Risk Factors and Control Measures for Musculoskeletal Injuries Presented by: Gina Vahlas, Ergonomist Chloe Eaton, Ergonomist
Agenda Musculoskeletal Injuries Risk factors Risk controls Tools and resources Regulation and Guidelines
Definition from the Regulation Musculoskeletal injury (MSI) defined: an injury or disorder of the muscles, tendons, ligaments, joints, nerves, blood vessels or related soft tissue that may be caused or aggravated by work.
Common terms you may hear Musculoskeletal Injuries (MSI) Overexertion injuries (O/E) Activity Related Soft Tissue Disorders (ASTD)
Types of MSIs Muscle strains Ligament sprains Tendonitis shoulder, hand/wrist, foot/ankle Bursitis shoulder, elbow, knee Epicondylitis Carpal Tunnel Syndrome Trigger Finger Plantar Fasciitis Overexertion Injuries Activity- Related Soft Tissue Disorders
Signs and Symptoms of Injury Signs heat redness swelling loss of range loss of strength muscle wasting reduced blood flow Symptoms pain tenderness numbness tingling cold sensation
Health Effects of MSI Could lead to chronic pain and permanent disability reduced likelihood of returning to work
Ergonomics Claims in Manufacturing Number of Claims STD Days Paid Claim Costs Ergo Claims % of All Claims Ergo Claims % of All Claims Ergo Claims % of All Claims 2002 3,798 32% 155,697 35% $31,150,958 27% 2003 3,661 32% 154,045 37% $29,212,139 28% 2004 3,667 32% 152,373 36% $27,443,541 28% 2005 3,679 30% 136,138 35% $25,254,605 26% 2006 3,472 29% 126,581 34% $21,434,681 28% Data Source: EDW as of September, 2007
Definition of Risk Factors OHS Regulation 4.49 lists 5 categories of workplace factors that must be considered : Physical Demands Workplace Layout Object Characteristics Work Environment Work Organization Contributing factors
Physical Risk Factors Physical Demands Force required Repetition Duration Work postures Local contact stresses
Other Risk Factors Workplace Layout Working reaches, heights, seating, floor surfaces Object Characteristics Size and shape, load condition and weight distribution, container, tool and equipment handles Work Environment Temperature Work Organization Work-recovery cycles, task variability, work rate
Force Forces are: Grip force Lift/lower/carry force Push/pull force
Force Gripping Pinch grip: Pinch grip - force applied between the finger & thumb Power grip: Power grip - force applied primarily between the finger and palm
Force - Pinch Grips
Force Lifting, lowering and carrying Defined as forceful by considering weight, frequency, duration and posture
Force Lifting and Lowering
Force Lifting and Lowering Load weight, shape, size Handles Stability of load
Force - Lifting and Lowering
Force Pushing and Pulling Pushing and pulling - such as with carts, dollies, and other wheeled devices
Pushing How would you identify and assess the risk associated with this?
Force - Pulling What s wrong with this? Other factors? Which is easier? Pushing or pulling.
Repetition Repeating similar motions with the same body part for more than 2 hrs total per day Intensive keying for more than 4 hrs per day
Repetitive Tasks
Repetition Machine Controlled
Duration This is actually a risk assessment factor! It is incorporated into risk identification and assessment worksheets A and B
Awkward Posture Awkward postures that deviate from neutral Estimate or measure the joint deviation before it is identified as a risk factor
Awkward Posture Postures can be affected by aspects of the workstation
Awkward Postures Bending Too Low
Awkward Posture Where are the awkward postures?
Awkward Posture - Working Too High
Awkward Posture - Working Too High
Awkward Posture - Shoulders
Awkward Posture Wrist And Hand
Combination of risks
Contract Stress Using the base of the palm as a hammer or using the knee to kick Magnitude always is defined subjectively
Contact Stress Pressure Points Pressure points include Sides of fingers Palms Wrists Forearms Elbows Knees
Contact Stress
Contact Stress
Contact Stress
Vibration
Vibration hand-arm vibration means vibration that is transmitted from vibrating surfaces of objects, such as hand tools, through the hands and arms; whole-body vibration means vibration that is transmitted to a worker s body from vibrating surfaces on which a worker stands or sits.
Vibration Exposure Limits Hand-arm vibration Using high vibration tools (impact wrenches, carpet strippers, chain saws, jackhammers, scalers, riveting hammers) for more than 30 minutes total per day. Using moderate vibration tools (grinders, sanders, jig saws) for more than 2 hours total per day.
Risk Control Employers must eliminate or minimize the risk so far as practicable [4.50] Guidelines define risk control as: elimination of exposure, or as a minimization in: magnitude of exposure duration of exposure frequency of exposure
Objective of Risk Control Develop safe work procedures: Engineering controls Working reaches, heights, tools, equipment Administrative controls Job design - task variety and organization Training and supervision Personal protective equipment Anti-vibration gloves, knee pads
Elimination of risk Forceful lifting of 100lb bags is eliminated by installing a vacuum lift.
Minimization of Risk Risks reduced to lowest practicable level Worksheet A - MSI risk factor identification Provides a level to which risk controls should aim to minimize the risk to workers.
Risk control for manual handling forces
Risk control for manual handling forces
Risk control for manual handling forces
Risk control for manual handling forces
Risk control for manual handling forces
Risk control for manual handling forces
Risk control for pushing or pulling forces
Risk control guidelines for working heights
Risk control guidelines for working reaches
Risk control for grip force
Risk control for awkward posture Reposition work Use cut-out work surfaces Use adjustable equipment-provide comfort Provide close, convenient storage Be innovative
Risk control for awkward posture by repositioning work
Risk control for awkward posture
Risk control for awkward posture
Risk control for awkward wrist posture
Risk control for awkward wrist posture
Risk control for awkward shoulder Arm raised above shoulder posture Suspended in-line tool
Risk control for awkward posture Bent neck Adjustable workstation
Risk control for awkward upper body postures
Risk control for awkward upper body postures
Risk control for contact stress Use tools with rounded, soft and padded handles Use high friction surfaces or moldable substances on handles Ensure support for forearms Use knee pads when kneeling
Risk control for contact stress Tool digging into hand and fingers Wider, longer and padded handle
Risk control for contact stress
Risk control for contact stress
Risk control for vibration Routine maintenance Low vibration tools Vibration-dampening wraps on handles Isolating tool from motor Anti-vibration gloves Suspending tools from support or fixture Anti-vibration floor mats when standing
Risk control for vibration Vibration dampening wraps Anti-vibration gloves
Regular housekeeping and maintenance
Is stretching and exercise a risk control?
Are back belts PPE?
Ergonomics (MSI) Requirements 4.53 Consultation 4.47 Risk Identification 4.48 Risk Assessment 4.50 Risk Control 4.51 Education & Training 4.52 Evaluation Policy & Procedure
WorkSafeBC Tools & Resources Safety in Manufacturing worksheets Making It Right Info Flip Worksheets A & B Lift/lower Calculator Push/pull Calculator MSI Booklets Regulation & Guidelines
Safety in Manufacturing One-page worksheets that can be used as a guide to identify ergonomics risk factors commonly found in the manufacturing industry Awkward Postures Contact Stress Forceful Exertion Repetition Static Postures
Making It Right Info Flip Booklet that covers: Risk factors Risk control options 7-Step Ergonomics Process
Risk Identification Tool Worksheet A Worksheet A - MSI Risk Factor Identification Identifies whether a risk factor is at moderate level or higher Provides a level to which risk controls should aim to minimize the risk to workers http://www2.worksafebc.com/pdfs/ergonomic s/msi_worksheet_a.pdf
Risk Assessment Tool Worksheet B Worksheet B - MSI Risk Factor Assessment Separates moderate from high risk tasks http://www2.worksafebc.com/pdfs/ergo nomics/msi_worksheet_b.pdf
WorkSafeBC Worksheets A & B Not covered in the worksheets: Workstation layout Objects handled Environment Work organization Regulation 4.47 says all these factors must be considered
On-line Lift/Lower Calculator http://www2.worksafebc.com/calculator/llc/default.htm
On-line Push/Pull/Carry Calculator http://www2.worksafebc.com/ppcc/default.htm
MSI Booklets Preventing MSIs Understanding the Risks of MSI Back Talk How to Make Your Computer Workstation Fit You http://www2.worksafebc.com/topics/erg onomics/home.asp
Occupational Health and Safety Regulation & Guidelines Ergonomics (MSI) Requirements OHSR 4.46-4.53 G4.46-4.53 http://www2.worksafebc.com/publication s/ohsregulation/home.asp
Thank you! Gina Vahlas, Ergonomist Gina.Vahlas@worksafebc.com 604-279-7632 Chloe Eaton, Ergonomist Chloe.Eaton@worksafebc.com 604-233-4069