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80LARC20Q0001

NASA intends to release a solicitation for Langley Research Center’s (LaRC) Occupational Health Program Support requirement.

Intent of the Draft Request for Quote- NASA is still in the process of finalizing its requirements, solicitation parameters, and acquisition strategy for this procurement. In an effort to inform this process, NASA is releasing this draft RFQ to give industry an opportunity to provide feedback on any aspect of the pending solicitation. The DRFQ is not a solicitation. NASA strongly encourages industry to carefully review this draft and identify any areas of ambiguity, inconsistency, or any other material concerns.

Information Requested from Industry NASA requests that interested entities submit information on company letterhead with proprietary markings and restrictive legends as appropriate. NASA will not disclose the specific feedback received from one firm with other interested entities. Respondents are requested to focus on those areas of the draft RFQ identified below, as well as any major areas of concern identified by the respondent regarding NASA’s approach. NASA will consider all feedback submitted and is not putting a page limit on responses to this RFI.

1. Exhibit A: Performance Work Statement– Please provide feedback on the requirements, including unnecessary or inefficient requirements.

2. Representations, certifications, and other statements of quoters or respondents Anticipated NAICS Code 621999 for this procurement.

3. Tab 04 Quote Instructions & Evaluation - Section A: Instructions, Conditions, and Notices to Quoters; and Section B: Evaluation Factors for Award

• A.15 (d) Relevancy details the technical performance areas that are intended to serve as the primary focus of the past performance evaluation.

• The following are ESTIMATED key milestone dates (NOTE: These are estimated dates only and may change at any time. Any significant changes will be posted to beta.sam.gov):

Milestone Date Industry Comments Due (DRFQ) January 17, 2020 RFQ Issuance February 7, 2020 Site Visit February 18, 2020 Quotes Due March 10, 20202 Award June 3, 2020

• B.3 Basis for Award and B.4 Method of Evaluation.

In light of this procurement strategy, NASA encourages potential quoters to take advantage of the opportunity presented through this draft RFQ to give all necessary feedback to NASA before the terms and conditions of the solicitation are finalized.

Please submit your comments/questions by 12:00pm Eastern Time on 17 January 2020 to larc-clinic2@mail.nasa.gov.

mailto:larc-clinic2@mail.nasa.gov

Information Requested from Industry

Please submit your comments/questions by 12:00pm Eastern Time on 17 January 2020 to larc-clinic2@mail.nasa.gov.

Verify the correct version before use by checking the LMS Web site.

Langley Procedural Requirements

LPR 1845.1 C

Effective Date: November 14, 2016

Expiration Date: November 30, 2021

Subject: Automated External Defibrillator Program Responsible Office: Safety and Mission Assurance Office

CONTENTS

PREFACE

CHAPTER 1 – INTRODUCTION

CHAPTER 2 – RESPONSIBILITIES

CHAPTER 3 – TRAINING AND SKILLS COMPETENCY REQUIREMENTS

CHAPTER 4 – RESPONSIBILITIES FOLLOWING USE OF AN AED

CHAPTER 5 – AED CASE REVIEW

CHAPTER 6 – INTERVIEW WITH AED RESPONDER(S)

CHAPTER 7 – AED INCIDENT REVIEW

CHAPTER 8 – MAINTENANCE OF AED EQUIPMENT

CHAPTER 9 – PRACTICE SESSIONS

CHAPTER 10 – RECORD KEEPING

CHAPTER 11 – ANNUAL QUALITY ASSURANCE REVIEW

CHAPTER 12 – AED PROTOCOL

APPENDIX A – DEFINITIONS

APPENDIX B – ACRONYMS

APPENDIX C – AED PROTOCOL

November 14, 2016 LPR 1845.1 C

PREFACE

P.1 PURPOSE

a. The purpose of the Automated External Defibrillator (AED) Program is to provide timely response to victims of sudden cardiac arrest caused by ventricular fibrillation.

Coronary heart disease is the leading cause of death in the United States.

b. The American Heart Association (AHA) estimates that 250,000 Americans die each year from sudden cardiac death as a result of coronary artery disease.

Sudden cardiac death due to ventricular fibrillation is a treatable condition and potentially survivable, when defibrillation is applied within the first minutes.

c. The quick response of emergency medical services (EMS) personnel in a community can have a significant impact on survival rates from cardiac arrest.

d. The use of an AED and properly performed cardiopulmonary resuscitation (CPR), early recognition, and application by trained lay rescuers can improve the outcome from cardiac arrest.

P.2 APPLICABILITY

a. This LPR is applicable to all NASA Langley Research Center (LaRC)

Organizations and all Federal civil service personnel on center.

b. This LPR is applicable to contractors, grant recipients, or parties to agreements only to the extent specified or referenced in the appropriate contracts, agreements, or grants.

c. In this directive, all mandatory actions (i.e., requirements) are denoted by statements containing the term “shall.” The terms: “may” or “can” denote discretionary privilege or permission, “should” denotes a good practice and is recommended, but not required, “will” denotes expected outcome, and “are/is” denotes descriptive material.

d. In this directive, all document citations are assumed to be the latest version unless otherwise noted.

P.3 AUTHORITY

Public Health Improvement Act, Title IV – Cardiac Arrest Survival, Pub. L. No. 106-505, November 13, 2000.

P.4 APPLICABLE DOCUMENTS AND FORMS

a. 74 Federal Register 41133 (August 14, 2009).General Services Administration

Guidelines for Public Access Defibrillation Programs in Federal Facilities

b. NPD 1800.2, NASA Occupational Health Program

c. NPR 1800.1, NASA Occupational Health Program Procedure

d. LAPD 1150.2, Councils, Boards, Panels, Committees, Teams and Groups.

e. LAPD 1440.7, Langley Research Center (LaRC) Records Management

f. LF 483, Monthly Automated External Defibrillator (AED) Safety Maintenance

Inspection Record (for Med Tronic and Philips AEDs)

P.5 MEASUREMENT/VERIFICATION

None

P.6 CANCELLATION

Cancels LPR 1845.1 B, Automated External Defibrillator Program, dated October 25, 2011.

Clayton P. Turner 11/14/2016 Deputy Center Director Date

DISTRIBUTION

Approved for public release via the Langley Management System; distribution is unlimited.

CHAPTER 1 – INTRODUCTION

This document outlines the requirements for all persons participating in the Langley Research Center (LaRC) Automated External Defibrillator (AED) program. All fully trained and certified AED responders are to be authorized and approved by the Medical Director to operate AEDs. The program does not replace LaRC Emergency Medical Services.

CHAPTER 2 – RESPONSIBILITIES

2.1 AED Responders

2.1.1 AED Responders are lay persons who have received training and passed testing requirements of the AHA and are qualified to perform CPR and use an AED. AED responders shall:

a. Receive AED/CPR Responder training and pass testing requirements of the AHA to qualify to perform CPR and use an AED.

b. Participate in a minimum of one of the quarterly practice sessions scheduled throughout the year by the AED Coordinator (AED-C) and approved by the AED Medical Director (AED-MD).

c. Notify the AED-C of current training status and facility location.

d. Notify the AED-C of any equipment problems.

2.1.2 A list of approved AED responders shall be maintained by the AED-C and posted at each AED location.

2.2 AED Medical Director

2.2.1 The AED-MD is the physician responsible for management and implementation of the AED Program. The AED-MD shall:

a. Assist in choosing the appropriate AED for use at the Center. The Food and Drug

Administration (FDA) currently requires a physician’s prescription to buy an AED.

b. Maintain guidelines for care protocols and processes for operations of the program.

c. Ensure quality assurance, compliance with protocols and proper training.

d. Provide positive reinforcement to trained AED responders, as well as corrective instruction.

e. Ensure critical incident de-briefing for AED responders.

f. Support integration of the Center’s AED program into the community Emergency

Medical Services (EMS).

g. Report equipment malfunction and incidents to the Center Occupational Health Officer (COHO) for referral to the LaRC Safety and Mission Assurance Office, NASA’s Office of Safety and Mission Assurance, Agency Occupational Health Program (OHP) and the FDA Medical Devices Reporting department.

2.3 AED Coordinator

2.3.1 The AED-C is an individual identified by the AED-MD to oversee the AED Program at LaRC and is responsible for coordinating activities and functioning as the primary liaison between the AED-MD and the program. The AED-C shall:

a. Maintain equipment according to manufacturer’s directions.

b. Maintain and inventory of supplies.

c. Maintain and publicize through various mediums (web, facility and safety heads, supervisors, etc.) a list of trained responders throughout the Center.

d. Maintain current training records in accordance with LAPD1440.7.

e. Ensure that appropriate written documentation and post incident debriefing sessions for any employees involved are completed.

2.4 Basic Life Support (BLS) Instructor

2.4.1 BLS instructors are persons certified as an AED and CPR instructor by the AHA.

BLS instructors shall:

a. Teach a minimum of four classes in a two-year period.

b. Attend quarterly instructor meetings with the AED-C.

c. Assist the AED-C in performing and evaluating practice sessions.

2.5 Employee Assistance Program (EAP)

2.5.1 The EAP shall offer stress debriefing for the AED responder following an incident.

2.6 Emergency Medical Services

2.6.1 EMS is a team of on-site emergency medical technicians (EMTs) with Advanced Cardiac Life Support (ACLS) training who shall assume responsibility for transporting patients to the nearest emergency room.

2.7 AED Control Committee

2.7.1 The AED Control Committee is a group of NASA civil service and contractor employees who will assist the AED-MD with all aspects of the AED Program. The AED Control Committee shall:

a. Meet at least biannually, after an event involving use of an AED, and upon the request of the AED-MD.

b. Determine appropriate placement of AED units throughout the Center.

c. With the concurrence of the AED-MD, make changes to the requirements of the

AED program based on lessons learned or changes in NPD 1800.2C or NPR 1800.1C.

2.7.2 The AED Control Committee shall consist of the following members:

a. AED-MD

b. AED-C

c. Head, Safety and Facility Assurance Branch/Safety Official

d. Occupational Health Officer

e. Union Representative

2.8 LaRC Supervisors

2.8.1 It is highly recommended that LaRC Supervisors incorporate AED awareness briefings annually as part of their monthly safety and/or staff meetings. Awareness should include AED locations, identification of AED responders, emergency numbers, and review of AED protocol. Assistance can be obtained from the AED-C.

CHAPTER 3 – TRAINING AND SKILLS COMPETENCY REQUIREMENTS

3.1 General training for LaRC AED Responders

a. AED responders shall complete the AHA Heartsaver AED and CPR course every two years.

b. All AED training equipment shall be specific to the AED equipment used on the

Center.

c. Quarterly practice sessions with the AED will be offered in accordance with AHA guidelines.

3.2 Initial Training for AED Responders

Initial training shall be in accordance with the AHA standards and include the following:

(1) Early activation of the EMS through calling 911 from a LaRC landline or 757- 864-2222 from a cell phone.

(2) How to perform rescue breathing using mouth-to-mouth and mouth-to-mask techniques.

(3) How to perform one-rescuer CPR on an adult victim.

(4) How to relieve adult foreign body airway obstructions in a conscious and unconscious victim.

(5) How to provide defibrillation with an AED in less than 90 seconds from placement at the training mannequin’s side.

(6) Recognizing the signs and symptoms of four major emergencies: heart attack, cardiac arrest, stroke and foreign body airway obstruction.

(7) Awareness of the links in the AHA chain of survival: Recognition of Cardiac Arrest and Activation of EMS, Early CPR, Rapid Defibrillation, Effective Advanced Life Support, and Integrated Post-Cardiac Arrest Care.

(8) Completion of a skills evaluation for CPR techniques and use of the AED.

3.3 AED Responder Re-Training

3.3.1 Re-training is required every two years.

3.3.2 Each AED Responder shall attend training sessions to maintain skills.

3.3.3 The AED-C shall be responsible for scheduling training and recording participation.

3.3.4 Re- training shall consist of the following:

a. Demonstration of AED use during a simulated case of ventricular fibrillation.

b. Demonstration of adult CPR techniques.

c. Knowledge of AED inspection procedures using LF 483, Monthly AED

Safety/Maintenance Inspection Record.

d. Satisfactory completion of a skills evaluation.

3.3.5 Any AED Responder who fails to attend and successfully demonstrate the above requirements shall no longer be certified as trained to use the AED until the above requirements are met.

3.3.6 Remedial training and evaluation results shall be reviewed by the AED-C and

AED-MD.

3.3 Responders Certified Outside of LaRC

a. Any employee who has not been certified to use an AED by the AED-MD and who has completed requisite training shall be certified by providing the following:

(1) Provide proof of successful completion of an AHA certified program.

(2) Possesses a current certification (within past 2 years).

(3) Satisfactorily perform the skills demonstration requirements stated within this section.

CHAPTER 4 – RESPONSIBILITIES FOLLOWING USE OF AN AED

4.1 When electrodes are applied to a patient and the AED is turned on, it shall constitute “use of the AED.” After any use of the AED, the Safety and Facility Assurance Branch shall ensure the AED is turned in to the LaRC Occupational Health Clinic (clinic) for transfer of data. If the clinic is closed, the AED shall be brought to the clinic on the next business day.

4.2 A hard copy of the data captured from the AED by either the AED-C or AED-MD shall be submitted to the AED Control Committee.

4.3 The AED responder shall notify the AED-MD and the AED-C immediately following use of the AED by calling 757-864-3192, and shall provide written documentation (i.e. recording of date and time, notifications, crowd control, escorting of EMS) as soon as possible on the day of the incident, but no later than the beginning of the next business day, to the AED-C who will determine if a critical incident debriefing is required.

4.4 Employee Assistance Program counselors shall be available to responders in the event of a critical incident. Responders shall respect the privacy of others and enforce confidentiality of the incident while advising only those on a need to know basis.

CHAPTER 5 – AED CASE REVIEW

5.1 The AED-C shall take the following actions after each emergency incident involving use of the AED:

a. Verbally notify members of the AED Control Committee of the incident and follow up with written documentation prior to the end of the business day of the incident, but no later than the beginning of the next business day. Such information should include the case outcome.

b. Conduct employee incident debriefing in accordance with Chapter 6.

c. Complete an incident follow-up report as deemed necessary by the AED-MD.

d. Restock any reusable items e.g. electrode pads, batteries, gloves, etc. Inspect unused supplies for any damage or expiration dates.

e. Inspect the AED for dirt and contamination and clean it as needed by following the procedures listed in the User’s Guide.

CHAPTER 6 – INTERVIEW WITH AED RESPONDER(S)

6.1 After the use of an AED or performing CPR, the AED-C shall contact the Employee Assistance Program office to schedule a stress debriefing for the responder(s). It is essential to allow AED responders the opportunity to talk through the event with program professionals and counselors after a crisis.. In addition, the NASA mishap investigation team may be used if the incident was caused by an accident.

6.2 The AED-C or the AED-MD shall review in person with the primary AED responder detailed information about the incident as soon as possible.

CHAPTER 7 – AED INCIDENT REVIEW

7.1 Any AED program deficiencies identified by the AED-C shall be promptly brought to the attention of the AED-MD for analysis and resolution.

7.2 Defects and deficiencies noted in the AED unit shall be followed by:

a. Completing an incident report and forwarding it to the AED-MD.

b. Placing the defective AED out of service until it is inspected and repaired by an authorized service representative.

c. Completing the Safety/Maintenance Inspection Record addressing the problem.

d. Presenting the incident report and inspection record to the AED Control

Committee.

CHAPTER 8 – MAINTENANCE OF AED EQUIPMENT

8.1 The AED-C shall ensure the LF 483 is completed on a monthly basis for all AEDs to assure the equipment is in proper working condition.

8.2 AED responders throughout the Center shall notify the AED-C immediately if they hear a chirping alarm being emitted from an AED, as this alarm is a warning the AED has noted a deficiency during a daily internal systems check.

8.3 The AED-C shall maintain a corrected LF 483.

CHAPTER 9 – PRACTICE SESSIONS

9.1 The AED-C shall schedule quarterly practice sessions at randomly selected facilities to allow for hands-on practice using established emergency procedures and to evaluate AED responders’ performance.

9.2 The objective is to have all certified responders attend a minimum of one practice session within a year period.

9.3 The AED-MD shall evaluate practice sessions and implement improvements to emergency processes and protocols.

CHAPTER 10 – RECORD KEEPING

10.1 The AED-C shall maintain written records of team member training and practice sessions.

10.2 Written documentation shall be maintained for daily, weekly, and post-use inventories, incident responses, and response outcomes.

10.3 All documentation on training, maintenance procedures, and practice sessions shall be maintained in accordance with LAPD 1440.7 and retained for two years.

10.4 Documentation of emergency responses shall be retained indefinitely.

CHAPTER 11 – ANNUAL QUALITY ASSURANCE REVIEW

11.1 To ensure ongoing quality assurance, the AED-C shall prepare an annual evaluation of the Center AED Program for the AED Committee that addresses the effectiveness of the following:

a. AED Training program

b. Quarterly practice sessions and team member feedback

c. Performance and maintenance of AED equipment

d. Emergency responses

e. Identification and implementation of process improvements

f. Documentation of outcome measures for treated victims of cardiac arrest

11.2 Interim reports shall be submitted on a quarterly basis to the AED-MD and Occupational Health Officer for review.

CHAPTER 12 – AED PROTOCOL

12.1 The AED protocol can be found in Appendix C.

12.2 Any deviation from this protocol shall be reported to the AED-C.

APPENDIX A – DEFINITIONS

Case Reviews – A continuing education program conducted by the Medical Director whereby each rescue effort is reviewed and evaluated as part of the Quality Assurance Program.

Medical Protocols – Specific procedures to be followed when using an AED, based on manufacturer’s instructions and medical guidelines.

APPENDIX B – ACRONYMS

ACLS Advanced Cardiac Life Support AED Automated External Defibrillator Program AED-C Automated External Defibrillator Coordinator AED-MD Automated External Defibrillator Medical Director AHA American Heart Association BLS Basic Life Support COHO Center Occupational Health Officer CPR Cardiopulmonary Resuscitation EAP Employee Assistance Program EMS Emergency Medical Services EMT Emergency Medical Technicians FDA Food and Drug Administration LPR Langley Procedural Requirement LAPD Langley Procedural Directorate LARC Langley Research Center LPR Langley Procedural Requirement NPD NASA Procedural Directorate OHP Occupational Health Program

APPENDIX C – AED PROTOCOL

• Check the victim for a response (no longer than 10 seconds)

• Locate phone, dial 911 from a LaRC landline or (757) 864-2222 from a cell phone to obtain Emergency Medical Services (EMS) support

• Locate AED and Responder

• Send someone to direct EMS to victim

• Begin CPR starting with compressions

• Give cycles of 30 compressions (at a depth of a 2 to 2.4 inches) and 2 breaths (1 second each)

• Push hard and fast (at least 100-120 compressions/minute) and release chest completely between compressions

• AED Arrives

• Open the AED and turn it on

• Place pads on victims chest

• Clear victim to analyze

• Follow the AED voice prompts

• Continue CPR until EMS takes over or victim starts to move

PREFACE

CHAPTER 1 – INTRODUCTION

CHAPTER 2 – RESPONSIBILITIES

CHAPTER 3 – TRAINING AND SKILLS COMPETENCY REQUIREMENTS

CHAPTER 4 – RESPONSIBILITIES FOLLOWING USE OF AN AED

CHAPTER 5 – AED CASE REVIEW

CHAPTER 6 – INTERVIEW WITH AED RESPONDER(S)

CHAPTER 7 – AED INCIDENT REVIEW

CHAPTER 8 – MAINTENANCE OF AED EQUIPMENT

CHAPTER 9 – PRACTICE SESSIONS

CHAPTER 10 – RECORD KEEPING

CHAPTER 11 – ANNUAL QUALITY ASSURANCE REVIEW

CHAPTER 12 – AED PROTOCOL

APPENDIX A – DEFINITIONS

APPENDIX B – ACRONYMS

APPENDIX C – AED PROTOCOL

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LPR 1820.2 C

Effective Date: June 20, 2017

Expiration Date: June 30, 2022

Langley Procedural Requirements

Subject: Ergonomics Program Responsible Office: Safety & Mission Assurance Office

TABLE OF CONTENTS

PREFACE ……………………………………………………………….……………………. iii

P.1 PURPOSE……………………………………………………………………………….iii P.2 APPLICABILITY…………………………………………………………………………iii P.3 AUTHORITY……………………………………………………………………………..iii P.4 APPLICABLE DOCUMENTS AND FORMS…………………………………………iii P.5 MEASUREMENT/VERIFICATION……………………………………………………iv P.6 CANCELLATION………………………………………………………………….…….iv

CHAPTER 1. Introduction

1.1 Background

1.2 Issuance and Control

1.3 Guidance, Definitions, and Terminology

CHAPTER 2. Responsibilities

2.1 Ergonomics Program Officer (ErgPO)

2.2 Occupational Medicine Clinic (Health Clinic)

CHAPTER 3. Guidance

3.1 MSD Hazard Evaluation

3.2 Office Environments

3.3 Industrial Environments

3.4 Laboratory Environments

3.5 Non-workplace Environments

3.6 Training

3.7 Additional Information

Appendix A Definitions and Terminology

Appendix B Acronyms

Appendix C Ergonomic Injuries and Their Symptoms

June 20, 2017 LPR 1820.2 C

PREFACE

P.1 PURPOSE

a. This Langley Research Center (LaRC) Procedural Requirements (LPR) sets forth the responsibilities and procedures for the LaRC Ergonomics Program and is part of the Center’s Safety Manual. The Safety and Mission Assurance Office (SMAO) is the LaRC contact for the Ergonomics Program.

b. The Ergonomics Program is designed to provide the framework for implementing a successful program for preventing and managing Musculoskeletal Disorders (MSDs).

P.2 APPLICABILITY

a. These procedural requirements are applicable to all LaRC facilities and employees.

The requirements of this LPR are to be incorporated into any contract under which contractor employees will be assigned to on-site LaRC activities that may lead to the development of MSDs.

b. It is the responsibility of Contractors to provide and implement their own ergonomics programs. As a minimum, these contractor programs shall be in accordance with the LaRC Ergonomics program as described herein.

c. In this directive, all mandatory actions (i.e., requirements) are denoted by statements containing the term “shall.” The terms: “may” or “can” denote discretionary privilege or permission, “should” denotes a good practice and is recommended, but not required, “will” denotes expected outcome, and “are/is” denotes descriptive material.

d. In this directive, all document citations are assumed to be the latest version unless otherwise noted.

P.3 AUTHORITY

NASA Policy Directive (NPD) 1800.2, NASA Occupational Health Program.

P.4 APPLICABLE DOCUMENTS AND FORMS

a. NASA Procedural Requirements (NPR) 1800.1, NASA Occupational Health Program

Procedure

b. NPR 8715.1, NASA Occupational Safety and Health Programs

c. NPR 8715.3, NASA General Safety Program Requirements

d. Langley Procedural Document (LaPD) 1700.2, Safety Assignments and Responsibilities

e. Langley Management System Center Procedure (LMS-CP) 4760, Reporting Injuries, Illnesses, and Compensation Claims

f. National Institutes of Occupational Safety and Health, “Elements of Ergonomics Programs”

g. Langley Form (LF) 19, Office Ergonomics Evaluation Checklist

P.5 MEASUREMENT/VERIFICATION

LF 19 is used to gather data for determining compliance in assessing worksites and in coordinating with clinic personnel.

P.6 CANCELLATION

Cancels LPR 1820.2 B, Ergonomics Program, effective April 25, 2013.

/s/ Clayton P. Turner June 20, 2017 Center Deputy Director Date

DISTRIBUTION

Approved for public release via the Langley Management System; distribution is unlimited.

CHAPTER 1 - INTRODUCTION

1.1 Background

1.1.1 Every effort shall be made to ensure that the work environment affords the necessary protection against musculoskeletal disorders (MSDs). MSDs may develop in workers whose jobs involve repetitive motions, force, awkward postures, contact stress, cold temperatures, excessive duration, and vibration.

1.1.2 The principle behind ergonomics is that by fitting the job to the worker through adjusting the workstation, rotating between jobs, taking frequent breaks, or using mechanical assistive devices, MSDs can be reduced and ultimately eliminated.

1.1.3 The aim of this procedural requirement is to:

a. Identify work practices and operations that may lead to MSDs.

b. Prevent MSDs among employees.

c. Provide a work environment free from ergonomic hazards.

d. Give priority to engineering and administrative controls to the greatest extent practicable to eliminate, or control work operations that may lead to the development of MSDs.

1.1.4 Ergonomic-related injuries are usually associated with prolonged exposure to inappropriate work conditions or practices rather than acute exposure injuries such as sprains and strains.

1.2 Issuance and Control

1.2.1 The Safety and Facility Assurance Branch (SFAB) is responsible for the issuance, distribution, and control of these procedural requirements. Revisions shall be reviewed with affected organizations and documented on a Transmittal Notice.

1.3 Guidance, Definitions, and Terminology

1.3.1 Appendices A, “Definitions and Terminology”; B, “Acronyms”; and C, “Ergonomic Injuries and Their Symptoms,” are included to assist with these procedural requirements.

CHAPTER 2 - RESPONSIBILITIES

2.1 Ergonomics Program Officer (ErgPO)

2.1.1 The LaRC Industrial Hygienist is the ErgPO and is responsible for:

a. Implementing and administering the Ergonomics Program (EP).

b. Evaluating levels of employee exposure to ergonomic hazards and recommending means of controlling exposures.

c. Ensuring that personnel are instructed, individually or in groups, by knowledgeable personnel concerning the health hazards associated with repetitive motions, force, awkward postures, contact stress, cold temperatures, excessive duration, and vibration and methods to mitigate them.

d. Maintaining survey data relative to MSD hazards and employee exposures.

e. Conducting an annual review of the ergonomic program and implementing changes to ensure coverage of all potential ergonomic hazards.

f. Conferring with the Supervisor, the Office of Human Capital Management (OHCM), and the LaRC Chief Medical Officer about placement or reassignment of personnel when notification concerning an employee with a significant musculoskeletal disorder (MSD) is received from the Occupational Medicine Clinic (Health Clinic).

Requests for reasonable accommodations will be addressed via provisions in NPR 3713.1, Reasonable Accommodations Procedures, and LMS-CP-3713, Reasonable Accommodations for Individuals with Disabilities.

g. Ensuring ergonomics consultative services are provided to Center personnel.

h. Ensuring worksite evaluations are scheduled and conducted.

i. Ensuring the employee’s supervisor is notified if a significant change in workstation layout is recommended

j. Conducting follow-up evaluations for personnel who have reported to the clinic for MSDs and for personnel who have modifications made to their work place in response to a MSD complaint.

k. Reviewing LaRC injury information to determine trending of ergonomic injuries.

2.2 Occupational Medicine Clinic (Health Clinic)

2.2.1 The Health Clinic is responsible for:

a. Obtaining work histories in support of the EP, and evaluating test results.

b. Scheduling and conducting appropriate medical examinations, and/or referring personnel to an appropriate medical consultant.

c. Notifying the employee’s supervisor if a change in job assignment or workstation layout is recommended as a result of a MSD.

d. Notifying and coordinating with the ErgPO when an employee reports with an MSD.

1820.2

2.3 Supervisors

2.3.1 Supervisors are responsible for:

a. Referring to the LaRC Health Clinic for examination personnel who have a potential

MSD.

b. Ensuring that employees report to the LaRC Health Clinic any potential MSD.

c. Enforcing the wearing of personnel protective devices (such as vibration-dampening gloves, knee pads, and computer glasses) to reduce the effects of MSDs on the employee.

d. Reviewing employee work activities and identifying tasks or locations that may pose an MSD risk.

e. Abating identified MSD hazards.

f. Ensuring the procurement (including credit card purchases) of appropriate ergonomic related protective equipment and other ergonomic devices by obtaining the approval of the ErgPO.

g. Notifying the ErgPO of new or previously un-reviewed work activities that are likely to result in MSDs so that ergonomic assessments can be made.

h. Ensuring employees are aware of ergonomic hazards in their work area that could result in a MSD or requesting assistance from the ErgPo if they are unsure if ergonomic hazards are present.

2.4 Employees

2.4.1 Employees are responsible for:

a. Notifying their supervisor or the ErgPo of activities that may present a risk for MSDs.

b. Reporting to the clinic for evaluation if they believe they may be experiencing symptoms of a MSD.

c. Performing work using good ergonomic practices or requesting assistance from the ErgPo if they are unsure of proper workstation setup or good ergonomic work practices.

Chapter 3 - GUIDANCE

The recommendations for implementing the Ergonomics Program are presented in this chapter. The recommendations include training of supervisors and employees regarding common MSDs and the signs/symptoms of exposure, evaluating employee workstations for ergonomic hazards, use of ergonomic devices to reduce the likelihood and severity of MSDs, and recordkeeping.

3.1 MSD Hazard Evaluation

MSD hazard evaluation includes identifying workstation layout and work practices, which are likely to result in MSDs.

3.1.1 Work Station Evaluations

3.1.1.1 Any employee who is experiencing discomfort or is concerned about workstation setup may request an evaluation. Evaluations may also be requested by supervisors or by the LaRC Health Clinic in response to a suspected MSD. Workstation evaluations are performed by the ErgPO or their knowledgeable designee.

3.1.1.2 Copies of the results of evaluations, along with the recommended actions, shall be distributed to the employee, his or her supervisor, the Occupational Medicine Clinic (Health Clinic), and the ErgPO.

3.1.1.3 Employees are also encouraged to perform evaluations of their own workstations. (See LF 19.)

3.2 Office Environments

MSD-related injuries in the office environment are most often associated with poor workstation arrangement and excessive computer usage without taking breaks. These injuries can be prevented through proper workstation design and the use of micro-breaks.

3.2.1 Engineering Controls

3.2.1.1 Engineering controls are always the preferred method for controlling hazards.

In office environments, the primary method of control is the selection of appropriate furniture and the proper position of the furniture and office equipment in relation to the worker.

3.2.1.2 The following describes the proper method for selection and use of office equipment:

a. Chairs. When purchasing chairs, the chair selected should be fitted to the individual who will be using it. In general, chairs should be highly adjustable, allowing adjustment of the following: seat height and tilt, armrest height and width, and back rest height. Chairs being purchased to address ergonomic concerns should have good lumbar support, a five-point star base, and wheels appropriate for the floor surface. The chair height should be positioned so the occupant’s thighs are roughly parallel to the floor with the feet flat on the ground, preventing pressure on the back of the lower thigh. A footrest may be necessary to achieve proper positioning. If the seat tilt is adjustable, it should be set for a slight forward tilt. The back height and angle should be set to provide good lumbar support. The armrests should be set so the elbows are directly below the shoulders. Existing chairs will be used until unserviceable unless there are indications that their use will lead to an MSD.

b. Work Surfaces. Work surfaces should be of a height such that the worker’s forearms are roughly parallel to the floor and deep enough to accommodate all necessary equipment such as monitors and keyboards. Additionally, the working position should not require the worker’s forearms or wrists to contact any sharp corners.

Articulated keyboard trays can be used to provide adjustability to workstations. An adjustable height desk can provide the worker with the flexibility to sit or stand when desired and still be able to be productive.

c. When non-standard ergonomic furniture is needed, such as an adjustable height desk, and the cost exceeds $600, additional justification is required before the furniture can be approved. The process for initiating the justification is as follows:

(1) The employee shall notify their supervisors of their concerns.

(2) The employee shall obtain medical documentation, either from the LaRC Clinic or from a private physician, to determine if the conditions warrant the purchase of the furniture. The medical documentation shall be provided to the LaRC Occupational Medicine Clinic for retention in the employee’s medical file.

(3) Request an ergonomic evaluation from the ErgPo.

d. When non-standard furniture is needed, such as an adjustable height desk, and the cost is less than $600, the process is as follows:

(1) The employee shall notify their supervisors of their concerns.

(2) The employee shall request an ergonomic evaluation from the ErgPo.

e. Computer Input Devices:

(1) Keyboards should be located directly in front of the worker at a height allowing their forearms to be roughly parallel to the floor. In addition, the angle of the keyboard should allow the wrists to maintain a neutral position. In general, this means the keyboard should not be tilted toward the worker and may in fact need to be tilted slightly away from the worker.

(2) Computer mice and trackballs should be positioned so the worker can use them without having to reach with the shoulder. Mice should be of a size that comfortably fits in the palm of the hand. Mice should not require the user to grip them tightly in order to use them.

(3) Wrist rests may be used with both keyboards and mice/trackballs. The hands should float above the keyboard, and the wrist rests should be used during periods of inactivity.

f. Computer Monitors. Computer monitors should be positioned directly in front of the worker. The height of the monitor should be set so that the top third of the monitor is at the height of level vision. The distance of the monitor should generally be at about the end of arm’s reach when sitting in working position or what best suits the vision of the user. To avoid glare, monitors should be positioned perpendicular to windows.

g. Lighting. Room lighting should be bright enough to prevent eyestrain. Computer monitors should be positioned to eliminate glare from overhead lighting or windows.

Individual bulbs may be removed from overhead lights to control lighting intensity and glare. The use of task lighting is effective for creating areas of localized lighting without increasing the overall brightness of a room.

h. Vision

(1) Vision is an often-overlooked factor in office ergonomics. Prolonged computer usage without taking frequent breaks can cause eyestrain. Frequent “micro-breaks” are recommended, in which the worker simply changes depth of focus for a short period of time.

(2) Workers who wear corrective lenses for vision are at additional risk due to the difference in reading and computer monitor distances. The focal length for most reading eyewear is set to approximately 18 inches. Since computer monitors are usually set at farther distances, this can cause eyestrain, and in many cases causes the worker to unconsciously hunch forward in order to find their focal length. This can result in neck and shoulder strain. Eyewear can be obtained with the correct focal length for computer use. Bifocal glasses users should position the computer monitor appropriately to take advantage of the reading portion of the glasses.

3.2.2 Administrative Controls

3.2.2.1 Administrative control measures include:

a. Breaks. Taking frequent breaks is perhaps one of the easiest ways to prevent injuries associated with prolonged computer usage. A break of a few minutes should be taken frequently, i.e., 5 minutes every hour. Studies have shown that it is effective in preventing injury and that productivity and accuracy are actually improved as a result of frequent breaks.

b. Equipment. Equipment, such as braces, should not be used unless recommended by a medical professional. Do not attempt to treat symptoms yourself by buying over-the-counter braces or splints. Improper selection of protective equipment can encourage continuing poor work practices and lead to further injury. Report any symptoms of MSDs to the clinic.

3.3 Industrial Environments

3.3.1 MSD injuries in industrial environments can occur from improper lifting and material movement techniques, from performing repetitive tasks, and from using hand tools. As each industrial environment is unique, only general guidance can be provided regarding evaluation of these types of worksites.

3.3.1.1 Engineering Controls. The use of engineering controls is always the preferred method to control hazards. The primary engineering controls for an industrial setting are the use of proper material handling equipment and design of work areas to prevent awkward or stressful positions or motions. The selection of ergonomically designed hand tools is also important.

3.3.1.2 Material Handling

3.3.1.2.1 The selection of proper handling equipment can be complex and should be made in consultation with knowledgeable personnel. Situations in which material-handling aids should be considered include the movement of large, heavy or awkwardly shaped items, and work environments where employees repeatedly perform lifts.

Manual lifting requirements are discussed in Section 3.3.1.5 a.

3.3.1.2.2 Common material handling equipment includes pallet jacks, pump-jack tables and mechanical lifting aids, such as vacuum lift assist devices.

3.3.1.3 Work Area Design

3.3.1.3.1 When designing industrial work areas, the types of tasks to be performed should be considered. Shelves and parts bins should be placed at heights that keep loads at the proper working height and do not require excessive reaching, and the active working area should be directly in front of the worker.

3.3.1.3.2 Work surfaces, such as benches, should also be kept at heights consistent with the working position of the employee (e.g., sitting or standing). Standing work locations should have floor mats and stools to increase worker comfort.

3.3.1.4 Tool Selection

3.3.1.4.1 Selecting appropriate hand tools can greatly increase worker comfort and prevent injuries associated with gripping small objects. Tool handles should allow workers to keep a neutral position during use and be large enough to grip comfortably.

Hand tools should be well balanced to reduce the amount of torque on the wrist. Do not use tools with finger grooves molded into them; there is no standard hand or finger size and these tools are likely to cause unnecessary pressure from the grooves.

3.3.1.4.2 Vibrating power tools have the ability to cause nerve injury. Whenever possible, tools with built-in vibration dampeners should be selected. Tool handles should be comfortable to grip and padded when possible. Tool handles should also be set at an angle consistent with their use position. As an example, consider installing screws: To install screws vertically above waist level, using an electric screwdriver with a handle that is on the same plane as the screw will allow the wrist to maintain a neutral position.

3.3.1.5 Administrative controls. Administrative controls include:

a. Lifting Techniques

(1) When lifting objects, care should be taken to use proper lifting techniques in order to avoid back injuries. More than one person should lift objects that weigh more than 40 pounds, are large, or are awkwardly shaped.

(2) If lifting from the ground, start the lift in a squatting position with the item between the knees. Use handles if provided, otherwise position the hands in locations that will provide adequate support. Pick the item up off the ground and straighten the legs, keeping the back straight. Keep the item as close to the body as possible and at about waist level while moving it.

(3) When moving items from elevated surfaces, ensure that the lift starts as close to the body as possible and do not twist the body while lifting.

b. Rotation of Duties. Rotate lifting duties among personnel who are physically capable of performing the lifts.

c. Protective Equipment. The use of protective equipment, such as back braces or lifting belts, is not recommended by NIOSH and should not be used unless recommended by a medical professional.

3.4 Laboratory Environments

3.4.1 Laboratory environments present some unique challenges that must be addressed on a case-by-case basis. In most cases they can be considered to be a combination of office and industrial environments, and the principles previously described can be applied.

3.5 Non-Workplace Environments

3.5.1 MSDs occur as a result of chronic exposure to improper working positions or techniques. Many people engage in activities outside the workplace that can pose ergonomic risks. Examples include: computer use, painting and drawing, woodworking, working on automobiles and other mechanical equipment, and gardening. It is important to note that these exposures are additive to exposure at work. This can even lead to personnel having a MSD injury that is difficult to diagnose and correct since the exposure condition may not occur in the workplace.

3.5.2 The principles used to prevent MSD injuries at work also apply to non-work settings.

3.6 Training

3.6.1 On-line training programs and site-specific training by Safety and Facility Assurance Branch (SFAB) personnel are available. Training includes the following:

a. Common MSDs

b. Signs and symptoms of MSDs

c. Correct workplace design and proper work habits

3.7 Additional Information

3.7.1 The Internet contains many resources regarding ergonomics, some of which are high quality and some of which are not. The following sites have been evaluated and are recommended resources:

a. Occupational Safety and Health Administration (OSHA):

http://www.osha.gov/SLTC/ergonomics/

b. National Institute for Occupational Safety and Health (NIOSH):

www.cdc.gov/niosh/homepage.html

c. Repetitive Stress Injury Information: www.MSDnews.com/

d. University of California at Los Angeles Ergonomics Program:

www.ergonomics.ucla.edu

e. Cornell University Ergonomics Web: http://ergo.human.cornell.edu/

f. United States Army Center for Health Promotion and Preventive Medicine (USACHPPM) Ergonomics Program:

https://safety.army.mil/soh/OCCUPATIONALHEALTH/Ergonomics/tabid/561/Default.

aspx

g. Department of Defense Ergonomics Working Group:

http://www.denix.osd.mil/ergoworkinggroup/

APPENDIX A – DEFINITIONS AND TERMINOLOGY

Cold Temperatures - reduce blood flow throughout the body and decreases tactile feedback. Reduced blood flow minimizes the nutrients that travel to the muscles.

Reduced tactile feedback will cause the hands to work harder than they have to.

Compression/Contact Stress - any outside object coming into contact with the body causes compression. Items such as a hard edge, sharp surface, corner, or excessive weight can cause damage to the body’s soft tissues (nerves, tendons, blood vessels, etc.).

Duration - the length of any period of work activity which poses a MSD risk. The longer the duration of a task, the greater the exposure and risk of an MSD.

Ergonomics - the application of knowledge about human capacities and limitations to the design of workplaces, jobs, tasks, tools, equipment, and the environment.

Frequency - the rate at which specific physical motions or exertions are repeated.

Force - physical exertion by or pressure applied to any part of the body to move, direct, or operate equipment. The less force required to operate equipment the less traumatic it is to the body. Ideally we want all systems to require a minimum of force.

Musculoskeletal disorders (MSDs) - disorders caused by improper job, tool, and workstation design, by application of excessive force on the body, or by unusual postures. In general, the term MSD applies only to injuries received from chronic exposure rather than to acute injuries such as strains and sprains. Other terms commonly associated with MSD are Cumulative Trauma Disorder (CTD) and Repetitive Stress Injury (RSI).

Posture - the position of any part of the body during a work activity. Neutral postures are important because they maximize the amount of strength a worker can exert, maximize comfort, and minimize the risk of injury.

Repetition - Repetition or use of the same body parts continuously throughout the workday is damaging to the body. Micro-traumas from repetition can result in inflammation of the tendons, muscle irritation or entrapment syndromes, and nerve irritation. Prolonged exposure to repetitive motions can result in even more traumatic injuries.

Segmental Vibration - Segmental vibration affects a part of the body. The most common type of segmental vibration is hand-arm; it is usually caused by a worker holding a vibrating hand tool for a long period of time. This action causes reduced blood flow to the fingers and can lead to blanching of the fingers.

Whole Body Vibration - Whole body vibration often occurs while standing or seated in vibrating environments, such as trucks or heavy machinery. It contributes to low back pain and is a major source of lost time in occupational environments.

Appendix B – ACRONYMS

EP Ergonomics Program

ErgPO Ergonomics Program Officer

LaRC NASA Langley Research Center

MSD Musculoskeletal disorder

OHCM Office of Human Capital Management

OMC Occupational Medicine Clinic

PPE Personal Protective Equipment

SFAB Safety and Facility Assurance Branch

Appendix C – Ergonomics Injuries and Their Symptoms

The following are common ergonomic injuries and their common symptoms. This list is not exhaustive and should not be used for self-diagnosis of an injury. It is merely a guide to understanding the warning signs of MSDs. Individuals experiencing symptoms should seek professional medical advice.

Injury Symptoms

Carpal tunnel syndrome

Symptoms include tingling, numbness, and…