preventing musculoskeletal disorders anne duffy. © copyright 2006 ontario safety association for...

Preventing Musculoskeletal DisordersAnne Duffy

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Objectives

• Increase awareness of MSD signs and symptoms

• Recognize MSD risk factors

• Understand how to eliminate or control MSD risks

• Describe the systematic approach to workplace MSD program development

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2004 LTI Accident Types Community & Health Care

Data Source: WSIB Firm ExperienceSnapshot Period: September 2005

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Client Handling vs MSD

Client handling requires a unique approach because:

• Weights being handled are beyond acceptable levels

• Handling bodies is different than boxes

• The human can be unpredictable and uncooperative

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MSD Definition

‘MSD are injuries and disorders of the musculoskeletal system where exposure to

various risk factors present in the workplace may have contributed to the development or

aggravated a pre-existing condition.’

‘MSD includes the muscles, tendons, tendon sheaths, nerves, bursa, blood vessels, joints and

ligaments’ (OHSCO, 2005)

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What’s in a name?

• Repetitive Strain Injury (RSI)

• Cumulative Trauma Disorder (CTD)

• Strain & Sprain

• Workplace Musculoskeletal Disorders (WMSD)

• Musculoskeletal Injuries (MSI)

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Primary Risk Factors

• High force – how much is too much?

• Awkward posture – working beyond optimal range of motion, static/dynamic

• Repetition – frequency, duration

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Secondary Risk Factors

• Contact stress

• Local or whole body vibration

• Cold temperatures

• Work organization

• Work methods

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Exercise

Identify the potential risk factors associated with the product you have.

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Safety Group Approach

1. Set a standard

2. Communicate the standard

3. Train to the standard

4. Review and revise

5. Recognize success

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Set a Standard for MSD Prevention

Through a systematic means of recognizing, assessing and controlling hazards, Name of organization will minimize the risk to its employees in developing work related musculoskeletal disorders.

The recognition of MSD risks will be accomplished through supervisors conducting workplace inspections that includes recognition of MSD risk factors and through employees reporting signs and symptoms of MSD early on to their supervisors.

The assessment of MSD risks will be accomplished through collection of information on the magnitude of MSD risk, the potential of the risk and the severity of the risk.

Controls will be implemented to eliminate or minimize MSD risks by promptly attending to identified risks, incorporating the potential for MSD risks in future purchasing considerations, job design, workplace design, return to work, etc….

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R.A.C.

MSD prevention

Recognize

Assess

Control

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Recognizing MSDCollecting Data

• Passive Surveillance• Incident data/claims costs

• Hazard/near miss reports

• PDA/job hazard analysis

• Absenteeism records

• Active Surveillance• JHSC/manager inspections

• Signs & Symptoms survey

• MSD risk identification checklist

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Recognize MSDSigns and Symptoms

“Sign” meaning you can “see” tissue change

• SwellingSwelling, redness, loss of skin colour

“Symptoms” meaning you can “feel” changes

• Aching, burning, cramping, numbness, pain, weakness

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Recognize MSDStages

1. Experience symptoms at work – can continue to work – decrease with rest, ice

2. Symptoms & signs come and go more frequently, even after work – usually seeks medical Rx

3. Symptoms & signs do not leave, disturbed sleep pattern, pain even while resting.

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Signs & Symptom Survey

OHSAH – Signs and Symptoms Survey

The purpose of the tool is to increase staff employee awareness, to detect potential MSD early before medical aid is required, and to make possible job improvements.

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PDA

• Gathering information on the job demands

• Summarizes the job as a whole

• Collect objective measurements where possible (weights, dimensions, repetitions)

• Not as detailed as a task analysis

• Proactive

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MSD Risk ID

MSD Risk Factor Identification

Worksheet

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Assessing MSDWhy Assess?

To prioritize the greatest risk• Magnitude – how many people

• Potential - likelihood

• Severity – how serious will the injury be

• Can be simple or complex

• Subjective or Objective

• Quantitative or Qualitative

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When to Assess MSD

• A work process/work practice is introduced or modified

• Opportunities for improvements

exist as a result of redevelopment or new construction

• Identify MSD risks during observation of work activities or inspections

• Increase in worker symptoms

• Injury has been reported

Proactive

Reactive

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Controlling MSD Applying Controls

• Involve the staff

• Be practical

• Does not have to be expensive

• Test possibilities

• Follow - up

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Controlling MSD Applying Controls

Ask yourself why do the risk factors exist?

• Workstation – proper set-up, adjustability

• Equipment – ergonomic design, size, operation

• Work organization – timelines, task rotation, shift work, control, stress

• Environment - lighting, noise, flooring, temperature

• Work practices - compliance, fitness level, wellness

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Workstation Design

• Keep the load close to the body

• Minimize bending and reaching

• Reaches should be between shoulder and knee level

• Waist height is most desirable

D

T

V

H

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Workstation Reach envelopes

50 cm

25 cm

50 cm80 cm

USUAL WORK: Forearm Length

OCCASSIONAL WORK: Full Arm Length

NON-WORK AREA: Beyond Arm Length

Adapted from: CCOHS Ergonomic Infogram E-A01

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Workstation Heights

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Tools

• Size

• Shape

• Vibration

• Balance

• Weight

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Posture

• Bend the tool, not the wrist

• Workplace layout

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Controls

• Engineering

• Administration

• Work practices

• Personal Protective Equipment

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MSD Controls

Engineering Administrative Work Practices PPE

Force Provide lift assist

Improve casters

Type of flooring

Height of the lift

Overall Range of lift

Safe work practice

Purchase smaller quantities

Shelf heights

Weights labeled

Push rather than pull

Lift training

Compliance

Hold load close to body

Testing the load

Good Visibility

Use 2 hands!

NO to back belts!!

Posture False bottom i.e. laundry bin,

Tilt equipment

Workstation/ table height

Adjustability

Size of cart

Swivel

Adjustable chair

Anti-fatigue mat

Purchase ergonomic equipment

Work organization

Preventative maintenance

Wellness Program

Breaks

Stretch

MSD Awareness education

Change postures often

Insoles

Repetition Mechanize Job enlargement

Employee rotation

Micro-breaks No wrist supports!!

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Exercise

Which tool would be more “ergonomically” sound?

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MSD Program Development

• Sr. Management Commitment

• Risk Assessment

• Develop Program Components

• Implement the Program

• Evaluate

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Program Development1. Management Commitment

• Developing clear goals and objectives

• Defining accountability mechanisms

• Assigning responsibilities

• Providing necessary resources

• Monitoring progress towards goals/objectives

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Program Development

Employee Involvement

• Encourage suggestions or reporting of concerns

• Dialogue about the workplace and work methods

• Seek input into design of work, equipment, procedures, risk assessment processes, purchases and training

• Evaluation and/or trials of equipment

• Employee surveys

• Task group participation

• Participation in developing the ergonomics process

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2. Risk Assessment

• Passive and Active Surveillance

• Tools

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3. Develop MSD Program Components

OSACH - Sample MSD Policy & Procedures

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4. Implement the Program

Safety Group Steps 2 & 3 • Communication• Education and Training

• Involve employees in design of the education/training program

• Learning by doing - "hands-on" methods of knowledge and skill acquisition

• Use multiple technologies and methods- audio-visual, computer, video, exercises, discussions

• Combine classroom and on-the-job training

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5. Evaluation

Leading indicators

• MSD risks

• Work productivity

• Evaluation of new equipment, tools and processes

• Evaluation of existing workstations/jobs

• Education and training

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5. Evaluation

Lagging indicators

• Injury statistics – MSD

• WSIB costs – MSD

• Absenteeism rates

• STD, LTD rates

• RTW statistics

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Initial Next Steps

• Who will coordinate MSD prevention?

• How will you obtain Sr. Management commitment for this initiative?

• Who else will be involved?

• When will you meet?

• How are you going to recognize MSD?

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Questions?

Concerns?

Comments?