Safe Manual Handling

All Accidents Are Preventable

- CHILDS PLAY

Safety is the over-riding priority

Manual Handling• This course has been designed to be delivered in four

modules:– Module 1 - Introduction to manual handling– Module 2 - Effects on the body– Module 3 - Base movement– Module 4 - Control strategies & risk assessment

• Completion of the course is required under the Manual Handling Operations Regulations

• You only have 1 back, it is important that you leave this course fully understanding what is expected of you - if you don’t ASK questions!

Manual Handling - Module 1• Introduction to manual handling:

– What is manual handling?

– National Statistics

• Function of the spine

– Vertebrae

– Discs

– Nerves

– Muscles

Manual Handling• What is Manual Handling?

– “Any transporting or supporting of a load (including the lifting, putting down, pushing, pulling, carrying or moving thereof) by hand or bodily force”.

– Manual Handling Operations Regulations 1992 (amended 2002)

• Manual handling injuries are the biggest cause of absence from the workplace.

• It is estimated that 3.5 million days p.a. are lost at a cost of £1 billion per year.

• The effect of these injuries on the individual can be devastating.

The Spine• The spine is made up of 33 bones in 4 elements

– Cervical

– Thoracic

– Lumbar

– Sacrum & coccyx

• The spine is the main supporting “rod” for the whole body.

• The bones protect the fragile spinal nerves from damage.

• The spine provides attachment points for other structures

– ribs

– pelvis

– shoulders

• Supports the body’s weight and loads moved by it.

The Spine• The vertebra of the spine are all different

and all are designed for a specific purpose:

• The cervical vertebra support the head• The thoracic vertebra provide

attachment points for the ribs and shoulders

• The lumbar vertebra support the abdominal cavity, and carry the most force during normal activity.

• The sacral vertebra provide an attachment point for your pelvis and transfer forces from the legs into the back.

Intervertabral Discs• Separate the vertebrae and provide a

cushion between the bones particularly in compression.

• Consists of a strong outer skin with a soft middle.

• Act as a shock absorber, spreading the load out evenly.

• Form a strong connecting link between the vertebrae.

• Allow movement between each bone whilst controlling the extent of movement in conjunction with ligaments.

• Damage to discs is one of the most common injury types and can be very long term in nature.

Nucleus

Annulus

Vertebra

Nerves• Nerves carry the signals from

various parts of the body to the brain and back again.

• The spinal nerves, like any other, are fragile and easily damaged.

• Pairs of nerves come out of the vertebrae on either side and are used for specific jobs.

• Any inpingement of a nerve will affect the function of the nerve at that level and at all points below.

• Damaged nerves do not regenerate, leading to loss of sensation and even paralysis.

Spinal cord

Spinal nerve branch

Muscles• Different muscles act on the spine to

allow it to move or to stabilise the spine whilst other limb movements occur.

• Like all other muscles, those around the spine fatigue when pushed to extremes and will therefore not fully support the spine.

• Strains and sprains are very common back injuries.

• The abdominal muscles support the lower spine.

• Muscles can work in a static manner - muscles not moving but supporting the load.

• Muscles can also be dynamic - directly working by either contracting or lengthening.

Exercise• Stand up and extend your arms in front of you.• Lean slightly forward so that the weight is on your toes,

but keep your heels on the ground.• Now lift heels and transfer weight fully forward.

• Describe the sensations that you felt.• Did you notice any static muscle activity?• What stopped you from falling over?

• Conclusion - muscle tension and in particular back muscle tension protects the back during manual handling activities.

Manual Handling - Module 2• Effects of manual handling on:

– Spine - fractures– Discs - “slipped discs”– Nerves - paralysis / impaired

sensation– Muscles - strains / sprains

• Causes of injury– Bad posture– Fitness / health status– Technique– Failure to follow defined safe

systems of work– Top heavy bending

“Slipped discs”• The term relates to a condition where

the disc doesn’t actually slip but puts pressure onto the spinal nerves with varying degrees of effect.

• The hard outer shell of the disc breaks down and allows the soft centre of the disc to bulge out onto the nerve.

• Usually occurs at the back of the disc nearest the nerves.

• Depending upon the location of the prolapse, different symptoms may be experienced:– Pain on or around the affected area– Loss of sensation– Loss of movement– Total paralysis

Lower back pain• The most common type of workplace back injuries, usual causes can

include:– Bad posture, losing the curve of the back– Lifting with legs straight - TOP HEAVY LIFTING– Lifting off balance– Lifting weights that are too heavy– Twisting with or without a load and not using the feet– Stetching or reaching– Pulling or pushing off balance or with the point of contact too high

or too low

Upper back and neck pain• Less common but can have increased risks due to the greater

abundance of nerves and the important tasks that they control:– breathing & heart– neck pain causing headaches– pain into arms and hands– greater disability effect if nerves totally damaged.

• Causes can include:– Placing a heavy load too high and using the shoulders to lift

those extra few inches– Lifting with your arms instead of the legs– Slumping after heavy exercise with head down, losing the curve

in the cervical spine.

Other manual handling injuries

• The back is not the only part of the body to be injured:– Changes in the functioning of the back can cause pain in the

hips, knees and ankles.– Hands, fingers and thumbs can be injured by the load and poor

technique.– Abrasions and lacerations– Fractures of other bones– Hernias - abdomen and groin– Foot injuries caused by dropping the load– Crushing injuries to hands – Lack of sleep due to pain– Depression

Facts about your back• Keeping the three curves in the

spine when you lift means that your back is ten times stronger than if your back is “straight”

• When leaning forward, even a few degrees without carrying a weight, you put six times the pressure on the 5th Lumbar vertebra.

• If you do the above whilst carrying a weight the load can be upto 20 times greater.

• 3 1/2 times more effort is required to lift a weight if your legs are bent more than 90 degrees.

Manual Handling Regulations 1992 (amended 2002)

• The Manual Handling Operations Regulations require that an employer:– Avoids manual handling so far as is reasonably practicable.– Undertakes suitable and sufficient assessments of the risks to which

his employees are exposed.– Reduce the risk of injury so far as is reasonably practicable.– Provide details on the weights and characteristics of the load.– Review the assessments where they are no longer valid or where

there has been a significant change.– Provide safe systems of work and any information, instruction,

training and supervision as may be necessary to reduce the risks to the employees.

– Ensure that where provided, manual handling aids are used and maintained in a safe manner.

Manual Handling Regulations • The Manual Handling Operations Regulations require that employees:

– make full and proper use of any system of work provided for his use by his employer.

– Take reasonable care for their own health and safety and that of others who could be affected by their acts or ommissions.

– Co-operate with their employer to enable compliance with health & safety legislation.

– Make use of appropriate equipment provided for him in accordance with his training and instructions.

– Not to interfere with anything provided in the interests of health & safety. (HASAWA)

– To report any condition to his employer regarding unsafe equipment. (HASAWA)

Manual Handling - Module 3

• Although the load may change, there is a generic movement that reduces the risk to you of injury.

• This is called the BASE MOVEMENT and involves the co-ordination of your:– Feet– Knees– Hands– Head– Arms– Body

• The principles of this technique don’t just apply to the workplace. If you use them at home it will help keep you fit and healthy.

• Think of how a baby picks items up off the floor when they are first starting to walk - this is good practice!!!

Base Movement 1• Feet

– place feet hip width apart, this provides a large base to balance the body.

– Put one foot, the lead foot in front of the other and to the side of the load. This provides a better balance and reduces the risk of stumbling. The body should be as close to the load as possible.

• Knees

– Relax the knees and sink down until contact is made with the load.

– The movement should be relaxed and fluent with no attempt made to keep the muscles tense and the spine unnaturally straight.

Get your centre of gravity close to the centre of the load

Leading foot

Base Movement 2• Hands

– tilt the load load with the lead hand, this is the same hand as your lead foot. Tilting the load allows you to gauge the weight of the load and to slip the other hand underneath the load easily.

– Grip the load with the palms of the hand and the roots of the fingers. This keeps the load under control and reduces tension in the forearms.

– One hand should be under the load and the lead hand at the opposite side of the load whenever possible.

• Head– The movement begins by raising the head, this returns the spine to its natural

curves at the time when the load is taken.– Take a breath at this point to help splint the spine, but you MUST start breathing

out when you start to lift to prevent exerting too much pressure on the abdominal muscles.

Lift head

Lifting head creates natural curves of the spine

Get a good hand grip, leading hand to leading foot

Base Movement 3• Arms

– Keep the arms close to the body and the elbows tucked in when carrying, this reduces the tension and fatigue in the arms and shoulders.

– The load should be supported around waist height to reduce unnecessary

muscle activity.

• Body– A smooth progressive forwards movement should be incorporated when

lifting to give momentum to the load and reduce the stress on the body.

Keeping the load close to you makes the operation safer as less stress is placed upon your body

Never lift like this, all the force is being carried by your weaker muscles

Stand up in a steady motion, don’t jerk as this causes injuries. X

A Good Base Movement flows!

Ensure that the movement flows in 1 motion, with practice this technique will become 2nd nature and will help prevent injuries caused by manual handling.

Manual Handling - Module 4• Pushing & pulling

• Risk assessing manual handling activities– Task– Individual– Load– Environment

• Job specific information, weights

Pushing• The principles of the base movement apply when pushing a load:

– get a good hand grip and firm foot base– push using the muscles of the leg not the back– use a steady flow as opposed to quick jerking actions– Pushing tends to be less strenuous than pulling as it uses body

weight

Pulling• Use exactly the same principles as for pushing:

– get a good hand grip and firm foot base– pull using the muscles of the leg not the back– use a steady flow as opposed to quick jerking actions

Risk assessment• The assessment of any manual handling activity follows the same

principles regardless of the task:– Task

• what is the task?• how frequently is it carried out?• does it involve bending, twisting or turning?• is the load to be held away from the body?• can the task be eliminated?• are distances involved?• are there sufficent rest breaks?

– Individual• what is their sex, age, size?• are they fit to carry out manual handling operations?• what training have they received?• do people work as a team?

Risk assessment

• Risk assessment continued:

– Load

• is the load bulky?

• is the load awkward to hold due to size or shape?

• are there any other specific hazards?

– Chemicals, liquids, uneven balance, or sharp edges?

• can the load be broken down into smaller parts?

– Environment

• are there wet or slippery floors?

• are there variation in floor level?

• is there low headroom?

• is the workplace excessively hot or cold

• are there other activities in progress at the same time?

• does the environment pose other ergonomic problems?

Risk assessment

• Risk assessment is not just a company function, you should make your own assessment before lifting anything :– this is the reason why you tilt the load at the start of the base

movement.– Plan the activity

• The risk assessment will lead to the development of safe systems of work:– To keep the risks as low as is reasonably practicable lifting aids

such as trucks, winches, hoists, jacks, levers should be used where possible. All these can assist the task but can present their own risks if not used correctly.

– Two person lifts and assistance during a task needs careful

planning and communication

Review & Recap

DVD safe lifting & manual handling, how to do it right

Questions