Manual Handling Train the Trainer

Course Content Day 1

Course Content Day 2

Course Content Day 3

Learning Outcomes

Course Assessment
Practical assessment Presentation (10 minutes) Demonstration of correct lifting technique Assessment will be made on the following criteria; Content as defined in the brief Communication clear, easy to understand Technical knowledge all facts correct Demonstration correct posture adopted Timing fills 10 minutes but doesnt over-run Pace not too fast Written assessment 30 minutes

Course Content

Reasons for Managing Health and Safety

Legal Dubai World Health, Safety and Fire Regulations and Standards Moral Moral obligation towards employees Staff morale and company image Economic Lost time through injury Insurance costs Replacing Staff

Manual Handling Injuries

Types of Workplace Incident

Manual Handling Body Parts

Slide 11

Manual Handling Types of Injury

Slide 12

Definitions

Manual Handling: Any transporting or supporting of a load (including the lifting, putting down, pushing, pulling, carrying or moving thereof ) by hand or bodily force Load: Discrete movable object, which includes any person or animal Manual Handling Injury: Bodily harm that arises from the inherent properties of the load

Employers Responsibilities
Employers have a responsibility to: Not require anyone to carry loads beyond their capability Ensure loads do not exceed 20kg Best practice is for employers to Avoid the need for manual handling operations which involve a risk of employees being injured Assess any hazardous manual handling operations that can not be avoided Reduce the risk to employees Provision of load information Review the assessment Consider individual physical capability, clothing, footwear and employees knowledge and training

Employee Responsibilities
Each employee while at work shall: Make full and proper use of any system of work provided for his use by his employer Co-operate with employer when assessments of a manual handling operation are being made Follow safe systems of work and make proper use of handling aids and personal protective clothing Report defects which arise in the above Participate in training provided in the interest of safety Inform the employer of medical conditions or pregnancy which, will affect their ability to handle loads safely

Hierarchy of Control

Avoid hazardous manual handling Assess any hazardous operations Remove risk factors identified in assessment Reduce the impact of the risk factors Monitor Manual handling training

Anatomy

Exercise 2 - The Human Body

Outline the purpose of the following: Bones The spine Muscles Tendons Ligaments Nerves Blood vessels

Structure of the Spine

Cervical vertebrae

Thoracic vertebrae

Lumbar vertebrae

Inter-Vertebral Discs

Vertebra Nucleus Inter-vertebral discs

Spinous processes

Spinal nerves

Prolapsed Disc

Vertebra

Spinal Cord

Disc Spinal Nerves Prolapse

Back Pain
Common causes of back pain can include: Prolapsed disc Slipped disc Partly prolapsed disc Degenerative disc Trapped nerves

Sprains & Strains

Ligaments are tissue which holds bones together A damaged ligament is called a sprain

Tendons link muscles to bone A damaged muscle is called a strain

Typical Manual Handling Injuries

Muscular
Sprains & Strains Hernias Ruptures Torn Ligaments RSI/WRULDs

Skeletal
Prolapsed Disc Fractures/Breaks Dislocation Crushed Limbs Arthritis

Superficial
Bruises Abrasions Burns Bites Lacerations/Cuts

Bending and Twisting

Bending down to pick up an object at floor level Muscles and soft tissues come under tension Discs are deformed Spine susceptible to damage at low levels of loading

Twisting particularly hazardous Muscle activity deforms discs

Cumulative Strain
Progressive degeneration resulting from the long-term misuse of tissue Stiffening of body and muscle tissue due to habitual, excessive or prolonged exertion Accumulation of actions rather than from any single incident Build up of fibrous layer over muscle tissue resulting in pain or injury Treatment Stretching reduces build up of fibrous tissue Warming up and warming down before work/exercise

Factors Leading to Cumulative Strain

Force - Excessive and or Prolonged muscle tension Awkward body postures Insufficient rest between periods of work Repetition of the task Lack of variety of movement in the tasks F A I R

Leading to: General body stiffening/loss of flexibility Rapid fatigue and pain Injury Muscular strains, carpel tunnel, tennis elbow WRULDs Physical inefficiency

G R I P

Human Capabilities

Lifting Weights

Handling Loads with Arms Outstretched

When handling loads away from the body, our capability is reduced The extent to which we are affected depends on how far the load is from the body

Manual Handling - Kinetic Lifting Techniques

Lifting Technique First Thoughts? Demonstration and Practice Efficient Movement Principles (EMP) & Kinetic Lifting Technique

Kinetic Lifting

The maintenance of correct posture during manual handling activities is achieved through the adoption of sound lifting techniques There are a number of important phases that need to be considered: Addressing the load Lifting the load Adjusting the load Carrying the load Putting down the load Manoeuvring the load

Efficient Movement Principles

These principles can be applied to any manual handling operation to reduce the risk for the Handler: Dynamic, stable base Soft hips and knees Maintain natural curves No twisting Effective use of muscles Chin in/Head up Elbows close to body

Efficient Movement Principles

Keep close to the load Grasp the load cross directional, direct hold Breathing abdominal pressure Use of body weight Apply forces in direction of movement Make use of friction Make use of momentum Commands and communication Move in a controlled way

The 7 Golden Rules Of Lifting

Rule 1 Stop and think Plan your lift Assess the load Know your carry distance Know where you are going to set the load down

The 7 Golden Rules Of Lifting

Rule 2 Adopt a stable position Close to the load Approaching the load at a corner

The 7 Golden Rules Of Lifting

Rule 3 Address the load - Bend your knees - Take a firm grip - Keep your back straight and look ahead

The 7 Golden Rules Of Lifting

Rule 4 Lift smoothly using your legs to take the strain Moderate flexion (Slight bending) Soft knees and hips Maintain balance and avoid twisting

The 7 Golden Rules Of Lifting

Rule 5 Move in a controlled manner Hold the load close to the centre of the body Move in the direction you are facing Keep your head up

The 7 Golden Rules Of Lifting

Rule 6 Putting the load down is just lifting in reverse Put the load down in front, then adjust Remember to bend your knees Keep your back straight

The 7 Golden Rules Of Lifting

Rule 7 Take care when positioning the load Slide the load into the desired place (friction) Dont over reach

Manual Handling Pushing and Pulling

Well managed pushing or pulling is a way to avoid manual lifting or carrying Can involve dragging, or the use of trolleys, barrows etc Principles of good manual handling techniques continue to apply

Manual Handling Pushing and Pulling

Pushing versus Pulling

Pushing is generally better as you can more easily maintain a stable base and can see where you are going without twisting. Pushing Initiating force to start moving then move with the load making small steps using the legs to move the load Slopes can increase resistance and create lack of control making good posture difficult Pulling Keep hands low near to hips and bend knees maintaining a low centre of gravity Short steps backwards keeping stable base

Pushing and Pulling Technique

Team Handling
A team approach can be used for handling loads that are: Large Heavy Awkward Good communication and Coordination are vital to ensure safe handling Guidelines (low risk) 2 persons 35kg 3 persons 40kg

Manual Handling Risk Assessment

Step 1 Identify the Hazards

Job/Task Analysis Inspections Observation of the work Speak to staff Environment Other work going on

Step 2 Decide who can be harmed

Operatives Maintenance staff Cleaners Contractors Visitors Members of the public Specific groups Young persons Pregnant women Lone workers Disabled

Step 3 Evaluate the Risk

It is essential for employers to evaluate the risk associated with the handling activity and the adequacey of any control measures Evaluate the level of risk Are existing control measures working? Can more be done to reduce the risk? You must also consider: The number of people involved The frequency of the task The duration of exposure

Step 3 Evaluate the Risk

When evaluating risk, we must take two factors into account: Likelihood 1. 2. 3. 4. 5. Unlikely Low Moderate High Expected Severity 1. Minor Injury - No 1st Aid 2. Minor Injury with 1st Aid 3. Less than 3 day injury 4. Greater than 3 day injury 5. Major injury (including Death)

Risk Rating Systems

Severity Likelihood

Minor injury

First aid injury

Lost time accident (<3 days)

Lost time Major Injury accident (>3 days)

Unlikely Low Moderate High Expected

1 2 3 4 5

2 4 6 8 10

3 6 9 12 15

4 8 12 16 20

5 10 15 20 25

Risk Rating Systems

High Frequency/Low Severity Paper Cuts in Printing Slips and Trips Low Frequency/High Severity Nuclear Reactor Meltdown Chemical Release, Explosion Any fatalities

Although they may produce the same score, greater management is needed to control high severity events. The same principle applies to manual handling activities.

Defining Acceptable / Tolerable Risk

Unacceptable Risk

25

Tolerable Risk

Broadly Acceptable Risk

Slide 55

Negligable Risk

How To Reduce Risk

Organisations have two options when it comes to implementing control strategies to reduce risks:

1. Reduce the likelihood 2. Reduce the severity To a point as low as reasonably practicable (ALARP)

Reducing Risk Rating

Severity Likelihood

Minor injury

First aid injury

Lost time accident (<3 days)

Lost time Major Injury accident (>3 days)

Unlikely Low Moderate High Expected

1 2 3 4 5

2 4 6 8 10

3 6 9 12 15

4 8 12 16 20

5 10 15 20 25

Slide 57

Step 4 Record Your Findings

Record your findings Establish a Corrective Action Plan Tell people if they have been given actions Make actions and timeframes achievable Undertake Work Procedure reviews

Communication / Feedback
The process must be visible Items to be recorded include details on: What was assessed? What are the identified risks? What control measures are in place? What control measures are being improved? Who is responsible for any identified Corrective Actions? What are timescales for improvement?

Step 5 - Review
Assessments should be reviewed following any changes to: Plant Process Personnel Undertake reviews based on risk High-risk activities reviewed more often Periodic review of all assessments Prioritise actions based on risk

Manual Handling Assessment

Environment

Load

Task

Other Factors Individual

Manual Handling Assessment

Task - Is load positioned away from the torso? - Is a good body posture possible? (twisting) - How far is the load carried? - Is there any pushing or pulling? - Is significant physical effort required? - Is the employee standing or sitting? - Is there opportunity for a rest or a break? - Is there an imposed work rate? (production line) - Visibility

Task

Vertical movement

Pushing or pulling

Task Stooping and/or Twisting

Manual Handling Assessment

Individual - Physical ability - Strength or height - Training or knowledge - Age - Existing medical conditions - Pregnant workers

Manual Handling Assessment

Load - Weight - Bulky or unwieldy - Difficult to grasp - Shape - Slippery surfaces - Can the contents shift - Loose items - Alive - Sharp edges - Hot or cold

Load

Obstructs view

Load

Manual Handling Assessment

Environment - Floor conditions (slippery, uneven, unstable) - Space constraints - Various levels (stairs, ladders, ramps) - Temperature (hot, cold, humid) - Wind - Lighting

Environment

Manual Handling Assessment

Personal Protective Clothing - Incompatibility - Female office staff (skirts and shoes may need to be taken into account) Work Organisation - Time - available time and work pressures - Staffing Levels loading up individuals - Communication changes of workload, priorities - Seasonal changes busy periods increasing levels of manual handling

Pushing and Pulling Risks

Factors to consider when evaluating risks associated with pushing and/or pulling include: Task Individual Load Environment Equipment Organisational factors

Pushing and Pulling Risks the Task

Load Distances Route Slopes Obstacles Effort required to start or stop the load Hand position Repetitive pushing or pulling

Pushing and Pulling Risks the Individual

Individual capabilities Shift work Physical attributes Existing conditions Health problems Pregnancy Physical or mental disability Task may determine capability Specialist training may be required

Pushing and Pulling Risks the Load

Weight Centre of gravity Stability What happens on slopes? Negotiating corners Size Visibility Bulky

Pushing and Pulling Risks Environment

Surfaces Condition Roughness Drainage Inclines or slopes Stairs Lighting Wind Temperature Constrains on posture Narrow passages Doorways

Pushing and Pulling Risks Equipment

Fit for purpose Maintained Wheels match surface Size Material Compatible with surface Handle height Brakes???

Pushing and Pulling Risks Organisational Impacts

Workload demands Deadlines Lack of control Working methods Communication Change management Motivation Morale

Good Practice - Manual Handling Risk Assessment

Carried out by teams - Range of views - Range of risk perceptions - Different ways of doing a task - Physical ability People involved are familiar with the task - How the job is done in practice (human behaviour) - Managers and supervisors Contact Health and Safety Department for advice Formally documented and communicated

Arrangements for Implementing Risk Assessments

Take action to remove hazards Alter equipment Modify the environment Training/briefings Tool box talks Safe systems of work Procedures Work instructions Notices Signs Warning labels

Risk Assessment Filters

The bodys capacity for handling loads can be affected by the nature of the task being carried out. In such instances, a filter should be applied to help determine what constitutes a safe load. Consider: - Lifting and lowering - Carrying for short distances - Pushing and pulling - Handling while seated

Risk Assessment Filters Human Capability

Risk Assessment Filters

Frequent lifting and lowering

Where operations are repeated Once or twice per minute Five to eight times per minute More than 12 times per minute Figures should be reduced by 30% 50% 80%

Twisting
If handler twists through (from front) 45 degrees 90 degrees Figures should be reduced by 10% 20%

Risk Assessment Filter - Sitting

Risk Assessment Filter Pushing and Pulling

Stopping or starting the load - Men 20 kg (200 Newtons) - Women 15 kg (150 Newtons) Keeping the load in motion - Men 10kg (100 Newtons) - Women 7kg (70 Newtons)

Worked Example Risk Assessment Filter

An operator has to load 30 x 25 kg sacks into a machine He is given 10 minutes to complete the task The space is restricted and he must twist through 45 degrees The sacks are lifted from a pallet at waist height, the machine is 30 cm higher than the pallet Is a detailed assessment required?

Exercise Risk Assessment Filter

Male worker employed 7 hours per day to load boxes weighing up to 15kg onto racking at various heights up to 2m, 25 operations per hour. Production line workers male/female. Seated 7 hour shift sorting potatoes. Waste/damaged potatoes dropped into a waste box located to the side of the operator. Customer service operator in a supermarket, loading shopping bags, taking loaded bags to customers car, located in the car park. Walking up to 150 m. Y/N

Y/N

Y/N

Exercise 3 Risk Assessment Filter

Loading a market stall with vegatables. From store 50ms away, loads are varied with maximum single item 25kg. Sack barrow and trolley available. Sales representatives taking a breif case with laptop computer to their car from the office. Female office worker required to unload stocks of paper and place them at floor level in the stockroom. Task involves pushing boxes away from the body to load them into the back of a store cupboard. Paper boxes weigh up to 10kg.

Y/N

Y/N

Y/N

Course Content

The MAC Tool

What is the MAC?

Manual Handling Assessment Charts (MAC): Produced by UK HSE to help businesses assess risks Screening tool utilising a numerical scoring system Assists with prioritising interventions Incorporates colour scheme to show risk rating (visual output)

MAC Scoring

Other Factors to Consider

Individual factors Age Gender Health status (I.e. previous back injury, hernia, pregnancy) PPE Training Psychosocial factors High workloads Tight deadlines Boredom

Not addressed in the MAC

Exercise Turning Cheese

Use the MAC Tool to assess the task of turning cheese

Training

The systematic development of attitude knowledge, and skill patterns to enable a person to perform a task adequately

Ensuring an Effective Training Environment

Competent instructor Defined training objectives A content of knowledge broken down into sequential units that can be readily assimilated A clear and orderly training programme An appropriate place in which to learn Suitable equipment & visual aids Sufficient time to attain the desired standard of knowledge and competence Frequent tests to ensure understanding

Principles of Manual Handling Instruction

Six main principles: Planning Preparation Practice Presentation Communication Confirmation

Course Planning
Define the target audience Identify any specific training needs Set course aims and objectives Think about costs, including time available Consider availability and shift pattern of workers Consider different learning approaches

I hear and I forget, I see and I remember, I do and I understand.

Confucius - 500BC

Course Preparation
Pre-session questionnaire Know your audience Session plan outline course content Resources Equipment Handouts Flip charts Activities Training pack etc Ensure suitability of training facilities Ensure suitability of training materials

Lesson Plan
Lesson plans should be developed to provide trainers with a structured programme Things to consider: Defined learning outcomes clearly stated Timings Identification of equipment/materials required Active delegate participation Exercises Opportunity for feedback and discussion

Exercise Preparing a Lesson Plan

You are required to deliver a one day manual handling awareness training course. Prepare a lesson plan to assist you in the delivery of such a course, to incorporate the following key principles: - Principles of Manual Handling - Human Anatomy - Manual Handling Injuries - Kinetic Lifting Techniques Remember to include a variety of elements, such as tuition, practical elements, exercises, discussion opportunities and assessment.

Practice
Plan and practice demonstrations Be a model of best practice Do not over demonstrate bad points Plan and practice your presentation Check your timing and control the pace and flow of your presentation Build confidence through positive feedback

Presentation

Be enthusiastic and confident Speak clearly and concisely Maintain eye contact and include your audience Avoid jargon Know your subject Dress to suit the occasion Be prepared Communicate effectively Motivate Demonstrate empathy Listen

Training Problems
Friends Colleagues Hecklers Know alls Pessimists Whisperers People who do not want to be there

What problems could be created and how can we manage them?

Communication

Key features of effective communication? Two-way exchange Understood (not too complex) Presented in suitable format (oral/visual)

Communication

Use Questions: To gain information To open up a discussion or debate To seek clarification To get someones co-operation To involve and motivate others To help people reflect and learn

Confirmation

Summarise key points to confirm objectives achieved Test to confirm knowledge and understanding Quiz Tests Formal and informal Exercises/Case studies Use a feedback form to: Identify areas of improvement Reflect on your own performance Update/improve the session Demonstrate professional approach

Exercise - Risk Assessment Workshop

Using the MAC Tool, Carry out a Manual Handling Assessment on the following activities: Calibrating weigh scales Charging solids Repairing pumps in the workshop Refilling GC machines

Exercise Risk Assessment Workshop

Exercise Risk Assessment Workshop

Exercise Risk Assessment Workshop

Exercise Risk Assessment Workshop

Exercise Risk Assessment Workshop

Exercise Risk Assessment Workshop

Exercise Risk Assessment Workshop

Exercise - Improvement Strategy

Consider the risk factors for manual handling activities (T.I.L.E.O) In groups develop a strategy to improve these issues within your organisation. Group 1 - Task Group 2 - Individual Group 3 - Load Group 4 - Environment

Directed Study - Revision Sheet

Physiology of the spine (to include functions of the spine and

discs), Musculoskeletal injuries Kinetic lifting technique Definitions: Manual Handling Load Injury Employer & Employee Responsibilities How to Avoid Manual Handling Risk Assessment Factors TILEO Hierarchy of Control

Course Content

Types of Lifting and Handling Aid

Powered Trucks, trolleys, vehicles
Fork lift truck (rider operated and walk along) Drum rotator

Non-powered trucks, trolleys and aids

Pallet truck Trolley

Tracks, conveyors, chutes, roller balls Adjustable height devices, rotary tilt tables Mechanical Hoists and vacuum lifting devices Various other aids, straps, friction glides etc

Types of Lifting and Handling Aid

Ergonomics

Ergonomics is a science concerned with the fit between people and their work. It puts people first Takes account of capabilities and limitations Ensures that tasks, equipment, information and the environment suit the each worker

Ergonomic Considerations

The job being done Physical & mental demands on the worker The equipment used Size, shape, and how appropriate it is for the task Information used Presented, accessed, and changed The physical environment Temperature, humidity, lighting, noise, vibration The social environment Teamwork and supportive management

Upper Limb Postures

Carpal Tunnel Syndrome

Median Nerve

Transverse Carpal Ligament Carpal Bones Flexor Tendons

Carpal Tunnel

Ergonomics Physical Aspects

Body size and shape Fitness and strength Posture The senses Vision Hearing Touch The stresses and strains on muscles, joints, nerves

Areas for Ergonomic Improvements

Control panels Worker machine interfaces Feedback systems from machines Locations of buttons or switches DSE Manual handling

Ergonomics solving problems

Minor alterations may solve most problems: Height-adjustable chairs Remove obstacles from under desks Correctly arrange items stored on shelving Raise platforms to help operators reach badly located controls Change shift work patterns or introduce job rotation

Ergonomics Solving Problems

Talk to employees Get them to suggest ideas Involve employees from the start Make sure that any alterations are properly evaluated by the people who do the job If there is no straightforward solution, get qualified advice

Improvement Cycle

Monitoring/Review

Inspection of activity To ensure effectiveness of new controls Accident figures Incident investigation Behavioural programmes New information New guidance New systems New equipment New substances

Example Assessment Questions

Describe the structure of the spine (5 marks) Outline the function of the spine (5 marks) Explain the considerations to be made when carrying out a manual handling risk assessment (10 marks) What is a prolapsed disc? (2 marks) What are the effects of a prolapsed disc? (3 marks) How does this type of injury occur? (3 marks)

Presentation - Assessment Criteria

Content Communication Technical knowledge Demonstration Timing Pace Demonstration