Safety & SecuritySafety & Security

Big Bend Community Based Care, Inc.Big Bend Community Based Care, Inc.

20092009

Welcome & ExpectationsWelcome & Expectations

This course is designed for the BBCBC system of care. This course is designed for the BBCBC system of care. To move through the course you will need to manually To move through the course you will need to manually

click your mouse to advance the slides.click your mouse to advance the slides. At the conclusion of the course you will be asked to At the conclusion of the course you will be asked to

submit an email of completion to the BBCBC training submit an email of completion to the BBCBC training department.department.

In addition to the PowerPoint presentation successful In addition to the PowerPoint presentation successful completion of this course requires that each participant completion of this course requires that each participant familiarize themselves with the following BBCBC familiarize themselves with the following BBCBC Operating Policies which can be accessed on the Operating Policies which can be accessed on the www.bigbendcbc.orgwww.bigbendcbc.org site: site: – Policy 1400: General Health & SafetyPolicy 1400: General Health & Safety– Policy 1404: Building MaintenancePolicy 1404: Building Maintenance– Policy 1405: Conflict Resolution & De-Escalation TrainingPolicy 1405: Conflict Resolution & De-Escalation Training– Policy 1406: Driver SafetyPolicy 1406: Driver Safety– Policy 1407: Policy 1407: Maintenance of a Safe, Hygienic Environment – Policy 1409: Custody & Issuance of KeysPolicy 1409: Custody & Issuance of Keys

Course ObjectivesCourse Objectives

1.1. Participants will be able to recognize and diffuse Participants will be able to recognize and diffuse potentially violent/hostile situations.potentially violent/hostile situations.

2.2. Participants will be able to identify how to intervene, Participants will be able to identify how to intervene, seek assistance, make appropriate contacts and seek assistance, make appropriate contacts and document situations that affect worker safety.document situations that affect worker safety.

3.3. Participants will develop an understanding of Participants will develop an understanding of universal precautions and infectious diseases and universal precautions and infectious diseases and learn how to incorporate prevention and appropriate learn how to incorporate prevention and appropriate responsiveness in the workplace.responsiveness in the workplace.

4.4. Participants will gain an overview of Office Participants will gain an overview of Office Ergonomics and be able to identify causes and Ergonomics and be able to identify causes and solutions for Cumulative Trauma Disorders .solutions for Cumulative Trauma Disorders .

Violence & ThreatsViolence & Threats

Workplace ViolenceWorkplace Violence

Violence can strike from the outside or Violence can strike from the outside or from within. from within.

The perpetrator can be a stranger or The perpetrator can be a stranger or someone known to all. someone known to all.

It can be the result of a robbery, jealous It can be the result of a robbery, jealous spouse or over a disgruntled employee or spouse or over a disgruntled employee or angry client. angry client.

The policy at BBCBC is one of zero The policy at BBCBC is one of zero tolerance toward violence. Because of tolerance toward violence. Because of this, all acts or threats of violence will be this, all acts or threats of violence will be taken seriously.taken seriously.

Workplace Violence (cont.)Workplace Violence (cont.)

BBCBC defines a threat or act of violence as follows:BBCBC defines a threat or act of violence as follows: Including, but not limited to, any act or gesture intended to harass or Including, but not limited to, any act or gesture intended to harass or

intimidate another person.intimidate another person. Any act or gesture likely to damage company property.Any act or gesture likely to damage company property. Any act or gesture likely to leave another person injured or fearing injury.Any act or gesture likely to leave another person injured or fearing injury.

All employees are responsible for helping to maintain a violence free All employees are responsible for helping to maintain a violence free workplace. To that end, each employee is asked to report the act or threat to workplace. To that end, each employee is asked to report the act or threat to his or her immediate supervisor and/or a member of the Administrative his or her immediate supervisor and/or a member of the Administrative Management Team. An incident/accident report form should be utilized for Management Team. An incident/accident report form should be utilized for this purpose. Reports may be made confidentially or anonymously if the this purpose. Reports may be made confidentially or anonymously if the employee feels the need.employee feels the need.

Each act or threat of violence will be investigated and appropriate action will Each act or threat of violence will be investigated and appropriate action will be taken. Any such act or threat by an employee may lead to discipline, up be taken. Any such act or threat by an employee may lead to discipline, up to and including termination.to and including termination.

Precautions and Warning SignsPrecautions and Warning Signs

There are certain precautions that employees of both BBCBC and its contract agencies can use to help protect themselves from danger.

There are warning signs and signals that, when observed and understood, assist in preventing disruptions or physical violence in the workplace.

Stages and Level of ViolenceStages and Level of Violence

Stage 1/Level 1 (Early Stage 1/Level 1 (Early potential for violence)potential for violence)

Dehumanizing other people, Dehumanizing other people, name calling, racial insults name calling, racial insults or sexual harassment, other or sexual harassment, other verbal abuseverbal abuse

Challenging authority, Challenging authority, insubordination, refuses to insubordination, refuses to cooperate with immediate cooperate with immediate supervisorsupervisor

Regularly being Regularly being argumentative, alienating argumentative, alienating client or co-workers, client or co-workers, consistently argues with co-consistently argues with co-workers or managementworkers or management

Spreads rumors or gossipSpreads rumors or gossip

Stage 2/Level 2 (Escalated Stage 2/Level 2 (Escalated potential for violence)potential for violence)

Ignoring or refusing to obey Ignoring or refusing to obey company policies and procedurescompany policies and procedures

Stealing from the agency or co-Stealing from the agency or co-workers, sabotaging equipment, workers, sabotaging equipment, client files or agency propertyclient files or agency property

Making threats verbally, in Making threats verbally, in writing, by E-mail or voice mailwriting, by E-mail or voice mail

Blaming others for all problems, Blaming others for all problems, sees self as victimized by sees self as victimized by managementmanagement

Stage 3/Level 3 (Potential for violence is Stage 3/Level 3 (Potential for violence is realized)realized)Displaying or brandishing a weapon Displaying or brandishing a weapon (knife, gun, etc.)(knife, gun, etc.)Physical fights, punching, kicking, Physical fights, punching, kicking, slappingslappingCommitting assault, arson, murder, Committing assault, arson, murder, suicidesuicide

De-Escalating Hostile/Violent De-Escalating Hostile/Violent SituationsSituations

Use effective listening and communication techniques such as:Use effective listening and communication techniques such as:– negotiation and mediationnegotiation and mediation– remain calm and listen attentively– maintain eye contact– be courteous and patient

Keep the situation in your control Involve the person in regaining control and encouraging self-calming Involve the person in regaining control and encouraging self-calming

behaviorsbehaviors Separate individuals involved in an altercationSeparate individuals involved in an altercation Offer a voluntary escort to guide the person to a safe locationOffer a voluntary escort to guide the person to a safe location Employ a time out period to allow the person to calm downEmploy a time out period to allow the person to calm down Signal a co-worker or supervisor that you need help Do not make any telephone calls yourself (this could be perceived as

threatening and escalate the situation) Keep talking, but follow instructions of the person with the weapon Don't risk yourself or others Never try to grab a weapon Watch for a safe chance to escape to a safe area

Protection in Parking Areas/Outside Buildings

Park within the designated parking areas, Park within the designated parking areas, especially when working after darkespecially when working after dark

Do not leave purses, briefcases, or other Do not leave purses, briefcases, or other valuables in sight, as thieves can easily valuables in sight, as thieves can easily smash a window and steal these items in smash a window and steal these items in secondsseconds

Be aware of surroundings at all times when Be aware of surroundings at all times when leaving the building, especially in late leaving the building, especially in late evening, attempt to leave with another staff evening, attempt to leave with another staff membermember

Visitors and ID BadgesVisitors and ID Badges

Visitors should check in with the receptionist and should be escorted while in the building and not allowed to wander freely. This too applies to children as well as adults, clients and professionals in the service centers as well as the BBCBC administrative office.

Employees should carry their BBCBC picture ID and business cards for presentation when requested for security reasons.

Additional Materials-Worker Additional Materials-Worker SafetySafety

Visit the Child Welfare Information Visit the Child Welfare Information Gateway:Gateway:

http://www.childwelfare.gov/http://www.childwelfare.gov/systemwide/workforce/systemwide/workforce/org_culture/worker_safety.cfmorg_culture/worker_safety.cfm

Domestic ViolenceDomestic Violence

Although this is a sensitive area, it is important for BBCBC and its contract providers to know if an employee has reason to fear the non-employee’s significant other, or if there has been any previous physical altercations or threats. With this knowledge, BBCBC and its provider agencies can assist the employee in designing a safety plan to reduce the likelihood of a problem occurring.

Medical IssuesMedical Issues

Infectious DiseasesInfectious Diseases

An infectious disease is a disease caused by bacterial, An infectious disease is a disease caused by bacterial, viral, fungal, or protozoan infection. Though some viral, fungal, or protozoan infection. Though some infectious diseases are not contagious, others may be infectious diseases are not contagious, others may be transmitted from animal to person (bird flu and cat transmitted from animal to person (bird flu and cat scratch disease) or from person to person. Examples scratch disease) or from person to person. Examples include viral illnesses, HIV/AIDS, meningitis, include viral illnesses, HIV/AIDS, meningitis, whooping cough, pneumonia, and tuberculosis.whooping cough, pneumonia, and tuberculosis.

Local Infectious DiseasesLocal Infectious Diseases

The most frequent local The most frequent local infections, including the infections, including the common cold, occur in common cold, occur in the upper respiratory the upper respiratory tract. A serious and tract. A serious and usually local infection of usually local infection of the respiratory tract is the respiratory tract is tuberculosis, which is a tuberculosis, which is a problem worldwide. problem worldwide.

Sites for Infectious DiseasesSites for Infectious Diseases

Other common sites of Other common sites of infection include the infection include the digestive tract, the lungs, the digestive tract, the lungs, the reproductive and urinary reproductive and urinary tracts, the eyes or ears. Local tracts, the eyes or ears. Local infections can cause serious infections can cause serious illnesses if they affect vital illnesses if they affect vital organs such as the heart, organs such as the heart, brain or liver. They also can brain or liver. They also can spread through the blood spread through the blood stream to cause widespread stream to cause widespread symptoms.symptoms.

Infectious Diseases and the Infectious Diseases and the Immune SystemImmune System

The outcome of any infection depends on the virulence The outcome of any infection depends on the virulence of infectious agents, the number of organisms in the of infectious agents, the number of organisms in the infecting inoculum and the response of the immune infecting inoculum and the response of the immune system. A compromised immune system, which can system. A compromised immune system, which can result from diseases such as AIDS or treatment of result from diseases such as AIDS or treatment of diseases such as cancer, may allow organisms that are diseases such as cancer, may allow organisms that are ordinarily harmless to proliferate and cause life-ordinarily harmless to proliferate and cause life-threatening illness.threatening illness.

Transmission of Infectious Transmission of Infectious DiseasesDiseases

Transmission of an infectious disease may occur through Transmission of an infectious disease may occur through one or more of diverse pathways including physical one or more of diverse pathways including physical contact with infected individuals. contact with infected individuals.

These infecting agents may also be transmitted through These infecting agents may also be transmitted through liquids, food, body fluids, contaminated objects, airborne liquids, food, body fluids, contaminated objects, airborne inhalation, or through vector-borne spread. Vectors may inhalation, or through vector-borne spread. Vectors may

be mechanical or biological.be mechanical or biological.

Mechanical Vectors and Mechanical Vectors and Infectious DiseasesInfectious Diseases

A mechanical vector picks A mechanical vector picks up an infectious agent on up an infectious agent on the outside of its body and the outside of its body and transmits it in a passive transmits it in a passive manner. An example of a manner. An example of a mechanical vector is a mechanical vector is a housefly, which lands on housefly, which lands on cow dung, contaminating cow dung, contaminating its appendages with its appendages with bacteria from the feces, bacteria from the feces, and then lands on food and then lands on food prior to consumption. The prior to consumption. The pathogen never enters the pathogen never enters the body of the fly.body of the fly.

Biological Vectors and Biological Vectors and Infectious DiseasesInfectious Diseases

In contrast, biological vectors harbor In contrast, biological vectors harbor pathogens within their bodies and deliver pathogens within their bodies and deliver pathogens to new hosts in an active manner, pathogens to new hosts in an active manner, usually a bite. Biological vectors are often usually a bite. Biological vectors are often responsible for serious blood-borne diseases, responsible for serious blood-borne diseases, such as malaria, and viral encephalitis,. such as malaria, and viral encephalitis,. Biological vectors are usually, though not Biological vectors are usually, though not exclusively, arthropods, such as mosquitoes, exclusively, arthropods, such as mosquitoes, ticks, fleas and lice. ticks, fleas and lice.

Universal PrecautionsUniversal Precautions

Work practice controls are designed to change the way in which a task is Work practice controls are designed to change the way in which a task is performed to reduce the likelihood of exposure to bloodborne pathogens. performed to reduce the likelihood of exposure to bloodborne pathogens.

The most important work practice control is implementation of "universal The most important work practice control is implementation of "universal precautions" which are a set of precautions recommended by the CDC which are precautions" which are a set of precautions recommended by the CDC which are designed to prevent transmission of human immunodeficiency virus (HIV), designed to prevent transmission of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and other bloodborne pathogens when providing first aid hepatitis B virus (HBV), and other bloodborne pathogens when providing first aid or health care. or health care.

Under universal precautions, blood and certain body fluids of all patients are Under universal precautions, blood and certain body fluids of all patients are considered potentially infectious for HIV, HBV and other bloodborne pathogens. considered potentially infectious for HIV, HBV and other bloodborne pathogens.

Body Fluids requiring the use of Universal Precautions Body Fluids requiring the use of Universal Precautions – Universal precautions apply to blood, other body fluids containing visible blood, Universal precautions apply to blood, other body fluids containing visible blood,

vaginal secretions and semen. Universal precautions also apply to tissues and to the vaginal secretions and semen. Universal precautions also apply to tissues and to the following fluids: cerebrospinal, synovial, pleural, peritoneal, pericardial, and amniotic following fluids: cerebrospinal, synovial, pleural, peritoneal, pericardial, and amniotic fluids. fluids.

– Universal precautions do not apply to feces, nasal secretions, sputum, sweat, tears, Universal precautions do not apply to feces, nasal secretions, sputum, sweat, tears, urine, and vomit unless they contain visible blood. urine, and vomit unless they contain visible blood.

– Universal precautions do not apply to saliva except when visibly contaminated with Universal precautions do not apply to saliva except when visibly contaminated with blood or in the dental setting where blood contamination of saliva is predictable. blood or in the dental setting where blood contamination of saliva is predictable.

– General infection control practices are used to further minimize the already minute General infection control practices are used to further minimize the already minute risk for salivary transmission of HIV. These infection control practices include the use risk for salivary transmission of HIV. These infection control practices include the use of gloves for digital examination of mucous membranes and endotracheal suctioning, of gloves for digital examination of mucous membranes and endotracheal suctioning, hand washing after exposure to saliva, and minimizing the need for emergency mouth-hand washing after exposure to saliva, and minimizing the need for emergency mouth-to-mouth resuscitation by making mouthpieces and other ventilation devices available to-mouth resuscitation by making mouthpieces and other ventilation devices available for use in areas where the need for resuscitation is predictable.for use in areas where the need for resuscitation is predictable.

Prevention Efforts in BBCBC Prevention Efforts in BBCBC OfficesOffices

Each one of our service centers have a Each one of our service centers have a constant flow of traffic by professionals, constant flow of traffic by professionals, caretakers and children. An exaggerated caretakers and children. An exaggerated effort is made to keep the lobby area clean effort is made to keep the lobby area clean as well as door handles, phones and as well as door handles, phones and conference areas. Special attention is paid to conference areas. Special attention is paid to toys in the common areas. Cleaning and toys in the common areas. Cleaning and good hygiene can also prevent:good hygiene can also prevent:

InfluenzaInfluenza The common coldThe common cold Strep throatStrep throat Intestinal disordersIntestinal disorders PneumoniaPneumonia

Preventing Infectious DiseasesPreventing Infectious Diseases

Wash your hands often/use an Wash your hands often/use an alcohol-based hand sanitizer, alcohol-based hand sanitizer, especially:especially:– After using the bathroom After using the bathroom – Before preparing food or eating Before preparing food or eating – After changing diapers After changing diapers – After blowing your nose and/or After blowing your nose and/or

using hands when sneezing or using hands when sneezing or coughing coughing

– After caring for a sick person After caring for a sick person – After playing with or handling After playing with or handling

your pet your pet

Pandemic FluPandemic Flu

BBCBC is dedicated to ensuring that BBCBC is dedicated to ensuring that employees needs are met should there employees needs are met should there be threat of such an event as a be threat of such an event as a Pandemic Flu. The following is an Pandemic Flu. The following is an excerpt from the Department of Health excerpt from the Department of Health regarding an outbreak of a Pandemic regarding an outbreak of a Pandemic Flu (such as Bird Flu). This checklist will Flu (such as Bird Flu). This checklist will help to gather the information and help to gather the information and resources you may need in case of a flu resources you may need in case of a flu pandemic.pandemic.

Flu Precautions & ResponseFlu Precautions & Response1. To plan for a pandemic:1. To plan for a pandemic: Store a two week supply of Store a two week supply of

water and food. This can be water and food. This can be useful in other types of useful in other types of emergencies, such as power emergencies, such as power outages and disasters.outages and disasters.

Have any nonprescription drugs Have any nonprescription drugs and other health supplies on and other health supplies on hand, including pain relievers, hand, including pain relievers, stomach remedies, cough and stomach remedies, cough and cold medicines, fluids with cold medicines, fluids with electrolytes, and vitamins.electrolytes, and vitamins.

Volunteer with local groups to Volunteer with local groups to prepare and assist with prepare and assist with emergency response.emergency response.

Get involved in your community Get involved in your community as it works to prepare for an as it works to prepare for an influenza pandemic.influenza pandemic.

2. 2. To limit the spread of germs and prevent To limit the spread of germs and prevent infection :infection :

People with respiratory illness should stay People with respiratory illness should stay home from work or school to avoid home from work or school to avoid spreading infections, including influenza.spreading infections, including influenza.

Avoid close contact with people who are Avoid close contact with people who are coughing or otherwise appear ill.coughing or otherwise appear ill.

Avoid touching your eyes, nose and mouth.Avoid touching your eyes, nose and mouth. Wash hands frequently to lessen the spread Wash hands frequently to lessen the spread

of respiratory illness.of respiratory illness. People experiencing cough, fever and People experiencing cough, fever and

fatigue, possibly along with diarrhea and fatigue, possibly along with diarrhea and vomiting, should contact their physician.vomiting, should contact their physician.

If you think you have influenza, please call If you think you have influenza, please call your health care provider and discuss your health care provider and discuss whether you need to be seen in their office, whether you need to be seen in their office, emergency department or stay home.emergency department or stay home.

Medical EmergenciesMedical Emergencies

If the injury is minor, provide first aid as If the injury is minor, provide first aid as necessary with a departmental First Aid Kit.necessary with a departmental First Aid Kit.

If the injury or condition is not minor call If the injury or condition is not minor call (9-(9-1-1)1-1). Give the operator the following . Give the operator the following information: information: – Location of victimLocation of victim– Type of injuryType of injury– Your name and call back numberYour name and call back number

Notify your supervisor of the situation.Notify your supervisor of the situation. Follow any further instructions the Follow any further instructions the 911911

dispatcher or you supervisor gives you.dispatcher or you supervisor gives you. Comfort victim until EMS arrives.Comfort victim until EMS arrives.

Office ErgonomicsOffice Ergonomics

Office ErgonomicsOffice Ergonomics

Ergonomics is the science of “designing the Ergonomics is the science of “designing the job to fit the worker, not forcing the worker to job to fit the worker, not forcing the worker to fit the job. Ergonomics covers all aspects of fit the job. Ergonomics covers all aspects of a job, from the physical stresses it places on a job, from the physical stresses it places on joints, muscles, nerves, tendons, bones and joints, muscles, nerves, tendons, bones and the like to environmental factors which can the like to environmental factors which can affect hearing, vision, and general comfort affect hearing, vision, and general comfort

and health.and health.

Cumulative Trauma DisordersCumulative Trauma Disorders

To understand CTDs, it is necessary to To understand CTDs, it is necessary to understand how the body works. Body understand how the body works. Body Movements are produced by contracting and Movements are produced by contracting and relaxing muscles. The muscles are attached relaxing muscles. The muscles are attached to bones by tendons. Tendons are smooth, to bones by tendons. Tendons are smooth, and in some parts of the body they glide and in some parts of the body they glide back and forth inside tubes called synovial back and forth inside tubes called synovial sheaths. The sheath produces a lubricant sheaths. The sheath produces a lubricant called synovial fluid to help the tendons glide called synovial fluid to help the tendons glide easily. CTDs result when repeated stress is easily. CTDs result when repeated stress is placed on the tendons, muscles, or nerves placed on the tendons, muscles, or nerves causing inflammation or damage. causing inflammation or damage.

Cumulative Trauma Disorders Cumulative Trauma Disorders (cont.)(cont.)

The following are some of the most common CTDsThe following are some of the most common CTDs:: TendonitisTendonitis – inflammation of the tendons – inflammation of the tendons TtensynoitisTtensynoitis – inflammation of the synovial sheath – inflammation of the synovial sheath Carpal Tunnel SyndromeCarpal Tunnel Syndrome – results when the median nerve – results when the median nerve

is compressed either form the swelling of tendons and is compressed either form the swelling of tendons and sheaths or from repeated bending of the wrist. sheaths or from repeated bending of the wrist.

Some of the conditions that my lead to CTDs are:Some of the conditions that my lead to CTDs are: Repetition Repetition – long or concentrated hours of typing or using – long or concentrated hours of typing or using

a mouse.a mouse. PosturePosture – long hours of sitting in the same position while – long hours of sitting in the same position while

typing, especially if it is in an uncomfortable or poorly typing, especially if it is in an uncomfortable or poorly supported position, or if the wrists are bent. supported position, or if the wrists are bent.

Lack of Rest Lack of Rest - intensive hours at the keyboard with few - intensive hours at the keyboard with few breaks breaks

Cumulative Trauma Disorders Cumulative Trauma Disorders (cont.)(cont.)

Symptoms of CTDsSymptoms of CTDs Tingling or numbness in the hands or fingersTingling or numbness in the hands or fingers Pain in fingers, hands, wrists, or even shooting up into the arms or Pain in fingers, hands, wrists, or even shooting up into the arms or

forearmsforearms Loss of strength or coordination in the handsLoss of strength or coordination in the hands Numbness or discomfort in the hands which wakes you up at night. Numbness or discomfort in the hands which wakes you up at night.

Carpal Tunnel SyndromeCarpal Tunnel Syndrome Carpal Tunnel Syndrome is a common problem that affects the hand Carpal Tunnel Syndrome is a common problem that affects the hand

and wrist. This condition, or syndrome has become the focus of and wrist. This condition, or syndrome has become the focus of much attention in the last few years due to suggestions that it may much attention in the last few years due to suggestions that it may be linked to occupations that require repetitive use of the hands such be linked to occupations that require repetitive use of the hands such as typing.as typing.

Preventing CTDs to hands and Preventing CTDs to hands and wristswrists

One of the keys to preventing CTDs is to keep your One of the keys to preventing CTDs is to keep your hands and wrists in a “neutral” position as possible. hands and wrists in a “neutral” position as possible. In other words, you want to avoid typing with your In other words, you want to avoid typing with your wrist bent to either side, or up or down. You do not wrist bent to either side, or up or down. You do not want your wrists to be flexed in any direction. want your wrists to be flexed in any direction.

The neutral position may be obtained by adjusting The neutral position may be obtained by adjusting your desk height, chair height, or keyboard position. your desk height, chair height, or keyboard position. Here are some tips for preventing hand and wrist Here are some tips for preventing hand and wrist CTDs:CTDs:– The keyboard should be slightly lower than normal desk The keyboard should be slightly lower than normal desk

height. If it not low enough, try raising your chair height. height. If it not low enough, try raising your chair height. Prevent your legs from dangling by using a footrest. Prevent your legs from dangling by using a footrest.

– ““Home row” of keys should be at elbow level Home row” of keys should be at elbow level

Preventing CTDs to hands and Preventing CTDs to hands and wrists (cont)wrists (cont)

While typing, it is best not to rest your wrists, and they should While typing, it is best not to rest your wrists, and they should not be bent up, down or to the side. This may be easier if they not be bent up, down or to the side. This may be easier if they back edge of the keyboard is tilted down slightly, away from back edge of the keyboard is tilted down slightly, away from you. The knuckle, wrist, and top of forearm should form a you. The knuckle, wrist, and top of forearm should form a straight line. Wrist supports or rests give you a place to rest straight line. Wrist supports or rests give you a place to rest your hands only when pausing from typing, not while you are your hands only when pausing from typing, not while you are typing.typing.

Do not pound the keys. Use light touch.Do not pound the keys. Use light touch. Use two hands to perform double key operations like Use two hands to perform double key operations like Ctrl-CCtrl-C or or

Alt-FAlt-F instead of twisting one hand to do it. instead of twisting one hand to do it. The elbows should form a 90 degree angle while “hanging” at The elbows should form a 90 degree angle while “hanging” at

the sides from the shoulders. They should remain relaxed in a the sides from the shoulders. They should remain relaxed in a lowered position while typing.lowered position while typing.

Take lots of breaks to stretch and relax. Take frequent “micro-Take lots of breaks to stretch and relax. Take frequent “micro-breaks” (lasting few seconds or so) as well as longer (several breaks” (lasting few seconds or so) as well as longer (several minute) breaks every hour or so.minute) breaks every hour or so.

Hold the mouse lightlyHold the mouse lightly Keep your hands and arms warm.Keep your hands and arms warm.

EyestrainEyestrain

Eyestrain is another ergonomic problem Eyestrain is another ergonomic problem frequently associated with the use of frequently associated with the use of computers and Video Display Terminals computers and Video Display Terminals (VDTs). Keep in mind that the solutions (VDTs). Keep in mind that the solutions presented here are only recommendations. presented here are only recommendations.

If following these recommendations seem to If following these recommendations seem to make matters worse, try something else! make matters worse, try something else!

If you aren’t experiencing headaches or If you aren’t experiencing headaches or eyestrain while you work on the computer, eyestrain while you work on the computer, don’t’ worry about making changes; don’t’ worry about making changes; obviously your setup works for you.obviously your setup works for you.

Symptoms of EyestrainSymptoms of Eyestrain

Sore, tired, itchy, dry, or burning eyes.Sore, tired, itchy, dry, or burning eyes. HeadachesHeadaches Difficulty focusing between the VDT and Difficulty focusing between the VDT and

source documentssource documents Blurred or double visionBlurred or double vision Color fringes/after imagesColor fringes/after images Increased sensitivity to lightIncreased sensitivity to light

Causes of SymptomsCauses of Symptoms Glare:Glare: Glare can be caused by Glare can be caused by

sources of light such as windows, sources of light such as windows, lamps , or overhead lighting.lamps , or overhead lighting.

Look at your monitor screen to see Look at your monitor screen to see if there are any blotches of light. if there are any blotches of light. While you may not be conscious of While you may not be conscious of this irritation, it can cause eyestrain this irritation, it can cause eyestrain over the course of a long day. over the course of a long day. Glare can also be caused by too Glare can also be caused by too much contrast between the screen much contrast between the screen background and the displayed text. background and the displayed text.

Solution:Solution: Adjust your monitor so Adjust your monitor so that it is not reflecting the light that it is not reflecting the light sources. Tilt the monitor down so sources. Tilt the monitor down so that it doesn’t reflect overhead light, that it doesn’t reflect overhead light, or move it perpendicular to or move it perpendicular to windows. Close shades or blinds if windows. Close shades or blinds if the computer cannot be moved. the computer cannot be moved. Move lamps so that they are not Move lamps so that they are not reflected directly in the monitor. reflected directly in the monitor. Use glare screens.Use glare screens.

Improper LightingImproper Lighting: if the : if the light in the work area is too light in the work area is too bright or too dim, the bright or too dim, the human eye has to work human eye has to work extra hard to compensate extra hard to compensate for these harsh for these harsh environmental factors. environmental factors. People may not even be People may not even be aware that their eyes are aware that their eyes are under duress, but over time under duress, but over time they may develop they may develop symptom of eyestrain. symptom of eyestrain.

Solution:Solution: use indirect, use indirect, ambient lighting and an ambient lighting and an adjustable light source at adjustable light source at the desk, where extra the desk, where extra illumination is required.illumination is required.

Causes of SymptomsCauses of Symptoms

Viewing angle and distanceViewing angle and distance: If : If your monitor is too far away, you may your monitor is too far away, you may have to strain to read the print. have to strain to read the print. Likewise, if it is too close, you may Likewise, if it is too close, you may also strain your eyes. If the monitor also strain your eyes. If the monitor is too high, you will have to angle is too high, you will have to angle your neck to look up at it, which could your neck to look up at it, which could cause your neck to be sore, and may cause your neck to be sore, and may contribute to headaches. Also, when contribute to headaches. Also, when you are continually looking up, you you are continually looking up, you may not fully close our eyes when may not fully close our eyes when you blink, and this can cause your you blink, and this can cause your eyes to dry out. eyes to dry out.

Uninterrupted focus on the Uninterrupted focus on the screen:screen: When people concentrate, When people concentrate, they blink less often. Sometimes they they blink less often. Sometimes they concentrate so hard that they blink concentrate so hard that they blink only once per minute, instead of the only once per minute, instead of the normal once every five seconds. This, normal once every five seconds. This, too, will cause the eyes to dry out and too, will cause the eyes to dry out and become irritated.become irritated.

Solution:Solution: Take micro-breaks! Take micro-breaks! Frequently look up from your monitor Frequently look up from your monitor and focus on an object several feet and focus on an object several feet away. Make a conscious effort to away. Make a conscious effort to blink. blink.

Eyewear: Eyewear: Many computer users Many computer users wear bifocals or trifocal lenses wear bifocals or trifocal lenses fitted for reading print and distance fitted for reading print and distance viewing. Sometimes these viewing. Sometimes these prescriptions may not be adequate prescriptions may not be adequate for computer work. for computer work.

Solution:Solution: If you wear glasses of If you wear glasses of any sort and frequently experience any sort and frequently experience headaches while working at a headaches while working at a computer, you should probably computer, you should probably check with your eye doctor to check with your eye doctor to make sure you are wearing the make sure you are wearing the correct prescription for such work. correct prescription for such work. Uninterrupted focus on the screen:Uninterrupted focus on the screen: When people concentrate, they blink less When people concentrate, they blink less often. Sometimes they concentrate so often. Sometimes they concentrate so hard that they blink only once per minute, hard that they blink only once per minute, instead of the normal once every five instead of the normal once every five seconds. This, too, will cause the eyes to seconds. This, too, will cause the eyes to dry out and become irritated.dry out and become irritated.

Solution:Solution: Take micro-breaks! Frequently Take micro-breaks! Frequently look up from your monitor and focus on look up from your monitor and focus on an object several feet away. Make a an object several feet away. Make a conscious effort to blink.conscious effort to blink.

Physical StressorsPhysical Stressors

Include repetitive motions such as those caused by Include repetitive motions such as those caused by typing or any continuous motion. This could include typing or any continuous motion. This could include work that causes vibration or heavy lifting, working in work that causes vibration or heavy lifting, working in an awkward position, or holding a telephone to your an awkward position, or holding a telephone to your ear with your shoulder. Repetitive motions, vibration, ear with your shoulder. Repetitive motions, vibration, excessive force, and awkward positions are frequently excessive force, and awkward positions are frequently linked to ergonomic disorders; however, the majority linked to ergonomic disorders; however, the majority to “Cumulative Trauma Disorders “(CTD’s) or to “Cumulative Trauma Disorders “(CTD’s) or “Repetitive Strain Injuries” (RSI’s) are caused by “Repetitive Strain Injuries” (RSI’s) are caused by repetitive motions that would not result in undue repetitive motions that would not result in undue stress or harm if only performed once. Carpal tunnel stress or harm if only performed once. Carpal tunnel syndrome, tendonitis, Tenosynovitis, Dequarvain’s syndrome, tendonitis, Tenosynovitis, Dequarvain’s Syndrome, Thoracic Outlet Syndrome, many back Syndrome, Thoracic Outlet Syndrome, many back injuries, and several other conditions may result from injuries, and several other conditions may result from repetitive motions.repetitive motions.

Environmental StressorsEnvironmental Stressors

Could include such things as indoor air quality or excessive Could include such things as indoor air quality or excessive noise. “Sick building syndrome, “with its accompanying noise. “Sick building syndrome, “with its accompanying headaches, congestion, fatigue and even rashes, can result headaches, congestion, fatigue and even rashes, can result from poor air quality in a building or office. Excessive noise from poor air quality in a building or office. Excessive noise around heavy machinery or equipment can cause around heavy machinery or equipment can cause permanent haring loss. Improper lighting can cause permanent haring loss. Improper lighting can cause eyestrain and headaches, especially in conjunction with eyestrain and headaches, especially in conjunction with computer monitors. computer monitors.

It is important to listen to the signals your body gives you. If It is important to listen to the signals your body gives you. If you suffer pain in the wrists or hands after a long day of you suffer pain in the wrists or hands after a long day of typing, examine your work area and work practices to see if typing, examine your work area and work practices to see if they may be causing the problems. Learn to make they may be causing the problems. Learn to make adjustments. Raise or lower chairs to avoid typing with your adjustments. Raise or lower chairs to avoid typing with your wrists at an odd angle. Adjust computer monitors to avoid wrists at an odd angle. Adjust computer monitors to avoid glare. Take frequent breaks from repetitive tasks to give glare. Take frequent breaks from repetitive tasks to give your body a rest. Always use proper lifting techniques. your body a rest. Always use proper lifting techniques. Sometimes small modifications to work procedures, posture Sometimes small modifications to work procedures, posture habits, and/or work station design can make a big difference habits, and/or work station design can make a big difference in the way you feel at the end of a day. in the way you feel at the end of a day.

ReferencesReferences

http://en.wikipedia.org/wiki/Infectious_diseaseshttp://en.wikipedia.org/wiki/Infectious_diseases http://www.idsociety.org/factsaboutid.htmlhttp://www.idsociety.org/factsaboutid.html http://www.edcp.org/factsheets/prevent.cfmhttp://www.edcp.org/factsheets/prevent.cfm http://www.health.state.ri.us/disease/communicable/thingstohttp://www.health.state.ri.us/disease/communicable/thingsto

do.phpdo.php

For More Information Visit: www.pandemicflu.gov The Centers for Disease Control and Prevention (CDC)

hotline, 1-800-CDC-INFO (1-800-232-4636), is available in English and Spanish, 24 hours a day, 7 days a week. TTY: 1-888-232-6348. Questions can be e-mailed to cdcinfo@cdc.gov.

Links to state departments of public health can be found at http://www.cdc.gov/other.htm#states.

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