2.3 Musculoskeletal hazards and risk control

Question 1

Define muskoloskeletal disorder?

Answer 1

Ill health conditions that affect the physical

structure of the body, such as bones, muscles, tendons, joints, ligaments and cartilage.

Question 2

Name 5 WRULD’s?

Answer 2

• Tendonitis and/or tenosynovitis;
• Carpal tunnel syndrome;
• Epicondylitis (tennis and/or golfer’s elbow);
• Capsulitis of the shoulder (frozen shoulder); and
• Bursitis

Question 3

Name some examples of repetitive operations and an example of what the WRULD is?

Answer 3

Keyboard operation
Where frequent and repetitive hand and finger movements are required,carpal tunnel syndrome.
Assembly of small components
Piecing components together on an assembly line,
Bricklaying
The potential for MSDs (especially lower back pain) to develop is great.
Checkout operators
The resultant stretching, twisting and lifting
may create a significant risk of muscular strains occurring.

Question 4

What needs to be assessed for display screen equipment?

Answer 4

• The chair – which should be stable (five castor base), and adjustable for seat height and tilt
• Monitor / screen – this should have a stable image, should be capable of adjustment to suit the user, e.g. height, screen contrast and brightness and should be readable.
• The keyboard should be tiltable and the characters must be legible.
• Desk – there should be enough space to allow sufficient leg room for postural changes and to arrange work or equipment. The surface should be non-reflective.
• Distracting noise should be minimised.
• Humidity of the building should be maintained between 40 and 60% relative humidity in order to prevent sore or dry eyes.
• Lighting – should be free of glare or distracting reflections as far as is reasonably practicable. Window blinds should be provided where needed.
• Space should be adequate to carry out the work.
The job being done
The job should be designed to allow for breaks from DSE use.
Special needs of individual staff
Certain medical conditions may increase risks. For example, an expectant mother may find that achieving a comfortable workstation set up is increasingly difficult as the pregnancy progresses.

Question 5

What factors need to be considered in matching the needs of the individual to the workplace?

Answer 5

Environment
• the job that is being done and the extent of the demands placed upon the worker;
• the equipment that is being used, e.g. its ease of use, weight, size, shape;
• how information is presented, accessed or amended;
• physical environmental factors such as temperature, humidity, lighting, noise, vibration; and
• the extent of support structures such as teams, management style (i.e. the social
environment).
Individual factors
• Their physical stature, for instance their body size and shape.
• Health, fitness, strength and posture of the individual.
• Sensory requirements or deprivation, especially sight, hearing and touch.
• Stresses and strains that are placed on the body, particularly muscles, joints and nerves.
Psychological factors should be considered such as:
• the mental capabilities of the person;
• personal characteristics, e.g. whether the person has an even temper or perhaps is
prone to angry outbursts, rash decisions or their ability to cope with pressure; and
• the individual’s knowledge and experience of the task.

Question 6

Nmae some ill health effects of poorly designed tasks and workstations?

Answer 6

Tendonitis
Tendonitis is inflammation (swelling) of a tendon that results in pain in the affected area. Tendonitis is caused by overusing a tendon (through repetitive work) or injuring it, perhaps in sports activity.
Tenosynovitis
Some tendons are protected by sheaths which are known as synovium. If these become inflamed, a condition known as tenosynovitis occurs.
Carpal tunnel syndrome
Causes pain, numbness and a burning or tingling sensation in the hand or fingers. It occurs when tendons become inflamed, increasing the pressure on the median nerve.
Epicondylitis
Epicondylitis is manifest in two forms – lateral (tennis elbow) and medial (golfer’s elbow).
Capsulitis (frozen shoulder)
Frozen shoulder is a painful and persistent stiffness of the shoulder joint
Bursitis
Bursitis is inflammation of a bursa, a small fluid sac normally found over joints and between tendons and bones.

Question 7

What 3 factors give rise to ill health conditions?

Answer 7

Task
Work that is of a repetitive nature is likely to affect particular sets of muscles, tendons or joints.
Environment
The work environment can have a major impact on both physical and psychological
wellbeing. Work in high temperatures, for instance, can readily lead to exhaustion, whereas work in very cold conditions may affect circulation and muscle movements. Poor lighting may result in fatigue
Equipment
Equipment that is difficult to use will undoubtedly have an impact on physical or
psychological wellbeing.Where possible, equipment should be adjustable to the
needs of individuals so that unnecessary physical and psychological stresses are avoided.

Question 8

Define ergonomics?

Answer 8

Regarded as the science concerned with the ‘fit’ between people and their work. The idea is basically that you should put people first, taking account of their capabilities and limitations, and then make sure that tasks, equipment, information and the environment suit each worker. In assessing the fit between a person and their work,numerous factors have to be considered.

Question 9

What control measures can be used for tasks, equipment and the environment?

Answer 9

Task controls could include:
• using machinery to eliminate the need for repetitive actions or to aid tasks that require a lot of physical effort;
• sufficient breaks or variety of tasks for individuals, e.g. job rotation;
• considering the positioning of plant, equipment and materials so that workers do not need to adopt awkward postures or excessive twisting, stooping or stretching;
• improving workflow to avoid high intensity periods of activity; and
• reducing weights to avoid the need for heavy lifting.

Environmental controls would involve creating, as far as is reasonably practicable:
• a comfortable temperature with good levels of lighting and ventilation;
• where the overall temperature is difficult to control, a method of ensuring that staff have sufficient personal means of staying warm (or cool);
• a method of minimising noise or, where possible, removing workers from distracting or harmful levels of noise; and
• the option for workers to be seated or standing while working.

Equipment controls might include:
• involving users in the testing and selection of tools or equipment and in particular PPE;
• ensuring that workstations have a sufficient range of adjustment to suit the needs of individuals;
• positioning equipment for ease of use and to avoid additional hazards, e.g. having to
reach over hot surfaces to operate a control;
• providing jigs, holders or harnesses to reduce the effort required to hold workpieces or tools; and/or
• regular inspection and maintenance of plant, equipment and tools.

Question 10

Name the types of manual handling injury’s?

Answer 10

• back injuries, perhaps as a result of twisting, lifting or pushing loads where the spine bears the stress, e.g. slipped or prolapsed discs, sciatica or lumbago;
• strains of muscles and sprains of tendons or ligaments caused by stretching or even slips, trips and falls – these weaken joints and restrict movement;
• hernia, i.e. a rupture in the musculature of the body cavity wall;
• cuts, abrasions and bruising from the surfaces of loads being handled; and/or
• broken bones – usually impact injuries caused by dropping loads.

Question 11

What is the assessment process for manual handling risks?

Answer 11

Task
Risk factors associated with the TASK might be:
• holding loads away from the body;
• twisting, stooping or reaching upwards;
• large vertical movement;
• long carrying distances;
• strenuous pushing or pulling;
• repetitive handling;
• insufficient rest or recovery time; and
• a work rate imposed by a process.

Individual
Risk factors associated with the INDIVIDUAL might be that the job:
• requires unusual capability, e.g. above-average strength or agility, especially when age and gender are taken into account;
• might endanger those with a health problem or learning / physical disability;
• could present a risk to pregnant women;
• may call for special information or training; and/or
• requires particular clothes or personal protective equipment that place restrictions on movements or posture that could compromise safe manual handling.

Load
Risk factors associated with the LOAD might be that it is:
• heavy, bulky or unwieldy;
• difficult to grasp;
• unstable or likely to move unpredictably (e.g. animals or liquids);
• harmful, e.g. sharp or hot or perhaps hazardous substances;
• awkwardly stacked; and/or
• too large for the handler to see over.

Environment Risk factors associated with the ENVIRONMENT might be:
• constraints on posture;
• bumpy, obstructed or slippery floors;
• variations in levels;
• hot / cold / humid conditions;
• gusts of wind or other strong air movements; and/or
• poor lighting conditions.

Question 12

What are the task controls for minimising the manual handling risks?

Answer 12

Task controls
Reducing the risk associated with a TASK could possibly be achieved by:
• using a lifting aid, mechanical assistance or partial automation;
• improving workplace layout to improve efficiency;
• reducing the amount of twisting and stooping;
• avoiding lifting from floor level or above shoulder height, especially heavy loads;
• reducing carrying distances;
• avoidance of repetitive handling;
• variation of the work, allowing muscles to rest whilst others are used; and/or
• pushing rather than pulling loads.

Question 13

What are the individual controls for minimising the manual handling risks?

Answer 13

Individual controls
For the risk factors associated with the INDIVIDUAL employers could:
• pay particular attention to those who have a physical weakness;
• take extra care of pregnant workers;
• give employees more information, e.g. about the range of tasks they are likely to face;
• provide protective clothing or PPE that is less restrictive;
• provide more training (making sure that it is specific to the job that the person is doing); and/or
• enlist advice from an occupational health advisor to analyse tasks and improve selection processes.

Question 14

What are the load controls for minimising the manual handling risks?

Answer 14

Load controls
Could the LOAD be made:
• lighter or less bulky?
• easier to grasp?
• more stable?
• less damaging or hazardous to hold?
If the load comes in from elsewhere, perhaps the supplier could help, e.g. by providing handles or smaller packages.

Question 15

What are the environment controls for minimising the manual handling risks?

Answer 15

Environment controls
The risk factors associated with the ENVIRONMENT may be controlled if you were able to:
• remove obstructions to free movement;
• provide and maintain flooring;
• maintain adequate lighting;
• avoid steps and steep ramps; and/or
• prevent extremes of hot and cold.
Additional considerations that could reduce risk would be to:
• maintain (and of course, provide) equipment that is suitable for the task, e.g. change or repair wheels, tyres, handles, grips, brakes, etc.;
• change tasks to reduce the monotony;
• make more use of workers’ skills and involve workers in decisions;
• make workloads and deadlines more achievable;
• encourage good communication and teamwork; and/or
• provide better training and information.

Question 16

What is the correct procedure in a lifting or handling activity?

Answer 16

• place the feet about hip or shoulder width apart and get a firm base;
• adopt good posture with the spine in its natural curve, and the head up;
• bend with the knees, using the thigh muscles to lift;
• gain a firm and secure grip;
• keep the load close (and especially the centre of gravity) to the trunk of the body; loads at arm’s length will place great strain on the spine;
• move steadily (if you have to jerk, perhaps the load is too great);
• avoid twisting – move the feet not the torso; and
• put the load down as carefully as you picked it up – place it before adjusting it to its final position.

Question 17

Name the maually opertaed loading equipment, their uses and hazrads?

Answer 17

Trucks and trolleys
Sack trucks (or sack barrows) are extremely common.
Slips, trips and falls may also occur, especially if floors are uneven or have potholes and the choice of tyre can significantly affect the associated risk of jarring of the spine or other injuries.
Pneumatic tyres will cope better with rough floors whereas solid tyres would be suitable for smooth indoor floors (e.g. a warehouse).

Pallet trucks
These are very common in warehouses (some types are also known as pump trucks) and can be manually or electrically powered.
They perform a similar function to forklift trucks in moving palletised items, and a major hazard for both types is the size of the loads that may be transported by means of them. Loads that are on pallets can be very heavy and thus crush injuries are not uncommon.
For manually operated pallet trucks, the weight of the load may require significant effort to start it moving and to control it when in motion. Floor surfaces need to be well maintained, as potholes and floor joints can cause the truck to stop suddenly.

People-handling hoists
For many workers in the healthcare sector, physical movement and handling of patients is a daily task. For this reason there is a large variety of patient handling hoists available to reduce or eliminate manual handling.
Some hoists will be permanently installed, generally require less physical
effort on the part of the carer, with the physical effort concentrating on preparing the patient for lifting. The hoist is then usually motor-driven along a track by means of a remote control device.
Other hoists are designed to be mobile and thus some physical effort will be required to
move them when a patient is being carried. The lifting operation will need to take into
account factors such as the route to be taken, e.g. access and egress from lifts, floor surfaces, doors and corners or obstructions along the way.
The ILO’s Maxiumum Weight Convention and Recommendation stipulate that any lifting equipment and associated tackle or slings should be inspected in accordance with a written scheme of examination drawn up by a competent person.

People-handling aids
While hoists will be useful for lifting patients, injuries to carers can occur when carrying out lateral or sideways movements of patients. Typically these situations may arise when moving a patient from bed to bed or to an operating trolley.
Transfer slides, sheets or boards may significantly reduce the effort required.

Question 18

What are the different types of energy sources for FLT?

Answer 18

• Battery-powered FLTs, when being charged, produce hydrogen with the risk of fire or explosion. It is essential that a well ventilated designated area is provided for charging the vehicle.
• Diesel FLTs are not suited to indoor use because of the fumes. The fuel also causes very slippery surfaces if spilt
• Liquefied Petroleum Gas (LPG) – also known as propane – is a relatively clean fuel and can be used indoors if there is good general ventilation.highly flammable.

Question 19

What precautions and procedures should be followed to reduce the risk when people and FLT are in close proximity?

Answer 19

• pedestrian segregation with marked areas on floors and/or barriers where appropriate;
• clear, well-signed crossing points where needed;
• one-way routes and turning circles where possible to reduce the need for reversing;
• traffic routes (aisles) should be wide enough, high enough and free of obstacles;
• speed limits and general signage;
• convex mirrors may be needed to increase visibility;
• minimising the use of ramps and other gradients;
• providing and maintaining good levels of lighting and ventilation if diesel or gas trucks are used;
• providing designated space for parking and maintenance of forklift trucks and for the charging of batteries; and
• fitting vehicles with audible alarms and flashing beacons.
Procedural controls will be needed to supplement these precautions, such as:
• a complete ban on non-essential personnel in areas where forklift trucks operate;
• provision and use of high visibility clothing and other PPE as appropriate;
• regular maintenance of vehicles;
• pre-shift (start-up) checks, coupled with a defect reporting procedure;
• maintenance of the workplace, e.g. floors, lighting etc.;
• enforcement of speed limits; and
• selection of the right equipment and personnel.

Question 20

What training do FLT operators need to undertake?

Answer 20

• knowledge of the operating principles and controls of the lift truck, especially where they
relate to handling attachments specific to the job;
• the contents of routine inspection and servicing of the lift truck, expected of the operator;
• use of the lift truck in conditions the operator is likely to meet on the job, e.g. slopes,
speed limits, safe systems of work and instruction on site rules; and
• the work being undertaken, e.g. loading / unloading particular types of vehicle.
The third stage of training – familiarisation – needs to be undertaken on the job, under close supervision.

Question 21

What procedures need to be in place for lifts and hoists?

Answer 21

Lifts and hoists are any equipment used in a static location for raising or lowering a load where the direction of the movement is constrained.

There is an additional potential for persons
to fall from height, be struck by moving parts of the hoist, or by projections while riding onthe platform.

Precautions and procedures
People must be prevented from getting underneath the lift and being at risk from
falling materials or being trapped should the platform itself come down on top of them.
All hoists and lifts
should be set up on solid ground and if installed for long-term use a concrete base is essential. Free-standing equipment on the outside of buildings needs to be secured to the structure.
Lift operators must be specifically trained in the safe use of the type of lift or hoist being operated, and all the landing levels should be clearly visible from the operating position.
Passenger cages must have integrated operating controls (i.e. in the cage). Since hoists and lifts are subject to LOLER 1998, they must have a statutory examination every six months by a competent person and the results recorded. If not used for people, the minimum inspection interval is 12 months.

Question 22

Name some hazards from conveyor belts.

Answer 22

It is possible therefore for people or their clothing to be drawn into or even entangled in the rotating rollers that drive the belt. Additional hazards could include cuts or friction burns from raw edges of the rubber belt. Since they are used in a variety of settings and may be placed at ground level, running up or downhill or overhead, there is also a possibility of items falling on to people below.

Question 23

Name 3 types of conveyor belts.

Answer 23

Roller, screw and belt

Question 24

What precautions and procedures need to be observed for conveyor belts?

Answer 24

The main physical precautions involve:
• the use of appropriate guarding – rotating drums should have fixed guards and sides of conveyors should be guarded to the extent practicable;
• the use of trip wires and emergency stops;
• good housekeeping to ensure free access to controls;
• walkways over rollers; and
• audible warnings to advise when the conveyor is about to start up.

Procedural controls require that staff follow basic principles such as:
• not riding or walking on conveyors;
• not overloading with materials or goods;
• replacing fixed guards after maintenance or clearing blockages / spillages;
• the use of a permit-to-work system and competent persons for repair or maintenance on screw conveyors; and
• avoiding loose clothing and tying long hair back if working close to moving parts /
wearing appropriate PPE.

Question 25

What are some hazards from using cranes?

Answer 25

• loads falling, either through being poorly attached or failure of load-bearing parts;
• collapse or overturning through structural failure (especially intower cranes), as a result of overloading or due to strong winds; and
• collision with other cranes or buildings.

Question 26

What precautions and procedures need to be adopted for cranes?

Answer 26

• the ground should be firm and level and able to take the load placed upon it, taking
into account the possibility that there may be cellars or other underground voids (e.g.
storage tanks);
• the SWL of the crane should be identified and must not be exceeded;
• the area should be cordoned off to prevent unauthorised access, e.g. by the public;
• overhead obstructions should be identified, e.g. power lines, other cranes;
• the route that the load is going to take should be considered, e.g. passage over buildings or equipment but never over people;
• valid certificates of statutory examination should be obtained prior to use;
• competent operators and banksmen / slingers should be used;
• weather conditions should be considered and lifting must not occur in high winds;
• means of communication; and
• emergency procedures.

Question 27

What are the requirements for lifting oiperations?

Answer 27

Strong, stable and suitable equipment
Lifting equipment should be of adequate strength and stability for each load, in addition to which every part of a load and anything attached to it must be of adequate strength.
All parts of the equipment (i.e. slings, chains, hooks, etc.) used for lifting must be strong enough for the loads being lifted and foreseeable failure conditions.

Position and installation
Lifting equipment should be positioned or installed in such a way as to reduce to as low as is reasonably practicable the risk:
• of the equipment or a load striking a person; and
• from a load drifting, falling freely, or being released unintentionally (thus crushing
someone or thing in its path).

Visible marks
Lifting equipment should be visibly marked with any appropriate information to be taken
into account for its safe use

Planning and supervision of lifting operations
Every employer shall ensure that every lifting operation is:
• properly planned by a competent person;
• appropriately supervised; and
• carried out in a safe manner.

Question 28

What is a simple plan for routine use of an overhead crane?

Answer 28

• assess the weight of the load;
• choose the right accessory for lifting, e.g. depending upon the nature and weight of the load and the environment in which it is to be used;
• check the anticipated path of the load to make sure that it is not obstructed;
• prepare a suitable place to set down the load;
• fit the sling to the load (using an appropriate method of slinging);
• make the lift (a trial lift may be necessary to confirm the centre of gravity of the load –
tag lines may be necessary to stop the load swinging);
• release the slings (boards or similar may be necessary to prevent trapping of the sling); and
• clear up.

Question 29

What are the requirements for equipment for lifting people?

Answer 29

• to prevent a person using it being crushed, trapped or struck or falling from the carrier;
• to prevent, so far as is reasonably practicable, a person using it, while carrying out activities from the carrier, being crushed, trapped or struck or falling from the carrier;
• with suitable devices to prevent the carrier from falling; and
• so that a person trapped in any carrier is not thereby exposed to danger and can be freed.

Question 30

What are the requirements for statutory examination of lifting equipment?

Answer 30

• should have enough appropriate practical and theoretical knowledge and experience of the lifting equipment so that they can detect defects or weaknesses, and assess how important they are in relation to the safety and continued use of the equipment;

• should not be the same person who performs routine maintenance as they would be responsible for assessing their own work;
• should be sufficiently independent and impartial to make objective decisions; and
• may be employed by a separate company, or selected by an employer from members of their own staff.

Question 31

When should lifting equipment be examined?

Answer 31

• before using it for the first time – unless the equipment has an EC Declaration of
Conformity less than one year old and was not assembled on site. If assembled on site, it must be examined by a competent person to establish the assembly was correct and safe;
• after assembly and before use at each location for equipment that requires assembly or installation before use, e.g. tower cranes; and
• regularly in service if the equipment is exposed to conditions causing deterioration that is likely to result in dangerous situations.