Is Hazardous Manual Handling the only Enemy?
The consequence of workplace musculoskeletal disorders (MSD’s) is well documented, with significant social and economic burdens for the injured worker, employer and health care system.
The gold standard approach for preventing MSDs should focus on the effective implementation of a risk management approach which considers all possible contributing hazards that may contribute to the development of MSDs.
In many instances though, the risk management approach is often only directed toward eliminating or reducing physical hazards directly related to the inherent characteristics of manual tasks. For most people, targeting control measures towards physical task characteristics seems intuitive. Reducing a worker’s exposure to force, awkward posturing and repetitive or sustained movements will help reduce physical stress on the body and help curtail injury.
Research, however, suggests that workplace psychosocial and organisational factors also present as significant risk factors for work related MSDs. Considering this, effective risk management for the prevention of MSD’s should not just focus on physical hazards but should also consider, identify, assess and control workplace psychosocial and organisation hazards that are known to contribute to the onset of MSD’s .
By definition, work-related psychosocial risks concern aspects of the design and management of work and its social and organisational contexts that have the potential for causing psychological or physical harm.
When it comes to understanding MSDs, these risk factors are often less tangible, less obvious, and are often not considered or easily accepted by workplaces as potential hazards for MSDs. Despite this, research highlights workplace psychosocial, organisational and cultural factors are independent risk factors for the development of MSD’s .
Examples of workplace psychosocial hazards that can contribute to MSDs include: time pressures; cognitive demands; hours of work; poorly defined work roles; poorly managed change; poor conflict management, lack of job control; lack of supervisor and/or co-worker support; organisational injustice; and inadequate reward and recognition.
Such workplace psychosocial risk factors may not only lead to occupational stress, but can promote a wide variety of mental and behavioural responses within a worker. A growing body of evidence now exists, highlighting how occupational stress can increase a workers risk of tissue damage and pain.
In the case of work related low back injuries, evidence highlights that poor supervisor and manager support, lack of social support from colleagues, low job control and poor job satisfaction are all independent risk factors for low back pain. These have also been shown to be causative to work related upper limb MSDs, as has a lack of task variation, job insecurity and working under time pressure and deadlines.
Similar to managing physical risk factors, a risk management approach to psychosocial hazards should be employed. The People at Work Project, a collaboration between the University of Queensland, The Australian National University, Workplace Health and Safety Queensland, WorkCover NSW, WorkSafe Victoria, Comcare, Safe Work Australia, and BeyondBlue, has developed People at Work, a psychosocial risk assessment tool which helps business understand and manage their psychosocial risks.
It promotes appropriate prioritisation of risks and provides direction for the implementation of appropriate prevention strategies to help create psychologically healthy and safe workplaces. Such strategies may need to be tailored at the job design, organisational or individual level.
Job design strategies might focus on changes to rostering, shift patterns, job rotation etc. Effective controls at this level may not only help reduce psychosocial hazards related to performing tasks but may also have a direct effect on reducing exposure to hazardous manual tasks.
At the organisational level, strategies to foster an improved WHS culture should be considered. This may include greater worker consultation in health and safety issues or ensuring supervisors and managers set the standard by modelling correct processes and procedures, whilst also employing transparent honest communication.
Regardless of where the intervention is directed, the success of controlling psychosocial risk is contingent on several variables:
Overt and visible senior management involvement is required. This can signal the importance of the process and can impart a sense of ‘support’ for the work force. This may include senior management being active in WHS committees or attending toolbox meetings. Direct and consistent organisational communication is also required to ensure that management commitment to addressing psychosocial issues is conveyed, and to help promote worker engagement. This may be achieved through focus groups, noticeboards, broadcast emails and management participation in WHS committees.
Furthermore, supervisor commitment and engagement is needed. Supervisors are often the direct link between workers and senior management. Supervisors who commit to a risk management process, role model correct processes and procedures, and who are approachable, supportive and non-judgemental, not only instil a positive health and safety culture, but will often be the first person to identify psychosocial risks for individual workers, or for the workplace as a whole.
Finally, worker participation and engagement are crucial. This can foster a greater sense of ‘work control’ and ‘support’ and may in fact assist in reducing the very stressors that contribute to psychosocial hazards. Furthermore, worker input ensures any interventions are specifically tailored to workers concerns.
Although these variables have been discussed in the context of effective management of psychosocial risk, they are equally important in the risk management process for hazardous manual tasks. The two are not mutually exclusive.
In summary, effective risk management of MSDs in the workplace is complex and requires more than just consideration of hazardous manual tasks. Understanding the nature and effect of psychosocial risk factors is critical. Furthermore, implementation of an effective risk management program that considers all possible risk factors requires strong leadership and workforce engagement – from front line workers through to senior management.
 Marras, W.S., Cutlip, R.G., Burt, S.E., Waters, T.R. Epidemilogical evidence on relative influence of workplace psychosocial versus physical factors on contribution of MSDS. Applied Ergonomics. 2009 Jan;40(1): pp. 15-22
 Johnston, J.M., Landsittel, D.P., Nelson, N., Garnder, L,I., Wassell, J.T. Stressful psychosocial work environment increases risk for back pain among retail material handlers. American Journal of Industrial Medicine. 2003 Feb;43(2):179-87