preventing musculoskeletal disorders anne duffy. © copyright 2006 ontario safety association for...
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Preventing Musculoskeletal DisordersAnne Duffy
2© Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law.
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?