Consideration for Stakeholders Regarding Hazard Identification and Risk Assessment as Part of the MSD Prevention Strategy for Ontario Richard Wells University of Waterloo .

Recommendations Ergonomic Sub-Committee Recommendations Included: Use a risk-based approach The method of assessing risk of injury or illness must be practical, relevant to the workplace, and easy to use, e.g. a checklist of risk factors, surveys. Common methodologies should be developed for use by all stakeholders and should be based on sound science and proven effectiveness. The method of assessing risk should consider the number of workers and work-task elements involved, in order to ensure a meaningful assessment.

Definitions Risk-Based Approach Hazard Identification Risk Assessment Based upon upstream indicators (hazards) rather than downstream (injuries) indicators. An approach based on a detailed evaluation of hazard and exposure potential at a particular site and risk when unacceptable levels are being exceeded Hazard Identification Determines whether or not (Y/N) a particular task/situation could cause an adverse effect -MSD Risk Assessment Incorporates number of steps, including hazard identification, to determine the probability that an adverse effect –MSD- could occur

Process Hazard Identification Risk Assessment Health and other Lagging Indicators Hazard Identification Hazard identification and risk assessment is part of a larger process Hazard or –ve Outcomes? N Y Risk Assessment Probability Unacceptable? N Y Control Strategy

Purpose The purpose of the hazard identification and risk assessment step in the OSHCO MSD Prevention Strategy for Ontario is to inform the prevention process. Prevention activities may span primary, secondary and tertiary prevention (return to work) activities The target for the process and tools are the Joint Health and Safety Committee members with special attention to medium to small companies.

Scientific Basis of MSD Hazard Identification There is very good evidence that MSDs have substantial work-related mechanical risk factors A common set of MSD risk factors have been identified by epidemiological studies Elevated levels of these risk factors are targets for control in primary, secondary and tertiary prevention activities Jobs and tasks with high levels of these risk factors exist in Ontario

Scientific Basis… While epidemiological studies have determined risk factors associated with increased risk of MSDs, the data does not permit estimation of the risk of developing MSDs for an individual

Use of Leading and Lagging Indicators A risk based approach should be used that identifies hazards before injuries occur; prevention activities should not wait for injury Simple checklists are limited in their ability to identify hazards and elevated risks therefore: if there are EITHER MSD hazards identified OR there exist MSDs and MSD related concerns, further assessment is required

Specification of Thresholds in Hazard Identification Approaches Strictly speaking, hazard identification is not possible because the physical hazards (forces, postures and repetition) are ubiquitous. A two step hazard identification and risk assessment process is really two risk assessments at different levels. A move to a single step process may be preferred, if possible

Specification of Thresholds… It is unreasonable to expect a simple checklist to accurately estimate the risk of developing MSDs because of multiple interacting risk factors, the difficulty of observing them, the large differences between workers and the relative lack of quantitative epidemiologic data on dose-response relationships

Specification of Thresholds… The physical hazards (forces, postures and repetition) are ubiquitous in workplaces and too sensitive (low) a threshold on a hazard identification tool will overwhelm a workplace with the requirement to perform further full risk assessments

Specification of Thresholds… While science cannot provide precise estimates of numeric thresholds for development of MSD’s, concrete benchmarks can be set that are informed by a variety of existing scientific evidence and may be justified to aid the OH&S system and workplaces in prevention activities

Levels of Action A three level approach is seen in many risk assessment approaches (e.g. ACGIH, Washington State and BC):

BC WSIB Provided Checklist Risk Classification ACGIH HAL/ Lifting BC WSIB Provided Checklist Washington State HSE UK GREEN: Nominal risk Action: Continue to monitor “ Conditions to which it is believed that nearly all workers may be repeatedly exposed without adverse health effects” YELLOW: Elevated risk Above Action Limit: require general controls; administrative controls including education and surveillance Moderate risk if above levels on MSI Risk Factor Identification: -Use Worksheet B -controls will be required -Education Caution Zone Job if above levels on Caution Zone: -Perform Hazard Zone checklist on risk factors found. If “YES” to any risk factors then a full risk assessment of the job to be done. ORANGE: Higher Risk Above Threshold Limit Value. Above the maximum recommended ergonomic exposure. –Put in place engineering controls High risk if above levels on MSI Risk Factor Assessment: Controls must be implemented without delay. Hazard Zone Job if above levels on Hazard Zone Worksheet: If a hazard exists, it must be reduced below the hazard level If “YES” to Risk Assessment Questions implement controls

Workplace Knowledge, Training and Resources Training and guidance material is needed to effectively use hazard identification approaches, including checklists Because identification of hazards requires observations of multiple workers interacting with their work environment, even evaluation of simple mono-task jobs can occupy substantial periods of time; risk assessment requires yet more resources

Workplace Knowledge… In general, tools that have been shown to be better related to MSD risk require substantial training and knowledge to use effectively. Existing, effective MSD prevention activities should be acknowledged

Risk Assessment The choice of a risk assessment approach depends on the situation being assessed and there is no one tool that is appropriate for all scenarios. While the outputs of some methods for MSD risk assessment have been shown to be related to MSD risk, they do not permit a clean separation of “safe” and “unsafe” jobs;

Future Development There is rapid improvement in the identification of risks factors and their quantitative relationship to MSD risk and the development and validation of risk assessment methods The purpose of this non-regulatory process in Ontario is to improve the prevention of MSDs: methods can relatively easily evolve as the scientific knowledge develops and workplace knowledge and skills develop