Repetitive Strain Injuries Guide

One relatively common injury at work is that of a repetitive strain injury, or “work related upper limb disorder.”

They tend to arise from one of the two following scenarios, either:

1. Some form of repetitive desk-based work featuring poor ergonomics; or

2. A frequent manual handling activity that is physically demanding and/or undertaken at an unsafe pace or frequency, often in unsafe circumstances.

Desk/office-based work

The main law that governs desk-based type work is that of The Health and Safety (Display Screen Equipment) Regulations 1992.

As with most health and safety laws, the starting point is the requirement upon the employer to undertake a risk assessment of the workstation. Regulation 2 states:

2.—(1) Every employer shall perform a suitable and sufficient analysis of those workstations which–

(a)(regardless of who has provided them) are used for the purposes of his undertaking by users; or (b)have been provided by him and are used for the purposes of his undertaking by operators, for the purpose of assessing the health and safety risks to which those persons are exposed in consequence of that use.

The regulation goes on to state that such analyses must be revisited if there is any reason to suspect they are no longer valid. For example, the user of that work station may change, as could the desk or other equipment thereon: remember, risk assessments are only useful if they are current and up-to-date.

A key question often then arises as to who can complete the risk assessment – can employees be left to complete them on their own?

The 1992 regulations do not actually stipulate who must complete the assessment but employers need to bear two things in mind here:

– The duty to provide a safe system of work falls upon the employer, not the employee. Leaving uninformed employees to work through risk assessments they do no understand, without guidance and review, is liable to leave hazardous work practices overlooked. If a court later rules that the assessment was not adequate it will be the employer that is held to blame, not the employee (provided the employee completed the assessment as fully and honestly as possible).

– Regulation 3 requires workstations to meet the requirements of Schedule 1 to those regulations, the contents of which are extracted below. Again, it is the duty of the employer to ensure these requirements are met rather than for the employee to flag up where they are not met. Employers therefore need to ensure they know the contents of Schedule 1 and that the undertaking and reviewing of risk assessments is in that context.

Schedule 1 reads as follows:

1. Extent to which employers must ensure that workstations meet the requirements laid down in this schedules

An employer shall ensure that a workstation meets the requirements laid down in this Schedule to the extent that–

(a)those requirements relate to a component which is present in the workstation concerned; (b)those requirements have effect with a view to securing the health, safety and welfare of persons at work; and (c)the inherent characteristics of a given task make compliance with those requirements appropriate as respects the workstation concerned.

2. Equipment

(a) General comment

The use as such of the equipment must not be a source of risk for operators or users.

(b) Display screen

The characters on the screen shall be well-defined and clearly formed, of adequate size and with adequate spacing between the characters and lines.
The image on the screen should be stable, with no flickering or other forms of instability.
The brightness and the contrast between the characters and the background shall be easily adjustable by the operator or user, and also be easily adjustable to ambient conditions.
The screen must swivel and tilt easily and freely to suit the needs of the operator or user.
It shall be possible to use a separate base for the screen or an adjustable table.
The screen shall be free of reflective glare and reflections liable to cause discomfort to the operator or user.

(c) Keyboard

The keyboard shall be tiltable and separate from the screen so as to allow the operator or user to find a comfortable working position avoiding fatigue in the arms or hands.
The space in front of the keyboard shall be sufficient to provide support for the hands and arms of the operator or user.
The keyboard shall have a matt surface to avoid reflective glare.
The arrangement of the keyboard and the characteristics of the keys shall be such as to facilitate the use of the keyboard.
The symbols on the keys shall be adequately contrasted and legible from the design working position.

(d) Work desk or work surface

The work desk or work surface shall have a sufficiently large, low-reflectance surface and allow a flexible arrangement of the screen, keyboard, documents and related equipment.
The document holder shall be stable and adjustable and shall be positioned so as to minimise the need for uncomfortable head and eye movements.
There shall be adequate space for operators or users to find a comfortable position.

(e) Work chair

The work chair shall be stable and allow the operator or user easy freedom of movement and a comfortable position.
The seat shall be adjustable in height.
The seat back shall be adjustable in both height and tilt.
A footrest shall be made available to any operator or user who wishes one.

3. Environment

(a) Space requirements

The workstation shall be dimensioned and designed so as to provide sufficient space for the operator or user to change position and vary movements.

(b) Lighting

Any room lighting or task lighting provided shall ensure satisfactory lighting conditions and an appropriate contrast between the screen and the background environment, taking into account the type of work and the vision requirements of the operator or user.
Possible disturbing glare and reflections on the screen or other equipment shall be prevented by co-ordinating workplace and workstation layout with the positioning and technical characteristics of the artificial light sources.

(c) Reflections and glare

Workstations shall be so designed that sources of light, such as windows and other openings, transparent or translucid walls, and brightly coloured fixtures or walls cause no direct glare and no distracting reflections on the screen.
Windows shall be fitted with a suitable system of adjustable covering to attenuate the daylight that falls on the workstation.

(d) Noise

Noise emitted by equipment belonging to any workstation shall be taken into account when a workstation is being equipped, with a view in particular to ensuring that attention is not distracted and speech is not disturbed.

(e) Heat

Equipment belonging to any workstation shall not produce excess heat which could cause discomfort to operators or users.

(f) Radiation

All radiation with the exception of the visible part of the electromagnetic spectrum shall be reduced to negligible levels from the point of view of the protection of operators’ or users’ health and safety.

(g) Humidity

An adequate level of humidity shall be established and maintained.

4. Interface between computer and operator/user

In designing, selecting, commissioning and modifying software, and in designing tasks using display screen equipment, the employer shall take into account the following principles:

(a)software must be suitable for the task; (b)software must be easy to use and, where appropriate, adaptable to the level of knowledge or experience of the operator or user; no quantitative or qualitative checking facility may be used without the knowledge of the operators or users; (c)systems must provide feedback to operators or users on the performance of those systems; (d)systems must display information in a format and at a pace which are adapted to operators or users; (e)the principles of software ergonomics must be applied, in particular to human data processing.

As can be seen, Schedule 1 sets out many obligations for employers to meet, not delegable to employees (please note that there are other obligations relating to lighting, space, ventilation etc applicable to work premises generally, set out in the Workplace (Health, Safety and Welfare) Regulations 1992).

Practically speaking, whilst Schedule 1 gives some specifics, it does not cover everything, such as specific dimensions, angles and distances. It is these specifics that often make the difference, over years of use. There are however a number of helpful guides online, such as by the Health and Safety Executive (HSE) a link to which is as follows:

www.hse.gov.uk/pubns/ck1.pdf

The regulations also require employers to:

– Provide information to employees regarding the risks assessed and preventative measures taken;

– Organise the daily routine of workers so as to minimise the risk of injury; and

– Take steps to protect the eyesight of workers, including to provide an eyesight test upon request (as well as follow-up tests beyond that

Whilst some injuries arise as a result of employers not doing the basics set out above, sometimes there are trickier scenarios such as unusual workplace set-ups that do not fit well with the HSE guides and/or employees with particular health situations. In these scenarios we would recommend that expertise, such as ergonomics and/or occupational health is consulted. An ergonomics expert will be able to analyse the workplace set-up and identify potentially hazardous outcomes. Occupational health assessors will be able to consider the particular health situation of the employee in question, reaching out for additional and more specialised medical expertise where necessary. This might at first sound like a lot of trouble to go to but in our view the time and costs would be far eclipsed by the wasted time, costs and energy arising from an employee suffering injury and potential consequent litigation.

Above all, if the law is complied with fully and a pro-active approach is maintained by the employer throughout, the chances of a display screen equipment type injury will be low.

Also remember:

– Employees working from home, which has of course become much more common consequent the Coronavirus pandemic, have the same rights (and risks) that they had when working in the office so, unfortunately, the same degree of assessments and review will have to apply. If the employer faces obviously insurmountable practical issues, such as the employee wanting to work from multiple locations throughout the year, some of which may be some distance from the office, then, in our view, the employer would likely discharge their duty by explaining the risks to employees, pointing out they cannot physically assess the employee’s preferred locations and requiring the employee to complete a thorough assessment of each and every workplace, via Zoom or Teams or similar, under the observation of someone with suitable knowledge and training.

– The recent trend of “hot-desk” working in which employees do not have fixed workstations but, rather, work at varying locations in the office when collaborating for instance, can cause havoc with the regulations as the entire point is to arrive at a situation safe for that particular worker, using the specific equipment they use and doing the particular tasks they are required to do. Practically speaking, much collaborative work is geared towards group discussions, presentations etc, which will lessen the risk of injury as workers will be moving around etc. However, in our view, employers who leave employees to undertake full days’ work of display screen equipment usage, but at changing workstations, are taking a substantial risk (unless they were to do sufficient and informed assessments upon everyone who had changed, at the start of each day, which is unlikely to be practical).

Manual handling type injuries

Here situations can range from things like Hand Arm Vibration Syndrome (damage to the nerves and circulation due to repeated and frequent use of vibrating equipment) and Carpal Tunnel Syndrome (compression of nerves in the arm, which can also arise following repetitive and vibrating work equipment), to tendon and other muscle damage.

There are a number of laws that can apply in these situations, sometimes overlapping with one another depending upon the type of case, such as:

– The Manual Handling Operations Regulations 1992. These laws require employers to first do all they can to avoid manual handling (such as by investing in new technology) and then, if not possible, to reduce the risk of injury as low as possible. When looking at how to reduce the risk of injury as low as possible employers need to look not only at the weight of the loads, but other things such as: the pace of work, the amount of work, whether it is difficult to manoeuvre due to its dimensions, whether employees are working in confined spaces that prevents safe lifting technique, and more.

The full list is at Schedule 1, which reads as follows:

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

Factors	Questions
The loads	Are they: - heavy? - bulky or unwieldy? - difficult to grasp? - unstable, or with contents likely to shift? - sharp, hot or otherwise potentially damaging?
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?
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?
Other factors	Is movement or posture hindered by personal protective equipment or by clothing?

Similarly to the Display Screen Equipment Regulations above, an employer who does not have regard to the factors set out in Schedule 1 when undertaking a risk assessment is unlikely to have undertaken an adequate risk assessment.

One common mistake we see employers making is failing to apply the risk assessment requirements to the specific task at hand. For instance, sometimes manual handling issues are bundled in with more general assessments, in which employees are told they should always ask for help with loads, and how to lift safely by bending the knees etc. What the employer has failed to do though is to look at, and keep under review, the specific situation the employees face “on the ground” each day. For instance, it is no use telling employees to request help if there is no one available to help, or if the pace of work means employees cannot stop to team up. Similarly, trying to lift safely might be impossible in the conditions at play. Again, employers will often fall down by treating risk assessments as “tick box exercises” whereas a quality and relevant risk assessment should prevent virtually any injury in the workplace.

The manual handling regulations were added to in 2002 with a new provision at Regulation 4(3), which requires employers to take into account the particular situation of the employee concerned.

The addition reads as follows:

4. Regulation 4 of the Manual Handling Operations Regulations 1992(1) shall be amended by adding the following paragraph—

“(3) In determining for the purposes of this regulation whether manual handling operations at work involve a risk of injury and in determining the appropriate steps to reduce that risk regard shall be had in particular to—

(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.”.

Therefore, it is imperative that the employer focuses upon the individual doing the task, as opposed to generic “one-size-fits-all” assessments, reprinted each year.

The Control of Vibration at Work Regulations 2005

These regulations basically set out the maximum levels of vibration that employees can be exposed to, and over what timescales. The provisions are of course too complex to try to explain here and employers will require expert input in order to calculate the vibration levels employees are being exposed to.

Interestingly, one thing we have observed in practice is that the amount of vibration emitted by an item of work equipment can vary dependent upon the condition of the equipment. For instance, we acted successfully for a commercial tyre fitter who worked for a number of companies and his evidence was that refurbished and/or poorly maintained pneumatic wrenches or “guns” would emit much more vibration than newer and/or better maintained equipment.

The Provision and Use of Work Equipment Regulations 1998

These laws set out how work equipment must be used safely. One such law, at Regulation 4, stipulates that work equipment must only be used in circumstances where it is safe to do so. Furthermore, these regulations require all employees who use work equipment to have received suitable and sufficient information and training in how to use work equipment, and the risks involved.

Regrettably, many RSI or work-related-upper-limb-disorder injuries can leave lasting effects upon injured workers. For instance, whilst carpal tunnel release surgery can correct most of the condition, people are left with scarring and, in our experience to date at least, many people describe some ongoing nerve issues. Similarly, HAVS is also often permanent and can leave workers unable to do the type of work they did before. Unfortunately, many of these conditions present after years of doing the harmful work in question, meaning a lot of damage can be done before workers receive adequate medical advice so as to fully appreciate the situation.

How long do I have to make a claim?

This is a critical point for these types of cases. Generally, the law states people have three years from the date of injury to start court proceedings. However, whilst the date is obvious for a one-off event, what if the damage was done over a period of time? In these situations we look at what we call “the date of knowledge.” This basically means the date the person should have known they had suffered injury as a result of their employer’s negligence. For example, if someone saw their GP on the 1st June 2022 and was advised they had suffered a particular injury likely due to their work then the three year clock will begin counting down from 1st June 2022 i.e. court proceedings would have to be issued by 1st June 2025. This can be a tricky issue in these cases and sometimes the courts will be very strict in how they interpret the date of knowledge so if in doubt do not delay – seek urgent legal advice.

Case Success Example

Aston Knight Solicitors recovered £16,000 for a commercial tyre fitter who suffered HAVS and carpal tunnel injuries. Mr L worked for a number of commercial tyre fitting companies and had to use pneumatic air wrenches throughout each day. No sufficient risk assessments were undertaken to ensure he was not exposed to hazardous levels of vibration and, as a result, he unfortunately developed both carpal tunnel syndrome and Hand Arm Vibration Syndrome. Whilst his carpal tunnel syndrome was mostly cured via surgery, his HAVS was unfortunately likely to be permanent.

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