WELCOME
SAFER
MOVING & HANDLING
TRAINING
DAY
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
1
WHAT IS MANUAL HANDLING ?
Manual Handling is the transporting or supporting of a
load by one or more people and includes
And which by means of its characteristics or of
unfavourable ergonomic conditions, involves risk,
particularly of back injury
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
2
COURSE CONTENT
Legislation
Structure of the Spine
Injury to the Spine
Fitness
Ergonomics
Principles of Safer Moving & Handling
Practical – Inanimate & Animate Loads
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
3
WHY ATTEND THIS TRAINING DAY ?
To prevent back injury & its consequences
Pain & decreased mobility
Affects hobbies, family & social life
Financial consequences if unable to
work
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
4
STATISTICS
80-90% of population will suffer with
back pain
1/3 of all injuries reported to HSA are
caused by manual handling
12.3 million working days lost each year
in U.K. due to musculoskeletal injuries
Many injuries build up over a period
of time rather than as the result of one
incident
Early return to work key to recovery
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
5
LEGISLATION
Safety Health & Welfare Work Act (2005)
Safety Health & Welfare at Work (General
Application) Regulations 2007
Manual Handling of loads (Part 2 Chapter 4 Reg.68-69)
Protection of Pregnant, Post Natal & Breast feeding Employees
(Part 6 Chapter 2 Reg. 147-152)
Human Rights Act (2003)
Disability Rights Act (2005)
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
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DUTIES OF THE EMPLOYER
(S.H.W.W. Act 2005) Section 8
Manage Health & Safety
Provide safe place & systems of work
Prepare a safety statement (brought to the
attention of the employee at induction & the relevant part to be
onsite if task is high risk)
Provide training & information
(In a form, manner & language likely to be understood)
Allow for the election of a safety
representative
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
7
DUTIES OF EMPLOYEE
(S.H.W.W. ACT 2005) Section 13
Take care of own health & safety & that of
others
Co-operate with employer
Attend training & undergo assessment
Use P.P.E. provided
Report safety defects (Systems/equipment)
Not be under the influence of an intoxicant
that may endanger them or others
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
8
2007 MANUAL HANDLING REGULATIONS
The employer must ……….
Avoid hazardous manual handling (Pt.
does it, profiling bed)
Assess tasks that cannot be avoided
(T.I.L.E.) Schedule 3
Take account of sensitive risk groups
(Pregnant & breast feeding women, children &
young workers, night & shift workers)
Reduce the risk (Equipment, extra staff,
change work practices)
Provide information (Weight & C.O.G. of
load)
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
9
SCHEDULE 3
CHARACTERISTICS OF THE LOAD
Too heavy/large
Un weildy/difficult to grasp
Unstable/contents likely to shift
Stooping/twisting
Contours/consistency esp. in collision
PHYSICAL EFFORT REQUIRED
Too strenuous
Twisting movement of trunk
Sudden movement of the load
Made with body in unstable posture
WORKING ENVIRONMENT
Not enough Room (vertically)
Unable to handle loads at safe height
Floor uneven/variations in levels
Floor or footrest unstable
Temperature, Humidity, Ventilation
REQUIREMENTS OF THE ACTIVITY
Over frequent/prolonged Physical
effort of the spine
Insufficient rest/recovery of the body
Excessive lifting, lowering, carrying
Distances
INDIVIDUAL RISK FACTORS
Employee
Physically unsuited to carry out task
Wearing unsuitable clothing, footwear
Does not have adequate/appropriate
Knowledge or training
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
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In Practice This Means That….
Full body lifts must be avoided
in almost all situations unless



Event unforeseeable
Accident like RTA
Human rights
Safety First
X
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
11
CONDEMNED LIFTS
X
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
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PROTECTION OF PREGNANT,POST
NATAL & BREAST FEEDING
EMPLOYEES 2007
Applies to women
WHO ……….
Are Pregnant
Have recently given
birth (14 weeks)
Are breastfeeding
(26 weeks)
Safety First
The employer
MUST……
Carry out a risk
assessment (Schedule 8)
&
If necessary ↓ risk by……
Changing work conditions
/ working hours
Alternative work
H & S leave
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
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SUMMARY
Safety Health & Welfare Work Act (2005)
Safety Health & Welfare at Work (General
Application) Regulations 2007
Manual Handling of loads (Part 2 Chapter 4 Reg.68-69)
Protection of Pregnant, Post Natal & Breast feeding Employees
(Part 6 Chapter 2 Reg. 147-152)
Human Rights Act (2003)
Disability Rights Act (2005)
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
14
STRUCTURE
OF
THE SPINE
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
15
OBJECTIVES
Skeletal system
(Bones & joints of spinal column)
Discs
Soft tissue
(muscles & ligaments)
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
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SKELETAL SYSTEM
Central Region:( Skull, ribs, spine, pelvis )
Provides support & protection
Outer region:- ( Arms & legs)
Allows movement
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
17
SPINAL COLUMN
33 irregular shaped bones (vertebrae)
S-shaped
Lumber region most often
injured when handling loads
Sacro-iliac joint (Pregnancy)
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
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POSTURE
Keep spine in natural
s-shape position
So that trunk is in
alignment
With minimal
pressure on joints &
soft tissue
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
19
POSTURES TO BE AVOIDED
STOOPING
X
X
HOLDING
LOADS AWAY
FROM THE
BODY
Safety First
TWISTING
X
OVERREACHING
X
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
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LUMBAR SPINE
5 Vertebrae
Joined by discs & facet
joints
Considerable movement
Takes most of the force
acting on the spine DISC g
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
FACET
JOINT
21
DISC STRUCTURE
Spongy centre
Tough outer layer
80% water
Normal Disc
No blood supply
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
22
DISC FUNCTION
Absorbs shock
Gives flexibility to the spine
Allows space for nerves to
emerge
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
23
EFFECT OF MOVEMENT ON THE DISC
Pressure increased towards the back
when bending forwards & to the
front when bending backwards
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
24
AVOID STOOPING
X
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
25
FACET JOINTS
A joint is where 2 bones meet
A ‘facet joint’ is formed when the
vertebrae interlock with the one
above & below
Take approx. 20% of the force
on the spine
These joints are prone to wear
& tear (Arthritis)
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
26
SOFT TISSUE: LIGAMENTS
Taut bands of fibrous
tissue
Flexible but not elastic
(Avoid over-stretching)
Poor blood supply
(Heal very slowly)
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
27
Muscle Structure
Muscles
composed of
bundles of fibres
 Ability to shorten
& lengthen
produces
movement

Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
28
SOFT TISSUE: MUSCLE
MUSCLES WORK
DYNAMICLY & STATICALLY
X
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
29
SUMMARY
Skeletal system
(Bones & joints of spinal column)
Discs
Soft tissue
(muscles & ligaments)
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
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HOW THE SPINE
IS
INJURED
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
31
OBJECTIVES
Injury to:
Facet Joint
Soft tissue
Disc
Bone
Safety First
Disc►
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
32
DISC DEGENERATION
Natural Ageing Process
Begins @ age 30
Disc Looses its Water
Content
Accelerated by poor posture
& lifting techniques
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
33
EFFECTS OF DISC DEGENERATION
SLACK LIGAMENTS
Safety First
SLIPPED DISC
&
ARTHRITIS
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
34
SOFT TISSUE INJURIES
Overstretched
X
Muscles are torn when cold
 Ligaments are torn because they are not
elastic & slack if disc degenerated

Overloaded

Muscles are torn if load is too heavy
X
AND IF

Muscles do not have enough time to
recover (repetitive work)
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
35
SLIPPED DISC
Usually result of
CUMMULATIVE
damage
Initially unaware of
damage as no nerves in
inner part of disc
Wall of disc may fail &
jelly may bulge against a
nerve
Stooping/twisting must be
avoided
Safety First
(Prolapsed Disc)
Bulging Disc
Prolapsed Disc
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
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STOOPING Vs STRAIGHT LIFT
X
Safety First
P
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
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AVOID STOOPING & TWISTING
X
STOOPING
TWISTING
P
Safety First
X
P
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
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WHAT IS TO BE LEARNT?
As we do not always initially feel pain when
we cause damage to our spine we may think
all is o.k.
But
Be warned!!!
Injuries can build up over time. Bad
postures and bad handling techniques may
cause problems later on in life.
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
39
BONE INJURY
Arthritis (Wear & tear)
Incorrect movements done
repetitively
Sacro-iliac joint
(Ligaments slacken)
(Pregnant women be careful as
ligaments slacken)
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
40
SUMMARY
Injury to:
Facet Joint
Soft tissue
Disc
Bone
Safety First
Disc►
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
41
FITNESS FOR WORK
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
42
OBJECTIVES
 What
is fitness
 Muscles relevant to manual handling
 Safety when exercising
 Benefits of fitness
 Stretch break & How to use large leg
muscles when moving & handling (weight
transference/ankle, knee & hip movements)
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
43
WHAT IS FITNESS
“Ability to do ones daily work with enough energy left over”
Strength
Aerobic (Heart & lungs)
Flexibility
Endurance
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
44
RELEVANT MUSCLE GROUPS
FLEXIBILITY
Calves
Hamstrings
STRENGTH:
Quadriceps (Thighs)
Abdominals (Stomach)
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
45
ELEMENTS OF SAFE
STRETCH
Warm up/cool down
Avoid sudden jerky movements
Stretch to point of slight discomfort
Hold stretch for 30 seconds x 3 times
Stretch for minimum of 6 weeks to
restore flexibility
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
46
BENIFITS OF FITNESS
More stamina and energy
Decreased risk of injury
Improved mental alertness
Improved sense of well-being
May live longer!!! If not, you’ll
definitely….
‘Get more out of life !!!!!’.
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
47
SUMMARY
 What
is fitness
 Muscles relevant to manual handling
 Safety when exercising
 Benefits of fitness
 Stretch break & How to use large leg
muscles when moving & handling (weight
transference/ankle, knee & hip movements)
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
48
ERGONOMICS
AT
WORK
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
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OBJECTIVES
Definition of Ergonomics
Manual Handling
Assessment
Benefit of Ergonomics
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
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Definition
Ergonomics aims to “fit the job, environment
and equipment to the person” instead of
making the person fit the above (e.g. car, sports
equipment, kitchen design.
This will ensure that work is done in a way that
minimises physical and mental effort while
maximising efficiency.
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
51
POSTURES TO BE AVOIDED
STOOPING
X
X
HOLDING
LOADS AWAY
FROM THE
BODY
Safety First
TWISTING
X
OVERREACHING
X
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
52
YOU MUST ASSESS YOUR JOB TO SEE IF
YOU ARE CAPABLE OF DOING IT SAFELY
T task
I individual
L load
E environment
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
53
CASE STUDY
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
54
T.I.L.E.
TASK
Loads away from the body
Twisting/stooping
Reaching upwards
Long carrying distances
Strenuous effort
Large vertical movements
LOAD
INDIVIDUAL
Require unusual capabilities
Hazard to those with health problems
Hazard to those who are pregnant
Require special information/training
Require PPE
Safety First
Heavy
Bulky/unweildy
Difficult to grasp
Unsteady/unpredictable
Harmful –
Co-operative
Attachments
Walking aids
ENVIRONMENT
Poor floors
Variations in levels
Constraints on postures
Lighting conditions
Strong air movements
Hot, cold humid conditions
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
55
SOLUTIONS
SHORT TERM SOLUTIONS LONG TERM SOLUTIONS
Training for staff
Use wheelchair to bring
Mr Scot to the
toilet & walk back
Walking Frame
Raised toilet seat
Grab rails in bathroom
Safety First
Relocate Mr Scot to room
with ensuite
Move Mr Scot into high
low bed
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
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BENEFITS OF ERGONOMICS
If you assess your job, you will be…
Better able to recognise potentially
harmful tasks
Safer – decreased risk of injury
More comfortable – more energy, less
stress
More efficient & productive
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
57
SUMMARY
Definition of Ergonomics
Manual Handling
Assessment
Benefit of Ergonomics
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
58
PRINCPLES OF
SAFER
MOVING
&
HANDLING
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
59
OBJECTIVES
The thought process involved before
loads are moved
Principles of moving and handling
Team handling
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
60
BEFORE ANY HANDLING TASK
“Think before you begin”
AVOID
Must you do the task at all?
Can the patient do it themselves/is there a profiling
bed available ?
If you must do the task, Assess – T.I.L.E
Can the task be made more manageable by:
Encouraging the patient to help
Getting help from other staff member
Using equipment
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
61
SAFER HANDLING PRINCIPLES
(Set of tools)
Assess (TILE) Know your own capabilities
Broad Base
Bend Knees/ use weight transference
Good Back Posture (Neutral position &
avoid combined bending & twisting)
Good Grip (Palmer/elbows tucked in)
Get Close To The Load
Move smoothly & keep head up when
lifting & handling
Move with feet (don’t twist)
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
62
SPINAL BIOMECHANICS
P
Safety First
X
X
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
63
TEAM HANDLING
Be aware of limitations of team handling
Work with people of similar height
Appoint a leader
Plan the manoeuvre
Agree a command, to ensure a smooth coordinated movement
‘Ready Steady Action Word’
(Action word can be Slide, Sit, Stand etc)
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
64
SUMMARY
The thought process involved before
loads are moved
Principles of moving and handling
Team handling
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
65
CHECKLIST FOR USING
HOISTS
Assess – What are the
patients needs?
Does the hoist meet those
needs?
Is the hoist appropriate for
the environment?
Check the patients weight Vs
capacity of hoist
Follow manufacturer’s
instructions.
Has visual inspection been
carried out?
Remember pushing & pulling
techniques
Safety First
Have as many carers as
situation requires
Be confident in use of the
hoist
Ensure hoist is serviced 6
monthly
Remove and Report if faulty
Remember brakes off except
when parked & hoisting from
the floor
Check emergency lowering
button
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
66
USE OF SLINGS
Assess and establish patients needs
Be familiar with slings available
(amputee, toileting)
Select correct sling for task
Use correct size of sling
Check sling for signs of wear/tears
Safety First
© Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M.I.S.C.P. MIOSH
67