Most care worker jobs involve carrying out some type of manual task using the body to move or hold an object or person. Manual tasks cover a wide range of activities including stacking shelves, helping clients to move and entering data into a computer. Some manual tasks are hazardous and may cause musculoskeletal disorders. These are the most common workplace injuries across Australia. (www .safeworkaustralia.gov.au/sites/swa/about/publications/pages/hazardous -‐ manual -‐ tasks -‐ cop)
A musculoskeletal disorder, as defined in the WHS Regulations, means an injury to, or a disease of, the musculoskeletal system, whether occurring suddenly or over time. It does not include an injury caused by crushing, entrapment (such as fractures and dislocations) or cutting resulting from the mechanical operation of plant.
MSDs may include conditions such as:
MSDs occur in two ways:
as defined in the WHS Regulations, means a task that requires a person to lift, lower, push, pull, carry or otherwise move, hold or restrain any person, animal or thing involving one or more of the following:
These factors (known as characteristics of a hazardous manual task) directly stress the body and can lead to injury
A person conducting a business or undertaking has the primary duty to ensure, so far as is reasonably practicable, that workers and other persons are not exposed to health and safety risks arising from the business or undertaking
A person conducting a business or undertaking must manage risks to health and safety relating to a musculoskeletal disorder associated with a hazardous manual task.
Workers have a duty to take reasonable care for their own health and safety and that they do not adversely affect the health and safety of other persons. Workers must comply with any reasonable instruction and cooperate with any reasonable policy or procedure relating to health and safety at the workplace.
Consultation with workers and their health and safety representatives is necessary at each step of the risk management process. Workers know the equipment and activities that contribute to their discomfort and may have practical suggestions for solutions.
It is important to consult workers as early as possible when planning to:
Workers should be encouraged to report problems with manual tasks and signs of discomfort immediately so that risks can be managed before an injury occurs.
The first step in managing risks from carrying out manual tasks is to identify those tasks that have the potential to cause MSDs. Hazards that arise from manual tasks generally involve interaction between a worker and:
Review available information
Look for trends
Observe manual tasks
Hazardous manual tasks can also be identified by looking at how people actually work and focusing on their postures and movements. A manual task is hazardous if it involves any of the following characteristics:
A risk assessment involves examining the characteristics of the hazardous manual task in more detail to assess whether the forces, movements and postures are undertaken in such a way that they give rise to the risk of MSDs.
You should carry out a risk assessment for any manual tasks that you have identified as being hazardous, unless the risk is well -‐ known and you know how to control it
A risk assessment can help you determine:
Systems of work, or the way work is organized. This can influence the physical and mental demands that a manual task places on a worker.
The sources of risk include:
Workers will also have different physical and psychological characteristics and these individual factors may increase the risk, for example:
Skills and experience – being inexperienced in a job may increase the risk
Physical characteristics – an overload situa tion may result from a mismatch between the worker and the task
Unaccustomed work – workers who are new, have transferred from another job or are returning from extended leave and whose muscles are not conditioned to the work.
|Managing risks Hierarchy of Controls||Example|
|Level 1 Elimination||The client stands up and walks to the dining room with supervision only.|
|Level 2 Substitution||Replace manual wind up beds with electric beds|
|Engineering||Use mechanical lifting aids
Provide workstations that are height adjustable
|Level 3 Administrative||Rotate workers between different tasks
Train workers to use control measures Persona l protective equipment Specific procedures followed.
No worker should fully lift a person (other than a small infant) without assistance from, mechanical aids, assistive devices or another worker. All people handling activities are a po tential source of injury and the risks associated with this hazardous manual task must be eliminated or minimised so far as is reasonably practicable. With people handling, the health and safety of the person being handled needs to be Considered, as well as the health and safety of the worker(s). The physical condition of the person being handled; their ability to understand, communicate and their behaviour, will affect how the people handling activity is undertaken and the risks involved. When people are being handled, controls may include a mobility risk assessment; optimizing the person’s ability to assist and the use of appropriate mechanical and/or assistive devices.
Training in the type of control measures implemented should be provided during induction into a new job and as part of an on -‐ going manual task risk control program . Training should be provided to:
The training should include information on:
The training program should be reviewed regularly and also when there is change to work processes, plant or equipment, implementation of new control measures, relevant legislation or other issues that may impact on the way the task is performed. Records of induction a nd training should be kept. The records can include information such as the date of the session, the topics dealt with, and the name and signature of the trainer and each of the workers who attended the session.
Administrative control measures do not address the risk factors or source of the risk – they only attempt to reduce risk by reducing exposure to those risk factors.
The risk of MSDs may be minimised by rotating staff between different tasks to in crease task variety.
Regular rest breaks provide opportunities for workers to prevent the build -‐ up of, or recover from the effects of, fatigue in muscles and mental fatigue.
Team handling is manual handling of a load by two or m ore workers. Team handling brings its own risks and requires coordination. It should only be used as an interim control measure.
The best time to eliminate or minimise the risk of MSDs is in the design and planning stage – wh en hazards and risks can be ‘designed out’ before they are introduced into a workplace. Nursing homes that carry out a high level of manual tasks will have particular design requirements to
Where possible, place items used in manual tasks so they are:
Examples of control measures that should be considered when handling loads include:
Tools and equipment should be well maintained by carrying out regular inspections and servicing in accordance with the manufacturer’s specifications.
Mechanical equipment may eliminate or reduce the need for workers to lift, carry or support items or people. A wide range of mechanical aids is available.
Aids should be
Pushing and pulling loads
Pushing loads is preferable to pulling because it involves less work by the muscles of the lower back, allows maxi mum use of body weight, less awkward postures and generally allows workers to adopt a forward facing posture, providing better vision in the direction of travel.
Reduce the effort required to start the load in motion by:
Regulation 38: A person conducting a business or undertaking must rev iew and as necessary revise risk control measures:
A review should be conducted using the same method used when the hazardous task is first identified.
Care workers need to follow the work instructions of the organization when performing hazardous manual tasks.
RISK MANAGEMENT PROCESS (from code of practice appendix A)
What is the manual task?
(Are workers) Using the body to lift, lower, push, pull, carry or otherwise move, hold or restrain any person, animal or thing.
Is the manual task hazardous?
(Is) Application of force – repetitive, sustained, high, sudden
(Is) Posture – sustained, awkward
(Is) Movement – repetitive
(Is) Vibration – present
What is the risk of MSD?
How often and how long are specific postures, movement or forces performed or held?
What is the duration of the task?
Does the task involve high or sudden force?
Does the task involve vibration?
WHAT IS THE SOURCE OF RISK?
Work area design and layout
Systems of work
Nature, size, weight and number of persons, animals or things handled
Control the risk
Is the task necessary?
Can the source of risk (work area layout, envir onment, etc) be changed?
Can mechanical aids be used to perform the task?
What training is needed to support the control measures?
Review the risk
A discomfort survey can help identify hazardous manual tasks. Early reporting of symptoms c an lead to risk controls being put in place before injury occurs.
The survey sheet below will help you identify and record instances where workers experience discomfort that:
re-occurs the next day, or
persists after rostered days off.
Encour age workers to report pain or discomfort at work or at any other time. Follow up the reasons for the problem.
Even if only one worker reports problems, assess the presence of a risk factor.
|Job work location|
|Time on this job: Less than 3mths Supervisor||3mths to 1 yr||1 to 5 yrs|
|1.Do you suffer from swelling, numbness, tingling, ‘pins and needles’ stiffness, aches and pains in any part of the body? Indicate in the diagrams where the problem occurs|
|2. Rate the level of discomfort/pain on a scale of 1 to 5
1. _________ 2. _________ 3. _________ 4. _________ 5. _________
Just noticeable Moderate Unbearable
|3. What do you think caused the problem?|
A number of tools are available from Safe Work SA to help assess and manage risk. They are found in the appendices of the code of practice. They have bee n copied below. The training package stipulates that you should be able to use these tools.
APPENDIX D –RISK ASSESSMENT WORKSHEET
Location of task: Management rep: Description of hazardous manual task: Health and Safety rep: Date of assessment: Others ( workers, consultants): Reason for identification Existing task Change in task, object or tool Report of musculoskeletal disorder(MSD) New task New information
STEP 1 – Does the task involve repetitive or sustained movements, postures or forces? As a guide;
repetitive means the movement or force is performed more than twice a minute and sustained means the posture or force is held for more than 30 seconds at a time.
|Postures and Movements||place a tick in the ‘yes’ column each time you observe repetitive movement or sustained posture||yes||This action happens when...||because... (describe why) This is the source of the risk||If any boxes are ticked, what are possible controls to reduce the risk|
|Bending or twisting e.g. more than 20 degrees||Forwards|
|Bending e.g. more than 5 degrees||Backwards|
|NECK OR HEAD|
|Bending or twisting e.g. more than 20 degrees||Forwards|
|Bending e.g. more than 5 degrees||Backwards|
|Arms and hands|
|Above shoulder height|
|Reaching more than 30 cm (forward or side)|
|Twisting, turning, wringing, picking or grabbing actions|
|Squatting, crawling, kneeling, lying, semi-lying, jumping|
|On one leg|
|Very fast movements|
|Lifting or lowering|
|Using one side of the body or one hand|
|Exerting force on one side|
|Pushing, pulling or dragging|
|Fingers close together or wide apart|
|Uneven, fast or jerky movements|
|Holding supporting or, restraining|
Does the task in step 1 involve a long duration?
|More than 2 hours over an entire shift|
|Continually for more than 30 min at a time|
If you ticked yes the task is a hazard and must be controlled.
STEP 3– DOES THE TASK INVOLVE HIGH OR SUDDEN FORCE?
FORCES (Tick yes if the task involves any of the following high or sudden forces, even if the force is applied only once)
|Yes||This action happens when...||This action happens because... (describe why) This is the source of the risk||If any boxes are ticked, what are possible controls to reduce the risk|
|Lifting, lowering or carrying heavy loads|
|Throwing or catching|
|Hitting or kicking or jumping|
|Applying a sudden or unexpected force including:
handling a live person or animal or applying uneven, fast or jerky forces during lifting, carrying, pushing or pulling or Pushing or pulling objects thatare hard move or stop eg a trolley
|Exerting force while in an bent, twisted or awkward posture including:
supporting items with hands are above shoulder height or moving items when legs are in an awkward posture, working with fingers pinched together or held wide apart
Using a finger grip or pinch grip or an open handed grip
|Exerting a force with the non-preferred hand|
|Needing to use two hands to operate a tool designed for one hand|
|The task can only be done for short periods of time|
|Two or more people need to be assigned to handle a heavy, awkward or bulky load|
|Workers report pain or significant discomfort during or after the task|
|Stronger workers assigned to do the task|
|Employees say the task is physically very strenuous or difficult to do|
|Workers think the task should be done by more than one person, or seek help to do the task as it requires high force|
STEP 4- IS THERE HAND, ARM OR WHOLE BODY VIBRATION?
Tick yes if any of the following environmental factors are present in the task.
Driving for long periods
Driving on rough roads
Frequent use of hand powered tools or use for long periods
Using high grip forces or awkward postures when using power tools
Use of machines or tools where the manufacturer’s handbook warns of Vibration
Workers being jolted or continuously shaken
Use of a vehicle or tool not suitable for the environment or task
STEP 5 – IS THERE A RISK?
Did you answer yes in step 1 and step 2?
The task is a risk. Risk control is required.
Did you answer yes in step 3?
The task is a risk. Risk control is required.
Did you answer yes in step 4?
This task requires further investigation
To aid prioritisation of timing and resourcing risk controls you may also need to consider:
Number of ticks or risk factors
Additional factors such as injuries associated with the task.
These items capture degree and likelihood of harm. You will also need to consider the availability and suitability of risk controls for the task.
(1) What are the 5 steps that should be taken when making an assessment of risk.
(2) Say why the tasks below can be regarded as hazardous manual tasks.
Brushing a client’s hair.
Replacing soap in a dispenser
Pushing a wheelchair
Using a sling lifter
Changing an incontinence pad
Lifting a linen bag.
(3) How can you reduce the risk of MSD for yourself in each of the above tasks?http://www.safeworkaustralia.gov.au/sites/swa/about/publications/pages/hazardous-manual-tasks-cop
*Note : these tools are the same as those in the SA code of practice
RECORD FOR DEMONSTRATION AND PRACTICE OF MANUAL HANDLING SKILLS
Student to complete
|Skills||Attended demonstration or viewed on youtube||Practiced in skills lab||Date|
out of bed
|Use of slide sheet for
rolling a client in bed
moving client up or down bed
|Assist client to stand from a chair
|Walk with client
1x assist with frame
|Use of full assist lifter|
|Assisting client up from floor after a fall
Assessment; Answer the following questions