ELEMENT 9B: Musculoskeletal Risks and Controls

9.1 Types, Causes and Examples of Musculoskeletal Hazards

9.2 Assessing the risks from repetitive physical activities, manual handling &
poor posture
1. Workers are required to pick up small pasta pieces from a delivery conveyor and transfer them to foil
trays on a separate conveyor during the production of pre-prepared pasta dishes. This work is carried out
standing in front of the conveyors for an 8-hour shift. An ergonomic risk assessment is to be carried out.
a. Outline the ergonomic risk factors to be considered in this assessment. (5)
b. A number of workers have complained about pains in their arms, shoulders and back. Other than
automation outline control measures that could help reduce the ergonomic risks these workers are exposed
to. (5)

a. In carrying out an ergonomic risk assessment of the operation described in the scenario, the factors that would
need to be taken into account include:
i. The individual factors, such as worker height;
ii. The repetitive nature of the task involving frequent movements of the upper body to pick up the pasta
and place it in foil trays;
iii. The continuous nature of the operation over an eight hour shift;
iv. The posture adopted by the operators including standing and reaching from one conveyor to another;
v. The expected work rate and the speed of the conveyors;
vi. The height of the conveyor in relation to that of the individual workers and the total pattern of
continuous work with the number and length of the breaks allowed.
b. Control measures to reduce the ill-health effects include:
i. Adjusting the height of the conveyors and re-positioning them in parallel;
ii. Arranging the work so that it might be carried out from both sides of the conveyor to prevent over-
reaching;
iii. Providing seating for the operators to enable them to change their position from time to time;
iv. Reducing the speed of the feed conveyor;
v. Using scoops or other tools to pick up the pasta;
vi. Introducing job rotation with other less demanding tasks;
vii. Providing information to the workers on the benefits of changing their posture and stretching on a
regular basis;
viii. Carrying out pre employment health screening to determine existing problems which might make
applicants unsuitable for the task and introducing health surveillance and encouraging workers to
report any problems that might arise.

2. Farmers, veterinary workers and sheep shearers often need to manually handle live animals such as sheep,
pigs or goats as part of their work. In these situations, the load is the live animal.
a. Describe factors associated with the load that increase the risk of these manual handling activities. (4)
b. Outline a range of other factors that should be considered when carrying out manual handling risk
assessments in these situations. (6)
c. Outline practical control measures that could be used in these situations to help reduce the risk of a
manual handling injury. (10)

a. Factors associated with the load that increases the risk of these manual handling activities include:

1|Page
ELEMENT 9B: Musculoskeletal Risks and Controls

i. Weight of the animal and the variation in the weight.

ii. Awkward grip, chances of sliding off the grip giving rise to peak stresses while handling, possibility of
needing forward bending as well as twisting and bending of the torso due to unpredictability of motion
of the load
iii. Chances of injury from horn, teeth, tusk, hooves etc.
iv. Aggressive tendency depending the species and breed of the animal and mood of the animal
v. Risk of infection through the livestock
b. Other factors to be considered includes:
i. The floor conditions in the farm, chances of slippery floors
ii. Size of the livestock to be managed and the number of workers in charge.
iii. Work shift duration and the exposure duration along with breaks allowed
iv. Physical and individual conditions of the farmers and experience working in similar situation
v. Temperature and environmental conditions including lighting
vi. Working postures due to shape of structures such as barricades, dividers etc. in the farm
c. Control measures in these situations include:
i. Specialist skill training in animal handling techniques and awareness if animal behaviour.
ii. Work organization with more than pairs or as a small team, short breaks and avoiding prolonged
duration of handling
iii. Good housekeeping
iv. Good hygiene habits of the livestock and personnel
v. Barricades and fixtures, crates or lifting aids built taking need for interaction in consideration.
vi. The need for appropriate PPE, such as gloves, protective boots and snugly fitting clothing
vii. Selection of breeds on the basis of docility
viii. Sedating the animal before handling.
ix. Health surveillance and reporting
x.

3. Workers in a busy restaurant frequently use hand-held trays to carry plates of food and drinks from the
kitchen to the customers’ tables. These hand-held trays can be heavy and unstable. There are regular
incidents where workers drop the trays. To help reduce these incidents, the employer has decided to
introduce on-powered trollies, on wheels, that will be used by the restaurant workers to transport their
customers’ food and drink orders.
a. Outline what the employer should consider when selecting suitable non-powered trollies for this task. (14)
b. Comment on how this change could affect the manual handling risks to the workers. (3)
c. Comment on how this change could affect other risks to the workers and to customers’ safety and health.
(3)

a. Factors to be considered while selecting suitable non-powered trollies include:

i. Consultation with the workforce
ii. Trial use of multiple options
iii. Observation of practices in other similar restaurants to identify pros and cons of different options
iv. Height of trolley compared with the height of personnel
v. Suitability of handles and provision to adjust size
vi. Adequate rim height to prevent falling off of the objects placed on the cart.
vii. Suitability of the wheel for the floor to provide smooth rolling, presence of sharp edges or corners
potentially dangerous in busy setting
viii. Spacing and arrangement in restaurant to decide on the size of the trollies

2|Page
ELEMENT 9B: Musculoskeletal Risks and Controls

ix. Availability of multiple sizes for utility and for different people
x. Conformity with relevant standards
b. The risk of carrying heavy trays filled with food causing strain of hand muscles and joints can be reduced along
with the chances of accidents of falling trays. But if not carefully implemented, this can pose a new risk for the
workers in the form of pushing the cart around, if the height of the handle is not appropriate for the height of
the person pushing or if pushing involves expending great force due to the mismatch of wheels for the floor type
along with the hazard of hitting other employees or customers if the brakes are not provided and functional.
Also, there is the risk of cuts and bruises from the edges and corners of they are not smooth enough. Frequent
bending to access the bottom most tray can be a hazard for the vulnerable group too.
c. Other risks include reduction of food being spilled on floor causing slips and trips. But if not addressed, there is
always the risk of fire exit being blocked with the cart or the cart accidentally moving on its own when not
secured properly. There is also the risk of improper brakes which can lead to bumping hazards for the
employees and the customers. It can also cause space restriction reducing comfortable mobility.

4. A parcel sorting depot is experiencing a high number of manual handling related injuries. The employees
handle a large number of different parcels and packages each day.
a. Identify the different types of hazard that may be inherent in the loads being handled. (6)
b. In order to reduce the level of manual handling required, the employer has decided to invest in a range of
non-powered handling devices, (trolleys, trucks etc). Describe the steps that should be taken when selecting
such devices and introducing their use. (10)
c. Outline a range of additional control measures that could be introduced to minimise the risks associated
with manual handling. (4)

a. The different types of hazard that could have identified included:

i. Weight of load and the fact that the weights would be unknown;
ii. Parcels may be difficult to grasp, as they are likely to be smooth with no handholds with unstable
contents which are likely to move or with the centre of gravity not in the centre of the parcel;
iii. Awkward shapes would be common or parcels that are too large for the handler to see over;
iv. Sharp edges or corners and the possibility that the contents might spill out, some of which could be
hazardous.
v. Stretching and reaching to heights to access parcels from stacks
vi. Risk in moving heavy load to a distance carrying it.
b. Steps to be taken when selecting non powered handling devices and introducing their use are:
i. Consultation with employees both in selection and trials
ii. Seeking advice from suppliers and contemporaries on suitability
iii. Requesting equipment on a trial basis to check whether it solves the problem without creating new ones
iv. Observing the equipment in use at other organisations
v. Considering the requirements for maintenance
vi. Ensuring the proposed use will be within the safe working load of the device
vii. Ensuring there is sufficient room to manoeuvre
viii. Ensuring the suitability of the device in the light of the stability and surface of the terrain on which it was
to be used
ix. Checking that braking controls were adequate and that the handle height was adjustable between waist
and shoulder and
x. That the design of the equipment was such as to prevent parcels from falling off.
xi. As far as introducing the use of the devices, this would require consideration of operator training,
storage when not in use, maintenance arrangements and a procedure for reporting defects; and

3|Page
ELEMENT 9B: Musculoskeletal Risks and Controls

xii. Ensuring there are a sufficient number of devices available which are readily accessible.
c. Additional control measures that could be considered includes:
i. Changing the workplace layout to reduce carrying distances, twisting and stooping and
ii. avoiding lifting from floor level or above shoulder height;
iii. Varying the work and its duration and pace;
iv. Marking up loads with information such as the weight and the heavy end;
v. Introducing mechanical assistance such as conveyors or fork lift trucks;
vi. Using team lifting where appropriate and
vii. Providing training in manual handling.

5. A worker on a production line is required to stand in front of his workbench, which is 750mm deep and set
at waist height. The worker must frequently lift a 20kg item of equipment from his workbench onto an
unpowered roller conveyor which is behind it. The conveyor is set slightly higher than the workbench (see
diagram).

a. Explain why the current method of working is not acceptable. (4)

b. Outline practical measures that might be considered to reduce the ergonomic related risk to the worker. (6)

a. The degree of stooping and bending required coupled with the need to handle loads away from the body will
increase stress to the lower back, with the frequency of the operation increasing the risk with the result that
injury, particularly to the back, would be caused. The issue of handling loads at arm’s length, such as the fact
that it imposes around five times the stress and the 20kg load size exceeds the good practice guidelines.
Acceptable load being carried at an arm’s length is restricted at 10kg for men and 7kg for women accounting for
the fact that the job is repeated.
b. Practical measures that might be considered to reduce ergonomic related risk to the worker includes:
i. Reducing the weight of the load;
ii. Providing a mechanical device such as counter balanced lifting arm to move the equipment onto the
roller conveyor;
iii. Re-arranging the work-station so that the conveyor is at the side of the bench enabling the equipment
to be slid onto the rollers;
iv. Design modifications like slotted and rimmed conveyor and uni-directional wheeled board which can be
pushed onto the conveyor which can be rotated and reused;
v. Reducing the depth of the work-station to reduce the distance the load has to be lifted away from the
body;
vi. The possibility of introducing job rotation together with the provision of frequent breaks for the
operators.

4|Page
ELEMENT 9B: Musculoskeletal Risks and Controls

6. A company has decided to close its offices and allow the 30 workers to work from home. The company will
provide each worker with their own portable (laptop) computer for use at home and on their daily visits to
customers.
a. Outline the factors which should be considered to minimise ergonomic risks to their workers when
purchasing these laptops AND bringing them into use. (10)

The initial selection and purchase of the equipment is of prime importance if the computer is to be used on the
move where consideration would need to be given to the provision of as large a screen as possible; to the weight of
the equipment; to the provision of light weight carrying cases or trolleys and to the provision of friction pads to
stop the computer slipping during use.

During home use consideration would have to be given to the provision of a separate mouse and keyboard and a
separate screen or docking station as well as the provision of other workstation equipment such as a chair and desk.

Other factors which would have to be considered would be the involvement of the users in the selection of the
equipment; revising the display screen equipment and manual handling risk assessments to reflect the new mode
of working and providing training on the use of the portable machines with reference to carrying out risk
assessments on workstations created at home or on the move; on minimising the ergonomic risks associated with
correct set-up and use, for example on the importance of taking regular breaks and on minimising the manual
handling risks associated with carrying the laptop.

7. Work Related Upper Limb Disorders (WRULDs) can develop whilst carrying out work including
assembling components on a production line, preparation of filtered coffees in coffee shops or supermarket
cashiers handling and packing shopping items.
a. Identify the signs and symptoms of WRULDs. (2)
b. Outline control measures that could reduce the risk to workers of developing WRULDs. (8)

a. Few of the signs and symptoms includes tenderness or pain in the shoulder, arms and even neck; stiffness and
weakness and tingling, numbness and cramp. Also includes reduced sensation in palm, side fingers and thumb
(carpel tunnel syndrome). There are disorders which cause pain in elbow like epicondylitis along with
inflammation.
b. Control measures that could reduce the risk to workers of developing WRULDs include:
a. Reducing repetition by breaking up the periods of work and introducing several short breaks;
b. Reducing the amount of force required to complete an operation by the provision of lightweight tools;
c. Reducing the distance an item has to be moved and eliminating the need to lift the item by using
alternative methods such as sliding;
d. Maintaining handles and controls to avoid the need for unnecessary force;
e. Providing supports, jigs and counter balances;
f. Ensuring that the correct tools are used for the operation and that they are maintained on a regular
basis.
Additional measures would involve:
g. Finding the correct working position by designing work equipment for workers of differing size and build
and those who are left-handed and providing adjustable chairs and footrests and tools with a suitable
size grip;
h. Improving the work environment by ensuring the working temperature is comfortable and that workers
do not have to work in proximity to air vents and air conditioning system outlets;
i. Ensuring a good standard of lighting avoiding reflection and glare and using local lighting or personal
lamps where these are thought to be necessary;

5|Page
ELEMENT 9B: Musculoskeletal Risks and Controls

j. Possibility of job or worker rotation should be considered with the introduction of warm up activities
before starting work.

8. Outline issues that need to be considered when selecting adequate seating to minimise the ergonomic risk
to workers. (10)
Issues to be considered when selecting adequate seating to minimize the ergonomic risk to workers include:

i. Seating to allow freedom of movement, with rollers and provision for rotation fitted on allowing access to
the necessary spots on workstation according to the job performed. When in need of stability, stable base to
be preferred
ii. Seating to be comfortable with adequate cushioning and lower back support, firm but not creating pressure
points, adjustable in both directions
iii. Seating to have provision for adjusting height to make it possible to accommodate different people and
different uses. It should be able to make the eye level match with the top of Display screen
iv. Adequate footrest to be considered for employees who cannot comfortably place his or her feet flat on floor
v. Seating width and depth of the chair should be adequate according to the size of the person, too big seat for
short person can cause them to lean forward while working hence causing strain to the back muscles along
with seating angle
vi. Current workstation design is to be considered to allow spacing between the seating and the work-desk for
the workers to comfortably accommodate their legs
vii. Adjustable armrest to accommodate a selection of sizes
viii. Comfortable and breathable seating material that is durable and would not soak up moisture easily.
ix. Devoid of sharp corners or edges which can cause injuries or can exert pressure, especially in armrest and
base
x. Castor wheels with more than 5 points for stable support without tipping and easy access

9. The Health and Safety Executive’s (HSE’s) manual handling assessment charts (MAC) is a tool that can be
used to determine manual handling risks of various types of activity, including lifting operations. The
MAC tool assigns numerical scores to a range of risk factors.
a.
i. Identify FIVE risk factors in the MAC tool that should be considered for a lifting operation
carried out by an individual. (5)
ii. For EACH of the risk factors identified in (a) (i), describe how the numerical scores vary as
the lifting operation changes. (5) Reference to the exact numerical scores is not required.
b. Explain why using the MAC tool alone may not result in a fully ‘suitable and sufficient’ risk assessment. (5)
An internet-based delivery organisation operates a large warehouse where workers pick loads weighing
between 2kg and 20kg. The workers carry these loads to an area where the items are stacked on to pallets.
The organisation decides to use the HSE’s variable manual handling assessment chart (V-MAC) to assess
the manual handling risks to its workers, who work 8-hour shifts.
c. Outline why the V-MAC tool is suitable in this scenario. (4)
Delivery drivers use pallet trucks to load the stacked pallets on to delivery vehicles.
d. Comment on the use of the V-MAC tool in this situation. (1)

a.
i.
Load/frequency, distance of hand from the lower back, vertical lift region, twisting or bending, postural
constraints, grip provision on the load, floor surface, other environmental conditions
ii. Green or low score of 0 for safe condition, 2/3 (red/purple) for most risky condition.
b. Factors not included:
i. Repetition of the work

6|Page
ELEMENT 9B: Musculoskeletal Risks and Controls

ii. Individual capabilities and susceptibilities

iii. Working conditions like seated handling, handling livestock and animals, load sliding activities, pushing
and pulling, walking with load etc.
iv. Manual handling coupled with non-powered tools
v. Selection bias
c. V-MAC is suitable because:
i. The job involves repetitive manual lifting and carrying
ii. The job is carried away regularly everyday
iii. The handling lasts for more than four hours
iv. The weights of the loads were significantly different (>2kg difference between the lightest and heaviest
d. As this doesn’t involve repetitive manual handling job, done regularly for more than 4 hours a day, this can’t be
assessed using V-MAC tool.

10. Bulldozer drivers at a large construction site have reported incidences of back pain which they believe are
caused by exposure to whole body vibration.
a. Outline a range of control measures that could be used to minimise the risk of the drivers experiencing
back pain caused by exposure to whole body vibration. (7)
b. Suggest THREE other possible work-related causes of the back pain being experienced by these bulldozer
drivers. (3)

a. Control measures that could be used to minimise the risk to bulldozer drivers from exposure to whole body
vibration include:
i. Selecting a vehicle with the size, power and capacity best suited for the terrain and task
ii. Organising traffic routes used by bulldozers to avoid as far as possible the need to travel on rough and
uneven surfaces
iii. Maintaining site roadways and vehicle suspensions
iv. Ensuring that an individual’s exposure to whole body vibration is kept below recommended thresholds
v. Fitting suspension seats with vibration damping characteristics and adjusting these to suit the weight of
individual drivers to avoid “bottoming out”
vi. Organising work patterns including job rotation to ensure that drivers have breaks away from the vehicle
vii. Advising them on how to minimise exposure to whole body vibration by avoiding jolts and shocks.
b. Other possible work-related causes for the back pain such as:
i. Poor posture
ii. Sitting for long periods of time
iii. The poor layout of controls requiring the driver to stretch and twist to reach a particular control or to
obtain good vision
iv. Incorrect seat adjustment or no method provided for adjustment which could make hand and foot
controls difficult to operate
v. The repeated climbing into and jumping down from a high cab
vi. Carrying out other construction related activities such as the manual handling of heavy loads.

11. Outline the factors that should be considered in relation to the job, the individual and the work
environment when carrying out an assessment of ergonomic risks in a workplace. (10)
The Job factors that should be considered when carrying out an assessment of ergonomic risks in a workplace include:

i. Duration
ii. Repetition

7|Page
ELEMENT 9B: Musculoskeletal Risks and Controls

iii. Work rate

iv. Opportunity for breaks
v. Equipment used as part of the job – amount of force exerted for operating it, risks in design and layout of the
controls
vi. Posture adopted to carry out the job, involvement of frequent twisting and turning

The individual factors that should be considered when carrying out an assessment of ergonomic risks in a workplace
includes:

i. Shape and size of the individual, measurements when relevant

ii. Strength and musculature
iii. General fitness, mobility
iv. Age, gender and sensory ability such as hearing, vision
v. Susceptibility, vulnerability, preexisting condition
vi. Mental capability, level of experience, knowledge and level of training

The working environment related factors that should be considered when carrying out an assessment of ergonomic risks
in a workplace includes:

i. Work-station design
ii. Lighting
iii. Temperature
iv. Noise
v. Humidity
vi. Space
vii. Floor conditions

12.
a. Give the meaning of the term ‘ergonomics’. (2)
b. Outline the effects on health and safety which can arise from poor ergonomic design. (4)
c. Lifting and handling aids are frequently used to reduce the risk from manual handling when lifting loads.
Outline the factors to consider when selecting lifting and handling aids. (4)

a. Ergonomic principle is designing the workplace, work methods and work equipment to suit the worker or
ensuring a good fit between the person and their workplace as far as tools, equipment and workstation are
concerned.
b. Physical harm in terms of discomfort, fatigue, back strain and work related upper limb disorders (WRULDs) as
well as mental harm as evidenced by increased stress, lack of motivation and an increase in error leading to
accidents or incidents.
c. Factors to be considered would include
i. seeking advice and information from suppliers, occupational health nurses and hygienists;
ii. Observing solutions in use from similar industries and if possible trying out a variety of aids before
purchase.
iii. It will be important to check that the aid is in conformity with the relevant standards;
iv. That it is safe working load is suitable for the work to be done;
v. To ensure that it can be used where there may be space constraints and to enquire as to its
maintenance requirements;
vi. The suitability of the safe working load or conformity to standards;

8|Page
ELEMENT 9B: Musculoskeletal Risks and Controls

vii. The influence the selection process on the lifting and handling aids.

13. Window cleaners frequently use extending ladders. They unload the ladders from the roof of their van,
carry them to position and extend them to reach higher windows. When they have cleaned the windows,
they load the ladders back on to the roof of the van before moving to the next location.
a. Outline manual handling risk factors when using these ladders. (7)
b. You are not required to include any risks relating to working at height in your answer. The employer
wants workers to store the ladders inside the van and not on the roof. Comment on how this change could
affect the manual handling risks. (2)
c. Outline ONE change in working practice that could eliminate the manual handling risks from using
extending ladders for the window cleaners. (1)

a.
i. Lifting heavy object
ii. Carrying to a distance
iii. Team handling
iv. Heavy material with risks of bruising
v. Repetitive work
b. Reduced risk of lifting but increased risk of hitting inside the van walls and causing peak stress and
musculoskeletal injury
c. Extended brush and hose system or MEWP

9|Page