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Manual Material Handling Document

The document 'Manual Materials Handling' by M.M. Ayoub and Anil Mital discusses the complexities and safety measures associated with manual materials handling in various industrial settings. It covers topics such as injury frequency, design criteria, and the physiological and biomechanical aspects of lifting and carrying. The book serves as a comprehensive guide for understanding and improving manual handling practices to reduce injuries and enhance worker safety.

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0% found this document useful (0 votes)
14 views

Manual Material Handling Document

The document 'Manual Materials Handling' by M.M. Ayoub and Anil Mital discusses the complexities and safety measures associated with manual materials handling in various industrial settings. It covers topics such as injury frequency, design criteria, and the physiological and biomechanical aspects of lifting and carrying. The book serves as a comprehensive guide for understanding and improving manual handling practices to reduce injuries and enhance worker safety.

Uploaded by

tafadzwa1045
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Manual Materials Handling

Manual Materials Handling


by

M.M. Ayoub

Texas Tech University, U SA

and

Anil Mital

University of Cincinnati, USA

London and New York


UK T aylor & Francis Ltd, 11 N e w Fetter Lane, L ondon E C 4 4EE

USA T aylor & Francis Inc., 29 W est 35th Street, N e w Y ork N Y 10001 007

Copyright © M. M. Ayoub and A. Mital 1989

R e p rin te d in 2001, 2002

Transferred to Digital Printing 2003

Taylor & Francis is an imprint o f the Taylor & Francis Group

A l l rights reserved. N o pa rt o f this publication m a y be reproduced, stored in a


retrieval system , or transmitted, in a n y fo r m or by a n y means, electronic,
electrostatic, m agnetic tape, mechanical, photocopying, recording or otherwise,
w ith o u t the prior perm ission o f the copyright owner.

The authors and publishers have made all reasonable efforts to secure
permission for the reproduction of figures and tables within this work.

British Library Cataloguing in Publication Data


Ayoub, M.M.
Manual materials handling.
1. Materials handling. Manual lifting. Safety measures
I. Title II. Mital Anil
612 '.76

ISBN 0-85066-383-0

Library o f Congress Cataloging in Publication Data

is available

Typeset in 11/12pt Bembo by Chapterhouse, The Cloisters,


Formby
Printed in G reat Britain by H obbs T he Printers Ltd
Contents

Preface xi

Chapter 1. The Materials Handling Problem 1


1.1 Introduction 1
1.2 Manual Materials Handling Injury Frenquency and Cost 1
1.3 Affected Industrial Populations 4
1.4 Scope of the Book 7
Chapter 2. Variables in Manual Materials Handling 9
2.1 W orker-Task-Environm ent ‘System’ Concept 9
2.2 The ‘W orker’ Component 12
2.2.1 Age 13
2.2.2 Sex 15
2.2.3 Body -Weight 16
2.2.4 Anthropom etry or Body Build, and Body Composition 17
2.2.5 Static and Dynamic Endurance 18
2.2.6 Strength 19
2.2.7 Training/Experience 21
2.2.8 Physical Fitness 23
2.2.9 Psychological Factors 23
2.3 The ‘Task’ Component 26
2.3.1 Frequency 31
2.3.2 Task Duration 35
2.3.3 Object Size 37
2.3.4 Object Shape 40
2.3.5 Couplings 41
2.3.6 Object W eight/Force Application (Exertion) 46
2.3.7 Load Distribution and Stability 46
2.3.8 Vertical Lift Height 48
2.3.9 Workplace Geometry 49
2.3.10 Distance Travelled/Slope and Traction 50
2.3.11 Posture/Technique 50
2.3.12 Asymmetrical Lifting/Carrying 54
2.4 The ‘Environm ent’ Component 54
2.4.1 Temperature and Humidity 54
2.4.2 Noise, Illumination and Vibration 56
2.4.3 Altitude 56
2.5 Interactive Effects of System Components 57
2.6 System Response Measures 59
vi M anual Materials Handling

Chapter 3. Design Criteria 60


3.1 Introduction 60
3.1.1 Stress/Strain Concept 60
3.1.2 M M H Stresses 60
3.2 The Biomechanical Approach 60
3.2.1 Biomechanical Analysis for M M H 60
3.2.1.1 Definitions and Applications of Biomechanics 60
3.2.1.2 The Body as a System of Levers 62
3.2.1.3 Stress on the Musculoskeletal System 63
3.2.1.3.1 Static Analysis 64
3.2.1.3.2 Analysisof One - Segment Link 64
3.2.1.3.3 Analysisof Two Links 66
3.2.1.3.4 Analysisof Multiple Links 68
3.2.1.3.5 Analysisof Internal Forces 69
3.2.1.4 Dynamic Analysis 72
3.2.1.5 Three - Dimensional Modelling 78
3.2.1.6 Stress on the Lumbosacral Spine 80
3.2.1.6.1 Symmetric Lumbar Loading 81
3.2.1.6.2 Asymmetric Lumbar Loading 84
3.2.1.6.3 The Role of Intra - Abdominal
Pressure in Spinal Loading 85
3.2.1.6.4 Use of EMG in Spinal Loading 88
3.2.1.7 Factors Affecting Biomechanical Stress on
MMH 88
3.2.1.7.1 Tissue Characteristics 88
3.2.1.8 Task Characteristics 90
3.2.1.8.1 Load Size and Shape 90
3.2.1.8.2 W eight of Load 92
3.2.1.8.3 Position of Load Relative to the
Spine 92
3.2.1.9 Biomechanical Design Criterion 92
3.2.1.9.1 Design Criterion 92
3.2.1.9.2 Models Using the Biomechanical
Criteria 95
3.2.1.9.3 Lifting Capacity Determinations 95
3.3 The Physiological Approach 97
3.3.1 Classification of Activity 97
3.3.1.1 Dynamic Activity 97
3.3.1.2 Isometric Activity 99
3.3.1.3 Semi-dynamic Activity 99
3.3.2 Physiological Response to Lifting 99
3.3.2.1 Energy Cost 100
3.3.2.2 Heart Rate 102
3.3.2.3 Blood Pressure 102
3.3.2.4 Blood Lactate Level 102
C o n te n ts vii

3.3.3 Physiological Fatigue 103


3.3.3.1 Endurance Time 104
3.3.3.1.1 Bink’s Logarithmic Formula 104
3.3.3.1.2 Graphical Interpretation, W ith
Example 104
3.3.4 Physical Fitness for Lifting 107
3.3.4.1 Aerobic Capacity 107
3.3.4.1.1 Aerobic Lifting Capacity 108
3.3.4.2 Anaerobic Threshold 109
3.3.5 Design Criterion 111
3.3.5.1 Criterion Limit 111
3.3.5.2 Factors Affecting the Design Criterion 111
3.3.5.3 Models Using the Physiologic Criterion 111
3.3.5.3.1 Frederick’s Model 111
3.3.5.3.2 G arg’s Model 112
3.3.5.3.3 Asfour’s Model 113
3.3.5.3.4 Intaranont’s Model 113
3.3.6 Comparison of Models w ith Limitations 114
3.4 The Psychophysical Approach 116
3.4.1 Rationale for Use of the Psychophysical Design
Criterion 116
3.4.2 Principles of the Psychophysical Design Criterion 118
3.4.3 Factors Affecting the Psychophysical Design Criteria 119

Chapter 4. Lifting and Lowering Activity Data Bases 121


4.1 Strength versus Capacity 121
4.2 Strength Data for Two - Handed Lifting and Lowering Activities 122
4.3 Capacity Data for Two - Handed Lifting and Lowering Activities 130
4.4 Strength Data for One - Handed Lifting and Lowering Activities 148
4.5 Capacity Data for One - Handed Lifting and Lowering Activities 152
4.6 W ork-Rate Recommendations for Two-Handed Lifting Tasks 159
4.6.1 Box Size Effects 159
4.6.2 Frequency Effects 163
4.6.3 Effects of Height Level 163
4.6.4 Comprehensive Maximum Acceptable W eight of Lift
Data Base 163
4.7 Performance Ceilings for One- and Two-Handed Lifting Tasks 163
4.7.1 One - Handed Lifting Tasks 166
4.7.2 Two - Handed Lifting Tasks 166
Chapter 5. Pushing, Pulling, Carrying and Holding Data Bases 167
5.1 Strength Data for Two - Handed Pushing and Pulling Activities 167
5.2 Capacity Data for Two - Handed Pushing and Pulling Activities 174
5.3 Strength Data for One - Handed Pushing and Pulling Activities 179
5.4 Capacity Data for One - Handed Pushing and Pulling Activities 180
5.5 Strength Data for Two - Handed Carrying Activities 180
viii Manual Materials Handling

5.6 Capacity Data for Two - Handed Carrying Activities 183


5.7 Strength Data for One - Handed Carrying Activities 184
5.8 Capacity Data for One - Handed Carrying Activities 185
5.9 Holding Data Base 185

Chapter 6. Job Design/Redesign and Screening Procedure 189


6.1 Principles of Job D esign/Redesign 189
6.1.1 Eliminating M M H 190
6.1.2 Decreasing Job Demands 190
6.1.3 Minimizing Body Movements 191
6.2 Principles of Screening Procedures 193
6.2.1 Back X - Ray Films 193
6.2.2 Strength Testing 194
6.2.3 Medical Examinations 194
6.2.4 Psychological Tests 196
6.2.5 Job Simulators 196
6.2.6 Rating Methods 196
6.3 Criteria for Screening of Personnel 197
6.4 Tools for Job Design/Redesign and Screeningw ith Examples 198
6.4.1 Job Severity Index 198
6.4.1.1 Using JSI as a Job Design/Redesign Device 198
6.4.1.2 Using JSI as a Job Screening/Placement
Device 206
6.4.1.3 JSI Validation 208
6.4.2 Job Design/Redesign in Conjunction w ith JSI 208
6.4.3 N IO SH Guidelines for Job Design/Redesign 209
6.4.4 Comparing JSI M ethod and N IO SH Guidelines for Job
Design/Redesign 210
6.4.5 Lift Strength R atio 211
6.4.5.1 Using the Lift Strength Ratio as a Job
Design/Redesign Tool 212
6.4.6 M ital’s Model for Evaluating ManualHandling Jobs 214
6.4.6.1 A Numeric Example 216
6.4.7 Lifting Optim ization Model for Job Design/Redesign 224
Chapter 7. Pre-employment Strength Testing 226
7.1 W hy Measure Human Strengths? 226
7.2 Classification and Definition of Strengths 226
7.3 Measurement of Strengths 228
7.3.1 Assessment of Isometric (Static) Strengths 229
7.3.2 Assessment of Isotonic Strengths 233
7.3.3 Assessment of Isokinetic Strengths 234
7.3.4 Assessment of Isoinertial Strengths 241
7.4 Prediction of Strengths 242
7.4.1 Prediction of Isometric Strengths 243
7.4.2 Prediction of Isokinetic Strengths 251
7.4.3 Prediction of Isoinertial Strengths 255
C o n te n ts ix

7.5 Additivity of Strengths 256


7.6 Relationship Between Strengths and Acceptable W eights of Lift 260
7.7 Repetitive Dynamic Strengths and Manual Lifting Capabilities 262
Chapter 8. Training and Manual Handling 265
8.1 Introduction 265
8.2 The Concept of Safe Lifting 265
8.3 Training Programmes: Methods and Approaches 268
8.3.1 Training Programmes W ithin Industrial Organizations 268
8.3.2 Training/Rehabilitation Programmes Outside the
Industrial Organization 270
8.4 Effectiveness of Training Programmes 272
8.5 Summary 273

Chapter 9. Determination of Rest Allowances 274


9.1 The Need for Rest Allowances 274
9.2 Methods of Determining Rest Allowances 274
9.2.1 Metabolic Energy Expenditure Rate Models for
Determining Rest Allowances 276
9.3 Limitations of the Metabolic Energy Expenditure Rate Method 277
9.4 A Comprehensive Metabolic Energy Model for Determining
Rest Allowances 278
9.4.1 Data Collection and Results 278
9.5 Model Development 281
9.5.1 Concept 281
9.5.2 Assumption 281
9.5.3 Model Structure 283
9.5.4 Model Validation 284
9.5.5 Example 285
9.6 Com puter Program 286

Appendix 290
Software Program: Calculating Rest Period Duration 290
References 297
Index 321
Preface

For nearly four decades, manual handling of materials has been a major topic of interest
to professionals from a number of disciplines, including engineering, ergonomics,
physical therapy and rehabilitation, orthopaedic surgery, w ork physiology and
biomechanics. The primary reason for this is the devastating cost and human suffering
caused by the severity of material handling related injuries. Prevention and control of
these inuries is a global concern, shared by many researchers and organizations.
Over the years, the application of ergonomics and ergonomic principles has resulted
in a vast scientific literature dealing w ith various aspects of manual materials handling
problems, published in numerous scientific journals and conference proceedings
worldwide. W ith the added contribution of much data from the authors’ published
and unpublished w ork, this book is the first significant effort to review an extensive
amount of published literature and condense relevant findings for use by researchers
and practitioners. The book, as a whole, highlights the problems and hazards of
manual materials handling and provides ergonomic and engineering solutions for
alleviating them.
The nine chapters of the book provide a comprehensive overview of manual
materials handling. The first chapter deals w ith the problem and its importance.
Research literature dealing w ith the vast number of variables that influence materials
handling capacities of individual workers are reviewed in the second chapter. The
third, and the primary focus of the book, discusses design criteria based upon
biomechanics, physiology and psychophysics. The next tw o chapters are devoted to
design data for activities such as lifting, pushing and carrying. In the sixth chapter the
focus is on job design, redesign and screening procedures that are presently available.
The relevance of pre -employment strength testing and training are dealt w ith in the
next tw o chapters, and in the last chapter the need for providing rest allowances is
discussed along w ith a method for determining them.
We hope that this book fills a critical void and proves useful to both researchers and
practitioners w ho are committed to solving the multifaceted manual materials
handling problem. The book should also be useful to individuals who need to have
background information in this area.
Finally, we realize that even though, over the two - year w riting period, every effort
was made to include all available information, it is possible that some relevant
literature was inadvertently overlooked. We hope that such omissions, if any, are not
serious and in no way undermine what we believe to be the importance of this book.

xi
xii Preface

Acknowledgements

A number of individuals provided invaluable assistance during the w riting of this


book. In particular, the authors wish to thank D r Joseph Selan, w ho lent his support
by assembling a considerable amount of material for the text, D r H . C. Chen for his
considerable efforts in preparing the artw ork and collecting material, and M r Hong - Ki
Kim and Ms Sarah Farnsworth w ho worked diligently to collect and assemble support
materials for certain chapters.
The authors are also indebted to all their graduate students, especially Ms Marta
Miller w ho patiently traced and checked all the references for their correctness for pub ­
lication, and last, but not least, to Ms Beverly Strickland for typing the manuscript
and making numerous changes.

M. M. Ayoub and A. Mital


Lubbock and Cincinnati
July 1989
Chapter 1
The Materials Handling Problem

1.1 Introduction
Research in the area of manual materials handling (MMH) has been conducted for
over a quarter of a century and continues to be performed today. The research, basic­
ally, has entailed the establishment of acceptable handling limits using several different
approaches, and the application of ergonomic principles to job design, employee place­
ment and employee training. The reason for this immense quantity of research is that
M M H , in particular manual lifting, represents a major cause of injury to industrial
workers and cost to industry. In this chapter, the scope of the M M H problem con ­
fronting industry is discussed.
The question of sex and age differences has been addressed w ith regard to back
injury statistics. According to Laughery and Schmidt (1984), age and sex variables do
not affect back injury rates significantly. Possible explanations given by the authors
include: (1) job assignments may be based on age and/or sex, and (2) older workers are
generally more experienced at their job. Figure 1.1 presents age and sex-specific ratios
of compensation claims according to the Bureau of Labor Statistics’ Supplementary
Data System (SDS). Contradicting the Laughery and Schmidt (1984) conclusions,
Figure 1.1 indicates a significant decrease in injury claims as worker age increases. Less
work experience associated w ith younger workers may be a partial explanation. Also,
a process of self-selection may occur on many physically demanding jobs, w ith the
individual lacking the necessary capacities to perform the job thus dropping out (either
by choice or because of injury), which leaves the job for workers w ith capacities better
suited to the job demands.

1.2 Manual Materials Handling Injury Frequency and Cost


Back injuries, particularly injuries to the lower back, occur w ith alarming frequency.
Caillet (1981) estimates that 70 million Americans have suffered back injuries, and that
this number will increase by 7 million people annually. Approximately 5 million
people are partly disabled because of back injuries, and 2 million people are not able to
w ork at all because of back injuries. O ther estimates indicate that 6*5 million
Americans lie in bed on any given day because of back pain. This estimate increases by
1*5 million m onthly (Keim, 1981). The cost of such a prevalent pain problem is exor ­
bitant for industries. Klein etal. (1984) estimate that 19*0-25*5% of all workers’ com ­
pensation claims are due to back pain. Table 1.1 details types of events or exposures

1
2 M anual Materials Handling

< 20 25 - 29 35 - 44 55 - 64
20 - 24 30 - 34 45 - 54 65 +

AGE GROUPS

Figure 1.1. A g e - and sex-specific ratios o f compensation claims in 2 6 S D S States due to strains/sprains o f the back
(Klein et al., 1984) with permission o f Am erican Society o f Occupational Medicine

Table 1.1. 1979 workers ' compensation claims in the 2 6 S D S States fo r back strains/sprains according to type o f
event or exposure (after K lein et al., 1984)

N o. of % o f all back
Type claims strains/sprains

L ifting objects 1 37 3 2 7 48* 1


O ver - exertion, not elsewhere classified 25 823 9 -0
Pulling or pushing objects 25 557 9 -0
Voluntary bodily m otions 1 8 909 6 -6
H olding, w ielding, th row in g or carrying objects 16181 5-7
Involuntary bodily m otions 133 5 3 4 -7
Falls on w ork in g surfaces 12150 4 -3
O ver - exertions, not elsewhere classified 6433 2 -3
O thers, individually less than 2% 29 735 10*4

Total 285468 100 - 1


The Materials Handling Problem 3

leading to back strains/sprains in addition to the number of claims and percentages of


all back sprain/strains according to SDS. As Table 1.1 indicates, nearly 50% of all back
strains/sprains were precipitated by the manual lifting of objects.
According to Khalil et al. (1984) low -back pain is the second largest pain problem,
headaches being the first. W hite (1983) reported that more than 70 million people, in
the USA alone, see a physician annually complaining of low -back pain, while 17
million return to their physicians due to chronic low -back pain. Loesser (1979)
estimated that, because of low -back pain, approximately 170 million w orking days are
lost each year in the USA. This is indeed an expensive industrial problem considering
that not only do industries pay w orkm en’s compensation, but also spend billions of
dollars on tests, treatments, claims, lawsuit awards, settlement and surgeries. Table
1.2 includes the type of injury, the number of cases and the mean cost per case
according to SDS. Additionally, Figure 1.2 summarizes the National Safety Council’s
w ork injury and cost statistics from 1972 -84 (National Safety Council, 1972-84).
Figure 1.2 reveals tw o intriguing facts regarding MMH - related injuries. First,
despite improved medical care, increased automation in industry, and more extensive
use of pre - employment examinations, only a marginal decline in worker injuries is
observed. Secondly, the cost of these injuries has increased at an alarming rate,
although the figure suggests that these costs may be levelling off. Although outside
the realm of this text, the possibility that the lack of decline in worker injuries is
related to the increased potential monetary gains associated w ith a work - related injury
cannot be dismissed.

WORK INJURY AND COST STATISTICS

BY YEAR

COST: Bil
cn
UJ
GC INJU: Mil
D

>-
UJ

o
z

73 75 77 79 81 83
YEAR

Figure 1.2. W ork injury and cost statistics


4 Manual Materials Handling

Table 1.2. M ean medical and indemnity compensation costs fo r 1979 workers ' compensation claims due to back
injuries in fiv e “Closed ” S D S States by type o f injury (after K lein et al., 1984)

N o . o f cases Mean cost


Type reporting cost data per case ($)

Medical payment

Inflamed joints 200 4689


D islocation 762 3533
Fracture 344 1888
Strains/sprains 1 1 740 470
Laceration 24 425
C ontusion 578 303

Indem nity com pensation

D islocation 2906 19 536


Inflamed joints 235 7120
Fracture 848 6 710
N erve involvem ent 132 5045
Strains/sprains 33 794 3036
Laceration 40 2712
C ontusion 1101 1439
Burn/scald 23 891

1.3 Affected Industrial Populations


Back pain has been categorized into occupational and non -occupational origins. The
context of this text dictates the exploration of occupational origins of back pain. The
origin is categorized as occupational if the relationship between the w ork tasks and
back injuries can be established.
Nurses experience more back injuries than most occupational groups (Jensen, 1985,
1986; Klein et al., 1984), and are particularly vulnerable to low -back pain by virtue of
their occupation (Harber et al., 1985). Harber et al. (1985) studied a varied American
population of nurses which included a large spectrum of back pain, not just severe
cases of back pain to which researchers often restrict their investigations. It was found
that the prevalence, incidence and lost w ork time were high, and interference w ith
effective w ork was great. According to Harber etal. (1985), these parameters had been
underestimated by the employee health service and need to be addressed.
In the Harber et al. (1985) study, questionnaires were sent to 1000 nursing staff
members which included nurses, vocational nurses and administrative staff. Five
hundred and fifty persons responded by the closing date. Overall, 52% of nurses
reported the development of lower back pain in the previous six months, while only
20% of the unit service co -ordinators, w ho conduct clerical activities in the nursing
units, reported the development of lower back pain. Twenty - nine percent of the nurses
reported taking medicine for back pain, while 9% reported missing work due to back
pain. W hile these staggering statistics delineate a widespread problem, the reader
should be aware that the prevalence of back injuries for nurses may not be reflected in
traditional injury statistics. Only 4% of the respondents had been hospitalized for back
pain and 2% reported a history of surgery for these disorders. Furthermore, only 125
nurses had reported having seen a physician because of occupational back pain.
The Materials Handling Problem 5

Nurses are not the only occupational group characterized by back injuries. Cons ­
truction and mine workers also are plagued by back injuries. Descriptive data from the
1979 w orkers’ compensation claims from the Bureau of Labor Statistics’ SDS reveals
that construction workers have the highest incidence ratio; 1*6 claims per 100
workers over a year, while they are ranked fourth for number of claims according to
Klein et al. (1984). Mine workers are rated second, having an incidence ratio of 1*5
claims per 100 workers. Table 1.3 describes the distribution of compensation claims for
back sprains/strains by industry employment. Estimated employment in each industry
is given as are the claims per 100 employees.

Table 1.3. 1979 ratios (claims per 100 workers)o f compensation claims fo r back strains/sprains in 26 S D S States,
by industry (after K lein et al., 1984)

Estimated Claims
N o. of em ploym ent per 100
Industry claims in (1000s) em ployees

Construction 31028 1 9 6 4 -2 1 -6
M ining 4946 3 1 9 -5 1 -5
Transportation 25338 2 1 6 6 -7 1 -2
M anufacturing 92 556 8 8 7 1 -4 1 -0
Agriculture 6077 6 7 7 -0 0 -9
Services 53 3 1 3 7 3 7 1 -5 0 -7
W holesale/retail trade 56 745 8 9 5 6 -3 0 -6
Governm ent (state &
local) 14 463 5 8 5 9 -9 0 -2
Finance 4032 2 0 6 3 -6 0 -2

Total 285 468 3 8 2 5 0 -1 0 -7

Additional research reveals that back injuries account for 21% of all injuries in
underground coal mines, 15% of all injuries in underground metal mines and 18% of
all injuries in underground non -metal mines. W hen these injuries are categorized into
various injury types, the strain/sprain injury type is dominated by back injuries
(Stobbe et al.y 1986).
O n average, 3 - 4 weeks of w ork are lost per case because of strain/sprain injuries.
According to Stobbe et al. (1986), back strains/sprains are the most frequent kind of
strain/sprain, although not necessarily the most severe in terms of days lost from
work.
Back strains/sprains in the underground coal mining industry accounted for an
average of 21*1 and 19-5 days lost in 1983 and 1984, respectively. The number of days
lost accounted for 52% of all days lost associated w ith strains/sprains, while back
injuries accounted for 55% of all strain/sprain injuries. Back strains/sprains in under ­
ground metal/non - metal mining accounted for an average of 7*9 and 5*8 w ork days
lost in 1983 and 1984, respectively. The number of days lost accounted for 61% of all
days lost associated w ith strains/sprains, while back injuries accounted for 52% of the
strain/sprain injuries.
Establishing causal relationships for back injuries and pain is often a difficult chore
6 M anual Materials Handling

due to the intertw ining causal variables. However, researchers have been able to isolate
certain broad areas of concern.
The main causes of nurses’ high frequency of back injuries are believed to be lifting
and manoeuvring patients. This belief is based on personal experience of individual
authors, unpublished analyses of hospital injury records and surveys (Jensen, 1985). In
the survey by Harber et al. (1985), respondents associated lifting a patient in bed
(48%), helping patients out of bed (30%), moving beds (27%) and lifting a patient to
a gurney [trolley] (22%) w ith back pain. This study does suggest that much of the
back pain is work - related since there is a significant difference between nurses and
administrative employees, and that the results are consistent among different time
frames.
The study by Snook et al. (1978) supports the contention that the main source of
back pain is w ork related. In this study, a correlation of 0.88 was found between a
specific act or movement at w ork and compensable back injuries. However, it may be
that the nurses have been trained such that they believe that back pain is associated
w ith patient handling and thus attribute pain to patient handling by virtue of their
training; a self-fulfilling prophecy. According to Jensen (1985), w ith the available
information, it can be estimated that 38 - 46% of all back episodes, and 73 - 81% of all
compensable back pain are attributed to patient handling. However, Jensen (1985)
warns the reader that these statistics are based on the few available studies, and
suggests that more rigorous studies be conducted to verify such statistics.
Unlike accident data from the nursing occupation, no causal inferences have been
made w ith regard to the construction or mining occupations. However, Stobbe et al.
(1986) offer accident classification information of strains and sprains (Table 1.4), and
the sources of strains and sprains (Table 1.5) and activities at the time of back strain or
sprain (Table 1.6) for underground coal, metal and non -metal miners. The tables
indicate that manual handling is pre - eminently associated w ith worker injuries.

Table 1.4. Accident classification strain and sprain injuries (after Stobbe et al., 1986)

Coal M etal/n on - m etal

1983 1984 1983 1984

R o o f fall 1*9* 21 10 3 -2
Material handling 551 5 1 -8 4 1 -2 4 5 -4
Hand tools 40 4 -7 121 8 -5
Powered haulage 9 -0 9 -8 3 -3 5 -0
Machinery 5 -0 5 -2 7 -5 9 -6
Slips/falls 16 - 2 18 - 5 25 -8 2 0 -9
Step/kneel on object 4*6 41 7-5 3*5
Strike/bum p 1-8 21 0 -3 0 -4
Other 2 -3 1 -8 1 -3 3 -5

Baseline 2475 2776 306 282

* Figures are percentage o f baseline at b ottom o f colum n.


The Materials Handling Problem 1

Table 1.5. Sources o f strain and sprain injuries in mining (after Stobbe et al., 1986)

C oal M etal/non - m etal

1983 1984 1983 1984

General supplies 10*6* 9 -7 7*5 60


B elt/con veyor 4 -0 4 -0 00 0 -0
Cable handling 8 -8 9 -8 2*3 1 -4
Tool use 3 -8 4 -4 1 0 -5 12 - 1
M ining machinery 4 -2 4 -0 1 0 -8 8 -9
Metal N E C , - d oors, pipes, etc. 6 -0 6 -4 6*9 6 -7
R ock , coal, ore, etc. 131 11 - 3 1 3 -7 1 1 -7
M ine transport 51 5 -8 20 3 -5
Post, crib, timber, etc. '7-4 8 -9 4 -9 6 -7
B ottom condition 13 - 7 15 - 7 2 1 -2 1 5 -6
Other 23*3 20 - 1 2 0 -3 2 7 -3

Baseline 2475 2776 306 282

Figures are percentage o f baseline at bottom o f colum n.

Table 1.6. A ctivity at time o f injury strain and sprain back injuries (after Stobbe et al., 1986)

C oal M etal/non - ■metal

1983 1984 1983 1984

Material handling 38 - 0 * 3 5 -0 2 9 -9 38*2


Tim bering 9 -4 9 -6 1 0 -4 6 -9
Cable handling 1 0 -4 12 - 1 30 2 -8
S h ovel/m ove rock, coal, etc 9 -1 81 5 -5 4 -9
Machine repair 60 50 5 -5 2 -8
Equipment R L T D 1 0 -6 131 1 2 -8 1 3 -2
W alk in g/run n in g 4 -2 3 -8 6*1 6 -3
Other 12 - 2 13 - 3 26*8 2 5 -0

Baseline 1367 1507 164 144

* Figures are percentage o f baseline at b ottom o f colum n.

1.4 Scope o f the Book


The theme of this book is to expose the reader to the available information directly
concerning manual materials handling. A wide range of topics are covered from
variables influencing the M M H activity, to designing optimal M M H tasks, to deter ­
mining rest durations. More specifically, Chapter 2 lists and describes variables that
affect M M H activities. Chapter 3 addresses criteria necessary to design M M H
activities which originate from three different approaches; the biomechanical,
physiological and psychophysical approaches. Chapter 4 describes different data bases
from which lifting and lowering activities can be designed which include strength and
capacity data for one- or two - handed M M H activities. Similarly, Chapter 5 describes
8 Manual Materials Handling

different data bases from which pushing, pulling, carrying and holding activities can
be designed. Chapter 6 lends insight into screening procedures and/or design /re ­
designing M M H tasks. Chapter 7 is devoted to strength testing procedures which
include assessment of isokinetic, isotonic and isoinertial strengths. Chapter 8
continues w ith a discussion about training and know n effects of training. And finally,
Chapter 9 describes the determination of rest allowances.
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