Ergonomic Implementation To Prevent Low Back Pain.pdf

Ergonomic Implementation To Prevent Low Back Pain

1. dr. Gianto Sunardi, HIMA, NLP
Webinar KPC 2023

2. Ref. NIOSH
Seider et all (2020) : Ergonomics factors contribute to HNP
Manual Handling : Odd Ratio 8,5 ; Awkward Position : Odd Ratio 4.5
Combine Manual Handling + Awkward Position (Forward Bending) : Odd Ratio15,5

3. Ilmu yang mempelajari interaksi antara
manusia dengan elemen-elemen lain dalam
suatu sistem, serta profesi yang
mempraktikkan teori, prinsip, data, dan
metode dalam perancangan untuk
mengoptimalisasian sistem kerja/aktifitas
hidup agar sesuai dengan kebutuhan, titik
kelemahan, batas kemampuan dan
keterampilan tubuh manusia.

4. Kegagalan dalam Mengelola Ergonomi

5. Kegagalan dalam Mengelola Ergonomi
Boeing menghabiskan $350 juta per tahun
untuk perawatan kesehatan karyawan, lebih
banyak daripada biaya yang dihabiskan untuk
komponen aluminium untuk membangun
pesawat terbang per tahun- Ref. HFE 2018

6. at Work, at Off Work, on Move & at Sleep

7. PREVENTION IS BETTER THAN CURE

8. Human Factor Ergonomic/HFE
Model Penerapan di Organisasi :
❑Reactive HFE/ “palliative ergonomics.”
❑Proactive HFE/ “membuat persyaratan penerapan HFE
dalam sistem kerja”
❑Generative HFE/ “integrasi HFE kedalam rencana organisasi
dalam mencapai tujuan organisasi”

9. Human Factor Ergonomic/HFE
FMJ/Fit Man for the JOB Versus FJM/Fit JOB for the MAN

10. Human Factor Ergonomic/HFE
FJM/Fit JOB for the MAN
adalah Fokus dari Ergonomi Kerja
(“Work stations – Tools - Equipment”)

11. Human Factor Ergonomic/HFE
summary

12. Human Machine
Semua sistem/bagian tubuh saling terkoneksi, sehingga kondisi tidak ergonomi dapat menyebabkan
kerusakan semua bagian tubuh selain tulang, otot, sendi, saraf dan pembuluh darah.

13. Know Human Limitation is KEY FOR SUCCESS IN ERGONOMIC Intervention

14. How Body Works

15. How Body Works

16. How Body Works

17. Pathophysiology
awkward posture, high force, and
long duration or high frequency (Repetition)

18. posture

19. posture

20. posture

21. posture

22. posture
Lumbar Most Active Movement
Flexion Movement:
75% on L5 – S1
20% on L4 – L5
5-10% L1-L4

23. posture

24. posture

25. posture

26. posture
Vertebrae Disc : 80% water (gel), the above factors reduce water content & reduce intra
disc tension, creating tear of anulus fibroses and herniated nucleus pulposus
Ref. International Journal of Spine Surgery, April 2021

27. Spinal Compression Tolerance Limit (SCTL)
Genaidy et al. (1993) :
▪SCTL is greatest in 20–29-year-old,
▪SCTL declining by 22% in 30-39 years,
▪SCTL declining by 26% in 40-49
▪at ≥ 60 years old the SCTL has declined by 53%

28. Bending your back make HNP Worst
Herniated Disc

29. posture
POOR! BETTER!

30. posture
POOR! BETTER!

31. Stand up from Sitting

32. posture
5kg 12kg 18kg 22kg 60kg

33. posture
POOR! BETTER!

34. posture
Total Duration > 2 hours per day is Danger for your back
Angles from 0 to 20 degrees are acceptable for 5 minutes and angles from 20
degrees to 60 degrees can be held from 3 to 1 minutes

35. posture
500 N
350 N

36. Mr. A (Distance object 50 cm)
Elbow Level
Upper body weight 40 Kg Vertical Compression (C1) 400 N
Object Weight 10 Kg Object Vertical Compression (C2) 100 N
Cummulative Center of Grafity (100 N x 0.5 m) = 50 N
Back Extensor Force (Balance) (C3) (50 N / 0.05) = 1000 N
Total compression to the spine (C1+C2+C3) = 1500 N
Mr. B (Distance object 10 cm)
Elbow Level
Upper body weight 40 Kg Vertical Compression (C1) 400 N
Object Weight 10 Kg Object Vertical Compression (C2) 100 N
Cummulative Center of Grafity (100 N x 0.1 m) = 10 N
Back Extensor Force (Balance) (C3) (10 N / 0.05) = 200 N
Total compression to the spine (C1+C2+C3) = 700 N

37. PROVEN WAY ERGONOMIC IMPROVES PRODUCTIVITY

39. Child “play nature ergonomic”

40. posture
Total Duration > 2 hours per day is Danger for your neck

41. force

42. force

43. force

44. Line of Strength 
Use legs muscles rather than
your back and arms
Maintain correct posture
and natural alignment

45. force

46. force

47. force

48. A power grip is 5 times
stronger than a pinch grip
4.5 Kg 1Kg
=
force

49. duration & frequency
Our Limit:
•Sitting 30 minute change
position
•Avoid Frequent lifting more
than twice per minute for
more than 2 hours per day
cumulative

50. Vibration is believed to cause a range of problems.
These include:
disorders of the joints and muscles and especially the spine (WBV)
disorders of the circulation (hand-arm vibration)
cardiovascular, respiratory, endocrine and metabolic changes (WBV)
problems in the digestive system (WBV)
reproductive damage in females (WBV)
impairment of vision and/or balance (WBV)
interference with activities
discomfort.
Vibration
Ref. A HANDBOOK ON WHOLE-BODY VIBRATION EXPOSURE IN MINING 2009
Boshuizen et al. (1992) report a very high prevalence of back pain among fork
lift truck drivers exposed to vibrations of 0.8 m s–2 (68% compared to 25% in
comparable control subjects).

51. Step Up & Down
Workers who have to work
with the spine flexed
forwards :
•by 60 degrees for more
than 5% of the day or
•30 degrees for more than
10% of the working day)
or
•rotated (more than 30
degrees) suffer back pain
(Hoogendoorn et al., 2000)

52. 11

53. Principle 1. Work in Neutral Position

54. Principle 1. Work in Neutral Position

55. Principle 1. Work in Neutral Position

56. Principle 1. Work in Neutral Position

57. Principle 2. Reduce Excessive Force
If it can be done easily , why do it hardly ?

58. Principle 2. Reduce Excessive Force

59. Principle 3. Keep Everything in Easy Reach

60. Principle 3. Keep Everything in Easy Reach

61. Principle 3. Keep Everything in Easy Reach

62. Principle 3. Keep Everything in Easy Reach

63. Principle 3. Keep Everything in Easy Reach

64. Principle 4. Work at Proper Height

65. Principle 4. Work at Proper Height

66. Principle 4. Work at Proper Height
66

67. Principle 4. Work at Proper Height

68. Principle 5. Reduce Excessive Motions
68

69. Principle 6. Minimize Fatigue and
Static load
69

70. Principle 7. Minimize Pressure Point
70

71. Principle 7. Minimize Pressure Point

72. Principle 7. Minimize Pressure Point
72

73. Principle 8. Provide Clearance
73

74. Principle 9. Reduce Excessive Motions

75. Principle 10. Alternate Task & Exercise

76. Video Display Terminal (VDT) Worker Activities Design
Principle 10. Alternate Task & Exercise
Constrained sitting for 8 hours per day is a risk factor for low back pain. Burdorf
et al. (1993) investigated low back pain among crane drivers, straddle-carriers and a
control group of office workers. Twelve-month pain prevalence was 50% in crane
drivers, 44% in straddle operators and 34% in office workers.

77. Principle 11. Maintain a Comfortable
Environment
77
Vibration
absorbance

78. OBESITY & LBP

79. •Reduced blood flow to the disc (reducing the
flow of nutrients to joints and muscles) or
weakened the disc and spine joint
•Increase pain signal to the brain
•Increase risk of Osteoporotic of the spine
Cigarette Smoking and Low Back Pain -Cindy G. Broden
University of North Dakota-1993

80. Get Enough “Ergonomic” Sleep
Prevent LBP
Most people are about 1% taller when they wake up in the morning than
when they go to bed at night for this reason (expansion/remodelling of vertebra disc)

81. Get Enough “Ergonomic” Sleep
Prevent LBP

82. Get Enough “Ergonomic” Sleep
Prevent LBP

83. Get Enough “Ergonomic” Sleep
Prevent LBP
Get up from Sleep

84. Muscles Strengthening Exercise
Exercise = “Body Maintenance”

86. Workplace Ergonomic Programs
Early Sign ERGONOMIC Problems
❑Numbness
❑Swelling
❑Tingling
❑Discomfort
❑Irritation
❑Stiffness
❑Insomnia
❑Burning Sensation

90. Workplace Ergonomic Programs
❖Survey Tools
❑ BRIEF Survey : Baseline Risk Identification of
Ergonomic Factors
❑REBA Survey : Rapid Entire Body Assessment
❑RULA Survey : Rapid Upper Limb Assessment
❑NIOSH liftings Equitation
❑WAC 296-62-05174

92. RWL = LC ×HM ×VM ×DM ×AM ×FM ×CM

93. Artificial Intelligent in Ergonomic
Assessment (Quick & Accurate)

94. Control

95. Impact of Ergonomic in Productivity
(Direct Impact)
Analysis :
1.Static postures (ergonomic Hazard)
2.Too Much Time Consuming (Works Stepping)
▪Going Down Take Brick (Step 1)
▪Take Brick (Step 2)
▪Going Up (Step 3)
▪Attach Brick to make wall (Step 4)
(4 STEPS)
Impact
1.Back pain after certain times exposures
▪Absent from works
▪Get Treatment
▪Disables
2.Not Efficient Work (1 days only could make 3m2 Wall)
3.Potential Over budget (treating employee and
inefficient works)

96. Impact of Ergonomic in Productivity
(Direct Impact)
Analysis :
1.Static postures much reduce (ergonomic Hazard is controlled)
2.Cutting Time Consuming (Works Stepping Reduced) Up to 50%
▪Take Brick (Step 1)
▪Attach Brick to make wall (Step 2)
(2 STEPS)
Impact
1.Employee Remain Healthy
2.Efficient Work (1 days could make 10m2 Wall)
3.Production Cost reduced (Company Profit Increase)
ROI ~ RETURN OF INVESTMENT

97. Ergonomic Intervention
Improve Safety

98. Capacity : 150 L
Capacity : 150 L
15 L
5 L5 L
Requires 10 times
Requires 15 times
WHICH ONE MORE EFICIENT ?
A
B

99. Capacity : 150 L
Capacity : 150 L
15 L
5 L5 L
Requires 10 times
Requires 15 times
WHICH ONE MORE EFICIENT ?
After 6 round, develops fatigue and pain
on shoulder, on 7 round he stop due to
sprain injury on the back. In long term
potential for MSD including back pain or HNP
He is able finish the job eventually and remain
free of symptoms

100. Implementation of Improve Tools

101. Implementation of Improve Tools