Back Pain Musculoskeletal Disorder Updated October 2010

Transcription

1 Back Pain Musculoskeletal Disorder Updated October 2010 According to the Health and Safety Executive back pain is the most common health problem for British workers. Approximately 80% of people experience back pain during their life time. Back pain and back injuries can cause recurring health problems, which can affect all aspects of daily life and activity. Nationally it is estimated that there are around 1.1 million people with some form of back complaint caused by work. Back pain is a major cause of sickness absence from work with an estimated 12.3 million days lost annually because of these. There is evidence that suggests women are more likely to suffer from back pain than men but that they take fewer days off. Most back pain is due to the muscles, ligaments and joints of the back being out of condition. Tackling back pain caused by work needs good management and partnership approaches. Employers and workers need to work in partnership along with others, such as occupational health advisors, to prevent/minimise back pain injury in the workplace. Many UNISON members including those working in health, social care, caretaking and portering are in occupations carrying above average back injury rates. Other UNISON members, such as administrative workers and those working in parks, suffer back pain as a consequence of lifting heavy or awkward objects regularly. Several people will manage the problem themselves without seeing a doctor, however, it is recommend that you do see your doctor if you are worried about back pain or if the pain persists or suddenly gets worse. Back pain can limit work activity but this does not necessarily mean that continuing to work will do harm. In the past it was accepted that bed rest was the response to back pain. Evidence now shows that rest does not help the process of recovery. Trying to reduce the pain by avoiding movement HEALTH AND SAFETY INFORMATION SHEET Page 1 of 11

2 slows recovery and can lead to long term back problems. It is much better to keep as normally active as possible. Preventing musculoskeletal disorders such as back pain and managing them in the work place is one of the current priorities for the Health and Safety Commission. The term musculoskeletal disorder (MSD s) covers a multitude of ailments. What they have in common is pain and some limitation of daily activities. Aches and pains in joints and soft tissue (muscle and tendons) after unaccustomed activity such as starting a new job can affect anyone and people usually recover from them in a few days. Risk factors causing MSD s can be found in almost every workplace and around 11.6 million working days a year are lost to work related MSD s. UNISON s message to its members working right across the public sector workforce is that manual lifting should be avoided wherever possible. UNISON has members in occupations with the highest average annual incidence rate reported by rheumatologists between 2001 and Causes of Back Pain Almost every worker is at some risk of back pain; however, there are several factors that increase the risk such as: Bending and twisting; Lifting repeatedly and heavy lifting; Repeating an action too often; Working in a fixed position for too long without breaks; Using too much force; Uncomfortable working positions; Adverse working conditions /environment e.g., hot, damp, cold, and wet; Manual handling in awkward places; Driving long distances or over rough ground Stretching, twisting or reaching. HEALTH AND SAFETY INFORMATION SHEET Page 2 of 11

3 There is an increased risk of injury when a number of these factors are involved or where there are prolonged periods of working in these conditions. Manual Handling Injuries can happen to anyone and not just those moving heavy loads and objects. Back injury can occur if a load is lifted incorrectly or the weight alters and if the lifting is required frequently and regularly. What is Manual Handling? A number of duties undertaken by UNISON members are considered as manual handling. Some examples are:- Moving patients from beds, chairs or stretchers etc; Collecting and emptying rubbish bins; Pushing wheelchairs and trolleys. Manual handling operations means any transporting or supporting of a load including the lifting, putting down, pushing, pulling, carrying or moving by hand or bodily force. The human effort may be direct or indirect e.g. pulling a lever. Introducing mechanical assistance such as a powered hoist, may reduce but not necessarily eliminate manual handling, since human effort is still required to move, steady or position the load. What are the employers legal duties There are strict laws designed to ensure that employers take action to prevent injury as a result of manual handling. Each employer should have a written policy as part of their overall safety policy. The main law is the Manual Handling Regulations. These are covered in detail in UNISON s Guide to the Six Pack. Very simply, employers must do the following: Avoid hazardous manual handling operations as far as is reasonably practicable HEALTH AND SAFETY INFORMATION SHEET Page 3 of 11

4 This can mean redesigning the work, or the workplace, to see whether lifting or moving can be made unnecessary or, if that is impossible, introducing mechanical equipment. Because equipment must be used correctly, employers must also provide proper training. Remember, equipment does not always eliminate manual handling and can introduce different risks. Members should never be asked to lift a person on their own, or take full body weight. But where equipment has been introduced for lifting patients or clients many employees have felt that this is either too troublesome or undermines the dignity of the client, and so the equipment goes unused. Further advice on this issue can be found in a separate information sheet Lifting of Home Care Clients If equipment is introduced the views of the workforce, and the needs of any clients, should be considered. However, if effective lifting equipment is provided, employees should use it so long as it can be operated easily and safely, and they have been properly trained. Assess any hazardous operations that cannot be avoided This means that employers must carry out a risk assessment, before work commences, to identify if there is any possibility of an employee being injured. The Manual Handling Regulations have a number of factors listed in a schedule and these have to be taken into account when making an assessment of any manual handling operations. These include characteristics of the load, working environment, individual capability and the actual tasks involved. Remember, even if equipment has been introduced, it may not totally remove the need to lift. The risk assessment must be suitable and sufficient. An example of what should be included in an assessment is given at the end of this guide. Remember that it is management s responsibility to do a risk assessment not the safety rep s. but safety reps should be consulted. HEALTH AND SAFETY INFORMATION SHEET Page 4 of 11

5 Remove or reduce the risk of injury using the risk assessment as the basis for action This means, if manual handling can t be avoided, employers must take appropriate steps to reduce the risk of injury to employees to the lowest level reasonably practicable. Employers will try to use the phrase reasonably practicable to say that it will cost too much money. However, the courts have said that employers cannot put workers health at risk just because they cannot afford to make changes. After the risk assessment Once an assessment has been carried out it must be reviewed if the method of working changes or there is an accident. Any assessment must be recorded and kept regularly accessible. Safety reps have a right to see the records of the assessments and can demand to know what action has been taken. Assessments should not only cover the main place of work. They must also look at employees who work away from the employers premises, such as refuse collectors, ambulance staff, and groups such as home carers and community nurses who have to lift in other people s houses. The regulations state there will sometimes be a limit to employers liability to influence the working environment; but the task and perhaps the load will often remain within their control, as will the provision of effective training so it is still possible to establish a safe system of work. This means that employers cannot shrug off their responsibilities to employees working away from the employers premises. Training Every employee who has to lift or move any load must be given training. Training should be provided for all staff with special training for groups of workers involved in specific manual handling tasks. It is important that training is carried out before any manual handling duties are undertaken. The training should include: HEALTH AND SAFETY INFORMATION SHEET Page 5 of 11

6 Recognising possibly dangerous handling operations. Using handling and lifting equipment. Good handling and moving techniques. Individual capabilities and limitations. Where and when to record any incidents or injuries. The reality of back and spine injury. It should cover: How to recognise harmful manual handling functions: Appropriate systems of work; Use of mechanical aids; Good handling techniques. Once employees have been trained they should be given refresher training on a regular basis to ensure that manual handling policies and procedures are adhered to and that up to date best practice is applied. Training programmes should meet the needs of specific groups and develop good practice based on the assessment of current training status and the skills required to supervise, monitor and establish safe and best practice. The minimum training programme must include the following elements:- Understanding of the assessment process Back care Manual handling techniques * Mechanical handling aids * General fitness principle *The training must be targeted to the needs of individuals and work processes. HEALTH AND SAFETY INFORMATION SHEET Page 6 of 11

7 Other areas to be considered include:- Establishing a recall system,which ensures that employees, including part - time, workers have time set aside at least once a year for refresher training. Providing additional refresher training as appropriate after injury as part of the rehabilitation process. Maintaining clear and accurate records of attendance for training events The Role of Health and Safety Representatives As a UNISON Health and Safety representative you a legal right to. Formally inspect the workplace at least every three months: this can include talking to members about any health and safety problems they are concerned about. Investigate when there has been or there is potentially a notifiable accident or dangerous occurrence. Encourage members to contact you, as the health and safety representative, at the earliest possible time of an accident, or when they see a potential hazard. Investigate members complaints and let them know that they can talk to you if they have health and safety related problems. Investigate when there is a change in working conditions. This includes either the introduction of new equipment, a new process or task and when there is a proposal to open a new room, transfer departments from one site to another or to open a complete new unit Health and safety representatives are also entitled to be consulted under the Management of Health and Safety Regulations. These regulations require employers to consult Safety Representatives in good time concerning:- The introduction of measures which may substantially affect health and safety. HEALTH AND SAFETY INFORMATION SHEET Page 7 of 11

8 The arrangements for appointing people to assist with health and safety. Health and safety information which the employer is required to provide. Planning and organization of health and safety training. Health and safety implications of the proposed introduction of new technology Health and safety representatives have a variety of rights under the law. However, it is important to note that if as a health and safety representative you miss a potential hazard in the workplace then you are not held legally responsible. It is management s responsibility to ensure that safe working environments with safe systems of work are provided for employees. Manual handling Policies Employers should consider developing good manual handling policies. One of the main features is that it should cover all employees, and explain the meaning of manual handling, what is required under the regulations and what the managers need to do. The policy should cover risk assessments and the reasons for them. All manual handling policies will need to identify the groups of workers that it covers. The aim is to ensure that staff avoid unnecessary manual handling activities and that arrangements are made for staff to receive suitable and sufficient information, instruction and training accordingly. Inspecting for lifting and handling hazards checklist The following checklist can be used by safety representatives to carry out lifting and handling inspections. Posture or movement Does work involve: Frequent or prolonged stooping? Stretching or reaching above shoulder height? HEALTH AND SAFETY INFORMATION SHEET Page 8 of 11

9 Sideways twisting of the body? Unbalanced or uneven carrying of loads (for example, one handed carrying)? Sitting in uncomfortable position with back unsupported? Methods of work Can work be changed to make it safer: Can mechanical equipment be used (for example, adjustable trolleys, hoists, lifts)? Are there sufficient rest breaks to allow staff to recover from physically demanding work? Are there enough trained and experienced staff to cope at all times (including absence cover, night and weekend working)? Can work routines be changed to spread physically demanding work more evenly between staff and shifts? Can the lifting be shared? Work environment Is lack of space or poor layout causing problems: Is there enough space to move freely and change posture? Is there enough space to use mechanical equipment when needed? Are floors clean, even, slip-resistant and free from obstructions? Is workplace temperature too hot or cold? Is lighting adequate (for example, not too dim or causing glare)? Could hoists, lifts or ramps be installed to reduce physical strain? Are heavy items stored at a convenient height or adjustable to suit the user (to avoid stooping or reaching above shoulder height)? Are work surfaces at a comfortable height or adjustable to suit the user? Do work surfaces allow a convenient arrangement of equipment on them) to avoid twisting or stretching)? Are work surfaces at compatible height (to reduce lifting from one to another)? Furniture and equipment Are safety reps consulted before new furniture and equipment is introduced? Is new furniture and equipment tested by users on a trial basis before it is purchased? Are workstations and seating adjustable to suit the user and the work, for example when working with VDUs? HEALTH AND SAFETY INFORMATION SHEET Page 9 of 11

10 Does seating give proper back support? Are foot rests provided where needed? Are staff trained and encouraged to adjust furniture and equipment before use? Is furniture and equipment checked and maintained regularly? Is faulty equipment and furniture taken out of service and replaced? Are staff trained and encouraged to use mechanical equipment to reduce physical strain? Loads When the load is inanimate: Is the weight of loads known and clearly marked? Are loads securely packed, so the contents won t shift or spill? Do loads contain dangerous substances, or are they slippery, sharp or too hot or cold to hold? Can loads be made smaller and lighter (for example, by ordering smaller units)? When the load is a person: Are lifting and handling needs included in patient/client care plans? Are staff warned about particular handling problems (for example if patient/client is confused, violent or injured)? Are patients/clients given training so they can assist as much as possible? Are staff ever expected to lift people alone? Is there an agreed procedure in case of patient/client falls? Training Is training given to all staff carrying out manual handling work and are supervisors and managers also trained in back pain prevention? Does training include the use of mechanical and adjustable equipment and furniture? Are staff retrained when new equipment or work methods are introduced? Do trainers have sufficient expertise in the prevention of back pain? Are training courses monitored for their effectiveness? Clothing and footwear Do uniforms, protective equipment and other clothing that has been provided allow easy movement? HEALTH AND SAFETY INFORMATION SHEET Page 10 of 11

11 Is appropriate non-slip footwear provided where needed? Non discrimination Is there an agreement not to unfairly discriminate against individuals in or applying for jobs with a risk of back pain (for example, just because they are women or over a particular age. Each individual should be considered on their merits)? Is there an agreement to relocate staff who are at special risk of back injury (for example because of pregnancy or existing back problems)? Accident reporting Is there a system for reporting and monitoring accidents, near-misses, injuries and ill-health? Are incidents investigated and action taken to prevent them happening again? Are safety reps always informed when accidents and incidents occur? HEALTH AND SAFETY INFORMATION SHEET Page 11 of 11