Safety Work

OSH 3001, Fundamentals of Occupational Safety and Health 1

Course Learning Outcomes for Unit VI Upon completion of this unit, students should be able to:

4. Explain the integration of key processes necessary for the control of occupational injuries and illnesses. 4.1 Identify methodologies used to recognize workplace musculoskeletal disorders (MSDs). 4.2 Approximate musculoskeletal forces generated by incorrect lifting.

5. Recommend strategies for the control of common workplace hazards. 5.1 Determine control measures to prevent MSDs in a given workplace.

Course/Unit Learning Outcomes

Learning Activity

4.1 Unit VI Lesson Chapter 8 Unit VI Assessment

4.2 Unit VI Lesson Chapter 8 Unit VI Assessment

5.1 Chapter 8 Unit VI Assessment

Reading Assignment Chapter 8: Ergonomic Hazards: Musculoskeletal Disorders (MSDS) and Cumulative Trauma Disorders (CTDS)

Unit Lesson Musculoskeletal Disorders According to the Occupational Safety and Health Administration (OSHA, n.d.-a), one-third of all worker injury and illness cases were musculoskeletal disorders (MSDs). MSDs are those injuries and illnesses that affect the muscles, nerves, ligaments, tendons, and blood vessels within the body. In the workplace, these are oftentimes caused by ergonomic issues. However, what is ergonomics? Ergonomics is the science of fitting the job to the worker, not the worker to the job. By incorporating ergonomics into the workplace, we can lessen the possibility of musculoskeletal disorders (OSHA, n.d.-a). The following are some examples of work-related MSDs:

 carpal tunnel syndrome,

 tendonitis,

 rotator cuff injuries,

 epicondylitis,

 trigger finger,

 muscle strains,

 muscle sprains, and

 lower back injuries.

UNIT VI STUDY GUIDE

Ergonomic Hazards

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Although the proposed ergonomics standard was rescinded, OSHA does have ergonomic guidelines to help protect employees from workplace MSDs. Employers are required to provide a safe and healthy workplace for employees; however, incorporating ergonomic programs in the workplace not only benefits the worker, it benefits the business as well. As humans, when we do not feel well or are uncomfortable, we may not put forth our best efforts at work. In fact, if the pain or discomfort becomes too severe, we may call in sick to work. Increased absenteeism may cause work to fall behind, resulting in a profit loss for the company. This pain or discomfort also decreases the worker’s quality of life outside of the workplace. If a worker calls in ill, the company may have to pay another employee overtime to perform the work. If the employee is permanently unable to perform the assigned tasks, the employer will have to hire another individual and train them, which can be an expensive and time-consuming process. Work-related MSDs are covered by workers’ compensation. If a company has a higher number of claims, it will negatively affect its experience modification rate (EMR), which will, in turn, raise workers’ compensation insurance premiums. On the other hand, if workers feel well, they are less likely to call in and are able to work and produce a quality product. Therefore, a company that takes the initiative to correct potential issues in the workplace that may result in worker MSDs may experience the production of a higher-quality product, decreased absenteeism, and a higher profit margin. Safety pays! Back and shoulder injuries are among the most common MSDs and are often related to manual material handling (OSHA, n.d.-a). Efforts should be made to reduce the amount of manual lifting needed in the workplace. This can be accomplished by providing mechanical material handling devices and designing workplaces to reduce the need for lifting. However, it is not likely that all manual lifting can be eliminated, so workers need to understand the mechanics of lifting and the limitations of the human body. Training in proper lifting should include the why as well as the how. Workers are told to lift with their legs and not their backs and to hold the load close to their bodies, but do they really understand why this is the best way to lift? Not following these two lifting rules puts excessive strain on the lower back, and using hands-on demonstrations can increase worker understanding and compliance (NIOSH, 2011). For example, have workers lift a five- pound box from the floor while holding the box close to the body, and then have the worker repeat the lift while holding the box at arm’s length. The box weighs the same five pounds but will feel much heavier. Increasing the distance from the body increases the load moment, also known as torque. As the moment increases, additional forces and stress are placed on the back muscles and spine. We can calculate the load moment using a simple formula:

Load Moment = Weight x Distance

Distance is expressed in feet (ft.), and the weight is expressed in pounds (lbs.). The unit for load moment is foot-pounds (ft-lbs.) and describes the force required to lift or hold the load. If we hold a five-pound box close to the body, the force to hold the box equals the weight of the box (5 lbs. x 0 ft. = 0 ft.-lbs., so the formula does not apply). If we hold the box two feet away from the body and apply the formula, we get 5 lbs. x 2 ft. = 10 ft.-lbs. The force required to hold the box has doubled.

Lifting a 5-pound box directly up has the effect of lifting 5 pounds. Lifting a 5-pound box away has the effect of lifting 12 pounds on your shoulder (OSHA, n.d.-b; OSHA, n.d.-c)

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If there is one thing that you will need to drive home to employers and employees, it is the need for early reporting of signs/symptoms of MSDs. Pain is the body’s early warning system. It tells us when something has been injured or is being injured, is under stress, or is diseased. All too often, we ignore that early warning system. For example, how many times at work have you noticed that your lower back hurts, or that your neck is extremely tense? What did you do? Most people will take some ibuprofen, aspirin, or Tylenol to take the edge off and then go back to work, in most cases continuing the same actions that are causing them discomfort to begin with. If the employee continues to self-medicate and does not change the behavior causing the problem, it will get worse and possibly lead to an injury. This is why it is imperative that employees are taught to spot the early warning signs of potential MSDs and to report them. Early reporting allows the occupational safety and health (OSH) professional or members of the safety team to intervene and evaluate the employee’s workstation or work tasks to determine what is causing the problem and how it can be remedied. Cumulative Trauma Disorder Cumulative trauma disorder (CTD) is a wide-ranging category of ergonomic-related injuries or illnesses that affect muscles, tendons, and ligaments. CTD is not an actual disease, but rather a concept used by medical professionals to understand or describe what caused or contributed to the condition (Orthopod, 2015). Included in this category are repetitive stress injuries (RSI), overuse strain (OS), and occupational overuse syndrome (OOS). There are many factors that contribute to CTDs:

 repetitive motion,

 poor tool or equipment design,

 fatigue,

 temperature extremes,

 vibration,

 awkward postures,

 static postures,

 length of exposure, and

 extent of exposure. Consider for a moment a stone cutter. He or she hits a stone 100 times and there is no visible damage to the stone; however, on the 101st time that the stone is hit, it splits in two. It is not that the 101st hit was any harder than the previous 100; rather, the stress from all the hitting accumulated and caused the stone to finally fracture. This is exactly how CTDs occur. Each exposure to the hazard increases the stress on the body, ultimately resulting in injury. Our bodies are like a spring; if you continue to wind the spring and never take the tension off, the spring will break. So, unwind the spring. Relieving the tension does not take significant time out of the workday; taking micro-breaks throughout the day greatly decreases the stress on the body. Rotate the joints, stretch, and do not forget your eyes. Did you know that increased eye strain also affects the neck and back? If you do a considerable amount of work in which your eyes must focus close-up, take a minute or so to focus your eyes in the distance and look back and forth. The effort costs nothing, and the results can save you from suffering pain and discomfort all while saving the company money in lost time and workers’ compensation costs. Employers often cringe when the OSH professional brings up the possibility of making ergonomic improvements to a workplace. The general belief is that purchasing ergonomic tools, workstations, etc., will be a costly venture. Ironically, not only do ergonomic interventions not have to be costly, but they can result in thousands of dollars of savings. For example, a large hospital laundry service was experiencing a significant amount of work-related lower back injuries. The injuries were a result of removing laundry from the very bottom of the large wheeled laundry totes that they used. These totes were approximately 3 feet high. The employees did not have a problem taking the laundry from the top of the cart, but as they got down to the last pieces in the bottom of the tote, they had to bend over deeply to reach them and lift primarily with their backs. The OSH professional easily identified what the problem was, but there was no money in the budget for a tote tipping device. One of the laundry workers came up with an idea. The worker took a large piece of rigid plastic and cut it to the size of the inside of the tote. He then drilled a hole in each corner of the plastic and ran a bungee cord from each corner to the corner of the tote. When the laundry was put into the tote, the plastic went down with the weight of the load. As the worker removed laundry from the tote, the bungee cords would bring the platform up, allowing them to remove the laundry without having to bend over. The improvement

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costs a mere $24 to make. The hospital incorporated these self-rising platforms into all of their totes for a minimal cost. Over a year’s time, they saved over $10,000 in workers’ compensation claims. More importantly, the laundry workers were no longer being injured. Although the ergonomic innovation applied in the example above was a huge success, not all are. As an OSH professional, you must ensure that your so-called fix does not create a new problem. For example, prior to the 1980s, many grocery store cashiers spent several hours per day typing numbers into their cash registers as they were checking out customers. As a result, many full-time cashiers experienced a repetitive stress injury (RSI), called carpal tunnel syndrome (CTS). In an effort to reduce these injuries, barcode scanners were introduced. The cashier would now take the item and run it across a surface that had a laser device that would read the barcode and automatically input the price. The incidence of CTS dropped drastically within the first year; however, the industry then saw an influx of epicondylitis and shoulder injuries. When they did an ergonomic evaluation of the cashiers’ stations once again, the problem quickly became evident. Cashiers were now taking the item, picking it up from the conveyer belt, and running it across the barcode scanner. They were performing this motion thousands of times per day, causing excessive stress on the elbow and shoulder. The new answer was barcode guns and self-checkout lanes. Occupational safety and health is a work in progress. As an OSH professional, you must realize that you will never get to a point in the field where everything is as safe as it can be and no changes are required. You must be vigilant, continue to assess, reassess, improvise, adapt, and overcome. You are not going to have all of the answers. Utilize your resources. Talk to the people on the front line who work at that machine or task every day. They are the subject matter experts for that particular job. Why would you not involve them in the safety aspects for it? Set yourself up for success, and do not forget to think outside the box.

References

National Institute of Occupational Safety and Health. (2011). Practical demonstrations of ergonomic principles (Publication No. NIOSH RI 9684). Retrieved from: https://www.cdc.gov/niosh/mining/UserFiles/works/pdfs/2011-191.pdf

Occupational Safety and Health Administration. (n.d.-a). Ergonomics. Retrieved from

https://www.osha.gov/SLTC/ergonomics/ Occupational Safety and Health Administration. (n.d.-b). Figure 5. Lifting a 5 lb box directly up has the effect

of lifting 5 lbs [Image]. Retrieved from https://www.osha.gov/SLTC/etools/pit/images/box_lift1.gif Occupational Safety and Health Administration. (n.d.-c). Figure 5. As the distance increases from the

shoulder, the moment, or apparent weight increases so that a 5 pound box seems to weigh 12 pounds [Image]. Retrieved from https://www.osha.gov/SLTC/etools/pit/images/box_lift_lastframe.gif

Orthopod. (2015). Cumulative trauma disorder. Retrieved from https://eorthopod.com/cumulative-trauma-

disorder/

Suggested Reading In order to access the following resources, click the links below: Access the resources below for additional information that is specific to ergonomics (training and principles). Occupational Safety and Health Administration. (n.d.). Ergonomics. Retrieved from

https://www.osha.gov/SLTC/ergonomics/index.html Med Trainer. (2014, June 3). Ergonomics training—the OSHA standard [Video file]. Retrieved from

https://www.youtube.com/watch?v=TDn1Y27Pb18 The transcript for this video can be found by clicking here.

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National Institute of Occupational Safety and Health. (2011). Practical demonstrations of ergonomic principles (Publication No. NIOSH RI 9684). Retrieved from https://www.cdc.gov/niosh/mining/UserFiles/works/pdfs/2011-191.pdf