the required tasks for the team are completed in a timely manner. You will notice that the
task list includes some items that have been discussed previously in this manual.
RESPONSIBILITY ASSIGNMENT MATRIX

TASK/ITEM

COMMENTS

OSHA Records Review

Nurses log review
Quality & productivity
records
Turnover, absenteeism
Awareness training
Screening Survey
In depth analyses
Monthly review

Safety Director
Health care provider
Engineering
department
Payroll department
Ergonomics trainer
Ergonomics team
Ergonomics team
Ergonomics team

START
DATE

ESTIMATED ACTUAL
FINISH
FINISH
DATE
DATE

Note: Please make sure to contact legal counsel to ensure compliance with any
federal or state privacy laws.
The project manager should select the documents that will be used throughout the process
to provide standardization. These should include checklists, analysis worksheets, and
symptom surveys. Some sample forms can be found in the appendices at the back of this
manual.

Ergonomics Training Needs

Although every employee should receive basic ergonomic training, it is recommended
that all managers, supervisors, and selected key individuals from each functional area
receive more intensified training. These individuals should be the leaders of the
ergonomic implementation within their respective work areas. This intensified training
for the group will serve both to spread the implementation workload and to achieve wider
engagement within each work function.
Training for new management and an explanation of their role in the ergonomics process
is critical. As with all processes, associates must be knowledgeable about the potential
health and safety hazards, including ergonomics risk factors. All team members should
go through an orientation procedure that familiarizes them with content of the

10

ergonomics process, reporting requirements, response process, exercise/wellness

program, checklists, and how they can impact the overall health and safety process.
In February 2005, the AAFA published its first ergonomics manual as part of the
AAFA/OSHA Alliance. This manual, entitled Ergonomics For Supervisors: Volume I,
was written as a basic ergonomics training manual and covers ergonomic principles that
apply to the work functions of a typical apparel/footwear factory. After selecting the key
individuals from each functional area, the facility ergonomic champion should either
conduct or arrange to have conducted training for the selected individuals using the
Volume I manual as the training vehicle. This will give the chosen ergonomics leaders a
common basis and background as they begin the formal implementation of the process.
The AAFA/OSHA manual consists of a teaching guide, participant workbooks, and a
CD-ROM presentation. For information in obtaining a copy of Volume I, visit the AAFA
website at www.apparelandfootwear.org under the legislative/trade news icon.

More specific training items are addressed in the following areas:

PROJECT MANAGER - If the project manager has not had training in ergonomics, then
that training should be scheduled as soon as possible. The manager and team members
should be trained in the following areas: team dynamics, facilitation, group problemsolving techniques, introduction to ergonomics, recognition and evaluation of risk
factors, signs and symptoms of musculoskeletal disorders, developing and implementing
ergonomic solutions, principles of motion economy and work station design, the use of
evaluation tools, and conducting an ergonomic analysis.
MEDICAL PERSONNEL Medical personnel will require training in addition to the
basic team member training listed above. These topics should include the anatomy of the
upper extremities, neck and lower back and the identification, assessment, treatment,
rehabilitation protocols of frequently occurring occupationally- induced MSDs.
MANAGEMENT OVERVIEW Management personnel in the facilities do not require
an in-depth knowledge level of ergonomics but should be trained in the basics. These
should include: the ergonomics-related risk factors in the company; the types, symptoms
and consequences of MSDs; the importance of early reporting; common measures to
reduce exposure to risk factors; and the existence and function of the ergonomic
committee. In addition, management should be trained in the specific protocols
employed by the company each managers responsibility within the protocol, their role
in follow-through, and cooperation with ergonomic initiatives in their area.
11

EMPLOYEES All employees should receive ergonomic awareness training at least

annually. New employees should have this training as part of their initiation. Topics
included should be the primary risk factors, how to recognize symptoms, the importance
of early reporting, the reporting procedures, and the existence and functions of the
ergonomics committee. Employees should also be advised as to how they can expect to
see problem jobs addressed over the coming months.
EMPLOYEES ON PROBLEM JOBS Once the worksite analyses have been completed,
the analyst should be able to prioritize which jobs have the most potential for ergonomic
problems. Employees on those jobs will require additional ergonomic training related to
the specific risk factors and changes on their job. Topics include: information on the
proper use of the tools and equipment; information on the risk factors specific to their
job; the controls planned or implemented to address them; descriptions of the early signs
and symptoms of the hazard related to their job; and emphasis on the importance of early
reporting.

Early Stages of Team Development

After technical training, the team should conduct additional practice sessions to ensure
continuity in analytical processes and problem solving. Several jobs should be identified
for group analysis. Each member should conduct each analysis individually, and then
share their results with the team. Discussions should center on differences between the
individual evaluations.

Data Assessment
In Section II various data collection areas were discussed. If the data collection was not
accomplished prior to issuing the project charter, it must be the initial task of the project
manager and ergonomics team. The areas for analysis include the OSHA 300 Logs,
Workers Compensation reports, group health insurance claims, first aid logs, lost time
and restricted duty records, worker turnover, absenteeism, and quality issues.

Baseline Surveys
Once the employee awareness training has been completed, the ergonomics team can
conduct a baseline survey of the jobs in their facility to identify obvious risk factors. A
few examples of these forms can be found in the appendices of this manual. High level
evaluation forms typically use a yes/no format, a simple point assignment process, or a
series of sketches/photos that demonstrate the risk factor under evaluation. Baseline
surveys are not definitive but along with earlier data can provide the team with a
prioritized focus on the jobs that require a more in-depth analysis. Baseline data will
also be valuable in documenting improvements made through the ergonomic
process implementation.
12

Worksite / Job Safety Hazard Analysis

Once baseline data assessment has been completed the ergonomics team should proceed
with individual job safety hazard analyses, also known as worksite analysis. Baseline
data will have provided information for assigning priority to the jobs with the highest
number of risk factors, the most people affected, or the jobs with the highest cost
associated with musculoskeletal disorders. It is also important to identify several jobs
where there appears to be an easy fix to the problem. These success stories should help
establish the ergonomics team as a results-oriented resource. The operations identified
by these procedures should be scheduled for a more detailed analysis and depending on
the level of expertise of the team may require analysis by a certified ergonomist. A Job
Safety Hazard Analysis (JSA) is used to identify, quantify, and document ergonomic risk
factors and associated hazards on a specific job. A sample JSA is included in Appendix
F. Previously proposed or implemented federal/state standards are provided in evaluation
forms in order to assign a point value to an ergonomic analysis. An example from the
National Institute for Safety and Occupational Safety and Health (NIOSH) is attached as
Appendix G. These forms offer a method to identify whether or not the risk factors on a
specific job under evaluation are under control or require control measures. Some
Before/After examples of jobs that implemented improvements after job safety hazard
analysis can be found in Appendix H.

Medical Management
As mentioned in the management support section, every employee should have
access to a health care provider and it is imperative that early identification and
reporting of symptoms of MSDs occur. MSDs are cumulative in nature, meaning that the
trauma accumulates with time. Lost time injuries can occur if conditions are not
addressed and resolved immediately. If an employee is seen rubbing or shaking their
hands this should be taken as a sign that symptoms may be present. At this point the
normal protocols should be investigated including notification of the first aid attendant
and the various ergonomics and safety related teams.
In some companies, health care provider screening procedures have been implemented to
assist management in selecting individuals who are suited to the functional aspects of
specific jobs. Check with your health care provider or legal department for the current
practices in your company. A baseline health examination should be made prior to the
assignment of new employees. An example of a post-offer screening tool has been
provided in Appendix I.
Conservative treatment is the best approach in musculoskeletal disorders with surgery
being the last option. An example procedure is included in this manual as a guide in
establishing one for your own company. Any employee with a possible MSD should be
encouraged to report to the medical department, the company physician, or an external
health care provider. Every encounter should be documented using established forms and
added to the occupational history of the individual. The health care provider should
perform screening tests to identify if there is a musculoskeletal disorder and determine if
treatment is indicated. A standardized physical examination should be performed

13

including inspection, palpation, and range of motion testing for the affected area.
Diagnostic tests may be performed depending on the capabilities of the health care
provider.
If positive physical signs are apparent on examination, or if the symptoms continue
without physical signs, a re-evaluation should be scheduled in no less than three working
days. If the condition worsens, the ergonomics committee should initiate a job analysis.
If the condition remains unchanged, further evaluation should be completed within three
working days. The health care provider should also advise the individual of the
advantages of seeking a second opinion regarding any recommendations for surgery.
If the health care provider recommends that the individual be placed on restricted duty,
the restricted employee should be placed in appropriate jobs consistent with his/her
capabilities and limitations. It is a valuable tool to have a catalog of standard job
descriptions that include all activities of the job. The health care provider may reference
these activities to assist in identifying alternate or return-to-work jobs.
An employee who has reported discomfort from work that has progressed to outside
medical intervention should be followed up by either an in-house nurse or an assigned
case manager. The nurse or case manager should be in contact with the health care
provider to understand the job restrictions and the rate of improvement related to the
healing process. As the health care provider sees the employee at different intervals,
he/she will be in a position to determine whether or not the employee is making progress
in healing. This information should be communicated to the plant management so all
medical orders can be followed and enforced. Every effort must be made to allow the
employee time to recover, both physically and emotionally, from an MSD.
The role of an in-house nurse or case manager is to work with the employee and help
them understand the process of getting well. Daily contact with the employee is
necessary to gauge how they are doing with healing. Any sign of a problem should be
addressed with the employee or directed to the medical care provider to correct the
situation.
Alternative Duty is a tool that can be useful in keeping an employee engaged in their
work ethic. It provides the environment of emotional support and allows the on-site
professionals an opportunity to foster good will toward the employee. Alternative Duty
also helps a person continue to earn their regular wages and benefits and keep up their
spirits, which assists the healing process.

Scheduled process review

Regularly scheduled reviews should be held to monitor the success of the process at a
minimum this should occur annually. An example of a quarterly ergonomic plant report
has been included at the end of this section. The ergonomic process should be reevaluated for areas of improvement. Statistics should be kept throughout the year
including the number of people trained, exams given and passed, and the number of
analyses conducted. A record should be kept on any job identified as being a priority,
including the number of employees on those jobs, as well as the percentage of those who

14

are experiencing or have experienced ergonomic issues. These results should be shared
with upper management as well as facility management. The review should emphasize
any reduction of the benchmarks identified in the initial data assessment. For example,
has turnover been reduced, and has there been an obvious decline in the number and cost
of workers compensation claims?
Annual reviews should ensure that files have been maintained on all job analyses and
their results, including the implementation of controls. Results of ergonomic risk
evaluations should be summarized by department and an ongoing prioritized list should
be kept to identify jobs for change. Where administrative controls have already been
implemented, there should be a review of the effectiveness of the controls and whether
they are being managed properly.
The purpose of the annual review is to provide for continual improvement efforts and to
ensure that management commitment and support continues. It also ensures that
procedures are in place and have been followed and that the ergonomic process efforts
have generated concrete results and improved company performance.
An example of a form that can be used in the review process is included on the next page.

15

Quarterly Ergonomics Process Review

Date: _________________________
Managers Name: _________________
Plant: ________________________
Plant Ergonomics Coordinator: ______________________
Ergonomics Implementation Team Members: 1. ________________________
2. ________________________
3. ________________________
4. ________________________
5. ________________________
List Ergonomics Goals and projected completion dates:
a. ____________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
b. _____________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
c._____________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
List status of ongoing Ergonomics projects and successful attempts at correcting
conditions that contributed to MSDs.
a.______________________________________________________________
______________________________________________________________
b.______________________________________________________________
______________________________________________________________
c.______________________________________________________________
______________________________________________________________
______________________________________________________________

16

List details of all new cases reported: Name, Date, Job, Condition, and Action taken.
1. ____________________________________________________________
______________________________________________________________
______________________________________________________________
2. ____________________________________________________________
______________________________________________________________
______________________________________________________________
3. ____________________________________________________________
______________________________________________________________
______________________________________________________________
Other Pertinent Comments:

Plant Manager Signature & Date ___________________________

List All Employee Ergonomics Complaints:
Name
1.
2.
3.
4.

17

Job Title

Dept.

Date

Complaint

ERGONOMIC PROCESS FLOWCHART

This chart presents an overview of the ergonomics process in which the vertical components are
somewhat interdependent. The green arrow shows that this is an iterative/continual improvement
process.

18

SECTION IV:
APPAREL/FOOTWEAR FOCUSED
PROCESS
This section will approach the implementation of ergonomics from the perspective of an
apparel/footwear manufacturing environment. In a typical facility, there can be three
clearly defined functional areas:
Manufacturing functions (cutting, sewing/assembly and finishing)
Distribution functions (receiving, stocking, pick/pack and shipping)
Office/clerical functions (data entry, customer service, scheduling, etc.)
Overall ergonomic concepts apply to all these functional areas. This section will begin
with a general overview, then address each area separately.

Functional Areas General Information

One of the key steps in the formation of any ergonomic process is a process of
workstation evaluation. Simply stated, workstation evaluation consists of comparing the
current physical layout and work methods of a given workplace or work task to
established ergonomic principles. When this comparison indicates ergonomic
deficiencies, controls should be put in place to remove or reduce these ergonomic
problems.
In the beginning stages of ergonomic implementation, two approaches to worksite
analysis can be applied:
begin analyzing a few known ergonomic problem areas
use a systematic approach to analyze the full range of work activities within
the functional area
While there may be a need to take on certain work activities early in the implementation
process because of known problems, it is recommended here to systematically analyze
the entire functional area and then set priorities based on analysis findings.
A key factor in the implementation of ergonomics is the ability to achieve early success
in the process. Not every work area will have a quick and/or easy solution to ergonomic
problems. By conducting a complete functional analysis, priorities can be balanced
between those work areas that can present relatively simple, quick-fix potential with
those that will prove to require longer-term solutions. This allows for initial success while
those work areas that will have slower improvement rates are in process. The approach
here should start with an overall analysis of each identified functional area.

19

General Ergonomic Information That Applies To All Areas

The three main factors that may contribute to a worker developing a Musculoskeletal
Disorder are awkward work posture, application of force, and repetitive motion.
While any one of the above factors may result in an MSD, ergonomists believe that it is
most often the combination of two or more of them that may cause the problem.
Specifically, force and awkward posture can require more effort and/or fatigue the body
so that it is less capable of repeating motions or tasks. Although excessive repetition
should be addressed, the other two factors may offer the best targets for ergonomic
improvement in the apparel/footwear factory.
The key to avoiding awkward work postures is the concept of working in neutral. This
simply means not working in an unnatural position. A natural work posture is one in
which the worker is able to perform the job without having to either bend or reach
excessively. The neck and shoulders should be in a relaxed position and the work being
performed should be at normal elbow height. The hands and wrists should not be in a
bent position. If the job is performed while seated, the feet should be comfortably
supported.
Since one of the main ergonomic principles is humans come in all shapes and sizes, a
primary ergonomic concept is that work stations must be adjusted to fit the specific
individual performing the job. In order to allow the worker to sit or stand in a neutral
position, tables and work aids may have to be raised or lowered. Chairs may also have to
be raised or lowered and foot rests may be required to provide the necessary support.
The position of parts to be assembled and the tools required for the operation should be
such that the worker is not required to bend or twist the hands and wrists to perform the
job. Many special tools are now available with ergonomic handles, meaning the tool
can be used in a neutral wrist position.
The establishment of a neutral work posture should often help to alleviate excessive
force, but it may be necessary to look for mechanical assistance in performing some tasks
to avoid overtaxing the muscular system.

1. Manufacturing (Cutting, Sewing/Assembly, Finishing) Ergonomics

The term Manufacturing Ergonomics refers to the application of ergonomic principles
in a manufacturing environment. In a typical apparel/footwear factory, cutting area
activities may involve loading product material on to spreading machines, cutting through
multiple layers of material, numbering individual product parts, and manual lifting.
In the sewing/assembly area, workers are often required to perform repetitive tasks while
in a seated position. During various manufacturing operations, the worker might apply
static force to match work parts while sewing, twisting and bending to bring parts to a
machine, bending wrists in non-neutral positions to maintain part alignment, and
engaging in other poor work postures.

20

In the finishing area, workers typically stand to perform pressing operations, folding and
pinning activities, and bagging/boxing of finished products. Ergonomic stressors include
standing for long periods in fixed locations, heat exposure from pressing equipment,
working in a bent position, and working above shoulder height.
Although lifting issues must always be considered, the main ergonomic concern in the
manufacturing area is the avoidance of those type injuries that fall under the heading of
MSDs
The ergonomic approach to manufacturing work stations is to adjust the work to the
worker. A primary approach is to look for individual workers who are performing their
jobs in an unnatural posture (bending, twisting, stretching, overextending, rotating,
leaning, etc.) and then find a way to change the work station to bring the employee into a
more neutral posture.
Steps for implementation of ergonomics within the manufacturing area
Step 1: Review each workstation or work activity and compare current conditions to
ergonomic principles.
Step 2: Work from a standardized ergonomic checklist to analyze the workstations in the
cutting, sewing/assembly, and finishing departments. The team should keep in mind that
an ergonomic checklist is designed to determine problems; developing solutions to these
problems is a later step. Several examples of checklists can be found in the Cut/Sew
Toolbox in Appendix J.
Step 3: Establish priorities for ergonomic improvement on a job-by-job basis. Those that
need ergonomic improvement can be classified as either having relatively simple
solutions or classified as needing more complex solutions. There is always the possibility
that the basic workplace for a specific job is adequate ergonomically, but it may still be
necessary to make adjustments for individual operators.
Step 4: Establish a project schedule for addressing each workstation in need of
improvement. The initial schedule should include a blend of simple and complex
solutions. Working through this schedule, the team should deal with each workstation as
best as possible and then move on to the next. Over a given time period, the ergonomics
of each manufacturing workstation will have been addressed and feasible solutions
implemented.
Step 5: Future ergonomics efforts should consist of individual adjustment of work
stations to new employees, training new employees in the least stressful method of job
performance, and follow-up to see that employees continue to adhere to the established
method.

21

Ergonomic Key Points For Manufacturing Areas

Avoid awkward positioning of hands, arms, neck, and shoulders by:
o Repositioning product or changing body posture.
o Minimizing distance between product and person.
o Eliminating repetitive over-shoulder-level reaching action.
o Eliminating reaching behind the body midline.
Keep wrists straight by:
o Repositioning hands to reduce wrist and elbow strain.
o Changing hand tools to allow gripping with a straight wrist.
Improve back posture by:
o Raising the work surface.
o Providing lumbar support.
o Providing a swivel chair to reduce twisting.
Avoid long periods of gripping by hand:
o Using clamps where possible.
o Minimizing pinch grips (the most stressful to the wrist).
Improve standing work by:
o Redesigning the job to allow sit/stand option.
o Installing foot bar to allow shifting of weight from foot to foot.
o Using sit/stand stools to allow alternate work positions.
o Using anti-fatigue mats to cushion floor.

2. Distribution Ergonomics
The term Distribution Ergonomics refers to ergonomic applications that primarily focus
on the physical movement of objects from one location to another such as in Distribution
Center (DCs). One of the main areas of concern is a back injury while lifting. There is
room for debate as to whether a back injury incurred while making a lift is an
instantaneous event or is a result of cumulative stress over time, with the current lift
simply being the last stressor the body could stand. From an ergonomic standpoint, the
necessary approach is to try to ensure that all lifts, from the first to the current, are
performed in the safest manner possible.
Similar to the manufacturing analysis, some distribution functions will prove to be
ergonomically adequate, some will have minor problems, and some will demonstrate
major ergonomic issues. Following the completion of this analysis using the distribution
checklist, the DC ergonomic team should establish priorities on a function-by-function
basis for ergonomic improvements. Some functions can be checked off as not needing
change. Those that do need ergonomic improvement can be classified either as having
relatively simple solutions or as needing more complex solutions.
Having completed this analysis, the distribution ergonomics team should establish a
project schedule for addressing each functional area in need of improvement. The initial
schedule should include a blend of simple and complex solutions. Working through this
schedule, the team should deal with each area as best as possible and then move on to the
next. Over a given time period the ergonomics of each distribution functional area will
have been addressed and feasible solutions implemented. Future ergonomic efforts
should consist of ergonomic evaluation of new processes, training new employees in the
22

ergonomically correct method of job performance, and follow-up to see that employees
continue to follow the established methods.
It is recommended that a given distribution center develop a customized DC ergonomics
manual for the facility based on the specific configuration, product, and other unique
characteristics of the site. Once the manual has been developed, employees in each area
should be trained in the ergonomic processes that have been identified for the location.
As with Manufacturing Ergonomics, we recommend that a systematic approach be used
to develop the ergonomic processes of each of the above listed DC functions.
Lifting and other aspects of manual material handling will be addressed as follows:
- Correct lifting techniques
- Determining what can be safely lifted
- Correct Pushing / Pulling techniques
Correct Manual Material Handling Techniques - Lifting
Objects to be lifted should be positioned in such a way to avoid having to twist the body
when making the lift. The ideal body position for lifting is keeping the head, back, and
hips in a straight line. To accomplish this, it is necessary to have the load as close as
possible to the body. Avoid having to reach out for a load. To lift objects from below
waist height, the knees should be bent rather than the back. The physical act of making
the lift should be accomplished with the legs not with the back. To release an object
that has been lifted, the reverse of the procedures described above should be used. The
following is a four step technique for safe lifting.
Step 1: Think and plan the lift
Many lifting accidents occur because of problems that are not considered before the load is
lifted. There are many factors to consider when planning a lift. For example, where will the
load be located? Where will the load be placed? Will the lifting area be constrained? Will
fork trucks in the area disrupt the lifting task?
Considering the lifting conditions, path, pick-up point, and set-down point can uncover
problems that can interfere with a lifting task before the load is lifted. For example, a person
lifts a large, heavy box and carries it over to place it on a table. When he gets to the table, he
finds that the table is not clear. He then has to put the heavy box down on the floor, clear the
table, and then lift the box onto the table. If the lift had been planned prior to starting, then
the second lift would have been unnecessary.
Step 2: Grab the load and bring it in close
The feet should be placed in a stable position, about 12 18 inches apart. One foot may be
behind the other, and at least one foot should be flat on the floor. If the object has handles or
hand holes, use a power grip to grasp and hold it. If the object has no handles, then use a
hook grip or ledge support grip to grasp the object.
At the beginning of the lift, position the load as close to the body as possible. Keep the load
close to the body throughout the lift, carry, and placement of the load. This will reduce the
stress on the spine and let the strongest muscles of the arms support the weight of the object.

23

For loads handled near the floor and are too large to fit comfortably between the legs when
lifting, consider using a lifting aid or a second person to help with the lift.
Remember to lift with the legs, not with the back. This means the back should be kept
vertically upright during the lift, carry, and placement of the load.
Step 3: Keep the hips and shoulders in line
When the hips and the shoulders are out of alignment, the spine and back are twisted.
During lifting tasks, this puts the back at greater risk of developing an injury, since the shear
forces on the vertebrae and the discs increase significantly. Twisting also reduces the
stability of the spinal column. Avoid twisting while lifting, carrying, or placing the load.
Step 4: Maintain stability
Instability of the person or the object during lifting activities could force a worker to use
sudden jerking motions or lose control of the load. Positioning the feet at the beginning of
the lift helps maintain stability. The load itself should be stable, with the weight evenly
distributed. The floor surface should also be free of hazards, such as water or trash, that
might cause someone to slip, trip, or fall while lifting.

If a lifted load must be carried, the object should be positioned to the front of the body.
Do not carry objects in an unbalanced manner. If large objects must be moved by either
push or pull, elect to push to utilize body weight to move the object. Pulling places more
strain on the back.

24

Determining What Can be Safely Lifted

There is a procedure to determine if a lifting task is even acceptable in the first place. The
National Institute of Occupational Safety and Health developed a lifting formula in 1981
and released an updated version in 1991. Although somewhat limited in application, these
formulas can be used to give a reasonable guideline as to whether or not a given lifting
situation is acceptable. Details of the application of the NIOSH lifting formula are
contained in the Warehouse Toolbox (Appendix K) of this manual. This section will only
present a general discussion of the specifics of the formula.
Ergonomists agree that there are factors other than weight itself that influence whether or
not a given lift is safe. In addition to the weight of the object, consideration must be given
to:
The distance the object is from the body.
The distance the object is from the floor at the origin of the lift.
The distance the object is from the floor at the end of the lift.
Any twisting of the body that occurs while making the lift.
How good is the coupling between the hands and the object being lifted.
How often is the lift made over a set time-period.
The NIOSH formula will allow you to calculate the lifting index (LI) for a particular lift.
The greater the value, the greater the risk that workers will sustain injury. NIOSH
recommends that the goal should be to design lifting jobs to achieve a LI of 1.0 or less. LI
values greater than 1.0 will reduce the number of workers who could safely make the lift.
A LI value of 3.0 should not be exceeded as this places virtually all workers at risk. The
LI concept can be used to establish priorities to identify which lifting tasks are in need of
ergonomic redesign so as to make them safer.
In summary, the ergonomic approach to lifting should be a two-step process. First, use
available research (the NIOSH formula) to determine the safety of a given lifting
situation. Second, be certain that workers employ the correct techniques as they go about
their daily routine of moving objects from one location to another.
Although many different activities may occur in an apparel/footwear distribution center,
most DC functions can be sorted into several basic functional categories:
Receiving finished goods.
Verifying quality control.
Stocking (put away) of received goods.
Picking of outbound units.
Packing of outbound units
Staging of outbound cartons.

Correct Manual Material Handling Techniques Pushing/Pulling

Many factors affect the amount of force that a worker can develop in a horizontal push
and pull:
body weight and strength
25

height of force application

direction of force application
distance of force application from the body
posture (bending forward or leaning backward)
friction coefficient (amount of friction or grip between floor and shoes)
duration and distance of push or pull

The initial force needed to get the object moving is usually much greater than the
continuous (sustained) force required to keep that object moving.
It is better and safer if pushing and pulling tasks require lower forces, particularly where
the task requires:
pushing or pulling an object when the hands must be above the shoulder or below
the waist level.
exerting a force for longer than 5 seconds.
exerting a force at an angle not directly in front of the body, e.g.,. not "straight
on.
Pushing is generally preferable to pulling. Pushing allows the worker to use large muscle
groups and apply more force to the load. Pulling carries a greater risk of strain and injury.
Possible controls/solutions include the following options:
1.

Eliminate the need to push or pull:

Automate the pushing and pulling tasks (examples include mechanical
rollers/conveyors and gravity feed system).
Use mechanical aids such as carts, dollies, lift trucks, or pallet jacks.
Avoid carrying wide or tall (bulky) loads.

2.

Reduce force required to push or pull:

Reduce the weight or size of load.
Maintain the wheels on carts in good working order.
Provide handles (where practicable).
Ensure that friction between the floor and the cart wheel is low.
Keep floor clean and free of debris.
Wear appropriate footwear to enhance friction and minimize slippage between
floor and shoes.
Minimize the distances over which objects are to be pushed or pulled (change
the layout of the workplace if necessary).
Train workers in the use of the correct body mechanics for pushing and
pulling.

Ergonomic Key Points for Distribution Functions

Receiving Finished Goods
Unloading cartons from truck
o Define ways to minimize overhead reach and twist. Look for use of
conveyors, platforms, ladders, hand trucks, pallet jacks, and fork lifts.

26

o Minimize fatigue. Look at incoming carton size and weight as well as

regulation of temperature at receiving dock.
o Minimize bending while building pallets. Look at layout and aisle
widths.
Unloading GOH (goods on hanger) from truck
o Minimize overhead reach, twist, and force. Look at portable booms,
standing platforms, and trolley-pushing restrictions.
o Minimize fatigue. Look at use of gloves and temperature regulation.
o Minimize bending and hand force when opening cartons containing
GOH. Look at staging layout for opening cartons containing GOH, as
well as use of carton openers.
Quality Control (QC) Verification
Quality control cartons
o Minimize bending, twisting, hand force, awkward postures, overhead
reach, and neck extension. Look at layout of QC area, use of carton
openers, slope of inspection tables, and use of platforms.
Quality control GOH
o Minimize overhead reach and neck-bending. Look at use of platforms.
Put away (Stocking) of Received Carton Goods
Moving cartons to warehouse areas
o Minimize bending when moving cartons. Look at use of hand trucks,
pallet jacks, and fork trucks.
Placing stock in storage location/racks
o Minimize reaching, climbing, and other awkward postures in placing
cartons. Look at use of platforms and ladders. Look at aisle widths and
shelf heights (tiers). Look at carton-opening techniques.
Put away (Stocking) of Received GOH
Transporting GOH to stocking area
o Minimize pushing or pulling force to move GOH. Look at preventive
maintenance on casters of racks and carts. Look at amount of garments
being pushed or pulled on trolleys.
Placing GOH on storage rails
o Minimize reaching and climbing. Look at overall layout for aisle
widths and other obstructions. Look at use of platforms and ladders to
avoid reaching and unsafe climbing.
Systems entry
o Minimize hand forces and awkward postures. Look at scanner
configuration. Look at height and design of standing workstations.
Picking of Outbound Units
Picking folded garments from shelves or open cartons
o Minimize overhead and/or forward reach, bending, and other awkward
postures. Look at overall layout for maneuvering of pick carts. Look at
preventive maintenance of casters on pick carts. Look at use of

27

platforms and/or ladders for reaching higher pick locations. Look at

use of grabbers for low pick locations.
o Minimize bending and twisting when opening new cartons. Look at
use of neutral height location to open new cartons.
Picking GOH from tiered racks (1 or 2 tiers)
o Minimize overhead and forward reaches. Look at use of platforms and
ladders to avoid reaching and unsafe climbing. Look at use of
grappling poles to lower GOH from 2nd tier locations. Look at use of
gloves. Look at amount of GOH being pushed or pulled on trolleys to
packing area.
Packing Individual Orders
Minimize overhead or forward reach and bending or twisting.
o Look at packing station design for assembly of cartons. Look at ability
to work in neutral position. Look at alignment of computer
workstation for systems entry.
Moving containers from packing table to conveyor. Look at carton weights.
Look at orientation of packing table to conveyor to avoid twisting. Look at
use of gravity to assist movement of cartons.
Outbound Staging and Shipping
Building outbound pallets
o Minimize awkward arm and shoulder movements. Look at layout of
work area for building outbound pallets relative to carton
presentation from conveyor.
o Minimize twisting. Look at movement of carton from conveyor to
pallet. Look at shrink-wrap application. Look at pallet label location
for scanning.
o Minimize weight. Look at control of carton weights and controls for
pallet height.
Transport pallets to staging area
o Minimize bending, twisting, and handled weight. Look at powered
pallet jacks or forklifts. Look at layout of path from pallet-building to
outbound staging area.
Transferring cartons to truck
o Minimize overhead reach and twist. Look at use of fixed or portable
conveyors into truck. Look at use of hand trucks. Look at use of
standing platforms within truck for upper levels.
o Minimize fatigue. Look at carton weights and regulation of
temperature.

3. Office/Clerical Ergonomics
The term Office/Clerical Ergonomics refers to ergonomic applications that primarily
focus on those issues facing the worker who spends long periods of time at a keyboard
entering data or performing word processing activities. As with manufacturing workers,
the main ergonomic concern here is the avoidance of cumulative MSDs, but other
problems need to be addressed including eyestrain and misuse of typical office hand
28

tools. As in manufacturing, different size people may be using the same office
workstation and consequently, individual adjustments will be essential. In office
environments the main focus is posture, posture, posture!
Because of the commonality of work tasks, it is somewhat easier to standardize an
office/clerical work station. There is a systematic approach to adjusting for the specific
individual. Poor work posture in the office/clerical environment may come from a
number of sources because there are so many contact points. The goal is to work with all
of the contact points until the optimum posture can be obtained.

Step 1: Start with the chair. The feet should be supported on the floor with the thighs
above knee level and the angle of the knees should be 90 to 120.
- The seat pan should be 25% wider than the individuals hip width while standing.
- There should be a fist width of distance between the chair edge and the back of
the lower leg at the knee.
- A sloped or waterfall edge will eliminate pressure on the underside of the
thigh/leg.
- An adjustable lumbar support should be provided.
- A swivel feature will reduce/eliminate the need to twist the back.
- If armrests are required, they should support the arms with the shoulders and
elbows at a natural, relaxed position, and provide for a straight line as described
below.
- Note that just providing a chair with ergonomic features does not resolve posture
issues. Many cases of back, hip, and leg problems can be related to poor chairs
and/or poor seated postures of employees who do not know how to position and
adjust their ergonomic chairs. Training employees on proper use of chairs is
critical.
Step 2: The keyboard should be placed to provide an elbow angle of 90 to 120 with the
elbow, wrist, and middle finger in a straight line.
- If the chair was raised, the work station may not allow adequate thigh/knee
clearance in this case adjustments may be needed.

29

If the chair was raised, the feet may now become unsupported, requiring a foot
rest. (Note: it is almost always a good option to provide for alternate postures. A
foot rest can be used even when the feet are flat on the floor.)
If a mouse is also used, it should be located next to and at the same height and
angle as the keyboard.

Step 3: Office tasks need to be evaluated to determine the range of tasks that are
performed. The primary task should take priority when making accommodations. The
primary work area should provide for relaxed shoulders with the elbows at a relaxed
distance from the body.
- If the mouse is the primary tool, the work station should be adjusted to provide
optimum posture during its use.
- If the keyboard is primary, adjust for the keyboard.
- If a combination is necessary, consider both in adjusting postures/positions.
- If the primary task is using the computer, the monitor should be positioned
directly in front of the user.
o In general, the monitor should be at arms length with the top line of text
at eye level.
o When the user wears bifocals, the monitor may need to be closer and
lower to prevent awkward neck postures. (Note: when any user requires
prescription lenses, there should be a dedicated pair for computer use as
the typical focus point of glasses is closer than arm distance, causing the
user to lean forward.)
o Continuous computer use also contributes to eyestrain. The user should
blink regularly to keep the eyes moistened, breath regularly, and take
frequent breaks. The 20/20/20 exercise is: every 20 minutes, look afar 20
feet for 20 seconds. (Computer Induced Eyestrain, Miami Herald 09/06)
- If the job requires tasks that reference heavy binders, they should be placed in a
location that does not encourage the user to use extended reaches from a seated
position.
- If possible, tasks should be alternated throughout the day to provide for different
postures and for the use of different muscle groups.
Ergonomic Key Points for Office/Clerical Functions
Coordinate all contact points in the workstation for optimum posture.
Provide an adjustable ergonomic chair with lumbar support.
Keyboard location should provide for a straight line between elbow, wrist, and the
middle finger.
The primary task should take priority in workstation design and adjustments.
Monitor position may depend on whether the user has prescription lenses.
Place the mouse at the same level and angle as the keyboard.
Add a footrest if the feet are not supported.

30

Office CHECKLIST can be found in Toolbox for Offices (Appendix L).

Checklists will help to determine if there should be a priority in adjusting workstations.
If no priority is evident, simply start with the first workstation and analyze and make
proper adjustments as you go forward completing all workstations. When this process is
complete, future efforts will consist of adjustments of workstations for new employees,
training new employees in the ergonomically correct method of job performance, and
following up to see that all employees continue to follow the established method.

31

Summary
Assuming that top management has given the ergonomic green light, the first question to
be addressed in implementing an ergonomics process is Where do we start? The
implementation approach recommended in this section is aimed at a systematic process to
cover the range of work activities that are typically found in an apparel or footwear
manufacturing company.
Step 1: Train key facility employees who will be the leaders of ergonomic
implementation within their particular work areas.
Step 2: Have ergonomic teams established to cover the three main facility areas
manufacturing, distribution and office/clerical.
Step 3: Conduct an ergonomic analysis of each area using standard checklists.
Step 4; In manufacturing and distribution, prioritize specific work areas in need of
ergonomic intervention by severity of problem and ease of solution. Then begin to make
improvements selecting a balance of quick fix and longer-term solution work areas.
Step 5: In office/clerical, make necessary adjustments as each workstation is analyzed.
Step 6: As the ergonomic work in each main area is completed, ongoing efforts should
consist of individual adjustment of workstations to new employees, training new
employees in the ergonomically correct method of performance, and follow-up to see that
employees continue to follow the established method.
Step 7: Future ergonomic implementation should also include periodic revisiting of
addressed work areas as new methods and/or technology allow for even better solutions
and the ergonomic evaluation of any new work process that might be introduced.

32

Section V Conclusion and Resources

Conclusion
Ergonomic-related injuries in the Apparel and Footwear industries cost these industries
millions of dollars each year. These injuries continue to be one of the causes for the very
high Workers Compensation costs in the industry. In addition to this high cost, injuries
and illnesses cause productivity losses and, in a global competitive environment, this is
an important factor. Many companies in the Apparel and Footwear industries have made
a substantial effort to reduce work-related injuries caused by heavy lifting, repetitive
motion, awkward and static work postures, vibration, and other recognized ergonomic
stressors. The results achieved by these companies demonstrate that there are effective
ways to protect Apparel and Footwear industry employees from injury while maintaining
or increasing productivity, quality, and employee morale. This Ergonomics Guideline
was designed to guide Apparel and Footwear manufacturers through the process of
developing an effective ergonomics process.
The previously completed AAFA-OSHA Alliance Volume I :Ergonomics for
Supervisors was an introductory manual for the Apparel and Footwear industries. This
guideline, AAFA-OSHA Alliance Volume 2: A Guide to Implementing an
Ergonomics Process provides practical suggestions for employers to reduce the
number and severity of workplace injuries by identifying, evaluating, and controlling
hazards by using methods that have been work-proven in the Apparel and Footwear
manufacturing industry. It presents several case studies that have worked in the industry.
This voluntary guideline is intended for Apparel and Footwear manufacturing,
distribution, and office facilities. Other employers with similar work environments may
find the provided information useful. However, care should be taken to ensure that
ergonomics solutions are developed to meet the specific hazards and requirements of
different environments.
Ergonomics is an exciting opportunity for the Apparel and Footwear industries whether
or not there are ergonomic related injuries. When ergonomics is done well we do not just
make the workplace safer. We make it more efficient. We improve our products quality
the first time with less rework. We make our delivery schedules more often. We respect,
honor, and serve the most expensive assets our organizations have: our workforce. When
our employees, supervisors, managers, and owners understand the principles of
ergonomics we increase shareholder value and the result is working smarter, not harder!
The American Apparel & Footwear Association recognizes that the Occupational Safety
and Health Act of 1970 requires in addition to compliance with hazard-specific
standards that all employers have a general duty to provide their employees with a
workplace free from recognized hazards likely to cause death or serious injury. This
guideline is designed to help employers meet this responsibility.
This guideline is advisory in nature and informational in content. This document
does not represent a new regulatory standard and imposes no new legal
requirement. An employers failure to implement this guideline is not in violation of
the Occupational Safety and Health Act of 1970.

33

Web Site Resources

34

A Primer Based Workplace Evaluations of Musculoskeletal Disorders (select the

Table of Contents): http://www.cdc.gov/niosh/ephome2.html
American Apparel & Footwear Association: www.apparelandfootwear.org
American Conference of Governmental Industrial Hygienists: http://www.acgih.org/
American Furniture Manufacturers Association: http://www.Afma4u.org
American Industrial Hygiene Association: http://www.aiha.org/
Board of Certified Professional Ergonomists (to find certified ergonomics
practioners): www.bcpe.org/
Center for Disease Control Ergonomics:
http://www.cdc.gov/od/ohs/INDHYG/ergolead.htm
Cornell University (office ergonomics): www.ergo.human.cornell.edu
Elsevier (publisher of scientific, technical and health information):
http://www.elsevier.com/
ErgoWeb (current news): www.ergoweb.com
Ergoworld (ergonomics and human factors meta site): www.interfaceanalysis.com/ergoworld/
Federal OSHA index page for the Meatpacking Industry:
http://www.osha.gov/SLTC/meatpacking/index.html
Federal OSHA Ergonomics Guidelines for the Meatpacking Industry:
http://www.osha.gov/Publications/osha3123.pdf
National Institute for Occupational Safety and Health: http://www.cdc.gov/niosh/
North Carolina State University Department of Industrial Engineering:
http://www/ie.ncsu.edu/
OSHA (federal developments): www.osha.gov
PubMed (research academic journal articles): www.ncbi.nlm.nih.gov
Taylor and Francis Publishing (academic journals): http://www.tandf.co.uk/journals/
Washington State Department of Labor and Industry, Ergonomics:
http://www.Ini.wa.gov/wisha/ergo/

APPENDIX A

FINANCIAL IMPACT ANALYSIS

The following calculations will assist you in estimating the impact of ergonomics-related
claims (injuries and illnesses) on your profit and sales.
1. To calculate the Direct Cost (DC), review your insurance loss data and identify
the total value of the insurance claims for ergonomic-related injuries and illnesses.
These consist of medical cost and indemnity payments.
2. Calculate the Indirect Cost (IC) which can range from 3 to 4 times that of Direct
Costs.
DC X (3 or 4) = IC
3. Calculate the Total Cost (TC) by combining your Direct and Indirect Costs.
DC + IC = TC
4. To calculate impact of ergonomic-related claims (injuries and illnesses) on your
profitability, use your profit margin to determine sales your company would need
to generate in order to pay for your ergonomic injuries and illnesses.

35

Calculate Profit Margin (PM); divide your Total Profits (TP) by Total Sales
(TS) to get your Profit Margin.
TP/TS = PM

Divide the Total Cost of ergonomic injuries and illnesses by your profit
margin to determine sales your company must generate in order to pay for the
losses. Keep the profit margin in decimal form (example: .04)
TC/PM = Sales required to pay for Losses

APPENDIX B
ERGONOMICS PROCESS CHARTER
The following example for an Ergonomics Charter is provided only as a guideline to
assist a company in putting its intentions into written format. Deletions and/or additions
can be made to suit your companys specific needs. This example does not constitute a
legal document. However, this document should be cleared with legal counsel or the
legal department to make sure it is compliant with any applicable state laws, especially if
an employee will not be hired if he or she cannot pass the health examination.
ERGONOMICS CHARTER
COMPANY recognizes that musculoskeletal disorders (hereinafter MSDs) are an
occupational illness present in the apparel industry. MSDs are chronic soft tissue
problems of the musculoskeletal and peripheral nerve system including, but not limited
to, tendonitis, tenosynovitis, carpal tunnel syndrome, epicondylitis, and low back strain.
The parties also recognize that the control of MSDs is a complex issue often requiring the
application of a number of different control methods and technologies that may differ
from operation to operation. These include feasible engineering controls that materially
reduce or eliminate job-related MSD stressors; employee and supervisory training and
education; early recognition of the problem; early and proper medical diagnosis,
treatment, care, and follow-up; and feasible administrative controls.
COMPANY will establish an ergonomics process for all production, office and
maintenance employees. The process will include the following five elements: (1)
establishment of an ergonomics committee; (2) job analysis; (3) hazard control; (4)
employee training; and (5) medical management. Statistical data regarding training;
information concerning medical management; number of jobs identified as high risk;
number of employees at risk; and results of job analysis and implementation of controls
shall be included among the subjects to be discussed at annual meetings.
COMPANY will provide training to plant personnel responsible for the conduct of the
ergonomics process at each facility. Each facility shall establish an ergonomic committee
which shall implement the ergonomic process. The committee will also be responsible
for the review and follow-up of the process as a whole and of individual components of
the process, including job analysis and hazard control, to assure that ergonomic hazards
are materially reduced or eliminated to the extent feasible. The committee shall meet at
least _____.
COMPANY agrees to utilize outside consultants in situations where in-house efforts
concerning reduction of job ergonomic stressors are not successful. _____ reserves the
right to disagree with the consultants recommendations. The consultants reports will be
made available to the ergonomics committee.

36

The ergonomics process at each facility will operate on a continuous basis. In particular,
hazard abatement and controls shall proceed as quickly as feasible. Facilities that have
initiated elements of this process shall not be required to repeat those aspects.
JOB ANALYSIS: The ergonomics committee at each facility will establish a written job
analysis program consisting of the following components:
- A) Analyze the facilitys injury and illness experience, utilizing the OSHA 300
Log related to potential ergonomic illness, workers compensation reports, and
work-related sickness and accident data to identify jobs with potential ergonomic
hazards. A minimum of _____ year(s) or a statistically valid sample of data shall
be analyzed.
- B) Conduct a baseline symptoms survey of all employees at the time of
awareness training to identify additional jobs that may contain risk factors for
MSD and to measure progress of the ergonomic process. A follow-up survey
shall be conducted during the third year following implementation of the process,
and shall be repeated within 36 months thereafter.
- C) Establish priorities and timetables to institute feasible corrective action. The
committee will review and revise the priorities necessary, taking into account
such information as job change, new injury and illness analysis, and style
changes.
- D) Survey and evaluate each facility job identified under A) and B) using a basic
job checklist to determine the existence of ergonomic risk factors. The analysis
will be conducted by persons who have completed practical ergonomic training or
its equivalent. Job analysis and redesign will be conducted with input from
employees whose jobs will be affected by the modification.
- E) All other jobs will be evaluated to determine the existence of ergonomic risk
factors. The first plant-wide cycle of the job analysis program shall be completed
at each facility no later than:______
- F) The company agrees to establish an information-sharing system that can be
used by all facilities for the purposes of identifying ergonomic stressor jobs and
jobs presenting a low risk of MSD as well as possible corrective actions.
IMPLEMENTATIONS OF CORRECTIVE MEASURES. Based on the results of the job
analysis program, each facility shall implement feasible measures to control ergonomic
risk factors.
- The company shall inform and familiarize affected employees as to the use of
controls implemented at their work stations. (This information shall be in
addition to general ergonomics awareness training.)
- The facility will maintain documentation of modification activity, including the
job or workstation identified for modification, the number of workers affected, the
nature of modification, the projected completion date, the actual completion date,
and where available the cost of the modification when completed. Where
abatement is delayed, the reasons for the delay will be recorded along with a new
abatement date.
- The company agrees to consider and implement feasible ergonomic-safe workplace design into the production lines of new styles.

37

GENERAL TRAINING. Ergonomics training will be conducted for personnel at all

facilities.
- Practical ergonomics training. Appropriate personnel will receive practical
ergonomics training in the use of the basic job/risk factor checklist referenced
earlier, problem identification, and implementation of ergonomic solutions. This
training shall be approximately ___ hours, consisting of classroom and hands-on
problem solving techniques. Candidates for this training shall be selected at each
location based on plant needs. Select employees in health and safety, industrial
engineering, manufacturing, medical, and _____ shall receive this training.
- Employee education and training. The company agrees to design and implement
an ergonomics awareness education and training program for production, office,
and maintenance employees, including supervisors, at all facilities.
o General ergonomics awareness training of at least one-half hour in length
will be conducted for these employees at all facilities. The training will be
administered to newly hired employees during new-hire orientation or no
later than 15 working days.
o The training and education program will include a general introduction to
ergonomics including the topics of force, frequency, and posture. The
program shall also include the study of causes and recognition of MSD
symptoms, the existence of the ergonomics committee, and the need to
report early MSD symptoms to the facility medical department.
o All newly hired and transferred employees who are assigned to a job
identified in A) or B) of the Job Analysis section will be informed as to
the proper use of the tools and equipment required in the performance of
their assigned duties.
o The company shall review with the employees the application of
ergonomic principles to the prevention of MSDs specific to their jobs on
an annual basis during regular safety talks.
MEDICAL PROGRAM. The company shall establish a medical management program
of early detection and treatment of MSDs at each of the facilities by _____
- The company will ensure the availability of employee health care services
- The company agrees to provide MSD education and training for appropriate
internal health care providers who render medical care related to MSDs.
Referrals will be made only to outside medical personnel competent in the
diagnosis and treatment of MSDs.
- The health care provider shall conduct periodic workplace walk-throughs to
remain knowledgeable about operations and work practices, to assist in
identifying jobs appropriate for restricted employees, and to maintain close
contact with the employees.
- All newly-employed production and maintenance employees will receive a
baseline health examination prior to being assigned to positions involving
exposure to ergonomic stressors. The baseline health examination will be
documented and filed with the employees medical records.
- Employees will be encouraged to report early signs and symptoms of MSDs to the
facility medical department. Employees shall not be discriminated against
because they request and visit the medical facilities or because they sustain
previously diagnosed MSD problems or are at increased risk.

38

APPENDIX C
INJURY PREVENTION EXERCISE PROGRAM
The following is an example of a program in use in the industry. There
are conflicting opinions about the benefits of exercise programs. You
should consult your medical and legal departments before implementing
a volunteer or mandatory exercise program in your company.
Injury Prevention through Stretching
Exercise programs with structured movements are growing elements of industries
attempts to combat the effects of work demand on their employees. Many research
articles support such components within a comprehensive Injury Prevention Program.
NIOSH found that rest breaks, when timely and effectively taken, were shown to improve
worker comfort and increase performance. The idea of avoiding and reversing the effects
of awkward and sustained postures through stretching exercises may be a beneficial way
to achieve this end.
Exercise can be completed in short periods of time while at work such as during break or
before or after a shift. Ultimately, the goals of programs such as these are to heighten
employees awareness of the need to maintain their health. We all use our bodies to
produce work. While we may not live with the same job all our lives, we will most
certainly live with the same body. The positive benefits of an exercise programs may
provide the following:
GENERAL BENEFITS
1. Enhanced alertness
2. Increased productivity
3. Increased quality of work
4. Increased employee safety
PHYSICAL AND PHYSIOLOGICAL BENEFITS
1. Increased circulation and blood flow
2. Improved posture
3. Improved breathing and cardiovascular condition
4. Decreased stress
5. Improved general health habits

39

Issues and Recommendations

For Exercise Programs
1. Pre-shift exercises should have leaders and these leaders should rotate on a regular
basis.
2. Leader rotation schedule should be agreed upon by the group.
3. Teams can be formed and extensions of the core exercise program can be made.
4. Coordination and ongoing consultation from the health care provider is necessary.
5. Incentive programs can be developed to encourage participation. Ideas for these
programs can come from employees, health care providers, or Human Resource
personnel.
6. Exercise programs may be mandatory for identified high-risk jobs, but voluntary
participation is encouraged by all associates.
Pre-Shift Exercise - Group
Instructions:
1. Relax during all stretching; tense muscles will not stretch well.
2. Hold stretches for 5-10 seconds or as long as possible until then.
3. You should feel a pulling type of discomfort but not a sharp one.
4. Any discomfort after a stretch should not last more than a few minutes.
5. Throughout all stretching try to keep back straight and head upright.
6. Cease and report any exercise that is painful.
7. Report stretches that may be difficult for the individual another technique for the
stretch may be available.
8. Maintain normal breathing while exercising.

40

PRE-SHIFT EXERCISES

HOW TO STRETCH?

slowly & gently

stretching/pulling; not sharp pain

any discomfort should end soon after releasing stretch

cease and report any painful exercise while remembering to breathe normally during
exercising.

relax during stretching

WHY TO STRETCH?

brings nutrients to muscles

releases tension

reduces pain

promotes healing

...and makes you feel good!

WHEN TO STRETCH?

at beginning of shift and before returning to work after lunch

throughout shift

Regularly, to make gains

41

Frequently Asked Questions About Our Working Bodies

1. What are musculoskeletal disorders (MSDs) and how do they occur?
MSDs come from two sources: repetitive motion and sustained posture. Repetitive
motion can cause tissue damage as muscles contract to move the body. Sustained posture
can cause damage by cutting off the blood supply to working tissues, making them tight
and inflexible. Sustained posture is often the most significant risk factor for fatigue and
wears damage leading to injuries. A sustained contraction shuts down blood flow and
quickly depletes nutrients necessary for work and repair. Repetition also produces
fatigue and a shut-down in blood supply by tightening muscles and making them
inflexible.
2. Why should we do Stretching Exercises?
Flexibility is vital to the working body. Lack of flexibility causes the body to work
harder to move and maintain movements and positions. Tight muscles require more
energy and reach fatigue much faster than flexible muscles, reducing the productivity of a
persons body. Flexible muscles, on the other hand, are easy to move and stay adequately
nourished by the circulation longer. This allows for longer periods of muscle use and,
therefore, greater productivity of the working body.
3. What is fatigue?
Fatigue is a chemical process in the muscle. When energy (oxygen and sugars) is used,
waste products (lactic acid) are created which are toxic and irritating to the muscle. This
causes the pain experienced when a muscle is tired of working.
4. How can stretching reduce fatigue?
Since fatigue is a problem with blood chemistry in the muscle, getting adequate amounts
of blood to the muscle is the logical goal. Stretching actually increases the absorption of
blood into a muscle. This process is best described by using the example of a sponge
underwater. The squeezing actually forces water from the sponge and releasing it refills
the sponge completely with water. Done regularly, the muscle can stay nourished and
free from toxic wastes and friction damage.
5. What else does blood do?
Wear and tear on muscles that work hard is very common. In fact, its normal. The
blood has vitamins, nutrients, and other chemicals that effectively repair this wear and
tear damage regularly.

42

6. If the blood repairs the damage, then why do these wear and tear injuries
occur?
This is a good question and the answer should convince anyone of the value of preventive
stretching. On jobs requiring high-frequency repetitions without much rest between
repetitions, the body may be working at a rate significantly higher than the blood can
repair the damage. Everyone has a different rate of repair. The people whose bodies are
slow to repair are the ones most likely to get injured. The bodys rate of repair also
changes depending on fitness levels and the general health of a person.
7. What if the stretching exercises hurt?
These exercises are safe for most everyone. Any worker with a medical condition that is
aggravated by the exercises should see a therapist for an alternative method of stretching.
If there is no way to accommodate the worker for preventive stretching, then of course
exceptions may be made for the part of the program which causes difficulty.
8. What if I cannot find time to do exercises?
The exercises take only seconds. They can be done sitting, standing, or walking. Some
can be done even while working. It is usually a matter of attitude when time is the
excuse given for someone not doing exercises.

43

Examples of stretching exercises can be found on the next page. We acknowledge

that the purpose of these exercises is not to improve fitness levels or to make someone
more athletic or flexible. The purpose is to reduce fatigue by increasing the
circulation of blood throughout the muscle tissues and tendons. This is medically and
biologically possible and simply a matter of application.

44

APPENDIX D
EARLY REPORTING FORM
NAME:
DATE REPORTED TO MANAGER:
(Circle all that apply)
1.

I have a problem in my (left and/or right)

back

neck

shoulder

elbow

wrist

hand

What symptoms do you have?

pain

swelling

weakness

other____________________________
3

When do you have symptoms described above?

at work

after work

How long have you been experiencing the symptoms?

less than a month

at home - evening / at home - sleep

2-3 months

4-6 months

6 mo.-1yr.

over 1 year

How often do the symptoms described occur?

during work activity during non-work activities

daily

How long do the symptoms described above last?

constantly
until I move around
no specific time

What have you done which helps with your symptoms?

weekly

aspirin/ tylenol/ ibuprofen ice / heat rest / massage

muscle creams or lotions
THIS FORM MUST BE SENT TO THE MEDICAL DEPARTMENT ON THE
DAY IT IS COMPLETED.
Associate:

____________________________________

Supervisor: ____________________________________

45

APPENDIX E
ERGONOMICS PROCESS AUDIT
Date: ________________________
Audit Site: _____________________
Audited By: ____________________
1.
2.

3.
4.
5.

A. Management Commitment
Is there a Plant Health & Safety Policy and is it posted in conspicuous
locations throughout the facility?
Is there a written Corporate Ergonomic Process available? (Plant
Manager, Safety Coordinator, Medical Technician, Committee should
each have a copy)
Is there an assigned Ergonomics Coordinator?
Does he/she have management support and authority to establish and
maintain an ergonomic process?
Is there an annual audit of the ergonomics process?
B. Employee Involvement

6. Is there an active Ergonomics Committee?

Please list members
A.
B.
C.
D.
7. Does this Committee meet every quarter?
8. Are minutes kept of the Committee activities?
9. Is the quarterly plant ergonomic report completed and on file? (This
report lists completion of projects and/or issues to be addressed)
10. Are the activities of the Committee communicated to the associates?
C. Worksite analysis
11. Has the facilitys ergonomic-related injury and illness experience been
identified?
12. Have baseline symptom surveys of all employees been conducted?
13. Is there a prioritized list of jobs needing corrective action?
14. Are job ergonomic hazards reviewed annually / periodically?
15. Is there available a Job Safety & Hazard Analysis that incorporates
ergonomic risk factors for each manufacturing job?
Please list all identified jobs:
A.
E.
B.
F.
C.
G.
D.
H.

46

Yes

No

Points
4
4

4
4
4
4

4
4
4
4
4
4
4
4
4

D. Medical Management
16. Are First Aid attendants available for each shift?
17. Are the First Aid Attendants trained to recognize ergonomic
symptoms?
18. Is there a system for early reporting of ergonomic-related
symptoms?
Please describe & list the reporting procedures:
1.
2.
3.
4.
19. Are all ergonomic cases documented utilizing a symptom evaluation
form?
20. Are associates in identified high-hazard work areas surveyed
annually to monitor risk factors?

Yes

E. Training and Education

21. Are newly hired associates given an overview of the ergonomic
process during orientation?
22. Is training conducted annually addressing ergonomic risk factors
and the ergonomic process?
23. Is management trained annually to recognize ergonomic-related
conditions and symptoms?
24. Is there a process for documenting and reporting ergonomic
problems by employees?
25. Are all employees encouraged to report ergonomic illnesses early?
TOTAL POSSIBLE:
TOTAL :

Yes

No

4
4

No

Evaluating Your Audit

This audit provides you with a relative measure to the status of your ergonomic
process. For each item that is marked "Yes", you receive a certain amount of points.
An excellent ergonomic process would receive 100 points. If your ergonomic process
is not perfect, then you can use this audit form to identify areas that need
improvement.
If you responded "No" to any item on the audit form, then you have identified an area of
your ergonomic process that can be improved. For example, lets say that you answered
"No" to item 15, Is there, available a Job Safety & Hazard Analysis that incorporates
ergonomic risk factors for each manufacturing job?" You might consider identifying and
analyzing each production job in your facility. This would help you identify and
document the ergonomic risk factors associated with your jobs. It would also give you a
tool with which to train your associates about the conditions and hazards they will need
to address. Overall, this would improve ergonomic awareness and help you identify good
ergonomic work procedures.

47

Points
4
4

Points
4
4
4
4
4
100

To come into compliance with this process, please list your action plan and dates
for completion for all items answered "No".

Question #

48

Plan of Action

Date

APPENDIX F
JOB SAFETY HAZARD ANALYSIS

49

APPENDIX G
NIOSH CAUTION ZONE CHECKLIST

50

51

52

53

54

55

56

57

APPENDIX H
ERGONOMIC EXAMPLES

58

Ergonomic Example #1
Name: Roller Bearing Packing Table
Primary task: Workstation for packaging garments into cartons and transporting to
conveyor system.
Description: Improves material handling. Roller bearing workstation helps the
individual in moving heavy carton from table to conveyor with minimal exertion.
Before: Associate would push or lift
heavy cartons of garments from
packing table onto conveyor belt
putting stress on lower back,
shoulders, and arms.

After: Associate can now adjust the

table to a customized working height
and the roller bearing allows the
carton to move easily over the table
top and onto the conveyor with little
effort.

Ergonomic Notes: Table can be adjusted to accommodate individuals of varying

height. Roller bearings attached to the workstation help in moving cartons onto
conveyor.
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements.
Estimated Cost: Roller Bearings $100 (for enough roller bearings for one table).

59

Ergonomic Example #2
Name: Carton Content Verification Workstation
Primary task: Used to hold cartons to scan and visually check contents.
Description: Improves work posture and position. Tilted workstation allows
individual of lower height to work in his or her normal range of motion. The
addition of an anti-fatigue mat improved stance while at workstation.
Common Components of Adjustability:
Table height
Anti-Fatigue Mat thickness
Before: Associate would stand on a
hard cement floor without any relief.
The table used to hold carton caused
associate to raise arm to access
contents.

Conveyor height
Platform height (potential trip hazard)
After: The worktable is tilted to
allow easier access to the contents of
cartons. The anti-fatigue mat adds
comfort to the workstation.

Ergonomic Note: The thickness of anti-fatigue mats can be used to make minor
adjustments to individual height. A platform can provide height but must be
designed in such a way to avoid a trip hazard. Conveyor height adjustment would
accomplish the needed height adjustment at some additional cost.
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements.
Estimated Cost: Table height Adjustment $25, Anti-Fatigue Mat $100 (3x5)
Alternative Improvement Cost: Platform (not shown) $200, Lower Conveyor
(shown) $800.

60

Ergonomic Example #3
Name: Office Workstation
Primary task: Clerical (data entry, telecommunications, filing, etc.)
Description: Adjustable workstation to allow individual to position and work within
his or her normal range of motion.
Common Components of Adjustability:
Chair height
Armrest, adjustable
Back support (Supplemental)
Foot support
PC Display level and position
Before: Stationary or fixed
workstation limited adjustability
and put associate in awkward
posture.

Chair tilt
Back support (Chair)
Wheels and Swivel
Keyboard level and position
Data tray level and position
After: Associate is able to make
adjustment to the workstation. The
chair, side armrests, back support,
keyboard tray, mouse rest, and
footrests are all adjustable.

Ergonomic Note: Adjustability allows periodic changes in position throughout the

day to prevent individual from having to maintain a posture that becomes
uncomfortable/tiring.
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements.
Estimated Cost: Chair $300, Footrest $100, and Keyboard Tray $100.

61

Ergonomic Example #4
Name: TrucKool System
Primary task: Reduces interior temperatures to allow associates safe access for
loading and unloading trailers.
Description: A TrucKool study concluded that the in-trailer temperature can be
reduced up to 25 degrees F. General Information: sprinkool-usa.com.
Before: Temperatures in the trailers
during the middle of the day were
unbearable.

After: The sprinkler system keeps the

trailer cooler and allows associates safer
access during the hot hours of the day.

Ergonomic Notes: Improves working environment so associates can safely access

trailers and be more productive.
Special Note: Associates must be trained in proper use of system. A significant
improvement in productivity can be realized through the increase in the efficiency
of operators movements.
Estimated Cost: Truckool System $3000 per 2 doors.

62

Ergonomic Example #5
Name: Powered Pallet Jack
Primary task: Moves heavy pallets of products throughout warehouse and on/off
trailers.
Description: Improved material handling. Powered pallet jack will enhance the
movement of pallets to and from trailers and around the warehouse. It eliminates
the need to push and pull heavy loads manually.
Before: Associates were required to
manually handle pump jack to lift
pallets. Pushing and pulling of the jack
places stress on back, shoulders, and
arms.

After: Associate now uses the powered

pallet jack to lift, move, and position
pallets. This reduces the stress on the
back, shoulders, and arms.

Ergonomic Notes: Reduces exertion and fatigue in moving pallets around warehouse.
Reduces potential of back pulling and/or pushing injuries.
Special Note: Associates must be trained in proper use of powered industrial trucks.
The powered pallet jack must be locked out if not in use. A significant improvement
in productivity can be realized through the increase in the efficiency of operators
movements.
Estimated Cost:
Powered Pallet Jack
Rider Pallet Truck (not shown)

63

$5,000
$15,000

Ergonomic Example #6
Name: Overhead Hoist and Box Lift Assist Air Suction Device
Primary task: Positions raw material box to access contents.
Description: Improved material handling. An overhead hoist, rail, and vacuum air
system were added to the process to assist in lifting heavy boxes of supplies.
Before: Two associates were required to
lift a 125-lb. box in order to position box
to access contents. Stress on back,
shoulders, and arms occured. Also
there was potential risk of dropping the
box.

After: One associate now controls the

lift. He can lift a 125-lb. box and
position it with little or no stress.

Ergonomic Note: The lift assist eliminated one associate from the process. It reduced
stress on the lower back, shoulders, and arms.
Special Note: Associates must be trained in proper use of lifting device and unit must
be locked out if not in use. A significant improvement in productivity can be
realized through the increase in the efficiency of operators movements.
Estimated Cost: Overhead Hoist and Box Lift Assist Air Suction Device

64

$8,000

Ergonomic Example #7
Name: Yarn Transport Buggy/Rack
Primary task: Transports supply packages to each machine throughout department.
Description: Improved material handling. Metal handles with rubber grips were
added to the interior side of rack to help keep hands/wrists in a neutral position and
out of contact with support posts and machinery. It improved associates grip
strength and maneuverability of racks.
Before: Associates would grab and use
After: Associate is able to reduce grip
the metal side rails or use the package
strength, keep hands/wrist in a neutral
holding pegs to help control rack
position, and improve ability to
movement in the aisles.
This was
maneuver racks. Rubber grips were
dangerous and awkward. Hands and
added to assist in coupling with the
fingers were caught between machines
rack.
and racks.

Ergonomic Note: This reduced contact incidents against other objects. It improved
maneuverability of the racks and reduced the stress on the hands, wrists, shoulders,
and lower back.
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements.
Estimated Cost: The handles and rubber grips were installed internally at a cost of
$50.00 per unit.

65

Ergonomic Example #8
Name: Packing Side-Tilt Buggy
Primary task: Stores finished product for shipment to customers.
Description: Improved material handling. Buggy has a tilt mechanism to reduce the
amount associate has to bend and reach into box to pack finished product.
Before: Associates would lean over into
the box and put the body in an awkward
position. The upper body would contact
the edge of the box, resulting in overreaching to pack finished product.

After: The contact point was lowered to

waist level, reducing the reach distance.

Ergonomic Note: The adjustments to the buggy reduced the associates contact
points, reduced reach distance, and reduced stress on the lower back from poor
posture.
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements.
Estimated Cost: The buggies were made for $400 per unit.

66

Ergonomic Example #9
Name: Drop-Side Buggy
Primary task: Transports and stores supply packages for associate to use when
loading machine.
Description: Improved material handling. Buggy has a drop side door mechanism to
reduce the amount associates have to bend and reach into buggy to retrieve supply
package.
Before: Associates would lean over into
the box and put the body in an awkward
position. The upper body would contact
the edge of the box resulting in overreaching to retrieve supply package.

After: The contact point was lowered to

waist level, reducing the reach distance.

Ergonomic Note: The adjustments to the buggy reduced the associates contact
points, reduced reach distance, and reduced stress on the lower back from poor
posture.
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements.
Estimated Cost: The buggies were modified internally for $200 per unit.

67

Ergonomic Example #10

Name: Coupling Tool
Primary task: Connects to large supply packages to assist the associate in lifting and
transporting to machines.
Description: Improved material handling. The device is a hand-held single unit that
expands against the package tube when the handle is squeezed. This allows the
associate to avoid the use of a pinch grip and to use a more neutral power grip.
Before: Associates would bend over and
use the hand with a pinch grip.

After: The pinch grip is eliminated and

a power grip in a neutral position is
used. The grip is padded to improve
grip contact point. The distance of the
reach is reduced.

Ergonomic Note: The use of the coupling device eliminated the pinch grip, reduced
reach distance, and reduced the stress on the lower back from poor posture.
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements.
Estimated Cost: The coupling device was custom-made for $300 per unit.

68

Ergonomic Example #11

Name: Rubber-Coated Gloves
Primary task: Assists utility associate in lifting finished packages from the machine to
the transport buggy for packing.
Description: Improved material handling. The gloves improved coupling with the
finished package and protected the hand from the sharp plastic edges.
Before: Associates would use bare hands
with a pinch grip and would make
contact with sharp edges of the package
cone.

After: The pinch grip is still used but

the grip strength is lessened because of
improved contact with the package.
The hands are protected from the sharp
contact points in the package cone.

Ergonomic Note: The use of the gloves improved coupling, allowing for a better grip
with the finished product, and prevents cuts from sharp edges.
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements.
Estimated Cost: The gloves were $2.00 a pair.

69

Ergonomic Example #12

Name: Electric Lift
Primary task: Assists the associate in lifting box carts to work on damaged or clogged
wheels.
Description: Improved working position and material handling. The lift raises the
height of the box cart to a more neutral position for the associate to work on. It
helps avoid awkward bending and squatting work positions.
Before: Associates would have to bend
and squat down to access the bottom
wheels on the box cart.

After: The box cart is raised to neutral

level for the associate to work on the
wheels. This eliminates the bending
down and awkward working position.

Ergonomic Note: The use of the lift improved the working height and reduced the
stress on the back, shoulders, and arms. Secondarily, it improves the ease of
maintenance on the box cart wheels, which assists in material handling.
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements.
Estimated Cost: The electric lift was $2,500.

70

Ergonomic Example #13

Name: Air System Electrical Shut-Off Switch
Primary task: Turns off the air suction system that collects wastes from each
machines spindles.
Description: Improved working position. The shut-off switch allows the associate to
turn off the air suction system to access the waste collection point without having to
force open and hold open the door.
After: Associate turns off the collection
system before accessing the waste
Before: Associates would have pulled
collection
point.
This
eliminates
open the door that was under pressure
forcefully
opening
the
door
under
and held it open with the arms and
pressure and sustaining an awkward
back.
working position.

Ergonomic Note: The use of the switch improved work position and reduced the
stress on the back, shoulders, and arms.
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements.
Estimated Cost: The air system electrical shut-off switch was $40 per switch. The
switch was installed internally.

71

Ergonomic Example #14

Name: Pedal Extensions
Primary task: This pedal disengages the spindle from the drive mechanism to allow
the operator to access spindle for work.
Description: Improved working position. The pedal extension improves the working
position by eliminating the need for the operator to raise the foot in order to make
contact with the pedal.
Before: Associates would have raised
the foot to reach and make contact with
the pedal. This made for an awkward
stance.

After: Associates foot stays on the

ground and eliminates the need to raise
the foot off the ground and work in an
awkward position.

Ergonomic Note: The use of the pedal extension improved working stance and
reduced the stress on the back and legs.
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements.
Estimated Cost: The pedal extensions were $500 for a 144-end machine. The units
were installed internally.

72

Ergonomic Example #15

Name: Extension Hook
Primary task: Sets product into overhead guides.
Description: Improved working position. The extension hook allows the associate to
work from the floor level. It eliminates the need to position and to walk up and
down a ladder.
Before: Associates would position a
ladder and climb up to access the
overhead guides.

After: Associates using the extension

hook works from the floor level and
eliminates the use of a ladder.

Ergonomic Note: The use of extension hook improves work conditions. It eliminated
the use of ladders, which put stress on the back, shoulders, arms, and legs.
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements.
Estimated Cost: The extension hook was $10 per unit. They were designed and made
internally.

73

Ergonomic Example #16

Name: Access Ladder and Work Platform
Primary task: Provides access to high areas to work on motors and machines.
Description: Improved working position. The access ladder and work platform
eliminate the need to position a ladder to work from an awkward position.
Before: Technicians would need to
position a ladder and climb up to access
overhead drive motors. The associate
would work in an awkward position off
of the ladder or on top of machine.

After:
Technicians now use a
permanent ladder to access a work
platform to work on the machine. It
eliminated awkward working positions.

Ergonomic Note: The use of an access ladder and work platform improves working
conditions for the machine technicians. By eliminating the use of the ladders as a
work platform, the platform removed the awkward working positions and reduced
stress on the back, shoulders, arms, and legs.
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements.
Estimated Cost: The access ladder and work platform cost $3000 per unit. They were
installed internally.

74

Ergonomic Example #17

Name: Ring Knife
Primary task: Ring Knife is used to cut loose ends when tying off thread packages.
Description: Improved working hand position. The ring knife eliminates the need for
an associate to use and hold a pair of palm scissors in an awkward position.
Before: Associates would hold a pair of
scissorsAss
in the palm of the hand while
cutting and tying loose end of package.
The associates tended to hold the
scissors most of the day in their hands.

After: Associate now uses a ring knife,

which eliminates the need for scissors
along with the stress of holding them all
day.

Ergonomic Note: The use of a ring knife improves working conditions by reducing
the stress on the hand, fingers, and wrist from holding onto a pair of scissors all day.
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements.
Estimated Cost: The ring knife cost $0.72 per unit vs. $7.75 for a pair of palm
scissors.

75

Ergonomic Example #18

Name: Dye Tube Storage Rack
Primary task: Storage and access of thread dye tubes.
Description: Improved working position. The racks allow associates to access thread
dye tubes from an improved neutral position, reducing awkward bending and
reaching.
Before:Ass
The associate would bend over
and reach deep into carton to retrieve
dye tubes.

After: Associates now have open access

to dye tube cartons at more neutral
height, which eliminates the need for
bending down and reaching into carton.

Ergonomic Note: The use of the storage racks improves working posture by reducing
the bending and reaching distances to access dye tubes. This reduces stress on the
back and arms.
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements.
Estimated Cost: The storage racks cost $500 per unit set and were built and installed
internally.

76

Ergonomic Example #19

Name: Cutting Station Holder
Primary task: Cutting station holder was designed to hold a tube or pirn of thread.
Description: Improved working position. Allows the associate to use both hands to
clean filament thread off of tube or pirn. Both hands are required when cutting.
This moves the hand out of the cutting zone.
Before: Associates would have to hold
and brace the tube against something
and cut, reaching away and down. This
would put them in an awkward position
and expose one hand to cutting zone.

After: Associate places tube in holder

and depresses a button, which activates
a clamp that holds the tube in place.
This allows them to work in a more
neutral position and follow safer cutting
procedures.

Ergonomic Note: The use of the holder improves the working posture, eliminating
the need to brace the tube. It also moves the hand holding the tube away from the
cutting zone. There is less stress on the hands, arms, and shoulders.
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements. When using a knife, a cutresistant glove should be worn on the opposite the hand holding the knife.
Estimated Cost: The holder was designed and installed internally for a cost of $500.

77

Ergonomic Example #20

Name: Powered Expandable Conveyor System
Primary task: Assists the shipping department in the loading and unloading of
trailers at different dock doors.
Description: Improved working conditions and position. The conveyor extension
improves the working position and the distance the operator has to carry boxes into
and out of the trailers. The conveyor can extend the full length of a trailer. Boxes
coming off the conveyor are positioned at a neutral height.
Before: Associates would use hand
trucks to load and unload trailers. They
would maneuver hand trucks over dock
plates and trailer floor.

After: The expandable power conveyor

system delivers the boxes at a neutral
height at the point of storage in the
trailer. This eliminates travel distances.

Ergonomic Note: The use of the power extension conveyor system improved working
conditions and positions. It reduces the carrying and lifting distances, reducing
stress on the back and legs. The use of a fan improves conditions in the trailer by
helping to circulate air throughout (hot or cold).
Special Note: A significant improvement in productivity can be realized through the
increase in the efficiency of operators movements.
Estimated Cost: The powered expandable conveyor system was approximately
$39,000 to purchase.

78

APPENDIX I
POST-OFFER SCREENING
The following is an example of a post-offer screening process that may be conducted by
your health care professional. Consult with your companys legal and medical
departments before considering implementation.
POST-OFFER FUNCTIONAL SCREEN INSTRUCTIONS
AND UNDERSTANDING OF TESTING
This test is an evaluation of the physical demands of the essential functions of the job.
For this exam the applicant will be tested on each of the essential functions that are
required to complete the job. Applicants are expected to do each test to their maximum
ability. The applicant should not attempt to handle more weight than capable of handling
because it would cause undue strain. Undue strain is that which causes pain and/or
discomfort. If at any time during the test the applicant becomes lightheaded, experiences
dizziness, becomes disoriented or experiences any other unusual symptom, the individual
should inform the testing administrator immediately.
All testing will be demonstrated. Applicants are expected to ask any questions they may
have prior to proceeding to the actual tests.
There are certain risks with this type of functional testing. Since applicants are expected
to give their maximum effort, it is always possible to get a sprain or strain injury.
However, following the test instructions carefully minimizes any risk of injury.
Applicants must sign off to indicate that they understand the testing procedures, that they
dont have any questions, that they are ready to complete the functional testing, and that
they have answered all questions pertaining to their health truthfully and to the best of
their knowledge. A sample report is included in this appendix, which looks at basic
elements of a test (i.e. employee history, testing of essential physical job demands, lifting
technique, flexibility, strength, cardiovascular fitness, hand and wrist testing, overall
impression, and score). Each test must be developed specifically for the particular job.
Functional screen tests show that about five percent of the applicants are rejected for the
jobs based on the test results.

79

POST-OFFER FUNCTIONAL SCREEN EVALUATION

Date:
Evaluee:
Social Security #:
Evaluator:
1. Evaluee was examined and (does, does not) pose a direct threat.
Direct threat means a significant risk of substantial harm to the health or safety of
the individual or others that cannot be eliminated or reduced by reasonable
accommodation. The determination that an individual poses a direct threat shall be
based on an individualized assessment of the job. This assessment shall be based on a
reasonable medical judgement that relies on the most current medical knowledge
and/or on the best available objective evidence. In determining whether an individual
would pose a direct threat, the factors to be considered include:
a.
b.
c.
d.

The duration of the risk;

The nature and severity of the potential harm;
The likelihood that the potential harm will occur; and
The imminence of the potential harm.

Baseline data, which should be kept separate from this individuals personnel
file, has been collected. This data includes measurements and documentation
of evaluees:
Musculoskeletal history
Active and passive joint movements of the spine, legs, and arms
Muscle strength including back strength
Flexibility
Lifting ability and technique
This information should be kept on file and used to periodically review evaluees
performance status to encourage employee to be responsible for his or her own wellbeing. This information should be used as a reference point if this evaluee sustains an
injury and his or her pre-injury status is needed.
2. Comments:

80

POST-OFFER FUNCTIONAL SCREEN EVALUATION

FOR SELECTOR AND UTILITY POSITIONS
A. History
1. Name:
2. Date of Exam:
3. Prior to fitness testing, is there any physical reason why you should not
participate in this testing evaluation?
No
Yes
If yes, please explain:
B. Testing of Essential Physical Job Demands
1. Selector Procedure
Job task: client will lift 80 lbs. from floor, carry it 5 feet, and place weight at a
1-foot height
Client
was
was not able to perform the task with safe lifting
technique.
2. Selector Procedure
Job task: client will lift 40 lbs. from waist level, carry it 5 feet, and place
weight at a 5-foot height
Client
was
was not able to perform the task with safe lifting
technique.
C. Lifting Technique
Poor
Severe postural deviations noted throughout static positioning and dynamic
movements. Requires Maximum to Dependent assistance to assume the
proper position or technique.
Below Average
Unable to maintain a spine-neutral position while performing a lifting
technique without three or more of the following Near-Maximum Effort
Signs:

Average
Above Average
Superior

81

1. Assessory Muscles
2. Posterior Trunk Lean
3. Elbow Extension
4. Hands Slipping/Difficulty Holding Box (Decreased Box Control)
5. Shaking/Quivering
6. Raises on Tip-Toe (Compensatory Strategies)
7. Vertical Trunk Alignment Decrease
8. Props Box on Thigh
9. Irregular Steps
10. Increased Thoracic Kyphosis with Protraction of the Shoulder Girdle
Able to maintain a spine-neutral position while performing functional lifting
with fewer than three Near-Maximum Effort Signs
Able to maintain a spine-neutral position while performing functional lifting
with No Near-Maximum Effort Signs
Able to maintain a spine-neutral position while performing repetitive
functional lifting (5 connective lifts) with No Near-Maximum Effort Signs

D. Flexibility
1. Hamstrings (supine, leg extended, hip passively flexed with knee held in
extension)
R
L
2. Hip Flexion (supine, actively flexed hip and knee)
R
L
3. Shoulder Range of Motion
R
Comments, if not full range of motion (FROM),___________________________
_________________________________________________________________
L
Comments, if not FROM_____________________________________________
__________________________________________________________________
4. Back
Toe touch
Heel walk
5. Knees
Full squat

1. Hamstrings
2. Hip Flexion

inches from floor

can perform

cannot perform

can perform

cannot perform

Flexibility Key
Poor Below Avg. Average
<45
45-60
60-70
<114 114-122
123-135

Above Avg.
70-80
136-140

Superior
>80
>140

E. Strength
1. Back extension* (prone, hands behind head):# _______________________
2. Abdominal curls* (hands behind head): #
_______________________
3. Push-ups or modified push-ups for women* (elbow must go to full extension
and at least 90 of flexion): #
4. Grip Strength
R
Percentile
L
Percentile
*must be continuous in a one-minute time frame
Strength Key
1. Back extension
2. Abdominal curl
3. Push-ups
4. Grip Strength
(see chart)

82

Poor
<6
<11
<6
10th%

Below Avg.
26-38
11-22
6-14
25th%

Average
39-51
23-44
15-30
50th %

Above Avg.
52-66
45-54
31-42
75th%

Superior
>66
>54
>42
90th%

F. Cardiovascular Fitness
BP
/

Pulse

Respirations

Perform 3-minute step test on a 12-inch-high bench with a stepping rate of 24

steps per minute
Pulse after exercise
G. Hand & Wrist Testing
Tinels sign
Right
Left
Phalens sign
Right
Left
Finklesteins
Right
test
Left

+
+
+
+
+
+

H. Impression
Poor

Below Avg.

Average

Above Avg.

Superior

Lifting Technique
Essential Job Demands

Pass

Fail

Pass / Fail
If lifting technique poor or unable to pass essential job demands, client fails. Do not
proceed with rest of test.
Strength 35%

14

21

28

35

Flexibility 15%

12

15

Cardiovascular
Fitness 35%
(see chart)

14

21

28

35

Hand & Wrist Testing 15%

Total Score

Pass
Pass (>75 points)

Fail
Fail (<75 points)

Comments:

P.T.

83

Health Care Provider

APPENDIX J
TOOLBOX FOR MANUFACTURING
CUT/SEW

84

This is an example of a simple checklist for manufacturing.

WORKSTATION CHECKLIST
Negative responses require further investigation, rank by number of "no" responses
Job:

Department:

Analysis performed by:

Start date:

Completion Date:

1) Does the workspace allow the operator full range of movement?

Yes

No

2) Are workaids and/or accessories available?

Yes

No

3) Can the height of the work surface be adjusted easily?

Yes

No

4) Can the work surface be tilted or angled?

Yes

No

bending or twisting at the wrist?

Yes

No

reaching behind the midline of the body?

Yes

No

reaching above the shoulder?

Yes

No

static muscle loading?

Yes

No

full extension of the arms?

Yes

No

raised elbows?

Yes

No

lifting bundles over 20 pounds from a seated position?

Yes

No

6) Are the workers able to vary posture?

Yes

No

7) Are the hands and arms free from sharp edges on work surfaces?

Yes

No

8) Is an armrest provided where needed?

Yes

No

9) Is a footrest provided if needed? Or can the treadle be adjusted?

Yes

No

10) Is the floor surface flat and free of obstacles?

Yes

No

Yes

No

12) Are chairs or stools easily adjustable and suited to the task?

Yes

No

13) Are all task elements visible from comfortable positions?

Yes

No

5) Is the workstation designed to reduce or eliminate:

11) Are cushioned floor mats provided for employees required to stand
for long periods?

85

This is an example of point assignment checklist based on duration of exposure.

RISK FACTOR

<1 Hr

1-4 Hr

4 Hr >

0
0

1
0

3
1

5-15 lbs

>15<30 lbs

>=30<50 lbs

>50 lbs

easy

>=30<50 lbs

heavy

>5<15 lbs

>=15<30 lbs

>30 lbs

Neck/shoulder: bend/overhead

Extended reach

Elbow / forearm twist

Hand / wrist : bend/pinch

Trunk - twist / bend

Knee: squat/kneel

USING POWER TOOLS

PRESSURE POINTS

SAME POSITION

ENVIRONMENT - cold/hot,
light/glare, vibration

CONTINUOUS KEYBOARD
USE

INCENTIVE WORK or NO
WORKER CONTROL OVER JOB
PACE

REPETITIVE
every few seconds
every few minutes
LOAD FORCE (lift)

LOAD FORCE (push/pull)

LOAD FORCE (carry > 10 ft.)

AWKWARD POSTURES :

TOTAL SCORE = 10 or more?

86

CAUSE OF
RISK
FACTOR

PROPOSE
D
SOLUTION

COMMENT

This is an example of an observation form for a workstation.

COMPANY:

FACILITY:

OPERATOR
OPERATION

ANALYST:

PRODUCTION INFORMATION:
# OF OPERATORS PERFORMING JOB
SHIFT start:

DATE:

Job rotation plan

SHIFT end:

work

BREAK SCHEDULE :
DAYS PER WEEK :

ENVIRONMENT:

COMPONENTS :
ELEMENTS:
EQUIPMENT :
TOOLS:
NOISE :

DUST:

LIGHTING:
POSTURE OBSERVATION
FEET INTERFACE:
Right

Left

UPPER / LOWER LEG POSTURE:

UPPER LEG / BACK POSTURE:
CHAIR INTERFACE:
SHOULDERS:
NECK FLEXION:
NECK DEVIATION:
LEFT ARM / ELBOW / SHOULDER:
Abduction / adduction
Forward / backward
Rotation
LEFT HAND:

Deviation
Flexion / extension
Rotation

RIGHT HAND:

Deviation - ulnar / radial

Flexion / extension
Rotation

RIGHT ARM / ELBOW / SHOULDER:

Abduction / adduction
Forward / backward
Rotation
REPETITION:
CYCLE TIME OBSERVED:
CYCLE TIME STANDARD:
FORCE:
static
lifting
pedal activation pressure
contact
comments

87

pinch

rest min

APPENDIX K
TOOLBOX FOR WAREHOUSE

88

MATERIALS HANDLING CHECKLIST

Negative responses indicate potential problem areas that should receive further
investigation.
Job: _________________________

Department: ________________________

Analysis performed by: _______________________________________________

Start Date: ____________________ Completion Date: _____________________
1. Are the weights of loads to be lifted judges acceptable by the
workforce?
2. Are materials moved over minimum distances?
3. Is the distance between the object load and the body minimized?
4. Are the walking surfaces:
level?
wide enough?
clean and dry?
5. Are objects:
easy to grasp?
stable?
able to be held without slipping?
6. Are there handholds on these objects?
7. When required, do gloves fit properly?
8. Is the proper footwear worn?
9. Is there enough room to maneuver?
10. Are mechanical aids used whenever possible?
11. Are working surfaces adjustable to the best handling heights?
12. Does material handling avoid:
movements below the knuckle height and above shoulder height?
static muscle loading?
sudden movements during handling?
twisting at the waist?
extended reaching?
13. Is help available for heavy or awkward lifts?
14. Are high rates of repetition avoided by:
job rotation?
self-pacing?
sufficient pauses?
15. Are pushing or pulling forces reduced or eliminated?
16. Does the employee have an unobstructed view of handling the task?
17. Is there a preventive maintenance program for equipment?
18. Are workers trained in correct handling and lifting procedures?

89

Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No

90

91

APPENDIX L
TOOLBOX FOR OFFICES

92

Performance Oriented Ergonomic Checklist For VDT/Computer

Workstations
(adapted from ErgoWeb, by the Cornell University Human Factors Group, Dept. Design
& Environmental Analysis, 1996)
Introduction
Among Ergonomists there is general agreement with regard to proper computer
workstation set-up, and the optimal body postures assumed by people performing tasks at
the workstations. Unfortunately, quick and easy solutions to ergonomic problems, such as
wrist rests, seldom help and sometimes they actually make matters worse. Likewise,
recommending specific dimensions for workstations without knowledge of the
anthropometrics of each user, the dimensions of equipment, and the nature of the work to
be done can result in sub-optimal workstation arrangements.
This performance oriented checklist is designed to help you to evaluate what is needed
for a good ergonomic workstation arrangement. Specific dimensional constraints
intentionally are omitted and replaced by a principles-oriented approach for this checklist.
A checklist is a guide to good decision-making, not an end point in itself. No checklist
alone is able to capture the interactions and complexities of all possible combinations of
people, task, equipment, and work environment. However, use of this checklist, along
with an understanding of the principles of Ergonomics, should allow you to identify
workstations which need redesign work, and it should give you guidance on the goals of
any workstation redesign that is required.
At a minimum, while using this checklist, remember that designing for ergonomics
requires understanding and consideration of

the physical and psychological attributes of the person or population of people

that will perform the job;

the design and arrangement of the workstation furniture, computer hardware,

computer software, and other workstation accessories;

the tasks required to perform the job; and

the work environment, including such things as noise and temperature, but also
management and organizational methods and constraints.

The interaction between these general topics is critical and will define the postures
assumed, forces exerted, and repetitions performed by the person(s). Remember, all parts
of the body are linked together. Consequently, a modification in one area may have
significant impact on another no single change can be performed without considering
the effects on other areas. For example, lowering seat height so that someone may
comfortably rest his/her feet on the floor may force a stressful upper body posture if the
monitor position and table or keyboard height are not adjusted in concert (this is often a
good reason to provide a footrest).

93

When using this checklist,

ask not whether the person can merely achieve these general goals, but whether
the design of the workstation, task, and environment interfere with, obstruct, or
outright inhibit a person from achieving them.

remember that it is worded for use when reviewing one person and that person's
VDT/computer workstation, tasks, and working environment. If more than one
person must use the same workstation, the checklist should be applied to each
individual, and an easily adjustable workstation becomes even more important.

remember that there is no "perfect posture for all time" and that a dynamic posture
(frequent changes in posture) is a good way to reduce stress and redistribute
pressure related to long duration static postures. However, work can be sustained
for longer times without causing harm if the person is working in a neutral
posture.

remember that the checklist is not all inclusive, and may not cover all of the topics
important to your specific situation.

remember that a good ergonomics approach should improve comfort,

productivity, and quality, as well as health and safety.

"NO" responses indicate conditions that may be associated with higher risk of
illness/injury and steps should be taken to address the source of the problem. "YES"
responses to questions indicate acceptable ergonomic design conditions.

94

VDT/Computer Workstation Posture Checklist

1. POSTURE
"NO" answers to ANY posture question identify the item that may be contributing to
ergonomic risk and this should be addressed immediately. For a more detailed and
systematic analysis of postural risks, this checklist should be followed up by undertaking
a Rapid Upper Limb Assessment ( RULA) analysis of the worker's posture.
Lower Body

Is the person able to rest the feet comfortably?

Is the person able to sit with the knees in a comfortable position?

Is the person free of uncomfortable pressure points, obstructions, or other

interferences in the lower extremities?

Upper Body

Is the person able to work with the head in an upright position, without bending
the neck to the side or forward greater than 20?

Is the person able to work with the head facing forward of the plane of the upper
body the majority of the time, such that repetitive or long duration head rotation is
minimized?

Is the person able to reach to objects on the workstation without extended

reaching, especially where the reaching is held for long durations, is repetitive, or
requires trunk/torso deviations?

Is the person able to work with comfortable arm positions, or approximately:

o neutral shoulder positions (upper arms tucked close to the body and
hanging relaxed, not abducted out to the side, extended forwards or
backwards, raised up, or hunched)?
o comfortable elbow positions that do not force shoulder or elbow positions
from approximately neutral?
o neutral wrist positions (hands in a straight line with the lower arms, hands
not flexed down towards the palm not extended up, nor bent towards the
little finger, nor bent towards the thumb)?

Force Static Body Posture

95

Do the workstation design and job requirements cause non-neutral body positions
to be held constant for extended periods of time?

2. WORKSTATION AND ENVIRONMENT DESIGN FEATURES

Seat Surface

Is the seat surface height-adjustable, such that the person is able to set it at an
individually comfortable height in relation to the required work activities?

Is the seat surface of appropriate size, such that it is deep and wide enough to
comfortably accommodate the specific person?

Is the seat slope adjustable, such that the person is able to achieve a comfortable
angle, either forward or rearward sloping?

Is the seat comfortable and is the front well rounded ("waterfall" front edge), such
that the person does not experience excess pressure on the under side of the leg
due to the forward edge?

Overall, is the seat comfortable to the person who is required to use it?

Seat Backrest

Can the person easily adjust the height of the backrest to provide mid-lumbar
support (lower back region)?

Can the person easily adjust the angle of the backrest relative to the seat surface?

Can the person easily adjust the backrest to alter the depth of the seat?

Overall, is the backrest comfortable to the person who is required to use it?

Work Surface

With the lower limbs in comfortable positions and feet on the floor, can the
person achieve a comfortable work surface height?

Is the width of the work surface appropriate, such that all required task
accessories and duties can be located within comfortable reach and viewing
distance?

Is the work surface sufficient to place the computer, and keyboard if necessary,
directly in front of the person and provide for an upright posture?

Is the area under the desk large enough to accommodate the legs and any
accessories, such as footrests and arm rests?

Computer Monitor/VDT

96

Is the person able to easily adjust the height of the monitor?

Is the person able to easily adjust the distance of the monitor forward and back?

Is the person able to easily adjust the tilt (up/down) angle of the monitor?

Is the person able to easily adjust the left/right rotation of the monitor?

Keyboard

Is the keyboard detachable from the VDT/computer monitor?

Is the person able to easily adjust keyboard height?

Is keystroke pressure comfortable to the person?

Has the person correctly adjusted the angle of the keyboard so that the
hands/wrists are in a neutral posture when typing? Placing the keyboard in a
preset angle-negative-tilt keyboard tray that is height-adjustable and allows users
to access the keyboard in a wrist-neutral posture.

Mouse

Is the shape and button activation comfortable and easy to operate for the person?

Is the person able to reach and operate the mouse without extended, long duration,
or repetitive reaching and with the shoulders, arms, and wrists in a neutral
posture?

Is the mouse on a position-adjustable platform surface, so that this can be used

within the person's immediate reach zone?

Document Holder for Data Entry Tasks

Is there a special holder or support for the source document?

Is the person able to easily adjust the document holder height, distance, and
angle?

Does the device prevent the document from vibrating?

Is the device located such that the person is not required to twist the head/neck
back and forth between the document and screen extensively or for long
durations?

Support for the Hands and Arms

Are seat or other padded armrests available?

Are armrests adjustable (height, lateral position)?

Is a broad, flat keyboard palm support available to support the hands in a neutral
posture in between bursts of typing movements?

The wrist rest is not to be used to support the hands during typing.

Most wrist rests are soft and curved, which can put extra pressure on the
carpal tunnel and increase the probability of a musculoskeletal disorder.

Is the palm supported for mouse use?

Support for the Feet

97

Are the feet flat on the floor when the person is sitting comfortably at the
workstation?

Is a footrest available if needed and can the height and tilt be easily adjusted?

Office Lighting

Are lighting levels in the VDT/computer monitor area comfortable to the person?

Is the monitor screen placed such that light from windows and overhead lighting
do not cause glare? If not, are glare screens or other glare-reducing methods used?

Are diffusers or louvers used on overhead lights to reduce the possibility of glare?

Is indirect lighting used?

Are movable task or desk lights available?

Do work surfaces have a matte finish to reduce light reflection?

Do windows have curtains, drapes, or blinds to block light where glare from that
source is a problem?

Temperature

Is the person comfortable with the ambient temperatures?

Is the person comfortable with the temperatures of any equipment or surfaces she
or he must contact?

Vibration

Is the person exposed to any uncomfortable building vibration (e.g. from

mechanical systems, outside traffic)?

Is the person exposed to uncomfortable equipment vibration (e.g. from internal

fans)?

Is the person exposed to any uncomfortable keyboard vibration (e.g. wobble from
an unstable keyboard tray)?

Noise

Are sound levels at comfortable levels, allowing conversation and other

communications without significant effort?

Is the person exposed to any uncomfortable equipment noise (e.g. printer noise)?

Ventilation

98

Is air circulation sufficient?

Is air quality satisfactory?

Is the air too dry or too humid?

Electrostatic Electricity

Is the person exposed to static electricity shocks?

3. THE WORKER
Fatigue Control

Is the person allowed to take rest pauses or breaks from tasks that require long
duration or repetitive postures, forces, keying, or mousing activities?

Is there job rotation or substitution of tasks which require a different type of

activity where posture, force, and repetition hazards have not been addressed by
design?

Vision

Does the person wear bifocal glasses, causing him/her to tilt the head to see
through the appropriate lens area?

Are workers with symptoms of eye strain, burning sensation in the eyes, blurred
vision, irritated eyes, or headache examined for vision problems?

Psycho-Social Issues

Does the person have some involvement and control over the work process?

Is there good communication between the person and supervisors?

Has the person been adequately trained?

Is the software "user-friendly"?

If you answered "NO" to any of the questions in the Worker section of this checklist,
administrative issues may be contributing to ergonomic risk. A review of training and
other administrative policies is recommended.
A note regarding "ANSI/HFES 100-1988, American National Standard for Human
Factors Engineering of Visual Display Terminal Workstations."
The recommendations in "ANSI/HFES 100-1988, American National Standard for
Human Factors Engineering of Visual Display Terminal Workstations," while often
relied upon for ergonomics guidance, are influenced more by anthropometry (body
dimensions) than by the full spectrum of ergonomics principles that should guide the
design of furniture, tools, equipment, and tasks for computer workstations. ANSI/HFES
100-1988 is centered around the "upright" sitting posture, sometimes referred to as the
"90-90-90", or "90 degree" posture, indicating the approximate joint angles at the hip,
knees, and elbows. This is not the only posture available for seated workers, not the only
posture supported by furniture designed to be used for computer intensive work, and not
a recommended working posture for sustained periods. ANSI/HFES 100-1988 is
currently being revised, and is scheduled to be open for public review in the near future.

99

This is an example of a simple yes/no checklist to establish priority for further analysis.
OFFICE WORKSTATION CHECKLIST
Negative responses require further investigation, rank by number of "no" responses
Job:
Analysis performed by:
Start date:

Department:
Completion date:

1) Are keying / mouse activities interspersed with other tasks?

Yes

No

2) Does the person perform pause exercises with change of focus?

Yes

No

3) Are the keyboard tray and mouse at the same height and angle?

Yes

No

4) Is the desktop adequate to accommodate all work tasks?

Yes

No

5) Is the workstation designed to reduce or eliminate:

bending or twisting at the wrist?

Yes

No

bending or twisting of the back?

Yes

No

bending or twisting of the neck?

Yes

No

glare from light sources?

Yes

No

full extension of the arms?

Yes

No

raised elbows?

Yes

No

sharp edges?

Yes

No

6) Is the top of the monitor screen at or slightly below eye level?

Yes

No

7) Are the feet supported by the floor or a stable foot rest?

Yes

No

8) Does the seat provide: full width support, lumbar support, and clearance
behind the knee?

Yes

No

9) Is the wrist rest only used for breaks between keying tasks?

Yes

No

10) Are the chair and keypad tray adjustable?

Yes

No

11) Does the area beneath the work surface provide adequate clearance
for thighs, legs and feet?

Yes

No

12) Is the task free of frequent forceful exertions (stapling, lifting)?

Yes

No

13) Are the thighs above knee level and the knees at least 90 degrees?

Yes

No

14) Does the person use the telephone with the head in a neutral
Position and shoulders relaxed?

Yes

No

15) Is the source document for typing held at the same height and angle
as the monitor screen?

Yes

No

100

101