Thought Leader Interviews

Susan Hardesty, MS, OTR, on Ergonomics and Injury Prevention in the Histology Laboratory

Susan Hardesty, MS, OTR, on Ergonomics and Injury Prevention in the Histology Laboratory

We got in touch with Susan Hardesty, MS, OTR after she downloaded our Ergonomics and Safety in the Histology Laboratory whitepaper. As Susan is an occupational therapist and specialist in ergonomics at Eskenazi Health in Indianapolis, IN, we thought she would have important and interesting information to share with histologists and histology lab managers about minimizing injuries in the laboratory.

What is your background?
My primary training is as an occupational therapist, and I have my masters in ergonomics.

How do you interact with hospital employees?
Typically I receive a request by an employee, observe them working, and make recommendations.

How do you interact with histologists in your role?
This is a new role for the hospital, so I’m only starting to be involved with the histology laboratory. Last year I had a request from a histologist to visit her laboratory. She had been a histologist for a while and didn’t have an injury but wanted to be proactive. Later, she had neck pain and her doctor recommended that she follow up with me again.

What observations did you have about the histology laboratory?
Histology laboratories have interesting challenges. For example, the laboratory has adjustable chairs at the microtome. Typically, the chair should be adjusted so that your elbows are above the level of your work surface, but when I raised her chair the histologist’s neck was craning over her slides. When her chair was lower her neck wasn’t in pain. So, there’s a balance that needs to be met. I like to say, “Your eyes guide your movement.” By adjusting her seat so that her eyes could easily see her specimens, her neck was in a neutral position, yet her elbows were still flexed.

What recommendations do you have for histologists to stay healthy and minimize injuries?

  • Rotate what you do in the laboratory to not continuously be using the same repetitive movements. Try to stand occasionally, even for a minute or two to change your position.
  • Notice the other movements that might use the same muscle groups that you are using with histology processes. For example, are you using the same muscle groups to open doors as you do to turn a microtome wheel? If so, try to avoid those movements by using your whole body to open the door or using automatic doors.
  • Make sure everyone has a current eye exam because if you can’t see then you get closer to your work. Details in histology laboratories are extremely small. If you have to wear readers or other glasses, you should do so. Make sure to look far away once in a while to give your eyes a break and relax the muscles around your eyes.
  • Outside of work, be careful of smart phones and other devices. Histologists spend much of their day looking down, for example at the microtome, water bath, and embedding station. If you go home and look at your phone in the same position, you’re adding to the cause of the pain. Also, make sure you’re not using the same fine motor movements to hold and use your phone that you do to hold tweezers and transfer sections. A PopSocket, a grip that sticks to the back of your phone to help you hold it more comfortably, can help with this.
  • Stretch your body in the opposite direction of the position you’re frequently in. Stretch out your shoulders and chest. This is applicable outside of work, for example when you are driving you can reach your right arm behind the passenger seat head.
  • Change your mouse to a vertical one that can put your wrist in a neutral position so that you’re not using the mouse with the same small motions that you use with tweezers.
  • Lighting is important. If the lighting breaks or burns out on your instrument, make sure your replacement is appropriate; for example, that it is strong enough or reduces glare. You can try to wear glasses that have lights on them.
  • Make adjustments so that your monitor is easier to read. If it’s too far from you or tucked behind other equipment, a monitor arm can be helpful. If you can’t bring it closer, increase your font to decrease visual and neck strain.
  • Take the time to set up your work environment. Keep work items closer to you on the table.
  • Stay hydrated.

What changes would you make to histology laboratories to improve ergonomics?
I would use height adjustable surfaces whenever possible, especially for microtomes and embedding stations. I would change embedding stations so that they could be angled so that a histologist could look at it without craning their neck. In general, I would change instruments so that they could be positioned better without changing the integrity of the machine.

When you suspect an injury, what steps do you recommend?
Tell their supervisor and find out if they have an ergonomic specialist, or OT/PT that they could go see or have come observe them work. It’s hard to recognize bad postures or patterns and having an outside person come in is helpful. A lot of times people know what to do but it’s helpful to have someone reinforce that.

What can histology laboratory managers do to improve the ergonomics of their laboratories?
Management is important in terms of embracing good work habits. New work habits are hard to adopt, especially if they are slower or less comfortable, even if strain is lessened. But you will be able to work longer and more comfortably if you are working in the best posture. Sometimes management has been out of the laboratory long enough to forget what technicians are experiencing but being proactive about supporting more ergonomic work habits is important.

Thank you for speaking with us, Susan!

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