Assessment

Risk Factors

Any of the workers previously diagnosed with any of the following CTD's: Carpal tunnel, Tendonitis, Tenosynovitis, De Quervain's disease, Trigger Finger, White finger, Hand Arm Segmental Vibration Syndrome, Muscle strains, or Back ailments?

Any worker complaints concerning ergonomic issues?

Do employees perform high repetition tasks? (100 reps/hour to 2000 per/day)

Do the employee's routine tasks require repeated heavy lifting? (>20 lbs) or occasional heavy lifting (>50 lbs)

Are employees using awkwardly designed tools, which cause the worker to operate the tool outside of a neutral position for an extended period of time? (> 1 hour)

Do employees perform tasks with an awkward head or neck position for an extended period of time? (1 to 3 hours)

Do employees perform tasks that require awkward back angles to be held for extended periods of time (2 to 3 hours)? [i.e…hunching, bending, or squatting]

Do employees perform tasks with an awkward elbow angle for an extended period of time (1 to 3 hours) or with extreme force application?

Do employees perform tasks with an awkward elbow abduction angle for an extended period of time (1 to 3 hours) or with extreme force application?

Do employees perform tasks with an awkward wrist flexion angle for an extended period of time (1 to 3 hours) or with extreme force application?

Do employees perform tasks with an awkward wrist extension angle for an extended period of time (1 to 3 hours) or with extreme force application?

Do employees perform tasks with an awkward back/hip flexion angle for an extended period of time (1 to 3 hours) or with extreme force application?

Do employees perform tasks with an extreme reaching distance for an extended period of time (1 to 3 hours) or with extreme force application?

Do employees perform tasks with an odd workstation height (either standing or sitting) for an extended period of time (1-3 hours) or with extreme force application?

Are high impact tools used routinely? [i.e., riveters, bucking bars, or impact wrenches]

Are high vibration producing tools used routinely? [i.e., die grinders, sanders, weed eaters]

Do employees perform tasks at an extreme height (high or low) for an extended period of time (1 to 3 hours) or with extreme force application?

Are there any other areas of concern either from your observations or employee complaints?

Completion

Overall Assessment (Risk Level)

Recommendation

Name and Signature of the Assessor
Name and Signature of the Reviewer