Musculoskeletal Disorders (MSDs)
July 9, 2019
HSE’s main focus is on health and safety issues related to pain and disorders caused by the work a person does, whether this occurs in the neck, shoulders and arms (Upper Limbs), back, or hips, knees and ankles and feet (Lower Limbs). These pages also cover manual handling and the impact of using display screen equipment.
Key messages about MSDs are:
- you can do things to prevent or minimise MSDs;
- the prevention measures are cost effective;
- you cannot prevent all MSDs, so early reporting of symptoms, proper treatment and suitable rehabilitation is essential.
Risk factors causing MSDs can be found in virtually every workplace from commerce to agriculture, health services to construction.
Back pain
Most people have back pain at some time. Usually the pain is not caused by anything serious and it settles within a matter of days or weeks.
Medical evidence from the Royal College of General Practitioners and the Faculty of Occupational Medicine focuses on three key messages for sufferers to deal with back pain:
- Stay active
- Try simple pain relief
- If you need it, seek advice
For some examples of what others have done to reduce the incidence of back pain at work and how organisations have worked to rehabilitate sufferers and get them back at work, go to the ‘case studies‘ section.
For information to help employers, managers and employees prevent and manage the effects of back pain in the workplace visit the back pain section.
Upper limb disorders (ULDs)
The term upper limb disorders (ULDs) is used as an umbrella term for a range of disorders of the hand, wrist, arm, shoulder and neck. It covers those conditions, with specific medical diagnoses (eg frozen shoulder, carpal tunnel syndrome), and other conditions (often called ‘repetitive strain injury’ or RSI) where there is pain without specific symptoms. Symptoms may include pain, swelling and difficulty moving.
For information to help employers, managers and employees prevent and manage the effects of ULDs in the workplace visit the ULD section.
Lower limb disorders (LLDs)
Lower limb disorder (LLD) is used for a range of disorders of the hips, legs, knees, ankles and feet. It covers those conditions with specific medical diagnoses (eg osteoarthritis of the knee and hip), and other conditions where there is pain without specific symptoms. Symptoms may include pain, swelling and difficulty moving.
For information to help employers, managers and employees prevent and manage the effects of LLDs in the workplace visit the LLD section.
Display screen equipment (DSE)
DSE includes all the potential issues that may result from using display screen equipment, which used to be referred to as VDUs (visual display units) and includes use of computer equipment in both the workplace and at home if you are a home-worker. ULDs, headaches and visual problems can all be associated with working at a poorly designed workstation.
For information to help employers, managers and employees prevent and manage the effects of risks of working with DSE visit the DSE section.
Manual handling
Manual handling covers a wide variety of tasks including lifting, lowering, pushing, pulling and carrying. Injuries can occur almost anywhere, when people are at work or at home, and for many reasons like heavy loads or awkward postures. In addition, previous or existing injury can increase the risk.
Early reporting of symptoms, proper treatment and suitable return to work plans can help most people recover from their injuries and return to work. However some people may need to take longer periods off work and possibly even leave work entirely. The injured person may find that their lifestyle, leisure activities, ability to sleep and job prospects are affected.
MSD – Manual handling
Manual handling relates to the moving of items either by lifting, lowering, carrying, pushing or pulling. The weight of the item is an important factor, but many other factors can create a risk of injury, for example the number of times you have to pick up or carry an item, the distance you are carrying it, where you are picking it up from or putting it down (picking it up from the floor, putting it on a shelf above shoulder level) and any twisting, bending, stretching or other awkward posture you may adopt while doing a task.
Manual handling injuries are part of a wider group of musculoskeletal disorders (MSDs). The term ‘musculoskeletal disorders’ covers any injury, damage or disorder of the joints or other tissues in the upper/lower limbs or the back. Statistics from the Labour Force Survey (LFS) indicate that MSD cases, including those caused by manual handling, account for more than a third of all work-related illnesses reported each year to the enforcing authorities 
.
There is evidence that, as well as manual handling, heavy manual labour, awkward postures and a recent or existing injury are all risk factors in the development of MSDs. The Manual Handling Operations Regulations 1992 (MHOR) require employers to manage the risks to their employees. They must:
- Avoid hazardous manual handling operations so far as is reasonably practicable, by redesigning the task to avoid moving the load or by automating or mechanising the process.
- Make a suitable and sufficient assessment of the risk of injury from any hazardous manual handling operations that cannot be avoided.
- Reduce the risk of injury from those operations so far as is reasonably practicable. Where possible, provide mechanical assistance, for example, a sack trolley or hoist. Where this is not reasonably practicable then explore changes to the task, the load and the working environment.
Medical and scientific knowledge stress the importance of an ergonomic approach to look at manual handling as a whole, taking into account the nature of the task, the load and the working environment, and requiring worker participation.
Free tools
HSE has developed tools to help employers analyse lifting, carrying and team handling (the MAC tool and the V-MAC tool), repetitive upper limb tasks (the ART tool) and pushing and pulling (the RAPP tool). Depending on the task, you may find it helpful to use more than one tool, for example you may need to pick up a box of items (lifting), carry it to a workstation (carrying), then distribute the contents to other locations such as pigeon holes or a filing cabinet (repetitive movements).
For more information about each tool click on the following links
- MAC tool – lifting, carrying, lowering
- V-MAC tool – where load weights vary
- ART tool – repetitive upper limb tasks
- Push/Pull tool (RAPP) – moving loads by pushing and pulling
5 Simple Rules for Effective Incident Report
January 9, 2019
Incident reporting is essential. No matter what steps are taken, training is given and precautions are taken, there will always be an element of accidents and incidents that occur in any environment. Whether it be tripping, slipping, dropping things, scratching cars, stubbing toes, falling from a height, being hit by an opening door, TVs falling off walls…things happen. The way in which organisations then handle such eventualities can be quite reflective of the inner workings of the organisation itself:
Is a company still stuck in the 80s using an Incident Reporting book kept in reception gathering dust and presenting a GDPR nightmare?
Has the company moved into the late 90s or even 00s and record things using Excel spreadsheets? (Did you know Excel is turning 33 this year?!)
Is the company bang up to date with modern solutions allowing for efficiency and increased access and uptake of procedures?
Do you know where your company falls on the scale above?
1 – MAKE IT ACCESSIBLE
Whatever system you choose to use to manage your incident reporting, make sure that all of your employees have access to the system. From your office staff to your field sales team, the people in the manufacturing plant down the road and the contractors coming on site. Everyone should know how to appropriately report incidents that occur while under your care.
Is there an app you want them to use?
If you still use a book where is it kept and who is responsible for it?
Do you require any additional evidence such as photos or witness statements?
Is there a requirement to tell anyone after an incident has been reported? What if people are travelling on business, what does that mean for reporting an incident?
2 – MAKE IT RELEVANT
Any solution you use should be relevant and adaptable to your individual needs. Every organisation is different so why should anyone assume one product is suitable for everyone? Make sure your own areas of concern are covered – for example; you don’t need a fancy vehicle incident reporting function if you don’t have any company vehicles…but you might need a personal injury graph to see whereabouts most bodily injuries occur…
Does your current solution meet the individual needs of the organisation?
Who in the business NEEDS to be informed about different types of incidents?
What happens if there are RIDDOR reportable incidents – is there suitable data in your current system to meet all of the requirements?
Do the reports reflect the information needed or are they reporting on unnecessary elements which could potentially be wasting crucial time which could be better spent elsewhere?
3 – MAKE IT KNOWN
Whatever your system is, it is no use to your organisation if your employees don’t know about it. Look at your communication methods and make sure you receive support to get your employees using your chosen system. All too often great systems are implemented by the board or one department but not communicated internally so no one else knows about it…make sure you consider the wider teams and how to make sure they are as well informed as you are.
If a visitor were to walk into your organisation and fall over in reception while someone from the IT team happened to be walking by. Would the employee from the IT department know how to report the incident, who to report it to and critically what information from the visitor would be required?
Is the system for reporting so complicated that when faced with an actual incident it would simply add to the anxiety of the individual?
Have you considered something as simple as putting a poster up in the canteen or bathrooms – the places where people spend down time – actually letting them know about what to do if they trip on their way out of the door?
Are your employees open to reporting incidents or do they fear repercussions / accusations?
4 – MAKE TIME TO TRAIN
Using any system is simple if you know how to use it, especially if you are the one that created, implemented or instigated the system in the first place. Make sure that everyone else who needs to know has a suitable level of training. For example, all staff may need to know how to report an incident, but only some of them will need to be involved in the management of the incident, for example reporting to the HSE or at a Board Level and taking steps to prevent re-occurrences etc.
It is worth considering what would be the easiest way to train your employees on your Incident Reporting system – Do they respond to: Videos, Webinars, Newsletter pieces, Incentives, Classroom training, e-Learning courses, peer training, team by team training….?
If the person who administers your Incident Reporting system was suddenly unavailable or decided to travel round Africa for 2 months, would anyone else in the organisation know how to take over the system or is it so bespoke and convoluted that only one person will ever be able to get the value out of it that you require?
Is your system based on standard principles but has been personalised to your own needs or is it a system put together by an individual and been built on over years?
5 – MAKE IT WORK HARD
You should be constantly evaluating your systems to make sure they are the best solution for you at the current time. Incident reporting systems are no different. Processes, technologies, laws, best practices, requirements change all the time. You need to constantly assess to make sure you are not falling behind the curve and relying on potentially out of date, but familiar, ways of working.
When was your system last updated?
Have you seen something in an industry publication or heard something at a conference that made you feel embarrassed of your own system or methods of working?
If you are using or considering a software solution, how is your provider keeping ahead of the competition and importantly keeping your data safe?
If your current system isn’t a system you would recommend to anyone in a similar position to yours then why are you even using it?
Risk at Work – Personal protective equipment (PPE)
September 25, 2018
Employers have duties concerning the provision and use of personal protective equipment (PPE) at work.
PPE is equipment that will protect the user against health or safety risks at work. It can include items such as safety helmets, gloves, eye protection, high-visibility clothing, safety footwear and safety harnesses. It also includes respiratory protective equipment (RPE).
Why is PPE important?
Making the workplace safe includes providing instructions, procedures, training and supervision to encourage people to work safely and responsibly.
Even where engineering controls and safe systems of work have been applied, some hazards might remain. These include injuries to:
- the lungs, eg from breathing in contaminated air
- the head and feet, eg from falling materials
- the eyes, eg from flying particles or splashes of corrosive liquids
- the skin, eg from contact with corrosive materials
- the body, eg from extremes of heat or cold
PPE is needed in these cases to reduce the risk.
What do I have to do?
- Only use PPE as a last resort
- If PPE is still needed after implementing other controls (and there will be circumstances when it is, eg head protection on most construction sites), you must provide this for your employees free of charge
- You must choose the equipment carefully (see selection details below) and ensure employees are trained to use it properly, and know how to detect and report any faults
Selection and use
You should ask yourself the following questions:
- Who is exposed and to what?
- How long are they exposed for?
- How much are they exposed to?
When selecting and using PPE:
- Choose products which are CE marked in accordance with the Personal Protective Equipment Regulations 2002 – suppliers can advise you
- Choose equipment that suits the user – consider the size, fit and weight of the PPE. If the users help choose it, they will be more likely to use it
- If more than one item of PPE is worn at the same time, make sure they can be used together, eg wearing safety glasses may disturb the seal of a respirator, causing air leaks
- Instruct and train people how to use it, eg train people to remove gloves without contaminating their skin. Tell them why it is needed, when to use it and what its limitations are
Other advice on PPE
- Never allow exemptions from wearing PPE for those jobs that ‘only take a few minutes’
- Check with your supplier on what PPE is appropriate – explain the job to them
- If in doubt, seek further advice from a specialist adviser
Maintenance
PPE must be properly looked after and stored when not in use, eg in a dry, clean cupboard. If it is reusable it must be cleaned and kept in good condition.
Think about:
- using the right replacement parts which match the original, eg respirator filters
- keeping replacement PPE available
- who is responsible for maintenance and how it is to be done
- having a supply of appropriate disposable suits which are useful for dirty jobs where laundry costs are high, eg for visitors who need protective clothing
Employees must make proper use of PPE and report its loss or destruction or any fault in it.
Monitor and review
- Check regularly that PPE is used. If it isn’t, find out why not
- Safety signs can be a useful reminder that PPE should be worn
- Take note of any changes in equipment, materials and methods – you may need to update what you provide
Types of PPE you can use
Eyes
Hazards
Chemical or metal splash, dust, projectiles, gas and vapour, radiation
Options
Safety spectacles, goggles, face screens, faceshields, visors
Note
Make sure the eye protection chosen has the right combination of impact/dust/splash/molten metal eye protection for the task and fits the user properly
Head and neck
Hazards
Impact from falling or flying objects, risk of head bumping, hair getting tangled in machinery, chemical drips or splash, climate or temperature
Options
Industrial safety helmets, bump caps, hairnets and firefighters’ helmets
Note
- Some safety helmets incorporate or can be fitted with specially-designed eye or hearing protection
- Don’t forget neck protection, eg scarves for use during welding
- Replace head protection if it is damaged
Ears
Hazards
Noise – a combination of sound level and duration of exposure, very high-level sounds are a hazard even with short duration
Options
Earplugs, earmuffs, semi-insert/canal caps
Note
- Provide the right hearing protectors for the type of work, and make sure workers know how to fit them
- Choose protectors that reduce noise to an acceptable level, while allowing for safety and communication
Hands and arms
Hazards
Abrasion, temperature extremes, cuts and punctures, impact, chemicals, electric shock, radiation, vibration, biological agents and prolonged immersion in water
Options
Gloves, gloves with a cuff, gauntlets and sleeving that covers part or all of the arm
Note
- Avoid gloves when operating machines such as bench drills where the gloves might get caught
- Some materials are quickly penetrated by chemicals – take care in selection, see HSE’s skin at work website
- Barrier creams are unreliable and are no substitute for proper PPE
- Wearing gloves for long periods can make the skin hot and sweaty, leading to skin problems. Using separate cotton inner gloves can help prevent this
Feet and legs
Hazards
Wet, hot and cold conditions, electrostatic build-up, slipping, cuts and punctures, falling objects, heavy loads, metal and chemical splash, vehicles
Options
Safety boots and shoes with protective toecaps and penetration-resistant, mid-sole wellington boots and specific footwear, eg foundry boots and chainsaw boots
Note
- Footwear can have a variety of sole patterns and materials to help prevent slips in different conditions, including oil – or chemical-resistant soles. It can also be anti-static, electrically conductive or thermally insulating
- Appropriate footwear should be selected for the risks identified
Lungs
Hazards
- Oxygen-deficient atmospheres, dusts, gases and vapours
Options – respiratory protective equipment (RPE)
- Some respirators rely on filtering contaminants from workplace air. These include simple filtering facepieces and respirators and power-assisted respirators
- Make sure it fits properly, eg for tight-fitting respirators (filtering facepieces, half and full masks)
- There are also types of breathing apparatus which give an independent supply of breathable air, eg fresh-air hose, compressed airline and self-contained breathing apparatus
Note
- The right type of respirator filter must be used as each is effective for only a limited range of substances
- Filters have only a limited life. Where there is a shortage of oxygen or any danger of losing consciousness due to exposure to high levels of harmful fumes, only use breathing apparatus – never use a filtering cartridge
- You will need to use breathing apparatus in a confined space or if there is a chance of an oxygen deficiency in the work area
- If you are using respiratory protective equipment, look at HSE’s publication Respiratory protective equipment at work: A practical guide
Whole body
Hazards
Heat, chemical or metal splash, spray from pressure leaks or spray guns, contaminated dust, impact or penetration, excessive wear or entanglement of own clothing
Options
Conventional or disposable overalls, boiler suits, aprons, chemical suits
Note
- The choice of materials includes flame-retardant, anti-static, chain mail, chemically impermeable, and high-visibility
- Don’t forget other protection, like safety harnesses or life jackets
Emergency equipment
Careful selection, maintenance and regular and realistic operator training is needed for equipment for use in emergencies, like compressed-air escape breathing apparatus, respirators and safety ropes or harnesses.
Skin at work: Outdoor workers and sun exposure
May 24, 2017
What is the problem?
Too much sunlight is harmful to your skin. A tan is a sign that the skin has been damaged. The damage is caused by ultraviolet (UV) rays in sunlight.
Who is at risk?
If work keeps you outdoors for a long time your skin could be exposed to more sun than is healthy for you. Outdoor workers that could be at risk include farm or construction workers, market gardeners, outdoor activity workers and some public service workers. You should take particular care if you have:
- fair or freckled skin that doesn’t tan, or goes red or burns before it tans;
- red or fair hair and light coloured eyes;
- a large number of moles.
People of all skin colours should take care to avoid damage to the eyes, overheating and dehydration.
What are the harmful effects?
In the short term, even mild reddening of the skin from sun exposure is a sign of damage. Sunburn can blister the skin and make it peel.
Longer term problems can arise. Too much sun speeds up ageing of the skin, making it leathery, mottled and wrinkled. The most serious effect is an increased chance of developing skin cancer.
What can you do to protect yourself?
- Keep your top on.
- Wear a hat with a brim or a flap that covers the ears and the back of the neck.
- Stay in the shade whenever possible, during your breaks and especially at lunch time.
- Use a high factor sunscreen of at least SPF15 on any exposed skin.
- Drink plenty of water to avoid dehydration.
- Check your skin regularly for any unusual moles or spots. See a doctor promptly if you find anything that is changing in shape, size or colour, itching or bleeding.
Where can you get further information?
The following free leaflets have been produced by HSE:
- Keep your top on: Health risks from working in the sun [1]
- Sun protection: advice for employers of outdoor workers [2]
The following website also provides useful information:
