Musculoskeletal Disorder (MSD) Prevention Centre of Research Expertise for the Prevention of Musculoskeletal Disorders CRE-MSD

  • View
    219

  • Download
    3

Embed Size (px)

Text of Musculoskeletal Disorder (MSD) Prevention Centre of Research Expertise for the Prevention of...

  • Slide 1
  • Musculoskeletal Disorder (MSD) Prevention Centre of Research Expertise for the Prevention of Musculoskeletal Disorders CRE-MSD www.cre-msd.uwaterloo.ca Presented by Richard Wells, Ph.D. CRE-MSD, IWH Presentation to the Minister of Labours Ergonomics Sub-Committee of the Manufacturing Panel, May 5 th, 2005
  • Slide 2
  • MSDs: The Problem MSDs are a problem in Ontario Reported MSDs greatly underestimate the burden MSDs have a substantial work component
  • Slide 3
  • What are MSDs? Musculoskeletal disorders (MSD) are injuries and disorders of the musculoskeletal system where exposure to various risk factors present in the workplace may have either contributed to the disorders' development, or aggravated a pre-existing condition (OHSCO MSD Strategy Development Committee, 2005)
  • Slide 4
  • MSDs are a problem in Ontario For the period 1996-2002, MSD accounted for: (a) more than 40% of all lost time claims; (b) more than 48% of all lost time claim related lost time days; and, (c) more than 42% of all lost time benefit claim costs (averaged over the period). Source: WSIBs Information Warehouse and Prevention Strategy For Musculoskeletal Disorders (MSD) In Ontario
  • Slide 5
  • Reported MSDs greatly underestimate the burden in Ontario Office Environment. In the last year due to MSD Lost days at work Pain > 12 times or > 7 days in last year, moderate intensity Reported to workplace Saw health practitioner Work aggravates pain to some extent Any neck or upper limb pain 15% 20% 22% 29% 51% 60% Polanyi et al 1997
  • Slide 6
  • Reported MSDs greatly underestimate the burden in Ontario Not only is there a burden on the individual, but there is an decrease in their output Amongst the 51% of office workers who reported that their neck and upper limb pain was aggravated by work: 7% had difficulty sticking to their work routine or schedule7% had difficulty sticking to their work routine or schedule 9% had difficulty concentrating on work9% had difficulty concentrating on work 16% had difficulty using pens, computer keyboards etc. for at least half of the workday16% had difficulty using pens, computer keyboards etc. for at least half of the workday Polanyi et al 1997
  • Slide 7
  • MSDs Have a Substantial Work Related Component Risk factors for upper limb RSI/MSD in a large Canadian office WORK ORGANIZATIONAL/ PSYCHOSOCIAL FACTORS PHYSICAL FACTORS Low skill utilization High psychological demands Low social support Deadlines - weekly Poor screen position Time on keyboard (5h vs. 1.5h) Female vs. Male Relative Risk of Having RSI Polanyi et al., (1998) INDIVIDUAL FACTORS
  • Slide 8
  • MSDs Have a Substantial Work Related Component Risk factors for Low Back Pain in a Canadian auto assembly plant Work Organizational/ Psychosocial Factors Self rated physical demands Cumulative disk compression Peak hand force Peak shear Physical Factors Job satisfaction Social support Over-education Social environment Low job control Norman et al., 1998, Kerr et al., 2001 Hagberg et al (1995), Bernard (1997), NRC/IOM (2001)
  • Slide 9
  • Prevention OH&S System knows enough to prevent MSDs now; research frontiers continue to expand Ontario needs to consider physical and work organizational factors for prevention Different kinds of prevention activities needed at different stages of MSD Different organizations need different supports Guidelines and Regulations Why Participatory Ergonomics? Dont reinvent the wheel! Programs to prevent MSD
  • Slide 10
  • We know enough to prevent MSDs now! Occupational risk factors can be addressed Work organizational/ psychosocial AND physical factors are associated with high rates of MSDs THIS IS GOOD NEWS We can change identified organizational and physical workplace factors Individual factors are likely not as changeable
  • Slide 11
  • Example: Approaches to Prevention of Low Back MSD Many approaches are talked about Back belts? Product redesign? Job enlargement? Rebalancing? Exercise programs? Lift Tables? Back school? Adjustable Platforms? Stretching programs? Job rotation? Adjustable furniture Hoists? Health promotion? Teams?Improved Tools?
  • Slide 12
  • Eliminate/ Substitute Engineering Controls Administrative Controls Personal Protective Equipment Training Increase workers capacity Redesign (Product) Platforms, Hoists, Rebalancing (Process) Job enlargement, Job rotation, Teams, etc Back belts, etc Back school, etc Health Promotion, Exercise programs, Stretching programs, etc Strategies to prevent low back MSD
  • Slide 13
  • One Root Cause of Low Back Pain High cumulative loads on the low back Lifting/pushing/pulling of light to moderate loads many times per shift Holding non-upright trunk postures for long duration x 500+ http://www.ahs.uwaterloo.ca/~wells/NAACL.ppt
  • Slide 14
  • Interventions for Low Back Pain Re-position load PROCESS) ( PRODUCT- PROCESS) Reduce forces PROCESS) ( PRODUCT PROCESS) Reduce proportion of cycle loaded or total time loaded ( PRODUCT-PROCESS-ADMIN) Reduce number of movements ( PRODUCT-PROCESS-ADMIN) http://www.ahs.uwaterloo.ca/~wells/NAACL.ppt
  • Slide 15
  • Research shows we can prevent MSDs now Mechanical lift- assists installed in acute and chronic care facilities Earlier return to work when lift assists used Newer ceiling lifts likely to produce even larger reductions Evanoff et al 2003, Engst et al 2005
  • Slide 16
  • Ontario needs to consider physical and work organizational factors Because there are both physical and work environment (psychosocial) factors that contribute to disability: Physical: e.g., Forces, postures repetition Work Environment: e.g., Job Control, Supervisor Support Ontario needs to consider physical and work organizational factors in prevention activities NRC/IOM (2001)
  • Slide 17
  • Need to consider physical and work organizational factors Example: Garage mechanics Injured mechanics are told to change working techniques and use lifting equipment Mechanics coped best when they were supported by managers and supervisors Achieving positive results from MSD prevention activities requires that organizations create positive attitudes towards work modifications. TORP, et al 1999
  • Slide 18
  • Primary, Secondary and Tertiary Prevention of MSDs "...provide workplaces that are comfortable when we are well and accommodating when we are ill." (Morken et al 2002) Combining primary and secondary preventive interventions can yield greater impact than the sum of impacts from separately implemented interventions. (Frank et al 2005) "...clinical management + ergonomic modification best combination..." (Loisel et al 1997 Sherbrooke Model of Workplace Disability Prevention)
  • Slide 19
  • Time, weeks Symptoms/ Disability PrimarySecondaryTertiarySecondary Reduce MSD risk factors to prevent creation or aggravation of MSD and permit the largest possible workforce to perform job work smarter not harder Primary, Secondary and Tertiary Prevention of MSDs Monitoring and reporting schemes to detect MSD and initiate abatement of risk factors and restoration of health Disability resulting in Lost Time triggering abatement of risk factors, accommo- dation to disability, restoration of musculoskeletal health and early and safe return to work Monitoring and reporting schemes to detect MSD and initiate abatement of risk factors and restoration of health At work, little disability or limitations At work, some disability and limitations Off work, substantial disability and limitations At work, some disability and limitations ?
  • Slide 20
  • Primary, Secondary and Tertiary Prevention of MSDs Address all three prevention strategies simultaneously It may not be helpful to think only in terms of these three classic types of prevention activities: MSDs tend to have a variable history A large proportion of the population will have an MSD at some point in their life (especially low back pain)
  • Slide 21
  • Who benefits from (1, 2, 3) prevention initiatives? Workers whose symptoms developed as a direct result of current work Workers who have cumulative damage from previous work experiences Workers who develop back pain after a weekends yard work or caring for their small children they have responsibilities outside work. Workers who have age related changes
  • Slide 22
  • Effective Prevention Effective prevention of MSDs requires that workplaces need to be simultaneously performing activities that: Detect MSDs Reduce risk factors, Accommodate disability, Facilitate restoration of musculoskeletal health Participate in early and safe return to work
  • Slide 23
  • You dont have to reinvent the wheel! MSD prevention builds on the same foundations as other workplace health and safety prevention programs Leadership Participation Policy Training Hazard Identification Hazard Control Resources
  • Slide 24
  • You dont have to reinvent the wheel! MSD Prevention Program Health Promotion Stress Prevention AB C D F Production Engineering Examples: A) Reducing vibration for LBP & HAVS B) Improving manual materials handling for slips and falls C) Maintaining adequate lighting for tasks D) Improving social support for accommodation E) Designing for lower forces and improved postures ____________________ F) Adding stretching exercises for flexibility E

Recommended

View more >