Applied Ergonomics 1971,2.1, 33-36
Chapter 13 Design of work for the disabled This chapter details the ergonomic approach to the employment of disabled workers. Basic principles involved in adapting machines to suit disabled workers are discussed.
This chapter was based on an 'Ergonomics for Industry' booklet (No 3) by S. Griew entitled 'Design of work for the disabled'.
The ergonomic approach to the employment of disabled workers is a special example of the ergonomic approach to the design of work in general. It involves paying special attention to the known capacities and limitations of particular persons, rather than to the capacities and limitations of human beings in general. However, modifications to the design of work aimed at reducing the strain of a job for a disabled person may also benefit other workers. The number of registered disabled persons in this country is over 634 000. To use all these efficiently and productively would be to increase the nation's effective labour force very significantly indeed.
What is a disability? A distinction must be made between a disability, in the purely medical sense, and a handicap, in the purely occupational sense. Many badly disabled people are well able to do their jobs. A person with a pronounced stammer is likely to be severely handicapped as a d0or-to-door salesman, less so in a job in an office, but possibly not at all in a job at the bench in a factory. A man with restricted use of one arm may be unable to drive heavy lorries, or to operate certain machines in a factory; other jobs, however, may be well within his capacity. In order to decide whether a physical disability is also an occupational handicap, it is vital to know precisely what limitations it places upon the person suffering from it and about the demands of the jobs upon which he may be employed. There is a well-known case of a wages clerk of 48 who, as a result of a motor accident, lost his right arm from below the elbow. His employers decided that they could no longer employ him in his old job, and offered him instead the choice of becoming a messenger or taking a small pension and leaving the firm altogether. No one, not even the man himself, questioned the wisdom of this decision. Four months passed before someone asked the rather obvious question, was he right- or left-handed? In fact he was left-handed, and consequently in no way prevented from doing the job he had before his accident. Given the artificial arm, with which he had by this time been fitted, his job demanded nothing of him with which he could not cope. Here is an example of a particularly severe and permanent physical disability which upon only superficial examination proves to be no handicap in employment. An increasing number of firms both in this country and abroad, realising the importance of this distinction, keep detailed records of the physical demands of every job in their factories, and as a matter of course regularly assess the capacities of all employees whether they are disabled or not. This form of complementary job analysis and worker assessment goes far beyond the usual, rather superficial investigation of the training, experience and 'character' of workers, and the physical and 'mental' demand of jobs. Those who engage on these more detailed analyses, for instance, tend to deny the value of such terms as 'heavy work', 'semi-sedentary work', 'responsibility' and 'initiative', and look for more precise and objective information about workers and jobs. They are convinced that this sort of information pays dividends in terms of lower labour costs, increased productivity, reduced labour turnover and absenteeism, especially where their disabled workers are concerned.
How to get the best from handicapped workers
Fig 13.1 At a travel goods factory a paraplegic employee operates a sewing machine with a special elbow control in place of the customary foot pedal.
Often a disabled worker's handicaps at work are only temporary. Given a little time, and the right help, they may well disappear completely. The factory doctor or someone on the hospital staff can usually advise on this, if consulted. Should grounds exist for believing that the handicap is temporary, it is usually well worth while to consider encouraging the disabled worker to work at 'half-steam' for a month or two, and to seek opportunities of getting the special help and exercises which may have been advised. Special rehabilitation workshops are becoming a common feature in large firms throughout the world, but it is not essential to have such special facilities. Given good medical advice, and imaginative supervision, a great deal can be done towards the rehabilitation of the temporarily handicapped worker at his usual workplace.
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The Department of Employment has gained much experience in the field of industrial rehabilitation. As part of its employment service, the Department runs special units where, during courses lasting from two to twelve weeks, handicapped workers can get rehabilitation of the most up-to-date type. (Details of the provisions made in this country for the rehabilitation and re-settlement of the disabled are given in 'Services for the Disabled', 2nd edition, 1961, London: I-IMSO.) In all its forms, rehabilitation involves the gradual re-establishment of capacities and skills which have 'run down' either because of injury or because of disuse during convalescence, and of a man's confidence in his ability to manage a job. With rehabilitation it is often possible to avoid permanent handicap and so prevent the loss to industry of much valuable skill and experience. An interesting 'by-product' of rehabilitation is that it often encourages the fruitful use of capacities which have lain undeveloped previously. Should the handicap be permanent, however, though many purely psychological benefits may be derived from a course of rehabilitation, some additional action will be needed. Since it will be necessary in some way to restore the balance between the worker's capacities and his job's demands, something will have to be done either to the worker or his job.
Fig 13.2 A worker in a shelving factory who has lost both legs and is confined to a wheelchair, carries out the operation of attaching metal fittings to the shelves. His bench is specially constructed so that tools and fittings are within easy reach and the shelf is held by a special fixture.
Two obvious solutions suggest themselves. The first is simply to look for a job which is within the worker's limited capacities. This involves guiding him into alternative employment, on the basis of the information about the jobs in the factory and about his own capacities, and then giving him any necessary training for the new job. In doing this, though, one is asking the handicapped worker to make a fairly big adjustment. While this may be feasible for the younger worker, for the worker over forty it may be more than he can take - on top of all his other troubles. Also, by forcing him to change his job, one is really throwing aside the years of experience which have gone into making him the valued worker he still basically is, and the ideal replacement may be difficult to find. The second course of action is to modify the job so that it no longer lies beyond his changed capacities. In some cases this course is impracticable, but these are very few. This second course of action, fitting the job to the handicapped worker, is, of course, the ergonomic approach to the problem. Some of the more common limitations which medical officers sometimes place upon the activities of disabled workers, and some examples of how jobs may be modified to meet them, are described in the following.
L i m i t e d m o v e m e n t of lower limbs
The basic principle involved in adapting machines to suit workers with leg disabilities is well illustrated by the aids to disabled drivers brought out by motor manufacturers throughout the world. If the driver's clutch foot is inoperative, for example, the clutch is brought up to the steering column and operated by the hand. In a well-known firm in Holland one can see a group of girls, paralysed from the waist down, operating small presses which normally require the full use of feet and legs. A power-assisted control, operating the press, has been placed in a position which enables it to be manipulated easily by the edge of one hand. Many jobs normally done standing at a bench or machine tool do not necessarily demand constant stretching over the work, or walking around it. A properly designed stool or chair may allow a worker with a leg disability to do the job sitting as efficiently as standing, and with less fatigue.
L i m i t e d m o v e m e n t of upper limbs Fig 13.3 A one armed w o o d w o r k e r operates a dove-tailing machine w i t h no adaption to the machine, and a rubber f i x t u r e on his artificial arm which is used to hold the material in place.
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Probably the most impressive and imaginative example of the ergonomic approach to the design of equipment for workers with disabled arms comes from Norway. In order to maintain a fully staffed typing pool, a firm took on a group of girls whose finger dexterity was unimpaired, but who had previously been thought incapable of typing because of very limited arm movement and control. Suspended from the ceiling above each work-place was a system of pulleys,
weights and counter-balances attached to slings in which typists rested their arms. These devices succeeded in compensating for the lack of arm movement and control. With them, the girls quickly learned to become efficient typists. Similar examples can be seen in other parts of the world. In one case in this country, a small device, costing about £5 to build, enabled a driller whose range of arm movement had been severely reduced, as the result of an accident, to return to his machine the day after his return from convalescence. The device consisted of nothing but a system of levers which enabled him to feed the drill to the work by making a horizontal movement of about four inches with a control placed at elbow level. So successful was this modification that the firm applied it to a large number of the drilling machines in their machine shops.
No bending, stooping, lifting or carrying Many workers who have become disabled have been taken off their jobs because, inevitably, some degree of stooping, bending, lifting or carrying was involved. Is stooping, bending, lifting and carrying really inevitable, though? For example, workers engaged in taking small metal plates from shearing machines in a rolling mill, making a cursory inspection of them, and stacking them in piles on the floor had habitually to stoop, bend and lift at their work. The introduction of a raised conveyor belt and a few trolleys of the right height made it possible for men to work in an upright position most of the time, and this greatly increased the scope of the job for many types of disabled workers. Fig 13.4
Specially adapted rivetting
machine to provide strengthening exercises for injured legs.
The principle involved in this example, as in so many which can be quoted, is very simply this: bring the job within the easy reach of the worker. A disabled worker, whose reach is often more limited than the able-bodied, benefits particularly from the application of this simple rule. Sometimes, bending and stooping are caused by the impossibility of seeing what one is doing without going into contortions to do so. The work may simply be too far away, or another part of the equipment may obscure one's view. Many machine tools suffer from these defects, and it is not uncommon to see a machine shop full of workers who are bent nearly double for most of their working day. By securing machines at unusual angles it is possible to bring cutting tools within easy view of their operators, without at the same time having to change the positions of controls so much that they become difficult to operate. Recent experiments in turning ordinary centre lathes through angles of about 90 ° have resulted in impressive improvements in working posture. Workers who normally spend a good part of their working lives bending forward in an uncomfortable manner are able, with the modified machines, to sit at their work with as straight a back as they wish. Not only are machines modified in this way likely to be suitable for the disabled worker who is not allowed to stoop and bend, but they are also likely, by reducing fatigue, to improve the performance of the able-bodied worker.
Work in quiet conditions only Protection from excessive noise may be achieved in a number of ways. The greatest benefit is gained by eliminating or reducing the noise at source, by enclosing it in a sound-proof room, if this can be done, or by damping it in some way. Sound absorbing materials can be used in lining the walls of very noisy workshops. Failing this, workers can be supplied with their own ear protectors, usually in the form of muffs or plugs.
No close visual work
Fig 13.5 Single spindle drilling machine adapted to supply a flow of warm air to the hands for therapeutic purposes.
People with failing eye-sight are not necessarily debarred from all jobs appearing to require close visual work. Apart from the fact that years of experience may have taught them to do the job so skilfully that they often need to use their eyes only spasmodically, visual activity can be greatly assisted by the proper use of lighting. Directing light from the side, rather than from directly above, will often improve visibility and so reduce the need to have too much light on the work. Getting just the right amount of contrast between the working
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surface and the surroundings will do a lot to reduce the types of 'eye-strain' to which many people are prone and from which some disabled workers suffer badly. The extreme case of the blind or partially blind worker requires certain rather special considerations. The experts at the Royal National Institute for the Blind (224 Great Portland Street, London Wl) give advice in these cases. The fact that so many blind persons are employed successfully and productively on jobs which are normally done by workers with perfect sight suggests, however, that the ergonomic approach can be applied very profitably in their cases as well.
No dust, fumes, etc
Fig 13.6 Winding cable forms at an electrical assembly factory. The framed stands allow the boards to be adjusted to the most convenient height.
Chest complaints are very common in this country, particularly among older people, and it is often advisable to keep people with disabilities of this type away from atmospheres in which there is a lot of dust, fumes and smoke. A great deal can be done to remove the stress of air pollution by providing workers with masks and respirators. Recent advances in the design of such devices make them much more comfortable and manageable than they are usually imagined to be. Specialist advice is needed, however, since the right type of device is essential, and they may be inappropriate in the case of some disabilities and working conditions.
Light work only Even heavy work can sometimes be brought within the range of physically disabled workers. The systematic introduction of rest-pauses can transform really strenuous jobs into ones which can be tackled by those who would not have been able even to consider them in their original form. It is wise, however, not to try to lighten the physical demands of jobs in a 'hit and miss' manner. Skilled medical and physiological advice is needed before the precise capacity of a worker for heavy work can be assessed, and a careful and systematic examination of the job, usually involving special techniques for measuring energy expenditure, must be made to find out precisely what physical demands it makes. Sometimes minor reorganizations within the company will bring apparently heavy jobs within the scope of physically disabled workers. For instance, in a firm employing over 50 typewriter mechanics it was found difficult to employ disabled workers because so much of the work involved carrying machines up and down stairs to and from customers' offices. After someone had had the idea of restricting the work of the disabled to the benches in the workshop, a new and, as it happened, a large source of manpower became available to the firm.
Who should be responsible? Fig 13.7 A blind employee at a woodworking factory operates a drilling machine in the production of cupboard door handles using a simple jig to fix the position of the handle.
Acknowledgements Illustrations in chapter 13 were provided by the following sources: Figs 13.1, 13.2, 13.3, 13.6 and 13.7 Remploy Ltd Figs 13.4 and 13.5 Vauxhall Motors Ltd.
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Most of these modifications are very simple. There is really no reason why any firm, however small, should not employ the ergonomic approach to the employment of disabled workers. There are three groups of people who should clearly be concerned in the day-to-day problems of employing this approach. First, when considering whether to hire a disabled person, the personnel officer should be prepared to think along ergonomic lines. Second, the factory doctor should be brought in to explain precisely what limitations the employee's disability places upon his employment. Third, someone technically competent must be available to devise the actual modifications. Production engineers, work-study engineers and designers have no shortage of bright ideas, but without being told exactly what is required they cannot be expected to produce it. In many cases it is necessary to obtain specialist advice, and someone in the firm should be acquainted with the sources of this advice. A booklet by K. F. H. Murrell, called 'Data on Human Performance for Engineering Designers', and published by the journal Engineering, gives a simple and valuable account of the main principles of ergonomics, and this, together with other chapters in this series, will serve to introduce the approach.