Application of Ergonomic Approaches in the Work of a Taxi Driver - Essay Example

of the of the HEM16-Ergonomics for Health Professionals Submitted PROBLEMS AND ERGONOMIC APPROACHES IN TAXI DRIVERPOSITION Introduction We often treat the human body like a machine. The truth is that the human body is a complex mechanism, composed of many parts and systems that correlate and cooperate with each other. But it is not a machine. It is made of flesh and blood, and expends energy in the carrying out of any activity. It needs to be rested and replenished at suitable intervals. Proper attention to food, refreshment and the avoidance or management of stress will prevent it from excessive wear and tear and enable its owner to live life to the fullest and best extent possible. All this is possible with ergonomics. The science of ergonomics relates to the provision of health and safety conditions within a workplace. According to the International Ergonomics Association: “Ergonomics is the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance” (IEA, 2000). The ergonomic rearrangement of appropriate aspects within a workplace can provide comfort to operators and can have a significant impact on executing several daily tasks in a more accurate and convenient way (Donald, 2007). The purpose of this assignment is to redesign the work environment, meaning the seating arrangement for a professional taxi driver based on the principles of ergonomics. If it is found that the shape of the taxi is such that the taxi driver’s seating is cramped and uncomfortable, a shift to a vehicle with a more spacious interior may also be recommended. As can be seen from Picture 1 taken of the taxi driver at work, he feels cramped and uncomfortable and this position moreover is not congenial to long hours of work with minimal movement. In fact this is the problem with most sedentary occupations. This study will explore the faults that exist within the work environment in relation to comfort or discomfort and will develop a plan of suggested interventions. Its primary aims are for the driver to minimize the symptoms of pain in the lower back that he has been experiencing, as well as to enhance comfort at work. The foundation of such a plan begins with understanding both somatic and cognitive limitations of human behaviour, in relation to their interaction with products available (Jacobs, 2008). The application of ergonomic principles supports this relationship by diminishing the present symptoms and by preventing injuries caused by repetitive movements, faulty posture and over use of body muscles. However, before attempting to apply ergonomic actions it is necessary to carefully examine the driver’s complaints and ergonomically assess the workplace in order to identify existing errors (Jacobs, 2008). Description of the Case & Associated Problems The subject is a professional taxi driver. He has been driving a taxi for five years now and works for approximately six hours per day. This profession is considered to be difficult as per occupational standards but is necessary for him, as he is studying and working at the same time. He has been complaining of low back pain since the last six months, which he suspects has originated from the uncomfortable driving posture coupled with the long hours of minimal movement on the job. The car is fitted with a manual rather than an automatic gearbox. The driver’s symptoms are reported to be a moderate pain in his lower back. However he has failed to seek treatment so far due to lack of time and his erroneous perspective that the symptoms will eventually ease with time. (Picture 1) I observed these problems when I asked the subject to sit down as he normally would in his vehicle. As can be seen from the picture, he is sitting at the wrong angle and moreover there is no lumbar support. Both of these issues are contributing to the back pain he has been experiencing for the last 6 months. DISCUSSION OF THE PROBLEM & GENERAL REMEDIES IN THE AVAILABLE LITERATURE Various factors may result to problems within a workplace that may either be associated directly with work or may be non-work related (Osmond, 2009). Repetitive driving injury is one of the latest diagnosed medical conditions and according to Adams’ study nearly half of the British population suffers from it (Adams, 2001). The five most common symptoms reported from drivers include foot cramps, neck stiffness, side ache, eye strain and low back pain (Adams, 2001). In fact, prolonged driving is an identified factor for developing low back pain (Walsh et al 1989; Gyi & Porter 1998) often troubling drivers at work. Other factors such as long sitting posture, incorrect seating position, vibration due to the road surface, loss of lumbar lordosis and asymmetric forces adding pressure on the spine can individually or combined lead to low back pain (Stellman, 1998). Variables such as gender, lifestyle and motivation may also influence the symptoms (Stellman, 1998). Before assessing different aspects of the workplace, it’s essential to consider the driver’s body standards as well as to examine the body posture since it is able to trigger a variety of musculoskeletal conditions (Kounkel, 2005). The facts that this driver is of large build with BMI of 25.7 (1.89cm / 92kg) and a slough posture holder, might have contributed to the present symptoms of pain. His seating has to be in line with his seated height, eye height, shoulder reach etc. and the central rear view mirror has also to be adjusted accordingly. His seating should be such that his back pain is minimized through lumbar support, exercise, massage and rest. Gear box should also be comfortably within his reach for arm length, as should also the brake and accelerator pedal for his knees and feet. Lumbar Support Drivers with symptoms of low back pain have essentially benefited from the use of a lumbar support especially during long drives. The lumbar roll is designed to support or even exaggerate lumbar curvature in sitting position in order to relieve tension on the affected structures and correct poor posture (Mcduff, 2010). Even though the effects of lumbar support are well supported, this driver has been found to never use lumbar support as he believed that the seat alone is supportive enough. Backrest The correct adjustability of the backrest of the seat can help in maintain the correct sitting position and prevent possible injury of the back, neck or even hip joint. During the assessment of the workplace the backrest was found to be reclined at 45 degrees from vertical position resulting to the forward leaning of the head and neck as it is presented in Picture 1. This forward head posture contributes to the rounded appearance of the back which can increase tension and stiffness in the back muscles, add stress on spinal joints and contribute to low back pain sensation (Berger, 2007). Seat Position Another important aspect the driver needs to remember before starting the vehicle is to make sure that the seat is positioned correctly. Taking into consideration the driver’s height, the seat appears to be close to the steering wheel, resulting in extensive flexion to the elbows and knees. The wrong position of the seat can limit the driver’s space and can be a risk factor for bad posture (Jacobs, 2008). This can also be seen from the anthropometric tables that are generally used to detect the causes of such maladies-his seating must be considered in relation to his seated height, eye height, arms and shoulder reach and knee length while in seated position. Head Restraint The field of Ergonomics is not only concerned with providing comfort to the workers, but also in ensuring safety. Therefore protection of the neck while driving and position of arms and shoulders while driving can be equally important in preventing whiplash injury in the event of collision. As seen in the picture, the head restraint is wrongly positioned as it cannot provide support to the head if the driver leans back from his driving position. Most people tend to ignore adjusting the headrest before starting to operate a vehicle, whereas it can be a very important safety device. Stress Factors Driving is a task that requests maximum concentration of the driver at all times (Fink, 2000). In order to work more efficiently is necessary to identify some stress factors at work that might interfere with the driver’s comfort and result in fatigue. It is not easy to come up with a universally acceptable definition of psychological stress because psychological stress relies to a great extent on the diversity of people. In the encyclopaedia of stress the definition is: "Stress is a real or perceived challenge, either endogenous or exogenous that perturbs body equilibrium or homeostasis" (Fink, 2000). Stress factors while driving may come from various different sources and situations. This driver has reported that the need to drive in bad weather conditions increases his psychological stress especially due to the limitation of availability of information that makes driving much more difficult. Another source of potential stress influencing the driver are secondary tasks such as communicating with passengers particularly at nights as people travelling that time are going home after a night out drinking (Adams, 2001). Dealing with other driver’s faults while driving can be another major stress factor at work, due to how dangerous it can be for the personal safety of both drivers and passengers. Emotional issues associated with work often appear to express in a more physical manner, in a way that often links to the problem (Fink, 2000). Therefore critical thinking is important in order to come up with suitable interventions for the driver that will ensure comfort and reduce stress at work. SUGGESTED INTERVENTIONS Posture People who need to work for long period of time in a static posture have been found to be related with the development of musculoskeletal disorders as muscles of the back become tired, and relaxed (Jacobs, 2008). Most drivers often concentrate on the car and the surrounding environment while driving but rarely think about how to maintain a correct sitting posture- the most basic component of comfort. Principles to keep in mind when redesigning the workplace for drivers concern the training of individuals to adopt a proper sitting posture which means sitting in positions where the least possible stress is placed on the supporting structures (Houglum, 2010). It has been suggested for the driver to sit with his back straight, holding the shoulders backwards. The driver must also ensure that buttocks are touching the back of the chair and thus prevent sloughing. More importantly, all three spinal curves should be maintained with special emphasis on the lumbar spine, which is the region from which most musculoskeletal problems arise (Houglum, 2010). This body part must be fully supported in order to relieve present symptoms of pain and to avoid discomfort. One way to achieve this is with the valuable use of lumbar support, an inexpensive and adaptable tool necessary for correcting sitting posture and relieving pain in the long run (Mcduff, 2010). Adjustments The wrong reclination of the back rest in this workplace results in the forward head posture (Picture 1) which can be a risk factor for developing pain in the neck and lumbar area due to the torque which increases significantly the further from the midline the head is positioned (Jacobs, 2008). The correct reclination is considered to be when the backrest remains in contact with the spine up to the shoulders height (Kounkel, 2005). Therefore in this workplace it should be readjusted further forward suggested at 15 degrees angle from the vertical position (Kounkel, 2005). A common mistake most drivers do is positioning the headrest against the neck and not against the head, something that decreases practicality and safety functioning of the device. Specifically, the optimal position is described as having the head restraint readjusted so that the top of its level is in line with driver’s ears (Young et al, 2005). The driver should be able to rest the head when needed, something that as it can be seen in the picture is not given the appropriate attention. Maintaining a seat in correct position is not a difficult task, but there are a few key areas needed to be mentioned for this driver’s optimal comfort. Ideally, when holding the steering wheel (2 and 10 o’clock position) the elbows should create a 90 degree angle allowing freedom of movement which is a necessity in order to safely and effectively operate the vehicle (Kounkel, 2005). Moreover, correct position of the seat will ensure that the airbag has sufficient space to expand in case of a collision. RECOMMENDATIONS The mirrors of the car should be adjusted accordingly in order to allow the driver look into them without needing to move the head much (Walsh et al, 1989). Another useful suggestion for the driver would be to position the central mirror at the height and angle that would require the driver to have the correct posture in order to look into it. This will serve to keep the driver alert, provide a steady reminder of the right posture to be adopted when driving the vehicle and allow for maximal concentration on long or difficult routes. Drivers who need to drive for long period of time are much more vulnerable to stress factors that will eventually lead to fatigue and discomfort. Being under the influence of extensive psychological stress for a long period of time can cause imbalance functioning of the body and result in the drivers’ exposure to disease. In stressful situations the driver should try de-stressing the body by taking deep breaths which will relax the muscles and will increase blood circulation (Gokhale et al, 2008). In addition, since inactivity and immobilization from long static posture has been known to increase muscle group stiffness (Knudson, 2003), the driver is recommended to stop and take breaks after approximately every half hour of driving. The driver should park aside and perform some auto-stretching exercises targeting muscle groups such as the hip flexors, hamstrings and opening the thorax- body parts that are most influenced by the sitting posture. Finally, compounded fatigue can be the result of a long workday, therefore it is recommended to the driver to exercise for a short time after finishing work. It has been suggested that any exercise such as going to the gym, swimming or yoga relaxation can result in reducing psychological stress (Walsh et al, 1989). As for short term solutions for relieving low back pain a lumbar support cushion should be given in maintaining the lumbar curve of the spine. The lumbar roll should not be removed even when the symptoms are seen to be reducing. Moreover the lumbar roll should be checked regularly to ensure that it provides an even pressure along the lumbar area. It may also be considered to change the gear box from a manual to an automatic one in order to avoid repetitive strain injury; this will be a beneficial move in the long run. However changing the gearbox to an automatic one can cost money and the economic status of the driver does not allow it at the present time. CRITICAL EVALUATION The changes suggested above are a small and inexpensive way to ensure the comfort and efficiency of this driver. The ergonomic perspective begins with educating the driver on how to maintain a correct sitting posture while driving, which is the basis for relieving symptoms in the lower back and ensuring further avoidance of developing the same conditions in the future (Kounkel, 2005). The addition of lumbar support will provide further support to the lumbar region and will relieve pain from stressed structures of the lower spine (Mcduff, 2010). Proper adjustments of the backrest and seat position together with the head restraint will help in maintaining this individual’s spinal curves close to the position desired and will enhance the general sense of comfort and the safety of this driver (Jacobs, 2008). The recommendations given above in performing stretching exercises during the breaks from work, or even taking the time to exercise for a short period of time after finishing work will eventually lead to a considerable reduction in the mental stress and will enhance the sense of well being of this driver (Berger et al, 1988). The changes are especially designed for this individual taking into consideration the symptoms reported and his body standards. Comfort of the driver should in turn lead to considerable reduction in the mental stress, fatigue while working and in a sense of relief of the symptoms he has reported. CONCLUSION Maintaining ergonomic thinking and applying daily ergonomic principles to workday situations is much more pervasive than it used to be. An ergonomic approach to problems becomes more and more essential in the life of workers in general. The goals of ergonomics are concerned with the efficiency and safety of individuals in relation to machines and the surrounding environment, along with the welfare of the persons involved (Singleton et al, 1991). Through this assignment, it has been established that ergonomic thinking and the application of ergonomic principles to workday situations can lead to better, more comfortable, healthier and safer work environments. In this assignment a taxi driver and his current body posture on the job was observed and described. An ergonomic assessment of the work situation identified an incorrect body posture; moreover the lack of lumbar support and prolonged driving with minimal movement was contributing to lower back pain. In addition to correct body posture and exercise to relieve back pain, certain adjustments to vehicle’s controls were also recommended, based upon the application of ergonomic principles. It is hoped that the application of the recommendations for both health and safety of the driver will alleviate his symptoms of low back pain and make for a more comfortable driving experience. References Adams, C. (2001): Driving through the English countryside in pain. Available at < http://ergonomics.about.com/od/everydayergonomics/qt/repdriveinjury.htm> Accessed on 11 May 2011. Berger, B.G. & Owen, D.R. (1988): Stress Reduction and Mood Enhancement in Four Exercise Modes: Swimming, Body Conditioning, Hatha Yoga, and Fencing. Research Quarterly for Exercise and Sport, Vol. 59, Iss. (2), p148-59. Berger, P. (2007): The journey to pain relief: A hands-on guide to breakthroughs in pain treatment, First U.S Edition. Donald, A.N. (2007). The Design of Future Things. New York: Basic Books. Fink, G.(2000)(Eds).: Encyclopedia of Stress. California: Academic Press. Gokhale E. & Adams, S. (2008): 8 steps to a pain-free back. China: Quality Books, Inc. Gyi D.E & Porter J.M. 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