A Hazardous Manual Task is any task that requires a person to lift, lower, push, pull, carry or otherwise move, hold or restrain any person, animal or thing involving repetitive or sustained force, high or sudden force, repetitive movement, sustained or awkward posture or exposure to vibration.
Disability services assist people with injury, age-related, physical and developmental disabilities to achieve and maintain optimum function. Work is undertaken in a diverse range of locations. Risk control strategies which eliminate or minimise hazardous manual tasks must be balanced against the duty of care to clients to maintain dignity and develop independence. Clients often have complex care needs that require innovative and well planned approaches and these have to be implemented in ways that ensure workplace safety. Workers in the disability industry face many physical demands in addition to ‘lifting’ which forms only a small part of the manual handling that workers in the disability industry perform.
The manual handling of people, particularly assisting clients with daily activities such as personal care and mobility tasks constitute a large proportion of the manual handling activities performed by care workers in disability and community care services. Approximately 50% of all injuries in the health and community services sector 2011/2012 were related to manual handling, this indicates the risks associated with lifting, pushing, pulling, carrying, holding, moving or restraining people and objects during the provision of care are significant and require ongoing management. Most manual handling injuries are preventable through better approaches to managing risks.
Safe Work Australia have anlaysed data from workers compensation statistics relating to the occurrence of worker-related Musculoskeletal disorders (MSD) over the period from 2009 to 2014. 60% of all serious claims during this period related to MSD. It was noted that whilst the frequency rate was decreasing the median time lost from work and compensaiton paid was increasing. The frequency rate for residential care services was 15.3 or over three times higher than the rate for all employees. One in three invovled the back.
The management of these risks is often complex as there are physical risks to the worker and client but also wider risks to the client of loss of independence and autonomy. There is interplay of many factors e.g. social, medical, financial, psychological, relational and environmental which affects the level of complexity in managing manual handling risks. A risk control hierarchy needs to be implemented in the context of the specific needs of clients. The challenge to the disability sector is to provide essential services to people with disabilities and simultaneously meet WHS obligations.
Many disability service organisations today have a goal of minimal or no lifting wherever practicable. Organisations with a commitment to risk management have the potential to eliminate or reduce the risks associated with hazardous manual tasks.
Some of the benefits of reducing manual handling injuries go beyond strictly financial terms. Benefits can include:
- reduced pain, suffering and restricted mobility for injured workers
- increased quality of life for injured workers and their families
- increased future earning capacity of injured workers
- increased workplace morale
- increased productivity leading to increased employer profits
- lower staff turnover.
Service providers in the Disability and Community Care Sector are obliged to apply the principles of Disability Services Legislation and also to meet their obligations as employers under Work Health and Safety Legislation. Reference should be made to the Model Code of Practice _ Hazardous Manual Tasks found on the Safe Work Australia website.
Risk Management and Hazardous Manual Tasks
Under Work Health and Safety Legislation persons in control of businesses or undertakings (PCBUs)must ensure the health, safety and welfare of workers and others in relation to manual handling. This includes reviewing safe working environments, furniture and equipment, work practices, and the provision of training. Under the Model Code of Practice for Hazardous Manual Tasks organisations are required to manage manual handling risks in a systematic way by identifying hazards, assessing or quantifying the risks(if not known) and applying risk control strategies.
A consultative approach may identify the need for manual handling assessments in the workplace. Many lifting operations, for example the occasional lifting of a small, light object, will involve negligible manual handling risk. Risk assessment is only required when control measures are not readily identified. The nature of the work in Disability Services means that risk assessment should take place as part of client assessment processes so that WHS controls are incorporated and implemented as part of clients’ support plans.
Hazardous Manual Tasks can cause musculoskeletal disorders and these injuries may result from:
- Moving, transporting, transferring clients
- Repetitive movements
- Lifting and carrying materials and equipment
- Working at incorrect heights
- Lack of physical space
- Heavy physical work
- Poor workplace design
- Poor postures and actions
- Sudden unexpected load bearing
- Poor physical fitness
- No mechanical aids being used
- No training in manual handling techniques and the use of mechanical aids
- Unpredictable, changing, large loads
Manual handling hazards should be identified when conducting initial client assessments. Assessments should also be conducted on locations in which the support is to be provided such as the homes of clients, day centres etc. Manual handling risks may also be identified during the completion of tasks.
Consultation between management, workers, clients and, if appropriate, their families or advocates is an important part of the hazard identification process.
Once a hazard is identified it is important to assess the risk level. This includes assessing how likely is it that the hazard will cause injury or illness and how severe the injury or illness may be if it occurred. You may complete a client manual handling assessment or a non-client manual handling assessment depending on the manual handling hazard identified.
You don’t need to lift heavy things to damage your back – repetitive movements with light weights can be just as harmful
A manual task is hazardous if it involves any of the following characteristics
- repetitive or sustained force
- high or suden force
- repetitive movement
- sustained and/or awkward posture
- exposure to vibration.
To determine the risk factors as the following questions:
- Does the task involve repetitive movement, sustained or awkward posture or repetitive or sustained forces
- Does the task involve long duration
- does the task invovle high or sudden force
- does the task involve vibration
Is there a risk?
Identify the main sources of the risk. They may be
- work area design and layout
- the nature, size weight or numbe rof things handled in performing the manual task
- systems of work
- the environment in which the manual task is performed.
Eliminate or control the risks. Ensure that work practices are designed to eliminate risk and be consistent with the safe handling of objects. Eliminating the risk is the most effective way to make work safe but if you can’t eliminate it – control it. Some case studies developed under the DSOP project demonstrate how to control manual handling risks using the I'm OK Approach.
A PCBU must ensure that:
- all objects are, where appropriate and as far as reasonably practicable, designed, constructed and maintained so as to eliminate risks arising from the manual handling of the objects
- work practices used in a place of work are designed so as to eliminate risks arising from manual handling
- the working environment is designed to be, as far as reasonably practicable and to the extent that it is within the employer’s control, consistent with the safe handling of objects.
If it is not practical to eliminate manual handling risks you must design the work activity to control them and if necessary:
- modify the design of objects or the work environment, taking into account work design and work practices
- provide mechanical aids or as a last resort use team lifting
- ensure staff are trained in manual handling techniques, correct use of aids and team lifting procedures
The Regulation stresses that an employer must, as far as reasonably practicable, achieve risk control by means other than team lifting. If considering the installation of lifting equipment the article by Mary Matz titled "Patient Handling Equipment Coverage and Space Recommendations" should be consulted. You should also consult with workers and trial lifting equipment prior to purchase to ensure it is suited to your client group and needs as well as your work environment and current equipment.
Testing and Inspection requirements for lifters
When using hoists to move clients 6 monthly inspection of slings and 12 monthly inspection and load testing of hoists is required in the standards. A sample protocol for sling inspection is provided. There have been multiple incidents reported where slings have failed and serious injuries including death have resulted. In at least one case in the UK the service provider was prosecuted and found guilty for failure to implement an inpsection program. The Therapeutic Goods Administrator also recommends regular visual inspection of the welds, bolts, nuts and strapping on the hoist for signs of wear or damage. If an electrick actuator is present to move the boom check manufacturer's instructions regarding replacement timeframes based on amount of use of hoist.
The Hierarchy of Control – ‘as low as reasonably practicable’
There are six ways to deal with hazards or control risks to health and safety
- Eliminate - the hazard or risk, discontinue the practice
- Substitute - substitute the hazard for something that gives rise to a lesser risk e.g. choose an alternate venue with greater accessibility.
- Isolation – isolate the hazard, separate the hazard in time or space from the person at risk i.e. use of a hoist
- Engineer - Design in safety, plan for safety through changing the work environment e.g. inclusion of a ramp, widen doorways.
- Administration - Change work methods, develop safe work practices and procedures.
- Personal protective equipment - this should not be the only control used and generally regarded to be of minimal benefit with manual handling.
Manual handling injuries may be eliminated or minimised by:
- Eliminate the task (for example, use of a wheelchair taxi rather than lifting the client and the wheelchair into a car).
- Eliminate the task by the use of engineering controls (for example, changing the equipment or materials used).
- Reduce the amount of handling involved (for example, change work practices).
- Reduce repetitive work by introducing variations in work activities
- Alter the layout of work areas to avoid twisting, sideways bending or excessive reaching.
- Reorganise storage areas so that heavier and frequently used items are stored between knee and shoulder height, ensure weight of products is manageable.
- Carry smaller loads.
- Use of lifting devices.
- Maintain and regularly inspect all equipment used for manual handling tasks.
- Match skills and abilities of workers with client needs.
If client condition changes, review manual handling procedure.
Provide information and training on risk assessment and safe lifting techniques at induction and during in-service training programs.
Providing access and encouragement for exercise programs for staff.
An example of a common manual handling issue is the transfer of clients in and out of vehicles. The attached document provides some examples of vehicle manual handling controls which may prove useful.
Larger clients(weight and/or size) especially when receiving services within the home pose even higher risks. It is essential that services assess the client's size regularly and ensure that equipment available matches the tasks undertaken. There are a number of suppliers who provide specific equipment for bariatric clients and these should be consulted when developing manual handling plans for such clients.
Monitor & Review
Risk controls can be immediate, short to long term. You need to monitor and review your controls on a continual basis and communicate/consult the results with your staff
Ongoing monitoring and review is an integral part of risk management. After applying controls to eliminate or reduce identified hazards, it is important to assess their effectiveness. Some controls might create other, unforseen hazards. It is important to continue to consult with everybody involved.
You must review your risk assessment if:
- there is evidence that it is no longer valid
- an illness or injury occurs
- a significant change occurs in work practices or procedures to which the risk assessment relates.
Risk management need not be costly. Many simple and inexpensive measures can greatly reduce risk. You need to consider the potential exposure of your organisation if you do not actively manage manual handling risks.
Communication and consultation is the key element to good risk management practice. Ensure you document each stage of your risk management process i.e. how, what, when and by whom to achieve a positive outcome
The approach recommended in the Health and Community Services Sector is known as the minimal lift approach. This means that manual handling tasks are eliminated where possible and, where they can’t be eliminated, equipment is used to reduce the risk of a manual handling injury to as low a level as possible – leading to safer manual handling. This approach should be documented in a manual handling policy.
The minimal lifting approach includes:
- providing adequate levels of appropriately skilled staff
- consulting with staff on risk assessment and the development of control strategies, not just on the selection of equipment
- the trial and purchase of handling equipment
- the assessment of clients to determine their specific manual handling needs and standardising the method of handling
- prohibiting manual lifting (including team lifting) except in emergencies
- educating and training staff in correct use of aids and equipment, manual handling techniques, client assessment and risk assessment
- providing appropriate mechanical lifting aids and equipment to assist staff in moving/transferring clients
- encouraging appropriate client mobility and independence
- enforcing the use of equipment, when required, through supervision and post-training support
- reviewing work systems and practices to identify risks, eliminate unnecessary manual handling and improve work practices on an ongoing basis
- designing facilities to support safe systems of work and safe handling of clients and equipment.
- See recent safety alert from Victoria regarding ceiling hoists.
Training and Supervision and Manual Handling
Train your workers in work health and safety obligations including manual handling and ensure they follow the procedures by providing adequate supervision. Effective on-the-job instruction and adequate supervision will help workers become aware of safety issues and perform their jobs consistently and safely.
Manual handling training should be included in the initial induction training provided to staff. General manual handling training should include the following as a minimum:
- describe the legislation
- describe the health and safety effects
- participate in hazard identification, risk assessment and control
- identify risk factors
- assess risks
- control risks
- communicate and consult
- design a management program.
You should also provide specific training for specific manual handling tasks and this should be provided on an ongoing basis.
Where a manual handling tasks is assessed as risky but cannot be eliminated or controlled through engineering or redesign a safe work procedure should be prepared and communicated. ADHC have developed a Manual Hanlding Resource which documents a safe work procedure for a range of client transfers and provides instruction in how to undertake these safe transfers through both demonstration on DVD and documented procedures. This resource is a useful tool for development of individual procedures and training in same. The resource may be purchased from ADHC.
You must supervise your workers. To determine the level of supervision consider the level of risk in the job as well as the skills, experience, competence and age of the workers. Ensure they can carry out each of the tasks required and assess them regularly until they can do the task without supervision.
Some workers and some jobs require more supervision than others. A worker new to the industry, young workers or workers with language difficulties may require extra help to do their job safely but if you spend the time with them they will not only work more safely, they’ll also be more productive.
Keep training records to keep track of who’s been trained, how they performed and whether further training is also required.
Reporting safety matters
Have a process for reporting manual handling issues and act on these reports.
Reporting procedures help you obtain information about manual handling issues in the workplace, identify problems when they arise and address them.
Reporting and investigating incidents and injuries assists you to:
- understand why they occurred
- make decisions and set priorities
- analyse trends and safety issues
- identify hazards and risks that were previously unnoticed
- develop new safe work procedures or prevention strategies
The success of your safety reporting system rests with you and your workers. Your workers must be keen to use it – so involve them in the process and advise new workers as part of their induction.
Some manual handling issues can be resolved easily. However, if there is a significant safety issue that can not be resolved immediately record:
- who made the report
- to whom the report was made
- the date of the report
- the nature of the problem
- action taken
- further action required
Review your safety reports to identify trends and identify underlying problems.
Handling or using backpacks
Carrying a heavy backpack can be a hazard to the neck, shoulders and back. A back pack should not be more than 10-15% of body weight. The backpack should be made of firm material to avoid sagging, with well padded shoulder straps and a waist belt to allow weight distribution and stabilisation. When provided for community access limit the contents to absolute necessity and provide a range of sizes to allow correct fitting, . When the worker sits down with the backpack on it should not extend above the shoulders. Always wear over both shoulder with the waist belt done up. The bottom of the backpack should rest in the curve of the lower back. It should never rest more than 10cms below he waist. Pack the backpack so that heavy items are close to your back.
Manual handling is any activity to lift, lower, push, pull, carry or otherwise move, hold or restrain a person or object.
A source or a situation with a potential for harm in terms of human injury or ill-health, damage to property, damage to the environment, or a combination of these.
The process of recognising that a hazard exists and defining its characteristics.
The likelihood and consequence of a potential injury or harm occurring.
The overall process of estimating the magnitude of risk and deciding what actions will be taken.
The part of risk management that involves implementing policies, standards, procedures and physical changes to eliminate or minimise risks.
Risk management process
The systematic application of management policies, procedures and practices to the tasks of establishing the context, identifying, assessing, controlling, monitoring and communicating risk.
Hierarchy of controls
The preferred order to use when addressing the risks controls required to ensure health and safety.
Safe Work Australia Code of Practice on Hazardous Manual Tasks
Model Work Health and Safety Act
Model Work Health and Safety Regulation
Safe Work Australia Code of Practice - How to Manage Work Health and Safety Risks
Best Practice Guidelines for Manual Handling Risk Management in Disability and Community Care DADHC 2006
Lifting and Moving People: Choosing the Right Equipment WorkCover NSW 1998
Guidelines for the Prevention of Manual Handling Activities Department of Ageing , Disability and Home Care (DADHC) 2004
DADHC Best practice Manual Handling Guidelines
Safe Work Procedure Proforma DADHC
Manual Handling Risk Identification Checklist DADHC
Small Business Safety Checklist
National Disability Services, ‘DSOP’ Project 2006 – Manual Handling Guide
Note: This material has been prepared using the best information available. You should always check current legislation in relation to your own circumstances actions you may need to take to ensure you have complied with the law.