The most common cause of back injuries at work and how to avoid them?

In my experience, the most common cause of back injuries at work tends to be unsafe manual handling activities. Basically, lifting too much or in otherwise unsafe circumstances.

Much of these issues tends, in my view, to arise from failing to take a preventative approach to health and safety matters. As Benjamin Franklin once said: “An ounce of prevention is work a pound of cure.”

So what must employers do to prevent manual handling and back injuries?

Let’s take a look at the key steps:

1. Undertake a detailed risk assessment

Risk assessments are seen as the cornerstone of the health and safety system.  There isn’t really any particular form or wording that has to be used, though plenty of examples can be found online.  The risk assessment simply needs to be comprehensive and clear.

Generally, the most important thing is a common sense approach: looking at the work done as part of each person’s role, identifying risks to their health and safety and then set out what action will be taken to eliminate or reduce those risks.

When it comes to work that involves manual handling extra things need to be taken into account in the risk assessment.  These additional requirements are set out in Schedule 1 of the Manual Handling Operations Regulations 1992, which I extract below:

SCHEDULE 1 FACTORS TO WHICH THE EMPLOYER MUST HAVE REGARD AND QUESTIONS HE MUST CONSIDER WHEN MAKING AN ASSESSMENT OF MANUAL HANDLING OPERATIONS

Factors	Questions
1.  The tasks	Do they involve:
	- holding or manipulating loads at distance from trunk?
	- unsatisfactory bodily movement or posture, especially:
	- twisting the trunk?
	- stooping
	- reaching upwards?
	-excessive movement of loads, especially:
	- excessive lifting or lowering distances?
	- excessive carrying distances?
2.  The loads	Are they:
	- heavy?
	- bulky or unwieldy?
	- difficult to grasp?
	- unstable, or with contents likely to shift?
	- sharp, hot or otherwise potentially damaging?
3.  The working environment	Are there:
	- space constraints preventing good posture?
	- uneven, slippery or unstable floors?
	- variations in level of floors or work surfaces?
	- extremes of temperature or humidity?
	- conditions causing ventilation problems or gusts of wind?
	- poor lighting conditions?
4.  Individual capability	Does the job:
	- require unusual strength, height, etc?
	- create a hazard to those who might reasonably be considered to be pregnant or to have a health problem?
	- require special information or training for its safe performance?
5.  Other factors	Is movement or posture hindered by personal protective equipment or by clothing?

However, in 2002 extra requirements were included to state that the employer must also consider:

(a)the physical suitability of the employee to carry out the operations;
(b)the clothing, footwear or other personal effects he is wearing;
(c)his knowledge and training;
(d)the results of any relevant risk assessment carried out pursuant to regulation 3 of the Management of Health and Safety at Work Regulations 1999;
(e)whether the employee is within a group of employees identified by that assessment as being especially at risk; and
(f)the results of any health surveillance provided pursuant to regulation 6 of the Management of Health and Safety Regulations 1999.”.

Whilst a lot of companies might see doing a risk assessment as an inconvenience or “box ticking” exercise, the reality is that a good risk assessment, which need not take too much time to do, will prevent the vast majority of workplace accidents which will save the employer a large amount of time and money in the longer-term such as avoiding increased insurance premiums, employees off sick, time lost in investigating accidents and claims and so forth.

2. Communicate and explain the results of that risk assessment to employees

The biggest mistake that I continually see employers making is that they might undertake a reasonable risk assessment but they then just file it away, leaving employees (including the supervisors who would be responsible for implementing the risk assessment) entirely oblivious to the results of the risk assessment.

I would go as far as saying that in around 11 years of dealing with work injury cases I cannot recall a single case in which employees were aware there had even been a risk assessment, let alone what the results of it were.

The risk assessment is only as good as its dissemination throughout the workforce: supervisors and workers need to know what risks have been identified and what the control measures are.  Furthermore, actively involving workers in the risk assessment process leads to far better risk prevention systems because workers and immediate supervisors are well placed to identify risks they face on a daily basis.

As employers must provide health and safety training to workers (see below), a great opportunity to go through the risk assessment with employees is at this stage.

3. Implement the risk assessment properly

A risk assessment that only works “on paper” is just a waste of time for everyone involved.  For instance, if a control measure of “two man lift” is set out for lifting a heavier item, but the reality is that there is not enough staff available and so workers are forced into a situation whereby they have to lift the item alone then the law is broken irrespective of whether there was a great risk assessment.

This links in with item 2 i.e. involving the workforce in the risk assessment – if a control measure cannot or is not working “on the ground” then the employer needs to look again at the risk assessment.  Further, failing to comply with safety control measures previously identified in a risk assessment pretty much always results in a company being held liable for an employee’s injuries.

4. Keep the risk assessment under review and revise as appropriate

Similarly to item 2 above, this appears to be seldom known by employers.  Typically a risk assessment is done and then filed away and the only time it is reviewed tends to be when a claim is made against the company i.e. after an accident.

In reality, no first risk assessment will be perfect, plus most work gradually changes over time such as with the introduction of new technology or work processes, reorganisation of roles etc.  There is therefore a need to always keep the risk assessment under review and this goes hand-in-hand with keeping the workforce in the loop regarding the contents of the risk assessment.

This also links in with the need to ensure the workforce is actively involved.

5. Pay attention to the hierarchy of control measures

The way the Manual Handling Operations Regulations 1992 are worded is that employers need to avoid lifting injuries in the following order:

(a) Do everything possible to avoid manual handling in the first place.  These days there are often machines available that will avoid the need for human lifting activities and these need to be looked at first and only if human lifting cannot be avoided should the employer look at step two:

(b) Reduce the risk of manual handling injuries to the lowest level reasonably possible.  This basically comes down to doing a good risk assessment and then doing everything possible to make the work as safe as can be such as: two man lifts, safe lifting training, taking steps to keep weights of items down such as ordering larger numbers of smaller boxes of components etc

6. Provide decent health and safety training – and make sure workers follow it

We all know the classic “how to lift a box safely” type training, bending at the knees and so forth, but it is important, as with doing a good risk assessment, not to look at health and safety training as just a “tick box” exercise.  I have seen many companies run through basic “how to lift a box” type health and safety training on the employee’s first day, sometimes with little relevance to the work they will actually be doing, and then just move in with that box ticked.  A better approach could be to begin with going through the risk assessment findings, so that the employee knows what hazards come with the job, and then provide training to minimise those hazards i.e. training tailored to the job.  The employee could then shadow or be accompanied by a more senior colleague for an introductory period to ensure they are doing things safely.

Linking in with some of the above items, if risk assessments change then make that a health and safety training refresher – why has the change taken place?  If there has been an accident then why did it happen and how can a similar accident be prevented?

Summary

When it comes to manual handling safety (and generally) employers tend to fall into three categories:

1. Small companies who just ignore health and safety altogether in the mistaken belief complying with the law will be expensive and waste time.  These types of companies tend to have dissatisfied employees (who realise their employer does not care), repeated accidents further sapping morale and productivity, expensive employers liability insurance premiums and poor reputations.

2. Bigger companies who view health and safety as a “tick box” exercise to avoid being sued.  These companies lose time, money and energy producing risk assessments and training that is ineffective only to end up vulnerable to accident at work claims anyhow because risk assessments were not enforced, training was irrelevant etc.

3. Companies who look at their legal requirements and then follow them.  Done properly, these companies tend to be near invincible when it comes to liability for health and safety issues.  They don’t lose workers’ time to injuries, face claims, pay higher premiums or otherwise – in exchange for a small amount of time in keeping on top of health and safety they reap numerous rewards, including increased employee morale.  Perhaps it’s no coincidence these tend to be the larger and more successful companies.

It is my firm view that following the right steps and keeping on top of manual handling safety issues will always be the cheapest, easiest and quickest approach.

By James Winterbottom, Solicitor