Connected – October 2011
- Can a holistic approach prevent slips, trips, falls AND musculoskeletal problems?
- New booklets address contributory factors in high risk industries
- Start early and reduce life long risk of low back disorder related disability
- DPI New Entitlement Claims – Monthly Result
Can a holistic approach prevent slips, trips, falls AND musculoskeletal problems?
Slips, trips and falls often result in discomfort, pain and injury in the workplace. Almost all
industries rank their top two injury categories as ‘musculoskeletal problems’ and ‘slips, trips
and falls’.
Many musculoskeletal problems develop gradually over time, whilst slips, trips and falls are
usually sudden traumatic injury events. Yet few of us realise that both can be prevented and
managed using the same holistic approach.
In the past, attempts to address slips, trips and falls tended to look no further than the
immediate event, e.g. ‘slipped on wet surface’. This meant that interventions were often too
simplistic, e.g. ‘ensure all spills are cleaned up immediately’. Although good housekeeping is
important, we also need to identify and address other factors that can lead to a slip, trip or fall.
For example:
- worker rushing to meet a deadline
- poorly maintained pipes leaked fluid onto the floor
- poor lighting meant the worker didn’t see the leaked fluid
- worker carrying a heavy load which impaired balance and made for a harder landing.
We already know that single factor interventions don’t work well for preventing
musculoskeletal problems. The same applies to preventing slips, trips and falls. Let’s stop
looking for a single causative factor such as a slippery floor, or incorrect footwear, and instead
take a multi-factorial approach to these problems.
Take a multi-factorial approach to preventing slips, trips and falls
To prevent and manage musculoskeletal problems and slips, trips and falls effectively, our
advice is to start by setting up a basic health and safety system in your workplace. See
‘ACC366 How to implement safer workplace practices’ which offers guidance on this topic.
You can find it in the tool list at the end of this story.
Once a health and safety system is in place, the DPI Programme’s seven groups of
contributory factors model can help us look at the issue of slips, trips and falls more
holistically. For example you could consider the effects of poor housekeeping systems,
production pressure, the aging work force, worksites that are exposed to the elements and
many other contributory factors.
And here’s the good news – if you’re already implementing a DPI Programme approach
to preventing and managing musculoskeletal problems in your workplace, you’re probably
already preventing and managing some slips, trips and falls as well.
Different issues but the same contributory factors
Many of the contributory factors that can lead to musculoskeletal problems can also
directly contribute to slips, trips and falls. We’ve highlighted some examples below but
the possibilities are endless, as these contributory factors act in combinations and tend to
influence each other.
Individual factors
- Nutrition and hydration – can affect physical performance, attention span, fatigue
levels and much more - Fitness, strength and balance – affects a worker’s ability to stay upright and avoid
musculoskeletal pain or injury - Ageing workforce – older workers have the benefit of experience but may be less
physically resilient.
Psychosocial factors
- Communication – can influence whether or not contributory factors are identified and
addressed - External pressure on productivity – can lead to hurrying, shortcuts and incidents
- Level of worker control over tasks – can create frustration or boredom, leading to
inattention and human error incidents.
Work organisation
- Operational decisions – influence time pressure and/or risk taking
- Shift and break scheduling – influence staff fatigue levels and attention span
- Reporting procedures and processes – influence communication through the
organisation and subsequent recognition and resolution of emerging problems - Training – influences staff skills, knowledge and their work practices.
Workplace layout and awkward postures
- Poor workplace design – can create hazards such as obstructions to vision or access,
gradients or unseen changes in surfaces - The workstation and work area set up – may require over-reaching to do tasks
- Postures and positions – these too are affected by the set up of the workplace.
Task invariability
- Tasks that change little over time – can lead to fatigue, inattention, boredom,
frustration and human error incidents.
Loads and forceful movements
- Heavy, difficult or oversized handling – can contribute to discomfort, pain and injury
and/or a slip, trip or fall, especially if the worker becomes weary, inattentive or
loses balance - Use of excessive force – can put workers at risk of injury.
Environmental issues
- Weather – wind or wet surfaces
- Poor lighting – therefore hazards not visible
- Excessive or irritating noise (inside or outside) can lead to distraction.
Near Miss reporting as first line prevention for slips, trips and falls
Early Reporting is a key aspect of any successful health and safety system. For
musculoskeletal problems, early reporting of emerging discomfort can help to address
contributory factors before injury occurs.
In a similar way Near Miss or Near Hit reporting helps to prevent slips, trips and falls. A near
miss report is an opportunity to prevent an actual slip, trip or fall happening in the future.
It allows you to identify the factors that contributed to the near miss, and do something to
reduce or resolve them.
Encourage workers to report early
Ensure workers understand that it’s just as important to make a near hit report as it is to
report an actual incident. Workers need to know:
- how to make a near miss or early report
- that management supports near miss and early reporting
- that these are important ways they can help each other stay safe at work.
Ensure that workers have easy access to the necessary reporting forms. When a report
is made, take appropriate action to resolve any problems you find. Ensure any hazards
identified are entered into your Hazard Control Register. This way their control can become
part of your workplace’s health and safety system.
The same management response works for both problems
If an injury incident does occur, use the same process to manage slips, trips and falls as for
musculoskeletal problems:
- apply first aid as necessary and get medical assistance if required
- ascertain the seriousness of any injury – look for ‘Red Flags’
- look for opportunities for injured workers to stay at work, promote work based
recovery whenever possible - keep in contact with injured workers if they are off work and implement a return-to-
work plan - investigate and remedy ALL contributory factors associated with the incident, not just
the obvious ones.
Tools to help prevent and manage musculoskeletal issues AND slips, trips and falls
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New booklets address contributory factors in high risk industries
Nine booklets are now available to order that identify industry specific contributory factors and
offer simple preventive suggestions. We’re going to profile some of them over coming months
and first up is wool-harvesting. We hope you enjoy these and get a sense of the challenges
each industry faces.
Shear Hard Work
Breakfast is at 4am, before sunrise. Thirty minutes later vans and utes rattle down gravel
roads towards the next farm on the shearing contractor’s list. As lights go on in the
woolshed, shearers and wool handlers warm up, sharpen blades, check equipment and set
their ‘stations’ up for the day. All this happens before a single sheep is shorn.
As work begins the wide range of contributory factors that can lead to discomfort pain and
injury in the woolshed become apparent. Here are just a few of them:
- backwards drag of a 60 to 80kg sheep from the pen to the shearing position
- standing in one position for long periods
- continually bending and reaching to pick up fleece
- poor work organisation, such as jobs not being shared around to vary work, lack of
training, pressure from seasonal deadlines - working in unpredictable shed environments with variable weather conditions.
Given the strenuous nature of wool harvesting it’s easy to see why many entitlement claims in
this industry relate to musculoskeletal problems. These claims cost ACC nearly $1.2 million in
2010. Clearly discomfort, pain and injury issues have a significant impact on the performance
and productivity of this vital industry.
People who can influence contributory factors in wool harvesting
Everyone in the wool harvesting industry can contribute to reducing or eliminating factors that
contribute to injuries in the woolshed. For example:
The grower – that is, the farmer that grows the wool. The grower can positively influence
many contributory factors that exist in wool harvesting. Wool harvesters use the shearing
facilities on their farms and ideally growers should have their sheep ‘dagged, dry, drafted and
empty’ to support safe shearing.
Wool harvesting workers – these people bring another set of contributory factors to the mix.
A lot depends on their fitness, stamina, attitudes to work and their ability to work together as a
team.
The shearing contractor – brings growers and wool harvesters together and ensures that
workers are properly prepared for work, well fed and have adequate rest. They also keep
effective communication going between the farmers and the workers.
Of course there are some contributory factors you can’t do anything about – most of all
the weather and the possibility of wet sheep. However if you address as many of the other
contributory factors as you can, workers will be in the best possible position to deal with the
factors you can’t change.
Wool-harvesting in a DPI Programme context
In conjunction with the wool harvesting industry, ACC has produced a short booklet called
‘Wool harvesting, Preventing and managing discomfort, pain and injury (ACC4438)’,
which encourages readers to take a multi-factorial approach to preventing and managing
musculoskeletal problems. It gives a brief and practical overview of contributory factors in
wool harvesting, with advice about how to address them.
Get your copy
Download PDFs of these resources from the DPI Toolbox (contact Maddy if you need help to
log on) or call 0800 844-657 to order printed copies.
ACC4438 Wool Harvesting - Preventing & Managing Discomfort, Pain and Injury
ACC5846 Farm Workers Preventing & Managing Discomfort, Pain and Injury
ACC5847 Construction Workers Preventing & Managing Discomfort, Pain and Injury
ACC5848 Fruit Harvesters Preventing & Managing Discomfort, Pain and Injury
ACC5849 Healthcare Workers Preventing & Managing Discomfort, Pain and Injury
ACC5850 Horticultural Workers Preventing & Managing Discomfort, Pain and Injury
ACC5851 Hospitality Workers Preventing & Managing Discomfort, Pain and Injury
ACC5852 Road Transport Workers Preventing & Managing Discomfort, Pain and Injury
ACC5853 Sawmill Workers Preventing & Managing Discomfort, Pain and Injury
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Start early and reduce life long risk of low back disorder related disability
Low back disorders are a major public health problem and a leading cause of lost productivity
and work disability. A recent study has helped to clarify which health-related and socio-
demographic individual factors may increase the risk of low back disorder related disability. The
study also concludes that these types of potential injuries can be identified early in life and that
addressing them early will have long term positive effects.
A study in the May 2011 Journal of Occupational and Environmental Medicine reports that
musculoskeletal pain, obesity, and smoking are among the factors associated with an increased
risk of work disability due to low back disorders.
Using data from a large study of Finnish twins, the researchers looked for factors associated
with a higher or lower risk of going on disability pension for low back disorders. The use of twin
data avoided potential confounding effects of genetic factors and childhood environment.
Which factors were associated with disability?
The factor most strongly related to disability was pain in the neck, shoulder, or back, which
resulted in more than a twofold increase in risk of disability. Other risk factors were frequent
use of analgesic drugs (pain relievers), being a former or current smoker, having some type of
chronic disease and being a manual worker.
Increased education and higher income were associated with a lower risk of back-related
disability. Strangely, being overweight increased disability risk in men, but not women.
Early intervention suggested as long term prevention
Some of these risk increasing factors are potentially avoidable, e.g. musculoskeletal pain,
smoking and obesity. These factors can be addressed in younger workers to help reduce their
life long risk of disability related to low back disorders.
Dr. Ropponen and co-authors concluded that: "Health interventions early in work-life may be of
importance both to improve workability and prolong working careers, particularly in occupations
including physical loading."
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DPI New Entitlement Claims – Monthly Result
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