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ATLANTA-The only way to truly improve workplace ergonomics is to actually go out and talk with employees, a risk control consultant says.

"I call it E.B.W.A., Ergonomics By Walking Around," said Pamela Simonian, assistant vp-risk control consulting for Sedgwick James of California Inc. in Orange, Calif.

By walking around the worksite, employers can more readily assess what workstation problems or work habits may be causing repetitive stress injuries, including carpal tunnel syndrome.

It is important to understand that "only some of the people are going to be doing the wrong thing," she said, noting that one ergonomic solution will not fit everyone. "It depends on the individual."

Ms. Simonian gave advice to risk managers on more effective approaches to ergonomics during a session at the Risk & Insurance Management Society Inc. conference last week.

Employers also can educate and train a few people about the risk factors and loss prevention involved with repetitive stress injuries.

Those "self-directed work teams" in turn can educate and train fellow employees in their work areas, she said.

While group sessions are OK, "lasting impact comes with one-on-one training," she said.

Employees with repetitive stress injuries who work at home present a different ergonomics challenge to employers.

If you can't see the person's workstation or work habits, "you can't solve the problem," Ms. Simonian said.

Therefore, "you must be creative."

Ms. Simonian suggests having a third party take several pictures or a video of the person while working at his or her home workstation.

The third party can be a spouse, a friend of the worker or a representative of the company's insurer, if it has a local office nearby, she noted.

In most cases where an employee complains of pain in the upper extremities due to repetitive motion while working, the solutions can be found in-house, Ms. Simonian said.

However, in those cases where in-house expertise and certain "gadgets and gizmos" do not stop the pain, employers need to send the injured employee to an ergonomics expert.

Ms. Simonian gave attendees advice on a host of ergonomic solutions to workstation problems but reiterated that a solution for one employee may not work as well for another.

Among her recommendations, Ms. Simonian suggested foot rests that are easily adjustable and carpeted on the surface so feet do not slip while resting.

"Today, the best workstations have adjustable desks, so feet are flat on the ground" and foot rests are unneeded, she said.

The cause behind some hand pain may be the size of the computer mouse an employee is using, she said.

Large hands using a small mouse tend to squeeze the mouse while moving it around, which over time can cause pain. This can be solved by supplying the employee with a larger mouse.

For other employees, the solution may be switching to a tracking ball.

"Most people don't have this problem, but if you do, there are alternatives in the market. Mice come in a variety of sizes and cost about $79 each," Ms. Simonian said.

To prevent the problems that might arise due to too much reaching with the computer mouse, Ms. Simonian suggests a "mouse bridge" that fits over the numerical keypad located on nearly all computer keyboards.

"This is great for PC operators with no use for the number pad," she said.

Other tips given during the session came from Dr. Arthur J. Simon, medical director at Workplace Medical Solutions in Atlanta.

Dr. Simon told risk managers that most employees complaining of carpal tunnel syndrome really only have tendinitis, an inflammation that can produce similar pain but requires quite different treatment.

"You have to take a good history" of the hurt employee, Dr. Simon said.

By doing this, an employer may find the employee actually is pregnant or suffers from diabetes, arthritis or a thyroid condition, which can mimic the pain caused by carpal tunnel syndrome.

"Make sure all metabolic situations are under control. Then, after ruling that out, you need to look at the employee's workstation," Dr. Simon suggested.

If an employee does have carpal tunnel syndrome, surgery is not the immediate answer, Dr. Simon said.

Eighty-five percent of the people with carpal tunnel are cured by wearing metal-based splints at night, a soft splint during the day and by taking non-steroid anti-inflammatory drugs, according to Dr. Simon.

"A majority of these people are back to work in two weeks" on a gradual return-to-work schedule, Dr. Simon said.

By the end of four to five weeks, they are typically back to work full time.

The session was moderated and coordinated by Diana Jeanne Rich, workers compensation manager for Freedom Communications Inc. in Irvine, Calif.