Fy14 SH 26336 Sh4 Sample Ergonomic Assessment Report
Fy14 SH 26336 Sh4 Sample Ergonomic Assessment Report
Fy14 SH 26336 Sh4 Sample Ergonomic Assessment Report
Assessment
Assessment completed by
Sample Report
Assessment completed at
3:26 PM on 12/19/15
Company Name
Test company
Company Address
1234
Spokane
Specific Location
Have any workers been previously diagnosed with any of the following cumulative
trauma disorder (CTD's): Carpal Tunnel, Tendonitis, Tenosynovitis, De
Quervain's Disease, Trigger Finger,White Finger, Hand Arm Segmental
Vibration Syndrome, muscle strains or back ailments?
Response:
Yes
Hazard specifics
None listed
Mitigation techniques:
Other: Workers with previous ergonomic related injuries in the past are at
increased risk in the future. Additional care should be taken to accommodate
individuals that have experienced conditions such as Carpal Tunnel,
Tendonitis, Tenosynovitis, De Quervain's Disease, Trigger Finger, White
Finger, Hand Arm Segmental Vibration Syndrome, muscle strains, or back pain.
Encourage employees to report symptoms early before they develop into a
disability.
Question #2
Have there ever been any worker complaints concerning ergonomic issues? Body
soreness: back, shoulders, neck, hips, knees, and/or feet.
Response:
Yes
Hazard specifics
None listed
Mitigation techniques:
Administrative Control: Conduct an ergonomic job specific assessment. Observe
body movements and their frequency. Look for awkward movements that involve
moving materials with bad postures away from neutral. Establish an ergonomics
program that can be used to reduce injury by controlling hazards.
Response:
Yes
Hazard specifics
None listed
Mitigation techniques:
Engineering Control: Observe job tasks and research ways to reduce frequency
of material handling through automation or engineering controls.
Response:
No
Hazard specifics
None listed
Mitigation techniques:
None.
Question #5
Are employees using tools well suited to the task? (i.e. usage of
tool maintains neutral positions/postures)
Response:
No
Hazard specifics
None listed
Mitigation techniques:
Engineering Control: Redesign or install tools that promote neutral postures.
Response:
Yes
Hazard specifics
None listed
Mitigation techniques:
Engineering Control: Redesign or install adjustable workstations to reduce
awkward joint angles. Encourage workers to change posture through out work
shift. Position work in ways that eliminate long/excessive reach, decrease
joint flexion/extension requirements, and promote neutral postures. Avoid
requiring employees to work below knees and above shoulders. Provide tools that
promote neutral joint angles.
Administrative Control: The greater the elbow angle the greater the
stress.Train workers to keep elbows closer to body and in neutral posture as
they work. Establish ergonomic training that is specific to the job to make
workers aware of ergonomic hazards.
Question #7
Do employees ever perform tasks requiring excessive force application?
Response:
No
Hazard specifics
None listed
Mitigation techniques:
None.
Question #8
Are high impact and/or high vibration tools routinely used? (e.g. riveters,
bucking bars, die grinders, sanders, weed eaters, or impact wrenches.)
Response:
No
Hazard specifics
None listed
Mitigation techniques:
None.
Question #9
Is ergonomic job specific training given to workers?
Response:
Yes
Hazard specifics
None listed
Mitigation techniques:
None.
Question #10
Are procedures in place to accommodate fluctuations in staffing levels?
Response:
Yes
Hazard specifics
None listed
Mitigation techniques:
None.
Question #11
Are channels in place for employees to communicate ergonomic concerns?
Response:
Yes
Hazard specifics
None listed
Mitigation techniques:
None.
Question #12
Do jobs have unnecessary steps? Observe jobs to determine this.
Response:
None
Hazard specifics
None listed
Mitigation techniques:
None.
Question #13
Have workers been observed showing signs of fatigue? Does a worker's production
rate decrease near the end of work shift?
Response:
Yes
Hazard specifics
None listed
Mitigation techniques:
Engineering Control: Environmental factors contribute to the onset of fatigue.
Insufficient lighting, loud noise, and warm temperatures increase fatigue.
Brighten up and quiet down the work space and cool down the temperature.
Response:
Yes
Hazard specifics
None listed
Mitigation techniques:
Engineering Control: Adjust work station height to keep work as close to
neutral posture as possible.
Question #15
Does the location of materials promote reaching? (Material greater that 18
inches in front of the worker.)
Response:
Yes
Hazard specifics
None listed
Mitigation techniques:
Engineering Control: Adjust material flow closer to worker to minimize reaching.
Response:
Yes
Hazard specifics
None listed
Mitigation techniques:
Engineering Control: Line up materials in angles that reduce the twisting
when workers are transferring them.
Administrative Control: Increase the frequency of job rotation from jobs with
high frequency of twisting to jobs with no twisting. Establish ergonomic
training that is specific to the job to make workers aware of ergonomic hazards
and ways to control them.
Question #17
Are there potential obstacles on floor that can prevent a clear path of travel?
(Uneven, slippery, sloping, or trip hazards.)
Response:
Yes
Hazard specifics
None listed
Mitigation techniques:
Engineering Control: Control source of hazards.
Response:
Yes
Hazard specifics
None listed
Mitigation techniques:
Engineering Control: Adjust workstation to reduce material handling in awkward
positions.
Administrative Control: Increase the frequency of job rotation from jobs with
high frequency of over head or below knee work to jobs with none. Establish
ergonomic training that is specific to the job to make workers aware of
ergonomic hazards.
Question #19
Does the material handling require placing objects accurately/precisely?
Response:
Yes
Hazard specifics
None listed
Mitigation techniques:
Engineering Control: Install a sorting system that organizes the materials
automatically to reduce stress on workers. Lift table can be used to reduce
reaching when materials have to be placed.
Response:
Yes
Hazard specifics
None listed
Mitigation techniques:
None.