|
| OSHA's Advisory
Committee on Construction Occupational Safety and Health prepared
this document as part of the continuing debate on whether to produce
an ergonomics standard to prevent work-related musculoskeletal disorders.
The recommendations were originally posted on the OSHA website, at
www.osha.gov, in
August 1999. |
Most injuries in
construction workers are sprains and strains of the muscles. Construction
work can also cause injuries to the joints, bones, and nerves. These injuries
often occur from constant wear and tear on the body. Taken together these
injuries are called musculoskeletal disorders. Generally, musculoskeletal
disorders in construction workers affect the hand and wrist, the shoulders,
neck and upper back, the low back, and the hips and knees.
There are a number of
well-known diagnoses of musculoskeletal disorders. They include:
- Carpal Tunnel
Syndrome, a problem of the nerve in the hand and wrist, caused by
repeated bending of the wrist, holding tools or materials tightly, constantly
pressing the wrist against a hard object. Classic symptoms include:
numbness, tingling, burning and pain. In severe cases, there may be
wasting of the muscles at the base of the thumb; dry shiny palm; clumsiness
of the hand.
- Raynaud’s
Syndrome or White Finger Disease, a problem of the nerves and blood
vessels in the hands often caused by use of vibrating hand tools. Workers
have numbness and tingling of the fingers, often brought on by cold
weather. Fingers turn pale white, then blue and then red. Numbness and
weakness prevent a good grip and interfere with the ability to work.
Smoking can aggravate this condition by decreasing oxygen available
to the fingers.
- Tendinitis,
an inflammation and soreness in tendons, caused by repeated movement
of a joint. Depending on where the injury occurs, a different name is
assigned to the disease. Common tendinitis problems include : Tenosynovitis
(usually in the wrist), Trigger finger (palm side of any finger other
than the thumb), De Quervain’s Disease (tendons in the thumb),
Epicondylitis (tennis elbow). Symptoms include a burning pain or dull
ache, swelling or puffiness, snapping or jerking movements (crepitus),
Ganglionic cysts (a thick mucuous fluid which can form within a tendon
sheath). Tendonitis is associated with work that requires repetitive
motions like using a staple gun (asbestos abatement workers), rotating
or twisting motions (screw driving). Tools that are tool small or too
large for the hand can also put stress on the tendons.
- Thoracic Outlet
Syndrome, a problem caused by reduced blood flow in the shoulder
and arm caused by overhead work or carrying heavy items in the hands
with the arms straight down.
- Carpet Layers’
Knee, caused by repeated use of a knee kickers while laying carpeting
- Back Pain,
caused by repeated lifting of materials, by sudden movements, whole
body vibration, lifting and twisting at the same time, bending over
for long periods of time. Back problems, which seem to appear overnight,
may have been building up slowly over a period of time.
- Degenerative
disc disease is caused by damage to the gel-like cushions between
the spinal vertebrae or bones. Released gel presses on the nerve. Symptoms
of this disorder include numbness, pain and weakness, usually in the
leg and hips, but sometimes in the arms and upper back.
Of course there are
many other types of musculoskeletal injuries and problems, including strains
and sprains, muscle and joint pains, broken bones, etc., which may be
related to work on the construction site. A sprain is an injury or
tear to a ligament. Ligaments attach one vertebrae to another and
help support the spine. Strains is an injury to muscles that have
been stretched or used too much. Strained muscles and sprained ligaments
both irritate the muscles around them. This adds to the pain and discomfort.
Different types of
construction work are often associated with different types injuries.
For example, workers who do overhead work, such as painters and sheet
metal workers, tend to have many more shoulder and neck problems. Trades
at the highest risk of shoulder problems include: scaffold erectors, insulators
and painters Workers who work at floor level and kneel while working,
like floor layers and roofers, sheet metal workers and insulators have
many more knee problems. Other trades which kneel a lot and have a higher
risk of knee injuries include roofers and carpenters. Carpenters and other
trades that require constant use of hand tools, have more hand and wrist
problems. Tendinitis in construction workers is most common among roofers
and sheet metal workers and masons. It is also well known among rodmen
who twist wire ties have ganglionic cysts (often called bible bumps) on
their wrists. Raynaud’s Syndrome is common among workers like lumberjacks,
jack hammer users and others that use vibrating hand tools. Carpal tunnel
syndrome has been reported in carpenters, electricians and sheet metal
workers. Working as a laborer or scaffold erector where heavy lifting
and carrying is common, is associated with back problems. Each of these
types of work expose the construction worker to a different type of risk
factor. Risk Factors are activities, actions, conditions or exposures
that can increase your chance (risk) of developing a musculoskeletal disorder.
There are some differences in the risk factors that are associated with
musculoskeletal disorders of the hands, wrist, neck and shoulder also
known as the upper extremities, the back, and the hips, knees, ankles
and feet or the lower extremities.
Risk factors for
musculoskeletal disorders of the hands, wrist, neck and shoulder may include:
- Forcefulness
or muscle effort.
- Awkward body
posture.
- Repetitive work.
- Vibration from
hand tools.
- External contact
stress from tools and sharp objects.
Each of these risk
factors is discussed in detail below.
1. Forcefulness
or Muscle Effort
Force is the amount
of effort it takes to do an activity or work. Pushing, pulling, gripping
a tool are examples of activities that require you to exert force or muscle
effort. Keeping your body in one position for a period of time (for example,
doing overhead work) also requires muscle effort. The more force you
have to exert, the greater the stress on your body.
The type of grip
you use also makes a difference in the amount of effort you have to use.
A pinch grip which uses only the fingers to hold an item, requires
more muscle effort than a power grip. A power grip (full-hand grip),
which uses the larger muscles of your arm, has about four times the strength
of a pinch grip. A pinch grip can cause fatigue and injury.
The position
of your hands and arms in relation to your body will also affect the amount
of force you need to exert. If your wrists are bent downward, backward,
or to one side or the other you will need to use more force to do your
work. The more time you spend with your wrists bent while working and
exerting muscle effort, the greater your risk of developing a musculoskeletal
disorder.
A slippery handle
or a handle with a small diameter is hard to hold, so you tend to grip
it more tightly (apply more force). When your hands and fingers are cold,
you grip tools more tightly to control them.
Gloves which
are too tight or too loose or made of certain materials (some chemical-resistant
gloves) make you grip tools more tightly. However, it is important to
remember that gloves are an important part of Personal Protective Equipment
(PPE) and should be worn when required.
2. Awkward Body
Postures
Think about the most
comfortable working posture for your neck, shoulders, arms, wrists and
hands. Your shoulders are down and relaxed, your arms are close to your
sides, elbows bent and wrists and hand straight, almost as if you were
going to shake hands with someone. This is called a neutral posture. When
your working posture is out of the neutral position, the stress on your
joints, muscles, tendons, nerves and blood vessels is increased.. The
amount of muscle effort is also increased and your risk of fatigue and
injury also increases. It takes more muscle effort to work at eye
height than to work at elbow height. Working with your arms raised is
a very awkward posture which puts stress on the muscles, tendons and joints
of your arms, hands and shoulders. Working at elbow height also allows
you to use your body weight to push the tool being used.
3. Repetitive
Work
Nailing a deck and
screwing drywall are examples of repetitive tasks. Doing the same motions
over and over again puts stress on muscles, tendons and joints.
4. Vibration from
Hand Tools
Damage to the blood
vessels and nerves in your hand and fingers can result from the long term
use of powered hand tools. Rotary hammers, chainsaws, grinders and jackhammers
all cause vibrations to travel through the hand. The risk of conditions,
such as Raynaud’s Syndrome, from powered hand tools is increased
if you are also exposed to cold, because the cold causes you to use a
much tighter grip on the tool.
5. Contact Stress
(Tools and Sharp Objects)
Tools and materials
(wood, metal) can press against the soft part of the palm of your hand
or other soft tissues of your body. When tools or sharp edges press into
the palm of your hand, they can press on or compress the soft blood vessels
and nerves in your hand. When blood vessels are compressed, the amount
of blood that gets through to the tissues is reduced. Compressed nerves
can cause numbness and tingling. Continuous compression may cause irreversible
damage to the blood vessels, nerves and surrounding tissue.
There are a number
of common risk factors associated with injuries to the back. They include:
- Lifting
- Pushing, pulling,
tugging
- Twisting, reaching,
sideways bending, unequal lifting
- Working in a
single position
- Whole body vibration
1. Lifting
Lifting is a forceful
movement requiring energy and muscle effort. It stresses muscles, tendons
and ligaments and increases forces on your spine. This is true even if
you use proper lift techniques. If you bend from the waist and lift at
the same time, the forces on your spine are increased even more. This
is also true if you reach, twist or hold the object away from you body
as you lift. Using one arm to lift an object or carrying and object on
one shoulder or one hip also places extra (and uneven) stress on the spine.
Factors that affect the stress of a lift on the back and other parts of
the body include:
- Size and weight
of the object. If the object is too big or bulky you won't
be able to do a squat lift (bent legs, straight back). If you have to
bend from the waist to lift an object, the stress on your lower back
is three times greater than if you lift with a straight back.
- Horizontal
distance of the lift. If you hold the object away from your body,
with your arms out in front of you, your back muscles have to work much
harder to hold the object. When the object is held away from your body,
the forces on your lower back increase. Lifting with the load away from
your body also puts stress on your arms and shoulders.
- Vertical distance
of the lift. Try to keep the vertical distance of lifts between
knuckle and shoulder height. The lift should not start below knuckle
height nor end above shoulder height. Lifting from below knuckle height
puts stress on the legs and knees as well as on the back. Lifting above
shoulder height puts stress on the upper back, shoulders and arms.
- Twisting or
bending done at the same time as the lift. Bending or twisting while
lifting greatly increases the stresses on the spine over a straight
lift.
- Amount of
lifting. Repeated lifting , even lift light loads may cause localized
muscle fatigue or whole body fatigue. Fatigue increases the risk of
accident and injury. Frequent lifting also puts stress on the discs,
tendons and ligaments of the back.
2. Pushing, pulling,
tugging and sliding
- Pushing, pulling,
tugging and sliding objects require muscle force or effort. They put
a strain on your lower back. They also stress the muscles, tendons and
joints of your shoulders, arms, upper back and legs. The amount of force
these movements require depends upon:The amount of force you use to
pull or push the object.
Pushing uses less force and allows you to use your own upper
body weight.
- Body posture while
pushing or pulling. If you are in an awkward posture you will have to
exert more force to move the object.
- Condition of
the walking surface.
High friction
between the object and the surface, for example over gravel, causes
you to exert more force or push harder to move the object. Slippery
surfaces reduce the amount of traction, leading to the possibility
of slips and falls.
- Slope of the
work surface
The greater the
slope the harder it is to push the item.
- Weight of the
object
- Position of the
object.
3. Twisting, Reaching,
Sideways Bending, Unequal Lifting
Any amount of twisting,
reaching or bending while lifting causes more stress on the back.
- Reaching upward
usually causes you to arch your back. This increases the forces on the
lower spine. It also puts stress on the upper back, shoulders and arms.
- Forward reaches
that are longer than the length of your arm and require you to bend
or stretch put stress on your lower back and on your legs.
- Bending sideways
or twisting your trunk puts stress on your lower back.
- Carrying an
object on one shoulder, arm, hand or hip puts more stress on one
side of the spine.
Remember:
The more reaching, twisting, sideways bending and unequal lifting/carrying
you do, the greater your risk of back injury.
4. Working in
a Single Position (static postures)
Working in one position
for an extended period of time causes muscle fatigue. Bending over, leaning
forward, and/or working with arms above shoulder height for a period of
time stresses the lower back, neck and shoulders. Even sitting for long
periods causes back fatigue.
If you have already
have low back pain, constant standing can be painful. Putting inserts
in your boots and standing on padding rather that hard ground or concrete
may help. It's important to move around, change positions and rest your
muscles as often as possible.
5. Whole Body
Vibration
Whole body vibration
is mainly a problem for heavy equipment operators and truck drivers. Over
time, certain types of vibration can cause little changes (cumulative
traumas) in the spine that can build up until there is permanent damage.
Other risk factors
contribute to the development of musculoskeletal disorders on the site.
The include:
- Floor surfaces
and obstacles in the work area & House keeping Practices
- Height of the
work
- Working beyond
your capacity
- Lifting techniques
- Tool belts
- Temperature
1. Floor surfaces
and obstacles in the work area & House keeping Practices
Good housekeeping
practices are important to reducing musculoskeletal disorders
- Mud, wet, oily
surfaces and poor housekeeping are serious slip, trip and fall hazards.
- Materials, wires,
power cords and tools on the ground are common causes of slips and trips.
Slips and trips cause back injury.
- Reaching over,
under or around an object or barrier increases the stresses on the lower
back..
2. Height of the
work
Work areas not designed
so that both tall and short people can work comfortably are a problem
for each:
- Tall people may
need to bend over to stoop to do certain jobs. This increases the stress
on their lower spines and tires their muscles.
- Shorter people
may need to reach up to do a job. Bending backwards while reaching up,
increases the pressure on the lower spines. Working with raised arms
can also cause fatigue and shoulder, neck and elbow problems.
3. Working beyond
your capacity
Being physically
fit has many advantages but strong muscles and fitness do not necessarily
protect the spine from injury. Lifting affects spinal discs no matter
how fit or strong you are.
It is important
to remember that everyone has limitations. Working beyond our limitations
puts all workers at risk for injury.
4. Lifting techniques
Lifting involves
many different muscle groups. Lifting from the ground to waist level uses
muscles of the leg and thigh. Lifting between the waist and the shoulder,
uses mostly back muscles. Lifting above shoulder height uses muscles of
the upper back and shoulder. Most of us have been taught that the proper
lift technique is the squat lift with the knees bent and back straight.
A squat lift puts stress on the lower leg, knees and thighs. It also requires
a lot of energy.
The proper lift depends
more on the size and shape of the object you are lifting than of
any set technique. If an object is too big or bulky you may not
be able to hold it against your body as you lift. When you hold an object
away from your body, the forces on your spine increases. This happens
no matter what lift technique you use.
People who do a lot
of lifting will often lift freestyle rather than squat. Freestyle (what
most of do when no one is watching back bent, legs almost straight) puts
more stress on the back but requires less energy than squat lifting.
It is important to
be careful about the way you lift. No matter how you lift, if the object
is too heavy, back injury may occur. The best way to prevent back
problems is to eliminate or reduce the need for heavy lifting.
5. Tool Belts
Wearing a tool belt
which can weigh anywhere from 25 to 60 pounds puts stress on the lower
back and hips. Adding suspenders to your tool belt can help redistribute
the weight, but it requires adjustment until you get the shoulder-waist-hip
distribution that's best for you. Suspenders can also cause shoulder discomfort.
The best strategy is to reduce the weight of your tool belt. If you don't
need it, don't carry it.
6. Temperature
Cold can increase
the risk of muscle strain. Muscles tend to tense muscles when it is cold;
this makes strain more likely. (Note: Add the OSHA Cold Stress card
as an appendix or the URL if on the Web Site)
Heat Stress
is a concern when working in hot or humid environments. Heavy physical
work raises your body temperature. Heavy work in hot environments can
lead to a series of problems including dehydration, heat cramps, confusion,
heat exhaustion and heat stroke, which is life threatening.(Note: Add
the OSHA Heat Stress card as an appendix or the URL if on the Web Site)
Non-Work-Related
Risk Factors for Musculoskeletal Disorders
Some risk factors
for musculoskeletal disorders have nothing to do with work. Certain medical
conditions such as rheumatoid arthritis, diabetes, hormone imbalances
and pregnancy can increase your chances of getting some musculoskeletal
disorders. Your general health and age as well as spare-time activities
may also play a part in the development of musculoskeletal disorders.
If you work for yourself or on your own house in the evening and weekends,
chances are you are being exposed to some of the same risk factors you
face on your job. Even if your free time activities are very different
from your work activities they may involve similar risk factors, such
as repetitive actions, mechanical stress or awkward postures. If, for
example, you're a pitcher during softball season, play a lot of tennis,
or have hobbies which involve fine precision work (carving, model-making)
you may be exposed to risk factors of musculoskeletal disorders. .
Remember that
the greater the number of risk factors you are exposed to, the higher
your risk of developing musculoskeletal disorders. The longer your exposure,
the higher your risk.
In most cases, the
cause of musculoskeletal disorders can traced body movements and the demands
of the job. Given the physical nature of construction jobs, it is not
surprising that many complain of back, shoulder, or knee problems. Many
of these conditions could be prevented if we reduce the amount of awkward,
heavy, repetitive activities required by the job. While construction jobs
will never be like desk jobs (and who would want that anyway?), they can
be made to be safer.
Elements of a
Good Health and Safety Program
Successful programs
aimed at reducing musculoskeletal disorders have six essential elements.
Your program may include more elements. The six essential elements include:
- Management commitment
and employee participation.
- Hazard awareness
and identification.
- Job hazard analysis
and solution development.
- Training.
- Medical management
and alternative duty.
- Program evaluation.
Management Leadership
and Employee Participation
Management commitment
to control and reduce work-related musculoskeletal disorders starts at
the top and must run through every level in the organization. The commitment
includes assigning program responsibilities and the authority to those
that run the program, providing adequate financial, personnel and material
resources, analysis of the worksite activities and infrastructure to identify
risk factors and hazards, information dissemination, training and medical
management.
The most effective
solution to reducing safety and health hazards on the construction site
is a combination of leadership and worker involvement. Involved employees
provide input and report the presence of risk factors on the site, report
symptoms and injuries, suggest and design solutions and provide the central
resource for maintaining a risk free project. If there is a functioning
safety committee on your project, control and prevention of musculoskeletal
disorders should be one of its areas of concern. If there is no committee,
consider forming one to address musculoskeletal disorders and other safety
and health concerns on your project..
Hazard Awareness
and Identification
Superintendents,
foremen and workers must be aware of risk factors and hazards on their
jobs and in their work environment that lead to musculoskeletal disorders.
A key component of a successful program is the ability of the workforce
to learn, identify and report the risk factors, hazards, signs and symptoms
of musculoskeletal disorders. Skills in hazard awareness are developed
through training programs and hands-on practice. There are many programs
and free materials available in print and on the web that can help in
this training. Information on where to get some of this information is
included in the back of this manual.
Job Hazard Analysis
and Solution Development
A Job Hazard Analysis
helps find what risk factors or hazards exist on the job site. Careful
evaluation of the job site identifies risk factors and hazards; use of
checklists help record your observations for further examination. Several
check lists for recording risk factor and hazards are included in this
manual. Once the risk factors, hazards and injuries are identified and
recorded, the safety and health committee, in collaboration with management,
contractors and workers, have the facts to develop solutions, e.g., improve
site housekeeping through the alteration of material delivery schedule,
use self-raising platforms or buddy system for lifting, etc. Some general
solutions are listed below.
Training
Training provides
the basis for consistent awareness, identification, analysis, targeting
and control of musculoskeletal disorders hazards. The training should
reach workers, foremen, and superintendents as well as others participating
in the musculoskeletal disorders control program at no cost to them.
Medical Management
and Alternate Duty
The key to rapid
successful return to health, duty and productivity is prompt access to
health care for assessment, treatment and follow-up. The longer a worker
is away from work the less likely the worker will return. Replacement
of a skilled workers is expensive or, at times, difficult to impossible.
It is a benefit to workers and employers to bring an injured worker back
to alternate or reassigned duties as soon as medically appropriate.
Program Evaluation
Evaluating the effectiveness
of a program is just as important as instituting the program. Is your
program reducing musculoskeletal disorders, hazards and risks? Does an
initial upsurge in musculoskeletal disorders reporting mean your project
became less safe because of the program?
Does this upsurge
mean that a hidden population of injured workers has gotten treatment
and will be returned to a healthier level of life and productivity? Have
you successfully identified and targeted your musculoskeletal disorders
hazards? Program evaluation will help answer all these and more questions.
Checklists are useful
tools for determining the presence of symptoms, hazards and risk factors
of musculoskeletal disorders at your work-site. Checklists are a way of
collecting the same kind of information each time you look at a site.
They also serve as reminders to look at the most important activities
related to musculoskeletal disorders on the site.
The following checklists
are sample approaches to learning about hazards on your work-site, identifying
solutions and how well your prevention program is working. These kinds
of checklists can be changed to suit your worksite or your personal styles.
Worksite Evaluation
Checklist
Why should
I fill out the checklist?
This checklist is
intended to help develop an "eye" for musculoskeletal problems
and to prevent injuries.
Who fills out
the checklist?
Jointly updated by
contractors and workers or their representatives
How often do
I update the checklist?
Every 2 weeks or
as a site changes. Changes may include but are not limited to weather
conditions, introduction of new workers on the site, new materials, change
in operations, new phase of the project, etc.
Do I need to
fill out the entire checklist?
Each time the checklist
is updated fill out the Job Site Information Section. Some parts
of the checklist may not apply to your kind of work. Fill out what applies
to your job or site activities.
Job Site Information
Date: _________________
Site: ___________________________________________ General Contractor:
_____________________________________________________
Subcontractor: _________________________________________________________
Worker/Representative: __________________________________________________
Name / Signature: ______________________________________________________
(Person filling out this form)
List those tools
and materials weighing over 20 lbs that are lifted by hand. These might
include bricks or blocks, drywall, plywood, rebar, structural iron, roofing
materials, forms, jack hammers, tampers, saws, pneumatic wrenches or anything
over 20 lbs. Fill out the box
Tools/materials
over
20 lbs |
Jobs
where lifting
occurs |
Job
titles |
Possible
solutions to
lifting |
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
List the materials
and tools weighing over 50 lbs that workers lift without assistance; how
often do they perform these lifts each day. Fill in the box below.
|
Job
title
|
Item
being lifted over 50 lbs
|
#
times/day
|
Possible
Solution
to eliminate lift
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
Are there handles
for materials that must be carried? Yes____ No____
If there are no handles,
why?
How can handles be
easily installed?
If there are handles,
are the handles easy to use and comfortable? Yes____ No____
Are workers encouraged
to get someone's help to lift heavy materials?
Yes____ No____
Why not? _______________________________________________
Are dollies, hand-trucks,
wheelbarrows or other assists available for moving materials?
Yes____ No____
Why not? _________________________________________________
If dollies, hand-trucks,
wheelbarrows or other assists are available, are they being used?
Yes____ No____
Why not? _________________________________________________
Are materials delivered
as close as possible to where they will be used?
Yes____
No____ How can the delivery schedule be changed?
What jobs cause workers
to lift overhead? Fill in the box.
|
Job
title
|
Item
being lifted
|
#
times/day
|
Possible
Solutions to reduce lift
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
Are materials stored
on walking or working surfaces?
Yes____ Do workers have to bend down to pick up or lift materials? Yes____
No____ No____
Could the materials
be stored at waist height?
Yes____
No____
Why not?________________________________________________________
Which tasks do workers
have to reach far to pick up or lift materials? Fill in the box.
| Job title |
Item being lifted |
# times/day |
Possible Solutions
to reduce lift |
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
Tools
Are tools kept sharp
and in good condition?
Yes____
No____
Why not?____________________________________________________
What can be done
to improve tool maintenance?________________________________
What tools weigh
more than 20 lbs? Fill in the box.
| List
tools more than 20 lbs |
Who
uses them |
Alternative
tools less than 20 lbs |
| |
|
|
| |
|
|
| |
|
|
| |
|
|
What hand tools use
on site vibrate? Fill in the box.
|
List
hand tools that vibrate
|
Who
uses them
|
Ways
to reduce vibration
exposure
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
What hand tools have
to be used in awkward postures or in difficult positions? Fill in the
box
|
List
hand tools
|
Who
uses them
|
Ways
to reduce awkward
postures
|
| |
|
|
| |
|
|
| |
|
|
List the hand tools
that have poor handle designs, grips that are too big or small, blow cold
air on the workers' hands or have chilled handles. Fill in the table
| List
hand tools |
Who
uses them |
Check
the problems the tool has |
Possible
solutions |
| |
|
bad
design |
grip
size |
cold
air |
chilled
handles |
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
Repetitive Work
List the jobs that
require motions be repeated many times for 1 hour or are repeated throughout
the workday? Can the repetitions be reduced by job rotation or rest breaks?
Fill in the box.
Job
description |
Job title of
workers |
Describe
repeated
motions |
Repeated
many times
for 1 hour?
(yes/no) |
Repeated
throughout
the day?
(yes/no) |
Rest breaks
possible?
(yes/no) |
Job rotation
possible?
(yes/no) |
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
Awkward Postures
List the jobs that
require work at shoulder height more than 1 hour per day; jobs that require
overhead work more than 1 hour per day? Can scaffolds, platforms or other
equipment reduce work above shoulder height?
| Job description |
Job title of
workers |
Work at
shoulder
height for 1
hour or more
(yes/no) |
Overhead
work for 1
hour or more
each day
(yes/no) |
Scaffolds,
platforms, etc.,
possible
(yes/no) |
Other
solutions? |
| |
|
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
Kneeling
List the jobs that
require or kneeling for more than 1 hour a day? Are kneepads or cushions
available? Are the pads or cushions being used? Fill in the box.
| Job description |
Job title of
workers |
Kneepads or
cushions
available
(yes/no) |
Kneepads or
cushions used
regularly
(yes/no) |
Equipment
available to
reduce
kneeling? |
Other
solutions? |
| |
|
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
Working in one
posture or position for a long period
List the jobs that
require workers to stay in one position for a long time. Fill in the box.
| Job description |
Job title of
workers |
Possible solutions |
| |
|
|
| |
|
|
| |
|
|
| |
|
|
Twisting, Turning,
Bending
List the jobs that
require a lot of twisting, turning or bending. Are there ways of reducing
twisting, turning or bending? Fill in the box
| Job
description |
Job
title of
workers |
Check
the motion the job requires |
Possible
solutions |
| |
|
Twist |
Turn |
Bend |
Combination |
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
Surfaces for Walking
and Working
List the jobs where
the working and walking surfaces are not clean and dry; obstructed; uneven
or not level. How can the surfaces be improved? Fill in the box.
|
Location
of Working or Walking Surface
|
Condition
of Work Surface
Check all that apply
|
Ways
to reduce or fix the condition
|
| |
Wet/
slippery |
Obstructed |
Uneven |
Steep
slope |
Other
condition(s)
(list) |
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
Worksite Lighting
Conditions
List the work areas
that are lit with artificial lighting. Is there enough light to do the
work? To see materials being moved? Are walking surfaces adequately illuminated?
Do shadows restrict visibility? Does glare restricts visibility? Fill
in the box.
Work Sites
w/artificial
lighting |
Work
Sites
w/natural
lighting |
Enough
light to do
work
(artificial or
natural) |
Walking
surfaces
well lit?
(yes/no) |
Shadows
restrict
visibility?
(yes/no) |
Glare
restrict
visibility?
(yes/no) |
Possible
solutions |
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
| |
|
|
|
|
|
|
Standing
List the jobs that
require workers to stand all day. Which jobs require standing on concrete
or steel? Fill in the box.
| Jobs
requiring standing all day |
Jobs
standing on concrete or steel all day |
Use
anti-fatigue
mats (yes/no) |
Use
job rotation (yes/no) |
Use
adjustable stools on work site? (yes/no) |
Other
solutions? |
| |
|
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
Sitting
List the jobs that
require sitting for more than one continuous hour. Are workers sitting
in the cold to do the job? Sitting on building materials to do the job?
Fill in the box.
|
Job
description
|
Job
title of workers sitting
|
Sitting
in cold to do job (yes/no)
|
Sitting
on building materials or structure to do job
(yes/no)
|
Possible
solutions?
|
| |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
Heavy Equipment
Operators
List the types of
heavy equipment operating on the site. On which machines do operators
need to lean forward to see or do their work? Do they have to stretch
or use awkward postures to reach the equipment controls? Are the seats
comfortable for the operators? Does the seating in any of the equipment
vibrate a lot? Are the mirrors in the right spots for good visibility?
Fill in the box.
|
Equipment
type on site
|
Number
of pieces of each type
|
Need
to
lean forward to see?
(yes/no)
|
Stretch
or awkward postures to use controls?
(yes/no)
|
Mirrors
in the right places?
(yes/no)
|
Good
seats?
(yes/no)
|
Seats
vibrate?
(yes/no)
|
Solutions
to reduce the problem?
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
Training
List the training
courses that superintendents had on preventing musculoskeletal disorders?
What courses do they need to take? Fill in the box. If no courses were
taken, write NONE on the first line.
|
|
Name
of courses taken & year taken
|
Name
of courses needed
|
|
Name
of Superintendents
|
|
|
| |
|
|
| |
|
|
| |
|
|
List the training
courses that foremen had on preventing musculoskeletal disorders? What
courses do they need to take? If no courses were taken, write NONE on
the first line. Fill in the box.
|
|
Name
of courses taken
|
Name
of courses needed
|
|
Name
of Foremen
|
|
|
| |
|
|
| |
|
|
| |
|
|
List the training
courses that foremen had on preventing musculoskeletal disorders? What
courses do they need to take? If no courses were taken, write NONE on
the first line. Fill in the box.
|
|
Name
of courses taken
|
Name
of courses needed
|
|
Workers
|
|
|
| |
|
|
| |
|
|
| |
|
|
Recording Signs
and Symptoms of Musculoskeletal Disorders
List the jobs and
job titles of workers that have reported muscle pain, joint, back or neck
pain in the last 2 weeks. What is the possible cause of the symptom, for
example, lifting, awkward postures, working in one position for long periods,
repetitive work, something else? You might also want to look at OSHA 200
logs, first aid logs or any other sources of information that is available
on your site. Fill in the box.
| Symptom |
Jobs |
Job Title |
Possible cause |
| Muscle pain |
|
|
|
| Joint Pain |
|
|
|
| Wrist or hand
pain |
|
|
|
| Elbow or shoulder
pain |
|
|
|
| Knee pain |
|
|
|
| Ankle or hip
pain |
|
|
|
| Back Pain |
|
|
|
| Neck Pain |
|
|
|
Reporting
| Do
workers feel free to report symptoms of musculoskeletal disorders,
without fear of reprisal? |
Yes
|
No
|
| Do
workers feel free to report hazards associated with musculoskeletal
disorders? |
|
|
| Does
the company have an incentive program that discourages reporting of
symptoms or injuries? |
|
|
| Are
hazards quickly remedied when reported? |
|
|
| Do
workers feel free to report suggested solutions? |
|
|
| Do
workers feel free to report injuries? |
|
|
| Do
foremen have the same freedom to report information about musculoskeletal
disorders? |
|
|
| Do
superintendents have the same freedom to report information about
musculoskeletal disorders? |
|
|
Solutions
Now that you have
reviewed all of the jobs for hazards and risk factors related to musculoskeletal
disorders, this is the time to consider solutions that best fit your worksite
and budget, but which fix the problems.
Based on your review,
list the jobs on site that are the most hazardous for musculoskeletal
injuries?
-
-
-
-
-
Work with the superintendents,
foremen and workers to analyze the hazards you have noted as well as,
risk factor information to select appropriate solutions. The analysis
may be as simple as providing anti-fatigue mats for workers who stand
on concrete all day, or as complex as developing a rotation schedule for
workers who must work in cramped spaces all day.
List the suggested
solutions according to the ease of getting done, the expense and the potential
to eliminate the identified risk factor or hazard (effectiveness)?
Proposed solutions
Most effective -
- - - - - - - - - - - - Easiest to get done- - - - - - - - - - - - - Least
expensive
-
-
-
-
Least effective
- - - - - - - - - - - - - Hardest to implement - - - - - - - - - - - -
Most expensive
You also might want
to develop a schedule that allows you to check back periodically to see
if the solution actually worked.
Every health and
safety program should have one part of its activities dedicated to the
elimination of work-related musculoskeletal disorders, The most effective
programs are evaluated on a regular schedule, especially as worksites
change. This checklist provides a cursory evaluation of the main elements
of your program to reduce musculoskeletal disorders. Fill this out to
see where your program is working and where it might need improvement.
If you answer No to any question, jot down why this activity does not
occur in your organization.
Management Leadership
and Employee Participation
| |
Yes
|
No
|
Reason
for No
|
Possible
solutions
|
| Is
there program participation by the site safety & health manager? |
|
|
|
|
| Is
there program participation by superintendents? |
|
|
|
|
Is
there program
participation by foremen? |
|
|
|
|
| Are
workers/representatives active throughout the program? |
|
|
|
|
| Can
participation be improved? |
|
|
|
|
Hazard Awareness
and Identification
| |
Yes
|
No
|
Reason
for No
|
Possible
solutions
|
| Does
the program ensure that superintendents, foremen and workers are able
to identify symptoms, hazards, risk factors and abatements of musculoskeletal
disorders? |
|
|
|
|
| Does
the program ensure superintendents, foremen and workers collect and
report their information related to musculoskeletal disorders? |
|
|
|
|
Job Hazard Analysis
and Hazard Control
| |
Yes
|
No
|
Reason
for No
|
Possible
solutions
|
| Does
the program ensure that MSD information is reviewed on a regular schedule? |
|
|
|
|
| Does
the program identify controls that are feasible for the worksite? |
|
|
|
|
| Once
identified, are the controls put into effect on the worksite? |
|
|
|
|
Training
| |
Yes
|
No
|
Reason
for No
|
Possible
solutions
|
| Are
workers, foremen or superintendents trained about musculoskeletal
disorders and the program? |
|
|
|
|
| Has
the training resulted in changed attitudes, work organization or behavior? |
|
|
|
|
| Give
examples of improvements due to last training |
|
|
|
|
Program Evaluation
| |
Yes
|
No
|
Reason
for No
|
Possible
solutions
|
Does
the program include a
periodic evaluation? |
|
|
|
|
Does
this evaluation drive
program improvements? |
|
|
|
|
Is
this evaluation share
throughout the organization? |
|
|
|
|
Medical Management
and Alternate Duty
| |
yes |
no |
why not |
Possible
Solutions |
| Does the
program generally ensure prompt access to appropriate health care? |
|
|
|
|
| Does the
program ensure prompt access to appropriate health care for assessment
of a condition? |
|
|
|
|
| Does the
program ensure prompt access to appropriate health care for treatment
of a condition? |
|
|
|
|
| Does the
program ensure prompt access to appropriate health care for follow-up
of a condition? |
|
|
|
|
| Does the
program provide medically appropriate alternate or reassigned duties? |
|
|
|
|
EXAMPLES OF ERGONOMIC
SOLUTIONS IN CONSTRUCTION
| PROBLEM |
SOLUTIONS |
| Manual handling |
Pre-job planning
to minimize handling, improved housekeeping to prevent trips, increased
use of carts/dollies/hoists/mechanical handling, ladder hoists/gin
poles/daisy chains/cranes for moving materials on/off roofs, chain
falls, motorized buggies, carrying handles, extension handles for
carrying large or awkward materials (like drywall), Break up loads
(cement in 47 lb bags), Shoulder pads for carrying on shoulders, Ergonomics
training, Pre-job stretching program, weight labeling of materials,
Getting help (two person lifts) |
| Weight of building
materials |
Light-weight
concrete blocks, fiberglass ladders, cement in smaller packages (47
LB), 3 ft wide drywall |
| Hand tools |
Handles that
are more comfortable, better grips, right size for the hand, allow
a power grip for heavy work and pinch grip for fine work, allow a
neutral wrist posture, reduce the amount of force needed, lighter
weight tools when appropriate, power tools (cordless screwguns), tool
sharpeners for cutting tools |
| Vibrating tools |
Vibration absorbing
padding on handles, anti-vibration gloves, vibration-dampened handles
on pavement breakers |
| Whole-body Vibration |
Vibration-dampened
seating |
| Overhead work |
Drywall lifts,
scissors lifts, extension poles/stands for operating tools overhead,
work platforms |
| Work at ground
level |
Tables/stands
for bring work to waist height, storage of materials at waist height,
adjustable height scaffolding for bricklayers, pipe stands for steam-fitters/plumbers,
D handle/longer handles for shoveling, rebar tying devices, stand-up
fastening systems for roof insulation |
| Awkward Postures-
Operators |
Better visibility
for equipment operators, better cab design |
| Repetitive work |
Power tools,
micropauses/ rest breaks, job rotation |
| Kneeling |
Knee pads, Pants
with knee pad pockets, rest and stretch breaks |
| Standing on
concrete |
Shoe inserts,
sit/stand stools, Bucket seat (converts a 5 gal bucket into a seat),
floor mats, rest breaks |
This paper appears in the eLCOSH website with the permission of the author
and/or copyright holder and may not be reproduced without their consent. eLCOSH is an
information clearinghouse. eLCOSH and its sponsors are not responsible for the accuracy of
information provided on this web site, nor for its use or misuse.
|