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<td><a href="https://misportal.jlab.org/ll/index.jsf?function=view&lessonId=1140">ENG-1-0125 Repetitive Work Results in Tennis Elbow Injury</a></td>
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<h2 style="white-space:nowrap">Statement of Lessons Learned</h2>
<pre>On January 25, 2021, a Thomas Jefferson National Accelerator Facility (TJNAF) Machine Shop employee was diagnosed with tennis elbow in his right (dominant) arm after performing a majority of his assigned work on a manual lathe for three weeks. Activity required for the work included intermittent gripping, pulling and manual adjustments to material. The injury resulted in restricted work assignments.</pre>
<h2 style="white-space:nowrap">Discussion of Activities</h2>
<pre>The majority of the Machine Shop work assigned to the employee from January 4-25, required using a manual lathe (see photo attached). Typical work pieces for this machine are not heavy but require significant manual interactions, including drilling, use of a cheater bar, chuck tightening, adjustment of knobs and levers, and movement of the tail stock (up to 20lbs). Additionally, a typical work piece takes approximately four hours from start to finish. The employee intermittently performed other tasks on other equipment in January, but the majority of his assignments were performed using the manual lathe.
On January 13, the employee visited an external medical provider for a pre-existing condition where he told the provider about elbow pain, swollen knuckles and tendon roll-over. The provider gave no restrictions at that time. Several days later, the shop supervisor and employee had a discussion regarding the type of work and volume being performed, but there was no direct inquiry or mention of pain or injury. There was no further communication on the topic until the employee gave the supervisor an externally prescribed work restrictions on January 25.
</pre>
<h2 style="white-space:nowrap">Analysis</h2>
<pre>Investigation of this event determined that the change in assigned equipment and the anticipated time required per piece should have prompted a work planning control review with the objective of preventing a repetitive motion injury (ergonomic hazard). Note: Part of TJNAF work planning control review requires a review of lessons learned of which there are four previous notable events relating to "tennis elbow" dating back to 2013. All of which determined the root cause of the injuries to be related to ergonomic issues.
Job Scoping - There was no established prompt or process by which the supervisor or employee would recognize, thus properly mitigate, the circumstances that lead to the repetitive motion injury.
Communication was Less than Adequate - There was no established prompt or process for the employee to tell the supervisor that he was experiencing elbow pain, even though it was discussed with an external medical provider
</pre>
<h2 style="white-space:nowrap">Recommended Actions</h2>
<pre>Develop, implement or revise existing work planning process to account for work in the que, machine assignment, task proficiency, and expected length of time for work to be completed. When appropriate, include relief measures such as task rotation, alternate tool use, and regular scheduled rest breaks.
Communicate to all major department supervisors the expectation that employees, who suspect or are experiencing pain during work, are to promptly communicate this to the supervisor.
Work with Occupational Medicine and the training department to develop an "Ergonomics of the Upper Body" awareness module for supervisors and employees so they are better able to recognize and include in work planning mitigation techniques to relieve ergonomic issues on the job.
Conduct an extent of condition review on all previous ergonomic related work restriction cases that includes a causal analysis to determine mitigating actions going forward.
</pre>
<h2 style="white-space:nowrap">JLab Preventive Measures</h2>
<pre>See Recommended Actions above.</pre>
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<h2>Comments</h2>
<h5 style="white-space:nowrap">3/19/2021 8:14:14 AM by Bailey, Mary Jo</h5>
<pre>Submitted to individuals current in:
SAF607: HAND TOOLS & LADDER SAFETY
MED05: Understanding of the ergonomics and techniques for lifting heavy objects safely</pre>
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<legend>Summary</legend>
<table>
<tr class="row">
<td class="label" nowrap>Lesson ID:</td>
<td class="dataval">1140</td>
</tr>
<tr class="row">
<td class="label" nowrap>Status:</td>
<td class="dataval">OK</td>
</tr>
<tr class="row">
<td class="label" nowrap>Doc ID:</td>
<td class="dataval">2021-JLAB-1140</td>
</tr>
<tr class="row">
<td class="label" nowrap>Priority:</td>
<td class="dataval">Caution</td>
</tr>
<tr class="row">
<td class="label" nowrap>Safety Related:</td>
<td class="dataval">YES</td>
</tr>
<tr class="row">
<td class="label" nowrap>Originator:</td>
<td class="dataval">Bailey, Mary Jo</td>
</tr>
<tr class="row">
<td class="label" nowrap>Issued:</td>
<td class="dataval">3/19/2021 7:57:40 AM</td>
</tr>
<tr class="row">
<td class="label" nowrap>Approved By:</td>
<td class="dataval">Bailey, Mary Jo</td>
</tr>
<tr class="row">
<td class="label" nowrap>Approved On:</td>
<td class="dataval">3/19/2021 8:14:14 AM</td>
</tr>
<tr class="row">
<td class="label">Source:</td>
<td class="dataval">
TJNAF NE
</td>
</tr>
<tr class="row">
<td class="label" nowrap>Location:</td>
<td class="dataval">TJNAF</td>
</tr>
<tr class="row">
<td class="label" nowrap>Cost Savings:</td>
<td class="dataval"></td>
</tr>
<tr class="row">
<td class="label" nowrap>Contact:</td>
<td class="dataval">Vince Pope, EngDiv, 757-269-7300, VPope@jlab.org</td>
</tr>
<tr class="row">
<td class="label" nowrap>Queued Emails:</td>
<td class="dataval">287</td>
</tr>
<tr class="row">
<td class="label" nowrap>Sent Emails:</td>
<td class="dataval">0</td>
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<tr class="row">
<td class="label" nowrap>Viewings:</td>
<td class="dataval">1 times</td>
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<li><a target="_blank" href="https://misportal.jlab.org/ll/downloadAttachment?attachmentId=5884">TJNAF Tennis Elbow-Lathe.pdf</a></li>
</ul>
<hr>
</fieldset>
<fieldset>
<legend>Hazard Issues</legend>
<ul class="lesson_attribute_listing">
<li>Ergonomics - Lifting, Carrying, Repetitive Motion</li>
<li>Machine Tools</li>
</ul>
</fieldset>
<fieldset>
<legend>Skills</legend>
<ul class="lesson_attribute_listing">
<li>SAF607: HAND TOOLS & LADDER SAFETY</li>
<li>MED05: Understanding of the ergonomics and techniques for lifting heavy objects safely</li>
</ul>
</fieldset>
<fieldset>
<legend>Distribution/Notification</legend>
<ul class="lesson_attribute_listing">
<li>*Division Safety Officers (DSOs)</li>
<li>*Safety Wardens</li>
<li>*ESH&Q Liaisons</li>
<li>*DOE Notification</li>
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