Musculoskeletal Disorders to the Back

1. Musculoskeletal Disorders to theBack Recognition and Control

2. Manual Materials Handling Lifting/Lowering Pushing/Pulling Carrying Weights and Forces Frequency of activities Load Center of Gravity

3. Work Related Low Back Pain (LBP) Overexertion was claimed as the cause of LBP by over 60% of LBP patients Two Thirds of Overexertion claims involved lifting One fifth of Overexertion claims involved pushing or pulling loads

4. MSD Injuries from Lifting 30% of Shoulder WMSDs 22% of Elbow WMSDs 43% of Back WMSDs 13% of Hand/Wrist WMSDs Source: SHARP technical report No. 40-6-2002

5. Evidence for Causal Relationship Between Physical Work Factors and Back-Related MSDs

6. Common Risk Factors for Back MSDs • Force • Frequency • Posture • Duration • Environment • Vibration

7. Back Injury Risk Factor Examples • Awkward Postures • Bending • Twisting • Reaching, etc.

8. Back Injury Risk Factor Examples • Lifting/Forceful Movements • Weight of load • Location (position of load w.r.t. worker) • Frequency • Stability • Coupling

9. Back Injury Risk Factor Examples High Frequency and Lifting Overhead

10. Back Injury Risk Factor Examples Lifting or Lowering Floor Level Lifting above Shoulder Height

11. Look for Clues – Use Assessment Tools • Sample Checklists • General Checklists • Kodak Ergonomics Checklist for Material Handling • NIOSH Manual Material Handling Checklist • Risk Factor Checklists • Hazard Evaluation Checklist for Lifting, Carrying, Pushing or Pulling (T.R. Waters) • Washington Awkward Postures Checklist • REBA – Trunk/Legs • Analysis Tools • Websites

12. Look for Clues – General Checklists Kodak’s Ergonomic Checklist for Material Handling Source: Kodak’s Ergonomic Design for People at Work, as adapted in NIOSH 2007-131

13. Kodak’s Ergonomics Checklist for Material Handling

14. Kodak’s Ergonomics Checklist for Material Handling, cont.

15. Kodak’s Ergonomics Checklist for Material Handling, cont.

16. Look for Clues – General Checklists NIOSH Manual Material Handling (MMH) Checklist Source: http://www.cdc.gov/niosh/docs/97-117/eptbtr5f.html

18. Look for Clues – Risk Factor Checklists Hazard Evaluation Checklist for Lifting, Carrying, Pushing or Pulling Source: T. R. Waters, “Manual Materials Handling”, in: Physical and Biological Hazards of the Workplace (Second edition). Edited by P. Wald and G. Stave. New York: John Wiley and Sons, 2002.

19. Hazard Evaluation Checklist for Lifting, Carrying, Pushing or Pulling

20. Look for Clues – Risk Factor Checklists Washington State Department of Labor and Industries – Hazard Zone Checklist for Awkward Postures Source: http://www.lni.wa.gov/Safety/Topics/Ergonomics/ServicesResources/Tools/

21. Washington State Department of Labor and Industries – Hazard Zone Checklist for Awkward Postures

23. Calculator Exercise Determine risk factors using checklist Use Washington State “calculator to analyze Lifting Jobs” to determine if the task is hazardous

24. Prioritize Jobs for Improvement • The frequency and severity of the risk factors you have identified that may lead to injuries • The frequency and severity of complaints, symptoms, and/or injuries • Technical and financial resources at your disposal • Ideas of workers for making improvements • Difficulty in implementing various improvements • Timeframe for making improvements

25. Make Improvements • Questions for selecting improvement options: • Reduce or eliminate most or all of the identified risk factors? • Add any new risk factors that have not been previously identified? • Be affordable for our organization (e.g., is there a simpler, less expensive alternative that could be equally effective)? • Affect productivity, efficiency, or product quality? • Provide a temporary or permanent “fix”? • Be accepted by employees…will it affect employee morale? • Be able to be fully implemented (including training) in a reasonable amount of time?

26. Follow Up • Questions for evaluating improvements: • Reduced or eliminated fatigue, discomfort, symptoms, and/or injuries? • Been accepted by workers? • Reduced or eliminated most or all of the risk factors? • Caused any new risk factors, hazards, or other problems? • Caused a decrease in productivity and efficiency? • Caused a decrease in product and service quality? • Been supported with the training needed to make it effective?

27. Improvements • Easier Ways to Manually Lift, Lower, Fill, or Empty Containers • Management Guidelines for Safer Lifting • Employee Guidelines for Safer Lifting • Easier Ways to Manually Carry Containers • Alternatives to Manual Handling of Individual Containers

28. Specific Improvements • Plan the workflow to eliminate unnecessary lifts. • Organize the work so that the physical demands and work pace increase gradually. • Minimize the distances loads are lifted and lowered. • Position pallet loads of materials at a height that allows workers to lift and lower within their power zone (Between 30 to 50 inches). • Avoid manually lifting or lowering loads to or from the floor. • Convert a carry to a push or pull

29. Review of Improvement Options

30. Improvement Options for Lifting Lifting Device Team Lift Turntable

31. Improvement Options for Lifting Adjustable Work Platforms Portable Stairs Adjustable Work Surfaces

32. Improvement Options for Awkward Postures Remove Sides of Receptacles Add Handles to Containers Workstation Cut-Outs

33. Other Improvement Options • Washington State Ergonomics Idea Bank • http://www.lni.wa.gov/safety/topics/reducehazards/ergobank/default.asp

34. Reference Ergonomic Guidelines for Manual Material Handling NIOSH 2007-131 http://www.cdc.gov/niosh/docs/2007-131/

35. References • Musculoskeletal Disorders and Workplace Factors, NIOSH Publication No. 97- 141, 1997. • Ergonomic Guidelines for Manual Material Handling, NIOSH Publication No. 2007-131, 2007. • Bureau of Labor Statistics Annual Survey, 1996. • Washington State Department of Labor and Industries SHARP Technical Report 40-6- 2002, 2002. • Elements of Ergonomic Programs, NIOSH Publication No. 97-117, 1997. • T. R. Waters, “Manual Materials Handling”, in: Physical and Biological Hazards of the Workplace (Second edition). Edited by P. Wald and G. Stave. New York: John Wiley and Sons, 2002. • Kodak's Ergonomic Design for People at Work, Second Edition, Hoboken, NJ: John Wiley & Sons, Inc., 2007. • Washington State Department of Labor and Industries Ergonomics Website: • http://www.lni.wa.gov/safety/topics/ergonomics/default.asp • Cornell University Ergonomics Website: • http://ergo.human.cornell.edu • University of Michigan 3D Static Strength Prediction Program Website: • http://www.engin.umich.edu/dept/ioe/3DSSPP • Ohio State University Biodynamics Website: • http://biodynamics.osu.edu/research.html

36. Tier II – Analysis Tools • Quantitative Analysis Tools • NIOSH Lifting Equation • http://www.cdc.gov/niosh/94-110.html • ACGIH Threshold Limit Values for Lifting • www.acgih.org/store • University of Michigan 3D Static Strength Prediction Program • http://www.engin.umich.edu/dept/ioe/3DSSPP/ • Ohio State Lumbar Motion Monitor • http://biodynamics.osu.edu/research.html • Snook’s Psychophysical Tables • http://libertymmhtables.libertymutual.com/CM_LMTablesWeb/taskSelection.do? action=initTaskSelection