1. Define and Measure Problem Overview of the Basic Approaches to the Recognition, Measurement, and Control of Work-related Musculoskeletal Disorders 1 Revised 3/06

2. Organization of the Rule Subpart A - Purpose Subpart B - Scope Subpart C - Forms and recording criteria Subpart D - Other requirements Subpart E - Reporting to the government Subpart F - Transition Subpart G - Definitions 2

3. Recording Criteria Subpart C - Recordkeeping Forms and Recording Criteria  1904.4 Recording criteria  1904.5 Work-relatedness  1904.6 New case  1904.7 General recording criteria  1904.8 Needlesticks and sharps  1904.9 Medical removal  1904.10 Hearing loss  1904.11 Tuberculosis  1904.29 Forms 3

4. 1904.4 – Recording Criteria Covered employers must record each fatality, injury or illness that:  is work-related, and  is a new case, and  meets one or more of the criteria contained in sections 1904.7 through 1904.11. 4

5. 1904.29 - Forms OSHA Form 300, Log of Work-Related Injuries and Illnesses OSHA Form 300A, Summary of Work- Related Injuries and Illnesses OSHA Form 301, Injury and Illness Incident Report 5

6. 6

7. 7 Incidence Rates N Hours worked Rate per 100 full time workers = Formula for calculation x 200,000

8. Injury Analysis Frequency (Total Recordable Case Rate) Severity (DART Rate)

9. Upper Extremity WMSDs Tendon Disorders  Tendonitis  Tenosynovitis  Lateral Epicondylitis  Medial Epicondylitis  Ganglion Cysts Nerve Disorders  Nerve entrapments  Carpel Tunnel Syndrome Neurovascular Disorder  Hand Arm Vibration Syndrome  Thoracic Outlet Syndrome

10. Location of Upper Extremity Disorders

11. Overview of Symptoms Ganglion Cyst Synovial sheath swells and holds fluid Often seen in the wrist as a bump Epicondylitis (lateral and medial) Unsheathed tendons become irritated Pain that extends from elbow through forearm

12. Overview of Symptoms Tenosynovitis Swelling of the synovial sheath Pain and swelling Tendonitis Tendon becomes inflamed Pain, swelling, weakness, tenderness

13. Overview of Symptoms Nerve entrapments  Carpel tunnel syndrome Swelling of the tendons in the wrist area that place pressure on the median nerve Symptoms include pain, numbness, and tingling of the hand (thumb and first 3 digits)

14. Overview of Symptoms Neurovascular disorders  Thoracic Outlet Syndrome Compression of the nerves and blood vessels of the neck and shoulder Symptoms like CTS extending up the arm  Hand Arm Vibration Syndrome Disorder of the small vessels and nerves of the fingers and hand Results from vibrating hand tools Localized blanching at the fingertips with numbness on exposure to cold or vibration

15. Back Pain 2 nd leading ailment that affects the 25–50 age group Back injuries account for ~ 20% of all workplace injuries and illnesses Costs $20-50 billion a year

16. The Spinal Column 7 cervical vertebrae 12 thoracic vertebrae 5 lumbar vertebrae 5 sacral vertebrae 4 coccygeal vertebrae

17. The Basics Two Basic Structures 1. Vertebrae 2. Discs

18. Injuries of the Back Pinched nerves  Static postures, improper posture  Acute trauma Pulled Muscles  Heavy lifting  Improper lifting technique

19. Symptoms of Back Pain Pain (dull, consistent and sharp) Numbness Tingling Aching

20. What if I do not have MSDs www.bls.gov

21. A Proactive Problem-Solving Approach 1. Look for Clues 2. Prioritize Job Improvements 3. Make Improvements 4. Follow-Up

22. Body Part Discomfort Map

25. Look for Clues – Observe Work Activities o Physical Work Risk Factors o Lifting/forceful movements, awkward postures, whole body vibration o Unnecessary handling of materials o Symptomatic Worker Behaviors o Fatigue, discomfort, ‘pain behaviors’, etc. o Increased absenteeism, turnover rates or complaints and reduced morale o Workplace Design Issues o Are workers modifying tools, equipment, or workstations on their own? o Malfunctioning equipment o Productivity Issues o Production bottlenecks, reduced level of quality, missed deadlines, increase in waste/scrap, etc.

26. Look for Clues – Use Assessment Tools o Checklists o General Ergonomics Evaluations o Risk Factor / Activity Specific o Task Analyses

27. Early Detection Program