Musculoskeletal Disorders at work what you should know but mightn t think to ask

Transcription

1 Musculoskeletal Disorders at work what you should know but mightn t think to ask Dr. Jodi Oakman Assoc. Professor Wendy Macdonald Centre for Ergonomics and Human Factors

2 1. MSDs are a very large OHS problem 2. What are MSDs? 3. Evidence on work-related causes of MSDs 4. Current ISCRR funded project 5. Toolkit for Risk Management of MSDs

3 MSDs are the most frequent causes of physical disability, at least in developed countries (WHO, 2003) As mortality from infectious diseases reduces worldwide, the global population is ageing and the numbers of people in the oldest age groups are increasing. As the prevalence of many musculoskeletal disorders increases with age, the likely result is that there will be a growth in the number of people with chronic disabling disorders. (WHO, 2003) La Trobe University 3

4 MSDs are a very large OHS problem Australia... NDS serious claims* p % of claims *Serious claims: % of claims by nature of injury or disease, p. 4

5 What are MSDs? A diverse group of injuries and disorders Many (most?) arise from cumulative trauma CTDs, RSIs La Trobe University 5

6 DIRECT EFFECTS Biomechanical Load Cumulative tissue damage Pain sensitisation e.g. cumulative compression INDIRECT EFFECTS Biomechanical load Muscle Tension Hormones etc. Stress Response e.g. work overload, lack of job control Stressor load

7 Current workplace MSD risk management Australian (and international) workplace practices (poorly documented) Focus on designing workstations, equipment and tasks to reduce biomechanical hazards of specific tasks MSD risk management in 4 Melbourne companies (manufacturing, warehousing) Manual Handling focus Training in safe movement techniques in 2 of the 4 Above does NOT reflect current research evidence on what are the main work-related causes of MSDs, and the kinds of interventions that are effective La Trobe University 7

8 Current project at La Trobe University Developing a risk management toolkit for workplace use in reducing current levels of MSDs in healthcare workers Worked with 3 organisations... 2 large hospital networks 1 ambulance service Previous project with manufacturing and logistics Plans to extend to other sectors

9 Our conceptual framework

10 Project Method Occupational target groups (jobs) selected in consultation with the organisations Focus groups and interviews with people from each group Information from these used to modify a survey previously developed and validated in manufacturing / warehousing sectors Survey then implemented online / paper

11 People in focus groups Organisation 1 Personal assistants: 13 Food services: 7 Allied health: 6 Total n= 26 Organisation 2 Personal assistants: 5 Food services: 5 Environmental services: 4 Sterile processing team: 12 Total n= 26 Organisation 3 Rural: 3 Metro: 8 Total n= 11

12 Survey constructs Manual handling hazards WOAQ: Relationships with manage t Reward / Recognition Workload Relationships with colleagues Physical environment Safety Culture Teamwork Role Clarity Bullying Workability Mental Health Job Satisfaction Work/life Balance Discomfort/Pain levels (proxy for MSD risk) Time off work

13 Ratings of Discomfort / Pain... total score out of 60 Neck, Shoulders Hands, Fingers Arms HOW OFTEN have you felt discomfort or pain? Middle to Lower Back for each y area where g you ve ) felt it (that is where you circle 1 or higher)... HOW BAD has it been? Never Occasional ly HOW OFTEN Sometimes Often AND Almost always For each body area where there s been some discomfort or pain (i.e. marked as 1 or higher) circle a number below to show HOW BAD Neck, Shoulders Mild 1 Hands, Fingers Arms Middle to Lower Back Moderate 2 Severe discomfort 3 Mild 1 Moderate 2 Severe discomfort 3 Mild 1 Moderate 2 Severe discomfort 3 Mild 1 Moderate 2 Severe discomfort 3 Hips, Bottom, Legs, Feet Hips, Bottom, Legs, Feet Mild 1 Moderate 2 Severe discomfort 3

14 Respondents Organisation 1 Organisation 2 Organisation 3 Responses n=254 (37.9%) n=160 (32%) n= 978 (33%) Mean age 44.2 years 46.2 years (19-71 years) (23-74 years) (20-65 years) Mean time in job 7 years 11 years 12 years Any discomfort? 85% yes 84% yes 83% yes Lost time due to pain/discomfort 34.1% 44.4% 59.5% Mean discomfort score / (range 0-46) 17.3 (range 0-55) (range 0-55)

15 Key workplace predictors of discomfort levels: Organisation 1 WOAQ (-.26) Physical Work Factors (.30) Discomfort

16 Key workplace predictors of discomfort levels: Organisation 2 WOAQ (-.19) Physical Work Factors (.42) Discomfort

17 Key workplace predictors of discomfort levels: Organisation 3 Physical Work Factors (.34) Age WOAQ (-.26) Gender Job Satisfaction Discomfort

18 Predictors of DISCOMFORT manufacturing, warehousing MODEL 1 Workplace Factors WOAQ Score (-.474); Manual handling (.471); Workload (.308); Work faster to meet targets/deadlines (.205); Time employed there (.111) MODEL 2 above + Hazardous Personal States Exhaustion Score (.441); Job (dis)satisfaction (-.358); Work- Life Balance (-.296). MODEL 3 above + Work Site: No effect MODEL R 2 Adj. R 2 R 2 Change Sig c of F change

19 Lost time Different set of predictors in each organisation Organisation 1 and 3: WOAQ significant predictor in whether people take time off work Organisation 2: Physical work (note smaller sample size for this organisation)

20 In summary Up to 35% of variance in predicting discomfort scores can be accounted for by the measures of workplace physical and psychosocial risks Variation between organisations More measures of other aspects of the workplace were used but are not reported here, because we trying to come up with a common set of measures for a standard toolkit

21 Project results at this stage Confirmed that an MSDs risk management toolkit must address psychosocial hazards as well as physical hazards Results very useful in recent participative workshops in each organisation involving employee reps, supervisors, OHS reps, Union reps, Managers, OHS personnel together they identified potentially costeffective interventions. But toolkit needed to achieve sustainability

22 What is a toolkit? As defined by WHO Occupational Health people: A toolkit provides practicable, user-friendly guidance on how to reduce risk from a particular hazard, or risk of a particular health problem such as MSDs It must include: Evidence-based conceptual framework Description of the process to be followed One or more tools (e.g. risk assessment procedures) to be used as part of the overall process WHO plans to develop a toolbox of various toolkits for use in improving various aspects of occupational health

23 Why this toolkit is needed Current MSD risk management strategies don t reflect research evidence as depicted in our framework model Barriers to more effective MSD risk management : Usual approach is too narrowly focused on just a subset of hazards Common concepts of a hazard focuses attention on a single event or object as the problem, rather than several interacting agents or events

24 What will our toolkit look like? Currently in early stage of development working with the organisations to customise toolkit to their existing OHS management systems Will be interactive, allowing users to customise further, and to enter their own workplace data to obtain guidance on risk control options Future work will entail implementation, evaluation and comparison of data across different sectors A key question to what extent will we need to customise for different jobs/sectors?

25 Users of toolkits Toolkits are mainly intended for use by nonexperts in their own workplaces... employers, workers or their representatives, etc Particularly useful in workplaces when access to specialist expertise is limited e.g. SMEs In emerging economies and developing nations

26 Where next? The current project has focused on large organisations, need to understand what kind of toolkit would be most useful in smaller workplaces Evaluation of interventions and whether they reduce MSDs is needed and we are currently seeking funding and organisations willing to participate

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28 MSDs RISK MANAGEMENT FRAMEWORK La Trobe University 28

29 LIST OF TOOLS A: Powerpoint presentation for use in training senior managers B Powerpoint presentation for use in training all members of the MSDs risk management team C MSD Risk Assessment Survey Module D: MSD Hazard Assessment Survey Module E: Data Analysis & Reporting Software Package: Instructions for Use F: Guidelines for customising Tools C and D see Section 3.2(b) G Draft for use in recruiting survey participants see Section 3.2 H: Instructions and set of Templates for use in identifying and prioritising risk control options for manual handling hazards see Section 3.3(a) I: Optional Task Analysis Methods for occasional use to compare Manual Handling Hazard Control Options ManTRA, and the QEC see TOOL H Instructions J Instructions and set of Templates for use in identifying and prioritising risk control options for psychosocial hazards see Section 3.3(b)

30 This research is supported by funding of a Development Grant from WorkSafe Victoria and the Transport Accident Commission (TAC), through the Institute for Safety, Compensation and Recovery Research (ISCRR).

31 THANK YOU