NEBOSH International General Certificate

in Occupational Safety and Health

Unit IG2

Element 6: Musculoskeletal Health

 Learning Objectives
• Describe work processes and practices that may give rise
to work-related upper limb disorders and appropriate
control measures.

• Describe the hazards and control measures which should

be considered when assessing risks from manual
handling activities.

• Describe the hazards and controls associated with

load-handling equipment and the requirements for
lifting operations.

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 6.1: Work-Related Upper Limb
Disorders

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 Musculoskeletal Disorders and Work-Related Upper
Limb Disorders
• Musculoskeletal disorders (MSDs):
‒ A collection of injuries to the skeletal system and the soft

tissues associated with that system.

• Back injuries and back pain:
‒ E.g. back muscle strain, ligament damage and disc injury.

• Work-Related Upper Limb Disorders (WRULDs):

‒ E.g. carpal tunnel syndrome and tenosynovitis.

• Other chronic soft-tissue injuries:

‒ Associated with sitting, standing or kneeling for long periods

of time at work.

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 High-Risk Activities/Repetitive Operations
Repetitive activities that involve significant risk of
musculoskeletal disorders:
• Display Screen Equipment (DSE)
use.
• Keyboard operation.
• Factory assembly of small
components.
• Supermarket checkout operation.
• Bricklaying.

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 Musculoskeletal Disorder Risk Factors

TASK FACTORS
Repetition EQUIPMENT
Force FACTORS
Posture Design
Twisting Adjustability
Rest

ENVIRONMENT
FACTORS
Lighting
Glare
Other factors,
e.g. temperature

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 Matching the Workplace to Individual Needs

Ergonomics is concerned with the interaction between

people and:
• The tools, equipment or machinery that they are using.
• The workplace environment.
• Organisational factors.

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 A Typical Example: Display Screen Equipment

Risks:
• WRULDs.
• Back pain.
• Eye strain.
• Fatigue and stress.

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 Group Exercise
What aspects of a DSE workstation would you
need to consider to carry out a risk assessment?

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 The Control Measures
• Workstation assessment.
• Provide basic DSE workstation equipment to minimum
standards.
• Plan the work routine.
• Provide free eyesight tests and spectacles, if required.
• Provide information and training on:
‒ Risks.
‒ Preventive measures.
‒ I.e. ergonomic use of the workstation.

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 The Control Measures

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 The Control Measures
Additional points: Specific measures for
laptops:
• Desk layout.
• Document holder. • Short-duration work
only.
• Workplace lighting.
• Docking station.
• Telephone headset.
• Breaks.
• Eye test.

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 DSE Control Measures

• Workstation assessment.
• Provide basic DSE workstation equipment to minimum standards.
• Plan the work routine.
• Provide free eyesight tests and spectacles, if required.
• Provide information and training on:
‒ Risks.
‒ Preventive measures.
‒ i.e. ergonomic use of the workstation.

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 End of Module 6.1 Exercise
1. What factors increase the risk of musculoskeletal
injuries?

2. What health effects can arise due to the use of DSE?

3. What control measures should be implemented to

reduce the risk of DSE injuries? (NB not the contents of
a DSE assessment.)

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 6.2: Manual Handling

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 Manual Handling

The lifting, carrying,

pushing and pulling of a
load by bodily force.

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 Group Exercise
What common injuries occur when carrying out a
manual handling task?

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Common Types of Manual Handling Injury
• Back injury – prolapsed disc.
• Tendon and ligament injuries.
• Muscle injuries.
• Hernias.
• WRULDs.
• Cuts, burns, dislocation and broken bones.

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 Good Handling Technique
1. Before lifting: 3. Setting down:
• Check the load. • Use the same
• Plan the route of the carry. principles as
• Establish a firm grip. lifting.
• Maintain good
balance.
2. The lift: • Set the load down
• Bend the knees and use the leg and then adjust its
muscles to lift. position using
body weight.
• Keep the back upright.
• Keep the load close to the body.
• Avoid twisting, overreaching, jerking.

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 Assessing Manual Handling Risks

Four main factors:

• Task.
• Individual.

• Load.
• Environment.

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 Group Exercise
Identify the specific factors that would need to be
considered to carry out a manual handling risk
assessment.

Use the following general factor headings:

• Task.
• Individual.
• Load.
• Environment.

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 The Task
• Height of load.
• Repetition of task.
• Carry distance.
• Stooping.
• Twisting.
• Rest breaks.
• Vertical distance.
• Above shoulder height.
• Overreaching.

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 Individual Capabilities
• Unusual ability required?

• Significant risks to vulnerable people?

‒ Pregnant workers.
‒ Workers with pre-existing back injuries.

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 The Load
• Weight.
• Size and bulk.
• Stability.
• Centre of gravity.
• Grip.
• Is it hot, sharp, etc.?

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 The Environment

• Space restrictions. • Changes in floor level.

• Floor condition: • Light levels.
‐ Slippery? • Temperature.
‐ Uneven?
• Humidity.

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 Avoiding or Minimising the Manual Handling
Risks
• Eliminate.
• Assess.
• Use handling aids.
• Modify the:
‒ Task.
‒ Load.
‒ Environment.
• Match individual capabilities to the activity.

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 Avoiding or Minimising the Manual Handling
Risks
• Automation. • Pallet trucks.
• Mechanisation. • Cranes.
• Conveyor systems. • Hoists.
• Forklift trucks.

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 Avoiding or Minimising the Manual Handling
Risks
• Trolleys.

• Barrel lifts.

• Gin wheels.

• Trucks.

• Hoists and lifts.

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 Avoiding or Minimising the Manual Handling
Risks
The Task: The Environment:
• Rest breaks or job rotation. • Rearrange workspace.
• Eliminate stooping or twisting. • Level uneven floors.
• Table lift. • Additional lighting.

The Load:
• Smaller loads. The Individual:
• Stabilise loads. • Match individual capabilities to
• Mark centre of gravity. the activity.
• Attach handles.
• Several workers.

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 6.3: Load-Handling Equipment

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 Load-Handling Equipment

Caged Platform Two-Wheeled

Truck Platform Truck

Pallet Truck
Sack Truck
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 Hazards and Controls for Manually Operated
Load-Handling Equipment
Hazards:
• Manual handling risks (bodily force is still needed).
• Instability of the load.
• Moving up, down or across slopes.
• Poor parking.
• Other pedestrians may be struck.
• Trapped feet.
• Trapped person being handled.
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 Hazards and Controls for Manually Operated Load-
Handling Equipment

Controls:
• Trained workers only. • Use the brakes (if fitted).
• Follow manufacturer’s • Care when moving or lowering the
recommendations. load.
• Avoid uneven ground and slopes. • Safe parking and storage.
• Use ramps over steps. • Routine inspection and maintenance.
• Safe working load. • Safety shoes or boots.
• Securing the load.

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 People Hoists and Handling Aids
Patient hoists:
• Used for moving people:
‐ Can be manual or powered.
‐ Can be mobile or fixed.
• Consider the environment:
‐ e.g. difficult to push on
carpet.
• Regular inspection needed.

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 People Hoists and Handling Aids
Small handling aids:
• Slide sheets and transfer board slide patient from trolley
to bed.
• Avoid lifting the person.

Wheelchairs:
• Can be powered though most are pushed.

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 Group Exercise

What accidents could occur with the use of a forklift

truck?

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 Forklift Trucks
Hazards:

• Overturn of the truck.

• Fall of the load.

• Striking pedestrians.

• Fall or entrapment of persons

riding on forks.

• Fall from loading dock.

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 Forklift Trucks
Precautions:

• Restricting use. • Safe working load limits not

• Visual inspection before use. exceeded.

• Routine maintenance. • Speed limits.

• Using proper working platform • Never travelling with the forks

to lift people. raised.

• Secure and stable load. • Never travelling with

obstructed vision.

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 Forklift Trucks
Battery-Powered Trucks
Hazards: Precautions:
• Explosion from hydrogen gas • Charge batteries:
while charging. ‐ In well-ventilated areas.
• Corrosive acid. ‐ No ignition sources.
• Manual handling. • Use PPE when handling acid.
• Arcing, shock, burns or fire. • Mechanise battery handling.
• Environmental - battery • Electrical safety:
disposal. ‒ Insulated tools.
‒ Gloves.

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 Forklift Trucks
Diesel-Powered Trucks
Hazards: Precautions:
• Dermatitis from the diesel. • Use in well-ventilated
• Slip hazards. areas.

• Environmental pollution • Spill kits.

from large spills. • Use gloves when handling
• Toxic exhaust fumes. diesel.

• Bulk storage of diesel.

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 Forklift Trucks
Liquefied Petroleum (LPG)-Powered Trucks
Hazards: Precautions:
• Explosion risk from LPG. • Use in well-ventilated
areas.
• Toxic exhaust fumes.
• Mechanise LPG cylinder
• Manual handling.
handling.
• Storage of LPG cylinders
• Store spare cylinders in a:
or bulk.
‒ Secure.
‒ Safe.
‒ Well-ventilated location.
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 Lifts and Hoists
Hazards:
• Falling objects.
• Being struck by the load.
• Entanglement in moving parts.
• Falls from height.
• Being struck while riding on the platform
of the lift by:
‒ Landing levels.
‒ Parts of any enclosure.
‒ Other projections.

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 Lifts and Hoists
Precautions:
• Suitable for its intended use.
• Safety devices, e.g. brakes
• Preventing people getting: working.
‒ Underneath the hoist or lift • Competent operators.
platform.
• Information, instruction and
‒ Access to an unprotected training.
landing edge.
• Routine maintenance.
‒ Struck by landings or other
• Routine inspection and thorough
obstructions when being
examination.
carried on the platform.
• Maximum safe working load.

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 Conveyors
Hazards:
• Drawing-in hazards at in-running nip
points.
• Entanglement with rotating parts.
• Falling objects:
‒ Especially from overhead conveyors.

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 Conveyors
Precautions:
• Alarms to warn of start of
movement.
• Information, instruction and
• Guards on moving parts. training form operators.
• Emergency stops/pull-cords. • No loose clothing/long
• Exclude people from area. hair/jewellery.
• Guards beneath overhead • Inspection and maintenance.
conveyors to catch falling • Defect reporting.
objects.

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 Group Exercise

What could go wrong with a

mobile crane during its
operation?
Try to explain why.

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 Cranes
Hazards:
• The crane collapsing or toppling over.
• The arm (boom or jib) striking structures.
• Falling load.
• The load striking objects or people.
• Contact with live overhead cables.

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 Cranes

Factors causing instability:

• Overloading.
• Uneven or unstable ground.
• Not using outriggers correctly.
• Use in high winds.
• Extending the jib or boom too far.
• Structural failure.

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 Requirements for Safe Lifting Operations

General requirements:
• Suitable for the task and appropriately rated.

• Equipment stable and secure.

• Visibly marked with Safe Working Load (SWL).

• Lifting operations planned, carried out and supervised by

competent persons.

• Equipment for lifting persons may require additional

inspections.

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 Requirements for Safe Lifting Operations
• Planning and preparing the lift:

‒ Risk assessment by competent

person.
‒ Check crane test records.
‒ Trained operators.
‒ Correct type for the job and
terrain.
‒ Load within safe lifting capacity.

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 Requirements for Safe Lifting Operations
• Carrying out the lift: ‒ Check weather conditions.
‒ Use PPE (hard hats, gloves, high
‒ Careful siting.
visibility, boots)
‒ Use outriggers correctly.
‒ Warning signs.
‒ Plan and supervise lifts.
‒ Attach slings carefully.
‒ Banksman (signaller).
‒ Carry out a test lift.
‒ Overload indicators work.
‒ Guide using tag lines.

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 Requirements Statutory Examination of Lifting Equipment

Examples from EU/UK: Lifting Operations and Lifting Equipment

Regulations 1998 (LOLER)
Thorough examination:
• Before it is used for the first time.
• Periodically.
• After an event that may have affected its strength and stability.

Frequency of thorough examination:

• every 12 months - where not used to carry people,
• every 6 months - where used to carry people,
• every 6 months - lifting accessories, by a competent engineer.

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 End of Section 6.3 Exercise

1. What are the potential hazards arising from the

use of a manual pallet truck to move a heavy
load?

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 Summary
In this element, we have:
• Defined ergonomics, identified the MSDs associated with poor work
design and identified factors that influence ergonomic risk.
• Described the application of ergonomic principles to DSE use.
• Outlined the main types of injury associated with manual handling
as MSDs and WRULDs.
• Described the four main factors that have to be considered during a
manual handling risk assessment: the task, individual capabilities,
the load and the environment.

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 Summary
• Explained how risk associated with manual handling can be
controlled.
• Noted the basic principles of safe lifting technique before the lift,
during the lift and when setting down.
• Considered the hazards and safety precautions associated with
different types of lifting and moving equipment.
• Outlined the typical hazards.
• Outlined the general precautions.
• Explained how lifting equipment should be routinely inspected
and subjected to thorough examination by a competent
engineer.

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