E. F. Rooney, R. R. Morency
L. L. Bean,Inc., Freeport, ME, 04033
In response to increasing cumulative trauma disorders of the upper extremities and back in the mid to late 1980's, L. L. Bean implemented many initiatives to reduce their incidence and severity in its Manufacturing division. In 1989 L. L. Bean also began to implement Total Quality Management as a way of doing business. The combination of good management and effective health and safety programs resulted in a -79% reduction in lost-time incidents. In order to evaluate the effectiveness of the ergonomics program in the reduction, a practical evaluation method for quantifying ergonomic changes was developed.
Like many companies in Maine and the nation in the mid to late 1980's, L. L. Bean experienced a rising incidence of cumulative trauma disorders (CTD's), predominantly of the upper extremities and back. Our worksites had always been clean, well lit, and apparently safe. However, the emergence of these "new" occupational illnesses, CTD's, changed our perspective on workplace health and safety. Ergonomics became a key strategy to prevent workplace injuries/illnesses, as well as to return partially disabled employees to the work force.
During this period, the practical definitions of work-related conditions seemed to broaden. In its meatpacking guidelines, whereas OSHA defines occupational injuries as, "caused by instantaneous events in the work environment", OSHA's definition of occupational illnesses includes the statement, "unless the illness was caused solely by a non-work-related event or exposure off-premises, the case is presumed to be work related" (OSHA, 1991).
Workers' compensation case law in Maine gradually incorporated definitions like these over the 1980's. Cumulative trauma disorders like tendonitis, carpal tunnel syndrome, bursitis, and epicondylitis seemed to come out of the woodwork as employees, doctors, employers and others realized the potential connection of CTD's with work. We aggressively developed and implemented health and safety programs to address the increasing incidence of CTD's.
During the same period our company adopted Total Quality Management(TQM), a quality improvement philosophy and management system based on the work of Deming(1986), Juran(1964), and Crosby(1979) in the 1950's. Until then, like many good manufacturing companies, we had utilized Frederick Taylor's(1923) scientific management principles to achieve high production rates. With TQM's focus on quality and overall productivity, it allowed us to re-examine the way our 400 employees had successfully produced shoes and canvas luggage in the past. New management in our Manufacturing division proactively adopted TQM and focused a lot of time and energies on improving workplace health and safety.
TQM effectively places responsibility for workplace health and safety with area management and the responsibility for providing innovative and effective programs with Employee Health and Safety. Employee Health's mission and objectives are aimed at helping area management and employees to achieve and maintain a healthy and safe workplace. To achieve that mission and objectives, the "right things" (programs or processes) needed to be developed (see Figure 1). Through "customer-supplier" alignments, the Health and Safety Department helped our "internal customers" (area management and employees) in our Manufacturing division implement the right programs to help reduce the incidence of CTD's.
From 1988 through 1990, 70-90% of Manufacturing's lost-time claims were classified as CTD's, occupational illnesses. Our focus became not only preventing as many injuries or illnesses as possible, but also accommodating employees with CTD's that might have only partially been caused or aggravated by work activities. Ergonomics was a cornerstone of our focus.
From 1989 through 1991, with the help of Employee Health and Safety, Manufacturing was able to achieve a -78.8% reduction in lost-time incidents.
Because of the multi-disciplinary approach to reducing injuries/illnesses, it was impossible to quantify the specific contribution of each program to the subsequent reduction in lost-time incidents. However, as part of TQM, we try to measure the contribution of our programs in order to make sure we are doing the "right things right" to achieve our objectives. We subsequently developed a practical method to objectively quantify the improvements in acknowledged risk factors for CTD's.
Ergonomics in Manufacturing moved through three phases from the mid-1980's to today.
Phase 1: Ergonomics was typically focused on improving jobs in which employees had an injury/illness. Emphasis was on reacting to problems as they developed. Training of supervisors, engineers, budget analysts, human resource specialists, and others was accomplished, but there was not yet an effective system to implement changes.
Phase 2: Ergonomics was applied to jobs more proactively in the late 1980's. Ergonomic design teams included health and safety specialists as well as engineers and employees to look at jobs for ergonomic improvement. There was now a more formal framework to implement changes, but focus was still on justifying ergonomic changes in relation to overall productivity.
In this period, an external expert was brought in to intensively train six people to videotape, analyze, and use a team approach to make changes in jobs. The method helped us learn how to make sound, objectively evaluated, ergonomic changes ourselves.(Wick, et al., 1990) However, whereas we began to see some immediate benefits from this training, the management framework was not yet in place to maximize the effect of ergonomics.
Phase 3: Ergonomics became a part of the overall job and work flow design just like productivity and quality. In TQM, workplace health and safety is an integral part of management and employee performance expectations and rewards. Ergonomics has become an integral part of manufacturing and is included in all workplace planning and changes.
Since we could not measure the effect of ergonomics changes on the reduction in lost-time incidents independent of other factors, we decided to measure the improvement in risk factors that experts in the literature feel contribute to cumulative trauma disorders. We would evaluate our program based on percent improvements in those risk factors and the number of jobs and employees affected by the improvements.
The basic framework of our methodology evolved to closely follow the proposed OSHA ergonomics guidelines and other recommended approaches (Keyserling et al.,1991; OSHA, 1991), utilizing an ergonomics design team approach. The core team included the ergonomics specialist, standards analyst/engineer, occupational health nurse, and a member of our Maintenance Department. In looking at any jobs, the affected employee(s) and supervisor were always included and were an integral part of the process.
The program started with worksite analysis. We used a combination of methods including: monitoring OSHA-200 logs and workers compensation claims; measuring incidence rates; conducting plant surveys; studying reports from supervisors, employees, and health and safety personnel; and other methods. Data collected by the Health and Fitness Specialists as they implemented worksite stretch programs provided additional information on what parts of the body employees felt the most fatigue and soreness. Our ergonomics specialist became closely involved with any planned changes in products or work processes.
In jobs where quick fixes (e.g. obvious postural changes) were needed, changes were implemented immediately. However, in situations requiring a more thorough analysis, a seven step process was used: (Drury and Wick, 1984)
Our concern was with new types of hazards: excess force, angle, repetitions, and awkward unsupported postures. Typical conditions that created these were identified:
Initially many modifications consisted of 2x4's, 1/2 inch plywood, and angle iron. These modification materials, though simple, were inexpensive, easy to install, and very effective. After implementation employees almost always felt the improvement. If not, we would keep working at it.
As awareness and support increased, department budgets for ergonomic improvements also increased. Our solutions became much more creative:
The Ergonomics Specialist worked closely with the Occupational Health Nurse and onsite Physical Therapist to help return partially disabled employees to the workplace. Aggressive medical management included early reporting of symptoms, onsite physical therapy, an active modified work program, work hardening that transitioned employees into our health and fitness program, and close follow-up of employees with symptoms.
Joint evaluations of the worksite by the affected employee, the supervisor, the ergonomics specialist, physical therapist, and occupational health nurse helped tailor the worksite specifically to fit the employee's capabilities and restrictions. Engineering and work practice controls, administrative controls, and personal protective equipment were used to return the employee to work in his or her own or modified job. Any ergonomic changes made for partially disabled employees were evaluated for transfer to other similar jobs.
In the first two years of the ergonomics program, education and training was focused on the ergonomics team, managers, and supervisors. Employees were brought into the process and educated as changes were made to their jobs. Employee insights, participation, and buy-in to any changes were critical.
Overall ergonomics training for all employees in the plant is being conducted in 1981 and 1982.
In order to evaluate the effectiveness of ergonomic changes independent of the other programs, assessment of the improvement was made for each intervention. Categories of 0-10%, 11-25%, and 26+% were established. Force was measured in pounds using grip and pinch meters or a scale if it was a lift. Repetitions were counted using slow motion video analysis. Angles (i.e. ulnar deviation) were measured in degrees with a protractor using slow motion video analysis. Posture was measured in degrees and was estimated visually.
Since one person performed all the measurements, reliability was somewhat controlled. However there was no independent check of the evaluator's measurements. Overall, in 1990 there were 373 modifications of the risk factors to 214 workstations. (Many jobs had more than one risk factor modified.)
There are some limitations to our system. We do not actually know that the risk factors we are measuring are the cause of the lost-time incidents. Likewise, we also do not know that the improvements in those risk factors are actually contributing to the reduced lost-time rates. Postural measurements were somewhat subjective. And there were also no independent verification of any of the measurements.
To make sure that what we are measuring is valid, we rely on expert opinion and the literature. That is, that the posture, angle, force, and repetition improvements will lead to improved ergonomics and decreased CTD's. (Keyserling,et al.,1991) We continually watch the literature for validation of the risk factors on which we focus.
As we expand the measurement system company-wide and involve others in the measurements, we are beginning to quantify postural improvements to improve their accuracy. We are systematically training persons taking the measurements and are performing periodic audits to ensure accuracy and reliability.
Although not perfect, what we end up with is a reasonable system to make sure we are doing the right things right; that we are changing the right aspects of the jobs looked at; and that the changes result in improvements. Although lacking in scientific rigor, it is a system that works well for us. It enables us to effectively work with area management and employees to carry out our mission to improve the health and safety of the workplace.
We would like to thank John Wick (J and J Consulting, Issaquah, WA) for helping us develop the ergonomics expertise within L. L. Bean.
Crosby, Philip B., 1979, Quality is Free, (New York: New American Library).
Deming, W. E., 1986, Out of the Crisis, (Cambridge, Mass.: Massachusetts Institute of Technology, Center for Advanced Engineering Study)
Drury, C.G., and Wick, J.L., 1984, Ergonomic Applications in the shoe industry, In: Proceedings of the 1984 International Conference on Occupational Ergonomics, Toronto, pp. 489-493.
Juran, J.M., 1964, Managerial Breakthrough, (New York: McGraw-Hill). Keyserling, W.M., Armstrong, T.J. and Punnett,L.,1991, Ergonomic job analysis: a structured approach for identifying risk factors associated with overexertion injuries and disorders. Applied Occupational and Environmental Hygiene, 6(15), 353-363.
National Institute of Occupational Safety and Health, 1981, A work practices guide for manual lifting, DHHS, Pub. No.81-122, (NIOSH, Cincinnati, OH).
Occupational Safety and Health Administration, 1991, Ergonomics program management guidelines for meatpacking plants, U.S. Department of Labor, OSHA 3123.
Putz-Anderson, V.(Ed.), 1988, Cumulative trauma disorders: a manual for musculoskeletal diseases of the upper limbs, (London: Taylor and Francis).
Taylor, F.W., 1923, Principles of Scientific Management, (New York: Harper).
Wick, J.L., Morency, R., Waite, J., and Schwanda, V.,1990, Ergonomic improvement in a barr-tack sewing job: a case study, Advances in Industrial Ergonomics and Safety II, edited by Biman Das, (London: Taylor and Francis), pp. 285-288.
To work with area management and employees to achieve and maintain a healthy and safe workplace, and promote the health, safety, and fitness of employees.
"Right things" to achieve objectives.
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