OT 886 - Enviornmental Determinants of Occupation

Final Exam

Age-friendly community

an age-friendly community is one in which policies, services, settings and structures support and enable people to age actively

community

For this purpose, we can think of the community as the geographic area where the older adult lives

- Hamlet, village, town, city, metropolis

- Conceptualized as a continuum

Urban and rural

- Attachment to place is referenced in the literature, for both urban and rural

communities

- While older adults living in urban and rural settings may have very different experiences (i.e. they experience their community differently from each other), they remain attached to the way they experience their own community

- One in four residents of rural Canada (23%) is older than 65, proportionally higher than the national average (13%)

rural communities

- They are bypassed (isolated, service poor and economically depressed)

- They are bucolic (representing the pleasant aspects of the countryside and country

life)

- Out-migration of younger people seeking employment in urban areas will place

pressure on informal systems (combined with a lack of formal services)

- Canada has some 3000 rural communities that vary in size, distance from service centres

and employment opportunities

- Rural communities need to be considered in planning for age-friendly communities

Barriers/facilitators to achieve "age-friendly"

Person = Physical/cognitive, socio economic

Environment= Physical, institutional, social/cultural

Occupation= Valued occupations, task demands, roles

Four common objectives of age friendly communities

- Address basic needs of the older adults (e.g. housing, safety and information about services)

- Promotes social and civic engagement

- Optimizes physical and mental health and well-being

- Maximizes independence for those who are frail or who have a disability

WHO domains

8 domains

• Outdoor spaces and buildings

• Housing

• Transportation

• Respect and inclusion

• Social participation

• Civic participation and employment

• Communication and information

• Community supports and health services

Age-friendly benefits

- Social connectivity

- Active aging - "the process of optimizing opportunities for health participation and security in order to enhance quality of life as people age"

Social connectivity and age-friendly communities central themes:

- Factors in the environment are interrelated and interact with each other to influence social connectivity

- Environmental influences can be close or distal (to individuals or groups)

- The fit between the person and the

environment is critical in determining

social connectivity

- Person factors and the conditions in the environment change over time (temporal), therefore, social connectivity is dynamic

- There are certain leverage points (within

the person or the environment) that are

key in determining social connectivity

Components of social connectivity

1. Creating connections

2. Empowerment

3. Social influence

4. Access to material resources and services

The power of social networks

- Linked to positive health outcomes

- Lower risk of mortality

- Lower morbidity

- Lack of social relationships can be as strong a risk factor for mortality as smoking obesity or lack of physical activity

The importance of empowerment & social influence

Empowerment

- Increases the influence of the older adult

- Challenges ageist attitudes & beliefs

- Might occur at the level of the

individual, organization or community

Social Influence

- Results in social change

- May be individuals who influence each other through direct contact, or can be organizational or

community levels

Aging in Place

- "Aging in place means having the social supports and services you need to live safely and independently in

your home or community for as long as you wish and are able"

- Definition evolving to "remaining in the current community and living in the residence of one's choice

The community setting - Aging in Place (Key elements)

- Home modifications

- Support services

- Community integration

- Health care access

- Technology use

what is the village model

Grassroots community organization

- Focus on helping people to age in place

- Formed by a group of neighbours

Functions:

• Connecting to services

• Promote active aging

• Promote social activities

Co-housing

- Neighbourhoods that combine the autonomy of private

dwellings with the advantages of shared resources and community living

- Individuals have their own space clustered around a 'common house'

NORCs

Naturally occurring retirement communities (NORCs)

• Communities where people remain or move to

when they retire

• Many older adults will live in communities that

were not necessarily planned as retirement

communities

• Over time the demographic of the community

changes with the relative proportion of older

adults to younger adults raising

• Fostering NORCs occurs through identification of

the NORC and developing partnerships amongst

the stakeholders** to meet local needs and

support individuals to age in place

• **Older adults, service providers, building

owners/managers, local governments

(Greenfield, 2014)

Local example of a NORC

Oasis is a model that supports healthy living at various settings

across Kingston. Oasis supports older adults to live independently in their own homes

Goals

• Maintain or improve physical fitness and well-being

• Improve nutrition

• Reduce isolation

• Enhance health system navigation

• Board with shared decision making and engagement of the

membership

Becoming more age-friendly

(barriers)

Barriers

• Inconsistent leadership or

leadership changes

• High turnover in local governments

• Inconsistency between municipal

and other levels of government

• Complex initiatives where there's

inconsistency between

partnerships

Becoming more age-friendly

(facilitators)

Facilitators

• Strong leadership

• An age-friendly committee

• Elected officials with a

commitment to becoming age-

friendly

• Consistency between municipal

and other levels of government

• Multi-sectoral partnerships

Addressing community inequities for age- friendly communities

• Policy change that address

community disadvantages that

may exist

• Dedicated human

capacity/resources to address

disparities

• Scale and intensity of initiatives

needs to match the proportionate

level of disadvantage within the

community - certain communities

will need access to larger grants

for age-friendly initiatives

Age-friendly planning (Federal)

Committee phase

• Involve multiple stakeholders

• Elected officials, senior staff, private/public businesses, volunteer sectors, seniors and senior-serving orgs

Assessment phase

• Determine community assets, what contributes to age-friendliness

• Identify what the community is doing well (serves as a baseline)

Planning phase

• Identify ways to build upon strengths and issues to address

• Develop plans for action/evaluation and Identify champions

Implementation phase

• Taking small (or larger steps) forward toward the goals

• Consider collaborative efforts

Monitoring progress

• Evaluate/re-evaluate plans and adjust priorities

• Ongoing process

Age-friendly planning (Ontario)

Define Principles

• Create planning structure around the local initiative

• Determine what domains are relevant (e.g., physical environment, social environment, and/or personal well-being

Assess Needs

• Collect information about the age-friendly priority in the community

• Engage people through various means to collect information and leverage the assets of the community

Develop an Action Plan

• Select specific action plans to address the key gaps in the community

• Select priorities, set goals and objectives, identify resource needs, set the action plan, ensure engagement from

stakeholders

Implement and Evaluate

• Changes, programs, initiatives take place with QI cycles for evaluation

• Funding both short and long term required, and evaluation should address goals and objectives

Low tech -

- items that can be constructed or developed with readily accessible tools & materials

- low cost items

Examples: using an elastic band around a jar lid to assist in opening it; long-handled shoe horn; universal cuff; using phone books to boost the height of a keyboard.

high tech -

- complex mechanisms with less apparent means of functioning and operation, i.e. the average person couldn't build it themselves

- typically rely on computer technology, embedded micro-chips, etc.

Examples: speaker phones; adapted keyboards; power beds

Hard Technology

durable items that can be seen and/or felt.

example: dressing stick, grabber

soft technology

- people and their knowledge

Examples: manuals, help pages, YouTube videos and technical assistants

where do OTs use assistive tech?

- for BADL/IADL devices (transfer board, bath seat, raised toilet seat, grab bars)

- switches (switch adapted toys, activating a communication devices, controlling a kitchen appliance)

- software/hardware adaptations (scanning software, screen reading software, text to speech software)

- mobility/transportation devices (hand controls for driving, handybar and swivel seat, power wheelchair joystick controls)

What is the HAAT model:

Human: sensory skills, motor skills, cognitive skills, emotional factors

Activity: chosen areas of participation based on individual preferences and role demands.

Assistive Technology: various options available to enable performance

Surrounding all of this is the Context - the physical, social, and institutional environments that dictate how it will all work and what is possible.

what is the SETT framework

This model is used to problem solve around potential technology solutions, and helps the IEP or AT team systematically consider key factors in the school situation relative to the child.

what the STUDENTs abilities are and what areas of need are identified.

characteristics of the student's learning ENVIRONMENT

TASK - focuses on what the student needs to do, or is expected to do

TOOLS - focuses on both the devices and services that the student has available

Fundamental Assessment Process (FAP)

1. Intake/referral - this is pretty straightforward

2. Needs identification - determined through a collaborative team approach

3. Identification of desired outcomes - working with the client (and other stakeholders) to determine feasible goals and specify key features of desired outcomes

4. Collaboration - work as a team throughout the process

5. Skills assessment - assessment of the client's skills by relevant team members and identify how skills match to the device characteristics

6. Device trials - also pretty straightforward

7. Revisit desired outcomes - considering the device trails as matched to skills

8. Procurement of device - includes the identification of funding possibilities and the full range of accessories and specifications that meet the client's needs

9. Technology implementation - includes set-up, fitting and training

10. Follow-up/Follow-along - ongoing monitoring of goal achievement and need for modification

what is human - technology interface

With any electronic devices, there are a variety of ways that humans can input information, or communicate with the equipment. This is called the human-technology interface.

keyboards, mice, phone or ABM dial pads, etc. Strength, ROM and motor control are important aspects of the human-technology interface.

what to consider about cognition:

- ability to understand and use various software and hardware programs

- reading level in terms of computer or augmentative & alternative communication (AAC) devices

- memory skills

- attention span

- does the client have a basic understanding of cause and effect (i.e. actions taken result in a device doing something)

there needs to be balance between:

the physical and cognitive load of an activity

sensory functioning

Vision and hearing are key issues to consider, partly due to the importance they hold with respect to conducting a valid assessment.

Psycho-Emotional Functioning

A major factor in adoption of technology is the attitudes and emotional status of the client

Some key elements to consider include:

task focus - is this a person with good task completion skills who is likely to tolerate a tedious learning process?

frustration tolerance - any advanced technology is sure to have glitches. Will the client tolerate problems?

judgment - some technologies, such as power chairs, scooters, environmental controls and computers require good judgment skills, and the ability to use the device safely.

motivation - if the client has low interest in an activity, it may be that they will be unlikely to try something new, persist through a long period of training, or to work through the inevitable technology glitches. Be careful, though - for an individual who has been experiencing occupational deprivation due to an inability to control the environment, communicate, or make independent choices, the use of AT may be just the thing to enable and generate enthusiasm for participation.

3 contexts to consider

Physical context

Social/cultural context

Institutional context

types of modifications:

Home safety equipment:

- These are typically nonpermanent pieces of equipment that can be easily put in place for client use (e.g. Raised toilet seats/ Toilet seat elevators, Commodes, Bath seats/ Tub transfer benches etc)

Home Modifications:

- Basic Home modifications (e.g. Grab bars, changing door handles, removing doors from hinges for extra clearance, etc.)

- Major Home modifications (e.g. ramps, walk in showers, stair glides, porch lifts, ceiling lifts, kitchen modifications, etc.).

assessments:

Person

- Consider the persons height, width, weight, and reach.

- Consider the persons mobility needs (e.g. mobility aids, falls risk, safety).

- Consider the persons future needs (e.g., aging in place, degenerative disorders, etc.)

Equipment

- Wheelchair or walker turning radius, width, clearance, etc.

Environment

- Toilet height, door widths, bench height, tub clearance, bed height, couch height, ceiling type, wall surfaces, etc.

Measurement tips:

- When measuring door widths consider the most-narrow point of entry... This is usually not as simple as door frame to door

frame.

- When measuring ceiling heights consider if the ceiling/ floor is even when selecting the best place to measure. It's easiest against the wall but it may not be ideal if the ceiling is uneven or if it changes.

assessing home environments as an OT:

- Knowledge of occupation and occupational performance

- Human performance (i.e. performance components)

- Knowledge of disability

- Knowledge of universal design and application to home modifications

- Knowledge of equipment

- Knowledge of guidelines, standards, regulations and Codes (professional and those related to the built environment)

- Task analysis skills

person factors:

- Gaining rapport first is important and an essential ingredient to home assessment

- What is important to the person, what do they like/value about their home and what do they want to/need to preserve

- Verifying information rec'd and gathering collateral information from others (e.g., partner, family, caregiver)

- Consider cognitive screening

- Are there 'red flags' that indicate a need for further testing

- Consider mobility screening for falls risk and anticipate needs

- Observation of ADLs as possible, the "how" of doing is important

- Also consider - body size (e.g., height), reach, eye level, elbow height, and if mobility equipment is being used the space needed to accommodate equipment.

minor home modifications (access) - threshold ramps

- Threshold ramps can be either rubber or metal and are made to butt up against the lip of a door threshold or a curb. They are typically 6 inches in height or less, very lightweight, and can be used on both the inside and outside of a doorway.

- These ramps are simple, cost-effective solutions for people using a wheelchair, walker, or scooter to maneuver over a small barrier

minor home modifications (access) - Portable ramps

- Portable wheelchair access ramps are the most versatile of all wheelchair ramps, come in several designs and

many sizes.

- Portable ramps offer many advantages over permanent ramps, not the least of which is lower cost. Portable wheelchair ramps are great for people who are out in the community on a regular basis as they can be used as needed with little exertion by a care giver or attendant. That said, a person who does not ambulate will find it difficult, if not impossible to carry and set up a portable ramp

minor home modifications (access) - Folding ramps

- Folding ramps (sometimes called "suitcase" ramps) consist of either bi-fold (two panels) or tri-fold (three panels)with hinges between each panel. The bi-fold ramps fold over once while the tri-fold ramps has three folds. The folding ramp should only be used for personal use. It can be used for access into wheelchair-accessible vans, or it can be placed over a small set of stairs that lead into a home

minor home modifications (bathrooms)

Evidence in practice Guidelines used:

- Canadian Standards Association (CSA)

- U.S. Uniform Federal Accessibility Standards (UFAS)

- Ontario Building Code (OBC)

- Ottawa-Carleton Common (OCC)

Minor Home

Modifications

bathroom requirement for grab bars:

2 grab bars minimum

- on Faucet wall and Back wall

- Non-slip surfaces

- Drywall reinforcement is required

Minor Home Modifications: Kitchen, living room and bedroom

- Layout- everything within reaching distance

- Move furniture so there is clear maneuvering space

- Remove rugs

Major home Modification (access) - modular ramp

Modular - A modular ramp is typically a larger, more permanent fixture but it doesn't require a building permit because it can be disassembled and reassembled at another location. They are constructed out of rampsections that are built off-site and then transported to the site for speedy assembly.

- Aluminum is typically the best material to use for outdoor, commercial wheelchair ramp applications because it does not rust or warp,and it is the most cost-effective option

Major home Modification (access) - permanent ramp

Permanent - Permanent ramps are made from wood or concrete and cannot be moved or adjusted once theyare set it place, so a building permit is required. Unlike modular ramps, they are built completely on-site, so theinstallation and construction time is much longer. These types of ramps are typically used for residences whenaesthetics are more important than longevity and code compliance. S

Ramp design

There are 4 common configurations: straight, switch-back, U-shaped and L-shaped

Slope: rise/run

Important features: Approach

Handrails

Clear width

Landings (direction change and length)

Vertical platform lifts

- 'straight-though' lift

- 90 degree exit lift

(Consider client factors & the physical environment Major home Modification)

Ramp or platform lift

Wooden Ramp

- Less than 30" rise

- Consider the run required for independent use

- Consider the maintenance (snow removal, applying sealants, etc.)

- Will have a life span of 15-20 years

Vertical Platform Lift

- Greater than 30" rise

- Does not require as much room as a ramp

- If serviced regularly, little extra cost or maintenance• - Will have life span of 10-15 years

Stair-chair lift - the individual:

- Short to long-term use

- Ambulatory and (relatively) stable condition

- Absence of major cognitive impairments

- Safe to transfer at the top of the 'flight'

- Good trunk control and balance with ability to sit

90/90/90 independently

- Meets manufacturer guidelines for weight

Stair-chair lift - the environment:

- Straight run is optimal and most cost effective

- Power supply

- Barriers or hazards (clutter)

Inclined platform lift - the individual

- Uses their own seating system (w/c)

- Ambulation not required but user needs to be

able to get on/off platform and operate controls

- Not appropriate for walkers

- Consider safe operation

- Consider power and / or power failure(s)

- Consider weight capacity and device weight +

client weight

Inclined platform lift - the environment

- Need 5-7' clear at the bottom of the stairs

- Need a load bearing wall for mount

- Stairs need to be 36" wide

- Head room is very important (make sure you

consider the seated height of your client with their

device)

Residential elevator lifts - things to consider:

- Space and feasibility

- Power and power outages

- General safety considerations

- Manufacturers recommendations for weight restrictions/ safety

- Building permit required

- Cost

- Lifts and residential elevators should comply with the latest Canadian Standards Association (CSA) standards

what is wellness:

"Wellness is an active process of becoming aware of

and making choices towards a healthy and fulfilling

life. It is more than being free from illness, it is a

dynamic process of change and growth. A good or

satisfactory condition of existence; a state

characterized by health, happiness, and prosperity;

welfare."

accommodation: supporting legislation

- Ontario Human Rights Code

- Accessibility for Ontarians with Disabilities Act

- Health and Safety Act

- Precedential Case Law

types of accommodations:

modified time

modified duties

modified work environment

A medical authorization or prescription does not entitle an employee to:

- Compromise their own safety

- Compromise the safety of others

- To be inappropriate or rude

- To have unexcused absences

- To be impaired at work

The University has the right to request medical information to:

- Determine whether an absence is bona fide

- Assess prognosis of future attendance

- Evaluate fitness to return to work

- Determine appropriate accommodation

- Plan organizational workflow

Ongoing Medical Documentation:

Even when accommodation is medically supported, the University's accommodation

obligation is not indefinite.

- Employees are responsible for ensuring that accurate and up-to-date medical information

is provided to the University

- Employees are responsible for advising their managers of any changes which may affect

their accommodation

- The University is permitted to inquire into, and request proof of, an ongoing need for the

accommodation, which may include an Independent Medical Examination (IME)

*If changes require disclosure of medical information, the employee should report

information directly to the Return to Work and Accommodation Specialist, EWS

accommodation plan:

- Limitations being accommodated

- Accommodations provided

- Emergency response information

- Responsibilities of those involved

- Timeframe before review

responsibilites of a leader:

prevention: Create awareness and reduce potential hazards through education

early intervention: Observe and respond to changes in performance or behaviour

recovery at work: Ensure an Accommodation plan is in place

when absence is required: Communicate and set expectations with team

return to work: Plan and prepare for progressive return to work with all stakeholders

when do you refer to an OT for assistance:

- Intersection between performance challenges, skill deficiency, and potential existence of a medical condition

- Concerns regarding employee health and safety based on observed behaviours

Canadian Psychological Health and Safety Standard

The Standard provides information to help organizations implement key components, including scenarios for organizations of all sizes, an audit tool, and other resources and references

examples of implementation of CPHSS:

- Psychological support providing resources for employee mental health concerns

- Workload Management-providing appropriate timelines that will result in a successful completion of assigned tasks

- Balance- recognition of the need for balance between the demands of work, family and personal life

what is work:

- Employment, volunteer work, social enterprise, sheltered workshops, work integration social enterprise (WISE)

- "Positive and important activity that provides a significant contribution to individual meaning and life satisfaction"

- Has intrinsic value, but not always from a historical perspective

- Continually changing in terms of the type of work, setting and demographics

what is work context:

Location where a task is completed

Typically, productive occupations

work as an area of occupation:

Employment pursuits and interests -> Identification of work opportunities based upon interests and skills

Employment seeking and acquisition -> Recruiting for job opportunities (e.g.application)

job performance -> Work skills and patterns

Retirement prep and adjustment -> Identifying and selecting avocational interests

volunteer exploration -> Determining opportunities for unpaid "work"

volunteer participation -> Performing unpaid "work"

Institutional environment of work:

The Employment Standards Act, 2000 (ESA)

- Public holidays

- Hours of work and overtime

- Termination notice and pay

- Vacation time and pay

- Leaves of absence

- Minimum wage

Occupational Health and Safety Act (OHSA)

- Rights and responsibilities related to work safety

- Aimed a making workplaces safer

- Outlines worker rights, worker responsibilities, employer and supervisor responsibilities

workers rights vs responsibilities:

Rights

- Know about workplace hazards and what to do about them

- Participate in solving workplace health and safety problems

- Refuse work they believe is unsafe

Responsibilities

- Follow the law and workplace health and safety policies and procedures

- Wear and use PPE required by the employer

- Work and act in a way that won't hurt themselves or others

- Report any hazards to their supervisor

Supervisor responsibilities:

Supervisors must

- Tell workers about hazards and respond to their concerns

- Show workers how to work safely and make sure they follow the law and workplace health and safety P&P

- Make sure workers wear and use correct PPE

- Do everything reasonable to protect workers from injury

Employers responsibilities:

Employers must

- Make sure workers know about hazards by providing information/instruction to supervisors

- Make sure supervisors know what is required to protect workers

- Make sure everyone follows the law and the workplace health and safety P&P

- Make sure workers wear and use the right PPE

- Do everything reasonable to protect workers from getting hurt or getting a work-related injury

Workplace Safety Insurance Board (WSIB) Ontario:

Key principles

- No-fault insurance

- Administered by an agency set up by the government (in accordance with legislation)

- Benefits paid as long as the disability lasts and is tied to the workers pre-injury income

- Financed by employers, collective liability

- Includes "Work Reintegration Program"

- Maintenance of the employment relationship, whenever possible, between the worker and original employer.

- Reintegrating workers into decent, safe and sustainable work

- Effective and meaningful input and choice on the part of the worker to ensure their commitment and active

participation

- Service standards for providers and WSIB staff

- Effective cost management of the program

- Ensuring workers are fairly compensated for wage loss

Ontario Human Rights Code (OHRC):

"The Code states that every person has a right to equal treatment with respect to employment without discrimination or harassment because of race, ancestry, place of origin, colour, ethnic origin, citizenship, creed, sex, sexual orientation, gender identity, gender expression, age, record of offences, marital status, family status or disability.

The right to "equal treatment with respect to employment" covers every aspect of the workplace environment and employment relationship, including job applications, recruitment, training, transfers, promotions, apprenticeship terms, dismissal and layoffs. It also covers rate of pay, overtime, hours of work, holidays, benefits, shift work, discipline and performance evaluations."

OHRC and disability

- 30-50% of human rights claims cite the ground of disability

- Most are in the area of employment

- The ORHC "Policy and guidelines on disability and the duty to accommodate"

speak to ensuring the Code is upheld in the area of employment

- The Policy was originally published in 1989 and revised in 2000

The Policy and guidelines on disability and theduty to accommodate:

- Individuals have the right to be accommodated in the workplace-

There is duty to accommodate

- Accommodation is fundamental, and an integral part of the right to equal treatment

- Duty to accommodate means that "the terms and conditions of the workplace, or the functions of a job, may have to be changed" - Acknowledgement is made for operating rules, collective agreements, P&P, legal requirements and health and safety legislation that must be considered

- Accommodation with dignity (reference to inclusive design)

The Policy standards for workplace accommodation:

- The needs of persons with disabilities must be accommodated in the manner that most respects their dignity, to the point of undue hardship*

- There is no set formula for accommodation - each person has unique needs, and it is important to consult with the person involved

- Taking responsibility and showing willingness to explore solutions is a key part of treating people respectfully and with dignity

- Voluntary compliance may avoid complaints under the Code, as well as save the time

and expense needed to defend against them"

- *includes 3 considerations: cost, outside sources of funding and health and safety

requirements

The Policy and roles:

- The person with a disability

- The employer

- The union or professional association

occupational choice and identity:

- Occupational choices (including work) are closely tied to our sense of who we are (our identity)

- We often think about ourselves in various ways, and these are often tied to roles

- Over the lifespan our roles will change - we adopt new ones, drop others

components of occupational identity:

- One's sense of capacity and effectiveness for doing

- What things one finds interesting and satisfying to do

- Who one is, as defined by roles and relationships

- What one feels obligated to do and holds as important

- A sense of familiar routines of life

- Perceptions of one's environment and what it supports and expects

work values -> meaning

intrinsic -> personal growth, autonomy, interest

extrinsic -> pay and security

social -> contact with people and societal contribution

power -> prestige, authority and influence

physical environment of work:

Preventing injuries at the workplace

- Ergonomics

Assessing and modifying workplaces

- Job Demands Analysis (JDA)

Return to work

- Functional Capacity Evaluation (FCE)

- Work Hardening Program (WHP)

Physical Considerations

- Size, Layout, Furnishings, Equipment, Facilities, Location

Ergonomics:

- Focus on the work practice and the risk for injury secondary to postural or material- handling extremes or excess

- Addresses human performance and well-being related to equipment, tools and the environment

- Goal is to improve health and safety with efficiency of the worker and workplace

- Interventions may be proactive (prevention) or reactive (addressing problems)

- Work settings and processes are designed to maximize productivity while satisfying cost and space limitations - sometimes this is at the cost of the worker

Domains for Ergonomic Assessment and Intervention

- Workstations/seating

- Job Tasks (i.e. JDA)

- Tools

- Materials Handling

basic ergonomic principles:

posture and positioning:

- maintain a neutral spine

- perform tasks as close to body as possible

- avoid extreme lifting

- avoid excessive bending

- take micro breaks

- work area in direct field of vision

AVOID:

- repetitive movements

- over exertion

- performing tasks in non neutral positions

ergonomic process:

Information gathering and analysis

- Risk factors

- Ax. Tools (e.g. NIOSH, RULA, REBA)

- Physical environment

- Root causes

Solutions

- Engineering

- Behavioural

- Administrative

- PPE

hierarchy of control:

(most effective)

- elimination (physically remove the hazard)

- substitution (replace the hazard)

- engineering controls (isolate people from the hazards)

- administrative controls (change the way people work)

- PPE (protect the worker with personal protective equipment)

(least effective)

JDA:

Job Demands Analysis

- Defines the actual demands of job

- Analytical process designed to collect data about a job

- Objective observation and quantification of a job, it's tasks and subtasks

Essentials of any JDA

- Description of observable activities (or end products)

- Generalization of the results that are verifiable and replicable

- Identification of required work behaviours (independent of the person's skills and traits)

Two main purposes of JDA:

- Injury prevention

- Disability management/rehabilitation

Contents of the JDA:

- Job title

- Job description

- Job summary

- Essential job duties

- Physical demands/work positions

- Cognitive/psychological demands

- Environmental conditions

- Tools/equipment

- Summary/recommendations (as appropriate)

Methods of the JDA:

- Review all job documentation

- Interview

- Observation

- Videotaping

- Measurements (# of repetitions of movements, force, weights, distances)

- Checklists/inventories

JDA limitations:

- Lack of standards

- Lack of specificity

- Subjectivity (i.e. bias of assessor and personal interpretation)

- Validity and reliability

level of work: sedentary:

exerting up to 10lbs of force occasionally, involves sitting most of the time but may involve walking or standing for brief periods

level of work: light:

exerting up to 20 lbs of force occasionally, up to 10lbs frequently, requires a significant degree of walking or standing, requires sitting most of the time but entails pushing and pulling arm or leg controls

level of work: medium:

exerting 20-50 lbs of force occasionally, up to 10-25lbs frequently

level of work: heavy:

exerting 50-100lbs of force occasionally, 25-50lbs force frequently