1. Musculoskeletal disorders: manager’s training www.ohtoolkit.co.uk

2. Contents What is the issue? What is the issue in our organisation? Why should we deal with MSDs? What are our responsibilities? How could we deal with MSDs in our workplace? What next?

3. What is the issue? Musculoskeletal disorders (MSDs) are the most common occupational illness in Great Britain, affecting 1 million people a year Source: www.hse.gov.uk/msd/index.htmwww.hse.gov.uk/msd/index.htm

4. What is the issue? MSDs are conditions that affect the nerves, tendons, muscles and supporting structures, such as the discs in your back They result from one or more of these tissues having to work harder than they are designed for The symptoms of MSDs differ in severity – from mild and periodic, to severe, chronic and debilitating

5. What is the issue? Work-related MSDs When MSDs are caused or made worse by the work environment, they’re called work-related MSDs (WRMSDs)

6. What is the issue? MSDs can affect any part of the body, but two important areas in terms of work are: the back the upper limbs

7. What is the issue? Back pain This is the most common MSD The HSE estimates that 9.3 million working days (full-day equivalent) were lost in Great Britain in 2008/09 through MSDs (mainly affecting the back) that were caused or made worse by work On average, each person suffering took an estimated 17.2 days off in that 12-month period Source: www.hse.gov.uk/msd/msdprogramme.htmwww.hse.gov.uk/msd/msdprogramme.htm

8. What is the issue? However… The HSE goes on to explain: “Most people have back pain at some time. Usually the pain is not caused by anything serious and it settles within a matter of days or weeks.” Source: www.hse.gov.uk/msd/msdprogramme.htmwww.hse.gov.uk/msd/msdprogramme.htm

9. What is the issue? Upper limb disorders MSDs which affect the arm, hand, shoulder and neck are called upper limb disorders (ULDs). When these are work- related, they are termed WRULDs

10. What is the issue? Causes WRMSDs are associated with work patterns that include: fixed or constrained body positions continual repetition of movements force concentrated on parts of the body, such as the hand or wrist a pace of work that does not allow sufficient recovery between movements continued…

11. What is the issue? repetitive and heavy lifting bending and twisting exerting too much force exerting a force in a static position for extended periods of time psychosocial factors such as low job control and isolation

12. What is the issue? Generally, none of these factors acts separately to cause WRMSDs Most occur as a result of a combination and interaction between factors Heat, cold and vibration also contribute to the development of WRMSDs Source: www.ccohs.ca/oshanswers/diseases/rmirsi.html andwww.ccohs.ca/oshanswers/diseases/rmirsi.html www.hse.gov.uk/msd/faq.htm

13. What is the issue? What are the signs and symptoms of WRMSDs? Pain is the most common symptom – sometimes joint stiffness, muscle tightness, redness and swelling of the affected area With ULDs, some people also experience sensations of ‘pins and needles’, numbness, skin colour changes, and decreased sweating of the hands Source: www.ccohs.ca/oshanswers/diseases/rmirsi.htmlwww.ccohs.ca/oshanswers/diseases/rmirsi.html

14. What is the issue? WRMSDs can progress in stages from mild to severe Early stage: aching and tiredness of the affected limb(s) during work shift; disappear at night and during days off; no reduction of work performance Intermediate stage: aching and tiredness occur early in the work shift and persist at night; reduced capacity for repetitive work continued... Source: www.ccohs.ca/oshanswers/diseases/rmirsi.htmlwww.ccohs.ca/oshanswers/diseases/rmirsi.html

15. What is the issue? Late stage: aching, fatigue and weakness persist at rest; inability to sleep and to perform light duties Recognising symptoms early can help a quick, effective response Source: www.ccohs.ca/oshanswers/diseases/rmirsi.htmlwww.ccohs.ca/oshanswers/diseases/rmirsi.html

16. What is the issue in our organisation? Insert your own data

17. Why should we deal with MSDs? Legal – our responsibility under health and safety law Moral – our obligation as a good employer Financial – dealing with MSDs at work should reduce sickness absence levels

18. What are our responsibilities? The Health and Safety at Work 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

19. What are our responsibilities? The Management Regulations 1999 require suitable and sufficient assessments of health and safety risks at work to be carried out This includes assessing, eliminating and controlling the risks to the musculoskeletal system

20. What are our responsibilities? The HSE explains… The first step is to assess all the MSD risks your tasks generate Next, try to eliminate as many of them as possible, by redesigning the tasks or providing mechanical aids The appropriate control measures can depend upon the sort of work your employees carry out and what it is ‘reasonably practicable’ for your company to do continued... Source: www.hse.gov.uk/msd/faq.htmwww.hse.gov.uk/msd/faq.htm

21. What are our responsibilities? When considering precautionary measures, make sure that you consult you workforce as they often have first- hand knowledge of the risks associated with a specific task or tasks Once the precautionary measures have been introduced, you should monitor their effectiveness and make sure that any new risks have not been introduced Source: www.hse.gov.uk/msd/faq.htmwww.hse.gov.uk/msd/faq.htm

22. How could we deal with MSDs in our workplace? The HSE separates MSDs into three categories: manual handling upper limb disorders and back pain Source: www.hse.gov.uk/msd/msdprogramme.htmwww.hse.gov.uk/msd/msdprogramme.htm

23. How could we deal with MSDs in our workplace? Manual Handling There is specific legislation outlining what to do about manual handling in the workplace (The Manual Handling Operations Regulations – amended 2002) Further help in developing and implementing a management strategy for avoiding, assessing and reducing the risks from manual handling can be found in the free leaflet – ‘Getting to grips with manual handling’

24. How could we deal with MSDs in our workplace? ULDs Small companies can use the free HSE leaflet ‘Aching arms (or RSI) in small businesses’ for guidance about how to manage ULDs More comprehensive and detailed advice is outlined in HSG60 ‘Upper limb disorders in the workplace’. There’s also a risk filter and risk assessment worksheet on the HSE website

25. How could we deal with MSDs in our workplace? ULDs As well as making sure that specific risks to upper limbs are dealt with and controlled, ensuring that the Display Screen Equipment Regulations are fully implemented will also help tackle upper limb risk A free HSE leaflet entitled ‘Working with VDUs’ is also available

26. How could we deal with MSDs in our workplace? Back pain Managing the risk from manual handling will go a long way to helping prevent back pain in the workplace In addition, making sure the risks from working with display screen equipment are managed, particularly the risk from sitting for a long periods of time, will also contribute to reducing back pain The HSE gives advice about what an employer can do to help staff with back pain…

27. How could we deal with MSDs in our workplace? Back pain be positive and helpful in removing obstacles to their recovery make sure they have the right information and advice on how to cope with back pain and lead a normal life give them a copy of The Back Book continued... Source: www.hse.gov.uk/msd/backpain/employers.htmwww.hse.gov.uk/msd/backpain/employers.htm

28. How could we deal with MSDs in our workplace? Back pain reassure them that you are concerned about them and want to help ask what they find difficult about the job – this may give you a chance to make jobs less physically demanding as a temporary measure to help them stay at work or return to work quickly continued... Source: www.hse.gov.uk/msd/backpain/employers.htmwww.hse.gov.uk/msd/backpain/employers.htm

29. How could we deal with MSDs in our workplace? Back pain if they have seen their doctor, tell them you are willing to discuss the situation with the doctor and to work with them to support any treatment that is recommended if they go off sick it is important to keep in touch – discuss whether modified work or a gradual build-up to normal duties will help them return to work return-to-work advice for back pain and other MSDs is available from the HSE

30. How could we deal with MSDs in our workplace? If we find we have a problem, there is good advice about dealing with the issues on the HSE’s ‘best practice’ pages Source: www.hse.gov.uk/msd/experience.htmwww.hse.gov.uk/msd/experience.htm

31. What next? Generate a plan for your organisation, eg: set up a risk management system for avoiding, assessing and reducing all types of MSDs establish an absence and return-to-work management system for anyone affected by an MSD You can get more information from the HSE and IOSH See: www.hse.gov.uk/msd/risk.htm and www.ohtoolkit.co.ukwww.hse.gov.uk/msd/risk.htmwww.ohtoolkit.co.uk