Ergonomics - barriers and opportunities

Surgery

Introduction

Ergonomics aims to improve productivity, safety, and satisfaction at work, as well as other aspects of life away from work. Although Ergonomics has achieved many successes, there are many areas in which it has been applied badly, inadequately, or not at all despite a great need for it. Its failures have caused concern (Chapanis 1988).

The aims of an applied science like ergonomics are of no use if they are not fulfilled. It is therefore important to understand reasons for its failures, with a view to correcting them. Without this understanding, ergonomics will continue to fail. These matters will be discussed under the following headings:

1. Some beneficial applications of ergonomics
2. Some failed applications of ergonomics
3. Why isn't ergonomics applied more successfully?
    3.1. Lack of accurate awareness
    3.2. Poor communication between designers and users
    3.3. Inadequate detailed knowledge
    3.4. Poor credibility of ergonomics
    3.5. Cost of expert ergonomic advice
4. Overcoming the failures

1. Some beneficial applications of ergonomics

Since 1949 when Ergonomics was formally defined, it has brought benefits to many areas - factory work and safety, aerospace programs, vehicles, sport, the disabled, design of consumer items, and facilities for travel. Many examples are found in textbooks, journals, and the everyday experience of both experts and the general community. Ergonomics also gives a basis for many standards and codes of practice, encouraging good design and standard habits of work.

Twenty specific examples were presented by a past president of the Human Factors Society (Harris 1985), who also showed how they fulfilled basic ergonomic aims. His examples included the design of aircraft flight decks and evacuation systems, textured paths for the blind, test cards for poisonous substances for use by agricultural inspectors, better work vests for operators of mining machinery, emergency information systems, and reducing rear-end car crashes through high-centre-mounted rear light indicators.

2. Some failed applications of ergonomics

In the 1960's the father of biomechanics, Erwin Tichauer, proposed new designs which were ingenious but achieved little or no use (Time 1969). He devised pliers with handles bent to save bending the forearm, stepladders with 3 fixed legs instead of two folding pairs, and telephone dials with half-rings indenting the edge, for "easier" use. Despite their logical basis they achieved little or no success. A new design of surgical needleholder based on detailed ergonomic analysis of hand grip and movements (Patkin 1969) likewise failed to achieve any practical success. However the principles and methods of analysis were later applied successfully to the design of microsurgical instruments (Patkin 1978, Vickers 1978), a new field.

Habit has prevented adoption of logical improvements in other areas - replacement of the QWERTY keyboard by Dvorak's design, Esperanto as an international language, the metric system, and phonetic spelling. A recent paper,(Patkin 1988) proposed teaching ergonomics to a wider range of people than previously, to help overcome resistance to change.

3. Why isn't ergonomics applied more successfully?

3.1. Lack of accurate awareness

Many engineers, architects and others who design for users have no training in ergonomics. Their knowledge of it may be limited to misleading articles by journalists concentrating on Repetition Strain Injury ("RSI").

3.2. Poor communication between designers and users

Architects mostly communicate with clients through drawings cluttered with detail and therefore difficult for non-experts to understand. A solution is to replace measurements with a faint background grid of 1 cm squares and making drawings much larger on a scale of one-to-ten. Separate cut-outs are used to show how items such as furniture and trolleys, and the people who use them, will fit into the built environment. This technique has been applied to hospital design, a notorious area for mistakes (Patkin 1991). Simple kits using this method are given to clients by some manufacturers of office furniture. However it does not help much with heat and cold, smells, ventilation, lighting, and noise.

Ergonomists themselves communicate badly, especially in the jargon of Human-Computer Interaction (HCI), the very area in which language and concepts are supposed to be made easier for the user. Ergonomists should be good at presenting information to each other. Yet at every Ergonomics conference they often present 35 mm slides and overhead transparencies which are illegible or confusing, despite known rules (Patkin 1991).

3.3. Inadequate detailed knowledge

Large companies still sell many products with obviously bad features, even in the area of high technology where principles for good design should be well known. Lightweight word processors are a powerful help for portable note-taking. However they should have an on-off switch whicn is much stiffer than the alphanumeric keys and controls to prevent accidental turning on in a brief-case, simple menus for transferring multiple files, and include a simple system for connection to a larger personal computer. The keyboard should not be noisy to use, to save embarrassment for the user and annoyance to others in a lecture theatre.

3.4. Poor credibility of ergonomics

This has occurred because of contradictory expert advice or advice given for emotional or political reasons instead of scientific ones. Good examples are seating, lifting, and ergonomists presenting medical hypotheses to explain RSI.

Seating: In 1980 office-workers were advised to sit with the main joints of their arms and legs at right angles (Cakir et al 1980). Others advised that the seat should be much lower (Coe 1980), slope forward (Mandel 1981), or have the arms and legs more extended (Grandjean (1984) or have the keyboard slope downwards away from the worker (Stack 1988). Such opinons must be put into a realistic context. For example one in twenty individuals prefers Mandal's chair design but most people prefer conventional chairs for their work.

Lifting at work: This is another area where ergonomists give contradictory advice (Patkin 1990) - lifting with knees or back straight, partly bent, or bent, or kinetic lifting, as well as job redesign to minimize lifting.

Misleading ergonomic advice given for political or emotional reasons: This occurred during the RSI epidemic in Australia in the 1980's, where the reputation of ergonomists suffered and they were largely replaced by experts in rehabilitation for several years. The experience may well be repeated in Europe and North America.

One problem was lack of a generally accepted medical model to explain arm pain, in office workers especially. There are competing theories of neck tension, mechanical damage to connective tissue, and local muscle damage. Ergonomists, without training in pathology give unproven explanations: "Joint dysfunction, the most frequent finding [in a random sample of 220 workers with arm pain], is likely to be the result of degradation of collagen fibres due to prolonged and/or repetitive strains resulting in "creep" This is the increasing deformation (strain) of tissue under constant (or repetitive) load (stress) over time; i.e. the weakening of the tissues by abuse" (Grieve 1992). Ergonomists might heed the advice of a Swedish orthopaedic surgeon, Alf Nachemson, who said "physicians should not treat back pain; nor should psychologists. Politicians should." (quoted in Fordyce 1988). Ergonomists should leave pathology to physicians.

The "Hawthorne Effect" is often quoted misrepresenting the original data. This showed that productivity increased as rest breaks were made more frequent, and increased further as they were made less frequent again. It was supposed to show that interest in the activities of workers stimulated them to work harder. However Parsons (1974) showed this conclusion was not justified. Workers were paid by results, and slower workers were replaced by faster ones. The wider question of how scientific errors are copied from one textbook to another (Gould 1990) is as important to ergonomics as to other applied sciences.

3.5. Cost of ergonomic expertise

Many projects, such as those described by Harris (see above) are expensive, requiring a team of ergonomists and support services for many weeks or months. The time to translate ergonomic concepts into products for sale may be much longer than a client expects. Expert systems may help shorten this time.

4. Overcoming the failures

Ergonomists already have special interest in change, adapting Western ergonomics to less developed countries (Manuaba 1991) and in technology transfer (Shahnavaz 1991). Ergonomists can learn also from the general process of diffusion of innovations ( Rogers 1983).

This analysis suggests an agenda at three levels - individual ergonomists, regional and national associations, and our International Ergonomics Association. The agenda includes improving professional standards and accreditation, pushing for engineers, architects , and others to have some training in ergonomics both as undergraduates and in continuing professional education, encouraging standards or legislation where appropriate, informing the general community, and promoting the credibility as well as the value of ergonomics. With interest and energetic application in such areas, Ergonomics and its practitioners can look forward to a bright and rewarding future for themselves and for the world.

References

Cakir A, Hart DJ and Stewart TFM (1980) Visual Display Terminals. A manual covering ergonomics, workplace design, health and safety, task organization. John Wiley & Sons.
Chapanis A (1988) To communicate the Human Factors Message, you have to know what the message is, and how to communicate it. Keynote address HFA Canada, reprinted Ergonomics Australia (1992) 6,3, 25-31 and 6,4,19-23.
Coe JB (1080) Proof and practice: the design of a VDU workstation. In: Proc. 17th Ann Conf ESANZ, Sydney, 187-197.
Fordyce WE (1988) Pain and Suffering: A reappraisal. American Psychologist 43 (Apr) 267-283.
Gould SJ (1991) Bully for Brontosaurus, p.156-7. Penguin.
Grandjean E, Hunting W, and Nishiyama K. Preferred VDT workstation settings, body posture and physical impairments. Applied ergonomics 15,2,99-104.
Grieve EFM and Thompson D (1992) Arm pain in industry, in Contemporary ergonomics. Proc. Erg. Soc. Annual Conf., England, 110-114. Taylor & Francis.
Harris DH (1985) Ergonomics Contributions to Tourist, Agricultural and Mining Industries. Proceedings, 22nd ann. conf. Erg.Soc. Aust., 1-8.
Mandal AC (1981) Seated man (Homo sedens). The seated work position. Theory and practice. Applied Ergonomics 12, 19-26,
Manuaba A (1991) Developing ergonomics sound technology transfer from Japan to Asean countries, the role of ergonomics societies, in Designing for everyone, proceedings of the 11th congress of the IEA, vol 2, 1395-1397. Taylor & Francis.
Parson HM (1974) What happened at Hawthorne? Science 183, 922-932.
Patkin M (1969) Ergonomic design of a needleholder. Med. J. Aust. 2, 490-3.
Patkin M (1978) Ergonomics and the operating microscope, in Advances in Ophthalmology, 37, 53-61. (Karger, Basel).
Patkin M (1978) Selection and care of microsurgical instruments ibid. 37, 23-33.Patkin M (1988) Ergonomics for everyone. In Preprints, Conf. on Erg. Occ.Safety & the Environment, Beijing. Vol 1, 46-58.
Patkin M and Gormley J (1991) Skill, excess effort, and strain. In Towards Human Work ed.
Kumashiro M and Megaw ED, 145-150, Taylor & Francis.
Patkin M (1991) Hospital architecture: an ergonomic debacle, in Hospital Ergonomics. Collections colloques, ed. Estryn Behar M et al. In press. Octares editions, Toulouse.
Time (1969) Build a better mousetrap. May 2, 50-52.
Rogers EM (1983) Diffusion of innovations 3rd ed. Free Press, New York.
Shahnavaz H and Abeysekera J (1991) Round table discussion on ergonomics education and training in industrially developing countries, in Designing for everyone, proceedings of the 11th congress of the IEA, vol 2, 1736-1737. Taylor & Francis.
Stack B (1988) Repetitive strain injury - prevention and rehabilitation, in Preprints, Conf. on Erg. Occ.Safety & the Environment, Beijing. Vol 1, 444-453.
Vickers DW (1978) Design of microsurgical instruments, in Advances in Ophthalmology, 37, 53-61. (Karger, Basel).

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Contents

Introduction
1. Some beneficial applications of ergonomics
2. Some failed applications of ergonomics
3. Why isn't ergonomics applied more successfully?
    3.1. Lack of accurate           awareness
    3.2. Poor           communication           between           designers           and users
    3.3. Inadequate           detailed           knowledge
    3.4. Poor credibility           of ergonomics
    3.5. Cost of expert           ergonomic advice
4. Overcoming the     failures

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This is a report on a small but enjoyable conference at Wuhan, one of the "Three Furnaces" of Chine and home to SEPRI, the national organisation responsible for the health and safety of almost 3 million workers in the coal, iron and steel industry.
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Ergonomics - barriers and opportunities Michael Patkin
The Whyalla Hospital, South Australia, and
The Communication Research Institute of Australia, Canberra

Wuhan 1991