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Upper limb disorders

Employers must protect workers from the risks of developing upper limb disorders (ULDs) caused by work. Upper limb disorders include aches and pains in the shoulders, arms, wrists, hands and fingers, as well as in the neck. They can be caused or made worse by work, for example on assembly lines, in construction, meat or poultry processing and in work with computers.

Protect your workers

You must:

Consult and involve your workers and make sure they know how to report any injuries.

Causes of upper limb disorders at work

Upper limb disorders are more common in tasks at work that involve:

Other things that may have an influence are:

Workers may be more likely to suffer upper limb problems if there is more than one risk factor in their work.

Symptoms

Your workers may have symptoms in their upper limbs such as:

A number of disorders can affect upper limbs, such as:

Some of these are reportable.

Encourage workers to report any signs and symptoms at an early stage, before they become more serious, so you can take steps to reduce the risk. People with ULDs usually completely recover if the problem is recognised early and treated appropriately.

If your workers have symptoms, consider taking advice from an occupational health provider on a worker’s fitness for work and any restrictions or adaptations to their work.

Assess the risk

As an employer, you have a duty to assess risks in your workplace:

Ask workers about any risks from their work – often they may be able to suggest solutions.

You can use HSE’s simple filter PDF to help you identify jobs with higher potential risks that are worth looking at in more detail.

Note that the 2-hour period in the filter is not a fixed limit and it should be applied taking account of the task and the person carrying it out. For example, if there is a lot of repetition and/or force required for a period shorter than 2 hours, or the worker has a medical condition affecting their neck or upper limbs, you should do a full risk assessment.

If the risk filter indicates you need to do a more detailed assessment, the Assessment of Repetitive Tasks tool (ART) lets you assess individual risk factors and prioritise your control measures using a colour-coding and scoring system. The scores provide clear action levels as a result of your assessment. However, the ART tool may not amount to a full risk assessment, as some aspects, such as individual factors, are not covered.

You can use HSE’s ULDs risk assessment worksheets PDF from Upper limb disorders in the workplace to carry out a more detailed assessment than the ART tool provides. The worksheets help you to analyse the risk factors in your workplace in more detail and include space to note down problems, causes and possible control options.

If items weigh more than 8 kg and the task involves manual handling, consider using the MAC tool.

Psychosocial factors

As well as considering the physical aspects of the work, you also need to take account of psychosocial risk factors. These may affect workers’ psychological responses to their work and workplace conditions. Examples are high workloads, tight deadlines and lack of control over the work and working methods, which may make people more likely to develop and report ULDs.

Reduce the risk of upper limb disorders

You may not be able to prevent all cases of upper limb disorders, but there are things you can do to help prevent symptoms happening or getting worse, whether they are caused by or made worse by work.

The most effective ways to avoid or reduce the risk are:

If you cannot eliminate the risk:

Test any changes on one or two workers before making changes for everyone and monitor regularly to make sure your controls are working.

There are more specific examples of how to reduce the risk.

If a task is causing or contributing to a ULD, the worker may need to stop doing that task for a while. Temporary modified duties could help them recover.

The NHS has evidence-based advice about upper limb disorders at work and there is other useful advice for workers.

The law

There are no specific regulations about managing the risks of upper limb disorders, but employers have legal duties under the Health and Safety at Work Act and the Management of Health and Safety at Work Regulations. The Health and Safety (Display Screen Equipment) Regulations and the Control of Vibration Regulations may also apply.

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