Enabling a better working world© Crown Copyright, HSL 2015
Enabling a better working world
MSDs and health and safety
culture
9th March2016
Matt Birtles
Enabling a better working world© Crown Copyright, HSL 2015
What we do?
Health Effects
Microbiology
Biological
Monitoring
Exposure
Modelling
Medical Unit
In/Organic
Measurement
Fibres
PPE
Ergonomics
Psychology
Pedestrian
Safety
Noise &
Vibration
Safety culture
Accident
investigation
Risk
Assessment
Fire Safety
Process
Safety
Comp
Modelling
Explosives
Mech Eng
Metallurgy
Control and
Instruments
Field Eng
Hazard Reduction
Human Factors
Health Improvement
Enabling a better working world© Crown Copyright, HSL 2015
Who am I?
"An expert is somebody who is more
than 50 miles from home, has no
responsibility for implementing the
advice he gives, and shows slides."
Edwin Meese III
Enabling a better working world© Crown Copyright, HSL 2015
Background: MSDs
Enabling a better working world© Crown Copyright, HSL 2015
Background: MSDs
Enabling a better working world© Crown Copyright, HSL 2015
Background: Definitions
Safety culture is the mix of shared values, attitudes
and patterns of behaviour that give an organisation
its particular character (Confederation of British Industry)
Safety climate is the shared perceptions with
regard to the meaning and priority employees attach
to the policies, procedures and practices they
experience, and the behaviours they observed
getting rewarded and supported in the workplace (Zohar, 2000)
Enabling a better working world© Crown Copyright, HSL 2015
Safety Climate Tool
Enabling a better working world© Crown Copyright, HSL 2015
Safety Climate Tool
Enabling a better working world© Crown Copyright, HSL 2015
Safety Climate Tool
Enabling a better working world© Crown Copyright, HSL 2015
Safety culture excellence
Enabling a better working world© Crown Copyright, HSL 2016
ASCENT: A framework for safety culture improvement
Focus groups
Interventions
SMART action plans
Intervention impact
evaluation
Senior management commitment
Project plan
Survey
Data analysis
Steering group
Communication strategyFoundation
Analyse
Focus
Interviews
Leading & lagging
indicators
Workshops
Act
Evaluate
Process evaluation
Enabling a better working world© Crown Copyright, HSL 2016
Understand the issues & commit
to action
Create the right
organisational environment
Assess the risk of MH in the
workplace
Reduce the risk of MH wherever
possible
Educate & train the workforce in
MH technique & equipment
Manage any episodes of MSDs
Carry out regular checks on
effectiveness
Ugly duckling turning swan?
Enabling a better working world
Enabling a better working world
MSDs and health and safety
culture: Literature review
findings
Enabling a better working world
Review aim
To examine the research evidence on the relationship
between health and safety (H&S) culture and
musculoskeletal disorders (MSDs)
Review questions:
– Does H&S culture impact on the development and/or
management of MSDs?
– Are there specific cultural / organisational factors
that contribute to the development of MSDs?
Introduction
Methodology
Initial search of literature (2012-2015)
N=75
Full papers requested
N=38
Exclusion of papers that were outside of
scope
N=14
Number of papers included
N=24
Independent
review by 2
researchers
Project team
meeting to
reach
consensus
H&S culture and MSDs
Small number of studies on the relationship between safety climate and MSDs (N=5)
Assessment of safety climate typically involved measuring employee perceptions of management commitment to H&S and availability of policies/procedures
Consistent findings that perceptions of a poor safety climate are associated with musculoskeletal pain/discomfort
Key findings
H&S culture and MSDs
Key findings
Key findings Industry Sample
Positive safety climate (SC) associated with
reduced MS complaints
Various 1095 workers
Positive SC negatively associated with MS pain –
Mgmt commitment and prioritisation most important
Various 404 workers
SC indirectly related to MSDs Various 464 workers
Poor SC associated with increased risk of
experiencing MS discomfort and unsafe behaviours
Agriculture 300 workers
Mgmt safety commitment predicted MS pain -
those who perceived supervisors not committed to
safety were 50% more likely to experience back
pain
Food/Poultry
processing
403 workers
Psychosocial factors and MSDs
Majority of studies focused on the role of psychosocial
factors in the development of MSDs
Psychosocial risk factors refer to:
“The way in which individuals interact with the demands of
their job, and their work environment. This includes the
social contacts within their job.” (Kompier and Van Den
Beek, 2008)
Key findings
Examples of psychosocial risk factors
Psychosocial
risk factor
Description Examples in the workplace
Work demands The mental and physical
requirements of the job
• Working very fast
• Constant time pressures
• High workload
• Pressure to work overtime
Job control Perceived amount of input
over the way work is done
• Limited/no control over work speed/scheduling
own work
• Limited break opportunity
• Little/no opportunity to make own decisions
• Poor task variation
Social support Perceived support from co-
workers and immediate
superiors
• Little/no help received from colleagues and
immediate superiors
• Poor willingness to listen to work problems
Quality of
leadership
Perception of degree to
which immediate superiors
are good leaders
• Poor ability of managers to plan work
• Poor ability of managers to solve problems
Psychosocial factors and MSDs
Consistent evidence that the presence of psychosocial risk factors influences the risk of developing musculoskeletal problems e.g.
• High demands, low control, low support significantly associated with MSDs
• Combined exposure to physical demands and poor psychosocial risk factors can increase the risk of developing MSDs
Studies on leadership have shown that:• Perceptions of poor leadership associated with increased
levels of reporting of MSD problems e.g. reported lower back and shoulder pain
Key findings
Summary
Small but consistent body of evidence that
perceived safety climate may contribute to the
experience of musculoskeletal
problems/discomfort
Important psychosocial risk factors are work
demands, job control and social support
Multi-faceted approach needed to manage
MSDs?
Enabling a better working world
HSL ‘Make it Happen’ model for culture change
Interactive influences of
organisation, job and
individual
characteristics on H&S
behaviour
© Crown Copyright 2014
© Crown Copyright 2014
HSL ‘Make it Happen’ model for culture change
Influences from the physical
and social environment in
terms of the job and the
organisation and external
society
© Crown Copyright 2014
HSL ‘Make it Happen’ model for culture change
Encompasses the capability to
perform a particular behaviour
e.g. the necessary skills
and knowledge.
HSL ‘Make it Happen’ model for culture change
Encompasses motivation in
terms of both the automatic
(e.g. sub-conscious drivers
such as risk perception bias
(latency, complacency,
familiarity), heuristics, habits
and emotions and reflective
(e.g. values, mental models,
sets of beliefs) that guide our
decisions and actions e.g.
about cost/benefit, severity of
consequence and ability to
control, goals, plans,
conscious intention.
Enabling a better working world© Crown Copyright, HSL 2016
Influences on behaviour/OSH performance:
Physical context
Organisation
• Policies/procedures, SSoW (e.g. usability,
practicality)
• Safety Management Systems
• Resources (staff, equipment, training)
• Health surveillance scheme, etc.
• Support with champions
Job
• Job design/environment (e.g. posture,
exposures, shift patterns, workload, etc)
• Lifting aids (availability, accessibility,
maintenance)
• Competence/Training
An agency of the Health & Safety Executive Enabling a better working world
Influences on behaviour/OSH performance:
Social context
Job/organisation• Committed & supportive leadership
• Safety culture (just, flexible, reporting,
learning)
• Vision and value for safety
• Supervisor role
• Worker involvement/autonomy
• Team cooperation/support
• Open communication
• Change management
Extra-organisational influences• Foresight systems to consider
emerging hazards, new regulations, etc.
Enabling a better working world© Crown Copyright, HSL 2016
Influences on behaviour/OSH performance:
Individual
Capability
Knowledge:
• Information/update
• Education/training/refresher
• Knowledge sharing
• Personal susceptibility
Skills:
• Intra & interpersonal skills (assertiveness,
situation awareness, leadership, decision-
making, teamwork, etc.)
• MH skills
Enabling a better working world© Crown Copyright, HSL 2016
Influences on behaviour/OSH performance:
Individual
Motivation/decision making
Automatic:
• Cognitive/perceptual bias
• Skills automaticity/habits
• Weights labelled
Reflective:
• Knowledge-based
• Expectations of others
• Self-efficacy (confidence in skills)
• Beliefs about consequences of performing
behaviour (+/-)
• Intention; goals
Enabling a better working world
© Crown Copyright 2014
HSL ‘Make it Happen’ model for culture change
Interactive influences of
organisation, job and
individual
characteristics on H&S
behaviour
Enabling a better working world
Part 2 !
Enabling a better working world
What’s coming up
4th edition of L23 (2016)
Updated MAC / VMAC (2017)
Risk Assessment of Pushing and Pulling (RAPP tool, 2016)
Background
Enabling a better working world
HSE’s guidance on the Manual Handling
Operations Regulations 1992
4th edition due soon
Priced publication and free to download
Restructured
Simplified language
L23 4th edition
On the horizon
Enabling a better working world
Avoid hazardous operations SFAIRP Reg4(1)(a)
Assess any hazardous operations that cannot be avoided Reg 4(1)(b)(i)
Reduce the risk of injury SFAIRP Reg 4(1)(b)(ii)
Monitor / review the job if it changesReg 4(2)
Manage the workplace to ensure personnel conform Reg 5
Legal duties under MHOR 1992
The legal bit
Enabling a better working world
Part 1: The Regulations and brief
guidance
Part 2: Guidance on carrying out manual
handling risk assessments
Part 3: Detailed guidance on assessing
risk factors
Part 4: Guidance on mechanical
assistance and good handling techniques
Appendix: Choosing the right level of
detail for risk assessments
New structure
L23 4th edition
Enabling a better working world
Updated guidance
Links to other HSE online
guidance
Simplified initial filter
Can use MAC/RAPP as part of
assessment
‘TILE’ checklists will be on line
L23 4th edition
On the horizon
Enabling a better working world
Removed two-thirds and one half
factors for two and three person
handling
– limited evidence
– recent studies suggest the 85% figure
suitable
– This will also change in the MAC
Detailed changes
L23 4th edition
Enabling a better working world
Removed 2% of load figure from
pushing and pulling risk filter
Making the push/pull filter based on
assessing posture
– Is the posture upright and the trolley etc.
obviously easy to move?
Detailed changes
L23 4th edition
Enabling a better working world
Detailed changes
Removed reductions due to
frequency and twisting
Enabling a better working world
Risk assessment
L23 4th edition
Suggested approach to the level of
detail required for risk assessments
1 Simplified filter
2 Use HSE tools or similar
3 Use detailed checklists
Enabling a better working world
How detailed should the assessment be?
L23 4th edition
No
No
No
Does the task meet the assumptions
of the correct simple filter and does
the filter class it as low risk?
Are all MAC or RAPP scores Green?
Assess additional risk factors or
do full risk assessment
Reduce risk to as low as reasonably
practicable
Reduce risk to as low as reasonably
practicable
No
Assessment finished
Are there any risk factors that are not
in MAC or RAPP? (See Appendix
paragraph 32)
Yes
Assessment finished
Assessment finished
Sim
ple
filter
MA
C/R
AP
PF
ull
assessm
ent
Yes
Yes
Enabling a better working world
Current HSE/HSL project to update MAC• Consultation with users
• HSE/HSL workshop
• Producing prototype
• Will test with external users and amend
Updating the MAC tool
The MAC
Enabling a better working world
Users expressed interest in an electronic version
Planned changes• Team handling to include carrying
• Revised team handling weight boundaries
• Extra images
• Review / clarify wording
• Add “other factors” box
Updating the MAC tool
The MAC
Enabling a better working world
Updating the MAC tool
The MAC
“Other factors” box
Large vertical movements of the load
Risk of sudden movement of loads
A rate of work imposed by a process
Unstable loads or with shifting contents
Sharp, hot or potentially damaging loads
Require unusual strength, height,
training
Require special information or training
An absence of the correct or suitable
ppe being worn
Enabling a better working world
The V-MAC
V-MAC: Assesses variable loads/frequencies
An add-on to the MAC
Looks at daily load
Spreadsheet based
Enabling a better working world
The V-MAC
MAC load weight/frequency limitations
Assumes the same load is handled all day – not always the case
– Mixed loads
– Bursts of activity
– Different activities
– Job rotation
‘Average load’ may ignore highest load levels
‘Highest load’ may over-score the risk
Enabling a better working world
The V-MAC
Use the V-MAC to assess the
load weight/frequency risk
Then use the MAC for the other
risk factors
V-MAC: The basics
Enabling a better working world
The V-MAC
Using V-MAC – advantages
Useful to assess jobs where the weights handled are
variable
It assesses lifting over the whole working shift
Assesses bursts of activity with pauses between when
there is no manual handling
Takes account of different shift lengths
Includes allowances for breaks
Enabling a better working world
The V-MAC
Using V-MAC – guidance
http://www.hse.gov.uk/msd/mac/VMAC/
How to use
When to use
Advantages and limitations
Four worked examples
FAQs
Links to background reports
Enabling a better working world
Risk Assessment of Pushing and Pulling -
the RAPP tool
Forthcoming part of HSE’s MSD toolkit
Going through final editing process
Same principles as the MAC
– Flow chart of risk factors
– Assessment guide
– Traffic light system
– Score sheet
Pushing and pulling
The RAPP tool
Enabling a better working world
Obstacles along
the route
Section A – Wheeled equipment
The RAPP tool
0
1
2Poor
Reasonable
Good
Start
Load weight
Posture
Hand grip
Work pattern
Travel distance
0
2
4
8Very High
High
Medium
Low
0
3
6Poor
Reasonable
Good
Other factors
Floor surface
Condition of the
equipment
Complete score
sheet
0
1
3Poor
Reasonable
Good
0
1
3Long
Medium
Short
0
1
4Poor
Reasonable
Good
0
1
2Several
Few
None
0
2
3High
Medium
Low
0
2
4Poor
Reasonable
Good
Enabling a better working world
A-1 Load weight – Identify the type of equipment; Note the total weight moved (load
carried and weight of equipment)
Loads on wheeled equipment
The RAPP tool
Low capacity – with one or two
wheels
Low G/0 Medium
A/2
High R/4 Very High
R/8
Unacceptable P
Less than
50 kg
50 – 100 kg 100 – 200
kg
More than
200 kg
Load exceeds
equipment
design capacity
Medium capacity – has 3 or
more fixed wheels or castors
Low G/0 Medium
A/2
High R/4 Very High
R/8
Unacceptable P
Less than
250 kg
250 – 500
kg
500 – 750
kg
More than
750 kg
Load exceeds
equipment
design capacity
Enabling a better working world
A-1 Load weight – Identify the type of equipment; Note the total weight moved (load
carried and weight of equipment)
Loads on wheeled equipment
The RAPP tool
High capacity – steerable or
runs on rails
Low G/0 Medium
A/2
High R/4 Very High
R/8
Unacceptable P
Less than
600 kg
600 – 1000
kg
1000 –
1500 kg
More than
1500 kg
Load exceeds
equipment
design capacity
Enabling a better working world
Posture assessment
The RAPP tool
Low G/0 Medium A/3 High R/6
Torso is largely
upright, and
Body is inclined in direction of
exertion, or
Body is severely inclined, or worker squats,
kneels, or needs to push with the back against
the load, or
Torso is not twisted,
and
Torso is noticeably bent or twisted. Torso is severely bent or twisted, or
Hands are between
hip and shoulder
level
Hands are behind or on one side of the body
or above shoulder level.
A-2 Posture – Observe the general position of the hands and the body during the operation