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

2. 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.

3. 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

4. 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

5. 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.

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

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

14. 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

15. 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

16. 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

17. 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;

18. 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