Preventing Musculoskeletal Disordersin the Workplace

Protecting Workers

Health Series

No 5

Preventing Musculoskeletal Disorders

in the Workplace

Prof. Dr. rer. nat. Alwin Luttmann

PD Dr.-Ing. Matthias Jäger

Prof. Dr. med. Barbara Griefahn

Institute for Occupational Physiology

at the University of Dortmund

Institut für Arbeitsphysiologie

an der Universität Dortmund

Ardeystrasse 67

D-44139 Dortmund

Germany

and

Dr. med. sc. Gustav Caffier

Dr. med. Falk Liebers

Dipl.-Ing. Ulf Steinberg

Federal Institute for Occupational

Safety and Health/

Bundesanstalt für Arbeitsschutz

und Arbeitsmedizin

Nöldnerstrassie 40-42

D-10317 Berlin

Germany

Cover page layout

Tuula Solasaari-Pekki

Finnish Institute of Occupational Health

Design and layout

M/s Safire Graphix, New Delhi, India

Other booklets from the Protecting Workers Health Series:

No.1 : Preventing health risks from the use of pesticides in agriculture

No.2 : Understanding and performing economic assessments at the company

level

No. 3 : Work organization and stress at work

No.4 : Raising awareness of Psychological Harassment at Work

WHO Library Cataloguing-in-Publication Data

Preventing musculoskeletal disorders in the workplace/Alwin Luttmann … [et al.]

Protecting workers health series ; no. 5.

1. Musculoskeletal diseases – prevention and control 2. Workplace

3. Risk factors 4. Guidelines I. Luttmann, Alwin. II. Series

ISBN 92 4 159053 X (LC/NLM classification: WA 440)

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Preface

Disorders of the musculoskeletal system represent a main cause for

absence from occupational work. Musculoskeletal disorders lead to

considerable costs for the public health system. Specific disorders of the

musculoskeletal system may relate to different body regions and

occupational work. For example, disorders in the lower back are often

correlated to lifting and carrying of loads or to the application of vibration.

Upper-limb disorders (at fingers, hands, wrists, arms, elbows, shoulders,

neck) may result from repetitive or long-lasting static force exertion or

may be intensified by such activities. The severity of these disorders

may vary between occasional aches or pain to exactly diagnosed specific

diseases. Occurrence of pain may be interpreted as the result of a

reversible acute overloading or may be a pre-symptom for the beginning

of a serious disease.

The purpose of this document on the prevention of musculoskeletal

disorders is to inform about risk factors and to influence the actions of

employers and the behaviour of workers in such a way that risks of

physical loadings, dangerous to health or unnecessary fatiguing, are

avoided or diminished. The document has been prepared in such a way

that it can be used by employers, supervisors, and occupational health

trainers when designing work and work environment or for preparing

information materials and training programs. In consequence, application

of the guide should be helpful to reduce harm to individuals, to influence

the efficiency of work positively, and to reduce costs on the public health

system.

It is intended that this booklet be used by employers, supervisors and

occupational health trainers to help them recognise risks that may lead

to musculoskeletal disorders, as well as to design work itself and the

work environment in a way which is safe for the employee.

Acknowledgement is expressed to the following reviewers: Thomas R.

Waters, Ph. D., National Institute for Occupational Safety and Health,

Cincinnati; Dr. Hisashi Ogawa, World Health Organization, Regional

Adviser for Occupational Health, Regional Office for the Western Pacific,

Manila; and Evelyn Kortum-Margot, Occupational Health Programme,

World Health Organization, Geneva, Switzerland.

Examples of physical loadings at work which may be dan-

gerous to health:

Kneeling for long duration Manipulation of heavy loads

Sitting for long duration

Whole-body vibration

Static work and awkward

posture

Contents

Part 1: Objectives

1.1 Work-related musculoskeletal disorders – a definition 1

1.2 Characteristic health problems 2

1.3 Basic risk factors for the development of 3

musculoskeletal disorders

1.4 Factors to be considered in prevention 12

Part 2: Guidance

2 Guidance on main risk factors 15

2.1 Risk factor: Manipulation of heavy loads 15

2.2 Risk factor: Work with high force exertion 18

2.3 Risk factor: Working in unfavourable body postures 19

2.4 Risk factor: Monotonous repetitive tasks 22

2.5 Risk factor: Long-lasting loadings 23

2.6 Risk factor: Physical environmental conditions 25

Appendix: Basic rules for preventive actions in practice 27

Summary 29

Conclusion 30