WORK RELATED MUSCULOSKELETAL DISORDERS (WMSD): ARE YOU AT

RISK?

Presented by: Smith Temitope Saidat (PT)

DO YOU OVERUSE YOUR BODY?

Overview

• Definitions

• Injuries from performing manual tasks – mechanism and statistics

• Anatomy and biomechanics

• The risk management process applied to manual tasks

• Who’s responsible, socioeconomic impact of MSDs

• Legislation’s and occupational health and safety

• Conclusion and questions

Work-Related Musculoskeletal Disorders (WMSD) accounted for 60% of reported illness after work place

accidents.

Nationally in the USA, it accounts for almost 42% of all health claims paid, a total of $410.3 million of worker’s

compensation claims in the years 1995-1997

GOAL OF THIS PRESENTATION

To give and empower workers with the knowledge and skills to identify hazardous manual tasks and to assess and control risks arising from

those tasks.

What are MSDs? • Impairments of muscles, joints,

tendons, ligaments and nerves which may be localized or multiple.

• They regions commonly affected are the back, neck, shoulders and upper limbs, also lower limbs

What is The Musculoskeletal System?

The Musculoskeletal System includes the following:

Bones – The load-bearing structure of the body

Muscles- Tissue that contract to create movement

Tendons – Tissues that connect muscles to bones

Ligaments – Tissues that connect bones to bones

Cartilage – Tissue that provides cushioning and reduces friction between bones

Nerves – Communication system that links muscles, tendons and other tissue with the brain

Any injury to any of these structures is called MSD

WHAT ARE WRMSD's

They are by definition a subset of musculoskeletal disorders (MSDs) that arise

out of occupational exposures

Many (most?) arise from cumulative trauma or repeated manual tasks.

LEGISLATIONS ON WRMSD'S

Definitions

Manual task is a label given to any activity that requires a

person to use their physical body (musculoskeletal system)

to perform work without any mechanical aid.

This includes work that involves the use of force for: Lifting/lowering; pushing/pulling; carrying; moving; holding;

or restraining anything

and work that involves: Repetitive actions; sustained postures; and concurrent

exposure to vibration

Hazardous manual tasks refer to any manual tasks that involve

certain characteristics that increase the risk of injury, including:

Repetitive or sustained application of force Repetitive or sustained awkward postures Repetitive or sustained movements Application of high force Exposure to sustained vibration Involve handling of person or animal Involve handling of unstable or unbalanced loads that are

difficult to grasp or hold

Hazardous manual tasks can lead to a variety of injuries and

conditions collectively referred to as musculoskeletal

disorders (MSD) including: Sprains and strains of muscles, ligaments and tendons Back injuries, including damage to the muscles, tendons,

ligaments, spinal discs, nerves, joints and bones Joint injuries or degeneration, including injuries to the

shoulder, elbow, wrist, hip, knee, ankle, hands and feet Bone injuries Nerve injuries Muscular and vascular disorders as a result of hand-arm

vibration Soft tissue hernias

How do Injuries Occur?Injuries occur when forces on structures of the

musculoskeletal system (e.g. muscle, ligaments, tendon, bone) are greater than they can withstand

Acute injuries• Happen immediately

• Can become chronic• Re-injury possible Chronic injuries

Pain or symptoms lasting more than a month

Cumulative trauma Happens over time

An Activity is Likely to Become an Injury

When:

– You perform the activity frequently

– You do the activity a long time

– The work intensity is high – There are a combination of factors

Repetitive Motions

Same posture or motions again and again Repetitive motion can be very frequent over short

period of time

Cumulative trauma can be less frequent but

repeated over time

time injury

timeinjury

Common Signs or Symptoms of WMSDs

Painful joints Pain in wrists, shoulders, forearms, knees,

etc. Pain, tingling or numbness in hands or feet Fingers or toes turning white Shooting or stabbing pains in arms or legs Back or neck painSwelling or inflammationStiffnessBurning sensationsWeakness or clumsiness in hands; dropping

things

TYPES OF WRMSD's COMMONLY SEEN ARE: Carpal Tunnel Syndrome

Usually caused by repetitive wrist motions which results in increased pressure to median nerve.

Symptoms include Pain, numbness, tingling on the thumb side of hand , burning sensations, wasting of muscles at base of thumb, dry palm

Epicondylitis (elbow tendonitis)

Repeated or forceful rotation of the forearm and bending of the wrist at the same time

Symptoms are Pain, weakness, swelling, burning sensation or dull ache over affected

areas tendonitis

Tension neck syndromeProlonged restricted posture either stooped

posture or forward chin posture

Symptoms include pain in the neck or with movement (tension headaches)

Thoracic outlet syndromeUsually caused by prolonged shoulder flexion, extending arms above shoulder

height and carrying loads on the shoulder

Pain, numbness, swelling of the hands

Degenerative Disc Disease, Ruptured /

Herniated Disc:

These are MSD's which affect the intervertebral disc of the spine, from the neck to the back.

Commonly seen are the Cervical Spondylosis and

Lumbar Spondylosis.

Mechanical Back SyndromeMechanical low back pain is the general term

that refers to any type of back pain caused by strain on muscles of the vertebral

column and abnormal stress. Its mostly secondary to:

Traumatic injury Lumbar sprain or strain

Degenerative disease of discs, facet joints, disc herniaton

Congenital disease: Kyphosis, Scoliosis

Paget's Disease s.

TOP 5 WRMSD’s IN HEALTH WORKERSMSD Aggravating Factors Prevalence

LBP(lumbar spondylosis, lumbar spondylisthesis, saitica, scoliosis)

Poor posturing, pregnancy, joint laxity, prolonged sitting and standing, overweight, bad sleeping apparatus, bad footwears, poor lifting techniques, muscle weakness and imbalance.

All health workers (high prevalence in Nurses, Physiotherapists, Orderlies and Assistants)

Cervical Spondylosis Bad sitting, walking, standing, writing, working and sleeping positions, constant lifting objects on head and neck region, inappropriate working apparatus and workstation, constant use of computer.

All health workers

Knee Osteoarthritis/ Knee pain

Prolonged standing, bad workstations, bad footwears, poor lifting techniques, bad posture, overweight, genetic predisposition,

All health workers (high prevalence in Nurses, Surgeons, Orderlies and Assistants)

Rotator Cuff Syndrome (Adh. Capsulitis, O.A Shoulder)

Bad Posture, bad workstations and apparatus, prolonged and repetitive overhead movements,

All health workers (high prevalence in Nurses, Orderlies and Assistants)

Plantar Fasciatis/ Calcaneal Spur

Prolonged standing and walking, bad footwears, overweight, genetic predisposition.

All health workers

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Name Your Most Risky Tasks

List three examples of tasks that you do at work that expose you to any of the risk factors on your handout.

1. ______________________2. ______________________3. ______________________

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What is Ergonomics?

The goal of ergonomics is to design the job to fit the worker,

NOT fit the worker to the job.

EnvironmentTask/job

Worker

Benefits of Ergonomics Include:

safer jobs with fewer injuries

increased efficiency and productivity

improved quality and fewer errors

improved morale

Ergonomic Goals:

Finding ways to make strenuous, often repetitive work, less likely to cause muscle and joint injuries -- and still get the

job done.

Keeping young bodies from wearing out prematurely, and mature bodies from giving out early.

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Neutral postures

• Head and neck – level or bent slightly forward, forward facing, balanced and in-line with the trunk

• Hands wrists and forearms – all straight and in-line

• Elbows – close to the body and bent 90o to 120o

• Shoulders – relaxed and upper arms hang normally at the side of the body

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Neutral postures continued

• Thighs and hips – parallel to the floor when sitting; perpendicular to the floor when standing

• Knees – same height as hips with feet slightly apart when sitting; aligned with hips and ankles when standing

• Back – vertical or leaning slightly back with lumbar support when sitting; vertical with an S-shaped curve when standing

Source: NIOSH IC 9509: Ergonomics Processes Implementation Guide and Tools for the Mining Industry

Risk Control: Elimination

• The ultimate control measure is to eliminate the hazardous manual task

• Best practice includes:– Eliminating potential hazardous manual tasks

during the design of workplaces, equipment, tools, plant and systems of work

– Incorporating ergonomics specifications into purchasing procedures

PROPER LIFTING TECHNIQUE

Fatigue

Discomfort

Pain

Injury

Disability

Break the Injury Cycle

re-injury may be likely

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Approach to risk control

Eliminate the hazardous manual task

or

Redesign the work, workplace or equipment to minimise the risk of injury (musculoskeletal disorders)

and

Provide appropriate manual task training

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Risk control measuresAlter the source (underlying cause) of the risk by altering:• design and layout of the workplace• nature of the load (including using mechanical aids or

assistive devices)• nature of the items used during manual tasks (including

hand tools)• working environment• work organisation and work practices, including systems of

work

to minimise the risk of injury (musculoskeletal disorder) as far as is practicable

RISK CONTROL MEASURES

RISK CONTROL MEASURES

Alter the work

Alter work organisation and work practices, including systems of work, to reduce the risk of injury by taking work breaks

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Alter work environment

Alter the work environment to reduce the risk of injury

(musculoskeletal disorder) by altering the:• thermal environment – reducing and managing exposure to

cold, hot, humid and windy conditions• floor surfaces and housekeeping – selecting and

maintaining appropriate floor surfaces, steps and ramps and keeping work areas clean, tidy and free of clutter and obstacles

• lighting – selecting lighting to suit the task being performed • vibration – controlling exposure to vibration, at the source;

and/or the path of the vibration; and/or the vibration received by the worker

We all share responsibility for tackling MSDs

• They are a problem for:

– employers

– workers and their safety representatives

– government

– health and safety institutions

– policy-makers

WRMSDs cost money

Business loses productivity

Higher medical and social costs for government - back pain costs the UK health service £5 billion a year

Individuals and families suffer too!

Employee responsibilities

Safety isn’t all down to your employer

You also have a responsibility to protect yourself

Be aware of WRMSD risks and their impact on your health

Know how to avoid or lessen the risks

Become informed and start a campaign for workplace health and safety activities

s

Employers’ responsibilities

Legally required to assess workplace risks and act to ensure the safety and health of workers

WRMSDs are preventable if the right action is taken to modify tasks and to eliminate or reduce risk.

Provide user-friendly machines and equipment.

Promote awareness on the high prevalence of WRMSDs by offering of training and information.

A Five Step Process for Finding Work-Related

Musculoskeletal Disorders Hazards in Your Workplace

Five-step process for preventing WMSDs

Identify jobs that may have hazards

Educate and involve employees

Evaluate jobs for hazards

Identify and implement solutions

Re-evaluate to make sure solutions are effective

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Conclusions• Cumulative trauma occurs over time

– may not result in an injury for many years

– may be disabling

• Applying ergonomics = injury prevention

• Understand injury risk factors

• Some situations may have little room for improvement, but with others you have the control to improve:

– equipment

– work practices

– Body mechanics

THANK YOU