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Preventing and Enforcing
Musculoskeletal Hazards in the
         Workplace
         Anne Duffy, Provincial Ergonomist
          Specialized Professional Services
        Occupational Health and Safety Branch
                  Ministry of Labour




           www.ccohs.ca
Objectives

•   Defining what is an MSD
•   Determining how big is the MSD
    problem
•   Ensuring prevention resources are
    available
•   Enforcing compliance with health and
    safety legislation

                              Ministry of Labour   2
MSDs
MSDs are injuries and disorders of the musculoskeletal
 system such as: muscles, tendons and tendon
 sheathes, nerves, bursa, blood vessels, joints/spinal
 discs, and ligaments.

MSDs may be caused or aggravated by various
 hazards or risk factors in the workplace.

MSDs do not include musculoskeletal injuries or
 disorders that are the direct result of a fall, struck by,
 or against, caught in or on, vehicle collision, violence,
 etc.
                                           Ministry of Labour   3
MSD Data Definition
Step 1: find all lost time claims based on CSA
  Z795-96 nature of injury codes (total of 16
  codes)

e.g.:
   – 021 sprain, strain, tear; 029 other injuries to muscles,
     tendons, ligaments; 082 sprains, bruises; 09720
     nonspecific injuries/disorders back pain; etc.




                                            Ministry of Labour   4
MSD Data Definition – cont.
Step 2: find a subset of claims found in step 1 by
  selecting claims that are coded with the following
  type event code (type of accident) – (8 codes)

e.g.
  – 20 bodily reaction and exertion; 22 overexertion; 23
    repetitive motion; 25/26 static posture with and
    without force; etc.




                                          Ministry of Labour   5
Ontario MSD Data Overview
• From 2003-2007, it is estimated that MSDs resulted in
  direct claim costs of over $640,000,000 and in over
  6,000,000 days of lost time from work
• During this same time period, the total lost-time injury
  (LTI) rate decreased by 22%, while the MSD-related LTI
  rate decreased by 15%
• Despite the decrease in the MSD-related LTI rate, MSDs
  accounted for 43 per cent of all LTIs in Ontario in 2007,
  an increase from 40% in 2003
• 2007 MSD-related costs account for 43% of total LTI
  costs up from 41% in 2003

Source: Ontario WSIB Enterprise
                                           Ministry of Labour   6
       Information Warehouse
Preventing MSDs
                A Priority for all
  Ontario Health and Safety System Partners
• Ministry of Labour (MOL)
• Workplace Safety and Insurance Board (WSIB)
• Health and Safety Associations (HSAs)
   – 12 sector-specific safe workplace associations
   – Workers’ Health and Safety Centre
   – Occupational Health Clinics for Ontario Workers
• Institute for Work & Health (IWH)
                                       Ministry of Labour   7
Ergonomics Initiatives
• MSD Prevention Strategy for Ontario
• MSD Prevention Guideline for Ontario, Resource
  Manual, Toolbox and website
• Research
   – IWH – research, systematic reviews, knowledge
     transfer
   – CRE-MSD – research, seed grants, sector
     conferences
• WSIB – Hot spots website, safety groups, fund
  projects (pictograms)
• Safety Associations – resources, training,
                                     Ministry of Labour   8
  consulting
MSD Prevention Strategy for Ontario
• MSD Prevention Guideline
• Sector specific prevention resources
• Enhance awareness and knowledge of MSDs for
  front line health and safety system staff
• Enhance awareness and knowledge of MSDs for
  employers/workers
• Integrate into existing systems/initiatives
• An MSD business case
• Safe Design
• Research
                                Ministry of Labour   9
OHSCO MSD Prevention Guideline for Ontario

   www.wsib.on.ca/wsib/wsibsite.nsf/Public/PreventMSD




                                        Ministry of Labour   10
OHSCO MSD Prevention Toolbox




                    Ministry of Labour   11
MSD Prevention Toolbox
Structure of toolbox – 3 parts
• Getting Started (19 tools)
   – MSD hazard awareness
   – MSD hazard identification tools
   – Control strategies
• Beyond the Basics (10 tools)
   – Hazard recognition surveys
   – Risk assessment
   – MSD program elements
• More on In-Depth Risk Assessment (22 information
  sheets)

                                       Ministry of Labour   13
Prioritizing Jobs and Tasks for Risk Assessment




                                   Ministry of Labour   15
WSIB
• Road to Zero
• MSDs identified as one of four top priority
  hazards
• Generate firm risk assessment data




                                 Ministry of Labour   17
Research Partners
• Research – MSD prevention
• Systematic Reviews
• Sharing Best Evidence
• Workshops – MSDs in Transportation,
  Manual Handling, Job rotation
• Position papers
• Bring researchers and workplace parties
  together
                               Ministry of Labour   18
Health & Safety Associations
• Sector specific expertise – 12 sectors plus
  Workers Centre and Occupational Health
  Clinics for Ontario Workers
• Consulting, training, publications
• 100’s resources on MSD prevention




                                 Ministry of Labour   19
www.preventionbestpractices.org/msd.html
Enforcing Ergonomics
Minister’s Ergonomics Sub-Committee


    Pains and Strains Campaign



          High Risk Initiative



         Safe at Work Ontario
                                 Ministry of Labour   21
Ergonomics Sub-committee
Six key recommendations:
   – Increase education and awareness of MSDs
   – Focus on MSD prevention in MOL targeting
     initiative
   – Enhance training for inspectors on MSD
     prevention
   – Improve access to resource materials
   – Improve tracking of ergonomic-related inspections
   – Increase ergonomic expertise

                                        Ministry of Labour   22
Pains and Strains Campaign
•   Enhanced training of MOL inspectors
•   Better tracking of ergonomics activity
•   Increase awareness of ergonomics-related hazards
•   Availability of resources
•   Promote prevention
•   Progressive enforcement




                                      Ministry of Labour   23
Safe at Work Ontario
Includes a proactive component to Regional Ergonomists
   field work
2008/09
• Firms with an MSD frequency rate over 8.0 and more
  than 50 employees
• Participate in general blitzes
2009/10
• Firms with high MSD claim count
• Firms within rate groups with history of high MSD
  frequency rates
• MSD Provincial blitz
                                       Ministry of Labour   24
MSD Blitz
• Cross-Program blitz, Month of April 2009, carried out by
  Inspectors
• Highly focused on specific types of workplaces and
  tasks
   o Industrial – Retail grocery food sales
        Transporting goods on carts
        Handling products at heights
        Cashier workstations




                                          Ministry of Labour   25
MSD Blitz – cont.
o Healthcare – Nursing and Retirement homes
     Resident lifting, transferring and repositioning
o Construction – Homebuilding, Low Rise Forming
     Access/Egress to sites
     Installation of work platforms
     Moving forms from interior to exterior of poured
    foundation
     Transporting forms from one site to next
o Mining – Handling of drills



                                        Ministry of Labour   26
Enforcing Ergonomics
• Occupational Health and Safety Act
    o Training of workers on hazards
    o General duty clause – take every precaution
      reasonable
    o Maintenance of equipment
    o Risk Assessment

•   Industrial Regulation
•   Construction Regulation
•   Mining Regulation
•   Healthcare Regulation
                                        Ministry of Labour   27
How is your company addressing MSD prevention?
•   Is MSD prevention an element of your written health
    and safety policy/ procedures?
•   Is there evidence of an MSD hazard identification
    process?
•   Do you know which jobs are causing musculoskeletal
    discomfort?
•   Have workers, supervisors, JHSC members received
    any training on MSD prevention?
•   Are workers encouraged to report signs and
    symptoms early?
•   Are MSD reports investigated?

                                         Ministry of Labour   28
Concluding Comments
• MSD prevention requires ongoing enthusiasm and
  commitment
• MSD hazards need to be identified and controlled
  with the same diligence of other safety hazards
• Worker involvement is key – participatory ergonomics
• Often the beneficial results are not immediately
  apparent due to the cumulative nature of these
  hazards



                                         Ministry of Labour   29
Work Should Not Hurt!

        Thank you

Any comments or questions?




                    Ministry of Labour   30
Contact
                            Anne Duffy
                       Provincial Ergonomist
                 Specialized Professional Services
               Occupational Health and Safety Branch
                         Ministry of Labour

                                416-326-1410

                          Anne.Duffy@ontario.ca

Canadian Centre for Occupational Health and Safety
www.ccohs.ca

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Musculoskeletal Hazards in the Workplace

  • 1. Preventing and Enforcing Musculoskeletal Hazards in the Workplace Anne Duffy, Provincial Ergonomist Specialized Professional Services Occupational Health and Safety Branch Ministry of Labour www.ccohs.ca
  • 2. Objectives • Defining what is an MSD • Determining how big is the MSD problem • Ensuring prevention resources are available • Enforcing compliance with health and safety legislation Ministry of Labour 2
  • 3. MSDs MSDs are injuries and disorders of the musculoskeletal system such as: muscles, tendons and tendon sheathes, nerves, bursa, blood vessels, joints/spinal discs, and ligaments. MSDs may be caused or aggravated by various hazards or risk factors in the workplace. MSDs do not include musculoskeletal injuries or disorders that are the direct result of a fall, struck by, or against, caught in or on, vehicle collision, violence, etc. Ministry of Labour 3
  • 4. MSD Data Definition Step 1: find all lost time claims based on CSA Z795-96 nature of injury codes (total of 16 codes) e.g.: – 021 sprain, strain, tear; 029 other injuries to muscles, tendons, ligaments; 082 sprains, bruises; 09720 nonspecific injuries/disorders back pain; etc. Ministry of Labour 4
  • 5. MSD Data Definition – cont. Step 2: find a subset of claims found in step 1 by selecting claims that are coded with the following type event code (type of accident) – (8 codes) e.g. – 20 bodily reaction and exertion; 22 overexertion; 23 repetitive motion; 25/26 static posture with and without force; etc. Ministry of Labour 5
  • 6. Ontario MSD Data Overview • From 2003-2007, it is estimated that MSDs resulted in direct claim costs of over $640,000,000 and in over 6,000,000 days of lost time from work • During this same time period, the total lost-time injury (LTI) rate decreased by 22%, while the MSD-related LTI rate decreased by 15% • Despite the decrease in the MSD-related LTI rate, MSDs accounted for 43 per cent of all LTIs in Ontario in 2007, an increase from 40% in 2003 • 2007 MSD-related costs account for 43% of total LTI costs up from 41% in 2003 Source: Ontario WSIB Enterprise Ministry of Labour 6 Information Warehouse
  • 7. Preventing MSDs A Priority for all Ontario Health and Safety System Partners • Ministry of Labour (MOL) • Workplace Safety and Insurance Board (WSIB) • Health and Safety Associations (HSAs) – 12 sector-specific safe workplace associations – Workers’ Health and Safety Centre – Occupational Health Clinics for Ontario Workers • Institute for Work & Health (IWH) Ministry of Labour 7
  • 8. Ergonomics Initiatives • MSD Prevention Strategy for Ontario • MSD Prevention Guideline for Ontario, Resource Manual, Toolbox and website • Research – IWH – research, systematic reviews, knowledge transfer – CRE-MSD – research, seed grants, sector conferences • WSIB – Hot spots website, safety groups, fund projects (pictograms) • Safety Associations – resources, training, Ministry of Labour 8 consulting
  • 9. MSD Prevention Strategy for Ontario • MSD Prevention Guideline • Sector specific prevention resources • Enhance awareness and knowledge of MSDs for front line health and safety system staff • Enhance awareness and knowledge of MSDs for employers/workers • Integrate into existing systems/initiatives • An MSD business case • Safe Design • Research Ministry of Labour 9
  • 10. OHSCO MSD Prevention Guideline for Ontario www.wsib.on.ca/wsib/wsibsite.nsf/Public/PreventMSD Ministry of Labour 10
  • 11. OHSCO MSD Prevention Toolbox Ministry of Labour 11
  • 12.
  • 13. MSD Prevention Toolbox Structure of toolbox – 3 parts • Getting Started (19 tools) – MSD hazard awareness – MSD hazard identification tools – Control strategies • Beyond the Basics (10 tools) – Hazard recognition surveys – Risk assessment – MSD program elements • More on In-Depth Risk Assessment (22 information sheets) Ministry of Labour 13
  • 14.
  • 15. Prioritizing Jobs and Tasks for Risk Assessment Ministry of Labour 15
  • 16.
  • 17. WSIB • Road to Zero • MSDs identified as one of four top priority hazards • Generate firm risk assessment data Ministry of Labour 17
  • 18. Research Partners • Research – MSD prevention • Systematic Reviews • Sharing Best Evidence • Workshops – MSDs in Transportation, Manual Handling, Job rotation • Position papers • Bring researchers and workplace parties together Ministry of Labour 18
  • 19. Health & Safety Associations • Sector specific expertise – 12 sectors plus Workers Centre and Occupational Health Clinics for Ontario Workers • Consulting, training, publications • 100’s resources on MSD prevention Ministry of Labour 19
  • 21. Enforcing Ergonomics Minister’s Ergonomics Sub-Committee Pains and Strains Campaign High Risk Initiative Safe at Work Ontario Ministry of Labour 21
  • 22. Ergonomics Sub-committee Six key recommendations: – Increase education and awareness of MSDs – Focus on MSD prevention in MOL targeting initiative – Enhance training for inspectors on MSD prevention – Improve access to resource materials – Improve tracking of ergonomic-related inspections – Increase ergonomic expertise Ministry of Labour 22
  • 23. Pains and Strains Campaign • Enhanced training of MOL inspectors • Better tracking of ergonomics activity • Increase awareness of ergonomics-related hazards • Availability of resources • Promote prevention • Progressive enforcement Ministry of Labour 23
  • 24. Safe at Work Ontario Includes a proactive component to Regional Ergonomists field work 2008/09 • Firms with an MSD frequency rate over 8.0 and more than 50 employees • Participate in general blitzes 2009/10 • Firms with high MSD claim count • Firms within rate groups with history of high MSD frequency rates • MSD Provincial blitz Ministry of Labour 24
  • 25. MSD Blitz • Cross-Program blitz, Month of April 2009, carried out by Inspectors • Highly focused on specific types of workplaces and tasks o Industrial – Retail grocery food sales Transporting goods on carts Handling products at heights Cashier workstations Ministry of Labour 25
  • 26. MSD Blitz – cont. o Healthcare – Nursing and Retirement homes Resident lifting, transferring and repositioning o Construction – Homebuilding, Low Rise Forming Access/Egress to sites Installation of work platforms Moving forms from interior to exterior of poured foundation Transporting forms from one site to next o Mining – Handling of drills Ministry of Labour 26
  • 27. Enforcing Ergonomics • Occupational Health and Safety Act o Training of workers on hazards o General duty clause – take every precaution reasonable o Maintenance of equipment o Risk Assessment • Industrial Regulation • Construction Regulation • Mining Regulation • Healthcare Regulation Ministry of Labour 27
  • 28. How is your company addressing MSD prevention? • Is MSD prevention an element of your written health and safety policy/ procedures? • Is there evidence of an MSD hazard identification process? • Do you know which jobs are causing musculoskeletal discomfort? • Have workers, supervisors, JHSC members received any training on MSD prevention? • Are workers encouraged to report signs and symptoms early? • Are MSD reports investigated? Ministry of Labour 28
  • 29. Concluding Comments • MSD prevention requires ongoing enthusiasm and commitment • MSD hazards need to be identified and controlled with the same diligence of other safety hazards • Worker involvement is key – participatory ergonomics • Often the beneficial results are not immediately apparent due to the cumulative nature of these hazards Ministry of Labour 29
  • 30. Work Should Not Hurt! Thank you Any comments or questions? Ministry of Labour 30
  • 31. Contact Anne Duffy Provincial Ergonomist Specialized Professional Services Occupational Health and Safety Branch Ministry of Labour 416-326-1410 Anne.Duffy@ontario.ca Canadian Centre for Occupational Health and Safety www.ccohs.ca