Reduce employee stress. Enhance employee health and safety. Lower costs by improving equipment, the work environment, and employee attendance and morale. Increase performance. Optimize efficiency. These objectives are probably shared by good managers everywhere. They are also the five primary goals of ergonomics.

Once an esoteric concept espoused only by a handful of industrial engineers, and then erroneously considered by many as simply an office fad, ergonomics has become a key health and safety issue for employers today. For as people's jobs become increasingly sedentary and computer-reliant, desk-bound workers are engaging in minimal movement throughout the day. In other words, employees are moving less as they work. This has resulted in a skyrocketing of cumulative problems caused by poor ergonomics, forcing business to take a close look at ways to improve the match between the worker and the workplace.

Ergonomics can be defined simply as the study of physical work habits. More specifically, the aim of this discipline is to design jobs and tools (including chairs, desks, lighting, computer equipment, telephones and multiple accessories) that fit the physical and psychological requirements and capabilities of employees. Ergonomic concepts emphasize working smarter and more safely, not harder, thereby reducing stress and fatigue in the work environment, and preventing costly injuries.

Ergonomic Injuries Skyrocket

Since 1989, CTDs like carpal tunnel syndrome, which commonly affects a worker's wrists and hands, have been more prevalent than all other occupational diseases combined. (Symptoms include numbness, burning and aching in the fingers and hand, weakness in the wrist or hand and a prickling sensation radiating up the inner forearm. Long-term effects can include extreme difficulty in performing simple manual tasks.)

Carpal tunnel syndrome is now recognized to afflict nearly two million workers and to cost American business an estimated $20 billion annually. And with increasing reliance on computers in the workplace (40 percent of the U.S. labor force currently works at computer keyboards), experts estimate that the average person faces as much as a 1-in-10 chance of eventually developing this debilitating disorder. Further, if something is not done to stem the tide of CTDs, projections suggest that fully one-half of all office workers will suffer symptoms by the year 2,000.

Ergonomically related ailments such as carpal tunnel syndrome and other CTDs, back problems (second only to the common cold in the amount of sick days they cost American business each year), vision problems like eyestrain, headaches and neck aches place an enormous financial burden on employers - an estimated $113 billion annually. Such expenses include higher worker's compensation insurance premiums, replacing injured employees, training new hires and delays in completing critical projects.

Conversely, statistics show that employers who take a pro-active approach to ergonomic planning can reduce worker's compensation costs by one half to two thirds in one year. While there clearly are associated expenses, the net result is substantial dollar savings as well as more comfortable, productive and loyal employees with a higher level of job satisfaction.

Customizing the Workplace

Environmental issues such as temperature, noise and air quality as well as psychosocial or stress-inducing factors (ranging from a surge in workload to job insecurity or lack of management support) are also examined.

Comprehensive planning that incorporates both short- and long-range goals is the key to a successful ergonomics program. "Since your efforts will involve a certain amount of capital expenditure, you can schedule this when you would replace equipment anyway," suggests R.J. Banks, an ergonomics consultant with State Compensation Insurance Fund, California's public worker's compensation insurance company. That way you can critically evaluate all equipment for its ergonomic worth before making any replacement decisions.

Implementing Preventive Ergonomic Programs

- physical position or posture a person assumes while doing a job

- amount of force or exertion required to perform a task

- repetitiveness of the job

- duration of exposure and amount of time between repeated movements for the employee's body to recover

- amount of vibration and cold temperature

To remedy ergonomic defects, determine what parts of the job are causing problems. Is it the tools being used, placement of materials, force that workers must apply, body position of workers, or environmental concerns such as noise, excessive temperature or vibration? Then develop interventions or modifications to eliminate hazards by changing the way the job is performed, using new tools, rotating jobs or, as a last resort, automating the job.

Such measures need not involve great expense. For example, if people of various heights stand at one table, shorter people can use a platform to get the work to elbow height. Or, if some employees need a lumbar support for their chair or car, a small pillow or a rolled-up towel will suffice.

Training and Follow Up Essential

She also suggests following up with employees whenever they've been given training and a new tool. Ask if the tool is being used and, if not, why. All too often Banks finds the reason is that employees were excluded from decision-making. "When purchasing new equipment, involve employees in the process," she emphasizes. "Ask them to try items under consideration to see if they work."

Banks cautions against applying "band aid solutions" such as wrist rests or back belts (lumbar corsets) without analyzing the underlying cause of problems. "Sometimes back supports can encourage employees to lift more than they should, or continue lifting improperly, and further injuries develop," she notes. "You need to carefully examine individual tasks and design out the risk of injury."

Free Advice Offered

Expert ergonomic consultation also may be provided free of charge by your local OSHA office. Often overlooked, such services work largely with small employers to provide confidential advice on improving workplace health and safety.

A final option is to hire an independent expert to evaluate existing conditions and provide a range of suggestions to improve them.

Hot Spots Vary

In an office, a good chair should definitely get top priority. Another ergonomic hot spot is workstation organization and design, including the location of computer monitors.

"Also take a look at the standard desk design," dares Nancy Osterman, an ergonomics specialist with Quill Corp., an office furniture distributor. "Desks weren't really designed for women. They were created for the average male height range - 5 feet 6 inches to 5 feet 10 inches. The average woman is 5 feet 4 inches. Taller men also have difficulties fitting into the typical desk, as do overweight people."

In retail establishments, special attention should be paid to lifting procedures for unpacking and loading merchandise and older scanning technologies. In addition, retail employers should make sure they have procedures in place for employees to mitigate their stress in dealing with the public.

For those who drive in their work, critical issues are seat support, the number of seat adjustments available, and measures to mitigate vibration that travels into the spine, hands and shoulders. Precautions should also be taken to prevent sitting for excessively long periods (get out once per hour and walk around) or lifting immediately upon arriving at a destination (always stretch first and walk around).

When evaluating manufacturing lines, the key issues are how to structure repetitive tasks and object placement to avoid injuring employees. Ergonomic tips include keeping parts and tools within easy reach and encouraging standing employees to place one foot up on a footrest or stool to relieve pressure on their lower backs.

"Ergonomics is a winning proposition," says Len Welsh, special counsel to California's Occupational Safety and Health Administration (CAL OSHA). "The question is how to individualize better practices to meet the needs of each company."

Getting the Most for Your Ergonomic Investments

- Buy cantilevered or height-adjustable work surfaces that hang on modular panels for maximum flexibility. Then you can raise and lower surfaces to suit individuals.

- Do your homework. Go out and research the market before you buy to avoid purchasing a product that's really not optimal for your specific situation.

- Always test products by using them. Some things may look enticing in a brochure, but don't work when you install them.

- Before buying in mass, install a few alternatives to test with your employees.

- Ergonomics is very individual. What works for one person does not necessarily work for another. Target products that give the end user the most flexibility.

- Ergonomically correct equipment doesn't necessarily cost more, and the most expensive product isn't always the most desirable. Some simple items actually provide the best solutions to problems.

- Train employees how to use equipment to get maximum value from your products.

- Don't be afraid to ask for expert advice, even if it requires a small cash outlay. Paying an ergonomics consultant for a few hours of time usually is money well spent.

- To broaden your selection, choose vendors who represent a wide range of manufacturers.

- Check manufacturer's warranties. Major purchases like system furnishings should have 5-10 year warranties.

- Ask if there are additional charges for delivery and installation.

- Unless you have an in-house equipment installation team, you're better off relying on manufacturers or dealers, who are trained on all aspects of the product, to provide installation. Remember that if a product is damaged during installation, the question of responsibility becomes much clearer if your dealer is also the installer.

- Where there are regulations and standards that dictate tolerances (such as the American National Standards Institute) for items such as lighting and seating, find out if the equipment under consideration complies with these standards.

Basic Ergonomic Principles: Doing It Right

"Always remember, however, that general rules must be modified to fit individual differences," cautions Dennis Halliday, a physical therapist and owner of SPORTFIT, a private physical therapy clinic in San Ramon, California.

Sitting

- A proper chair is probably the most important purchase, ergonomically speaking, since approximately 70 percent of all employees work while sitting. Of those, 90 percent will suffer from back pain in their working careers due to ill-fitting chairs.

- Be sensitive to individual spine curvature. Everyone is built differently and the chair they use should reflect their height and body weight.

- The chair should have an adjustable seat height to allow the occupant to sit with thighs parallel to the floor, with both feet planted firmly on it. Elbows should also be at 90 degree angles or slightly higher.

- Choose a firm seat cushion with high-density foam and fabric that "breathes." The padding should be easily compressible, but not too stiff.

- Look for a chair with an adjustable seat angle to reflect the task of the occupant. A difference in the seat's angle can reduce significant pressure on the discs of the spine.

- Select a seat with soft edges. Older chairs with hard edges can cut off circulation to the upper thighs. Also be sure to extend your knees two or three inches past the edge of the chair.

- Make sure the chair's armrests are adjustable for an extra measure of support. This feature is important if the worker plans to do different tasks during the day, especially typing.

- The chair should have wheels to facilitate rolling across the floor.

- To reduce the amount of stress on the discs, your back should not be perfectly vertical and ramrod straight. Rather than forming a perfect "L" with your body, lean back in the chair slightly - but without slumping.

- If your chair lacks lumbar support, use a small pillow or rolled-up towel to reduce pressure on your lower back.

- Arrange your work area to avoid twisting.

- Take frequent breaks (at least once an hour) to stand, walk and stretch your neck, shoulders and back.

- Use a headset if you spend much time on the phone or talk and type simultaneously. This will help avoid neck and shoulder pain.

- Place your computer monitor at or slightly below eye level in a position that avoids glare. Try drawing the blinds and using indirect lighting, or positioning your screen at a 90-degree angle to the windows.

- Use an adjustable document holder placed at screen height and 18 to 20 inches from the keyboard. This helps reduce eyestrain if you frequently turn to read hard copy while using a computer.

- Place your keyboard at elbow level. Your forearms and wrists should form a straight line, parallel to the floor; your fingers should follow their natural curve downward.

- Keep your wrists straight when keyboarding, using a wrist rest or rolled-up towel to support them.

- If you need corrective lenses, wear them or your posture will be compromised.

Driving

- Take breaks regularly. Road vibration relaxes muscles and ligaments and makes them more prone to injury.

- Arrange the seat back so you have a 113° to 110° torso-to-thigh angle.

- Wear gloves to absorb road vibration.

- Hold your steering wheel at the clock face positions of 5 and 7 to reduce wrist strain.

- Rest your forearms on a pillow in your lap to reduce any strain on your shoulders and upper back.

- Sit close enough to the steering wheel to avoid having to bend forward to see over it.

Lifting

- Bend your knees, not your back.

- While lifting, keep your elbows near the hips.

- Get the load as close to your body as possible.

- Face the object being lifted with toes pointing toward it. Turn your whole body together when you move. Don't twist and bend or twist and lift.

- Pushing is better than pulling. Stay close to your load, keep your elbows locked at your sides, bend your knees and push with your legs.

- Don't bend forward at the waist. Bend at the hip joint.

The Perils and Prevention of Shoulder and Neck Strain Syndrome

SNSS, a group of pain symptoms originating with the muscles between the lower neck and the shoulder, is also the most common CTD (cumulative trauma disorder) of the upper body. Although it is often misdiagnosed or discounted, Gillick asserts that SNSS is one of the easiest CTDs to diagnose, alleviate and prevent, as he details below.

Who Is Most Vulnerable?

Common in adults, regardless of age, SNSS occurs more frequently in women and is often associated with - and worsened by - psychological stress and tension. SNSS - which occurs at least as frequently as low back strain - is rare in limber athletes or yoga practitioners.

How Can SNSS Be Identified?

The spectrum of SNSS symptoms ranges from just "a tight neck" to severely incapacitating neck, shoulder, forearm and hand pain and weakness.

What Are the Most Common Causes of SNSS?

Cause: The shoulders are shrugged for a prolonged period to elevate the elbows for work at a desk, table, counter, computer, cash register or sink that is at or above a relaxed elbow level.

Prevention: The work surface must be at or slightly below relaxed elbow level with the shoulders rotated forward in an unstrained position. If chair elevation is used to accomplish the appropriate position, a foot rest may be needed to keep the relaxed knees at least as high as the pelvis to prevent back strain.

Cause: Holding a headset between the shoulder and ear while writing, typing or rifling through files is one of the most common sources of neck and shoulder pain.

Prevention: Use a headset or speakerphone.

Cause: Placement of the computer keyboard on top of a desk, slanted up, with the mouse at an elevated reach.

Prevention: Ergonomically correct level is at or below relaxed elbow level - with the shoulders relaxed forward. The mouse - or preferably a mouse alternative, such as a trackball that requires less wrist and shoulder motion - must be at the same level and not require elevated reaching. A wrist rest is recommended, along with a keyboard that is mounted flat or with a reverse cant, or one affixed to a moveable tray.

Cause: Prolonged maintenance of a palms-down hand position at two o'clock and ten o'clock (near the top of the steering wheel) contributes to and aggravates SNSS. A vibrating steering wheel or stick shift, and off-road vehicles, are also culprits.

Prevention: Drive with hands in an unstrained position with palms up at five o'clock and seven o'clock (near the bottom of the steering wheel). Pad the vibrating steering wheel and gear shift. Also consider driving an automatic transmission vehicle.

Cause: If a pen or pencil is grasped tightly (because normal size implements are thin with poor friction on the grip), strain is transmitted up into the wrist, forearm, shoulders and neck. Also, if the work surface is above elbow height, the shoulder is shrugged with the elbow elevated in order to write.

Prevention: Modify your writing instrument or use one that is properly engineered, i.e., fattened and cushioned with a rubbery substance such as a foam tube or equipped with an easy flow cartridge. Make sure the writing surface is at or below elbow height.

Cause: A sleeping posture in which the upper body and/or neck is kinked or torqued (twisted), or an arm is placed overhead, which not only aggravates SNSS, but can be its sole cause.

Prevention: The neck and shoulder muscles must be in a neutral position in order to allow for rest and recovery at night. In this position, the chin is tucked gently, the shoulders are rolled slightly forward in a neutral or "slouched" position, and the arms - flexed at the elbow - are tucked near the torso with the elbows at or below the chest level.

This usually means sleeping on the side, curled, with a folded pillow under the head (not head and shoulder, as this results in upper body twisting), and a pillow between the knees.

Cause: Maintenance of a shoulders back "military brace" posture, commonly the case when working with computer monitors that are above eye level, can lead to cervical strain and tension headaches.

Prevention: Shoulders should be in a neutral anatomic position, i.e., greatly rotated forward with the chin slightly down. In this position, a relaxed gaze focuses downward four to six inches for every 18 inches from the eyes (10 to 15 degrees).

Cause: The shoulders are continually shrugged, consciously or unconsciously, in response to heavy or sliding straps - be these bra or slip straps, suspenders, unwieldy backpacks, purses or briefcases.

Prevention: Use shoulder straps as sparingly as possible, or preferably straps that do not slip at all. Carry a light purse or briefcase - and not on the shoulder. Wear a backpack with a cross-strap (in front and/or back). Try a "T" bra or sports bra.

Is SNSS a Work-Related Disease?

- A kitchen food preparation area positioned at - or higher than - relaxed elbow height. Instead, consider using a long work stool or a low butcher block table.

- Holding the telephone between the ear and shoulder while doing other things such as writing, cooking or washing dishes.

- Working above mid-chest level when painting, sanding or wallpapering.

- High handle bars on a motorcycle, because of vibration and shoulder shrug.

- Holding knitting or cross-stitching close to the eyes (at or above relaxed elbow height); use proper eyeglasses instead.

- Any type of vibration to the heads, arms or neck. One remedy is to put foam padding on offending tool handles.

Also keep in mind that stress or poor sleep (caused by such things as divorce, deadlines, noise, problems with children or illnesses) plays a large role in worsening SNSS.

How Do We Treat and Prevent SNSS?

- Identifying all the motions, activities or postures that precipitate and aggravate SNSS during work and non-work hours.

- Removing the causes of fatigue in the neck and shoulder muscles through ergonomic, common-sense modifications of the work and non-work environments.

- Neutralizing trigger areas by breaking the muscle cramping - through such treatments at acupressure, point massage (especially good for home usage is Brookstone's Mini-Massager), physical therapy routines - particularly at the beginning - including ultrasound and deep heat pressure, as well as hot showers, baths and Jacuzzis.

- Avoiding exercises such as jogging, jumping rope, step aerobics and high-impact aerobics, as well as power lifting, repetitive overhead or behind-the-back weight machines and unstructured weightlifting. Preferable exercises include stretching, yoga, water aerobics, non-contact martial arts and level walking on non-concrete surfaces.

- Preventing reoccurrence by diligently identifying and removing the causes. Remember, there is always another "right way" to accomplish a task.

While there is no magic remedy for SNSS, controlling this problem is within the grasp of every sufferer. Remember that the principles and practices of appropriate ergonomics must be employed at work, home, play and sleep for successful whole-body wellness. The benefit-to-cost ratio is very high in a well-thought-out and body-friendly lifestyle.

Excerpted with permission from Small Business Success magazine, Volume X, produced by Pacific Bell Directory in partnership with the U.S. Small Business Administration and the Partners for Small Business Excellence.