NOTE: This document is provided for historical purposes only.
Carol Stuart-Buttle, Stuart-Buttle Ergonomics
DR. RODGERS: Carol Stuart-Buttle told me not to read this, but I think I will, anyway. She is one of the few people I know who actually has a degree in ergonomics. After receiving her degree from Aston-Birmingham, in England, she came to the States and received a degree in physical therapy. I happened to meet her at the University of Iowa where we were attending Tom Cook's seminar on ergonomics. We were all trying to get the cheap rate home. We stayed over Saturday and we had a chance to meet each other and learn about what we're trying to do.
She's done a lot of work for the small and large businesses, she's been a consultant since 1987, and she has an important background to help tell us how to get as much ergonomics information, on a scientific basis, into our programs when we're trying to start teams, programs, and processes in plants. Carol.
MS. STUART: Thank you, Sue. And I'd like to thank NIOSH and OSHA for inviting me to speak.
I also would like to say that it was great to follow David Carroll; I think my talk is going to be very short; he's illustrated most of the points that I'm going to be making. But I've got a few other generalizations to make of small companies.
Small businesses, I've been asked to talk about. I think it's a very interesting area, actually, to work with. First of all, I'd like to say what I've seen as some of the features of effective programs in small businesses. I say in small businesses when actually, I think you'll see a lot of similarities with large businesses; but there are specific characteristics that make it easier in small businesses, I think, to accomplish ergonomics in the way that I feel is the most effective.
To begin with, I think it is very important to identify where the problems are. Now small businesses don't always collect a lot of data. I think the effective programs I've seen do collect data, and certainly David Carroll has the data to say where are the problems, and also then to really look for the root causes. And I think that's an important aspect, because if you really don't look at the context of the system, some of the points that Sue is making, you tend to be fixing a symptom; and that certainly doesn't go for the best -- for really the most effective use of ergonomics.
The other aspect that I have noticed is that the effective companies integrate ergonomics with other company processes, and I think this is a feature that is a natural approach among small businesses. Because of the many hats that are being worn, as David attests, there's more chance of someone from manufacturing, someone who's the production manager, being responsible for safety and health, and a team approach is just the way that they approach most of improving the workplaces.
So integrating with other company processes becomes an easier aspect than for large corporations. Utilizing information resources I think has been very evident in the effective companies; it's also what I've seen as a big problem with a lot of the small businesses.
There's people still out there who do not know what ergonomics is. If they've heard the term, they don't have it very well defined, and a lot of people are putting their heads in the sand because they don't know where to begin with it. But there are a lot of useful resources. I think much of the problem is having a time crunch, and not going and really focusing on addressing the whole issue of ergonomics and what it can do for them as a business.
So it's an issue of underutilized resources. I think there can be better ones generated, though, by trade associations for example. I think trade associations can play a great role to promote the benefits of ergonomics.
But the other aspect of effective programs is fitting the small business characteristics, one of which is informality; and I don't think that you necessarily have to change some of these characteristics or become a different beast, if you will, to be effective.
Less formal actually means that sometimes it's less paper shuffling, and actually less wasted effort. You just get to the root of the problem, you just get on with it, and you effect the change promptly.
It also, because of size, makes it easier for a better, quicker response to the problems that you might see; and that goes along with employee involvement, management responsiveness, or management involvement; that's a more natural aspect, also. And again, the participatory aspect and the quick response I've seen in most companies.
I see problems arising more in middle sized companies when there's rapid change, and often a change of growth and then communication really goes haywire, and suddenly people aren't able to fulfill the job functions that they originally had; new people aren't being hired, and very often safety and health suffers, or workers' compensation control and case management aspects.
These are some of the features that I see of effective programs; but a fundamental problem, I find is for small companies to hear of ergonomics and what it really can do, and also the definition of ergonomics. I still hear people say "Oh, we don't have any ergonomic problems; we don't have carpal tunnel." And they only know of carpal tunnel. They have lots of back problems, "but that's not an ergonomics issue, that's a lifting problem."
So there is a very, very limited view of what ergonomics is. It's a big problem if there is not a good definition. Because if you're in a small company you don't always have the injuries and illnesses that really can provide a cost/benefit to make the changes. If you don't have a full definition, then you can't do good cost-benefits, and really see that it was worthwhile to make some changes.
And so I think it limits that lost-benefit equation and ergonomics needs to be taken out of just an injury mindset, and a safety and health mindset, and really incorporate looking at performance. Certainly those who are successful with ergonomics often mature to that point of recognizing a broad definition, but I think ergonomics would certainly be snapped up much more quickly if that definition was spoken of more.
As far as what sort of programs I've seen small businesses embracing, it is nothing new to have these sorts of components that you see up here; this is the meat packing guidelines; they've been out for a very long time, and I see that they're very widely used as a guide.
Obviously what's involved in all these components is employee involvement, it integrates or wraps the process, if you will.
These guidelines are based on safety and health management, and I think what often confuses the picture and confuses the definition of ergonomics is having all of these elements as being ergonomics. To me, medical management is medical management; there's nothing about ergonomics in medical management; it's managing medical cases. It affects the injury and illness records that become one measure of how well the workplace is doing, so that it gets included into an ergonomics program.
I think medical management is an extremely important aspect; any company that is facing a lot of injuries and illnesses should start by addressing the medical management aspect. However, all of these program elements I fully support; they're so basic, they're hard to argue against; and they're all very similar to continuous improvement elements, and they work. I've seen them really work.
Let me take a few examples, then, from -- some basic components of the program. A successful program is based on the balance of what you focus on within your program, according to what your problems are. It's not necessarily a focus on automation, as the message some people are getting; that automation is correlated with ergonomics. If you can't automate, you can't fix the problem; and I don't think that's true at all.
So the first example then is a workers' compensation evaluation one. This is a food industry; when they first implemented an ergonomics program, began to address ergonomics, they were at about $3 million per year in workers' compensation. After one year, they had improved by 70 percent, and subsequently another 10 and then another 70 at the end of three years.
A dramatic improvement in the first year. It happens that their injuries and illnesses were totally overboard, it was the thickest bunch of logs I've ever seen for the size of company. But what they really focused on and what really affected those changes in that first year was medical management. It wasn't redesigning the workplace; they had no medical management really in place, nor case management.
Medical management can be a big problem for small businesses. Sometimes access to knowledge of how to even assess services, or to realize that they can really control that issue. When people get hurt they disappear out of the plant; companies feel they don't have control over the quality, the information they can get back from medical services, or how to access quality industrial medical services, for example, that can be very useful to help them control the problems.
So I think there's a lot of assistance needed in accessing medical management. A major lack of knowledge though is in case management and partly because individuals in the small businesses are wearing many hats, and again it's yet another whole area for them to learn and become familiar with.
Companies need to control the data, especially the quality of diagnoses that come back from physicians that contributes to getting to the root of what the problems are and meaningful changes to the job.
This is an illustration of another process, obviously poultry processing. And this is a department in poultry processing that typically has the highest incidence rates; it's breast deboning, so that you can get your deboned breast parts in those tidy little packages.
Although in poultry plants, you hear of cumulative trauma disorders and back problems, I've walked in to find the biggest problems have been lacerations and dermatitis by far, although they are not necessarily the most expensive problems.
So there are a lot of issues to address in terms of the safety and health. Now what is possible, actually, in this department is automation; but it's not so easy. It's all very well to say it; you have to have a very uniform bird, and not all companies can accomplish that, for various reasons.
So what can be done? Well, quite a lot can be done, and this illustrates some of the benefit in terms of the numbers. This graph shows the percentage difference in incidence rates, after implementation of an ergonomics program. You can see in the first year that there was an increase which is typical to see, as there's a tremendous educational process going on. But a dramatic improvement is seen in the second year, and subsequently in the other two it levels off.
But although the incidence level does not improve much between years 3 and 4 the costs of workers' compensation have reduced by 42 percent, so there continues to be a lot of improvements.
So what was done? There's only so much that you can do in the engineering aspect of that work area. You can certainly fine-tune the postures that are being adopted. Where the companies really found that there was benefit was addressing training. They were being trained in terms of technique; it's a high skill to be on the deboning line, especially for shoulder cuts; and they found that training really was inadequate. People were trying to hold the line without the skill to do the job.
So they invested in really focusing on technique training, and that's really where they got such improvements. So again, changes are not necessarily engineering ones.
The company also got a lot of yield improvements, incidentally. So they began to really go beyond and look at other facts than just getting the measurement of the incidence rates.
Another example, then, to bring out a point I'd like to share with you is from tile manufacturing, where machines stamp out ceramic tiles which are manually placed in a container for the kiln. This actual shot doesn't illustrate the extensive reach that there is to the back of the stack of tiles. There was excessive reach, a lot of problems in terms of the wrists; and quite a lot of skill, because they were picking up a 4 inch stack, 4 inch in width, of small, 1x1 inch tiles.
You can see that there's a certain skill involved from the amount of rework piled down on the conveyor. Another step that they had to do that really contorted the wrist, was sweeping the stack of tiles against a brush that sat vertically in order to get dust off, to achieve quality.
Their cumulative trauma incidence rate was 6.3. The company made a number of changes. The changes that they made were comprehensive; that's one point that I'd like to make: Work pace, task technique, employee training, job design. It's often not just one thing that's going to take care of the problem.
Out of these approaches I'd like to emphasize that they stopped brushing. The important point is that I got the company to think, do they need to do it? They questioned the process, which you've heard other people endorse yesterday and today. The company asked if there was a better way to do the job rather than just reposition the brush.
Rechecking the quality they found that actually there was little benefit to brushing; they'd improved the dust control so it wasn't worth doing anymore. So it's important to really look at the system.
Their improvements were down to zero cumulative trauma disorders; they still hold that since '93, and they haven't stopped there; they continue to make things more and more comfortable, focusing much more on fatigue issues. And they've got considerable net savings.
In summary, then, there's some similarity to what really makes effective ergonomics in small businesses as in large. But it's a question of scale. Ergonomics provides a competitive edge, but I think that is when there is understanding of the full definition of ergonomics; designing for best performance. It is then that a company can realize true cost/benefits. Otherwise, it may be expensive in some circumstances, if you don't look at those other values of production and quality.
Effective problem solving leads to cost-effective solutions. Good data are needed to really know where the problems are. Also great benefits can come from improving aspects other than engineering, such as job design, and technique training, and these benefits shouldn't be underestimated.
A comprehensive approach I believe also yields the best benefits. Approaches such as improving management, for example, of medical management, adopting a systems perspective, integrating with production methods, and being proactive are important. I haven't mentioned ‘proactive' much, but actually if you really integrate ergonomics into the production system then it's a matter of course that you're designing it better when production methods change.
The final point I'd like to say is that seeing the big picture does not necessarily mean a burdensome ergonomics program. Being much more broad minded doesn't make ergonomics more complex. It makes it effective.
Small business in particular, once they get the message of ergonomics, tend to be actually less bogged down in the procedures and the paperwork aspect of a program than are sometimes larger companies. Small companies involve production engineers more and they can respond very quickly in making changes and really keep things moving. And since all our workplaces are dynamic, the ability to be responsive is an important part of effective ergonomics.
Thank you.
DR. RODGERS: Thank you, Carol.
