As human beings, ironically, it is often the body’s more vital functions that we take for granted – for example, the beating of our heart, or the movement of our rib cage inflating our lungs. Unless something goes wrong, we almost forget about the role these vital functions play in keeping us alive.
Even in areas where function is less critical, there is still much we take for granted. Some may be surprised to hear that the biceps muscle is sometimes referred to as the ‘feeding muscle’. It seems obvious once it is pointed out, but it may be that we have never thought much about it’s function in our day to day lives. How else do we get that donut from the plate to our mouth if not for simple flexion at the elbow? For that matter, how aware are we of the complex co-ordination required in the 20-odd muscles of the forearm that enable us to pick up the donut in the first place?
Proper functioning of the upper extremity is necessary for many of the activities of daily living we take for granted. Brushing our hair, writing an email, lifting a box – all would be severely limited were it not for the correct performance of the muscles, nerves, joints and bones of the upper limbs. The design of the hands and upper limbs and their daily use – and abuse – leaves this area of the human body highly vulnerable to injury.
The term ‘upper limb disorder’ (ULD) covers a large number of musculoskeletal conditions that affect the shoulder, elbow, forearm, wrist or hand. Some conditions are well defined with well established treatment protocols (e.g. carpal tunnel syndrome) while others, such as non-specific arm pain, are less well defined.
Research suggests that upper limb disorders are fairly common in the general population although we can’t be certain exactly how common. In 2005/06 an estimated 374,000 people in Great Britain suffered from an upper limb disorder that was caused by, or made worse by, their work.
There are many businesses that carry out work that may involve a risk of ULDs. High-risk activities will include:
- work that requires repetitive hand or arm movements e.g. assembly-line work, food processing or packing.
- the use of computers where any precautionary measures have not been undertaken.
- work that involves the use of hand-held tools or machinery – everything from screwdrivers, wrenches, hammers to heavier industrial tools.
We have a legal duty to protect the health and safety of ourselves and our employees. This includes taking steps to avoid upper limb disorders (ULDs) or to prevent them worsening if they have already occurred.
Here are some areas to consider:
- Identify and assess the risk of ULDs
Have we identified activities in our workplace that we suspect may give rise to ULDs? For example, look out for activities that involve the use of the hands and arms; repetitive actions; the use of force; actions performed over a long time; awkward working positions; and vibration etc.
Once areas are identified, we can then undertake a suitable risk assessment. ‘Upper limb disorders in the workplace’ (HSG60), an HSE publication, gives valuable advice on how to target the hazards and risks associated with ULDs. A more specific risk assessment tool – the Assessment of Repetitive Tasks (ART tool) can also be used and is found on the HSE website (www.hse.gov.uk/msd/uld/art/).
- Communicate to employees
Work with your employees on these issues and make sure they know about the risks involved and give advice on how to minimise them, eg. by taking regular rest breaks, having the correct posture and sharing high-risk tasks. Getting them involved in reducing the risks of ULDs is essential.
- Know the signs and symptoms of ULDs
The early reporting of symptoms is also important in preventing ULDs. Look out for complaints of aches and pains in the back, shoulders and upper limbs. Other symptoms may include numbness and tingling, burning sensations, feelings of warmth, swelling, cramp etc. We may also observe improvised changes the employees have made to work equipment, furniture or tools. This may also point to the fact that they are suffering some discomfit and have not as yet informed anyone.
- Eradicate or reduce the risk of ULDs
Ideally, by avoiding the work processes or equipment that pose a hazard we may be able to eliminate risk that gives rise to ULDs. This may not always be practicable of course. Using your health and safety risk assessment to identify areas of high-risk and introducing appropriate control measures will help minimise the risk of ULDs on your employees.
Control measures might include: rotating staff between different tasks; reducing the time spent by one person on a high risk activity; finding alternative equipment that is more more advanced power tools that cause lower levels of vibration, better ergonomic seating for display screen equipment users, well-designed workstations, equipment designed to reduce load handing e.g. conveyors.
- Train staff in minimising the risk of ULDs
Training is an important element in your management of ULD risk. Many tasks involve only a small ULD risk if carried out properly – but this can increase significantly if guidelines aren’t followed. Sitting at a computer workstation, for example, is a common enough activity and may not involve significant risk if guidelines are followed. However if employees are unsure about how to adjust their seats correctly, about when to take appropriate breaks, or about how to position the computer’s screen, keyboard and mouse correctly, then this risk increases significantly.
- Manage ULDs that do occur
Do we successfully manage any ULDs that do occur? Has occupational health been provided and are systems in place for employees returning to work after an ULD?
We may take things for granted, but implementing effective ULD prevention and management strategies will hopefully spare ourselves and our staff the pain that follows when something does go wrong.