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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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Musculoskeletal Disorders Management and Prevention

Damon Peterson BSc (Hons) Ost Med

Osteopaths For Industry Ltd


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“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


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Musculoskeletal Disorders nourishment and exercise, not too little and not too much, we would have found the safest way to health”-Management and Prevention

  • MSD – understanding the issues

  • Legal framework/Health and Safety Law

  • Strategies for risk reduction and injury management

  • Rehabilitation – case study


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Musculoskeletal disorders nourishment and exercise, not too little and not too much, we would have found the safest way to health”

  • 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)


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Musculoskeletal disorders in the workplace nourishment and exercise, not too little and not too much, we would have found the safest way to health”

Where do the problems exist?

  • Manual handling

  • Display screen equipment

  • Upper limb disorders

Are all MSD’s work related?


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Accidents causing injury nourishment and exercise, not too little and not too much, we would have found the safest way to health”


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Site of handling accidents nourishment and exercise, not too little and not too much, we would have found the safest way to health”


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Type of handling injury nourishment and exercise, not too little and not too much, we would have found the safest way to health”


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Commonest factors behind MSD nourishment and exercise, not too little and not too much, we would have found the safest way to health”

  • 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


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7 Cervical Vertebrae nourishment and exercise, not too little and not too much, we would have found the safest way to health”

12 Thoracic Vertebrae

5 Lumbar Vertebrae

Sacrum and Pelvis

The spine


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The spine nourishment and exercise, not too little and not too much, we would have found the safest way to health”

Spinal Cord

Vertebrae

Nerves Emerging from Spinal Canal

Discs


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Mechanical loading and the process of injury nourishment and exercise, not too little and not too much, we would have found the safest way to health”

  • 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


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Warning signs nourishment and exercise, not too little and not too much, we would have found the safest way to health”

  • 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


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Legal requirements nourishment and exercise, not too little and not too much, we would have found the safest way to health”

  • 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)


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HSE initiative for 2005 nourishment and exercise, not too little and not too much, we would have found the safest way to health”

Backs!

2005


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Seven-stage approach to the holistic management of MSD nourishment and exercise, not too little and not too much, we would have found the safest way to health”

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


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Manual Handling Operations Regulations 1992 (as amended) nourishment and exercise, not too little and not too much, we would have found the safest way to health”


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Duties of Employers nourishment and exercise, not too little and not too much, we would have found the safest way to health”

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


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Full height nourishment and exercise, not too little and not too much, we would have found the safest way to health”

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)


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Manual Handling Assessment Charts - MAC nourishment and exercise, not too little and not too much, we would have found the safest way to health”


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Training – myths and reality nourishment and exercise, not too little and not too much, we would have found the safest way to health”

  • Habits of a lifetime

  • Technique vs. principles

  • ‘Real world’ training

  • Cultural change


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Manage any episodes of MSI nourishment and exercise, not too little and not too much, we would have found the safest way to health”

  • Reporting and recording

  • Referral

  • Diagnosis and return to work

  • Surveillance

Adapted from: Upper Limb Disorders in Workplace, HSE publication


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Healthcare provider relationships nourishment and exercise, not too little and not too much, we would have found the safest way to health”

rhematology

pain

management

osteopathy/

physiotherapy

occupational

health

M S I

general

practice

orthopaedic

surgery

rehabilitation

medicine

psychology


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British Polythene Industries plc (bpi) – Case Study nourishment and exercise, not too little and not too much, we would have found the safest way to health”

“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


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British Polythene Industries plc (bpi) – Case Study nourishment and exercise, not too little and not too much, we would have found the safest way to health”

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


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Musculoskeletal Injury Management nourishment and exercise, not too little and not too much, we would have found the safest way to health”

malingering

unjustified absence

work related

non-work related

access to

treatment


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British Polythene Industries plc (bpi) – Case Study nourishment and exercise, not too little and not too much, we would have found the safest way to health”

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


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British Polythene Industries plc (bpi) – Case Study nourishment and exercise, not too little and not too much, we would have found the safest way to health”

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


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Total Number of Treatments for Concluded Referrals nourishment and exercise, not too little and not too much, we would have found the safest way to health”

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


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21% nourishment and exercise, not too little and not too much, we would have found the safest way to health”

32%

Work-related

Non Work-related

Unspecified

47%

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

Work-Related Breakdown


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Fit For Work Analysis nourishment and exercise, not too little and not too much, we would have found the safest way to health”

6%

4%

Yes

No

Restricted

90%

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


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What are the consequences of not managing MSI’s nourishment and exercise, not too little and not too much, we would have found the safest way to health”

  • 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


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Musculoskeletal Disorders nourishment and exercise, not too little and not too much, we would have found the safest way to health”-Management and Prevention

Rehabilitation and

Return to Work

  • Prevention:

  • Assess and Reduce the Risk

  • Feedback:

  • Monitor and Improve