Articles on ergonomics

Better Workplace: Ergonomics at Work

Dr. Amol Kadu, Orthopedist
What is "ergonomics"? Ergonomics means “Fitting the job to the worker.”Ergonomics... is the science and practice of designing jobs and workplaces to match the capabilities and limitations of the human body. As early as in18th century doctors noted that workers who required to maintain body positions for long periods of time developed musculoskeletal problems.Within last 20 years, research has clearly established connections between certain job tasks and RSI or MSD. To understand the problem we should know what are the reasons behind these problem. What two elements are at work?•       Static work: Musculoskeletal effort required to hold a certain position, even a comfortable one.•       Force:  Amount of tension our muscles generateThese forces cause excessive and repetitive stresses on the muscles, joints and tendons and gives rise to various musculoskeletal problems. Hence, it becomes imperative for us to create a working environment which is ergonomically fit for the work.Benefits of Ergonomics•       Ergonomics helps to prevent injuries •       Ergonomics Improves quality of work •       Improves quality of life & Reduced fatigue and discomfortWhat? Overuse injuries, soft tissue injuries which occur gradually also known as Cumulative Trauma Disorders (CTDs) or Repetitive Strain Injuries (RSIs) are Work-related  Musculo-Skeletal Disorders(WMSD). Common WMSDs are:•       Carpal tunnel syndrome•       Slipped spinal discs•       Rotator cuff tendinitis•       De’quervain’s tendinitis•       Trigger finger•       Carpet layer’s knee•       Tennis elbow       Heavy, frequent, or awkward lifting, pushing, pulling or carrying loads, working in awkward postures, intensive hand work, like pinching, gripping, repetitive postures, vibrations are the common causes of WMSDs.The common symptoms are painful joints like wrist, knees, shoulders, tingling, numbness in fingers, severe nagging pain in both legs and feet, severe back ache or neck pain, reduced range of movements in joints, loss of grip or difficulty in holding objects.To avoid these problems, dictum "Prevention is better than cure" fits perfectly... So ,lets start by knowing how we can avoid these problems. To get started:a)      Warm up & stretch before activities that are repetitive, static or prolongedb)      Take frequent breaks from ANY sustained posture every 20-30 minutesc)       Respect pain   -  positions or stop painful activityd)      Recognize early signs of inflammatory process, & report  earlye)      Maintain proper postures while sitting and standingf)       Avoid lifting heavy weights.g)      Slide objects instead of lifting them h)      Store heavy items where  you won’t have to bend or reach to lift themi)        Use ladders to get items down from high shelves.j)       Hold objects closer to your body when liftingThe key is to Relax yourself at work. Its really important to create ergonomical habits and environment at work place to protect yourself.•       Take "stretch pauses": Take frequent breaks from ANY sustained posture every 20-30 minutes. •       Improve your posture •       Move around as much as possible•       Warm up & stretch before activities that are repetitive, static or prolonged•       Recognize early signs of inflammation •       Help yourself to avoid such problems.•       Understand your work and do it right way.•       Work towards improving your working conditions•       Be ergonomical at work.•       Reporting problem early is important.It's really important to realise the importance of ergonomics at work and follow it at work. Otherwise , over the months & years the work will take its toll on your body.So, be fit and keep ur workplace fitter!

Workplace Ergonomics to Prevent Back Pain

Dr. Uthra Mohan, Physiotherapist
While most people consider pain as a negative symptom, it is in fact the body’s method to let you know that something is wrong. Back pain has become the most common problem of present generation due to sedentary lifestyle, long working hours, bad posture and lack of fitness. It is no more just a problem of aged population.Can young people get chronic back pain?The answer is yes. Working for prolonged hours without breaks or strenuous work can often lead to chronic back pain. Fortunately, there are simple ways to prevent it.Work ergonomics for desk jobChair: Use chair with back rest up to your shoulder. Make sure that the back support is at 90 degrees to sitting surface. Always sit all the way back in your chair such that your hip is in contact with your back rest. Use chairs with arm rest so that your forearm can be supported.Feet: Preferably your feet should be touching the floor, not dangling in the air. Adjust the chair height accordingly or use a footrest.Knee:Your knees should at 90 degrees angle.Desk: Your desk should be at around your elbow level, so that you do not need to keep your shoulders elevated or lean forwards towards the table to work.Computer: When using computer, place the screen at eye level. While typing or using the mouse, keep your wrist in neutral position.Check your back posture every hour and correct it.Take shorts breaks after every 2-3 hours. Use this break to change your position or walk around for few minutes. Simple spine exercises like Mckenzie's (in sitting or standing position) can help to relax the spine muscles and alleviate the strain.Additional work ergonomicsAvoid frequent bending and twisting. Do a pivot turn instead of twisting from spine. Those having sitting job may use swivel chair.When carrying heavy bags, hold it close to your body. Preferably use backpacks instead of side bags.When lifting heavy objects from the ground, try squatting instead of bending forwards.How to know whether your posture is right?Correct posture is one of the foremost essentials to prevent back pain. There are simple steps to know whether you are maintaining proper back posture. A physiotherapist can guide you about how to check and correct it.Those having spondylosis or any other spine conditions, should seek additional medical advice for taking care of their spine.How to maintain right posture for long duration?Our posture is maintained by co-ordinated activation of postural muscles. It is necessary to have adequate strength in these muscles to keep up a proper posture.Even young people may develop postural muscle weakness due to strenuous work, habitual bad posture, sedentary lifestyle or lack of exercise. As age progresses, spondylosis can further aggravate this muscle weakness.Simple exercises targeting these muscles can help to build up their strength. You may consult a physiotherapist to assess your muscle strength and get a customized exercise protocol planned.

Physiotherapy Plus Ergonomics - for Total Wellness!

Dr. Aditi Kulkarni(P.T), Physiotherapist
Do you need an advice on injury prevention or other aspects of musculoskeletal or neurological conditions? Do you wish to improve your physical performance for sports? Are you planning to return to routine exercises following prolong period of inactivity or injury? Or planning to go out on adventure trip? The answer to improve your functional capacity or quality of life is physiotherapy under supervision of qualified physiotherapist.Physiotherapist & Ergonomist of “Be Active” clinic, Dr Aditi Kulkarni says “Physiotherapy has both curative and preventive disciplinary aspects”. As it is a drugless therapy it has become an integral part of healthcare industry and is becoming more & more popular among all age groups.In Be Active clinic physiotherapy, relaxation technique, tapping, electrotherapeutic modalities such as SWD, IFT, TENS, Wax Bath, EMS, Ultrasound and Traction machine along with lifestyle modification tips with the help of ergonomics are available under one roof.With the combination of above mentioned therapies one can hasten body’s natural healing processes by maximizing recovery & ensure optimal outcome on long-term basis, even in post operative rehabilitation and in chronic neurological conditions like Parkinson’s, Multiple Sclerosis, Paralysis, etc.Dr. Aditi also mentioned “ age or work related joint aches or dysfunctions, chest complications or sport injuries like pulled hamstrings, stress fractures, Osgood shatter disease/ runners knee, carpel tunnel syndrome, heel pain, ankle injuries or sprain” are some of the problems which can be cured completely with the help of physiotherapy and ergonomics.With the experience of practising in this field Dr. Aditi feels the real success of any treatment lies in healthy and happy atmosphere and cooperation between the therapist, patient and his family.

Fix Your Posture and Reduce the Risk of Back Ache With These 5 Simple Tips

Dr. Geetanjali Jha, Homeopath
A good posture is the first step to get rid of many small health issues.Pain in back due to bad posture !What exactly is this "good posture"? A good posture or an ideal posture is one that you acquire when you walk with a book kept on your head. Try it and see what happens to your body when you are trying to balance the book on your head and walking. This is what happens -1) You do not slouch.2) Your back is straight.3) Your head is held high and does not wobble.4) Your chin is pointed forward.5) Your shoulders are relaxed ( they should be if they are not).6) You walk in a straight line and with easy confident and deliberate steps.Right and wrong way to walk .This is a good posture , a healthy posture while standing up and walking. Similarly, imagine yourself sitting down, all of the above points should be in place except for the 6th point, while sitting in an ideal posture.The benefits of maintaining a good posture- 1) Strain on the nerves, muscles and ligaments is reduced.2) The risk of spinal curvature and spondylitis is reduced. 3) Body is relaxed.4) The stress on the alignment of bones and joints is reduced.5) Helps in preventing the abnormal wearing out of joints.6) Aids proper blood circulation throughout the body.7) Helps in getting better sleep.8) Reduces the risk of headaches of all kind.9) Prevents back pain.10) Last but not the least, helps to maintain a good appearance. Tips to acquire and maintain a good posture for relief in back pain and other related problems.1) The first step is awareness- In the above given points you have read the characteristics of a healthy posture. Pay attention to your body and check out if your posture checks out on all the 6 points. If not, try to correct which ever point is lacking on your own. If that is not possible, then check out the following steps. 2) Walking consciously - As mentioned above, walk as if an object is kept of your head and you have the responsibility of not letting it fall. Wear comfortable shoes if you are practicing out of home and if you are inside your home, you may practice bare foot. Better still, place a medium sized book on your head and walk at least 200 steps, including equal number of turns to the left and right. With 20 days of practice in this manner you will notice that your walk is become straighter, you  body is feeling lighter and more relaed and the pain in your back is reducing. If you were facing more problems like insomnia, cervical pains and pain in other joints, that shall also reduce. 3) Heel to hip position - Spread a yoga mat or a carpet on the floor and lie down with your back flat on the floor. Now bend your knees towards the ceiling and bring your heels towards your hips as much as you can, the target is to touch the heels to the hips, arms by your side. But do not over stretch in the first attempt. Now try to push your back into the floor as much as you can. Give 5 pushes , then relax your arms. Do this exercise 3 times. Then just relax, and lie down.4) Isometric exercise - These exercises strengthen the bones, joints and muscles. The key point of isometric exercise is that there is very little movement and more focus on holding a posture for as long as possible. This brings balance and strength in the core muscles and relieves back pain. A few of the positions one can practice are - (A) Wall pushing - Place your palms flat on the wall and stand upright at your arm's length. Bend your elbows breath out through your mouth and push yourself towards the wall. Hold this position for as long as possible, start with 5 seconds. Now take a breath in through your nose and push your self back to the starting position. Stay in this position for the same amount of time as you did in last position. Repeat 5 -10 times.Wall pushing.(B) Chair pose - stand with your back straight. If you want you can touch your back to a wall to maintain this posture. Bring your arms up in front of you like we do while taking an oath, but do it with both arms. Now take a deep breath, and exhale through your mouth while bending your knees and lowering your body to a position like sitting in a chair. Balance this posture for 5 seconds. Inhale and get up straight. Relax for 5 seconds, repeat 5 times. Chair pose.(C) Planks - One of the most famous and most practiced isometric eercise. Lie on your stomach, chin on the floor, palms at shoulder level, and toes on the floor for balance. Take a breath in and push yourself up with your hands, make sure your back is not arched but is straight like a wooden plank. Ask someone to watch your posture. Stay in this pose for a few seconds, as long as you can hold. If your body trembles in the beginning, it is normal. Slowly lower yourself down and ehale. Rela for a few seconds. Repeat 3-5 times. Planks.5) Yoga - Yoga is the best way to correct an unhealthy posture. A few of the best yoga poses for good posture are - (A) Taadasan - Stand with your feet about 2 inches apart. Relax your shoulders. Bring up your arms straight and clasp them at their maximum height. Now breath in and simultaneously stretch your arms further up and stand up on your toes. Imagine as if some body is pulling you up. Hold your pose and breath for a few seconds. Slowly exhale, bring down your arms and heels. Repeat 3 times.Taad asan.(B) Tiryak taadasan - Stand with your feet apart, the gap should be approximately as much as your shoulders. Clasp your arms up straight. Breath in , now bend side ways to the right while exhaling. Inhale and come back to starting position. Exhale and bend towards the left side. Inhale and come back to original position. This completes 1 round. Do 2 more rounds of this asana.Tiryak taad asan.(C) Surya namaskar - Surranamaskar is a series of 11 asanas, all of which have been known to relieve back pain and help in correcting the posture. Surya namaskar can be learnt from a yoga teacher and videos are also available on the internet. Practicing surya namaskar not only gives relief in back pain, but also corrects digestive disorders, helps in speeding up the metabolism, burns fat and generates strength from within and does much more good to the body. Surya namaskar.So correcting your posture is not all that hard, and comes with a lot of benefits in addition to getting rid of the back pain. Practice all or few of the above given tips and enjoy a healthy and happy body       

'Computer' Vision Syndrome? But I Do Not Work on a Computer!

Dr. Manoj Rai Mehta, Ophthalmologist
Computer Vision Syndrome (CVS) is now recognised as an "occupational illness" that afflicts people working on computer screens for extended hours of time.  With the advent of "smart phones" the screen has shrunk in size and the CVS has assumed proportions of a "Pandemic" and is no longer restricted to IT professionals alone!  Let us try to establish a connection between different variables that interact in this complex situation:Screen size and illumination vary from flat screen monitors to laptops to tablets to smart phones.  Background illumination.   Font size is variable to a significant extent as also the background colour and contrast.There are pictures, movie clips, animation clips, geometrical designs of different shapes that need quick processing by brain.Ergonomics of an office/work place or household.Posture.   The distance at which a screen is held. From office the CVS has invaded households and now every family member is at risk including household helpers!  Thus CVS is caused by interaction of several factors- small screen, small font size, fast moving images on a small screen, strong illumination of screen, bad posture, poor background illumination.  A smart phone can be carried any where and young adults who get hitched to it can carry it to their bed and peer at the screen without regular blinking in any posture, close to face for an indefinite time.Symptoms of CVS are non specific but nagging and annoying: Watering of eyes, irritation, burning sensation, brow-ache, headache, deep ache in the head, tiredness, lack of freshness, redness of eyes etc.  There are posture related symptoms also such as neck stiffness, pain in the neck, back stiffness and pain etc.All the symptoms are exaggerated by lack of quality sleep, inadequate rest, lack of breaks during work, anxiety etc.Management is simple-ergonomic setting up of computer screens/laptops in the offices.  Periodic breaks for relaxation.  Open areas in offices for fresh air and relaxation from focusing at near distance.  Lubrication of eyes with preservative free artificial tear eye drops, rolling of eyes and blinking completely a couple of times.  Stretching exercises for neck and back under supervision.  Avoid smoking and excessive consumption of tea/coffee under misconception of freshening up. Watching television or a movie after a long day is no relaxation for eyes, in fact it is additional stress.  Play outdoor games instead. Tablets and smart phones use should be curtailed, at least for watching movies, serials, matches etc.  Increase font size for a comfortable reading.  Do not take tablets and mobiles to bed and keep them away from bedside for charging as well.    Good habits, disciplined life style with regular exercise and balanced diet helps in keeping CVS away.   

What Is Ergonomics?

Dr. Vishwas Virmani, Physiotherapist
Ergonomics is the process of designing or arranging workplaces, products and systems so that they fit the people who use them.Most people have heard of ergonomics and think it is something to do with seating or with the DesignRailway train seatsSeats for forkliftsCommercial kitchens - design, fitoutCrane cabin designDesign of rehabilitation equipmentDesigning for disabled usersDisabled workers: modification of equipment to suitEmergency Services Rooms - design, layoutIndustrial hand trucks: designKerb design and risksLocomotive cabin interiorsOutpatients' departments: designShip interiorsSupermarket entrancesSupply stores and their layoutSpace planning generallyTrolley design (hospital)Warehouse design and layoutSearch and rescue operations - control room" class="glossaryLink " style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; font-size: 13px; line-height: 20px; font-family: Verdana; box-sizing: border-box; text-decoration: none !important; color: rgb(109, 109, 111); border-bottom-style: dotted !important; border-bottom-width: 1px !important; border-bottom-color: rgb(0, 0, 0) !important;">design of car controls and instruments – and it is… but it is so much more. Ergonomics applies to the DesignRailway train seatsSeats for forkliftsCommercial kitchens - design, fitoutCrane cabin designDesign of rehabilitation equipmentDesigning for disabled usersDisabled workers: modification of equipment to suitEmergency Services Rooms - design, layoutIndustrial hand trucks: designKerb design and risksLocomotive cabin interiorsOutpatients' departments: designShip interiorsSupermarket entrancesSupply stores and their layoutSpace planning generallyTrolley design (hospital)Warehouse design and layoutSearch and rescue operations - control room" class="glossaryLink " style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; font-size: 13px; line-height: 20px; font-family: Verdana; box-sizing: border-box; text-decoration: none !important; color: rgb(109, 109, 111); border-bottom-style: dotted !important; border-bottom-width: 1px !important; border-bottom-color: rgb(0, 0, 0) !important;">design of anything that involves people – workspaces, sports and leisure, HealthVaricose veins and their prevention (flight attendants)" class="glossaryLink " style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; font-size: 13px; line-height: 20px; font-family: Verdana; box-sizing: border-box; text-decoration: none !important; color: rgb(109, 109, 111); border-bottom-style: dotted !important; border-bottom-width: 1px !important; border-bottom-color: rgb(0, 0, 0) !important;">health and SafetyDiving boards and their propertiesDangerous Goods assessmentsCrash testing of vehiclesDogs biting postmenDrilling - offshore oil and gasElevated work platformsExplosives manufactureFelling treesFirefightingFlight attendant uniformsFlying a helicopterGas and oil platforms (offshore)Guarding of machines (training, advice)Guarding of pressesHarnesses (and safe restraint)Helicopters - pilot's flying positionLaying explosivesOff-shore oil platformsPetrol stationsQuarry workRefuelling jet aircraftRibbed roofs and working on themSafety harnesses and similar restraintsSawmills and work performed thereShot blastingSterilisation (hospitals)Laboratory safetyReducing slips in a soap factorySlips and falls generallyEscalators" class="glossaryLink " style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; font-size: 13px; line-height: 20px; font-family: Verdana; box-sizing: border-box; text-decoration: none !important; color: rgb(109, 109, 111); border-bottom-style: dotted !important; border-bottom-width: 1px !important; border-bottom-color: rgb(0, 0, 0) !important;">safety.Ergonomics (or ‘human factors’ as it is referred to in North America) is a branch of science that aims to learn about human abilities and limitations, and then apply this learning to improve people’s interaction with products, systems and environments.Ergonomics aims to improve workspaces and environments to minimise risk of injury or harm. So as technologies change, so too does the need to ensure that the tools we access for work, rest and play are designed for our body’s requirements.Why is Ergonomics important?In the workplace: According to Safe Work Australia, the total economic cost of work-related injuries and illnesses is estimated to be $60 billion dollars. Recent research has shown that lower back pain is the world’s most common work-related disability – affecting employees from offices, building sites and in the highest risk category, agriculture.Ergonomics aims to create safe, comfortable and productive workspaces by bringing human abilities and limitations into the DesignRailway train seatsSeats for forkliftsCommercial kitchens - design, fitoutCrane cabin designDesign of rehabilitation equipmentDesigning for disabled usersDisabled workers: modification of equipment to suitEmergency Services Rooms - design, layoutIndustrial hand trucks: designKerb design and risksLocomotive cabin interiorsOutpatients' departments: designShip interiorsSupermarket entrancesSupply stores and their layoutSpace planning generallyTrolley design (hospital)Warehouse design and layoutSearch and rescue operations - control room" class="glossaryLink " style="font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; font-size: 13px; line-height: 20px; font-family: Verdana; box-sizing: border-box; text-decoration: none !important; color: rgb(109, 109, 111); border-bottom-style: dotted !important; border-bottom-width: 1px !important; border-bottom-color: rgb(0, 0, 0) !important;">design of a workspace, including the individual’s body size, strength, skill, speed, sensory abilities (vision, hearing), and even attitudes.

Ergonomics in Dentistry:

Dr. Yogesh Rao, Dentist
Introduction- Prior to 1985, low back pain was the most commonly reported musculoskeletal disorder (MSD) or repetitive injury for dentists and dental hygienists. Since then, there has been a rise in MSDs from extended workdays, awkward postures, prolonged standing/unsupported sitting, and a host of other problems caused by poorly designed workstations, improper work habits, and instruments that are difficult to manipulate. The current workstation in most dental officesrequires that the practitioner lean forward, flex his neck forward and laterally, hold his shoulders abducted and his arms flexed, with this position being held statically for most of the workday.Dentists need to tightly grip thin, sharp instruments and make a high volume of short, forceful movements with the muscles of their wrists and hands to treat heavy calculus and other conditions. The human body is not built to handle these kinds of stresses, and the positions in which dentists repeatedly put themselves through their work place them at great risk for developing MSDs.                                    Conditions can vary from mild recurrent symptoms to severe and incapacitating. Early symptoms of MSDs include pain, swelling, tenderness, numbness, tingling sensation, and loss of strength. These injuries result in costly insurance payments, extended periods of time away from work, and decreasing work performance, job satisfaction, and energy levels. For many dental practitioners, musculoskeletal pain and the development of repetitive strain injuries have caused them to take a leave of absence, shorten their work hours, reassign their duties to other dental staff, or undergo surgery, and some dentists have been forced into premature retirement. Until recently, this problem has not been given much attention, but with increasing numbers of dentists developing painful symptoms, changes must be made to the way they practice to allow for longevity in their careers.Some Signs of MSDs•Decreased range of motion•Loss of normal sensation•Decreased grip strength•Loss of normal movement•Loss of coordinationSome Symptoms of MSDs•Excessive fatigue in theshoulders and neck•Tingling, burning, or other painin arms•Weak grip, cramping of hands•Numbness in fingers and hands•Clumsiness and dropping ofobjects•Hypersensitivity in hands andfingersSome Risk Factors for MSDs•Repetition•Forceful exertions•Awkward postures•Contact stress•Vibration•Poorly designedequipment/workstation•Improper work habits•Genetics•Medical conditions•Poor fitness level•Physical/mental stress•Lack of rest/recovery•Poor nutrition•Environmental factors•Poor lightingOff theJob Activities That Can Contribute to MSDs•Home computer use•Repetitive activities using thefingers•Sports activities•Prolonged/awkward postures athome•Use of household tools•Activities involving repeatedheavy lifting, bending, twisting, or reachingMSD HazardsAwkward PosturesPosture is a term used for the position of various parts of the body during an activity. For most joints, a good or “neutral” posture means that the joints are being used near the middle of their full range of motion. The further a joint moves towards either end of its range of motion, or the further away from neutral, the more awkward or poor the posture becomes and the more strain is put on the muscles, tendons and mligaments around the joint. For example, when arms are fully outstretched, the elbow and shoulder joints are at the end of their range of motion. If an individual pulls or lifts repeatedly in this position, there is a higher risk of injury (OHSCO, 2007).The use of awkward postures is perhaps the greatest risk factor for those in the dental field. Researchers have confirmed the presence of awkward postures specifically in the neck, back, shoulders, hand and wrist for dental professionals. Awkward postures are often adopted due to improper seating, improper patient positioning and/or poor work techniques. Common awkward postures in dental practice include elbow and wrist flexion and thumb hyperextension, which have been shown to stress neurovascular structures and ligaments.Static PosturesStatic postures are defined by those which are held for a long period of time and may result in fatigue and injury. Oxygen is delivered to the muscles and joints by blood. When a posture is held for a prolonged period of time there is a reduction in blood flow to the tissues. This results in a reduction of nutrient and oxygen supply with lactic acid and other metabolites accumulating, which can result in pain and tissue damage. Researchers have found that even 30 degrees of forward shoulder flexion or abduction can cause a significant impairment in blood circulation within the shoulder / neck region (Jarvholm, 1989). Furthermore, dental practitioners have been observed statically holding postures requiring greater than 50% of the body’s musculature to contract. This results in increased muscular effort which can lead to muscle overload, decreased blood flow and increased pressure on muscles and joints (Park 2009). Static gripping for durations exceeding 20 minutes was also noted during instrumentation tasks within dental practice (Sanders, 1997).ForceForce refers to the amount of effort created by the muscles as well as the amount of pressure placed upon a body part. All tasks require workers to use their muscles to exert some level of force, however, when a task requires them to exert a level that is too high for a particular muscle, it can damage the muscle or related tendons or joints and/or other soft tissue (OHSCO, 2007).An example of a gripping task requiring high force application could be holding small instruments for a prolonged period of time. This task is commonly performed with a pinched grip where the fingers are on one side of the object and the thumb is on the other. This form of gripping is undesirable as it requires a much greater force application than a power grip (object in the palm of the hand). Researchers have suggested that excessive use of a pinch gripping is the greatest contributing risk factor in the development of MSDs among dental hygienists (Sanders, 1997). Additionally, scaling procedures involving both waving and rotary motion power strokes have been classified as the most demanding task required of hygienists (Horstman, 1997).Repetitive MovementsThe risk of developing an MSD increases when same or similar parts of the body are used continuously, with few breaks or chances for rest. Highly repetitive tasks can lead to fatigue, tissue damage, discomfort, and, eventually injury. This can occur even if the level of force is low and the work postures are not awkward (OHSCO, 2007).VibrationAlthough vibratory tools are used in the dental field research has shown that the daily vibration exposure of dentists is relatively low with respect to the exposure action value (European Union Vibration Directive, 2010). A long work history in dental filling and root treatment as well as high BMI seem to be associated with frequent finger symptoms perceived as vibration-related by dentists.Health EffectsWristThe risk factors associated with dental work that most commonly affect the wrists are chronic repetitive movements, awkward and static positions, mechanical stresses to digital nerves such as sustained grasps on instrument handles, extended use of vibratory instruments and inadequate work breaks. The wrist is in constant demand, often sustaining excessive and repeated stresses and strains. The safest position for the wrist is a straight or neutral position. Special care should be used to avoid bending the wrist downwards (flexion) or outwards (ulnar deviation).Carpal Tunnel Syndrome (CTS)CTS is one of the most common problems that affect the hand and wrist. CTS occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers (although not the little finger), as well as impulses to some small muscles in the hand that allow the fingers and thumb to move.Tendonitis of the WristTendonitis is an inflammation of tendons, which are the structures that attach muscle to bone. Tendonitis of the wrist is accompanied by pain, swelling and inflammation on the thumb side of the wrist, and is made worse with grasping and twisting activities (e.g. polishing and scaling). People with this disorder have often noted an occasional “catching” or snapping when moving their thumbGuyon’s SyndromeGuyon's canal is a space at the wrist between the pisiform bone and the hamate bone through which the ulnar artery and the ulnar nerve travel into the hand. Compression of ulnar nerve occurs in this space at the base of the palm. It is commonly caused by repetitive wrist flexing or excessive pressure on palm/base of hand. It is characterized by pain, weakness, numbness, tingling, burning in the littlefinger and part of the ring finger.NeckPain and discomfort are the most common complaints reported in the neck/shoulder region amongst dental professionals. Studies have also shown that female dentists reported neck symptoms 1.4 times more often than male dentists (Mangharam, 1998).Myofascial Pain Disorder (MPD)MPD is characterized by pain and tenderness in the neck, shoulder, arm muscles, and a restricted range of motion. Possible causes include overloaded neck/shoulder muscles.Cervical SpondylosisThis disorder is characterized by intermittent/chronic neck and shoulder pain or stiffness, headaches, hand and arm pain, numbness, tingling, and clumsiness. Possible causes include age-related spinal disc degeneration leading to nerve compression and spinal cord damage, arthritis, and time spent with the neck in sustained awkwardpostures.Disc ProblemsIn a seated posture the pressure in the lumbar discs increases by 50% as compared to standing. Additionally, sitting in an unsupported posture can cause twice the amount of stress as compared to standing. During bending (forward flexion) and twisting (rotation) motions of the spine, the pressure on the lumbar discs increases by 200% (Fisk, 1987). This type of pressure on the disc can lead to a bulge or herniation, causing compression on a spinal nerve.Some Tips for Working With Good Posture:(1) Always try to maintain an erect posture. By positioning your chair close to the patient, you can minimize forward bending/excessive leaning over the patient. Keep your feet flat on the floor to promote a neutral or anterior tilt to your pelvis, which keeps your back aligned and promotes the natural curvatures of your back. Remember that your head weighs as much as a bowling ball, and when you lean forward and flex your neck, you force your muscles to hold up the weight of your head, rather than the bones and discs in your spine.(2) Use an adjustable chair with lumbar, thoracic, and arm support. Having a good chair is essential in maintaining good posture, because what you sit on provides the base of support from which you work all day long. When you think about it, you work 8 or more hours per day, 5 days per week, 4 weeks per month, and about 11 months out of the year, which makes a highquality chair with adjustable features well worth the cost of saving your back, neck, arms, and hands. You should look for important features like adjustable height, width, tilt, backrest, seat pan, and armrests, because in most dental offices many people of different sizes use the same workstation.(3) Work close to your body. Position your chair close to your patient, and position your instrument tray close to you. This way, you don’t have to overextend yourself to reach your patient or your instruments, putting excessive stress on your back, shoulders, and arms. Think of the 90° rule of having your elbows, hips, knees, and ankles all forming 90° angles. If you find yourself reaching out far beyond these angles too often, then you’re not properly positioned and you should adjust the position of your chair/instrument tray.(4) Minimize excessive wrist movements. Be conscious of how you position and move your wrists, and try to keep them in a neutral position (palms facing each other, shoulder width apart with wrists straight), which puts your muscles and tendons in a much better relationship to perform the work. You will have to move your wrists into various positions as you work on your patients, but try to be aware of these movements so you can minimize potentially damaging hand positions.(5) Avoid excessive finger movements. When you combine the excessive forces needed to hold your instruments with the amount of repetitions that you perform each day, you can see the tremendous toll that this takes on the small muscles of your fingers. Retrain yourself to use your shoulders and arms to position your hands, rather than making the small, forceful movements with your fingers.(6) Alternate work positions between sitting, standing, and side of patient. Switching positions allows certain muscles to relax while shifting the stress onto other muscles and increasing your circulation. When you work on alternate sides of the patient or rotate the position of your instrument table, you allow each side of your body to share the stress, rather than performing the same motion in the same way, which causes cumulative trauma in the overused side.(7) Adjust the height of your chair and the patient’s chair to a comfortable level. If your chair is too low and the patient’s chair is too high, this causes you to elevate your shoulders and can lead to neck problems and pinched nerves. Alternately, if your chair is too high and the patient’s chair is too low, you’ll have to flex your neck down and bend your wrists back to compensate, which can lead to neck and hand problems. Remember the 90° rule and keep your elbows at a 90° angle with your wrists straight and shoulders relaxed.(8) Consider horizontal patient positioning. If your workstation allows the patient to be reclined into a horizontal position, this allows you to sit above the patient’s head with good ergonomic posture, and you can use each arm equally in more natural positions. If the workstation does not accommodate this position, consider buying a quality reclining chair for the patient when you replace the old one.(9) Check the placement of the adjustable light. Position the adjustable light so you don’t have to strain your neck to be able to see in the patient’s mouth. It is important to adjust this light with each new patient because of the different height of each person. The light should be adjusted again when a new dentist uses the workstation because his/her sitting eye height is different, and this will affect his/her ability to see into the patient’s mouth(10) Check the temperature in the room. Make sure the temperature in your workspace is not too cold because this will decrease the circulation and blood flow to your extremities. Most often, the dental work environment is damp and cold, so be certain to wear gloves and warm up your hands before working on a patient.Referernces-1) Ergonomics in Dentistry, Part 1 | Dentistry Today2) Occupational Health Clinics for Ontario Workers

Office Ergonomics Checklist

Dr. Vishwas Virmani, Physiotherapist
There are simple yet effective office ergonomics checklist that you can carry out at your workstation, to make sure you’re comfortable, safe and productive at the office.1. Posture – Activity – ExerciseMaintain proper posture, paying careful attention to positioning of head, neck/spine, arms/wrists, hips/thighs and feet. Basically, ensure the small of your back is supported, your shoulders relaxed (not slumped, not elevated), and that there is no pressure under your thighs.Alternate between different postures on a regular basis.When keyboarding, use minimum force while striking the keys.Keep a neutral position, where the forearms, wrists and hands are in a straight line.Avoid awkward reaching for work tools such as telephone, mouse and reference materials.Avoid resting elbows, forearms or wrists on hard surfaces or sharp edges.Take frequent mini-breaks throughout the day to give muscles and joints a chance to rest and recover.Alternate between work activities which use different muscle groups to avoid overuse.Give eyes a break by closing them momentarily, gazing at a distant object and blinking frequently.Proper exercises are a complement to a complete office ergonomics program. Consult with us to select appropriate exercises.2. Lighting – Air – NoiseMaintain appropriate light levels for specific tasks. More illumination is usually needed to read a document than a computer screen.Reduce or eliminate glare by using window shades, diffusers on overhead lighting and anti-glare filters for computers.Adjust the contrast and brightness on your computer screen to a comfortable level.Get a regular eye exam and if necessary, wear corrective lenses. Tell your eye specialist how often you use the computer.Clean the computer screen and other surfaces regularly.Reduce the number of dust collecting items like papers and files on your desk.If necessary, use a portable air cleaner to reduce airborne particles like dust, pollen and mold.Maintain a comfortable temperature by using layers of clothing or a portable fan or heater.Be considerate to others working in the area and conduct meetings and conversations in appropriate areas.Position fabric partitions to reduce noise from conversations, foot traffic and equipment, like copiers and printers.Identify distracting noises and try headphines, ear plugs, soft music or a quiet fan to reduce or mask the noise.3. Work Style – Organization – BreaksReduce stress by planning ahead and setting realistic expectations for what you can accomplish during the workday.Organize your workload to help even out busy and slow times, to avoid feeling “swamped”.Vary tasks to make the day more interesting. For example, deliver a message in person instead of phoning.Avoid long periods of repetitive activity. For example, alternate computer work with other tasks like phone calls, filing, copying and meetings.Organize equipment, supplies and furniture in the most efficient arrangement for daily tasks.Enhance privacy by using office partitions and privacy filters for computer screens or documents.Acknowledge ideas and accomplishments of co-workers on a regular basis.Develop stress reduction and relaxation techniques which work for you at the office and at home.Personalize your office with a few favorite items, like artwork, photos and plants.Take mini-breaks that re-energize, invigorate and refresh.Follow these same ergonomic guidelines at home, in meetings and while travelling.