The document reviews literature on the differences in manual materials handling techniques between experienced workers and novices, with a focus on the implications for training. It highlights that existing training programs have shown limited success in reducing low back injuries and emphasizes the importance of understanding expert techniques and adapting training methods accordingly. The findings indicate that effective training should consider individual and workplace factors, as well as the realistic context of manual handling tasks.

1. Do experienced workers adopt different manual
materials handling techniques compared to novices
and can these be used as examples for training? A
literature review
Mark Boocock, Grant Mawston, Liz Ashby and
Fiona Trevelyan
mark.boocock@aut.ac.nz
Health & Rehabilitation Research Institute /
Centre for Occupational Health & Safety Research
Auckland University of Technology
New Zealand

2. Epidemiology and back pain
15-40% of the general population in developed countries are
affected by low back pain (LBP) and 80% will experience at
least one episode in their life-time
In 2010-2011 back injuries cost the ACC an estimated NZ$230
million
Those aged 40 to 54 years contributing to approximately 42% of
the total costs
A high incidence of low back injuries are associated with
manual handling, particularly repetitive lifting
Dempsey (1998); Frymoyer et al. (1983); Marras et
al. (1993); McCoy et al. (1997)

3. Manual handling training
Training programmes appear to have had little success
in reducing low back injuries and their effectiveness
appears contested
Gagnon (2003)
Reasons may stem from:
 Inadequate training methods due to lack of applicability or
lack of rationale
St-Vincent et al. (1989)
 Lack of consideration for adaptability to suit variations in
task, workplace and worker
Sedgwick and Gormley (1998)
 Quality of training programme rarely questioned

4. Manual handling training
Training programmes are often based on the widespread
convention that the ‘leg-lift’ is the correct technique for
lifting
No proper consideration of the physical realities of
manual handling
 workplace: load placement with respect to height,
depth, obstacles; load format and heterogeneity
Contrasting strategies of experts and novices is a
potential means to encourage workers to identify new
ways of handling and may provide a more effective
approach to manual handling training
Gagnon (2003)

5. Manual handling fail

6. Aims and objectives
To undertake a detailed and systematic literature review
to identify experimental studies that have compared
experts and novices performing manual materials
handling tasks
To identify individual and workplace factors that are
important to a workplace training programme

7. Methods: inclusion/exclusion
Keywords – drawn from major publications and systematic reviews,
terms inclusive of:
 Experience: e.g. novice, expert, skill
 Manual handling: e.g. lifting, patient transfer, psychophysical
 Training: e.g. education, learning, teaching, knowledge transfer
EBSCO electronic database searched (incl. Academic Search
Premier, CINAHL, Medline, AMED, Health source, Ergonomic
abstracts, Psych and Behav Sci collection)
Inclusion criteria Exclusion criteria
Experimental studies Observational studies
Comparison between experts and novices or
different skill levels
Training techniques of experts performed by
novices
Manual handling (lifting, lowering, push/pull,
carry)
Not published in English
Biomechanical, physiological and/or
psychophysical measures
Completed early Aug 2014

8. Results: studies identified
1,740 titles/abstracts
screened
57 abstracts read
5 retrieved from reference
list of included studies
16 studies
5 main outcome measures
Postural / handling factors: e.g. kinematics, stability, movement of the centre of gravity (CoG)
Kinetic (forces): e.g. spinal compressive and shear forces, net joint moments
Psychophysical ratings: e.g. perceived ratings of discomfort (RPD), maximum acceptable weights of lift
(MAWL)
Muscle activity: electromyography (EMG) of back muscles
Physiological measures: muscle oxygenation, heart rate

9. Results: tasks / activities
Box handling: e.g. palletising,
asymmetric lifting, workplace factors
(weight, horizontal and vertical reach
distances, with and without handles)
repetitive 8 hr workdays
Sheep shearing: drag and shear sheep
in flexed postures
Patient transfers: single person; mobile
floor hoist; electric ceiling lift
Subject numbers low, mean=15, median=10 per group

10. Results: definition of an expert/novice
Experience varied greatly across studies:
 Years of experience often used to define people as experts
 Recognition from co-workers
 Few lifetime back injuries
Novices Experts
Little or no experience Involved with training and instruction
Students Industrial workers
Junior, intermediate class Sensor, Open class
College students with no
experience
Warehouse selectors from a local distribution centre
No MH experience At least 1 yr full time in a lifting job
No experience in frequent
lifting tasks
>3yr in a frequent lifting tasks for at least 10hr/wk, from
local warehouse
3-6 months experience and no
injury in preceeding yr
Min 5 yr experience, low incidence of injury, no injury in
preceding yr, positive recommendations from peers,
unions or managers

11. Results: postural and handling factors
Footwork, load manoeuvres
(tilting/handgrips) and body posture
differentiated novices and expert
handling strategies
Footwork strategies showed experts
were at an advantage for reducing
mechanical work, especially load transfer
duration and trajectory
Box manoeuvring (tilts and handgrips)
affected mechanical work by reducing
load transfer duration and trajectory and
minimising knee flexion
Expert (A & B) Novice (C & D)
Expert Novice
Gagnon (2005)

12. Results: kinetic factors
Effect of experience appears weak to moderate for spinal
compression and shear forces, and lumbar moments
Experienced workers have been shown in some studies to increase
spinal compression loading (20%) and have higher spine extension
moments than novices
Suggested to stem from muscle co-activity (spine stability) and better
balance maintenance
Granata et al. (1999); Lee and Nussbaum (2014)
Rate of lifting may be important – experienced
workers increased spinal loading when forced to
work at slower rates and novices increased loading
when forced to work at faster rates
Marras et al. (2006)

13. Results: physiological responses
Limited number of studies (2) have investigated physiological
responses
 Muscle oxygenation of the erector spinae
 Heart rate and oxygen uptake
Experienced workers showed significantly less oxygen saturation
increases in the erector spinae than novices for an 8hr repetitive
lifting task
Experienced workers may have developed
more efficient motor strategies to use less
oxygen or their back muscles were more
adapted
Novices at the end of the workday could be at
higher risk of muscle injury - better break
scheduling
Yang et al. (2007)
Mital (1987)

14. Results: psychophysical (perceptions)
Discomfort reporting appears to be more a reflection of
experience than work risk factors
Novice workers report much higher discomfort levels than their
experienced counterparts
Experienced subjects may have more efficient motor patterns
which reduces spinal load and thus discomfort
Parakkat (2007)
Personality traits - experienced
perceivers (less suited to the task)
acted similar to novice workers in
terms of compressive and shear spinal
loading
Chany et al. (2006)

15. Discussion: approach to training
“Bend your knees not your back” or
“lift with your legs not your back”
Experts may use this strategy, but only in a specific condition
Plamondon et al (2014)
Promoting this slogan without any context (work task, work
environment, etc) would be a mistake because work conditions
change and preclude the application of this rule
Graveling (1991)
An expert handler is not only skilful in handling loads but also
extremely wise in planning his work and avoiding stressful work
situations
Lortie (2001)

16. Discussion: what to teach?
The degree to which the task is meaningful, challenging and
familiar contributes to task realism
A need for clear definitions of novices and experts
 “naivette” – one who is completely ignorant about a domain
 “apprentice” – one who is learning about a domain
 “master” – elite group of experts
Farrington-Darby and Wilson (2001)
A better understanding of ‘expert’ techniques could
help in redesigning efficient training programmes
Involvement of knowledgeable employees,
ergonomic assessment of tasks and quality of
training appear important when developing training
programmes