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Manual Handling

Presented by:

Steve PettittHead of Health, Safety and Environment

Housekeeping

Learning Outcomes

Course ObjectivesThis course provides essential information about manual handling, the associated hazards and the ways in which they are controlled including: Incident statistics Anatomy of the spine Types of injuries and the causes Health and Safety law and manual handling Managing the risks Understanding safe lifting techniques Incident reporting and investigation The importance of strengthening exercises

What is Manual Handling

DefinitionThe Manual Handling Operations Regulations 1992 defines manual handling as:

“The transporting or supporting of a load by hand or some other part of the body including the lifting, putting down, pushing, pulling, carrying, moving or intentionally dropping or throwing a load”.

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Why is Manual Handling an Issue

RIDDORThe Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013Applies to work related: Deaths Specified major injuries such as fractures (less fingers

and toes) Dangerous occurrences Prescribed diseases Absences or inability to undertake normal work

exceeding 7 days

2013/14 Statistics The Labour Force Survey (LFS) estimated 909,000

working days lost An average of 6.6 days lost for each injury (LFS) This represents 24% of reported injuries (RIDDOR)

RIDDOR Incidents Employees Self -employed Total

Fatalities 0 0 0Specified, DO or Diseases 1431 59 1490Over 7 day events 16923 162 17085Total 18354 221 18575

Occupation Groups Most at RiskOccupations with most reported handling injuries and highest injury rates during 2013/14 were: Storage occupations had the highest numbers with

2,028 handing injuries ( but with a rate of 523 injuries per 100,000 employees)

Nurses and care & nursing assistants, taken together, accounted for 1,929 injuries (but with a rate of 1,982 injuries per 100,000 employees)

Consequences for the Organisation Investigation by the HSE / Local Authority:

• Fees for intervention• Enforcement action• Prosecution:

o Fineso Imprisonment

Civil action by Injured Party leading to:• Compensation payments

Press coverage:• Reputation

Consequences for the Injured Party Pain and suffering Long recovery time Inability to work Loss of income Restricted lifestyle

Injuries caused by manual handling are rarely fatal

but ......They can and do cause permanent disabilities

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Anatomy of the SpineThe Spine

The spine, or backbone, consists a series of vertebrae extending from the skull to the small of the backIts main functions are to: Provide support for the upper

skeleton Allow movement Protect the spinal cord Act as a shock absorber

The VertebraeThe spine comprises of 33 small bones or vertebrae: 1-7 form the cervical region (7) 8-19 form the thoratic region (11)

20-24 form the lumbar region (5)

25-30 forms the sacrum (6)

30-33 forms the coccyx (4)

Lumbosacral Joint (L5-S1)

Intervertebral DiscsThe intervertebral discs are layers of cartilage which: Separate vertebrae Act as shock absorbers Cushion the forces produced during movement

Repeated flexion under load causes the nucleus to migrate damaging the disc fibres

MusclesMuscles: Muscles are bundles of fibre

which enable movement They receive messages from

the brain causing them to contract or relax

Connected to the skeleton by tendons when they contract the bones are drawn towards the muscle

Ligaments and NervesLigamentsTough fibrous tissue with limited elasticity which connects bones or cartilages to muscles or holds together a jointThey can be damaged if stretched too far or torn (a sprain)NervesBundle of fibres in the body that transmits impulses of sensation to the brain or spinal cord, and impulses from these to the muscles and organsIrritated nerves can cause severe pain (sciatica)

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Manual Handling Injuries

Injury Locations

Type of Back Injuries Work Related Upper Limb DisordersWRULD affects the shoulders, arms and wrists and is mainly caused by: Excessive force Excessive repetition Lack of recovery time or rest Poor static posture Stress and tension Individual susceptibility

Causes of Back PainIt is not only caused by heavy work or heavy weights but can also be due to: Poor static posture Sitting too long in one position Sudden movement Vibration during handling Psychological stress

ErgonomicsErgonomics is the science concerned with the ‘fit’ between people and their work It puts people first, taking account of their capabilities and limitations Secondly it aims to make sure that the tasks, equipment, information and the environment fit each worker Applying ergonomics to the workplace can: Reduce the potential for accidents Reduce the potential for injury and ill health Improve performance and productivity

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Health and SafetyLaw

Health and Safety at Work etc ActThe Health and Safety at Work etc Act 1974 The Act places a general duty on employers to

ensure the health, safety and welfare at work of their employees

There is also a specific duty to ensure the safe use, handling, storage and transport of articles and substances so far as is reasonably practicable

Management RegulationsThe Management of Health and Safety at Work Regulations 1999 The Regulation requires employers to assess the risks

associated with work activities This risk assessment should identify whether there is

a risk of injury from all manual handling operations in the workplace

Manual Handling RegulationsThe Manual Handling Operations Regulations 1992, as amended 2002, states that:

(1) Each employer shall:(a) so far as is reasonably practicable, avoid the need for his employees to

undertake any manual handling operations at work which involve a risk of their being injured.

(b) where it is not reasonably practicable to avoid the need for his employees to undertake any manual handling operations at work which involve a risk of their being injured –(i) make a suitable and sufficient assessment of all such manual handling

operations to be undertaken by them(ii) take appropriate steps to reduce the risk of injury to those employees

arising out of their undertaking any such manual handling operations to the lowest level reasonably practicable, and

(iii) take appropriate steps to provide any of those employees who are undertaking any such manual handling operations with general indications and, where it is reasonably practicable to do so, precise information on:

(aa) the weight of each load, and(bb) the heaviest side of any load whose centre of gravity is not

positioned centrally.

Manual Handling RegulationsThe regulations set out hierarchy which employers must follow, so far as is reasonably practicable, to prevent or reduce the likelihood of injury.Every effort should be used to avoid manual handling in the first instance but if this is not possible employers must: Assess the task Reduce the risk Monitor the task Inform and train staff on the risks

e.g developing a safe system of work

Eliminating or Reducing the RiskElimination can be by: Automation or mechanisation such as the use of

cranes or forklift trucks Management such as arranging for delivery of heavy

articles to the point of useReducing can be achieved by: Design such as changing the layout of workplace to

minimise manual handling operations Use handling aids such as trolleys or sack barrows Supplying in smaller sized containers or storing

heaviest materials at waist level

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Manual Handling Risk Assessments

Detailed Risk Assessment Required?If the load limit guidelines are exceeded a full risk assessment should be undertaken: The chart on the next slide gives guideline weights for

lifting and lowering No manual handling activity is completely safe but using

these guidelines as part of a well thought out risk assessment will help reduce the risks

Lower weights should be specified if there are any factors that could have an adverse effect on the activity or if it involves twisting or bending

If the task is being carried out frequently then weights should also be reduced

Load Limit Guidance 15 Litres = 15Kg Assessing Manual Handling RisksThere are five factors to be considered when assessing the risks of manual handling:

1. Type of task2. Individual performing task3. The load to be handled4. The environment5. Other factors

Remember T . I . L . E

Assessing the TaskWhat things should we consider when we look at the task?

Position of trunk Height of lift Distance of carry Number of persons Repetitive handling Excessive pulling

Excessive pushing Insufficient rest Holding position Handling seated Twisting or stooping

Assessing the IndividualWhat is it about the people who are doing the job that might affect their health and safety? Necessary physical attributes Special knowledge or training requirements Disabilities or disadvantages (illness or expectant

mother) Confidence about the lift

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Assessing the LoadWhat is it about the load which might affect our health and safety? Kind of load Weight, size or shape Difficult to grasp / unstable Problematic (rough, hot etc.) Availability of mechanical aids Clothing Unpredictable movement

Assessing the EnvironmentWhat is it about the place which might affect our health and safety? Space constraints Walking surfaces Steps, slopes or variations in levels Lighting Hot, cold, rain, ice or humid conditions Strong air movement

Assessing Other FactorsWhat other factors might affect our health and safety? Personal protective equipment (PPE) requirements Work organisation

• Planning and scheduling tasks• Communication and consultation• Changes in workload• Sufficient training

Stress Short cuts Showing off Shifts e.g end of the day And then there are other people!

The Final Stages

Determine how to ensure the safety of those who handle loads and if its not safe do not allow MH

Upload the assessment onto AssessNET (Notting Hill’s health and safety database)

Implement the findings of the risk assessment Communicate the findings to all those who are

affected such as at team meetings Monitor the effectiveness – such as Job Safety

Analysis (watching from afar how loads are handled – which may be different if the person knows they are being observed)

Review, at least annually, always with the objective of avoiding handling or reducing the risk

Risk Assessments Tools / Guidance

The Lever Effect In a standing position, the balance point of the body

is straight through the centre (the weight at front of body is balanced with the rear)

Handling any load disturbs the balance as the back muscles are tensed to compensate for the load and this causes a lever effect

The further a load is held away from the body the greater the lever effect

The lever effect is reduced the closer the load is to the body

Stooping also increases the lever effect

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The Lever EffectDepending on the lengths of the two lever arms, the lever can: Cut the effort you need to lift the load, in which

case you are working at an advantage Increase the effort you require, making you work at

a disadvantage

The loads lever arm---------------- x the load = effort

Your lever arm

Manual Handling Assessment ToolThe Manual Handling Assessment Tool (MAC) tool has been developed by the Health and Safety Executive to help the user identify high risk workplace manual handling activities.The tool can be used to assess the risks posed by lifting, carrying and team manual handling activities. It is designed to help you understand, interpret and categorise the level of risk of the various known risk factors associated with manual handling activities. The MAC incorporates a numerical and a colour coding score system to highlight high risk manual handling tasks.

Safe Lifting Techniques

The liftHow is this achieved safely:

1. Plan the Route2. Assess the load3. Correct position of feet4. Straight back5. Correct grip6. Lift smoothly

Planning Where is the load going to Are there obstructions

along the way Is there somewhere to set

it down

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Assessing the Load Determine the weight Look for sharp edges See if weight is evenly distributed Keep heaviest side to body Decide how to hold the load

If it is too heavy use a trolley or get assistance

Positioning of Feet Comfortably apart One foot positioned in direction of

movement Other foot where it can give maximum

thrust to the body To maintain good balance feet should

never be too close together on the ground

Keep a Straight Back Lower the body by relaxing the knees Keep your back straight (but not

vertical) Keep load close to body Keep chin in and head back

Correct Grip Take a firm grip by using the

palms of the hands and roots of fingers

Taking weight on finger tips will create pressure at the end of fingers and could strain muscles and tendons in the arms

A full palm grip will reduce muscle stress to the arms and decrease the possibility of the load slipping

Lifting If lifting from ground make maximum

use of legs Keep back straight but inclined

forward As lift proceeds and the legs are

straightened the back returns to vertical position

Positioning of feet and bending of knees are the key factors in maintaining a straight back

Lifting Thrust from back foot and straightening of knees will

move body forwards and upwards – briefly off balance

Immediately countered by bringing the back foot forward as if walking

Lift now completed - forward movement results in smooth transition from lifting to carrying

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Carrying and Setting DownCarrying Make sure you can see where you are

going Avoid twisting the body – move your feet

instead If you need to change your grip – set the

load down – not whilst walkingSetting Down Use the correct stance for lifting and set

the load down gently

In Summary Plan the route, the lift and the set down point Position your feet - bent knees, straight back Firm grip, lift smoothly, Move the feet – do not twist body Keep the load close to the body Put down smoothly – then adjust for final position

The Golfers LiftThis technique is very useful to avoid back injury when lifting out of a bin or picking small objects off the floor.For this technique, the knees do not bend. One leg is allowed to come off the floor behind the lifter and acts as a counter balance. The opposite hip bends and the body becomes almost parallel to the floor, except for the leg bearing the person's weight. One arm reaches to pick up the object while the other is often leaning on an object for support, such as a countertop or the top end of a golf club.

Demonstration and Practical

Pushing a LoadPushing

The principles of the base movement apply when pushing a load: Get a good hand grip and firm foot base Push using the muscles of the leg not the back Use a steady flow as opposed to quick jerking actions Pushing tends to be less strenuous than pulling as it

uses body weight

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Pulling a LoadPulling

Use exactly the same principles as for pushing: Get a good hand grip and firm foot base Pull using the muscles of the leg not the back Use a steady flow as opposed to quick jerking actions

Team LiftingTeam Handling (problems)

What are the problems with team lifting? Communication

• How to grasp or lift• When to lift• What level to carry at• Which route• When and where to set down

Co-ordination Disparity of individuals – size, speed and strength Awkward areas

Team Handling (solutions) Consider other options

• Avoid• Mechanise the task• Use of handling aids• Split the load down

Verbally run through sequence Walk the route (preparing as necessary) One person taking charge – giving instructions Stick to established teams

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Incident Reporting

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Reporting Manual Handling Incidents

All manual handling incidents are to be reported including near misses

Reporting incidents is a core duty for all Employees

Investigating Incidents

Managers are responsible for investigating in order to: Establish root cause(s) Put in place measures to

prevent a reoccurrence

“Those who fail to study the past are condemned to relive it”

George Santayana (1863 –1952)

Strengthening Exercises

Strengthening Exercises

The following slides outline a series of simple exercises to reduce the risk of suffering an injury.

By completing the following stretches prior to undertaking any manual handling task, you are reducing the risk of injury.

If any of the following stretches cause you pain or discomfort, STOP the stretch immediately.

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PositionStand with the feet shoulder width apart and the arms behind the bodyActionGrasp the left wrist with the right hand. Pull the left arm down and to the right. Tilt the head to the right. Hold this position for 10-15 seconds. Repeat the action with the right wrist, pulling the right arm down and to the left. Tilt the head to the left.

PositionStand and extend the arms upward and over the head. Interlace the fingers with the palms turned upward.ActionStretch the arms up and slightly back. Hold this position for 10-15 seconds.VariationThis stretches the rectus abdominous muscles. Stretch to one side, then the other. Return to the starting position.

Neck & Shoulders Abdominal

PositionStand and interlace the fingers behind the back.Action Lift the arms behind the back so that they move outward and away from the body. Lean forward from the waist. Hold this position for 10-15 seconds. Bend the knees before moving to the upright position.Return to the starting position.

PositionStand with the arms extended to the front at shoulder height with the fingers interlaced and palms facing outward.Action Extend the arms and shoulders forward.Hold this position for 10-15 seconds.Return to the starting position.

Chest Upper Back Stretch

PositionStand with the feet shoulder width apart. Raise the right arm, bending the right elbow and touching the right hand to the back of the neck.Action Grab the right elbow with the left hand, and pull to the left. Hold this position for 10-15 seconds. Return to the starting position. Do the same stretch, and pull the left elbow with the right hand for 10-15 seconds.

PositionStand. (For variation, lie on the stomach.)ActionBend the left leg up toward the buttocks. Grasp the toes of the left foot with the right hand, and pull the heel to the left buttock. Extend the left arm to the side for balance. Hold this position for 10-15 seconds. Return to the starting position. Repeat with the right leg. Extend the right arm for balance. Hold this position for 10-15 seconds. Return to the starting position.

Overhead Arm Pull Thigh Stretch

PositionStand with the knees slightly bent.ActionBend forward keeping the head up, and reach toward the toes. Straighten the legs, and hold this position for 10-15 seconds.

PositionSit on the ground with both legs straight and extended forward with the feet upright about 15cm (6”) apart. Put the hands on the ankles or toes.ActionBend from the hips, keeping the back and head in a comfortable, straight line. Hold this position for 10-15 seconds. (Variation for greater stretch: Stretch and pull back on the toes.)

Hamstring Stretch Hamstring Stretch Seated

PositionLunge slowly to the left while keeping the right leg straight, the right foot facing straight ahead and entirely on the floor.ActionLean over the left leg while stretching the right groin muscles. Hold this position for 10-15 seconds. Repeat with the opposite leg.

PositionSit on the ground with the soles together. Place the hands on or near the feet.ActionBend forward from the hips, keeping the head up. Hold this position for 10-15 seconds.

Groin Stretch Standing

Groin Stretch Seated

PositionStand straight with the feet together, arms extended downward, elbows locked, palms facing backward, fingers extended and joined, and head and eyes facing front.ActionMove the right foot to the rear about two feet, and place the ball of the foot on the ground. Slowly press the right heel to the ground. Slowly bend the left knee while pushing the hips forward and arching the back slightly. Hold for 10-15 seconds. Return to the starting position. Repeat with the left foot. Return to the starting position.

PositionStand with the feet shoulder width apart and the left foot slightly forward.ActionBend forward at the waist. Slightly bend the right knee, and fully extend the left leg. Reach down and pull the toes of the left foot toward the left shin. Hold this position for 10-15 seconds. Return to the starting position. In a similar manner, pull the toes of the right foot toward the right shin, and hold for 10-15 seconds.

Calf Stretches Calf Stretches

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Position

Sit on the ground with the right leg forward and straight. Cross the left leg over the right while sitting erect. Keep the heels of both feet in contact with the ground.

ActionSlowly rotate the upper body to the left and look over the left shoulder. Reach across the left leg with the right arm, and push the left leg to your right. Use the left hand for support by placing it on the ground. Hold this position for 10-15 seconds. Repeat this stretch for the other side by crossing and turning in the opposite direction.

Position

Lie on the back with the arms straight beside the body. Keep the legs straight and the knees and feet together.

Action 1- Bring the left leg straight back toward the head, leaving the right leg in the starting position. Bring the head and arms up. Grab the bent left leg below the knee, and pull it gradually to the chest. Hold this position for 10-15 seconds. Gradually return to the starting position. Repeat these motions with the opposite leg.

Action 2 - Pull both knees to the chest. Pull the head up to the knees. Hold for 10-15 seconds. Return to starting position.

Hip & Back Stretch Seated

Hip & Back Stretch Lying Down

PositionStand with your feet shoulder width apart and hands on your hips.ActionRotate the hips clockwise while keeping the back straight. Repeat the action in a counterclockwisedirection. Do this three times in each direction

Position

Stand with the back straight and feet shoulder width apart. Extend the arms outward to shoulder height.

Action

Rotate the shoulders forward, and make a large circular motion with the arms. Repeat the action in the opposite direction. Do this three times in each direction.

Hip Stretches Arm Stretches