Audit

Pain/Stiffness?

Chair

Seat Height

Seat Back

Seat Pan Depth

Seat Pan Tilt

Armrest Position

Keyboard and Mouse

Keyboard Height

Keyboard-to-User Distance

Keyboard Slope

Mouse-to-User Distance

Mouse Height

Monitor

Monitor Height

Screen-to-User Distance

Monitor Alignment with User

Visual Comfort with Screen

Work Environment and Surface

Leg Clearance at Workstation

Placement of Frequently Used Items

General Task Lighting

Work Practices

Frequency of Microbreaks

Keyboarding Posture

Sitting Posture

Phoning Posture

Alternate Tasks

Evaluation Comments and Recomendations

Required Items to Achieve Safe Workstation Design

Adjustable Ergonomic Chair

Adjustable Keyboard/Mouse Tray

Lumbar Support Cushion

Monitor Riser

Foot Rest

Wristrest Pad

Anti-glare Screen

Reference Document Holder

Telephone Headset

Office Ergonomics Training

Other

Review and Verification (The evaluator has reviewed neutral body position, safe workstation design, best work practices, and recommendations with the user.)
Employee Signature
Evaluator Signature
Ergonomic Evaluation Guidelines
Chair

Seat Height - Adjust seat so feet are flat on the floor or footrest, knees are bent at right angles, and thighs are horizontal to the floor

Seat Back - Adjust seat back so it supports the lumbar curve of the spine.

Seat Pan Depth - Adjust the seat pan depth so the seat cushion is between one and four inches from the back of the knees.

Seat Pan Tilt - Adjust seat pan tilt so hips and top of thighs are at right angles or greater.

Armrest Position - Adjust armrests so they are out of the way during typing, but may provide support during other activities.

Keyboard and Mouse

Keyboard Height - Adjust keyboard height so arms and forearms are at right angles or slightly greeter and forearms and hands form straight lines.

Keyboard-to-User Distance - provide enough distance to allow user to relax shoulders with elbows hanging close to body.

Keyboard Slope - Position keyboard at flat or slightly negative slope.

Mouse-to-User Distance - Mouse should be directly next to keyboard.

Mouse Height - Adjust mouse so it is as close to and on the same level as keyboard.

Monitor

Monitor Height - Adjust monitor height so top of screen is at or slightly lower than eye level.

Screen-to-User Distance - viewing distance is approximately arm's distance away (16"-28")

Monitor Alignment with User - monitor and keyboard should be placed directly in front of user.

Visual comfort of screen - monitor should be placed perpendicular to window or light source to avoid glare.

Work Environment and Surface

Leg clearance at workstation - do not allow any contact between thighs and desk and allow room to move legs without contacting desk.

Placement of frequently placed items - place with arms reach or as close as possible.

General task lighting - ensure lighting is not direct or to bright

Work Practices

Frequency of Microbreaks - get out of chair at least once per hour, microbreak every 30 minutes

Keyboarding Posture - keep wrists straight, avoid supporting wrists on any surface while typing.

Sitting Posture - upright or slightly reclined posture, maintain hollow in lower back.

Phoning posture - avoid tilting head/neck to cradle phone. Use hand to hold receiver.

Alternate tasks - break up long periods of continuous computer use by performing small tasks or errands.

Photograph of Workstation
Proper Workstation Setup
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.