As you might know, there is much social buzz about the health concerns related to sedentary work, especially for those who sit for the majority of their workday. There is also a common misconception that anyone who sits to do their work, should stand up for their right to kick the chair to the curb and exclusively use a standing work station. This move, may in fact create new risk factors that will have you looking for that chair again.
 
The ergonomic research motivating us to stand supports the idea that when compared to sitting, the position of standing creates less compression forces on our low back, in addition to the more obvious benefits of increased circulation to your extremities and the increased caloric expenditure. What isn’t talked about as much is the idea that moving from static sitting, to static standing is not much of an upgrade. Just ask anyone who stands for the majority of their workday. These folks often experience low back pain, heel or forefoot pain, muscle fatigue and other discomforts.
 
We are designed to be moving creatures, doing work that uses a variety of positions and muscle groups. Therefore, it holds true that we should be designing our workstations to move with us. Instead of throwing out your existing office furniture, look around and get creative.
 
Here are some practical workstation options to choose from, which allow a single user to change positions while they work:

(Whichever option you choose, remember to use a desktop stopwatch or widget to limit your sitting and standing to an hour, and stretch between positions.)

1. Create a standing station that also allows you to sit. This may require you to install a counter height desk or table (slightly lower than your elbows when standing). You will need a monitor riser or arm. If you use a laptop, you will need a laptop stand and an external keyboard. Have an ergonomic task stool with foot rest ring handy for the standing station if you need to perch a cheek, or take a quick break from standing.

2. Create a height adjustable work station by purchasing a unit that attaches to a standard desk to allow you to adjust the unit up or down, from sitting in an ergonomic task chair to standing, with products such as an Ergotron, Varidesk, or other. These move the keyboard and monitor up and down with some adjustment. 

3. Purchase a height adjustable desk surface that moves up and down as you do. An adjustable keyboard tray and monitor arm will be required for ergonomic positioning as you move from sitting to standing. You will require an ergonomic task chair for the sitting position.

It is important to know the ergonomic guidelines for setting up sitting and standing workstations. See our customized Office Stretching Poster and Ergonomic Guidelines Poster at http://enablingaccess.ca/shop-enabling-access-inc-ergonomic-and-stretching-posters.html

Marnie Courage, OT Reg. (MB)
Managing Director
Enabling Access Inc.
 

A concussion is a mild traumatic brain injury caused by a blow to the head, neck or upper body and may include symptoms such as a headache, dizziness, nausea or loss of consciousness. Unfortunately, some people go undiagnosed, or misdiagnosed and continue to experience memory, attention deficits, poor emotional control, and other lasting symptoms, which prevent them to returning to work months after their injury.

Returning to work after a physical injury is difficult and with a concussion, the experience is complicated further by the interfering cognitive and psycho-emotional symptoms. Often folks are returned to work too quickly without the appropriate supports in place, or healthcare providers are waiting for the employee to recover before recommending a return to work plan.

The following are some tips for case managers and employees when returning to work following a concussion:

1)    Once the initial 3-4 week acute injury phase has passed, don’t wait until the employee has “recovered” before returning to the workplace. Instead, discuss opportunity for modified duties as the employee learns to manage their symptoms while being exposed to increasing physical and cognitive demands.

2)    Understand that this RTW plan may take longer than a standard 4-6 weeks, as unlike physical injuries, the complexity of symptoms experienced by someone with a concussion may necessitate more time.

3)    Consider psychological treatment for co-existing mental health conditions like depression and anxiety that may be associated.

4)    Determine workplace accommodations required, prior to the employee returning to the workplace to reduce risk of being overwhelmed.

5)    Ensure all cognitive, perceptual, and physical limitations are being accommodated, by involving an occupational therapist.

6)    Consider a gradual return to work experience to build tolerance to the physical and cognitive demands of the job.

7)    Promote good communication between the employee, the employer and the case manager/therapist to ensure a dynamic return to work plan that is flexible to change with the employee’s needs.

8)    Consider allowing the employee to seek quiet/dark space periodically through their shift to reduce the sensory overload they may be experiencing. If employee is sensitive to light allow a visor or sunglasses to be worn.

9)    If computer work is involved, symptoms of headaches and nausea can be aggravated. Allow for gradual exposure and breaks for sustained monitor work. Avoid scrolling tasks and instead read full page before scrolling down to next section.

10) Daily communication is required with the employee to assess if the accommodations are helping and to come up with possible solutions to help manage any other aggravated symptoms.

Marnie Courage, OT Reg (MB)
Owner/ Managing Director
Enabling Access Inc.
marnie@enablingaccess.ca
www.enablingaccess.ca 

The following tips can help prevent musculoskeletal disorders from developing and promote good ergonomics in the classroom:

1. Sit/Stand Teaching - alternate between standing and perching on a teller stool to prevent static positions and fatigue.

2. Introduce Standing Work Stations - bar height tables at the side or back of the room, to allow students opportunity to stand and learn.
3. Introduce 2 minute movement breaks, every 30 minutes, and have students alternate the leading of stretching routine.
4. Avoid awkward postures - reduce writing on chalk/white board above shoulder height; use podium or standing height desk for reading books/documents to class.
5. Wear low heeled footwear that support the arch and cushion the forefoot, if standing the majority of the workday.
6. Keep a water bottle on your desk to keep you hydrated and promote walking to fill it up the bottle, and to use the bathroom on breaks.
7. Have a therapy ball or mov’n sit cushion available to allow students who have difficulty sitting still to have some movement built into their day. Use a signup sheet, so everyone gets a chance to move and learn.
8. Use good computer ergonomics-Set up the keyboard and mouse at same height; raise/lower chair so wrists are flat on the keyboard (not bent); use a foot rest if feet not supported on floor; raise or lower monitor so you are looking straight at the top 1/3 of the screen; ensure space between edge of seat and behind knee; raise backrest to lumbar cushion supports the curve of your low back.
9. Pin up stretching posters and ergonomic guideline posters in the classroom a resource.

10. Identify and report any environmental ergonomic risk factors in your classroom or with the furniture in your classroom, so your supervisor can address and mitigate the risks.

Marnie Courage, OT Reg. (MB)
Owner & Managing Director
Enabling Access Inc.

Just as an antagonizing strain of virus infects a population and a new vaccine is created to fight it off, symptoms of Presenteeism sneak up on a workplace long before Absenteeism does, and the treatment is all in the prevention.

“Presenteeism is the action of employees coming to work despite having a sickness that justifies an absence and as a consequence, they are performing their work under sub-optimal conditions.”[1]

Some may ask why these employees don’t take time off, and from what surveys have uncovered, it has more to do with the pressures they feel to stay at work and the workload that will be waiting for them when then return. Many workplaces make the error of measuring absenteeism and sickness rates and figure if those numbers are low and productivity is good then their employees are generally healthily.

The unfortunate truth is that many employees, who are undergoing stressful events in their life (either at home or at work) are pushing through life with a mental health affliction that is not being treated, gets worse, and can lead to long term disability claims.

Presenteeism possible causes:

• High production expectations
• Role Conflict
• Relationship issues with co-workers/supervisors
• Reduced decision authority
• Fear of job security

Possible costs to the Workplace:

• Reduced production
• Reduced Morale
• Toxic Workplace Culture
• Us Versus Them
• Absenteeism
• STD/LTD claims

The vaccine is not a single dose and instead takes multiple doses in the form of Mental Health Check-Ins. A workplace should examine the health of its employees on a continuous base, instead of asking for a doctor’s note once the employee reports an illness. Having human resource policies in place that support employees and provide regular health assessments that include mental health screenings can be the early intervention the employee needs to get back on track.

Learning about workplace conflicts before they erupt, can be very helpful in diffusing situations and keeping employees happy and healthy. Having a Conflict Resolution Specialist, Counsellor or Occupational Therapist at close hand could be a powerful vaccine. Creating a workplace culture of acceptance, trust and respect may be difficult to build, but one based on mistrust, unfair workloads and pressures to attend, can easily fall.

[1] C. Biron et al., “At work but ill: psychosocial work environment and well-being determinants of presenteeism propensity,” Journal of Public Mental Health, 5 (2006) 26  

Marnie Courage, OT Reg. (MB)

Owner /Managing Director

Enabling Access Inc.

marnie@enablingaccess.ca

If your workstation includes an “L-shaped” desk, you may be positioned in the corner of the two desks, where your computer is located. Often one desk is designated for paper work and the other is chaired for coworkers or client interactions. Many of you would say this is how the workstation was set up when you were assigned the office space and so that is how it has remained. There are a few ergonomic risks that exist for employees who are positioned in the corner of two desks that I wanted to share:

Risk Factors:

1. The armrests on your chair most likely hit the front edge of the desks as you approach the corner to do your computer work. I have met many people that have removed their armrests, so they don’t interfere with positioning the chair closer to the corner of the desks. Without arm rests your upper back and shoulders do more work supporting your arms and by mid-day your body is fatiguing, posture is compromised and discomfort sets in.

2. If your armrests are still in place you probably are not able to get close enough to your keyboard and mouse on the desk surface, requiring you to reach to access those tools. This forward reach causes discomfort between your shoulder blades, upper back and shoulders.

3. Further discomfort in the corner position can be caused by your chair being positioned too low in relation to the desk. The lower you are seated, the more shoulder shrugging, elbow abduction (away from the body) that is demonstrated. This awkward positioning results in upper back, shoulder and neck discomfort.

Quick Fixes and Cautions:

DO NOT REMOVE YOUR ARMRESTS. These accessories are required to support your forearms and allow your shoulders to relax while you work and should be positioned at a height so your elbows are bent at 90 degrees.

Ask for a “Corner Creator” which is a flat piece of plastic or metal and sits on the desk surface between the two desks to create a straight edge. The keyboard and mouse are positioned close to the front edge of this Corner Creator and will allow you to move your chair closer to these devices without interference from your armrests or without having to reach to your keyboard.

If you can, reposition your computer, keyboard and mouse to the straight edge of one of the two desks, (you may need longer computer cords from IT).  Working at this straight edge will allow you to get closer to your work, prevent reaching and the resulting discomforts.

Marnie Courage, OT Reg. (MB)

Managing Director

Enabling Access 

Marnie@enablingaccess.ca

Whether your company was introduced to the world of social media via your tech savvy IT rep or you were strong-armed into joining the conversation by the ever growing influence of young employees, the result is the same: You have opened the can of time sucking worms that social media is. If it is your role to keep up with health and safety best practices, networking with other safety professionals or staying on top of professional development opportunities, then you need to focus on how to use your social media time wisely.

Here are some social media tips for health and safety folks to keep current and still keep up with your workload:

1. Create measurable objectives for your social media program. For example:

"To keep customers and employees up to date with company health and safety initiatives, industry news, and engage potential employees and customers in discussions relevant to the health and safety of our employees by posting educational web resources and intelligent perspectives on trending topics, using built-in social media analytics to track followers, impressions, comments and clicks."

2. Establish rules for who posts to these sites and what gets posted.

3. Create a schedule for your social media tasks broken down into daily, weekly and monthly tasks including searching for relevant web resources and news, updating status, and engaging in discussions.

4. Use social media management applications like Tweetdeck or Hootsuite to see at a glance what others are posting, who is mentioning your company and to schedule posts to more than one site by saving your drafted status to post at a later time. 

5.  Concentrate your time to complete your tasks instead of "surfing" the web and social media sites throughout your day. Use the timer on your computer to limit the time you spend searching for information to post and reading posts. If you are short on time there is no harm in reposting someone else's posts as long as you work in original thoughts regularly.

6. On Twitter use keywords to search for relevant information like #ergonomics, #safety, #health, #wellness, etc.

7. Follow news and journal publications relevant to Health and Safety to keep current with industry news.

8 Use blog readers like RRS, Blogger and others to narrow down Health and Safety blogs to follow.

9. Don't hesitate to "unfollow" or "unlike" anyone who is posting information not relevant to Health and Safety so you are not bombarded by information you need to weed through.

10. Be transparent in your posts. If the post is provocative then expect negative comments and always respond to negative comments, even if you need to recant a statement or admit you did not represent your company's opinion.

Please share here any other tips Health and Safety professions would benefit from so we can be more mindful of how we spend our social media time. 

Marnie Courage, OT Reg (MB)

Owner/ Managing Director

Enabling Access

In the disability management world, returning an injured employee back to work has presented many challenges for the HR departments of industrial companies. Often the jobs are physically demanding and offering modified or light duties can create friction between employees who continue to do the hard work and the injured employees who get to do “the easy stuff”.

Pressure to accommodate injured workers from Workers Compensation Boards,  and  threats of being fined by Provincial Workplace Safety and Health, keep disability management staff motivated to create jobs that injured workers can return safely to.

Unfortunately, these modified duties may include tasks that do not contribute to maintaining or improving the productivity of the workplace.  In addtion, often these injured employees are conducting these duties for an undefined amount of time. Moreover, the cost of  the WCB claims and bringing in other employees to cover the injured worker’s job tasks may negatively affect productivity and have a financial impact on the company.

Disability Managers should be challenging physician’s to clearly define the physical restrictions of the injured workers by having them  review the job demands analysis of the target job and checking off the duties that the patient should be able to safely conduct. Most importantly, they should be encouraged to stipulate exactly how long the injured employee is restricted so they don’t end up in modified duty wasteland.

Where appropriate, the employer can order a Functional Capacity Evaluation to objectively and functional test which tasks the injured employee is safely able to perform.

If the Disability Manager is getting frustrated with return to work options, creating modified duties for injured employees or having trouble getting injured workers off modified duties, they could invite their Workers Compensation Adjuster to discuss options for accommodation within reason and have independent medical assessments conducted to challenge the employee's physican's note.

Marnie Courage, OT Reg. (MB)

Owner/Managing Director

Enabling Access

There is much written about workplace ergonomics, specifically dealing with risk factors that may result in musculoskeletal injuries, including repetitive strains, which account for almost 50% of workplace injuries in Manitoba (Safe Work MB). Less is written about the ergonomics of housework that present similar risk factors and may lead to injuries preventing you from doing the job of living.

Think about the tasks you do during your workday, the positions you assume and the strength requirements you meet in your daily work tasks. If you are engaging in activities and tasks at home that involve the same positions, and present similar strength requirements, your risk for injury is increased.
 

Consider a person who’s job is mainly computer based, involving static seated positioning, requiring a flexed neck to read documents on the desk, involving repetitive typing and filing. They should be aware that exposing themselves to household tasks with these physical demands, such as spending extended time on the home computer, flexing their neck when standing to do dishes at the sink and over the counter for meal preparation, scrubbing to cleaning the bathtub, etc will present similar ergonomic risk factors.

Reduce your exposure to ergonomic risks at home by:

1. Limit or break up the activities you engage in at home that require the same awkward postures, repetitive movements and forces on your body that you are exposed to in your workday.
2.  Have family members take turns doing more physically demanding tasks by creating a sign up chart so everyone knows their tasks for the week.
3. Try not to do all your chores in one afternoon and instead spread them out over the week.
4. Build in stretch breaks to tasks that require awkward postures like bending, twisting, reaching, etc.
5. If grocery shopping and lugging bags from the car puts you at greater risk of injury because you do similar physically demanding work, consider purchasing a grocery deliver service.

6. When taking out the garbage try filling two smaller bags instead of one big one to carry and distribute the weight evenly between both sides of your body.

7. Purchase a long handled dust pan and use a Swiffer wet jet instead of bending down if you have symptoms in your low back.

8. You can use a swiffer wetjet in your bathroom to clean your tub and avoid awkward twisting and bending needed to scrub the tub.

9.On your days off try to set goals that will allow for rest time so you can recharge and have energy to get your list of chores completed.

10. Remember to use proper body mechanics when lifting, bending and reaching during your chores to protect your back and limit your exposure to ergonomic risks at home.

Mrnie Courage, OT Reg. (MB)

Owner/Managing Director

Enabling Access

marnie@enablingaccess.ca

Running my business from my home office with a seven month old has forced me to modify how I work. Instead of spending hours in front of my desktop computer up in my office, I am grabbing fifteen minutes here and there on my smart phone and tablet whenever and where ever I can .This change in working behaviour has brought with it new aches and pains that no APP (that I can find) will fix.

With devices getting smaller and more portable to keep up with the busy lifestyles we lead, the physical demands have changed but the work related aches and pains have followed. Repetitive Strain Injuries are common and our busy fingers, thumbs, and wrists are taking the heat. Here are a few tips to reduce discomfort and increase productivity in our tech savvy day:

• Pain in the thumb-Thumb pain can be related to texting with the thumb when holding the mobile device in the same hand. Instead hold the phone in one hand use index finger of the opposite hand with full arm movements, so you are not making small repetitive  movements with the finger. Of course this might mean you will have to put down your coffee.

• Pain in the neck -Instead of holding the phone to your ear with neck flexed to the side, use the Hands Free option, unless you are listening to a co-worker vent about your jerk of a boss, when he is sitting in your office.

• Pain in the neck-The portability of a tablet far surpasses the ergonomics. To use a tablet, you either hold it in your hands or set it on a table/desk to use. The nature of its design requires that you flex your neck down to view. When possible,  bring your tablet up closer to your eye level to reduce upper back and neck pain, and don’t use your tablet on your tummy  while lying in bed, as your neck will surely be flexed and you might just fall asleep waiting  for a cat video to load.

Pain in the eyes- When reading web content on your device, the continous scrolling requires that you read moving  text, for some this can causes eye strain or headaches, and if you are me....motion sickness. Scroll down and read the whole screen before you scroll again. Virtual vertigo can feel very real!

• Pain in the eyes- If you wear glasses, but don’t always have them on, you may have trouble reading the font on your phone. Go to your settings and  increase the size of the font so you can leave your glasses where you lost them.

• Look for “short cut” key combinations to reduce the number of keystrokes or button pushing on your phone or tablet or use voice activation when you can, to dial a contact, or search the web for delivery options at 11 pm, because you just realized you haven’t taken you r eyes off your device since you got home from work.

• Wrist pain- Using a touch on-screen keyboard on a tablet is slow and requires that your wrists be extended (bent up) to type on the screen in front of you. To reduce wrist pain, get a tablet cover with WIFI keyboard, and make writing long emails, reports or editing your kid’s resume so he will actually get a job and move out someday.

There seems to be an APP for everything, but until someone comes up with one that will help us tweak our tech behavior to prevent injuries, we might want to listen to our bodies whispers of discomfort before they become screams of agony.

Marnie Courage OT Reg. (MB)

Owner of Enabling Access

marnie@enablingaccess.ca

One challenge that small and large businesses have in common is being able to afford the strategies that they believe will lead them to achieving their business goals. Certainly, one of those strategies is to retain and protect valued employees by ensuring their health and safety at work. The costs associated with workplace injuries, employee lost time, WCB and disability claims far outweigh the costs of implementing some proactive ergonomics.

Here are some cost effective ergonomic considerations that will help your staff stay safe and will help you stay within your budget:

1. Provide ergonomic screening assessments and accommodation for all new employees to ensure the proper set up of furniture and accessories and to prevent future musculoskeletal injuries. This could be a simple checklist tool that outlines ergonomic risk factors for chair, desk and accessory set up and include commonly recommended items for quick implementation.

2. Provide ergonomic education to new and existing employees to promote healthy working behaviors, proper body mechanics and will teach them how to recognize symptoms of MSI's, so early intervention can be introduced before their condition becomes chronic.

3. Choose task chairs that accommodate most of your employees, offering adjustable seat depths and backrest heights. For the very short, very tall and very wide, there are some chairs that you can order different sized seat pans and back rests to mix and match as your employees require. One example is the Global Tritek Ergo Select.

4. Create an Ergonomic Solutions Catalogue for your workplace that includes products from your office supply and furniture vendors, as a go-to list of commonly prescribed ergonomic solutions. This will make it easy to quickly implement the solutions when ergonomic risk factors have been identified.

5. Provide Ergonomic Assessor Training for designated employee/s to conduct the ergonomic assessments in house, saving on professional consultation fees associated with each ergonomic assessment that will be required.

6. Get connected with social media; namely Facebook, LinkedIn and Twitter, using the hashtag #ergonomics, read blogs and evidenced based articles on ergonomics to keep current with best practices in the field.

If you are part of a large business, creating an ergonomics committee using your WPHS group is a great way to get the topic of ergonomics on an agenda. If you are part of a small business, appointing an Ergonomic Coordinator would be the first step to creating accountability and designating some of the above duties. Regardless of the size of the company, the goal is the same; spend as little as possible and protect your employees as much as you can. 

If you have some cost-effective ergonomic methods that have been successful in your workplace, please share!

Marnie Courage, OT, Reg(MB)

Owner/Managing Director

Enabling Access

marnie@enablingaccess.ca

As an occupational therapist that is seven months pregnant, I am writing about this topic to bring awareness to employers and to other pregnant employees, the essential accommodations that should be considered and provided to working pregnant women. The literal pain in my butt that is shooting down my leg as I sit here typing away at my computer, is my reminder that accommodation is not just about an employer's responsibility to have a job waiting for the pregnant employee upon their return from maternity leave, but about providing administrative, environmental, and ergonomic supports to reduce her pregnancy symptoms while accommodating the physical and physiological changes that occur over those 9 months. The employer's goal should be to promote comfort and productivity as well as prevent musculoskeletal injuries from developing in their valued pregnant employee.

Pregnancy definitely morphs a women's body inside and out, so it is not surprising that there are changes to the musculoskeletal system that places us at risk of acquiring an musculoskeletal injury like carpal tunnel syndrome, low back pain, sciatica, pelvic girdle pain and many other pregnancy-related conditions (curses).

Healthy pregnant women gain on average 25 to 35 pounds, if they started off with a healthy BMI. However if the woman is overweight before pregnancy or gains more than the average weight during pregnancy, the stressors to the musculoskeletal system are increased. To complicate the risks there are also waves of hormonal and chemical changes that make us forget what "Normal" ever felt like. Here are some examples of how these changes impact our bodies:

Forces across weight bearing joints are increased.

Exaggerated lordosis (lumbar curve) of the lower back, forward flexion of the neck, and downward movement of the shoulders typically occur to compensate for the enlarged uterus and change in center of gravity. Stretching, weakness, and separation of abdominal muscles further impede neutral posture and place even more strain on muscles that support the spine.

Joint laxity in the anterior and posterior longitudinal ligaments of the lumbar spine creates more instability in the lumbar spine and can predispose to muscle strain.

There is widening and increased mobility of the sacroiliac joints and pubic symphysis of the pelvis in preparation for the fetus' passage through the birth canal.

A significant increase in the anterior tilt of the pelvis occurs, with increased use of hip extensor, abductor, and ankle plantar flexor muscles Stance is widened to maintain trunk movement.

Fluid retention can cause compression of certain vulnerable structures such as the median nerve in the wrists or the sciatic nerve in the lower back and legs.

Let's not forget about the well-known symptoms that affect most us as at some point in the pregnancy (or all the way through for other) like morning sickness, fatigue, difficulty concentrating and forgetfulness (Baby Brain).

With this cyclone of symptoms following us to work, extra supports are required to allow us to function and make it through the day as a productive employee. While application of sound ergonomic principles benefits all workers, the following actions can be considered when modifying a pregnant worker's job:

-Assign less physical tasks.
-Restrict lifting to 25 pounds or less.
-Adjust work (flexible scheduling, day shift rather than night shifts, etc.).
-Vary tasks to avoid static posture.
-Adjust height of work surfaces and chairs.
-Install foot rests.
-Limit standing to less than three hours per day.
-Offer shorter, more frequent breaks.
-Reduce the amount of work performed at heights.
-Provide more space for moving around.
-Remove obstacles in the work area, particularly those placed at lower levels.
-Promote safe lifting techniques.
-Provide a quiet space for taking breaks when headaches or nausea ensue.

Accommodations that have worked for me at my workplace include, taking stretching breaks many times throughout the day as muscle fatigue sets in, starting a walking routine at lunch to alleviate sore joints moving my keyboard lower to change the angle of my wrists and reduce the beginning signs of nerve compression, sitting on a supportive cushion to relieve coccyx pain.
 

Most workplaces have pregnancy accommodation guidelines built into their employee's manual or at least in the Policies and Procedures Binder tucked away in someone's office.  Many workplaces, however still do not have clear guidelines that focus on individual pregnancy accommodations, which is important to consider since each woman experiences pregnancy differently.       

The Canadian Human Rights Commission protects pregnant workers from discrimination and outlines the employer's obligations to accommodate us. If you believe you are being discriminated against at work visit the links below to read about your rights and the best practices for accommodating pregnant women. Canadian law puts a heavy fine on companies if they are found to have committed acts of pregnancy discrimination.

Share your pregnancy workplace accommodation nightmare or success story here to help other readers going through the "invasion of the body snatcher's" pregnancy experience.

Further Reading:

http://www.chrc-ccdp.ca/pdf/pregnancy_grossesse-eng.pdf

http://www.uptodate.com/contents/musculoskeletal-changes-and-pain-during-pregnancy

http://ehstoday.com/news/ehs_imp_34483/

http://www.ncbi.nlm.nih.gov/pubmed/7973486

http://www.ehow.com/how_2106073_deal-pregnancy-discrimination.html#ixzz1n2xPnR46

http://www.ehow.com/about_6601639_discrimination-pregnant-women-  workplace.html#ixzz1n2xhLBsM

Marnie Courage, OT Reg.(MB)

Managing Director

Enabling Access

marnie@enablingaccess.ca

One of the issues that face Health and Safety Officers in the industrial workplace is balancing pressures from management or corporate office to reduce workplace injuries while not affecting production or taking workers off the shop floor. Here are some ways your Health and Safety folks can approach injury prevention without becoming a cog in the company wheel:

-Introduce a stretching program by recruiting a volunteer from each department to lead a stretching routine that can be conducted at the beginning of each shift. Remember that a simple warm up before stretching is more important than stretching alone, to get blood flowing and get muscles ready for the physical work.

-Provide “Manual Material Handling” or other courses in the proper use of body mechanics to the Supervisors, so they understand safer ways to do the work and will be able to identify when employees are using unsafe behaviours in their department.

-Introduce a “Safety Coach Program” that gives supervisors opportunity to demonstrate safe behaviour during the working shift and identify unsafe behaviour by giving out coach cards to employees with “Safe” and “Unsafe” labels.  If the employee demonstrates an unsafe behaviour, the supervisor demonstrates the safer alternative and checks in later to ensure the employee has adopted the new behaviour. Supervisors are encouraged to give out at least 5 cards a week which keeps them watching how the work is being done and employees receive incentives for exhibiting safe behaviour.

-If you can manage to justify the ROI of safety training on work hours to the decision makers, then getting a group off the floor for 45 minutes, providing “Introduction to Ergonomics” or “Safe Manual Material Handling” with demonstration and a practical component using the equipment they handle, will undoubtedly change some unsafe habits. Offering these sessions around the clock to accommodate all shifts is recommended. Groups of approximately 30 seem to work best.

-If there are too many barriers to getting workers off the floor and you are the one man/women safety show, ask for 5 minutes at the beginning of a shift, per department, for you to demonstrate 1-2 safety tips that will help keep the employees safe. Work through the facility 5 minutes at a time!

-Please don’t forget about your office staff. Even though the big cost of injuries comes from those that happen in the shop, musculoskeletal injuries in the office can creep up on people and land them a short term disability claim, which adds up! Provide an “Introduction to Office Ergonomics” workshop as a lunch and learn for the office staff to make them aware of how to set up their workstations and how to use their bodies to conduct their work safely.

-Be present in the shop and learn from the employee on how the work is done. You don’t want to be seen as the “Safety Police”, instead you want them to think of you as “Safety Support.” Don’t just walk around pointing out everything that is unsafe (hopefully you have already done this in your Risk/Hazard Analysis) but talk to employees and get their feedback about what is working and what seems unsafe to them, they will be more willing to volunteer information if you are not seen as “Them” in the us versus them all-to-common workplace culture.

-Brag about safety accomplishments to management or corporate office!  Let them know that your efforts are changing behaviours for the better. If you gain their support you are more likely to get their buy-in for introducing more training and the associated injury prevention cost savings.

-Share what works and what doesn’t with like businesses you know to get creative ideas so you are not reinventing the safety training wheel with each effort.

-Set yearly and quarterly safety training and assessment goals to use as outcome measures. It’s not just about statistics; it's about how you get there. Set the path for the training and assessments you would like to have completed, or like in any plan; if there are no goals, nothing happens!

Marnie Courage, OT Reg (MB)

Managing Director 

Enabling Access

marnie@enablingaccess.ca

1. Be a "Positive Pat"
Research shows that having just one "Negative Nancy" or "Doug the Downer" in the bunch can affect the workplace culture negatively, and decrease the productivity of the working group. Try to keep a positive perspective even when your co-worker is pointing out, convincingly, all the potential headaches, complications and timewasters the new software program will bring with it. If you think, speak and behave with a positive attitude, the small stuff will roll off your back and you will lessen the health effects of stress that work life inevitably produces.

2.  Be a Contributor not a Contaminator

If you like Dr. Phil, you will relate to this one.  Phil has used the above phrase when referring to the actions of individuals in a relationship and I find it also applies to employee relations. As our co-workers know too well, there are often many things about our work to complain about. Complaining tends to keep us problem focused and perseverating on frustrating issues, contaminating the workplace. Try to spin the focus to finding solutions when faced with a problem at work, disagreement with a co-worker or boss and you can feel good about being part of the solution, being a contributor, instead of being a contaminator.  Avoid joining in on what seems like light hearted teasing or bullying  of co-workers, trash talking the boss and other contaminating behaviours.

3. Walk it off
With email being the primary mode of communication in the workplace, visiting your co-worker to share some important news or notifying your secretary that the photocopier is low on ink have been replaced by email notifications.  If your job requires you to sit for the majority of your day, you are burning less calories, compromising your circulation and assuming static positions that cause muscle fatigue and discomfort, more so than an employee who gets to stand or walk for some of their day. You can introduce a "Steps to Health" pedometer campaign that tracks the distance you walk in a day and will surely get people moving. You can make the resolution this year to include more walking in your workday, to leave your workstation at lunch, to get water of coffee, and to visit your co-workers to share information, and the will to walk just might spread.  

4. Become Ergonomically Inclined
Advocate to your Health and Safety Committee for an ergonomic education session for all employees to review the principles of ergonomics and to help you all with setting up your equipment and furniture and to apply healthier working behaviours. If your workplace does not have an internal ergonomics program or does not outsource ergonomic services, there is still much you can do to prevent musculoskeletal injuries and be more comfortable and productive as you work. There are many free references and checklists online to help you set up your workstation to improve the fit and function of your furniture.  Search "office ergonomics guidelines" to understand how to position your equipment and apply proper body mechanics to conduct your work in a healthy manner. You could then post the ergo information on your wellness bulletin board, so everyone benefits.

5. Improve Your Food For Thought
We know spikes in blood sugar and the corresponding drops between meals contribute to weight gain in people working sedentary jobs. We are supposed to eat smaller more frequently to stabilize blood sugar, but this task may be difficult to master with the conveniences of fast food.  Many people are not hungry first thing in the morning and skip breakfast, the meal that gets our metabolism engine started, just to get that extra 10 minutes of sleep and race to work. Often lunches are purchased in food courts, cafeterias and fast food restaurants, most offering high sugar and high fats in exchange for speedy service.  Snacks in vending machines are commonly filled with sugar, trans fats and quick burning foods that spike your blood sugar. Caffeine in coffee and soft drinks effect blood sugar the way eating sugar does and will spike your blood sugar level, dehydrate you and deprive you of the water your body needs to stay healthy. You can advocate for a water cooler next to the coffee maker to remind employees they have a healthy fluid choice, request healthier snacks in the vending machines, start a weekly "Healthy Plate Pot Luck Lunch", start a "Healthy Brown Baggers" lunch recipe club, keep healthy snacks at your workstation to prevent those lows mid-morning and mid-afternoon that nearly put us to sleep at our desks. Avoid sugary snack bars and choose high protein snacks likes nuts and cheese to keep you alert and feeling well.

Marnie Courage, OT Reg (MB)

Managing Director 

Enabling Access

marnie@enablingaccess.ca

Now that most people are aware of office ergonomics, employer's obligations though legislation, have an ergonomics program or at least have invested in equipment from the 2000's, employees are able to freely identify risk factors at their workstations without fear of being labelled a "squeaky wheel".

The Return on Investment (ROI) for creating a workplace ergonomics program is obvious; reduced costs associated with injuries, decreased employee lost time and WCB rates, increased productivity and employee morale. What might not be as clear is whether it is better to hire an Ergonomist or train employees to conduct the ergonomic assessments in your workplace. Here are some considerations for you to keep in mind when at this crossroad:

Hiring an Ergonomist: Professional fees in Canada can range from $85-$150/hr  for a certified ergonomist/ergonomic specialist to conduct individual assessments. The Profession of Ergonomics is widely represented by several disciplines and choosing the right Ergonomic Consultant should include researching the consultants to find the right fit for your workplace.  You may want to choose an Ergonomists with a medical background like physiotherapists and occupational therapists  to accommodate employees with medical issues and disabilities. Occupational Therapists also treat clients with Mental Health issues, which is a great skill set to have when looking at workplace issues that might affect the employee's health including stress and production deadlines.

An office ergonomic assessment report usually takes about an hour and the report may take longer. The report should outline all the ergonomic risk factors and provide recommendations in the areas of administration, engineering and behaviour. These professionals should be keeping your suppliers and your budget in mind when making recommendations to allow for ease of implementation. Beware of Ergonomic Specialists that represent ergonomic product retailers, although it is unethical to recommend products they could benefit gains from, it does happen, so an independent consulting firm is a better choice for feature focused not brand focused recommendations.

A good Ergonomist stays in touch with best practices in ergonomics, ergonomic products and equipment features, so you can rest assured they have seen it all and have a solution for most everything they encounter. They can answer questions about products and  barriers you experience, so t your ergonomic issues are solved quickly and cost effectively.

If you are a large office of more than 50 people, you may find hiring an Ergonomist to conduct an ergonomic assessment for every employee that identifies a risk factor, could break your budget, both with professional fees and the cost of implementing the recommendations. You may choose to create a priority list of those employees needing assessments that you could approve as your budget allows.

Training Employees to be Assessors: If you are interested in saving money on professional fees you may want to invest in having one or two employees trained to be Ergonomic Assessors. They would obviously not have the expertise that a professional Ergonomist does, but they could learn to identify risk factors and solve ergonomic issues for their co-workers. Choose employees who are on your Workplace Safety and Health Committee or who are interested in the area of ergonomics, as it will be adding to their current job responsibilities and will require outside time researching ergonomic products and solutions.

You should research Ergonomic Assessor Training in your area to determine which company you will hire to train your employees and what your budget allows for. Often these courses are between $900-3000 so it's worth it to shop around. The training for office ergonomic assessors should be at least a full day that includes theory and guided practice so the participants can learn what information they need to collect, how to identify risk factors and how to solve those risks through administrative, engineering and behavioural changes. Ensure the instructor is a professional ergonomist so their expertise seeps into the veins of the participants. Ask about consultation fees for supporting the newly trained Ergonomic Assessors, so that if they need questions answered or help with a tough ergonomic scenario, the consultant is available to provide support with no hidden charges.

The advantage of training your employees to do the assessments is that you save on professional fees with every assessment, but remember the cost of the solutions will be the same, or more if your in-house assessors do not have the inside scoop on no or low cost solutions or where to get products or solutions for less. It is a good idea to send your in-house assessors for professional development workshops and training ongoing,  to make sure they are current with Ergonomic best practices.

Final thoughts on this are; Hiring an ergonomist to conduct hundreds of assessments may bust your budget, but if you hire one for the occasional assessment and to handle the assessments for employees with medical issues, you benefit from their ergonomic expertise, medical background, problem solving and product knowledge. Training employees to be Ergonomic Assessors saves on professional fees but solutions may cost more due to lack of experience,  no medical background modest product knowledge. If you are hiring a professional Ergonomist, ensure they do not represent ergonomic product brands, have good medical background and share references. If you are Training your employees to be Ergonomic Assessors, ensure the training company provides on-going support, and send them to workshops and additional training moving forward to assist them in keeping up with best practices.  

Marnie Courage, OT Reg. (MB)

Managing Director

Enabling Access

marnie@enablingaccess.ca

After attending a session on "Ergonomics In Health Care" and discussing injury prevention initiatives by hospitals and long term care facilities, I was struck by how much money, and effort goes into these government and privately funded programs to ensure the safety of the Health Care employees.

Patient lifting and handling  training has been around for years is in integral part of protecting nurses and other hospital staff from MSI's, and most places do a great job of offering the training regularly to reduce employee injures and lost time. With the shift to e-health from paper charting, it is not surprising  that we are now seeing a rise in upper extremity MSI's due to nurses and medical staff using the portable computer stations in the hallways and nursing stations.

 With computer related injuries on the rise in hospitals,  I can't help wonder how small community based disability serving health care companies like private home care, respite , residential agencies, day programs and employment support programs are dealing with this challenge.  For these agencies, generally they have by law a Workplace Safety & Health Committee or maybe only one WPSH rep, but  they usually can't afford consultation from a professional ergonomist or hire can hire a safety officer or have resources to pull together an ergonomics committee. So, I'm left thinking that other than regular lifting and transferring training, these high risk employees and their office staff may not be addressing all the ergonomic risk factors in their jobs, especially if using computers have become an essential function in their work day.

There are many online  office ergonomics guidelines as well as patient lifting and handling guidelines available for community agencies to use and adapt for their specific business. My hope is that these companies will apply the principals of office ergonomics when buying furniture and equipment for their office staff, accommodating injured workers,  and make computer ergonomics as big of a priority as the patient lifting and handling, in reducing the MSI's related to caring for people with disabilities in the community.  Because of the large sample populations in hospitals,  there are many studies about computer related MSI, but I have yet to find a study about computer related injuries in community health care, due to the variety of settings and nature of work.

I have been discussing the need for more ergonomic training with community health care agencies and will be bringing these groups  together in Winnipeg , Spring 2012 for a two day "Improving Ergonomics in Community Health Care"- A Workshop  for caregivers and managers,  that will include a trade show of disability and ergonomic related products, a half day Client Lifting and Handling Certification Training , a half day of Office Ergonomics Training, and a full day of breakout sessions dealing with topics related to protecting employees from injury from pre-employment to return to work, following an injury. If you would like to take part in this initiative or would like to share resources with other community health care companies, please submit your name and email and I will add you to the network.

Marnie Courage, OT Reg.(MB)

Managing Director

Enabling Access 

Often production demands in Industrial workplaces ebb and flow. When they flow, employers may have to bring in more man power to quickly meet the rising demand for product. Many Industrial workplaces struggle with trying to find the right people for the job, when bulk hires are required.  HR reps can be challenged with first finding enough suitable applicants to interview and offer positions to, hoping they meet the skills and abilities criteria.

According to Statistics Canada, Manufacturing Companies have the highest work related injuries among industries, with Manitoba having the highest in the country. In addition, Injuries usually occur within the first 6 months of employment, putting these new hires at risk of injury, lost time and disability. Finding the right people for the job involves more than just interviewing folks with the appropriate work experience and skills; it also includes ensuring these potential new hires can manage the physical demands of the job.

Post-offer Pre-placement Testing (POPPT) is an objective process to ensure the potential worker has the physical capabilities to perform the job.  It is a proven method for screening potential new hires that have been given a conditional offer of employment, while securing the employment is dependent of the passing of a customized test, which includes simulation or actual carrying out of the essential job tasks.

Usually testing is administered for only the most physically demanding jobs, or jobs with the highest rates of injuries. The testing has to be administered to all applicants, as testing only those who you suspect may not be able to do the physical tasks, is discrimination according to ADA.  A policy should be developed to outline those identified positions that testing will be conducted for, as well as outline if Fit For Duty Testing will be done every 2, 5, or other specified year period, to ensure current employees are still able to safely do their work.  

Post Offer Pre-placement Testing assists the employer:

-during the hiring phase, by minimizing poor placement decisions, determining true level of function, compared to the job demands and ensuring the potential hires are able to safely conduct the work.
 
-with Fit For Duty Testing done regularly for identified positions to ensure employees are still able to safely conduct their jobs.
 
-when an employee has been injured, the level of disability compared to POPPT results can help determine entitlement by examining  level of function prior to the injury.
 
-in the rehabilitation process by knowing previous level of functioning.
 
-by Reducing Escalating Costs associated with injuries.
 
-by using best practices to keep up with changing labour legislative focus.
 
-to maintain a team of healthy workers supported by strong injury prevention initiatives.

A professional occupational therapist develops, conducts and scores the testing to ensure reliability and validity of the standardization for all testing. The pass/fail results are provided to the employer who is then responsible for communicating the results to the potential new hires. Between this Pre-employment testing, Work Safe Education and Orientation, and Ergonomic Assessments for new hires, your HR reps, Health and Safety Officers are truly embracing a preventative approach to protecting employees from costly injuries at work.

Marnie Courage, OT Reg.(MB)

Managing Director

Enabling Access