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ergonomics for fire and ems departments introduction to ergonomics cumulative trauma

Ergonomics for Fire and EMS DepartmentsIntroduction to Ergonomics& Cumulative Trauma

University of Oregon

Labor Education and Research Center

This material has been made possible by a grant from the Oregon Occupational Safety and Health Division, Department of Consumer and Business Services

today s workshop
Today’s Workshop

Will provide information on:

  • Injuries
  • Cumulative Trauma
  • Risk factors for musculoskeletal injury
  • Elements of an ergonomics program
  • Resources for developing an ergonomics program
fire and ems work
Fire and EMS Work

Requires you to:

  • Always be prepared
  • Respond quickly
  • Think and react quickly
  • Not always in control of schedule
  • Work in hazardous situations

Physically & Emotionally Demanding


Firefighter Injuries, 2002

from the NFPA’s Survey of Fire Departments for U.S. Fire Experience

terms for musculoskeletal injuries
Terms for Musculoskeletal Injuries
  • Work-related Musculoskeletal Disorder (WRMSD)
  • Cumulative Trauma Disorder (CTD)
  • Repetitive Strain Injury
  • Overexertion or Overuse Injury
  • Strains and Sprains
  • Soft Tissue Injury
how do injuries occur
How do Injuries Occur?

Acute injuries

  • Happen immediately
  • Can become chronic
  • Re-injury possible
  • Chronic injuries
    • Pain or symptoms lasting more
    • than a month
  • Cumulative trauma
    • Happens over time
tissue repair
Tissue Repair

Phases of repair of soft tissue:

  • Acute (<72 hours): coagulates blood to stop bleeding, brings in WBC to clean up dead tissue and bacteria
  • Repair (48 hours to 6 weeks): deposition of new collagen (scar tissue)
  • Remodeling (3 weeks to 12 months): collagen remodeled to increase functional capabilities
tissue repair cont d
Tissue Repair (cont’d)
  • Body creates a scar internally much like a scar from an external wound
  • Scar tissue is fibrotic - not the same as the original tissue
    • laid down in chaotic manner to be strong
    • Reduced elasticity
  • If tissues are continually disrupted due to use repair is never complete
  • Adhesions form
  • A chronic inflammatory cycle is created
cumulative trauma cycle
Cumulative Trauma Cycle


microtrauma (small tears)

irritation to tissue

produces scar tissue

Keeps repeating

as long as

activity continues

  • results in:
    •  flexibility
    •  strength
    •  function

adhesions form

adhesions coalesce

break the injury cycle
Break the Injury Cycle





re-injury may be likely


disc herniations
Disc Herniations
  • Disc damage is frequently the result of cumulative, repetitive trauma
  • Outer disc fibers repeatedly tear and heal as a result of repetitive overloading
  • The disc weakens overtime (years) leading to herniation of the nucleus, causing back and leg pain, and numbness
what is ergonomics
What is Ergonomics?




The goal of ergonomics is to design the job to fit the worker,

NOT fit the worker to the job.

risk factors for musculoskeletal disorders
Risk Factors for Musculoskeletal Disorders
  • Excessive force
  • Awkward and/or prolonged postures
  • Repetition
  • Direct Pressure
  • Temperature Extremes
  • Vibration
  • Work organization
excessive forces
Excessive Forces

Common risky problems:

  • Lifting and carrying
  • Pushing and pulling
  • Reaching to pick up loads
  • Prolonged holding
  • Pinching or squeezing
awkward postures
Awkward Postures

Common risky postures:

  • Working overhead
  • Kneeling all day
  • Reaching to pick up loads
  • Twisting while lifting
  • Bending over to floor/ground
  • Working with wrist bent
repetitive motions
Repetitive Motions





Same posture or motions again and again

  • Repetitive motion can be very frequent over short period of time
  • Cumulative traumacan be less frequent but repeated over time
contact stress poorly designed equipment
Contact Stress/Poorly Designed Equipment

Common equipment problems to watch for:

  • Does not have a good grip
  • Too heavy
  • Hard to use
  • Uncomfortable
  • Bad condition
  • Wrong tool/equipment for the job
extreme temperatures
Extreme Temperatures

Common warning signs:

  • Dehydration
  • Compromised tissues
    • Muscle cramps
    • Restless leg syndrome
  • Poor circulation

Can lead to injury when you are:

  • Using reciprocating tools
  • Using grinding or impact tools
  • Using vibrating tools
  • Working in or on motorized vehicles
work organization
Work Organization

Common issues to look for:

  • Scheduling
  • Lack of planning
  • Communication
    • with crew
    • with other patient stakeholders
  • Work practices
an activity is likely to become an injury
An Activity is Likely to Become an Injury


  • You perform the activity frequently
  • You do the activity a long time
  • The work intensity is high
  • There are a combination of factors
name your most risky tasks
Name Your Most Risky Tasks

List three examples of tasks that you do at work to the risk factors that have 3 blanks next to them on your handout.

  • ______________________
  • ______________________
  • ______________________

Injury Prevention Program





labor & management




risk factors identified





ergonomic on line resources
Ergonomic On-line Resources

FEMA has Fire and EMS Ergonomics:

search for “ergonomics” on

Elements of Ergonomics Programs – NIOSH

Oregon OSHA

Federal OSHA

ergonomics program elements
Ergonomics Program Elements
  • Assessment of musculoskeletal hazards
  • Prevention and control of musculoskeletal hazards
  • Training
  • A medical management system
  • Procedures for reporting injuries
  • A plan for the implementation of the program
  • Methods for evaluating the program
assessment of hazards
Assessment of Hazards
  • Breaking each specific job

down into elements

  • Identifying conditions within a job that contribute to risk

Performed by person with ergonomics training:

    • Safety committee members
    • Line personnel
prevention and control
Prevention and Control
  • Set short term and long term goals
  • Think outside the box – come up with many solutions
  • Decide on the optimal solution by thinking about
    • Barriers
    • Cost
    • Amount of risk reduced
ergonomic solutions
Ergonomic Solutions

Personal control


Equipment or Engineering

Job organization

Personal protective



what and why analysis
What and Why Analysis
  • Tasks or steps involved
  • Body parts affected
  • Risk factors
  • Frequency/duration of task
  • Why is it done this way?
  • Potential solutions
  • Cost of solutions
  • Barriers


the task


& control

  • Cumulative trauma occurs over time
    • may not result in an injury for many years
    • may be disabling
  • Applying ergonomics = injury prevention
  • Understand injury risk factors
  • Some situations may have little room for improvement, but with others you have the control to improve:
    • equipment
    • work practices
    • bodymechanics
other ergonomics training topics
Other Ergonomics Training Topics
  • Job hazard analysis
  • Ergonomic solutions
  • Bodymechanics & Back Health
  • Ergonomics for command staff
questions and evaluation





Questions and Evaluation

Thank you for your attention