ARTICLE IN PRESS
Attachment D. Questionnaire
Form Approved
OMB No. 0920-XXXX
Exp. Date: xx/xx/20xx
Survey Practicing Ergonomist Survey of Tools and Methods - 2016 revision
Q1. Years experience as an Ergonomist:
0-5 years 6-10 years 11-20 years 21+ years
Q2. What is your current occupation?
Ergonomist |
Consultant |
Psychologist |
Engineer |
Manager |
Educator |
Physiotherapist |
Occupational Therapist |
Human Factors Engineer |
Occupational Health Specialist |
Other (describe below) |
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____________________________ |
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Q3a. What is your expertise specialization (please mark no more than 3)
Accidents/Error/Risk |
Job/Task Analysis and Design |
Anthropometry/Biomechanics |
Manual Control |
Attention/Perception |
Mental Models |
Controls/Data Entry Devices |
Performance |
Crew Team/Organizations |
Personnel Testing |
Decision Making |
Process Control and Automation |
Disabilities/Aging |
Rehabilitation |
Environmental Factors/Stresses |
Signal Detection/Classification |
Evaluation of Products/Systems |
Speech Recognition/Processing |
Forensics |
Systems |
Health and Safety |
Warning and Labels |
Information Display |
Workload |
Information Processing |
Other __________________________________ |
Job/Task Analysis |
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Public reporting burden of this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-xxxx).
Q3b. Please indicate the top 3 industries in which you spend the most time doing your ergonomics work? (Select only one for the column “1st”, one or none for the column “2nd”, and one or none for the column “3rd”).
1st |
2nd |
3rd |
Industry Sector |
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Agriculture, Forestry, or Fishing |
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Construction |
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Healthcare & Social Assistance |
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Manufacturing |
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Mining - except Oil and Gas Extraction |
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Oil and Gas Extraction |
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Services - except Public Safety |
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Public Safety |
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Transportation, Warehousing & Utilities |
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Wholesale and Retail Trade |
Q4. What is your highest degree?
Bachelor’s Degree Master’s Degree Doctorate
Q5. Please write in your major field of study for your highest degree: ______________________________________
Q6. Basic Measurement Tools
Basic Measurement Tool |
Have you used in the field? (mark one) |
If NO, would you if available? |
If YES, how useful would you rate the tool? 1= not at all useful 5 = very useful |
6.1 Tape Measure |
Yes No |
Yes No |
|
6.2 Digital Video Camera |
Yes No |
Yes No |
|
6.3 Digital Still Camera |
Yes No |
Yes No |
|
6.4 Stopwatch |
Yes No |
Yes No |
|
6.5 Laptop |
Yes No |
Yes No |
|
6.6 Tablet/Smart Device |
Yes No |
Yes No |
|
6.7 Light Meter |
Yes No |
Yes No |
|
6.8 Sound Level Meter |
Yes No |
Yes No |
|
6.9 Goniometer (joint angles) |
Yes No |
Yes No |
|
6.10 Spring Gauge |
Yes No |
Yes No |
|
6.11 Scale (load cell) |
Yes No |
Yes No |
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6.12 Slip Meter |
Yes No |
Yes No |
|
6.13 Distance measuring wheel |
Yes No |
Yes No |
|
6.14 Thermometer |
Yes No |
Yes No |
|
6.15 Anemometer (air velocity) |
Yes No |
Yes No |
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6.16 Sling Psychrometer |
Yes No |
Yes No |
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6.17a Other: _______________ |
Yes |
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6.17b Other: _______________ |
Yes |
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6.17c Other: _______________ |
Yes |
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Q7. Observational Techniques
Whole Body Assessment Techniques |
|||||
Observational Technique |
Have you ever used this for job analysis? |
If NO, why? (mark most important reason) |
If YES, in what format |
If YES, how often? |
If YES, why do you use it in the field? (mark most important reason) |
7.1 RULA (Rapid Upper Limb Assessment
|
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
___________________ |
7.2 REBA (Rapid Entire Body Assessment) |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.3 OWAS (Ovako Working Posture Analysis System)
|
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.4 PATH (Posture, Activity, Tools and Handling)
|
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.5 Biomechanical or digital human modelling (examples include Jack, Delmia, UofM 3DSSPP, among others)
Which one:
________________ |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
|
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.6 Body Discomfort Map (e.g. Corlett and Bishop Map) |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.7 JCQ - Job Content Questionnaire |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.8 PLIBEL |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.9 Rodgers Muscle Fatigue Analysis |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
Manual Handling Assessment Techniques |
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Observational Technique |
Have you ever used this for job analysis? |
If NO, why? (mark most important reason) |
If YES, in what format |
If YES, how often? |
If YES, why do you use it in the field? (mark most important reason) |
7.10 Psychophysical Material Handling Data (includes “Snook/Ciriello tables”) |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.11 NIOSH Lifting Equation |
Yes, 1981 version (original) Yes, 1993 version (revised) Yes, I’m not sure which version No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.12 Energy Prediction Model
|
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.13 ACGIH® Threshold Limit Value® (TLV®) for Lifting |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.14 Washington State (WISHA) Lifting Calculator |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.15 Ohio Bureau of Workers Compensation (BWC) - Lifting Guidelines |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.16 Health Safety Executive (HSE) Manual handling assessment charts (MAC tool) |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
Upper Extremity Assessment Techniques |
|||||
Observational Technique |
Have you ever used this for job analysis? |
If NO, why? (mark most important reason) |
If YES, in what format |
If YES, how often? |
If YES, why do you use it in the field? (mark most important reason) |
7.17 Psychophysical Upper Extremity Data (e.g. “Snook and Ciriello Tables”) |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.18 Strain Index
|
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.19 OCRA |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.20 TLV for Hand Activity (ACGIH) |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.21 TLV for Upper Limb Muscle Fatigue (ACGIH) |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.22 Health Safety Executive (HSE) Assessment of Repetitive Tasks (ART tool) |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.23 Muscle fatigue equations |
Yes No |
Not necessary in my job Do not find it useful Not familiar with Not available to me Too expensive Other |
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
Other Observational Assessment Techniques you have used |
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Observational Technique |
Who developed this? |
If YES, in what format |
If YES, how often? |
If YES, why do you use it in the field? (mark most important reason) |
7.24a OTHER
Describe:
________________
|
My company developed An outside organization developed for my company (proprietary) An outside organization developed (non-proprietary) I don’t know
|
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.24b OTHER
Describe:
________________
|
My company developed An outside organization developed for my company (proprietary) An outside organization developed (non-proprietary) I don’t know
|
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
7.24c OTHER
Describe:
________________
|
My company developed An outside organization developed for my company (proprietary) An outside organization developed (non-proprietary) I don’t know
|
Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with/have available for this analysis Cost considerations Appropriate for job Recognized/Requested by management Regulatory mandate Other: (explain below)
|
Q8. Direct Measurement Techniques
Direct Measurement Technique |
Have you ever used this tool for job analysis? |
If NO, why? (mark most important reason) |
If YES, how often? |
If YES, why do you use it in the field? (mark most important reason) |
8.1 Lumbar Motion Monitor (LMM) or other electrogoniometer for the trunk
|
Yes No |
Not necessary in my job Do not find it useful Not familiar with this tool Not available to me Too expensive Other:
_____________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with or have available for this Cost considerations Appropriate for job Recognized/Requested by management Regulatory requirement Other: (please explain)
__________________________
|
8.2 Electronic Wrist Goniometer
|
Yes No |
Not necessary in my job Do not find it useful Not familiar with this tool Not available to me Too expensive Other:
_____________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with or have available for this Cost considerations Appropriate for job Recognized/Requested by management Regulatory requirement Other: (please explain)
__________________________
|
8.3 Grip Dynamometer
|
Yes No |
Not necessary in my job Do not find it useful Not familiar with this tool Not available to me Too expensive Other:
_____________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with or have available for this Cost considerations Appropriate for job Recognized/Requested by management Regulatory requirement Other: (please explain)
__________________________
|
8.4 Pinch Dynamometer
|
Yes No |
Not necessary in my job Do not find it useful Not familiar with this tool Not available to me Too expensive Other:
_____________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with or have available for this Cost considerations Appropriate for job Recognized/Requested by management Regulatory requirement Other: (please explain)
__________________________
|
8.5 Instrumented Hand Tools (for force measurement) |
Yes No |
Not necessary in my job Do not find it useful Not familiar with this tool Not available to me Too expensive Other:
_____________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with or have available for this Cost considerations Appropriate for job Recognized/Requested by management Regulatory requirement Other: (please explain)
__________________________
|
8.6 Heart Rate Monitor
|
Yes No |
Not necessary in my job Do not find it useful Not familiar with this tool Not available to me Too expensive Other:
_____________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with or have available for this Cost considerations Appropriate for job Recognized/Requested by management Regulatory requirement Other: (please explain)
__________________________
|
8.7 Push/Pull Force Sensors
|
Yes No |
Not necessary in my job Do not find it useful Not familiar with this tool Not available to me Too expensive Other:
_____________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with or have available for this Cost considerations Appropriate for job Recognized/Requested by management Regulatory requirement Other: (please explain)
__________________________
|
8.8 Electromyography
|
Yes No |
Not necessary in my job Do not find it useful Not familiar with this tool Not available to me Too expensive Other:
_____________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with or have available for this Cost considerations Appropriate for job Recognized/Requested by management Regulatory requirement Other: (please explain)
__________________________
|
8.9 Vibration Measurement
|
Yes No |
Not necessary in my job Do not find it useful Not familiar with this tool Not available to me Too expensive Other:
_____________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with or have available for this Cost considerations Appropriate for job Recognized/Requested by management Regulatory requirement Other: (please explain)
__________________________
|
8.10a Motion capture/measurement (optical, requiring cameras)
|
Yes No |
Not necessary in my job Do not find it useful Not familiar with this tool Not available to me Too expensive Other:
_____________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with or have available for this Cost considerations Appropriate for job Recognized/Requested by management Regulatory requirement Other: (please explain)
__________________________
|
8.10b Motion capture/measurement (non-optical, not requiring cameras)
|
Yes No |
Not necessary in my job Do not find it useful Not familiar with this tool Not available to me Too expensive Other:
_____________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with or have available for this Cost considerations Appropriate for job Recognized/Requested by management Regulatory requirement Other: (please explain)
__________________________
|
8.11a OTHER
Describe:
________________
|
Yes
|
Not necessary in my job Do not find it useful Not familiar with this tool Not available to me Too expensive Other:
_____________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with or have available for this Cost considerations Appropriate for job Recognized/Requested by management Regulatory requirement Other: (please explain)
__________________________
|
8.11b OTHER
Describe:
________________
|
Yes
|
Not necessary in my job Do not find it useful Not familiar with this tool Not available to me Too expensive Other:
_____________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with or have available for this Cost considerations Appropriate for job Recognized/Requested by management Regulatory requirement Other: (please explain)
__________________________
|
8.11c OTHER
Describe:
________________
|
Yes
|
Not necessary in my job Do not find it useful Not familiar with this tool Not available to me Too expensive Other:
_____________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Efficient/Easy to use Only tool I am familiar with or have available for this Cost considerations Appropriate for job Recognized/Requested by management Regulatory requirement Other: (please explain)
__________________________
|
Q9. Do you use any Ergonomic Checklists?
Yes No (If YES, please list up to 3 below)
Checklist Name:
____________________________ |
In what format do you use it? Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other: ________________________________
|
How often do you use it? About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Checklist Name:
____________________________ |
In what format do you use it? Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other: ________________________________
|
How often do you use it? About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Checklist Name:
____________________________ |
In what format do you use it? Pencil & paper Desktop/laptop software Mobile device application (tablet, smartphone, etc.) Other: ________________________________
|
How often do you use it? About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Q10. Do you use any questionnaires or data collection tools for assessing workplace Psycho-Social factors?
Yes No (If YES, please list up to 3 below)
____________________________ |
How often do you use it? About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
____________________________ |
How often do you use it? About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
____________________________ |
How often do you use it? About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Q11. Do you use any assessment tools or guidelines to integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being? For example, advancing worker well-being by integrating policies, programs, and practices such as compensation and benefits with those related to health protection. In the United States, this may be known as Total Worker Health®.
Yes No (If YES, please list up to 3 below)
____________________________ |
How often do you use it? About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
____________________________ |
How often do you use it? About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
____________________________ |
How often do you use it? About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Q12. Do you use any Anthropometric Software or Tables?
Yes No (If YES, please list up to 3 below)
Anthropometric Software or Reference Name:
____________________________ |
How often do you use it? About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Anthropometric Software or Reference Name:
____________________________ |
How often do you use it? About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Anthropometric Software or Reference Name:
____________________________ |
How often do you use it? About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Q13. Do you use any Smart Device “Apps” for ergonomics purposes related to musculoskeletal health, and/or prevention of workplace injury? (Excluding apps you use only for your own personal health.)
Yes No
(If YES, Please list up to 3 smart device “apps” below. These can be products that were purchased commercially or that your organization has developed.)
Smart device “App” |
How did you obtain it? |
How often do you use it? |
Name or description:
_________________ |
commercial download developed in-house other (describe)
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Name or description:
_________________ |
commercial download developed in-house other (describe)
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Name or description:
_________________ |
commercial download developed in-house other (describe)
________________ |
About once per year or less About once every 6 months About every 3 months About once a month About once a week More than once per week |
Q14. Please describe any tools you use that we did not inquire about:
__________________________________________________________________________________________
Q15. Please describe any tools you would like to use that we did not inquire about:
_____________________________________________________________________________________
Q16. Other Comments:
_____________________________________________________________________________________
For Review Purposes Only – Do Not Disseminate
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | doi:10.1016/j.apergo.2005.01.007 |
| Author | Lowe, Brian D. (CDC/NIOSH/DART) |
| File Modified | 0000-00-00 |
| File Created | 2021-01-23 |