Develop an MSD Reporting System

There should be a method/system for employees to report MSD signs and symptoms and to get prompt responses. It may take either a formal or informal approach. Large employers may decide that a formal system of reporting that includes written documentation is appropriate to ensure that nothing falls through the cracks. Employers with fewer than ten employees, on the other hand, may find that oral reporting systems are adequate.

Your company probably has an injury and illness reporting system in place that can be adapted to accommodate MSD reporting. Regardless of how methods are tailored to meet the needs of a specific workplace and workforce, the process must be systematic and accessible to all employees.

A reporting system is important for a successful ergonomics program. In order for you to know that MSDs are occurring, employees must have a mechanism for reporting this information. A system that is well-known to employees is one way to ensure employee participation in the ergonomics program.

It's a good idea to designate at least one person to receive and respond to employee reports, and to take appropriate action. Depending on the workplace, that responsibility may be designated to front-line supervisors, a safety officer or safety committee, an occupational health nurse, or in small companies, the employer may encourage workers to report MSD signs and symptoms directly to him or her.

Build In-House Expertise

Training is recognized as an essential element for any effective safety and health program. For ergonomics, the overall goal of training is to enable managers, supervisors, and employees to identify aspects of job tasks that may increase a worker's risk of developing musculoskeletal disorders, recognize the signs and symptoms of the disorders, and participate in the development of strategies to control or prevent them. Training ensures that everyone involved is well informed about the hazards so they can actively participate in identifying and controlling exposures.

Ergonomics awareness training objectives should include:

• Recognize workplace risk factors for musculoskeletal disorders and understand general methods for controlling them.

• Identify the signs and symptoms of musculoskeletal disorders that may result from exposure to risk factors, and be familiar with the company's health care procedures.

• Know the process the employer is using to address and control risk factors, the employee's role in the process, and ways employees can actively participate.

• Know the procedures for reporting risk factors and musculoskeletal disorders, including the names of designated persons who should receive the reports.

Job analysis and control measures training objectives should include:

• Demonstrate the way to do a job analysis for identifying risk factors for musculoskeletal disorders.

• Select ways to implement and evaluate control measures.

Problem solving training objectives include:

• Identify the departments, areas, and jobs with risk factors through a review of company reports, records, walk-through observations, and special surveys.

• Identify tools and techniques that can be used to conduct job analyses and serve as a basis for recommendations.

• Develop skills in team building, consensus development, and problem solving.

• Recommend ways to control ergonomic hazards based on job analyses and pooling ideas from employees, management, and other affected and interested parties.

Training objectives are not intended to have workers, supervisors, or managers diagnose or treat ergonomic-related disorders. Rather, the purpose is to instill an understanding of what type of health problems may be work related and when to refer employees for medical evaluation. The training should include what is known about work and non-worker causes of musculoskeletal disorders and the current limitations of scientific knowledge.

Training should be understandable to the target audience and the materials used should consider the participants' education levels, literacy abilities, and language skills. This may mean providing materials, instruction, or assistance in languages other than English.

Open and frank interactions between trainers and trainees, especially those in affected jobs, are especially important. Employees know their own jobs better than anyone else and often are the source of good ideas for ways to improve them. At a minimum, employees must be given an opportunity to discuss ergonomic problems in their jobs as they see them and engage in relevant problem-solving exercises during the training.

Audit the Ergonomics Program

A comprehensive ergonomics program audit is also essential to periodically evaluate the whole set of safety and health management methods and processes to ensure that they protect against potential ergonomic hazards at a specific worksite. The audit determines whether policies and procedures are implemented as planned and whether, in practice, they have met the objectives set for the program.

Performing an audit will ensure that the overall ergonomics effort is consistent with the priorities and goals of your organization. Include accounting and engineering activities as well as safety in your audit. An ergonomic audit should focus on these areas.

• Identification of existing and potential problems.

• Ergonomic assessment of jobs with possible problems.

• Correction for and prevention of ergonomic problems.

• Medical management.

• Ergonomics training at all employee levels.

• Organizational issues and management.

When either performance or the objectives themselves are found inadequate, revisions to the program should be made. Without such a comprehensive review, its impossible to gage the effectiveness of the ergonomic controls you've implemented.

Risk Factors that Cause MSDs | Ergonomics

The physical stresses that can contribute to or cause MSDs are called "risk factors." The initial symptoms of MSDs may include fatigue, discomfort, and pain; as tissue damage worsens, other symptoms, such as weakness, numbness, or restricted movement, may also appear. Work-related MSDs occur when the risk factors that cause or contribute to musculoskeletal system pathology are associated with a person's job duties. Workplace musculoskeletal disorders are caused by exposure to the following risk factors:

Repetition

Doing the same motions over and over again places stress on the muscles and tendons. The severity of risk depends on how often the action is repeated, the speed of movement, the number of muscles involved, and the required force.

Forceful Exertions

Force is the amount of physical effort required to perform a task, such as heavy lifting or pushing/pulling, or to maintain control of equipment or tools. The amount of force depends on the type of grip, the weight of an object, body posture, the type of activity, and the duration of the task.

Awkward Postures

Posture is the position your body is in and affects muscle groups that are involved in physical activity. Awkward postures include repeated or prolonged reaching, twisting, bending, kneeling, squatting, working overhead with your hands or arms, or holding fixed positions.

Contact Stress

Pressing the body against a hard or sharp edge can result in placing too much pressure on nerves, tendons, and blood vessels. For example, using the palm of your hand as a hammer can increase your risk of suffering an MSD.

Vibration

Operating vibrating tools or equipment that typically have high or moderate vibration levels such as sanders, grinders, chippers, routers, drills, and other saws can lead to nerve damage.

Don't Wait to Start an Ergonomics Program

Data shows that employers with effective, well-managed ergonomics programs see significant reductions in the severity and number of work-related MSDs. These programs also generally improve productivity and employee morale and reduce turnover and absenteeism.

Even though OSHA's ergonomics standard has been rescinded, your workers' safety and health and rising workers' compensation claims are reason enough for you to carefully analyze your company's work environment, the equipment used, and the tasks performed from an ergonomics perspective. If you do not feel competent to make the evaluation, bring in outside assistance. There are various government and private agencies that are capable of doing a workplace analysis.

Common MSDs | Ergonomics

The most common MSDs in the workplace are tendon disorders such as tendinitis, tenosynovitis, De Quervain’s disease, trigger finger, Raynaud’s syndrome, and carpal tunnel syndrome. Tendon disorders often occur at or near the joints where the tendons rub against ligaments and bones. The most frequently noted symptoms of tendon disorders are a dull aching sensation over the tendon, discomfort with specific movements, and tenderness to the touch. Recovery is usually slow and the condition may easily become chronic if the cause is not eliminated.

Tendinitis

Tendinitis is tendon inflammation that occurs when a muscle or tendon is repeatedly tensed from overuse, vibration, or unaccustomed usage of the wrist and shoulder. With further exertion, some of the fibers that make up the tendon can actually fray or tear apart. The tendon becomes thickened, bumpy, and irregular in certain areas of the body, such as the shoulder, and the injured area may calcify. Without rest and sufficient time for the tissues to heal, the tendon may be permanently weakened. Tendinitis is common among power press operators, welders, painters, and assembly line workers in the automobile, appliance, and electronic production industries.

Tenosynovitis

Tenosynovitis is an inflammation or injury to the synovial sheath surrounding the tendon. These sheaths secrete synovial fluid which acts as a lubricant to reduce friction during movement. Repetitive motion using the hands and wrists may provoke an excessive secretion of synovial fluid, with the sheath becoming swollen and painful. Repetitions exceeding 1,500 to 2,000 per hour are known to produce symptoms associated with tendon sheath irritation in the hands. Tenosynovitis often affects workers in meatpacking and poultry processing. Also those whose tasks require buffing, grinding, sanding, sawing, and punch press operations.

DeQuervain's Disease

In DeQuervain’s disease, the tendon sheath of the thumb is inflamed. This disease is attributed to excessive friction between two thumb tendons and their common sheath. Twisting and forceful gripping motions with the hands, similar to a clothes-wringing movement, can place sufficient stress on the tendons to cause DeQuervain’s disease. Tasks involving these kinds of motions are frequently performed by butchers, housekeepers, packers, seamstresses, and cutters.

Trigger Finger

Trigger finger, another tendon disorder, is attributed to the creation of a groove in the flexing tendon of the finger. If the tendon becomes locked in the sheath, attempts to move that finger will cause snapping and jerking movements. The palm side of the fingers is the usual site for trigger finger. This disorder is often associated with using tools that have handles with hard or sharp edges or whose handles are too far apart for the user’s hand. Meatpackers, poultry workers, electronic assemblers, and carpenters are at risk of developing trigger finger.

Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS), a disorder affecting the hands and wrists, has probably received more attention in recent years than any other musculoskeletal disorder. CTS is the compression and entrapment of the median nerve where it passes through the wrist into the hand in the carpal tunnel. The median nerve is the main nerve that extends down the arm to the hand and provides the sense of touch in the thumb, index finger, middle finger, and half of the fourth or ring finger.

When irritated, tendons housed inside the narrow carpal tunnel swell and press against the nearby median nerve. The pressure causes tingling, numbness, or severe pain in the wrist and hand. The pain is often experienced at night. The pressure also results in a lack of strength in the hand and an inability to make a fist, hold objects, or perform other manual tasks. If the pressure continues, it can damage the nerve, causing permanent loss of sensation and even partial paralysis.

Carpal tunnel syndrome develops in the hands and wrists when repetitive or forceful manual tasks are performed over a period of time. Workers need to be aware of the symptoms and causes of CTS and what to do about them. Initially, they may have fatigue and pain which develops during the work day and disappears overnight with no physical symptoms. After a length of time, fatigue and pain develop earlier in the day, some physical symptoms such as clumsiness may occur which affect work performance, and there may be no overnight recovery.

When the case becomes full-blown, there is constant fatigue and pain with no overnight recovery and disturbed sleep results. At this point, work performance is inhibited to the extent of requiring off-duty time or light/restricted duty. Often workers do not associate their pain with their work because symptoms may only occur during evening or off-duty hours. When they finally seek medical help, surgery may be necessary and the road to recovery will take more time than anticipated.

Raynaud's Syndrome

Raynaud’s syndrome, or white finger, occurs when the blood vessels of the hand are damaged as a result of repeated exposure to vibration for long periods of time. The skin and muscles are unable to get the necessary oxygen from the blood and eventually die. Common symptoms include:

• Intermittent numbness and tingling in the fingers;

• Skin that turns pale, ashen and cold; and

• Eventual loss of sensation and control in the fingers and hands.

Raynaud’s syndrome is associated with the use of vibrating tools over time, such as pneumatic hammers, electric chain saws, and gasoline powered tools. After long-term exposure, the blood vessels in the fingers may become permanently damaged. This condition is also intensified when the hands are exposed to extremely cold temperatures.

There is no medical remedy for white finger. If the fingers are fairly healthy, the condition may improve if exposure to vibration stops or is reduced. Job activities that can lead to Raynaud’s Syndrome include chain sawing, jack hammering, use of vibrating tools, sanding, painting, and using a tool too small for the hand, often in a cold environment.

Other types of vibration may affect the entire body, producing overall fatigue and potential permanent damage. Vibration in conjunction with prolonged sitting may also result in degenerative changes in the spine. For example, drivers of tractors, trucks, buses, construction machinery, and other heavy equipment may suffer from low back pain, and permanent abdominal, spinal and bone damage.

Back Disorders

Pulled or strained muscles, ligaments, tendons, and disks are perhaps the most common back problems and may occur in almost half of the work force at least once during their lifetime. The majority of workplace back disorders result from chronic, or long-term injury to the back rather than from one specific incident. Only about four percent of back injuries are associated with a single traumatic incident.

Back disorders are frequently caused by the cumulative effects of faulty body mechanics:

• Excessive or repetitive twisting, bending, and reaching;

• Carrying, moving, or lifting loads that are too heavy or too large;

• Staying in one position for too long;

• Poor physical condition; or

• Awkward posture.

When back muscles or ligaments are injured from these repetitive pulling and straining activities, the back muscles, disks, and ligaments can become scarred and weakened and lose their ability to support the back, making additional injuries more likely.

Prolonged sitting stresses the body, particularly the lower back and the thighs, and may cause the lower back (lumbar) region to bow outward if there is inadequate support. This abnormal curvature (called kyphosis) can lead to painful lower back problems, a common complaint among office workers.

Other factors which are contributors to back injuries include the natural degeneration of the back due to aging, inactivity both at work and at home, seasonal activity undertaken without prior physical conditioning, stress, and vibration.