Musculoskeletal disorders - preventative action

The Health and Safety at Work etc Act 1974 requires employers to secure the health, safety and welfare of employees at work. This includes providing a safe place of work, safe systems of work, and information and training.

The Management of Health and Safety at Work Regulations 1999 (as amended) require suitable and sufficient assessments of health and safety risks at work to be carried out, so that the necessary preventive and protective measures can be taken, including health surveillance.

More relevant legislation

The European Agency for Safety and Health at Work outlines a variety of European Directives which have become law in the UK. These can be found here - European Directives.

  • The Provision and Use of Work Equipment Regulations 1998 Cover the provision of safe work equipment and its safe use.
  • The Workplace (Health, Safety and Welfare) Regulations 1992 Aim to ensure that workplaces meet the health, safety and welfare needs of each member of the workforce, which may include people with disabilities.
  • The Manual Handling Operations Regulations 1992 Introduced to establish measures to: avoid hazardous manual handling operations so far as reasonable practicable; make a suitable and sufficient assessment of any hazardous manual handling operation that cannot be avoided; and reduce the risk of injury from those operations so far as reasonably practicable.
  • The Personal Protective Equipment at Work Regulations 1992 These regulations seek to ensure that where the risk cannot be controlled by other means, personal protective equipment (PPE) is to be supplied. Regulations also require that PPE should be suitable for the task, adequately maintained and correctly worn.
  • PPE means all equipment (including clothing that protects against weather) which is intended to be worn or held by a person at work and which protects against one or more risks to health or safety, and any addition or accessory designed to meet the objective.
  • The Health and Safety (Display Screen Equipment) Regulations 1992 Established the carrying out of a suitable and sufficient analysis of workstations and a solution-focused risk assessment.

The Equality Act 2010 consolidates, harmonises and expands on existing discrimination law. Find out more on the Equality and Human Rights Commission website.

You can get more information on health and safety legislation on the HSE website.

Preventive action

The HSE’s Upper limb disorders in the workplace can be downloaded for free from their website. This document outlines how a positive management approach can enable managers and employees to minimise the risks from upper limb disorders. The HSE suggest a seven-stage approach to preventing and managing ULDs in the workplace:

  1. Understand the issues and commit to action

  2. Create the right organisational environment

  3. Assess the risk of ULDs in the workplace

  4. Reduce the risk of ULDs

  5. Educate and inform the workforce

  6. Manage any episodes of ULDs

  7. Carry out regular checks on programme effectiveness

It’s good for people to use their bodies at work, so it’s important not to give the message that working means harm. However, in some instances people can overload their musculoskeletal system at work, without any symptoms being evident in the early stages. This could be from sitting for too long or from doing what might traditionally be thought of as ‘heavy’ jobs. Therefore, its important to carry out risk assessments across the work site and to identify any possible musculoskeletal hazards to which the workforce is being exposed to prevent any cases occurring.

Risk assessments

Risk assessments for MSD risks could be manual handling risk assessments, display screen equipment risk assessments, general ergonomics assessments or, specifically, upper limb disorder risk assessments. Various risk assessment tools are outlined below, including some on the HSE website.

As with any health and safety issue, assessment isn’t enough it should be followed by action. See the HSE website for more advice.

Help to identify upper limb risks

The HSE has a leaflet on ULDs and how to manage them, as well as a leaflet on using display screen equipment.

For a more detailed risk assessment, refer to HSE’s publication Upper limb disorders in the workplace (HSG60). The assessment risk filter and risk assessment worksheets in HSG60 are available free on the HSE website.

RULA (rapid upper limb assessment)

This is an assessment for ergonomic investigations of workplaces where work-related upper limb disorders (WRULDs) have been reported. You can carry out an assessment online or offline.

Assessment of repetitive tasks (ART) tool

The assessment of repetitive tasks (ART) tool is designed to help you risk assess tasks that require repetitive movement of the upper limbs (arms and hands). It helps you assess some of the common risk factors in repetitive work that contribute to the development of ULDs.

Help to identify more general MSD risks

Getting to grips with manual handling is a good starting point, and there are free information sheets from the HSE that cover manual handling in various industries. These give basic guidance and highlight other sources of information.

National Institute for Occupational Safety and Health lifting equation

This equation can be used to assess manual handling operations. The tool and other information are located at the link above.

The manual handling assessment chart (MAC) tool is useful for identifying risk from various manual handling activities. The HSE states: ‘Using the MAC will help with the initial screening of possible high risk manual handling activities within the workplace. However, the MAC is NOT appropriate for all manual handing operations, and does NOT comprise a full risk assessment. Therefore it is unlikely to be acceptable if relied upon alone. To be “suitable and sufficient”, a risk assessment will normally need to take account of additional information such as individual capabilities (factors), and should conform to the requirements in the MHOR 1992’.

OWAS (ovako working posture system)

This tool is used to evaluate the postural load on people in different work environments. It identifies the most common work postures for the back, arms, legs and the weight of the load handled.

QEC (quick exposure check)

This tool is used for the assessment of exposure to risks for work-related musculoskeletal disorders. The link above will take you to the QEC and support materials.

REBA (rapid entire body assessment)

REBA is used to assess the entire body postures for the risk of work-related musculoskeletal disorders. The link above will take you to the Cornell University REBA worksheet and a presentation explaining how to use it.

Assessing whole body vibration

Exposure to whole body vibration can be linked with the development of back pain. Industry-specific leaflets on vibration are available from the HSE.

Assessing hand-arm vibration

Exposure to hand-arm vibration has been linked with the development of certain upper limb disorders. Industry-specific leaflets on vibration are available from the HSE.

NHS Choices gives advice as to what can cause back pain and has a helpful list of what to look for when surveying the work site.

Identifying unreported symptoms

Employees can have symptoms of an MSD but fail to report them. You can find out if this is the case in your work site by carrying out a survey on:

  • people wearing joint supports
  • changes that people have made to their workstation, such as adding padding, tape, cushions, using different seating and so on

In addition, you could carry out a body mapping exercise across the site. This encourages employees to note body parts that are causing them pains, aches or discomfort. For more information, see the Public and Commercial Services Union site (and other Union sites), the Hazards Magazine or the HSE body map questionnaire. Body mapping is a form of health monitoring. This is described in more detail on the HSE website.

How can I apply ergonomics in my workplace?

Making sure that the workplace is well set up in terms of ergonomics can help prevent MSDs. The HSE leaflet Understanding ergonomics at work explains how to fit the task to the person who’s doing the job. Another free leaflet Aching arms (or RSI) in small businesses explains how to manage upper limb risks.

Educating employees

As an additional aspect of managing MSDs, you can encourage your employees to look after themselves, particularly when it comes to back pain. You can get a range of information and training materials on back care from IOSH.

Ensuring good reporting mechanisms

It's generally accepted that the earlier you deal with an MSD issue the better. In order to make this happen, you need to make sure that the workforce is aware of what the risk factors are, what symptoms to look for and how to report them should any arise.

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