2. Musculoskeletal Disorders (MSDs) Control and Prevention

3. Objectives  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.

4. 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.

5. Musculoskeletal Disorders  MSD is an injury or illness to soft body tissue such as: MusclesMuscles NervesNerves TendonsTendons LigamentsLigaments JointsJoints CartilageCartilage Spinal DiscsSpinal Discs

6. Musculoskeletal Disorders include  Strains & Sprains  Soreness or Pain  Carpal tunnel syndrome  Connective tissue disorders

7. Musculoskeletal Disorders  are medical conditions that develop gradually over a period of time  do not typically result from a single instantaneous event.  do not typically result from a single instantaneous event.

8. MSDs are caused by BendingBending ClimbingClimbing CrawlingCrawling ReachingReaching TwistingTwisting OverexertionOverexertion Repetitive ExposureRepetitive Exposure

9. What are the Risk Factors?

10. Risk Factors  Work-related (applied also to household?) RF Environmental FactorsEnvironmental Factors Activity FactorsActivity Factors  Non work related RF Certain Medical ConditionsCertain Medical Conditions

11. Environment Risk Factors  Heat or cold  Lighting  Vibration  Tool design  Noise

12. Activity Risk Factors  Static or awkward postures  Improper gripping  Improper lifting  Repetitive Motion

13. Heat & Cold  Heat affects blood circulation & causes cramps, burns/rashes and general discomfort.  Cold affects the body's blood circulation, causes hypothermia, loss of flexibility, distraction and poor dexterity.  Comfortable temperature range 18-21°c (68 to 74 F)18-21°c (68 to 74 F) Humidity 20 – 60%Humidity 20 – 60%

14. Vibration  Excessive vibration causes pain to muscles, joints and internal organs  Soft tissue trauma to the hands, arms, feet and legs.

15. Lighting  Under & over lighted areas causes: HeadachesHeadaches Muscle strainsMuscle strains FatigueFatigue Eye strainEye strain  Poorly lighted areas also contributes to trip & fall hazards & poor coordination

16. Tool design  Handle shape  Control type  Control location  Vibration  Impact  Pressure

17. Noise  Noise peaks above 100 decibels cause: Headaches Increased blood pressure Muscle tension & fatigue Irritability & distraction

18. Force & Exertion  Forceful exertions place higher loads on the muscles, tendons, ligaments, and joints  Factors WeightWeight BulkinessBulkiness SpeedSpeed

19. Posture  Prolonged standing - varicose veins, back stress, pooling of blood in legs  Sitting without back support - low back stress  Seat too high - decreased circulation, (legs dangling over end) bruises

20. Posture  Shoulders rounded - Upper/lower back stress, respiratory distress  Leaning forward - Lower back stress  Arms extended or over-reaching - Stress to arm muscles, upper back stress

21. Posture  Elbows "winged" - Joint stress at shoulder, poor use of bicep muscles  Stepping backwards - Loss of balance, displaced gravity, muscle stress  Locking knees - Stress to back of knee, poor blood circulation  Bent Wrist – excessive force when gripping

22. Repetition  Frequent & prolonged repetition of the same movements cause muscle fatigue and stress  Factors that increase repetition hazards Number of cycles per minuteNumber of cycles per minute Force requiredForce required PosturePosture

23. Gripping  Factors that increase gripping hazards Bent wristBent wrist Surface areaSurface area Surface frictionSurface friction VibrationVibration Type of gripType of grip

24. Lifting  Factors that increase lifting hazards WeightWeight SizeSize RepetitionRepetition TwistingTwisting BendingBending ReachingReaching MethodMethod

25. Non-work Risk Factors  Certain Medical Conditions Such as: Rheumatic Arthritis, Diabetes, Obesity, Hormone Imbalances and Pregnancy.  Age  Spare time activities.

26. CONTROL MEASURES

27. Hazard Controls  Engineering Controls  Administrative Controls  Work Practice / household Controls

28. Engineering Controls  Re-design of work station  Re-design of tools  Lighting modification  Vibration control  Noise Control  Automation  Mechanical Lifting  Material Flow

29. Administrative Controls  Employee rotation  Job task enlargement  Adjustment of work pace  Redesign of work methods  Alternative tasks  Rest breaks

30. Work Practice Controls  Work techniques & procedures  Conditioning period  Training Lifting techniques  Personal Protective Equipment

31. Analysis tools at work place / Applicable also in households !!

32. Checklists  General Risk Analysis  Computer Work Stations  Hand Tool Analysis  Hazard Identification  Task Analysis  Workstation Evaluation

33. Program Elements

34.  Management Leadership  Employee Participation  Hazard Identification  Hazard Information  Medical Management  Program Evaluation  Record keeping

35. Management Leadership  Assign responsibilities  Provide authority, resources & information  Examine existing policies  Take action to correct problems  Communicate regularly with employees

36. Hazard Identification  Reports of signs, symptoms & hazards  Recommendations from employees & supervisors  Records review of existing safety & health records  Routine facility safety & health inspections

37. Information & Training  Signs & symptoms  Importance of early reporting  Specific hazards & controls  Reporting MSDs & hazards  How to recommend control methods  Protective Measures  Ergonomics program & their role  OSHA standard requirements

38. Employee Involvement  Report of signs, symptoms & hazards  Hazard control recommendations  Access to information

39. MSD Management  Prompt response  Work restrictions or other measures  Prompt access to a health care professional  Written Medical Opinion  Medical Follow-up

40. Program Evaluation  MSD records  Engineering Controls  Administrative Controls  Work Practice Controls  Opinions

41. Recordkeeping  Reports of MSD or hazards  Responses to employee reports  Job hazard analysis  Hazard control records  Ergonomics program evaluation  MSD management records

42. Forms

43. Program Forms  MSD Symptom Survey  MSD Survey Location  New Equipment Survey  Task Hazard Prevention Worksheet  Job Hazard Analysis  Job Task Steps  MSD Sign/Symptom Report  MSD Hazard Controls Log  Hazard Control Report

44. Solutions

47. The Solution to prevent MSD work related Risk Factors

48. What is Ergonomics?  the science of fitting jobs to people. –Ergonomics uses knowledge of physical abilities, limitations & human characteristics that apply to job design.

49. Ergonomic Design  considers the tasks, equipment & environment to provide efficient use of worker capabilities while ensuring that job demands do not exceed those capabilities

50. Objectives  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.