TABLE OF CONTENTS
INTRODUCTION     3
  Vision    3
  Goal      3
  Objectives     3
PROGRAM MANAGEMENT     4
  Management Commitment and Employee Involvement   4
  Program Review and Evaluation   5
  Responsibilities     5
TRAINING AND EDUCATION 9
  Coordination of Scheduling and Data Collection   9
  Types of Training.   10
  Evaluation.    11
SURVEILLANCE     11
  Passive Surveillance involves the analysis of existing records  and  data.
  12
  Active Surveillance  13
ANALYSIS AND DESIGN OF JOBS  13
  Job Analysis   13
  Design of Jobs.      16
MEDICAL MANAGEMENT     17
  Accessibility  18
  Health Surveillance. 18
  Identification of Restricted-Duty Jobs      18
  Medical Intervention.      18
  Record-keeping, Data Evaluation, and Action.     19
Original sources, used in the work      20
INTRODUCTION
      This  document  contains  the  information  needed  to  carry  out  an
ergonomics program.  Specifically, it  provides  information  on  the  goal,
objectives, and principles  of  the  program  and  the  responsibilities  of
staff, management, support offices, and service unit  ergonomics  teams  for
the program.
Vision
The Workplace Ergonomics Program was established to optimize worker  health,
safety, and  productivity,  and  minimize  physiological  and  psychological
stress utilizing consultative management.
					







Goal
The goal of the Workplace Ergonomics Program is  to  reduce  and/or  prevent
work-related injuries  and  illnesses  by  establishing  a  methodology  for
identifying ergonomic  stressors  in  the  workplace  and  for  implementing
appropriate interventions.
Objectives
The objectives of the Workplace Ergonomics Program, as administered  by  the
Workplace Ergonomics Program Coordinating Committee, are:
1. To identify existing and  potential  conditions  in  the  workplace  that
   could lead to injuries and illnesses.
2.  To  reduce  and/or  eliminate  exposures  to  such  conditions   through
   effective workstation and tool design and through proper work methods.
3. To ensure  evaluation,  diagnosis  and  treatment  of  repetitive  strain
   disorders, and to provide avenues for prevention.
4. To ensure that staff are sufficiently informed  about  ergonomic  hazards
   to which they are exposed so they may actively participate in  their  own
   personal protection through training and education.
PROGRAM MANAGEMENT
Management Commitment and Employee Involvement
      Management commitment and employee  involvement  are  crucial  to  the
success of the ergonomics program.  Management  commitment  is  demonstrated
by  the  provision  of  organizational  resources  and  the  assignment   of
accountability for the program.  Employee involvement is necessary not  only
for identifying existing and potential hazards, but also  for  participating
in their own personal protection.
      Management commitment provides visible involvement of managers at  all
levels.  It places a high priority on eliminating ergonomic stressors  while
assigning and communicating the responsibilities for various aspects of  the
program and requiring accountability for fulfilling  those  responsibilities
in
a timely manner.  Management provides authority and  adequate  resources  to
meet the assigned responsibilities.
      Employee involvement can be achieved through the implementation of  an
employee complaint/suggestion  procedure;  encouraging  early  reporting  of
injury/illness symptoms; involvement in the consultative management  process
associated with this program;  and  training  for  active  participation  in
their own personal protection.
      Below is a partial  list  of  actions  to  be  undertaken  to  achieve
management commitment and employee involvement:
Require  that  all  affected  employees,  including  their  supervisors  and
managers, take ergonomics training.
Include  statement  of  responsibility   for   safe   and   healthful   work
environments and policy directives.
Inform service unit heads that  they  are  to  assign  responsibilities  for
program  implementation  to  service  unit  ergonomics   teams   and   other
administrative  personnel,  as  appropriate,  and   provide   staffing   and
financial resources for implementation.
Hold service unit heads accountable for  the  progress  of  the  program  in
their service unit.
Provide  suggestion/complaint  boxes  for  ergonomic  safety/health   issues
within each service unit.  Require a response to each suggestion/complaint.
Encourage staff to report symptoms of  discomfort  promptly  to  supervisor,
health professional, or service unit ergonomics team.
Include bargaining unit staff in service unit ergonomics teams.
Issue memorandum to staff announcing the program.
Distribute summaries  of  this  program  document  to  all  staff  via  «The
Gazette» and service unit distribution channels.
Program Review and Evaluation
The Workplace Ergonomics Program shall be  reviewed  on  an  ongoing  basis.
The Workplace Ergonomics Program Coordinating Committee is  responsible  for
developing a program evaluation mechanism, and  producing  progress  reports
for management and staff.
      Further,  the  Workplace  Ergonomics  Program  Coordinating  Committee
meets periodically throughout each year with service  unit  ergonomics  team
leaders to assess progress.  This mechanism assures that WEPCC provides  the
needed support to the service unit teams.
Responsibilities
Workplace Ergonomics  Program  Coordinating  Committee  is  responsible  for
overseeing, coordinating, supporting, and reviewing the ergonomics  process.
 The responsibilities are:
Establishing performance expectations and benchmarks  in  consultation  with
the service unit ergonomics teams
Coordinating problem resolution in areas that affect more than  one  service
unit
Providing assistance  and  advice  on  technical  matters  to  service  unit
ergonomics teams
Reviewing program and reporting to management and staff
Service  unit  ergonomics  team  bears  responsibility  for  operating   the
Workplace  Ergonomics  Program  within  the  service  unit.   The  team   is
specifically responsible for:
 Performing surveillance, analysis and design of jobs
 Identifying specific training needs
 Coordinating its activities with Facility Design and  Construction,  Health
Services Office, Safety Services and labor organizations. Reporting  to  the
WEPCC and to the service unit head
Supervisors are responsible for:
 Cooperating with the service unit ergonomics team
 Referring employees with health concerns to Health  Services  in  a  timely
manner
 Reporting work area hazards promptly to the service unit ergonomics team
 Notifying the service unit ergonomics team when a work area needs  analysis
 Assisting in the correction of existing and potential hazards
 Assuring that recommendations are implemented following analysis
Staff members are responsible for:
Reporting work area hazards upon becoming aware of their existence
Cooperating with the service unit ergonomics team
Providing input to job analysis and design process
Actively engaging in their own  protection  by  following  recommended  work
practices and suggestions of work area consultants
Labor organizations are responsible for:
 Appointing a representative to each service unit ergonomics team
 Encouraging early reporting of symptoms by employees  and  referring  those
employees to appropriate offices
 Bringing ergonomic problems and potential problems to the attention of  the
service unit ergonomics teams and other responsible officials
      Facility Design and Construction (FD&C) is responsible for design  and
layout of work areas to assure compliance with  applicable  standards.  FD&C
staff participate in job analysis on an as-needed  basis.   Where  ergonomic
interventions are required, FD&C  provides  advice  and  assistance  to  the
service unit ergonomic teams to identify the best possible  solution.   FD&C
maintains information on ergonomically-correct  furnishings  and  equipment.
FD&C is also responsible for:
 Advising as to feasibility of adjustments to existing furniture
 Identifying adjustments to furnishings that can be made by the user
 Identifying adjustments  requiring  professional  installers  —  Reviewing
requests for service  for  workstation  modifications,  including  preparing
drawings and scheduling installers as necessary
 Helping in  the  selection  of  ergonomic  furniture/accessories  requiring
purchase, including review of all purchase requisitions
      Health Services Office is responsible  for  the  medical  surveillance
element of the Workplace Ergonomics Program.   The  Health  Services  Office
serves as a consultant to the  WEPCC  and  service  unit  ergonomics  teams,
providing instruction in  the  prevention,  early  recognition,  evaluation,
treatment, and rehabilitation of repetitive strain disorders.
      The Health Services staff assesses presenting signs and symptoms  and,
based on findings, directs  follow-up  analysis  and/or  treatment.   Within
staffing  constraints,  the  Health   Services   Office's   responsibilities
include:
 Recognizing employee injury/illness problems with ergonomic influence
 Participating in ergonomic evaluations of work
 Identifying restricted-duty jobs
 Performing periodic walkthroughs with service unit ergonomics teams
 Providing wellness education initiatives
 Analyzing health surveillance data  and  evaluating  results  —  Reporting
findings and recommendations
  Participating  in  the  development  of  interventions  and   reevaluating
previous actions
      Safety Services  provides  support  to  the  WEPCC  and  service  unit
ergonomics teams in the areas of safety, mishap/injury prevention,
industrial hygiene, environmental health,  and  emergency  response.  Within
limitations, influenced  by  availability  of  resources,  Safety  Services'
responsibilities are:
 Reviewing injury reports for evidence of cumulative trauma injury
 Compiling and reporting injury statistics related to injury cause factors
 Disseminating general and specific job safety and health information
 Providing expert advice and guidance in the  field  of  safety  evaluations
and ergonomic job analysis and design
 Establishing and maintaining a hazard abatement program
 Reviewing equipment acquisitions
Staff Training and Development  Office  (STDO):   The  Workplace  Ergonomics
Program Coordinating Committee  will  coordinate  with  Staff  Training  and
Development Office for the following functions:
 Keeping training statistics comprised  of  information  received  from  the
service unit ergonomics teams
Maintaining rosters of key trainers throughout
Accumulating statistics on course evaluations
 Providing periodic progress reports on ergonomics training and education
      In addition, STDO coordinates all training activities associated  with
the job-specific training carried out by key trainers/certified  workstation
consultants.  This includes, but is  not  limited  to,  providing  classroom
space  and  equipment,  scheduling  classes,  notifying  staff  of  training
sessions, keeping records  of  attendance,  including  course  descriptions,
objectives, and eligibility requirements in the STDO  course  catalogs,  and
announcing dates of courses in the STDO calendars.  STDO is not  responsible
for developing course content.
TRAINING AND EDUCATION
      The purpose of training and education is to ensure that employees  are
sufficiently informed about the ergonomic  hazards  to  which  they  may  be
exposed, in order to participate actively in their own protection.  It  also
reinforces ergonomic safety as a priority  of  the  institution,  and  gives
employees a clear picture  of  what  they  can  expect  from  an  ergonomics
program.  Effective training and education is essential to  the  success  of
the ergonomics program, and is a continuous process.
Coordination of Scheduling and Data Collection
Centralized data on the  training  program  is  kept  in  order  to  promote
adequate levels of participation among service units, and to coordinate  the
parts of the program that require cooperation.
      The Staff Training and Development  Office  gathers  information  from
the service unit ergonomics teams, coordinates  training  by  key  trainers,
and  provides  data  about  ergonomics  training  throughout   the.    These
responsibilities include:
 Keeping training statistics comprised  of  information  received  from  the
service unit ergonomics teams.
 Maintaining rosters of key trainers throughout the.
 Accumulating statistics on course evaluations.
 Providing periodic progress reports on the training and education program.
 Scheduling classes and coordinating support materials.
Types of Training.
The training program prepares participants  for  the  different  roles  they
play in the ergonomics.  There are seven types of training listed below.
1. Training for Service Unit Ergonomics Teams:  The service unit  ergonomics
   teams are responsible for  implementing  and  maintaining  the  Workplace
   Ergonomics Program at the service unit level.  The teams are  trained  by
   outside consultants.
2. Training for Key Trainers, (staff devoted to training employees  in  job-
   specific  principles  of  ergonomics).    These  key  trainers  will   be
   certified by outside consultants to conduct classes, perform  workstation
   consultations, and to recommend modifications.  They are responsible  for
   training employees in any service unit in addition  to  performing  their
   regular duties.
3. General Orientation:  Service unit ergonomics teams, in cooperation  with
   Facility Design and  Construction,  Health  Services  Office  and  Safety
   Services, provide an introduction to the general principles of ergonomics
   and to the Workplace Ergonomics Program in general orientation  sessions.
   All employees are required to take General Training  or  its  equivalent.
   New staff receives general training during new staff orientation.   Other
   staff will be scheduled to receive general training in a lecture setting.
4. Job-Specific Training:  Every employee (new, old, reassigned)  is  taught
   how to use tools and  equipment  for  maximum  efficiency  and  ergonomic
   comfort, and is responsible for using safe work  practices  on  the  job.
   Training for commonly used  tools  and  equipment  (e.g.,  video  display
   terminals) takes place in the classroom with interactive teaching methods
   (student participation and practice.)  Safety  practices  for  tools  and
   equipment that are unique to a work area are demonstrated on the  job  by
   supervisors. Trainees are expected to actively participate in  their  own
   protection  by  performing  self-assessment  of  their  work  habits  and
   implementing basic changes in their work areas.
5.  Management  Briefing:   Managers  are  responsible  for  supporting  the
   Workplace Ergonomics Program in their areas. Division chiefs,  directors,
   service  unit  heads,  and  some  administrative  officers  will   attend
   briefings by their service unit ergonomics team, with possible input from
   key trainers.
6. Training for Supervisors:  Supervisors ensure that employees follow  safe
   work practices and receive appropriate training  to  do  so.   They  must
   therefore  attend  the  job-specific  training  for  the  positions  they
   supervise.  In addition, supervisors  need  briefings  similar  to  those
   provided for managers in order to gain a complete understanding of  their
   responsibilities.
7. Support Training:  All support offices have  a  responsibility  to  keep
   ergonomic  knowledges  and  skills  current  and  to   apply   ergonomic
   principles in performing their duties.  Appropriate  technical  training
   should be provided for support staff on an as-needed basis.
Evaluation.
The WEPCC will develop evaluation mechanisms for training courses.
SURVEILLANCE
      The purpose of health and job risk factor surveillance is  to  provide
an ongoing  systematic  method  of  identifying  and  evaluating  cumulative
trauma disorders  (CTDs)  and  workplace  ergonomic  risk  factors;  and  to
monitor trends in  their  occurrences  in  specific  areas,  over  time  and
between locations.  The information developed in  the  process  is  used  to
plan ergonomic interventions  and  determine  the  need  for  action.   Data
collected through surveillance  makes  up  the  epidemiological  (incidence,
distribution, and  control  of  disease  in  a  population)  tools  used  in
assessing the workplace and employees and  determining  trends,  costs,  and
interventions.
      The  service  unit  ergonomics  teams  conduct  surveillance  in  both
passive  and  active  modes.   The  responsibilities  for  surveillance  are
interdisciplinary.  See Program Management.
 Passive Surveillance involves the analysis of existing records and data.
      1.  Analysis of Existing Records.   Medical and  safety  professionals
review certain  records  for  implications  of  ergonomic  factors  such  as
overexertion, forceful exertions,  awkward  postures,  and  repeated  motion
type  injuries.   They  forward  information  applicable  to  the  Workplace
Ergonomics Program  to  the  appropriate  ergonomics  committee/team.   This
records review process is a first step in determining the ergonomic  program
direction and for performing the job analysis.
Medical Records.
      Medical records include Occupational Health and Safety  Administration
(OSHA)  logs,  compensation  reports,  medical  visits,  and  as  necessary,
personal medical  records.   Information  of  a  personal  nature  regarding
treatment  and  the  injury  may  not   go   forward   to   the   ergonomics
committee/teams.
Safety Review.
      Safety Services conducts injury/illness reviews and/or  investigations
which identify suspect mishap cause factors useful.  The  resulting  reports
are useful in identification of specific jobs for ergonomic analysis.
Complaint Records/Suggestions.
      Service unit ergonomics  teams  can  use  employee  complaints  and/or
suggestions relating to a  work  process  to  identify  potential  ergonomic
problem areas.  Safety Services  can  assist  the  service  unit  ergonomics
teams in the review of such records.
      2.  Early Reporting of Symptoms.  Employees are encouraged  to  report
early signs and symptoms of discomfort to  their  supervisor,  service  unit
ergonomics team or directly to Health Services. This allows for  timely  and
appropriate evaluation, documentation and treatment or referral.
Active Surveillance
      Active Surveillance is the  solicitation  of  information  before  the
occurrence  of  an  event  which  would  precipitate  a  complaint.   Active
surveillance can be conducted at two levels of specificity.
      Level 1. Active Surveillance is less detailed.
             a.   Periodic  Walkthroughs.   A  walkthrough  is   useful   in
increasing the visibility and accessibility of  ergonomic  team  and  health
and safety professional.  It also acquaints health  care  and  safety  staff
with various areas.
            b.  Surveys.  The symptoms  survey  is  a  widely-used  tool  in
active surveillance.  It is useful in early identification  of  problems  as
well as for assessing the effectiveness of interventions.  There  are  other
such survey tools e.g., fatigue surveys, back history surveys.
            c.  Hazard Evaluations.  Service unit ergonomics teams  evaluate
jobs.  Use of checklists  facilitates  this  process.   The  purpose  is  to
observe, document and assess risk factors present.
      Level 2. Active Surveillance is more detailed.
            a. Health  Interviews  and  Physical  Examinations.   To  assure
effective medical management, it  is  necessary  to  establish  an  approach
which  incorporates  a  baseline  evaluation,  a   postconditioning   period
evaluation and a periodic assessment.  These  are  in  the  form  of  health
interviews and physical examinations. The target population is  asymptomatic
employees already in  or  being  placed  in  high  risk  jobs,  as  well  as
symptomatic employees.
ANALYSIS AND DESIGN OF JOBS
Job Analysis
Job Analysis in an ergonomics program is  a  systems  approach  to  identify
work activities that may result in or contribute  to  overexertion  injuries
and disorders of the back  and  upper  extremities,  often  referred  to  as
cumulative trauma disorders (CTDs).   The  objective  is  to  identify  work
activities that may result in or contribute  to  overexertion  injuries  and
disorders  of  the  back  and  upper  extremities,  often  referred  to   as
cumulative  trauma  disorders  (CTDs).   The  systems  approach   identifies
generic  risk  factors  such  as  forceful  exertions,   awkward   postures,
localized contact stresses, vibration, temperature extremes, and  repetitive
motions or prolonged activities  which  may  contribute  to  injury/illness.
The process involves documentation and study of the  work  by  service  unit
ergonomics teams.  It includes the worker, the supervisor,  and  specialists
trained and experienced in recognition  and  assessment  of  ergonomic  risk
factors.  Completion of  the  job  analysis  results  in  identification  of
ergonomic stresses, design of interventions and follow-up evaluation of  the
interventions.
There are two levels of job analysis.  They are:
1. Surveys/Walkthroughs (Level 1) are a basic  method  of  identifying  risk
   factors associated with the performance of work. Service unit  ergonomics
   teams, in consultation with health care and safety professionals, conduct
   the   surveys.    Checklists   are   useful   in   completion   of    the
   survey/walkthrough.  Other  resource  material  is  available  in  Safety
   Services.
2.  Analysis  (Level  2):  Ergonomics  team  members  conduct  detailed  job
   analysis in work areas after determining and prioritizing those jobs that
   warrant analysis.  All personnel conducting ergonomic job  analysis  must
   have  received  specific  training  in   ergonomic   job   analysis   and
   intervention techniques. The job analysis process  identifies  and  ranks
   specific risk factors, documents job attributes, and  assesses  ergonomic
   stress factors.
      a.  Documentation:  The following constitute documentation of the  job
analysis:
            (1)  Position description:  The  official  position  description
permits the analyst to compare job function to the intended  goal/objective.
 It is possible that the findings of the analysis  may  support  changes  in
position descriptions.
            (2)  Direct observation:  Risk factors in a  job  or  work  area
studied can be determined by direct observation.  The analysis includes,  as
necessary,  upper  extremity  repetitive   measurements   for   total   hand
manipulations per cycle, cycle time and total manipulations  or  cycles  per
shift.  Where appropriate force measurement determinations are needed  these
can be estimated as an average effort or  peak  force.   Force  measurements
can be obtained using appropriate test equipment (if available).
            (3)   Supervisor/employee  interviews:  Staff,  including  labor
organization representatives, provide a broad knowledge base  regarding  job
history and problems.  All job analysis  includes  on-site  interviews  with
employees, supervisors, and labor organization representatives.
            (4)  Videotaping  is  the  preferred  method  of  documenting  a
specific job analysis, in most cases.  It helps the analyst  understand  the
task demands on the worker, and  how  each  worker  accomplishes  the  task.
Videotaping requires the presence and activity of  the  worker.   Use  of  a
checklist aids in accurate documentation of conditions  present  during  the
analysis.  Where videotape equipment is not available use of a checklist  is
even more important.
      b.  Assessment of Ergonomic Stresses:  During the  detailed  analysis,
some specific actions and/or potential stressors are  evaluated  for  impact
on the worker.  There are four specific  stressors  for  which  the  analyst
should be alert.  They are noted below.
             (1)   Repeated  and  sustained  static  exertions:   Does   the
performance of work, required in the  position  description,  require  these
exertions, or do they result from a work practice?
             (2)   Forceful  exertions:   Where   forceful   exertions   are
identified  in  the  analysis  some  specific  steps  may  be  required  for
evaluation and intervention.  It may be  necessary  to  estimate  loads  and
friction  resistance,  make  posture   adjustments,   determine   need   for
mechanical aids, consider use of gloves, and evaluate muscle use with  tools
such as resistance meters and surface electromyography equipment.
            (3)  Localized  mechanical  stresses:   Does  the  work  require
specific forces and/or contact with areas of the worker's body?
            (4)  Posture stresses:  Identification of posture  stresses  can
be accomplished through job analysis observation  and/or  video  tape.   The
analysis may be  supplemented  with  instrumentation  noted  in  (2)  above,
analysis of orientation of the worker in relation to  the  work,  review  of
types of tools used, and use of anthropometric data.
Design of Jobs.
      When considering design or  redesign  of  jobs  the  objective  is  to
minimize  ergonomic  stresses  present  in  the  performance  of  the  work.
Interventions considered must eliminate or reduce employee exposure  to  the
potential for suffering from CTDs and other back and upper  extremity  pain,
while allowing accomplishment of the organization's mission.
      1.  Propose interventions.  A complete job analysis includes reporting
of the  findings,  recommendations  for  design  of  control  measures,  and
evaluation of actions taken.  The report  may  be  formal  or  less  formal,
depending on the extent of recommendations  for  change.    Intervention  is
accomplished through the application  of  appropriate  engineering  changes,
and/or implementation of
administrative  control  for  the  work.   Intervention   is   followed   by
evaluation.
      1.1 Engineering Changes include actual modifications to  the  physical
work  site  and  any  tools  or  equipment  used  in   the   work   process.
Determination of needed changes may require assistance  of  medical,  safety
and other recognized experts.
                 (1)  Tools — Are power assists available?  Can  handles  be
changed?
                 (2)  Machines/Equipment —  Are  changes  necessary  to  the
equipment?  Economic impact may be a necessary consideration in some cases.
      1.2  Administrative  Controls  are  necessary  as  interim  protective
measures, pending completion  of  required  engineering  changes.   In  some
situations administrative controls may be the only intervention needed.
            (1)  Work area — Can  changes  be  made  in  the  work/equipment
location and orientation?  Are proper chairs used?
            (2)  Methods — Is there another way  to  do  the  work?  Is  job
rotation allowed?
            (3)        Standards — If  standards  are  established  for  the
work, are they realistic, up-to-date?
            (4)        Schedules — Are schedules flexible enough to  provide
periodic rest  breaks  and/or  on-the-job  exercises?   Are  work  schedules
flexible?
            (5)  Education/Training — Are  employees  trained  to  recognize
problems and take proper action?
            (6)        Maintenance — Is equipment with moving  parts,  e.g.,
wheels, lifts, etc., properly inspected and maintained?
3. Evaluation.  Each intervention action taken to  prevent/reduce  CTDs  and
   other  related  disorders  requires  follow-up   evaluation   to   assess
   effectiveness of the action.  The evaluation can be accomplished through:
           a.       Job Analysis  —  using  the  methods  described  above,
              and/or
           b.       Active/Passive  Surveillance  —  methods  described  in
              Surveillance.
           c. Assessment — evaluation of information from a. and  b.  above
              to determine whether the goal has been achieved
MEDICAL MANAGEMENT
      The goal of medical management is to ensure evaluation, diagnosis  and
treatment of  repetitive  strain  disorders,  and  to  provide  avenues  for
prevention.  Integration of medical management is essential to  the  success
of the program.  All medical evaluations,  records,  and  data  as  well  as
results of surveys  etc.  are  handled  in  a  manner  which  preserves  the
anonymity of individual  employees  and  maintains  the  confidentiality  of
personal and medical  information.  The  components  of  this  program  are:
Accessibility; Health Surveillance; Identification of Restricted-Duty  Jobs;
Medical Intervention; and Record-keeping, Data Evaluation, and Action.
       Employee  investment  in  the  problems,  along  with  early  medical
intervention and good open communications between Health Services and  other
treating clinicians, are key to success.
Accessibility
      The health care providers must  be  accessible  to  the  employees  to
facilitate   treatment,   surveillance   activities,   and   recording    of
information.  This may be  accomplished  via  walkthroughs  and  educational
initiatives.  The walkthrough increases visibility and provides a forum  for
interaction and exchange of information.
      Health  Services  undertakes  educational  initiatives  for  different
types of cumulative trauma disorders (CTDs), their causes, prevention,  etc.
 These are carried out through  new  employee  orientation,  health  forums,
_Gazette_ articles, brochures, posters, etc.
Health Surveillance.
      The Health Services  Office  serves  as  a  principal  member  of  the
surveillance team assessing and analyzing symptoms surveys, and  encouraging
and receiving  early  reports  of  symptoms.   This  role  is  more  clearly
outlined under Surveillance.
Identification of Restricted-Duty Jobs
      The objective of a restricted-duty assignment is to provide  a  chance
for healing or rehabilitation of an injured area by assigning the worker  to
a position that does not  involve  the  use  of  the  injured  muscle-tendon
group.  This type of assignment is individualized to each worker. A list  or
data base of jobs categorized according to ergonomic risk from high  to  low
is to be developed.  The identification process requires job  analysis  (see
Analysis and  Design  of  Jobs).   As  these  job  analyses  are  completed,
relevant information is added to the official position description.
Medical Intervention.
      Appropriate medical evaluation and care is essential  to  prevent  the
development of  more  serious  medical  problems.   The  main  objective  of
medical management is to identify  and  treat  disorders  at  a  very  early
stage, and  minimize  progression  or  exacerbation.  This  includes  health
interviews and examinations. These  examinations  are  in  the  form  of,  a
baseline evaluation, a post conditioning period evaluation, and  a  periodic
assessment. The baseline or preplacement exam would  determine  capabilities
(as opposed to disabilities) and identify  required  job  restrictions.  The
examinations are job-specific, based on the official  position  description,
initiated by the supervisor or Human Resources, and administered  by  Health
Services.  The post-conditioning evaluation is done no later  than  1  month
after a  new  position  is  assumed  to  determine  if  there  are  symptoms
consistent with the breaking in of muscles as opposed  to  the  onset  of  a
cumulative trauma disorder  (CTD).   The  periodic  assessment  is  oriented
towards   early   detection   of   health   changes   in   at-risk   workers
Responsibilities are outlined in Program Management.
Record-keeping, Data Evaluation, and Action.
      It is important to  maintain  accurate  records.  OSHA  logs,  medical
records, compensation reports, and Safety Services injury reports,  as  well
as the results of symptoms surveillance, are the  epidemiological  tools  in
assessing the workplace and employees and determining trends and costs.
                     Original sources, used in the work
1. gopher://marvel.loc.gov:70/00/employee/health/ergonomics/program3
2. www.ergosci.com
3. www.osha.com
4. http://www.ergonomics.org/
5. http://www.combo.com/ergo/atwork.htm
6. http://www.usernomics.com/hf.html
7. http://www.cordis.lu/src/g_001_en.htm#SEARCH
8. http://www.cdc.gov/niosh/jobstres.html