38 F is io te ra p ie , J u n ie 1983, d e e l 39, n r 2 W o r k e r “ B” prev ious ly h a d to m a k e c o n ta c t with ten people, which is un de si ra b le . C o n t a c t sh o ul d be limited to two o r less c o n st a n t people. T he eight o t h e r pe op le m us t then r e po rt to the tw o selected pe op le , w h o then r e p o r t to W o r k e r “ B” . ' An exam pl e o f m o d ifyin g e q u ip m en t/m a ch in e ry can be illustrated with reference on c e ag ain to W o r k e r “ A ” . Instead o f pa p er s lying on eit he r side o f a ty pew riter, use o f a di ct a p h o n e w oul d re qu ire less b o d y m o v e m e n t a n d the a rm s are then kept in the mid-p ositio n. O th e r exam pl es are designing jigs for m ac h i ne r y o r f o r wo rk tasks to be ca rried o u t by o n e - h a n d e d wo rk er s; a n d ad vis ing em p lo ye rs a b o u t a d a p t a t i o n o f a s w it c h b o a r d f or a blind telephonist. O bvious exam pl es re g ar d i n g the m o d ification a nd rem oval o f architectural barriers are the re mo va l o f steps a n d the bui ldi ng o f r a m p s , o r the a d a p t a t i o n o f the swing d o o r to a sliding d o o r to a c c o m m o d a t e a w h e e l c h a i r- b o u n d worker. A n ex ample o f a n assistive device or aid, is a wri tin g splint, which w oul d be issued to a w o r k e r su ffering f r o m an injury t o his d o m i n a n t ha nd . P L A C E M E N T O F D I S A B L E D W O R K E R S Before final p la c em e n t, the oc cu p a ti o n a l t h er a p is t mu st ens ure th a t the w o r k e r is fully in d ep e n d en t in using public t r a n s p o r t , in h a n d li n g m o n e y a n d in p e r so n al care. H e mu st also be fully i n f o r m e d a b o u t w ha t will be exp ecte d f r o m him in the w o r k s i tu at io n, a n d be c a p a b le o f co m p l y i n g with w o r k n or m s. P la cem en ts are d o n e t h r o u g h close liaison with v o c at io n al officers o f the D e p a r t m e n t o f M a n p o w e r Ut ili zat io n, o r t h r o u g h per son al c ont act s. F ollow up is essential t o en su re th at the d i sa ble d w o r k e r ha s settled into his w o r k s i t ua ti on successfully. C O N C L U S I O N T h e role o f the o c c u p a ti o n a l th e r a p is t in the work sit u at io n , in my o p i n io n , has f o r so m e time n o w be en very m u ch with the d is ab led w o r k e r a n d n o t sufficiently with the w o r k e r w h o is at risk within the in d us tr ia l setting. T hi s st ate o f affairs, I a m sure , will g r a d u al ly ch an g e as i nd ust ry b e co m es m o r e a w a r e o f its high financ ial losses d u e to the p o o r heal th o f its wor ke rs, a n d the c o n tr i b u t io n o c c u p a ti o n a l t h e r a p y c an mak e. References C a n t o r , S. G. (1979). O c c u p a t i o n a l T h e r a p y a n d ( O c c u p a t io n a l M e di cin e — a merg er. A J O T 33, 631-634. Lew ch u c k, S. (1980). T he o c c u p a ti o n a l th e r a p is t in industry: A de ve lo pi ng challenge. C J O T 47, 159-164. AN APPLICATION OF PHYSIOTHERAPY TO SOUTH AFRICAN INDUSTRY* K A R E N E L S W O R T H , B.Sc. ( Ph ys io th e r ap y) , U.C .T. In a society whe re waiting lists are p a r t o f every ph ys io th era p y d e p a r t m e n t , as are ac ute s ho rt a ge s o f staff, it is time that p h y s io th er a pi st s b e cam e m o r e involved in a preventive role t h a n is the case at present. W h a t be tte r place t o d o this t h a n in the wo rk place where the m aj or ity o f co m p l a in t s begin a n d the m aj o ri ty o f the po p u l a t i o n are to be found. P h y s io t he r ap i st s have been fo u n d to be valuable m em be rs o f the O c c u p a t io n a l H e a l t h tea m in o t h e r co untries such as Sw eden, where th ere are over three h u n d r e d ph ysiot herapi sts in o c c u p a ti o n a l health, an d n u m b e r s are growing. Thes e t her ap ist s spen d their time involved in preventive studies a nd research o f w o r k i n g cond iti ons . They use five main topics f o r disc ussion a n d research: • Physical str ain fa ctors at wo rk , their e lim ina tio n or minim isa ti on, th eir r e la tio ns hi p to l o c o m o t o r di sorders a n d the pr e v en tio n a n d t r e a t m e n t o f such disorders. • W o r k in g p o st u r e a n d c o rre c tio n o f fact ors leading to stressful, tiring postures. • Preventive p au se gym nas tic s, use o f leisure time a n d breaks. • T h e role o f psychological fa ctors in musculo-skeletal disorders. ’ Ab str a ct o f pr oject c o m p le te d for final ye ar B.Sc. (Phy sio th er apy ). Received 17 S e p t e m b e r 1982. • E r g o no m i c s which co nc er n s the m ea su r in g o f wo rk in g place d im e n si o n s a n d w o r k e r a n t h r o p o m e t r y , well- designed mec han ic al aids a n d tools. A stud y was m a d e usin g three C a p e T o w n factories where the m an a ge r s ha d ag ree d to c o - o p e r a te wi th the following proc edu re: • All the sta ff were interviewed, as m an y were illiterate. E mp lo ye es e nt e r e d the office in dividua lly a n d were as sur ed o f the co nfidential n a tu r e o f the survey. They were a sk e d their na m e . age. o c c u p a ti o n in the fa cto ry and wh e th er they h a d any aches o r pains. If so they had to indic ate the a r ea on a n te r io r a n d p o s t e r io r d i a g r a m s o f the body. • A t o u r a r o u n d the fact or y followed the interview a n d an ex p la n at i o n was provided o f wha t each emp lo ye e or g r o u p o f em p lo y ees was doing. • O b s er v a ti o n s were m ad e a nd e ach m a j o r g r o u p of empl oy ees was assessed in th ei r wo rk sit u ati o n. • F r o m the results r e c o m m e n d a ti o n s f o r the entire fact ory , e.g. ligh ting a n d v e n ti la ti o n were made. C L O T H I N G M A N U F A C T U R E R ( F A C T O R Y A) Fifty eight per cent o f the em ployees interviewed were machinists, all female an d average age 25 - 30 years. A high incidence o f he ad a ch e , sho u ld er , u p p e r a n d low er back pain was f o un d , in that ord er. So m e lo we r leg pa in was also fo un d as m a n y o f the mach in ist s used tr ea d le m ac h in es not R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) P h y s io th e ra p y , J u n e 1983, v o l 39, n o 2 39 powe red by electricity. A list o f the m aj o r pr o b l em s o f this g r o u p fro m ass ess me nt was as follows: • P o o r sitting p o s t u re (usual po sition s t o o p e d sitting). • He ight of chair s a n d tables in ap p r o p r i at e . • Ch a irs provi de little or no s u p p o r t for l u m b a r spine. • Inco rre ct ha n d li n g te c hn iq u es (fr equ en t flexion and ro tat io n mov eme nts). • B or ed om . G a r m e n t eleaners were fo u n d to have similar pr o b l em s to the mac hinists, a n d when viewing their w o r ki ng situ ati on this was not surp ri sin g, as all were fo u n d to be in m uch the sa m e w o r k in g p o st u r e as the machinists. Pa c ke rs a n d i ro ner s were fo u n d to hav e on e main c o m pl a in t, viz. low ba ck pain. O n assessment th eir pr o bl em s was s u m m a r i se d as: • S t a n d in g mo st of the day. • Inco rre ct ha n d li n g tec hniques. FURNITURE M A N U FA CTUR ERS (FACTO RIES B AND C) The o t h er two fact ories c o -o p e r a ti n g in this st ud y were f ur n itu re m a n u f a c t u r e r s a n d were f o u n d t o have m o r e o r less the same co m p l a in t s, except for on e g r o u p o f employees. T h e r e were three main o c c u p a tio n s: • M a c h in e o p e r a t o r s • H a n d sande rs • Ge n er a l lab ou re rs. At these two fa ctories the general a t m o s p h e r e was not as plea san t as A. lighting was only fair, ve ntilatio n p o o r as the a ir was thick with sa w du st . T h e s t a f f/ e m p l o y e e re lat io ns hip was not as g ood as at A whe re all st a ff were k n o w n by na me a n d a p p e a r e d h a p p y in th e i r wo rk . Th er e was also f o u n d to be a m o r e ra p id t u r n o v e r o f s t a f f at the pine factories. The h a n d s a n d e rs at C were f o u n d to have the highest incidence o f c o m p l a in t , sho u ld e r, h a n d a n d lower back pain being the most c o m m o n . T h ei r p r o b l e m s are s u m m a r i s e d as follows: • N o w o r k in g surfaces provided. • Emplo ye es were using a r m muscles in ste ad o f body weight to s a n d objects. • N o sea ting available. • N o kn owl ed ge o f kinetic hand ling. • F r e q u e n t f l e x i o n / r o t a t i o n a n d e x t e n s i o n / r o t a t i o n mov eme nt. In c o m p a r is o n , th e h a n d s a n d e r s of B c o m pl a in e d pr im ar ily o f low b a ck pain as di d all general la bo u re rs a n d mach in is ts o f bo t h factories. B a lso ha d a hi gh incidence of h e ad a ch e a n d so re eyes. This factory h a d very long wo rk in g h o u r s a n d p o o r lighting in a small war eho us e. GENERAL R E C O M M E N D A T IO N S • E m p lo y e rs sh o u l d strive to w a r d s a be tter s t a f f /e m p lo ye e relationship. • L ighting sh o u l d be a d e q u a te p ar ticu la rly in the w a r eh o u s e of the pine factories. • T h e length of the w o r k i n g week sh o u l d not exceed forty- five h ou r s a n d rest pauses a re essential in every o c cu p a ti o n . It has be en f o u n d th at increasing the w o r k in g week sel dom increases p r o d u c ti o n . • Pause gymnastics may be i n tr o d u c e d to relieve m o n o to n y . T w o five-minute sessions o f exercise to ta p e d music with i ns tr uc ti on s e n ab l e w o r k e r s to chan ge p osi tio n a n d re tu rn to the j o b refreshed. • Possible i n t r o d u c t io n o f classes in larger c o mp an ies , dealing with specific p ro bl em s such as ba ck injuries a n d c ar d io -v as cu la r di sorders. • I n t r o d u c t i o n of b a c k g r o u n d music for time periods t h r o u g h o u t the day. R E C O M M EN D A TIO N S ON P O STU R E • S t a f f sh o ul d be advis ed on the use o f c ush io ns to su p po rt the l u m b a r spine. • W her e chai rs are t o o high, the legs can be s ho r te ne d to the co rre ct height. • All st af f s h o u l d be t a u g h t the basics of g o o d s t a n di ng a n d si tting posture . • I n st r u c ti o n sh o u l d be given on ho w to relax the muscles o f the sh o ul de rs , neck, a n d u p p e r back. • Co r re ct h a n d li n g tech niq ues s h o u l d be t a u g h t to all staff. In c o n c lu si on , ph ys io th er a p is ts are t rai ned in the principles o f a n a t o m y , physiology and psychology. In a dd iti on the pr e ven tio n of strain, stress, a n d ove ru se needs to be emph as ize d. A p o s t - g r a d u a t e co ur se has been established at U.C .T . f r om 1983. O c c u p a t io n a l p hy si o t h e r a p y will be the area o f the fu t u r e as p o p u l a t i o n s a n d in dustries co n tin u e to grow. BOOK REVIEW M A L A R IA W hat you should know about it Obtainable free from: Departm ent o f Health, Welfare & P ensions (Liaison Services), Private Bag X63, Pretoria 0001. A booklet that gives brief and readable inform ation about the history, geographical distribution, transm ission and epidem iology, clinical picture, prevention and control o f malaria. Suitable for lay readers. M A L A R IA Wat u daarom trent behoort te weet Gratis verkrygbaar van Departem ent van Gesondheid, W elsyn en P ensioene (Skakel-dienste), Privaatsak X63, Pretoria 0001. ’n Boek wat kort en leesbare inligting oor die geskiedenis, geografiese vespreiding, oordrag en epidem iologie, kliniese beeld, voorkom ing en beheer van malaria gee. Geskik vir lekelesers. R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. )