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By JOSH CLIFTON, editor of Workers' Compensation Report, a newsletter covering the field of workers' comp and ergonomics published by our parent company, LRP Publications

The obesity epidemic has had significant impact on U.S. employers in the form of increased workers' compensation costs and extended disability durations. However, according to a recent report, an ergonomic redesign of the typical office environment may hold the key to addressing this emerging problem area in the future.

The Mayo Clinic began a study in late 2007 to examine how an office environment could be redesigned to address the growing number of obese employees. James Levine, an endocrinologist at the clinic, developed a six-month study of an actual office that was re-engineered to increase daily physical activity or nonexercise activity thermogenesis (NEAT). The study took place at SALO, a financial staffing firm based in Minneapolis. Of the 45 employee volunteers involved in the study, 18 were studied for weight loss and other changes.

Levine says the scientifically designed office environment is the practical realization of a decade of research at Mayo Clinic. Levine has spent his career studying how humans expend energy. His research findings from 2005 showed that genomic and biological differences impact how many calories a person burns during everyday tasks. He says it proved the long-discussed concept of a "slow metabolism" as a factor in obesity. It also showed that people can increase their caloric "burn rates" by integrating more movement into their daily regime.

The room makeover for the office cost about $5 per square foot, according to Mayo Clinic researchers. The standing desks cost about $1,000 each, but the room requires no other office furnishings and no cubicles.

The result, according to Levine, is a traditional office floor that is transformed into a clean, sunny, open space with Plexiglas standing computer desks, complete with variable-speed treadmills. There are no desk phones or wall phones. All employees wear mobile phones on their belts along with a Mayo-designed tool that measures their vertical time and recognizes when they sit down. It also tells them how much more activity they need in order to meet their individual activity goals for the day.

Levine and colleagues made a number of other engineering changes to the office environment. Specifically, researchers removed chairs and traditional desk seating, introduced walking tracks, educated and encouraged staff to conduct walking meetings, added desks attached to treadmills, introduced games in the workplace, provided high-tech activity monitors and advised staff about nutrition.

"The idea is to introduce an environment that will encourage activity in the workplace," Levine says. "Just as it's hard to be a couch potato without a couch, it's hard to sit all day at work without a chair or a conventional desk or cubicle."

Levine says the results were impressive. The 18 individuals who were examined for weight loss lost a total of 156 pounds--143 of that in body fat. Individuals lost an average of 8.8 pounds--90 percent of which was fat. Triglycerides decreased by an average of 37 percent. The nine participants who had expressed a desire to lose weight lost an average of 15.4 pounds.

"This 'office of the future' is a functional environment that can also enhance weight loss and maintain health," Levine says.

Levine also says the new office design can be modified to fit any work need and is easily constructed in a short time. The cost of the changeover will be paid many times over by the benefits of a healthier staff.

Another finding of the study was that no productivity was lost due to the new environment. In fact, Levine says company officials noted that revenue rose nearly 10 percent during the first three months of the study, and the company recorded its highest-ever monthly revenue in January 2008--the study's midpoint.

BEHIND A DESK TO BEHIND THE WHEEL

The stress of long daily commutes is a constant concern for company vehicle operators. However, according to one health and safety expert, traffic and the long hours spent in shipping trucks and other vehicles can create more than just stress--it can result in a variety of musculoskeletal disorders.

Jennifer Valle, occupational therapist and certified hand therapist at the Baylor University Medical Center in Dallas, says these employees are at an increased risk of developing carpal tunnel syndrome and back pain.

"Repeated, prolonged gripping of anything--whether it's a steering wheel or a tool?can contribute to carpal tunnel syndrome," she says.

Researchers from the Manitoba Labor and Immigration's Workplace Safety and Health Division in Canada have found that musculoskeletal disorders account for more than 50 percent of injuries suffered by people who drive vehicles or operate machines as part of their job. The most common injuries are often related to low-back pain, which is due to long periods of sitting combined with whole-body vibration. Injuries to the knees and ankles are also common, and tend to occur when vehicles or machines are not properly exited. Carpal tunnel syndrome, neck and shoulder pain have also increasingly become a concern in recent years.

Back pain is a common complaint. According to previous research by ergonomists at Loughborough University in the United Kingdom, back pain is a common complaint among vehicle operators. The study found that lost-time absences due to back discomfort are six times greater for those who drive more than four hours a day.

Another study by the group, Reducing Back Pain in High Mileage Business Drivers, provided further evidence that low-back pain is a problem for these employees. In the majority of companies audited, researchers found that at least half of their drivers reported having low-back trouble in the past 12 months.

What is the cause of back pain for most vehicle users? According to ergonomists, employers should target two areas--prolonged, static postures and whole-body vibration. To prevent back-related MSDs, employers should:

--Focus on posture. Sitting in a prolonged, static posture in a vehicle for multiple hours each day is a common cause of back pain. Good posture plays a key role in the prevention of these disorders. This includes encouraging employees to familiarize themselves with the vehicle controls, such as seat, head rest and lumbar support adjustments. Employees should be encouraged to take regular breaks and stretch whenever possible.

--Provide comfortable, adjustable seating. A vehicle seat should have independent height and tilt adjustment. Electronic adjustment controls can be helpful when available. All adjustment mechanisms should be easy to use and positioned so that poor posture is not encouraged. The seat base should ensure that the user's thighs are adequately supported.

--The vehicle should provide an adjustable steering wheel and be centrally positioned to prevent awkward seating postures and pressure on the spine. The pedals should have adequate spacing.

--Reduce whole-body vibration. Similar to manual handling employees, drivers of delivery trucks, trains and buses often cope with disabling back pain that often results in surgery. The cause of these injuries is often whole-body vibration. Unlike hand-arm vibration that is commonly caused by powered hand tools, whole-body vibration is found in nearly every mode of transportation. Vibration is caused by engines, roadway or track that shake and rattle the body to a point that can lead to micro-fractures of the vertebrae, disc protrusion, nerve damage and acute low-back pain.

--To reduce whole-body vibration, it is important to improve vehicle suspension and use vibration isolation or dampening for seating. In addition, you can lower the risk of vibration by reducing driving speed.

Back pain isn't the only issue that should be addressed among vehicle operators. According to Valle, employers should also assess hand and wrist-related hazards. "There are activities you can do and modifications you can make to help alleviate the risk of developing carpal tunnel," she says.

Valle recommended that vehicle operators:

--Alternate hands. Switch the hand you drive with--periodically using your left, then your right.

--Keep your hand in line with your elbow and your wrist straight. "If you imagine the steering wheel as a clock, the best position to put your wrist in would actually be at three o'clock and nine o'clock," she says.

--Use a headset for phone use. Valle says something else drivers do which increases their risk of carpal tunnel syndrome is talking on their cell phones while driving?holding the device with their wrists bent. Cell phone use not only can result in neck and wrist pain, it can also be deadly. Each year an estimated 284,000 distracted drivers are involved in serious crashes. Common distractions cited were adjusting a radio or CD player, talking with other occupants in the car, adjusting temperature controls, eating or drinking, talking on cell phones and smoking. If you're going to use your cell phone in a vehicle, make sure your employees have an earpiece or headset. If that is not possible, drivers should only use their cell phones when parked.

--Consider wrist splints. Valle says wrist splints can also aid vehicle operators. "You can find them at most pharmacies and they will force you to keep your wrist in a straight position," she says. Valle says most vehicle operators who have already developed carpal tunnel symptoms can reverse them by making simple changes.

"A lot of times patients will come back and say 'I'm having fewer symptoms,' and that the activity modifications are working," she says.

November 1, 2008

Copyright 2008© LRP Publications