Monthly Archives: September 2014

Standing working

Can working in a standing position cause health problems?

Standing is a natural human posture and by itself poses no particular health hazard. However, working in a standing position on a regular basis can cause sore feet, swelling of the legs, varicose veins, general muscular fatigue, low back pain, stiffness in the neck and shoulders, and other health problems. These are common complaints among sales people, machine operators, assembly-line workers and others whose jobs require prolonged standing. 


How can working in a standing position be a problem?

A person’s body is affected by the arrangement of the work area and by the tasks that he or she does while standing. The layout of the workstation, the tools, and the placement of keys, controls and displays that the worker needs to operate or observe will determine, and as rule, limit the body positions that the worker can assume while standing. As a result, the worker has fewer body positions to choose from, and the positions themselves are more rigid. This gives the worker less freedom to move around and to rest working muscles. This lack of flexibility in choosing body positions contributes to health problems.

These conditions commonly occur where the job is designed without considering the characteristics of the human body. When job design ignores the basic needs of the human body (and individual workers), work can cause discomfort in the short term and can eventually lead to severe and chronic health problems. 


What are some of the health hazards?

Keeping the body in an upright position requires considerable muscular effort that is particularly unhealthy even while standing motionless. It effectively reduces the blood supply to the loaded muscles. Insufficient blood flow accelerates the onset of fatigue and causes pain in the muscles of the legs, back and neck (these are the muscles used to maintain an upright position). 

The worker suffers not only muscular strain but other discomforts also. Prolonged and frequent standing, without some relief by walking, causes blood to pool in the legs and feet. When standing occurs continually over prolonged periods, it can result in inflammation of the veins. This inflammation may progress over time to chronic and painful varicose veins. Excessive standing also causes the joints in the spine, hips, knees and feet to become temporarily immobilized or locked. This immobility can later lead to rheumatic diseases due to degenerative damage to the tendons and ligaments (the structures that bind muscles to bones). 


What are some recommendations for improving workplace design?

In a well-designed workplace, the worker has the opportunity to choose from among a variety of well-balanced working positions and to change between them frequently. 

Working tables and benches should be adjustable. Being able to adjust the working height is particularly important to match the workstation to the worker’s individual body size and to the worker’s particular task. Adjustability ensures that the worker has an opportunity to carry out work in well-balanced body positions. If the workstation cannot be adjusted, platforms to raise the shorter worker or pedestals on top of workstations for the tall worker should be considered. 

Organization of the work space is another important aspect. There should be enough room to move around and to change body position. Providing built-in foot rails or portable footrests allows the worker to shift body weight from one leg to the other. Elbow supports for precision work help reduce tension in the upper arms and neck. Controls and tools should be positioned so the worker can reach them easily and without twisting or bending. 

Where it is possible, a seat should be provided so that the worker can do the job either sitting or standing. The seat must place the worker at a height that suits the type of work being done. For work that requires standing only, a seat should be provided in any case to allow the worker to sit occasionally. Seats at the workplace expand the variety of possible body positions and give the worker more flexibility. 

The benefits from greater flexibility and a variety of body positions are twofold. The number of muscles involved in the work is increased which equalizes the distribution of loads on different parts of the body. Thus, there is less strain on the individual muscles and joints used to maintain the upright position. Changing body positions also improves blood supply to the working muscles. Both effects contribute to the reduction 

Quality of footwear and type of flooring materials are also major factors contributing to standing comfort. For further details on these subjects, refer to these related documents on OSH Answers:

How can job design reduce the ill effects of working in a standing position?

The basic principles of good job design for standing work are: 

  • Change working positions frequently so that working in one position is of a reasonably short duration. 
  • Avoid extreme bending, stretching and twisting. 
  • Pace work appropriately. 
  • Allow workers suitable rest periods to relax; exercises may also help. 
  • Provide instruction on proper work practices and the use of rest breaks. 
  • Allow workers an adjustment period when they return to work after an absence for vacation or illness so they can gradually return to a regular work pace.


How can work practices reduce the ill effects of working in a standing position?

A well-designed workplace combined with a well-designed job makes it possible to work in a balanced position without unnecessary strain on the body. Although the actual performance of the task depends on the worker (including how the worker stands, moves or lifts), work practices can make the job either safer or more hazardous. Proper training shapes individual work habits and should be provided by a supervisor who encourages the worker to use the skills they have learned. 

It is important that the worker be informed of health hazards in the workplace. In fact it is a legal requirement. The worker needs to understand which body movements and positions contribute to discomfort and that the conditions causing mild discomfort can lead to chronic injury in the long term. Worker training should also contain information on how to adjust specific workplace layouts to the individual’s advantage to reduce or eliminate health hazards. 

The worker should be aware that rest periods are important elements of the work. Rest periods should be used to relax when muscles are tired, to move around when muscles are stiff, to walk when work restricts the worker’s ability to change postures or positions, and so on. The worker should also be encouraged to report discomforts experienced during work. It may result in correcting working conditions. 

All these elements — training and supervision, coupled with active worker input — can result in sound work practices. It must be remembered that a well-designed job and workplace are essential to healthy and safe work. Without these, good work practices cannot be effective. 


What is an example of a workstation designed for a standing worker?

Workplace design should fit the variety of workers’ shapes and sizes and provide support for the completion of different tasks. 

Different tasks require different work surface heights: 

  • Precision work, such as writing or electronic assembly – 5 cm above elbow height; elbow support is needed. 
  • Light work, such as assembly-line or mechanical jobs – about 5-10 cm below elbow height. 
  • Heavy work, demanding downward forces – from 20-40 cm below elbow height.
 

What can workers do to reduce the discomfort of working in a standing position?

  • Adjust the height of the work according to body dimensions, using elbow height as a guide. 
  • Organize your work so that the usual operations are done within easy reach.
  • Always face the object of work. 
  • Keep body close to the work. 
  • Adjust the workplace to get enough space to change working position. 
  • Use a foot rail or portable footrest to shift body weight from both to one or the other leg. 
  • Use a seat whenever possible while working, or at least wh

What should workers avoid while working in a standing position?

    • Avoid reaching behind the shoulder line. Shifting feet to face the object is the recommended way. 
    • Avoid overreaching beyond the point of comfort. 
    • Avoid reaching above shoulder line.


What are some do’s and don’ts regarding footwear?

  • Your feet can only be as comfortable as the footwear permits. DO wear shoes that do not change the shape of your foot.
  •  
  • enDO choose shoes that provide a firm grip for the heel. If the back of the shoe is too wide or too soft, the shoe will slip, causing instability and soreness. DO wear shoes that allow freedom to move your toes. Pain and fatigue result if shoes are too narrow or too shallow. DO ensure that shoes have arch supports. Lack of arch support causes flattening of the foot. DO wear shoes with lace-up fastenings. DO tighten the lace instep of your footwear firmly. The foot is prevented from slipping inside the footwear. 

    DO use padding under the tongue if you suffer from tenderness over the bones at the top of the foot. 

    DO use a shock-absorbing cushioned insole when working on metal or cement floors. 

    DO choose footwear according to the hazard at your workplace. 

    DO select safety footwear, if required, that is CSA approved and carries the proper ratings for the hazard. The OSH Answers document Safety Footwearhas additional information.

    DO select footwear taking into account individual fit and comfort. Try them on and walk around for a few moments before buying. 

    DO NOT wear flat shoes. 

    DO NOT wear shoes with heels higher than 5 cm (2 inches). 


What do we recommend regarding floors in a workplace?

    • Keep work areas clean. 
    • Avoid standing on concrete or metal floors. Recommended for standing work are wooden, cork or rubber covered floors. 
    • Ensure that the floors are level and non-slippery. 
    • Cover concrete or metal floors with mats. Slanted edges on mats help prevent tripping. 
    • Do not use thick foam-rubber mats. Too much cushioning can cause fatigue and increase the hazard of tripping.
  •  the work process allows for rest.

Study Documenting Value of on-site Chiropractic Services at Corporations

CARMICHAEL, Calif., Sep 22, 2014 (BUSINESS WIRE) — The Foundation for Chiropractic Progress (F4CP), a not-for-profit organization dedicated to raising awareness about the value of chiropractic care, calls attention to a new report: “Impact of Chiropractic Services at an On-Site Health Center,”(Journal of Occupational and Environmental Medicine; September 2014) co-authored by Ross M. Miller, M.D., M.P.H., medical executive, Cerner Corporation; Sylvia L. Kindermann, M.P.H, senior research associate, Cerner LifeSciences; and Qingjiang Hou, M.S., scientist/biostatistician, Cerner LifeSciences. The studyconcludes that on-site chiropractic services are associated with lower overall healthcare utilization and lower subsequent costs when compared to off-site services, and follows an earlier study, “Value of Chiropractic Services at On-site Health Centers,” which found similar advancements, plus improved functional status of musculoskeletal conditions, linked with on-site chiropractic care.

“As the nation restructures its healthcare delivery system, employers are seeking innovative solutions that maximize value,” states Dr. Miller. “The on-site corporate health center is an attractive option based on its ability to control costs and deliver quality care. Evidence suggests that companies with an on-site health center consider the inclusion of chiropractic, as it offers great potential for higher return on investment.”

低頭族三大致命風險

大紀元記者朱文綜合報導)台灣名模黃志瑋14日開車時因低頭要接手機,發生擦撞翻車的事故,讓人們開始思考3C產品的一些影響。3C產品很方便可以隨時隨地講電話、發訊息,但是也給人帶來三大風險:研究發現,低頭族易發生意外、減壽、罹癌。

現在3C產品日新月異,不斷推陳出新,讓老、中、青都為之瘋迷。無論走到哪都可看到有人在低著頭滑手機,因忽視前方千變萬化的路況,而容易引發危險。研究也發現,常低頭的不良姿勢,會為健康帶來負面影響,甚至導致壽命減短,甚至帶來罹患腦癌的風險。
走路、開車低頭滑手機隱藏危機 
由美國安省癮癖與精神健康中心(CAMH)委託進行的兩年一次的《安省學生藥物使用和健康調查》,其2013年報告顯示,10年級至12年級擁有駕照的安省學生中,逾1/3曾經開車發短信。
美國國家安全署(National Safety Council)資深處長大衛·蒂特(David Teater)對媒體發言說,美國每天有近100人因為車禍死亡,其中,90%的車禍都是由駕駛人疏失,包括一心多用造成的。「任何一位認知心理學家都會告訴你,人類大腦一次只能專注於一件事情上,無法一心多用。」
另外,美國疾管局指,比起其他造成分心的因素,收發簡訊造成駕駛注意力轉移的頻率更高、時間更長。在美國高中生當中,開車時收發簡訊的風險被認為不亞於酒後駕駛。
不只開車發簡訊或回電話很危險,走路看手機的訊息同樣具危險性,當人在低頭時非常容易忽視前方迎面而來的人與車。
常低頭易駝背提高死亡率
英國《電訊報》(The Telegraph)刊文引述英國脊骨神經醫學會(United Chiropractic Association)的報告稱,英國脊骨神經科醫生警告,長時間低頭看手持電子產品、傳簡訊,會造成姿勢不良,對身體帶來的危機不亞於肥胖所造成的負面影響,可能會導致壽命減短。
滑手機減壽的原因?那是由於長期低頭操作電子產品讓身體保持前傾的不良姿勢,易造成駝背,駝背不只影響體態,還影響正常呼吸,易引起肺部與心血管疾病,對年長者的影響尤其嚴重。
英國脊骨神經醫學會執行委員埃絲特爾·佐納-莫恩(Estelle Zauner-Maughan)指,當人體頭部前傾、形成圓肩時,會因為肌肉受限、肋骨無法適當移動而不能完全呼吸,於是心臟與肺部將無法有效發揮完整功能。即使是僅有輕微駝背的老年人,死亡率也比沒駝背的老年人高出1.44倍。
協會建議民眾,尋求合格的脊骨神經醫師檢查身體姿勢是否正確,並減少低頭使用電子產品的時間,或是把電子產品放到與眼睛同高,避免姿勢不良。
手機不離手 癌症易找上門
英國《職業與環境醫學》期刊(Occupational and Environmental Medicine)的研究報告指,平均連續5個月,每個月使用手機15小時,患神經膠質瘤及腦膜瘤這兩種腦癌的風險增加2~3倍。
駕駛訓練班教練稱,無論走路或開車要使用智能手機,應該使用耳機以聽聲音代替看文字。我們要清楚看到前方隨時發生的狀況,才能立刻作適當處理以免危險發生。只要改善使用習慣及頻率,除了可以減少對自身健康的威脅,也可以避免因為分心造成公共意外,危害自己及他人。

案例研究表明脊骨神經治療會極大地幫助貝爾氏麻痺患者

面癱和貝爾氏麻痺的病人(其特點是面部神經麻痺,通常是導致下垂的效果臉的一側)通常沒有太多治療的選擇。只能使用類固醇和抗病毒藥物,電刺激或低強度激光療法,或是通過脊骨神經矯正技術和針灸改善身體神經的干擾。

在各種治療方案中,哪一種方法最好?一個研究研究表明,脊醫治療和低強度激光療法的混合治療最有效。

案例分析

美國麗莎脊骨神經科醫生概述了她有一個男病人誰是40歲的在她的辦公室持久癱在他的臉上的左側,為期10天之後的細節。他無法關閉他的眼睛,他從過度撕裂和燒灼感痛苦。此外,他有困難,使他的左嘴唇動起來,當他刷了牙時發現嘴流口水,。

在看脊醫前,他曾找過家庭醫生但是類固醇似乎沒有減輕他的症狀,他之後被轉介到神經專科醫生進行進一步的測試,但沒有發現特別的問題。之後,在脊醫的幫助下成了病症恢復的轉折點。

戲劇性的結果

脊醫在兩個星期內做了三次診療。第一次診療用電刺激和頸椎矯正的操作,之後病人可以明顯的活動他的左額頭。四天後在第二次診療時,病人已經報告有70-80%的改善。

第三次的脊醫頸椎矯正後, 病人已感覺到全部功能已經恢復,他甚至不覺得有必要第四次治療。四年後跟進報告中, 病人沒有進一步的問題。

研究表明,如果單採用激光治療通常需要14-66的療程,看症狀的決議。脊骨神經治療可加速復甦的這種案例研究。雖然還需要更多的研究來證實這類研究,但這個研究結果對許多患者帶來希望。

脊骨神經矯正治療具有一定範圍的用於減輕引起頸功能不全和頸痛頭痛有很大的幫助。

Reference
Rubis L. Chiropractic management of Bell palsy with low level laser and manipulation: a case report. Journal of Chiropractic Medicine 2013. 12, 288-291.