Ergonomic Study Operator Name(Required) First Last Department(Required)Please SelectWalther MFGShipping, Receiving, RecoveryQualityServiceFacilitiesEngineeringOtherJob Title (as noted on the Job Description)(Required)Specific Job(Required)Work Station and Location(Required)Evaluator(Required) First Last Supervisor(Required) First Last 1. PurposeThe purpose of this ergonomic study is to identify ergonomic risk factors associated with the workstation and determine whether improvements are needed to reduce the potential for: Musculoskeletal disorders (MSDs) Repetitive-motion injuries Shoulder, neck, back, wrist, and hand strain Awkward postures Excessive reaching Excessive force Contact stress Fatigue The evaluation should consider the employee’s actual work practices rather than relying solely on the workstation’s design.2. Workstation DescriptionPrimary Tasks Performed(Required)Products/components handled(Required)Approximate cycle time: seconds/minutes(Required)Cycles per hour(Required)Hours performing task per shift(Required)Shift length: hours(Required)Number of days per week(Required)Approximate weight of items handled(Required)Handedness(Required) Right Left Both Work position(Required) Standing Sitting Sit/stand Walking Other Describe Other Position(Required)3. Ergonomic Risk AssessmentScore each Risk Factor based on the conditions observed.Neck(Required) Maintains neutral head position Frequently looks downward Bends neck forward Rotates neck repeatedly Holds neck in a fixed position Neck Risk(Required) Low Moderate High Neck Posture observations(Required)Shoulders(Required) Arms remain below shoulder height Arms frequently reach forward Arms reach above shoulder height Shoulders remain elevated Repetitive shoulder movement Shoulder Risk(Required) Low Moderate High Shoulder Posture observations(Required)Wrists/Hands(Required) Wrist remains neutral Wrist flexion Wrist extension Wrist deviation Repetitive gripping Pinching High grip force Contact pressure Wrist/Hand Risk(Required) Low Moderate High Wrist/Hand posture observations(Required)Elbows/Arms(Required) Elbows close to body Frequent reaching Extended reaching Repetitive movement Static arm position Elbows/Arms Risk(Required) Low Moderate High Elbows/Arms observations(Required)Back(Required) Neutral posture Forward bending Twisting Side bending Static posture Frequent lifting Back posture Risk(Required) Low Moderate High Back posture observations(Required)Leg/foot posture(Required) Low Moderate High Leg/foot posture observations(Required)Reaching(Required) Low Moderate High Reaching observations(Required)Repetition(Required) Low Moderate High Repetition observations(Required)Force(Required) Low Moderate High Force observations(Required)Lifting(Required) Low Moderate High Lifting observations(Required)Pushing/pulling(Required) Low Moderate High Pushing/pulling observations(Required)Contact stress(Required) Low Moderate High Contact stress observations(Required)Vibration(Required) Low Moderate High Vibration observations(Required)Static posture(Required) Low Moderate High Static posture observations(Required)Workstation adjustability(Required) Low Moderate High Workstation adjustability observations(Required)Lighting/visibility(Required) Low Moderate High Lighting/visibility observations(Required)Tool design(Required) Low Moderate High Tool design observations(Required)4. Repetition AssessmentTask cycle time(Required)Repetitions per cycle(Required)Cycles per hour(Required)Approximate repetitions per shift(Required)Observed repetitive activities(Required) Gripping Pinching Screwing Pressing Sorting Assembly Reaching Lifting Pushing/pulling Other Other repetitive activities(Required)Repetition Risk(Required) Low Moderate High 5. Force AssessmentEvaluate the force required to perform the task.Grip force(Required) Low Moderate High Pinch force(Required) Low Moderate High Tool operation(Required) Low Moderate High Pushing(Required) Low Moderate High Pulling(Required) Low Moderate High Lifting(Required) Low Moderate High Force-producing activities observed:(Required)Potential corrective action:(Required)6. Workstation DimensionsRecord the actual dimensions of the workstation.Work surface height (inches)(Required)Seat height (inches)(Required)Seat depth (inches)(Required)Work surface depth (inches)(Required)Maximum reach (inches)(Required)Primary reach (inches)(Required)Monitor height (inches)(Required)Monitor height (inches)(Required)Monitor distance (inches)(Required)Keyboard height (inches)(Required)Frequently used tool distance (inches)(Required)7. Tool ErgonomicsEvaluate tools used at the workstation.Tool evaluation(Required) Tool weight acceptable Handle appropriately sized Handle allows neutral wrist Excessive grip force required Trigger requires excessive force Tool causes vibration Tool requires awkward wrist position Tool is balanced Tool can be suspended/supported Tool is appropriately positioned Recommended tool changes(Required)8. Material PlacementPrimary work zone: Frequently used items should generally be positioned close to the employee to minimize unnecessary reaching.Frequently used items within easy reach:(Required) Yes No Materials requiring extended reach:(Required)Materials located above shoulder height:(Required)Materials located below knee level:(Required)Recommended changes:(Required)9. Environmental FactorsLighting(Required) Acceptable Improvement Needed Glare(Required) Acceptable Improvement Needed Temperature(Required) Acceptable Improvement Needed Noise(Required) Acceptable Improvement Needed Vibration(Required) Acceptable Improvement Needed Floor condition(Required) Acceptable Improvement Needed Workspace clearance(Required) Acceptable Improvement Needed Housekeeping(Required) Acceptable Improvement Needed 10. Employee FeedbackThe employee should be interviewed during the evaluation.Does the employee experience discomfort while performing this task?(Required) Yes No location of discomfort and when does discomfort typically occur?(Required)Employee's recommended improvements:(Required)11. Overall Risk RatingErgonomic Risk(Required) Low – No significant ergonomic concerns identified. Moderate – Ergonomic improvements recommended to reduce exposure. High – Significant ergonomic risk identified. Corrective action should be prioritized. Critical – Immediate evaluation and corrective action recommended. 12. Evaluator Certification I certify that the workstation was evaluated based upon actual work activities, employee input, observed postures, repetition, force, workstation configuration, and environmental conditions. Evaluator Signature: _________________________________________________ Supervisor Signature: ________________________________________________
