Outfitting an office to fit employees, rather than making employees fit the office, increases productivity and reduces injuries, ergonomic consultants here say.

That includes setting up a chair, desk, and computer with great precision for an individual worker.

If a workstation has been set up correctly, "it puts you in a good position, and you don't have to hold yourself in a good position," deterring problems, says Jeannette Murphy, an ergonomics and injury-prevention specialist at St. Luke's Rehabilitation Institute.

The primary focus of ergonomics, the practice of designing workplaces and work activities to match the capabilities and limitations of the human body, is preventing musculoskeletal injuries, such as carpal tunnel syndrome, tendonitis, and back strain, all of which can occur in office settings, where repetitive actions, such as typing, reaching, and even sitting are common, she says.

Marilyn Wright, a Spokane-based occupational therapist with the Washington state Department of Labor & Industries (L&I), says that for businesses to pay proper attention to ergonomics is good for the bottom line.

Ergonomics not only improves employees' comfort, it makes their office movements more efficient and, by reducing costly injuries, also reduces absenteeism that such injuries would cause, she says.

While L&I says that rates of some work-related musculoskeletal disorders have been relatively flat or decreasing in recent years, in 2009, the department paid out $2.1 million for 377 claims of carpal tunnel syndrome alone—an average of $6,259 per claim. In addition to direct costs, the injuries resulted in an average loss of 22 work days per claim, L&I says.

Carpal tunnel syndrome occurs when tendons in the wrist swell and compress the median nerve near the palm of the hand. The condition, which L&I says is most common in computer keyboard users and assembly line workers, is caused by stress to the wrist from repetitive motions over time. Symptoms include numbness, tingling, and pain in the wrist and can progress to loss of muscle control. Severe cases are treated with anti-inflammatory drugs, splints, or surgery.

Wright and Murphy hope to prevent or reduce such injuries in the office by promoting ergonomic workplace design.

Murphy does most of her work in-house, through St. Luke's, and its parent organization, Spokane-based Inland Northwest Health Services, although she conducts workstation consultations on a fee basis.

St. Luke's has reduced its own overall musculoskeletal injury rate by 50 percent, to a rate that is well within state standards, she says.

"I've been doing workstation evaluations for years," she says. Now, she's starting to conduct evaluations in home offices for employees who telecommute.

Murphy says employers tend to update equipment and software regularly, but don't replace office furniture until it falls apart.

"Workstations often are based on old hardware," she says. "I usually find that furniture lags behind hardware."

The standard desk height used to be 30 inches, but now that keyboards are prevalent on most office desks, the desktop should be two to three inches lower to prevent strain on arms and wrists, Murphy says.

She says she conducts office assessments from the ground up, making sure workers have their feet flat on the floor or on a support when they're sitting.

Office chairsshould provide lower back support, and workers should be able to lean slightly backward with their feet flat on the floor or on a foot support, Murphy says. Chair seats also should have a horizontal adjustment, so the edge of the seat is within a couple of finger widths behind the inside of the knee joint, she says.

"Our chairs are $350 for just the basic features," Murphy says. "That causes sticker shock for employers, but chairs have to last."

People with shorter legs might need a foot support, but no one should rest their feet on the legs of a swivel chair, she says. Bending the legs more than 90 degrees for extended periods could contribute to a condition called deep-vein thrombosis, in which blood clots that form in the legs could dislodge and travel to the lungs, causing a pulmonary embolism, she says. An embolism is an obstruction of a blood vessel by the circulation of something that's abnormal, such as an air bubble.

Wright says several people recently have inquired about sitting on ball chairs, which makers claim help to strengthen and tone abdominal muscles.

"Based on research, we concluded that it isn't appropriate," she says. "It doesn't allow trunk muscles to relax, and that isn't a good work state."

Most of the office evaluations Wright conducts occur following an injury claim.

Through L&I, she also can conduct workplace evaluations upon request with the goal of preventing injuries.

"I can do more office visits ifemployers ask. It's a free service," she says.

During such evaluations, Wright looks for mismatches between workers and their workstations.

"I try to identify where people are reaching too far or too high, if they are craning their necks, or if their chairs are adjusted properly," she says.

She's finding that a lot of people don't adjust their chairs to fit.

"They never worked the levers and knobs, and don't know what position they should be in anyway," she says.

Some workstation modifications that reduce risks of musculoskeletal disorders can be inexpensive, Murphy says. "You can raise a computer screen with a ream of paper, so the top of the screen is at eye level," and that can help reduce neck strain, she says.

One recent ergonomically friendly trend is in larger computer screens that help prevent eye strain and muscle fatigue by keeping workers from having to lean forward to see what's on their screen, as happens often with smaller screens, Wright says.

Most employers and employees have realized the importance of positioning computer monitors properly, she says.

"Monitors really do have to be centered with the keyboard," she says. "They used to be tucked in a corner."

Murphy cautions, though, that a growing trend in using multiple computer screens presents new ergonomic challenges.

"Putting multiple monitors on a straight-edged desk causes awkward reading and turning," she says.

In such a case a curved, or horseshoe-shaped, desktop might be more comfortable.

Murphy, whose recent focus was on safe patient handling at St. Luke's, is planning to do more external counseling.

"I would like to do more with office ergonomics and physician workplaces," she says.

Depending on demand, Wright conducts quarterly workshops on applying workplace ergonomic concepts. The workshops are geared toward training supervisors or group leaders to help them share information with work groups.

"We prefer to train a couple of specialists in their group," she says, adding that L&I also can provide onsite training for complex problems that workshop training can't resolve.

L&I also can bring in more people if needed for larger workshops and offers online courses and tips in ergonomics, she says.