Manual handling and work related upper limb disorder

Manual handling

1. Element 6 Musculoskeletal Health

2. Learning Objectives Describe general requirements for work equipment Explain the hazards and controls for hand-held tools Describe the main mechanical and non-mechanical hazards of machinery. Explain the main control measures for reducing risk from machinery hazards.

3. 6.1 Work-Related Upper Limb Disorder

4. Work-Related Upper Limb Disorders Musculoskeletal disorders MSDs are injuries or pain in the human musculoskeletal system, including ligaments, joints, muscles, tendons, nerves, neck and back. They are caused by sudden exertion of loads over a period, repeated actions, exposure to repeated force, vibration, or awkward posture.

5. Work-Related Upper Limb Disorders Back injuries and back pain: may occur as a result of repeated lifting, or as the result of a single lift. Stoop lifting can increase stress on the back by up to six times a contributory factor of absenteeism e .g. back muscle strain, disc injury. Work-Related Upper Limb Disorders (WRULDs): any injury affecting the arms, hands and shoulders caused by repetitive motion, over-exertion, vibratory motion and/or stress. e .g. carpal tunnel syndrome and tenosynovitis.

6. High-Risk Activities/Repetitive Operations   Workers who repeatedly uses their hands, arms and back are potential to suffer musculoskeletal disorder. For instance:   Display Screen Equipment use Assembly line workers Cleaning and domestic staff Construction workers (brick laying) Hairdressers Meat and poultry processors Pottery workers Supermarket checkout activity Textile workers.

7. MSD/WRULD Risk Factors The Factors Giving Rise to Ill-Health Conditions Risk factors can be thought of as task, environment, or worker-related within an ergonomic approach. TASK FACTORS Repetition Force Posture Twisting Rest EQUIPMENT FACTORS Design Adjustability ENVIRONMENT FACTORS Lighting , Glare Temperature-Hot & cold, Vibration & Ergonomic The WRULD Risk factors are  

8. Ergonomic Matching the Workplace to the Individual Needs Ergonomics is concerned with the interaction between worker and The tools, equipment or machinery that they are using. The workplace environment.

9. DSE Display Screen Equipment DSE are devices or equipment that have an alphanumeric or graphic display screen. Example: laptops, touch screens and other similar devices. Risks Associated with the use of DSE WRULD – prolonged DSE operation including the use of keyboard and mouse. Back pain – prolonged DSE operation in a static posture, e.g. sitting for long hours. Eye Strain – caused due to viewing DSE for a long period, factors such as poor lighting, blurred image also cause visual fatigue. Fatigue and mental stress - DSE involves repetitive and monotonous movement, leading to frequent use of muscles causes fatigue and increases mental stress.

10. Control Measures Encourage users to report any symptoms. Provide basic DSE workstation equipment to minimum standards. Plan the work routine & Job rotation Carry out regular eyesight tests and spectacles, if required. Provide information and training on: H ealth r isks. Preventive measures. I.e. ergonomic use of the workstation.

11. DSE Control Measures(Minimum Standards) Adjustable angle to seat back. Lumbar support Adjustable seat height No excess pressure on thighs and back of knees Foot support Legroom with adequate clearance for postural change. Forearms at horizontal position while using keyboard. Minimal extension and movement of wrists on all the sides. Screen height and angle to allow comfortable head position. Space in front of the keyboard to rest hands/wrists while typing is in pause.   Additional points to consider: Adequate lighting without glare or reflections. Window covering if needed to minimise glare. Distract noise. Sufficient desk space with document holders.    

12. Specific Measures for Laptops The following may be considered when using portable DSE : Frequent breaks or changes of activity Regular eye and eyesight test. Train users on good ergonomic postures. Provide docking station equipment wherever possible and encourage to use them.  

13. 6.2 Manual Handling

14. Manual Handling Manual Handling Manual handling means lifting, pushing, pulling, carrying or moving loads using bodily force. Common Types of Manual Handling Injury Back injuries – Intervertebral Disc Damage ‘slipped disc’. . Tendon and ligament injuries. Hernias. WRULDs. Sprains Crushed limps Cuts & Abrasions.

15. Element 6.2 Manual Handling Technique G ood Manual Handling Technique Assess the load carefully. The feet should be apart with one leg in front of the other (alongside the load if it is on the ground) to increase the stability of the worker’s posture. Bend the knees, keep the back up right to maintain natural spine curve. Secure the load with firm grip, if possible, handles can be attached to secure a good grip. Use thigh muscles to lift the load.

16. Manual Handling Technique 6. Keep the load close to the body, hug the load as close as possible to the body. This may be better than gripping it tightly only with the hands. 7. Avoid twisting the back or leaning sideways, 8. Keep head up, once the load is held securely. 9. Move smoothly, do not jerk. 10 Put down, then adjust. If precise positioning of the load is necessary, put it down first, then slide it into the desired position.

17. Manual Handling Risk Factors Four main factors: L oad. I ndividual. T ask. E nvironment .

18. Manual Handling Risk Factors LOAD Heavy Bulky Difficult to manage Difficult to grasp (e.g. metals wet materials) Containing contents which are likely to move about whilst being carried Unstable (e.g. liquids, live animals) Hot, sharp or may cause any other injuries L OAD

19. Manual Handling Risk Factors INDIVIDUAL If the individual carrying out the activity is: Required to have unusual strength. Required to be tall. New or expectant mother. Pre-existing health condition if any. Required to have specific training. Required to be given information with complex details I NDIVIDUAL

20. T ASK TASK If the task involves Holding the load away from the trunk Moving the load, a considerable distance Introducing unsatisfactory body movements such as stooping, reaching twisting or stretching upwards Excessive lifting distances Excessive pushing or pulling A risk of sudden movement Frequent or prolonged physical effort The person undertaking the task having insufficient rest periods . A rate of work imposed by a process in the Workplace Manual Handling Risk Factors

21. ENVIRONMENT If the environment has: Space constraints preventing good posture Floors which are uneven, slippery or unstable Changes in levels due to steps or ramps Working surfaces at different heights Extremely hot or cold working environmental conditions Chance of strong wind gusts Poor lighting conditions Poor ventilation conditions E NVIRONMENT Manual Handling Risk Factors

22. Avoiding Manual Handling Risks -Eliminate – where every possible the manual handling operation must be eliminated by automation or mechanisation for example use of conveyor system, electric-powered pallet truck, overhead cranes etc. -Assess the Risk Carry out a manual handling risk assessment when the risk cannot be avoided. Involve workers in this process and consider the factors such as LOAD, INDIVIDUAL, TASK, and ENVIRONMENT. -Reduce the Risk Use manual handling aids such as hoists, trolleys, barrel lifts, gin wheels, sack trucks, wheelbarrow which requires physical force to lift, push or pull. Manual handling aids does not eliminate the manual handling risk, however it makes the task easier . Split the load or make it smaller or lighter which is easy to carry. If the load cannot split, then consider team handling or use mechanical handling equipment.

23. Minimizing the Manual Handling Risk The Load: Smaller loads. shape of the loa d sharp, hot, or slippery loads are difficult   lighter or less bulky easier to grasp more stable evenly stacked The Task: Rest breaks or job rotation. Eliminate stooping or twisting. Table lift. automating the system.   Avoid lifting from floor level Avoid lifting above shoulder height Vary Work routines Reduce the repetitive handling; and Push rather than pull. The Environment: Rearrange workspace so it does not cause slips or trip Improve lighting heat and ventilation Redesign work processes and procedures to a void steps or steep ramps Ensure staff maintain correct posture by redesigning the workplace if necessary. The Individual: Individual capability must always be given priority Employees must be given full details on the tasks they will be expected to undertake specific training must be given Procedures to protect new or expectant mothers must be in place Employees must be given information on the tasks they are likely to face in the workplace Policy and procedures must be adjusted to address temporary capability issues Work clothing and personal protective equipment (PPE),

24. 6.2 Load Handling Equipment

25. Hazards – Load Handling Equipment Using these aids is still associated with manual handling risk which may be lifting, pushing, pulling the load. Unsecured loads may fall causing a crush injury. Loss of control when used on steep access ramps. Blocking traffic routes when poorly parked. Colliding with other equipment or people work in and around the area. Trapped feet from the equipment wheels.

26. Controls - Load Handling Equipment Must be used by trained and competent workers only. Follow manufacturer’s instructions Avoid using on steep surfaces or uneven ground. Do not overload beyond safe working limits. Secure the loads during movement Use fitted brakes or chokes to avoid unintentional movement. Do not obstruct walkways, emergency routes, park in designated parking areas. Operate at safe speed to avoid collision between other equipment or fixed structure. Provide PPE to the workers, his-vis jackets, safety shoes to prevent crush injuries.

27. Patient Hoists, Slide sheets & Wheelchair Patient hoists: Used for moving people: Can be manual or powered. Can be mobile or fixed. Consider the environment: e.g. difficult to push on carpet. Regular inspection needed. Slide sheets It prevent lifting the patient & trained workers only Wheelchairs: Can be powered though most are pushed It promotes mobility for people

28. Powered Load Handling Equipment – ForkLift Trucks Hazards Overturning There are two main ways turnover: Lateral instability Longitudinal instability: Falling of Load Striking Pedestrian Trapped by Mast / Overhead Guard Fall from Height

29. Different Types of Powered Forklift Trucks Battery-Powered Trucks Hazards Explosion from hydrogen gas while charging. Corrosive acid. Manual handling. Arcing, shock, burns or fire. Environmental - battery disposal. Precautions Charge batteries: In well-ventilated areas. No ignition sources. Use PPE when handling acid. Mechanise battery handling. Electrical safety: Insulated tools. Gloves.

30. Different Types of Powered Forklift Trucks Diesel Powered trucks Hazards: Dermatitis from the diesel. Slip & Fire. Environmental pollution from large spills. Toxic exhaust fumes.CO Emission Bulk storage of diesel. High Noise Precautions: Use in well-ventilated areas. Spill kits. Use gloves when handling diesel. Ear Protection

31. Liquefied Petroleum (LPG)-Powered Trucks Hazards Explosion risk from LPG. Toxic exhaust fumes. Manual handling. Storage of LPG cylinders or bulk. Precautions Use in well-ventilated areas. Mechanise LPG cylinder handling. Store spare cylinders in a: Secure. Safe. Well-ventilated location Different Types of Powered Forklift Trucks

32. Precautions for Forklift Trucks General Precautions for Safe Use of Forklift Trucks The operator should be competent to operate a forklift The operator must carry out a pre-user check prior to shift start, this can be done with a help of checklist. Regular maintenance in accordance with manufacturer’s instructions. The load must be secured to avoid tipping. Do not exceed safe working limits. Do not raise people on forks, ensure a working platform is attached to the forks’ Maintain speed limits set by the employer. Never operate with forks in raised position. Do not overload which can obstruct operations vision. Do not operate on uneven surface or on potholes. Indoor operation must have a good level of lighting.

33. Pre-use Inspection Tyres check all for wear or damage, and pressure Fluids check oil, hydraulics, battery, fuel, and coolant Seating check the condition and adjustment Warning devices check lights, horns, reversing beeper and flashing light Capacity check that the load capacity data plate is fitted, legible and correct Mast check for signs of wear to the lift chains and guides Hydraulic cylinders and hoses check for any leaks Seat belt make sure it is in good working order Guarding check that all guards are in place. Controls check that all pedals and controls operate correctly Brakes check that all (including parking brake) operate correctly The forklift must be checked before start of every shift . The pre-use inspection may include:

34. Lifts and Hoists - Hazards Lifts and hoists are used for carrying people and goods between different levels. They are used in high rise building, found temporarily on construction sites, even mobile devices are used to lift people or material. The hazards associated with lifts and hoists are: Overturn or collapse Strike people beneath the cage or platform. May fail to stop in safe position e.g. top or landing level People may come into contact with fixed or moving objects, e.g. landing level structures. Platform/cage may fall to the ground from failure of supporting ropes. Overload can cause structural collapse; the lift may fall from high level. People may get trapped or entangled from the moving parts.

35. Lifts and Hoists - Precautions Lifts and hoists must be professionally designed, installed, and maintained to reduce risk. The precautions include: operated only by trained and competent people operated from one position only, e.g. ground level clear visibility of landing levels. lifts/hoists must be properly constructed of sound materials properly marked as to use either for equipment and materials only, or for passengers in addition to goods. Never allow passengers to ride on a goods only hoist safe working loads must be cleared marked. erected only by trained and experienced people following the manufacturer’s instructions lifts/hoists must be properly secured to the supporting structure thoroughly examined and tested. enclose the lifts / hoists and provide gates at all landings and at ground level.

36. Conveyors H azards Drawing-in occurs where clothing or limbs drawn in-running nip points Cuts and abrasion when contact with moving parts. Entanglement loose clothing, hair or jewellery being entangled with rotating rollers and drive mechanism Falling of objects from overhead conveyors, e.g. coal mines Noise from rotating rollers and motors Manual handling manual Loading and unloading Conveyors are different types such as belts, screw, and rollers to move loads or materials and are often used in manufacturing, food, airports and distribution line.

37. Conveyors Precautions Warning alarms Fixed guards Overhead conveyor must be enclosed Emergency stop buttons - pulling a wire or called as grab wire, provided along the full length. Do not ride on conveyor at any time. Do not overload conveyor outside its design limits. Avoid loose clothing, fingers, hair, or other body parts away from the conveyor during movement. Operator must be a trained person. Regular maintenance carried out competent person. Establish a system for reporting defects.

38. Cranes Cranes can lift an astounding load, basically used to shift loads from one place to another. Types of Crane Crawler Crane with fixed boom Rough Terrain Tower Crane Telescopic & mobile crane Floating crane Bridge and gantry crane Overhead crane

39. Cranes - Hazards Hazards Associated with Crane: Toppling or collapsing of crane Striking against fixed structure or. Falling of load People in and around may get strike due to mobile crane swing movement. Contact with overhead powerlines. Colliding with other cranes or moving vehicles

40. Cranes Precautions General requirements for Cranes Lifting operation must be carefully planned and supervised by competent person. Ground condition must be capable of bearing the load. Site crane on even and rigid ground level. Outriggers must be fully extended. Select the crane which is suitable for the task – capable of bearing the load capacity. Lifting equipment should have adequate strength and stability for load. SWL – safe working load must be clearly marked on the crane and on accessories. People are not allowed to lift without authorisation.

41. Factors Causing Crane Collapse Exceeding the operating capacity or operating radii. Operating on uneven ground condition. Fail to extend the outriggers. Operating in adverse weather condition such as rain or high wind. Structural failure due to wear and tear or load bearing parts being damaged.

42. Requirements for Safe lifting Operations Planning and Preparation identify the risks involved by carrying out a risk assessment, draw up plan to eliminate the or control the identified risks. check that the crane and any lifting accessories have a current thorough examination report. The crane operator must be trained and competent person. Select the crane suitable for the job, it will need to be able to lift the heaviest load at the required radius. making sure a rated capacity indicator (automatic safe load indicator) is fitted is in good working condition. selecting the most suitable lifting accessories ( eg chains, slings, wire rope, hooks, spreader beams etc) and method of slinging (choker sling, double wrap, cradle sling etc) relative to the weight, shape, centre of gravity, lifting points and load stability.

43. Requirements for Safe lifting Operations Carrying out the lift Followed by planning lifting operations are carried out under supervision of a competent person who controls operator, slinger and signaller. Crane must be sited on a firm level ground away from structures or overhead power lines. Use tag lines to guide loads, eg in windy conditions or on large loads Proper planning of load routes to avoid loads being lifted over people.

44. Crane Accessories Lifting accessories includes Slings Hooks Chain Shackles Eyebolts Lifting beams Cradles.

45. Crane Accessories Since these accessories are used in different environment, they need to be protected from physical damage, failure of lifting accessories could lead to fatal accidents. Lifting accessories must be attached and used correctly. Accessories must be correctly attached and safely to load by a competent person. Lifting accessories should be maintained in good condition. Lifting accessories are subject to checks – pre-user checks and statutory thorough examination and certified by an authorised person.

46. Periodic Inspection and Examination – Lifting Equipment Lifting equipment must be thoroughly examined prior to first use. Followed by any assembly or change in the location to ensure that it has been correctly installed and safe to start operation. Followed by an event that causes a deterioration of its strength or stability. A thorough examination must be done by a competent person.   Frequency of thorough examination are as follows: 6 months – lifting equipment used to lift persons and lifting accessories. 12 months – lifting equipment used to carry load or other lifting equipment.

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