Preventing Musculoskeletal Disorders

1. Preventing Musculoskeletal DisordersAnne Duffy

2. 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

3. 2004 LTI Accident Types Community & Health Care Data Source: WSIB Firm Experience Snapshot Period: September 2005

4. 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

5. 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)

6. What’s in a name? • Repetitive Strain Injury (RSI) • Cumulative Trauma Disorder (CTD) • Strain & Sprain • Workplace Musculoskeletal Disorders (WMSD) • Musculoskeletal Injuries (MSI)

7. Primary Risk Factors • High force – how much is too much? • Awkward posture – working beyond optimal range of motion, static/dynamic • Repetition – frequency, duration

8. Secondary Risk Factors • Contact stress • Local or whole body vibration • Cold temperatures • Work organization • Work methods

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

10. Safety Group Approach • Set a standard • Communicate the standard • Train to the standard • Review and revise • Recognize success

11. 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….

12. R.A.C. MSD prevention Recognize Assess Control

13. 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

14. Recognize MSDSigns and Symptoms “Sign” meaning you can “see” tissue change • Swelling, redness, loss of skin colour “Symptoms” meaning you can “feel” changes • Aching, burning, cramping, numbness, pain, weakness

15. Recognize MSDStages • Experience symptoms at work – can continue to work – decrease with rest, ice • Symptoms & signs come and go more frequently, even after work – usually seeks medical Rx • Symptoms & signs do not leave, disturbed sleep pattern, pain even while resting.

16. 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.

17. 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

18. MSD Risk ID MSD Risk Factor Identification Worksheet

19. 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

20. When to Assess MSD Proactive • 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 Reactive

21. Controlling MSD Applying Controls • Involve the staff • Be practical • Does not have to be expensive • Test possibilities • Follow - up

22. 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

23. D T V H 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

24. 50 cm 25 cm 80 cm 50 cm USUAL WORK: Forearm Length OCCASSIONAL WORK: Full Arm Length NON-WORK AREA: Beyond Arm Length Adapted from: CCOHS Ergonomic Infogram E-A01 Workstation Reach envelopes

25. Workstation Heights

26. Tools • Size • Shape • Vibration • Balance • Weight

27. Posture • Bend the tool, not the wrist • Workplace layout

28. Controls • Engineering • Administration • Work practices • Personal Protective Equipment

29. MSD Controls

30. Exercise Which tool would be more “ergonomically” sound?

31. MSD Program Development • Sr. Management Commitment • Risk Assessment • Develop Program Components • Implement the Program • Evaluate

32. Program Development1.Management Commitment • Developing clear goals and objectives • Defining accountability mechanisms • Assigning responsibilities • Providing necessary resources • Monitoring progress towards goals/objectives

33. 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

34. 2. Risk Assessment • Passive and Active Surveillance • Tools

35. 3. Develop MSD Program Components OSACH - Sample MSD Policy & Procedures

36. 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

37. 5. Evaluation Leading indicators • MSD risks • Work productivity • Evaluation of new equipment, tools and processes • Evaluation of existing workstations/jobs • Education and training

38. 5. Evaluation Lagging indicators • Injury statistics – MSD • WSIB costs – MSD • Absenteeism rates • STD, LTD rates • RTW statistics

39. 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?

40. Questions? Concerns? Comments?