a guide for the prevention of oos in the meat, poultry and fish processing industries (0.45mb)

A Guide for thePrevention of OOS in the

Meat, Poultry and FishProcessing Industries

L A B O U RD E P A R T M E N T O F

T E T A R I M A H IOCCUPATIONAL SAFETY & H E A LT H S E R V I C E

M u s cl eM i n d i n g

Published by the Occupational Safety and Health ServiceDepartment of LabourWellingtonNew Zealand

First Edition: August 1997

ISBN 0477-03598-1

CONTENTS

1. ABOUT THIS RESOURCE KIT ................................................ 5

A. Purpose of this Guide ...................................................................... 5

B. Contents of this Resource Kit ......................................................... 6

C. Status of this Guide ......................................................................... 6

D. Acknowledgements .......................................................................... 6

2. OOS: WHAT IT IS AND WHY IT OCCURS ............................ 7

Introduction ........................................................................................... 7

A. General Description of Occupational Overuse Syndrome ............. 7

B. Why OOS Occurs ............................................................................. 9

C. Recognising the Initial Symptoms of OOS ................................... 11

D. Occupations where OOS is Common............................................ 11

3. OOS AND THE HSE LEGISLATION ..................................... 13

Introduction ......................................................................................... 13

A. Application of the HSE Act ............................................................ 14

B. Methods of Identifying and Assessing Hazards for OOS .............. 15

C. Management of Hazards ................................................................ 18

D. Monitoring ..................................................................................... 18

E. Information, Training and Supervision ........................................ 19

F. Accident Reporting, Recording and Investigation ....................... 19

G. Review of Workplace ...................................................................... 20

H. Duties of Employees ...................................................................... 20

I. Application of the HSE Regulations: the Design of Plant andEquipment ..................................................................................... 21

4. HAZARD IDENTIFICATION AND CONTROL OPTIONS ......... 23

Introduction ......................................................................................... 23

A. Work Organisation and Task Scheduling ..................................... 24

B. Awkward Postures .......................................................................... 26

C. Task Invariability ........................................................................... 27

D. Static Load ..................................................................................... 27

E. Forceful and Rapid Movements ..................................................... 28

F. Fit, Reach and See ......................................................................... 30

G. Cold and Vibration ......................................................................... 31

H. Psychosocial Characteristics of Work ........................................... 33

I. Psychological Characteristics of the Worker ................................ 33

J. Behavioural Characteristics of the Worker ................................... 34

K OOS Hazards that Result from the Nature of the Product .......... 37

L. Other Environmental Hazards ...................................................... 38

M u s c l eM i n d i n g page 4

5. INFORMATION AND TRAINING FOR ALL IN THE WORKPLACE ................................................................................. 39

Introduction ......................................................................................... 39

A. What’s Meant by Information and Training? ................................ 39

B. Training .......................................................................................... 40

C. Sample Information about OOS for Employees ........................... 41

D. Personal Factors: the Way People use their Bodies ...................... 43

E. Accident Reporting ........................................................................ 47

F. Lifestyle Factors ............................................................................. 47

6. MANAGEMENT OF OOS PROBLEMS WHEN THEYOCCUR ............................................................................... 49

Introduction ......................................................................................... 49

A. Management Commitment ........................................................... 49

B. Policy Development ....................................................................... 49

C. OOS Reporting System.................................................................. 50

D. Management of Early Signs and Symptoms ................................. 50

E. Rehabilitation ................................................................................ 51

APPENDIX A: COST FACTORS IN OOS .................................. 53

APPENDIX B: HEALTH AND SAFETY POLICY ............................ 55

APPENDIX C: WORKSTATION DESIGN CHECKLIST ................. 57

APPENDIX D: ANTHROPOMETRIC ESTIMATES FOR NEWZEALANDERS....................................................................... 59

APPENDIX E: SELF-REPORT OF DISCOMFORT .......................... 61

APPENDIX F: VIDEO AND EXERCISES..................................... 63

APPENDIX G: SAFE BODY POSITIONS ................................... 67

APPENDIX H: KNIFE HANDLING ........................................... 69

APPENDIX I: WORKING TECHNIQUE .................................... 72

APPENDIX J: EXAMPLE OF A REHABILITATION PROGRAMME .. 73

APPENDIX K: DEFINITION OF SERIOUS HARM ....................... 79

BIBLIOGRAPHY .................................................................... 81

M u s c l eM i n d i n g

ABOUT THISRESOURCE KIT

This guide is part of a resource kit to assist employers toprevent Occupational Overuse Syndrome (OOS) in thefood processing industries, specifically in the processingof red meat, poultry and fish (including shellfish).

OOS is a costly problem in these industries. It alsoresults in a large number of ACC claims andnotifications of serious harm to the Occupational Safetyand Health Service (OSH).

This guide outlines a strategic approach to preventingOOS. The material may be used as part of training ororientation for new staff, returning workers and existingworkers in the industry. It is in loose leaf format so thatindividual sections can be removed, copied and usedseparately as required.

Other, more general, information on OOS managementis already available from OSH and should be used tosupplement what is here. Manual handling is also acommon problem in the food processing industries, andthere are OSH publications that deal with this as well.(See the Bibliography for a list of relevant publications.)

The recommendations in this guide are all based oncurrent standard practice. So far, reports on what‘works well’ in the prevention of OOS in the foodindustry are not available. Research on the effects ofinterventions such as the one proposed here have notbeen reported.

Commitment by management is essential beforeimplementing any programme to address OOSproblems. An effective programme will adopt a teamapproach and involve all employees, from workers on theprocessing lines to high-level managers.

Although intended primarily for employers, this guidewill also be of use to occupational health and safetypractitioners, those working within the industry, andanyone else with an interest in reducing the effects ofOOS.

1SECTION

A. PURPOSE OFTHIS GUIDE


OSH can provide initial assistance in dealing with OOSproblems and a list of OSH branch offices is included inthis guide (pages 83-84). For further assistance, youshould contact one of the private consultants whospecialise in this field (refer to the ACC publication Howto Select an Occupational Safety and Health Consultant:A Guide for Managers).

This resource kit contains the following items:

Guide: Muscle Minding: A Guide for thePrevention of OOS in the Meat,Poultry and Fish ProcessingIndustries

Video: Muscle Minding: for PeopleProcessing Red Meat, Poultry andSeafood

Poster: Stay Loose, Avoid OOS

As indicated, this guide is primarily a resource foremployers and management. The video and poster areaimed at employees and show how they can help to avoidoveruse problems in the workplace.

Further copies of the poster are available from OSH.

This guide is not a code of practice. It gives guidance onreducing the incidence of occupational overuse injuries.The overall approach is based on the Health and Safety inEmployment Act 1992, and following the guide will assistworkplaces to comply with the requirements of the Act.

In producing this resource kit, a number of workplacesand people have been of assistance and OSH would like toacknowledge their help in commenting on early drafts.We particularly thank those workplaces that allowed us tovisit their premises and film staff in the making of thevideo. The authors would like those concerned to acceptthis as a personal acknowledgement, as for variousreasons, OSH may not credit specific companies.

B. CONTENTSOF THIS

RESOURCE KIT

C. STATUS OFTHIS GUIDE

D. ACKNOWLED-GEMENTS


OOS: WHAT IT ISAND WHY IT OCCURS

This section gives a general description of whatOccupational Overuse Syndrome is, why it’s believed tooccur, and how it’s diagnosed. It also looks at thedifferent occupations where OOS is likely to be aproblem.

Occupational Overuse Syndrome (OOS) is an umbrellaterm covering a range of disorders characterised by painand/or other sensations in muscles, tendons, nerves,soft tissues and joints, with evidence of clinical signs.Symptoms such as pain, discomfort and muscleweakness may continue even after the initial clinicalsigns have diminished.

The disorders are caused, or significantly contributedto, by occupational factors that include prolongedmuscle tension, repetitive actions, forceful movements,and sustained or constrained postures, which exceed theusual ability of the body to rapidly recover.

Other medical conditions causing the same or similarsymptoms have been excluded (e.g. somerheumatological conditions, prolonged inactivity, ordisuse of muscles).

Current opinion suggests that OOS can be classifiedinto three groups which are referred to as localisedinflammations, compression syndromes and painsyndromes (see table overleaf).

Scientific evidence seems to indicate that, in the foodprocessing industries, localised inflammations andcompression syndromes are far more common thanpain syndromes.

2SECTION

A. GENERALDESCRIPTION OFOCCUPATIONAL

OVERUSESYNDROME

INTRODUCTION

CLASSIFICATION OF

OCCUPATIONAL

OVERUSE

SYNDROME


Explanatory notes for Table 1

• OOS is a complex problem that invariably hasmultifactorial causes. The number of possiblefactors is large, with much potential forinteraction. Organisational factors (such asexcessive workload), psychosocial factors (bothin and outside of work) and individualcharacteristics are known to increase the risk ofdeveloping OOS. These all have to be taken intoaccount when managing OOS.

• OOS should not be confused with the aches andpains that are a common part of life.

• The disorders included in the sub-types of OOSabove can also exist alone, without overuse oroccupation being the cause. These disorderswould then not be classified under the umbrellaterm OOS.

• OOS is not a clinical entity; it is an umbrellaterm. For this reason OOS on its own is not anadequate diagnosis. All classifications of OOSshould therefore be accompanied by a subtype,provisionally based, if necessary. For example,OOS - Carpal Tunnel Syndrome (provisional) orOOS - Epicondylitis. Multiple sub-types canalso be indicated, e.g. OOS - Epicondylitis andCervicothoracic Dysfunction.

Table 1: The Classification of Occupational Overuse Syndrome

Localised Compression PainInflammations Syndromes Syndromes

Trigger finger Carpal tunnel syndrome Chronic pain syndrome

De Quervain’s tenosynovitis Thoracic outlet syndrome Myofascial syndromes

Epicondylitis Ulnar nerve compression Fibromyalgia

Rotator cuff syndrome Radial nerve compression Regional pain syndrome

Bursitis Complex regional painsyndrome (Reflexsympathetic dystrophy)Cervicothoracic dysfunction

Postural syndromes

Muscle strain

Occupational Overuse Syndrome: Some Examples of Subtypes


• There is no distinction between paid and unpaidoccupations for the purposes of the definition ofOOS, and medical management will be similar.However, cover under the AccidentRehabilitation and Compensation Insurance Act1992 will depend, among other things, onwhether the occupation in which the conditionarose was paid or unpaid.

• There is some evidence that the localisedinflammations and compression syndromes aremore common in manual work compared tokeyboard work, where the pain syndromesappear to be more common.

It’s useful to consider the causes of OOS under twoheadings: what people do, and why they do it.

B. WHY OOSOCCURS

Table 2: OOS in Terms of What People do and Why they do it

In terms of what people do. In terms of why people dothose things.

People hold muscles tense The workstation and/orfor long periods. workplace is poorly designed.

Too much work is done.Insufficient breaks. Peopleare poorly trained.

People repeatedly make The work requires these move-forceful or jerky movements. ments. People are poorly trained

and use poor techniques.

People drive themselves People drive themselveshard in response to the beyond their capacity. Thedemands or work. demands of work are

unreasonable, or are linked to abonus system.

People react to social People are required to workstressors, at home and beyond their capacity or their atwork. coping skills are poorly

developed. People areunhappy at work.

Personal factors play A variety of factors may play aa part. a part here; i.e. individual,

physiological and psychologi-cal characteristics.


This table mentions various possible causes of overusesyndromes but makes no comment about the relativeimportance of each type of cause. This will vary in eachindividual case of overuse syndrome. Current opinion,however, is that no one cause should be isolated as thecause, and that prevention strategies should thereforeproceed along a broad front.

Much in the outline presented in Table 2 derives fromthe muscle tension theory of overuse syndromes, whichstates, in brief, that holding muscles tense for too longwithout a break is the primary cause of the initialdiscomfort and pain of overuse syndromes.

The muscle tension theory does not explain everythingabout the causes of overuse syndromes, in particularwhy some people develop pain that is more severe andlonger lasting other people. Nor does it explain whysome people spend long periods off work while others,with similar levels of pain, return to work.

Developments in knowledge about the human painsystem indicates that there are physiologicalmechanisms through which pain can be amplified fromthe initially mild symptoms. It has been proposed thatsome people are more susceptible to developing pain inthis way than others.

Many practitioners in the field of occupational medicinebelieve that ‘illness beliefs’ are the most importantfactor in the return to work of people off work withOOS.

Illness beliefs are beliefs about their illness held by theperson affected and include:

• The belief that pain is harmful or disabling,resulting in fear-avoidance behaviour such asguarded movements and fear of movement;

• The belief that all pain must be abolished beforeattempting to return to work or normal activity;

• The expectation of increased pain with activityor work;

• Catastrophising: the belief that pain isuncontrollable;

• A passive attitude to rehabilitation.

Various factors may influence illness beliefs. Anautomatic referral to physiotherapy and other manual


therapies or giving a person time off work (especiallywithout contact with the workplace) are two suchfactors.

Another difficulty with the muscle tension theory is thatit does not provide an obvious explanation for thegrowing emphasis on psychosocial factors as causes ofoveruse syndromes.

The early symptoms of the localised forms of OOS suchas ‘tennis elbow’ are often identifiable as somethingother than normal muscle pain.

The symptoms of OOS that develop into painsyndromes, however, are often those of normal musclediscomfort. These are readily reversible in the earlystages, and when there is time for recovery, muscleaching and pain normally disappear. If there isinsufficient time for recovery, then more seriousproblems may develop.

Initial feelings experienced by people with OOS mayinclude tingling and numbness in the fingers andhands; discomfort and aching in muscles; anddiscomfort or pain at the points where a tendon meetsthe bone, where a tendon runs through a sheath and inthe tendon itself.

Overuse syndromes are found in a large number ofoccupations, as well as among people who are not inpaid work. ACC statistics show that people in thefollowing occupations — to name a few — are affected:

• food processing workers;

• kitchen workers;

• sewing machinists;

• cleaners;

• panel beaters;

• librarians;

• clerks;

• carpenters;

C. RECOGNISINGTHE INITIAL

SYMPTOMS OFOOS

D. OCCUPATIONSWHERE OOS IS

COMMON


• metal polishers;

• painters;

• musicians;

• electronic assemblers;

• mail sorters;

• hairdressers;

• courtroom stenographers;

• sign language interpreters;

• keyboard operators.

Food processing is one of many occupations whereOOS occurs.


OOS AND THE HSELEGISLATION

INTRODUCTION

This section briefly reviews the requirements of theHealth and Safety in Employment (HSE) Act 1992 andthe Health and Safety in Employment (HSE)Regulations 1995. It then relates these requirements tothe specific hazards of OOS in the food processingindustries.

HEALTH AND SAFETY IN EMPLOYMENT ACT 1992

Under the HSE Act 1992, employers must take allpracticable steps to provide a workplace free fromhazards. The Act places particular emphasis on thedetection and management of significant hazards.

The Act is summarised in a number of OSHpublications. In brief, employers are required to takethe following steps:

1. Design for safety and health.

2. Identify, assess and control hazards.

3 Monitor employees’ exposure to hazards andtheir health.

4 Provide information, training and supervision.

Employees also have responsibilities under the Act.

The Act makes a distinction between harm and seriousharm, and between hazards and significant hazards.Where serious harm (which is defined in the FirstSchedule to the Act, see Appendix K ) has occurred —or has the potential to occur — employers must take allpracticable steps to reduce the likelihood of seriousharm occurring again.

A diagnosis of occupational overuse syndrome canindicate that serious harm has occurred and, byimplication, that significant hazards exist in theworkplace. All practicable steps must therefore be takento prevent harm occurring or recurring.

3SECTION


These steps are arranged in a hierarchy of actions:

(a) elimination of the hazard;

(b) isolation; and

(c) minimisation.

Where the minimisation option is used, effectivesystems to monitor exposure to significant hazards andto monitor personal health are required.

HEALTH AND SAFETY IN EMPLOYMENT REGULATIONS

1995

The HSE Regulations impose duties on employers,employees, designers, manufacturers and others andrelate to general safety in the workplace and to thedesign of plant and equipment.

A. APPLICATION OF THE HSE ACT

DESIGN FOR SAFETY

Employers should ensure that the physical aspects ofthe workplace are designed to be safe. (This is discussedlater under Application of the HSE Regulations).

Apart from the physical design of workstations andequipment, other risk factors for OOS that relate to the‘design’ of work are the way work is organised,especially its timing, payment systems and whetherexcessive overtime is worked.

Some assessment will be needed of the amount of workto be done in the time available, in particular, thebuilding in of time for breaks and the opportunities totake micropauses*.

IDENTIFY, ASSESS AND CONTROL HAZARDS

Employers must systematically identify hazards in theplace of work (these include existing and potentialhazards). These hazards must be assessed — andregularly reviewed — to determine whether or not theyare significant hazards. If it is determined that a hazardis a significant hazard, further action will be required.

* A micropause is a short break in work, of 5-10 secondsduration, accompanied by muscle relaxation. It allows for therestoration of blood flow in muscles which have been tense.


A significant hazard means a hazard that is an actual orpotential cause or source of:

(a) serious harm; or

(b) harm, (being more than trivial), the severity ofwhose effects on any person depend (entirely oramong other things) on the extent or frequencyof the person’s exposure to the hazard; or

(c) harm that does not usually occur, or is notusually easily detectable, until a significant timeafter exposure to the hazard.

The Act sets out the hierarchy of actions that must befollowed when a significant hazard is identified:

(a) Where practicable, the hazard must beeliminated.

(b) If elimination isn’t practicable, the hazard mustbe isolated.

(c) If it’s impracticable to eliminate or isolate thehazard completely, then the employer mustminimise the hazard to employees.

In addition, the employer must, where appropriate:

• Ensure that protective clothing and equipmentis provided, appropriate to the task, and isaccessible and used.

• Monitor employees’ exposure to the hazard.

• Seek the consent of employees to monitor theirhealth and, with informed consent, monitoremployees’ health.

• Provide information and training (see Section5).

The results of monitoring can be used to :

• Reassess the hazards; or

• Gauge the effects of the methods used tominimise the hazard.

Employees must be given the results of monitoring.

B. METHODS OF IDENTIFYING AND ASSESSINGHAZARDS FOR OOS

A number of standard methods for identifying hazardsare discussed in OSH publications, such as How to


Identify and Control Hazards. These methods aresummarised here, with particular reference to OOS.

When hazard identification is being carried out,employers are required to provide employees with theopportunity to be involved. It’s also important toinvolve employees when designing and redesigningplant, equipment and work methods.

ASSESSING WORKLOADS

The workload should be assessed to see if it’s within thecapacity of the people doing the work. As a first step,the ways in which the workload will be measuredshould be described.

It can be difficult to assess from first principles if aparticular amount of work can be accomplished by agroup of workers. This is due to the inherent difficultyof this type of assessment, the variability betweenindividuals, and the effects of training.

Often, a company uses set criteria to determine theamount of work to be accomplished. It’s sensible todiscuss these criteria with the workers and theirrepresentatives. If a change of workload is introduced,it should be carefully monitored.

It should be noted that people do respond to increaseddemands, but only up to a point. After a person reachesthat limit, degradation of performance sets in. Thismay be apparent in the short term, but may not showup until the longer term.

PHYSICAL INSPECTIONS

Inspections are carried out by walking around theworkplace, preferably in consultation with employeerepresentatives and staff who are familiar with the areaand the work. A checklist may be useful as a memoryaid. Physical inspections can be broken down intosmaller and smaller areas as expertise develops.

PROCESS ANALYSIS

Hazards are identified at each stage of the process. Anexample of this could be a fish filleting factory, where:

1. The product enters the factory warehouse.


2. The fish are weighed, stacked and put into coldstorage.

3. Cutting lines then behead, gut, fillet and skinthe fish.

4. The product is then trimmed.

5. The fish is layer packed.

6. The fish is check-weighed again, then frozen.

7. Product is delivered to suppliers.

Each stage of dealing with the product can posedifferent hazards, which can be assessed in turn.

ACCIDENT ANALYSIS

Details are analysed of both serious and non-seriousharm accidents and incidents.

VIDEO FILMING

Video filming is a valuable method of evaluatingmovements, especially where work is repetitive andperformed at a brisk pace. Slow motion replay can beused to study actions in detail.

Video filming can also be used as a training tool. Peopleoften experience muscle discomfort, aches and painsbecause of the hand and arm movements they make.These undesirable movements may be forced uponthem by the design of their workplace and hand tools,in which case the need for redesign will be made clearby the video. On the other hand, they may not knowthey are making undesirable movements and the videowill then show these.

RULA TASK ANALYSIS

Rapid Upper Limb Assessment (RULA) is a specific taskanalysis method. Muscle use, force applied and postureare assessed according to a standard method to give afinal single-number score for the task. The method isnot a precise indicator of risk but can be used toprioritise tasks for action. Using the method will raise


awareness about some of the risk factors for OOS. Thescore can be used to prioritise tasks for attention.

Copies of the method and score sheet are available fromall OSH branches.

C. MANAGEMENT OF HAZARDS

The obvious solution is to remove hazards. Engineeringmethods are the preferred control option for hazardsthat arise from the design of the workstation, tools andequipment. Such solutions include redesign of thework area, and the tools and equipment used, andcareful attention to the design of the flow of work andhow the product enters the work area. The focusshould be on reducing prolonged muscle tension,repetition, force and excessive manual handling.

Hazards posed by the organisation of the work require adifferent sort of control. This is discussed in the nextsection.

D. MONITORING

The HSE Act requires employers to monitor theemployee’s exposure to a significant hazard when itcannot be eliminated or isolated, and the personalhealth of the employee in relation to the hazard.

As a guide to the types of monitoring that can be carriedout:

1. Posture can be assessed by careful observation.Each body part can be assessed, and the posturerecorded can be judged against posturalguidelines.

2. Muscle tension may be monitored by the use ofelectromyography. (Electromyography is therecording of electrical currents generated inactive muscles.)

3. Cycle times of the work tasks can be measured.The times spent with excessive muscle tensionand the times spent relaxed can be recorded.

4. Personal health may be monitored by self-reports of musculoskeletal discomfort. It’sessential to have an early reporting system so


that when pain is experienced, it can beinvestigated straight away, and any changesmade where necessary. (See Appendix E).

E. INFORMATION, TRAINING AND SUPERVISION

Appropriate information must be provided to theemployee on identified hazards to which they areexposed, as well as specific health and safetyinformation such as:

• health and safety policies;

• how to prevent occupational overuse andmanual handling injuries;

• reporting of hazards;

• early reporting of symptoms to supervisors;

• standard operating procedures;

• emergency procedures;

• specific processes;

• the purpose of guards and safety devices; and

• the use and maintenance of personal protectiveequipment.

Employers should consider language and culturaldifferences in the provision of information toemployees.

Training should be an ongoing process and be tailoredto the individual’s needs, as people don’t learn at thesame rates. It should include formal and informalsessions.

Supervisors need to be trained to detect incorrectpostures and poor working techniques. They also needto know what to do with early reports of discomfort.

There are a number of trainers who are able to providespecialist training (refer to the ACC publication How toSelect an Occupational Safety and Health Consultant).

F. ACCIDENT REPORTING, RECORDING ANDINVESTIGATION

There needs to be a means for employees to reportaches and pains when they do arise. The importance of


early reporting is crucial in both detection and furtherprevention of OOS problems.

There may need to be a system initially to cope withexcess reporting — once awareness has increasedwithin the plant.

An accident register (in the prescribed format) must bemaintained by all employers, where non-serious harmand serious harm is recorded and investigated. Allincidences of serious harm must to be reported to OSHas soon as possible after their occurrence, thennotification must be made in writing, within 7 days.

If a diagnosis of OOS is made, or if a worker is unableto carry out normal duties because of the severity ofwork-related pain, then serious harm may haveoccurred. As a guide, being unable to carry out normalduties for seven days due to these causes should betaken as evidence of serious harm and should bereported to OSH.

Serious harm is permanent loss of bodily function; ortemporary severe loss of bodily function, includingmusculoskeletal disease (see Appendix K).

G. REVIEW OF WORKPLACE

There should be planned, regular review inspections ofthe workplace, together with an effective hazardreporting system. Checklists and hazard reports can beused as a guide.

The accident/incident register should also be regularlychecked.

H. DUTIES OF EMPLOYEES

Employees also have duties under the HSE Act. Theymust:

• Use or wear the equipment, and appropriateprotective devices or clothing that is specifiedfor the work.

• Inform supervisors of any hazard that may putany person in danger.

• Notify supervisors immediately of anydiscomfort experienced.


• Not carry out any activity that may cause harmto themselves, or to anyone else.

• Not remove any protective device, e.g. a knifeguard.

Where equipment, protective device or clothing issupplied by the employer, it should be appropriate forthe task and fit the individual. Workers should receivetraining in the use of this equipment.

I. APPLICATION OF THE HSE REGULATIONS: THEDESIGN OF PLANT AND EQUIPMENT

Design for human use should be the first considerationwhen reorganising a workstation or when designing anew work area. Consideration also needs to be given tohygienic design and ease of cleansing.

Regulation 66 (Part VII) of the Health and Safety inEmployment Regulations requires that ergonomicprinciples be taken into account by the designers andmanufacturers of plant and equipment.

Workstation design begins with an appreciation of safebody positions so that the ‘shape’ of the workstation iscorrect (see Appendix C) and incorporatesanthropometric data so that the workstation is thecorrect size (see Appendix D). Size limitations reflectthe need to make the workstation big enough for tall

Workstation designed so that work can be performedclose to the body.


people, and to bring things that must be reached for orgrasped close enough for short people.

The design of a workstation should accommodate eachperson likely to use it, rather than just the ‘average’person. For this reason, workstations may need to beadjustable.

The degree of adjustability required will also depend onthe number of different people who use the workstationand on the nature of the work.

Poorly designed workstations may require people towork with prolonged, undesirable postures; to makeoverly long reaches; or to twist or bend their bodies.These are risk factors for OOS.

To summarise these considerations:

1. Design workstations to ‘fit’ the person, using thecorrect ‘shape’ and ‘size’.

2. Work tables or stands may need to be adjustablewhen a range of employees use the sameworkstation.

3. Design equipment and tools to reduce muscleforces and prevent prolonged or frequentlyrepeated manual handling actions.

4. Suspend heavy tools or objects from an overheadsupport.

5. Substitute power tools for manual tools.


Working with arms raised above the heart is a risk factorin the development of OOS.

4SECTION HAZARDIDENTIFICATION ANDCONTROL OPTIONS

INTRODUCTION

Identification of hazards relating to causes ofoccupational overuse syndrome involves considerationof the worker, their actions, their workload andenvironment, and their workstation and tools (theknives and utensils they use on a regular basis).

The worksite analysis needs to identify existing hazardsand conditions, operations that create hazards, andareas where hazards may develop. It should alsoinclude regular assessment of injury records to identifyinjury patterns: where injuries occurred, what type ofinjuries occurred, and what type of tasks were involved.

The following lists are a guide to assist with hazardidentification and control. They are not exhaustive butmay be used as prompters.


Provide time for knife sharpening and tool maintenance.

A. WORK ORGANISATION AND TASKSCHEDULING

This is an important subject and considers the impactthat the nature of the work and the workload may haveon the worker.

Work organisation is the objective nature of the workprocess. It is the description of the way work isstructured, supervised and processed and theinstitutional features of work such as the nature of theorganisational chart; who is the boss; who has power,authority and responsibilities; and how work gets done.The nature of the tasks, including workload and taskcontent, are also part of work organisation.

The practical factors that need to be taken into accountin the workplace can include: the clarity of the tasks,their monotony, the chain speed or rate at which theproduct travels past the workers, other time pressures,staffing levels, pay systems, the effect of busy seasonsand other increases in workload, breaks in the work andovertime and shiftwork.

The nature of the tasks can change in a number ofcircumstances. For example: when new technology isintroduced, when the speed of the line is changed, whendifferent types of product are being processed or whenthe temperature of the environment or the product onthe line is altered. Regulating the speed at whichproduct enters the processing line is extremelyimportant and must be controlled.


CONTROL OPTIONS:

To ensure task clarity:

• Provide clear job descriptions and training.

• Ensure workers are familiar with theperformance specification.

• Provide feedback on whether workers aremeeting the performance specification.

• Create clear lines of reporting.

To provide interesting work:

• Reduce monotonous tasks to a minimum.

• Rotate tasks that are monotonous.

To prevent unreasonable workloads:

• Establish workloads that are sustainable in thelong term — undertake an assessment of thespeed of the production line versus injury costs,and maintain a level of work that preventsmusculoskeletal problems.

• Design a work/rest schedule that creates abalance between health and productivity. A 10-minute break every hour is advisable in manycases.

• Have employee input into the determination ofworkload.

• Have a means to assess staffing needs in specialcases — when operators are absent unexpectedlyor for extra duties or seasonal work.

Mesh glove should be worn to protect holding hand.


• Make allowances for breaks and micropauses inthe design of work schedules.

• Keep overtime and shiftwork to a reasonablelimit.

• Allow for a gradual build-up to full speed at thestart of a season or when a person is starting ajob.

• Provide time for sharpening tools and toolmaintenance.

• Ensure pay does not relate to a bonus system orpiece rate.

• Ensure payment systems do not increaseworkloads.

B. AWKWARD POSTURES

As is well established, the adoption of certain posturesmay act to load muscles forcefully and/or require themto contract for long periods. Poor postures may resultfrom the poor design of equipment and facilities; a lackof education, knowledge and training; or a general lackof ability to sense the state of one’s own body.

Provide adjustable workstations and allow for footrests.


CONTROL OPTIONS

• Assess job tasks, with the redesign of the workarea being the first option.

• Train employees on how to use tools and correctpostures.

• Consider how individual tools are used.

• Obtain feedback from employees on trials of newworkstations and tools.

C. TASK INVARIABILITY

This term applies to both the physiological andpsychological ‘sameness’, which are characteristic ofmany tasks that are repetitious and unchanging.Invariability often implies constant muscle tension.

CONTROL OPTIONS

• Provide job rotation so that workers carry outtasks that use different muscle groups.

• Organise team work within areas so thatmembers of the team can share the differentjobs.

D. STATIC LOAD

Muscles, tendons and nerves may all respond to staticloading in ways that are undesirable. Examples of staticloading are: work with arms outstretched; work abovethe heart, work with shoulders raised; lifting heavyweights; holding meat, fish, shellfish in the non-knifehand; and grasping a knife.

CONTROL OPTIONS

• Reassess employee tasks.

• Measure load and forces used (by use of video,task analysis).

• Bring work closer to centre of body (verticallyand horizontally).

• Reduce weights to be lifted.


E. FORCEFUL AND RAPID MOVEMENTS

Many external influences on the body require themuscles to exert force. The sizes of the forces that thebody must generate to react to the outside world, andthe manner in which those forces vary with time(variability, repetitiveness, work-rest cycle, recoverytimes, breaks), will influence tension in muscles,pressure in the carpal tunnel or in a muscle, frictionbetween a tendon and the sheath it runs in, andpressure or irritation of a nerve.

Some factors that modify the musculoskeletal load areits duration, the type of grip used and the diameter ofthe handle gripped, wrist postures, the use of gloves,and working technique or behaviour.

The design of hand tools and workbenches and thelocation of parts to be worked on or grasped play amajor part in preventing hazards such as from:

• Slippery tool handles;

• Heavy hand tools — more force is required;

• Deviation or flexion/extension of the wrist;

• Blunt knives;

• Trolleys that are awkward to manoeuvre;

• Pallet racks of awkward height, weight, shape;

• Inadequate clothing or gloves;

• Holding the product while cutting;

• Vibration from power saws and hand tools.

CONTROL OPTIONS

• Use knife or tool handles with texture grips inpreference to those with ridges and grooves.Wide handles should be used for ease of grip.There should be a range of handle sizes availableto meet the needs of different people.

• Have a wide range of equipment available forspecial needs, such as left-handed knives.Knives should be trialled to ascertain theireffectiveness, suitability and grip strengthrequired in use.

• Suspend heavy tools from tool balancers.


• Design and select tools that are of the minimumweight. The maximum weight of a hand toolshould be 4.5 kg.

• Have a regular maintenance schedule for toolsand equipment.

• Have a policy on knife sharpening. Providetraining in sharpening and safe handlingtechniques.

• Purchase trolleys designed for the job; maintainthem regularly, i.e. check wheels and oilregularly.

• Packing areas should accommodate a range ofheights. It’s preferable to have racks that moveup and down with a range of weights. Packingboxes and conveyor belts should be atapproximately waist height.

• There should be as little manual handling aspossible of the product, especially if it’s over 20kg.

• Regularly maintain and upgrade all vibratingpower saws.

PERSONAL PROTECTIVE EQUIPMENT

• Shoes and gumboots should be comfortablenonslip, heavy-duty.

• Knife-guards should be adequate for knife andsharpening equipment

• Protective clothing should be warm andunrestrictive.

Stretching and warm-up exercises before work promote bloodflow to the fingers.


• Arm guards should protect the ‘holding’ hand.

• Mesh gloves should be worn.

F. FIT, REACH AND SEE

Operators need to be able to fit the general height andsize of their workstations, reach the items they workwith and see clearly.

The following is a list of common errors:

• The workstation is too high or too low.

• The workstation is nonadjustable.

• Operators need to reach too high, too low or toofar forward to obtain necessary equipment.

• No stable base is provided on which to stand.

• There is no choice of standing or sitting positionto work in.

• Work must be consistently performed above thelevel of the heart.

• Work requires a twisting or turning movement.

• Work requires excessive bending of the neck orback.

• Working conditions are cramped.

• Lighting is too low for the task.

• Lighting is too bright or poorly positioned,causing reflections and glare.

CONTROL OPTIONS

• Design or select the workstation to fit a specifictask.

• Ensure work space is large enough to allow forthe full range of movements required.

• Provide an adjustable workstation which can bealtered for the operator’s height. (Time to makethe adjustments at the start of each shift will beneeded).

• Provide adjustable fixtures such as footstools,stands and platforms that can be changed to suitdifferent workers’ proportions.


• Place equipment that is used frequently withineasy reach.

• Provide space to enable work to be carried outwithout restriction.

• Fit rubber stoppers on the bottom of tables forstability.

• Analyse tasks. Many tasks in the food industryare best carried out at waist level. This is not aninviolable rule, and precision tasks may need tobe done at a higher level than this.

• Analyse the position required to carry out thetask; adjust workstation; bring work closer tothe operator.

• Boning areas should have adjustable tables and afootrest for the employee so that they areworking at approximately waist height.

• Provide adequate lighting over workstations,positioned to avoid reflections.

• Obtain ergonomic expertise when redesigningwork areas.

G. COLD AND VIBRATION

This category of hazards includes:

• Exposure to low temperatures (in the chilledboning room).

• Shock and impact loading (e.g. when using nut-runners, or the hand as a hammer).

• Whole body and hand arm vibration (vibratinghand tools cause an automatic muscletightening and may lead to disease).

• Contact with sharp edges (‘handlebar palsy’ incyclists, ‘bowler’s thumb’, using scissors).

Some have suggested that high noise levels may alsoincrease muscle tension.

COLD

Cold conditions may precipitate symptoms of OOS.When we perform dynamic work (with musclemovement) the body generates its own heat, especially


when the work is vigorous. In the food processingindustry, the work is ‘static’ and there’s little heatproduction. Therefore it’s very important to keep warmand relaxed.

Cold draughts are common from compressingmachinery. Cold air may cause feelings of local coolingof flesh. This can be so great as to reduce the bloodsupply to the extremities, which can increase the risk ofthe problem.

CONTROL OPTIONS

• Provide protective equipment and warmclothing in cold environments. Clothing needsto be unrestrictive and of a reasonable fit.

• Provide gloves where necessary.

• Encourage workers to wear thermalunderclothes.

• Redirect cool air blowing onto workers frompneumatic tool exhausts and prevent drafts.

• Ensure that workers who spend long periods infreezers take their breaks in warm areas.

VIBRATION

Vibration is a risk factor for OOS. Raynaud’sphenomenon or ‘white finger’ — a reduction in theblood supply to the extremities, usually the middledigits — may occur in response to vibration,particularly in cold and wet environments.

When it occurs, the fingers must be rewarmed slowly.

CONTROL OPTIONS

Stretching and warm-up exercises should be carried outbefore work to lessen the effects of the vibration.Employers should:

• Select vibration-free equipment.

• Reduce vibration at source.

• Reduce the time employees spend usingvibrating equipment.

• Minimise the occurrence of vibration bymaintenance of machinery.


• Mount equipment to prevent the transmission ofvibration to operators.

H. PSYCHOSOCIAL CHARACTERISTICS OF WORK

Psychosocial factors are the individual, subjectiveperceptions of the work organisation factors (see above).They often have the same names as the workorganisation factors but are different in that they carryan emotional value for the worker. Thus, the nature ofsupervision can have positive or negative psychosocialeffects..

Research suggests that if people can answer ‘yes’ to thequestions that follow, then they are likely to be atsignificantly less risk of musculoskeletal discomfort:

• Do you enjoy your work?

• Do you get on well with your supervisor?

• Do you get on well with your co-workers?

• Do you get support when you need it?

How people respond to these questions will depend, tosome extent, on their perception of the organisationalstructure, e.g. their job future, job security, productionpressures, supervisory style and their reaction to socialstressors at home and at work.

CONTROL OPTIONS

• Have a good climate of communication in theworkplace.

• Encourage team work.

• Encourage the prompt reporting of hazards,with appropriate action taken.

I. PSYCHOLOGICAL CHARACTERISTICS OF THEWORKER

It has been suggested that some psychologicalcharacteristics may contribute to the development ofdiscomfort at work, such as:

• a tendency to take on too much work;

• working through deadlines;


• being a competitive perfectionist;

• a tendency to be unaware of early warning signsof discomfort, or to ignore them;

• an inability to relax, or a poorly developed abilityto sense the state of one’s muscles.

However, there is little research to support or refute thehypotheses on psychological risk factors. Note too thatpeople with these characteristics may be the mostvaluable employees.

CONTROL OPTIONS

• Recognise the above characteristics during workand discuss with the employee.

• Assess workers during orientation induction.

• Provide training on prevention of OOS.

• Ensure breaks are taken regularly.

J. BEHAVIOURAL CHARACTERISTICS OF THEWORKER

This term refers to the way people hold and move theirhands and limbs to do their work. Sometimes, actionsare forced on people by the design of the equipmentthey are using, and its design will need alteration.

The following actions, particularly if carried on forsome time, are likely to lead to discomfort and pain:

• Prolonged abnormal postures of the back, neck,shoulders or arms, e.g. excessive forward

Train workers in using balanced, relaxed postures.


bending andforearms bentaway from midlineposition.

• Wrist extension, ifexcessive,particularly ifsharp movementsor force are involved(see Appendix I).

• Excessive ulnardeviation(sideways bendingof the hand towards the little finger) both inmovement or during sustained holding.

• Repetitive pronation-supination (turning of theforearm so the palm of the hand faces up, thendown).

• Overspanning (spreading the fingers out wide togrip objects).

• Excessive force in squeezing movements.

• Using pinch grips rather than power grips.

• Shock-loading to the hand, wrist and arm fromusing a hammer, or by tugging, jerking or sharptorque reactions.

• Repetitive picking up with the hands.

• Pressure placed on the hand by tool handles.

• Lifting heavy objects.

Provide information and training in safe knife handling.

Flexion

ExtensionUlnardeviation

Undesirable hand positions


CONTROL OPTIONS

• Analyse work positions, in consultation withworkers.

• Provide the results of analysis to supervisors ormanagers for change.

• Train workers and supervisors to:

- adopt balanced, relaxed postures;

- use good working techniques;

- use micropauses, let the body relax;

- have relaxed muscles generally.

• Provide time for:

- adjusting the workstation properly;

- doing exercises;

- taking breaks;

- stretching and limbering.

• Provide training in knife handling.

• Provide manual handling training. Ensure thereis as little manual movement of the product aspossible, especially if it is over 20 kg.

• Analyse the way tools and equipment are used(especially in high-risk areas, such as fishfilleting and boning). Trial new equipment forsuitability of use.

Force required to hold the knife while cutting fat and skin isone of the hazards in processing.


• Train workers how to use tools correctly andensure time is given during orientation for themto come up to speed gradually.

(Note the overlap with other types of risk factor listedunder Subsection I: Psychological Characteristics).

K. OOS HAZARDS THAT RESULT FROM THENATURE OF THE PRODUCT

In the processing of red meat, chicken, fish andshellfish, the texture of the meat varies greatly, as doesthe state in which it is cut. For example, fish may besemi-thawed and mussel shells are steamed to openthem. Red meat may be chilled or warm, depending onthe type of meat it is. Hence, the equipment requiredto open or cut the product varies as well. Some of thehazards in processing are:

• The effort required in handling heavy, awkwardcarcasses, or blocks of frozen or thawing fish.

• The force required to hold the knife whilecutting fat and skin around meat.

• The grip required when opening shellfish.

• The force required to hold the product.

• Wet conditions, making the product slippery.

CONTROL OPTIONS

• Suspend heavy meat carcasses or joints.

• Provide training in correct ways to handlecarcasses and large pieces of meat.

• Provide suitable knives for the different texturesof meat.

• Ensure regular sharpening of knives, andmaintenance of sharpening equipment.

• Regulate speed of process line so that excessivedemands are not placed on the workers.

• Provide training in specific specialty jobs, andallow workers time to build up to speed.

• Control the temperature of the product, for easeof cutting.

• Ensure that gloves are appropriate for the task.


L. OTHER ENVIRONMENTAL HAZARDS

Other hazards in the workplace environment include:

• Poor housekeeping, e.g. meat offcuts and fat onfloors.

• Standing on cold, wet concrete floors— this mayincrease muscle tension in the legs and back.

• Wearing uncomfortable gumboots.

(Many other workplace hazards which are not directcauses of discomfort or injury, such as in-running nipson conveyor belts, could also be mentioned here.)

CONTROL OPTIONS

• Sweep and wash the floors at regular intervals toavoid slipping hazards.

• Remove offcuts of product regularly.

• Provide insulating nonslip footwear.

• Provide anti-fatigue mats where possible.


5SECTION INFORMATION ANDTRAINING FOR ALL INTHE WORKPLACE

INTRODUCTION

The HSE Act requires employers to provide employeeswith information and training in a form that they canreadily understand. This section covers the content ofinformation and training required for the prevention ofOOS in the food processing industries.

A. WHAT’S MEANT BY INFORMATION ANDTRAINING?

Giving information is simply passing on verbal orwritten material. The Health and Safety inEmployment Act 1992 requires information to be givento employees concerning the hazards identified in theplant and the measures taken to counter them.

By itself, information has a very limited role in ensuringthe safe use of knives or discomfort-free work. Whatcounts is that employees ‘behave safely’. In particular,this means that they ‘use their bodies’ in ways that aresafe — and this needs time, opportunity and skilledcoaching with feedback.

Training is where a trainer coaches a person in ways ofdoing things, in this case carrying out physical actions,while monitoring the development of skill in the desiredactions.

The main health and safety problems that informationand training must address are the prevention of knifecuts and muscular discomfort, since the latter candevelop into occupational overuse syndrome (OOS).Employees need to know why and how musculardiscomfort (and in the extreme case, OOS) can occur.This will lay a foundation for the training they receive.


B. TRAINING

Training should recognise the immense skill needed todo most of the tasks in the food processing industryeffectively. There are no Olympic or CommonwealthGames events called the ‘Boning Marathon’ or the ‘200Oyster Shucking’. Yet the skill and proficiency of manya New Zealand worker equals that of an Olympicmedallist.

The aim of training for skill development is to promoterhythm and relaxation in the way physical actions areperformed. Relaxed, skilled performance looksattractive and effortless and has its basis in the adoptionof appropriate postures, rhythmical actions and safeworking techniques. As for all athletes, warm-upexercises should be performed before the ‘event’.

For an employer, the time and effort invested intraining will be repaid in the long term as tasks aredone more efficiently, leading to greater production;more effectively, leading to higher quality production;and more safely, leading to fewer injuries and lessdiscomfort.

Stretching frequently allows muscles to rejuvenate.


Aspects of the way people use their bodies are addressedbelow under C. Five topics are discussed separately butit’s the net effect of their application that counts — howthese points are integrated into the performance of aparticular task. This is a major challenge for trainers.

C. SAMPLE INFORMATION ABOUT OOS FOREMPLOYEES

Employees need simple information about the reasonsfor workplace discomfort so that they can appreciatewhy the various preventive suggestions are made. Themuscle tension explanation for OOS can be used toillustrate its causes. These causes can be presented intwo ways: (a) in terms of what people do and then (b) interms of why people do those things. (See table 2, page9).

Why we can get discomfort because of work

The basic cause of workplace discomfort is that musclesare held tense for too long. The idea of repetitivemovements is misleading. When we make repetitivemovements (typing, knitting or working with knives forexample) some muscles (especially the ones on the topof the forearm) remain tense all the time. It’s usuallythese muscles that get the problem.

The reason discomfort develops is like this:

Muscles and tendons receive blood through very finevessels passing between the muscle fibres. A tensemuscle squeezes on these vessels and they collapse,slowing the flow of blood.

When blood flow slows enough or stops, the musclemay switch to a form of working which is veryinefficient. This uses up the energy store in the musclevery quickly and leads to a build-up of acid wastes in themuscle (lactic acid). This is what causes the discomfortand pain.

Initially, this discomfort is normal fatigue. Muscles andtendons are able to resist fatigue and they will recoverquickly if they can relax between contractions. Regularrest breaks, including micropauses (see page 45), and/ora variety of tasks are needed to prevent the tensing ofmuscles and tendons beyond their limit for recovery.


Muscle pain can make the neighbouring muscles comeout tense in sympathy by a reflex action (the socalled‘splinting reaction’). This is a normal reaction to injuryand is good where bracing is needed for acute injurieslike a broken bone.

In chronic pain, however, a self-sustaining cycle oftension can occur. In the beginning, this discomfort isnormal fatigue. Muscles (and tendons) are able to resistfatigue and they will recover quickly if they can relaxbetween contractions. Regular rest breaks (includingmicropauses) and/or a variety of tasks are needed toprevent the tensing of muscles and tendons beyondtheir limit for recovery.

If the nerves don’t get enough blood, other problemsmay occur. Just as a tense muscle may deny itselfblood, so it may cause nerves to get cut off from aproper supply as well. Tense muscles may squeeze onnerves, causing numbness and tingling.

This simple explanation may be all that’s needed toexplain the feelings that people with this particular typeof discomfort often get.

The use of the electromyograph to measure muscletension is shown in the video.


So, the basic cause of these problems is:

Muscle tension x time.

Therefore, reducing tension by relaxing muscles andreducing the length of time for which tension is held —and giving muscles time to recover betweencontractions — are the keys to avoiding both short-term discomfort and long-term problems.

Relaxing — keeping muscle tension to a minimum —comes in a number of guises:

• Holding a relaxed posture.

• Knowing what relaxation feels like — andapplying it.

• Doing exercises.

• Using micropauses.

• Employing rhythm in the way tasks are done.

• Using safe working technique and skilledactions.

All of these are covered in the next section and morefully in the appendices.

D. PERSONAL FACTORS: THE WAY PEOPLE USETHEIR BODIES

Much of this guide is concerned with designing andorganising work so that people can do it with the leaststrain. This is called ‘fitting the task to the person’.

Training — or ‘fitting the person to the task’ — isanother consideration. In this context it’s reasonable toexpect that people who have knowledge about thesematters and put this knowledge into practice will bemore protected against discomfort.

POSTURE

Postures that avoid the need for muscles to be tense forlong periods are a needed foundation for the healthyand safe performance of tasks.

The elements of good posture are the foundation forworkplace design, so if the workstation design is poor,then good posture may be impossible. But poorworkplace design is not the only reason for poor


postures. Habits built up over time can contribute. Itmay simply be that a person does not realise that theyhave a poor posture. This lack of realisation may stemfrom an inability to sense the state of the muscles orbody parts. If this is the case, video filming andplayback can play an important role in training.

Features of safe postures all follow from the criterionthat muscles not be held tight and tense for longperiods. They are listed in Appendix G, which may becopied and distributed during training.

RELAXATION

Relaxation means the absence of tension in a muscle,above the natural resting amount. Relaxation is not‘doing something’, it is rather ‘stopping doinganything’. (Perhaps it isn’t hard to see why relaxationdoes not come naturally to many people). A parallel tomuscles stopping being tense is that thoughts also stop.This is, hopefully, impossible for most people, so it ishelpful to say that ‘our involvement with our thoughts’reduces to a minimum.

Having relaxed muscles while performing tasks is anessential skill. This is not to say that tasks should beperformed half-heartedly, or in a floppy sort of way, butthat the minimum tension necessary in each muscle isused to perform each element of a task, and thatmuscles that are not involved in the task are as relaxedas possible.

Watch a relaxed person in your workplace to see howthey hold their body.

Warm-up exercises appropriate to the task should be carriedout in a relaxed manner before starting work.


Relaxation does not come naturally, but there are goodways to learn it. They all involve feedback — immediateinformation on the state of the muscle.

EXERCISES

Three types of exercises are useful at work.

Warm-up exercises

Stretching warm-up exercises, appropriate to the task,should be carried out before work starts. Stretching iscarried out most safely after warm up, so some kind ofaerobic exercise is advisable beforehand, even if itinvolves no more than walking up several flights of stairs.

Traditional exercises of this nature are available frommany sources.

Exercises to promote blood flow

These are useful when muscles have been held tight andtense for long periods.

Exercises to lengthen tight muscles

When muscles have been held tight and tense for sometime they may also be shortened. Gentle lengtheningexercises are then useful.

Exercises are demonstrated in the video and describedin Appendix F, which may be copied and distributedduring training sessions.

MICROPAUSES

Micropauses are brief breaks in work that allow musclesto relax and refresh their blood supply.

Physiological research has shown that after severalminutes’ tension, a muscle can be completely refreshedif it relaxes for just a few seconds. When tension is heldfor a period approaching an hour, several hours arerequired before the muscle returns to normal.

Opportunities to take micropauses can be found inalmost any task. They should be taken frequently (everythree minutes at least, for 10 seconds) and a consciousendeavour should be made to relax the muscle duringthe pause. This means stopping holding a knife. Withtime, and as skill develops, the need for conscious effortwill lessen.


RHYTHM

Rhythm is built into performance when musclesalternate in their contractions to carry out tasks in anattractive, fluid manner. Rhythm takes on a life of itsown and supports action. It removes the need toconcentrate on each element of a task so thatconcentration can focus on the important or dangerouselements, such as using a knife safely.

Apart from skilled movements, rhythm also means analternation of action and rest. Taking breaks regularly,such as 10-minute breaks every hour where strenuousor repetitious work is performed, and frequentmicropauses taken every three minutes or so betweentasks or parts of tasks, should reduce discomfort andcan be expected to increase productivity.

Note that ‘rhythm’ is different from ‘beat’. Rhythm isflexible and accommodates variation whereas ‘beat’requires conformance to a set cycle — the very oppositeof rhythm. Machine-paced tasks, each with their own‘beat’, are more demanding than rhythmical tasks.

Like relaxation, rhythm is not something that can be‘taught’, but it can be acquired.

WORKING TECHNIQUE AND SKILL

The term ‘working technique’ refers to factors such as:

• The way joints are held while tasks areperformed;

• The way motions and movements are performedto accomplish tasks.

Working technique is explained more fully in Section 4.

Skill is when:

• The muscles required for the action or taskoperate effectively and economically; and

• No other muscles do unnecessary work.

Skill is thus a process of forgetting as well as learning— discarding the unneeded movements as well asdeveloping the needed ones.

Skill is a notable feature of work in the food processingindustry. Skill is evident in the fluid, seeminglyeffortless movements that experienced people make.


People new to a job often betray this fact by the manyunneeded movements they make. This is neither goodnor bad — time, practice and a climate ofencouragement will allow their skill to increase.

Research has shown that skill can always improve —there’s always a new skill level to go on to.

E. ACCIDENT REPORTING

Training in this area involves informing employees oftheir obligations to point out hazards, and to reportaches and pains to their supervisor. The sooneraccidents and incidents are reported, the sooner actioncan be taken to rectify any problems. (See Section 5d.)

F. LIFESTYLE FACTORS

What we do in our personal lives has an effect on howwe carry out our work. Exercise provides increasedmuscle tone, improves energy levels and enables thebody to better tolerate the demands of physical work.It’s therefore beneficial to prepare for the tasks involvedin employment, just as one would prepare forrecreational pursuits. Preparation for a 10-km run, forexample, would involve warming up and stretching themuscles to be used before starting the run. Dietcomplements exercise by providing the necessarynutrients to keep the body functioning.

Skill is a feature of all facets of work in the foodprocessing industry.


FITNESS

The movements carried out at work tend to be repeated.This means that muscles lack variety in the way theymove. (In some cases, this lack can be extreme.)Exercises that give muscles a variety of movement overtheir full range of contraction are necessary to offsetthis.

DIET

Carbohydrates and a variety of other foods such asvegetables and fruit provide the energy needed to carryout heavy manual tasks.

Complex carbohydrates include all types of bread,cereals (both hot and cold) and grain products.

These food sources also promote attentiveness whilecarrying out repetitious tasks that require heavyphysical exertion, and sustained or repeated muscleactivity.

The emphasis in this guide is on occupationally relateddisorders. However, other activities outside theworkplace that require intense, sustained orconstrained postures may contribute to overusesyndrome as well.


MANAGEMENT OFOOS PROBLEMSWHEN THEY OCCUR

INTRODUCTION

Management must be prepared to deal with OOSproblems if they do occur in the workplace. The firstprerequisite is that senior management recognise theproblem. Second is that they have the commitment tomake the needed changes in work tasks, workorganisation, workstation design, and so on.

That commitment needs to be supported by policies andprocedures that promote the actions necessary todischarge that commitment.

A. MANAGEMENT COMMITMENT

Essential elements of commitment are:

• A dedication to identifying, assessing andcontrolling hazards relating to OOS.

• Attention to design of plant and equipmentdesign, work schedules, process and flow.

• Attention to environment considerations, i.e.space, lighting, heat, cold.

• Having relevant managers/supervisors/ healthand safety personnel trained in the prevention ofOOS.

• A willingness to work in collaboration withemployees, union representatives, ACC andOSH officers.

• Budgetary provision for safety and health.

B. POLICY DEVELOPMENT

A health and safety policy on OOS is best developed incollaboration with workers and their representativesand would include:

6SECTION


• A general statement of commitment to theprevention and control of OOS.

• An expectation of staff commitment to followthe policy.

• Provision for the employment of temporarystaff if staff have to go off work, or duties needto be changed.

• Rehabilitation aspects included, such as earlyreturn to work guide.

The policy must be signed by the general manager ortheir representative. (See Appendix B.)

C. OOS REPORTING SYSTEM

To effectively manage OOS, there must be an earlyreporting system in place. This means:

• Training for all to recognise OOS symptoms.

• A delegated person responsible for takingaction once symptoms have been reported.

• Assessment of job tasks in relation tosymptoms.

• Provision of alternate duties.

• Liaison with medical staff to effectively managetime off work.

• Referral for correct diagnosis of symptoms.

There must be a health and safety culture within theworkplace, with all staff working towards the goal ofzero work-related injuries.

D. MANAGEMENT OF EARLY SIGNS ANDSYMPTOMS

It is preferred that the employee remain at work.However, this will depend on the severity of his/hersymptoms, alterations to the workplace and theavailability of alternative duties.

Immediately it’s known that a person has symptoms,an analysis of the work organisation, the design of theworkstation, and the person’s working techniqueshould be carried out. This needs to occur, along withan analysis of the symptoms and how they present.


It may be necessary to have a formal diagnosis at thisstage to determine what actions may have lead to thediscomfort.

It may be useful to consult a doctor with occupationalhealth experience. An ergonomist, an occupationaltherapist or other relevant practitioners may be calledin to give advice on the formal assessment of tasks,using techniques already described in Section 4.

Alternative duties (see Appendix J) can be provided if:

(a) The doctor diagnosing has agreed that theperson can stay at work without further injuringthemselves; and

(b) The alternative duties do not aggravate anysymptoms or bring on any other symptoms.

E. REHABILITATION

Rehabilitation/injury management is a process torestore the person with OOS to the fullest, physical,psychological, social, vocational and economicusefulness possible. It’s a process that depends on theactive co-operation and support of all parties concerned.

Basic principles in the management of an effectiverehabilitation programme are as follows:

• Immediate action should be taken in dealingwith reported injuries.

• An early start to treatment provides morechances for the worker to be actively involved inthe whole rehabilitation process, which in turnallows the person to feel valued and able tocontribute to his/her recovery.

• Ensure the person affected is able to understandthe nature of their problem and its contributingfactors. Simplify information/explanation toavoid the process being too complex tounderstand.

• Encourage an appropriate early return to work.This will help to maintain the worker’s physical,mental and emotional wellbeing.

• If a worker has been off for over a month, it’sadvisable to have them tested for ability to carry


out tasks. Rehabilitation or physiotherapycentres carry out these tests. They will set upthe tests to simulate work as much as possibleand put the person through a number of tasksand monitor their body’s physical reaction.

• Ensure regular communication is maintainedbetween everyone involved in the rehabilitationprocess, including the person affected.

• Ensure that everyone involved in the processhas the same outcome expectations.

Important points to note when reintroducing a personto work are:

• The injured operator needs to be involved inplanning for return to work duties.

• The person should be aware that their physicalmuscular strength and ability to perform thetask may have altered, so it’s vital they returnto normal work pace gradually.

• Duties should be modified to adapt to theperson’s capabilities.

• Others in the workplace need to recognisethese factors and support their return to work.

This is discussed in more depth in Appendix J.


AAPPENDIX COST FACTORS INO O S

The costs to a company of work-related accidents andill-health are often poorly appreciated.

Apart from the direct costs of an accident, or in thiscase, of a person having to leave work because of severemusculoskeletal pain, the associated indirect costs canbe very large.

Typical costs that might be incurred by a company areas follows:

DIRECT COSTS

• Possible ACC experience rating penalty, lastingup to five years;

• Medical treatment;

• Sick leave;

• Wage top up for staff on ACC;

• Possible court fines and legal fees;

• Costs of the redesign of workstations andequipment;

• Costs of specialist equipment e.g. supports,splints.

INDIRECT COSTS

• Loss of productivity;

• Loss of skilled staff;

• Cost of hiring new staff to replace injured staff;

• Cost of training new staff;

• Loss of quality as new workers are trained;

• Additional supervision of new workers;

• Time spent investigating the incident;

• Effects of loss of morale;

• Possible personal grievance claims;


• Loss of reputation;

• Loss of market share: loss of product orders.

INDIRECT COSTS EXCEED DIRECT COSTS

There is a range of estimates for the ratio between thedirect and indirect costs of an accident/incident.Typically a factor of between 4 and 8 is used. This meansthat for every dollar spent on the direct cost, between$4 and $8 will also be spent in some way.

If a profit margin of 10% is used, then the additionalactivity by a company needed to recoup these costs is asfollows:

Direct cost of incident $500

Indirect cost of incident $2000 - $4000

Total cost $2500 - $4500

Additional turnover requiredto offset these costs $25,000 -$45,000

These are all costs to the company. Not included arethe costs incurred by the person affected, ACC or by thepublic health system.

COSTS TO THE PERSON INJURED OR OFF WORK

• Possible home help;

• Medical costs;

• Rehabilitation costs;

• Loss of income;

• Pain and suffering;

• Effect on home life, hobbies and lifestyle;

• Effect on other family members;

• Travel to and from treatment providers.


HEALTH AND SAFETYPOLICY

INTRODUCTION

The standard components of a health and safety policyare detailed below, with some additional aspects that areparticular to occupational overuse syndrome.

A. HEALTH AND SAFETY POLICY

• The policy needs to be written down.

• The policy should be distributed to all staff.

• The policy needs to be supported by otheractions (described below) and financialconsiderations taken into account.

• The policy should be reviewed regularly, todetermine that it is both working and feasible.

• Channels for action need to be established.

B. GOALS AND RESPONSIBILITIES

• Information on health and safety performanceshould be collected.

• The health and safety policy should address thecurrent strengths and weaknesses of past andcurrent performances.

• Goals for health and safety need to be reviewedperiodically.

• Job descriptions should describe responsibilitiesfor health and safety.

• Required roles need to be described and criteriafor performance stated. The performanceassessment should consider health and safetyperformance.

• There needs to be a mentor for health and safety,and regular contacts with other health andsafety personnel.

BAPPENDIX


C. OOS POLICY

An OOS policy should cover:

• The inclusion of ergonomic criteria in thedesign of equipment and work.

• The assessment of jobs, tasks and equipment toidentify and assess hazards.

• Provision of information to staff.

• Training for staff.

• Provision for coping with changes in workloaddue to sudden jobs/orders, seasonal work, peopleaway from work unexpectedly, machinebreakdowns, etc.

• Early reporting of symptoms, and furtherreporting procedures.

• Development of a rehabilitation plan.

• Identification of suitable alternative duties.

• How workers and their representatives will beinvolved.


WORKSTATIONDESIGN CHECKLIST

There are many examples of workstation designchecklists based on ergonomic principles. Thefollowing* is one of the best-known and lists the basicprinciples of design for workstations and equipment:

1. The worker should be able to adopt an uprightand forward-facing posture.

2. Where vision is a requirement of the task, thenecessary work points should be visible with thehead and trunk upright, or just with the headinclined slightly forward.

3. All the work activities should permit the workerto adopt several different — but equally healthyand safe— postures without reducing theircapability to do the work.

4. Work should be arranged so that it can be done,at the worker’s choice, in either a seated or astanding position. When seated, the workershould be able to use the backrest of the chair, atwill, without necessitating a change ofmovements.

5. The weight of the body, when standing, shouldbe carried equally on both feet, and foot pedalsshould be designed accordingly.

6. Work should not be performed consistently at orabove the level of the heart. Where light handwork above the heart must be performed, restsfor the upper arms are a requirement.

7. Work activities should be performed with thejoints at about the midpoints of their range ofmotion.

8. Where muscular force must be exerted, it shouldbe by the largest appropriate muscle groupavailable, and in a direction co-linear with thelimbs concerned.

CAPPENDIX

*See The Ergonomics of Workspaces andMachines. 2nd Edition. Clark T S and Corlett E N,Taylor and Francis, London, 1995.


9. Where a force has to be exerted repeatedly, itshould be possible to exert it with either of thearms, or either of the legs, without undue force.

NOTE

This checklist describes the ‘shape’ of the body as itshould be positioned at the workstation. From this andanthropometric data (see Appendix D) the size of theworkstation can be estimated.

These two starting points lead to an initial workstationdesign which serve as a basis for a trial. Results fromsuch a trial can then be used to refine the design.Sometimes several rounds of trial/redesign are requiredbefore a workstation will cater for the acceptablepercentage of users.

OSH has published a fuller set of checklists for theanalysis of management systems and workplace designto prevent OOS (see Bibliography).


ANTHROPOMETRICESTIMATES FOR NEWZEALANDERS

The data in this appendix are given as a guide only. Theycan be used to obtain some initial measurement for thedimensions of workstations but they can never, used alone,define what will be convenient for a large range of users.

Some of the data will indicate the minimum distancesrequired between parts of workstations for body clearance(6 below), or for reaching to objects in front of the body.

Some useful rules of thumb:

1. Bench height. Set the bench at standing elbowheight less about 50mm. The exact height willdepend on the type of work to be done and theheight of the item being worked on. Precisionwork needs to be higher, for example, but not sohigh to cause people to work with raisedshoulders.

2. Add an appropriate amount for shoes — for men,25mm, and women 45mm — but depending onthe situation and the type of footwear worn.

3. Knuckle height is a useful reference point for theheight of handgrips and support rails.

4. Finger height is a useful reference point for theminimum height of controls.

5. Thigh thickness is a useful minimum distance forthe clearance between seats and the undersides ofdesks or workstations.

6. Buttock-knee length is a useful reference for theclearance between a chair back and any verticalsides of a workstation or desk that are an obstaclefor the knee.

One valuable aspect of the table is that it demonstrates justhow much short and tall people vary in their dimensions,and the consequent variability that may need to be builtinto a workstation.

DAPPENDIX


ANTHROPOMETRIC ESTIMATES FOR NEW ZEALANDERSMales 19-45 yrs Males 45-65 yrs

Body Dimension 5th 50th 95th 5th 50th 95th

1 Stature 1665 1770 1870 1650 1745 18402 Eye height 1560 1660 1760 1545 1635 17303 Shoulder height 1355 1455 1550 1340 1430 15254 Elbow height 1035 1115 1190 1025 1095 1165

5 Hip height 865 940 1010 855 925 9956 Knuckle height 710 770 830 700 760 8157 Fingertip height 605 670 725 605 660 7158 Sitting height 875 930 975 860 915 960

9 Sitting eye height 755 805 855 745 790 84010 Sitting shoulder height 555 605 655 550 595 64011 Sitting elbow height 200 250 295 195 245 29012 Thigh thickness 140 160 185 140 160 185

13 Buttock-knee length 555 605 650 555 595 64014 Buttock-popliteal length 455 500 555 450 495 54515 Knee height 505 555 605 500 550 59516 Popliteal height 405 450 490 400 440 480

17 Shoulder breadth 430 470 515 425 465 50518 Hip breadth 315 360 405 320 365 40519 Chest depth 205 245 275 230 265 29520 Abdominal depth 215 260 300 235 290 340

Females 19-45 yrs Females 45-65 yrs5th 50th 95th 5th 50th 95th

1 Stature 1555 1650 1750 1525 1630 17652 Eye height 1450 1550 1650 1425 1530 16353 Shoulder height 1255 1345 1440 1230 1330 14304 Elbow height 965 1035 1105 945 1020 1100

5 Hip height 765 835 905 750 885 8956 Knuckle height 680 740 795 670 730 7957 Fingertip height 580 640 705 565 635 6958 Sitting height 820 875 935 800 865 920

9 Sitting eye height 710 760 815 695 750 81010 Sitting shoulder height 525 570 620 510 560 61511 Sitting elbow height 195 240 285 190 235 28512 Thigh thickness 130 160 185 135 160 185

13 Buttock-knee length 535 585 620 530 585 63514 Buttock-popliteal length 445 490 540 445 490 54515 Knee height 470 510 555 460 505 55516 Popliteal height 365 410 455 355 405 450

17 Shoulder breadth 365 405 445 355 400 44018 Hip breadth 310 375 435 320 385 45019 Chest depth 200 245 290 225 270 31020 Abdominal depth 200 250 295 225 275 330

NOTE: there has never been a comprehensive survey of the sizes of the New Zealand population.These data are estimates based on measurements of British adults and the relation betweentheir average stature and the average stature of the New Zealand population.

ReferencesSize and Shape of New Zealanders. NZ Norms for Anthropometric Data. Wilson N, RussellD and Wilson B. Life in New Zealand Activity and Health Research Unit, University of Otago,1993.Bodyspace, Ergonomics, Anthropometry and Design. 2nd Edition, Pheasant S T, Taylor andFrancis, London, 1996.


SELF-REPORT OFDISCOMFORT

1. Name: __________________________________

2. Age: ___________

3. Are you:

Left-handed

Right-handed

4. Job title: ______________________________

5. Length of time in present job: _______________

6. Today’s date:______________________

7. Do you have discomfort now? Yes No

If yes, please describe it:_________________________________________

_________________________________________

_________________________________________

_________________________________________

8. When did you first notice any discomfort in thisjob?

_________________________________________

_________________________________________

9. Please describe the task that causes the mostdiscomfort:

_________________________________________

_________________________________________

_________________________________________

_________________________________________

EAPPENDIX


10. Please describe the tasks that are second mostserious cause of discomfort:

_________________________________________

_________________________________________

_________________________________________

11. Please shade on the body diagram below wherediscomfort is occurring:

12. Please shade on the diagrams of your handswhere any discomfort is occurring:

13. General comments:_________________________________________

_________________________________________

_________________________________________

_________________________________________

_________________________________________

_________________________________________

_________________________________________


VIDEO ANDEXERCISES

ABOUT THE VIDEO

The video accompanying this resource kit is a trainingtool aimed at workers. It covers the processing of redmeat, poultry and fish (including shellfish) and givesguidance on what workers can do themselves to preventOOS. It points out, however, that there’s a limit to whatemployees can do, and that plant, equipment andworkflow changes may be required.

The video gives a short explanation of why OOS occursand gives tips on how to reduce the likelihood of injuryby:

• using micropauses;

• sharpening the knife correctly;

• stretching and warming up muscles;

• holding the knife at a correct angle;

• performing specific exercises;

• understanding elements of the knife;

• adopting comfortable postures;

• standing close to workstations; and

• developing rhythm.

The video shows the use of an electromyograph (EMG),a device that measures muscle tension.

The video should be useful as part of an orientationprocedure and as part of up-skilling, reminding workersof the areas where they can take responsibility.

The following pages give a summary of the exercisesshown in the video, and can be copied and given to staff.

APPENDIXF


EXERCISES TO HELP AVOID OOS

The video Muscle Minding, which was produced specifically for peoplewho work in the meat, poultry and fish processing industries,demonstrates some simple exercises that will help with the prevention ofOccupational Overuse Syndrome (OOS). These exercises are explainedand illustrated below.

When should these exercises be done? To get the maximum benefit, youshould perform them at the start of your shift, during breaks and anyother time you feel the need for them.

While performing the exercises, it’s important to maintain a relaxedstance. Your legs should be roughly shoulder-width apart, yourshoulders should be relaxed, and your hands should be at the side of thebody to start with.

These exercises are all designed to promote blood flow and help lengthentight forearm muscles.

A. FOREARMS (40 SECONDS)

1. HAND FLAPS

With your arms loose at the side of the body, shake and flap your hands ina gentle and relaxed manner for 5 -10 seconds. Let your wrists gocompletely limp. Don’t use any forearm muscles to do the exercise.

2. FOREARM TURNS

Hold your arms out a littlefrom the body and slowlyrotate each arm so thatthe palms face out and up,to stretch the upper innerforearm muscle. Hold for5 seconds; making sureyour fingers are loose.Now rotate fully in thereverse direction. Relaxand flap hands again.

3. HAND FLAP

Repeat 1.

1


4. SECOND ARM TURN

Twist the wrist so palms turninwards and backwards, to stretchthe outside forearm muscle. Holdfor 5 seconds. Rotate fully in thereverse direction. Relax and flaphands again.

B. SHOULDERS

SHOULDER ROTATION (30 SECONDS)

Slowly rotate your shoulders forwards,upwards, backwards and then allowthem to drop, completing a largecircle, taking at least four seconds toperform this movement. Relaxmomentarily and then repeat theexercise one or two times. Now, dothis exercise in the opposite direction.

CHEST AND SHOULDER EXERCISES (ABOUT 20 SECONDS)

With yourneck straight,clasp yourhands behindyour head andgently stretchyour elbowsback untilyour shoulderblades feel likethey are close.Now stretcheach elbow out sideways, and hold this for five seconds. Relaxmomentarily and then move the elbows forward and as close together aspossible. Hold this for five seconds and relax.

2


C. HEAD

1. HEAD ROTATION (ABOUT 20 SECONDS)

Turn your head slowly (keeping your chin in),look to your left side and then behind you, gentlystretching at the end point. Hold for five secondsand return to the straight ahead position andrelax. Imagine a point of light moving slowlyaround the room, and follow it with your eyes.Now, repeat the exercise to the right side.

2. HEAD SHRUG AND STRETCH (ABOUT 20 SECONDS)

Raise your shoulders as high aspossible while tucking yourchin in. Hold for five seconds,then relax and go into neckstretch. Drop your shouldersand hold them downward,while stretching your headupwards. Make sure your headis not tilted forward orbackward during this exercise.

3. SHOULDER STRETCH

Start withyour rightarmstretchedback as faras it will go.Look to theleft andmove theright armhorizontally across the front of the body until it points to the left.Place the left arm over the right elbow and pull backwards to fullystretch for five seconds. Relax momentarily and repeat on the oppositeside.

3


SAFE BODYPOSITIONS

Safe body positions are those positions where whenmuscles are not held tense for long periods. Thefollowing features of safe body positions all stem fromthe idea of reducing muscle tension to a minimum. Thecomments in italics refer to features of your workplaceor to other reasons that may cause you to adopt anundesirable position.

Face straight on to your work

If your body turns constantly to one side then muscleson that side will be tense for long periods. (Workstationplaces work to one side: working to one side ratherthan drawing the work to be in front).

Stay upright

If your body constantly leans forward or leans over toone side, then the muscles in your lower back or yourside will be tense for long periods. (Workstation toolow).

Balance your head

If your head constantly tilts too far forward or back thenthe muscles at the top of your neck will be tense forlong periods. There are safe ways to look down, such asrotating the head on the top of the neck rather thanbending forward. (Workstation too low or too high:workpiece too close to your body).

Shoulders low and relaxed

If your shoulders are constantly raised, then themuscles on the sides of your neck/shoulders will betense for long periods. (Workstation too high: generaltension is often expressed in raised shoulders).

Elbows gently at your sides

If your elbows are constantly held out sideways, thenthe muscles on the top of your shoulders will be tensefor long periods. (Workstation too high).

GAPPENDIX


Work with your wrists straight

If your wrists are bent, it may be because your elbowsare pushed out, or your workstation is too high or low.

Have good foot support

Make sure your feet are well supported. If they dangle,your leg muscles have to stay constantly tense to keepthem in place.

Do some limbering movements from time to time

Do these to counter the effects of a static position.Once every hour or so is ideal.


KNIFEHANDLING

INTRODUCTION

This is a general section on knife safety, coveringaspects of knife handling as they relate to OOS. Itacknowledges the individual’s expertise with boning,filleting, trimming, shucking, slicing and does notattempt to override that.

Knife choice, handling, sharpening and maintenanceare key areas in the prevention of OOS in poultry, meatand fish processing. Injuries include (as well as cuts)wrist sprains and strains and these are due to repetition,force exerted and posture while carrying out their tasks.

One of the main problems experienced is the frequentbending and twisting of the wrist too far from thenatural position, particularly when movements are fastand jerky.

WORKPLACE POLICY

Each workplace should have a policy in place thatcovers:

(a) Selection of the correct knife for the task,including considerations such as comfort, fit,handle diameter and material, and blade shape.

Selection of the correct knife for the task is important.

HAPPENDIX


(b) Protective equipment to use with the knife, i.e.arm guard, scabbards, protective gloves, aprons,knife guards (including where and when to usethis equipment).

(c) Training by a suitably qualified person on:

- sharpening techniques;

- steeling techniques;

- general handling of knives;

- working techniques.

(d) A supervisory position or a buddy system untilthe new worker is suitably trained.

(e) Storage of the knife, its cleaning and sanitationtechniques.

SAFETY TIPS FOR WORKERS

Some extra safety tips for workers are:

• Never try to catch a falling knife.

• Keep your knife in the scabbard when not inuse.

• Wash the knife in boiling water before stoning.

• Make sure the steel is fitted with a guard.

• Make sure you have been shown how to sharpenthe knife before attempting it yourself.

KEY POINTS

There should be consultation between management,employees and safety and health representatives in theselection, trialling and training in the use of newknives.

Knives should be trialled for suitability in each differenttype of work or area, e.g. boning and slicing.

The handle needs to be large enough to provide a securegrip. This prevents the hand slipping forward over theblade (run through) and reduces the force required tohold the knife.

The handle design should reduce excessive wristbending — the principle is to bend the tool, not thewrist.


The line of action of the tool should coincide with theline of the action of the wrist and forearm.

The knife should be gripped evenly along the surface ofthe handle.

Sharpness of the knife is essential in reducing the forcerequired to make a cut. If the knife is blunt, more forceis needed to cut and this increases the risk of overuseproblems. Sufficient time should be provided for peopleto sharpen their knives.

Provide training in how to use knives and tools correctly.

Line of action of the knife should coincide with the line ofaction of the wrist and forearm.

Training in using a new knife is essential. Differentmethods may be required with different designs. Thework rate may need to be lowered to allow a lead-intime from training.

Reference

For further information, see Meat Industry Generic EntryLevel Unit Standard Sharpen and Maintain Hand Knives inthe Meat Processing Industry, available from the New ZealandQualifications Authority.


WORKINGTECHNIQUE

Safe working techniques all relate to the way musclesapply tension.

The way that joints are held while tasks are performed:

• Avoid marked bending up at the wrist,particularly if sharp movements or force areinvolved.

• Avoid excessive sideways wrist bending —during movement or in holding sustained handpositions.

The motions and movements used to accomplishtasks:

• Avoid repeated turning of the forearm (along itslength).

• Avoid over-spanning — wide opening andgripping movements of the fingers.

• Don’t apply excessive force in squeezingmovements.

• Use a power grip (as when holding a hammer)rather than a pinch grip (as when holding apencil).

• Avoid repeated shock loading to the hand, wristand arm from the use of a hammer, or bytugging, jerking or from sharp torque reactions.

• Avoid repetitive picking up with the hands. (Aswhen moving a pallet of paving blocks from thefront gate to the back yard).

IAPPENDIX


EXAMPLE OF AREHABILITATIONPROGRAMME

Rehabilitation is a process to restore the person withOOS to the fullest physical, psychological, social,vocational and economic usefulness possible. As such,it depends on the active co-operation and support of allparties concerned.

An appropriate early return to work should beencouraged, with time off work limited to a minimum.

A. PRINCIPLES OF RETURN TO WORKPROGRAMMES

Return to work plans need to be arranged in advance sothat the person returning can be dealt with promptlyand effectively.

The following elements of a return to work programmewill need to be considered:

• The identification in advance of alternativeduties.

• Communication between treatment providersand the employer.

• Contact with the person affected while he/she isaway from work.

• A workplace assessment, followed by anyindicated remedial action for the workplacedesign and for work practices.

• An assessment of the person’s physical skills.

• The identification of any training the personmight need.

• A gradual reintroduction to full work speed.

• Plans to review the effectiveness of theintervention.

A sample management outline for the resolution ofdifficult cases is presented in summary form overleaf.

JAPPENDIX


Have theemployee’ssymptomsimproved?

PLAN

DO

CHECK

All parties meet to discuss the results of thework site assessment. They develop anaction plan.

INFORMALMONITORING

CONSIDEROPTIONS

Yes

No

.

The employee reports the diagnosis to his/her supervisor. The supervisor and theemployee discuss the GP’s treatment planand its implications for the workplace.

The employee visits a general practitionerand an OOS condition is diagnosed.

The supervisor arranges for acomprehensive workplace assessment.

The employer puts the plan into effect.

The employer supports the employee andreinforces the treatment provider’srecommendations on workload, workstationand work techniques.

The employer reviews the situation two weeksafter the visit to the GP.

MANAGEMENT OF THE RETURN TO WORK: BASED ON THEQUALITY CYCLE


MANAGEMENT OF THE RETURN TO WORK: DETAIL

Have theemployee’ssymptomsimproved?

All parties meet to discuss the report of theworksite assessment. They develop an actionplan and set a review date.

Yes

No

The case should be treated as seriousharm. The coordinator notifies OSHimmediately and conducts aninvestigation.

The employer puts the plan into effect.

The employer supports the employee andreinforces the treatment provider’srecommendations on workload, workstation andwork techniques. The employer reviews thesituation two weeks after the visit to the GP ortwo weeks after the return to work after anyabsence.

Has the GPprescribed morethan 7 calenderdays off work?

A comprehensive worksite assessmentis carried out. The employee worksmodified or reduced duties.

Will theemployee be on

modified or reducedduties for 7 days

or longer?

The employee is diagnosed by a GP orcompany doctor as having a work-relatedOOS condition. The employee contacts thesupervisor. The supervisor and the employeediscuss the GP’s treatment plan and itsimplications for the workplace. Thesupervisor consults the coordinator.

The supervisor notifies theworksite injury coordinator, whoupdates the accident register.

The employer identifies the mostappropriate person to maintainweekly contact with and discussreturn to work options with theemployee.

With the employee’s consent, theemployer contacts the person’s GP,any other treatment providerinvolved and the ACC casemanager, to find out how theemployer may support therecommended treatment plan atwork and what long-term optionsneed to be considered, if any.

HasHas the

employeebeen clearedfor return to

work?

The employer ensures that a worksiteassessment has been completed, bya professional, at least one weekprior to the employee returning towork.

Yes

Yes

No

Yes

No

Informalmonitoring

Consideroptions


B. REINTRODUCTION OF AN EMPLOYEE AFTERABSENCE

A sample outline of a gradual reintroduction to workafter absence due to OOS is shown below. This shouldnot be regarded as a hard and fast procedure, but it doesindicate the type of regime that may be needed.

C. PROCEDURES FOR REINTRODUCING ANEMPLOYEE AFTER AN ABSENCE

After time off work due to injury, an operator’s musclesmay feel completely recovered, but they will also havelost physical condition. It’s essential for the person towork up to full production gradually. The followingpoints should be observed:

1. An injured operator may have been losing speedfor some time before going off work. Temporarystaff should be used to clear away any backlog ofwork, and to avoid overloading the remainingoperators in a section.

2. The injured operator should be invited back towork while still off work to discuss the probablecontributing causes to injury. This should bedone sufficiently early to implement changesbefore the operator returns to work.

3. The now-recovered operator should not work afull shift for the first four days. A suitable workschedule might be, after 1-2 weeks off work, asfollows:

DAY 1:

Four sessions of work (if the employee has beenoff work for 2 weeks), or six sessions of work (ifonly 1 week off work) of 15 minutes. Theemployee’s operating style should be monitoredduring these periods, and the adoption ofrelaxed work-styles made a necessary conditionof return to work. Temporary staff can beretained to take the bulk of the workload. Theoperator is given a relaxing task or is sentwalking for the intervening periods. At the endof Day 1, and every day after for 2 weeks, the


operator should be checked by the supervisor tosee how he/she is faring.

DAY 2:

Six sessions (if the employee has been off workfor 2 weeks), or 9 sessions (if only 1 week offwork) of 15 minutes. The operating style shouldbe monitored for at least half of these sessions,and relaxation again emphasised. As for Day 1,the periods when the operator is not at the workshould be filled with a non-stressful task whichdoes not involve heavy hand loads. For example,prolonged writing should be avoided, as shouldthe use of heavy directories or over-full filingcabinets.

DAY 3:

Five sessions (if the employee has been off workfor 2 weeks), or 7 sessions (if only 1 week offwork) of 30 minutes. Monitoring andintervening tasks as before.

DAY 4:

Review progress in the morning. If there aresigns of discomfort overnight, return to Day 1and check for other contributing factors.Otherwise proceed with 6 sessions (if theemployee has been off work for 2 weeks), or 7sessions (if only 1 week off work) of 45 minutes.

DAY 5:

Seven sessions of 45 minutes (if the employee hasbeen off work for 2 weeks), or 7 sessions of 50minutes (if only 1 week off work).

Hence, full production must include some hourlybreak. It should be possible to introduce a 10-minute break, although this may take someorganisation. The breaks do not have to beinactive, they only need to be different from theactivities which place stress on the musclesduring the main task.


D. ALTERNATIVE WORK DUTIES

When alternative work duties are assigned, care must betaken not to aggravate the prevailing symptoms byassigning the person to a task that requires the sameposture and muscle group to be used.

Alternative duties should be discussed and evaluated bythe health professional responsible for the person’srehabilitation before they are allocated a task. Thisallows the identification of potential hazards in eachperson’s case. Failure to carry out this fundamentalrequirement may result in further harm occurring.

Employers, supervisors and the employees shouldfollow the advice on work procedures or time frames setby the health professional in order to effect a full andspeedy recovery. By the same token, healthprofessionals should have knowledge of the conditionsthe employee works in.

Below is a list of alternative duties used by someorganisations to provide work for persons diagnosedwith OOS. Each case and task must be evaluated forindividual suitability. These duties may not be suited toeverybody, due to vibration, body positioning andmanual strength required, and are suggestions only.

Duties

assembling cartons visitor guide

specified parking waterblasting

stock yards deliveries/pickups

amenity cleaning rodent control

general housekeeping laboratory assistant

gardens and grounds quality assurance manuals

special projects filing.


DEFINITION OFSERIOUS HARM

At the print time of this document, the definition ofserious harm in the First Schedule to the Health andSafety in Employment Act is under review. There willbe extensive consultation with interested parties,commencing from mid-1997.

Please note that the wording below is a proposal only atthis stage, and is subject to change and approval by theMinister of Labour, following consultation.

In the meantime, the definition set out in the FirstSchedule to the HSE Act continues to apply.

If you have any comments to make, please direct themto the OSH Centre for National Support (for address,see page 83).

We intend to update this information as necessary.

PROPOSED AMENDED FIRST SCHEDULE (SERIOUSHARM) TO THE HEALTH AND SAFETY IN

EMPLOYMENT ACT 1992.

1. Any of the following conditions that amounts to, orresults in, permanent loss of bodily function, or whichare likely to render a person unable to carry outnormal employment duties for seven (7) calendar days:respiratory disease, noise-induced hearing loss,neurological disease, cancer, dermatological disease,communicable disease, musculoskeletal disease, illnesscaused by exposure to infected material, decompressionsickness, poisoning, vision impairment, chemical orhot-metal burn of eye, penetrating wound of eye, bonefracture, laceration, crushing.

2. Amputation of body part.

3. Burns requiring referral to a specialist registeredmedical practitioner or specialist outpatient clinic.

4. Loss of consciousness from lack of oxygen.

KAPPENDIX


5. Loss of consciousness, or acute illness requiringtreatment by a registered medical practitioner, from theabsorption, inhalation, or ingestion of any substance.

6. Any harm that causes the person to be hospitalisedfor a period of 48 hours or more, commencing within 7days of the harm’s occurrence.


BIBLIOGRAPHY

Legislation

Health and Safety in Employment Act 1992

Health and Safety in Employment Regulations 1995

OSH and ACC Publications

How to Identify and Control Hazards. OccupationalSafety and Health Service, Department of Labour,Wellington, 1993.

How to Select an Occupational Safety and HealthConsultant: A Guide for Managers. AccidentRehabilitation and Compensation InsuranceCorporation, Wellington, 1966.

Manual Handling Guidelines for the Workplace.Occupational Safety and Health Service, Department ofLabour, Wellington, 1991.

Occupational Overuse Syndrome: Checklists for theEvaluation of Work. Occupational Safety and HealthService, Department of Labour, Wellington, 1991.

Occupational Overuse Syndrome: Guidelines forPrevention and Management. Occupational Safety andHealth Service, Department of Labour, 1991 (Reprinted1995).

Occupational Overuse Syndrome: Treatment andRehabilitation - A Practitioner’s Guide. 2nd edition,ACC and Occupational Safety and Health Service,Department of Labour, Wellington, 1993.

Other New Zealand Publications

Knife Handling in the Meat Industry. Rata Sonny. MeatIndustry Training Board and New Zealand FishingIndustry Training Council, Accident CompensationCorporation, 1995.

Knife Management Manual, Sockburn Plant, AllianceGroup Ltd., Christchurch, 1994.

Meat Industry Generic, Unit No. 2503, Sharpen andMaintain Hand Knives in the Meat Processing Industry.NZ Qualifications Authority.


Additional Publications

Ergonomics in the Meat Industry, EmployeeInformation. American Meat Institute, ErgoTechIncorporated, Washington DC, 1991.

Ergonomics Program, Management Guidelines for MeatPacking Plants. Occupational Safety and HealthAdministration, US Department of Labor, 1990.

Fitting the Task to the Man: A Textbook of OccupationalErgonomics. 4th Edition, Etienne Grandjean, Taylor &Francis, London/New York, 1988.

Health and Safety Training for Meat Processors:Working Together to Eliminate Accidents. OntarioMinistry of Labour, United and Commercial Workers,Ontario Meat Council, Workers Health and SafetyCentre, Ontario, Canada, 1994.

Health Hazard Evaluation Report, HE 80-38-744Longmont Turkey Processors Inc. Pryor P and Singal M.Longmont, Colorado. Hazard Evaluations and TechnicalAssistance Branch, NIOSH, 1980.

Manual Handling and Noise in the Poultry ProcessingIndustry: Reducing the Risk. Department of Businessand Employment, Industry Services, Occupational Safetyand Health Authority, Victoria, Australia, 1995.

Model Code of Practice for Prevention and Managementof Repetition Strain Injury. National OccupationalSafety and Health Commission, Worksafe Australia,Sydney, 1986.

Psycho-social factors and work-related musculoskeletaldiseases. Bongers P, de Winter C R, Kompier M A J andHildebrandt U V. Scandinavian Journal of Work,Environment and Health, Vol. 19 (5) pp. 297- 312,October, 1993.

Repetitive Motion Disorders: The Medical ErgonomicsTraining Programme: A Guide for the Poultry Industry,Independent Poultry Task Force.

The Ergonomics of Workspaces and Machines. 2ndEdition. Clark T S and Corlett E N, Taylor & Francis,London/New York, 1995.

Work-Related Musculoskeletal Disorders: A ReferenceBook for Prevention. Kuorinka I and Forcier L (Eds).Taylor & Francis, London/New York, 1995.

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