Manual Handling Hazards, Risks And Control Measures

Did you know that every year, millions of people are injured as a result of manual handling accidents? In fact, it is one of the most common causes of workplace injuries. In this blog post, we will discuss the hazards and risks associated with manual handling, as well as the control measures that can be put in place to reduce the risk of injury. We will also take a look at how to conduct a risk assessment for manual handling tasks.

What Is Manual Handling?

Manual handling is any activity that involves lifting, carrying, or moving a load, whether it’s in your hand, on your shoulder, or pushed in front of you. It can also include pulling, lowering, or throwing a load. You might have to do this as part of your job, for example when you’re stacking shelves or loading a van.

Manual handling can be dangerous if not done correctly. The Health and Safety Executive (HSE) estimates that more than a third of all over-three-day injuries reported each year in the UK are caused by manual handling at work. These injuries include back pain, sprains and strains, and crush injuries to fingers, hands, and toes.

The term ‘manual handling’ is defined as the movement of a load by human effort alone. This effort may be applied directly or indirectly using a rope or a lever. Manual handling may involve the transportation of the load or the direct support of the load, including pushing, pulling, carrying, moving using bodily force, and, of course, straightforward lifting. Back injury due to the lifting of heavy loads is very common, and several million working days are lost each year as a result of such injuries.

Typical hazards of manual handling include:

• Lifting a load that is too heavy or too cumbersome, resulting in back injury; 
• Poor posture during lifting or poor lifting technique, resulting in back injury; 
• Dropping a load, resulting in foot injury; 
• Lifting sharp-edged or hot loads result in hand injuries. 

Types Of Manual Handling Injuries

Manual handling operations can cause a wide range of acute and chronic injuries to workers. Acute injuries normally lead to sick leave from work and a period of rest, during which time the damage heals. Chronic injuries build up over a long period of time and are usually irreversible, producing illnesses such as arthritic and spinal disorders.

There is considerable evidence to suggest that modern lifestyles, such as a lack of exercise and regular physical effort, have contributed to the severe long-term effects of these injuries.

The most common injuries associated with poor manual handling techniques are all musculoskeletal in nature and are:

• Muscular sprains and strains – caused when a muscular tissue (or ligament or tendon) is stretched beyond its normal capability leading to a weakening, bruising and painful inflammation of the area affected. Such injuries normally occur in the back or the arms and wrists; 
• Back injuries – include injuries to the discs situated between the spinal vertebrae (i.e., bones) and can lead to a very painful prolapsed disc lesion (commonly known as a slipped disc). This type of injury can lead to other conditions known as lumbago and sciatica (where pain travels down the leg); 
• Trapped nerve – usually occurring in the back as a result of another injury but aggravated by manual handling; 
• Hernia – this is a rupture of the body cavity wall in the lower abdomen, causing a protrusion of part of the intestine. This condition eventually requires surgery to repair the damage; 
• Cuts, bruising and abrasions – caused by handling loads with unprotected sharp corners or edges;
• Fractures – generally of the feet due to the dropping of a load. Fractures of the hand also occur but are less common; 
• Work-related upper limb disorders (WRULDs); 
• Rheumatism – this is a chronic disorder involving severe pain in the joints. It has many causes, one of which is believed to be the muscular strains induced by poor manual handling lifting techniques.

Musculoskeletal problems are the most common cause of absence, followed by viral infections and stress-related illnesses. These findings are based on an analysis of sickness management records for 11,000 individual employees across a range of private sector organizations. A recent study has found that musculoskeletal disorders (MSDs) account for nearly half (49%) of all absences from work and 60% of permanent work incapacity in the European Union.

It is estimated that this costs the UK economy £7 billion annually and Europe £240 billion yearly. The study, conducted across 25 European countries, found that 100 million Europeans suffer from chronic musculoskeletal pain – over 40 million of whom are workers – with up to 40% having to give up work due to their condition. In the UK alone, 9.5 million working days were lost in one year due to musculoskeletal problems.

In general, pulling a load is much easier for the body than pushing one. If a load can only be pushed, pushing backward using the back is less stressful on body muscles. Lifting a load from a surface at the waist level is easier than lifting from the floor level, and most injuries during lifting are caused by lifting and twisting at the same time. If a load has to be carried, it is easier to carry it at waist level and close to the body trunk. A firm grip is essential when moving any type of load.

Hierarchy Of Measures For Manual Handling Operations

With the introduction of the Manual Handling Operations Regulations, the emphasis during the assessment of lifting operations changed from a simple reliance on safe lifting techniques to analysis, using risk assessment, of the need for manual handling. The Regulations established a clear hierarchy of measures to be taken when an employer is confronted with a manual handling operation:

• Avoid manual handling operations so far as is reasonably practicable, either by re-designing the task to avoid moving the load or by automating or mechanizing the operations. 
• If manual handling cannot be avoided, then a suitable and sufficient risk assessment should be made. 
• Reduce the risk of injury from those operations as reasonably practicable by either using mechanical handling or making improvements to the task, the load and the working environment.

The Guidance given to the Manual Handling Operations Regulations (available in the HSE Legal series – L23) is a very useful document. It gives very helpful advice on manual handling assessments and manual handling training.

Manual Handling Risk Assessment

When it comes to manual handling in the workplace, there are a number of potential risks that need to be considered. In order to ensure the safety of employees, it is important to carry out a risk assessment. This will help to identify any hazards and put in place appropriate control measures.

The Regulations specify four main factors that must be considered during the assessment. These are the task, the load, the working environment and the capability of the individual who is expected to do the lifting.

The task should be analyzed in detail to cover all aspects of manual handling, including mechanical assistance. The number of people involved and the cost of the task should also be considered. Some or all of the following questions are relevant to most manual handling tasks: 

• Is the load held or manipulated at a distance from the trunk? The further from the trunk, the more difficult it is to control the load and the stress imposed on the back is greater. 
• Is a satisfactory body posture being adopted? The feet should be firmly on the ground and slightly apart, and there should be no stooping or twisting of the trunk. Reaching upwards should not be necessary, as this will place additional stress on the arms, back and shoulders. The effect of these risk factors is significantly increased if several are present while the task is being performed.
• Are there excessive distances to carry or lift the load? Over distances greater than 10 m, the physical demands of carrying the load will dominate the operation. The frequency of lifting and the vertical and horizontal distances the load needs to be carried (particularly if it has to be lifted from the ground and/or placed on a high shelf) are very important considerations. 
• Is there excessive pulling and pushing of the load? The state of floor surfaces and the individual’s footwear should be noted so that slips and trips may be avoided. 
• Is there a risk of a sudden movement of the load? The load may be restricted or jammed in some way. 
• Is frequent or prolonged physical effort required? Frequent and prolonged tasks can lead to fatigue and a greater risk of injury. 
• Is there sufficient rest or recovery periods? Breaks and/or changing tasks enable the body to recover more easily from strenuous activity. 
• Is there an imposed rate of work on the task? This is a particular problem with some automated production lines and can be addressed by spells on other operations away from the line. 
• Are the loads being handled while the individual is seated? In these cases, the legs are not used during lifting, and stress is placed on the arms and back. 
• Does the handling involve two or more people? The handling capability of an individual reduces when he/ she becomes a team member (e.g., for a three-person team, the capability is half the sum of the individual capabilities). Visibility, obstructions and the roughness of the ground must all be considered when team handling takes place.

The load must be carefully considered during the assessment, and the following questions asked:

• Is the load too heavy? The maximum load that an individual can lift will depend on the capability of the individual and the position of the load relative to the body. There is, therefore, no safe load. The figure given here is reproduced from the HSE guidance, which does give some advice on loading levels. It recommends that loads in excess of 25 kg should not be lifted or carried by a man (and this is only permissible when the load is at the level of and adjacent to the thighs). For women, the guideline figures should be reduced by about one-third. 
• Is the load too bulky or unwieldy? In general, if any dimension of the load exceeds 0.75 m (c. 2 ft.), its handling is likely to pose a risk of injury. Visibility around the load is important. It may hit obstructions or become unstable in windy conditions. The position of the center of gravity is very important for stable lifting – it should be as close to the body as possible. 
• Is the load difficult to grasp? Grip difficulties will be caused by slippery surfaces, rounded corners or a lack of foot room. 
• Are the contents of the load likely to shift? This is a particular problem when the load is a container full of smaller items, such as a sack full of nuts and bolts. The movements of people (in a nursing home) or animals (in a veterinary surgery) are loads that fall into this category. 
• Is the load sharp, hot or cold? Personal protective equipment may be required.

The working environment in which the manual handling operation is to take place must be considered during the assessment. The following areas will need to be assessed:

• Any space constraints which might inhibit good posture. Such constraints include lack of headroom, narrow walkways and items of furniture; 
• Slippery, uneven or unstable floors; 
• Variations in levels of floors or work surfaces, possibly requiring the use of ladders; 
• Extremes of temperature and humidity.
• Ventilation problems or gusts of wind; 
• Poor lighting conditions.

Finally, the capability of the individual to lift or carry the load must be assessed. The following questions will need to be asked:

• Does the task require unusual individual characteristics (e.g., strength or height)? It is important to remember that strength and general manual handling ability depend on age, gender, state of health and fitness. 
• Are employees who might reasonably be considered pregnant or have a health problem put at risk by the task? Particular care should be taken to protect pregnant women or those recently giving birth from handling loads. Allowance should also be given to any employee with a health problem that can be exacerbated by manual handling.

The assessment must be reviewed if there is reason to suspect that it is no longer valid or if there has been a significant change to the manual handling operations to which it relates.

Reducing The Risk Of Injury

This involves introducing control measures resulting from the manual handling risk assessment. TheGuidancee to the Regulations (L23) and the HSE publication Manual Handling at Work (INDG 143) contain many ideas to reduce the risk of injury from manual handling operations. An ergonomic approach is generally required to design and develop the manual handling operation. The control measures can be grouped under five headings. However, when it is reasonably practicable, the first consideration is mechanical assistance.

The task can be improved by changing the workstation layout by, for example, storing frequently used loads at waist level. Removing obstacles and using a better lifting technique that relies on the leg rather than back muscles should be encouraged. When pushing, the hands should be positioned correctly. The work routine should also be examined to see whether job rotation is being used as effectively as it could be.

Special attention should be paid to seated manual handlers to ensure that loads are not lifted from the floor while they are seated. Employees should be encouraged to seek help if a difficult load is to be moved so that a team of people can move the load. Adequate and suitable personal protective equipment should be provided where there is a risk of loss of grip or injury. Care must be taken to ensure that the clothing does not become a hazard (e.g., the snagging of fasteners and pockets).

The load should be examined to see whether it could be made lighter, smaller or easier to grasp or manage. This could be achieved by splitting the load, positioning handholds or a sling, or ensuring that the center of gravity is brought closer to the handler’s body. Attempts should be made to make the load more stable, and any surface hazards, such as slippery deposits or sharp edges, should be removed. It is very important to ensure that any improvements do not inadvertently create additional hazards.

The working environment can be improved in many ways. Space constraints should be removed or reduced. Floors should be regularly cleaned and repaired when damaged. Adequate lighting is essential, and working at more than one level should be minimized to avoid hazardous ladder work. Attention should be given to the need for suitable temperatures and ventilation in the working area.

The capability of the individual is the fifth area where control measures can be applied to reduce the risk of injury. The employee’s state of health and the medical record will first indicate whether the individual can undertake the task. A period of sick leave or a job change can make an individual vulnerable to manual handling injury. The Regulations require that the employee be given information and training.

The information includes the provision, where it is reasonably practicable to do so, of precise information on the weight of each load and the heaviest side of any load whose center of gravity is not centrally positioned. In a more detailed risk assessment, other factors, such as the effect of personal protective equipment and psychosocial factors in the work organization, will need to be considered. The following points may need to be assessed:

• Does protective clothing hinder movement or posture? 
• Is the correct personal protective equipment being worn? 
• Is proper consideration given to the planning and scheduling of rest breaks? 
• Is there good communication between managers and employees during risk assessment or workstation design? 
• Is there a mechanism to deal with sudden changes in the workload volume? 
• Have employees been given sufficient training and information? 
• Does the worker have any learning disabilities, and if so, has this been considered in the assessment?

Recent amendments to the Manual Handling Operations Regulations have emphasized that a worker may be at risk if he/she:

• Is physically unsuited to carry out the tasks in question; 
• Is wearing unsuitable clothing, footwear or other personal effects; 
• Does not have the adequate or appropriate knowledge or training.

The HSE has developed a Manual Handling Assessment Chart (MAC) tool to help the user identify high-risk workplace manual handling activities and the assessment of common risks associated with lifting, carrying and handling. The tool can assess the risks posed by lifting, carrying and team manual handling activities. It incorporates a numerical and color coding score system highlighting high-risk manual handling tasks. There are three types of assessment that can be carried out with the MAC:

1. Lifting operations; 
2. Carrying operations;
3. Team handling operations

The MAC is available on the HSE website.

Manual Handling Training

Training alone will not reduce manual handling injuries – there still needs to be safe systems of work in place and the full implementation of the control measures highlighted in the manual handling assessment. The following topics should be addressed in a manual handling training session:

• Types of injuries associated with manual handling activities; 
• The findings of the manual handling assessment; 
• The recognition of potentially hazardous manual handling operations; 
• The correct use of mechanical handling aids; 
• The correct use of personal protective equipment; 
• Features of the working environment that aid safety in manual handling operations; 
• Good housekeeping issues; 
• Factors that affect the capability of the individual; 
• Good lifting or manual handling technique

The ‘good handling technique’ given in the guidance on the Manual Handling Operations Regulations (L23) advises:

• Think before you lift; 
• Keep the load close to your waist; 
• Adopt a stable position; 
• Ensure a good hold on the load; 
• At the start of the lift, moderate flexion (slight bending) of the back, hips and knees is preferable to fully flexing the back (stooping) or the hips and knees (squatting); 
• Don’t flex your spine any further as you lift; 
• Avoid twisting the trunk or leaning sideways, especially while the back is bent; 
• Keep your head up when handling; 
• Move smoothly; 
• Don’t lift more than you can easily manage; and 
• Put down, then adjust. 

Finally, it must be stressed that if injuries involving manual handling operations are to be avoided, planning, control, and adequate supervision are essential.