Comprehensive Truck/Plant Ergonomic Assessment

• Employee Name:

• Prepared by: LGIS Injury Prevention Consultant

• Location
  Address

• LGA:

• Department:

• Job Role:

• Vehicle/Machine Type

  Select Grader Loader Sedan Wagon 4WD Van Truck Ute Bobcat Skid Steer Excavator Roller Street Sweeper Back Hoe Water Cart

  • Grader
  • Loader
  • Sedan
  • Wagon
  • 4WD
  • Van
  • Truck
  • Ute
  • Bobcat
  • Skid Steer
  • Excavator
  • Roller
  • Street Sweeper
  • Back Hoe
  • Water Cart

• If other, what type of vehicle/machine?

• Number Plate/Vehicle number

• Conducted on

  Date

Musculoskeletal Discomfort

• In the past week have you experienced any aches, pains or discomforts in your MS system?

  Yes

  No

• Body Location:

• VAS Average

• VAS MAX

• Level of Interference

  Select Nil Mild Significant

  • Nil
  • Mild
  • Significant

• Body Location:

• VAS Average

• VAS MAX

• Level of Interference

  Select Nil Mild Significant

  • Nil
  • Mild
  • Significant

• Body Location:

• VAS Average

• VAS MAX

• Level of Interference

  Select Nil Mild Significant

  • Nil
  • Mild
  • Significant

• Body Location:

• VAS Average

• VAS MAX

• Level of Interference

  Select Nil Mild Significant

  • Nil
  • Mild
  • Significant

Machine dissatisfaction

• Is there anything within your workstation that you feel is incorrect, malfunctioning or uncomfortable?

  Yes

  No

• Seat cushion

• Seat Backrest

• Suspension

• Access and Egress points

• Mirrors

• Camera

• Radio

• Load restraints

• Isolation switch

• Other, please detail:

• LHS Pre-Assessment Photo

  Media

• Centre Pre-Assessment Photo

  Media

• RHS Pre-Assessment Photo

  Media

Ergonomic Seat

• What features does the current seat provide:

Ergonomic seat features

• Seat pan slider

• Adjustable lumbar support

• Backrest angle

• Seat pan tilt

• Seat height

• Armrests

• Lower back tension

• Upper back tension

• Other features:

• Has the employee completed any adjustments?

  Yes

  No

• Does the employee understand the seat functions?

  Safe

  At Risk

  N/A

• Is the seat easily adjusted from the sitting position?

  Yes

  No

  N/A

• Is the suspension adequate for the employees weight?

  Yes

  No

  N/A

• Has the suspension been adjusted to support the employees weight?

  Yes

  No

  N/A

• Is there a 2 - 4 finger space at the back of the knee?

  Yes

  No

• Seat pan adjusted

• New seat required

• Is the seat of adequate width? Should not be <40cm

  Yes

  No

  N/A

• New seat required

• Does the chair fit the user?

  Safe

  At Risk

  N/A

• New seat required

• Is there adequate lumbar support?

  Yes

  No

• Is the lumbar support positioned correctly?

  Yes

  No

• Lumbar supported adjusted

• Additional lumbar support required

• Is the backrest adjusted to employee comfort? It should support the worker in both driving and/or operational postures.

  Yes

  No

• Backrest angle adjusted

• Is the seat tilt adjusted to employee comfort?

  Yes

  No

• Seat pan tilt adjusted

• Seat wedge required

• Does the backrest provide adequate upper back support?

  Yes

  No

• New seat required

• Is the seat height appropriate? The front edge should be slightly lower than the distance from the floor to the thigh when seated.

  Yes

  No

  N/A

• Seat height adjusted

• Can the seat height be adjusted? Average height 43cm (range 38-48cm)

  Yes

  No

  N/A

• New seat required

• Does the seat swivel to allow multiple working positions, if required

  Safe

  At Risk

  N/A

• Are the employees elbows positioned by their side when holding the steering wheel?<br>Or<br>Is the employee avoiding excessive forward lean when operating mid-levers?

  Safe

  At Risk

  N/A

• Seat position adjusted

• Are the employees ears in line with their shoulders when seated and looking forward

  Yes

  No

• Seat position adjusted

• How many operational hours has the seat been in use?

• Are the employees shoulders in line with their hips?

  Yes

  No

• Seat position adjusted

• Does the seat cushion still provide support?

  Safe

  At Risk

  N/A

• New seat required

• Does the chair have any malfunctions?

  Safe

  At Risk

  N/A

• New seat required

• Does the employee sit with their wallet in their rear pant pocket?

  Yes

  No

• Education provided

• Does the employee feel any vibration from the machine through the seat?

  Safe

  At Risk

  N/A

• Is the seat firmly mounted to the floor of the cab?

  Safe

  At Risk

  N/A

• Are there any additional concerns to note, please list:

Ergonomic Measurements

• Are the wrists between 170 - 190 degrees?

  Yes

  No

• Steering wheel position adjusted

• Are the elbows between 80 - 120 degrees?

  Yes

  No

• Seat height adjusted

• Are the hips between 95 - 120 degrees?

  Yes

  No

• Seat backrest angle adjusted

• Are the knees between 95 - 135 degrees?

  Yes

  No

• Seat position adjusted

• Seat height adjusted

• Are the ankles between 90 - 110 degrees?

  Yes

  No

  N/A

• Seat height adjusted

• Measure between buttock to back of knee (mm)?

• Measure between knee joint to floor with shoes (mm)?

• Top of shoulder to seat cushion (mm)?

• Drive console height: Measure between floor to steering wheel (mm)?

• How many kms has the vehicle completed (km)?

• How many hours are spent in the cab each day (hrs/24hr period)?

• Has the seat ever been replaced?

  Yes

  No

• Are there any additional concerns to note, please list:

Steering/Levers

• Is there adequate space in the footwell

  Yes

  No

• Can the employee easily reach and operate levers. Should not have to extend greater than 45cm with arms.

  Safe

  At Risk

  N/A

• Can the employee easily reach and operate the pedals.

  Safe

  At Risk

  N/A

• Are the employees elbows splayed out during operation?

  Yes

  No

• Is the cab area large enough for employee and appropriate PPE

  Safe

  At Risk

  N/A

• Does the employee rest their elbow or forearm for long periods on hard or sharp work surfaces?

  Yes

  No

• Can the employee feel any vibration from the equipment through the floor?

  Safe

  At Risk

  N/A

• Can the employee feel any vibration from the equipment through controls/levers?

  Safe

  At Risk

  N/A

• Is the cab noisy? Machine alarms, communications etc should be audible

  Safe

  At Risk

  N/A

• Can the employee control the temperature of the cab?

  Yes

  No

  N/A

• Are there any additional concerns to note, please list:

Mirrors/Cameras/Radio

• Does the machine have practical mirrors?

  Yes

  No

  N/A

• Do the mirrors have any obstruction of view?

  Safe

  At Risk

  N/A

• Are the mirrors placed in an appropriate viewing position? (Easy to view without excessive movements)

  Yes

  No

• Mirror position adjusted

• Are the mirrors clean and free of cracks or scratches?

  Safe

  At Risk

  N/A

• Mirrors cleaned

• Mirrors need replacing

• Are there reverse cameras in use?

  Yes

  No

  N/A

• Does the positioning of the camera encourage awkward postures or overuse?

  Safe

  At Risk

  N/A

• Is the operator twisting head to the side to view the camera monitor

  Safe

  At Risk

  N/A

• Camera monitor requires adjustment

• Is the view of the operation obstructed in any way (cab guards, pipes/hoses)?

  Yes

  No

  N/A

• Is the windscreen free of glare or distracting reflections?

  Safe

  At Risk

  N/A

• Is the windscreen easy to view? (No cracks, scratches, peeling tint and clean)

  Safe

  At Risk

  N/A

• Windscreen cleaned

• Tint needs replacement

• Windscreen needs replacement

• Is the placement of the CB control box / Hand mic a risk?

  Safe

  At Risk

  N/A

• CB control box/ Hand mic requires adjustment

• Does the employee have a good view of the ground (Heavy machinery only)

  Yes

  No

  N/A

• Are there any additional concerns to note, please list:

Access/Egress

• Is the initial step at an appropriate height? (50-60cm from ground)

  Safe

  At Risk

  N/A

• Access requires attention

• Are hand rails provided and are they adequate? First @ 1600mm; Second @ 2000mm

  Safe

  At Risk

  N/A

• Access requires attention

• Does the door orientation pose any access problems?

  Safe

  At Risk

  N/A

• Access requires attention

• What technique is used during access and egress?

  Safe

  At Risk

  N/A

• Education provided

• Does the surface of steps offer non-slip properties?

  Safe

  At Risk

  N/A

• Access requires attention

• Is there any damage to the access/egress equipment? (Steps, rails, doors)

  Safe

  At Risk

  N/A

• Access requires attention

• Are there any additional concerns to note, please list:

Ergonomics/Movement/Stretches

• Is a stretch program promoted?

  Yes

  No

  N/A

• Have any stretch resources been provided?

  Yes

  No

  N/A

• Are there any specific aches, pains or discomfort felt throughout the workday?

  Yes

  No

• Does the employee know any relevant mobilisation or stretching exercises to reduce aches, pains and discomforts experienced?

  Yes

  No

  N/A

• Is any ergonomic equipment currently used?

  Yes

  No

  N/A

• Was this equipment provided by the company?

  Yes

  No

  N/A

• Has this equipment been effective in reducing aches, pains and discomfort experienced?

  Yes

  No

  N/A

• How many hours has the ergonomic equipment been in use? (hrs)

• Equipment requires replacement

• Is the isolation switch positioned between waist and shoulder height?

  Yes

  No

  N/A

• Isolation switch requires adjustment

• Are there any additional concerns to note, please list:

Conclusion

• LHS Post-assessment

  Media

• Centre Post-assessment

  Media

• RHS Post-assessment

  Media

• Employee Signature:

  Sign