Manual handling basic awareness course

Learning outcomes

At the end of this course, learners will know:

 What manual handling is.

 Key responsibilities.
 The anatomy of the spine.
 Different injuries caused by poor manual handling. 
 How to evaluate a manual handling task using TILE.
 Safe lifting and handling technique.

What is manual handling?

The UK HSE describes manual handling as:

The transporting or supporting of loads, including lifting, lowering, pushing, pulling,

carrying or moving loads. A load may be either inanimate, for example a box or a
trolley, or animate, for example a person or an animal.

The size of the problem

Globally, millions of people suffer from work related injuries caused by poor manual
handling techniques. The best way to avoid this is to ensure you and your colleagues
are trained and understand best practices when undertaking any manual handling task.

In the UK, manual handling is the second biggest accident type reported by employers.

When we consider manual handling we often think of a large, heavy, strenuous task,
such as carrying a solid piece of furniture up a flight of stairs. Whilst this has some
obvious risks, it might surprise you to learn that relatively small light objects, being
moved by a stationary person a seemingly short distance with a repetitive action, also
has the potential to cause harm.

Everybody has different tolerances, which it is why it is so difficult to prescribe set

minimum or maximum limits for weight, size, distance etc. that someone must adhere
to, when undertaking a manual handling task, as a number of seemingly insignificant
factors have the potential to cause harm to one person but not another, specifically
when it comes to manual handling. 
Responsibilities

Employers
The UK Manual Handling Operations Regulations 1992 require employers to:
 Avoid the need for hazardous manual handling, ‘so far as is reasonably
practicable’.
 Assess the risk of injury from any hazardous manual handling that can’t be
avoided.
 Reduce the risk of injury from hazardous manual handling, ‘so far as is
reasonably practicable’.
In order to do this, employers should undertake a risk assessment of tasks that involve
manual handling.
Employees involved in the tasks or those with a thorough practical understanding of the
tasks should be involved in the risk assessment.
Employers must also provide training for employees that undertake any manual
handling tasks, such as this basic awareness course.  The training should include:
 Risk factors and how injuries can occur.
 Safe manual handling technique.
 Safe use of lifting and handling aids.
Employees
Employees also have responsibilities under Health and Safety law. The UK Manual
Handling Operations Regulations 1992 state:
‘Each employee while at work shall make full and proper use of any system of work
provided for his use by his employer’.
Under the Health and Safety at Work, etc. Act 1974, employees must also:
 Take reasonable care for their own health and safety and that of others who
may be affected by their activities.
 Co-operate with their employer to enable them to comply with their health and
safety duties.

The ILO and OSHA also provide guidance for manual handling

International Labour Organisation (ILO)

If employers require workers to lift something manually, every effort should be

made to:
 Reduce the amount of twisting, stooping and reaching.
 Avoid lifting from floor level or above shoulder height, especially heavy loads.
 Adjust storage areas to minimize the need to carry out such movements.
 Consider if the carrying distance can be minimized.
 Assess the weight to be carried and whether the worker can move the load
safely or needs any help - maybe the load can be broken down to smaller,
lighter components.
Always take into account:
 Individual capability
 The nature of the load
 Environmental conditions
 Training
 Work organisation

Occupational Safety and Health Administration (OSHA)

The USA's OSHA also provide guidance for manual handling tasks.
In addition to training and education, applying general safety principles - such as proper
work practices, equipment, and controls - can help reduce workplace accidents
involving the moving, handling, and storing of materials. Whether moving materials
manually or mechanically, your employees should know and understand the potential
hazards associated with the task at hand and how to control their workplaces to
minimize the danger.
Because numerous injuries can result from improperly handling and storing materials,
workers should also be aware of accidents that may result from the unsafe or improper
handling of equipment as well as from improper work practices. In addition, workers
should be able to recognize the methods for elimination - or at least minimizing - the
occurrence of such accidents. Employers and employees should examine their
workplaces to detect any unsafe or unhealthful conditions, practices, or equipment and
take corrective action.
Source: Materials Handling and Storage - OSHA 2236 – 2002 (Revised).
Anatomy

The anatomy of the spine

The structure of the spine

The anatomy of vertebrae

The vertebrae have discs between them to prevent the bones rubbing together, which
would not only be very painful, but would cause severe damage to the bones.
Together, the vertebrae and discs support the weight of the body.  
Lifting objects puts additional pressure on the spine by way of additional weight.
 Vertebral body: Solid bones which have attachments for muscle/tendons.
 Disc: Small amounts of cartilage which act as shock absorbers to the spine. 
 Muscles and tendons: Which are connected to the vertebrae.
 Spinal cord: Which connects the brain to the rest of the body and runs down
through the vertebrae, between the discs and the muscles.
 Nerve root: Receives and distributes sensory information.

When the spine is in its natural position, there is equal pressure on all of the discs.
When you bend or twist, the vertebrae move in the direction you’re moving in. As a
result, the discs are no longer flat and are subject to unequal pressure.
Poor Posture

The causes of back pain are many and various, but without exception, it will be
aggravated by poor posture, inadequate support and poor working practice. In other
words, bad ergonomics. It is important to maintain the correct spinal posture (the 'S'
curve) shown in this diagram. Kyphosis and lordosis are also referred to as curvature of
the spine.

Spinal effects of lifting whilst maintaining good posture

Manual handling capacity

When carrying a load, as it’s moved away from the body, increased levels of stress are
put on the lower back, regardless of the handling technique used.
As a rough guide, holding an object at arms length increases around five times the
stress on the lower back as opposed to holding it close to the body.
The image shows how individual handling capacity reduces as the load is held further
away from the body.

Manual handling capacity

In this diagram, the spine is leaning over, though in a straight line. With the weight
putting stress on the spine. The muscles now have to work to stop the spine bending
(muscles can only contract, not expand).
The strain on the muscles and tendons can be more than they can take without tearing,
and stress damage can accumulate at a rate faster than it can be repaired.
This can cause acute back pain, which may be triggered at a later stage by some
unrelated and even trivial movement, disguising the real cause.
The effects of poor lifting technique on the spine

The diagram shows poor lifting technique which can result in injury to the lower back.
The spine is leaning over and bent, stretching the muscles and tendons and squeezing
the discs. The squeezing of the discs raises the pressure inside even higher, making
them prone to bursting (this is know as a 'herniated', 'prolapsed' or 'slipped' disc).
The escaping bubble of disc wall can then press on the spinal cord, creating pain that is
often felt in some other part of the body ('referred pain' called sciatica). The discs
themselves have few nerves, so you can't feel this damage happening until it's too late.
Herniated discs will normally repair themselves, as long as the stresses that caused the
damage are not being repeated.
Types of injury

Muscle and ligament injuries

We all have individual capabilities and have a capacity for lifting.  If we attempt to lift a
load outside of that capacity, then there is a risk of tearing or pulling muscles and
ligaments in the back.
By keeping your back straight and using the correct techniques when manual handling,
you will find it almost impossible to tear or pull one of these muscles and ligaments.

Types of disc injury

Other types of manual handling injury
How to prevent manual handling accidents

If the manual handling task cannot be avoided, then the following applies:
 Read the risk assessment - ask questions if anything is unclear.
 Use lifting aids such as trolleys or sack barrows where appropriate.
 Adopt the correct handling position.
 Don't lift anything above the UK's HSE recommended lifting weight guidelines
.
 Split heavy loads.
 Carry out a multi-person lift.
 Ensure the area is clear of trip and slip hazards.
 Be aware of moving vehicles.
Evaluate the manual handling task
When planning a manual handling task, you should always refer to your company's
policies and safe systems of work.
TILE is used as an acronym to help you remember the things you need to think about
before undertaking a manual handling task:
 Task - what is it you're doing?
 Individual - who is doing it?
 Load - what are you handling?
 Environment - where are you doing it?
Safe manual handling
The UK HSE gives some simple things to do before and during the lift/carry
 Remove obstructions from the route.
 For a long lift, plan to rest the load midway on a table or bench to change grip
.
 Keep the load close to the waist. The load should be kept close to the body
for as long as possible while lifting.
 Keep the heaviest side of the load next to the body.
 Adopt a stable position and make sure your feet are apart, with one leg
slightly forward to maintain balance.
UK HSE steps to safe lifting
Think before lifting/handling. Plan the lift. Can handling aids be used? Where is the
load going to be placed? Will help be needed with the load? Remove obstructions such
as discarded wrapping materials. For a long lift, consider resting the load midway on a
table or bench to change grip.
Adopt a stable position. The feet should be apart with one leg slightly forward to
maintain balance (alongside the load, if it is on the ground). Be prepared to move your
feet during the lift to maintain your stability. Avoid tight clothing or unsuitable footwear,
which may make this difficult.
Get a good hold. Where possible, the load should be hugged as close as possible to
the body. This may be better than gripping it tightly with hands only.
Start in a good posture. At the start of the lift, slight bending of the back, hips and
knees is preferable to fully flexing the back (stooping) or fully flexing the hips and knees
(squatting).
Don't flex the back any further while lifting. This can happen if the legs begin to
straighten before starting to raise the load.
Keep the load close to the waist. Keep the load close to the body for as long as
possible while lifting. Keep the heaviest side of the load next to the body. If a close
approach to the load is not possible, try to slide it towards the body before attempting to
lift it.
Avoid twisting the back or leaning sideways, especially while the back is
bent. Shoulders should be kept level and facing in the same direction as the hips.
Turning by moving the feet is better than twisting and lifting at the same time.
Keep the head up when handling. Look ahead, not down at the load, once it has been
held securely.
Move smoothly. The load should not be jerked or snatched as this can make it harder
to keep control and can increase the risk of injury.
Don't lift or handle more than can be easily managed. There is a difference between
what people can lift and what they can safely lift. If in doubt, seek advice or get help.
Put down, then adjust. If precise positioning of the load is necessary, put it down first,
then slide it into the desired position.
Correct lifting technique
Lifting limits

Lifting aids
 Consider whether you can use a lifting aid, such as a forklift truck, electric or
hand-powered hoist, or a conveyor.
 Think about storage as part of the delivery process – maybe heavy items
could be delivered directly, or closer, to the storage area.
 Reduce carrying distances where possible.
 You need to be trained to use lifting aids and follow safe systems of work.
You have now completed this e-learning course and should understand:
 What manual handling is.
 Key responsibilities.
 The anatomy of the spine.
 Different injuries caused by poor manual handling.
 How to evaluate a manual handling task using TILE.
 Safe lifting and handling technique.