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Target safety issues to ensure older workers' well-being

Radiology Administrator's Compliance and Reimbursement Insider, June 1, 2008

The lack of a safety plan to meet older workers’ needs could cost facilities more later in the form of workers’ compensation claims.

In some cases, if an older worker’s safety issues rise to the disability level—meaning the problem substantially limits a major life activity—your facility may have a legal obligation under the Americans with Disabilities Act to reasonably accommodate that staff member.

Terry Jo Gile, MT(ASCP), MA, Ed, The Safety Lady^®, a healthcare safety expert in North Fort Myers, FL, discusses a few safety issues older workers face and some ways to address these challenges:

➤ Improving lighting. As employees age, proper lighting becomes more important. Staff members need more light to see, says Gile. Lighting is extremely important for all workers in an imaging facility. In general, a person aged 50 or older needs two to three times the amount of light in his or her work space compared to younger workers, says Gile.

Proper task lighting plays an important role in radiology safety. Elimination of glare helps, as do consistent light levels. Ambient light or daylight can be used when available. Task lighting should be no more than three times brighter than ambient light, says Gile.

Flat computer screens are helpful in eliminating glare and easing eyestrain. Employees can also turn off overhead lights or remove fluorescent bulbs to reduce light. In a four-bulb light fixture, remove the middle two bulbs if possible. Also, if bright fluorescent light causes difficulties, older workers can wear visors, says Gile.

➤ Coping with eyesight problems. As the eyes age, vision becomes less clear. Reading small fonts becomes difficult, even with the right glasses. To help older workers who may have trouble seeing small fonts, you should:

• Have a magnifying glass available for reading small print
• Add color contrast
• Use primary colors (blue, yellow, and red) for signs (pastels often cannot be discerned by older employees)
• Use a font size of 14 points or larger for e-mails and memos

➤ Preventing computer vision syndrome (CVS). CVS results from spending a large amount of time working at a computer terminal, says Gile. Common symptoms include:

• Eyestrain
• Blurred vision
• Dry, irritated eyes
• Double vision
• Headaches

Symptoms may occur due to prescription eyewear not designed for computer use, Gile says. Users without appropriate eyeglasses may try to compensate for blurred vision by leaning forward or tipping their heads back to look through the bottom portion of their glasses. Both actions can result in sore necks, shoulders, or backs, Gile says.

Most glasses or contact lenses do not correct the intermediate zone of vision at all, says Gile. Reading glasses correct near vision only and bifocals correct only near and far vision. Even lenses that do correct the intermediate zone, such as trifocals and progressive lenses, direct only a small portion of the lens to the intermediate zone and are not sufficient for comfortable computer work.

Computer glasses make a world of difference, says Gile. They correct blurred vision and relieve symptoms such as eyestrain and burning sensations. Encourage employees to visit an eye care professional regularly and to inform their physician about computer-related eyesight strain. Staff members can also use desktop software applications that enlarge the contents on the screen. This makes reading easier and reduces eyestrain.

➤ Preventing nighttime blindness. A monitor po-sitioned too close to a worker may contribute to nighttime blindness, particularly in older workers, says Gile. This condition makes focusing at regular or far distances difficult after a long day of up-close reading.

Gile recommends lowering computer monitors and tilting the screen upward. It is easier for employees to read at a lower height because it allows a more natural focus. Also, train employees to practice the 20/20/20 rule. Every 20 minutes, they should take a 20-second break to focus on a spot 20 ft. away. It gives the eyes a break and allows them to readjust to a distance beyond the screen.

➤ Avoiding falls. Accidental falls are hazardous for aging workers. Preventing falls isn’t just something to worry about with patients; it’s also something for radio-logy administrators to address with their workers. Skid-resistant floors that have some cushioning are helpful
in avoiding falls, as is eliminating clutter.

➤ Preventing back injury. Employers cite back trouble as the most frequent injury requiring days away from work, according to the Bureau of Labor Statistics. So make back injury prevention a priority, especially considering the current environment of rising workers’ compensation costs and reduced productivity. Sitting down for long periods can cause or aggravate back injury.

➤ Adjusting ergonomics. Task chairs that have a minimum of four-way (and preferably six-way) adjustability are best. The back of the chair should be able to move to 110º. In a slightly reclined position, the chair has a more positive effect on the body, reducing seated muscle activity and disc pressure in the lumbar region, says Gile.

The top of the monitor screen should be at eye level and directly in front of the worker, with the distance from your eyes and the screen between 18 and 26 inches, she adds. Screens that swivel horizontally and tilt or elevate vertically are ideal because they allow the monitor to move into a comfortable viewing angle and help avoid glare. This is especially helpful for employees who wear bifocals.

➤ Avoiding carpal tunnel syndrome (CTS). CTS is one of the most common job-related injuries, and if not properly treated, it can cause irreversible nerve damage and permanent disability of varying degrees, says Gile.Frequent breaks and changes of position may help avoid repetitive motion problems such as CTS. Instead of a 15-minute break every four hours, try a five-minute minibreak every hour to allow stretching of the muscles.

➤ Alleviating fatigue. Many radiology facilities must operate 24 hours per day. Employees on the night shift have an increased risk of cardiovascular disease, gastrointestinal disorders, obesity, diabetes, and sleep apnea, according to a 2004 study by Circadian Technologies in Stoneham, MA. Night shift workers are also prone to high absenteeism, turnover, on-the-job injuries, and technical errors.

Gile cites a 2006 study published by the American College of Occupational and Environmental Medicine in which 38% of employees experience low levels of energy, poor sleep, or a feeling of fatigue. The study says fatigue is more common in women, in workers over the age of 50, and in jobs with decision-making responsibility.

Encourage employees who work the night shift to buy black-out drapes and wear sleep masks at home so that they can sleep during the day. In addition, 20 minutes of aerobic exercise before work can help employees wake up, feel energized, and keep their hearts in shape.

➤ Helping stress. The long hours and high attention to detail needed in radiology work can raise stress levels, and
older workers can be more prone to ill effects from stress.

Eliminate clutter and reduce noise in your facility to cut down on stress for older workers, says Gile. Allow frequent breaks and encourage additional hydration to make older workers more productive. Tell employees to follow the
three Bs to lower their stress levels:

• Take frequent breaks
• Blink often to moisturize the eyes
• Remember to breathe

Tip: Talk to your older staff members, says Gile, and ask them what can be done to make their job more comfortable. Often, they will offer a simple and easy-to-adapt solution that will help others in your facility.

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