Lauren A. Hebert, PT - IMPACC (SSA Journal Volume 6 Number 6 - December 1992 pp. 32 - 35 )
Ergonomics is a primary issue in occupational health and safety today, touted as the answer to today's cumulative trauma disorder (CTD) epidemic. While ergonomics is a vital consideration to the management of CTD risks, it has not demonstrated itself to be the total answer. CTD encompasses risks often far beyond ergonomic considerations. CTD results partly from poor job design and partly from human behaviors that are independent of job design. An ergonomics program in the workplace will achieve maximum results when that program applies ergonomic job redesign where appropriate, and other alternatives where ergonomics may be impractical. A musculoskeletal injury control program must address the five "Es" of injury elimination: Ergonomics, Education, Exposure reduction, Exercise and Enforcement to be effective. Musculoskeletal disorders, including cumulative trauma disorders (CTD), are epidemic in today's workplace. The costs, frustrations and suffering are enormous. Examination of injury risk factors in the workplace reveals risks to be partly the result of faulty work design and partly the result of human behaviors unrelated to job design. Attitude problems are yet another factor. Ignorance of musculoskeletal function and disease of the part of both management and workers has led to counterproductive attitudes with regard to injury, fitness-for-work and safety commitment. This adds greatly to the incidence and costs of musculoskeletal injury claims. Ergonomics is currently being touted as the answer to the CTD problem. This implies that such problems are primarily the result of faulty job design. This further implies that presenting the worker with ergonomically proper job design will result in significant reduction in injury risk. Many people in industry even label cumulative trauma disorders as ergonomics injuries. Such assumptions can severely limit the effectiveness of musculoskeletal injury prevention programs by narrowing attention to ergonomic issues at the expense of other equally-valuable injury prevention strategies. Ergonomic correction of faulty job design of tools, procedures, work station and product is of vital importance to reducing CTD risk. But a strictly ergonomics approach to CTD control has limitations in many situations. Many jobs with a high incidence of CTD, for example, demonstrate no significant ergonomic design problems. Many other jobs that have undergone ergonomic improvements continue to demonstrate frequent claims for CTD. Still other job situations do not lend themselves to ergonomic modification because of excessive cost or lack of ergonomic alternatives. These are all situations where ergonomics is not the ultimate answer, indicating other considerations. Physical work leads to fatigue and wear damage of musculoskeletal tissues. CTD develops when the rate of wear damage significantly exceeds the rate of repair. This wear damage may result from either stressful job requirements or faulty work habits. Faulty work habits and poor fitness are usually not readily affected by ergonomic modifications. Presenting a worker with an ergonomically-perfect job design does not require the worker to position and user their body properly to perform the job nor take proper care of the working body. Wear damage caused by faulty job design is usually amenable to ergonomic modification. But excessive wear damage may also result form poor posture habits, inefficient movement habits, personal medical complications and poor employee fitness-for work. Inadequate rate of repair results from the aging process, poor circulation to working tissues, and lack of self-care by the worker. These factors are often not responsive to ergonomic modification. Alternatives to ergonomics are important to effective CTD control by addressing these non-ergonomic issues.