FOR GOOGLESCHOLAR IH67

· Agriculture, forestry and fisheries;

· Manufacturing, mining; Machine operators;

· Craft workers, tailors;

· Construction;

· Wholesale, retail and repairs;

· Hotels, restaurants and catering;

· Secretaries, typists;

· Loaders and unloaders.

Evidence suggests that MSDs affect women more than m en largely because of the type of work they do than because of any gender or other personal factors.

Physical causes of MSD include manual handling, loads, poor posture and awkward movements, highly repetitive movements, forceful hand applications, direct mechanical pressure on body tissues, vibration s, and cold work environments. Causes in the organization of work include pace of work, repetitive work, time patterns, payment systems, monotonous work, and also psychosocial work factors. Some types of disorders are associated with particular tasks or occupations.

To prevent musculoskeletal disorders effectively, the risk factors in the workplace must be identified and then practical measures taken to prevent or reduce the risks. Attention needs to be paid to: risk assessment; health surveillance; training; employee information and consultation; ergonomic work systems (i.e., looking at the effect of the whole workplace, equipment, work meth ods, and work organization, etc. to identify problems and solutions); and prevention of fatigue. These components of MSD prevention are already recognized in the European n practice (EASHW 2008c). Solutions of the MSD problem include:

1. Administrative solutions:

· A reduction in daily working hours, modification of work, and job rotation may reduce MSDs;

· The introduction of additional breaks into repetitive work may be achievable without the loss of productivity.

2. Engineering solutions:

· Technical ergonomic measures can reduce the workload on the back and upper limbs (e.g., in the case of ergonomic hand tools), and thus the occurrence of MSDs, without the loss of productivity;

· Technical interventions may also include redesign of physical environment, introduction of lifting and transfer aids, etc. (Figure 10.3).

3. Behavioral modification:

· Training on working methods in manual handling is not effective if it is used as the only measure to prevent low back pain;

· Physical training can reduce the recurrence of back pain and neck-shoulder pain. But to be effective, the training should include vigorous exercise and be repeated at least three times a week.

4. Implementation strategies:

· A combination of several kinds of interventions (multidisciplinary approach) – including organizational, technical and personal measures – is needed to prevent MSDs. Interventions based on single measures are unlikely to prevent MSDs;

· A participative approach that includes the workers in the process of change may have a positive effect on the success of an intervention. Figure 10.3 Hand-guided pneumatic balancer and folding trolley used as lifting and transfer aids