Things You Should Look For to Prevent Cumulative Trauma Disorders (CTDs)
A Checklist
Checklists as diagnostics and solution-finders aren’t always successful, but they can be used as learning tools.
This is one that has been successful in helping people “sharpen their eye” in looking for risk factors. Possible solutions to each problem are also listed. And there are almost always SEVERAL ways to fix a given problem.
| Things to look for: | Possible solutions, depending on further analysis: |
| Prolonged hunched or elevated shoulder while holding the phone | Telephone headset Speakerphone |
| Elbows splayed out (shoulder abduction) | Lower work surface Lower chair armrests Bring chair armrests in closer Awareness and habit training |
| Raised or tensed shoulders | Habit or tension training Lower work surface or keyboard Lower chair armrests Raise chair, if foot contact with the floor can be maintained |
| Twisting the head to the side | Bring viewed item closer to centerline of view |
| Elbow flexed for long periods using the telephone | Telephone headset Speakerphone |
| Elbow or forearm resting for long periods on hard or sharp work surface, chair armrests | Pad or round surfaces, corners, and armrests Replace armrests Telephone headset Habit training |
| Wrists bent to the sides when using side keys | Habit training Keyboard with more accessible keys or split keyboard design |
| Wrists bent back (extended) or forward (flexed) for prolonged periods | Habit training Wrist rest Lower, raise, or change slope of the keyboard |
| Wrists or palms resting for long periods on hard or sharp keyboard or work surfaces | Habit training Wrist rest Padded or rounded surfaces, corners |
| Hands held actively over the keyboard during keying pauses | Habit training Wrist or forearm rest |
| Rapid, sustained, or prolonged keying | Greater work variety Aggressive break schedule Reduce overtime |
| Forceful keying, key pounding | Habit training Light-touch keyboard |
| Significant amounts of hand stapling, punching, lifting, opening mail, or other forceful exertions, especially combined with awkward postures | Mechanical aids, such as electric stapler or punch Reduce size of lifted loads Bring heavy loads close to the body, at a medium height Substitute sliding (work surface) or wheeling (floor) Sharpen letter openers |
| Prolonged mouse use | Greater work variety Aggressive break schedule Alternate hands Alternative pointer devices Arm support, including small table Mouse close to body (extended keyboard tray) Learn keystroke substitutes for menus |
| Prolonged sitting, especially in only one posture | Greater work variety Aggressive break schedule Chair that supports posture change, through movement, size, or easy adjustability Habit training Move phone to the other side of the office to force standing, or suggest standing when on phone Check chair fit Monitor in-out mechanism Sit-stand work surface |
| Lumbar back area not supported | Lumbar cushion Backrest height and tilt Check chair fit, especially backrest/lumbar height |
| Feet dangling, not well supported, or a posture which seems to put pressure on the backs of the thighs | Lower chair Lower work surface Habit training Foot rest (last resort) |
| Chair backrest not used for long periods | Check chair fit, especially seat pan depth and height Check leg room Check monitor distance Habit training |
| Twisted torso | Rearrange work Provide more knee space U-shaped work surface layout Swivel chair |
| Frequent or prolonged leaning or reaching | Rearrange work Mouse pad wrist or forearm rest Bring mouse and keyboard closer to body |
| Working with one or both arms “reaching” toward a mouse or keyboard | Bring keyboard closer to body Mouse pad wrist or forearm rest Bring mouse closer to keyboard |
| Light sources that can be seen by the worker | Cover or shield light sources Rearrange work arena Lower other viewed objects to lower field of view |
| Reflected glare on the screen | Shield light sources Shade screen Glare screen Move monitor so light enter from side angle, not back Lower light levels Move light sources |
| Too much contrast between screen and surroundings or document; worker feels relief when bright areas are shielded | Lower ambient light levels Turn off or dim task lights Change screen polarity to black on white |
| Very bright ambient lighting (above 500 lux or 50 fc) or shadowed areas caused by over-illumination | Lower ambient light levels to 200-500 lux (20-50 fc) |
| Monitor closer than approximately 40 cm (16″) | Push monitor back Habit training for reclining Computer glasses Bring keyboard forward, possibly with a keyboard tray |
| Different viewed objects (screen, documents) at different distances from the eyes | Use document stand or otherwise equalize distances to within about 10 cm (4″) |
| Screen or documents not oriented perpendicular to the line of sight | Change monitor, document stand angle |
| Prolonged near focusing throughout the day with few far-focusing opportunities | Habit training Rearrange space to provide view Introduce glazing |
| Monitor image dim, fuzzy, flickers, small, or otherwise difficult to read | Upgrade monitor Use software to enlarge image |
| Shiny, low-contrast, or small-print documents | Improve lighting on documents if documents cannot be changed |
| Forward position of the head (peering) or squinting | Check for monitor image quality problems or monitor distance Suggest consultation with vision specialist |
| Eyestrain complaints | Check all aspects of visual environment Suggest consultation with vision specialist |
| Neck extended backwards, head tilted back, even slightly | Remove CPU from under monitor Remove tilt-swivel base from monitor (leave ventilation space) Check for bifocals and suggest full-frame “computer glasses” prescription |
| Neck flexed (downward) | Raise document or monitor to a comfortable height Adjust posture Habit retraining Check glasses for inadequate prescription |