Ergonomics for Fire and EMS Departments Introduction to Ergonomics & Cumulative Trauma

1. Ergonomics for Fire and EMS DepartmentsIntroduction to Ergonomics& Cumulative Trauma University of Oregon Labor Education and Research Center This material has been made possible by a grant from the Oregon Occupational Safety and Health Division, Department of Consumer and Business Services

2. Today’s Workshop Will provide information on: • Injuries • Cumulative Trauma • Risk factors for musculoskeletal injury • Elements of an ergonomics program • Resources for developing an ergonomics program

3. Fire and EMS Work Requires you to: • Always be prepared • Respond quickly • Think and react quickly • Not always in control of schedule • Work in hazardous situations Physically & Emotionally Demanding

4. Firefighter Injuries, 2002 from the NFPA’s Survey of Fire Departments for U.S. Fire Experience

5. Terms for Musculoskeletal Injuries • Work-related Musculoskeletal Disorder (WRMSD) • Cumulative Trauma Disorder (CTD) • Repetitive Strain Injury • Overexertion or Overuse Injury • Strains and Sprains • Soft Tissue Injury

6. How do Injuries Occur? Acute injuries • Happen immediately • Can become chronic • Re-injury possible • Chronic injuries • Pain or symptoms lasting more • than a month • Cumulative trauma • Happens over time

7. Tissue Repair Phases of repair of soft tissue: • Acute (<72 hours): coagulates blood to stop bleeding, brings in WBC to clean up dead tissue and bacteria • Repair (48 hours to 6 weeks): deposition of new collagen (scar tissue) • Remodeling (3 weeks to 12 months): collagen remodeled to increase functional capabilities

8. Tissue Repair (cont’d) • Body creates a scar internally much like a scar from an external wound • Scar tissue is fibrotic - not the same as the original tissue • laid down in chaotic manner to be strong • Reduced elasticity • If tissues are continually disrupted due to use repair is never complete • Adhesions form • A chronic inflammatory cycle is created

9. Cumulative Trauma Cycle Activity microtrauma (small tears) irritation to tissue produces scar tissue Keeps repeating as long as activity continues • results in: •  flexibility •  strength •  function adhesions form adhesions coalesce

10. Break the Injury Cycle Fatigue Discomfort Pain Injury re-injury may be likely Disability

11. Disc Herniations • Disc damage is frequently the result of cumulative, repetitive trauma • Outer disc fibers repeatedly tear and heal as a result of repetitive overloading • The disc weakens overtime (years) leading to herniation of the nucleus, causing back and leg pain, and numbness

12. What is Ergonomics? Worker Task/job Environment The goal of ergonomics is to design the job to fit the worker, NOT fit the worker to the job.

13. Risk Factors for Musculoskeletal Disorders • Excessive force • Awkward and/or prolonged postures • Repetition • Direct Pressure • Temperature Extremes • Vibration • Work organization

14. Excessive Forces Common risky problems: • Lifting and carrying • Pushing and pulling • Reaching to pick up loads • Prolonged holding • Pinching or squeezing

15. Awkward Postures Common risky postures: • Working overhead • Kneeling all day • Reaching to pick up loads • Twisting while lifting • Bending over to floor/ground • Working with wrist bent

16. Repetitive Motions injury time injury time Same posture or motions again and again • Repetitive motion can be very frequent over short period of time • Cumulative traumacan be less frequent but repeated over time

17. Contact Stress/Poorly Designed Equipment Common equipment problems to watch for: • Does not have a good grip • Too heavy • Hard to use • Uncomfortable • Bad condition • Wrong tool/equipment for the job

18. Extreme Temperatures Common warning signs: • Dehydration • Compromised tissues • Muscle cramps • Restless leg syndrome • Poor circulation

19. Vibration Can lead to injury when you are: • Using reciprocating tools • Using grinding or impact tools • Using vibrating tools • Working in or on motorized vehicles

20. Work Organization Common issues to look for: • Scheduling • Lack of planning • Communication • with crew • with other patient stakeholders • Work practices

21. An Activity is Likely to Become an Injury When: • You perform the activity frequently • You do the activity a long time • The work intensity is high • There are a combination of factors

22. Name Your Most Risky Tasks List three examples of tasks that you do at work to the risk factors that have 3 blanks next to them on your handout. • ______________________ • ______________________ • ______________________

23. Injury Prevention Program SAFETY ERGONOMICS HEALTH ERGONOMICS TEAM labor & management TRAINING JOB ANALYSIS risk factors identified HAZARD PREVENTION & CONTROL MEDICAL MANAGEMENT REVIEW

24. Ergonomic On-line Resources FEMA has Fire and EMS Ergonomics: search for “ergonomics” onhttp://www.fema.gov/ Elements of Ergonomics Programs – NIOSH http://www.cdc.gov/niosh/homepage.html Oregon OSHA http://www.orosha.org/consult/ergonomic/ergonomics.htm Federal OSHA http://www.osha.gov/SLTC/ergonomics/index.html

25. Ergonomics Program Elements • Assessment of musculoskeletal hazards • Prevention and control of musculoskeletal hazards • Training • A medical management system • Procedures for reporting injuries • A plan for the implementation of the program • Methods for evaluating the program

26. Assessment of Hazards • Breaking each specific job down into elements • Identifying conditions within a job that contribute to risk Performed by person with ergonomics training: • Safety committee members • Line personnel

27. Prevention and Control • Set short term and long term goals • Think outside the box – come up with many solutions • Decide on the optimal solution by thinking about • Barriers • Cost • Amount of risk reduced

28. Ergonomic Solutions Personal control Effectiveness Equipment or Engineering Job organization Personal protective equipment Bodymechanics

29. What and Why Analysis • Tasks or steps involved • Body parts affected • Risk factors • Frequency/duration of task • Why is it done this way? • Potential solutions • Cost of solutions • Barriers Assess the task Prevent & control

30. Conclusions • Cumulative trauma occurs over time • may not result in an injury for many years • may be disabling • Applying ergonomics = injury prevention • Understand injury risk factors • Some situations may have little room for improvement, but with others you have the control to improve: • equipment • work practices • bodymechanics

31. Other Ergonomics Training Topics • Job hazard analysis • Ergonomic solutions • Bodymechanics & Back Health • Ergonomics for command staff

32. ? ? ? ? Questions and Evaluation Thank you for your attention