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Ergonomic challenges
Hospital bed which can be elevated.
© G. Tjalvin, UiB
Work-related musculoskeletal diseases are very common at most workplaces, especially among healthcare workers. These conditions affect the muscles, nerves, tendons, and joints due to for instance repetitive tasks and heavy lifting. The causes of musculoskeletal disorders are often multi-factorial, but preventive measures, such as proper lifting techniques and ergonomic adjustments, can help to reduce the risk of developing musculoskeletal diseases. The risk factors need to be found and taken care of, to be able to prevent these challenges for health. This kind of work is often defined as ergonomics.
The expression ‘ergonomics’ is often defined as an applied science concerned with designing and arranging things people use, so people and things interact most efficiently and safely. Some use the expressions human factors or human engineering for the same issues.
Heavy load, heavy lifting
The most common problems that develop after heavy lifting is pain in the limbs and low back pain. These type of problems can develop both acutely and suddenly as well as gradually. When such a problem occurs, it often results in the person having to stop working. This can become an economic disaster for the worker and his/her family.
In addition to back problems, the workers who undertake heavy lifting at work may develop pains in knees and hips, and osteoarthrosis can develop. These kinds of problems tend to develop over time. The resulting health problems can be invalidating, and can make the worker’s life situation very difficult. Of course there are possible treatment methods, but these may be unavailable. Pain killers and medication to reduce inflammation can be expensive. Surgery is not always possible. The best thing is to prevent these diseases from developing in the first place.
Young woman carrying a 50 kg coffee sack on her shoulder, Tanzania. © B.E.MoenThere are different regulations and guidelines relating to lifting and carrying loads at work. Most specialists agree that heavy lifting can be defined as weights above 25 kg. If a load of this weight is carried, it is recommended that the transport distance should not exceed 20 m. on a level surface. When the weight-bearing happens on hills or staircases it should be limited to a height increase of 1 m.
These ‘rules’ are not very useful for health personnel, who often need to lift patients with a much higher weight. However, knowing this, underlines the importance of helping each other in the lifting, and to use technical devices if they are available.
These ‘rules’ are not very useful for health personnel, who often need to lift patients with a much higher weight. However, knowing this, underlines the importance of helping each other in the lifting, and to use technical devices if they are available.
Heavy lifting is:
– More than 25 kg
There are several ways to avoid having to carry heavy loads:
Using technical lifting equipment is an ideal solution, but it can be expensive and is not always available. Simple trolleys can be used when moving goods. The challenge is different in health care situation, when lifting and moving patients is needed. Technical equipment for lifting exists, but is not common in low-income settings.
A good method for reducing heavy loads in industrial settings is simply to avoid the problem altogether, by, for instance using a series of smaller loads. If producers of different goods use smaller loads instead of large ones, many back pain problems would disappear. In health care settings, this is not an option, and as mentioned earlier: Sometimes health care for heavy patients can be a major challenge.
Repetitive movements – assembly lines
This is an additional video, hosted on YouTube.
Workers at assembly line in a flower farm. © Gunhild Koldal/UiB
Factories often have assembly lines. They can increase effectivity in the production. For example, when large numbers of similar units, such as coffee bags, grain, rice, batteries or bundles of flowers are made and collected in packages for sale, an assembly line can be very useful. Much of the work related to such processes can be performed by machines, but very often there is a need for a person to perform a particular task or to undertake quality controls. Sometimes more complex montages of components can be performed using assembly lines, for instance during production of cellular phones. On such assembly lines, the workers put specific components on each phone. Afterwards, they send the phone along to the next worker who puts on another component and so on, until the phone is complete. Risk factors here are several:
-Position of the workers relative to the assembly line
-Space available for the worker
-The speed of the assembly line
-The possibility of breaks
Weight on the head
Carrying weight on the head is common in many parts of the developing world. It is an ancient tradition. Many women and men may be seen carrying burdens on top of their heads. It is observed in places where no inexpensive, or more efficient, ways of transporting workloads exist. Examples include women in India carrying baskets of bricks to workmen on construction sites. In East Africa, women can carry loads of up to 70% of their own body weight balanced on top of their heads. In some places, young women can carry 50 kg coffee sacs on their shoulders. What are the health risks related to this work? How much weight can a person carry without developing health problems?
Woman carrying a stone for building, India. © ColourboxExact answers are difficult to give, as research on this topic is scanty. It might be expected that carrying weight on the head could cause problems for the neck and back, such as micro fractures in the spine or nuclear prolapses. Such problems are serious and we need to avoid them.
Data-based guidelines might be a good starting point for establishing preventive measures. Based on studies from East Africa, it is suggested that up to 20% of the person’s body weight can be carried on the head with no extra exertion of energy. This means that for instance a person of 60 kg can carry 12 kg, or a man of 80 kg can carry 16 kg. However, researchers speculate that it is important to be trained from a young age in this kind of activity to be able to carry loads on the head without developing musculoskeletal problems. The method of carrying goods this way takes training time. This means that we should not only aim at reducing the actual amount of carried load to a maximum of 20% of the person’s weight. We should also take the time to gradually train the people who will perform this type of work.
We can carry 20%
of our own weight on the head
© University of Bergen/Author: B.E. Moen
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Better Workplaces in Low and Middle Income Countries
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Better Workplaces in Low and Middle Income Countries
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