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Repetitive strain injury advice for employers

Repetitive strain injury (RSI) is also known as work-related upper limb disorder. It can be a huge drain on your company’s productivity. Musculoskeletal problems, including RSI, are the biggest cause of ill health and sickness absence among staff in the UK,1 where they affect an estimated one million people.2

 

What is RSI?

RSI is a general term that refers to chronic pain in any part of your arms, including the elbow and wrist, hands, fingers, neck or shoulders. A chronic condition is one that lasts a long time, sometimes for the rest of the affected person's life. The pain results from repetitive movements or activities that require controlled posture. One of the most common causes is using computer and desk set ups that are not ergonomically sound.

 

Legalities

Criminal law

Every business has a responsibility to safeguard their employees from risk, and this includes the risk of RSI. There are a number of regulations that have implications for preventing RSI.

  • The Health & Safety at Work etc. Act (1974) and Management of Health and Safety at Work Regulations (1999) require employers to assess any risks to their staff and take reasonable steps to minimise them.3,4
  • The Health & Safety (Display Screen Equipment) Regulations (1992) were introduced under the Health & Safety at Work Act to enable the UK to implement the requirements of a European Directive. These regulations lay down a minimum requirement for work with display screen equipment (DSE). In this context DSE is most often the workstation including a visual display unit. These regulations form part of an employer’s health and safety duties.4
  • The Manual Handling Operations Regulations (1992) require that employers assess the risk for any manual handling tasks. The tasks must be assessed, looking at the load moved, environment and the person doing it to ensure that the risk involved is kept at a minimum.5

A civil action

The employer has a duty of care to employees to protect them from reasonably foreseeable injury or disease. The employer may be deemed negligent if there was knowledge that a problem existed or could exist and no action or insufficient action was taken.

 

Causes

There are a number of factors that put employees at risk of developing RSI. These include:

  • repetitive activities3,6
  • activities that involve force, such as lifting or carrying heavy objects3, 6
  • carrying out an activity for a long period of time without adequate rest periods3
  • poor posture or activities that require work in awkward or tiring positions3,6

Employees should ensure that the working environment (for example, desk layout or assembly line set-up), is designed so that staff can work with upright bodies and without having to twist or stretch.6 Twisting or stretching can increase the risk of them developing RSI or making an existing injury worse.6 For example, working with arms raised above the head or sitting in a fixed positions for long periods of time increases the risk of developing RSI.6

There are a wide variety of jobs that may lead to RSI, such as data-entry or typing, working on an assembly line or doing supermarket check-out work.2 Risk assessments can help to minimise the risks of RSI.

 

Risk assessments

Manual handling

Any manual handling the tasks that employees carry out must be assessed, looking at the load moved, environment and the person to ensure that the risk involved is kept at a minimum.5

Display screen risk assessments

Employers are required to analyse workstations in order to assess and reduce risks to staff.

Employers need to look at:7

  • the workstation including the equipment and the work environment7
  • the work carried out by the employee7
  • special requirements for the employee7

Staff should be asked to report any health problems. If any risks are identified, the employer must do all it can reasonably do to reduce them.

Limiting the risk of RSI in employeesShow all

Below are five steps towards minimising RSI risks in the work environment

Organisation Hide

Ensure good communication between employees and managers so that any problems are heard. Keep roles varied to help prevent fatigue and reduce stress by allowing workers to control how fast they work.5

Ergonomics Hide

Supply appropriate tools and equipment and ensure they are kept in good condition. Workers should be able to keep their wrists straight and their body upright while working.5,6 There should be enough space to work in, and training to adjust equipment to suit peoples specific needs should be offered.5

Information and individuals Hide

Employers should provide information about the risks of RSI, the importance of reporting problems, and making sure staff know how to adjust equipment to their individual size and shape.5 Provisions for people with disabilities must also be made.5

Environment Hide

Employees should do all they can to ensure that the work environment is as stress free as possible for workers. Appropriate clothing and equipment to reduce exposure to noise, vibration or glare should be supplied, and breaks from cold or hot environments should be scheduled.5

Health checks Hide

Employers should offer health checks if there is a type of illness associated with a job role.5 Staff need to know the symptoms of RSI, how to report them and what action will be taken. They need to be confident that positive steps will be taken and that reporting RSI issues will not be viewed in a negative light.5

 

Preventing RSI at workstations

The Health & Safety (Display Screen Equipment) Regulations (1992) include requirements to employees specific to workstations using display screens. These regulations also help limit the risk of RSI. These are described below.

Minimum workstation requirements

Workstations need to meet minimum requirements such as having adjustable chairs and appropriate lighting levels.7 These are described in detail in the schedule of The Health & Safety (Display Screen Equipment) Regulations (1992) and include screens, keyboards, desks, chairs, the work environment and software.8 These are listed in the box below.
 

Minimum workstation requirementsShow all

General comment Hide

The use as such of the equipment must not be a source of risk for operators or users.

Display screen Hide

The characters on the screen shall be well-defined and clearly formed, of adequate size and with adequate spacing between the characters and lines.
The image on the screen should be stable, with no flickering or other forms of instability.
The brightness and the contrast between the characters and the background shall be easily adjustable by the operator or user, and also be easily adjustable to ambient conditions.
The screen must swivel and tilt easily and freely to suit the needs of the operator or user.
It shall be possible to use a separate base for the screen or an adjustable table.
The screen shall be free of reflective glare and reflections liable to cause discomfort to the operator or user.

Keyboard Hide

The keyboard shall be tiltable and separate from the screen so as to allow the operator or user to find a comfortable working position avoiding fatigue in the arms or hands.
The space in front of the keyboard shall be sufficient to provide support for the hands and arms of the operator or user.
The keyboard shall have a matt surface to avoid reflective glare.
The arrangement of the keyboard and the characteristics of the keys shall be such as to facilitate the use of the keyboard.
The symbols on the keys shall be adequately contrasted and legible from the design working position.

Work desk. or work surface Hide

The work desk or work surface shall have a sufficiently large, low-reflectance surface and allow a flexible arrangement of the screen, keyboard, documents and related equipment.
The document holder shall be stable and adjustable and shall be positioned so as to minimise the need for uncomfortable head and eye movements.
There shall be adequate space for operators or users to find a comfortable position.

Work chair Hide

The work chair shall be stable and allow the operator or user easy freedom of movement and a comfortable position.
The seat shall be adjustable in height.
The seat back shall be adjustable in both height and tilt.
A footrest shall be made available to any operator or user who wishes one.

Environment

Space requirements Hide

The workstation shall be dimensioned and designed so as to provide sufficient space for the operator or user to change position and vary movements.

Lighting Hide

Any room lighting or task lighting provided shall ensure satisfactory lighting conditions and an appropriate contrast between the screen and the background environment, taking into account the type of work and the vision requirements of the operator or user.
Possible disturbing glare and reflections on the screen or other equipment shall be prevented by co-ordinating workplace and workstation layout with the positioning and technical characteristics of the artificial light sources.

Reflections and glare Hide

Workstations shall be so designed that sources of light, such as windows and other openings, transparent or translucid walls, and brightly coloured fixtures or walls cause no direct glare and no distracting reflections on the screen.
Windows shall be fitted with a suitable system of adjustable covering to attenuate the daylight that falls on the workstation.

Noise Hide

Noise emitted by equipment belonging to any workstation shall be taken into account when a workstation is being equipped, with a view in particular to ensuring that attention is not distracted and speech is not disturbed.

Heat Hide

Equipment belonging to any workstation shall not produce excess heat which could cause discomfort to operators or users.

Radiation Hide

All radiation with the exception of the visible part of the electromagnetic spectrum shall be reduced to negligible levels from the point of view of the protection of operators' or users' health and safety.

Humidity Hide

An adequate level of humidity shall be established and maintained.

Interface between computer and operator/user Hide

In designing, selecting, commissioning and modifying software, and in designing tasks using display screen equipment, the employer shall take into account the following principles:

(a) software must be suitable for the task;
(b) software must be easy to use and, where appropriate, adaptable to the level of knowledge or experience of the operator or user; no quantitative or qualitative checking facility may be used without the knowledge of the operators or users;
(c) systems must provide feedback to operators or users on the performance of those systems;
(d) systems must display information in a format and at a pace which are adapted to operators or users;
(e) the principles of software ergonomics must be applied, in particular to human data processing.

Source: The Health & Safety (Display Screen Equipment) Regulations (1992)

 

Breaks
Employers must set the routine of employees so that there are periodic interruptions or changes in activity to break up their time at the workstation.8

Eye tests
Employers must pay for regular eye tests for staff when requested. If glasses are needed to see the screen then the employer must pay for these also.8

 

Training and information
Employers must provide health and safety training to staff using the workstation, and be given information so that they use their workstation without putting themselves at risk of RSI. The employer should also describe how regulations have been met and how appropriate risk assessments were carried out.8

Further Information
For more information about controlling RSI risk in your workplace visit the Health and Safety Executive (HSE) website www.hse.gov.uk.

The HSE offer a range of guidebooks to help explain risk assessments and how to tackle risk in your workplace.

Next steps

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    Sources

    1. Table THORGP02. Health and safety executive. http://www.hse.gov.uk/statistics/tables/thorgp02.htm, accessed 8 January 2009
    2. Musculoskeletal disorders. Health and safety executive. http://www.hse.gov.uk/msd/index.htm, accessed 13 January 2009
    3. Aching arms (or RSI) in small businesses. Health and safety executive. http://www.hse.gov.uk/pubns/indg171.pdf, accessed 12 January 2009
    4. Musculoskeletal disorders - risk assessment. Health and safety executive. http://www.hse.gov.uk/msd/risk.htm, accessed 13 January 2009
    5. RSI Handbook. London Hazards Centre. http://www.lhc.org.uk/members/pubs/books/rsi/rsi_toc.htm, accessed 16 January 2009
    6. Preventing musculoskeletal disorders in the workplace. World Health Organization. http://www.who.int/occupational_health/publications/oehmsd3.pdf, accessed 16 January 2009
    7. Working with VDUs. Health and safety executive, 2006. http://www.hse.gov.uk/pubns/indg36.pdf
    8. Statutory Instrument 1992 No. 2792. Office of Public Sector Information. http://www.opsi.gov.uk/si/si1992/Uksi_19922792_en_1.htm, accessed 13 January 2009

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