Q&A column, 7/15

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Editor: Frederick L. Kiechle, MD, PhD

Submit your pathology-related question for reply by appropriate medical consultants. CAP TODAY will make every effort to answer all relevant questions. However, those questions that are not of general interest may not receive a reply. For your question to be considered, you must include your name and address; this information will be omitted if your question is published in CAP TODAY.

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Q. We recently reorganized the workflow in our blood bank in hopes of improving process control and reducing distractions. In doing so, we increased the potential for workplace injuries. The ergonomic issues are a major concern for a lot of workers. Employees on all three shifts are developing back and knee issues. We are an 800-plus-bed hospital lab with more than 30 people working in our department. The following issues have arisen:

1. The racks that hold the specimens are too far away for our reach, as are the centrifuges. We are always leaning and stretching forward to perform our work. The benches don’t have a lot of space, so the materials are deep.
2. The main centrifuge sits atop the registration bench and is two feet high. Continuous sitting, standing, sitting goes on. We perform about 150 type and screens a day. The printers that print in-house orders are also on this registration bench and, again, there is a lot of stretching and leaning forward to get these orders.
3. We have a tech who stands at the window issuing products all day. The bench there has a higher chair but with no room to fit a person’s legs or knees when sitting—drawers take up all the space, so sitting is a rarity.

A. Work-related musculoskeletal disorders, such as those affecting the back and knees, are typically the result of cumulative exposure to ergonomic risk factors over a prolonged period. The most common risk factors that predispose an individual to those disorders are exertions or excessive force; awkward postures or static or sustained postures; repetitive motions; contact stresses; vibrations; and extreme temperatures, particularly cold environments.

Employees should evaluate work tasks, jobs, and equipment that could result in these risk factors and attempt to reduce exposure to them. The optimum neutral postures for standing and sitting workstations are shown in Figs. 1 and 2. While performing working tasks or jobs, the employee should attempt to maintain these neutral postures.

Suggestions for problem No. 1

• If the work area is used for sitting and standing, make sure the work surface is 38 inches above the floor or, ideally, adjustable up and down. This is the standing elbow height of the 5th percentile individual and will allow for both standing and sitting postures. If it is possible to sit, then knee spaces need to be provided. Knee spaces should be 27 inches wide and at least 18 inches deep at the knees and 45 inches at the feet.
• Stand or sit close to the work surface to avoid reaching.
• Keep frequently used items within arm’s reach. Move items to the front edge of the work surface. Eliminate the need to reach across the body to retrieve supplies.
• If horizontal real estate is at a premium, then place other supplies vertically in tilt-front bins.

Suggestions for problem No. 2