Prevention of musculoskeletal disorders within

Telecommunication sector European Social Dialogue working group

Prevention of musculoskeletal disorders within Telecommunication sector III. Background report

Research team Veerle Hermans Marthe Verjans Rik Op De Beeck September 13, 2005

Prevention of musculoskeletal disorders within Telecommunication sector September 13, 2005 Page 2/2

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Contents 1 Analysis of good practices in literature ................................................................................................5

1.1 Introduction .................................................................................................................................5 1.2 Results ........................................................................................................................................5

1.2.1 Service technicians ........................................................................................................................6 1.2.2 Call centers ....................................................................................................................................7

1.3 Conclusion ................................................................................................................................11 2 Detailed questionnaire on MSD’s in the Telecommunications sector................................................13

2.1 Objective of the questionnaire ..................................................................................................13 2.2 Methodology .............................................................................................................................13

2.2.1 Development of the questionnaire ...............................................................................................13 2.2.2 Structure of the questionnaire......................................................................................................14 2.2.3 Analysis........................................................................................................................................14

2.3 Results ......................................................................................................................................15 2.3.1 General company information......................................................................................................15 2.3.2 General information regarding MSD ............................................................................................15 2.3.3 MSD within service technicians: Cause and prevention measures.............................................18 2.3.3.1 Service technician - Mechanical digging...................................................................................18 2.3.3.2 Service technician – Piping.......................................................................................................22 2.3.3.3 Service technician - Pulling, pushing and connecting cables ...................................................26 2.3.3.4 Service technician - Blowing and connecting optical fibres ......................................................31 2.3.3.5 Service technician – In house cable connector ........................................................................36 2.3.3.6 Service technician – Paving......................................................................................................40 2.3.3.7 Service technician – Repairing underground cables ................................................................44 2.3.3.8 Service technician – Pole workers............................................................................................49 2.3.3.9 Service technician – Pylon workers ..........................................................................................53 2.3.3.10 Service technician – Pole erection..........................................................................................57 2.3.3.11 Service technician – Aerial climbing .......................................................................................61 3.3.12 Service technician – Laptop use in vehicle ...................................................................................64 2.3.4 CONCLUSION SERVICE TECHNICIANS...................................................................................65 2.3.5 MSD within Call center workers: Cause and prevention measures.............................................67 2.3.5.1 Risks of MSD with regard to this activity:..................................................................................67 2.3.5.2 Hazards and prevention measures...........................................................................................67 2.3.5.3 Training and education with regard to MSD .............................................................................70 2.3.5.4 Medical examination .................................................................................................................71 2.3.5.5 Other .........................................................................................................................................71 2.3.5.6 Specific measures.....................................................................................................................72 3 Collection of data concerning MSD reported by law in each country within telecommunications sector........................................................................................................................................................73

3.1 Introduction ...............................................................................................................................73 3.2 Statistical sources .....................................................................................................................73

3.2.1 Recognised cases of occupational MSD: Total ...........................................................................73 3.2.2 Recognised cases of occupational MSD: ‘Construction’ / ‘Transport – storage and communication'.........................................................................................................................................75


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Tables

Table 1: Structure of the questionnaire ....................................................................................................14 Table 2: General company information ....................................................................................................15 Table 3: General questions: Overview .....................................................................................................16 Table 4: Data collecting on MSD by the companies ................................................................................16 Table 5: Risks of MSD within this activity.................................................................................................18 Table 6: Force - Hazards (ST Mec Dig) ...................................................................................................18 Table 7: Force - Prevention (ST Mec dig) ................................................................................................19 Table 8: Duration - Hazard (ST Mec Dig).................................................................................................19 Table 9: Duration -Prevention (ST Mec Dig) ............................................................................................19 Table 10: Posture - Hazard (ST Mec Dig)................................................................................................20 Table 11: Posture - Prevention (ST Mec Dig) ..........................................................................................20 Table 12: Other hazards and prevention measures (ST Mec Dig) ..........................................................20 Table 13: Risks of MSD within this activity...............................................................................................22 Table 14: Force - Hazards (ST Pipe) .......................................................................................................23 Table 15: Force - Prevention (ST Pipe) ...................................................................................................23 Table 16: Duration - Hazard (ST Pipe).....................................................................................................23 Table 17: Duration -Prevention (ST Pipe) ................................................................................................24 Table 18: Posture - Hazard (ST Pipe)......................................................................................................24 Table 19: Posture - Prevention (ST Pipe) ................................................................................................24 Table 20: Other hazards and prevention measures (ST Pipe) ................................................................25 Table 21: Risks of MSD within this activity...............................................................................................26 Table 22: Force - Hazards (ST Cable) .....................................................................................................27 Table 23: Force - Prevention (ST Cable) .................................................................................................27 Table 24: Duration - Hazard (ST Cable) ..................................................................................................28 Table 25: Duration -Prevention (ST Cable)..............................................................................................28 Table 26: Posture - Hazard (ST Cable)....................................................................................................29 Table 27: Posture - Prevention (ST Cable) ..............................................................................................29 Table 28: Other hazards and prevention measures (ST Cable) ..............................................................29 Table 29: Risks of MSD within this activity...............................................................................................31 Table 30: Force - Hazards (ST Fibres) ....................................................................................................32 Table 31: Force - Prevention (ST Fibres).................................................................................................32 Table 32: Duration - Hazard (ST Fibres)..................................................................................................33 Table 33: Duration -Prevention (ST Fibres) .............................................................................................33 Table 34: Posture - Hazard (ST Fibres) ...................................................................................................34 Table 35: Posture - Prevention (ST Fibres) .............................................................................................34 Table 36: Other hazards and prevention measures (ST Fibres)..............................................................34 Table 37: Risks of MSD within this activity...............................................................................................36 Table 38: Force - Hazards (ST Con)........................................................................................................37 Table 39: Force - Prevention (ST Con) ....................................................................................................37 Table 40: Duration -Prevention (ST Con).................................................................................................38 Table 41: Posture - Hazard (ST Con) ......................................................................................................38 Table 42: Posture - Prevention (ST Con).................................................................................................38 Table 43: Risks of MSD within this activity...............................................................................................40 Table 44: Force - Hazards (ST Pave) ......................................................................................................40 Table 45: Force - Prevention (ST Pave) ..................................................................................................41 Table 46: Duration -Prevention (ST Pave) ...............................................................................................41 Table 47: Posture - Hazard (ST Pave).....................................................................................................42 Table 48: Posture - Prevention (ST Pave) ...............................................................................................42 Table 49: Other hazards and prevention measures (ST Pave) ...............................................................42


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Table 50: Risks of MSD within this activity...............................................................................................44 Table 51: Force - Hazards (ST Repair) ....................................................................................................45 Table 52: Force - Prevention (ST Repair) ................................................................................................45 Table 53: Duration - Hazard (ST Repair) .................................................................................................46 Table 54: Duration -Prevention (ST Repair).............................................................................................46 Table 55: Posture - Hazard (ST Repair) ..................................................................................................47 Table 56: Posture - Prevention (ST Repair).............................................................................................47 Table 57: Risks of MSD within this activity...............................................................................................49 Table 58: Force - Hazards (ST Pole) .......................................................................................................50 Table 59: Force - Prevention (ST Pole) ...................................................................................................50 Table 60: Duration -Prevention (ST Pole) ................................................................................................50 Table 61: Posture - Hazard (ST Pole)......................................................................................................51 Table 62: Posture - Prevention (ST Pole) ................................................................................................51 Table 63: Risks of MSD within this activity...............................................................................................53 Table 64: Force - Hazards (ST Pylon) .....................................................................................................53 Table 65: Force - Prevention (ST Pylon)..................................................................................................54 Table 66: Duration -Prevention (ST Pylon) ..............................................................................................54 Table 67: Posture - Hazard (ST Pylon) ....................................................................................................54 Table 68: Posture - Prevention (ST Pylon) ..............................................................................................55 Table 69: Risks of MSD within this activity...............................................................................................57 Table 70: Risks of MSD within this activity...............................................................................................61 Table 71: Risks of MSD within this activity...............................................................................................67 Table 72: Prevention measures regarding chair ......................................................................................67 Table 73: Prevention measures regarding monitor ..................................................................................68 Table 74: Prevention measures regarding tracking devices ....................................................................68 Table 75: Prevention measures regarding laptop use .............................................................................68 Table 76: Prevention measures regarding keyboard ...............................................................................69 Table 77: Prevention measures regarding other accessories:.................................................................69 Table 78: Prevention measures regarding desk: .....................................................................................69 Table 79: Training methods on workstation set up ..................................................................................70 Table 80: Training methods on ergonomic principles ..............................................................................70 Table 81: Other prevention measures on MSD........................................................................................72 Table 82: Number and incidence rate (per 100 000 workers) of occupational diseases, EODS obligatory

list (general) ......................................................................................................................................73 Table 83: Number and incidence rate (per 100 000 workers) of occupational diseases, EODS obligatory

list (Construction) ..............................................................................................................................75


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1 Analysis of good practices in literature

1.1 Introduction

To analyse if literature information is present regarding good practices for prevention of musculoskeletal disorders, a literature study1 was performed concentrating on the telecommunications sector specifically. Searches were carried out on:

- Computer-based bibliographic databases - Journal contents databases (Medline, Ergonomics Abstracts Online, Contents Applied Ergonomics and Ergonomics) - Prevent Documentation Database (Info Source).

1.2 Results

Regarding service technicians, 15 documents were found, of which 4 were useful. It has to be emphasised that most often information is present regarding safety issues (e.g. falling from ladders) and only limited information is present regarding MSD and good practices. Regarding VDT work in general, a lot of information is available. Also regarding psychosocial issues in call centers recent information was found. However, when focussing on the aim of the literature survey - musculoskeletal problems in call centers -, 11 documents were found suitable. A brief summary of each of the documents is presented below.

1 Since the good practices project addresses practice on the floor, and since another project is being performed on research findings, documents regarding epidemiology or other research oriented results were not analysed.


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1.2.1 Service technicians

Reference Peeters J, 1998, Install telecom apparatus (paper course safety advisor), University of Antwerp.

Task description Make telephone centrals, install and connect cables Hazards Safety issues (falling from heights: ladders), lifting

Accidents: Falling from height (30%) Efforts, wrong movements (8%)

Prevention measures MSD

Use task description, location description and a list of used tools in an expert brainstorm meeting. Result: list of hazards and possible prevention measures: Smaller lifting objects Safer back training Tools

Reference Aaras A,

1994, The impact of ergonomic intervention on individual health and corporate prosperity in a telecommunications environment, Ergonomics 37(10): 1679-1696.

Task description Produce parts for telephone exchanges and cable form making: Join wires to terminals of a frame with a wrapping gun and sew wires together with plastic bands

Hazards MSD of neck, shoulder and back Prevention measures MSD

Ergonomic recommendations regarding work place layout

Reference McKenzie F, Storment J, Van Hook P,

1985, A program for control of repetitive trauma disorders associated with hand tool operations in a telecommunications manufacturing facility, Am Industr Hygiene Assoc Journal 46(11): 674-678.

Task description Use of hand tools Hazards MSD of arm, neck, shoulder and back: strains, tendinitis, ganglions

and carpal tunnel syndrome Prevention measures MSD

Set up of an engineering control programme: CTD and ergonomics presentation for engineering, supervisors and management with laboratory presentations and in-plant job critiques. Correct existing problems (pneumatic screwdrivers, wire wrap guns with pneumatic triggers, chairs and supports). Result: decrease in incidence rate from 2.2 to 0.5 cases per 200.000 work hours and decrease in lost workdays from 1001 to 129.

Reference Picart P,

1998, Téléphonie mobile: mise en sécurité des sites, Chantiers BTP 4: 10-13.

Task description Installation of mobile telecom: construction and maintenance of installations on several locations: pylon, water tower, roof terrace, …


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Hazards Falling, lifting Prevention measures MSD

Collective protection measures with risk analysis if individual exception Use of telescopique engines to facilitate the access at work and to avoid manual lifting of tools and materials. Clean circulation surface procedure

1.2.2 Call centers

Reference Norman K, Nilsson T, Hagberg M, Tornqvist EW, Toomingas A, 2004, Working conditions and health among female and male employees at a call center in Sweden, Am. J. Ind. Med., 46(1): 55 – 62

Aim Comparison between call center workers and other VDT users Results Call center workers spent longer continuous time in front of the

computer than professional computer users from other occupations; Deficiencies in workspace, keyboard and input device placement; Poor support from immediate supervisor, low control and limited opportunities to influence work; More musculoskeletal symptoms (especially neck and upper limbs problems) although shorter working career and younger operators than other computer users.


NA2

Reference Halford V, Cohen HH,

2003, Technology use and psychosocial factors in the self reporting of musculoskeletal disorder symptoms in call center workers, J. Safety Res 34(2): 167-173.

Aim Hypothesis: psychosocial factors may be of more importance than computer use factors in the development of MSDs.

Results Workload and management-worker relations have associations with poor worker health and possible long-term MSD problems


NA, more research necessary

Reference Ferreira M Jr, Saldiva PH,

2002, Computer-telephone interactive tasks: predictors of musculoskeletal disorders according to work analysis and workers’ perception, Appl Ergonomics 33(2): 147-153.

Aim To determine the relationship of ergonomic, organizational and psychosocial characteristics of call center work with the report of symptoms and absenteeism.

Results Duration in the job Low level of satisfaction Physical arrangement of the workstation Are related with neck-shoulder and hand-wrist MSD and MSD-induced time away from work.

Prevention NA

2 NA = not available


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measures MSD Reference Cook C and Burgess-Limerick R,

2004, The effect of forearm support on musculoskeletal discomfort during call centre work, Appl. Ergo 35: 337-342.

Aim To determine whether providing forearm support when using a normal computer workstation would decrease MSD in a call center. Support was given using the desk surface.

Results At 6 weeks, the group using forearm support generated significantly fewer reports of discomfort in the neck and back (although not statistically significant different between two groups) At 12 weeks, also less back discomfort was mentioned.


Use of forearm support has a number of advantages over a traditional floating posture and should be considered as an alternate working posture for keyboard users.

Reference Hales TR,

1994, Musculoskeletal disorders among visual display terminal users in a telecommunications company, Ergonomics 37(10): 1603-1621.

Aim To assess the relationship between workplace factors and work-related upper extremity musculoskeletal disorders among visual display terminal users in a telecommunications company

Results Seven psychosocial variables were associated with upper limb disorders: Fear of being replaced by computers Increasing work pressure Surges in workload Routine work lacking decision-making opportunities High information processing demands Jobs which required a variety of tasks Lack of production standard. The hand-wrist region was most effected (12% out of 22%).


NA

Reference Sprigg CA, Smith PR, Jackson PR,

2003, Psychosocial risk factors in call centres: an evaluation of work design and well-being, Health and Safety Executive Research Report 169, HSE Books: Sudbury, 92 p.

Aim To analyse if working, as a call handler is stressful and to analyse the psychosocial risk factors in 36 call centers.

Results Although the focus of this report was on psychosocial issues, additional risk factors regarding musculoskeletal problems were also mentioned. Dissatisfaction amongst the call handlers was mainly regarding the condition of computer ice, condition of keyboards, maintenance of chairs and storage space. 62% of the respondents said that they had experienced MSDs in the previous 7 days (although only 10% reported having to take time off work in the previous 12 months as a result of MSDs).

Prevention Training the call workers how to set up their workstations correctly


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measures MSD Conducting more DSE assessments Training call handlers to exercise during their shift Scheduling regular changes in activity or rest breaks

Reference Smith MJ, Bayehi AD,

2003, Do Ergonomics Improvements Increase Computer Workers' Productivity? An Intervention Study in a Call Center, Ergonomics 46(1-3): 3-18.

Aim This paper examines whether improving physical ergonomics working conditions affects worker productivity in a call centre with computer-intensive work.

Results Worker performance increased for 50% of the ergonomics improvement (decreased for 50%) 4.87% output increase for the ergonomics improvement group (3.46% output decrease for the control group)


NA

Reference http://www.teluguone.com/health/index.jsp?filename=callcentre.htm Aim To analyse the health problems of call center workers Results Call center workers are at the double risk of developing RSI when

compared to software professionals. Most important problems: Backaches in Call Center Operators : Neck Pain and Eye Strain :


Regular exercise for better circulation, tendon stretching, and flexibility Ergonomic corrections and use of light headphones frequent gaps after long hours Good diet to avoid accumulation of excess body fat.

Reference European Commission,

2000, Towards telework in call centers, DG Employment and Social Affairs: Luxembourg, 24 p.

Aim To provide a general overview of work in call centers Results Data and trends on people and call centers with key features in several

EU countries. Mentioned: Little attention is paid to ergonomic standards.


NA

Reference Choffat P, Desbazelle A, Eugène G,

1999, Etude de postes de travail utilisant le couple telephone-ecran dans des services de relation-clientèle, Archives des maladies professionnelles 60(8): 755-759.

Aim To describe the work in call centers and to analyse physical and mental risks.

Results Sedentary work Static postures


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Limited short breaks Neck problems due to headset Voice problems Psychosocial problems: time stress


NA

Reference Huws U, Paul J,

2002, How can we help? Good practice in call-centre employment, ETUC European Trade Union Confideration: Brussels, 72 p.

Aim The section Health and Safety covers: hazards and risks, relevant law and guidance, risk assessment, prevention and control, examples of good practice.

Results The following musculoskeletal problems are mentioned: Sit for long periods in fixed positions Little time to walk around, stretch or exercise while working Maintain awkward postures Partially support its own weight whilst performing intensive tasks Poor work stations (also at home: telework) or workstations of a standard design (no adjustability possible) Work-related stress factors


Proper risk assessment Create a positive OSH culture Visible commitment from the top Ergonomic workstations Appropriate instruction, information and training Ensure that breaks are taken


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1.3 Conclusion

The literature on good practices for service technicians’ tasks cannot be generalised, since they address different tasks and use of tools. It has to be concluded that there is an enormous gap in practical information on good ergonomic work task procedures. Regarding the information on call centres, it can be concluded that a good workstation layout is important to avoid sustained bad postures. Besides a proper placement of computer screen, keyboard and computer mouse, the use of additional specific tools can be interesting. However, a problem with the so-called ergonomic aids or tools is that often no scientific evidence exists regarding the positive effects of the equipment. When investigating new tools, it is important to analyse their effect using objective methodology and by asking the employee’s opinion. In general, the following recommendations can be mentioned (http://www.haworth.com/resource/ad/callcenter.htm): • When several different-sized people use workstations in shifts, a full-range of user-adjustability of

both the chair and work surface is very important. It is crucial that the chair fits the height requirements of the person using it. A chair of the wrong height will restrict circulation due to pressure from the seat pan or poor seated posture;

• The chair arm rests should also be adjustable in height so that the person may rest his or her elbows while working to relieve stress in the shoulders, arms and back while working. A waterfall front edge on the chair helps avoid pressure on the backs of the legs. From a seated position, the person should be able to comfortably reach essential reference manuals—without excessive stretching or twisting of the shoulders or torso;

• A sit-to-stand work surface can give people a physical break without leaving their workstations. In addition to allowing them to stretch while standing, height-adjustable work surfaces also let agents move about their workstations more freely—avoiding static postures while conducting business;

• At any work height, people should be able to view the monitor without any glare from overhead or workstation lights. Workstations should allow enough room for monitors to be placed at least 50cm away from the user. The larger the monitor, the farther away from the user it needs to be to avoid eyestrain. The keyboard and mouse should be able to be placed on a stable surface adjacent to one another.

• User-adjustable tools and storage elements are also helpful. When agents can place paper trays, diskette bins etc. exactly where they want them, it saves reaching and search time;

• When the new space is first occupied, it’s in everyone’s best interest to provide some basic training in furniture adjustability, equipment placement and use, and proper postures. A correctly adjusted workstation allows the agent to sit with feet flat on the floor and knees and hips bent at a 90-degree or greater angle. The back should be fully supported, adjusting the chair back height as needed. People should be able to place their hands on the keyboard or mouse, with upper arms hanging comfortably down at their sides. Elbows should be bent at 90 to 120 degrees and agents should maintain a neutral wrist positing (no bending).

• Ongoing reinforcement of furniture adjustability through news bulletins, refresher workshops, and new hire orientations are helpful to ensure that the ergonomics planning and investment continue to pay off in reduced opportunities for injury;

• With comprehensive planning that takes in work styles, amenities, technology, acoustics, and ergonomics, call centers can become pleasant and highly supportive work environments.


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Regarding specific additional tools, the following equipment is recommended (http://www.healthycomputing.com/): • Headsets facilitate hands-free phone use, while protecting the privacy of the conversation. A

headset has an earpiece for listening with one or both ears, and an attached microphone for speaking. Additional features of headsets may include ear buds that discretely fit inside the ear, cordless units that allow increased mobility, noise-cancelling microphones that cancel out background noise, and amplifiers to increase the audible signal. The weight of the headset is an important aspect;

• Speakerphones facilitate hands-free phone use, though there is little a user can do to maintain call privacy;

• Neck rests are large pieces of plastic or cushioned material that attach to the back of a receiver, minimizing the strain involved with wedging the receiver between the shoulder, neck and ear.

Information on specific call center products and sources can be found on, e.g.: http://www.callcenterguide.com/

HOW CAN WE HELP? GOOD PRACTICE IN CALL-CENTRE EMPLOYMENT. Ursula Huws, Jane Paul ETUC European Trade Union Confederation - ITUH building, Bd du Roi Albert II, 5, b-1210 Brussels, Belgium November 2002 - 72 p. What is a call centre? - Call centres in Europe, the general picture - Recruitment, training and staff development - Working hours - Work organisation - Managing a flexible workforce - Performance monitoring - Health and safety - Equal opportunities and workplace culture - Pay - Industrial relations issues - Conclusions. 03420/HBT ETUDE DE POSTES DE TRAVAIL UTILISANT LE COUPLE TELEPHONE-ECRAN DANS DES SERVICES DE RELATION-CLIENTELE. P. Choffat, A. Desbazelle, G. Eugène ARCHIVES DES MALADIES PROFESSIONNELLES (F) Vol. 60 - No 8 - Décembre 1999 - p. 755-759. Cette étude est partie du constat du développement des activités téléphoniques dans les relations directes entre les entreprises et leurs clients. Il s'agit d'une étude descriptive faisant la synthèse des observations de postes de travail avec téléphone et informatique assurant la réception d'appels téléphoniques. Elle présente les tâches à effectuer, les conditions d'environnement, d'organisation et d'évaluation. Elle analyse les contraintes qui peuvent être rencontrées sur les versants physique et mental, d'autre part. 42789/


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2 Detailed questionnaire on MSD’s in the Telecommunications sector

2.1 Objective of the questionnaire

The main objective of the questionnaire is to analyse the relation between working procedures, risk factors, training and injury/ illness rates for MSD within the service technicians and call centre workers of the telecommunications sector, to define best practices. This might help to control the MSD problems in the different companies with a common basis. The questionnaire includes the following: • Collection of non-statutory MSD data collected by companies and a description of the ways this is

used to improve the working practices. • Comparison of identified risk factors for MSD within these companies. • Collation and comparison of training schedules related to these activities for the avoidance of MSD. • Collation and comparison of written work procedures for work activities in scope. • Collation and comparison of health surveillance and rehabilitation protocols for MSD. • Comparison of specific measures developed for older workers undertaking this type of work. • Evaluation of health surveillance and rehabilitation measures in preventing MSD and speeding

return to work after injury/ illness.

2.2 Methodology

2.2.1 Development of the questionnaire

To develop a questionnaire in order to define best practices with regard to MSD in telecommunications sector, several steps were followed. 1. The survey on MSD (15 individual responses and overview report) carried out in 2004 was

analysed. This analysis created a general picture of the main hazards and hazardous activities with regard to MSD, although it was difficult to analyse it in detail due to the lack in consistency of data reporting by the different companies.

2. A study of literature and project on MSD in the telecommunications sector (see part 1) was undertaken.

3. To get a clear and practical view on the activities of the service technicians and the call centre workers in the telecommunications sector, several companies were visited. These visits to Belgacom, BT and France Telecom led to a specific overview of the different activities of the employees in the telecommunications sector. It was possible to identify the main risks and prevention measures related to each activity.

Based on this information, a draft questionnaire was sent out to the steering committee at 14 February 2005. The definitive questionnaire was developed taking into account the recommendations and amendments on 24 February.


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2.2.2 Structure of the questionnaire

The questionnaire (excel-file) begins with general questions regarding MSD. The following sheets are developed for the different activities of the service technicians. For each activity, a short description of the work procedure is made, the possible hazards regarding MSD and the related prevention strategies. To document the information, several pictures are attached. The last sheet of the questionnaire includes the hazards and prevention measures for call center workers.

Table 1: Structure of the questionnaire Sheet 1 Guidance notes Sheet 2 General questions Sheet 3 ST Mec Dig Service technician - Mechanical digging Sheet 4 St Pipe Service technician - Piping Sheet 5 ST Cable Service technician - Pulling, pushing and connecting cables Sheet 6 ST Fibres Service technician - Blowing and connecting optical fibres Sheet 7 ST Connect Service technician - In-house cable connector Sheet 8 ST Pave Service technician - Paving Sheet 9 ST Repair Service technician - Repairing underground cables Sheet 10 ST Pole Service technician - Pole worker Sheet 11 ST Pylon Service technician - Pylon climbing Sheet 12 ST Empty Service technician - Empty Sheet 13 Call cent Call centre employees of workers

2.2.3 Analysis

The quantitative analysis of the returned questionnaires is made in the statistic programme, SPSS 12.0. For the qualitative analysis, a standardised file of the questionnaire in excel is used to summarise explanations and comments of the participating companies.


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2.3 Results

17 of the 48 companies filled in the questionnaire.

2.3.1 General company information

Table 2 gives an overview of the number of employees, the proportion of service technicians and of call centre workers in the participating companies. There is a great difference in number of employees within the different companies and in the proportion of technicians and call center workers. Although not every company completed these figures, it can be concluded that 4 companies do not have service technicians (they outsource the technical tasks) and all participating companies have call centre workers.

Table 2: General company information

14859,00 34,0 11,086000,00 37,0 23,09500,00 ,0 7,02524,00 13,0 .7259,00 . .

105000,00 19,0 20,0130000,00 25,0 15,0

7996,00 23,0 62,014929,00 ,0 61,08311,00 . .5693,00 33,0 19,0

15000,00 20,0 10,033144,00 59,0 14,08925,00 ,0 18,0

62,00 . 67,06471,00 ,0 16,6

55794,00 28,6 .

Belgacom - BelgiumBT - UKCesky Telecom - CzechCYTA - CyprusEircom - IrelandFrance Télécom - FranceGermanyMatav - HungaryO2 - UKPortugal Telecom - PortugalSlovak Telekom - SlovakeyTDC - DenmarkTelefonica - SpainTelenor - NorwayTelepage Ltd - MaltaTeliasonera - FinlandTurktelecom - Turkey

Companyname

Number ofEmployees(whole timeequivalent):

Servicetechnicians

(%)Call centre

workers (%)

* Figures based on questionnaires completed by the participating companies in February – March 2005, update France Telecom September 2005 * Matav - Hungary: Figures subsidiary groups not included

2.3.2 General information regarding MSD

In the first sheet of the questionnaire, general information regarding MSD was asked to the companies. Table 3 gives an overview of these questions.


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Table 3: General questions: Overview Does your company collect data on the incidence and/ or prevalence of musculoskeletal disorders within service technicians and call centre workers? And how? Sick leave numbers regarding MSD for: Occupational diseases regarding MSD for: How does your company use these numbers to improve working practices? Does your company undertake health surveillance > for service technician workers > for call centre workers Does your company undertake rehabilitation for workers with musculoskeletal disorders?

Summary of the results: Data collecting on MSD seem to be common in more than half of the participating companies. 11 of 17 companies collect data on the incidence and/or prevalence rate of MSD for their service technicians and call center workers. Analyses on occupational accidents and incidents are the most prevalent method, followed by analysis of sick leave (table 4).

Table 4: Data collecting on MSD by the companies Methods for data collecting on MSD:

Number

Occupational Accident/Incident Analyses

7

Analysis of sick leave (One company: the manager in cooperation analyzes every incident of sick leave with the employee.)

4

Analysis of data from occupational health surveys and medical surveillance

3

Data of health insurance company and accident insurance

2

Annual reporting of occupational diseases regarding MSD, based on legal frame

1

Job-related illness: Employee can announce this during annual H&S audit by questionnaire. Ad hoc audit

1

Ergonomic surveys every two year and at request

1

Very little comparable quantitative occupational health and safety data is available for MSD within the different companies. With regard to sick leave the two main reasons are:

- The data are not separated for MSD in total figures - Data are not available due to legal restrictions (law does not allow to analyse reason of

sickness absenteeism) In most companies, data regarding MSD as an occupational disease are not collected. In some countries MSD is not considered as an occupational disease by the authorities.


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10 companies use occupational health and safety data regarding MSD to improve the working conditions:

- To improve ergonomics and training (3): • To review training and ergonomic equipment • To improve and create new workflows and work stations • To prioritise process engineering initiatives (performance planning, target setting and

performance evaluation) that reduce the risk for MSD - Risk analysis: To identify hazards and prevention measures to reduce these risks (2) - To sensibly management and employees in order to prevent the MSD. (2) - To discuss about prevention in the social dialogue with trade unions (1) - To evaluate company health improvement programs (1)

Almost every participating company with service technicians (10 of 13) undertakes health surveillance for these workers. Periodical surveillance (every six months, every year), also prior to employment, for every worker exposed to special risk at work based on legal frame is most common (6). One company undertakes healthy test at different ages (30, 35, 40, 45, 50, 53, 56, 59 and 62 years), one company sends the service technicians on recuperation stay3. Only 10 of the 17 companies undertake health surveillance for call centre workers. Periodical surveillance (Periodicity varies: six month, one year…), also prior to employment, for every VDU worker based on legal frame is most common (7). One company undertakes healthy test at different ages (30, 35, 40, 45, 50, 53, 56, 59 and 62 years), one company also investigates the mental load yearly with a checklist. Conclusion: More than half of the participating companies collect data on MSD and use these data to improve the working conditions. Several companies (6) do not collect these data. It is very difficult to compare the information of the different companies. Possible reasons are: - Companies collect data according to different criteria: Definitions on health outcomes regarding MSD and the diagnostic procedures are not standardised. - The differences between compensation systems and between the lists of legally and medically recognized occupational diseases makes it impossible to get a detailed view of the size of the problem. - The differences between insurance systems and lists of prescribed diseases in the member states makes an accurate assessment of the size of the problem very unlikely. Therefore, very little comparable quantitative occupational health and safety data is available for MSD within the different companies. There is a need for more rigorous data collection mechanisms that allow an analysis of trends and developments of risks so prevention actions can be taken (only common approach today is European Occupational Disease Statistics (EOSD) see part 3). Regarding the health surveillance in the participating companies, the different legal framework seems to be the main reason for the different information.

3 Recuperation stay in mountains. Company is owner of the hotel, which is used for rehabilitation. There is a spa and therefore it is a suitable area for recuperation stay of service technicians who work in hard climate conditions and shifts.


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2.3.3 MSD within service technicians: Cause and prevention measures

2.3.3.1 Service technician - Mechanical digging Mechanical digging is applicable in 3 of the participating companies. The other companies outsource this activity. The proportion of these workers within the companies varies between 3 and 10%. The duration of this activity differs between 2 and 7 hours a day.

• Brief description activity and devices Tasks:

- Mechanical digging (before and after piping and cabling, and solve disturbances) - Placing material to signalise the working area - Driving to different working areas with truck

Devices: Digging machine

• Risks of MSD with regard to this activity: On the average, the risks on MSD within this activity are low. The body parts most at risk for MSD within mechanical digging are neck/ shoulders and back (table 5) although the risks are rated medium.

Table 5: Risks of MSD within this activity

1 22 12 11 22 13 3

CountNeck/ shoulderCountUpperarm/ elbowCountForearm/ wrist/ handCountBackCountHipCountLeg/ kneeCountAnkle/ feet

Low risk Medium risk

• FORCE: Hazard and prevention measures Force seems to be a medium risk according to 2 companies; one company mentions the risk is low. Regarding force within mechanical digging, the main cause is handling the material to signalise the working area (table 6). Handling manhole frames and covers, metal sheets to cover ground openings and tools (generator, jack hammer) are mentioned by one company.

Table 6: Force - Hazards (ST Mec Dig)

3 33 33 3

CountLifting material to signalise the working areaCountCarrying material to signalise the working areaCountPulling/ pushing material to signalise the working area

Yes Total


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To prevent the impact of force, companies undertake several prevention measures (table 7), of which task specific training is mentioned by the 3 companies.

Table 7: Force - Prevention (ST Mec dig)

1 2 31 2 3 3 31 2 3

CountLifting devicesCountRestriction of liting objects weighting more than:CountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total

• DURATION: Hazard and prevention measures The three companies mention that duration is a medium risk within these service technicians. This is most common while working in the vehicle (table 8). Also working with hand tools is a cause within one of the companies.

Table 8: Duration - Hazard (ST Mec Dig)

1 2 3

3 3

CountRepetitive hand, wrist and arm movements while working indigging machine

CountRepetitive ankle/ feet movements while working in digging machine

No Yes Total

Several prevention measures regarding this hazard are undertaken (table 9). General training on ergonomic principles is most common; one company also allows a break after 4 hours working with the truck and offers anti drumming gloves to the workers.

Table 9: Duration -Prevention (ST Mec Dig)

1 2 32 1 31 2 31 2 31 2 3 3 3

CountSpecific ergonomic adjustments of digging machineCountAdjustable chairCountInstructions for correct ergonomic useCountJob rotationCountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total

• POSTURE: Hazard and prevention measures Also posture is a medium risk according the three companies. This is due to the prolonged static posture while working in the digging machine (table 10).


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Table 10: Posture - Hazard (ST Mec Dig)

3 3 3 3 3 3 3 3 3 3 3 31 2 3

CountProlonged seeting posture in digging machineCountProlonged flexion of head/ neck in digging machineCountProlonged rotation of head/ neck in digging machineCountProlonged flexion of the back in digging machineCountProlonged rotation of the back in digging machineCountLack of adjustable chair in digging machineCountTruck driving

No Yes Total

General training on ergonomic principles and use of mirrors is most common to prevent this hazard (table 11).

Table 11: Posture - Prevention (ST Mec Dig)

2 1 31 2 32 1 32 1 32 1 3 3 3

CountAdjustable chair in digging machineCountUse of mirrors in digging machineCountSpecific ergonomic devices in digging machineCountInstructions for right use of the ergonomic adjustmentsCountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total

• OTHER: Hazards and prevention measures Other hazards (table 12) within this activity appear to be medium. Several prevention measures are mentioned.

Table 12: Other hazards and prevention measures (ST Mec Dig) Hazards Prevention measures

Sudden movements of digging machine (1) Excessive whole-body vibration (1) Anti drumming gloves and shoes Slippery footing (1) Safety ankle boots with a good grip sole provided Injury of feet and hand by the tools (1) Outside work: weather conditions influence (1) Special protective clothing Heavy work (1) Balance between heavy and less heavy work Safety instruction chart: General safety

instructions, PPE, signalisation of working area

• TRAINING as prevention measures The 3 companies undertake training to prevent MSD within mechanical digging. Task specific training is described as:

- ST who starts with this job: Introduction training on health and safety with regard to their job is a part of Start Day (1)

- Training use of lifting devices (1) - Guidelines, brochures and Ergo coaches (2)


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General training on ergonomic principles, most common, is described as: - Regular training ‘health protection issues’ for all managers and employees (1) - Ergo coaches (2) - Class room literature (2)

• Specific measures

> Older workers

- If needed, retraining is given so that worker can be assigned alternative work (1) - Only for medical reason one can have an adapted function (1) - Recuperation stay in mountains. (see previously) (1)

> Workers who developed musculoskeletal problems

- Recuperation stay in mountains (1) Conclusion: Mechanical digging is applicable in 3 of the participating companies. The other companies outsource this activity. Force, posture and duration are considered as medium risks. As main causes of MSD, prolonged static postures and repetitive movements of forearm and hand while working on the vehicle are mentioned, followed by handling the material to signalise the working area. Specific ergonomic devices in the vehicle (adjustable chair…), lifting devices and training, on the task and on general ergonomic principles, can reduce MSD within the activity Mechanical digging.


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2.3.3.2 Service technician – Piping Piping is applicable in 6 of the participating companies. The other companies outsource this activity. The proportion of these workers within the companies varies between 5 and 28%. The duration of this activity differs between 1 and 8 hours a day.


- Remove paving stones, asphalt, and sand - Searching other underground structures - Manual digging (before and after piping) where place is not reachable for digging machine, or

precisely digging is preferred - Drilling - Piping - Placing material to signalise the working area - Driving to different working areas with truck

Devices: - A spade - A drill - Hand tools

• Risks of MSD with regard to this activity:

The body parts most at risk for MSD within piping are back, neck/ shoulders, forearm/ wrist/ hand and upper arm/ elbow (table 13).


1 3 22 3 12 2 2

3 35 14 2 5 1


Low risk Medium risk High risk

• FORCE: Hazard and prevention measures Force seems to be a high risk according 3 companies. One company mentions this risk is medium, one this risk is low. Regarding force within piping, the main causes are handling material to signalise the working area, handling paving stones… and pulling/pushing pipes (table 14). One company mentions also handling manhole covers as a hazard.


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Table 14: Force - Hazards (ST Pipe)

5 5 4 4

1 4 51 4 51 3 41 4 5

5 51 4 5

CountLifting material to signalise the working areaCountLifting pavingstones, asphalt, sand...CountLifting pipesCountCarrying material to signalise the working areaCountCarrying pavingstones, asphalt, sand...CountCarrying pipes to the working areaCountPulling/ pushing pipes to the working areaCountPulling/ pushing material to signalise the working area

No Yes Total

To prevent the impact of force, companies undertake several prevention measures (table 7). Task specific training seems to be the most common. As prevention measure for lifting manhole covers, one company mentions that heavy pre-cast concrete slabs are gradually being replaced with lighter metal covers; covers opened by 2 technicians together or using a hydraulic lifter. If pre-cast covers are too heavy to lift or jammed in place, civil engineering works will be requested.

Table 15: Force - Prevention (ST Pipe)

2 3 53 2 53 2 5

6 63 2 5

CountSpecific tools for transport of pipesCountLifting devicesCountRestriction of liting objects weighting more than:CountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total

Regarding tools for transport of pipes, one company describes that duct bore dividers are carried on cable trailers for long lengths .The same company uses a cable trailer for duct bore dividers and keys for frame covers. Another company has rules regarding manual lifting: heavy loads are lifted by more than one person together. Following restriction on manual handling is used in one company: operations performed frequently, loads are considered to be very heavy when above 20 kg. It's value increases to 30 kg in operations performed occasionally.

• DURATION: Hazard and prevention measures Four companies mention that duration is a medium risk within these service technicians, one company describes duration as a low risk. The main causes are listed in table 16. One company also describes repetitive back movement while working with mattock and shove.

Table 16: Duration - Hazard (ST Pipe)

1 3 4 4 4 4 4

CountManual diggingCountRepetitive hand, wrist and arm movements while working in drilling machineCountRepetitive ankle/ feet movements while working in the drilling machine

No Yes Total


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Only a few prevention measures are taken to overcome this hazard (table 17). Task specific training is the most common. One company mentions that the tools in use satisfy the requisites imposed by the European Union norms and regulations.

Table 17: Duration -Prevention (ST Pipe)

3 1 43 1 42 2 41 3 42 2 4

4 43 2 5

CountSpecific ergonomic adjustments of the drilling machineCountAdjustable chairCountErgonomic hand toolsCountInstructions for right use of the ergonomic adjustmentsCountJob rotationCountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total

• POSTURE: Hazard and prevention measures Posture is a high risk according 3 companies, medium according 3 companies and low according one company. This is due to the prolonged static posture while working in the drilling machine and while working underground (table 18).

Table 18: Posture - Hazard (ST Pipe)

5 5 5 5 5 53 1 42 2 43 1 42 2 43 1 43 1 42 3 5

CountNarrow working areaCountProlonged bending posture while working undergroundCountAwkward positions (kneeling,...) while working undergroundCountProlonged seeting posture in drilling machineCountProlonged flexion of the back in drilling machineCountProlonged rotation of the back in drilling machineCountProlonged flexion of head/ neck in drilling machineCountProlonged rotation of head/ neck in drilling machineCountLack of adjustable chair in drilling machineCountTruck driving

No Yes Total

Task specific and general training on ergonomic principles and ergonomic adjustments to the drilling machine (adjustable chair) are most common to prevent this hazard (table 19).

Table 19: Posture - Prevention (ST Pipe)

5 51 3 42 2 4 4 43 3 6

CountCushions, knee pads... for working undergroundCountSpecific ergonomic devices in drilling machineCountInstructions for right use of the ergonomic adjustmentsCountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total

• OTHER: Hazards and prevention measures


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Other hazards (table 12) within this activity appear to be medium according the companies. Wearing personal protective equipment (ant drumming gloves, safety ankle boots with a good grip sole) is mentioned by two companies as a prevention measure.

Table 20: Other hazards and prevention measures (ST Pipe)

31 22 12 21

CountExcessive vibration of power toolsCountExcessive whole-body vibrationCountSudden movements of drilling machineCountInappropriate or inadequate hand toolsCountSlippery footing

No Yes

• TRAINING as prevention measures

5 companies undertake training to prevent MSD within the service technicians Piping. Task specific training is described as:

- ST who starts this job: Introduction training on health and safety with regard to their job is a part of Start Day (1)

- Guidelines, brochures and Ergo coaches (3) - Assigning the inexperienced with an experienced worker (1) - On line training (1)

General training on ergonomic principles is described as:

- Regular training ‘health protection issues’ for all managers and employees (1) - Intranet: Internal norms on Health and Safety (1) - Class room literature, brochures and guidelines (2)


> Older workers - Early retirement, change job within company, have more rest (1) - Recuperation stay in mountains. (see previously) (1)

> Workers who developed musculoskeletal problems - Recuperation stay in mountains. (see previously) (1) - Change task or job, limit specific tasks par example lifting heavy loads - Worker would be assigned lighter duties. (1)

Conclusion: Piping is applicable in 6 of the participating companies. The other companies outsource this activity. Piping seems to be a specific task, since only a small proportion of the company workers perform this activity (between 5 and 28%). Many hazards can be found for piping activities: repetitive and heavy lifting, bending and twisting, repeating an action too frequently, uncomfortable working position, exerting too much force in pushing and pulling activities, working too long without breaks, adverse working environment and extreme outdoor climate (e.g. hot, cold, rain….) and the use of excessive vibration of power tools. Consequently, several prevention strategies can be mentioned: the use of specific ergonomic tools or materials for this task and task specific training to adopt correct postures.


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2.3.3.3 Service technician - Pulling, pushing and connecting cables This activity is a very common task within the participating companies: 11 of the 13 companies with service technicians undertake pulling, pushing and connecting cables. The proportion of these workers within the companies varies between 5 and 90%. The duration of this activity differs between 2.5 and 8 hours a day.


- Lifting covers of underground structures - Pushing and pushing cables - Connecting cables - Placing material to signalise the working area - Driving to different working areas with truck

Devices: - Hand tools - Road working guarding - Gas detection unit - Mechanical lifter - Jointing machines - Measure instruments (cable identifiers) - Cable cutters and pliers - Portable air compressor


The body parts most at risk for MSD within service technicians Cabling are neck/ shoulders, upper arm/ elbow, forearm/ wrist/ hand and back (table 21).


1 8 3 12 11 1 122 9 1 12 6 6 126 4 2 125 6 1 127 4 1 12


Low risk Medium risk High risk Total

• FORCE: Hazard and prevention measures Force seems to be a high risk according to 2 companies, 8 companies mention a medium risk, one a low risk. Regarding force within the service technicians Cabling, the main causes are handling covers of underground structures, cables, equipment and material to signalise the working area. One company also mentions pulling and pushing generator on wheels and moving cables for access.


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Table 22: Force - Hazards (ST Cable)

1 10 11 11 112 9 112 9 111 10 113 8 112 9 113 8 113 8 111 10 113 8 11

CountLifting covers of underground structuresCountLifting cablesCountLifting equipment for placing cablesCountLifting material to signalise the working areaCountCarrying covers of underground structuresCountCarrying cablesCountCarrying equipment for placing cablesCountCarrying material to signalise the working areaCountPulling/ pushing covers of underground structuresCountPulling and pushing cablesCountPulling/ pushing equipment for placing cables

No Yes Total

To prevent the impact of force, companies undertake several prevention measures (table 23). Task specific training and specific tools for transport of cables seems to be the most common.

Table 23: Force - Prevention (ST Cable)

4 7 11

5 6 114 7 117 4 112 9 111 10 115 7 12

CountSpecific tools, lifting devices for lifting covers of undergroundstructures

CountPolicy with regard to lifting covers of underground structuresCountLifting devicesCountRestriction of liting objects weighting more than:CountSpecific tools for transport of cablesCountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total

Regarding specific tools for lifting covers of underground structures, companies give several explanations:

- Specific hammers (cover rolled over a round metal pipe) and (hydraulic) lifters (2) - The covers of underground structures have to be opened with appropriate tools and equipment.

Users should not use improvised means to undertake this task in order to avoid lesions in the lumbar region and other type of lesions. (2)

- All manual handling activities are covered by legal regulations. These regulations state that where possible the need to use manual handling techniques to manoeuvre heavy plant and equipment must be avoided. Where it is not possible to avoid the practice, suitable mechanical aids must be used. In addition a suitable and sufficient risk assessment of the work must be undertaken. (1)

• In practice: Removal and replacement covers by manual methods must not be carried out unless the line manager has ensured that a site specific local risk assessment has been completed. (assessment checklist). A line manager must be consulted every time a cover cannot be lifted by the lifter. On completion of the assessment, the contents of the document should be briefed to the people who are to remove the cover by manual methods. Furthermore, a record has to be kept, for 6 months, by the line manager with a copy sent to Safety Consultancy Services. All people required removing cover by manual methods and their supervisors must be trained in the techniques.


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- In one company the policy regarding lifting is included in the safety manual. Regarding restrictions of lifting heavy loads, following items are mentioned:

- Guidance states that an optimum of 25 kg should be regarded as the maximum load to be lifted manually without a specific risk assessment incorporating local and individual characteristics, the regulations do not stipulate a maximum load which can be lifted, because of different physical characteristics of individuals (1)

- Operations performed frequently, loads are considered to be very heavy when above 20 kg. It's value increases to 30 kg in operations performed occasionally. (1)

- 50 kg red area - 30 kg yellow area - depends on the lifting situation: the workers are trained in this. (1)

- Maximum = 25 kg (1) Specific tools for transporting cables are; towlines (1), cable trailers (3), and a hose reel (1)

• DURATION: Hazard and prevention measures Ten companies mention that duration is a medium risk within these service technicians; one company describes duration as a low risk. The main causes repetitive hand, arm and wrist movements (table 24).

Table 24: Duration - Hazard (ST Cable)

4 6 10

1 10 11

CountRepetitive hand, wrist and arm movements while pulling andpushing cables

CountRepetitive hand, wrist and arm movements while connectingcables

No Yes Total

The prevention measures overcome this hazard are listed in table 25. Task specific training seems the most common.

Table 25: Duration -Prevention (ST Cable)

3 7 109 2 113 8 115 7 12

CountErgonomic design of equipmentCountJob rotationCountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total

Regarding the ergonomic design of equipment:

- The tools in use satisfy the requisites imposed by the European Union norms and regulations. (1)

- Most new equipment is now coming through with labels saying it has been ergonomically designed (1)

- Equipment test before use, explication of operation

• POSTURE: Hazard and prevention measures Posture is a high risk according 5 companies, medium according 5 companies and low according one company. This is mainly due to the prolonged static posture while pulling, pushing and connecting the cables (table 26).


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Table 26: Posture - Hazard (ST Cable)

2 9 115 6 112 9 113 8 114 7 116 4 103 8 11

CountNarrow working areaCountProlonged bending posture while pulling and pushing cablesCountAwkward positions (squatting, kneeling position...) while pullingCountProlonged bending posture while connecting cablesCountAwkward positions (squatting, kneeling position...) while connectingCountFurniture not properly adapted for this workCountTruck driving

No Yes Total

The prevention measures to minimise these hazards are listed in table 27. Again, task specific training is most common.

Table 27: Posture - Prevention (ST Cable)

5 6 115 6 117 4 113 8 115 7 127 3 10

CountCushions, knee pads... for working undergroundCountSpecific ergonomic devicesCountInstructions for right use of the ergonomic adjustmentsCountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention CountSpecific ergonomic devices in truck

No Yes Total

Specific ergonomic devices mentioned:

- Chairs and special protection of the knees (1) - Most pulling is performed by means of electrical winch and a jointing machine is used for

jointing (1)

• OTHER: Hazards and prevention measures Other hazards (table 12) within this activity appear to be medium according 7 companies and low according one. In one company, gas in the underground structures seems to be a hazard, in another company the outside work.

Table 28: Other hazards and prevention measures (ST Cable)

3 3 63 4 74 3 7

CountExcessive vibration of power toolsCountSlippery footingCountInappropriate or inadequate hand tools

No Yes Total

Prevention measures are:

- Engineering controls on power tools (2): emergency stop button - Personal protective equipment (2) - Safety instruction chart: General safety instructions, PPE, ... (1)



Research Centre

Several companies undertake training to prevent MSD within pulling, pushing and connecting cables. Task specific training is described as:


- Guidelines (2) - Brochures (3) - Ergo coaches (2) (who train the workers if the employees working environments agent ask for

it) - On line training (1) - Toolbox meeting (3) - Computer based training package (1) - Training in the field (by external service) (2)


- Regular training ‘health protection issues’ for all managers and employees (1) - Intranet (3): Internal norms on Health and Safety - Class room literature, brochures and guidelines (2) - Toolbox meeting (2) - Guidelines, brochures (2) - Ergo coaches (2) - Training in the field (by external service) (1) - Computer based training package (1) - Integral part of the training provided to the employer (1)


> Older workers

- Early retirement, have more rest (1) - Recuperation stay in mountains. (see previously) (1) - On medical advise, adaptation of work station/ area - Change job within company (2) - Doctors take into account the age of the operator and the working conditions during their

medical surveillance (1) > Workers who developed musculoskeletal problems

- Recuperation stay in mountains. (see previously) (1) - Change task or job, limit specific tasks par example lifting heavy loads - Worker would be assigned lighter duties. (2) - Adaptations of work station/ area or alternative work for victims of MSD. (1)

Conclusion: This activity is a very common task within the participating companies: 11 of the 13 companies with service technicians undertake pulling, pushing and connecting cables. Prolonged static posture and uncomfortable working positions, as well as lifting covers of underground structures are the main are the main causes of MSD within the service technicians Cabling. It is remarkable that for this task, some of the traditional prevention strategies are mentioned not to be suitable for this task, such as job rotation to reduce repetitive movements or restrictions in lifting. Also the presence of a policy on lifting is questioned. It is possible that in some companies these policies are indeed present, but are no followed up in practice. It is clear that a policy should not only be present in theory, but should be followed in practice to be effective as a prevention measure.


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2.3.3.4 Service technician - Blowing and connecting optical fibres This activity is a very common task within the participating companies: 11 of the 13 companies with service technicians undertake blowing and connecting optical fibres. The proportion of these workers within the companies varies between 3 and 70%. The duration of this activity differs between 2.5 and 8 hours a day.


- Lifting covers of underground structures - Blowing optical fibres - Connecting optical fibres - Placing material to signalise the working area - Driving to different working areas with truck

Devices: - Hand tools - Fusion splice machine - Cleaver - Optical Time Domain Reflectometer (OTDR) - Power meter - Box keys - Blowing generators - Road working guarding - Gas detection unit - Mechanical aids - Personal protective equipment - Cable cutters and pliers - Optical cable stripping tools - Impact tools for terminating cables

One company adds comment regarding this activity:

- Assembly in the shaft/cavity only takes place in exceptional circumstances. - The vehicles are set up ergonomically for this.


The body parts most at risk for MSD within service technicians Fibres are neck/ shoulders, upper arm/ elbow, forearm/ wrist/ hand and back (table 29).


4 5 2 114 7 113 6 2 111 6 4 117 4 115 5 1 118 3 11




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• FORCE: Hazard and prevention measures

Force seems to be a medium risk according 8 companies, 1 company mentions this risk is high, one this risk is low. Regarding force within blowing optical fibres, the main causes are handling covers of underground structures, fibres, equipment and material to signalise the working area. One company also mentions lifting the portable generator.

Table 30: Force - Hazards (ST Fibres)

1 9 101 9 101 9 102 8 102 8 102 8 101 9 102 8 102 8 102 7 93 6 9

CountLifting covers of underground structuresCountLifting fibresCountLifting equipment for placing fibresCountLifting material to signalise the working areaCountCarrying covers of underground structuresCountCarrying fibresCountCarrying equipment for placing fibresCountCarrying material to signalise the working areaCountPulling/ pushing covers of underground structuresCountPulling and pushing fibresCountPulling/ pushing equipment for placing fibres

No Yes Total

To prevent the impact of force, companies undertake several prevention measures (table 23). Task specific training and specific tools for lifting covers of underground structures seems to be the most common.

Table 31: Force - Prevention (ST Fibres)

1 9 10

5 5 104 5 96 3 94 5 93 7 105 6 11

CountSpecific tools, lifting devices for lifting covers ofunderground structures

CountPolicy with regard to lifting covers of undergroundstructures CountLifting devices

CountRestriction of liting objects weighting more than:CountSpecific tools for transport of fibresCountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total


- Specific hammers (cover rolled over a round metal pipe) and (hydraulic) lifters (2) - All manual handling activities are covered by legally regulations. These regulations state that

where possible the need to use manual handling techniques to manoeuvre heavy plant and equipment must be avoided. Where it is not possible to avoid the practice, suitable mechanical aids must be used. In addition a suitable and sufficient risk assessment of the work must be undertaken. (1)

• In practice: Removal and replacement covers by manual methods must not be carried out unless the line manager has ensure a site specific local risk assessment has been completed. (Assessment checklist). A line manager must be consulted every time a


Research Centre

cover cannot be lifted by the lifter. On completion of the assessment the contents of the document should be briefed to the people who are to remove the cover by manual methods and a record kept, for 6 months, by the line manager with a copy sent to Safety Consultancy Services. All people required removing cover by manual methods and their supervisors must be trained in the techniques.

- In one company the policy regarding lifting is included in the safety manual. Regarding restrictions of lifting heavy loads, following items are mentioned:

- Guidance states that an optimum of 25 kg should be regarded as the maximum load to be lifted manually without a specific risk assessment incorporating local and individual characteristics, the Regulations do not stipulate a maximum load which can be lifted, because of each individual's physical characteristics (1)


- Maximum = 25 kg (1) Specific tools for transporting fibres are: cable reel transporters (1), and a hose reel (1)

• DURATION: Hazard and prevention measures 7 companies mention that duration is a medium risk within these service technicians, 3 companies describes duration as a low risk, one as a high risk. The main causes are repetitive hand, wrist and arm movements (table 32).

Table 32: Duration - Hazard (ST Fibres)

2 7 9

4 6 10



No Yes Total

The prevention measures overcome this hazard are listed in table 33. Task specific training seems to be most common.

Table 33: Duration -Prevention (ST Fibres)

4 5 96 4 102 8 106 5 11

CountErgonomic design of equipmentCountJob rotationCountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total

• POSTURE: Hazard and prevention measures Posture is a high risk according 2 companies, medium according 8 companies and low according one company. This is mainly due to the prolonged static posture while connecting optical fibres (table 34).


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Table 34: Posture - Hazard (ST Fibres)

2 8 102 7 93 6 95 5 103 7 106 4 103 7 10

CountNarrow working areaCountProlonged bending posture while blowing fibresCountAwkward positions (squatting, kneeling position...) while blowing

fibres CountProlonged bending posture while connecting fibresCountAwkward positions (squatting, kneeling position...) while connecting

fibres CountFurniture not properly adapted for this workCountTruck driving

No Yes Total

The prevention measures to minimise these hazards are listed in table 35. Again, task specific training seems to be most common.

Table 35: Posture - Prevention (ST Fibres)

5 4 95 4 97 2 91 9 105 6 116 4 10

CountCushions, knee pads... for working undergroundCountSpecific ergonomic devicesCountInstructions for right use of the ergonomic adjustmentsCountTask specific trainingCountGeneral training on ergonomic principles and MSD


No Yes Total

Specific ergonomic devices mentioned:

- Chairs and special protection of the knees (1) - Most pulling is performed by means of electrical winch and a jointing machine is used for

jointing (1)

• OTHER: Hazards and prevention measures Other hazards (table 36) within this activity appear to be medium according 7 companies and low according one. In one company, gas in the underground structures seems to be a hazard, in another company the outside work.

Table 36: Other hazards and prevention measures (ST Fibres)

3 3 63 4 74 3 7

CountExcessive vibration of power toolsCountSlippery footingCountInappropriate or inadequate hand tools

No Yes Total


- Engineering controls on power tools (3): emergency stop button - Personal protective equipment (2) - Safety instruction chart: General safety instructions, PPE, ... (1) - Risk assessments (1)



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Several companies undertake training to prevent MSD within the service technicians, which connect and blow optical fibres. Task specific training is described as:


- Guidelines (3) - Brochures (4) - Ergo coaches (2) (who train the workers if the employees working environments agent ask for

it) - On line training (1) - Toolbox meeting (1) - Computer based training package (1) - Training in the field (by external service) (2)


- Regular training ‘health protection issues’ for all managers and employees (1) - Intranet (3): Internal norms on Health and Safety - Class room literature, brochures and guidelines (2) - Toolbox meeting (2) - Guidelines, brochures (1) - Ergo coaches (1) - Training in the field (by external service) (1) - Computer based training package (1) - Integral part of the training provided to the employer (1)


> Older workers

- Early retirement, have more rest (1) - Recuperation stay in mountains. (see previously) (1) - On medical advise, adaptation of work station/ area (1) - Change job within company (2) - Doctors take into account the age of the operator and the working conditions during their


- Recuperation stay in mountains. (see previously) (1) - Change task or job, limit specific tasks par example lifting heavy loads - Worker would be assigned lighter duties. (2) - Adaptations of work station/ area or alternative work for victims of MSD.(1)

Conclusion: This activity is a very common task within the participating companies: 11 of the 13 companies with service technicians undertake blowing and connecting optical fibres. Prolonged static posture and uncomfortable working positions, as well as lifting covers of underground structures are the main are the main causes of MSD within the service technicians Blowing and connecting optical fibres. Many hazards are mentioned, including lifting, carrying and pulling tasks. Many prevention strategies are present, of which specific tools are most often mentioned. Again instructions/guidelines on how to perform the task is not always considered as a prevention strategy.


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2.3.3.5 Service technician – In house cable connector This activity, like cabling and blowing optical fibres, is also a very common task within the participating companies: 11 of the 13 companies with service technicians undertake in-house cable connection. The proportion of these workers within the companies varies between 25 and 90%. The duration of this activity differs between 2.5 and 8 hours a day.


- Connecting cables in warehouses, telephone exchanges - Driving to different working areas with truck

Devices:

- Hand tools - Ladder/ stairs - Cable carrier box - Tool box - Measure instruments (cable identifiers) - Cable cutters and pliers - Impact tools for terminating cables - Cable stripping tools

Additional comment of one company:

- Employees who perform cable connections also perform other tasks. It is possible that several days pass without connecting cables.

- Other tasks: Installation of equipment, repairing equipment, correcting faults

• Risks of MSD with regard to this activity: Most of the body parts at risk for MSD within these service technicians are back, forearm/ wrist/ hand and neck and shoulders (table 37).


3 5 3 115 5 1 112 5 4 111 7 3 117 3 1 115 5 1 118 3 11



• FORCE: Hazard and prevention measures Force seems to be a medium risk according 5 companies, 6 companies mention this risk is low. Regarding force within in-house cable connection, the main cause is handling ladders. One company indicates handling a toolbox as a hazard within this aspect.


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Table 38: Force - Hazards (ST Con)

2 8 106 4 101 9 105 5 101 9 105 5 10

CountLifting ladderCountLifting furniture with customersCountCarrying ladderCountCarrying furniture with customersCountPulling/ pushing ladderCountPulling/ pushing furniture with customers

No Yes Total

To prevent the impact of force, companies undertake several prevention measures (table 39). Task specific training and ergonomic stairs seems to be the most common.

Table 39: Force - Prevention (ST Con)

3 7 106 3 91 9 105 6 11

CountErgonomic stairs (mobile stair)CountRestriction of liting objects weighting more than:CountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total

Regarding restrictions of lifting heavy loads, the participating companies mention following items:



- Maximum = 25 kg (2) Regarding ergonomic stairs:

- Stairs on electrical control (1) - Wheels of ladder fixed in rails (1) - Any form of mobile stair is better than climbing on the frame (1)

Several lifting aids are used by the in-house cable connectors to lift their equipment out of the vehicle: a system on vehicle to bring down ladder of top of vehicle (1), aids (hand truck, magnet, sucking cup, belt, sling) to lift equipment (1) and a hydraulic tailboard of vehicle to lift hose reel (1).

• DURATION: Hazard and prevention measures 4 companies mention that duration is a low risk within these service technicians, 4 companies describe duration as a medium risk, 3 as a high risk. According to 10 companies this is due to repetitive precise movements finger and wrist movements. Also repetitive feet and ankle movements during climbing the ladders seem to be hazards in one company. The prevention measures to overcome this hazard are listed in table 40. Task specific training seems to be the most common measure. One company mentions use of electrical and tested hand tools.


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Table 40: Duration -Prevention (ST Con)

3 77 37 3 105 6

CountErgonomic hand toolsCountInstructions for right use of the ergonomic adjustmentsCountJob rotationCountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes

• POSTURE: Hazard and prevention measures Posture is a high risk according to 5 companies, medium according 4 companies and low according 2 companies. This is mainly due to the prolonged static posture while connecting the cables (table 34).

Table 41: Posture - Hazard (ST Con)

10 10 10 102 8 101 9 10 10 102 8 102 8 103 7 103 7 101 9 10

CountProlonged standingCountProlonged flexion of the backCountProlonged rotation of the backCountContinued reaching at or above the shouldersCountAwkward positions (squatting, kneeling position...)CountProlonged flexion of head/ neckCountProlonged rotation of head/ neckCountLack of body supportCountPinch grip (thumb- forefinger)CountVehicle driving

No Yes Total

The prevention measures to minimise these hazards are listed in table 35. Training, both task specific as on ergonomic principles on MSD, are most common. One company mentions to reduce vehicle driving as much as possible.

Table 42: Posture - Prevention (ST Con)

5 5 105 5 104 6 104 6 102 8 103 8 117 3 10

CountChair, stool, knee pads,...CountErgonomic adjustment of stairCountErgonomic hand toolsCountInstructions for right use of the ergonomic adjustmentsCountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention CountSpecific ergonomic devices in vehicle

No Yes Total

According to two companies, all chairs which are used for a long period are ergonomic designed and adjustable. The height of the stairs is adapted to the work environment is added by another company.

• OTHER: Hazards and prevention measures Other hazards within this activity appear to be:

- Electric shocks (1) - Falling from steps/ ladder (1) - Getting something in the eye (1)


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- Cutting hands on connectors on frame (1) To prevent these hazards, companies use:

- Proper equipment (1) - Personal protective equipment (1) - Safety instruction chart: General safety instructions, PPE, ...


Task specific training is described as: - ST who start their job: Introduction training on health and safety with regard to their job is a part

of Start Day (1) - Guidelines (2) - Brochures (3) - On line training (1) - Toolbox meeting (1) - Computer based training package (1) - Task training in the field (by external service) (3) - Ergo training: how to use lifting devices, how transport hose reels and equipment


- Regular training ‘health protection issues’ for all managers and employees (1) - Training on manual handling and ergonomics (1) - Intranet (2): Internal norms on Health and Safety - Class room literature, brochures and guidelines (2) - Toolbox meeting (1) - Guidelines, brochures (1) - Ergo coaches (1) - Training in the field (by external service) (1) - Computer based training package (1) - Integral part of the training provided to the employer (1)


> Older workers - Early retirement, have more rest (1) - Recuperation stay (see previous) (1) - Doctors take into account the age of the operator and the working conditions during their


- Recuperation stay (see previous) (1) - Adaptations of work station/ area or alternative work for victims of MSD. (1) - If due to physical condition, worker cannot perform this activity, he will be offered the opportunity

to carry out less strenuous tasks and if necessary also retraining. Conclusion: 11 of the 13 companies with service technicians undertake in-house cable connection Prolonged static posture and repetition wrist and hand movements are the main are the main causes of MSD within the service technicians In-house cable connecting. A lot of emphasis is laid on training as the important prevention measure, both general ergonomics awareness training and task specific training. Furthermore, the use of an ergonomic ladder seems to be a necessary tool to reduce awkward postures during this task.


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2.3.3.6 Service technician – Paving Only 4 of the participating companies have service technicians that perform paving tasks. In most of the countries this activity is outsourced. The proportion of these workers within one company is 10% and they perform this activity during the whole day. For the other 3 companies, these figures are missing.


- Replacing paving stones, asphalt, … - Finishing roadsides - Placing material to signalise the working area - Driving to different working areas with truck

Devices: - Drill - Hammer - Angel grinder - Chisel - Pummel


The body parts most at risk for MSD within service technicians paving are leg/ knee, upper arm/ elbow and forearm/ wrist and hand (table 43).


1 3 4 2 2 4 2 2 41 1 2 42 2 41 3 42 2 4




Force seems to be a high risk according to 2 companies, 1 company mentions this risk is medium, for another company the risk is low. Regarding force during paving, the main causes are handling paving material, equipment and material to signalise the working area.

Table 44: Force - Hazards (ST Pave)

3 33 33 33 33 33 33 3

CountLifting pavingstones, asphalt, sand...CountLifting material to working areaCountLifting material to signalise the working areaCountCarrying pavingstones, asphalt, sand...CountCarrying material to signalise the working areaCountPulling/ pushing pavingstones, asphalt, sand...CountPulling/ pushing material to signalise the working area

Yes Total


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To prevent the impact of force, companies undertake several prevention measures (table 23). Training and restriction of lifting heavy objects are most common.

Table 45: Force - Prevention (ST Pave)

2 2 3 3 3 31 3 4


prevention

No Yes Total

Regarding restrictions of lifting objects, the companies make the following remarks:

- Where necessary, lifting of material is performed jointly by more than one person. (1) - Guidance states that an optimum of 25 kg should be regarded as the maximum load to be lifted

manually without a specific risk assessment incorporating local and individual characteristics, the regulations do not stipulate a maximum load which can be lifted, because of each individual's physical characteristics (1)

- Maximum = 25 kg (1) Two companies provide mechanical cranes in the back of the van to lift the heavy equipment. All lifting equipment is checked every six months and is certificated in one company.

• DURATION: Hazard and prevention measures Two companies mention that duration is a medium risk within these service technicians, one company describes duration as a low risk and one as high. The main causes of this hazard within 3 companies are repetitive hand and wrist movements while paving and digging. The prevention measures overcome this hazard are listed in table 46. Ergonomic hand tools and general training on ergonomic principles and MSD are most prevalent.

Table 46: Duration -Prevention (ST Pave)

3 3 2 21 1 21 2 31 2 31 3 4

CountErgonomic hand toolsCountInstructions for right use of the ergonomic adjustmentsCountCrane for mechanical placement of pavingstonesCountJob rotationCountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total

• POSTURE: Hazard and prevention measures Posture is a high risk according 2 companies, medium and low according 1 company. This is mainly due to the prolonged static while paving (table 47).


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Table 47: Posture - Hazard (ST Pave)

3 33 33 32 22 23 3

CountProlonged standing while diggingCountProlonged flexion of the backCountProlonged rotation of the backCountProlonged sitting on one or two kneesCountProlonged working in kneeling or squatting positionCountTruck driving

Yes Total

The prevention measures to minimise these hazards are listed in table 48. Training on the task and on general ergonomic principles, as well as specific ergonomic devices in truck are most common.

Table 48: Posture - Prevention (ST Pave)

1 2 31 2 3 3 31 3 4 3 3

CountCushions, knee pads...CountJob rotationCountTask specific trainingCountGeneral training on ergonomic principles and MSD


No Yes Total

One company also offers adjustable seats for these workers.

• OTHER: Hazards and prevention measures Other hazards within this activity are listed in table 49. One company also mentions that heavy work (legislation: certain tasks of this function are considered as heavy work) and weather influences.

Table 49: Other hazards and prevention measures (ST Pave)

3 33 33 3

CountExcessive hand-arm vibrationCountExcessive whole-body vibrationCountSlippery footing

Yes Total

Other prevention measures are:

- Safety ankle boots with a good grip sole provided (1) - Risk assessment (1) - Training how to use vibration tools (1) - Special protective clothing (1) - Balance between heavy and less heavy work (1) - Safety instruction charts: General safety instructions, PPE, ... (1)


Several companies undertake training to prevent MSD within the service technicians Paving. Task specific training is described as:

- Safety instruction charts (1) - Ergo coaches (1) - Class room lectures (1)


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- Computer based training package (1) - Training in the field (by external service) (2)


- Intranet (1) - Class room literature, brochures and guidelines (3) - Guidelines, brochures (2) - Ergo coaches (2) - Training in the field (by external service) (1) - Computer based training package (1) • Specific measures

> Older workers

- Change job within company (1) - Doctors take into account the age of the operator and the working conditions during their


- Worker would be assigned lighter duties. (2) - More adapted function (1)

Conclusion: Prolonged static posture and uncomfortable working positions, as well as lifting material are the causes of MSD within the service technicians Paving. Also whole body and hand-arm vibration are mentioned as important hazards. Several companies undertake training to prevent MSD and provide specific material (brochures, guidelines).


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2.3.3.7 Service technician – Repairing underground cables This activity is a common task within the participating companies: 11 of the 16 companies with service technicians undertake repairing of underground cables. However, the proportion of these workers within the companies varies largely between 5 and 90%. Also the duration of this activity differs: between 2 and 8 hours a day.


- Remove paving stones, asphalt, and sand… - Manual digging (before and after solve disturbance) in places to small to reach with digger - Searching other underground structures - Repairing underground structures - Welding - Removing and replacing isolation material - Lifting covers of underground structures - Placing material to signalise the working area - Driving to different working areas with truck

Devices:

- Welding equipment - Road working guarding - Gas detection unit - Box keys - Measure instruments (cable identifiers) - Cable cutters and pliers - Portable air compressor - Impact tools for terminating cables - Cables stripping tools - Jointing machines


The body parts most at risk for MSD within service technicians Repair are upper arm/ elbow, back, forearm/ wrist/ hand and neck and shoulder (table 50).


2 7 1 101 5 4 102 4 4 101 4 5 104 5 1 104 2 4 104 3 3 10




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Force seems to be a high risk according 2 companies, 6 companies mention this risk is medium, one this risk is low. Regarding force within repairing, the main causes within service technicians repair are handling covers of underground structures, cables, equipment and material to signalise the working area. One company also mentions pulling and pushing generator on wheels and moving cables for access.

Table 51: Force - Hazards (ST Repair)

1 8 96 3 91 8 93 6 91 8 97 2 91 8 92 6 83 6 93 6 92 7 9

CountLifting covers of underground structuresCountLifting cablesCountLifting equipment for placing cablesCountLifting material to signalise the working areaCountCarrying covers of underground structuresCountCarrying cablesCountCarrying equipment for placing cablesCountCarrying material to signalise the working areaCountPulling/ pushing covers of underground structuresCountPulling/ pushing cablesCountPulling/pushing equipment for placing cables

No Yes Total

To prevent the impact of force, companies undertake several prevention measures (table 52). Task specific training and specific tools for lifting covers seems to be the most common.

Table 52: Force - Prevention (ST Repair)

2 7 9

4 5 93 6 96 3 97 2 9

9 96 4 10

CountSpecific tools, lifting devices for lifting covers ofunderground structures

CountPolicy with regard to lifting underground structuresCountLifting devicesCountRestriction of liting objects weighting more than:CountSpecific tools for transport of cablesCountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total


- Specific hammers (cover rolled over a round metal pipe) and (hydraulic) lifters (2) - Counterbalanced or assisted opening of a manhole cover - The covers of underground structures are to be open with appropriate tools and equipment.

Users should not use improvised means to undertake this task in order to avoid lesions in the lumbar region and other type of lesions. (2)

- All manual handling activities are covered by legally regulations. These regulations state that where possible the need to use manual handling techniques to manoeuvre heavy plant and equipment must be avoided. Where it is not possible to avoid the practice, suitable mechanical


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aids must be used. In addition a suitable and sufficient risk assessment of the work must be undertaken. (1)

• In practice: Removal and replacement covers by manual methods must not be carried out unless the line manager has ensure a site specific local risk assessment has been completed. (Assessment checklist). A line manager must be consulted every time a cover cannot be lifted by the lifter. On completion of the assessment the contents of the document should be briefed to the people who are to remove the cover by manual methods and a record kept, for 6 months, by the line manager with a copy sent to Safety Consultancy Services. All people required removing cover by manual methods and their supervisors must be trained in the techniques.

In one company the policy regarding lifting is included in the safety manual. Regarding restrictions of lifting heavy loads, following items are mentioned:



Several companies’ uses a towlines and a cable drum as specific tools for transporting cables.

• DURATION: Hazard and prevention measures 7 companies mention that duration is a medium risk within these service technicians, 2 companies describes duration as a low risk. The main causes are repetitive hand, wrist and arm movements (table 53). One company also thinks fixing and removing cable covers is a hazard.

Table 53: Duration - Hazard (ST Repair)

2 7 9

9 9



No Yes Total

The prevention measures overcome this hazard are listed in table 25. Task specific training is most common. One company mentions that unwinding cables is electrical.

Table 54: Duration -Prevention (ST Repair)

3 6 96 3 97 2 91 8 96 4 10

CountErgonomic hand toolsCountInstructions for right use of the ergonomic adjustmentsCountJob rotationCountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total

• POSTURE: Hazard and prevention measures


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Posture is a high risk according 5 companies, medium according 5 companies and low according one company. This is mainly due to the prolonged static posture while repairing the underground cables (table 55).

Table 55: Posture - Hazard (ST Repair)

9 9 9 93 6 91 8 93 6 92 7 91 8 92 7 92 7 93 6 91 8 9

CountNarrow working areaCountProlonged flexion in back while working undergroundCountProlonged rotation in back while working undergroundCountAwkward positions (squatting, kneeling position...) undergroundCountProlonged seeting while working undergroundCountProlonged standingCountProlonged flexion of the back while standingCountProlonged rotation of the back while standingCountProlonged flexion of head/ neck while standingCountProlonged rotation of head/ neck while standingCountTruck driving

No Yes Total


Table 56: Posture - Prevention (ST Repair)

6 3 98 1 95 4 92 7 96 4 108 1 9

CountCushions, knee pads... for working undergroundCountErgonomic adjustmentsCountInstructions for right use of the ergonomic adjustmentsCountTask specific trainingCountGeneral training on ergonomic principles and MSD


No Yes Total

• OTHER: Hazards and prevention measures Other hazards within this activity appear to be medium according 3 companies and high according one. In one company gas, gats and rats in the underground structures seems to be a hazard, in another company the outside work. Two companies mention excessive vibrations of power tools, three companies slippery footing. Prevention measures are:

- Specific working clothes (1) - Personal protective equipment (1) - Safety instruction chart: General safety instructions, PPE, ... (1) - Risk assessment (1) - Vaccination (1) - Dosimeter (1)



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Several companies undertake training to prevent MSD within the service technicians Cabling. Task specific training is described as:

- ST who start their job: Introduction training on health and safety with regard to their job is a part of Start Day (1)

- Guidelines (2) - Brochures (2) - On line training (2) - Toolbox meeting (2) - Computer based training package (1) - Training in the field (by external service) (2)


- Regular training ‘health protection issues’ for all managers and employees (1) - Intranet (3): Internal norms on Health and Safety - Class room literature, brochures and guidelines (2) - Toolbox meeting (2) - Guidelines, brochures (2) - Ergo coaches (2) - Training in the field (by external service) (1) - Computer based training package (1)


> Older workers

- Early retirement, have more rest (1) - Recuperation stay (see previous) (1) - On medical advise, adaptation of work station/ area - Change job within company (1) - Doctors take into account the age of the operator and the working conditions during their


- Recuperation stay (see previous) (1) - Change task or job, limit specific tasks par example lifting heavy loads - Worker would be assigned lighter duties. (2) - Adaptations of work station/ area or alternative work for victims of MSD.(1)

Conclusion: Most companies perform this type of activity, which includes a lot of different tasks. Therefore, also a lot of different devices and tools are used. A lot of body parts are mentioned to be at risk for developing MSD. Posture seems to be the highest risk, followed by force and then duration of the activity. As the main causes for MSD, prolonged static posture and uncomfortable working positions while working underground, as well as lifting covers of underground structures are mentioned. Two companies mention excessive vibrations of power tools, three companies slippery footing as important hazards. Only task specific training seems to be the most important prevention measure. Not every company is convinced that general training or instruction work as a prevention measure. For some specific tasks the use of specific ergonomic tools can be an advantage to reduce MSDs.


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2.3.3.8 Service technician – Pole workers Pole workers are common within 11 participating companies. The proportion of these workers within the companies varies between 1 and 85%. The duration of this activity differs between 1 and 8 hours a day. The number of poles per company varies between 110 000 and 15 000 000.


- Lifting, carrying and placing ladder - Climbing on ladder - Climbing on pole - Working on pole - Placing material to signalise the working area - Driving to different working areas with truck

Devices: - Hand tools - Ladder - Personal protection - Road working guarding - Ladder tie - Safety belt - Tool bass - Sash line - Cable cutters and pliers


The body parts most at risk for MSD within pole workers are back, neck/ shoulder and forearm/ wrist/ hand (table 50).


3 6 2 115 4 2 114 6 1 111 7 3 117 4 115 4 2 115 5 1 11



• FORCE: Hazard and prevention measures Force seems to be a high risk according 3 companies, 6 companies mention this risk is medium, one this risk is low. Regarding force within the pole workers, the main causes are handling ladders, cables,


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equipment and material to signalise the working area (table 58).

Table 58: Force - Hazards (ST Pole)

1 9 10 10 10 10 102 8 101 9 10 10 10 10 102 8 102 7 91 8 9

CountLifting ladderCountLifting cablesCountLifting equipmentCountLifting material to signalise the working areaCountCarrying ladderCountCarrying cablesCountCarrying equipmentCountCarrying material to signalise the working

area CountPulling/ pushing cablesCountPulling/ pushing equipment

No Yes Total

To prevent the impact of force, companies undertake several prevention measures (table 59). Task specific training seems to be the most common. One company also mentions use of a tool bass.

Table 59: Force - Prevention (ST Pole)

7 3 107 2 9 10 104 7 11

CountReel system to transport hand tools (katrol)CountRestriction of liting objects weighting more than:CountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total

One company uses a toolbox-lifting machine for lifting equipment. Regarding restrictions of lifting heavy loads, following items are mentioned:

- Guidance states that an optimum of 25 kg should be regarded as the maximum load to be lifted manually without a specific risk assessment incorporating local and individual characteristics, the Regulations do not stipulate a maximum load which can be lifted, because of each individual's physical characteristics (1)


. • DURATION: Hazard and prevention measures

3 companies mention that duration is a high risk within these service technicians, 3 companies describe duration as a medium risk and 4 as low. The main causes mentioned by the companies are repetitive hand, wrist and arm movements while working on the cables The prevention measures overcome this hazard are listed in table 60. Task specific training is most common. One company mentions the use of electrical hand tools.

Table 60: Duration -Prevention (ST Pole)


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2 7 96 3 96 3 91 9 105 6 11

CountErgonomic adjustments of hand toolsCountInstructions for right use of the ergonomic adjustmentsCountJob rotationCountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total

• POSTURE: Hazard and prevention measures

Posture is a high risk according 4 companies, medium according 5 companies and low according one company. This is mainly due to the prolonged static posture while working on pole (table 61).

Table 61: Posture - Hazard (ST Pole)

1 8 91 9 102 8 101 9 102 8 102 8 101 9 10

CountContinued standing on poleCountContinued reaching at or above shouldersCountProlonged flexion in back while working on poleCountProlonged rotation in back while working on poleCountProlonged flexion of head/ neck while working on poleCountProlonged rotation of head/ neck while working on poleCountTruck driving

No Yes Total


Table 62: Posture - Prevention (ST Pole)

5 4 93 7 105 4 91 9 105 6 115 5 10

CountBack supportCountFeet supportCountInstructions for right use of the ergonomic adjustmentsCountTask specific trainingCountGeneral training on ergonomic principles and MSD


No Yes Total

Regarding back support, 3 companies mention that the safety belts have built in padding to protect the back. One company uses ladder rungs or bucket of cherry pickers. Use of special protective footwear and special steps on the ladder are mentioned as feet support.

• OTHER: Hazards and prevention measures Other hazards within this activity appear to be high according 1 company, medium according another and low according three. These are:

- Slippery footing (3) - Falling of pole - Creosote: allergic reaction (1) - Uneven ground (1)


- Safety ankle boots with a good grip sole (1)


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- Personal protective equipment (2) - Pole testing (1) - Risk assessment (1)


Several companies undertake training to prevent MSD within the pole workers. Task specific training is described as:


- Guidelines (3) - Brochures (4) - On line training (2) - Toolbox meeting (2) - Computer based training package (1) - Training in the field (by external service) (2) - Safety manual on intranet (1) - Training on the use of personal protective equipment


- Regular training ‘health protection issues’ for all managers and employees (1) - Intranet (3): Internal norms on Health and Safety - Class room literature, brochures and guidelines (2) - Toolbox meeting (2) - Training in the field (by external service) (1) - Computer based training package (1)


> Older workers

- Early retirement, have more rest (1) - Recuperation stay (see previous) (1) - On medical advise, adaptation of work station/ area (1)

> Workers who developed musculoskeletal problems - Recuperation stay (1) - Change task or job, limit specific tasks par example lifting heavy loads (1) - Worker would be assigned lighter duties. (3) - Adaptations of work station/ area or alternative work for victims of MSD.(1)

Conclusion: The body parts most at risk for MSD within pole workers are back, neck/ shoulder and forearm/ wrist/ hand. Again posture is mentioned as the most important hazard, followed by force and duration. Prolonged static work while working on pole is accompanied by awkward postures: working at or above shoulder level and bad postures of neck/shoulder and back. Also lifting and carrying heavy objects are causes of MSD within the pole workers. The adverse working environment and slippery footing specifically is also a main hazard. Task specific training is considered as the important prevention measure.


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2.3.3.9 Service technician – Pylon workers As pole workers, pylon workers are common within 11 participating companies. The proportion of these workers within the companies varies between 0.5 and 17%. The duration of this activity differs between 1 and 8 hours a day. The number of poles per company varies between 8 and 29 000.


- Climbing on pylons - Working on pylons - Driving to different working areas with truck

Devices: - Hand tools

Remark made by one company: Theses workers also perform other tasks than climbing pylons. This is not a full time task and also not a daily task. Other tasks: installation and servicing of wireless LAN's; installation and servicing of radio equipment.

• Risks of MSD with regard to this activity: The body parts most at risk for MSD within pole workers are back and neck/ shoulder (table 50).


2 8 1 114 5 2 115 4 2 111 8 2 118 3 114 5 2 116 3 2 11



• FORCE: Hazard and prevention measures Force seems to be a high risk according 3 companies, 6 companies mention this risk is medium, one this risk is low. Regarding force within the pole workers, the main causes are handling equipment and material to signalise the working area (table 64).

Table 64: Force - Hazards (ST Pylon)

10 101 8 9 10 101 8 91 8 91 7 8

CountLifting equipmentCountLifting material to signalise the working areaCountCarrying equipmentCountCarrying material to signalise the working areaCountPulling/ pushing equipmentCountPulling/ pushing material to signalise the working

area

No Yes Total


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To prevent the impact of force, companies undertake several prevention measures (table 65). Task specific training seems to be the most common. One company also mentions a bag with shoulder belts to transport equipment.

Table 65: Force - Prevention (ST Pylon)

2 8 105 5 101 9 105 6 11


prevention

No Yes Total

One company uses winches. Regarding restrictions of lifting heavy loads, one company mentions:


• DURATION: Hazard and prevention measures

3 companies mention that duration is a high risk within these service technicians, 3 companies describe duration as a medium risk and 4 as low. The main causes mentioned by the companies are repetitive hand, wrist and arm movements while working on the pylons. The prevention measures overcome this hazard are listed in table 66. Training seems to be most common. One company mentions the use of electrical hand tools.

Table 66: Duration -Prevention (ST Pylon)

5 3 85 3 86 2 82 6 83 6 9

CountErgonomic adjustments of hand toolsCountInstructions for right use of the ergonomic adjustmentsCountJob rotationCountTask specific trainingCountGeneral training on ergonomic principles and MSD

prevention

No Yes Total

• POSTURE: Hazard and prevention measures Posture is a high risk according 5 companies, medium according 5 companies and low according one company. This is mainly due to the prolonged static posture while working on pylon (table 67).

Table 67: Posture - Hazard (ST Pylon)

1 9 101 9 101 9 102 8 102 8 103 7 102 8 10

CountContinued standing while working on pylonCountContinued reaching at or above shouldersCountProlonged flexion in back while working on pylonCountProlonged rotation in back while working on pylonCountProlonged flexion of head/ neck while working on pylonCountProlonged rotation of head/ neck while working on pylonCountTruck driving

No Yes Total


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The prevention measures to minimise these hazards are listed in table 68.

Table 68: Posture - Prevention (ST Pylon)

5 5 106 3 95 4 92 7 94 6 107 1 8

CountBack supportCountFeet supportCountInstructions for right use of the ergonomic adjustmentsCountTask specific trainingCountGeneral training on ergonomic principles and MSD


No Yes Total

Explanation by these prevention measures is:

- Special climbing tools and special climbing equipment - Use of a special safety belt with back support - Use of special protective footwear - Technical rules


Other hazards within this activity appear to be medium according 1 and low according 2 companies. These are:

- Outside work (1) - Heavy work (according legislation certain tasks of this function are considered as heavy work)

(1) - Exposure to high- frequency radiation (1)


- Safety instruction chart: General safety instructions, PPE, ... (1) - Balance between heavy and less heavy work (1) - Specific working clothes (1) - Use of appropriate warning devices (1)


Several companies undertake training to prevent MSD within the pole workers are the same as for pylon workers. Task specific training is described as:

- ST who start their job: Introduction training on health and safety with regard to their job is a part of Start Day (1)

- Guidelines (3) - Brochures (4) - On line training (2) - Toolbox meeting (2) - Computer based training package (1) - Training in the field (by external service) (2) - Safety manual on intranet (1) - Training on the use of personal protective equipment


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> Older workers



- Recuperation stay (see previous) (1) - Change task or job, limit specific tasks par example lifting heavy loads (1) - Worker would be assigned lighter duties. (3) - Adaptations of work station/ area or alternative work for victims of MSD.(1)

Conclusion: Prolonged static posture while working on pylons (reaching, standing) combined with awkward postures of the back and neck/shoulder region, as well as lifting and carrying heavy objects are the causes of MSD within the pylon workers. The adverse working environment and extreme outdoor climate (e.g. hot, cold, rain….) is also a main hazard. A lot of training prevention measures are listed, ranging from general ergonomic awareness to specific task related instructions.


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2.3.3.10 Service technician – Pole erection Three companies undertake pole erection. The proportion of these workers within the companies varies between 10 and 40%.


- Working on pole - Unloading pole from lorry - Dressing pole - Carrying pole - Setting up road works guarding - Climbing on pole - Carrying digging tools - Lifting, placing and carrying ladder - Tarmac - Bags of backfill - Digging hole for pole

Devices: - Safety belt - Personal protection equipment - Shovel - Rabbiter - Various slings and strops - Pole erection unit - Locator 8a - Spade - Bags of backfill - Bags of tarmac - Spoil bag - Various hand tools - Pummeler


The body parts most at risk for MSD within pole workers are back, upper arm/ elbow and forearm/ wrist/ hand (table 69).


2 1 3 1 2 3 1 2 3 3 3 3 3 3 31 1 1 3




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Force seems to be a high risk according 2 companies. The main hazards are:

- Lifting ladders - Carrying ladders - Pulling/ pushing ladders - Lifting heavy loads - Carrying heavy loads - Pulling and pushing heavy loads - Lifting pole - Lifting road works guarding - Lifting digging equipment - Lifting stores for dressing poles - Carrying pole - Carrying road works guarding - Carrying digging equipment

To prevent the impact of force, companies undertake several prevention measures:

- Using plain - Using hydraulic boom - Use of a crane to lift pole - Use of slings to assist lifting - Proper ergonomically designed tools

- Restrict the lifting of heavy items - ST who start their job: Introduction training on health and safety with regard to their job, is a part

of Start Day, everyone receives brochures - Regular training 'health protection issues' for all managers and employees, Intranet: Internal

norms Health and safety - Proper training on the task - General training on MSD principles

- Job rotation - The right amount of people to do the task safely, most pole gangs are made up of four

people

• DURATION: Hazard and prevention measures One company’s mention that duration is a high risk within these service technicians, one company describes duration as a medium risk. The main causes mentioned by the companies are:

- Repetitive wrist and finger movements - Repetitive arm and elbow movements

To prevent the impact of duration, companies undertake several prevention measures:


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- Task specific training: various memos and briefings plus team meetings and have computer based training packages

- Job rotation - General training on MSD - ST who start their job: Introduction training on health and safety with regard to their job, is a part

of Start Day, everyone receives brochures - Regular training 'health protection issues' for all managers and employees, Intranet: Internal

norms Health and safety

• POSTURE: Hazard and prevention measures Posture is a high risk according 2 companies. This is mainly due to:

- Prolonged flexion in neck and back when digging - Prolonged rotation in back when digging - Prolonged movements of arms and elbows when digging - Prolonged movements of ankles and legs when digging - Prolonged bending of back/legs/arms when testing depth of hole - Awkward positions (squatting, kneeling) - Prolonged movements of arms and elbows when dressing pole - Prolonged movements of wrists when dressing pole - Prolonged movements of arms/legs

To prevent these hazards, companies undertake several prevention measures.

- Ergonomic design of hand tools - Task specific training - General training on MSD principles: monthly news letters and internet articles and team briefs - Personal protective equipment - Mechanical aids


Other hazards within this activity appear to be:

- Slippery footing - Contact with underground services - Contact with overhead services - Creosote - Risk assessments: to look for any pot holes or excavations and to look at weather situation

gloves Prevention measures are:

- Water/gas/electric prints and do risk assessment to see if there are any telecom cables or ducts in the area

- Training

• TRAINING as prevention measures Several companies undertake training to prevent MSD within the pole workers are the same as for pylon workers.


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Task specific training is described as: - ST who start their job: Introduction training on health and safety with regard to their job is a part

of Start Day (1) - Guidelines (3) - Brochures (4) - On line training (2) - Toolbox meeting (2) - Computer based training package (1) - Training in the field (by external service) (2) - Safety manual on intranet (1) - Training on the use of personal protective equipment




> Older workers



- Recuperation stay (1) - Change task or job, limit specific tasks par example lifting heavy loads (1) - Worker would be assigned lighter duties. (3) - Adaptations of work station/ area or alternative work for victims of MSD.(1)

Conclusion: This activity is only performed by 3 companies. It includes a lot of different tasks and the use of different devices. Prolonged static posture while working on pylons is the main cause of MSD. To prevent bad postures and movements of back and neck/shoulder region, the companies undertake several prevention measures. The adverse working environment (e.g. hot, cold, rain…) is also a main hazard. The training measures to prevent MSD within the pole workers are the same as for pylon workers.


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2.3.3.11 Service technician – Aerial climbing This activity is added by one of the participating companies.


- Working from pole - Working with cable - Terminating cable - Working from platform elevating - Working from ladder - Carrying ladder - Climbing on pole - Getting stores to site - Driving to jobs - Setting up road works guarding - Pole testing

Devices:

- Various hand tools - Road works guarding - Trailer for aerial climbing - Stores for terminating aerial cable on pole - Platform elevating - Various pulleys - Tools for tensioning aerial cable - Rods telescopic - Safety belt - Personal protective equipment - Ladder


The body parts most at risk for MSD within these workers are listed in table 70.

Table 70: Risks of MSD within this activity Low risk Medium High risk Neck/ shoulder x Upper arm/ elbow x Forearm/ Wrist/ hand x Back x Hip x Leg/ knee x Ankle/ feet x


The main hazards regarding force within aerial climbing are:


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- Lifting ladders - Carrying ladders - Pulling/ pushing ladders - Lifting cables - Carrying cables - Pulling and pushing cables - Lifting equipment - Carrying equipment - Pulling and pushing equipment - Lifting road works guarding - Carrying road works guarding

To prevent the impact of force, the company undertakes several prevention measures:

- Restricting the lifting of heavy items - Mechanical aids - Personal protective equipment - Job rotation: doing various tasks - Proper training for the task by external service - Training on ergonomic principles and MSD during team meetings and computer based training

package and safety forums

• DURATION: Hazard and prevention measures The main hazards regarding duration within aerial climbing are:

- Repetitive wrist and finger movements - Repetitive arm and elbow movements

To prevent the impact of duration, the company undertakes several prevention measures:

- Job rotation: doing various tasks - Proper training for the task by external service - Training on ergonomic principles and MSD during team meetings and computer based training

package, safety forums

• POSTURE: Hazard and prevention measures The main hazards regarding posture within aerial climbing are:

- Prolonged use of arms when terminating cable - Prolonged use of wrists and elbows when terminating - Prolonged use of ankles and legs when terminating - Prolonged twisting of back when terminating - Prolonged movement of head/neck when terminating

To prevent these hazards, the company undertakes several prevention measures.

- Job rotation: doing various tasks - Proper training for the task by external service


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- Training on ergonomic principles and MSD during team meetings and computer based training package, safety forums

- Training in the use of hand tools

• OTHER: Hazards and prevention measures Other hazards within this activity appear to be:

- Slippery footing - Falling from pole - Pole breaking - Creosote


- Risk assessments - Safety belts - Pole testing - Personal protective equipment


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3.3.12 Service technician – Laptop use in vehicle

A common activity within service technicians of the telecommunications sector is using a laptop in car/ vehicle. Seven companies mention this activity. According these companies, the risk on MSD due to laptop use in vehicle is medium. The companies mention a few prevention measures:

- Smaller laptop size - Ergonomic adjustments in vehicle for laptop use - Use of a special work force laptop - Laptop in security box - Use of a PDA - Workstation that fits into lorry - Laptops stored in a security box in front or back out of site


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2.3.4 CONCLUSION SERVICE TECHNICIANS

In general, 12 different service technicians’ activities were defined. Not every company performs these activities themselves and consequently outsource this activity. The table below represents the amount of companies performing the activity and the proportion of workers involved with this activity. Activity # Companies % Workers Mechanical digging 3 3-10 Piping 6 5-28 Pulling/pushing/connecting cables 11 5-90 Blowing/connecting optical fibres 11 3-70 In-house cable connector 11 25-90 Paving 4 NA Repairing underground cables 11 5-90 Pole workers 11 1-85 Pylon workers 11 0.5-17 Pole erection 3 10-40 Aerial climbing 1 NA Laptop use in vehicle 7 NA Risks The number of high, medium and low risks differs across the different tasks. In the table below the absolute figures are presented.

Activity Force Duration Posture Mechanical digging 0-2-1 0-3-0 0-3-0 Piping 3-1-1 0-4-1 3-3-1 Pulling/pushing/connecting cables 2-8-1 0-10-1 5-5-1 Blowing/connecting optical fibres 8-1-1 1-7-3 2-8-1 In-house cable connector 0-5-6 3-4-4 5-4-2 Paving 2-1-1 1-2-1 2-1-1 Repairing underground cables 2-6-1 0-7-2 5-5-1 Pole workers 3-6-1 3-3-4 4-5-1 Pylon workers 3-6-1 3-3-4 5-5-1 Pole erection 2-0-0 1-1-0 2-0-0 Aerial climbing NA NA NA Laptop use in vehicle NA NA NA Due to the different amount of companies performing the activity, it is difficult to compare these data. However, considering the large amount of high and medium risks, there are several tasks that acquire further attention, such as: • Pulling/pushing/connecting cables • Blowing/connecting optical fibres • In-house cable connector • Repairing underground cables • Pole and pylon workers


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Prevention measures A lot of different tools and devices are mentioned across the different companies. Some of them are very innovative and seem to be very usefull regarding prevention of MSDs. It is therefore important that knowledge about these different tools should be shared. Some of the traditional ergonomic prevention measures are not always indicated by the companies. For instance, job rotation. In the ergonomic literature, this measure is considered as an important technique to reduce physical overload, both in tasks where physical effort is very high or in tasks where repetition is high. Since many of the service technicians’ activities mention posture and force risks, job rotation could be helpful. The reason why job rotation today is not mentioned by the questionnaire can be the small proportion of workers performing specific tasks. If more workers are trained to perform this activity, tasks can be shared and consequently risk for developing MSD is reduced. Another important ergonomic rule is the importance of guidelines, general regulations and the development of company policies and procedures on certain aspects.


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2.3.5 MSD within Call center workers: Cause and prevention measures

Call center workers is the second large group of employees within the telecommunications sector. In all 17 participating companies, this group of workers is applicable. The proportion of these workers within the companies varies between 3 and 76%.

2.3.5.1 Risks of MSD with regard to this activity: According the participating companies, the body parts most at risk for MSD are the upper limbs: neck/ shoulder, forearm/ wrist/ hands, upper arm/elbow and the back.


1 11 56 9 21 11 52 13 2

16 116 115 1 1


Low risk Medium risk High risk

2.3.5.2 Hazards and prevention measures Workstation and equipment Prevention of MSD within call centre workers starts with providing the proper equipment and a sufficient workstation set up for the employees. The chairs used in the participating companies have basic ergonomic adjustments possibilities. Except for horizontally adjustable armrest, these are provided in only 7 of the 17 companies. Also other chair characteristics that are recommended in ergonomics are not common: seat pan depth adjustment, vertically adjustable armrests and reachable adjustment controls that have clear indicators.

Table 72: Prevention measures regarding chair

172 151 165 115 12

10 71 161 164 121 15

CountSeat height adjustmentCountSeat tiltCountAdjustable backrest height (lumbar support height)CountSeat pan depht adjustmentCountVertically adjustable armrestsCountHorizontally adjustable armrestsCountRounded seat pan front egde (waterfall front)CountCushioned seat pan and backrestCountAdjustment controls that are reachable and have indicatorsCountFive star base

No Yes

The introduction of VDTs gave rise to a debate about the possibility of harmful effects of operator exposure to ionizing radiation. For this reason, a specific type of filter was developed to be placed between the computer screen and the operator. However, emissions from VDTs have been measured


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and found to be negligible. But the filter seems to have another positive effect: the reduction of glare from indirect light conditions. Therefore, the filter is also called anti-glare screen. In this study it was found that in 3 of the participating companies an anti-glare screen is not provided when it is needed. All other ergonomic aspects are common in most of all the companies.

Table 73: Prevention measures regarding monitor

2 151 16 17 172 151 163 14

Tilt up and downSwivel side to sideHave contrast controlSufficient contrast between the characters and the backgroundNeither user or screen is directly facing windows or bright lightsWindow fitted with an effective adjustable system for attentuating daylight (e.g. blinds)Anti-glare screen provided as needed

No Yes

In practice, people often mention problems while using a computer mouse frequently. The specific long-lasting quasi-static position of the wrist while operating the mouse, may introduce a “mouse arm”. This overuse syndrome is characterised by a painful hand-wrist-forearm region. However, the computer mouse’s evaluated in this study, seem to fit comfortably within the most companies. In every company, mouse wrist pads are provided if needed.

Table 74: Prevention measures regarding tracking devices

2 15

3 143 14

CountMouse's shape fitcomfortably in theemployee's hand

CountMouse wrist pad needed?CountMouse wrist pad

provideded?

No Yes

Laptops were introduced in the working field traditionally for flexibility reasons. Nowadays, a lot of laptops are also used in fixed workstations. If so, it is recommended to have a separate keyboard, mouse and a separate monitor or laptop holder, to avoid long-lasting awkward postures of neck, shoulder and wrist. In 12 of the participating companies, employees use a laptop. Two of these companies do not provide a docking station with separate keyboard, three of them do not offer a separate mouse and four do not provide separate monitors.

Table 75: Prevention measures regarding laptop use

5 127 108 99 8

CountEmployee's working with laptopCountDocking station with separate keyboardCountDocking station with separate mouseCountDocking station with separate monitor

No Yes

16 companies mention that the copy machine, coffee... is centralised to encourage walking and standing.


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Table 76: Prevention measures regarding keyboard

171 152 144 125 11

CountSeparate from computer monitorCountTiltableCountSymbols on the keyboard adequately contrastedCountWrist pad needed?CountWrist pad provided?

No Yes

Almost every company provides additional accessories if needed. A stable document holder, that is adjustable and can be easily positioned, is only offered by 11 of the 17 companies. A footrest on the other hand, is available in 15 companies. This is positive, but it is necessary to emphasise that a footrest is only needed for those (smaller) persons that have to place their chair higher due to a non-adjustable table height.

Table 77: Prevention measures regarding other accessories:

3 134 125 111 151 152 143 13

CountDocument holder needed?CountDocument holder provided?CountDocument holder stable, adjustable and can be easaly positionedCountFootrest needed?CountFootrests available?CountHeadset needed?CountHeadset provided?

No Yes

Only in 9 companies work desk are adjustable in height.

Table 78: Prevention measures regarding desk:

1 15 161 15 167 9

CountEnough space to rest hands in front of the keyboardCountSufficient leg roomCountEmployee free from contact with sharp edges, blunts or hardsurfacesCountSufficiently large to allow all equipment and documents to be arranged?CountWork desk provide adjustable stand-up height

No Yes

Some companies also mention other ergonomic equipment used in your company for call center employees:

- Noise barriers (2) - Wave desks (1) - Green plants (climate) (1) -

In one company is further equipment available as recommended by the Company Medical Officer. Ten companies have specific procedures for buying ergonomic equipment.

- The Occupational Health Service is consulted (4) - Management discusses this issue with H&S specialists (1) - Ergonomic, safety-related and occupational health tests before implementation. (1) - Procurement group have specific standards to meet and they are trained (2)


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- The specifications of equipment and furniture purchased is according to European standards (1)

• Organisational factors Within 15 of the participating companies, the work of the employees in the call centres is repetitive. In 11 companies they have to work at very high speed and to tight deadlines. Both working on customers demand as working with marketing targets, vary between 0 and 100% within the companies.

2.3.5.3 Training and education with regard to MSD Several companies provide training to the call center workers regarding a proper workstation set up. The methods used are listed in table 79.

Table 79: Training methods on workstation set up

6 97 85 10

11 47 8

11 4

CountGuidelinesCountBrochuresCountIntranetCountToolboxmeetingCount Ergonomic trainigCountErgocoaches

No Yes

The guidelines regarding a proper workstation set up are provided on the intranet in three companies. On company has an “In House Guideline booklet on working with VDU’s”. Another company explains the guidelines in the annual training of the call center workers. Regarding brochures, folders and informative leaflets about the workplace are distributed in three companies. Brochures are provided on the intranet in one company. The intranet is also common to give the employees training on proper set up of the workstation:

- Full computer based training course and workstation assessment (2) - Guidance on working with VDU’s - E-learning (foreseen for this year)

Also toolbox meeting regarding workstation set up are provided. One company tries to encourage the call center workers to discuss issues with the line management. Also discussions at formal one to ones are encouraged. Regarding ergonomic training:

- Every year and on demand (1) - Company Medical Officer and experts on safety at work visit places of work every 2 years (1) - Supervisors guides workers on adopting a good working posture (1) - Ergonomic workplace action (ergonomics visiting call centers and explaining, correcting)

foreseen for 2005 Several companies also provide training to the call center workers regarding general ergonomic principles and MSD. The methods used are listed in table 80.

Table 80: Training methods on ergonomic principles


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7 79 69 6

13 28 7

11 4

Count GuidelinesCountBrochuresCountIntranetCountToolboxmeetingCountErgonomic trainingCountErgocoaches

No Yes

Guidelines regarding ergonomic principles are provided on the intranet within 4 companies. As before folders and informative leaflets about the workplace are distributed in three companies. Brochures are provided on the intranet in one company. The intranet is also common to give the employees training on general ergonomic principles:

- Full computer based training course and workstation assessment (2) - E-learning (foreseen for this year)

Regarding ergonomic training:

- Every year and on demand (1) - Company Medical Officer and experts on safety at work visit places of work every 2 years (1) - Supervisors guides workers on adopting a good working posture (1) - Ergonomic workplace action (ergonomics visiting call centers and explaining, correcting)

foreseen for 2005 Five companies also provide training in software for their call center workers.

2.3.5.4 Medical examination Twelve companies undertake medical examination for new workers:

- Carried out by physiotherapists (1) - On legal frame (2) - Whenever a new worker is admitted into the company, he/she has to under go a general check

up witch includes collecting blood (2)

Periodical medical examination of VDU workers is common within 13 companies. - Carried out by physiotherapists (1) - On legal frame (2) - Eye tests offered on a 1/2 year cycle (2) - Eye test every 2 years (1) - DSE work and psycho-social risks are both tested in the examination (1) - The doctor checks workers under 50, and who do not show any kind of specific health problems

like diabetes, every two years. Workers above 50 are checked every year. Workers with some kind of specific health problems are checked with the periodicity the doctor thinks if need be. (1)

- Every 3 to 5 years, depending on age (1)

2.3.5.5 Other 7 of the participating companies have a VDU code of practice on the intranet. A policy with regard to VDU is common within 10 companies


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- Part of the Health and Safety management system. (1) - Company wide policy relating to DSE assessment, line management responsibility, health

issues etc (1) - Collective agreement, legal basis (Ordinance on Work with Visual Display Units) (1)

12 companies allow breaks during work:

- 10 minutes after 75 minutes of work (1) - 10 minutes after every hour (1) - Regular breaks policy - documentation available online (1) - Workers do not have to constantly view the VDU while answering calls and between calls. (1) - Currently under review (1) - Regular breaks are a policy requirement (1)

Table 81: Other prevention measures on MSD

8 75 103 12

CountVDU Code of practiceCountPolicy with regard to VDUCountBreaks

No Yes

2.3.5.6 Specific measures > Older workers

- Limiting task (1) - On medical advise, adaptation of work station/ area (1) - No special measures are developed. Every case is individually treated. (1) - Doctors take into account the age during their medical surveillance (1)


- Adjusted the workstations or allow people to work at home where they can gain a more comfortable working position. No variety of non-VDU jobs for rehabilitation. (1)

- In case of an accident (1) - Individual assessments as required with Occupational Health (1) - Individual Case Management for employees with chronic complaints (1) - Only for medical reason one can have an other "more adapted" function (1)

Conclusion: Call center workers is the second large group of employees within the telecommunications sector. In all 17 participating companies, this group of workers is applicable. Working with computer screens and other display screen equipment can lead to upper limb disorders or back pain, as well as stress or visual fatigue. Companies seem to realise that prevention of MSD starts with providing the proper equipment and a sufficient workstation set up for the employees. Unfortunately, training in proper workstation set up and in ergonomic principles is not so widespread.


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3 Collection of data concerning MSD reported by law in each country within telecommunications sector

3.1 Introduction

Data collection on common basis with regard to MSD is important regarding the prevention of occupational diseases and accidents. It provides the necessary information for drawing attention to the magnitude of workplace health and safety problems, for setting further research priorities, and for targeting and evaluating interventions to improve worker safety and health. Data collection can also provide information that leads to detection and anticipation of new emerging risks. As concluded in the questionnaire, very little comparable quantitative occupational health and safety data is available for MSD within the different companies. Therefore, a common approach in data collection within the EU is described for the telecommunications sector.

3.2 Statistical sources

Title European Occupational Diseases Statistics - EODS

Acronym EODS

Institution Eurostat

Country EU URL http://epp.eurostat.cec.eu.int/portal/page?_pageid=1090,1137397&_dad=portal&_schema=PORTAL Geographical coverage

For incident occupational diseases the data are available for all old EU-Member States combined (EU 15) for the 1995 pilot data and for 12 Member States combined (Belgium, Denmark, Spain, Ireland, Italy, Luxembourg, the Netherlands, Austria, Portugal, Finland, Sweden and United Kingdom) for the 2001 data. For the deaths due to occupational disease 2001 data are available for 6 Member States combined (Belgium, Denmark, Italy, Luxembourg, Austria, and Finland). The EODS methodology is being implemented in the New Member States and in the Candidate Countries with first data to deal with the reference year 2004.

Description The harmonised data on occupational diseases are collected in the framework of the European Occupational Diseases Statistics (EODS), on the basis of a methodology developed from 1997. The data refer to incident occupational diseases recognised for the first time during the reference year and to deaths due to occupational disease. The deaths due to occupational disease are included if the person died because of an occupational disease during the reference year, regardless of when the occupational disease had been recognised for the first time. The indicators used are the number and incidence rate of incident and fatal occupational diseases. The incidence rate of incident occupational diseases is the number of incident


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occupational diseases per 100 000 persons in employment during the reference year. The incidence rate of deaths due to occupational diseases is the number of deaths due to occupational disease per 100 000 persons in employment during the reference year. The national EODS sources are the recognitions of occupational diseases by the public (Social Security) or private specific insurance for occupational diseases, or by other relevant national authority for countries having a « universal » Social Security system.

3.2.1 Recognised cases of occupational MSD: Total

As regards musculoskeletal diseases, the European Schedule of Occupational Diseases4 includes

specific conditions linked to vibration, local pressure and overuse of tendons, peritendinous tissues and of tendon insertions. Whereas for example disorders of the lower back and neck and shoulder region are accepted as occupational diseases by only a few Member States and only for specific forms of disease5. It is therefore difficult to collect comprehensive European level data on recognised occupational musculoskeletal disorders. According to the 2001 EODS data collection with 12 Member States providing data on recognised cases of occupational diseases, the most common musculoskeletal occupational diseases were tenosynovitis of the hand or wrist (5 379 cases) and epicondylitis of the elbow (4 585 cases). In addition there were 2 483 cases of carpal tunnel syndrome, a neurological disease of the wrist. If extrapolated to EU-15 in the ratio of the workforce of EU-15 and the participating countries there would be around 8 900 cases of tenosynovitis, 7 600 cases of epicondylitis and 4 100 cases of carpal tunnel syndrome recognised in EU-15.

Table 82: Number and incidence rate (per 100 000 workers) of occupational diseases, EODS obligatory list (general)

EU Number of cases, non-fatal, EODS

obligatory list Incidence rate, non-fatal, EODS

obligatory list 2001 2002 2001 2002 Musculoskeletal diseases (m00_to_m99)

11169 19169 12.9 22.3

Carpal tunnel (g560)

2483 4638 2.9 5.3

Arthrosis of the elbow (m192)

12 20 - -

Meniscal lesions (m232)

334 464 0.4 0.5

Hand or wrist tenosynovitis (m700)

5379 9422 6.2 11

Bursitis of elbow (m703)

183 270 0.2 0.3

Bursitis of knee 442 714 0.5 0.8 4 Commission Recommendation (EC) 3297/2003 of 19 September 2003 concerning the European Schedule of Occupational Diseases. 5 European Occupational Diseases Statistics (EODS) – Phase 1 methodology. Eurostat working papers. Population and social conditions 3/2000/E/no.19.


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(m704) Medial epicondylitis (m770)

428 698 0.5 0.8

Lateral epicondylitis (m771)

4157 7246 4.8 8.4

Arthrosis of the wrist (m931)

254 335 0.3 0.4

EODS

3.2.2 Recognised cases of occupational MSD: ‘Construction’ / ‘Transport – storage and communication'

Table 83: Number and incidence rate (per 100 000 workers) of occupational diseases, EODS obligatory list (Construction)

Construction Number of cases, non-fatal, EODS obligatory list

Incidence rate, non-fatal, EODS obligatory list

2001 2002 2001 2002 Musculoskeletal diseases (m00_to_m99)

1319 2445 20.2 37.7


241 428 3.7 6.6


- - - -


29 56 0.4 0.9


453 956 6.9 14.7


13 20 0.2 0.3

Bursitis of knee (m704)

160 211 0.4 1.3

Medial epicondylitis (m770)

27 85 2.4 3.3


548 1007 8.4 15.5


89 109 1.4 1.7

EODS

Table 84: Number and incidence rate (per 100 000 workers) of occupational diseases, EODS obligatory list (Transport, storage and communication)

Transport, storage and

Number of cases, non-fatal, EODS obligatory list

Incidence rate, non-fatal, EODS obligatory list


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communication 2001 2002 2001 2002 Musculoskeletal diseases (m00_to_m99)

190 349 3.4 6.4


29 104 0.5 1.9


- - - -


- 4 - 0.1


81 134 1.4 2.4


- 7 - 0.1

Bursitis of knee (m704)

6 13 0.3 0.3

Medial epicondylitis (m770)

15 18 0.1 0.2


82 172 1.5 3.1


- - - -

EODS

Documents

Prevention of musculoskeletal disorders within