Whenever workers move their bodies, they are at risk of a range of injuries. Movement-related injuries include: slips, trips and falls, strains and sprains (due to cumulative trauma or acute causes), repetitive motion disorders, hand injuries, and knee problems.

Data from the Bureau of Labor Statistics (BLS) on lost work-day injuries for 1996 supports the prevalence of movement-related injuries.

Added together, movement-related injuries accounted for almost two-thirds (65.6 percent) of all lost-time injuries. Sprains and strains accounted for 43.6percent of all lost-time injuries.

Numerous activities can result in movement-related injuries, including:

  • Handling equipment at arm's length;
  • Going down steps and stairs, especially while carrying objects;
  • Crossing slick, uneven, or cluttered decks;
  • Torquing levers and wrenches or turning pieces of equipment;
  • Carrying heavy or awkward loads;
  • Jumping, including swing rope transfers;
  • Working more than a few meters off the ground;
  • Lifting, particularly out of containers or overhead.

Traditional approaches

Many companies have attempted to prevent each type of accident separately. In other words, a company might develop an initiative to prevent slips and falls, launch another program to reduce strains and sprains, and yet another against hand injuries.

Traditional strategies for preventing movement-related injuries have included:

  • "Write it off." This assumes that injuries are not preventable, simply a cost of doing business.
  • Preventive maintenance and housekeeping. However, there are worksites where due to the nature of the work certain hazardous conditions are inevitable.
  • Tool design and redesign. This focuses on repositioning targeted work, adjusting the height of a workstation, or making the work mobile.
  • Training and education. Most movement-related training is classroom-based and focuses on teaching anatomy and physiology, which experience shows seems to be of more interest to those who have already been injured.
  • Selective hiring. Screening out workers who are "more prone" to a movement injury can violate laws such as the Americans with Disabilities Act (ADA) or bargaining unit contracts.
  • Medical management strategies. Optional/light duty, work hardening and return to work, are more treatment-oriented than prevention-oriented.

Though each of these approaches can be incorporated into a systematic safety plan, they have not really stemmed the tide of movement injuries. So what can organizations do, when they are faced with "subjective" injuries such as sprains and strains that are more difficult to diagnose than "objective," easily visible injuries such as fractures or abrasions?

Help people make smart moves

The key to reducing movement injuries is to proactively focus on movement safety. Adopt a human factors-oriented approach putting workers in control of their own movement safety - at work and at home. You can adopt this approach when:

  • Work environments are outdoors, involve multiple locations, or are otherwise uncontrollable.
  • Capital expenditure budgeting may not allow for instant full-scale implementation of mechanical aids.
  • It may not be fiscally possible to shut down an around-the-clock running plant to implement a safety redesign.
  • There are multiple sources of exposure at home, where sources of cumulative trauma can mount during hobbies and personal activities off-work.
  • Redesign and retooling must be complemented by training employees on how to adjust these new designs to their "personal ergonomics," and to use good attention and judgement.
  • Heightened performance, not just injury prevention, is an objective.

Strategy for movement safety

1. Take administrative control.See the real nature of the problem. Review medical records, look for trends - are certain sites, shifts, tasks more vulnerable? Check organizational policies and procedures to see if they support or discourage movement safety.

2. Modify the environment. Reduce distracting signs, put strong lighting into place, make standard ergonomic modifications, build major ergonomic design changes into plans for new facilities. Notice where appearance has overshadowed movement safety (such as hand rails that are beautiful, but too thick to be grasped by most people).

3. Place people in control. Boost their awareness of the benefits of movement safety - both at work and at home. Help them acknowledge personal contributing factors over which they have control. Provide training that helps them redirect forces more safely and boosts balance and usable strength. Help them learn how to recover from potential movement injuries as well as how to minimize damage from unpreventable situations.

4. Recover and reinforce. Use a wide range of audits - environmental, attitudinal, behavioral, procedural, statistical - to monitor progress. Encourage ongoing attention through coaching and reinforcement systems.

Safer behavior

If movement safety has a strong behavioral component, how can you realistically change individual worker behavior? There are four ways to accomplish this:

  • Enlist positive motivation.

    Because it's difficult to force safety on anyone, it is essential to make safety something employees want to do, rather than just have to do. The key is to show safety techniques that will help improve performance in their favorite sports and activities as well as show them how to be safer at work.

  • Make it practical.

    It is critical to teach employees how to do their work tasks safely. That means showing rail workers how to open bulkhead doors easily; assemblers how to put together parts with minimal strain on their wrists; delivery personnel how they can keep their footing working outdoors; distribution employees how to maneuver racks of product positioned over their heads; and various workers how to lift specific loads without wearing down their body.

  • Build personal control.

    Help all employees become the safety director of their own life. Remind them of the control they really have in movement safety.

  • Deputize the team.

    Finally, spread the message throughout your organization. Get everyone involved in your prevention efforts.

Robert Pater is director of Portland, Ore.-based Strategic Safety Associates (www.movesmart.com). The MoveSMARTR system has been employed by companies worldwide. He can be reached at: (503) 977-2094.

Environmental factors:

  • Temperature
  • Humidity
  • Moving across distances
  • Lighting
  • Noise
  • Working in confined spaces
  • Poor grips on handles
  • Surfaces: slippery, uneven, loose, hard
  • Vibration
  • Obstacles
  • Loads with unstable center of gravity (carrying bulky, liquid materials)
  • Awkward positions
  • Heavy work
  • Frequent bending, twisting
  • Forceful moves
  • Repetitive work
  • Stationary design
  • Excessive weight, asymmetric size of loads
  • Lack of adjustable workstations
  • Machine pacing

Human factors:

  • Not aware of hidden risks
  • Poor balance
  • Smoking
  • Pre-existing injuries
  • Poor body mechanics
  • Condition (out of shape, obese, inflexible)
  • Footwear, clothing
  • Not warming up
  • Uncorrected or obscured vision
  • Medication (even over-the-counter medications have some side effects, affecting balance)
  • Sex (women are more prone to knee injuries)
  • Aging
  • Attitude
  • Experience
  • Strength (especially abdominal)
  • Height
  • Fatigue
  • Unmanaged stress
  • Lack of attention
  • Rushing

Organizational/administrative factors:

  • "Write-it-off" attitude
  • Unrealistic expectations of workload
  • High pace
  • Forced overtime
  • Poor medical management
  • Blame-oriented accident investigations
  • Ineffective or non-existent training
  • Lack of strong communication with employees
  • Not involving workers in safety
  • Supervisors not effective, not trained, not motivated to promote safety
  • Audits that are poorly done, limited or absent
  • Negative organizational safety motivation
  • Management not actively involved in safety