Equipment for employees with rheumatoid arthritis
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
Click here: Second Opinion Arthritis Treatment Kit
For employees with rheumatoid arthritis, the correct positioning of chairs, desks, and other accessories, in an office is critical for both optimum performance as well as reduction of stress on joints.
The following advice is provided by the Arthritis Foundation
The "90° rule" can be applied. This means that a seated person’s hips, knees, and ankles should be kept at a 90° angle. The elbows should be kept at an angle of 90° or lower. If needed, a lumbar cushion may provide additional back support.
For employees who work in a non-office setting, for example in a factory, be sure that you understand how to lift heavy loads properly by using your largest and strongest joints. The Arthritis Foundation also offers the following tips for people with RA:
• Lift using the palms of the hands rather than gripping items with fingers
• Use arms for lifting rather than hands
• Hold items close to the body
• Slide items on the floor when possible
• Change positions often
Small changes in your daily routine may make your time at work easier and more comfortable. The following suggestions are offered to show how you can improve your productivity at work.
• Frequent short breaks taken throughout the day may help you conserve energy.
• An occupational or physical therapist can teach you how to perform work-related tasks in ways that will not stress joints.
• Assistive devices, such as tools to make using a computer easier or book stands to avoid neck strain while reading, may be useful.
• A flexible work schedule or other options, such as working by computer from home, may be helpful.
• Participating in a car pool is another way to conserve your energy.
Activities of Daily Living Accommodations:
Allow use of a personal attendant at work
Allow use of a service animal at work
Make sure the facility is accessible
Move workstation closer to the restroom
Allow longer breaks
Refer to appropriate community services
Allow access to a refrigerator
Reduce or eliminate physical exertion and workplace stress
Schedule periodic rest breaks away from the workstation
Allow a flexible work schedule and flexible use of leave time
Allow work from home
Implement ergonomic workstation design
Provide a scooter or other mobility aid if walking cannot be reduced
Fine Motor Impairment:
Implement ergonomic workstation design
Provide alternative computer access
Provide alternative telephone access
Provide arm supports
Provide writing and grip aids
Provide a page turner and a book holder
Provide a note taker
Gross Motor Impairment:
Modify the work-site to make it accessible
Provide parking close to the work-site
Provide an accessible entrance
Install automatic door openers
Provide an accessible restroom and break room
Provide an accessible route of travel to other work areas used by the employee
Modify the workstation to make it accessible
Adjust desk height if wheelchair or scooter is used
Make sure materials and equipment are within reach range
Move workstation close to other work areas, office equipment, and break rooms
Photosensitivity: This is a problem in patients who are are medicines that can sensitize their skin. It is also a problem in patients who have secondary fibromyalgia who are sensitive to environmental stimuli.
Minimize outdoor activities between the peak hours of 10:00 am and 4:00 pm
Avoid reflective surfaces such as sand, snow, and concrete
Provide clothing to block UV rays
Provide "waterproof" sun-protective agents such as sunblocks or sunscreens
Install low wattage overhead lights
Provide task lighting
Replace fluorescent lighting with full spectrum or natural lighting
Eliminate blinking and flickering lights
Install adjustable window blinds and light filters
Avoid infectious agents and chemicals
Avoid invasive procedures
Provide protective clothing
Allow flexible work hours
Allow frequent breaks
Allow work from home
Develop strategies to deal with work problems before they arise
Provide sensitivity training to coworkers
Allow telephone calls during work hours to doctors and others for support
Provide information on counseling and employee assistance programs
Modify work-site temperature
Modify dress code
Use fan/air-conditioner or heater at the workstation
Allow flexible scheduling and flexible use of leave time
Allow work from home during extremely hot or cold weather
Maintain the ventilation system
Redirect air conditioning and heating vents
Provide an office with separate temperature control
The ADA requires employers to provide reasonable accommodations to qualified disabled individuals in three areas of employment: 1) the job application process, 2) job functions, and 3) benefits and privileges of employment. A reasonable accommodation is any modification to a job, employment practice or process, or a work environment that makes it possible for an individual with a disability to successfully fulfill the duties of a job. Employers are not required to provide items primarily for personal use, such as purchasing a wheelchair.
Reasonable accommodations are not nearly as costly as many employers fear. A study conducted by the Job Accommodation Network (JAN) in 1990 showed that one third of all accommodations were accomplished with no cost to the employer and more than half cost $1,000.00 or less; eighty percent of the accommodations that JAN suggests cost less than $500.00. Additionally, most employers surveyed indicated that their company had benefited overall financially as a result of making job accommodations.
The individual with a disability will likely have a great deal of experience modifying tasks. It is logical to use his/her expertise. It is also important to consider the individual?s preferences as well as the employer?s needs. Working together to outline various options for accommodating the individual will likely be the most beneficial approach. Occupational therapists can also help by completing evaluations of the workstation and the employee?s functioning. The therapist can offer suggestions for modifying the workstation or the process the employee uses to complete a task. S/he will work with the employer and employee to find accommodations that are both effective and reasonable. Assistance is also available through organizations such as the regional ADA Disability and Business Technical Assistance Center, the Job Accommodation Network, and the local Vocational Rehabilitation office.
Accommodations for employees with arthritis may be administrative or mechanical in nature. Administrative accommodations may include reassigning or reallocating marginal duties, being flexible about how or when tasks are performed, and allowing a flexible work schedule or telecommuting. Reassignment to a different, available job is also an option if no other accommodation is effective.
Mechanical accommodations include modifying the employee?s workstation, modifying or providing special tools or equipment, and ensuring that the building, the work area, and other non-work areas used by employees, such as restrooms and break rooms, are accessible.
For example, an employee with osteoarthritis of the hips or knees may have difficulty standing all day. Providing a stool of the appropriate height would allow the individual to alternate between sitting and standing at a workstation without interrupting production. Another person may have difficulty sitting for long periods. If s/he works at a desk, a podium could be used to raise the work surface allowing the employee to change positions as needed.
More significant accommodations for an individual with arthritis in the lower extremities could include moving a workstation to a ground floor to alleviate the need to climb stairs, or providing another employee to assist with lifting or other physically demanding non-essential tasks.
Arthritis in the hands and arms can be particularly problematic for an individual whose job requires repetitive hand function such as factory assembly or typing. There are a number of adaptive tools available to assist individuals with grasping and manipulating objects. These tools may be especially effective if the individual has arthritis in only one hand. Moving the individual from a job requiring finger manipulations to one requiring gross handling may be an alternative for some individuals. Computer technology provides a number of alternatives for individuals with arthritis in the upper extremities. Adaptive keyboards that reduce stress on the arms are available through most computer dealers. Additionally, a number of voice-activated computer software packages are available to reduce the amount of actual typing the individual must perform. These programs are fairly inexpensive and user-friendly.
Some individuals with arthritis have more difficulty in the morning. Providing a flexible work schedule allowing the employee to start work later in the morning may significantly improve the individual’s ability to perform work functions. Many employers allow employees to work from home. This allows employees to set a schedule that best fits their needs and provides the opportunity to change positions and take breaks when needed.
These are only a few examples of appropriate accommodations for employees with arthritis. Many accommodations can be achieved with little cost to the employer and minimal disruption of the work site. Generally, the cost of the accommodation is far less than the cost of disability payments.
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