MSD Prevention Toolbox Overview
MSD Prevention Toolbox Overview
PART 3A:
MSD
Musculoskeletal Disorders
a MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Disclaimer
The material contained in this Toolbox is for information and reference purposes
only and not intended as legal or professional advice. The adoption and/or use of
the tools, information, and/or practices described in this Toolbox may not meet
the needs, requirements or obligations of individual workplaces.
The guidance in this Toolbox does not, in any way, limit or reduce the obliga-
tions that workplace parties have under Occupational Health and Safety Act
(R.S.O. 1990, Chapter O.1, as amended), or any of its regulations. The Occupa-
tional Health and Safety Act (OHSA) requires employers to provide information,
instruction and supervision to workers and to take every precaution reasonable
in the circumstances for the protection of workers. MSD hazards that are present
in the workplace must be recognized and precautions put in place to fulfill
requirements under the OHSA.
Workers also have duties under the OHSA, including the duty to use equip-
ment and protective devices provided to them to reduce their MSD risk, and
to report defects and hazards of which they are aware to their supervisor. The
OHSA also gives workers the right to participate, the right to know, and the
right to refuse work that they believe is dangerous to either their own health and
safety or that of another worker.
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Acknowledgements
This document, Part 3A: MSD Prevention Toolbox – Getting Started, is part of the Occupational
Health and Safety Council of Ontario’s Musculoskeletal Disorders (MSDs) Prevention Series. It
was developed in partnership with the members of the Occupational Health and Safety Council
of Ontario (OHSCO), with the support of the Centre of Research Expertise for the Prevention of
Musculoskeletal Disorders (CRE-MSD), and in consultation with representatives from Ontario’s
labour organizations, employer associations, and individual employers and workers.
Supporting organizations include:
■ Construction Safety Association of Ontario
■ Education Safety Association of Ontario
■ Electrical & Utilities Safety Association
■ Farm Safety Association
■ Industrial Accident Prevention Association
■ Institute for Work & Health
■ Mines and Aggregates Safety and Health Association
■ Municipal Health & Safety Association
■ Occupational Health Clinics for Ontario Workers
■ Ontario Forestry Safe Workplace Association
■ Ontario Ministry of Labour
■ Ontario Safety Association for Community & Healthcare
■ Ontario Service Safety Alliance
■ Pulp and Paper Health and Safety Association
■ Transportation Health & Safety Association of Ontario
■ Workers Health & Safety Centre
■ Workplace Safety and Insurance Board (Ontario)
The support and participation of everyone who contributed to the development of the MSD
Prevention Guideline for Ontario and its related documents is greatly appreciated
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More information, including sector specific materials, can be found online at:
[Link]/[Link].
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Occupational Health and Safety Council of Ontario (OHSCO)
Agreement N
Review questions on Getting Started, Check Sheet on causes of MSD
to see if you are already taking steps to reduce hazards?
MSDs. (page 7 - 8)
Y
Review accident/injury records AND Talk to
workers, supervisors, managers Review pages 28-43 for MSD hazard
control ideas
Continue to monitor
Are
accident/injury Brainstorm hazard control ideas/
workers
reports, pain and/or options (pages 44-45)
N reporting MSDs?
discomfort, and
AND/OR Do workers say they
consider a plan to
have pain or discomfort that they
address MSD hazards Identify preferred MSD hazard
feel is work/task
before claims, pain, control(s)
related?
etc. occur
Y
Identify MSD hazards. Talk to workers, observe jobs/ Agreement
tasks, use an MSD hazard ID tool (pages 9 - 23)
N
on MSD hazard
control(s)?
Agreement Agreement
on which hazard Y N on success of MSD
exposures should be hazard control?
controlled?
N Y
Communicate results and acknowledge
Use a more in-depth risk assessment. See Part 3B: success
MSD Prevention Toolbox - Beyond the Basics. For
assistance call your safety association or seek other
qualifed assistance (page iii, 48 - 50).
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At a high enough level any one MSD hazard can cause an injury (for example: lifting a heavy box
just once, even if the person is lifting properly). However the risk increases when more MSD
hazards are present (example: lifting the heavy box repeatedly overhead).
Why should you invest in MSD prevention? MSDs account for 42 per cent of all lost time
claims accepted by the Workplace Safety and Insurance Board (WSIB), 42 per cent of all lost time
claim costs and 50 per cent of all lost time days (averages for 1996 – 2004).
= + +
MSD prevention Saves you money Increased productivity Improved health, well-being
and quality of work and worker satisfaction
How can I do this with limited resources and money? The process for preventing MSDs in the
workplace can be simple. Any workplace can start to prevent MSDs by following the steps in the
Getting Started flowchart, and by reading the next page. Also, the check sheet on page 8 can be
used to compare what you are doing now against the recommended steps for getting started, and
tells you where to find tools in this Toolbox that can help with your MSD prevention efforts.
For help with MSD prevention, call your Health and Safety Association (see page iii). For
sector/job specific information, see [Link]/[Link]
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Conduct an MSD risk ■ Discuss identified MSD hazards with workers. Ask whether they
assessment agree that these hazards, or the activities where hazards have
been identified, are contributing to their MSDs, pain and/or
discomfort.
■ Determine if everyone agrees on the causes of the MSD hazards.
■ Shortly after the changes have been made, talk to the workers
Follow up and
about whether they think the control is working (less pain,
evaluate successes of
implemented controls
working as expected, no other hazards introduced).
■ Follow-up again after some time has passed to see if the control
is still effective and to consider cost benefit issues.
Communicate
■ Make all workers aware of successful MSD hazard controls and
results and recognize the efforts made to prevent MSDs in the workplace.
acknowledge success
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Occupational Health and Safety Council of Ontario (OHSCO)
FORCE
Force refers to the amount of effort made by the muscles, and the amount of pressure on body
parts as a result of different job demands. All work tasks require workers to use their muscles to
exert some level of force. However, when a task requires them to exert a level of force that is too
high for any particular muscle, it can damage the muscle or the related tendons, joints and other
soft tissue.
This damage can occur from a single movement or action that requires the muscles to generate
a very high level of force. However, more commonly, the damage results when muscles generate
moderate to high levels of force repeatedly, for a long duration, and/or while the body is in an
awkward posture.
Some job tasks result in high force loads on different parts of the body. For example, lifting a
heavy load that is far from the body increases the load on the lower back. This can potentially
damage both the spinal discs and the vertebrae.
Working with hand tools that have hard or sharp edges, i.e. resting the forearms on the hard
edge of a desk, can also potentially cause damage to tendons, muscles, blood vessels and nerves
under the skin. This is often referred to as contact stress (see below).
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Occupational Health and Safety Council of Ontario (OHSCO)
REPETITION
The risk of developing an MSD increases when the same parts of the body are used repeatedly, with
few breaks or chances to rest. Highly repetitive tasks can lead to fatigue, tissue damage, and, eventu-
ally, pain and discomfort. This can occur even if the level of force is low and the work postures are
not very awkward.
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Occupational Health and Safety Council of Ontario (OHSCO)
FORCE
POSTURE
REPETITION
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Occupational Health and Safety Council of Ontario (OHSCO)
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Occupational Health and Safety Council of Ontario (OHSCO)
Managers, supervisors, and workers know what MSDs are and what hazards ■ ■ In this document, pages 4-5,
can cause them 34-41
RECOGNIZE MSD HAZARDS AND RELATED CONCERNS
Incident/injury records are reviewed to find jobs/tasks where MSDs have been ■ ■ See the Resource Manual for
reported the MSD Prevention Guideline
for Ontario, pages 32-33
Workers, supervisors and managers are asked about job/tasks that they believe ■ ■
contribute to any pain or discomfort
Problem jobs/tasks are observed and an MSD hazard identification tool is used, ■ ■ In this document, pages 8, 10-
with full input and participation of workers who do the jobs/tasks 13, 14-17, 18 -23
CONDUCT AN MSD RISK ASSESSMENT
Problem jobs/tasks are prioritized for a simple risk assessment ■ ■ In this document, pages 24-25
Workers are asked to identify key concerns/activities/task demands that are ■ ■ See the Resource Manual for
contributing to MSDs, pain or discomfort the MSD Prevention Guideline
for Ontario, pages 37 - 40
Observations and MSD hazard identification tool results are compared to ■ ■
worker comments/concerns
Effort is made to agree on what issues/hazards should be addressed to ■ ■
help reduce the risk of MSDs (agreement between observations, hazard
identification tool(s), and worker comments)
Effort is made to agree on why these hazards exist for this job/task ■ ■ In this document, pages 26-27
CHOOSE AND IMPLEMENT MSD HAZARD CONTROLS
When MSD hazard controls are needed, workers, supervisors, maintenance, ■ ■ In this document, pages 28, 29-
and safety, personnel discuss/brainstorm ideas and options to control 33, 34-41 and pages 42-43
identified MSD hazard(s)
Possible controls for MSD hazards are selected and reviewed ■ ■ See the Resource Manual for
the MSD Prevention Guideline
Preferred control ideas are identified and action plans are developed for ■ ■ for Ontario, pages 52-53
implementation
FOLLOW UP ON AND EVALUATE SUCCESS OF MSD HAZARD CONTROLS
Workers are asked for their feedback on/opinions about MSD hazard controls ■ ■ In this document, page 44-45
Workers receive training on how to use MSD controls and are using them ■ ■ See the Resource Manual for
the MSD Prevention Guideline
Observations and the MSD hazard identification tool results are used to help ■ ■ for Ontario, pages 37 - 40
confirm that the exposure to the MSD hazard has been reduced
Reviews are done to ensure that no new hazards/concerns result from the ■ ■
MSD hazard control(s)
COMMUNICATE RESULTS AND CELEBRATE SUCCESS
Those involved in the process are acknowledged and the workplace is told ■ ■ See the Resource Manual for
about new MSD hazard control(s) the MSD Prevention Guideline
for Ontario, pages 59-61
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Occupational Health and Safety Council of Ontario (OHSCO)
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Occupational Health and Safety Council of Ontario (OHSCO)
INSTRUCTIONS
1. Document the job title or task, date and name of person(s) completing the worksheet.
2. Observe a number of different workers performing regular work activities.
3. Ask the workers who perform the job/task whether they think the objects are heavy, or the
task is difficult/tiring.
4. Ask the workers if they do a task/adopt an awkward posture repeatedly or for a long period
of time.
5. Check the appropriate box(es) that apply to the job/task
a. Only make a check mark when the specific hazard exists and when workers report that it
is difficult, tiring, heavy, done repeatedly, or done for a long time.
6. Write notes for any identified hazard to clarify the task or activity where it occurs.
7. Review the contents of the MSD Hazard Identification Tool with the workers who perform
the job. Ask them if there are additional task that were not captured.
8. Prioritize the jobs/tasks for risk assessment (see page 25).
Also see Section 5 of the MSD Prevention Guideline for Ontario and the Resource Manual for
the guideline for more information about MSD risk assessment.
See the next page for some more guidance on how and when to use this tool.
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Occupational Health and Safety Council of Ontario (OHSCO)
Notes:
If the physical demands related to the activity vary from day to day, due to different products/
services being produced or provided, ask workers if the activity being observed is more or less
demanding than on a typical day.
i) If less demanding, plan to come back when the demands are more typical and, if
appropriate, higher.
ii) If more demanding, complete the hazard identification tool. It may be that MSD
hazards are only a concern for certain products/services. You should also reuse the tool
when the demands are more typical.
iii) If typical, but there are times when the demands are higher, reuse the tool when the
demands are higher, especially if there are no MSD hazards identified when observing
typical demands.
Some MSD hazards, (e.g. lighting, aspects of work organization) are not addressed in this
tool. If these or other MSD hazards exist, make note of them and ask the workers who
perform the job to see if they think that these hazards are contributing to their pain/
discomfort or causing them other concerns.
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Occupational Health and Safety Council of Ontario (OHSCO)
Date completed:
General observations:
Notes:
Notes:
Notes:
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Occupational Health and Safety Council of Ontario (OHSCO)
Hand-Arm Vibration • using vibrating tools (impact wrenches, carpet strippers, chainsaws, ■
jackhammers, scalers, riveting hammers, grinders, sanders, jig saws, jack-leg
drills.)
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Occupational Health and Safety Council of Ontario (OHSCO)
INSTRUCTIONS
1. Document the job title or task, date and name of person(s) completing the worksheet.
2. Observe a number of different workers performing regular work activities.
3. Look at the pictures on the hazard identification tool. Do any of the postures, tasks, or other
hazards illustrated by the pictures exist for the job/task being observed?
4. Ask the workers who do the job/task if they think that any of the identified hazards also have
force, repetition, posture, and/or time concerns.
5. Mark that a hazard exists only if it is clear, by observation and/or from worker comments,
that:
a. For awkward/static postures:
1. Workers must exert a force (difficult, tiring, heavy) with the body part that is in an
awkward posture (check the F box).
2. Workers adopt this posture repeatedly (check the R box).
3. Workers adopt this posture and hold it for a long time (check the T box).
b. For manual material handling:
1. The task is difficult or tiring, the object lifted or carried is heavy, and/or the pushing/
pulling force is of concern (check the F box).
2. The task is done repeatedly (check the R box).
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3. The task requires the worker to adopt an awkward posture (check the P box).
4. The task is done for a long time without a break/change of activity (check the T box).
c. For gripping:
1. The task is difficult or tiring, and/or the amount of grip force required is of concern
(check the F box).
2. The task is done repeatedly (check the R box).
3. The task requires the worker to adopt an awkward posture (check the P box).
4. The task is done for a long time without a break/change of activity (check the T box).
d. For contact stress:
1. The force level of the contact stress is noted as a concern (check the F box).
2. Workers are exposed to contact stress repeatedly (check the R box).
3. The contact stress lasts for a long time (check the T box).
e. For sitting/standing:
1. Sitting/standing postures are poor (check the P box).
2. Workers sit/stand for a long time without a change in posture (check the T box).
f. For keyboarding/mousing:
1. Workers visibly ‘pound’ the keys or grip the mouse (check the F box).
2. The mouse is used repeatedly (check the R box).
3. Wrist, arm, and/or shoulder postures are poor when keyboarding or using the mouse
(check the P box).
4. Workers use the keyboard and/or mouse for a long time without a change in activity
(check the T box).
g. For using the knee or hand as a hammer:
1. Force levels on the knee or hand are noted as a concern (check the F box).
2. The knee and/or hand is used as a hammer repeatedly (check the R box).
3. The knee and/or hand is used as a hammer for a long time (check the T box).
h. For hot or cold:
1. The worker or parts of the worker’s body are exposed to temperatures of concern (too
hot, too cold) (check the F box – to represent exposure to hot or cold temperature
levels).
2. Workers are exposed to hot/cold temperatures repeatedly (check the R box).
3. Workers are exposed to hot/cold temperatures for a long time (check the T box).
i. For hand-arm or whole-body vibration:
1. The levels of vibration are noted as a concern (check the F box).
2. Workers are exposed to vibration repeatedly (check the R box).
3. The postures adopted are awkward while being exposed to vibration (check the P box).
4. Workers are exposed to vibration for a long time (check the T box).
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6. Write notes for any identified hazard to clarify the task or activity where it occurs.
7. Review the contents of the MSD Hazard Identification Tool with the workers who perform
the job. Ask them if there are additional tasks that were not captured.
8. Prioritize the jobs/tasks for risk assessment (see page 25).
a. Also see Section 5 of the MSD Prevention Guideline for Ontario and the Resource
Manual for the Guideline for more information about MSD risk assessment.
See notes on bottom of the second page of the tool for guidance on how to use this tool
when the task demands vary from day to day, due to different products/services being
produced or provided.
Some MSD hazards, (e.g. lighting, aspects of work organization) are not addressed in this
tool. If these or other MSD hazards exist, make note of them and plan to assess whether they
contribute to the MSD risk for workers.
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F P R T
Job/Task Information
Job title or task:
Date completed:
T T T T
F R F R F R F R
T T T T
Neck bent forward Neck bent backards Neck bent to side Neck rotated
F R F R F R F R
T T T T
Hands or elbows Arms out to Wrist bent up Wrist bent to
above shoulders the side or down either side
F R F R F R F R
T T T T
Kneeling Squatting Palm up Palm down
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F R F R F R
P T P T P T
Lifting Pushing/Pulling Carrying
Gripping
F R F R F R
P T P T T
Pinch Grip Grip Contact stress
Other
F R F R
P T P T
P T P T
Sitting Standing Keyboarding/Mousing Using knee or hand as a hammer
F R F R F R
P T P T T
Hand-arm vibration Whole-body vibration Hot/Cold temperatures
Notes:
If the activity-related physical demands required vary from day to day, due to different products/services
being produced or provided, ask workers if the activity being observed is more or less demanding than on a
typical day.
• If less demanding, plan to come back when the demands are both more typical and, if appropriate, higher.
• If more demanding, complete the hazard identification tool. It may be that MSD hazards are only a concern for
certain products/services. You should also reuse the tool when the demands are more typical.
• If typical, but there are times when the demands are higher, reuse the tool when the demands are higher, especially if
there are no MSD hazards identified when observing typical demands.
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■ This tool is to be used to identify job/task related MSD hazards for individual workers performing
computer based jobs/tasks.
■ This tool needs to be used with the full participation and input of the worker who works at the
computer workstation where the job/task is performed. Observations alone are not enough, and it
is not appropriate for the person(s) using the tool to base decisions only on what they see or think
about a job.
■ Other hazard identification methods such as analysis of injury, incident and first aid reports, worker
concerns, and discomfort/pain reports should also be considered.
■ This tool IS NOT intended to be used for:
- Return to work assessment/evaluations
- Job placement/worker selection
- Assessing the work relatedness of an injury or disorder
Instructions
1. Document the job title or task, date and name of person(s) completing the worksheet.
2. Observe the worker performing regular work activities at the computer workstation.
3. Ask the worker for opinions about specific issues that may be hard to observe (pressure on
the back of the knee, repeated trunk bending, adequate lighting, glare).
4. Ask the worker whether they perform a task or adopt an awkward posture repeatedly or for
a long period of time.
5. Check the appropriate box that applies to the job or task for each of the MSD hazards listed.
6. Review the contents of the tool with the worker who works at the computer workstation.
Ask whether additional tasks are performed that were not captured.
7. Attempt to reduce or eliminate MSD hazards identified using corrective options. The
corrective options listed represent possible solutions, but are not an exhaustive list.
8. Make notes on any attempts made to reduce or eliminate the MSD hazards or on any
further actions required.
See the next page for some more guidance on how and when to use this tool.
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Occupational Health and Safety Council of Ontario (OHSCO)
Notes:
If the task demands vary from day to day, ask the worker if the activities being observed are
more or less demanding than on a typical day.
■ If less demanding, plan to come back when the demands are both more typical and, if
appropriate, higher.
■ If more demanding, complete the hazard identification tool. It may be that MSD hazards
are only a concern when performing specific tasks/activities. You should also reuse the tool
when the demands are more typical.
■ If typical, but there are times when the demands are higher, reuse the tool when the
demands are higher, especially if there are no MSD hazards identified when observing
typical demands.
Some MSD hazards, (e.g. aspects of work organization, work practices) are not addressed
in this tool. If these or other MSD hazards exist, make note of them and plan to assess
whether they contribute to the MSD risk for individual workers.
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Occupational Health and Safety Council of Ontario (OHSCO)
Job/Task Information
Job title or task:
A. Chair
Is the hazard
MSD HAZARDS present? CORRECTIVE OPTIONS
Potential steps to reduce or eliminate the risk associated
Yes No with the MSD hazard.
1. Feet cannot rest flat on • Raise/lower chair to allow feet to rest comfortably flat on
floor ■ ■ floor.
• Use footrest if keyboard/desk height requires an elevated
chair.
2. Unable to sit with thighs ■ ■ • Adjust chair height so that feet remain flat on floor or
parallel to the floor, or footrest but thighs are also parallel to floor.
with a slight downward
angle from hips to knees
3. Front edge of seatpan • Choose a chair with 2-3 fingers width between front edge
presses into back of knee ■ ■ of chair and back of knees.
• Attach a removable back support cushion to existing
backrest to shorten seat pan.
• Choose a chair with a gently curved front edge on seat
pan.
4. Chair lumbar support • Raise/lower the back rest so the small of the back is in
NOT supporting the ■ ■ contact with the most outward curved areas of the back
small of the back (i.e. support.
the curve of the lumbar • Place a rolled up towel or attach a removable back support
spine) cushion to existing back support.
5. Space exists between • Arrange workstation to allow proper back support. (i.e.
spine and back rest ■ ■ position keyboard closer to user, bring monitor closer to
user).
• Remove or lower arm rests which may prevent sitting back
fully due to contact with front of desk or keyboard tray.
• Replace the seat pan if it’s too long and doesn’t allow for
sitting back fully in chair.
6. Armrests provide If armrests are too low/too high:
inadequate forearm ■ ■ • Add padding to bring them up to a comfortable level.
support when keying • Only use the armrest during short pauses from typing.
or mousing. Hunched
• Replace with armrests that can be adjusted to the correct
shoulders - armrests
height.
too high; leaning to one
side – armrests too low; If armrests are too wide:
elbows away from the • Adjust to bring them closer together.
body – armrests too wide • Replace seat pan on chair with a narrower one.
• Replace with width-adjustable armrests.
Notes:
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1. Head tilted up/down, • Raise/lower monitor so that eyes are in line with top
repeatedly or for a long ■ ■ line of text. Monitor may need to be lowered for bifocal
time, while working at desk wearers if they look at the monitor through the bottom of
their lenses.
• If using a number of paper documents, use document
holder that sits between the worker and the monitor.
4. Head is not directly over • Arrange workstation to allow for proper posture, (e.g.
spine (i.e. the head is ■ ■ sit back in chair, pull keyboard to user, change location/
forward and the chin is height of monitor).
out)
Notes:
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Notes:
D. Environmental
Is the hazard
POTENTIAL MSD HAZARDS present? CORRECTIVE OPTIONS
Potential steps to reduce or eliminate the risk associated
Yes No with the MSD hazard.
1. Too much/too little • Reduce the amount of light in work area, especially from
light ■ ■ ceiling-mounted light fixtures.
• Use low gloss, off-white colour on surfaces.
• Use appropriate task lighting.
2. Glare on monitor • Prevent source of glare from reaching monitor, (i.e. use
■ ■ opaque vertical blinds, use glare screens).
• Place monitor at right angles to windows.
• Use LCD monitors.
3. Temperature is less • Raise/lower temperature to individual comfort
than 20°C or more than ■ ■ • Wear more/less warm clothing.
24°C (dependent on • Use individual heaters where appropriate.
individual comfort and
season)
Notes:
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MSDs reported should include lost time and non-lost time (medical/first aid) claims
1
2
When there are MSD claims and/or reports of pain or discomfort, but no MSD hazards have been identified,
after talking with workers and using an MSD Hazard Identification Tool, it is suggested that you seek help from
someone who is qualified to help you with your MSD prevention efforts (see pages 48 - 50).
In addition to considering the factors in the above table, other considerations that may help you
prioritize your jobs for risk assessment include:
■ severity of MSDs or MSD concerns, or MSD hazards,
■ number of people reporting an MSD or MSD concern,
■ number of people who do the job or task,
■ percentage of people who do the job or task who have reported an MSD or MSD concern,
■ number of MSD hazards present,
■ number of people who do the job or task,
■ frequency with which the job or task is performed,
■ length for which the job or task is performed,
■ reports or concerns by supervisors or the JHSC,
■ high absenteeism, overtime or worker dissatisfaction,
■ productivity and/or quality problems.
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Worksheet to prioritize jobs or tasks for simple risk assessment
25
TASK/JOB MSDs REPORTED WORKER DISCOMFORT/ MSD HAZARD(S) PRIORITY LEVEL
OTHER CONCERNS IDENTIFIED
YES NO YES NO YES NO
Occupational Health and Safety Council of Ontario (OHSCO)
The following are examples of the kind of points to consider for each category:
PROCESS: MATERIALS:
- length of time allotted to tasks - packaging
- machine-paced tasks - weight and dimensions
- duration of task - storage location
- variety of tasks - quality
- production/quality standards
- communication between staff within the
department and outside the department
ENVIRONMENT:
- working space
- overcrowding
EQUIPMENT:
- temperature
- working height
- flooring
- location of controls and/or displays
- housekeeping
- operation of the controls
- mobility
- location HUMAN:
- association with other equipment - insufficient training on techniques/processes
- insufficient adjustability - insufficient supervision /coaching
- maintenance - production pressures and demands
- inappropriate response to reports of MSD
related concerns
- differences in work methods/techniques
- inconsistent use of equipment/controls that
help reduce MSD risk
26 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Assessing MSD hazards: Determining Root Cause Worksheet
Likely Causes of
MSD Hazards
Environment: Human:
27
Occupational Health and Safety Council of Ontario (OHSCO)
28 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
Gripping tools/equipment
■ Provide tools that allow workers to grip the tool using a power grip.
■ Eliminate the use of pinch or key grips as much as possible.
■ Choose tools that have triggers that allow for the use of multiple fingers rather than one
finger or a thumb.
■ Choose tools that can be used with the wrist straight.
■ Choose tools with vibration-reducing features.
■ Choose tools that are lighter and designed to reduce hand torque and kickback.
■ Ensure the tool is balanced and does not require extra muscular effort to hold it in
position.
■ Ensure the handle of a tool does not create pressure points in the palm of the hand.
■ Use tools with handles that fit the hand. For example, use a smooth, cushioned hand grip.
rather than one with hard ridges that space the fingers.
■ Provide rubber or sponge-type grips on tool handles.
■ Provide tools that can be safely used by either left-handed or right-handed workers.
■ Maintain tools regularly.
■ Inspect tools regularly. Ensure worn or damaged tools are fixed or replaced.
29 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
30 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
■ Provide self-elevating platforms in deep bins to keep items easily accessible and near the
top of the bin.
■ Provide false bottoms in deep sinks or containers.
■ Limit shelf heights to between knee and shoulder height.
■ Provide foot rests at standing workstations.
■ Ensure the type of flooring will minimize shock absorption to the worker’s body.
■ Provide anti-fatigue matting for standing work areas with hard floor surfaces.
■ Use devices such as lifts, duct jacks, scissor lifts, and extension poles or stands for operating
tools overhead.
■ Use adjustable scaffolds, aerial and other work platforms to raise the whole body closer to
work.
■ Place materials used often at appropriate height and less frequently used materials in less
desirable locations.
■ Use tables, benches, or stands to bring work to waist height.
Repetition
■ Implement well-designed job rotation.
■ Add different tasks to the job to increase the variety of activities.
■ Include flexibility in the job so the worker can control pace of work.
■ Use a work/rest schedule that allows for frequent changes of activity.
■ Encourage employees to take micro-breaks.
■ Mechanize the task where necessary.
Repeated impacts
■ Look for tools/equipment that will eliminate the need for repeated impacts:
- use rubber mallets/other tools instead of the hand, and
- use power stretchers for carpet installations.
■ Provide workers with well-designed padded gloves/knee pads.
■ Change fittings/parts/equipment to minimize the forces used with repeated impacts.
■ Limit the time duration required for repeated impacts.
Contact stress
■ Change or modify equipment (e.g. use a long-handled screwdriver to prevent the butt from
digging into the palm).
■ Change or modify work area to prevent sharp edges from digging into skin (e.g. cover
sharp or metal edges with padding).
■ Use personal protective equipment (e.g. use knee pads while kneeling; use padded gloves
when lifting heavy objects by narrow plastic strapping).
■ Improve or change work practice to reduce resting or leaning against sharp edges.
31 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
Whole-body vibration
■ Avoid sitting or standing for prolonged periods on vibrating surface if practicable (e.g.
avoid working on catwalks attached to vibrating machinery).
■ Isolate the source of vibration from the rest of the work space to prevent transmission of
vibration to the sitting or standing area (e.g. isolation of truck cabs from diesel engine
vibration).
■ Train and instruct operators and drivers to:
- adjust the driver weight setting on suspension seats,
- adjust the seat position and controls correctly to provide good lines of sight and support,
- adjust the vehicle speed to suit the ground conditions to avoid excessive bumping and
jolting,
- steer, brake, accelerate, shift gears and operate attached equipment smoothly, and
- follow worksite routes to avoid traveling over rough, uneven or poor surfaces.
■ Choose machinery suitable for the job:
- select vehicles and machines with the appropriate size, power and capacity for the work
and the ground conditions.
■ Maintain machinery and roadways:
- make sure that paved surfaces or site roadways are well maintained (e.g. potholes filled in,
ridges leveled, rubble removed),
- maintain vehicle suspension systems correctly (e.g. cab, tire pressures, seat suspension),
- replace solid tires on machines such as forklift trucks, sweepers and floor scrubbers before
they reach their wear limits, and
- obtain appropriate advice (from seat manufacturers, machine manufacturers and/or vibra-
tion specialists) when replacing a vehicle seat. Seats need to be carefully matched to the
vehicle to avoid making vibration exposure worse.
32 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
■ Other measures
- Introduce work schedules to avoid long periods of exposure in a single day and allow for
breaks where possible.
- Avoid high levels of vibration and/or prolonged exposure for older employees, people
with back problems, young people and pregnant women.
Cold temperatures
■ Ensure workers wear high-friction, well-fitting gloves.
■ Ensure that workers wear clothing that keeps them warm without adding a lot of bulk.
■ Ensure hand tools are stored in a warm place prior to use.
■ Provide alternating periods of cold and warm work (worker rotation) and allow workers to
take rest breaks in warm areas.
■ Avoid having workers use tools that discharge cold gases over the hand.
■ Provide local source heating (portable heaters) for workers.
■ Educate workers about the adverse effects of cold and its influence on MSDs.
■ Encourage workers to stay well hydrated.
Work organization
■ Ensure that repetitive or demanding tasks incorporate opportunities for rest or recovery
(e.g. allow brief pauses to relax muscles, change work tasks, change postures or techniques).
■ Incorporate task variability so that the worker does not have to perform similar repetitious
tasks throughout the full shift. Provide the worker with the opportunity to vary work tasks
by rotating jobs or increasing the scope of the job.
■ Ensure that work demands and work pace are appropriate.
Work methods
■ Evaluate jobs to determine whether work methods are compatible with worker capabilities.
■ Analyze the differences in work methods between individuals to find the best work
methods.
■ Ensure that the official work method is the best work method and corresponds with what
workers are actually doing.
33 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
=
+ +
LOWER GOOD LESS REDUCED
FORCE POSTURE REPETITION MSD RISK
LIFTING/LOWERING
HAZARDS
Lifting from the floor Overhead lifting Lifting out of a bin Lifting while reaching Lifting heavy loads
SOLUTIONS
34 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
SOLUTIONS
Use well-designed carts Use a powered pusher Use big wheels on carts/bins Use dollies/carts
35 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
SOLUTIONS
Use good power grips Use boxes with Use tools/equipment Use tool balancers for
good handles with good hand grips heavier hand tools
36 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
=
+ +
LOWER GOOD LESS REDUCED
FORCE POSTURE REPETITION MSD RISK
BACK/TRUNK POSTURES
HAZARDS
SOLUTIONS
ARM/SHOULDER POSTURES
HAZARDS
Hands above shoulder Elbows/arms away from body Arms behind the body
SOLUTIONS
Use long handle extensions Use lift tables with Keep lifts below shoulders Use adjustable height
turntables on them and above knees work platforms
37 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
Bending the wrist Bending the wrist up Bending wrist sideways Working with palm Working with palm
down facing up facing down
SOLUTIONS
Select tools that promote good wrist postures and power grips Choose tools that are right for the task/working height
HEAD/NECK POSTURES
HAZARDS
Neck bent forward Neck bent backward Neck bent to one side Neck turned to one side
SOLUTIONS
Raise task/equipment to Place important visual Provide head sets to reduce Angled doccuent holders/
reduce forward neck bending displays directly in front of user side bending of neck work surfaces improve
neck postures
38 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
+ + =
SOLUTIONS
Use good job rotation schemes Switch hands from time to time Use well-designed power tools Take breaks
39 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
SOLUTIONS
Raise bins/use spring loaded inserts Use height-adjustable tables/carts Use height-adjustable work platforms
40 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
SOLUTIONS
Use well-designed hoist for Use roller conveyors to Mechanize repetitive material Use specially designed
repetitive handling reduce repetitive handling where necessary equipment to reduce
lifting/handling repetitive handling/carrying
41 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
=
+ +
LOWER GOOD LESS REDUCED
FORCE POSTURE REPETITION MSD RISK
CONTACT STRESS
HAZARDS
Tool digging into Sharp edges digging into wrists Seat pan digging into Sharp edges
fingers/palm/hand back of the knee digging into body
SOLUTIONS
Use tools with handles Select equipment, tools with rounded Provide good support Adjust chair so feet are flat
that extend past the palm edges or provide padding for forearms on the floor and there is space
between seat and back of legs
SOLUTIONS
Use a rubber mallet instead of Use knee pads/padded gloves Use a mechanical device to
hand for hammering replace knee/hand hammering
42 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
SOLUTIONS
Use tools designed Use anti-vibration gloves Use good anti-vibration Keep roads/travel surfaces
to reduce vibration seat suspensions smooth
HOT/COLD
HAZARDS
SOLUTIONS
Drink water to keep hydrated Use local heat sources Use handwarmers/gloves
for whole body, hands to keep hands warm
43 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
EQUIPMENT: HUMAN:
- mechanize a process - training including:
- provide mechanical lifts, hoists, conveyors, - signs & symptoms of MSD
motorized carts - MSD hazard awareness
- improve workstation design/layout - how to report MSDs/MSD hazards
- workstation adjustability (sit/stand, height - work techniques and processes
adjustable)
- team-based solutions/participatory problem solving
- preventative maintenance
- reinforce need for use of equipment/controls that help
- pre-shift checklist/inspections reduce MSD risk
- move control, displays, tools for easier - improve communication/support from supervisors
use, visibility, access
- support for early reporting of concerns
- make sure controls are properly labeled/
colour coded - personal protective equipment (insoles, knee pads,
anti-vibration gloves)
- provide space for workers to move, allow
unconstrained postures - production pressures and demands
- provide material handling equipment for
moving materials
44 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Eliminating/controlling MSD risks: Developing Solutions Worksheet
If agreement on the root cause(s) is not reached, an in-depth risk assessment may be required. See Part 3B: MSD Prevention Toolbox – Beyond the Basics
risk of MSD
for workers
performing the
Task
Environment: Human:
45
Occupational Health and Safety Council of Ontario (OHSCO)
46 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
NO, HAVEN’T NO, HAVE SEEN IT YES, ONCE YES, A FEW YES,
EVEN SEEN IT BUT NOT USED IT OR TWICE TIMES REGULARLY
47 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
Ergonomists
Ergonomists have a variety of backgrounds, including engineering, kinesiology, occupational
therapy, physiotherapy, and psychology. These individuals will have specific specialized training,
education and experience related to the assessment of how humans interact with tools, equipment,
workstations, jobs, tasks, and organizations, and the design of systems to reduce risk and maximize
performance. Canadian Certified Professional Ergonomists (CCPE) are certified by the Canadian
College for the Certification of Professional Ergonomists and are members of the Association of
Canadian Ergonomists.
Association of Canadian Ergonomists [Link]
48 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
Kinesiologists
Kinesiologists are trained in the functional assessment and training of human movement in order
to improve function, reduce risk and promote health. Kinesiologists who have received specific
training, education, and have experience in the area of ergonomics can provide workplaces with
assistance related to MSD prevention. In Ontario, kinesiologists are certified by the Ontario Kinesi-
ology Association. In the near future, kinesiologists will be registered by the College of Kinesiolo-
gists of Ontario.
Ontario Kinesiology Association [Link]
Occupational Therapists
Occupational therapists are trained in the physical, psychosocial and cognitive sciences in order to
remove obstacles that can affect an individual’s function and their ability to participate meaning-
fully in their chosen occupation. Occupational therapists who have received specific training, educa-
tion, and have experience in the area of ergonomics can provide workplaces with assistance related
to MSD prevention. In Ontario, occupational therapists are registered by the College of Occupa-
tional Therapists of Ontario.
College of Occupational Therapists of Ontario [Link]
Physiotherapists
Physiotherapists are trained to break down the barriers to and improve physical function that may
be compromised due to surgery, illness and disease, injury, industrial and motor vehicle accidents,
and age related conditions. They also promote health and disease prevention. Physiotherapists
who have received specific training, education, and have experience in the area of ergonomics can
provide workplaces with assistance related to MSD prevention. In Ontario, physiotherapists are
registered by the College of Physiotherapists of Ontario.
College of Physiotherapists of Ontario [Link]
49 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
Occupational Health and Safety Council of Ontario (OHSCO)
Occupational/Industrial Hygienists
Occupational hygienists are trained in the recognition, assessment and control of workplace
chemical, biological and physical hazards. Occupational hygienists who have received specific
training, education, and have experience in the area of ergonomics can provide workplaces with
assistance related to MSD prevention. Occupational hygienists are certified in Canada through the
Canadian Registration Board of Occupational Hygienists.
Occupational Hygiene Association of Ontario [Link]
Chiropractors
Chiropractors are trained to assess, diagnose and treat disorders related to the spine, pelvis, extrem-
ity joints, and the nervous system. Chiropractors who have received specific training, education,
and have experience in the area of ergonomics can provide workplaces with assistance related
to MSD prevention. In Ontario, chiropractors are registered by the College of Chiropractors of
Ontario.
College of Chiropractors of Ontario [Link]
50 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started
PREVENTION TOOLBOX A
Occupational Health and Safety Council of Ontario (OHSCO)
51 MUSCULOSKELETAL DISORDERS PREVENTION SERIES | Part 3A: MSD Prevention Toolbox – Getting Started