The MSD Prevention Guideline describes activities for primary prevention (before an injury occurs). It is a Guideline for changing the work to help prevent MSD. The Guideline offers guidance on workplace physical space, on the organization of work, and on organizational policies, practices, and procedures that can help prevent MSD injuries. The Guideline has a focus on changing the workplace, not a worker focus.
To help workers suffering from MSD to return to work more safely, a workplace focus is needed to reduce workplace hazards as well as focusing on the individual worker.
The core message from ergonomics is “Fit the work to the worker, not make the worker fit the work”. If the work does not fit the worker, pain, fatigue, injuries, errors and poorer quality of products or services result.
Humans are wonderfully adaptable and can often continue to work in tasks that do not “fit” humans, BUT the adaptation has a cost and that cost to the worker may be the development of MSD.
There are specific approaches to identifying (recognizing) and eliminating MSD hazards, as well as assessing and reducing the risks associated with those MSD hazards.
If a hazard cannot be eliminated and the risk of developing an MSD reduced to zero, the hazard must be controlled, which reduces the risk associated with exposure to that [controlled] hazard.
Training on these specific topics by competent instructors should be done.
The general risk assessment procedure for MSD Prevention is similar to other workplace hazards. This procedure is sometimes call RACE:
Once the root (or underlying) causes of the MSD hazards have been determined, “controls” or workplace changes to eliminate them or reduce their effect are put in place.
Controls are divided into four main types, but often they are used in combination.
A worker has to lift a box from the floor. We know that lifting from the floor increases the risk of developing low back pain compared to lifting at waist level. (See Store-it-off-the-floor in the Quick Start Guide).
There are different ways of dealing with this situation. One of them is best!
Observe to see if the worker is lifting using “proper technique”, such as lifting with bent knees.
Ask why the box is on the floor in the first place.
Approach 1: Trying to change the technique of the worker by sending them to “Back School” or training so that they lift properly. This has not been shown to be effective in reducing the risk of low back pain.
Approach 2: Asking “Why is the box on the floor in the first place”. Is this because the organization’s equipment or the workplace policies and procedures allowed the box to be placed on the floor? Controlling the root cause of why the box was being stored on the floor could lead to changes in the height of tables or in delivery procedures (such as delivering the box to a waist-high table). These changes will address the root cause of the problem and are more likely to sustainably reduce the risk of developing low back pain (as well as generally improving the work).
Getting to the underlying cause and fixing the problem (using the hierarchy of controls) gives the best chance of sustainably reducing MSD risks to workers manually handling boxes.
The steps of the RACE risk-assessment procedure – identifying and controlling hazards - do not take place in isolation. The organization must have the means to manage, provide resources for, and oversee the cycle of prevention activities.
The main organizational level approach used in this Guideline is known as the Plan-Do-Check-Act approach, often shortened to PDCA. The PDCA approach makes it easier for the organization to prevent MSD, as it mimics the language and processes used for other Health and Safety hazards in the workplace. Of course, the Health and Safety Committee, perhaps with an “Ergonomics Committee”, could take on a leadership role and assist.
Having the full participation of workers is especially important for MSD prevention. A worker’s body feels the effects of an MSD hazard as high effort, fatigue or pain. They therefore have knowledge that no one else in the organization has. Change is always difficult. But with workers’ ideas and suggestions, the change will be the right one, and will have the right impact.