Headlines

As reported by the Hartford Business Journal, April 26, 2010.

Ergonomic Fixes More About Design Than Cost

Q&A visits with Dr. Martin Cherniak, professor of medicine at UConn Health Center and head of its Ergonomic Technology Center.

Q: You run the Ergonomic Technology Center at the Connecticut Health Center. How prevalent of a problem is this that it requires its own center?

A. The field of ergonomics fitting the job to the worker is a conventional term that describes a small part of our activities. We have worked in tool and work station design and have conducted physical factors type research on power tool design and exposure prevention and on hearing devices and speech communications research. In more recent years, we have worked closely with other academic groups in biomedical engineering and the social sciences in an area that we call work life. It involves the integration of workplace prevention, usually around ergonomics and physical organization of work with individual health and health promotion. Work organization becomes a significant program area. In terms of prevalence, musculoskeletal problems are the overwhelmingly largest category of work associated disorders. Because age and physical capacities influence susceptibility, they are an important part of the mix of factors. For example, back, knee, and neck problems are more prevalent with aging, independent of the work process. However, certain jobs are associated with a higher relative incidence of disease and injuries may involve prolonged disability in an aging workforce. For this reason, we cannot dissociate work conditions form individual risk factors.

Q. Has carpal tunnel syndrome become more or less prevalent? Is it an affliction that targets one gender over the other?

A. Carpal tunnel syndrome (CTS) is a common condition and frequently over diagnosed and over treated. It occurs in the general population with a much higher incidence in women. However, in working groups with intensive hand movement, the male-female ratio may approach unity.

Interestingly, in the workforce, the incidence is less age sensitive than neck or shoulder problems, for example. Many, even most, CTS problems in the office or sedentary workforce can be conservatively managed with less aggressive treatment and good workplace design. In manufacturing, there are a number of neurologic disorders, particularly those associated with power tools, that are misdiagnosed as CTS, but are actually quite different and will not respond to surgery. It is also the case that the single greatest cause of treatment failure, including surgical failure, is return to hand intensive work that may have provoked the original condition. It should also be recognized that the majority of cases of CTS will either improve without treatment, or more likely, remain stable and not progress. Given all of the ambiguities, it is difficult to determine if it is increasing or decreasing. We have certainly seen workforces in well designed workplaces where the incidence is lower than in the general population.

Q. How willing are companies to embrace changes in ergonomics? It seems as if some companies may not have the funds to make the changes, i.e., it might be better to keep somebody employed rather than fix the ergonomics and have to cut staffing.

A. Many ergonomic solutions are not costly and the involvement of internal managers and workers in design and change will often lead to practical solutions that are in tune with company culture and resources. In general, companies that incorporate ongoing process review and change into production practices, rather than considering ergonomics as operating costs, will produce operational efficiencies. There are, of course, major capital equipment changes, but these are often made for production rather than health reasons. When carefully analyzed, the major costs dispositions are not the result of ergonomic related process changes; they are more likely to be the result of workforce aging and disability costs. There is a good deal of decision making that is not necessarily rational. For example, some employers will rush into health promotion, health fairs, etc. because it is either currently popular, or serious diseases have occurred in visible personnel. Realities are often quite different. In Connecticut, we have a skilled but older workforce. We have very good data that indicates that this workforce can produce well into the sixth decade with lost-time injuries and conditions occurring with no greater prevalence than in younger workers. That requires intelligent work design and practices.