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DATE: ______________

LABORATORY LOCATION: _________________________________

COMPUTER WORKSTATIONSYesNo
1. Is a seat provided? [ ][ ]*
2. Is the seat height adjustable within the recommendations?[ ][ ]*
3. Is lumbar back support provided?[ ][ ]*
4. Is a footrest provided?[ ][ ]*
5.Is there ample leg room? [ ][ ]*
6. Are all adjustability features easy to use?[ ][ ]*
7. Is there ample room to accommodate a keyboard and a computer mouse so the employee can rest their arms at their side and forearms parallel to the floor?[ ][ ]*
8. Is there ample room to place the monitor at arm length's distance?[ ][ ]*
9. Is the monitor at the recommended height?[ ][ ]*
10. If documents are frequently used, is there a document holder?[ ][ ]*
LABORATORY BENCHES
1. If the worker stands, is anti-fatigue matting supplied?[ ][ ]*
2. Is the height of the bench appropriate for the work that is performed?[ ][ ]*
3. Is there adequate leg room?[ ][ ]*
4. Do contact stressors exist such as bench tops with sharp edges?[ ][ ]*
LABORATORY CHAIRS
1. Can all laboratory chairs be adjusted to accommodate all of the employees who need to use the chairs?[ ][ ]*
MICROSCOPES
1. Do the shoulders appear rounded and/or is the worker hunched over?[ ]*[ ]
2. Is there excessive neck flexion (>25 degrees)?[ ]*[ ]
3. Are there contact stresses between sharp edges and the forearms?[ ]*[ ]
4. Is the microscope pulled out to the edge of the workbench?[ ][ ]*
5. Are armrests or padding provided? [ ][ ]*
6. Is there sufficient leg room?[ ][ ]*
7. Does the worker rest their feet on the lab stool?[ ]*[ ]
8. Is there a foot rest provided? [ ][ ]*
9. Has the individual been trained how to properly sit at a microscope workstation? [ ][ ]*
10. Are microscope work breaks provided?[ ][ ]*
PIPETTING
1. Are manual pipettors used?[ ]*[ ]
2. Are electronic pipettors provided? [ ][ ]*
3. Are latch-mode pipettors provided?[ ][ ]*
4. Is the pipettor designed to reduce contact with sharp edges? [ ][ ]*
5. Has the individual been trained how to properly operate the pipettor (e.g., pickup tips, eject tips, program electronic pipettor, etc.). [ ][ ]*
6. Does the worker pipette more than 2 hours per day?[ ]*[ ]
7. Are frequent breaks provided?[ ][ ]*
8. Is the pipettor computer-controlled to allow for computer-activated multiple dispensing instead of finger-activated dispensing?[ ][ ]*
FINE MOTOR SKILLS
1. Are vials with the fewest amount of threads allowable used?[ ][ ]*
2. Does the worker perform dissection or micro-manipulation with forceps more than 5 hours per week?[ ]*[ ]
3. Are frequent micro breaks provided?[ ][ ]*
4. Do contact stresses exist between the forearm and workbench?[ ]*[ ]
MICROTOME AND CRYOSTAT
1. Does the worker use excessive wrist flexion and extension when operating the microtome or cryostat? [ ]*[ ]
2. Is the workstation at a height that reduces arm abduction as much as possible?[ ][ ]*
3. Does the worker have access to an automatic microtome/cryostat?[ ][ ]*
4. Are frequent breaks provided? [ ][ ]*
5. Is a fully adjustable chair provided? [ ][ ]*

NOTE: You should follow up on all responses with a "*" beside the box.
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