LECTURE 18:

WORK-RELATED MUSCULOSKELETAL DISORDERS

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Musculoskeletal:
Skeletal muscle + Bone structure + Soft Tissues

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Musculoskeletal
1. 2. 3. 4. 5. 6. 7. 8. Skeletal muscle Bone structure Joint Ligament Tendon Bursa Related blood vessels Nerve

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Functions

Muscle contract and stretch

Force on bone and joints

Movement/ Posture/ Physical exertion

TASK

Functions

1. Body movement and posture: Integration between - Muscle-joint-bone

2. Voluntary process through nerve innervations and electrical stimulation

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Muscles capability

LIMITED:Mental
Strength/Power Duration Frequency

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Physiology requirements for action

Basic elements Energy: glucose, protein, fat and oxygen. Bloos supply. Minerals: Calsium (Ca), Sodium (Na) and Potassium (K) Nerve supply Mechanical Contraction: dynamic or static. Contraction strength: Number of activated motor unit; cross section; and length (limited). Tetanus

METABOLIC Temperature Lactic acid

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Contraction-Stretch mechanism
Characteristics 1. 2. 3. 4. 5. 6. 7. Contraction Length Tension Blood supply Oxygen consumption Metabolic product Duration of activity Static (Isometric) Continuous Not change Not change Less Less Lactic acid Short Dynamic (Isotonic) Repetitive Change Change Increase Increase CO2 + H2O Long

8.

Example

Holding
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Walking
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Work Related Musculoskeletal Disorder (WRMSDs)

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Structures involved:
1. 2. 3. 4. 5. 6. 7. 8. Skeletal muscle Bone structure Joint Ligament Tendon Bursa Related blood vessels Nerve

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General Symptoms and Signs

LEVEL 1: Early stage Pain Aching Discomfort LEVEL 2: Intermediate Numbness Prolong symptoms in level 1.

Inflammation Disturb movement: weakness/stiffness

LEVEL 3: Disabilities Prolong level 1 and 2; Difficult to recover Permanent disabilities

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Human susceptibility HUMAN AT WORK

WRMSDs

HAZARD

Chronic Tissue Inflammatory and Degeneration Acute Injury

WORKSTATION

RISKS EXPOSURE

Physical Force
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Source of Hazards (Ergonomic Components)

WORK ORGANIZATION Physical Environment Workstation
Tools/ Machine

Task

Human

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Contributing factors
Workplace designs are mismatched to the human capabilities, limitation and other characteristics

1. 2. 3. 4. 5. 6.

Contributing factors Awkward postures Repetitive motions Forceful exertions Pressure points (e.g., local contact stress) Vibration Environent: High/cold temperature
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1. Awkward postures
Repeated or prolonged: Reaching Twisting Bending Working overhead Kneeling Squatting Holding of fixed positions Pinch grips
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Adverse effects
Increasing the exertion on smaller muscle groups Impairs blood flow and
Increases the rate of fatigue and weakness
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2. Repetitive Motions
the same types of movements are performed over and over again using the same muscles, tendons, or joints.
Examples of jobs - machine-controlled pace include working on assembly, packaging, or quality-control lines.

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3. Forceful Exertions

Exerting large amounts of force can result in fatigue and physical damage to the body.

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The amount of force depends on a combination of factors:

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Load shape, weight, dimensions, and bulkiness Grip type, position, and friction characteristics Amount of effort required to start and stop the load when moving it Length of time continuous force is applied by the muscles Number of frequencies the load is handled per hour or work shift Amount of associated vibration Body posture used Resistance associated with moving the load. Duration of the task over the work shift Environmental temperature Amount of rotational force

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4. Pressure Points (local contact stress)

Pressure points - the body pressing against hard or sharp surfaces. Certain areas of the body - susceptible because nerves, tendons, and blood vessels are close to the skin and underlying bones include the sides of the fingers, palms, wrists and forearms, elbows, and the knees.

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5. Vibration
Part or whole body expose to continuous or of very high intensity of frequency. Example: Hand-arm vibration - such as sanders, grinders, chippers, routers, impact guns, drills, chain saws, and circular saws.

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Adverse effects
fatigue, pain, numbness, tingling, increased sensitivity to cold, and decreased sensitivity to touch in the fingers, hands, and arm.
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6. Environment
High/cold temperature of workstation. Poor lighting/vision.

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Risk Impact

WRMSDs
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WMSDisorders
Common Diseases:
1. Ligament/tendon injuries. 2. Backbone(vertebrae): Acute/Chronic backache. 3. Wrist and hand: Carpal Tunnel Syndrome. 4. Tendon: Tendinitis/Tenosynovitis. 5. Bursa: Bursitis 6. De Quervains. 7. Thoracic Outlet Syndrome. 8. White hand syndrome.
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1. Ligament/tendon injuries
Rani Lueder, CPE. Humanics ErgoSystems, Inc.

Healthy tendon

Damaged tendon

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2. PID

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3.. Carpal Tunnel

Carpal Tunnel Syndrome When lining around tendons is inflamed, there is less space for the nerve and it becomes compressed.

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4. Tendonitis
Tendonitis or tenosynovitis
is an inflammation of the tendon or tendon sheath

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5. Bursitis
Bursitis
bursa becomes inflamed due to excessive friction or rubbing.
A bursa is a sac like cavity filled with slippery fluid found between tendons and bony prominencereduces friction

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Other related diseases

1. 2. 3. 4. 5. Varicose vein or ulcer dilatation of vein. Osteoarthritis joint damage. Peripheral arteritis. Neuropathy. Etc.

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Implications
Individual: Sickness absenteeism; Disabilities; Loss of job. Organization: Image; Productivity: loss competent person, retraining; High cost for long term treatment such as rehabilitation. Government: SOCSO reclamations.
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Thank you

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