Preventive Ergonomics:

A Guide to AT and Accommodations in the Workplace

BJ Bolender and Sue LeHew, April, 2006

 

As part of the ATAZ staff training program, the ERGO and Physical Considerations session includes a discussion and suggestions for preventive ergonomics.

In the workplace, AT is provided for staff and clients for two reasons:

  1. To increase productivity

  2. To minimize fatigue


Great accommodations and common sense modifications that are at no cost or minimal expense are provided in the website for JAN: Job Accommodations Network. The main link is below, and other links are provided at the end of this handout

http://janweb.icdi.wvu.edu/

Topics for presentation include the following common disability and medical conditions: back and neck problems, upper extremity limitations, lower extremity limitations, and many conditions including CFS, neuropathy, arthritis, obesity and diabetes. In the workplace, the most important priorities for accessibility are environmental (such as physical access to the workplace and circulation inside the workplace) and the actual workstation, often a computer workstation. Provided at most One-Stop Centers in Arizona are the following AT resources:

  1. Ergonomic chair: adjusts for height, back rest, and has adjustable arm rests

  2. Powerlift desk: adjust for height of wheelchair users, those of different statures, and those who must use a computer standing in lieu sitting

  3. Ergonomic keyboard: "wave" style to separate the hands and provide good hand position while keyboarding. May also have alternative keyboards such as one that has a keyguard of help to those whose hands shake.

  4. Trackball and/or touchpad mouse: for those who cannot use a regular mouse

  5. Microsoft Windows accessibility features:
    - - - Sticky Keys: (for those who need to type two or more keys at once to perform an action)
    - - - Mouse Keys: (the numeric keypad may be used instead of a mouse. The "5" becomes the "click" and keys around the 5 are navigational. Also has double click, click lock and click or button release)
    - - - On-Screen keyboard: a virtual keyboard appears on screen for users to enter text using a mouse, trackball, touchpad, joystick mouse, mouse keys or other alternative pointing device

  6. TextHelp software: word prediction software that reads text documents and reduces time and tasks of text entry

  7. DragonNaturally Speaking Preferred: software to read content and enter content without the use of a keyboard or mouse

Accessibility in the One-Stop Site: environmental issues

The following may or may not be present on-site: ramp, automatic doors, accessible restrooms, signage at appropriate heights and locations, adequate "horizontal access" to move between rooms, adequate space for accessible workstations, and accessible parking space that is adequate for clients with disabilities.

General Preventive Ergonomics for all:

  1. What you can do: maintain a neutral position at your workstation (Think 90% angles to position your ankles, knees, hips, elbows)

  2. Your chair: Support the above full body position while sitting

  3. Your workstation surface: support neutral wrist position, straight wrists

  4. Standing job tasks: allow for breaks, change of position, floor mats

  5. Frequent short breaks: Every 20 minutes, take a 1 to 5 minute break to change your position, whether seated or standing

Back and Neck Considerations:

  1. Get the right chair for YOU, matching it to your workstation. If you have diagnosed physical condition

  2. Cushion technology: Usually for wheelchair users and is prescribed by a physical motor specialist such as a PT, OT, or Rehabilitation Engineer. If fatigue is an issue for a wheelchair user, consider requesting a SEATING EVALUATION from the individual's health plan. The primary care physician can write a prescription for the seating evaluation along with the Rx for the wheelchair.

  3. Research accommodations for both sitting and standing job functions


Upper Extremity Limitations:

  1. Carpel-tunnel Syndrome: Use ergonomic keyboard and seating devices, use "Stretchware" (software that interrupts your workflow at the computer to remind of breaks and exercises that will reduce physical strain and fatigue)

  2. Rotator-cuff and shoulder conditions: anticipate strain caused by handling and lifting workplace items that are heavy and awkward to position

  3. One-hand: (full use of one hand only) Try alternative keyboards such as 1 Hand Dvorak keyboard layout (available free for left or right hand layouts) along with products like Dragon Naturally Speaking to preserve function in remaining hand.

  4. One-hand: (use of just one or a few fingers) Try word prediction software such as Text Help to reduce manual typing and increase typing speed. Definitely try using Sticky Keys!

  5. No hands: Use DragonNaturally Speaking Professional version, and use the on-screen keyboard in the Windows Accessibility features, with a "head mouse" or switch. Some people will bring to work their own special AT devices.

  6. Use Sticky Keys and Mouse Keys as needed to aid keyboarding


Lower Extremity Limitations:

  1. Wheelchair/scooters: need environmental supports within the workplace, such as: accessible restrooms, adequate aisle space, ramps, automatic door openers, automatic door switches at upper and lower placements, adequate and accessible parking spaces, adequate workstation space for AT equipment and movement within the workspace, and accessible circulation of facility interior spaces

  2. Think about the 24 hour battle of gravity vs. positioning and job tasks

  3. Reduce susceptibility to pressure sores (decubiti): injury can occur in as little as 20 minutes with a sustained position

  4. Feet and ankles: fatigue and stamina issues

  5. Crutch/appliance/prosthetics: fatigue issues and insure proper fit


Other Common Physical Accessibility Issues and Medical Conditions:

  1. Arthritis

  2. Diabetes

  3. Cerebral Palsy, Muscular Sclerosis, Muscular Dystrophy

  4. Fatigue: Chronic Fatigue Syndrome, Fibromyalgia, Sleep Disorders

  5. Chronic Pain and Cumulative Trauma Disorders

  6. Stroke

  7. Epilepsy

  8. Stature conditions and Little People

  9. Burn injuries, sprains, broken bones and surgery-recovery


Selected links for workplace accommodations and AT

http://www.jan.wvu.edu/Erguide/
Employer's Practical Guide to Reasonable Accommodation under the Americans with Disabilities Act (ADA)

http://www.jan.wvu.edu/Erguide/Three.htm#D1
Work-site Accessibility

http://www.access-board.gov/adaag/checklist/a16.html
Americans with Disabilities Act Accessibility Guidelines (ADAAG) Checklist for Buildings and Facilities

http://www.usdoj.gov/crt/ada/checkweb.htm
Checklist for Readily Achievable Barrier Removal

http://atarizona.com/docs/General/Readily%20Achievable%20Barrier.PDF
Readily-Achievable Barrier Removal - .pdf download from ATAZ website

http://www.jan.wvu.edu/media/ampu.htm
Fact Sheet: Amputation

http://www.jan.wvu.edu/media/Arthritis.html
Arthritis

http://www.jan.wvu.edu/soar/other/ataxia.html
Accommodation Ideas: Ataxia

http://www.jan.wvu.edu/media/back.htm
Back conditions

http://www.jan.wvu.edu/media/CP.html
Accommodation and Compliance Series: Employees with Cerebral Palsy

http://www.jan.wvu.edu/media/cfs.html
Accommodation and Compliance Series: Employees with Chronic Fatigue Syndrome

http://www.jan.wvu.edu/media/ChronicPain.html
Accommodation and Compliance Series: Employees with Chronic Pain

http://www.jan.wvu.edu/media/CTDs.html
Accommodation and Compliance Series: Employees with Cumulative Trauma Disorders

http://www.jan.wvu.edu/media/Diabetes.html
Accommodation and Compliance Series: Employees with Diabetes

http://www.jan.wvu.edu/media/epilepsy.html
Accommodation ideas for employees with epilepsy

http://www.jan.wvu.edu/media/Fibro.html
Accommodation and Compliance Series: Employees with Fibromyalgia Syndrome

http://www.jan.wvu.edu/soar/leg/leg.html
Leg Impairments

http://www.jan.wvu.edu/soar/littleperson/littleperson.html

Little People

http://www.jan.wvu.edu/media/MS.html
Accommodation and Compliance Series: Employees with Multiple Sclerosis

http://www.jan.wvu.edu/media/MD.html
Accommodation and Compliance Series: Employees with Muscular Dystrophy

http://www.jan.wvu.edu/soar/obesity/obesity.html
Obesity

http://www.jan.wvu.edu/soar/other/onehand.html
One Hand Use

http://www.jan.wvu.edu/media/whee.htm
Paraplegia: Accommodation Ideas for Wheelchair Use

http://www.jan.wvu.edu/media/Sleep.html
Sleep Disorders

http://www.jan.wvu.edu/media/Wheelchair.html
Quadriplegia: Accommodation and Compliance Series: Employees Who Use Wheelchairs

http://www.jan.wvu.edu/media/stro.html
Accommodation Ideas for Stroke

http://www.jan.wvu.edu/media/burninj.html
Accommodating employees with burn injuries