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Ergonomic Applications to Dental Practice dr shabeel pn www.hi-dentfinishingschool.blogspot.com
Overview ,[object Object],[object Object],[object Object],[object Object]
What is Ergonomics? Job Characteristics Human Capabilities ,[object Object]
Ergonomics is Not New Early emphasis:  Improving pilot performance via optimal layout / type of controls & displays ,[object Object],[object Object],[object Object],[object Object]
Application of Ergonomics in Design Tools Workstations Work methods Environments
Ergonomic Design Goals ,[object Object],[object Object],[object Object],[object Object]
Consequences of Poor Design ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
U.S. Navy Ergo-Injuries Source: OSHSYS RAW DATA FY 89 to FY 97  Non Ergonomic Related Cases Declined Ergonomic - Carpal Tunnel Syndrome, Chrondromalacia, Back Strain, Multiple Strain
WMSDs in Dentistry ?  ? ? ? ? ? ? ? ? ? ? ? ? ?
WMSDs in Dentistry Reasons for Early Retirement Among Dentists ,[object Object],[object Object],[object Object],[object Object],[object Object],Source:  Burke et al., 1997
WMSD Symptoms Among Dentists Source:  Finsen et al., 1998
WMSD Symptoms Among Dental Hygienists Source:  Liss et al., 1995 * indicates difference is significant
What Factors Contribute to WMSDs? ,[object Object]
What Factors Contribute to WMSDs? ,[object Object]
What Factors Contribute to WMSDs? ,[object Object]
What Factors Contribute to WMSDs? ,[object Object]
Ergonomics Standard Setting Activities ,[object Object],[object Object],[object Object]
OSHA Ergonomics Standard   History ,[object Object],[object Object],[object Object],[object Object]
OSHA Ergonomics Standard   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANSI Z-365 Control of Cumulative Trauma Disorders ,[object Object],[object Object],[object Object],[object Object]
Navy/DoD Ergonomics Policy ,[object Object],[object Object],[object Object]
DOD Ergonomics Program  Elements Workplace Analysis Hazard Prevention and Control Education and Training Program Evaluation and Review Health Care Management
DOD Ergonomics Working Group  Tool Box Level I  Ergonomics Methodology Guides Computer Based  Ergonomics Training Job Requirements/ Physical Demands Survey Ergonomics Program Management Guidelines Web Site  http://chppm-www.apgea.army.mil/ergowg/index.htm
Applying Ergonomics Principles to Dental Work ,[object Object],[object Object],[object Object]
Ergonomics in Dentistry Tool/Instrument Design ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Goals :  Reduce force exertion; Maintain hand/wrist in neutral posture
Ergonomics in Dentistry Hand Instruments ,[object Object],[object Object],[object Object],[object Object]
Ergonomics in Dentistry Automatic Handpieces ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ergonomics in Dentistry Syringes and Dispensers ,[object Object],[object Object],[object Object],[object Object],[object Object]
Ergonomics in Dentistry Magnification Systems ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Goal :  Improve neck posture; Provide clearer vision
Ergonomics in Dentistry Workstation Layout ,[object Object],[object Object],[object Object],[object Object]
Ergonomics in Dentistry  Operator Chair ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Goal :  Promote mobility and patient access; accommodate different body sizes
Ergonomics in Dentistry  Patient Chair ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Goal :  Promote patient comfort; maximize patient access
Ergonomics in Dentistry  Posture/Positioning ,[object Object],[object Object],[object Object],[object Object],Goal :  Avoid static and/or awkward postures
Ergonomics in Dentistry  Work Practices ,[object Object],[object Object],[object Object],[object Object],[object Object]
Ergonomics in Dentistry  Scheduling ,[object Object],[object Object],[object Object],[object Object],[object Object],Goal :   Provide sufficient recovery time for staff to avoid chronic muscular fatigue
Ergonomics in Dentistry  Prosthetics Labs Naval Station Rota Spain  Clinic Case Study :   Lab techs mentioned chronic back, shoulder & neck discomfort / pain during periodic Industrial Hygiene survey from  working at non-adjustable bench in obviously stressful static postures -- with no forearm support nor bench edge padding
Ergonomics in Dentistry  Prosthetics Labs Naval Station Rota Spain  Clinic Case Study  --  Post  intervention improvements offered by Kavo ergonomic lab benches  :  Lab techs affirm GREATLY increased comfort / decrease in  back, shoulder & neck discomfort / pain. KAVO dental prosthesis lab benches offer ample forearm supports and workpiece support centering prosthesis  directly   below  technician which optimizes spinal / neck / head vertical alignment
Ergonomics in Dentistry  Prosthetics Labs Naval Station Rota Spain Clinic Case Study :  Lab  technicians now work in optimized ergonomic posture.  In addition to forearm supports and central workpiece support (locally-ventilated for air contaminant removal !) , the table also has much improved overhead lighting, a magnifying lens and a drill speed control operated by the tech’s right knee
ERGONOMICS SUMMARY ,[object Object],[object Object],[object Object]
Need More Information? ,[object Object]

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Ergonomic Applications to Dental Practice

  • 1. Ergonomic Applications to Dental Practice dr shabeel pn www.hi-dentfinishingschool.blogspot.com
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  • 5. Application of Ergonomics in Design Tools Workstations Work methods Environments
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  • 8. U.S. Navy Ergo-Injuries Source: OSHSYS RAW DATA FY 89 to FY 97 Non Ergonomic Related Cases Declined Ergonomic - Carpal Tunnel Syndrome, Chrondromalacia, Back Strain, Multiple Strain
  • 9. WMSDs in Dentistry ?  ? ? ? ? ? ? ? ? ? ? ? ? ?
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  • 11. WMSD Symptoms Among Dentists Source: Finsen et al., 1998
  • 12. WMSD Symptoms Among Dental Hygienists Source: Liss et al., 1995 * indicates difference is significant
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  • 22. DOD Ergonomics Program Elements Workplace Analysis Hazard Prevention and Control Education and Training Program Evaluation and Review Health Care Management
  • 23. DOD Ergonomics Working Group Tool Box Level I Ergonomics Methodology Guides Computer Based Ergonomics Training Job Requirements/ Physical Demands Survey Ergonomics Program Management Guidelines Web Site http://chppm-www.apgea.army.mil/ergowg/index.htm
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  • 36. Ergonomics in Dentistry Prosthetics Labs Naval Station Rota Spain Clinic Case Study : Lab techs mentioned chronic back, shoulder & neck discomfort / pain during periodic Industrial Hygiene survey from working at non-adjustable bench in obviously stressful static postures -- with no forearm support nor bench edge padding
  • 37. Ergonomics in Dentistry Prosthetics Labs Naval Station Rota Spain Clinic Case Study -- Post intervention improvements offered by Kavo ergonomic lab benches : Lab techs affirm GREATLY increased comfort / decrease in back, shoulder & neck discomfort / pain. KAVO dental prosthesis lab benches offer ample forearm supports and workpiece support centering prosthesis directly below technician which optimizes spinal / neck / head vertical alignment
  • 38. Ergonomics in Dentistry Prosthetics Labs Naval Station Rota Spain Clinic Case Study : Lab technicians now work in optimized ergonomic posture. In addition to forearm supports and central workpiece support (locally-ventilated for air contaminant removal !) , the table also has much improved overhead lighting, a magnifying lens and a drill speed control operated by the tech’s right knee
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Editor's Notes

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  3. 3 3 3 Ergonomics comes from the combination of two Latin words, “ergos,” meaning work, and “nomos” meaning natural laws or systems. Hence, in its broadest sense, ergonomics is the science of work. Practically applied, ergonomics seeks to optimize the functioning of systems by ensuring that they are compatible with human capabilities and needs. When applied to job design, ergonomics seeks to - improve productivity - reduce the number of problem tasks that make it difficult to staff them - increase the number of jobs within the capabilities of women and older workers
  4. 4 4 4 Ergonomics is not really new - it only seems that way with the new emphasis from the news media and regulators. The term was actually first cointed in 1850 by a Polish scientist. Interest in ergonomics was heightened during WWII, as increasingly complicated technologies were introduced into aircraft. These items were placed into the aircraft with little thought as to how the pilot or maintenance personnel would react to new systems. Unfortunately, the initial result was a rash of accidents with subsequent loss of life. Maintenance issues also became more complex, and aircraft turnaround became longer. As a result, human interaction with aircraft and other military systems became a key issue then and remains an important issue now. Interest in occupational ergonomics increased in the late 1970s with the beginning of the information age. As computers became more commonplace in the workplace, the percentage of hand intensive tasks increased as jobs requiring gross whole body activity were automated. Work pace increased along with productivity demands from management. At the same time, equal employment laws and occupational health and safety standards were enacted. As a result the workforce today is much more diverse than at any other period of our history; yet the tools and tasks performed by workers in many inudstries have not changed much since WWII.
  5. Same data in previous ‘How did we get here side” in table instead of graph representation Source: John Bodi OSHSYS Data reduction using the Raw data FY 89 to June 98. Underestimates 98 costs and cases Chondromalacia Definition: A softening or wearing away and cracking of the cartilage under the kneecap, resulting in pain and inflammation. The cartilage becomes like sandpaper because the kneecap is not riding smoothly over the knee.
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  12. 17 17 16 Given the spiraling numbers and costs of these disorders, you might be wondering how the AF Medical Service has responded. On March 6, 1998, an interim ergonomics policy was signed into effect by Gen Mabry, requiring implementation of integrated risk-based ergonomics programs “to specifically and prudently address WMSDs”. These programs must contain the elements shown in the slide. The program elements are typical of all effective occupational safety and health programs.
  13. 18 18 17 9 Key Point: The AF has tools/resources to address WMDs now. - The AF PREMIER (PReventing Musculoskeletal Illnesses through ERgonomics) Program provides: -- a template for developing an installation level ergonomics regulation (Management Guidelines), -- tools for workplace analysis and hazard prevention and control (Job Requirements/Physical Demand Survey, Level I Guides), -- guidelines for health care management and material acquisition, -- quality performance indicators (QPIs) for program evaluation and review. - Introductory and advanced ergonomics training is available through USAFSAM and USACHPPM. -- 500+ Bioenvironmental Engineers (BEEs) and Public Health Officers (PHOs) trained in use of AF PREMIER Program tools. -- Computer based training in office ergonomics (Ergoeaser) available on CD ROM. - Resources are readily accessible by AF personnel. -- PREMIER program available through DTIC (AL/OE-TR-1996-0158) -- Ergonomics/PREMIER program information available on Internet (http://www.brooks.af.mil/AF/OE/OEMO/afergo.htm). -- PREMIER Program on CD ROM under development.
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  17. 23 23 22 HCP is responsible for ensuring that work-related illnesses are appropriately recorderd and referred to PH for investigation. Should also be involved in efforts to monitor trends for WMSDs across base by participating in reviews of sign-in logs, OSHA 200 forms and individual employee medical records. To facilitate early evaluation of WMSDs all employees must be educated on the causes and symptoms of WMSDs and encouraged to report symptoms to superviosors with subsequent referral to medical. Important to avoid potential disincentives to employee reporting. Written health care management protocols should be established. One example is the Clinical Practice Guidelines developed for Acute Lob Back Problems by the USPHS, Agency for Health Care Policy and Research (attached to Gen Mabry’s policy letter). HCPs should also perform evaluations of employees with known ergonomic hazards. These should include medical/occupational history and a brief non-invasive physical exam. Not currently incorporated into AF Physical Exam protocols. Conservative treatment deserves adequate trial before surgery is contemplated (at least 6 months).
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