Mitigating Work-Related Musculoskeletal Disorders in Employees Through Structure

1. MITI GATING Work-Related Musculoskeletal Disorders in Employees THROUGH STRUCTURED ERGONOMICS TRAINING 1

2. Abstract Employee well-being is increasingly becoming every organisation’s priority. The definition of employee well-being goes beyond physical health; it cuts across various factors that affect an individual’s life while at and away from work. As office goers spend increasing amounts of time keeping pace with market developments as well as personal growth, employers seek to enable their ambitions by creating a culture of holistic wellbeing through various initiatives, including ergonomics training programs. However, in the current, contemporary business environment, work-related musculoskeletal disorders (WMSDs) are becoming a growing concern due to their impact on employees’ productivity and wellbeing. While organisations make efforts to generate awareness in their employees about its probable risk factors, a detailed and human-centric approach is required to address these concerns at their source. Several studies conducted by Godrej Interio’s Workplace and Ergonomics Research Cell have revealed compelling statistics, such as the fact that 91% of the employees are not fully cognisant of the factors in the workplace that can put their well-being at risk and lead to the development of WMSDs. In light of this insight, Godrej Interio’s Workplace and Ergonomics Research Cell has identified the effectiveness of structured ergonomics training in minimising the risk of Work-Related Musculoskeletal Disorders (WMSDs) amongst office goers for their long-term wellbeing. Our study aimed to present a systematic and informed approach to educating office goers. Additionally, we focused on DSE ( Display Screen Equipment) users in particular to raise awareness about the benefits of implementing office ergonomics principles. Our study aimed to present a systematic and informed approach to educating office goers. We focused on DSE (Display Screen Equipment) users to raise awareness about the benefits of implementing office ergonomics principles. 2

3. Key Takeaways Training is a primal element of a successful occupational ergonomics program. The sole purpose of training in ergonomics is to equip people with the skills, knowledge, abilities, and tools to accomplish their designated responsibilities. Training cannot singlehandedly help reduce ergonomic injuries. A structured approach to understanding and mitigating workplace risk parameters is equally pivotal. Parameters like office layout, thermal, acoustic, and visual comfort, and user interaction with work tools, chairs, and desks must be considered. There was improvement observed in the overall comfort and reduction in pain complaints by the implementation of ergonomic guidelines at work. The study intervention group showed significant behavioural improvements in workstation habits like taking timely postural breaks, following ergonomic work postures, performing office stretches, and engaging in daily exercise. 3 3

4. Introduction Employee wellbeing has evolved to integrate physical, emotional, financial, and social aspects, encompassing career, community, and purpose as salient pillars to actualise a culture of holistic wellbeing. HR leaders worldwide understand that comprehensive wellness is the lynchpin of building a resilient workforce. One of the most important pillars to take into account is a conducive work environment. Fostering a healthy work environment can make employees feel well-cared-for, valued, and motivated. Organisations today are designing the work environment as a means to enhance wellbeing, leading to a healthier and more engaged workforce. The hybrid work model has brought about fundamental shifts - mental health has been destigmatised, physical workspaces have been optimised and technology has become more pervasive. However, this upsurge in technology has resulted in prolonged working hours for employees, giving rise to Work-Related Musculoskeletal Disorders (WMSDs), a predominant deterrent to employee health and productivity. According to the Centers for Disease Control and Prevention, “Musculoskeletal disorders (MSDs) are injuries or disorders of the muscles, nerves, tendons, joints, cartilage, and spinal discs.” However, WMSDs are conditions in which the work environment and the tasks performed at work significantly worsen the condition, especially if it persists for an extended period of time. The Bureau of Labor Statistics of the Department of Labor defines them as “Musculoskeletal system and connective tissue diseases and disorders when the event or exposure leading to the case is a bodily reaction (e.g., bending, climbing, crawling, reaching, twisting), overexertion, or repetitive motion. They do not include disorders caused by slips, trips, falls, or similar incidents.” Some examples include sprains, strains, tears, back pain, carpal tunnel syndrome, and hernia. Additionally, they are associated with high costs to employers such as absenteeism, lost productivity, increased health care, disability, and worker’s compensation costs. 4

5. Several studies conducted by Godrej Interio’s Workplace & Ergonomics Research Cell in the past support the fact that employees around the world run the risk of WMSDs: of employees complained about WMSDs while working from office 76% They are a result of factors like inappropriate postures, lack of postural breaks, incorrect work-tool interaction, and inappropriate furniture while working from office. of employees reported concerns related to body pain while working from home Factors like sedentary postures, a lack of ergonomic remote workspaces, and prolonged working hours aggravate WMSDs while working from home. 82% year-old individuals are worst affected The severity of pain varies from acute to recurrent attacks, resulting in decreased productivity at work and deterioration in personal lives. 26-40 of employees experienced pain in one focused area and over 50% of employees experienced pain in multiple areas 46% Probable causes attributable to this are awkward sustained posture, repetitive movement, and excessive gadget usage, among others. of employees took a leave of 3-4 days in the last six months on account of physical pain Physical pain is a serious, yet unresolved health issue for many. When left untreated for an extended period of time, their condition deteriorates, subsequently leading to a loss of efficiency for the employee and loss of productivity for the organisation. 15% 5

6. Risk Factors Leading to WMSDs in Office Employees WMSDs are caused by several risk factors in the office environment. However, we have identified the 3 most common risk factors causing discomfort in employees in the workplace: 1 2 3 Inappropriate posture at work Long working hours and static muscle load Incorrect work tool integration 1) Inappropriate Posture at Work An estimated 1.71 billion people have musculoskeletal conditions worldwide and a leading cause of this is incorrect postures maintained by the workforce across businesses and industries. According to our findings, there are as many different work styles as there are people. Every individual’s interaction with the workplace infrastructure is unique. However, there are some common threads observed in the types of postural errors made by employees. During our assessment, we identified 11 common posture mistakes observed in employees based on user interaction with the workspace and the usage of gadgets. 6

7. Users tend to blame the seating infrastructure when they experience discomfort or pain after extended use. However, it is often not only the infrastructure but also the user’s incorrect posture that results in pain. 7 7

8. 2) Long work hours and static muscle load Our “Keep Moving” study reveals the patterns that employees exhibit while at work, as well as how those may contribute to the development of WMSDs. Through our study, we were able to deduce that several employee job profiles necessitate prolonged sitting, whether at their desks, in meetings, or at conferences. This involves the prolonged use of electronic devices such as laptops or desktop computers. Here are some of the alarming statistics: of employees spend more than 9 hours a day seated Humans are designed to be active, and sitting for long hours raises the risk of heart diseases, diabetes, strokes, high blood pressure, and cholesterol, which affects the overall well-being of employees. 64% of employees use laptops for a minimum of 6-7 hours Several physical health risks such as eye strain, finger pain, backache, neck pain, and sleep disturbances have all been linked to continuous and excessive use of gadgets. 50% of employees remain physically inactive during work hours Various studies reflect that physical inactivity is the gateway for WMSDs among employees, which decreases productivity and affects employees’ quality of life. 60% of the employees are unaware of the ill effects of maintaining a static posture Employee awareness is the first step in dealing with WMSDs. Employees can only take appropriate corrective measures after they have been educated about incorrect postures and their effects. 95% 8

9. 3) Incorrect Work-Tool interaction Our study on “Gadget Usage in Indian Workplaces and The Impact on Employee Health” reveals the adverse effects of prolonged usage of gadgets on employees’ health. Over 56% of employees suffered from WMSDs The surveyed population encountered various maladies such as back pain, limb pain, headache, fatigue, and distraction after prolonged use of gadgets. Nearly 45% reported a tingling sensation in their arm, shoulder, or hand When employees continuously operate a smartphone, hand-held device, or laptop at a height without a keyboard, they tend to develop repetitive strain injuries. Understanding ergonomic concerns associated with different gadgets: Desktop The primary risk factor while operating a desktop is its lack of mobility. Users are compelled to work from their designated space for long hours. This results in employees adopting awkward postures. Laptop Laptop users face difficulties with the gadget design, resulting in an incorrect posture. For e.g., Laptops have an in-built keyboard. This results in users adopting an inward posture causing pain in the shoulders and upper back. Smartphone and Tablet: The small screens in smartphones cause users to strain their cervical spine and upper back muscles. Holding the phone up to the ear for long causes pain in the elbows, neck, and shoulders. In addition, they can also cause text neck syndrome and carpal tunnel syndrome. The severity of a neck muscle strain varies depending on the size, location, and timely redressal of the tear of the fibres in the neck muscle. It can range from mild to severe ache. 9

10. The Human-Centric Approach Prevention of WMSDs among employees is a challenge for many workplaces today, according to several studies on ergonomics among office goers. Organisations striving for holistic employee wellbeing have brought the significance of ergonomic interventions into sharp focus. In the light of this, the Workplace and Research Cell at Godrej Interio investigated the role of a structured approach to ergonomics training in reducing the risk of WMSDs among office goers. The goal was to closely examine factors like awareness, workstation habits, and work behaviour to augment comfort and wellbeing at work. A before and after study of 500 office goers was conducted to gain comprehensive insights into employee behavioural tendencies and their interaction with the workspace, infrastructure, and work tools. Demographic data, work hours, work profile, and the aforementioned parameters were accumulated using a digital questionnaire, employee interaction, and site visits. Organisations striving for holistic employee wellbeing have brought the significance of ergonomic interventions into sharp focus. 10 10

11. The Assessment Phase: Ergonomic Risk Factors Identified Amongst Office Goers As a part of the assessment phase, our study revealed the areas with the highest reported pain complaints, and the duration of pain in the sample studied. We found that the job tasks that require the use of the same motions or muscles for long periods increase the probability of fatigue. Generally, if the period of continuous work increases for the tasks that require extended muscle contraction, then correspondingly more rest or recovery period is required. Areas with the highest reported pain complaints Headache 54% Eyes 49% 28% Heels Legs 44% 40% Knee Wrist 27% Lower Back 45% 24% Upper Back 39% Shoulder Neck 51% Duration of Pain 13% Less than 3 months From 3 to 6 months 30% More than 6 months 15% 11 11

12. It was observed that 68% of employees experienced pain issues while working and 13% of these are already in an acute phase. A few prominent pain areas that were observed amongst office employees during the research were: Headache There are a number of probable causes for developing a headache while at work. To list a few, there are factors like cognitive stress of completing a taxing task, prolonged use of a laptop or computer screen, and maintaining an incorrect posture while sitting. Eye strain Godrej Interio’s survey on computer vision syndrome explains how excessive gadget usage while working from office and home leads to visual fatigue, headaches, and watery eyes, among other effects. Neck pain Numerous cases of neck pain are classified as ‘soft-tissue’ rheumatism or postural neck pain. When the head is held too far forward or inclined at an angle for too long, the muscles, tendons, and other soft tissues of the neck can become overstretched, causing pain. 12 12

13. Our research highlighted the following ergonomic risk facts: 1. Long working hours and static postures cause discomfort at work: • While 12% of employees are spending more than 10 hours at work, 61% are spending more than 9 hours During these hours, they are confined to their desks for more than 7.5 hours on average per day This prolonged sitting and extra hours at work cause stress and strain on the musculoskeletal system • • 2. The break pattern varies for employees and is influenced by the nature of their job: • 6% of office goes took a postural break at the recommended interval of 1 hour 30% of employees sat for 2-3 hours at a stretch 15% sat for more than 4 hours at a stretch on account of their job responsibilities • • 3. Work environmental factors like infrastructure, work tools, illumination and thermal comfort. • • 40% of office goers use inappropriate work chairs 56% of workstations in were improperly illuminated resulting in complaints related 87% of laptop users and 60% of desktop users reported musculoskeletal pain 50% reported neck, shoulder, and elbow pain on account of lack of integration between work desk and chair • • 4. Lack of productivity on account of absenteeism: • Almost 12% of employees took an average of 1-3 days of leave in a span of the last 6 months on account of WMSDs and body pain The remedial measures these employees took to counter the pain were limited to rest breaks and symptom management until it significantly affected their work or daily lives • In our survey, we discovered that employees resorted to certain remedial measures and symptom management to curb the pain caused by WMSDs including taking medication, engaging in various forms of physical activity, seeking physiotherapy, and resting. However, these measures proved to be futile in addressing the root cause. 13

14. Remedial measures adopted by employees to combat pain caused by WMSDs Take medicines or use ointments Exercise, walk, yoga, etc Physiotherapy, use of ortho accessories like bands Rest, sleep, massage Did not do anything According to the primary data collected during our research, only 30% of DSE users are aware of ergonomic principles. A certain number of users have a general understanding of ergonomics. However, it was inadequate and not compatible with their workstations. 14 14

15. “ manner in which the report was What our client said about the audit in the assessment phase: The audit was conducted in a systematic and organised manner comprising interviews and personal contact with the employees working in office spaces at our site. We highly appreciate the detailed prepared and presented by you (The Godrej Interio Team). Dr. J. Vishumohan, Chief Factory Medical Officer at JSW Steel Salem Works “ and sitting on desks and chairs. Display screen equipment (DSE) and ergonomics are a dominant and inseparable part of our modern working and personal lives. Hybrid working models have increased the time span we spend on our devices Shiilpaa Surve, General Manager - Talent Management, Nucleus Office Parks 15

16. The Corrective Phase: Learning the Principles of Ergonomics to Mitigate WMSDs During this phase, guidelines are formulated based on the initial assessment of workplace and employee behaviour. The training program participants are engaged in the program through a participatory approach where they understand the risk factors and learn the principles of ergonomics to mitigate the same. The duration of this program is 90 minutes, including a Q&A session. Biomechanics of neutral postures at work, ergonomic self-assessment technique, guidelines on posture management, work desk adjustment, work tool interaction, user behaviour, and microbreak techniques are the areas that are worked upon during the training program. A participatory approach where employees are involved in understanding the risk factors and learning the principles of ergonomics to mitigate the same. 16 16

17. “ What clients said about the training on the corrective phase: We believe that the real life examples of poor postures and wrong sitting habits, leaves a positive impression on the participants, in order to improve their postures and workstation ergonomics.” Mr Bhushan Damle, Senior Manager, Risk Management, Idemitsu Lube India Pvt Ltd. Sharad Dhage, Deputy Manager, Admin, Horiba “ I would like to thank Godrej Interio on behalf of HORIBA. It’s great to see employees making small changes to their work habits and feeling comfortable at work.” 17

18. The above approach resulted in a significant rise in employee awareness of ergonomic work principles: Awareness about Ergonomics Principles Awareness about Work Postures 100% 100% 30% 20% Pre Intervention Post Intervention Pre Intervention Post Intervention During our sessions, we found that 92% of employees implemented the ergonomic strategies they learned during our training, in their work routine, and in their individual work behaviour. Ergonomic strategies adopted by employees Invested in ergonomic chair for WFH setup 35% Visual breaks & 20-20-20 rule 32% Movement breaks after 30 to 45 mins 92% 67% Stretch breaks 18 18

19. Employees who were primarily working on laptops for long hours accessorised their laptops to assume better work postures. However, post the training program, 34% of employees invested in accessories thereby adopting a better work posture. Laptop Usage 39% 60% did not accessorize their laptop. Post training program 34% invested in accessories for their laptop for a better work posture. 17% 10% 8% 6% 3% 10 hrs & more 7 to 9 hrs 30 mins to 1 hr 2 to 3 hrs 4 to 5 hrs 6 to 7 hrs 19

20. The Preventive Phase: Implementation of Ergonomic Principles to Prevent WMSDs As a part of the program, focused educational interventions are initiated immediately post- training/corrective phase, every week for 3 months. This exercise is performed to reinforce learnings and recall the guidelines that were issued during the program. During the preventive phase, 90% felt that the ergonomics program helped employees improve their overall comfort while working and 47% felt that their pain levels had reduced significantly with simple changes in their work behaviour. Reduction in MSD pain complaints 68% 21% Before Intervention After Intervention The recommended measures employees took were focused on their work habits. Post the session, they were mindful of their work posture. They started taking microbreaks during long work hours and engaged in exercise 3- 4 days a week. Engaged in regular exercise Microbreaks 68% 35% 84% 17% Pre Intervention Post Intervention 20 21

21. Posture correction 100% 32% Pre Intervention Post Intervention Employees went ahead and followed various ergonomic strategies like adjusting the screen and doing eye exercises to prevent eye strain and headaches. Ergonomic strategies followed by employees for reducing eye strain and headache Adjusted monitor 8% screen Corrected illumination of workspace 25% Eye exercise 10% 50% 20-20-20 Rule 21 21

22. What our clients had to say about the training on the preventive phase: Mr Selvam.S, Manager - HSE, Indian Additives Limited “ “ Post training immediately we started to implement weekly tips provided as weekly reminders and was helping to reinforce positive work behaviour.” The content was extremely informative and incredibly useful. We have attended several trainings before but can’t recall any of them having such a strong impact.” Mr Santosh Khalate, Manager - EHS, Umicore Autocat India Pvt Ltd 22

23. Conclusion Be it our health or our work, habit formation is key to sustained performance. A systematic approach to problems minimises errors and improves productivity. Similarly, a systemic approach to identifying occupational risk factors and ergonomic solutions is the ideal remedy to long-standing WMSDs. In order to counter and reduce their prevalence, organisations must critically assess parameters like employee behaviour, and work tool interaction prior to opting for a training program. In addition, they should consider environmental parameters like illumination, and thermal and acoustic comfort, which equally affect employee health. This pre-training assessment is key to formulating ergonomic guidelines that are strictly relevant to the organisation’s workforce. It is hypothesised that structured training allows employees to consciously engage in ergonomics knowledge and skills garnered during the program. Organisations must include behaviour training programs pertaining to ergonomics in their annual training calendars, spreading them out consistently every 3 to 6 months for greater ergonomic guidelines retention. Prioritising employee wellness programs and wellbeing at large goes a long way in guaranteeing the growth, stability, and sustainability of an organisation and its workforce. Godrej Interio’s Workplace and Ergonomics Research Cell strives to aid employees and organisations stay healthy, across the world. Some more training programs that we offer are: 23

24. Wellness@Work Program Wellness@Work is a comprehensive initiative by Godrej Interio’s Workplace and Ergonomics Research Cell. Over the years, our program has been a key knowledge advocate in the space of workplace trends and ergonomics. Our team comprises Workspace professionals, Occupational Therapists and Ergonomists who come with research and advisory experience spanning across corporate, government and healthcare organisations. The team’s work with these organisations focuses on maintaining a continuous understanding of changing work patterns and office spaces, issues arising thereof and helping employees improve their Ergonomic and Wellness Quotient : The Human Centric Approach 1. Assessment: This step comprises an evaluation of the workspace with a 360-degree view while making use of standardised tools and assessment scales. Assessment considers the furniture, user behaviour, and the task at hand. It also evaluates the thermal environment, illumination and noise levels at the office. Assessment is a scientific study that observes users when they work in a dynamic environment at their offices. This study is largely conducted to make both employers and employees familiar with ideas that can enhance the ergonomic & wellness quotient in workspaces. 2. Correction: Post assessment, the gathered observations are examined in depth. A carefully curated program is then formulated for the organisation by our ergonomic experts. These experts come with an array of experience. Not only do they keep the facts and proven theories in mind but also consider the insights gathered by us during on-site assessments and observations. Diving deep into the process of correction: Ergo @work: This module encompasses a classroom-like training setup where ergonomic experts take users through the subject of ergonomics and introduce employees to its importance. Through the module, the experts create awareness about the right ergonomic postures to be adopted while working. Ergo @desk: This module comprises a live demonstration of appropriate work postures while seated at a desk. It ensures that users set up their workstations correctly and is immensely useful for users to set up their workspaces in line with ergonomic principles individually. 24

25. Yoganomics @work: This module consists of simple exercises demonstrated by experts. These exercises are prescribed to be practised by all employees, while at work, during breaks or at regular intervals. This regime is specially designed to help their muscles, tendons and ligaments relax. E-Learning Module: As people work from home through the pandemic, e-learning modules are finding favour among office goers. These modules have proved to be a game-changer and the ideal medium to ensure that users adopt the right sitting stances while working in the changed scenario. Employees can take these sessions at their convenience. The module is designed to allow admin / HR to track user understanding and progress. Prevention: Prevention of WMSDs is exceptionally beneficial to individuals as well as the organisation they are associated with. Our experts engage users with simple yet insightful wellness tips which they can practice on a continuous basis post-assessment and training. This activity will act as a quick recap of the lessons from the training program. 25

26. About Godrej interio Godrej Interio (GI) is India’s premium furniture brand in both home and institutional segments with a strong commitment to sustainability and centers of excellence in design, manufacturing and retail. Led by the largest in-house design team in the country in the furniture category and awarded with 42 India Design Mark Awards till date, GI aims to transform spaces with its thoughtfully designed furniture to create brighter homes and offices with products that have the highest design quotient in aesthetics, functionality and technology. With consistent pursuit of excellence and a special focus on health and ergonomics, GI’s product portfolio comprises a massive range. Today, we design and manufacture furniture for office spaces, homes, educational institutes, healthcare facilities, laboratories and more. Along with furniture we offer Audio Visual and 360 Degree Turnkey solutions. Each of our product range frevolves around comfort and aesthetics while delivering well-designed, fun and functional urniture solutions. Briefly, Godrej Interio transforms dream spaces to life! GI commitment to the environment has resulted in manufacturing products with lesser environment footprint. Our pioneering efforts include designing less environment burdening products, usage of eco-friendly materials and setting up less polluting and consuming processes, ensuring eco- friendly packaging and transportation and finally the extended responsibility of recycling/ reuse of used furniture and scrap, thus ensuring a lifecycle approach to green. Currently present in over 650 cities with 250 exclusive showrooms and 800 dealers, GI is one of the largest divisions of Godrej and Boyce Mfg. Co. Ltd., part of the Godrej Group, one of India’s largest engineering and customer product groups. Disclaimer This paper represents the opinions of the authors and is the product of professional research. This report has been prepared for the exclusive use and benefit of the addressee(s) and solely for the purpose for which it is provided. Unless we provide express prior written consent, no part of this report should be reproduced or distributed. While every attempt is made to ensure that the information contained in this document is true to its best. However, Godrej and Boyce Mfg. Co. Ltd., its employees, representatives, affiliates or any of its divisions, etc. shall not be responsible for any reliance made on this paper or for any errors / omissions in information obtained from the source while preparing this paper. 26

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