Musculoskeletal Musculoskeletal Disorders (MSDs) Disorders (MSDs)
Control and PreventionControl and Prevention
ObjectivesObjectives You will be capable to
identify the most common MSD in the society identifying risk factors.
You will be also capable to identify strategies that help in the prevention and creation of suitable society for those patients.
MSDs in KSA
On the top of the health problems encountered in urban Primary Health Care in Riyad, 1996.
Out of 1001 patients, 381 (38.1%)had MSDs.
Out of 404 male patients 132 (32.7%) had MSDs.
Out of 597 female patients, 249 (41.9%) had MSDs.
Musculoskeletal DisordersMusculoskeletal Disorders
MSD is an injury or illness to soft MSD is an injury or illness to soft body tissue such as:body tissue such as:
• MusclesMuscles• NervesNerves• TendonsTendons• LigamentsLigaments• JointsJoints• CartilageCartilage• Spinal DiscsSpinal Discs
Musculoskeletal Disorders Musculoskeletal Disorders includeinclude
Strains & SprainsStrains & Sprains Soreness or PainSoreness or Pain Carpal tunnel syndromeCarpal tunnel syndrome Connective tissue disordersConnective tissue disorders
Musculoskeletal Musculoskeletal Disorders Disorders
are medical conditions that are medical conditions that develop gradually over a period of develop gradually over a period of timetime
do not typically result from a do not typically result from a single instantaneous event. single instantaneous event.
MSDs are causedMSDs are caused byby•BendingBending•ClimbingClimbing•CrawlingCrawling•ReachingReaching•TwistingTwisting•OverexertionOverexertion•Repetitive ExposureRepetitive Exposure
What are the Risk Factors?
Risk FactorsRisk Factors Work-related (applied Work-related (applied
also to household?) RFalso to household?) RF•Environmental FactorsEnvironmental Factors•Activity FactorsActivity Factors
Non work related RFNon work related RF•Certain Medical ConditionsCertain Medical Conditions
Environment Risk FactorsEnvironment Risk Factors
Heat or coldHeat or cold LightingLighting VibrationVibration Tool designTool design NoiseNoise
Activity Risk FactorsActivity Risk Factors Static or awkward Static or awkward
posturespostures Improper grippingImproper gripping Improper liftingImproper lifting Repetitive MotionRepetitive Motion
Heat & ColdHeat & Cold Heat Heat affects blood circulation & affects blood circulation &
causes cramps, burns/rashes and causes cramps, burns/rashes and general discomfort. general discomfort.
ColdCold affects the body's blood affects the body's blood circulation, causes hypothermia, circulation, causes hypothermia, loss of flexibility, distraction and loss of flexibility, distraction and poor dexterity.poor dexterity.
Comfortable temperature rangeComfortable temperature range •18-21°c (68 to 74 F)18-21°c (68 to 74 F)•Humidity 20 – 60%Humidity 20 – 60%
VibrationVibration Excessive vibration causes pain to Excessive vibration causes pain to
muscles, joints and internal organsmuscles, joints and internal organs Soft tissue trauma to the hands, Soft tissue trauma to the hands,
arms, feet and legs. arms, feet and legs.
LightingLighting Under & over lighted areas causes:Under & over lighted areas causes:
•HeadachesHeadaches•Muscle strainsMuscle strains•FatigueFatigue•Eye strainEye strain
Poorly lighted areas also Poorly lighted areas also contributes to trip & fall hazards & contributes to trip & fall hazards & poor coordinationpoor coordination
Tool designTool design Handle shapeHandle shape Control typeControl type Control locationControl location VibrationVibration ImpactImpact PressurePressure
NoiseNoise Noise peaks above 100 decibels Noise peaks above 100 decibels
cause:cause:•Headaches•Increased blood pressure
•Muscle tension & fatigue
•Irritability & distraction
Force & ExertionForce & Exertion Forceful exertions place higher Forceful exertions place higher
loads on the muscles, tendons, loads on the muscles, tendons, ligaments, and joints ligaments, and joints
Factors Factors •Weight Weight •BulkinessBulkiness•SpeedSpeed
PosturePosture Prolonged standingProlonged standing - -
varicose veins, back stress, varicose veins, back stress, pooling of blood in legspooling of blood in legs
Sitting without back Sitting without back supportsupport - low back stress - low back stress
Seat too highSeat too high - decreased - decreased circulation, (legs dangling circulation, (legs dangling over end) bruisesover end) bruises
PosturePosture Shoulders roundedShoulders rounded - Upper/lower - Upper/lower
back stress, respiratory distressback stress, respiratory distress
Leaning forwardLeaning forward - Lower back - Lower back stressstress
Arms extendedArms extended or over-reaching or over-reaching - Stress to arm muscles, upper - Stress to arm muscles, upper back stressback stress
PosturePosture Elbows "winged"Elbows "winged" - Joint stress at - Joint stress at
shoulder, poor use of bicep shoulder, poor use of bicep musclesmuscles
Stepping backwardsStepping backwards - Loss of - Loss of balance, displaced gravity, balance, displaced gravity, muscle stressmuscle stress
Locking kneesLocking knees - Stress to back - Stress to back of knee, poor blood circulationof knee, poor blood circulation
Bent WristBent Wrist – excessive force – excessive force when grippingwhen gripping
RepetitionRepetition Frequent & prolonged repetition Frequent & prolonged repetition
of the same movements cause of the same movements cause muscle fatigue and stressmuscle fatigue and stress
Factors that increase repetition Factors that increase repetition hazardshazards
•Number of cycles per minuteNumber of cycles per minute•Force requiredForce required•PosturePosture
GrippingGripping Factors that increase gripping Factors that increase gripping
hazardshazards•Bent wristBent wrist•Surface areaSurface area•Surface frictionSurface friction•VibrationVibration•Type of gripType of grip
LiftingLifting Factors that increase lifting Factors that increase lifting
hazardshazards•WeightWeight•SizeSize•RepetitionRepetition•TwistingTwisting•BendingBending•ReachingReaching•MethodMethod
Non-work Risk FactorsCertain Medical Conditions
Such as: Rheumatic Arthritis, Diabetes, Obesity, Hormone Imbalances and Pregnancy.
AgeSpare time activities.
CONTROL MEASURES
Hazard ControlsHazard Controls Engineering Controls Administrative Controls Work Practice / household
Controls
Engineering ControlsEngineering Controls Re-design of work stationRe-design of work station Re-design of toolsRe-design of tools Lighting modificationLighting modification Vibration controlVibration control Noise ControlNoise Control AutomationAutomation Mechanical LiftingMechanical Lifting Material FlowMaterial Flow
Administrative ControlsAdministrative Controls Employee rotationEmployee rotation Job task enlargementJob task enlargement Adjustment of work pace Adjustment of work pace Redesign of work methodsRedesign of work methods Alternative tasksAlternative tasks Rest breaksRest breaks
Work Practice ControlsWork Practice Controls
Work techniques & proceduresWork techniques & procedures Conditioning period Conditioning period Training Training Lifting techniquesLifting techniques Personal Protective EquipmentPersonal Protective Equipment
Analysis tools at work place / Applicable also in households !!
ChecklistsChecklists GGeneral Risk Analysiseneral Risk Analysis Computer Work StationsComputer Work Stations Hand Tool AnalysisHand Tool Analysis Hazard IdentificationHazard Identification Task AnalysisTask Analysis Workstation EvaluationWorkstation Evaluation
Program Elements
Program ElementsProgram Elements Management LeadershipManagement Leadership Employee ParticipationEmployee Participation Hazard IdentificationHazard Identification Hazard InformationHazard Information Medical Management Medical Management Program Evaluation Program Evaluation Record keepingRecord keeping
Management LeadershipManagement Leadership Assign responsibilities Assign responsibilities Provide authority, resources & Provide authority, resources &
informationinformation Examine existing policies Examine existing policies Take action to correct problemsTake action to correct problems Communicate regularly with Communicate regularly with
employeesemployees
Hazard IdentificationHazard Identification Reports of signs, symptoms &
hazards Recommendations from
employees & supervisors Records review of existing
safety & health records Routine facility safety & health
inspections
Information & TrainingInformation & Training Signs & symptoms Signs & symptoms Importance of early reporting Importance of early reporting Specific hazards & controlsSpecific hazards & controls Reporting MSDs & hazardsReporting MSDs & hazards How to recommend control methods How to recommend control methods Protective MeasuresProtective Measures Ergonomics program & their roleErgonomics program & their role OSHA standard requirements OSHA standard requirements
Employee InvolvementEmployee Involvement Report of signs, symptoms Report of signs, symptoms
& hazards& hazards
Hazard control Hazard control recommendations recommendations
Access to information Access to information
MSD ManagementMSD Management Prompt response Prompt response Work restrictions or other Work restrictions or other
measuresmeasures Prompt access to a health care Prompt access to a health care
professionalprofessional Written Medical OpinionWritten Medical Opinion Medical Follow-upMedical Follow-up
Program EvaluationProgram Evaluation MSD recordsMSD records Engineering ControlsEngineering Controls Administrative ControlsAdministrative Controls Work Practice ControlsWork Practice Controls OpinionsOpinions
RecordkeepingRecordkeeping Reports of MSD or hazardsReports of MSD or hazards Responses to employee Responses to employee
reportsreports Job hazard analysisJob hazard analysis Hazard control recordsHazard control records Ergonomics program Ergonomics program
evaluationevaluation MSD management recordsMSD management records
Forms
Program FormsProgram Forms MSD Symptom SurveyMSD Symptom Survey MSD Survey LocationMSD Survey Location New Equipment SurveyNew Equipment Survey Task Hazard Prevention WorksheetTask Hazard Prevention Worksheet Job Hazard AnalysisJob Hazard Analysis Job Task StepsJob Task Steps MSD Sign/Symptom ReportMSD Sign/Symptom Report MSD Hazard Controls LogMSD Hazard Controls Log Hazard Control ReportHazard Control Report
Solutions
The Solution to prevent MSD The Solution to prevent MSD work related Risk Factorswork related Risk Factors
What is Ergonomics?What is Ergonomics? the science of fitting jobs to the science of fitting jobs to
people. people.
–Ergonomics uses knowledge Ergonomics uses knowledge of physical abilities, limitations of physical abilities, limitations & human characteristics that & human characteristics that apply to job design.apply to job design.
Ergonomic DesignErgonomic Design considers the tasks, considers the tasks,
equipment & equipment & environment to environment to provide efficient use provide efficient use of worker capabilities of worker capabilities while ensuring that while ensuring that job demands do not job demands do not exceed those exceed those capabilitiescapabilities
ObjectivesObjectives You will be capable to
identify the most common MSD in the society identifying risk factors.
You will be also capable to identify strategies that help in the prevention and creation of suitable society for those patients.