SurgiTel Ergo Practice News

Approach to Clinical Ergonomics/Safety: Identifying Ergonomics/Safety Gaps

ErgoPractice News – June 2015 – Article 2
By Jin Chang PhD

Large industrial organizations have ergonomics/safety program managers who continue to improve their ergonomics programs for the safety of their employees and to increase productivity. First, they identify gaps between where they are and where they want to be. Then they identify ergonomic tools to reduce the gaps and implement the ergonomics/safety programs. The successful implementation of ergonomics/safety programs most often includes a series of training.

However, there are no ergonomics/safety program managers for clinicians. Therefore clinicians have to identify their own ergonomics/safety gaps and search on their own for the ergonomic tools to eliminate or reduce the ergonomics gaps.

The first step of the gap analysis is to identify the ergonomic gaps in your practice. In order to find ergonomic gaps, you may start by asking yourself these questions:
  • Do I hunch to improve my vision? Getting closer to objects help us see better, but working such postures will create chronic neck and back pain.
  • Am I tilting my head too much? / Do my loupes force me to excessively tilt my head? The recommended head tilt to prevent neck pain and injuries is less than 20-degrees. Most traditional loupes may excessively force you to tilt your head.
  • Am I squinting to see? Generally, most overhead lights are too bright when we use loupe-mounted headlights. You will know your overhead light are too bright if they overpower your headlight and are straining to see details.
  • Do my headlights help me see anatomical details I need to see for my procedures? LED headlights have become very popular and this technology allows for several types of LED lights: neutral, cool, and extremely cool. In general neutral LED lights offer better color accuracy, but for certain surgical procedures, cool or extremely cool lights may enhance certain anatomical features.
  • May my headlight or overhead lights be hurting my eyes? Bright light with a strong blue spectrum or dispersed blue lights may be damaging your eyes over time. Achromatic beams will be the safest to eyes.
  • Does my stool help me work with a neutral posture? If you sit for procedures, the selection of the right ergonomic stools is very important for neutral lower back posture support.

Young clinicians may be able to work with poor ergonomics for a long before noticing the damage they are doing. Then, by the time chronic pain or injuries are felt, much damage may have been done. Many young clinicians think they do not have any ergonomics gaps because they do not feel strong pain. For long-term health, we should pay attention to clinical ergonomics while we are healthy. When you get injured, it could be too late.

The following are some helpful resources about these topics which may help answer your questions and there is information on ergonomics consultants who may help you find your ergonomic gaps and help implement an ergonomic practice for the relief of your pain and for the protection of your long-term health.


Ergonomic References

  1. Pulsat, BM, Fundamentals of Industrial Ergonomics (ISBN 0-88133-889-0), Waveland Press, Inc., Prospects Heights, IL, 1996
  2. Murphy D, Ed, Ergonomics and the Dental Care Worker, Am Public Health Assoc, Washington DC, 1998
  3. Pollack-Simon, L, All the Right Moves, Dental Economics-PennWell Corp., Tulsa, OK, 2002
  4. Valachi B, Practice dentistry pain-free, Posturedontics Press, Portland, OR, 2008,
  5. Chaffin DB, Localized muscle fatigue: definition and measurement, J Occupation Med 15(4): 346-354, 1973
  6. Rucker LM, Surgical telescopes: posture maker or posture breaker? In, Murphy D, ed, Ergonomics, and the dental care worker. Am Public Health Assoc, Washington DC, 1998, 191-216
  7. Chang BJ, Ergonomic benefits of surgical telescopes: selection guidelines, J Cal Dental Assoc, Vol.30.No2., 2002: 161-169Bethany’s article
  8. Chang, BJ, Declination Angle: The Key Factor for Custom Loupes, Oral Health, July, 2014, 46-49.
  9. Practicing Dentistry Pain-Free, September 2014, by Timothy J. Caruso, PT, MBA, MS,
  10. CAPublicHealth. “Video 4 Loupes: Looking Closely at Our Choices.” YouTube. California Department of Public Health, 30 Sept. 2014. Web. 29 June 2015.
  11. Ergonomics Best Practice:
  12. Surgery and Ergonomics, Ramon Berguer, MD; Arch Surg. 1999; 134(9):1011-1016. doi:10.1001/archsurg.134.9.1011
  13. Surgeons experience more ergonomic stress in the OR, Jeannie Glickson, Bulletin, American College of Surgeons, April 1, 2012
  14. Assessing Posture in Surgery: Video Sampling of Microsurgery, Denny Yu(1), Adam Frischknecht(2), Cooper Green(1), Steven Kasten(2), Thomas J. Armstrong(1); (1)University of Michigan, Industrial and Operations Engineering; (2)University of Michigan Hospital; Proceedings of the Human Factors and Ergonomics Society Annual Meeting September 1, 2013, 57: 1790-1794
  15. Clinicians Report, Smaller and lighter LED headlamps, A Publication of CR Foundation, April 2012,
  16. Clinicians Report, Is your LED headlamps damaging your eyes?, A Publication of CR Foundation, March 2013,
  17. Price Curing Lab. “The Blue Light Hazard in Medicine and Dentistry.” YouTube. Price Curing Lab, 22 July 2012. Web. 24 Apr. 2015. <>.
  18. Clinicians Report, Infection Control Challengers with Dental Loupes and Headlights, A Publication of CR Foundation, February 2015,


Ergonomics Consultants who analyze your working postures and help improve your working postures are:

Be sure to stay tuned to the ErgoPractice News as better ergonomic tools and techniques are being developed. The next time you upgrade your cellphone or your computer, ask yourself ‘have I upgraded my loupes, lights, or other tools recently for my health?’

And if you find yourself caught up in investment costs, consider how much you have invested in your car versus how much time you spend using it. Now think about how many hours a day you use your loupes and headlights. Shouldn’t you continue to invest in your patient care and personal health?