• Marion Edwin
    21
    Just a comment for the cleaning related query... I am guessing that with the increased cleaning activity that has occurred due to Covid-19, that most cleaners will have had a physical work-load increase, alongside the likelihood of an increase in stress. Have employers recognised the associated risks? Same thing applies for those thrust into working from home without preparation - less well set-up, plus stress and for some longer hours of work, results in the potential for much increased health risk. I feel sure that physio's/ACC will be picking up the pieces over the next months.
  • Tony Donahoe
    9
    One of the biggest issues is that a "sore back" is couple of days to a week or more off work and if it is a workplace accident then its paid by ACC. This is not helped by GPs who are more than willing to sign off on the classic "strained back" for five days. Back injuries are probably over reported because of this type of behavior.
  • Mark Kenny-Beveridge
    8
    Yup Thanks Marion. The mirror tip was told to me in the late 90's and much has evolved. I look at driving like work station ergonomics, which includes all the factors you have mentioned. My work to date has information and advice we can provide on all the factors you mention except for the 'driver set up' Considering there are so many variables the seat alone can be set to, information on a 'good' would be great. Thanks for the link Professor Crawford
  • Prof Joanne Crawford
    25
    Hi Marion
    I agree that work design is crucial. In Europe training is the most common intervention, although there is evidence that training for manual handling activities does not prevent back pain https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005958.pub3/full
  • wendy spence
    2
    interesting having practiced in the field for 30 years I would say manual handling has changed in weight, loading and carrying. So definitely having accurate data would be useful.
    What I do see is people who lack some of the core features of MSK e.g. strength, flexibility, poor tissue status etc and along with NCD factors as others have noted above, there is a fit for purpose issue. Secondly the best success I have seen in changing behaviours is not only evidence based practice and systems but one where the person makes the changes and is in control. That interface is critical. Some of our programmes are fabulous evidenced based but application is poor.
  • Prof Joanne Crawford
    25
    Hi Tony
    I can't comment on NZ yet but in the UK there was a complete shift in how back pain was treated after a systematic review of treatments and outcomes. We used to be told to go lie down for 6 weeks. Now after initial assessment we are told to move if its mechanical back pain. There is also encouragement to get back to work and that you dont need to be 100% pain free to get back to work. However, there is a need to work with GPs, occupational physicians and ergonomists to reduce the workplace risk.
  • Peter Bateman
    134
    Fifteen minutes left, so it's time to get those last questions in! Go on, everything you ever wanted to ask about MSDs and psychosocial risk, but were afraid to ask.
  • Marion Edwin
    21
    Hi Tony, a doctor or physio might answer this differently, but in my experience, in NZ the occupational medicine fraternity have been well aware of the benefit of remaining as active as possible with many back injuries/ 'sore backs', and there has been a huge amount of information in the injury treatment/management sector about the recommended 'keep active' approaches. It may not be that well appreciated by some in the health and safety roles/sector though?
  • wendy spence
    2
    what is the single most important action we could take to make a difference to the level of MSD's increasing?
  • Mark Kenny-Beveridge
    8
    Good points raised by Tony. With your reply in mind, what are your views on Employer vs worker responsibility and accountability for 'fitness for work. It is accepted that employers must ensure people are trained for work, but how far does it go to ensure people are physically fit for work, i.e. supporting/supplying exercise/stretching programs for physical work deemed at risk of MSD?
  • Prof Joanne Crawford
    25
    Hi Wendy
    Agree, we are all getting heavier. Taking this from a hierarchy of control context can we eliminate the manual handling? If we can't what measures can be put in place. One solution in a Swedish hospital was the use of lifting aids. The argument was it took too long and the patients didn't like it. When it was explained to the patients why the lifting aids were needed, the patients were fine with this new method. Need to get everyone who is involved in the process.
    There needs to be a change in the viewpoint about fit for purpose, however, we should be designing to fit everyone, not just the strongest. With demographic change we need to think about diversity in risk assessment. Absolutely agree - participation by those doing the jobs and tasks is critical in any change.
  • Chris Hyndman
    43
    Hello Again Joanne,
    Could one of the "issues" with MSD related injuries be that we are continually seeking comfort in our activities?
    Are we masking stresses and strains on the body by making these positions bearable for longer periods and are actually encouraging sedentary work?
  • Prof Joanne Crawford
    25
    Hi Wendy
    Thats a good question! When we are setting up work processes, think about the human in the work system and does it fit them both physically and psychologically. Most often I have been involved in trying to change systems after they have been set-up - much harder to do.
  • Marion Edwin
    21
    Good work then Mark! My own mental checklist would include: legs supported so weight is spread between feet, backs of thighs, and trunk support; lumbar support; steering wheel positioned so not over-reaching; rest position at wheel with hands low and with a range of alternate hand positions possible - including those necessary for all driving maneuvers; and overall position so that you can see and do all the necessary driving tasks, and you are generally relaxed. Some vehicles do have poor fit for individuals that makes it hard to comfortably maintain a driving position - modifications or alternate vehicle models are sometimes necessary. Also for some people they need to be told not to hold onto the gear lever all the time (I have seen injuries related to that habit), or other odd habits and positions. Some of the central consoles aren't the right height for people, and create constrained postures.
  • Prof Joanne Crawford
    25
    Hi Mark
    That is a really good question and its clear in the health and safety legislation who has responsibility in the workplace. Who has personal responsibility, I suspect there is a need for a bigger debate around that. Organisations can help through health promotion activities but people have to buy-in to those. There is evidence that healthier workers are better for the business but where does organisational responsibility stop and individual responsibility take over. In the UK for example firefighters are assessed for fitness annually but police officers are not. That provides a lever, but do we want to go down that route for all jobs?
  • wendy spence
    2
    thanks Joanne & others really enjoyed this session and I hope something comes out of it as a multi disciplinarian and integrated approach + stakeholders is needed
    will be really interested to look at the models you have suggested
  • Peter Bateman
    134
    Joanne, on behalf of everyone, many thanks for your enthusiastic participation and breadth of expertise on this topic. And let's hope for some NZ collaboration with the group in Australia.
    You can give your typing fingers a break now!
  • Prof Joanne Crawford
    25
    Hi Chris
    I think there is a global issue around sedentary work and the longer term health impacts are more of a lever than advice from an ergonomist (I hope). The message we need to get out to people is that movement is important. Not sitting all day, or standing all day but moving. The UK legislation on display screen equipment states that individuals should take a screen break before the onset of discomfort and fatigue or every 45-55 minutes). We need to find ways to do this as part of our working time.
  • Prof Joanne Crawford
    25
    Thanks everyone, its been great and hope to meet you all face-to-face at some point. Going to move now!
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