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Ergonomics

University of Virginia Library Ergonomics Evaluation Form



NAME:
DEPARTMENT:

DATE:

ERGO TEAM SIGNATURE:

EMPLOYEE CHECKLIST
  1. While working at your computer/desk, do you have any back/shoulders/neck pain? YES / NO
  2. While typing, do you have any pain in forearms/wrists/hands? YES / NO
  3. While sitting for a long period of time, do you have any legs/feet pain? YES / NO
  4. Do you have watery eyes or eye strain? YES / NO
  5. Is the lighting in your work area comfortable? YES / NO
  6. Is the air quality comfortable? YES / NO
  7. Do you take task breaks? YES / NO
  8. Do you do stretching exercises? YES / NO

HEAD/NECK BACK/UPPER BODY

  1. Are your hips and back resting comfortably against the back of the chair? YES / NO
    Your ears/shoulders/hips should be in a vertical line.

  2. Does your chair have arm rests? YES / NO
    Arm rests, when used, should comfortably support upper body and neck muscles but should not interfere with arm motions.

  3. Does your chair provide good lumbar support? YES / NO
    If not, adjust your chair backrest up/down or forward/back, or add cushion for support. Your adjustable chair height should be 15" - 21" above the floor.

  4. Does your chair have a waterfall (front edge curves downwards) seat? YES / NO
    A waterfall seat prevents discomfort behind the knees.

  5. Does the seat of your chair fit you? YES / NO

FOREARMS/WRISTS/HANDS

  1. Do you have a wrist rest? YES / NO

  2. Do you feel that you need a wrist rest? YES / NO
    A padded wrist rest may help support the wrists/palms during rest periods.

  3. Are your elbows bent at a 90? angle? YES / NO

  4. Is your desk height comfortable? YES / NO
    Desk height should be 29" - 30" (keyboard tray should be 3" lower).

  5. Is your keyboard at a comfortable height and angle? YES / NO

  6. Is your mouse placed next to the keyboard? YES / NO
    An adjustable mouse platform with wrist rest may help.

LEGS/FEET

  1. Are your feet flat on the floor? YES / NO
    You should have 2" of space between the front edge of chair to back of knees.

  2. Do you have a foot rest? YES / NO
    A foot rest may help increase circulation in legs, relieve stress on back and keep legs at a comfortable angle.

  3. Are your thighs parallel to the floor? YES / NO
    Your knees should be level to or slightly higher than your hips.

EYES

  1. Is the top of your monitor screen at eye level? YES / NO

  2. Do you wear bifocals? YES / NO
    The distance between your eyes and screen should be approximately arm's length (24"). If you wear bifocals, you may need to lower your monitor. Monitor platforms may be used to adjust screen height.

  3. Do you wear contacts? YES / NO
    Ask your doctor if he recommends using rewetting drops while you are working at the computer.

  4. Do you have glare on your screen? YES / NO
    Change direction of screen or workstation to reduce light from outside or overhead. A shading hood or anti-glare screen may also help.

  5. Is your monitor directly in front of you (not off to one side)? YES / NO

  6. Do you use a copy holder? YES / NO
    Adjustable copy holder will help place materials at desired distance and angle.

ENVIRONMENT/PERSONAL

  1. Do you use a task light for reading? YES / NO
    Task lighting may help to reduce glare/reflection.

  2. Is the air quality comfortable? YES / NO
    Adjust air vents. Reduce sunlight by pulling shades/blinds down. Make sure air filters are cleaned regularly.

  3. Do you include non-computer related tasks in your workday? YES / NO
    Other task, examples of that do not include keyboarding are, i.e. reading, filing, etc.

  4. Do you include stretching and eye exercises during your work day? YES / NO
    There are examples of these exercises on the WorldWideWeb (See "Stretch Breaks")


COMMENTS:














STATEMENT: "MY SIGNATURE INDICATES THAT I REALIZE THESE ARE RECOMMENDATIONS THAT MAY ASSIST ME TO ELIMINATE INJURIES THAT MAY OCCUR ON THE JOB. I WILL TAKE THESE RECOMMENDATIONS INTO CONSIDERATION."

Signature:

Date:

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