Back Injury Prevention

EDUCATION AND
TRAINING

JOB ANALYSIS

WORK
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JOB DESCRIPTION

JOB PLACEMENT
JOB OFFER PLACEMENT
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INJURY
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• Industrial Therapy is working to the impact of
back injuries on industry, through innovative ,
enlightened prevention, and management
stratergies.
• Industrial back injuries and their associated
costs have a dramatic and severe effect upon
the financial viability of many companies and
costs of many products.
 Back Injury Consultant
• When industrial therapists become involved in
back injury prevention and management, they
should think of themselves as “ consultant”, not
just a therapist, because they should do much
more than simply rehabilitate injured back.
• They must also explore and address the
company’s attitude and practice which can
significantly affect the incidence and severity of
these injuries.
• The consultant should inform the client that
he can offer a much more intervention – one
that helps them start a back injury prevention
process.
• By using a process oriented approach, the goal
of awareness is accomplished, while more
importantly fostering the development of
policies, practices, and procedures which
facilitates the move from awareness to action
 Back injury prevention is a process that
incorporates management, ergonomics,
fitness for work , education , and training.

Management

Fitness for Back injury Ergonomics

work prevention

Education &
training
 Intervention Strategies
• It is important for the therapist, potential consultant and
experienced consultants, to take a comprehensive
process-oriented approach to the prevention of back
pain. As the cause of back pain is multifaceted.
• Back injury prevention is most effective when four
primary and interrelated intervention strategies work in
concert:
 Management practices: Organizational management,
Medical management, and claims management.
 Ergonomics
 Fitness for work
 Education and training
• Organizational management approaches
place paramount importance on the actions
and responses of the management team.
• Strategies which help management develop a
comprehensive, prevention-oriented
philosophy and provide a way to handle
injuries when they do occur are imperative
(very imp).
• Medical management methods provide
employees with knowledge about warning
signs and symptoms, so that intervention can
happen as soon as possible.
• Companies should be ready to implement
modified duty, on-the-job Work Hardening,
and ergonomic measures where warranted.
• Claims management principles should be
understood and followed by company benefits
personnel.
• There should be a formal written Claims
Management Policy outlining the steps from point
of injury, through acute care, then rehabilitation,
and return –to- work. Regular communication
with the injured employee and medical providers
throughout this process is essential.
• Ergonomics helps to provide a safer,
more productive workplace as part of the
overall prevention process.
• For eg: ergonomic changes may help
workers choose less risky behaviours.
• Risk of injury has been reduced due to
ergonomic modification supported by
management, the remaining risk can be
lessened through worker related
interventions such as body mechanics
training or instruction in the proper use of
new ergonomic equipment.
• Fitness for work is important to all preventive
process. No matter how well a company
performs in all other areas, injuries will still be
a problem if members of the work force are not
fit to perform the physical demands of jobs.
• Employees can do to facilitate on-the-job
fitness to motivate and educate individuals to
practice healthier lifestyles away from job.
• Education and training is the vehicle used by
consultants to provide the information
necessary to implement an effective back injury
prevention process.
• Hourly employees, supervisors, and upper-level
managers- must be part of the education and
training process.
• A instruction in proper body mechanics is
important for the hourly employee, information
on the effects of management policies and
practices is important to managers and
supervisors. Educational programs should
 Back injury prevention strategies
• Organisation management strategies:
1. Gain support from all levels of management
2. Establish manager accountability for implementation
and effectiveness of policies and procedures
3. Change manager attitudes by making them
accountable for injuries
4. Establish and communicate work procedures and
rules.
5. Develop good communication between managers
and employees to show that management cares
about their employees’ well being
• Gaining support:
• For a corporate back injury prevention process
to be successful, management must support it.
• There is good evidence that back injury
prevention procedures can reduce Workers
Compensation costs.
• The management helps to make a decision to
implement effective interventions, policies, and
procedures.
• Providing Authority:
• In back injury prevention the management
must provide authority for implementation,
establish accountability for actions to be taken
and delegate responsibility to appropriate
team members to put recommended policies
and procedures onto effect.
• Changing attitudes towards work injuries:
• Managers and supervisors should be accountable for
the injuries occurring in the department which will
help the company to become more proactive and less
active.
• Training for the supervisor:
 Eliminate problem workers: job assesment placement
 Understand the nature of back injuries: mode and
cause of injury.
 Convey a positive attitude
 Assume the claim is real
 Solicit employee involvement
• Establishing work procedures and rules:
• Management should be aware of their
policies ,procedure, and practices communicate to the
workforce.
• Issues as poor housekeeping and lack of preventive
maintenance, communicate a message to employees
that safety is not really a corporate priority
• When the risk inherent in jobs cannot be reduced or
eliminated, job rotation can be a workable and
effective.
• Work rules and procedures within a company need to
be evaluated and communicated within the overall
context of a safe work environment.
• Medical management Strategies: active involvement by
management with the medical providers who actually
treat injured employees is equally important.
• Encourage early, aggressive treatment of reported
injuries
• Find competent physicians and therapists
• Encourage employees to see designated medical
providers
• Provide modified duty and on-the-job work
hardening ,making sure medical providers understand it
• Make sure medical providers consider ergonomic
factors in the treatment plan
• Claims management :
• Worker injuries need to be managed as well as
treated.
• Medical providers treat the individual but the
company manages the case.
• Workers compensation insurance company will
be involved in case management temporally
but company management should know
medical management principles.
 Contd
Claim Management Strategies
• Emphasize regular and effective communication
with the injured employee and medical providers
• Establish specific written claims management
policies, and adhere to them
• Know and internalize medical management
principles to make sure they are being followed
correctly
• Progress towards case closure when maximum
benefit from medical treatment is achieved.
• Case closure consideration
• Injured worker will achieve maximum benefit
from medical treatment.
• Employee has recieved multiple medical
opinions.
• An unusual amount of time has lapsed since
injury.
 Ergonomics

• Ergonomics is one of the essential components

of an effective injury prevention process.
• It is defined as the science of designing
workplace, machines, and tasks with the
capabilities and limitations of the human body
in mind.
• By applying principles of ergonomics, the
company and its employees can make a safer,
more productive work environment.
 Purpose of Ergonomic Survey
• It is important to evaluate the worksite or
ergonomic survey of work area.
• To familiarize the prevention team with the
work process, tasks, and procedures so that
any education or training courses can be
customized to address specific problem areas.
• To identify problem areas that should be
redesigned or modified to prevent injuries.
• Work too low: An employee will be forced to stand
or sit with the head forward, shoulders slightly
rounded, and the low back in a forward bent position.
Thework may be raised or tilted toward the worker.
The work station should be adjustable.the right work
height also depends on type of work :
• Most work should be perform at elbow height
• Light, percision work should be performed with the
hands above elbow height.
• Heavy work should be performed with the hands
below elbow height.
• Work to high: Continuously working at or
above shoulder level can be very stressful.
Tasks that cause the elbows to exceed a
45angle away from the sides or front of the
body should be made to lower the work
height or raise the worker.
• By using raised work platforms, rearranging
storage areas,or by providing stair patform
ladders that are safer than step ladders.
• Work too far away: if the worker is standing or
sitting, repetitive or continued forward reaching
at arm’s length is very stressful.the least
stressful work position involves working with
hands positioned between elbow and waist
height, with the elbows held close to the sides
and front of the body. In some cases, providing
toe space under a work surface can bring the
work 6 to 12 inches closer to the work.
• Work activities in confined areas or that
require twisting: if there is limited space for
employees to move objects, they will often
twist to complete the task. Repetitive twisting
is one of the most damaging movements for
back. There should be enough space for the
employee to pivot the feet when lifting or
moving an item. Sometimes the items should
be placed apart, so the employee must turn
and step rather than twist.
• Prolonged standing on hard, concrete surfaces:
The muscles of the low back work to maintain
the standing position. A foot rail,box, or stool
allows the workers to raise one foot and reduce
stress. Rearranging the work so the employee
alternates between standing and sitting tasks,
or allowing a brief stretching break periodically
throughout the day may also effectively reduce
fatigue. Antifatigue mats, visco-elastic
cushioned shoe inserts, shoes with leather
uppers, cushioned soles and heels designed for
work, also reduce strain on the legs and back.
• Sitting or standing in a static position for
prolonged periods: When work requires
concentration or does not allow movement,
the back can become fatigue or tense. Work
spaces might be rearranged to assure that
people move periodically. Jobs that are
designed to provide a variation between
sitting and sitting activities are less likely to be
related to pain or injury because they facilitate
normal joint and muscle movement.
• Sitting with the back unsupported: Sitting
work increases pressure within the disc more
than standing work. This effect becomes even
more pronounced if the worker slouches
forward to complete work.Chairs and stools
should provide support for the lower back and
pelvis and allow the feet to rest on the floor or
foot support, comfortably.The head, shoulders
and hips should be aligned and supported in
an erect, well-balanced position.
 Contd........
• Ideally , the chair adjustment controls should be
easily accessed from the sitting position. The
back support should be easily adjustable to
enable control of its height, angle, and position
relative to the seat pan. The height and seat pan
angle should adjust easily to accommodate
variations in work tasks. If the back support of
chair is flat, a rolled towel, small pillow, or
cushion can be used to fit the inward curve of
low back.
• Frequent manual material handling: Any time
employees lift and carry objects, even when
proper body mechanics are used, there is
potential for a problem. Manual materials-
handling tasks should be reduced by usage of
lifts tables, lift trucks, hoists, work dispensers,
conveyers, and similar mechanical aids when
possible.
 Four principles of task design for manual
material handling should be followed:
• Minimize the weight or bulk.
• Minimize the vertical and horizontal lifting
distances.
• Provide sufficient time for stressful tasks,
• Work with, rather than against, gravity
whenever possible.
 Awkward or oversized loads: Manual handling
of an awkward or oversized load can be a
dangerous task if not performed properly.
• Employees should be encouraged to ask for
help or use an assistive device if they are
unsure of their ability to handle a load safely.
• If a load is oversized and is being handled
manually, repackaging the material, using
mechanical assistance or performing a team
lift should be considered.
Miscellaneous hazards: Pieces of metal, paper
and liquid spills on the floor are all potential
hazards for trips, slips and falls.
It is important, therefore that the quality and
regularity of housekeeping and maintenance
is at acceptable levels.
Absorbent material should be readily available
to handle spills, and proper non-slip footwear
should be worn.
• Benefits of exercise:
• Improve cardiovascular condition
• Improve flexibility and strength
• Promote relaxation
• Control fatigue through position reversal and
circulation stimulation
 Company fitness Strategies
• Provide exercise alternatives which may
include:
I. Subsidized health club memberships.
II. A corporate fitness center
III. On-the-job exercise
IV. Mandatory exercise of previously injured
workers.
• Acquire and maintain employee support.
• Emphasize exercise frequency
• Assess each employee and provide
individualized exercise programs that are
functional and biomechanically sound.