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Course 722 - Ergonomics Program Management

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Symptoms Survey

Symptom surveys and special tests can offer a means for detecting problems that may be missed in more general medical exams and reports. Workers completing a symptom survey form such as shown below can identify parts of their bodies that are experiencing increased levels of discomfort as a result of poor job design. Although this survey is fairly easy to administer, the following procedures should be followed for best results:

  • No names should be required on the forms, and the collection process should ensure anonymity.
  • Survey participation should be voluntary in nature.
  • Workers should fill out the form on their own (but if needed, the surveys should be administered to groups by a trained person offering explanations).
  • The survey should be conducted on work time.

Unless the company is prepared to act on the results of a symptom survey, it should not be conducted. Analysis of the information from a symptom survey is complex. One of the major difficulties is deciding what responses on the questionnaire indicate a problem that may need further evaluation. One approach for scoring results from a survey of this type is to rank-order the number and severity of complaints by body part from the highest to the lowest in frequency and severity. Those jobs linked with the body part showing the most complaints or the highest severity ratings would become the primary candidates for follow-up efforts at analyzing job risk factors and determining needs for risk reduction measures. A second survey, using the same form, completed after ergonomic changes have been made to correct problem jobs, can indicate whether the intended benefits have been achieved. Comparisons of the worker survey data gathered before and after ergonomic changes can furnish this information. One caution here is to allow sufficient time after the intervention to permit the workers to become accustomed to the job change and allow other novelty effects to subside. The second survey should be made no less than 2 weeks (and preferably 1 month) after the changes and should be made at the same time and day of the week as the initial survey. Comparisons of Monday morning results with those obtained on Friday afternoon may give faulty results because of differences in employee motivation.

The health care professional providing medical services to an employer may use special tests for medical screening or more in-depth diagnostic purposes to confirm suspected cases of musculoskeletal disorders. These may involve the worker moving his or her limbs through a range of motions or various maneuvers, with or without resistance applied by the examiner, to determine whether distinctive signs of pain occur. By pressing their fingers against a body part, examiners can also determine areas of tenderness.

Symptoms Survey Form

__________
Plant
__________
Dept #
Job Name______________________________

________ ___________________________ Years _____ Months
Shift Hours worked/week Time on THIS Job

Other jobs you have done in the last year (for more than 2 weeks)

______
Plant
______
Dept #
______________
Job Name
_____months _____weeks
Time on THIS Job
______
Plant
______
Dept #
______________
Job Name
_____months _____weeks
Time on THIS Job

(If more than 2 jobs, include those you worked on the most)

Have you had pain or discomfort during the last year?
[ ] Yes [ ] No (if NO, Stop here)

If YES, carefully shade in the area of the drawing which bothers you the MOST.

(Complete a separate page for each area that bothers you)

Check Area: [ ]Neck [ ]Shoulder [ ]Elbow/Forearm [ ]Hand/Wrist [ ]Fingers
[ ]Upper Back [ ]Low Back [ ]Thigh/Knee [ ]Low Leg [ ]Ankle/Foot

1. Please put a check by the word(s) that best describe your problem
[ ]Aching [ ]Numbness (asleep) [ ]Tingling
[ ]Burning [ ]Pain [ ]Weakness
[ ]Cramping [ ]Swelling [ ]Other
[ ]Loss of Color [ ]Stiffness

2. When did you first notice the problem?__________(month) __________(year)
3. How long does each episode last? (Mark an X along the line)
_____/_____/______/______/______/
1 hour 1 day 1 week 1 month 6 months
4. How many separator episodes have you had in the past year?____________________
5. What do you think caused the problem?________________________________________
________________________________________________________________________
6. Have you had the problem in the last 7 Days? [ ]Yes [ ]No

7. How would you rate this problem? (mark an X on the line)
NOW
None___________________________________________________________ Unbearable
When it is the WORST
None___________________________________________________________ Unbearable

8. Have you had medical treatment for this problem? [ ]Yes [ ]No
8a. If NO, why not? ________________________________________
8a. If YES, where did you receive treatment

[ ] 1. Company Medical Times in past year ____________________
[ ] 2. Personal doctor Times in past year ____________________
[ ] 3. Other Times in past year ____________________
Did treatment help? [ ]Yes [ ]No

9. How much time have you lost in the last year because of this problem? _____ days
10. How many days in the last year were you on restricted or light duty because of this problem? _____ days
11. Please comment on what you think would improve you symptoms

_________________________________________________________________________

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