“Orange Light Theory of Functional Fitness”

When we perform post-offer pre-employment physical ability tests, we remind applicants of the strength demands as defined by their potential new employer as we get to the strength portion of the test. While the main reason for telling them is so that we are clear and transparent about the expectations of the testing process, it also helps to set up a discussion with each applicant about their physical status.

Every post-offer applicant gets a quick reminder that if they are currently working out in a gym or at home, they should continue to do that once they start their new job. More importantly, they should not treat their job as a workout. If they aren’t currently working out, we tell them to go a gym, find a work out app to use at home, check out the available workout videos on places like YouTube or Amazon Prime Video, but most importantly to start doing something. Many of these come with position specific reminders – for patient transporters to start walking more if they don’t walk regularly because the position can require several miles of walking per shift, for train conductors to hit the stairs once in a while because their new employer has been adding as many double decker train cars as they possibly can, etc. The typical response is “I used to work out all the time but {insert some life event} got in the way….I swear as soon as I get this job, I will start working out, running, etc.”

Fortunately or unfortunately, depending on how you want to look at from an employment standpoint or a health/fitness standpoint, we have been seeing a lot of people that are just that tiny bit stronger than the essential demands of their soon to be position require. This is good for them, because they pass this phase in the process of pursuing their new job. But, it is not a lot of cushion from a physical abilities standpoint. When we see areas that they can improve in strength in the data collected during the test, we try to share that with them, just as we try to share some better techniques with them if their positioning to lift from floor height could use some improvement.

But, a lot of people as soon as they are aware of the fact that they have demonstrated the required strength start to tune out those pieces of advice and the statement they made about working out after getting the job has already started to fade into distant echoes. Because of this, I have tried getting a little more creative in trying to get these new hire candidates to understand the importance of keeping in shape and maybe even increasing their strength a little bit more.

 

My new go to explanation for the need to increase strength is the “Orange Light Theory” – almost everyone that comes through our doors, whether they drive or not, knows what it means when that little orange light begins to glow on the dashboard. The tank isn’t empty yet, but a gas station better be in the near future or there will be a problem. For those candidates who just squeak by on the essential demands by a couple of pounds of lifting or carrying strength, I explain to them that they passed – they still have gas – but that the orange light is on. They need to get a little stronger so that they have a reserve of strength to help them on those days when they work overtime or when they have to pick up the slack because someone called out sick, or when the unexpected happens like pipes bursting and causing a lot of work to happen in a short time – or more importantly, having the energy at the end of the day to play with their kids.   Giving them this visual seems to help put their current strength in a context that they can understand better.

While testing applicants to determine whether or not they meet the essential physical and postural demands for a position is the reason for performing a post-offer pre-employment physical abilities test, it is a great opportunity to help give enough knowledge to applicants to give them a reason to take ownership of their physical fitness so that hopefully, they don’t return to us for a functional capacity evaluation due to an injury.

An orange light comes on to let drivers know that they are almost out of fuel.
That pesky orange light comes on and lets you know that you are almost empty. We need to have a high enough fitness level to limit our body’s orange light from needing to come on while performing work related tasks.

Job Demand Lessons from the US Open

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Sporting events with storied traditions are not typically the settings for learning new lessons in the world of essential demands for job positions.  However, the 2018 US Open is a great lesson for employers in reviewing both their “essential job demands” as well as their post-offer physical abilities testing process. 

Each of the four tennis Grand Slam tournaments has their own specific styles – Wimbledon has grass courts and white tennis outfits, the French open is a demanding tournament due to its clay surface, the Australian Open has hard surfaces like the US Open, but the roof can be closed so play can continue during inclement weather, and the US Open is played on a hard court surface.  Until this year, the US Open had one unique functional difference from its three peers – ball boys and girls were required to be able to throw the ball overhand across the court, accurately, to their peers when balls were needed.  In the other three tournaments, the ball is rolled across the courts, underhand.  The US Open is also the only Grand Slam tournament that allowed adults over the age of 18 to apply as a ball boy or girl.

This year, the US Open determined that by changing the essential demand for this exchange of tennis balls on the court from throwing to rolling, it would open the applicant pool to a broader base of applicants. The US Open has not attributed the change to a decrease in the number of applicants with a strong enough throwing arm and adequate throwing accuracy but to a desire to increase the applicant pool to include those who may not have been able to be applicants due to this singular demand but meet all of the other demands.  This change marks an end to a several decades long tradition of throwing the tennis balls.

But, was it truly an essential demand to begin with?  Not necessarily.  As has been mentioned, most tournaments are able to function adequately with the balls being rolled across the courts.  It was an entertaining method of performing the task, but changing the method does not reduce the completion of the end result – the ball gets from one side of the court, whether it is rolled or thrown. 

What essential job tasks do you have that may have another method or technique for being performed that does not impair (either from a safety or a financial hardship aspect) the end result of the job task?  If this task is changed to an alternate method, have you accurately modified your post-offer physical abilities tests or the job demands description that are utilized during treatment and return to work testing? 

Post-Offer Physical Abilities Success Story

“You can arrive at your dream a lot of different ways, but you also arrive there as a different version of yourself based on whatever pathway you choose.”  – Joanna Gaines

Post-offer physical abilities testing is something that should really be straight forward.  Testing based on the minimum essential postural and physical demands for the position that has been offered to the candidate.  Seems pretty simple, the candidate either meets or does not meet the minimum essential demands.  But, it isn’t always that simple because the process involves people.

When a candidate fails a post-offer physical abilities test, the employer has to choose what path they will take.  Some employers may look to see if the candidate’s abilities meet the demands of different position.  Other employers may offer the candidate the opportunity to repeat the test at a later date.  Some employers may choose to not re-test.

One of the employers that we work closely with allows candidates to work on improving in the areas in which they did not meet the demands and attempt the test again with the next new hire class.  This particular employer has a fairly high passing rate (which is due to a phenomenal hiring process by the employer that helps to make sure that the demands of the position are consistently reinforced during every contact with the candidate), so the number of candidates who do not meet the demands is fairly low.  Of those that do not meet the demands on the initial test, some come back to test again.  It is a good job with solid benefits and is worth the time and effort for these candidates to try again.  Nearly everybody who re-tests comes back physically stronger and with improved range of motion and physical abilities and passes the test.  Many comment that not meeting the demands on the initial test was a significant wake-up call about their previous level of fitness.  They wish they were able to start the jobs with their original classmates but they are also content with the fact that they have not only done what was required to earn the job but have made lifestyle changes that will benefit them for years to come.  We don’t mind repeat tests for this employer as we know most candidates return, changed for the better.

Recently, we had a second test for a candidate from a different employer.  This candidate’s scenario was much different.  It was the first post-offer failure for the employer and it was a result of lack of medical treatment for an auto-immune disorder that attacked the candidate’s upper extremities in a way that did not allow the candidate to meet the minimum essential demands.  The employer did not have alternative positions with decreased physical demands to offer.  As the candidate had not yet received treatment for their condition, we suggested to the employer (along with the instruction of talking to their lawyers) that if the candidate has a change in physical function due to treatment that they be re-tested. 

When this candidate was scheduled for a second test, I was unsure of what to expect.  Luckily, the candidate returned with significantly improved function due to appropriate medical treatment and they were able to meet the minimum essential postural and physical demands of the position.  The candidate told us that as a result of not meeting the demands for a position,  they realized that they needed to become more proactive with their physician in seeking a successful treatment regimen for their condition.  For this candidate, not only did they obtain the position they wanted on the second test, they were able to become a successful advocate for their own healthcare status and understand the importance of that in keeping their condition in check. 

In each of these success cases, the post-offer candidates arrived at Point B – meeting the demands and obtaining the position – but they also arrived at Point B as improved versions of themselves with better fitness and abilities, and in the second case a better advocate for their own healthcare.

 

Friday Five – 4/13/18

The Friday Five is a set of five links that I have come across this week that pertain to ergonomics, occupational health, safety, human performance, or human factors.  For whatever reason, I found them interesting, but they are provided with minimal or no commentary and are not meant to be endorsement for a given product or research paper.

The topic this week is going to be a little bit different – ergonomics and space.  I noticed that Mike Massimino had posted on Twitter yesterday (@AstroMike) that it was #InternationalDayOfHumanSpaceFlight.  When I read his biography, one of the things that struck me from an ergonomics standpoint was the section about the attempts to automate the final Hubble repairs but in the end, it needed to be performed by human astronauts – and they needed to modify/create tools to get it done.  So, in honor of @AstroMike and all of the other astronauts who have done work in space, here is the Friday Five.

Due to the fact that we perform Post-Offer Physical Abilities testing at Biokinetics, this first study is interesting to me.  Taylor et al. looked at 8 NASA astronauts to look at performance on a series of tasks to determine whether task performance can be predicted when in a weighted suit.

Hackney et al.  look at the astronaut as an athlete (it’s an apt comparison, similar to the industrial athlete that we talk about within the occupational/industrial health realm) and what can be done to counter the decline of musculoskeletal strength and endurance during space flight to ensure that crew safety and mission success are not negatively impacted by astronaut performance.

Walters and Webb used a NASA Task Load Index to look at factors such as physical demands and effort for personnel involved in robotic surgery.  The goals were to determine appropriate staffing levels based on workload to maintain efficiency, team satisfaction, and patient satisfaction.

Strauss et al. reviewed data from extravehicular mobility training to look at the injuries and complaints that occurred during training at the Neutral Buoyancy Laboratory when astronauts were training in space suits to perform tasks and use the data to determine the best multidisciplinary approach to resolve these issues.

Petersen et al.  investigated a new testing battery to look at fitness of astronaut candidates for the European Space Agency.

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This is a shot of the Space Shuttle Discovery at the Steven F. Udvar-Hazy Center of the National Air and Space Museum that I took on March 30, 2018.  Back in 2001, I was lucky enough to get to spend a short period of time in one of the mock-up shuttles at Johnson Space Center that was used for training the astronauts.  It still amazes me that the astronauts could spend the time in orbit and perform science missions in the crew space which wasn’t very large.  We were also able to watch some of the training that was going on in the NBL from one of the control rooms.  I’d like to think that the training we witnessed was part of the data set for the paper by Strauss.

 

 

Friday Five – 4/6/18

It’s been a while, but I am going to get this started back up with a new edition of the Friday Five.

The Friday Five is a set of five links that I have come across this week that pertain to ergonomics, occupational health, safety, human performance, or human factors.  For whatever reason, I found them interesting, but they are provided with minimal or no commentary and are not meant to be endorsement for a given product or research paper.

Kesler et al.  looked at the impact of the size of SCBA units (the self-contained air packs that firefighters wear) as well as fatigue (based on different bouts of work-recovery) on the gait of firefighters.  As can be imagined, there are changes based on both parameters. A second study with similar parameters by Kesler looked at the impact on balance.  A third study by Kesler’s team looked at physiological stress and work output – as can be imagined, the baseline fitness of the individual firefighters has an impact on these values.

Putting ergonomics programs into place within companies has always been a tricky intervention.  Visser et al. compare participatory ergonomics programs of a face-to-face nature and e-guidance programs to see how well they work.  There are some interesting findings.

Michel et al. looked at the collaboration in the return to work process in French occupational centers in dealing with patients who had chronic low back pain.  There are some interesting aspects to the communication between the different participants in the rehab process.

Hegewald et al. take a look at the data on technical devices to reduce musculoskeletal injuries during patient handling.  The overall finding is very interesting.

As we have had the discussion with some surgeons who are located in our building, the review by Stucky et al. on complaints of surgeons of work related pain and musculoskeletal complaints and surgical ergonomics is very interesting.  Of note, operating exacerbated complaints in 61% of the surgeons but only 29% sought medical treatment.

 

 

Friday Five – 6/9/17

The Friday Five is a set of five links that I have come across this week that pertain to ergonomics, occupational health, safety, human performance, or human factors.  For whatever reason, I found them interesting, but they are provided with minimal or no commentary and are not meant to be endorsement for a given product or research paper.
These links were generated during a PubMed search on the terms: ergonomics workplace and ergonomics musculoskeletal

Love et al.  look into the ergonomic issues associated with home health care workers and what can be done to reduce the risk of injury.

Ceshi et al. examine the impact of exhaustion, workplace demands, and workplace resources affect decision making and the subsequent impact on performance.

Pandalia et al.  investigate usage of a Composite Lifting Index to assess risk of low back pain in material handling tasks.

Chen et al. looked at the psychophysical limits on lifting a weighted box between younger and older female workers.  Women between the ages of 50 and 63 years old chose weights that were approximately 24% less than the younger co-hort (between 20 and 32 years old).

Antonucci et al. examined the effect of drill bit wear on vibration and task performance.  Drill bit wear creates an increase in the vibration of the drill and increases time to complete task performance.  Antonucci et al. recommend instituting drill bit replacement protocls for when drill bits become worn.

 

 

What Not To Do Wednesday – 5/24/17

Some days, what not to do is right in front of you.  When I was walking from the parking lot into the building, I noticed the ladder leaning against the building to access the roof.  The first thing that jumped out at me was the fact that the top of the ladder was extended just barely beyond the top edge of the wall.  It was not anywhere close to the minimum 3 feet that it should have extended past the access point between the ladder and the roof.

I went inside and grabbed my business partner to point out the ladder, but also to show him the new NIOSH Ladder Safety App.  It’s a simple but useful app that I’ve used out in the field on a couple of previous occasions to document fixed ladders on a worksite.  The nice thing about it is that it has a measuring tool that can tell you whether a ladder is placed at too shallow an angle, the appropriate angle, or too steep an angle.  When I placed my phone on the ladder, the ladder was at too shallow an angle – 72 degrees.  The shallow angle placement of the ladder is compounded by the fact that the feet of the ladder are placed on a downward sloping section of pavement.  Between the shallow angle, sloped pavement, and lack of ladder extension beyond the access point, this is a catastrophe waiting to happen.

Correcting these mistakes is a simple fix:

  • Extend the ladder further – there is still plenty of extension left in this ladder.
  • Check the angle of the ladder to make sure that it isn’t too shallow or too steep.  The NIOSH Ladder Safety App is free and easy to use.  Almost everyone has a smart phone so there is no excuse not to use the app.

What Not To Do Wednesday – 5/10/17

This is a special WNTDW Worker’s Compensation Fraud edition.  A woman in Fort Lauderdale took advantage of a fallen piece of sprinkler in an attempt to create a work related injury.  While words are good and a picture tells a 1,000 words – nothing does justice to a story like this as much as video.

As was mentioned during a “30 Tips in 30 Minutes” session at the New Jersey Self-Insured Association convention last week, one of the most important things that can be done after an incident is not only to secure witness statements but secure any video that may be available of the incident in question.  This video was worth 18 months of probation.

Nike’s Marathon Fail – What Can We Learn

Over the past weekend, the culmination of Nike’s project to break 2 hours for the marathon distance came up just 24 seconds short.   The current world record for the marathon distance was set in 2014 by Dennis Kimetto when he ran a 2:02:57 to win the Berlin marathon.

Nike spent an incredible amount of resources in time, technology, and human capital in order to make this attempt.  While they were beat by the clock, they were successful in designing the Nike Zoom Vaporfly Elite.  A shoe that is 4% more energy efficient than any other shoe on the market – a running shoe so good that at least one runner who had the opportunity to train and race in it began to have nightmares that people were coming to take it away from her.

There are some important lessons that can be taken from Nike’s attempt:

  • Testing is important, but it is not everything.  Nike used a treadmill test developed by Andy Jones, PhD, a sports physiologist who identified Paula Radcliffe’s marathon potential, to help identify their potential record breaking runners.  However, Eliud Kipchoge’s potential on the treadmill test protocol was not as promising – because it was only the second time he had ever run on a treadmill.  There is a reason why physical abilities testing is not supposed to include tasks that can be performed better by those that are skilled than those that are novices.
  • Just because it improves performance doesn’t mean it works #1 – Nike left no stone unturned in their pursuit to find the performance gains necessary to break 2 hours.  One of the tweaks involved using webbed shirts that created a sling to support the arms while running.  This helped to improve performance but runners did not like the feel as they felt like they had T-Rex arms.  That’s great that something improves performance, but if it doesn’t “work” for the worker, it doesn’t work.
  • Just because it improves performance doesn’t mean it works #2 – Nike experimented with track spikes for improved performance and they also experimented with taking away anything that wasn’t needed.  The shoes were incredibly light, but unwearable.  This drove Nike’s team to try to design what they termed the “right weight” shoe.  Tools and processes should be designed to fit the task and the workers performing the task – the best tool or process takes both of these into consideration.
  • Use what you’ve learned from other areas – Back in the days of Nike’s affiliation with Lance Armstrong and his chase of Tour de France titles, Nike and Trek created the F1 project that looked at the different variables that created minor amounts of drag, such as where the race number is placed on the cycling jersey.  Nike applied these techniques to the running uniforms as well as the formation of the pacers to help reduce fatigue in the racers created by breaking their own wind.  Don’t reinvent the wheel, see what has been learned in other areas that applies to the task at hand.
  • You can’t control all of the variables –  Nike controlled as many variables as possible down to the track, pacers, etc.  The one set of variables that they had no control over was the weather.  In a task where they were trying to shave 2.4% off of the world record time, every variable matters.  The optimal temperature for the event had been determined to be 50 degrees Fahrenheit or lower with a humidity of 70%. Race day temperature on the track was 53 degrees with 79% humidity.  Three degrees doesn’t seem like much, but it was a six percent difference in the wrong direction from the optimal temperature.   We can control what we can and have to deal with the rest as it happens. Also, when dealing with people performing labor oriented tasks whether inside or outside, what would seem like small differences in temperature can make a huge difference in task performance.

It will be interesting to see how Nike applies the lessons that they have learned from this attempt to future attempts at breaking the record.  I hope that they make another attempt in the future.

Friday Five – 4/28/17

The Friday Five is a set of five links that I have come across this week that pertain to ergonomics, occupational health, safety, human performance, or human factors.  For whatever reason, I found them interesting, but they are provided with minimal or no commentary and are not meant to be endorsement for a given product or research paper.

These links were generated during a PubMed search on the terms: applied ergonomics

Lee et al. investigated the position of two different wearable sensor systems on the posture of construction workers while performing assigned tasks in a laboratory.  As those who have worked with motion capture devices know, placement of these sensors is everything in terms of collected data.

He et al. look at using Google Glass to monitor eye blinking in drivers to determine signs of drowsiness.  Distracted driving is something that we’ve hit upon in other posts.  Technology such as this may be able to go along way in helping drivers to recognize when they are too fatigued to drive safely.

Schmidt et al. investigated a different way of dealing with fatigue during long drives through the use of a cooling device to help improve alertness.

Armstrong et al. reviewed the impact of two paramedic services transitioning to a powered stretcher to help reduce injuries related to patient transport.  This appears to be a cost-effective solution with a reduction in injuries during patient transport.

Hlavenka et al. investigated the effect of neck posture during lifting tasks on both lumbar spine posture and activation of trunk musculature.  They indicate that a retracted neck posture may help to lower the risk of pain and injury during lifting tasks.