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Day 1 Sunday, 1 November 2020 9:46 AM Assignment 1 notes - Using anatomical ranges and proper physiological terms - Encouraged and advised to use photos - Don't just put admin as suitable duties, make sure you report 3 suitable duties. - Can choose case study with the most research behind it, so you can make realistic RTW timeframes with the most up to date research. Has to be evidence or justification supported - Need appropriate referencing and research to justify the selection of what we use. All case studies come with a yellow flag/psychological barrier in there - address and factor this into RTW plan. See if that may impact in RTW timeframes - see if literature reflects that. Discussion part is generally done quite poorly. How to overcome this? Get GP to refer to psychologist (and justify, if literature suggests this). - APA referencing - Use the template, keep things necessary but brief. Assessment 3 notes: workstation assessment - Choose a workstation that actually may need some work - Ensure notes and comments throughout the checklist - Take a few photos, with worker in and out of the work station. Photos should reflect what we are discussing in that point. - Workstation dimensions - keep it brief and put it in a table. Assessed dimensions (table height, depth, width, monitor height and angle etc). Is access to standards document SAI global. Then put in relevant recommendations/current standards. - Can potentially do a home office environment. - Recommendations and estimations of costs normally done poorly - must justify all recommendations. Notes also done in the word docs in the file Activity 11, OSHA Notes on posture- arms are too close when typing, cramped up - Modified work station to avoid glare, but causes her to twist Notes on seating- no arm rests used, On the spot fixes, - Move computer straight towards her to stop twisting - apparently she was facing straight - See if there is lumbar support - Use a document holder - Education on using the back rest to get lumbar support Questions we can ask Trinity- Frequency of using documents Worksite Prac Page 1 - Frequency of using documents - Dual monitor for data entry? Can use this for assignment task 3 (checklist) Activity 11, HSE VDU checklist - May have had pre-existing injuries and had previous modifications already - Using a vertical mouse - Had to pivot to answer phone calls- how often does she use the phone? Can she have headset on all the time or have the telephone moved? Activity 11, differences between OSHA and HSE HSE VDU has pictures , OSHA does not OSHA looks at more postural and environmental OSHA more comprehensive, and I'd probably use it more Activity 13 AHRR Form 6 weeks post operation, FCE assessments we would choose (10) specific to Mick, ACL tear, MCL avulsion 1) 6mwt or step test 2) Maximal lift 5rep f2w 3) Postural tolerance test - looking at walking/standing/sitting/crawling/crouching 4) Job stimulated tasks, Shovelling wheel burrowing, transferring loads on and off 5) Unilateral Max carry 6) Unilateral Endurance lift 7) Step test 8) Job simulated line marking Activity 14 Modify an exercise program given and 10 FCE activities As RC, we still can ask what is happening with exercises, so you can relay it back to Dr etc. Case: 43 year old worker at novatel with RC injury. Current: Bench press 3x5 - don't agree Decline DB chest press 3x10 - don't agree Back squat 3x10 - not necessary Bicep curl 3x12 - Could be beneficial Crunches 3x20 - not necessary Upright row 3x12 - could do more damage because of how restricted it is Side laying db external rotation 3x12 - already had comprehensive physio treatment, may not need to do this again (unless it's a warm up) Calf raises 3x10 - not necessary New: Worksite Prac Page 2 New: 1) 2) 3) 4) 5) 6) 7) 8) Seated chest press machine - 3x10 Seated row - 3x10 Bicep curls dumbbell - 3x10 (looking at hand position, hammer underhand overhand) Farmers carry laps (or even in front) Face pulls to increase strength F G H FCE 1) 2) 3) 4) 5) 6) 7) 8) ROM Grip strength Carry (unilateral) Job simulation task Postural tolerance test - Standing, overhead (wiping or reaching). Waist to shoulder Overhead Push/pull Questions For desk, want ALL the dimensions even for seats. Can find relevant recommendations through research as well. Worksite Prac Page 3 Day 2 Monday, 2 November 2020 2:11 PM Assignment 2 breakdown (50% of the total mark) - Make sure you select a task that is actually risky enough - Apply the tools correctly - Use the rubric headings as the headings in the report (except references/legislative/industry, this is an application mark) - Project scope and plan: Brief 1-2 sentence on what the task is and the workplace that it occurs in (i.e. warehouse for x industry). Plan are steps you've taken to do assignment (find hazardous task, contact site for onsite assessment, checklist etc etc) - Executive summary: Is NOT an introduction, it should be like an abstract in a study (half a page maximum) - Intro + lit review: why you've chosen the task, give a little bit of info about the workplace (reader needs to understand how big the workplace is to understand if the recommended strategies are realistic). Lit review: Industry related stats from the ABS, peer reviewed literature. Can access ACU library or scihub. Keep them within 5-10 years old. Anything directly related to industry, similar to industry (i.e. broaden it to warehouse). Find links from similar papers - Workplace obs, inspection + data collection +task analysis and discussion: Insight into the worksite (environmental factors for eg), all the information to apply the tools (a lot of students oversee this) - don't make task more risky than it is. If a task comes up as moderate risk vs high risk, be genuine in application of tools so that you'll get a better mark. If you use the postural tools, make sure you note which photo you're applying that tool to. Typically, students provide 3 photos. i.e. start of the lift, middle of the lift, end of the lift. How often the task is performed (one off or continuous, rest time, how long does each repetition take?). Once tools are applied, need a bit of a discussion. Acknowledge you choose an average height rather than all possible variants and talk about the limitation (under rate and overrate some risks). - Corrective action plan: will need to apply risk matrix before this. Can be sourced online (probability vs impact rating). Take into account, the history of the task (i.e. a task may be performed for years without a reported injury, so you cannot say an injury is more likely. Context for injury history will help with risk matrix scoring). Corrective action plan: Hierarchy of control - understand each of the different aspects of HoC. Students generally put all of the section and give strats for each section, but if you apply an engineering control then some admin controls might not be necessary. Make sure there are at least two options, i.e. option 1 will be the most expensive, then option 2 will be less effective but more cost efficient one. Need to also suggest monitoring and evaluation strategies: analysis of injury records, organising quarterly review with employees to get task feedback, look at productivity measures. Re-apply the tools to see if there has been a substantial change in the level of risk. May not be picked up from the tool, and if so don't include that as a strategy - Conclusion and summary: brief summary of ergo tools you're going to use, and give a nice and concise recommendation with costing. NIOSH tool - It is a lifting equation. Need to assess it at origin of the lift, and destination. Will give you safest amount for both points. Also gives a lifting index: how risky the actual lift is, based off of what the person is actually lifting vs what they should be lifting at that level. Some mistakes students make is they only give one value (i.e. only at beginning or end). - Designed to be the maximum amount a 40 year old woman could lift safely. Generally a little bit lower than the SNOOK tables. The maximum amount that should be lifted if everything is perfect, according to the NIOSH, is 23kg (the load constant). - Can only be applied where there are no extremes of temperature (i.e. not in a fridge or cool section, or hot rooms/outside). SNOOK does not have anything specified about temp limitations - NIOSH is for a two handed lift only. - Has to be an element of control with the lift - i.e. throwing a garbage bag into compactor negates the use of NIOSH - Load has to be stable - (could argue containers with fluids could not be stable). Generally little cans don't count, but larger objects will. From video: Horizontal distance origin (Ho), from middle of feet to where hand is Worksite Prac Page 4 Horizontal distance origin (Ho), from middle of feet to where hand is Vo is distance from bottom of object to where hand is Ao is angle of asymmetry, his feet are facing one direction and trunk in another. Look at angle between these. Frequency (F) is a value assuming that once this task is done, another starts. If he was only doing this task, you see how many lifts done over 15 minutes, then average them out (NIOSH assumes continuous lifting for at least 15 min). Duration would just be short (up to an hour) medium is 1-2 hours, long is >2 hours. Time task is performed. Coupling (C) how hard the item is to hold - there is a decision making tree you can use. ' Horizontal Destination (Hd) is from hands to middle of body Vertical height at destination (Vd) is distance from ground to item Distance (D): |Vd-Vi| Asymmetry angle at destination (Ad) Load = 25kg Ho = 50cm Vo = 40cm D = 60cm Ao = 70deg F= 6/min C= good Duration = short Hd = 30cm Vd = 100cm RWL is risk with lifting (origin o, and destination d) When doing multipliers, overestimate risk if there isn't an exact match i.e always round up RWLo= 23x(horizontal multiplier) x (vertical multiplier) x (distance multiplier) x (asymmetry multiplier) x (coupling multiplier) x (frequency multiplier). In this task, the riskiest component was the horizontal multiplier. The variables we cannot change is the total space available, table height, can't easily change load characteristics (unless they order in smaller sizes). Weigh up whether increase in frequency is better than decrease in weight. 5.19kg is the maximum someone should lift at the origin in the lift in the video and example. RWLd = 11.72 kg at destination Intervention perspective, you will get better outcomes by addressing the changes at the origin (or whatever point is worse). I = index Io = 25/5.19 = 4.82 Id = 25/11.72 = 2.1331 Between 1-3 is considered risky, but other factors will determine if changes needed (ease of change, if there were previous injuries etc). Risk index over 3 (for assignment) is good, as it will mean you have to redesign the task. How to reduce risk here, Origin (could use mechanical aid, like a pallet jack). Would there be enough space there? Would the frequency of use of the pallet jack justify its cost? Could also have empty pallets underneath to elevate and prop it up. Could also do manual handling technique training to reduce horizontal reach. Encourage this alongside another strategy. Had to acknowledge here that pallets had 3 different heights and you took average, which would overestimate the risk at the highest level, and underestimate it at the lowest level. Snook table - Most people can safely lower than they can safely lift - Can also assess pushes and pull and carries - Can also analyse multiple components of the task - For pushing and pulling, you use pushing/pulling force. Takes surface friction into account. To include this with assignment, you either need a force gauge or do mathematical equations to find pushing/pulling force. Worksite Prac Page 5 pushing/pulling force. - Snook tables broken up into gender norms, so you get different values. - Measurement in Snook goes floor to knuckle height, so also takes into account for different user sizes. - Width value is the same as the H value for NIOSH - Will have to acknowledge the table does not match measured values, so you had to overestimate. - Want lift to be suitable for 75% of population measured - Here, it will be 12kg at origin. - Here, the load that is lifted is above the load that is recommended for 10% of the population to safely lift. - In some situations, you look at 90% of pop measured, especially in combined tasks. I.e. lift and carry. Can go to carry section and see, so for carry the load should be 13kg. For lifting at 90% of pop, should be 8kg. Use the lower of the two task values as maximum acceptable weight for entire task. REBA tool - Rapid entire body analysis - You pick a posture that is risky, and use the tool to analyse that specific posture. Not looking at entire task, just a snapshot of it. You should choose a posture that is the highest risk posture for that task. Assess the posture that person is doing more frequently too. - Can use apps on phone to look at angles at certain positions. i.e. HUDL - Video, he picks up object, ducks under a pipe, and squats to drop it off - Step 1: neck +2 +1 for side bend, +3. - Step 2: trunk: +3 +1 for side bend +1 for twist so +5 - Step 3: legs +2 for walking - Step 4: posture score A: 8 - Step 5: Force score/load score lifting 25kg so +2 for load - Step 6: Score A: 10 (step 4+5) - Step 7: upper arm position = 3 because +2 plus abducted - Step 8 :lower arm position = +2, lower range,. Use objective tools IRL - Step 9: wrist position Some flexion so +2 - Step 10: Posture score B= 5 - Step 11: Coupling score fair +1 - Step 12 (10+11) = 6 - Step 13: 11, no additions - SO final REBA score is 11. 11+ is a very high risk, implement change. Ideally for assignment, you'd want to be over 8. Positive aspects of the REBA: - no calculations to apply - More visual, can make do without goniometer - Without a tool, could be subjective. - Bottoms out early from a force load perspective, although risk of 40kg is much higher than 20kg. For assignment, you need 2 tools to analyse the task. i.e. REBA + NIOSH/SNOOK. Get two different types of information. Cheese turning example: Reba would be most appropriate Cannot use NIOSH because of temperature Strategies to fix: - Could potentially fix the storage, but may not be possible - Having another staff do some of the task, reduce the load - Have rest breaks - Do a task at one level, then move to another level (to reduce static postural loading) - Environment is a risk hazard, could have floor mats, but that's not necessarily the biggest musculoskeletal risk. The static loading is worse. - Could do an engineering control by adding in a machine. Worksite Prac Page 6 Mantra Tool - Looking at entire task. - Unlike the REBA, where you look at a specific posture, you apply this to the entire task. - Compared to the other tools, this one takes into account vibration. For example, you could look at the posture of someone drilling into concrete, but vibration will add to level of risk - Also takes into account the speed of movement - Disadvantages are: force, speed and awkwardness ratings are subjective Application: watching guy put spools of wire onto rods Total time: 2-4 hours so 2 Duration: up to 1 hour continuous, so 3 Cycle time: 10-30 seconds, so 4 These values might not be the same for each body, cycle time might be higher for arms vs legs as an example. Repetition risk factor: 4 (from table) Force: Rating of force is subjective, rated according to the individual. Subject rates the 20kg lift of 4/10. So Force score is 2 for LL. For the back, 3. Neck and shoulder: 3. Arm/wrists/hand: 4. Speed of movement: legs: 3, back: 2, neck/shoulder: 4, Arm: 5. Awkwardness: legs: 2, back: 3, neck/shoulder: 3, arm: 3. Exertion risk: Ideally for Mantra, you want multiple aspects come up with a level of risk. ART Tool Assessment of Repetitive Tasks of the upper limbs (ART Tool) Task description • The worker curls croissants into a crescent and pinches the ends together; • The worker curls about 50 – 60 croissants per minute; • Croissants weigh 60g each. There is no indication of any particular force required; • The shift pattern is 07:00 – 15:30 with one 50-minute break at 09:00 and one 30-minute break at 13:30; • Workers carry out this task daily. They rotate to other similar hand intensive tasks throughout their shift. However, for the purposes of this assessment, assume that workers perform this task for the whole shift; • Pinching the work piece causes cramping in the right hand and fingers; • This work is carried out in a cold environment. Before you begin the assessment, watch the video for a few minutes to become familiar with the task and view the task from different angles. https://www.youtube.com/watch?v=nln3-laOlfo Possible solutions to consider? ART Score: 12+0+7+6=25 for L 12+0+8+6=26 for R Any score over 22, high risk and look to investigate. Largest risks apply in the frequency repetition and awkward postures for arm wrist and hand. Intervention could only really aim at frequency, but would be extremely difficult as you'd need a suitable task to rotate into, which is probably not feasible. Worksite Prac Page 7 Final Scenario Replacing a truck tyre 50kg tyre, Multiple injuries with this specific task, a lot of disc injuries etc. Greatest risk: Load, Posture, Jerky nature, Speed, having to use lever to generate large amounts of torque and force. - Can use REBA, with multiple posture measures. ART won't take into account the force and jerky nature - MANTRA could work too as it takes into account the speed and jerky nature, would probably be better Interventions: - Have two people working, one could help with leverage - Could he potentially take the wheel off and then replace it Worksite Prac Page 8