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There is an old carpenter’s axiom, ‘measure twice, cut once’.  The lesson? Careful, informed planning is essential to ensure a positive outcome.  Hurry to complete a project, and you do so at your peril. A lot of wasted wood cut just a skosh too short.  

Ideally, Ergonomics should play a central role in the design and build out of any building where people will work.  Understanding the needs and limitations of the human body at rest and in movement should inform the work of architects, designers and builders.   Have you ever worked in a business environment where the building structure, layout, space allocation for job tasks, movement & pass-through, while up to all current day building codes, seems to interfere or impede productivity?   The workspace allocated per employee in office environments is often driven by cost issues (cost per sq foot), rather than building an understanding of the tasks employees would be asked to perform….THEN DESIGN TO MEET THOSE NEEDS.   Or, perhaps the business, like most, have gone through significant expansion in their use of technology. New tools are forced into existing environments; this reality introduces risk factors into the workplace.  Or, the employer needs to support as many workstations in an area as possible, with little or no regard for human factors and ergonomic realities.  (think CALL CENTER – have you ever walked through a large call center – YIKES – an MSD factory). 

A growing part of our ERGOLAB practice is consulting within a hospital environment.  Nursing injuries are on the rise. OSHA accident and injury data has identified nursing as one of the most dangerous professions in the US.   Why?  THE PERFECT STORM OF FACTORS; 

  • HEAVY LIFTING – On average, a nurse  lifts 1.6 TONS of human body weight every shift.  Injuries from heavy lifting leave 50% or more working in chronic pain
    or at least 12% leaving the profession, many with permanent disabling injuries.  The rate of Musculoskeletal Disorders or MSDs in healthcare workers exceeds that of workers in construction, mining and manufacturing.
  • FATIGUE – Nurses walk 1/3 of every shift due to poorly designed floor layouts and inadequate storage at the point of care. A nurse walks more than 6  miles per shift.
  • TECHNOLOGY – New technologies have transformed healthcare; unfortunately, many of the nation’s hospitals were built before the invention of computers. Tools and technology is crammed into every nook and cranny on patient care floors.  Nurses spend HOURS at computer workstations that are poorly designed, forcing out of neutral body postures and increasing the risk of MSDs. 
  • EMPLOYEE SAFETY NOT A PRIORITY – Present day hospital culture is about PATIENT SAFETY concerns and conversations; employee safety is a distant second.   The typical hospital will have a Patient Safety Officer, with enterprise level responsibilities and resources. That same hospital will relegate Employee Safety responsibilities to any number of ‘owners’ at the middle management level. 
  • MORE WITH LESS – Financial challenges resulted in nursing layoffs – nurses are asked to do more…..much more….with less.  40 % of nurses today work in excess of 12 hours
    per shift. Longer hours, more shifts, less down time.  

Intelligent hospital design, leveraging human factor and ergonomics expertise would alleviate MANY of the factors listed above.  Lifting tools and technologies exist that could eliminate injuries due to heavy lifting.  Floor plan design must evolve to eliminate unnecessary walking that contributes to fatigue, then injury.  Technology can be better integrated at the point of care, with ergonomic solutions to minimize MSD risk.   Any design must have adaptable, changeable and flexible enough to meet accommodate changes in technology. 

The good news….a VERY real opportunity exists in the coming decade to address hospital design issues and create the care center of the future.  The healthcare industry is experiencing a construction boom: 

  • Hospital construction spending is forecasted at $36.8 billion by 2011 with expected annual increases year to year (source – Center for Medicare & Medicaid Service)
  • 58% of existing hospitals plan to add beds in the next few years to accommodate aging baby boomer populations (source – Nurse Executive Center – CNO Survey)

Ergonomics must be one of the guiding principles in future hospital design.   Let’s not ‘assume’ that Ergonomics is central to the design methodology….DEMAND IT.  Make sure the development teams have MEASURED TWICE…before they finalize design.  The costs of business as usual are too high.

Have something to say on this topic?  Please add your comments. 

If you’d like to discuss our consulting services in this area, please contact Frances Pisano at 401-529-8398 or fpisano@pisanoassociates.com

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Our ERGOLAB team spends a lot of time working in office environments; the day man met PC was a glorious one for workplace accountability – nothing like a digital trail to keep things on the up and up….not so great for the human body.  Why?  As work tasks became more and more automated, our work days became more sedentary. 

Our body was not designed to sit for 8 hours a day; we’re all familiar with the Ergonomics axiom, “the best body posture (position) is the NEXT body posture (position).  Our bodies were designed to hunting, gathering, foraging for food, and sometimes running away VERY quickly when WE became the potential ‘food’ (…and NO, battling the crowds at your local farmer’s market does not qualify as ‘foraging’).   We need movement, we need a variety of position and posture to maintain good body health and flexibility. 

In the past, corporate Health & Safety leadership often overlooked the needs and risks within their office environments; cubicle dwellers don’t use pneumatic equipment, drive a forktruck or work with hazardous materials. Accidents and injuries occurred in other places in the enterprise, except the occasional slip, trip or fall, the office harbored few (or so they thought) risks.  Now, with 20+ years of data  and learning behind us, we understand the very real and very expensive risks associated with unmanaged office ergonomics.  With the average cost of ONE musculoskeletal disorder averaging $25,000 in direct costs and 5 to 8 times that number in indirect costs…a passive approach to office ergonomics is NOT good business. 

Still…old myths and misconceptions in Office Ergonomics die hard. 

Misconception #1

The right chair will solve ALL your problems.  WRONG!   A personal pet peeve and a myth that must DIE (and remember, we SELL ergonomic chairs and tools at www.ergonomicedge.com ).  The office chair, while very important, is one element within an INTEGRATED Ergonomic solution.  Office system manufacturers spend millions to reinforce the belief that a chair (more importantly, their chair) is the answer.  There is no magic chair. Or for that matter keyboard tray, mouse, docking station or document holder.  Products are tools our ERGOLAB Ergonomists use, case by case, client by client, to build an Ergonomic solution, properly designed, personally adjusted, with adequate employee education and product training (you’d be amazed how many companies have NO IDEA how their existing chairs adjust…).  At ERGOLAB, we lead with Ergonomic guidance first…products are a very very distant second.  

Misconception #2

Repetitive Motion is the #1 cause of ergonomic injury.   WRONG!    Yes, repetitive ‘Out-of-Neutral’ motions can and do cause injuries. An example would be anyone who works on spreadsheets for long periods of their day; these folks do A LOT of cutting and pasting within the spreadsheets.  Over the long term, overuse can lead to pain, discomfort and injury.   What surprises most corporate Health & Safety Managers, is that STATIC  “Out-of-Neutral” body postures cause far more injuries….we are a generation of leaners and reachers.   Sitting in a chair for hours at a stretch invites poor postures; next time you are in a lengthy meeting, check out the body positions of everyone around you…..leaning, slouching, etc.  All positions that put extreme stress and pressure on our bodies.   

This underscores the value of careful, thoughtful office design; the cubicle footprint is often driven by ECONOMIC imperatives, rather than ERGONOMIC imperatives.  Think  adjustability of worksurfaces, up/down, in/out.  Make sure all employee tools fall within the REACH ENVELOPE…don’t ask an employee to reach and lean to talk on the phone or lean forward to view a monitor.    

Misconception #3

Office Ergonomics is a ‘hard sell’ in these tough economic times.   WRONG!   Now is precisely the time to integrate Office Ergonomics into your Health & Safety plans for your next fiscal year.  Let’s face it, everyone is working with reduced headcount. This means your current work staff needs to do more…..MUCH MORE….with less.  You need these employees to stay healthy and productive.  Beyond this, Worker’s Compensation costs are soaring…a proactive Ergonomics approach is about preempting injury. Fewer injuries, fewer claims, lower PREMIUMS.   In tough economic times, you can’t afford NOT to invest in Office Ergonomics. 

Misconception #4

Every employee needs the same Ergonomic tools.  WRONG!      Ergonomic solutions are personal; an employees height and body size, health conditions, work functions and personal habits all contribute to and inform an Ergonomic solution.   A good starting place for 90% of the employee population is an adjustable Ergonomic chair and quality adjustable keyboard – but REMEMBER – the workstation MUST be designed with the employee’s idiosyncratic needs in mind. As before, an Ergonomic solution. There is no one size fits all.

 Need some guidance in creating and implementing an Ergonomics program for your business?   Give us a call – 401-527-7047, or email me at cdavis@ergonomicedge.com.

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Well….the cat is out of the bag.  All this time, American business has been worried about a new attempt by OSHA to create an Ergonomic specific regulation.  Business organizations like the US Chamber of Commerce and others were lining up resources for another fight.  Well folks….it looks like the ‘war’ was won without a single shot.   Hidden in plain sight, is all the regulatory muscle OSHA needs; the general duty clause.

WHAT?  Yes it’s true. During an April 7th web chat, Deputy Assistant Secretary Jordan Barab stressed that OSHA’s enforcement of ergonomic issues is a key strategic component, and will increase, noting that the general duty clause will be used to cite ergonomic violations.   THE GENERAL DUTY CLAUSE.  It’s not sexy or flashy….but this approach and regulation has teeth.  

The General Duty Clause of the United States Occupational Safety and Health Act (Federal OSHA) states:

29 U.S.C. § 654, 5(a)1: Each employer shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees.”

29 U.S.C. § 654, 5(a)2: Each employer shall comply with occupational safety and health standards promulgated under this act.

29 U.S.C. § 654, 5(b): Each employee shall comply with occupational safety and health standards and all rules, regulations, and orders issued pursuant to this Act which are applicable to his own actions and conduct.

Couple the above general duty clause with the new column in the OSHA 300 log capturing Musculoskeletal Disorders in the workplace, and you can begin to see why an Ergonomic specific regulation might not be necessary!

Assistant Secretary for OSHA Dr. David Michaels commented that,

OSHA’s field staff will be looking for ergonomic hazards in their inspections and we will be providing them with the support and back-up they need to enforce under the general duty clause. In addition, we will be examining employer logs to see if MSDs are accurately reported,” illustrating the increased emphasis on recordkeeping logs, during OSHA inspections. Michaels stated that OSHA plans to “take a hard look” at employer policies that discourage injury reporting.

You have to give OSHA leadership their ‘props’…the approach is an intelligent, common-sense approach.  No big expensive fight.  Apply the regs that are there….end of story.  

What are your thoughts on OSHA’s new tact????  Agree or disagree??

If you’d like to discuss, feel free to email me at cdavis@ergonomicedge.com or 401.527.7047.

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Great research from the Gartner Group!  Gartner has been tracking the acceptance and use of new technologies; in particular, the acceptance of newer touchscreen technology.    What was once the fantasy of the Star Trek and Star Wars generations (I am a Star Wars kid – Star Trek was already in re-runs – REALLY)  is now reality; Kindle, iPod, iPhone, iPad…the list goes on and on. 

Touchscreen is a game-changer that increases user productivity.    What’s surprising, is the slow adoption of BUSINESS to adopt the new technology.  According to Gartner,  

The immediate productivity gains promised by the flood of touch-enabled devices coming to market in 2010 will be slow to materialize in the enterprise.

For more on the Gartner research follow this link –  http://www.gartner.com/it/page.jsp?id=1336913

I asked our ERGOLAB team about the growing touchscreen use; some food for thought about the Ergonomic implications;

  • Parents should continue to proactively manage their children’s use of ALL technology, regardless of interface (keyboard, mouse or touchscreen).   The inherent risk of long-term use of computing or gaming tools are about body postures while using ANY technology.  Out-of-neutral body postures over time contribute to pain, discomfort and eventual injury.  Parents, for more guidance on your kids and avoiding Ergonomic issues – check out our blog post   http://bit.ly/ERGOLABKids
  • Any touchscreen requires the user to sit within arm’s reach of the device.  Simply replacing a traditional computer monitor with a touch-enabled screen is not acceptable.  In most cases, this new screen will be outside of the acceptable ‘Reach envelope’. What is the Reach Envelope?

The following tool (image provided by John Wick of J&J Consulting)  is used to layout and organize seated workstations to ensure that there are no extreme posture requirements and to ensure that the individual is primarily assuming neutral working postures.

The point of operation should be within the primary zone (within 14”) “where the hands do the work”.  The location of tools (phone books, files, stapler, phone, calculator, etc.) can cause extreme ranges of motion in the wrist, elbows, shoulders and back and should be placed within the secondary zone in order to eliminate extreme positions (within 24”) of the individual and laterally 45 degrees from the shoulder (figure 1) (1). This criterion is based on anthropometric data representing 90% of the population.  Those either under 4’11” or over 6’2” may need further accommodations.

  • Most of the new touch-enabled tools are mobile, hand held devices.   Our recent blog posts on the Apple iPad scratch the surface of the Ergonomic issues related to this new category of touch-enabled tools. 

The Apple iPad has all the Ergonomic challenges associated with the laptop AND takes another step in the WRONG DIRECTION.  Typing on the iPad touchscreen while the iPad rests on a flat surface will force the neck into more extreme static neck flexion or extension depending on the users posture. Eye strain is also a risk.  TRANSLATED – typing on the iPad for any stretch of time will create neck pain, possible eye strain and could cause injury. 

The ability to attach a keyboard to the iPad (the iPad Dock) was a good move by Apple; but no consideration was given into the lack of adjustability of the height of the screen once it is attached to the iPad Dock. This was a missed opportunity by Apple to address head-on the Ergonomic issues related to laptop use (these issues are well-documented).  The ability to telescope the iPad up and down would allow the iPad to be adjusted to the proper height for the user, ensuring neutral neck postures and subsequently, comfortable viewing.

What are your thoughts on touchscreen technology and the Ergonomic implications?  We’d love to hear from you.

If you’d like to connect directly on this blog post or any Ergonomic issue, I can be reached by phone 401.527.7047 or e-mail cdavis@ergonomicedge.com.

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I can remember when I started out in the professional world, my father gave me some advice, in his words, “In business there are 3 things you NEVER discuss”  (for fear of offending or alienating with anyone with a differing point-of-view);

1. Religion

2. Sex

3. Politics

Well….after our blog post 2 days ago on ERGOLAB’s concerns with the ergonomic issues of the Apple iPad, I am nominating another topic that is not open to discussion or questioning. 

    4.     Apple (and anything having to do Apple, it’s products, leadership etc)

The response from Apple nation was impressive and loud. Apple has a fantastic reputation for excellence in product design; creating products that anticipate consumer needs intuitively. Apple users are passionate and proud of their community.  

Some reader comments;

– Apple might be leaving the heavy lifting to the after-market.  Similar to the iPod series, the iPhone, and the iTouch, Apple is relying on the secondary market to address the ergonomic issues around the product; outside ideas and design will fill the gaps.  If this is their thinking, we are a little disappointed Apple did not address the issues within the core design.  This device does not come cheap; after investing $499 for the iPad unit; ergonomic accessories could add another $100 or more to that price tag.  Our concern is that many consumers will do without the enhancements; due to budget or ignorance of the ergonomic risks.

– Under pressure to deliver a tablet device to the market (Apple’s original target date was October 2009), Apple chose to release an interim model. An enhanced version will be offered at a later date. If this is the case, delay your purchase and wait for increased functionality and sound ergonomics. Particularly if you plan on using the iPad as a small format ‘writing’ or ‘creating’  tool.

-Loving the iPhone and slamming the iPad is hypocritical.  Yes, the iPhone poses some ergonomic issues, texting being #1 on the list.  Human Factors research proves that the mechanics of texting, regardless of device, are damaging.  I would counter your comments with this; the iPhone was never positioned or marketed as a replacement for the laptop.  The Apple iPad is being marketed in this way; a SLIPPERY SLOPE in our eyes. People will use this device for writing, with or without the iPad Dock accessory, that usage is high risk. 

– A very agitated Apple worshipper demanded that I return my iPhone, my laptop and go back to those big ugly, clunky desktops of yesteryear.  I hit a nerve with him. 

                                                                                                                                                                                                                                                                                                                                                                                                                                             The Apple iPad has ergonomic flaws. 

Take a look at the Apple provided promotional photo to the left, our ERGOLAB team identified several risk factors FROM APPLE’S OWN MARKETING MATERIALS!

Photo 1 – The left hand holding this device is in EXTREME STATIC ulnar deviation, which is a well-known risk factor for the wrist.  Check out the extended index finger; this product will lead to overuse of the index finger due to repetitive and prolonged scrolling. Don’t get us started on the risks to the ‘one-finger’ typists who will use iPad for emailing, document creation and more.

Photo 2 – Both wrists are in EXTREME STATIC wrist extension. This position is often the culprit, in causing carpal tunnel syndrome (CTS) and other wrist Repetitive Strain Injuries (RSI).

These identified risks scratch the surface ergonomically.  The Apple iPad is not well-designed to support computing – writing emails or creating documents.  Typing on the iPad, while it is laying on a flat surface, creates static neck flexion which causes discomfort, pain and possibly REAL INJURY. 

If you buy this product – do not type for long stretches. Repetitive Strain Injuries (RSI) can and will occur.  If you choose to adapt your iPad; adding the docking system and keyboard, static neck flexion is reduced, BUT STILL PRESENT.  Injury is possible even with investment in the iPad Dock with keyboard.

The bottom line; using this device ‘as-is’ poses real risk of injury. It’s our responsibility at ERGOLAB to surface these issues, it’s our job, it’s what we do.  Just don’t shoot the messenger.

What’s your point-of-view on the Apple iPad?  We’d love to hear from you.

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I was in a meeting with a new client last week.  “Linda” (not her real name), is the Director of Environmental Health & Safety for a growing biotech firm.   Our firm has been brought in to address a growing number of Repetitive Strain Injuries in the company’s lab facilities.  “Linda” shared her frustrations with the company’s past approach to Repetitive Motion injuries;

“We wait until something bad happens, until it’s too late to avoid injury and the costs associated with the injury. We practice Whack-a-Mole Ergonomics.  When an employee complains of pain…WHACK…only then can I get them support.   Another issue in a different part of the company, WHACK…again, band-aid the issue with a product or even bring in an Ergonomist to take a closer look at that employees issues.  We spend all our time WHACKING and reacting; we need to get ahead of the issues.” 

Linda’s Whack-a-Mole analogy describes the reality in most companies; expertise and instruction is brought in after pain &/or injury.  When the average direct cost of a Musculoskeletal injury is $25,000 (that excludes indirect costs that average 4 x that number based on OSHA data) – the cost of Whack-a-Mole Ergonomics can add up quickly.  A significant part of our Ergonomic practice is working with client’s to build a PROACTIVE Ergonomics program within their company.  Following is an Action Plan you can use today, to take control of Ergonomic issues in your company, and leave the Whack-a-Mole approach behind.  For a deeper discussion on how to implement this program you can email me at cdavis@ergonomicedge.com.

Proactive Approach to ERGONOMICS:

Action 1.0

Build a business case on the value of the PROACTIVE approach to Ergonomics.  Leverage the resources that are available from OSHA, NIOSH, National Bureau of Labor & Statistics and academia – Cornell, UCLA and others.  Using your company’s historical OSHA recordable data; build an air-tight case for why the proactive approach is better business. Focus on the bottom line impact.

Action 2.0

With your business case in hand – pitch Executive leadership and secure commitment to a long-term Ergonomic program.

Action 3.0

Ensure Ergonomics is integrated into your fiscal planning cycle; the program must be integrated into your Environmental Health & Safety strategy. The EHS community may also need to be sold on the approach; share your business case. 

Action 4.0

Identify Ergonomic consulting resource for support of activity (in most cases companies do not have resident expertise).  Potential partner should have deep experience in task assessment and redesign across all company environments (Manufacturing, Material Handling, Warehousing, Office, Laboratory, Field etc). In addition, review firm’s methodology, ensure actions measurable (as you will be asked to demonstrate program value at some point – be ready for this – put onus on consultant/partner). Talk with current and past clients. 

Action 5.0 – Getting Started

5.1 – Build a Communication Plan around the launch and ongoing merchandising of your Ergonomic program. Included in this plan – Introduction to Ergonomics training for all employees (baseline understanding and value of Ergonomics), Company Champions Program – identify internal Ergonomic program Champions by functional area.

5.2 – Launch program with company-wide Pain & Discomfort Survey. It’s purpose – isolate work environments, tasks and employee categories with injury markers. Outcome – map out high/medium/low risk tasks – permits company to prioritize and align investments

5.3 – Isolate high risk tasks for assessment & redesign – launch Ergonomics work…

Building support and positive momentum is central to getting in front of Ergonomic issues.  If you have any questions, we’re here to help!

Some valuable links to assist you in building your Ergonomics business case:

Puget Sound Human Factors & Ergonomics Society Chapter Cost Benefit Analysis Calculator  – http://bit.ly/PugetHFESCalc

Cornell Ergonomics ROI Calculator – http://bit.ly/CornellROI

OSHA eTools – Computer Workstations – http://bit.ly/OSHAeTools

NIOSH – http://bit.ly/NIOSHErgo

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At ERGOLAB, we spend a lot of time with prospective clients, assisting them in building a business case for why Ergonomics must be included in their company’s  Health & Safety programs for the coming year.  The pitch takes data;  hard proof that Ergonomics delivers measurable, bottom line impact to an enterprise.  We include findings from our completed programs, as well as data from the Public sector resources; OSHA, NIOSH and academia.  Of these outside resources, no report is more meaningful and valuable than the Workplace Safety Index.    

For 10 years, Liberty Mutual, in partnership with the US Bureau of Labor & Statistics and the National Academy of Social Insurance have tracked the leading causes of workplace injury and the aggregated costs associated with those injuries.  The report, known as the 2009 Liberty Mutual Workplace Safety Index or WSI, was made available this week. This year’s report captures injury data from calendar year 2007. The report deep dives the Top 10 injury categories, as these injuries are responsible for just over 86% of all costs associated with workplace injury.    

TOP 10 – Category / Cost / % of total    

  1. Overexertion – Injuries caused from  lifting, pushing, pulling, holding, or carrying a heavy object  – $12.7B, 24%
  2. Fall on same level – $7.7B, 14.6%
  3. Fall to lower level – $6.2B, 11%
  4. Bodily reaction – injuries from slips or trips without falling – $5.4B, 11.2%
  5. Struck by object – $4.7B, 9%
  6. Highway incident – $2.5B, 4.7%
  7. Caught In/ Compressed By – $2.1B, 3.9%
  8. Repetitive Motion – $2.0B, 3.8%
  9. Struck Against Object – $2.0B, 3.8%
  10. Assaults or Violent Acts – $0.6B, 1.1%

    

 What do these numbers tell us?    

ERGONOMICS IS MAKING AN IMPACT.    

Over the 10 year span of the research, Repetitive Motion injuries like carpal tunnel and tendonitis have declined by over 35%.  Proactive Ergonomic strategies, like task assessment and redesign, are making an impact.  In particular, the work done in improving working conditions in OFFICE ENVIRONMENTS has delivered results.  Office technology like computers, keyboards, and computer mice are more ergonomically designed, informed by years of Human Factors & Ergonomics research.  The office environment is better equipped to support the SEATED human body for longer periods of time; as an example, office chair design has leaped forward, providing improved support and adjustability.  Improvements in other tools like keyboards trays, task lighting and adjustable worksurfaces ensure neutral posture and reduce/eliminate extensions beyond the reach envelope.      

ROOM FOR IMPROVEMENT – ERGONOMICS CAN DO MORE    

OVEREXERTION driven injuries, from lifting, pushing, pulling an object have dropped by 5.7% over the ten year span of the study, some improvement, however more work needs to be done.  The human body is being asked to perform physical tasks BEYOND its abilities.  The bottom line, these work tasks must be identified, assessed and redesigned.     

In an earlier blog post we discussed the impact Patient Handling is having on Nursing / Healthcare Provider Safety.  Everyday, the American nurse lifts an average of 1.5 tons of weight.  The result; injury and lost productivity.  This is one example of many existing in US business today.  Ergonomic task assessment and redesign is essential; the cost to the US economy is staggering; $24B in direct costs.      

COSTS CONTINUE TO RISE.

Even as the number and severity of workplace injuries decline (or stay flat). Costs continue to increase.  Over the ten year span of the study (1998 to 2007), costs  increased between 5.4% to 5.8%  year to year on average.   Not surprising, as healthcare costs everywhere are spiralling out of control.  This cost escalation only reinforces the need to continue to focus on injury reduction and elimination.  Of course, Ergonomics can and will play a role in this activity.       

Are there work tasks within your business that you’d like to discuss?  We’re here to help.    

For a closer look at the WSI, use the following link – http://bit.ly/8513J9    

 

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