What is back pain and musculoskeletal disorders?

Back pain is part of a group of health conditions called musculoskeletal disorders. This is a term used to describe strains, sprains and overuse problems affecting the body’s muscles, joints and nerves. The back, neck, shoulders and upper limbs are particularly at risk. Problems can include everything from backache and slipped discs to upper limb disorders that cause pain, numbness, swelling and tingling in the hands and wrists. These conditions are often caused or made worse by work activities.

Musculoskeletal problems are the most common form of work related ill health in Great Britain. It is estimated that 4.5 million working days are lost each year due to back pain alone.

There has been research carried out to look at the musculoskeletal health of cleaners. This research found that:

• 74% of cleaners had experienced muscular aches, pains and discomfort during the previous 12 months.
• 53% of cleaners had sought medical advice for these aches and pains.
• 23% of cleaners had been absent from work as a result of aches and pains within the previous 12 months.

Recent accidents to cleaners reported to the Health and Safety Executive (HSE) show that approximately 2700 cleaners per year are involved in accidents that cause them to be absent from work for more than 3 days. 34% of these reported accidents are as a result of moving and handling.

Why are cleaners at risk?

Cleaning work is demanding and labour intensive and changes within the industry means that cleaners increasingly work under time constraints. Many tasks involve heavy manual work, putting strain on the heart, muscles and other tissues.

The main causes of aches, pains and discomfort in cleaners are:

• Manual handling - This includes lifting, pulling, push/pull, carrying and holding loads. This can include heavy equipment and items such as polishers, vacuums, ladders, furniture and laundry.
• Awkward postures – This includes reaching, stretching, crouching, and kneeling. Work can involve these postures being undertaken repeatedly over duration and while exerting force.
• Work organisation - This included high work speed, time pressures, poor training and often little consideration on how cleaning can be done.
• Using vibrating equipment – This equipment can be heavy and requires forceful exertion, it can also be poorly maintained and less well designed.

Recognising a problem

There can be indicators of musculoskeletal problems in the workplace. These include:

• An increase in sickness absence.
• Reports of pain and discomfort from cleaners.
• Reports from safety representatives.
• Low motivation and dissatisfaction of cleaners; not wanting to do certain tasks.
• Cleaners adapting their own equipment.
• Cleaners wearing splints, bandages or back supports.

Managing the risk

Musculoskeletal disorders, such as back pain, have a significant impact on the lives of those involved. Employers have a legal duty to manage the risk of musculoskeletal disorders which their workers are exposed to. However, accident and ill health cost employers’ time and money so it also makes good business sense to properly manage the risk.

Before anyone can start to control the risks in the workplace they need to know what they are, how serious they are and who is exposed to them. The first step to managing the risk is through risk assessment. This should be carried out to decide if there are enough precautions in place or if more needs to be done to prevent harm.

An assessment of the risk of musculoskeletal problems in cleaners should take account of:

• All cleaning tasks.
• The individual capacity of the cleaner.
• The loads involved.
• The work environment.

This assessment should also consider the main risk factors such as manual handing, awkward postures, work organisation and vibration from equipment.

Hazardous activities should be avoided if it is reasonably practicable (unless the cost of avoidance is grossly disproportionate to the risk).

In practice, employers have found that initiatives for reducing musculoskeletal problems in the workplace are most successful if they involve employees and their representatives working together on risk assessment and investigating accidents.

What help is available

The booklet ‘Caring for Cleaners’ has been produced by HSE specifically to help the cleaning industry manage the risk of musculoskeletal disorders. This publication gives guidance and case studies on how to prevent and manage the risk of musculoskeletal disorders. It also provides useful tips and ideas along with checklists to help with risk assessments.

More information on musculoskeletal disorders can also be found on the HSE's MSD website. This includes a Manual Handling Assessment (MAC) tool and details of the recent Better Backs campaign which was run in October and November.

Working together

The Cleaning Industry Liaison Forum is a working group with representatives from the industry’s trade associations, employers, trade unions, the Health and Safety Executive, local authorities and trade unions.

This forum is chaired by HSE and has agreed the health and safety priorities for the industry. Musculoskeletal disorders are one of these priorities where further work is planned. 

HSE launched the Better Backs campaign in early 2006. To find out more about how to tackle back pain or when to visit the GP, visit the website or you can call the HSE Infoline on 0845 345 0055.

Reference:

• Caring for cleaners is available from HSE Books, PO Box 1999, Sudbury, Suffolk CO10 2WA. Tel: 01787 881165