YAMNUSKARM05920221001RRC

Element 6

Musculoskeletal Health

Learning Objectives
Once you’ve studied this element, you
should be able to:

1 Describe the risk factors that may give rise

to work-related upper limb disorders and
appropriate control measures.

2 Describe the hazards and control measures

which should be considered when
assessing risks from manual handling
activities.

3 Describe the hazards and controls

associated with load-handling equipment
and the requirements for lifting operations.

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Contents

Work-Related Upper Limb Disorders 6-3

Musculoskeletal Disorders and Work-Related Upper Limb Disorders 6-3
Musculoskeletal Disorder Risk Factors 6-4
Managing the Risk of Musculoskeletal Disorders 6-5
A Typical Example: Display Screen Equipment 6-6

Manual Handling 6-9

Common Types of Manual Handling Injury 6-9
Good Handling Technique 6-10
Controlling Manual Handling Risk 6-10

Load-Handling Equipment 6-15

Hazards and Safe Use of Manually Operated Load-Handling Equipment 6-15
Powered Load-Handling Equipment 6-17
Requirements for Safe Lifting Operations 6-23
Requirements for Statutory Examination of Lifting Equipment 6-24

Summary 6-26

Practical Assessment Guidance 6-27

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Work-Related Upper Limb Disorders 6.1

Work-Related Upper Limb Disorders

IN THIS SECTION...
• Musculoskeletal disorders (MSDs), such as back pain and Work-Related Upper Limb Disorders (WRULDs), can
result from repetitive tasks, such as Display Screen Equipment (DSE) use, checkout operation and bricklaying.
• Many factors influence ergonomic risk, such as repetition, force, posture, twisting, rest breaks, equipment design
and adjustability, and workplace lighting.
• DSE use can cause WRULDs, back pain and eye strain.
• Precautions for safe use of DSE include: ergonomic assessment of the workstation; provision of basic equipment;
short, frequent breaks; eye tests; and the provision of information and training.

Musculoskeletal Disorders and Work-Related Upper Limb

Disorders
When workers sit or stand for long periods of time or carry out repetitive
activities, or activities that require them to adopt uncomfortable postures,
they are subject to stress and strain on their bodies. This can cause injury to
the skeletal system and the soft tissues associated with that system, such as
muscle sprains and strains, tendon and ligament injuries, joint injuries and
nerve damage. Collectively, these chronic soft-tissue injuries are referred to
as musculoskeletal disorders (MSDs).

Typical MSDs associated with poor work design are:

• Back injuries and back pain – associated with repetitive handling or

poor posture and movement while standing or sitting for long periods
of time. Injuries such as back muscle strain, ligament strain and disc
injury are common and a significant cause of workplace absence. Badly designed workstations lead to
ill health
• Work-Related Upper Limb Disorders (WRULDs) – a collection
of conditions that affect the arms and hands. Examples include carpal tunnel syndrome (inflammation of a
nerve in the wrist that causes tingling sensations, pins and needles, numbness in the fingers and arm pain) and
tenosynovitis (inflammation of the tendons in the forearm that makes finger movement difficult and painful).
Early symptoms of WRULDs often include tingling sensations, numbness and discomfort but then progress to
more severe pain and immobility.

• Other chronic soft-tissue injuries – associated with sitting, standing or kneeling for long periods of time at
work (e.g. painful knee joints as a result of having to kneel down to work under floorboards).

High-Risk Activities/Repetitive Operations

The following repetitive activities all involve significant risk of MSDs:

• Display Screen Equipment (DSE) use.

• Keyboard operation.
• Factory assembly of small components.
• Supermarket checkout operation.
• Bricklaying.

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6.1 Work-Related Upper Limb Disorders

Each of these activities has a range of factors associated with them that
increase the risk of MSDs occurring. Next these risk factors will be examined
before applying them to a typical workplace activity – the use of DSE.

Musculoskeletal Disorder Risk Factors

Various factors influence the risk of MSDs from work activities. These relate
to the task that the worker is doing, the equipment that they are using and
the environment in which they are working. These factors can be applied
to any repetitive work activity, whether it is DSE use, checkout operation,
factory assembly line work or bricklaying on a construction site.

An uncomfortable posture leads to

MSDs, such as lower back pain

TOPIC FOCUS
Ergonomic factors that influence risk relate to the task, the equipment and the environment.

Task factors include:

• Repetition – the need for repetitive movements when carrying out the task (e.g. typing for several hours).
• Force – the physical force required to perform the task and the strain this puts on the body (particularly
strenuous tasks) (e.g. closing stiff catches on a machine).
• Posture – any requirement to adopt an awkward posture (e.g. stooping over into a bin to pick out
contents).
• Twisting – any twisting action required by the task (e.g. twisting the wrist when using a screwdriver).
• Rest – the potential for the worker to rest and recover from any fatigue (e.g. a worker on a production
line cannot stop the line; they have to keep working even when fatigued).
Equipment factors include:

• Equipment design – the shape of the equipment and how this affects ease of use (e.g. a large, shaped
handle on a scraper makes it easier to hold and use).
• Equipment adjustability – the scope there is for the user to adjust the equipment to suit their personal
preferences (e.g. the height of the seat for a computer user).
Environmental factors include:

• Lighting – the availability of natural and artificial light, and the effect on the worker’s ability to see the
work clearly.
• Glare – the light from a screen that can cause headaches or eye strain, and can also cause workers to
adopt poor postures in order to avoid the discomfort.
• Other environmental parameters – in particular, temperature, humidity and ventilation that will directly
affect the worker’s ability to perform the task and their comfort.
If one or a combination of the above factors is inherent in the work, then ergonomic risk exists.

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Work-Related Upper Limb Disorders 6.1

Managing the Risk of Musculoskeletal Disorders

Countless activities involve significant MSD risk. For example, bricklaying on a construction site involves several of the
risk factors noted above, such as:

• The work is repetitive.

• Awkward posture and twisting is necessary.
• Rest periods may be infrequent.
• The work area may be extremely cold and windy or hot, humid and airless.
In general terms, the control of MSD risk can be achieved by introducing changes to the:

• task and the way that it is done;

• tools, equipment and machinery being used; and
• workplace environment;
to suit the individuals carrying out the work.

Matching the Workplace to Individual Needs

DEFINITION
ERGONOMICS

The study of the relationship between the worker, the work that they are doing, the tools and equipment that
they are using, and the environment in which they are working.

The risk of MSDs can be reduced by adapting the workplace to suit the individual needs of workers. This is often
referred to as applying an ‘ergonomic’ approach.

Ergonomics is concerned with the interaction between people and:

• The tools, equipment or machinery that they are using (e.g. the ease of use of control panels).
• The workplace environment (e.g. suitability of lighting).
• Organisational factors (e.g. shift patterns or hours of work).
The aim of ergonomics is to minimise ill-health effects and optimise efficiency by adapting the workplace to suit the
individual. This means taking into account both a person’s physical attributes (such as height, shape, muscle strength,
etc.) and their mental attributes (processing speed, decision-making ability, etc.). For example, ergonomic principles
can be applied to a manual-handling operation to reduce the risk of injury.

This approach can be taken by carrying out an ergonomic risk assessment on work activities where there is a high risk
of MSDs (i.e. a risk assessment is carried out with special focus and consideration of the ergonomic issues associated
with the work).

In some cases, it may be appropriate to put restrictions on the individuals doing the work (i.e. restricting those people
who have a known WRULD to light duties to avoid further injury). The first step in achieving controls is to undertake
a risk assessment.

The following examples illustrate the ill-health effects that can occur due to ergonomic risks and the possible control
measures that may be implemented.

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6.1 Work-Related Upper Limb Disorders

A Typical Example: Display Screen Equipment

The Risks
Use of DSE, or computers and keyboards, is a common workplace activity that has several associated ill-health issues,
including:

• WRULDs – associated with repetitive use of the keyboard and mouse for long periods of time.
• Back pain and other MSDs – associated with sitting in a fixed position, perhaps with poor posture, for long
periods of time.
• Eye strain – temporary eye fatigue associated with prolonged use of the screen.
• Fatigue and stress – associated with the type of work being done (e.g. call centre staff may be subjected to
verbal abuse during telephone calls).
These health effects can occur when using desktop computers but are becoming increasingly common in association
with the use of laptops and other mobile devices when they are used for long-duration work.

The Control Measures

Control measures appropriate for DSE use are to:

• Carry out an assessment of the user’s workstation to ensure that the

equipment and environment meet minimum standards and that the
workstation can be adjusted to suit the user.
• Provide basic workstation equipment that meets minimum standards in
terms of good ergonomic design.
• Plan the user’s work routine so that they can take short, frequent breaks
from screen and keyboard use.
• Provide users with a free eye test and, if required, spectacles for screen
use.
• Provide information and training to users on the potential health risks of The portability of laptops allows
DSE use and the preventive measures – in particular, ergonomic use of them to be used in a casual manner
the workstation. that is inappropriate for long-
duration use
In many countries and regions, these measures are incorporated into legal
standards. For example, in the EU, they are subject to a directive that in Great Britain is incorporated into the Health
and Safety (Display Screen Equipment) Regulations 1992.

Some of the minimum standards for workstation equipment and good practices for posture and workstation use are
illustrated in the following figure.

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Work-Related Upper Limb Disorders 6.1

Good ergonomics at a DSE workstation

The numbers represent the points to assess and illustrate correct positioning:

1. Adjustable height and angle to seat back. 6. Space for postural change, no obstacles under the desk; this
allows the user to fidget and change position as they work.
2. Good lumbar support.
7. Forearms approximately horizontal when hands are on the
3. Adjustable height seat to bring the hands keyboard.
to a comfortable position on the keyboard.
Seat also has a stable five-star base. 8. Minimal extension, flexion or deviation of wrists; wrists
should be straight and flat when on the keyboard indicating
4. Correct seat-height adjustment and keeping proper seat height adjustment.
the feet supported prevents excess pressure
on underside of thighs and backs of knees. 9. Screen height and tilt should be adjustable so as to allow
comfortable head position.
5. Foot support if user cannot get their feet on
the floor. 10. Space in front of the keyboard to support hands/wrists dur-
ing pauses in typing; a wrist-rest can provide further support
if required.

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6.1 Work-Related Upper Limb Disorders

Additional points:

• The desk should be laid out to minimise the need for twisting or overreaching (e.g. when reaching for a
telephone).
• A document holder may be required.
• If frequent telephone use is necessary when using the keyboard, a headset may be required.
• Workplace lighting should be provided to avoid reflections on the screen and glare.
Unfortunately, some of these good ergonomic principles cannot be applied when using a laptop. If laptops are going
to be used in the workplace:

• Aim for short-duration rather than long-duration use.

• When used for long durations, apply the same management approach of workstation assessment: frequent
breaks, eye test, information and training.
• Provide a docking station and/or separate screen, keyboard and mouse as required to allow the user to convert
the laptop to a more adjustable configuration.

MORE...
Browse the following website for some more information on MSDs:

www.hse.gov.uk/msd

Legal Standards

• ILO C155 – Occupational Safety and Health Convention, 1981 (No. 155).
• ILO R164 – Occupational Safety and Health Recommendation, 1981 (No. 164).

STUDY QUESTIONS
1. Outline the aim of ergonomics in a simple phrase.
2. Identify the health risks arising from DSE workstation use.
3. Identify the ergonomic risk factors associated with a repetitive task.
4. Identify the key requirements relating to the following parts of a DSE workstation:
(a) Work surface/desk.
(b) Keyboard.
(c) Chair.
(d) Space.

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Manual Handling 6.2

Manual Handling

IN THIS SECTION...
• Manual handling is a common cause of musculoskeletal injury, such as:
–– Injury to the back (e.g. a prolapsed disc), tendons, ligaments, muscles.
–– Work-Related Upper Limb Disorder (WRULD).
• Safe lifting technique involves following simple precautions before and during the lift, and when setting down.
• Manual handling can be assessed by looking at four main factors:
–– The task.
–– The load.
–– The environment.
–– Individual capabilities.
• The risk associated with manual handling can be controlled by:
–– Automating or mechanising the handling.
–– Using handling aids.
–– Modifying the task, load or environment.
–– Ensuring individual capabilities are matched to the activity.

Common Types of Manual Handling Injury

DEFINITION
MANUAL HANDLING

The lifting, carrying, pushing and pulling of a load by bodily force.

Manual handling can involve very repetitive movements of relatively small loads (e.g. handling small components on
a production line); in other instances, it can involve one-off movements of very large and heavy items (e.g. handling
structural steels into position in an inaccessible location).

All these manual handling activities generate the possibility of injuries, most of which are musculoskeletal injuries.

Common types of manual handling injury include:

• Back injury – the spine is made up of individual bones (vertebrae) separated by tough pads (intervertebral discs).
Wear and tear can occur to these discs so that they become distorted – this is called a prolapsed disc. This causes
extreme pain and discomfort and is often accompanied by nerve pain because the distorted disc traps nerves
where they enter the spinal cord. This type of injury is perhaps the most serious of all manual handling injuries
since recovery is often slow, incomplete and, in some instances, the casualty will have to undergo surgery to repair
the defect or may end up permanently disabled.
• Tendon and ligament injuries – tendons and ligaments are the connective tissues that join muscle to bone, and
bone to bone respectively. When tendons and ligaments are overloaded, they tear, causing extremely painful
injuries which can take a long time to heal. In some instances, recovery is incomplete and an operation may be
required.

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6.2 Manual Handling

• Muscle injuries – overloaded muscle tissue can tear. This is painful and
likely to lead to short-term impairment.
• Hernias – when the sheet muscle that surrounds the gut is overloaded,
it can distort and tear. This usually happens in the lower abdomen and
can be a painful injury that will not repair naturally. In many instances,
an operation is required.
• WRULDs – chronic soft-tissue injuries can occur to the arms, wrists
and hands as a result of repetitive movements. This is a generic term for
many different medical conditions, such as carpal tunnel syndrome and
tennis elbow. WRULDs usually involve inflammation and discomfort
through overuse of muscles, tendons or ligaments and, frequently, there
is irritation to the nerves that causes additional pain. WRULDs usually
start as minor discomfort that gradually worsens to severe pain and Worker with back injury
immobility. They can result in corrective surgery, and even disability if
left untreated.
• Cuts, burns, dislocation and broken bones – physical injury may result if the load is hot, sharp or dropped on
the feet.

Good Handling Technique

Workers should be trained in efficient movement principles that incorporate basic safe lifting techniques. The
following technique minimises the risk of MSDs:

• Before Lifting
–– Check the weight, centre of gravity and stability of the load.
–– Plan the route of the carry.
–– Establish a firm grip.
• The Lift
–– Bend the knees and use the leg muscles to lift.
–– Keep the back relatively upright but try to maintain its natural S-shaped curve.
–– Keep the load close to the body.
–– Avoid twisting, overreaching and jerking.
• Setting Down
–– Use the same principles as when lifting.
–– Maintain good balance.
–– Set the load down and then adjust its position using body weight.

Controlling Manual Handling Risk

Manual handling activities have to be assessed in order to control the risks of injury to the workers undertaking them.
This risk assessment is different from the general risk assessment introduced earlier in this course because it focuses
exclusively on the hazard of manual handling and ignores all other hazards.

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Manual Handling 6.2

Manual handling risk assessment focuses on four main factors:

• The task.
• The individual.
• The load.
• The environment.

HINTS AND TIPS

An easy way to remember the factors in a manual handling risk assessment is by using the acronym ‘TILE’ for
Task, Individual, Load, Environment.

In many countries and regions, this risk assessment is subject to legal standards and guidance. For example, in the
EU, it is subject to a directive which has been transposed into British law as the Manual Handling Operations
Regulations 1992.

The Task
The focus here is on the movements required of the worker as they handle
the load.

The task can be assessed by asking questions such as:

• At what height is the load being picked up, carried or put down?
• Is the task very repetitive?
• Is a long carrying distance involved?
• Does the task involve stooping (where the worker has to keep their legs
straight and bend their back) to move the load?
• Does the task involve twisting (turning the shoulders while the feet stay
still)?
Holding a load away from the torso
• Can rest breaks be taken as the worker requires them?
when lifting increases risk of injury
• Does the task involve lifting the load through a vertical distance?
• Does the task involve reaching above shoulder height?
• Does the task involve the worker holding the load away from their trunk (torso)?
Each of these risk factors increases the risk associated with the task. For example, picking up a load at waist height,
carrying it a short distance and putting it down at waist height is a simple task that does not complicate the risk
associated with the handling. But picking up the same load from floor height (risk factor 1) from the bottom of a box
that requires the worker to stoop down into the box (risk factor 2) then carrying the load at arms’ length
(risk factor 3) for a distance of 15 metres (risk factor 4) and putting it down above head height (risk factor 5)
increases the risk associated with the task very significantly.

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6.2 Manual Handling

Individual Capabilities
The focus here is on the worker carrying out the handling activity.

Individual capabilities can be assessed by asking questions, such as:

• Does the activity require unusual ability? Some handling activities require unusual strength, stamina, size or
technique.
• Does the activity present significant risk to vulnerable individuals, such as pregnant women or people with pre-
existing back injuries?

The Load
Here, the focus is on the load that is being handled.

Though the load is usually an inanimate object, in some workplaces it may

be an animal or a person (e.g. in a hospital, patients have to be moved from
bed to gurney (a wheeled stretcher/trolley), from a wheelchair to a bath,
etc.).

The load can be assessed by asking questions, such as:

• How heavy is the load?

• How large and bulky is the load?
• How stable is the load?
• Where is the centre of gravity of the load?
How stable is this load?
• Is the load difficult to grip?
• Is the load hot, sharp or otherwise hazardous?
For example, the risk associated with handling a concrete block of 12kg is lower than that associated with handling a
bundle of flexible plastic pipes, each three metres long, that weighs the same.

The Environment
The focus here is the environment in which the handling takes place.

The environment can be assessed by asking questions, such as:

• Are there restrictions on the space available?

• Is the floor surface slippery or uneven?
• Are there changes in floor level (steps, stairs, etc.)?
• What are the light levels like?
• What is the temperature and humidity?
For example, handling activities carried out outdoors on a poorly lit construction site in freezing conditions when
there is ice on the ground will be a higher risk than similar activities carried out indoors in a warm, well-lit area.

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Manual Handling 6.2

Avoiding or Minimising the Manual Handling Risks

Employers should avoid manual handling where there is a risk of injury
wherever possible. If this can’t be achieved, the risks must be assessed and
control measures introduced to reduce the risks to an acceptable level.

Control of manual handling risk can be achieved by using a simple hierarchy:

• Eliminate the manual handling.

• Assess the manual handling that cannot be eliminated.
• Use handling aids.
• Modify the task, load or environment.
• Ensure individual capabilities are matched to the activity.
Eliminate the manual handling – automate or mechanise the handling
Electric hoist moving load
activity. Conveyor belt systems, forklift trucks, electric pallet trucks, cranes,
hoists and other types of mechanical moving or lifting equipment provide a
way of moving loads without the need for workers to use bodily force.

Assess the manual handling that cannot be eliminated – look at the four factors of: task, load, environment and
individual capabilities.

Use handling aids – consider the use of a piece of equipment that does not completely eliminate the manual
handling but does make it much easier. For example, a sack truck does not eliminate the need to push the load, but it
does eliminate the need to carry it.

There are many handling aids available such as trolleys, barrel lifts, gin wheels, trucks, hoists and lifts that require some
manual effort to lift or support the load, but give the worker mechanical advantage.

Modify the task, load or environment – answer the appropriate questions listed earlier. There are usually some
simple solutions that present themselves.

Modifications may be possible to reduce the significant risk factors, such as:

• The Task:
–– Control repetitive handling by introducing frequent rest breaks or
job rotation to minimise the length of time that an individual worker
has to perform the task.
–– Eliminate stooping and twisting by changing the layout of the
workstation.
–– Use a table or lift to bring the load to waist height to eliminate
picking up from floor level.
• The Load
–– Break down a heavy load into smaller parts.
–– Use several workers to handle a large, bulky load rather than just
one.
Some manual handling aids
–– Stabilise an unstable load by securing it or putting it into a container.
–– Mark up a load with an off-centre centre of gravity so that workers can see where the centre of gravity is.
–– Attach handles to a load that is difficult to grasp.

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6.2 Manual Handling

• The Environment
–– Rearrange the workspace to allow more space for the handling activity.
–– Level an uneven floor.
–– Supply additional lighting in a poorly lit location.
Ensure individual capabilities are matched to the activity – check if the activity requiring an unusual ability can be
carried out by the workers. For example, if unusual strength and size are required, then the worker must have those
characteristics; if a particular technique is required, the worker must be trained so that they develop that technique.

If the activity presents significant risk to vulnerable individuals, such as pregnant women or people with pre-existing
back injuries, those people will have to be prohibited from carrying it out.

MORE...
Browse the following website for some more information on manual handling:

www.hse.gov.uk/msd/manualhandling.htm

Legal Standards

• ILO C155 – Occupational Safety and Health Convention, 1981 (No. 155).
• ILO R164 – Occupational Safety and Health Recommendation, 1981 (No. 164).
• ILO C127 – Maximum Weight Convention, 1967 (No. 127) (to be revised).
• ILO R128 – Maximum Weight Recommendation, 1967 (No. 128) (to be revised).

STUDY QUESTIONS
5. Outline the main injuries associated with manual handling.
6. Outline the meaning of the term WRULD and explain how WRULDs might occur.
7. Identify the risk factors associated with a load during a manual handling operation.
8. Identify the main risk factors presented by the working environment in relation to manual handling.
9. Identify the best way of minimising the risks of manual handling.
10. Identify the vulnerable types of individuals who might be more prone to manual handling injury.

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Load-Handling Equipment 6.3

Load-Handling Equipment

IN THIS SECTION...
• There are many different types of lifting and moving equipment, such as manually operated trucks and hoists, and
powered load-handling forklift trucks, lifts, hoists, conveyors and cranes.
• Typical hazards associated with lifting and moving equipment are:
–– Collapse or toppling of the equipment.
–– Falls from height.
–– Falling objects.
–– Being struck by the equipment or the load during movement.
• General precautions for safe use include ensuring that the equipment is:
–– Suitable in terms of strength and stability.
–– Correctly positioned and installed.
–– Visibly marked with the safe working load.
–– Used by competent operators under appropriate competent supervision.
–– Maintained in a safe working condition.
–– Only used for carrying people if it has been designed for that purpose and all additional safety requirements
have been implemented.
• Lifting equipment should be routinely inspected and subjected to a statutory thorough examination by a
competent engineer.

Hazards and Safe Use of Manually Operated Load-Handling

Equipment
Loads are frequently moved around the workplace using lifting and moving
equipment. This equipment may rely on some form of manual effort (such
as a trolley, sack truck or pallet truck) or it may be fully powered (such as a
forklift truck, hoist, conveyor or crane). Though these devices are useful in
minimising the risks associated with manual handling, they do present their
own hazards. The hazards and safety precautions of various types of lifting
and moving equipment now follow.

Hazards and Controls for Manually Operated

Load-Handling Equipment
There are many different types of manually operated load-handling aids and
equipment, such as trolleys, sack trucks, pallet trucks and person-handling
hoists (e.g. bath hoist). Loads are frequently moved around
the workplace
Hazards associated with this type of equipment include:

• Manual handling risk associated with pushing or pulling the truck.

• Instability of the load causing the load to fall.

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6.3 Load-Handling Equipment

• Movement up, down or across slopes causing loss of control.

• Poor parking of the truck causing obstruction in a traffic route.
• Other pedestrians possibly being struck during manoeuvring.
• Trapped feet under the wheels or when lowering the load.
• Entrapment of the person being handled.
Precautions for safe use of manually operated equipment include:

• Restricting use to trained workers only.

• Following manufacturer’s recommendations.
• Avoiding uneven ground and slopes.
• Using ramps over steps.
• Observing the safe working load limits of the truck.
• Securing the load if necessary.
• Using the brakes (if fitted) whenever the truck is stationary.
• Taking care when moving or lowering the load.
• Ensuring safe parking and storage to avoid obstruction.
• Having routine inspections and maintenance.
• Using safety shoes or boots to avoid crush injuries.

Lifts and Hoists

A wide variety of items can be included in the phrase ‘lifts and hoists’ from a simple, manually operated chain hoist to
a passenger lift in a multi-storey building. Larger hoists will be looked at later.

People Hoists and Handling Aids

In some sectors, workers may have to move people, such as hospital
patients, and those needing assistance with living requirements in the home.
There are a variety of moving and handling aids available, which include:

• Patient hoists – these can be manual (where the hoist is lifted by

operating a manual crank handle) or powered, and may be mobile or
permanently mounted in a ceiling track. Hoists should only be used by
trained personnel and the safe working load of the hoist should not be
exceeded. The suitability of the equipment for the working environment
must also be considered (e.g. pushing a mobile hoist on a carpet or
over rugs may be difficult). Lifting equipment of this type should be
inspected regularly to ensure it remains in good working order.
• Small handling aids, such as slide sheets and transfer boards – these
are used to assist the transfer of patients (e.g. from bed to trolley in a A manual, mobile hoist used to lift a
hospital). The slide sheet is placed beneath the patient and they are patient
pulled over the slide onto the bed. This allows for the rapid transfer of the patient without lifting them and is
used by trained people.
• Wheelchairs – a form of handling aid, wheelchairs help in the movement of people. Though they can be
powered, most wheelchairs used to transfer patients are simply pushed.

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Load-Handling Equipment 6.3

To make sure that workers are competent in using mobility assistance equipment, training in handling techniques
should include instruction in the:

• Different types of equipment available, and their appropriate use.

• Safe use of hoists and their slings.
• Re-charging of electric hoists.
• Safe use of smaller aids, such as handling belts and transfer boards.
• Identification of possible faults and safety checks that should be made each time before use.
• Procedures to follow when equipment is damaged and unsafe to use, or if it fails during use.

Powered Load-Handling Equipment

Forklift Trucks
There are many different types of forklift truck, but they share a range of
common hazards and safety precautions.

The hazards associated with forklift trucks are:

• Overturn of the truck – the narrow and short wheelbase of the

truck makes it unstable, so it can fall over sideways or tip forwards or
backwards very easily. (Some of the poor practices that might cause a
forklift truck to overturn are covered in Element 8.)
• Fall of the load – the load may fall from the forks of the truck onto the
driver or others standing nearby during a lifting operation.
• Striking of pedestrians – like all vehicles, a forklift will cause serious
injury if it hits a pedestrian.
Counterbalance forklift truck
• Fall or entrapment of a person riding on the forks – workers often
use the forks of a forklift as a working platform. This practice may result
in a fall from height or the worker becoming trapped between the mast of the forklift and fixed structures.
• Fall from loading dock – another common accident is where the forklift truck either falls through or off the
loading dock that it was driving over to access the back of a lorry.
The engine type and fuel of the forklift truck are also a source of concern:

• Battery-powered trucks are commonly used in indoor workplaces. Batteries present several hazards in their own
right:
–– Charging lead-acid batteries emit hydrogen gas which is explosive.
–– Lead-acid batteries contain dilute sulphuric acid which is corrosive.
–– Batteries are extremely heavy and present a manual handling risk if they have to be changed for charging
purposes.
–– The electricity can cause arcing, shock, burns or fire.
–– Battery contents are an environmental hazard requiring appropriate disposal.
• Diesel-powered trucks are commonly used outdoors. Hazards include:
–– Dermatitis, caused by contact of diesel with the skin.
–– Diesel spills, which are a significant slip hazard.

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6.3 Load-Handling Equipment

–– Large spills, which might pollute the environment.

–– Exhaust fumes, which are toxic.
–– Those hazards associated with the bulk storage of diesel.

DEFINITION
LIQUEFIED PETROLEUM GAS (LPG)

Propane or butane gas, or mixtures of the two. Can be transported and stored in bulk tanks or in small
portable cylinders (e.g. camping gas).

• Liquefied Petroleum Gas (LPG)-powered trucks have the following hazards:

–– LPG is an explosive gas.
–– Exhaust fumes are toxic.
–– LPG cylinders are heavy and present a manual handling risk during changing.
–– Those hazards associated with the storage of replacement cylinders or bulk storage of LPG.

TOPIC FOCUS
The precautions for safe use of forklift trucks include:

• Restricting use to trained operators only.

• Routinely visually inspecting the truck before use.
• Routinely maintaining the truck in accordance with the manufacturer’s recommendations.
• Never using the forklift to lift people unless a proper working platform is attached.
• Ensuring that the load on the forks is secure and stable.
• Ensuring that the safe working load limits of the truck are not exceeded.
• Observing site speed limits.
• Never travelling with the forks raised.
• Never travelling with obstructed vision.

Forklift trucks powered by different types of fuel require different precautions:

• Battery-powered trucks:
–– Batteries must be charged in well-ventilated areas only, away from ignition sources.
–– Sulphuric acid should only be handled when wearing appropriate Personal Protective Equipment (PPE)
(gloves, apron and eye/face protection).
–– Battery handling should be mechanised.
–– The electrical risk may require the use of insulated tools and gloves.

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Load-Handling Equipment 6.3

• Diesel-powered trucks:
–– These should only be used in a well-ventilated area.
–– Spill kits should be available.
–– Gloves should be worn when handling diesel.
• LPG-powered trucks:
–– These should only be used in a well-ventilated area.
–– LPG cylinder handling should be mechanised.
–– Spare cylinders must be stored in a secure, safe, well-ventilated location.

TOPIC FOCUS
Pre-use checks should be carried out on forklift trucks at the beginning of each shift; these checks must cover:

• Tyre pressures.
• Parking brakes and service brakes.
• Steering.
• Fuel, oil and water systems for levels and leaks (in a combustion engine truck).
• Batteries, to ensure they are charged, are leak-free, chargers are off and leads are stored, and the battery
retention device is secured.
• Lifting and tilting systems (including hydraulics) are working, are leak-free and hydraulic fluid levels are
correct.
• Audible warning.
• Lights.
• Mirrors.
Any defects should be reported to the supervisor for immediate rectification.

Lifts and Hoists

Earlier small, manually operated ‘people hoists’ were covered; here the use
of larger powered hoists, from passenger lifts to construction site hoists, is
discussed.

The main hazards associated with hoists are:

• Falling objects, such as the load falling from the hoist, or the hoist itself
falling due to structural failure.
• Being struck by the load during a lifting operation.
• Becoming entangled in moving parts.
Additional hazards exist when the equipment is used to carry people, such
as with a passenger lift, including:

• Falls from height from a landing level or from the platform of the lift A material hoist for moving materials
itself. up and down a scaffold
during roof work
• Being struck by landing levels, parts of any enclosure or other
projections while riding on the platform of the lift.

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6.3 Load-Handling Equipment

Precautions for safe use of hoists and lifts include:

• Ensuring that the hoist or lift is suitable for its intended use – in particular, people should only be carried on
equipment specifically designed for that purpose.
• Preventing people from getting underneath the hoist or lift platform or the load during a lifting operation by
enclosing the base of the lift or hoist with a fence.
• Preventing people from gaining access to an unprotected landing edge – with a passenger lift, having safety
interlocks fitted on the doors at each landing.
• Preventing people being carried on the lift platform from being struck by landings or other obstructions as the lift
moves by constructing an enclosure around the lift platform.
• Observing the maximum safe working load of the lift or hoist which should be clearly displayed.
• Ensuring that all safety devices; such as brakes, freefall brakes and interlocks; are in full working order.
• Restricting the use of the hoist or lift where necessary to trained, competent people only.
• Providing information, instruction and training as required.
• Ensuring routine maintenance by competent engineers.
• Ensuring routine inspection and thorough examination as required.

Conveyors
Conveyors have belts, rollers or screws to move articles or material around
and are frequently used in manufacturing and distribution.

The main hazards associated with conveyors are:

• Drawing-in hazards or ‘in-running nip points’ – where fingers might be

drawn into moving parts.
• Entanglement – where loose clothing might become entangled with
rotating parts.
• Falling objects – from overhead conveyor systems.
The precautions for safe use of conveyors include:
A belt conveyor used to move
• Warning alarms or sirens to alert people that the belt is about to start
aggregate at a quarry
moving.
• Guarding of moving parts to prevent drawing in and entanglement as far as is possible.
• Ensuring that emergency stop buttons or pull-cords are fitted and available for use.
• Barriers to exclude people from the area (protects also from falling objects).
• Fitting guards underneath overhead conveyors to catch falling objects.
• Information, instruction and training for operators.
• Controlling loose clothing and long hair (e.g. by the use of overalls and hairnets in the workplace).
• Maintenance by authorised persons to ensure safe running.
• Provision of a defect reporting system.

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Load-Handling Equipment 6.3

Cranes
Many different types of cranes are used in workplaces, from small derricks
bolted to the floor at the edge of a loading bay, to large tower cranes
positioned at the top of skyscrapers during construction. The mobile crane
is used as a typical example.

The main hazards associated with a mobile crane are:

• The crane collapsing or toppling over.

• The boom or jib (arm) of the crane striking against other structures
during movement.
• The load (or part of it) falling.
• The load striking against objects or people while being manoeuvred.
• Contact with live overhead cables. Mobile crane

TOPIC FOCUS
Factors that might make a mobile crane unstable and topple over include:

• Overloading the crane beyond its lifting capacity.

• Siting the crane on uneven or unstable ground.
• Failing to use the outriggers correctly.
• Using the crane in high winds.
• Extending the boom or jib of the crane too far out for the weight being lifted.
• Structural failing of parts (perhaps due to lack of maintenance).

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6.3 Load-Handling Equipment

Summary of handling options available

Source: INDG398 (rev1) Making the best use of lifting and handling aids, HSE, 2013
(www.hse.gov.uk/pubns/indg398.pdf)

TOPIC FOCUS
General requirements for safe lifting operations:

• The equipment should be strong enough for the lifting task (rated for the load to be lifted) and suitable
for the operation (e.g. forklift trucks must only carry people if a suitable attachment has been installed,
such as a man-rider cage, and if the truck has been subjected to any necessary inspections in order to
allow the lifting of people).
• The equipment should be stable and secure (e.g. mobile cranes with outriggers (stabilising legs) must be
located on firm, level ground to avoid the outriggers sinking and the crane tipping).
• Lifting equipment should be visibly marked with the Safe Working Load (SWL), which is the maximum
load that the device is permitted to lift.
• Lifting operations should be planned, carried out and supervised by competent persons. For example,
though it is possible to hire a crane and a driver, the lift should also be planned and supervised throughout.
It is common practice to carry out a ‘contract lift’ whereby the planning and execution of the entire lifting
process is contracted out to the hire company.
• Equipment that is used to lift people may be subject to additional regulatory inspections.

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Load-Handling Equipment 6.3

Requirements for Safe Lifting Operations

The requirements for safe lifting operations include:

• Planning and preparation of the lift:

–– Carrying out a lifting risk assessment by a competent person to determine the correct controls, which will
form the basis of the lifting plan for the operation.
–– Checking that the crane has been maintained and has an in-date certificate of thorough examination (see
later).
–– Restricting use of the crane to trained and competent operators only.
–– Ensuring the crane or lifting device is of the correct type for the job and terrain; that it is strong and stable.
–– Ensuring that the load to be lifted is within the safe lifting capacity of the crane (and that the safe working
load is visibly marked). Safe lifting capacity will vary with the length of the boom or jib and the distance away
from the crane that the boom or jib is positioned to (the radius), so capacity can vary from one lift to the
next.
• Carrying out the lift:
–– Carefully siting the crane on even, stable ground in a safe position away from structures or overheads that
might be struck during the lifting operation.
–– Using the outriggers correctly.
–– Ensuring that each lift is planned and supervised by a competent person, and that the operator and slingers
are competent.

DEFINITION
SLINGER

The competent person responsible for preparing and slinging a load in readiness for a crane lift, and for
attaching or detaching load slings from the crane hook.

–– Providing a banksman (signaller) to give directions to the crane

operator with good means of communication between the driver
and other operators.
–– Ensuring that safety devices, such as overload indicators, are
operational and are used correctly – these devices are frequently
disabled or ignored by the crane operator.
–– Checking weather conditions and obeying any manufacturer’s
recommendations about maximum wind speed. For a mobile
crane, typical maximum safe wind speeds would be 14 metres per
second (31 miles per hour).
Crane lift being supervised
–– Using PPE, such as hard hats, steel toe-cap boots and high-
visibility clothing.
–– Using signs to warn of the operations and exclusion of personnel from the area.
–– Ensuring that special requirements for lifting equipment are used for lifting people – equipment which may
be used to lift people will be subject to more stringent examination requirements than equipment used to
move goods.

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6.3 Load-Handling Equipment

It is also important to consider the lifting accessories that are used to attach the load to the crane: items such as
chains, wire ropes, nylon slings or eye-bolts and shackles. These must be:

• Attached to the correct lifting points.

• Fitted to the load by competent people.
• In good condition.
• Regularly checked by pre-use visual inspection and subjected to thorough examination.
On lifting, a test lift is usually carried out where the load is lifted just off the ground to test the equipment and
balancing, before being lifted smoothly into position. Tag lines may also be used in some lifting operations in order to
guide the load into position. Loads should never be left suspended or lifted over people.

Requirements for Statutory Examination of Lifting

Equipment
Lifting equipment is placed under a great deal of strain. If it is not maintained in good working order, it can fail
catastrophically. This will almost certainly happen under load, when maximum damage will be done.

Fatalities frequently occur as a result of catastrophic lifting equipment failures. There are, therefore, legal
requirements about the thorough examination of lifting equipment to ensure strength and stability. For example, in
the EU, lifting equipment is subject to the Use of Work Equipment Directive (2009/104/EC). In Great Britain, this
is transposed as the Lifting Operations and Lifting Equipment Regulations 1998 (LOLER).

Lifting equipment should be thoroughly examined:

• Before it is used for the first time (unless it has an in-date certificate of thorough examination from the
manufacturer or previous owner).
• Before it is used for the first time where the way that it has been installed will make a difference to its strength
and stability.
• Periodically.
• After an event that may have affected its strength and stability.
The frequency of ‘periodic’ thorough examination will typically be every:

• 12 months where it is not used to carry people.

• Six months where it is used to carry people.
• Six months for lifting accessories (lifting chains, slings, etc.).
This thorough examination must be carried out by a competent engineer.

MORE...
Follow the link below for some more information on lifting equipment:

www.hse.gov.uk/work-equipment-machinery/loler.htm

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Load-Handling Equipment 6.3

Legal Standards

• ILO C155 – Occupational Safety and Health Convention, 1981 (No. 155).
• ILO R164 – Occupational Safety and Health Recommendation, 1981 (No. 164).
For construction sites:
• ILO C167 – Safety and Health in Construction Convention, 1988 (No. 167).
• ILO R175 – Safety and Health in Construction Recommendation, 1988 (No. 175).

STUDY QUESTIONS
11.W hat are the most common risks associated with the following lifting/moving equipment?
(a) Forklift trucks.
(b) Sack trucks.
(c) Lifts and hoists.
(d) Cranes.
12.W hat PPE might be appropriate when working with the following lifting/moving equipment?
(a) Pallet trucks.
(b) Cranes.
13. What are the typical safety precautions for safe use of a mobile crane?

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Summary

Summary

This element has dealt with some of the hazards and controls relevant to repetitive work activities, manual handling
and load-handling equipment.

In particular, this element has:

• Defined ergonomics, identified the MSDs associated with poor work design and identified factors that influence
ergonomic risk such as repetition, force, posture, twisting, rest breaks, equipment design and adjustability, and
workplace lighting.
• Described the application of ergonomic principles to DSE use.
• Outlined the main types of injury associated with manual handling as MSDs such as injury to the back, tendons,
ligaments, muscles and WRULDs.
• Noted the basic principles of safe lifting technique before the lift, during the lift and when setting down.
• 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.
• Explained how risk associated with manual handling can be controlled by automating or mechanising the
handling; using handling aids; modifying the task, load or environment; and by ensuring individual capabilities are
matched to the activity.
• Considered the hazards and safety precautions associated with different types of load-handling equipment, such
as manually operated trucks and mechanically operated forklift trucks, lifts, hoists, conveyors and cranes.
• Outlined the typical hazards as:
–– Collapse or toppling of the equipment.
–– Falls from height.
–– Falling objects.
–– Being struck by the equipment or the load during movement.
• Outlined the general precautions as:
–– Suitability in terms of strength and stability.
–– Correctly positioned and installed.
–– Marked with the safe working load.
–– Used by competent operators under competent supervision.
–– Maintained in a safe working condition.
–– Only used for carrying people if the equipment has been designed for that purpose and all additional safety
requirements have been implemented.
• Explained how lifting equipment should be routinely inspected and subjected to thorough examination by a
competent engineer.

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Practical Assessment Guidance

Practical Assessment Guidance

Part 2 – Risk Assessment

The second step in the practical assessment is to carry out a risk assessment exercise and record the results on Part 2
of the NEBOSH form.

The Part 2 Form

Part 2 of the NEBOSH form is shown below:

Note: These forms are for reference purposes only. Please visit the NEBOSH website to obtain the official forms to
submit your assessment.

This table appears self-explanatory but it needs to be completed by carefully reading and following the NEBOSH
guidance. We will start with the first step where you are required to identify the hazard category and hazard.

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Practical Assessment Guidance

Please note that Part 2 of the risk assessment form does not give any indication of word count. As this risk assessment
is being done for the purposes of an academic assessment (rather than for work), you should write enough
information so that the examiner can clearly understand your intention. Remember that the examiner does not know
your workplace and will not be visiting it. It is better to explain things properly rather than write too little on the form.
A Part 2 risk assessment that is 10 pages long and contains several thousand words is likely to be better than one that
is only four pages long and contains only 500 words.

Hazard Category and Hazard

As you know from your Unit IG1 studies, the first step in the risk assessment process is to identify the hazards. And a
hazard is something with the potential to cause harm. So the first row of the risk assessment form is where you need
to identify the specific hazards that you intend to talk about in the assessment.

You need to identify at least 10 significant hazards. These must come from at least 5 of the hazard categories that
are dealt with in the Unit IG2 course. The hazard categories are:

Radiation Work
Work-related
equipment Work-related
upper limb
driving
disorders

Mental
Manual
ill health
handling
Load-
Movement of Vibration
handling Noise
equipment people and
vehicles

Substance
abuse Hazardous
substances

Confined
spaces
Electricity
Fire
Slips and
trips
Health, welfare
and work
environment

Working at height Lone working

Work-related
violence

There are 20 categories, so it should be fairly straightforward for you to pick your hazards from 5 or more of them.

As stated in Part 1 of this assessment guidance, you may have a very broad range of hazards in your workplace –
possibly a lot more than the 10 or so required in this assessment – so you will need to be selective and pick the most
significant hazards from a very broad range. It is fine to have more than 10 hazards, but don’t have too many as it is
not necessary for the purpose of the assessment and they may detract from your work. Selecting 12 to 14 different
hazards from at least 8 different hazard categories would be a sensible approach.

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Practical Assessment Guidance

If you struggle to find 10 hazards in your workplace, or you can only find hazards from 2 or 3 hazard categories, then
it would suggest that you have not chosen the right workplace to carry out your practical assessment.

Remember that in a risk assessment, you are not just looking for hazards that are poorly controlled or for things that
are wrong. This is not an inspection. You are looking for things that have the potential to cause harm. Some of your
hazards may be very poorly controlled and some of them may be very well controlled. The key thing is that all of your
10 or more hazards must have significant potential to cause harm in the form of either physical injury or ill health.

As you complete the first row of the risk assessment form, remember to write the information that is requested,
in the right order. You need to put the hazard category first and the hazard second. For the hazard category, simply
select the name of the topic from the above list of 20. For the hazard itself, identify it by referring to the specific
activity or area where it exists.

For example, ‘Electricity and use of mains-powered portable electrical equipment in the outdoor yard area’ would
be an acceptable entry. It identifies the hazard category first (Electricity) and then goes on to identify the specific
electrical hazard to be dealt with in the assessment.

But ‘Faulty mains-powered drill’ would not be an acceptable entry. It does not identify the hazard category, it does
not properly identify the specific hazard (no mention is made of where the drill was or if it was in use) and it is far
too specific in its focus on one faulty item. Remember this is a risk assessment, so you are looking at the proper
management of various types of hazards across your chosen workplace. You are not simply conducting an inspection
looking for defects.

The key things to remember here are:

• There must be at least 10 hazards.

• The hazards must come from at least 5 different hazard categories.
• The category is identified followed by the hazard – which is identified using a little information so the examiner
can see the specific nature of the hazard.
Do not identify:

• Fewer than 10 hazards. If you only identify 9, your assessment will be referred.
• Trivial or fanciful hazards. The examiner does not want to know about A4 paper cuts in the office or microwave
radiation from mobile phones causing brain cancer. Stick to the significant hazards that are widely recognised by
the authorities.
• Hazards from fewer than 5 hazard categories. If you talk about fire safety, fire safety, fire safety, and only fire
safety, your assessment will be referred.
Once you have identified your hazards, you can then move on. The next step asks you to identify who might be
harmed and how.

Who Might be Harmed and How?

The second step of the risk assessment process is to identify who might be harmed and how for each of the specific
hazards that have been identified.

When identifying who might be harmed, remember from your Unit IG1 studies that we are interested in broad
categories of people such as workers, contractors, visitors and members of the public. We are also interested in
groups of people or individuals who might be more vulnerable to the hazard in question, such as new and expectant
mothers, young people, lone workers, people with disabilities, etc. Do not name individuals. Identify the groups
of people who might be harmed by each hazard. You can identify vulnerable people by reference to their specific
characteristic that makes them more vulnerable to the hazard, for example: ‘Machine operators in the workshop and
the cleaner who is a lone worker.’

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Practical Assessment Guidance

You must then write a short description about how these people might be harmed. This should include information
about when and how they are exposed to the hazard and the type of harm(s) that might occur. If different people are
exposed to the hazard in different circumstances, then say so. If the hazard can cause a range of physical injuries and/
or ill-health effects, then say so.

For example:

• ‘The machine operator is exposed to the most intense UV radiation from the source, but all other workshop staff
can be exposed if they are in the area when the operation is in progress.’
• ‘Workers in the room are exposed to this hazard all of the time because it is constantly present.’
• ‘Members of the public will occasionally trespass across the marshalling yard. This happens about once a week.’
• ‘The solvent is a skin irritant and a skin sensitiser so is capable of causing a range of health effects such as primary
contact dermatitis and secondary allergic dermatitis (where the skin suffers a severe allergic reaction to contact
with very small amounts of the solvent).’
The key here is to give the examiner an insight into how various people might be harmed by the specific hazard. This
is an opportunity for you to demonstrate knowledge that you have learnt from your studies of the Unit IG2 study
text and your background research done for this assessment. It is, therefore, a good idea to write more rather than
less.

Do not make superficial comments such as ‘everyone’ for every hazard and do not exaggerate the effects of hazards.
It is unlikely that workers will die from manual handling operations. A more foreseeable outcome is that they will
receive a range of injuries including muscle strains, tendon and ligament injuries, or prolapsed spinal discs. Remember
that the examiner is looking for informed statements.

That’s the first two parts of the risk assessment form completed.

Information about the next step – what you are already doing and what further controls/actions are required? – is
presented at the end of Element 7.

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