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MANUAL MATERIALS HANDLING (MMH 1)WHAT IS MANUAL MATERIALS HANDLING?Manual materials handling (MMH) means moving or handling things by lifting, lowering, pushing, pulling, carrying, holding, or restraining. MMH is also the most common cause of occupational fatigue, low back pain and lower back injuries.What makes manual materials handling hazardous?MMH is always hazardous but the level of hazard depends on what you are handling, what the task is, and what the conditions are at the workplace or work site.For example, the material or load that you are handling may be: Too heavy for the task that you are doing. Located too high or low for a safe lift. Too big or may have a shape that makes it hard to handle. Wet, slippery, or have sharp edges that makes it hard to grasp. Unstable or can shift its centre of gravity because it contains material that can flow (e.g., water, sand, a partially filled drum, or concrete in a wheelbarrow). Too big to let you see where you are putting your feet.The task can make MMH hazardous if a worker: Uses poor lifting techniques (lifting too fast, too often or too long; lifting with back bent or while twisting or reaching too far; lifting while sitting or kneeling, etc.). Has to move material over long distances. Does not take appropriate rest breaks; insufficient recovery time. Has a combination of handling tasks (e.g. lifting, carrying and lowering). Wears clothing that restricts movement or reduces grip strength.The conditions where you are working can also contribute to hazards of MMH and result in injuries, for example: Walking surfaces that are uneven, sloping, wet, icy, slippery, unsteady, etc. Differences in floor levels or walking surfaces. Poor housekeeping that causes slip, trip and fall hazards. Inadequate lighting. Cold or very hot and humid working conditions. Strong wind or gusty conditions. Working at high pace. Movement is restricted because of clothing or personal protective equipment. Space is small or posture is constrained or both.MMH COMPACT BAGSWhat are some tips for carrying compact bags?The best way to handle a bag depends on its size, weight and how far it is to be carried.When lifting, remember to: Straddle the end of the bag. Bend the hips and knees. Keep the back straight. Grasp the bag with both hands under the closer end. Keep elbows inside the thighs. Lean forward, straightening the knees to set the bag upright. Readjust the straddle position moving feet closer to the bag. Readjust the grasp, with one hand clasping the bag against the body and the other under it. Stand up by thrusting off with the back leg and continuing in an upward and forward direction. Thrust the bag up with the knee while straightening the body. Put the bag on the shoulder opposite the knee used to thrust the bag up. Stabilize the bag on the shoulder. Move off without bending sideways.What should be done when lowering the bag?Avoid unloading a bag from the shoulder directly to floor level. Use an intermediate platform or get help from a coworker. Stand close to the platform. Place one foot in front of the platform. Bend hips and knees. Keep the back straight. Ease the bag off the shoulder and put it upright on the platform. Pull the bag slightly over the edge of the platform. Stand close to the platform with the bag touching the chest. Clasp the bag against the body with one hand, the other hand holding bottom of the bag. Step back. Bend hips and knees, keeping back straight. Ease the bag on the floor.

MMH COMPACT LOADSHow should a compact load be lifted?A compact load can be lifted between the knees.

When lifting, remember to: Look and plan ahead. Make sure your path is free of obstructions. Stand close behind the load. Check that you can get a good grip on the load. Wear gloves, if necessary, to prevent scrapes or bruises. Straddle the load: Place the leading foot flat beside the load in the direction of travel. Place the rear in the direction of travel. Bend the hips and knees. Keep your back straight. Grasp the load with elbows inside the thighs: Use a power grasp for loads with handles. Use slings or hooks to improve grasp when loads do not have handles. Use blocks under loads without handles to make lifting them up easier and safer. Use a ledge grasp for loads without handles.

Grasp with one hand at the outer, upper corner, over the leading foot and the other hand on the lower, opposite corner. Lean forward with the rear arm straight. This position gets the load moving. Stand up by thrusting off with the back leg and continuing in an upward and forward direction. Keep the load close to the body. Use your thigh and leg muscles, not your back, as you lift in one, smooth motion. Keep the rear arm straight. Move off without twisting the body. Keep the load at a reasonable height so you can see where you are going. What should be remembered when putting a load down? Take a wide stance with one foot in front of the other. Keep the load close to the body. Keep the back straight. Bend the hips and knees. Set the load down onto the ground. Keep the load tilted to avoid bruising fingers. Remove fingers from under the load. Stand up smoothly, easing muscles. Avoid jerky releases.MMH DRUMS AND BARRELSHow should drums and barrels be lifted?Handling drums and barrels can be dangerous. Do not handle drums and barrels without training. Use lifting equipment or assistance devices whenever possible.How should a drum be raised from the ground?Use mechanical aids whenever possible. Do not attempt to raise a full drum alone. Make sure that the drum is empty before raising it. Stand at the end of the drum. Place one foot forward at the side of the drum, the other behind. Bend your hips and knees. Keep the back straight. Grasp the rim about 15 cm from the ground with the elbows inside thighs. Stand up by thrusting off with the back leg and continuing in an upward and forward direction. Bring the back leg forward as if you are walking. Keep close to the drum. Stop at the balance point to change hand grip. Set the drum on its base by moving back leg forward. Use the body weight as a counter balance.

How should a two-person lift be done? Use two people to lift a full drum. Use the same technique as with one person, but have two people squatting at either side of the drum.

How should a standing drum be moved? Stand close to the drum with feet apart. One foot at the front and the other behind. Keep knees slightly flexed. Put your hands firmly against upper rim of the drum. Keep arms straight with the elbows "locked". Rock the drum gently to get the feel of its contents before you move it. Push the top of the drum away by extending the back leg and shifting your body weight onto your front leg. Stop tilting the drum at the balance point. Use back leg as a counter balance. Use a drum-tilting lever for up-ending filled drums that reduces the effort required to move such drums manually.

Use a tilting drum stand to move emptied barrels and drums.

Should drums be lifted manually when they are stacked?No. Always use cranes or lift trucks to stack drums.MMH GENERAL PRACTICEWhat types of protective clothing should be worn?DO WEAR Lightweight, flexible, tear and puncture-resistant clothing. Safety boots with toe caps and slip-resistant soles. Protective gloves, appropriate for the materials being handled.DO NOT WEAR Aprons, coats. Clothing with exposed buttons, zippers or loose flaps. Heavy duty mitts.What should you do before lifting? Always check before lifting to see if mechanical aids such as hoists, lift trucks dollies or wheelbarrows are available. Get help with heavy or awkward loads. Assess the weight of the load. Identify the weight of the load. Be sure that you can lift the load without over-exertion. Be sure that the load is "free" to move. Check that the planned location of the load is free of obstacles and debris. Be sure that the path to the planned location of the load is clear. Grease, oil, water, litter and debris can cause slips and falls. Particular handling and lifting techniques are needed for different kinds of loads or materials being handled (for example,compact loads,small bags,large sacks,drums and barrels,cylinders,sheet materialslike metal or glass). Do not lift if you are not sure that you can handle the load safely.What are some general tips for lifting? Prepare for the lift by warming up the muscles. Stand close to the load and face the way you intend to move. Use a wide stance to gain balance. Be sure you have a good grip on the load. Keep arms straight. Tighten abdominal muscles. Tuck chin into the chest. Initiate the lift with body weight. Lift the load as close to and as centred to the body as possible. Lift smoothly without jerking. Avoid twisting and side bending while lifting. Avoid carrying loads with only one hand.MMH HANDHOLDS ON LOAD AND GRIPPING AIDSDoes a good grip matter?Yes. Good handholds make lifting and carrying easier and safer. Use the "power grip" on loads with handles.

Use the "hook grip" on loads with cut-out handholds.

Curl your fingers around the edge. Do not hold the load with finger tips. Use containers with handles located more than halfway up the side of the container.

Use the "ledge grip" to handle regularly shaped objects without handles.

Hold the object with hands placed diagonally.

Wear gloves where practical.What should I know about grip aids?Use gripping aids to lift or carry awkward loads that do not have handles. Various types are avalable including: Use lifting straps for cylindrical objects. Use carrying handles for boxes. Use a 'Gator grip' to handle awkward objects with sharp edges.

Use vacuum lifters to handle sheet materials or plates. Use furniture straps to lift and move heavy, bulky objects. Position buckle between the body and the load. Keep body straight.

MMH HEALTH HAZARDSCan MMH affect your health?Manual material handling (MMH) is the most common cause of occupational fatigue and low back pain. About three of every four Canadians whose job includes MMH suffer pain due to back injury at some time. Such back injuries account for about one third of all lost work and even more than one third of all compensation costs. More important than financial cost is human suffering. Each year several thousand Canadian workers are permanently disabled by back injuries. Many others are unable to return to their former jobs. Their lives are disrupted.All these facts make prevention of back injuries a crucial and challenging problem for occupational health and safety. This document focuses on preventing back injuries caused by MMH in the industrial workplace and is limited to the handling of inanimate objects.What are the immediate health effects of MMH ?Immediate and short-term effects include accidental injuries and fatigue. Sharp or rough surfaces, and falling and flying objects are common causes of wounds, lacerations or bruises during MMH. The worker can also suffer these injuries by falling or by colliding with objects.Fatigue is a common and expected effect of MMH. The effort required to perform MMH tasks uses up muscular energy. Where the pace of work is not too high, workers can find enough time between individual tasks to recover their energy, and work can be resumed and continued safely throughout the whole shift. On the other hand, a fast pace of work shortens the time between tasks and does not allow the workers to restore their energy. As a result, workers who try to maintain such a fast pace may become increasingly tired as the shift progresses. Recent development in research on the causes of back injury shows that even a moderate pace of lifting, not necessarily at the maximum lifting limit, if maintained for a prolonged time without breaks rapidly decreases workers' lifting ability by speeding up their fatigue. Fatigue not only causes instant and obvious discomfort but its effects add up over time. For that reason, fatigue can also contribute to serious injuries to the musculoskeletal system. These injuries can later develop into chronic conditions that can become difficult to treat effectively. Additionally, fatigue decreases workers' alertness, making them more likely to act without due caution. This, in turn, increases their risk for accidents.What are the long-term effects of MMH?More serious problems related to MMH are the long-term health effects -- chronic back pain.Back pain can result from various causes. The most common causes are strains and cramps in the back muscles. Back pain can also result from tears in the tendons connecting the back muscles to the spine, or from sprains and tears in the ligaments interconnecting the vertebrae (bones of the spine). Less frequently, it arises from direct damage to the vertebrae or the discs that separate them.A worker can sustain a back injury from a single episode such as lifting too heavy a load, slipping and falling, or receiving a blow to the back. However, most often it is not the single episode that causes back injury. It is the repetition, as in manual handling, that contributes most to the occurrence of injuries. Performing MMH tasks continually, even at a moderate intensity, will cause mechanical stress to accumulate in the worker's back, increasing the likelihood of injury. Eventually, even a mild effort in MMH can result in back injury and disabling back pain. Recovery from back injuries can take a long time and further injury may occur, making the problem worse.Which work factors contribute to back injury during MMH?Work-related factors include the weight of the load lifted, the range of the lift, the location of the load in relation to the body, the size and shape of the load, distance and duration the load is carried, and the number and frequency of lifts performed. Excessive bending and twisting also increase the risk for back injury.For most workers, lifting loads over 20 kilograms results in an increased number and severity of back injuries. While the weight of the load is the most obvious factor, it is not the only one that determines the risk of injury. The location of the load is also important. A load lifted far from the body imposes more stress on the back than the same load lifted close to the body. A bulky object is harder to lift than a compact one of the same weight because it (or its centre of gravity) cannot be brought close to the body. Lifting a bulky object also forces a worker into an awkward and potentially unbalanced position. The preferred range for lifting is between knee and waist height. Lifting above and below this range is more hazardous.How often the worker performs MMH tasks, and for how long, are extremely important factors. Frequently repeated and long-lasting tasks are the most tiring and therefore the most likely to cause back injury. Highly repetitive MMH tasks also make the worker bored and less alert. This, in turn, can affect safety. Workers need rest breaks in preventing excessive fatigue. Frequency and duration of rest breaks are important factors to be considered.Poor layout of the workplace also increases the risk for injury. For example, shelving that is too deep, too high or too low causes unnecessary bending or stretching. Lack of space to move freely increases the need for twisting and bending. Unsuitable dimensions of benches, tables, and other furniture force the worker to perform MMH tasks in awkward positions that add stress to the musculoskeletal system. Similar stressful body movements occur where work areas are overcrowded with people or equipment.Training is a very important component to back injury prevention. Workers must be educated about correct lifting techniques for the tasks they do. New employees, those changing jobs, or those returning to work need to know the correct techniques and the dangers of not lifting correctly before beginning their job tasks.Sometimes specific job tasks require wearing the personal protective equipment. These may hinder movement while lifting and cause injuries. Be sure that a job hazard analysis is performed and these restrictions have been addressed.Tasks that involve manual handling exceeding the worker's physical capacity and a poor workplace layout are the most common causes of back injuries. Physical capability includes elements such as gender, physical size, age, pregnancy and any previous injury.Are there environmental factors that contribute to back injury?Temperature and humidity affect the worker performing MMH. When it is too hot and too humid, the worker tires more quickly and becomes more susceptible to back injury. On the other hand, cold temperatures decrease the flexibility of muscles and joints. This stiffness also increases the likelihood of musculoskeletal injuries.Inadequate lighting in the work area indirectly affects the worker performing MMH, particularly where the precise placement of handled objects is important. In compensating for poor visibility the worker often must handle objects in an awkward position for extended periods of time. Poor lighting on steps and stairways, ramps, and loading docks increases the potential for accidents resulting in back injuries. By misjudging distances, the height of steps, or ramp angles the worker can easily lose balance and fall while carrying a load.Whole body vibration alone can cause back pain. It imposes compression on the spine that gradually damages the discs between the vertebrae. Combining MMH with vibration multiplies the risk for injury.Are female workers at greater risk for back injury?The capacity to perform MMH varies considerably among individuals. In general, the lifting strength of women as a group is less than that of men. However the individual ranges of strength are wide. This means that some women can safely handle greater loads than some men. Therefore, discrimination against women for MMH is not justified. In a situation where selection is the only way to minimize the possibility of injury, women and men should be given an equal opportunity of being selected for the job. However there are certain working conditions that even alone and more particularly when combined with MMH create greater health hazards for women. Owing to body composition and structure, women are less tolerant of heat and whole body vibration. Such hazardous conditions should be fully controlled and not serve as an excuse for gender discrimination.Is age a risk factor for back injury?Ageing diminishes strength. Since the rate of decline varies greatly with the individual, discrimination against older workers solely on this basis is unjustified. Statistics show that back injuries among workers over 45 years of age are less frequent than among those between 20-45 years of age. Experience seems to counterbalance decreasing physical capacity. With experience come skills, dexterity and practical know-how for completing tasks, all of which are very important factors contributing to safe MMH. The unskilled, inexperienced worker is at greater risk in tasks that require skills in handling. On the other hand, the older, experienced worker is at risk in tasks requiring sheer physical strength.MMH HOISTING AND MOVING HEAVY OBJECTSSelecting the right equipment for the task minimizes handling. Use a pulley to eliminate manual lifting.

Select multiple pulleys according to the weight of the object to be hoisted.

Mount pulley on movable frame to lift and move heavy objects.

Use a portable floor crane to lift and move heavy objects. Use lifting magnets in combination with hoists where appropriate.

Use lift tables to lift objects or to level work. Select the lift table according to the weight of the anticipated load.

Use a portable conveyor to move materials.

Use a combination of lift tables and rollers to move materials horizontally and vertically.

MMH LARGE AND HEAVY SACKSHow should heavy large sacks be lifted?Lift heavy and large sacks in two stages using an intermediate platform.When lifting, remember to: Straddle the end of the sack. Bend the hips and knees. Keep the back straight. Don't stoop. Grasp the bag with both hands under the end closest to you. Keep elbows inside the thighs. Lean forward and straighten the knees to set the bag upright. Move your feet closer to the sack. Squat with the sack between the thighs with one foot flat on the floor in front of the other. Grasp with elbow inside the thighs. With one hand clasp the sack against the body and the other hand is holding the bottom of the sack. Stand up in one smooth motion. Place the sack upright on the platform. Place one foot in front of the other with the front foot along side of the platform. Bend the hips and knees and keep the back straight. Put one shoulder against the sack. Readjust your grasp. Lean the sack on the shoulder. Stand up and straighten the hips and knees. Make sure your hands and feet are clear when putting the load down.

How should bulky sacks be lifted?Bulkier sacks are easier to carry on your back. Lift onto your back from a platform as described above. Move the sack to the edge of the platform. Put your back against the sack. Grasp with both hands on the upper corners of the sack. Ease the sack onto the back, bending hips and knees before taking the weight. Keep the back straight. Stand up and straighten the hips and knees. Stabilize the sack. Move away without bending sideways.

How should a "two-person lift and stack" be done? Position one person on either side of the sack. Squat with one foot balancing behind the sack. Keep back straight. Grasp with the outer and on the upper corner, the other holding the bottom of the sack. On one person's command: Stand up and straighten the hips and knees. Move towards the stack Put the sack on the stack

MMH LAYOUTS FOR STORINGWhat should be remembered when setting up a storage area? Store materials at a convenient height. Leave the lowest shelf unused if necessary. Use vertically mobile shelves to avoid bending and overhead reaching.

Use bin racks for storing small items.

Store heavy and frequently used materials at waist height.

Do not store materials at floor level.

Use hand trucks with elevating devices in storage and loading areas.

Winch operated.

Coil handling.

Position work. Use trucks with a tilting device to avoid bending.

Box tilter. Use elevating platforms to avoid overhead reaching.

MMH MATERIALS FLOWWhat can be done to reduce the amount of times material is moved or handled? Optimize the movement of materials to eliminate unnecessary manual handling steps. Options include: Combining operation locations. Shortening carrying distances. Monitoring inventory so that stock is not moved more than necessary. Use conveyors to link workstations and reduce carrying distance. Store materials close to where they are needed. Use rollers to eliminate manual lifting and carrying. Use floor rollers while loading or unloading trucks to reduce lifting.

Use a sliding bed while loading and unloading small trucks to avoid overreaching and carrying in an awkward position.

Eliminate extra loading or unloading steps where possible. Unload as close as possible to the place where material will be needed.

Use ramps to avoid lifting and dragging over edges.

Use containers that allow fluids to pour or empty without lifting the container. Use a powered stair climber to reduce effort of carrying of loads, and reduce force needed to move loads up and down stairs.

Use vacuum lift to eliminate manual lifting and carrying of large packages, containers, boxes and barrels.

MMH MECHANICAL AIDS FOR TRANSPORTING MATERIALSWhat mechanical aids can be used?Mechanical aids reduce physical effort, making materials handling easier and safer. Check for the availability of mechanical aids before lifting or moving loads. Select the right equipment to complete the task. Do not operate any equipment if you are not trained to use it. Keep the equipment in good and safe operating condition. It saves effort while transporting loads. Make sure equipment is maintained properly and inspected regularly. Visually inspect the equipment for any defects such as loose wheels or damaged platforms before use. Use rolling platforms to assist in carrying and handling heavy objects where limited space does not allow for comfortable body position.

Use a hand truck to move bulky objects.

Use a shelf truck to move a variety of objects.

Use a platform truck to move heavy, irregularly shaped objects.

Use a semi-live skid for temporary storage of work.

Select the rack or bin that suits the task and mount on semi-live skid or platform truck.

What other mechanical aids can used?Specific tasks or objects require specialized equipment. Select the right equipment to complete the task. Equipment is rated for different capacities, which determine the maximum weight the equipment can safely handle, and the conditions under which it can handle those weights. Do not operate any equipment if you are not trained to use that equipment. Keep the equipment in good and safe operating condition. It saves effort while transporting loads. Visually inspect the equipment for any defects such as loose wheels or damaged platforms before use. Be sure that the load is securely in place before moving. Always push the equipment rather than pull it. Select a stair climbing truck when moving a load on stairs.

Choose a sturdy frame hand truck with larger wheels to move materials in rough terrain. Additional set of handles allows for assistance.

Use a pump truck to move materials stored on pallets.

Move and dump waste materials with dump trucks. Move and empty drums with tilting drum cradles and drum dollies.

Handle sheet materials with an "A" frame hand truck or dolly.

Use a forklift to move heavier and stackable material.MMH MECHANICAL AIDS: LEVERS AND ROLLERSWhy and how should levers be used?A lever is a bar or rod that can be used to reduce the effort when lifting loads. To be effective, the lever must rest on a pivot (fulcrum). Using levers reduces the force required to handle materials and avoids bending and stooping. Use a steel bar to shift an object horizontally.

Use the lever and rollers to move a load horizontally.

Use rollers on an angle to change the direction of the load.

Use "Come-Alongs" to move heavy load. Ensure load is fully on the skid to prevent drag or resistance.

Mount lever on wheels to assist in when moving load. Ensure that wheels can be locked.

Lever on a rolling platform lifts and moves objects.

Lever on wheels lifts and moves manhole covers.

Lever on wheels lists and moves coils. Use an extended handle to lift, shift or move objects without bending.MMH SHEET MATERIALSHow should sheet materials be lifted?Handling sheet material single-handed is always difficult and hazardous. Store the sheet materials at a convenient height above ground. Do not lift and carry sheets without training. Always wear appropriate safety shoes or boots to prevent materials falling on your feet.What should be done when lifting sheet material? Stand close to the pile of sheets in a walking stance. Grasp sheet firmly at the mid-point of its long side with the closer hand. Pull sheet up and toward the body. Change grip using your other hand and put your fingers on top of the sheet. Pull sheet up to the vertical position and to the side until one half is off the pile. Grasp the lower edge of the sheet with the free hand and support the hand by placing it on your knee. Stand up without bending and twisting body.

What should be done when carrying the load? Use drywall carts to carry sheet materials. Get help from another person where carts are not available. Apply carrying handles for manual carrying. Grasp the carrying handles firmly when carrying the load. Always use gloves and carrying handle for glass and other materials with sharp edges. Make sure the pathway is clear and has no obstructions. MMH TALL CYLINDERSHow should tall cylinders be lifted? Use carts or tracks to transport cylinders

Make sure that two people transport a cylinder if a cart cannot be used. Use lifting straps to improve grip.

How should one person lift a cylinder onto a platform? Roll the cylinder to within 1 metre of the platform. Position the forward foot around the cylinder, the back foot about 30cm behind the cylinder. Bend knees slightly. Place one hand on the valve protective cap, the other hand underneath the cylinder about 30 cm from the ground. Tilt the cylinder onto the thigh of the back leg. Balance the cylinder on the thigh by pressing down with the back hand while lifting the cylinder with the forward hand. Extend both knees to initiate and forward movement of the cylinder and continue by pushing up and forward with the arms until the cylinder is located on the platform. Climb on the platform. Straddle the cylinder at the valve end. Grasp the valve protective cap of the cylinder with both hands between the thighs. Lean forward and straighten the knees to set the cylinder upright.

MMH TEAM HANDLINGWhat is team handling?"Team handling" occurs when more than one person is involved during the lift. Use team lifting and carrying where other solutions are inappropriate. Remember that the combined strength of the team is less than the sum of individual strength. Select team members of similar height and strength. Assign a leader to the team. Determine a set of commands to be used such as "lift", "walk", "stop", "down". Make sure that everyone knows what to do when they hear the command. Follow the commands given by the team leader. Practice team lifting and carrying together before attempting the task.What should be done when lifting and carrying long objects as team? Use a shoulder pad to reduce compression. Carry load on the same shoulder. Walk in step.

What should be done when lifting and moving furniture as a team? Use straps. Adjust the length of the straps according to your height.

Use webbing around straps to secure them from slipping off. Obtain assistance while loading a heavy object on the truck. Use your body weight to tilt the object. Place the lip of the truck under the object.

Tip the truck back with assistance.

Move off. The assisting person directs the movement.

MMH WORG SPACE LAYOUTWhat are some important elements of a workplace layout?Layout or organization of the work area which allows materials to be handled without excessive bending, twisting and stretching reduces injuries. Have all materials at work level. Use adjustable elements at the workplace.

Workbench with adjustable height and tilt improves working position.

Self-adjusting platform automatically matches worker's height. Ensure that there is enough room to turn around to prevent twisting.

Use adjustable supports or suspenders to operate heavy tools.

Tool suspender reduces muscular effort and compression on the back.

Tool support eliminates over-stretching and overreaching. Use bins that allow easy access.

Lift-and-tilt device and side opening on bin reduces bending.What is the most likely kind of injury resulting from manual materials handling?It is probably fair to say that every worker who lifts or does other manual handling tasks is at some risk for musculoskeletal injury. Low back injury is the most likely kind of injury. The complete elimination of this risk is not realistic because MMH usually involves awkward postures and repeated forceful movements. However, people can reduce the number and the severity of manual handling-related injuries substantially by using safe work practices.How can we prevent back injury resulting from MMH?To prevent occupational back injuries, it is essential to identify the factors of MMH that make the worker more susceptible to injury or that directly contribute to injury.When efforts to prevent injuries from MMH focus on only one risk factor, they do not significantly reduce the injury rate. A more successful approach such as the one offered by ergonomics combines knowledge of engineering, environment, and human capabilities and limitations. The following aspects should be considered: organization of work flow job design/redesign (including environment) pre-placement procedures, where necessary training

How does organization of the work flow reduce the risk for back injury due to MMH?Often, poor planning of the work flow results in needless or repeated handling of the same object. When articles are temporarily stored in one place, moved to another, stored again, and moved again, a more efficient work flow can eliminate many potentially harmful MMH tasks.How does job design/redesign reduce the risk for back injury due to MMH?The design or redesign of jobs involving MMH should be approached in the following stages: eliminate heavy MMH decrease MMH demands reduce stressful body movements pace of work and rest breaks improve environmental conditionsHow do you eliminate heavy MMH?Consider using powered or mechanical handling systems if eliminating MMH tasks completely is not possible. Mechanical aids lower the risk for back injury substantially by reducing the worker's physical effort required to handle heavy objects.Manual handling such as lifting and carrying can be easier and safer if mechanized by using lift tables, conveyors, yokes or trucks. Gravity dumps and chutes can help in disposing of materials. Mechanical aids also reduce the need to select workers for the task, but it is essential that the worker is properly trained in the safe use of the available equipment.

How can we decrease MMH demands?Where possible, use mechanical aids. The next step is to decrease the manual material handling demands. There are several ways to achieve this: Decrease the weight of handled objects to acceptable limits. Reduce the weight by assigning two people to lift the load or by splitting the load into two or more containers. Using light plastic containers also decreases the weight of the load. Change the type of MMH movement. Lowering objects causes less strain than lifting. Pulling objects is easier than carrying. Pushing is less demanding than pulling. Change work area layouts. Reducing the horizontal and vertical distances of lifting substantially lowers MMH demands. Reducing the travel distances for carrying, pushing or pulling also decreases work demands. Assign more time for repetitive handling tasks. This reduces the frequency of handling and allows for more work/rest periods. Alternate heavy tasks with lighter ones to reduce the build-up of fatigue.How can we reduce stressful body movements in MMH?It is important that the design of MMH allows the worker to do tasks without excessive bending and twisting. These body motions are particularly dangerous and can cause back injury even when not combined with handling loads. Provide all materials at a work level that is adjusted to the worker's body size. Eliminate deep shelves to avoid bending. Ensure sufficient space for the entire body to turn. Locate objects within easy reach. Ensure that there is a clear and easy access to the load. Use slings and hooks to move loads without handles. Balance contents of containers. Use rigid containers. Change the shape of the load so the load can be handled close to the body.How do we set up a proper work pace, and a beneficial ratio of work to rest breaks, to reduce the risk for back pain due to MMH?Pace of work, particularly when externally imposed, may significantly contribute to the worker discomfort, and consequently to the onset of musculoskeletal injuries, including low back injuries. As a rule, pressure to work at a certain pace coming from management creates the mental need to work in a hurry. This in turn creates tension not only in the mind but also in the body. Tensed muscles are much more prone to injury, leading to WMSD.Very recent research on the causes of back injury shows that workers at high risk for back pain (for example, those who lift for a living or where lifting is significant part of their job) need more frequent and longer breaks. Even a moderate pace of lifting (not necessarily at the maximum lifting limit) if maintained for a prolonged time without breaks, rapidly decreases workers' lifting ability by speeding up their fatigue. It also means that in the second half of the working day, the risk for contracting low back injury (and, for that matter, any other musculoskeletal injury) is higher. And because of this it would be wise to assign heavier tasks at the beginning of the working day rather than at the end (but after the worker is "warmed up").It would be ideal if workers could work at their own pace and have some freedom to take a rest break when they start feeling the effects of fatigue. However, this might be impractical. It seems reasonable to incorporate two additional 15-minute breaks, mid-morning and mid-afternoon, in addition to the 30-minute lunch break, If that schedule is still not feasible, shorter but more frequent breaks can do as well.It is also important that novices whose jobs involve lifting and MMH be given time to adjust by allowing them more breaks.

How can we improve the environment to reduce the risk for injury due to MMH?The design of the work environment is an important element of back injuries prevention. Keep the temperature of the working area between 18C and 21C when practical. In extreme cases that require heavy MMH in temperatures above 30C, rest periods or light work load tasks may account for 75 percent of the work time. Wear properly designed clothing to decrease the heat absorption by the body and to increase evaporation. This is particularly important for people required to work in high temperature environment. Encourage using proper protective clothing for people working in a cold environment. This is essential to protect the worker from hypothermia and to preserve dexterity needed for safe work. Illuminate the work area for MMH tasks at the level of 200 lux. Use task lights or other additional light sources to improve the ability to see clearly where MMH requires fine visual discrimination. Use angular lighting and colour contrast to improve depth perception. This helps the worker where MMH involves climbing stairs or moving in passageways.When the MMH tasks are done outdoors, the temperature conditions including the humidex (in hot weather) or wind-chill factor (in cold weather) have to be monitored very closely. Reduce MMH tasks by half when the temperature exceeds 28C. Stop MMH when the temperature exceeds 40C. Restrict MMH to the minimum possible when wind-chill drops below -25C. Stop MMH when wind-chill drops to -35C.How effective is pre-placement screening in back injury prevention?The objective of pre-placement screening is to select individuals less likely to be injured in work involving MMH. X-rays, medical examination, physiological testing may be hazardous under certain circumstances or may not be specific enough to achieve the intended objective. They do not reduce the occurrence of occupational back injury among selected individuals. Worse, the selection procedures can be abused when applied as a substitute for work design.The only situation where pre-placement screening may be justified as a preventive measure is where a job involves heavy MMH in an unpredictable and uncontrollable environment. Examples of these are firefighting, mine and water rescue, and police work. Even here, the selected tests should closely reflect with the anticipated requirements of the job. By far the best pre-selection method, if one must be used, is performance of the actual task.Does training reduce back injuries?There is little evidence to indicate that training alone reduces the number of MMH injuries. When combined with work design, training is an important element in the prevention of injuries. Proper training also shows the worker how to actively contribute to the prevention of injuries. A good training program should: make the worker aware of the hazards of MMH demonstrate ways of avoiding unnecessary stress teach the worker to handle materials safelyInstruction on how to lift "properly" is the most controversial issue concerning training in MMH. There is no single correct way to lift because lifting can always be done in several ways. Because of this, on-site, task specific training is essential. In fact, it is sometimes safer to allow the worker to use common sense acquired by experience rather than to force new biomechanically correct procedures. But there are some general lifting rules. Prepare to lift by warming up the muscles. Stand close to the load, facing the way you intend to move. Use a wide stance to gain balance. Ensure a good grip on the load. Keep arms straight. Tighten abdominal muscles. Tuck chin into the chest. Initiate the lift with body weight. Lift the load close to the body. Lift smoothly without jerking. Avoid twisting and side bending while lifting. Do not lift if you are not convinced that you can handle the load safely.It is also important that workers: take advantage of rest periods to relax tired muscles; this prevents fatigue from building up report discomforts experienced during work; this may help to identify hazards and correct working conditions.Finally, there is an aspect of training that cannot be overlooked if training is to be part of an effective prevention program.Workers should be educated that muscles, tendons and ligaments are not prepared to meet the physical stress of handling tasks when they are not "warmed up." They are more likely to pull, tear or cramp when stretched or contracted suddenly under such conditions. This, painful enough by itself, can lead to more serious and permanent injury if physically stressful work is continued. Warming up and mental readiness for physically demanding tasks are important for any kind of MMH, but particularly for occasional tasks where the worker is not accustomed to handling loads. Workers are more likely to have "ready-to-go" attitude for the task ahead when they understand that other preventive measures are also tried.