Michael Patkin's
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Publication history, Reflections & comments
Ergonomics can make a vital contribution to Australia through better design and improved productivity. It can help the "clever country" recover better from the current depression.
The image of Ergonomics faded in the 1980's. Many people, especially managers, still recall vividly the RSI epidemic and the fiascos created by so-called expert diagnosis and advice. This loss of credibility occurred because of inexperienced practitioners and poor national efforts.
With the benefit of hindsight, new directions can now be charted for ergonomics. Fortunately there are signs that the J-curve of ergonomics, unlike economics, is now moving upwards. To sustain this, an accurate diagnosis of the reasons for this must be appreciated more widely among ergonomists.
In this new age ergonomists must concentrate on core skills, separate their subject from politics, and avoid claiming expertise in areas in which they are not trained. The opportunities which remain are enormous.
Any technology has a lifecycle of ups and downs. After early success, exaggerated claims are accepted until their failures appear. Disillusionment is followed by rejection, then reappraisal. More limited but valid claims are then endorsed.
Just as occurred with the introduction of antibiotics, or computing, or innovations in management, so ergonomics has been through a bumpy ride, made rougher by influences from the politics of occupational health and safety (OHS). As well as novelty, its Utopian flavour attracted some.
However the news about ergonomics is mostly good. Textbooks and journals record many advances and successes, with many improvements in OHS based on solid ergonomic foundations. Often it is not possible to separate advances due to ergonomics from those due to new technology, industrial engineering or better management practices, especially in heavy industry and industrial design. More obvious advances due to ergonomics have been in the aerospace program, in cockpit and cabin design, and in military systems except for their victims, who were simply maimed or killed more efficiently.At a meeting of the ESA in Toowoomba in 1986, past president of the Human Factors Society, Doug Harris, described 20 specific ergonomic successes from the previous two years (Harris 1986). Example included reduction of rear-end car crashes through fitting a high centre-mounted stop lamp to vehicles, development of the Kodak disc camera, safer aircraft evacuation, and investigative techniques for law enforcement. Many of these ideas came from his own consulting firm of 20 people.
In Queensland, Geoff McDonald's work on tractor accidents (McDonald 1967) has improved design for safety. Personal research on applying ergonomics to microsurgery (Patkin 1978a,b) examined control of fine hand movement and optimizing visual feedback with the operating microscope. Resulting recommendations for performance standards were taken up by instrument manufacturers and surgeons world-wide.
By contrast, some advances later claimed for ergonomics turned out to be wrong. The naive first interpretation of the Hawthorn effect was that taking an interest in people increased productivity, and not the shorter working time between breaks. The real reason turned out later to be payment for piecework.
Fashions change in science and industry as much as elsewhere. The devil of stop-watch and clipboard, F.W.Taylor, is now reviled by ergonomists in the east (Zinchenko et al. 1989) as well as commentators in the west (Zuboff 1988). He had been a hero of Lenin's in the 1920's. At that time groups of American businessmen were feted in the USSR where they shared their skills of "efficiency". Today the last reminders of Stalin's Taylorism and the Stakhanovite worker - the faithful horse in Orwell's well-known grim parody "Animal Farm" - are seen in the heroic portrayal of muscular workers on the base of the obelisk in Tienanmin Square in Beijing.
The Ergonomics Society of Australia and New Zealand was formed in Adelaide in 1965. Afterwards an academic group of several score people met at yearly conferences and small meetings of state branches. Overseas this was a decade of optimism, when Ergonomics in the UK and Human Factors in the United States were contributing to industry and the aerospace program, which in turn fed money and encouragement back.
However in Australia, Erwin Tichauer, the father-to-be of biomechanics, was disparaged by a typically blinkered government department in New South Wales in the early 1960's. He moved to Texas Tech University and then to New York University Medical Centre. There his unique talents in ergonomics were recognized and supported. In retirement the walls of his New York apartment have presidential citations and other distinguished awards, while the ergonomics literature bears powerful testimony to the substance of his contributions. He was featured in Time magazine, where typically a reporter highlighted isolated examples such as a three-legged step-ladder and a bent pair of pliers designed to avoid wrist strain, rather than his overall approach to job analysis and redesign. A minor example of overselling ergonomics was my redesign of traditional surgical needleholders based on an analysis of handgrips (Patkin, 1969). This was persuasive enough to win a Prince Philip Industrial Design Award two years later, but not useful enough to achieve more than limited demand from surgeons or any commercial reality.
By 1981 Australia found a new role for ergonomics, in the onslaught by the trade unions on grave neglect of OHS. In that year the ACTU appointed John Mathews as first director of its Occupational Health and Safety Unit. It little guessed the dramatic impact and overkill his contribution would provide. The senior union official responsible for his appointment was to tell me several years later that Mathews' undoubted scientific ability was outrun by his emotions and his politics. Today, this ex-Marxist has "moved on from OHS ... too far ahead of the unions & especially the ACTU - but they're catching up now" (Mathews, personal communication accompanied with best wishes, 1989).
2.1 The RSI pandemic in Australia
For 10 years, Repetition Strain Injury was wrongly blamed for a wide variety of physical symptoms. It caused enormous loss of time from work for alleged injury and for managers a distracting preoccupation with physical measures to prevent it. However RSI was far from all bad. Much of the interest in it arose from good intentions, often misplaced. Some arose from journalists, either eager for a headline or seeing themselves defending workers at the barricades against evil employers. Some came from self-styled experts enjoying the limelight.
The RSI peak in December 1984 was accompanied by frantic theories on its cause and control, ranging from "injury" allegedly demonstrated on electron microscopy (Dennett et al. 1988) to a host of other explanations (Patkin 1990, Quintner et al., 1991). Within five years of this peak, RSI had virtually disappeared from Telecom Australia, (Hocking, 1989). as well as from other large organizations and from the media. Politically-biassed analysts like Bammer Quintner, ibid.) did not acknowledge the role of psychological and hysterical factors in the pandemic. These are now obvious as it runs its course in North America (where gimmicks like wrist supports for typists are now big business) and Europe, especially England, where journalists have discovered RSI just like their Australian counterparts ten years earlier. Theories as to its decline in Australia are as numerous as those about its causes. The likeliest is that the Australian public got bored with RSI.
During this time, many instant experts in ergonomics made claims for their wares, including salesmen for office chairs, therapists, and obvious quacks. One of these from the United States claimed phony affiliations to NASA and the University of California. He peddled seminars and a mesh to put over video screens to prevent "Video Operators Distress Syndrome".
Another problem, closer to home, was the failure of the Ergonomics Society of Australia under my presidency to develop professional registration for ergonomists. This was not to be achieved for another five years, highlighting another problem of ergonomists - an inability to run their own organizations efficiently, discussed below.
However the RSI pandemic helped to spark major changes both in OHS and management style. Worksafe Australia was established and there was restructuring of some major Australian industries (Kelty 1991). One striking success was the introduction of new technology for mail sorting at Australia Post, thanks largely to successful ergonomic intervention (Mathews 1990).
At international conferences Australians had frequently heard experts from countries such as Sweden explain how ergonomics had prevented industrial problems in their industry, by contrast with dismal experience in Australia. Nemesis punished this hubris. A series of studies on "dermatitis" in video operators (Berlinguet et al. 1990) showed the same imaginary basis as previous well-documented epidemics of mass hysteria Colligan et al. 1982), unrelated to physical factors.
Much is said, rightly, of the damage inflicted on Australia by greedy entrepreneurs of the late 1980's. Less is said of the earlier manipulation of OHS issues, including ergonomics, for increased wages or other industrial advantages. Little has been said, till recently, about the traditional Australian "sickie", which has suffered marked reductions as people have become more concerned about job security (Advertiser 1990). Organizations like WorkCare in VI have totted up billion-dollar losses
When ergonomists failed to solve problems with their existing knowledge they began to look desperately at the wider setting of work, in terms of Organizational Design or Macro-ergonomics. It might seem difficult to criticize this interest when the new president of the International Ergonomics Association [Hendrick 1991] is eminent in this field. However such moves in the Australian context have been problematic.
Much of the knowledge needed to remedy faults in job design already exists among those doing the job, rather than their managers. One of the roles of the ergonomist in the 1980's in Australia was to act as a catalyst or facilitator for change. Among many rude jokes made about consultants then, one was that they borrowed your watch, read the time, and then sent you an account for this. There was a fine line between establishing staff meetings, or Quality Circles, and charging for ineffective talk-fests.
Much of the inadequacy of ergonomists at the time was due to focussing on fashionable ergonomic factors of the time, by ergonomists with too little training or experience to carry out adequate job analysis. They failed to recognize bad industrial relations as the root cause of many difficulties. Managers in Australian organizations were understandably disillusioned when ergonomists, often with approval from unions, They failed to solve the problems of factories or offices, especially government departments. Ergonomic chairs, desks, and keyboards made no difference to the distracting problems of sick leave attributed to compensable work injury. Cynicism was reflected by the failure of senior labour politicians such as the otherwise outspoken health minister, Neil Blewett, to support the "cause" of RSI.
Today similar territorial claims to cure problems at work are made by other specialists. Some technical writers claim that industrial problems can largely be resolved by better documents at work, for example a 30 page booklet about job specifications which fits into the shirt pocket ( Stafford, 1991). He recommends that the technical writer make detailed tours of organizations, in a style reminiscent of Management by Walking About.
Such claims to authority in the workplace by different groups now extend to being part of the initial design brief for a new project. Ergonomists have claimed that the mission statement for a large organization should include ergonomics as its next leading priority. Others want a place reserved here for OHS, or energy conservation, or environmental responsibility, or worker participation, or some other theme. What these conflicting claims indicate is the importance of a total approach in order to understand organizations, though not to claim the ability to cure their problems.
3.1 Defining a concept of "systems"
Ergonomists repeatedly claim they are adopting a "systems approach" in their analyses. This sounds like an "everything" approach or even a power grab by different groups found in many organizations today. (The nursing bureaucracy in hospitals over the past five years is a good example).
A useful lesson is to ask ergonomists, or engineers, how they define a system. Even those who teach these subjects lack a ready response. To fill this vacuum, here is one definition:
"A system is a set of items, each of which may have structure, function, energy, information content, and links to other items. (Here a lawyer would insert a comma instead of a full-stop to indicate the need to include the next sentence). Its behaviour or output can not be predicted from how individual items behave, either as individuals or as aggregations forming smaller systems. For practical purposes, all systems are part of larger ones, and atomic indivisible items do not exist, as all items are in turn systems themselves."
This definition neither includes teleology for natural systems, nor excludes a sense of purpose for a manufactured system. It applies to anything to which the label of system is applied, most notably "socio-technical systems" of people and technology involved in work.
Such a definition grates on the instincts of engineers, who have difficulty in accepting unpredictability or lack of control. Politicians, who deal with the art of the possible, certainly do. Their metaphor for a system is "it seemed like a good idea at the time". More profound thinkers such as Donald Hofstadter, certainly do, using his more elegant concept and phrasing of "emergent properties". This is the stuff of evolution, quantum mechanics, real rather than Marxian economics, and the recently fashionable Chaos Theory.
The lessons of unpredictability and scientific humility must be learned by ergonomists as well as technologists and scientists, and - dare one say - by today's over-confident occupiers of the High Moral Ground of any flavour. The paradigm of "paradigm shift" applies to its philosophers and activists as much as to their less verbose fellows.
4. Specific ergonomic controversies and failures
Throughout the 1980's, the credibility of ergonomics suffered through conflicting or obscure dogmas or failures in several major areas. Some unusual ideas flourished (Malt 1977, Stack 1988). Several of these are now discussed.
A good example is advice on the ideal office chair. The conventional wisdom in 1980 was that office-workers should sit with the main joints of their arms and legs at a right angle (Cakir et al 1980). A New Zealand ergonomist (Coe 1980) was adamant that seats should be placed much lower. A Danish ergonomist (Mandel 1981) said chairs should slope forwards; his fervent claims, echoed by many salesmen, was rejected by other studies despite its attractive accompanying theory. The best-known ergonomist of all (Grandjean 1984) rejected the right-angle approach, which could be described as the "Teutonic T-square", in favour of the "Swiss slouch", despite his location in German-influenced Zurich.
At the University of Michigan Center for Ergonomics, Armstrong and others carried out numerous investigations of musculo-skeletal strain at work, quoting confident diagnoses of carpal tunnel syndrome (Armstrong et al. 1987). These were rejected by leading medical experts, including rheumatologists (Hadler 1987), physicians, and orthopaedic surgeons. In Australia, a Perth group (Quintner 1991) attributed most or all arm strains at work, especially in offices, to tension on the brachial plexus. Others (quoted in the same source) hotly refuted this.
Back injuries and the best technique for lifting have been another fruitful source of controversy and failure (Patkin et al. 1990) In Australia there emerged an absurd ban on lifting anything heavier than 16 kg at work. Doubtless the same vulnerable workers would not lift a child over 3 years, or spouse, or anything at home that weighed more, while their weekend sport would also be limited to avoid any possibility of slight strain. While penalties and concern about compensation for injuries forced bad employers to provide lifting devices or extra staff, good employers were penalized.
4.3 Human-computer interaction
When Ergonomics began formally forty years ago it recognized the central role of humans as information processors in the human-machine relationship. Very soon this recognition was diluted by preoccupations with anthropometry, physiological measurements, lighting and other environmental factors, and a host of other areas of activity.
Developments in computing led to an explosive growth of interest in HCI. Australians had the privilege of learning from visitors like Ben Shneiderman, Wilbert Galitz, and Brian Shackel among others. We had the gumption to finally have a special interest group, CHISIG, which threatens to outgrow the ESA in size and influence, and has almost done so.
Unfortunately HCI has fallen into a trap. Among some researchers it has become a cult with its own jargon and over-complicated arguments about concepts such as mental models. This is the very science which is supposed to make information easier to manage rather than more difficult. At Interact'90 in Cambridge, England, attended by over 500 delegates, there were pseudo-debates set up as if the participants were bad-boy wrestlers shaping up for The Fight Of The Century. Most people who attended could not understand the discussion. Those who claimed to were not able to explain it. Even the cultish MacIntosh favoured by this in-group is user-hostile at times.
Today there are many examples of quite simple computer systems where usability has been ignored. One is an otherwise desirable word-processor, the Tandy WP2. This is a lightweight and cheap electronic typewriter, very suitable for the briefcase. The disk drive with it is also light and robust. What is quite third-rate is the user interface, the user manual, and no simple software to transfer files to a personal computer for any rework. Such software has to be bought elsewhere.
4.4 Architecture and domestic furniture
British architects have been castigated by no less than Prince Charles for poor taste in urban design. At the everyday level, the design of public and private buildings has been a fiasco in ergonomic terms, despite early papers on the subject (Cowan 1966). Hospitals are an excellent example, funded by public money for public use, confusing and awkward to move through and work in, and often requiring rebuilding (Patkin 1990). A major social problem of such institutions is lack of a common meeting-area, where informal discussions can facilitate work and solve many problems. Sir Gus Nossal at the Walter and Eliza Hall Institute in Melbourne, designed changes to the building to ensure that there was only one place for morning and afternoon coffee, so that staff could meet at least twice a day.
Post-occupancy evaluation (POE) is a technique for reviewing how well a building has fulfilled its intended function, as well as its original design concept. Elementary blunders are common. Entrances to x-ray departments are made too narrow for beds and need widening. Bad planning for privacy of patients in wards leads to rabbit-warren design fragmenting communication between patients, nursing, and medical staff. Car parks are inadequate and insecure against personal attacks on nursing staff at night. The list of such problems is a long one.
4.5 Ergonomists minding their own business badly
Societies of ergonomists should be better organized than other groups - ergonomists are supposed to be able to advise others on how to design and run things better. This should apply to general information about themselves, membership applications, constitution, and procedures.
An Administration Manual written for the ESA in 1985 and distributed widely in draft form for comments is still not in general use in the Society today. Its constitution, which could have been an exemplar for other organizations, is a legalistic document despite earlier proposals for a more usable one. Bureaucrats won instead. Proposals for professional accreditation of ergonomists in Australia were put in place little over a year ago after 6 years of "preparation".
The poor quality of 35 mm slides and other audiovisual aids at ergonomic conferences is poor (Patkin et al. 1991, Kanis et al. 1991, Venemans et al, 1991). Some of the world's leading ergonomists show slides which are quite illegible. If ergonomists can't get this right, who can?
Ergonomists are not managers, or experts in industrial relations, or physicians. In Australia some have called themselves ergonomists after two years of part-time study and with no experience, especially under supervision. The worst among these are sheltered in government jobs where legislation gives them powers based on politics, where they can do great damage.
In other areas ergonomics has done too little. Architecture is one, and the usability of personal computers (including documentation and user interface) is another. It is true that Industrial Design Awards in Australia have increasingly included ergonomic aspects in awarding prizes. However there are still too many tools, machines, and items of other kinds which ergonomists have failed to put their stamp on.
Lack of understanding of ergonomics underlines much of its poor credibility and acceptance . Many Australians today, especially managers, if asked "what is ergonomics?" will reply that it is about office desks and keyboards and preventing RSI, about which they remember so many broken promises.
A national society in Ergonomics must exercise strong national leadership to re-educate Australia about what Ergonomics can and can not do. It has a vital responsibility to establish and raise standards of practice among the recognized profession practitioners. It has a further vital responsibility to ensure Ergonomics is an appropriate component of the training of engineers, architects, and managers so they know when to seek expert help. Last, it is up to ergonomists to define the limits of their skills and not to make misleading claims for what it can assess and what it can achieve.
Such ideals require an ergonomics community which is well-motivated, competent, energetic, rational, experienced, realistic, aware of its limitations, and not tempted to exploit the subject for other ends.
Ergonomics in Australia got too big in a hurry, came through turbulent times, and lost direction. It must now use the wisdom of other popular cliches - simplicity, core business, and sticking to the knitting, while very aware of the other disciplines close by.
References
Advertiser (1990) Fewer staff on 'sickies' amid job loss fears.December 29, 1990, p.2.
Armstrong, T.J., and Silverstein, B.A. (1987) Upper-extremity pain in the workplace - Role of Usage in Causality, in Clinical Concepts in Regional Musculoskeletal Illness, ed. Hadler, N.J.Grune & Stratton, Orlando, Florida
Berlinguet, L., and Berthelette D. (1990) editors, Work with display Units 89. North Holland 1990.
Cakir, A., Hart, D.J., and Stewart, T.F.M., Visual Display Terminals. A manual covering ergonomics, workplace design, health and safety, task organisation (John Wiley & Sons, Chichester 1980).
Coe, J.B., Proof and practice : the design of a VDU work-station In: Proc 17th Ann Conf Erg Soc ANZ, Sydney, (1980) 187-197.
Colligan, M.J., Pennebaker, J.W., and Murphy, L.R. (1982) Mass Psychogenic Illness: A Social Psychological Analysis. Lawrence Erlbaum, New Jersey.
Cowan H.J. (1966) Architecture and Ergonomics. Third Annual Australian Ergonomics Conference, University of Sydney.
Dennett, X. and Fry, H.J.H. (1988) Overuse Syndrome: A Muscle Biopsy Study. Lancet, 1, 905.
Grandjean, E., Hunting, W., and Nishiyama, K., Preferred VDT workstation settings, body posture and physical impairments. Applied Ergonomics (1984) 15,2, 99-104.
Hadler, N.J. (ed.) Clinical Concepts in Regional Musculoskeletal Illness, Grune & Stratton, Orlando, Florida 1987
Harris, D. (1986) Ergonomics Contributions to Tourist, Agricultural, and Mining Industries. Proceedings 22nd Ann.Sc. Conf. ESA Toowoomba, p. 1-8.
Hendrick, H.W. (1991) Ergonomics in organizational design and management. 34,6, 743-756.
Hocking, B. (1989) "Repetition strain injury" in Telecom Australia (letter) Med, J. Aust., 150, 724.
Kanis, H. & Leopold, F. (1991) Unheard-of Working Conditions. Designing for Everyone. Proc. 11th Congress, Int. Erg. Assoc., Vol. 3., ed. Queinnec, Y. and Daniellou, F. Taylor & Francis, Paris 1991.p. 1-2.Kelty, Bill (1991) The Age (newspaper, Melbourne), 25 October, p.11.
McDonald G.L. (1967) Accident Research applied to Tractor Accidents. Proceedings ESA Ann. Sc. Conf. Sydney
McGregor, D. The Human Side of Enterprise. New York: McGraw-Hill 1960.
Malt, L.G., Keyboard design in the electronic era. Paper presented at the Printing Industry Research Association Eurotype Forum (Conference Paper No. 6) London, September 1977.
Mandal, A.C., Seated man (Homo sedens). The seated work position. Theory and practice. Applied Ergonomics (1981) 12, 19-26.
Mathews, J. (1991) Australia Post: Introduction of Optical Character Recognition Mail Sorting Technology. Studies in Organizational Analysis and Innovation, No. 2. Industrial Relations Research Centre, University of New South Wales.
Patkin, M. (1969) Ergonomic design of a surgical needleholder. Med. J. Aust., 2, 490-3.
Patkin, M. (1978a) Ergonomics and the operating Microscope. Advances in Ophthalmology, 37, 53-63 (Karger, Basel 1978).
Patkin, M. (1978b) Selection and care of microsurgical instruments, ibid., 37, 23-33.
Patkin, M. (1990) Neck and Arm pain in Office Workers: Causes and Management, in Promoting Health and productivity in the Computerized Office, ed. Sauter, S., Dainoff, M., and Smith, M. Taylor and Francis, London.
Patkin, M. and Gormley, J. Skill, Excess Effort, and Strain, in "Towards Human Work: Solutions to Problems in Occupational health and Safety. ed. Kumashiro, M., and Megaw, E.D. Taylor & Francis, London, 1991
Patkin, M. and Sless, D. (1991) The Ergonomics of Lecturing with 35 mm Slides, in Designing for Everyone. Proceedings of the 11 Congress of the International Ergonomics Association, Vol. 1., ed. Queinnec, Y. and Daniellou, F. Taylor & Francis, Paris 1991. p.695-697.
Quintner J., and Elvey, R. (May 1991) The neurogenic hypothesis of RSI, Working Paper No. 24 in Discussion paper on the pathology of Work-Related Neck and Upper Limb Disorders and the Implications for Diagnosis and Treatment, ed. Bammer, G. National Centre for Epidemiology and Population health, Australian National University.
Stack, B., Repetitive strain injury - prevention and rehabilitation. Preprints of international conference on ergo-nomics, occupational safety and health and the environment. 1, 444-453 ( Beijing, 1988)
Stafford, R. (1991). Documentation as an agent of cultural change. Paper, Australian Society for Technical Communication (NSW) Seminar 91 - "Working smarter, not harder".
Venemans , P.J. and Zimmerman.E. Guidelines to improve Ergonomic Aspects of Scientific Posters, in Designing for Everyone. Proceedings of the 11 Congress of the International Ergonomics Association, Vol. 1., ed. Queinnec, Y. and Daniellou, F. Taylor & Francis, Paris 1991.. p.3-4.
Zinchenko,V. and Munipov, V. (1989) Fundamentals of Ergonomics. Progress Publishers, Moscow.
-o0o-
1. Introduction
2. Ergonomics in Australia
2.1 The rsi pandemic
in Australia
3. Macro-ergonomics
3.1 Defining a concept
of "systems"
4. Specific ergonomic controversies
and failures
4.1 Arguments about
seating
4.2 Manual handling
4.3 Human-computer interaction
4.4 Architecture and
domestic furniture
4.5 Ergonomists minding
their own business badly
5. Completing the diagnosis
6. Conclusion - the remedies
References
_____________
Limits to ergonomics Michael Patkin
The Whyalla Hospital
South Australia 5600
A paper to the 1991 Annual Conference of the Ergonomics Society of Australia
check for para 4.3