NEBOSH International General Certificate

in Occupational Safety and Health

Unit IG2

Element 6: Musculoskeletal Health

Learning Objectives

• Describe work processes and practices that may give rise to work-
related upper limb disorders and appropriate control measures.
• Describe the hazards and control measures which should be
considered when assessing risks from manual handling activities.
• Describe the hazards and controls associated with
load-handling equipment and the requirements for lifting operations.
6.1: Work-Related Upper Limb Disorders

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MSDs& WRULDs
• Musculoskeletal disorders (MSDs):
 A collection of injuries to the skeletal system
and the soft tissues associated with that system.
• Back injuries and back pain:
 E.g. back muscle strain, ligament damage and
disc injury.
• Work-Related Upper Limb Disorders (WRULDs):
 E.g. carpal tunnel syndrome and tenosynovitis.
• Other chronic soft-tissue injuries:
 Associated with sitting, standing or kneeling
for long periods of time at work.
High-Risk Activities/Repetitive Operations

Repetitive activities that involve significant

risk of musculoskeletal disorders:
• Display Screen Equipment (DSE) use.
• Keyboard operation.
• Factory assembly of small components.
• Supermarket checkout operation.
• Bricklaying.
Musculoskeletal Disorder Risk Factors

TASK FACTORS
Repetition EQUIPMENT
Force FACTORS
Posture Design
Twisting Adjustability
Rest

ENVIRONMENT
FACTORS
Lighting
Glare
Other factors,
e.g. temperature
Matching the Workplace to Individual Needs

Ergonomics is concerned with the

interaction between people and:
• The tools, equipment or machinery
that they are using.
• The workplace environment.
• Organisational factors.
A Typical Example: Display Screen Equipment

Risks:
• WRULDs.
• Back pain.
• Eye strain.
• Fatigue and stress.
The Control Measures

• Workstation assessment.
• Provide basic DSE workstation equipment
to minimum standards.
• Plan the work routine.
• Provide free eyesight tests and spectacles,
if required.
• Provide information and training on:
 Risks.

 Preventive measures.

 I.e. ergonomic use of the workstation.

The Control Measures
Additional points:
• Desk layout.
• Document holder.
• Workplace lighting.
• Telephone headset.
Specific measures for laptops:
• Short-duration work only.
• Docking station.
• Breaks.
• Eye test.
DSE Control Measures

• Workstation assessment.
• Provide basic DSE workstation equipment
to minimum standards.
• Plan the work routine.
• Provide free eyesight tests and spectacles,
if required.
• Provide information and training on:
 Risks.
 Preventive measures.
 i.e. ergonomic use of the workstation.
6.2: Manual Handling

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Manual Handling

The lifting, carrying,

pushing and pulling of a
load by bodily force.
Common Types of Manual Handling Injury

• Back injury – prolapsed disc.

• Tendon and ligament injuries.
• Muscle injuries.
• Hernias.
• WRULDs.
• Cuts, burns, dislocation and broken
bones.
Good Handling Technique
1. Before lifting:
3. Setting down:
• Check the load.
• Use the same
• Plan the route of the carry. principles as
• Establish a firm grip. lifting.

2. The lift: • Maintain good

balance.
• Bend the knees and use the leg
muscles to lift. • Set the load
down and then
• Keep the back upright. adjust its
• Keep the load close to the body. position using
body weight.
• Avoid twisting, overreaching,
jerking.
Assessing Manual Handling Risks

Four main factors:

• Task.
• Individual.
• Load.
• Environment.
The Task

• Height of load.
• Repetition of task.
• Carry distance.
• Stooping.
• Twisting.
• Rest breaks.
• Vertical distance.
• Above shoulder height.
• Overreaching.
The Load

• Weight.
• Size and bulk.
• Stability.
• Centre of gravity.
• Grip.
• Is it hot, sharp, etc.?
The Environment

• Space restrictions.
• Floor condition:
 Slippery?
 Uneven?
• Changes in floor level.
• Light levels.
• Temperature.
• Humidity.
Avoiding or Minimising the Manual Handling Risks

• Eliminate.
• Assess.
• Use handling aids.
• Modify the:
 Task.
 Load.
 Environment.
• Match individual capabilities to
the activity.
Avoiding or Minimising the Manual Handling Risks

• Automation.
• Mechanisation.
• Conveyor systems.
• Forklift trucks.
• Pallet trucks.
• Cranes.
• Hoists.
Avoiding or Minimising the Manual Handling Risks

• Trolleys.
• Barrel lifts.
• Gin wheels.
• Trucks.
• Hoists and lifts.
Avoiding or Minimising the Manual Handling Risks

The Task:
• Rest breaks or job rotation.
The Environment:
• Eliminate stooping or twisting.
• Rearrange workspace.
• Table lift.
• Level uneven floors.
The Load:
• Additional lighting.
• Smaller loads.
The Individual:
• Stabilise loads.
• Match individual capabilities to
• Mark centre of gravity. the activity.
• Attach handles.
• Several workers.

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6.3: Load-Handling Equipment

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Load-Handling Equipment

Caged Platform Two-Wheeled

Truck Platform Truck

Pallet Truck
Sack Truck
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Hazards & Controls for Manually Operated Load-Handling Equipment

Hazards:
• Manual handling risks (bodily force
is still needed).
• Instability of the load.
• Moving up, down or across slopes.
• Poor parking.
• Other pedestrians may be struck.
• Trapped feet.
• Trapped person being handled.
Hazards & Controls for Manually Operated Load-Handling Equipment
Controls:
• Trained workers only.
• Follow manufacturer’s recommendations.
• Avoid uneven ground and slopes.
• Use ramps over steps.
• Safe working load.
• Securing the load.
• Use the brakes (if fitted).
• Care when moving or lowering the load.
• Safe parking and storage.
• Routine inspection and maintenance.
• Safety shoes or boots.
People Hoists & Handling Aids

Patient hoists:
• Used for moving people:
 Can be manual or powered.
 Can be mobile or fixed.
• Consider the environment:
 e.g. difficult to push on
carpet.
• Regular inspection needed.
People Hoists & Handling Aids

Small handling aids:

• Slide sheets and transfer board slide
patient from trolley to bed.
• Avoid lifting the person.
Wheelchairs:
• Can be powered though most are
pushed.
Forklift Trucks

Hazards:
• Overturn of the truck.
• Fall of the load.
• Striking pedestrians.
• Fall or entrapment of
persons riding on forks.
• Fall from loading dock.
Forklift Trucks

Precautions:
• Restricting use.
• Visual inspection before use.
• Routine maintenance.
• Using proper working platform to lift people.
• Secure and stable load.
• Safe working load limits not exceeded.
• Speed limits.
• Never travelling with the forks raised.
• Never travelling with obstructed vision.
Forklift Trucks
Battery-Powered Trucks

Precautions:
Hazards:
• Charge batteries:
• Explosion from hydrogen
 In well-ventilated areas.
gas while charging.
 No ignition sources.
• Corrosive acid.
• Use PPE when handling
• Manual handling.
acid.
• Arcing, shock, burns or
• Mechanise battery handling.
fire.
• Electrical safety:
• Environmental - battery
 Insulated tools.
disposal.
 Gloves.

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Forklift Trucks

Diesel-Powered Trucks

Hazards: Precautions:
• Dermatitis from the diesel. • Use in well-ventilated
• Slip hazards. areas.

• Environmental pollution • Spill kits.

from large spills. • Use gloves when handling
• Toxic exhaust fumes. diesel.

• Bulk storage of diesel.

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Forklift Trucks
Liquefied Petroleum (LPG)-Powered Trucks
Hazards:
• Explosion risk from LPG.
• Toxic exhaust fumes.
• Manual handling.
• Storage of LPG cylinders or bulk.
Precautions:
• Use in well-ventilated areas.
• Mechanise LPG cylinder handling.
• Store spare cylinders in a:
 Secure.

 Safe.

 Well-ventilated location.

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Lifts and Hoists
Hazards:
• Falling objects.
• Being struck by the load.
• Entanglement in moving parts.
• Falls from height.
• Being struck while riding on the platform
of the lift by:
 Landing levels.
 Parts of any enclosure.
 Other projections.
Lifts and Hoists
Precautions:
• Suitable for its intended use.
• Preventing people getting:
 Underneath the hoist or lift platform.

 Access to an unprotected landing edge.

 Struck by landings or other obstructions

when being carried on the platform.
• Maximum safe working load.
• Safety devices, e.g. brakes working.
• Competent operators.
• Information, instruction and training.
• Routine maintenance.
• Routine inspection and thorough
examination.
Conveyors

Hazards:
• Drawing-in hazards at in-
running nip points.
• Entanglement with rotating
parts.
• Falling objects:
 Especially from
overhead conveyors.
Conveyors
Precautions:
• Alarms to warn of start of movement.

• Guards on moving parts.

• Emergency stops/pull-cords.
• Exclude people from area.
• Guards beneath overhead conveyors to
catch falling objects.
• Information, instruction and training form
operators.
• No loose clothing/long hair/jewellery.
• Inspection and maintenance.
• Defect reporting.
Cranes

Hazards:
• The crane collapsing or toppling
over.
• The arm (boom or jib) striking
structures.
• Falling load.
• The load striking objects or
people.
• Contact with live overhead
cables.
Cranes

Factors causing instability:

• Overloading.
• Uneven or unstable ground.
• Not using outriggers correctly.
• Use in high winds.
• Extending the jib or boom too far.
• Structural failure.
Requirements for Safe Lifting Operations

General requirements:
• Suitable for the task and appropriately
rated.
• Equipment stable and secure.
• Visibly marked with Safe Working
Load (SWL).
• Lifting operations planned, carried out
and supervised by competent persons.
• Equipment for lifting persons may
require additional inspections.
Requirements for Safe Lifting Operations

• Planning and preparing the

lift:
 Risk assessment by
competent person.
 Check crane test records.
 Trained operators.
 Correct type for the job and
terrain.
 Load within safe lifting
capacity.
Requirements for Safe Lifting Operations
Carrying out the lift:
• Careful siting.

• Use outriggers correctly.

• Plan and supervise lifts.

• Banksman (signaller).

• Overload indicators work.

• Check weather conditions.

• Use PPE (hard hats, gloves, high visibility,

boots)
• Warning signs.

• Attach slings carefully.

• Carry out a test lift.

• Guide using tag lines.

Requirements Statutory Examination of Lifting Equipment

Examples from EU/UK: Lifting Operations and

Lifting Equipment Regulations 1998 (LOLER)
Thorough examination:
• Before it is used for the first time.
• Periodically.
• After an event that may have affected its strength
and stability.
Frequency of thorough examination:
• every 12 months - where not used to carry
people,
• every 6 months - where used to carry people,
• every 6 months - lifting accessories, by a
competent engineer.
Summary

In this element, we have:

• Defined ergonomics, identified the MSDs associated with poor work
design and identified factors that influence ergonomic risk.
• Described the application of ergonomic principles to DSE use.
• Outlined the main types of injury associated with manual handling as
MSDs and WRULDs.
• Described the four main factors that have to be considered during a
manual handling risk assessment: the task, individual capabilities, the
load and the environment.
Summary

• Explained how risk associated with manual handling can be

controlled.
• Noted the basic principles of safe lifting technique before the lift,
during the lift and when setting down.
• Considered the hazards and safety precautions associated with
different types of lifting and moving equipment.
• Outlined the typical hazards.
• Outlined the general precautions.
• Explained how lifting equipment should be routinely inspected
and subjected to thorough examination by a competent engineer.