Cumulative Trauma Disorders (CTDs)
The personal computer has become an all pervasive universal work tool. Jobs from the shop floor to the executive office now involve frequent, repetitive computer use. This means that people in the workplace are typing and clicking at an unprecedented pace. Frequent and, and for some, constant computer use have led to an explosion of injuries heretofore seen mostly in the manufacturing, production and shipping industries. Collectively, these injuries are known as cumulative trauma disorders (CTDS).

Define
CTD is an umbrella term that covers a number of injuries caused by forceful or awkward movements repeated frequently over time. Other aggravating factors include poor posture, an improperly designed workstation, poor tool design, and job stress. CTDs occur to the muscles, nerves, and tendons of the hands, arms, shoulders, and neck.

Enforcement by OSHA
Although the ergonomics guidelines developed by OSHA are voluntary, at least for the foreseeable future, the agency does claim it will use the general duty clause of the OSH Act to enforce the guidelines in certain situations. OSHA’s criteria for applying the general duty clause are as follows:

1. Is there currently an ergonomic hazard that is causing injuries?
2. Does the employer in question know about the hazard (or should the employer know)?
3. Are the injuries caused by the ergonomic hazard resulting in serious physical harm?
4. Are there feasible alternatives available to the employer for reducing, abating, or minimizing the hazard?
Although the use of the general duty clause to enforce voluntary ergonomics guidelines is controversial and has been questioned by many employers in theory, in practice this is the approach OSHA will use.

OSHA’s ergonomic guidelines are focused on the following industries:
• Patient handling
• Shipping and receiving
• Baggage handlers
• Warehouse
• Beverage and water handling and delivery
• Retail
• Garbage and trash collecting
• Assembly work
• Piecework assembly
• Product inspection
• Meat, Poultry and Fish
• Machine loading
• Textile manufacturing
• Food preparation
• Banking
• Cabinet making
• Tire making

CTDs: Work Related or Non Work Related?
CTDs present a difficult challenge to safety and health professionals on two levels. First, identifying the source of the employee’s injury can be difficult because of the interplay or non work related activities such as hobbies, playing musical instruments, medications, previous surgeries, hypertension, and other disorders. Second, treatment and rehabilitation can be hindered by outside activities. Consequently, prevention programs should be broad enough to take outside activities into account.

Preventing CTDs
The best way to prevent CTDs is proper work design. In addition, it also helps to make employees and management aware of the hazards that can cause it. These hazards include poor posture at the workstation, inappropriate positioning of the hands and arms, a heavy hand on a keyboard or mouse, and any other act that repeatedly puts the body in an unnatural posture while using the hands. Ergonomically sound workstations can help prevent CTDs, especially when they can be modified to fit the individual employee. However, even the best ergonomic design cannot prevent a heavy hand on the keyboard or mouse. Consequently, ergonomics is only part of the answer: Following are some preventive strategies that can be applied in any organization:

1. Teach the warning signs: CTDs occur cumulatively over time. Warning signs: weakness in the hands or forearms, tingling, numbness, heaviness in the hands, clumsiness, stiffness, lack of control over the fingers, cold hands, and tenderness to the touch.
2. Teach how to stretch: Employees whose jobs involve repetitive motion work such as typing many help prevent CTDs by using stretching exercises.
3. Teach employees to start slowly: Teach employees to limber up, then begin slowly and increase
pace gradually.
4. Avoid wrist splints: Teach employees to position their hands properly without using wrist splints. Splints can cause the muscle that they support to atrophy, thereby actually increasing the likelihood of problems.
5. Start an exercise group: Exercises that strengthen the hands and forearms coupled with exercises that gently stretch hand and forearm muscles may be a preventive measure.
6. Select tools wisely: CTDs are most frequently associated with the repetitive use of video display terminals and hand tools. Note that ergonomically designed hand tools will not overcome poor job design. Good job design and proper tools selection, together, are the best strategy.

Requirements for a full ergonomic program consist of the following components:

• Management leadership and employee participation
• Training
• Record Keeping

Resource: www.osha.gov

If you have any questions pertaining to your companies Occupational Health and Safety program, please email Rick Scott at rscott@aplusbenefits.com