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Musculoskeletal Disorders Management and Prevention. Damon Peterson BSc (Hons) Ost Med Osteopaths For Industry Ltd. “If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health”.

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slide1

Musculoskeletal Disorders Management and Prevention

Damon Peterson BSc (Hons) Ost Med

Osteopaths For Industry Ltd

slide2

“If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health”

Hippocrates 460 – 377 BC

slide3

Musculoskeletal Disorders-Management and Prevention

  • MSD – understanding the issues
  • Legal framework/Health and Safety Law
  • Strategies for risk reduction and injury management
  • Rehabilitation – case study
slide4

Musculoskeletal disorders

  • 49% of adults report low back pain annually
  • 30% of adults become chronic sufferers
  • 85% of sufferers receive no specific diagnosis
  • The cost to the NHS is £512million per year
  • MSD’s cost society £5.7 billion (1995/1996)
slide5

Musculoskeletal disorders in the workplace

Where do the problems exist?

  • Manual handling
  • Display screen equipment
  • Upper limb disorders

Are all MSD’s work related?

slide9

Commonest factors behind MSD

  • Force:forceful movement
  • Posture:awkward/sustained or static
  • Repetition:focusing to specific tissue
  • Duration:body tissue unable to recover
  • Vibration:whole body or upper limb
slide10

7 Cervical Vertebrae

12 Thoracic Vertebrae

5 Lumbar Vertebrae

Sacrum and Pelvis

The spine

slide11

The spine

Spinal Cord

Vertebrae

Nerves Emerging from Spinal Canal

Discs

slide12

Mechanical loading and the process of injury

  • Most musculoskeletal disorders have a multifactorial aetiology and focusing on the culminating event may give a false picture of the causes
  • The majority of MSD’s are cumulative and occur over time
  • Specific tissue or groups of different tissue working in combination can become irritated by repeated or prolonged loading
slide13

Warning signs

  • Injury and illness records
  • Jobs which workers are reluctant to do
  • Jobs where workers complain of discomfort
  • Workers having made adaptations to workstations, tools or chairs
  • Workers requesting to be deployed or taken off a job
  • Splints or bandages being warn, and/or
  • Use of pain-killers

Adapted from: Upper Limb Disorders in Workplace, HSE publication

slide14

Legal requirements

  • Health and Safety at Work etc. Act 1974
  • Management of Health and Safety at Work Regulations 1999
  • Workplace (Health, Safety and Welfare) Regulations 1992
  • Health and Safety (Display Screen Equipment) Regulations 1992
  • Provision and Use of Work Equipment Regulations 1998
  • Personal Protective Equipment at Work Regulations 1992
  • Manual Handling Operations Regulations 1992
  • Reporting of Injuries, Diseases and Dangerous Occurrences Regulation 1995 (RIDDOR)
slide16

Seven-stage approach to the holistic management of MSD

I

Understand the issues

and commit to action

II

Create the right

organisational environment

III

Assess the risk of MSD

in your workplace

Reduce the risk of MSD

in your workplace

IV

V

Educate and inform

your workplace

Manage any episodes of MSD

VI

Carry out regular checks

on programme effectiveness

VII

Adapted from: Upper Limb Disorders in Workplace, HSE publication

slide18

Duties of Employers

A VOID - hazardous manual handling operations where reasonably practicable

A SSESS - hazardous manual handling operations which cannot be avoided

R EMOVE - identified risk factors

R EDUCE - the risk of injury

M ONITOR - changes made

MHT - manual handling training

slide19

Full height

10 kg

(22 lb)

5 kg

(11 lb)

7 kg

(15 lb)

3 kg

(7 lb)

Shoulder height

20 kg

(44 lb)

10 kg

(22 lb)

13 kg

(29 lb)

7 kg

(15 lb)

Elbow height

15 kg

(33 lb)

25 kg

(55 lb)

16 kg

(35 lb)

10 kg

(22 lb)

Knuckle height

20 kg

(44 lb)

10 kg

(22 lb)

13 kg

(29 lb)

7 kg

(15 lb)

Mid lower height

10 kg

(22 lb)

5 kg

(11 lb)

7 kg

(15 lb)

3 kg

(7 lb)

Risk assessment filter

3 kg

(7 lb)

slide21

Training – myths and reality

  • Habits of a lifetime
  • Technique vs. principles
  • ‘Real world’ training
  • Cultural change
slide22

Manage any episodes of MSI

  • Reporting and recording
  • Referral
  • Diagnosis and return to work
  • Surveillance

Adapted from: Upper Limb Disorders in Workplace, HSE publication

slide23

Healthcare provider relationships

rhematology

pain

management

osteopathy/

physiotherapy

occupational

health

M S I

general

practice

orthopaedic

surgery

rehabilitation

medicine

psychology

slide24

British Polythene Industries plc (bpi) – Case Study

“Savings of £12 for every £1 spent”

“This rehabilitation scheme created the solutions we needed in terms of health and safety and occupational health. It was popular with the workforce and their representatives, and it made excellent business sense”

Andy Collinson, Group Health & Safety Manager, bpi

slide25

British Polythene Industries plc (bpi) – Case Study

Ensure:

  • ‘Champion’ of the Service is in place at outset

Select the Right Supplier:

  • fast and convenient access to treatment centre(s)
  • case by case feedback progress reporting (free from confidentiality constraints)
  • centralised efficient administration support with referrals managed through to resolution
  • advice and assistance from supplier in implementing the service especially with educating the workforce
slide26

Musculoskeletal Injury Management

malingering

unjustified absence

work related

non-work related

access to

treatment

slide27

British Polythene Industries plc (bpi) – Case Study

Practicalities of Rehabilitation

  • define process of referral and escalation process
  • ensure proper clear lines of communication and responsibility with service provider
  • ensure site management is supported by service provider (medical advice on individual cases)
  • facilitate graduated return to full duties for those employees who require it
  • readdress prevention if necessary
slide28

British Polythene Industries plc (bpi) – Case Study

Rehabilitation Statistics

  • over 90% of injuries assessed and treatment started within 72 hours
  • between 60% - 80% of employees do not take time off, even though they have been referred for treatment

Taken from MMS National Ltd yearly collated figures for all industries 2004/2005

slide29

Total Number of Treatments for Concluded Referrals

Taken from MMS National Ltd yearly collated figures for all industries 2004/2005

work related breakdown

21%

32%

Work-related

Non Work-related

Unspecified

47%

Taken from MMS National Ltd yearly collated figures for all industries 2004/2005

Work-Related Breakdown
slide31

Fit For Work Analysis

6%

4%

Yes

No

Restricted

90%

Taken from MMS National Ltd yearly collated figures for all industries 2004/2005

slide32

What are the consequences of not managing MSI’s

  • Loss of earnings
  • Loss of ability to work
  • Problems in quality control and productivity
  • Decrease in efficiency
  • Sickness absence
  • Costs of staff replacement and training
  • The risk of litigation
  • The risk of bad publicity
  • A rise in insurance premiums and costs of compensation to injured workers
  • The human cost of pain

Adapted from: Upper Limb Disorders in Workplace, HSE publication

Adapted from: Upper Limb Disorders in Workplace, HSE publication

slide33

Musculoskeletal Disorders-Management and Prevention

Rehabilitation and

Return to Work

  • Prevention:
  • Assess and Reduce the Risk
  • Feedback:
  • Monitor and Improve
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