These topics were identified during the practitioner focus group meetings in Chicago, Seattle, and Washington, D.C. Some of the issues identified in the focus groups applied to more than one industry, while others were primarily applicable to specific sectors or industries. Selected examples of these specifics topics are listed in this appendix.
Study the design and use of ergonomic and anti-vibration seats to reduce the risk of MSD. Redesign seats in fork trucks to prevent twisting. Review the ergonomic problems with seatbelts. Study the use of ergonomically designed controls on fork trucks.
Study the use of: 1) ramps and two-wheeled carts to manually unload trucks; 2) ergonomic rack designs (such as push-back [self-fronting], self-running, rotating, and height-limiting storage racks); 3) pull tools for pulling product closer to the lifter; 4) cherry pickers for retrieving objects stored at higher heights; 5) bar-coding to improve the efficiency of locating stored items in the warehouse; 6) automatic and locking dock plates; 7) different container designs; and 8) color-coding or labeling products to identify weight or weight category.
The health care industry faces many unique issues related to patient transfer, which is responsible for many MSD. Solutions must be devised for the range of health care settings, including hospitals and nursing homes, ambulances, and home health care. Further research is needed, as the occurrence of MSD has continued even after the incorporation of training, lifting teams, and lifting equipment. More research is needed on: 1) patient issues (weight, disruptiveness, unpredictability, acceptance of the transfer, and risks to the patient from the transfer); 2) the use and limitations of lifting patients and equipment in different settings (institutions, ambulances, home care); 3) the use, makeup, and limitations of lifting teams; 4) effective training in patient transfer to avoid MSD; 5) the economic benefit and feasibility of a 'no-lift' program; and 6) the commitment of management to effective interventions.
Design retractable monitors for ICU and CCU that obviate the need for awkward neck postures or extended arm reaches.
Conduct more research on the ergonomic impact and design of medical equipment, such as dental tools, surgical instruments, design B transducers, ultrasound equipment, bronchoscopes, pipettes, stopper removers, respiratory therapy equipment, microscopes, old anesthesiology equipment, and patient-lifting equipment. Conduct research on opening medication that is unit-dose wrapped.
Evaluate ergonomic factors related to various jobs, including health care food services, custodial workers, X-ray technicians, dentists and dental workers, and surgeons.
Conduct more research on the ergonomic impact and design of tools and equipment (anti-vibration gloves, adjustable tables, stress-reducing tools, adjustable paint roller poles, fiberglass ladders, power tools, vice manual tools, lift trucks instead of manual labor, drills with levers to reduce force required during overhead work, stools with wheels, magnetic lifts, and smaller forklifts).
Evaluate administrative interventions, such as rotating the crew, rotating work tasks (skills cross-training within trade/craft classifications), or working in teams with job rotation within teams.
Evaluate effective training and safety programs for apprentice programs, including safety and ergonomic information, education on MSD, lifting, micro-breaks, and tool selection. Include in training programs planning for specific hazardous tasks (proper equipment, personnel, logistics, safety, and job hazard analysis) and the potential for MSD due to fatigue or increased susceptibility. Review safety incentive programs based on hazard recognition and continuing education.
Conduct more research on the ergonomic impact and design of tools and equipment (pruning shears for nursery workers).
Evaluate how ergonomic improvements can be made considering the natural, immutable factors that agricultural workers must deal with (weather and the natural positioning of produce in the field either overhead or below the worker's knees).
A unique issue in agriculture and food-processing is that the product is living or perishable. This impacts work pace, environmental conditions (temperature and wet or dry conditions), and other factors. Research is needed on ways to mechanize handling jobs in food- processing facilities to avoid repetitive motion disorders; this is a difficult issue because the product is often soft or fragile, and automated methods may damage it.