Appendix 23-A Physical Risk Fact Ergonomic Checklist The Physical Risk Fact Ergonomic Checklist can be used as a screening tool to identify ergonomic stresss in the wkplace. F each categy determine whether the physical risk facts rate as a caution hazard by placing a check ( ) in the appropriate box. Risk of developing a Wk-Related Musculoskeletal Disder is increased when ergonomic risk facts occur in combination. If a hazard exists, it must be reduced below the hazard level to the degree technologically and economically feasible. If the task rates a caution, then it should be periodically revaluated since changes in the wk environment may create new ergonomic stresss. Ensure significant contributing physical personal risk facts are not present. The checklist can be used f typical wk activities which are a regular and feseeable part of the job, occurring me than one day per week, and me frequently than one week per year. OPNAV 5100/20(2-05) Evaluat: Date: Department Name: Location: POC Name: Phone Number: Job Position Evaluated: Follow-up Date: Number of employees perfming job: Email address: Recommendations / Follow-up / Job Description:
AWKWARD POSTURE 1. Wking with the hand(s) above the head, the elbow(s) above the shoulders 2. Repeatedly raising the hand(s) above the head, the elbow(s) above the shoulder(s) me than once per minute n/a 3. Wking with the neck bent (without suppt and without the ability to vary posture) me than 30 degrees f - me than 30 degrees f me than 4 hours total per day, - -me than 45 degrees me than 2 hours total per day 23-A-2
4. Wking with the back bent fward (without suppt and without the ability to vary posture) me than 30 degrees f - me than 30 degrees f me than 4 hours total per day, - -me than 45 degrees me than 2 hours total per day 5. Squatting 6. Kneeling 23-A-3
HIGH HAND FORCE 7. Pinching an unsuppted object(s) weighing 2 me pounds per hand, pinching with a fce of 4 me pounds per hand per day (comparable to pinching half a ream of paper the fce required to open two wooden clothespins) - per day with no other risk facts, - me than 3 hours day with highly repetitive motion, Extension - me than 3 hours per day with significant wrist deviation in flexion (> 30 o ), extension ( > 45 o ), ulnar deviation (> 30 o ) Deviation 8. Gripping an unsuppted objects(s) weighing 10 me pounds per hand, gripping with a fce of 10 me pounds per hand (comparable to clamping light duty automotive jumper cables onto a battery) - per day with no other risk facts, - me than 3 hours day with highly repetitive motion, - me than 3 hours per day with significant wrist deviation in flexion Flexion 23-A-4
(> 30 o ), extension ( > 45 o ), flexion, ulnar deviation (> 30 o ) 23-A-5
HIGHLY REPETITIVE MOTION 9. Repeating the same motion with the neck, shoulders, elbows, wrists, hands (excluding keying activities) with little no variation every few seconds 10. Perfming intensive keying Reference: Appendix 23-B Computer Wkstation Checklist - me than 6 hours per day with no other risk facts, - per day with wrists bent in flexion (> 30 o ), extension ( > 45 o ), ulnar deviation (> 30 o ) AND high, fceful exertions of the hand(s) Either: - me than 7 hours per day with no other risk facts, - per day with wrists bent in flexion (> 30 o ), extension (> 45 o ), ulnar deviation (> 30 o ) 23-A-6
REPEATED IMPACT 11. Using the hand (heel/base of palm) knee as a hammer me than 10 times per hour me than 2 hours me than once per minute me than 2 hours HEAVY,FREQUENT OR AWKWARD LIFTING 12. Lifting object (Heavy) Weighing me than 75 pounds once per day me than 55 pounds me than 10 times per day perfm lift analysis using the NIOSH Lifting Equation the current Lifting Index in the ACGIH TLV guide 23-A-7
13. Lifting objects (Frequent) 14. Lifting (Awkward posture) Weighing me than 10 pounds if done me than twice per minute Or Objects weighing me than 25 pounds above the shoulders, below the knees at arms length Or me than 25 times per day perfm lift analysis using the NIOSH Lifting Equation the current Lifting Index in the ACGIH TLV guide perfm lift analysis using the NIOSH Lifting Equation the current Lifting Index in the ACGIH TLV guide MODERATE TO HIGH HAND-ARM VIBRATION 15. Using impact percussive type tools such as impact wrenches, carpet strippers, chain saws, percussive tools (jack hammers, scalers, riveting chipping hammers) other tools that typically have high vibration levels me than 30 minutes me than 30 minutes - perfm analysis using the Hand - Arm Vibration Analysis Tool Guide in the ACGIH TLV guide 23-A-8
16. Using grinders, sanders, jigsaws other hand tools that typically have moderate vibration levels - perfm analysis using the Hand - Arm Vibration Analysis Guide in the ACGIH TLV guide Drawings / Comments: 23-A-9