Work in hot or cold environments

The risk to the health of workers increases as conditions move further away from those generally accepted as comfortable. Risk of heat stress arises, for example, from working in high air temperatures, exposure to high thermal radiation or high levels of humidity, such as those found in foundries, glass works and laundries. Cold stress may arise, for example, from working in cold stores, food preparation areas and in the open air during winter.
Assessment of the risk to workers’ health from working in either a hot or cold environment needs to consider both personal and environmental factors. Personal factors include body activity, the amount and type of clothing, and duration of exposure. Environmental factors include ambient temperature and radiant heat; and if the work is outside, sunlight, wind velocity and the presence of rain or snow.

Temperatures in indoor workplaces

Environmental factors (such as humidity and sources of heat in the workplace) combine with personal factors (such as the clothing a worker is wearing and how physically demanding their work is) to influence what is called someone’s ‘thermal comfort’.
Individual personal preference makes it difficult to specify a thermal environment which satisfies everyone. For workplaces where the activity is mainly sedentary, for example offices, the temperature should normally be at least 16 °C. If work involves physical effort it

Ventilation

Workplaces need to be adequately ventilated. Fresh, clean air should be drawn from a source outside the workplace, uncontaminated by discharges from flues, chimneys or other process outlets, and be circulated through the workrooms.
Ventilation should also remove and dilute warm, humid air and provide air movement which gives a sense of freshness without causing a draught. If the workplace contains process or heating equipment or other sources of dust, fumes or vapours, more fresh air will be needed to provide adequate ventilation.
Windows or other openings may provide sufficient ventilation but, where necessary, mechanical ventilation systems should be provided and regularly maintained.

WORKSTATIONS

Are you sitting comfortably?

Key points from the checklists:

Postures A bolt-upright posture is unsuitable for long periods of work and for all people; postures that work for occasional keying, for example with the keyboard set back on the desk, cause problems when used for intensive keyboard work.

Wrist rests The OSHA guidance says these can hold the wrist and forearm in awkward postures.

Desk adjustment Fully adjustable desk height, eg. for standing or sitting use, is becoming common in Scandinavia but doesn’t get a mention in HSE’s checklist.

Mice Mouse use gets the full treatment in the OSHA document and there is recognition in HSE’s checklist that forearm support is essential – some of the OSHA recommendations could cause problems.

Consultation Only the Swedish checklist asks how workers are involved in the design of workstations, work tasks and equipment purchase.

Keypads Numerical keypads are causing problems for which there are currently no solutions.

Phones Telephone use is factored into the OSHA guidance.

There is no best buy. Spend some time looking at all of these, and don’t treat HSE’s as a standard. Both the Swedish checklist – in spite of the translation – and the OSHA list make crucial points that the HSE checklist misses.

My computer, my way is another online guide that will help you make your PC more accessible. Easy to use sections give help on: Seeing your screen; using your keyboard and mouse, and help with language and reading.

References

Computer workstations, OSHA checklist, USA. online

Checklist for datascreen workplaces in an office environment, Prevent, Sweden, ISBN: 91 7522682 0. [pdf]

The HSE checklist is available in the publication Working with VDUs (INDG36 rev2), free from HSE Books or [pdf]

My computer, my way www.abilitynet.org.uk/myway/

Hazards Campaign 2008 report

This year the conference is held on the Keele University campus, near Stoke-on-Trent.

I arrived here in the pouring rain but soon found the Atmosphere was very good from the delegates. It really is good to meet up with friends from previous conferences and to making new friends at this one. Tonight’s session entitled Drama on Death at Work kicked off the conference at 7.30pm followed by a video/dvd showing the following

Mesothelioma

Simon Jones Campaign

Workers Memorials

This concludes the first day at around 10pm

Saturday starts at 9am with the Formal plenary in the main theatre

I’m looking forward to the following Campaign The Black approach – the way for occupational health? By Professor Andy Watterson (Sterling University) & our very own Doug Russell (head of H&S USDAW)

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Saturday 19/07/08

Busy day.

Started at 7am with breakfast

9am, Formal plenary in main theatre

10am – 11am Coffee break

11am -1pm 1^st Workshop session

1pm – 2.30pm Dinner

2.30pm – 4pm Campaign Debates

4pm -4.30 Coffee break

4.30pm – 6pm Fringe & Information meetings

7.30pm Dinner, Social/Bar/Music.

Speakers at the plenary included;

Karen Messing (Gender & Work Technical Committee, International Ergonomics Association)

Gave a take on women’s musculoskeletal problems in Québec, Canada.

Gave a great talk on the above subject with some quick witted remarks thrown in. Plenty of facts and figures to prove just how so-called company eggheads where getting there facts wrong.

Mike Ironside UCU Keele
Talked about Keele University, how and why it was formed. To give the working glass a better education back in the 1950/60’s. And why today they are getting rid of 35/40 lecturers himself included and asking for the support of delegates to sign the partition…….which was dually done.

Andy Turner ROHAS/Hazards Campaign

His talk was about accidents fatal and non-fatal, what the government said it had done and what the facts shown it had done. Startling evidence that when a government of any political persuasion bend the facts to suit themselves, i.e. government state that their was 141 works accidental deaths when the true figure was 369. They omitted casual workers, emigrants workers and students!

Shocking was the following facts;

1500 – 1700 workers killed each year due to works accidents where companies

50,000 work related accidents, this figure included non-employees. i.e. Customers having slips, strips and falls, etc.

Michael Lees. Gives talks on Mesothelioma (Asbestos Cancer)

His wife a teacher died 7yrs ago due to breathing asbestos dust in the classrooms of the 25 schools she taught in during her career.

How that government, local and national had so called experts to say the asbestos did not cause cancer! And how they then put a plan to get rid of the asbestos which has yet to be completed.

My 1st Workshop was Fire Safety.

This was more of a question/answer which allowed the speaker Andy Glass from the Brigade to elaborate on the answer bringing in fact above how the government and LA’s (local authorities) are going to spend 9.2 million setting up a task force of private companies and 9.0million to run it JUST in case the Brigade go on strike as they do not have any army, navel or air force personal as they are away fighting.

If they would only spend the money on the Fire Brigades you would not have a possibility of them going out on strike!

“RSI” and Upper limb Disorder

The term RSI (Repetitive Strain Injury) is generally agreed as an umbrella term for a number of upper limb disorders. However whilst many medical professionals will have their own preferred term for these conditions and disorders, the term RSI is recognised by most people.There are two significant groups of RSI conditions, often known as Type 1 RSI and Type 2 RSI. Type 1 RSI conditions have good pathology (i.e. measurable evidence in the form of swelling, deformation, dysfunction etc). Type 2 RSI conditions do not have clear pathology and consequently some medical professionals do not accept that these conditions exist.

It is generally accepted that there are about 20 different Type 1 RSI conditions, which include carpal tunnel syndrome, and tenosynovitis. For these conditions diagnosis and treatment is generally well understood.

It is more difficult to obtain a diagnosis and treatment for Type 2 RSI conditions. With the lack of good pathology for these conditions, diagnosis relies on eliminating potential conditions where the detailed symptoms and circumstances do not match. This process is difficult without specialising in these conditions.

Since the Type 1 RSI conditions can be diagnosed more readily, a more specific term is usually used to describe the condition. The overall terms of RSI, or Work Related Upper Limb Disorders (WRULD) are therefore often used for the Type 2 RSI conditions. Other terms used to define Type 2 RSI conditions include ‘diffuse RSI’, ‘cumulative trauma disorder’, ‘occupational overuse syndrome’, ‘non-specific pain syndrome’, ‘non-specific arm pain’ and ‘myofasic pain syndrome’.

Unfortunately diagnosis and treatment of Type 2 RSI conditions is not always well understood either within the medical profession, or within the working environment.

Type 2 RSI conditions can be the result of intensive computer operation, particularly if care is not taken with posture and positioning of equipment. In particular many sufferers of this condition consider that intensive use of the mouse has been a major cause of their RSI condition. The initial early signs and symptoms of aches in the fingers, hand or arm at the end of a long day are often not recognised. It will often not be recognised until acute and possibly debilitating pain is experienced.

There is no easy cure for Type 2 RSI conditions, although preventative measures have been known for some time and are included within health and safety legislation.

Treatment of Type 2 RSI conditions will often require a number of complimentary approaches. Often lifestyle changes will be helpful. Treatment can include some of the following: removal of causative activities; physiotherapy; trigger point therapy; acupuncture; medication (low doses to relax muscles); neural stretching exercises; improvements to diet; careful exercise (swimming is often found useful); postural improvements (e.g. Pilates, Yoga, Alexander Technique).

Recovery from Type 2 RSI conditions may be achieved. The earlier the condition is recognised and effective action taken, has a significant impact on recovery time. Recovery in some cases can be achieved in a few months, but it is often measured in several years. Recovery can also occur in stages, allowing a gradual return to normal activity. However full recovery is not always possible.

How RSI affects the Employee

What Can Happen?
When people first begin to experience symptoms due to RSI they are unsure of what is happening to them. The symptoms initially can be quite mild twinges with a bit of numbness or tingling. However as the condition develops the pain increases until it is with the person for 24 hours, leading to weeks on end of pain and disability, reality sets in, usually confirmed by doctor’s diagnosis.

Difficulties
During this time, difficulty occurs in carrying out workplace tasks, domestic tasks, any hand-orientated hobbies have to be given up (sport, crafts etc.). Being off work on long-term sickness absence results in reduced salary, financial worry and stress fear of job loss, leading to depression, which in turn exacerbates pain levels, and the downward spiral of ill health begins.

Taking Action
Employees have a responsibility to report their injury once they realise what is happening, record the pain in the accident book, and pursue accurate diagnosis and treatment. They must also ask for a risk assessment to be carried out at work, and plan their home life by obtaining help from friends and family, if possible, to reduce the strain on their hands and arms. RSI must not be ignored, you can’t wish it away, and you must get treatment and adjust your life to the condition.

The Employer
In the event of Repetitive Strain Injury symptoms being experienced, there are various strategies that need to be implemented. Reasons for ignoring RSI can include fear of disclosure and keeping the accident book “tidy”, seeking to avoid potential litigation, embarrassment and guilt at having caused someone to become ill, which affects the image of the company, annoyance and irritation because targets are not being met, thereby inviting criticism from a higher tier of management.

Acknowledge the Situation
We ask employers to be unafraid to admit there is a problem, as ignoring RSI does not make it go away but makes things worse. Evidence of good practice within the workplace could be a way of keeping down insurance premiums. Certainly frequent legal claims are one way of increasing insurance premiums.

Taking Action
Encourage workers to report pain and record it. Body mapping is a useful tool showing where pain and inflammation are occurring. Encouraging the worker to seek effective diagnosis and treatment, pursue a pain management programme, consider alternative therapies, is the way forward.

It is important to note that working over the pain can cause further damage, the more chronic the condition the longer it takes to make a recovery, therefore the correct balance must be found.

Consultation
Conduct an effective risk assessment in consultation with the worker, looking at equipment, workload and stress. Just issuing a questionnaire to the worker is a useless exercise. The workstation needs to be observed and measurements taken, as well as posture being assessed, talking to the worker about any problems with equipment and posture, and about the volume of work expected to be undertaken.

Back to Work
When someone is on the road to recovery it can be conducive to their physical and mental state to embark on a gradual return to work, with shorter hours increasing gradually. This rehabilitative approach means that some of their work is being done, a valued and knowledgeable employee can be retained, and there is some financial benefit to both employer and employee. This may indicate a need for sickness absence policies to be rewritten, taking into account state benefits and salary payment.

Communication
Encourage “open channels” between worker, line manager, senior management, occupational health professionals, and human resources officer. Each one of these has an important role to play, together with a helpful and supportive attitude from colleagues.

If trades union membership is established within your organisation learn from trades union safety representatives. A unionised workplace is a healthy workplace, a healthy workplace saves money. Be aware of the dangers and educate yourself and your staff by encouraging a positive health and safety culture within the organisation.

Who Can Help
There are many organisations that are able to help in this day and age. The Department of Work and Pensions’ Disabilities Adviser can arrange for the provision of an ergonomic assessment and equipment, and funding to pay for a support worker to assist the injured person. A wealth of advice is available from the Health and Safety Executive, and various web sites on the Internet. RSI help-lines are for people with RSI, their families and also for employers.

Costs to the Employee
RSI and other long-term medical conditions can be an expensive business.

Costs to the employee include lost salary, medication and medical treatment expenses, and travel costs whilst obtaining treatment. In the event of a long-term illness people can lose their car, their home, and suffer breakdown of family relationships caused by the stress of their illness, leading to a downward spiral into poverty.

Costs to the Employer
Costs to the employer include lost salary, lost productivity via absence of a knowledgeable employee, additional salary costs for temporary employees, legal and medical specialist fees in the event of litigation, and increased insurance premiums caused by litigation.

Costs to Government
Costs to the Government, include loss of income tax and national insurance contributions, payout of various benefits, cost of medical treatment from the GP through to consultants at hospital, plus medication and therapy. There is also the cost of administrator’s salaries within the benefits system, Social Security Appeals Tribunal’s staff and medical specialists fees.
Repetitive strain injuries are preventable disabilities
This is why we must all work together and stop the spread of RSI

Strain Injuries At Work: Prevention and Management

Excessive force imposed on muscles, tendons, joints and the nervous system by some job demands and working practises are the starting point to strain injuries occurring.Provided the forces exerted are of a short duration, with adequate rest periods, they will generally be within the physical capacity of the body sinews and tissues. However overloading of the tissues caused by very frequent exertions of forced static postures can be harmful, resulting in loss of capacity in the affected limbs.

Examples
Holding a tool with a bent wrist whilst having to apply pressure combines force and awkward posture, and having to perform the same task repeatedly adds to the frequency factor further increasing the risk involved, so in that movement you have got static load and repetitive movement.

Working overhead with the arms extended upwards, (wiring cable in) or having to work with the back bent and the arms extended horizontally in an awkward part of the building to reach the area needing attention, or holding a trowel and tray with mortar whilst plastering or pointing brickwork.

Painting ceilings, where the head and neck is extended at an awkward angle and one arm applying the paint with brush or roller, and the other arm holding on to maintain balance.

The Three Main Factors
FORCE – the application of excessive manual force

FREQUENCY AND DURATION OF MOVEMENT – including rates of working which are too intense and repetitive whether of a single or combined nature, and

AWKWARD OR RIGID POSTURE – of hand, wrist, arm or shoulder, and where kneeling or crouching posture is required there will be strain on the legs, ankles and feet.

The human body is designed to cope with a wide variety of movements, forces, pressures and stresses, but what is often not realised are the points in the body which give way under the strain, and that is where the limbs connect to the spine. At the top of the spine where shoulders and neck connect, this is known as the cervical spine area, and when damage occurs here pain can appear in the arms and sometimes the legs. This is known as referred pain, and is due to the damage in the discs, where a build up of tissue can cause pressure trapping the nerves. In the lower part of the spine, known as the lumbar area, again referred pain can occur in the legs, which is a pain similar to sciatica.

Prevention
When carrying out work which involves the three factors, it is important to take short rest breaks, particularly when working at a keyboard, to refresh the muscles/tendons, and perhaps incorporate a short exercise of flexing the limb, to remove the feeling of strain, stimulating the circulation, thereby refreshing the system and removing the toxins that build up in the system when you are still for too a long time. In the case of the head and shoulder stiffening, there are exercises available which again can correct the posture.

For anyone experiencing pain, tingling, numbness, it is important to recognise what is happening to your body, report symptoms, look at the risk assessment on your job, seek help from your General Practitioner and a physiotherapist who is suitably qualified to a postgraduate level and who is knowledgeable about treating RSI.

Named Types of Injuries
Most publicity these days is given to cases of computer-induced injury, due to the increased computer usage in working life, and which is the least understood injury. Research at University College Hospital London calls this “Diffuse RSI” which seems to be nerve injury. However it is well documented that many manual trades suffered from various types of repetitive strain injuries, (Washer woman’s wrist, telegraphist’s finger, etc.) and I use the term RSI as an umbrella term to cover various named medical conditions.

This collection of diseases and injuries, in itself a history of the afflictions that visit working people, shows the breadth and depth of illness and injury. In order to be recognised, for industrial injuries purposes, the medical condition must have been proved clinically beyond all doubt, and this is known as the epidemiology of the condition, and must have been approved by the Industrial Injuries and Advisory Commission, commonly known as IIAC.

A4 Cramp of the hand or forearm due to repetitive movements. For example writer’s cramp. Anyone involved in prolonged periods of handwriting, typing of other repetitive movement of fingers hand or arm, for example typists, clerks and routine assemblers. (So you see even that is not necessarily totally due to clerical work – a routine assembler usually works in the electronics industry where small components are assembled).

A5 Subcutaneous cellulitis of the hand (Beat Hand). Manual labour causing severe or prolonged friction or pressure on the hand, for example miners and road workers using picks and shovels. But this also could include gardeners digging, or even the use of a screwdriver causing pressure in the palm of hand.

A6 Bursitis (swelling) or subcutaneous cellulitis arising at or about the knee due to severe or prolonged external friction or pressure at or about the knee. (Beat Knee). Manual labour causing severe or prolonged external friction or pressure at or about the knee, for example workers who kneel a lot.

A7 Bursitis or subcutaneous cellulitis arising at or about the elbow due to severe or prolonged external friction or pressure at or about the elbow. (Beat Elbow). Manual labour causing severe or prolonged external friction or pressure at or about the elbow, for example jobs involving continuous rubbing or pressure on the elbow

A8 Traumatic inflammation of the tendons of the hand or forearm, or of the associated tendons sheaths. (Tenosynovitis). Manual labour, or frequent or repeated movement of the hand or wrist, for example routine assembly workers. (However it is common among keyboard and computer mouse operators, and those whose arms and hands are involved in jobs as varied as stirring large containers of soup, butchering meat, planing wood, using a manual screwdriver regularly, and other repetitive/static load jobs too numerous to mention.

A11 Vibration White Finger – the symptoms of episodic blanching (whiteness due to circulation seizing up) occurring throughout the year, in thumbs and fingers. Caused by handheld chain saws in forestry, or handheld rotary tools in grinding, sanding or polishing of metal, or the holding of material being ground or polished by rotary tools, or the use of handheld percussive (vibrating) metal working tools, are the use of handheld percussive drills or hammers, offer holding of material being worked upon by handling machines. (So you see this covers a wide range of tools).

A12 Carpal tunnel Syndrome – this is caused by the use of handheld powered tools whose internal parts vibrate so as to transmit without vibration to the hand, but excluding those which are solely powered by hand. (Excluded for example, are sewing machines, which do vibrate, and upon which the hands do rest, but are not classed as causing the injury, as the machine is not handheld).

Claiming Benefits
What also is not generally known is that claim for industrial injuries benefit can be made even if you are still working, but you are injured due to a work-related condition. Another thing that is not generally known when claiming for industrial injuries benefit, is that if you have an accident whilst on the way to work, travelling to and from work or at lunchtime and on the way home, you can also claim for industrial injuries benefit.

Therefore it is always beneficial to check via your union office, and then the citizens advice bureaux or local welfare rights advice centre, on whether or not you would qualify in the event of this happening to you. Useful leaflets, which can help regarding claiming benefits, are available from the Benefits Agency.

Guide for Young People: How to Avoid RSI

How to Avoid RSI

This is intended as a brief guide for young people, to make them aware that using computers with a keyboard and mouse, playing on games consoles, and texting on mobile phones can cause repetitive strain injuries. Read the equipment instruction manual – play hunt the RSI warning, it’s usually in very small print. Children as young as seven have been known to develop Diffuse RSI. Some students taking GCSEs and A-levels cannot write their own exam papers due to RSI, and have to rely upon dictating answers to teachers. It is quite common for students at university to find that writing their dissertation results in chronic RSI.Repetitive Strain Injury (RSI) is a general term covering a variety of medical conditions which happen due to over-strain, such as writer’s cramp or tendonitis.Repetitive action is when you do the same movement over and over again, for long periods of time, when it causes first of all strain, and then injury. Which is why we call it Repetitive Strain Injury.

It is similar to a sports injury, so if for instance, while running and your leg was sprained, you wouldn’t run on it until it was better and the pain went away, and the muscles had recovered from the injury.

Similar things can happen with your hands and arms, so be careful not to over use them in the same old way if they feel “sprained” it is important to rest them and seek treatment.

The combination of repetitive movements, poor posture, and over use of computers, games consoles and mobile phone texting/games-playing, without taking rest breaks, can cause injury to the nerves, muscles and tendons, in the fingers, hands, wrists, arms, elbows, shoulders, and neck, which if ignored, may lead to long-term damage.

Bad habits in the way you sit, use or misuse your body, or don’t exercise, can cause problems, as you get older. Be aware and listen to what your body is saying – a whisper is a warning to take care – a shout is a definite cry for help because of damage done already.

Never, ever, ignore these symptoms as long-term damage can happen.

Be very aware of stiffness, sharp pain or dull ache, numbness or tingling, or poor grip, which may come on after a heavy session on the computer using either the keyboard or the mouse, or when using a pen, or with thumb movements when using a Games Console, or when texting on a mobile phone.

Try to take breaks between hand activities, of a few minutes each half-hour or ten minutes each hour. Massage your hands and arms to restore the circulation and refresh the muscles and tendons. Flex your fingers, and stretch your arms out to the side, above your head, then to your sides, keeping your spine straight. This applies at home or at school – if possible.

Do warm up exercises – the same as when you do before. Gentle exercise can only help.

Checklist at the Computer
* Be aware that laptop computers force you into a hunched position and force the hands into a claw like position.

* Check your body position – straighten up and flex and move – try not to get “lost in time and space” for hours on end.

* Don’t sprawl in the chair, or twist your spine, or crane your neck

* Is your chair height adjustable and is the back support adjustable?

* Is the desk or table height suitable and comfortable, is there enough space for your legs under the desk?

* Do you need a footrest?

* Is the monitor at the proper viewing distance for you (usually 60cm from your eyes)?

* Is the monitor straight in front of you (correct), instead of off to the side (incorrect)?

* Is it positioned to avoid glare/reflection?

* Is there enough desk space for the keyboard and space for your hands and forearms to rest, while you check your work?

* Do you use a paper holder or is there enough space for your work papers?

* Is there enough desk space for you to use the mouse in the central position, or to change hands, to avoid developing “mouse arm” (stiffness, numbness and pain) caused by holding one arm rigidly out to one side and clutching the mouse in a claw-like position.

Checklist for Games Consoles
* When using a games console do you sit hunched over it with your head tilted back gazing at the screen? And are your hands and arms rigid with the thumbs/ fingers moving at speed?

* Take a break and move around to give your hands, arms, neck, shoulders, and your eyes a change of scene.

Checklist for Mobile Phones
* Be aware that by using a mobile phone and holding it in one hand, with that hand in a claw position, and when moving the thumb rapidly over the keypad, puts an enormous strain on tendons in the arm.

* In between times, massage your hand and thumb, and rotate your hands at the wrists, in clockwise and anticlockwise directions. If it already hurts to text, use the fingers of the other hand or the end of a pen to press the keypad, reduce using your phone, and get medical help.

Should you feel any of these symptoms

* Keep a diary of any aches and pains, and when, and for how long you use the equipment.

* Tell your parents or teacher, or school nurse to help you contact your doctor, who may refer you to hospital for physiotherapy.

* But remember – prevention is better than cure – you only have one body & one life.