Musculoskeletal Disorders to the Back

Musculoskeletal Disorders to the Back

اسلاید 1: Musculoskeletal Disorders to the BackRecognition and Control

اسلاید 2: Manual Materials HandlingLifting/LoweringPushing/PullingCarryingWeights and ForcesFrequency of activitiesLoad Center of Gravity

اسلاید 3: Work Related Low Back Pain (LBP)Overexertion was claimed as the cause of LBP by over 60% of LBP patientsTwo Thirds of Overexertion claims involved liftingOne fifth of Overexertion claims involved pushing or pulling loads

اسلاید 4: MSD Injuries from Lifting30% of Shoulder WMSDs22% of Elbow WMSDs13% of Hand/Wrist WMSDs43% of Back WMSDsSource: SHARP technical report No. 40-6-2002

اسلاید 5: Evidence for Causal Relationship Between Physical Work Factors and Back-Related MSDsStrong EvidenceEvidenceInsufficient EvidenceRisk FactorLifting/Forceful MovementXAwkward PostureXHeavy Physical WorkXWhole Body VibrationXStatic Work PostureX

اسلاید 6: Common Risk Factors for Back MSDsForce Frequency Posture Duration Environment Vibration

اسلاید 7: Back Injury Risk Factor Examples Awkward PosturesBendingTwistingReaching, etc.

اسلاید 8: Back Injury Risk Factor ExamplesLifting/Forceful MovementsWeight of loadLocation (position of load w.r.t. worker)FrequencyStabilityCoupling

اسلاید 9: Back Injury Risk Factor Examples9High Frequency and Lifting Overhead

اسلاید 10: Back Injury Risk Factor ExamplesLifting or Lowering Floor LevelLifting above Shoulder Height

اسلاید 11: Look for Clues – Use Assessment ToolsSample ChecklistsGeneral ChecklistsKodak Ergonomics Checklist for Material HandlingNIOSH Manual Material Handling ChecklistRisk Factor ChecklistsHazard Evaluation Checklist for Lifting, Carrying, Pushing or Pulling (T.R. Waters)Washington Awkward Postures ChecklistREBA – Trunk/LegsAnalysis ToolsWebsites

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

اسلاید 13: Kodak’s Ergonomics Checklist for Material HandlingConditionX if a ConcernCommentsREPETITION  High-speed process line or work presentation rates  Similar motions every few seconds  Observed signs of fatigue  WORKSTATION DESIGN  Work surface too high or low  Location of materials promotes reaching  Angle/orientation of containers promotes non-neutral positions  Spacing between adjacent transfer surfaces promotes twisting  Obstructions prevent direct access to load/unload points  Obstacles on floor prevent a clear path of travel  Floor surfaces are uneven, slippery, or sloping  Hoists or other power lifting devices are needed but not available  

اسلاید 14: Kodak’s Ergonomics Checklist for Material Handling, cont.LIFTING AND LOWERING  Heavy objects need to be handled  Handling bulky or diffi cult-to-grasp objects  Handling above the shoulders or below the knees  Lifting to the side or unbalanced lifting  Placing objects accurately/precisely  Sudden, jerky movements during handling  One-handed lifting  Long-duration exertions (static work)  PUSHING/PULLING/CARRYING  Forceful pushing/pulling of carts or equipment required  Brakes for stopping hand carts/handling aids are needed but not available  Carts or equipment design promotes non- neutral postures  Long-distance carrying (carts not available)  

اسلاید 15: CONTAINERS/MATERIALS  Lack adequate handles or gripping surfaces  Are unbalanced, unstable, or contents shift  Obstructs leg movement when being carried  OTHER  Inappropriate work techniques used  Buildup of process material /product increases worker effort  Personal protective equipment needed but not available/used  TOTAL SCORE (Optional) To score, add up the total number of Xs identified.Kodak’s Ergonomics Checklist for Material Handling, cont.

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

اسلاید 17: NIOSH Manual Material Handling (MMH) Checklist No responses indicate potential problem areas which should receive further investigation. NIOSH Manual Material Handling (MMH) Checklist No responses indicate potential problem areas which should receive further investigation. NIOSH Manual Material Handling (MMH) Checklist No responses indicate potential problem areas which should receive further investigation. 1. Are the weights of loads to be lifted judged acceptable by the workforce?[ ]yes[ ]no2. Are materials moved over minimum distances?[ ]yes[ ]no3. Is the distance between the object load and the body minimized?[ ]yes[ ]no4. Are walking surfaces 4. Are walking surfaces 4. Are walking surfaces         level?[ ]yes[ ]no        wide enough?[ ]yes[ ]no        clean and dry?[ ]yes[ ]no5. Are objects 5. Are objects 5. Are objects         easy to grasp?[ ]yes[ ]no        stable?[ ]yes[ ]no        able to be held without slipping?[ ]yes[ ]no6. Are there handholds on these objects? [ ]yes[ ]no7. When required, do gloves fit properly?[ ]yes[ ]no8. Is the proper footwear worn?[ ]yes[ ]no9. Is there enough room to maneuver?[ ]yes[ ]no10. Are mechanical aids used whenever possible?[ ]yes[ ]no11. Are working surfaces adjustable to the best handling heights?[ ]yes[ ]no12. Does material handling avoid[ ]yes[ ]no        movements below knuckle height and above shoulder height? [ ]yes[ ]no        static muscle loading?[ ]yes[ ]no        sudden movements during handling?[ ]yes[ ]no        twisting at the waist?[ ]yes[ ]no        extended reaching?[ ]yes[ ]no13. Is help available for heavy or awkward lifts?[ ]yes[ ]no14. Are high rates of repetition avoided by 14. Are high rates of repetition avoided by 14. Are high rates of repetition avoided by         job rotation?[ ]yes[ ]no        self-pacing?[ ]yes[ ]no        sufficient pauses?[ ]yes[ ]no15. Are pushing or pulling forces reduced or eliminated?[ ]yes[ ]no16. Does the employee have an unobstructed view of handling the task?[ ]yes[ ]no17. Is there a preventive maintenance program for equipment?[ ]yes[ ]no18. Are workers trained in correct handling and lifting procedures?[ ]yes[ ]no

اسلاید 18: Look for Clues – Risk Factor ChecklistsHazard Evaluation Checklist for Lifting, Carrying, Pushing or PullingSource: 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.

اسلاید 19: Risk FactorsYESNO1. General  1.1 Does the load handled exceed 50 lb.?  1.2 Is the object difficult to bring close to the body because of its size, bulk, or shape?  1.3 Is the load hard to handle because it lacks handles or cutouts for handles, or does it have slippery surfaces or sharp edges?  1.4 Is the footing unsafe? For example, are the floors slippery, inclined, or uneven?  1.5 Does the task require fast movement, such as throwing, swinging, or rapid walking?  1.6 Does the task require stressful body postures, such as stooping to the fl oor, twisting, reaching overhead, or excessive lateral bending?  1.7 Is most of the load handled by only one hand, arm, or shoulder?  1.8 Does the task require working in extreme temperatures, with noise, vibration, poor lighting, or airborne contaminants?  1.9 Does the task require working in a confi ned area?  2. Specific  2.1 Does lifting frequency exceed 5 lifts per minute?  2.2 Does the vertical lifting distance exceed 3 feet?  2.3 Do carries last longer than 1 minute?  2.4 Do tasks that require large sustained pushing or pulling forces exceed 30 seconds duration?  2.5 Do extended reach static holding tasks exceed 1 minute?  Hazard Evaluation Checklist for Lifting, Carrying, Pushing or Pulling

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

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

اسلاید 22:

اسلاید 23: Calculator ExerciseDetermine risk factors using checklistUse Washington State “calculator to analyze Lifting Jobs” to determine if the task is hazardous

اسلاید 24: Prioritize Jobs for ImprovementThe 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

اسلاید 25: 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? Make Improvements

اسلاید 26: Follow UpQuestions 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?

اسلاید 27: ImprovementsEasier Ways to Manually Lift, Lower, Fill, or Empty ContainersManagement Guidelines for Safer LiftingEmployee Guidelines for Safer LiftingEasier Ways to Manually Carry ContainersAlternatives to Manual Handling of Individual Containers

اسلاید 28: Specific ImprovementsPlan 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

اسلاید 29: Review of Improvement Options

اسلاید 30: Improvement Options for LiftingTeam LiftLifting DeviceTurntable

اسلاید 31: Improvement Options for LiftingPortable StairsAdjustable Work PlatformsAdjustable Work Surfaces

اسلاید 32: Improvement Options for Awkward PosturesRemove Sides of ReceptaclesWorkstation Cut-OutsAdd Handles to Containers

اسلاید 33: Other Improvement OptionsWashington State Ergonomics Idea Bankhttp://www.lni.wa.gov/safety/topics/reducehazards/ergobank/default.asp

اسلاید 34: ReferenceErgonomic Guidelines for Manual Material HandlingNIOSH 2007-131http://www.cdc.gov/niosh/docs/2007-131/

اسلاید 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. Kodaks 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

اسلاید 36: Tier II – Analysis ToolsQuantitative Analysis ToolsNIOSH Lifting Equationhttp://www.cdc.gov/niosh/94-110.htmlACGIH Threshold Limit Values for Liftingwww.acgih.org/storeUniversity of Michigan 3D Static Strength Prediction Programhttp://www.engin.umich.edu/dept/ioe/3DSSPP/Ohio State Lumbar Motion Monitorhttp://biodynamics.osu.edu/research.htmlSnook’s Psychophysical Tableshttp://libertymmhtables.libertymutual.com/CM_LMTablesWeb/taskSelection.do? action=initTaskSelectio