Health and Safety ReportVolume 16, Issue 01

Working to meet a tight deadline, Kerry has been painting the interior of a new home without taking regular breaks. Painting involves a number of hand and body positions: bending, stretching, wrist shaking, dabbing motions and brushing actions. Working through the pain of hand cramping and awkward positions can lead to painful repetitive strain (RSIs) injuries for Kerry. He might not know it but these common workplace injuries can even be permanent.

Repetitive Strain Injury (RSI) Awareness Day is February 29^th. As the only “non-repetitive” day of the year, it’s the ideal date to devote to raising awareness of repetitive strain injuries. This year RSI day is on Wednesday, February 28^th.

Repetitive strain injuries, also known as musculoskeletal disorders (MSDs), are a serious workplace concern causing pain and suffering for many workers and are the most frequent type of lost-time injury and the single largest source of lost-time cost in Canada.

Causes

Many work tasks require repetitive movements. These can be particularly hazardous when they involve the same joints and muscle groups over and over and when we do the same motion too often, too quickly, and for too long. Gripping, holding, bending, twisting, clenching, and reaching – these are ordinary movements that we naturally make every day. What can make them hazardous is the continual repetition of the movements, especially when done in awkward or fixed positions or with excessive force.   

Work involving movement repeated over and over is very tiring because the worker doesn’t have time to fully recover in the short periods between movements. Eventually, it takes more effort to perform the same repetitive movements. When the work activity continues in spite of pain or fatigue, injuries can occur.

Work pace determines the amount of time available for rest and recovery of the body between cycles of a particular task. The faster the pace, the less time is available for rest and the higher the risk for developing RSI.

Stress levels increase when workers have no control over the timing and speed of work because of external factors like assembly line speed or quota systems. With higher stress levels comes muscle tension causing fatigue and again increased risk for repetitive strain injuries. When the worker cannot control their own work speed it goes against a natural human characteristic to work at varying rates at different times of the day.

Force is the amount of effort our bodies must use to move, lift objects, or to use tools. More force equals more muscular effort, and consequently, a longer time is needed to recover between tasks. Since in repetitive work, as a rule, there is not sufficient time for recovery, the more forceful movements develop fatigue much faster. Although no one really knows when musculoskeletal disorders will develop, workers performing forceful movements are at risk.

Exerting force in certain fixed or awkward hand positions, such as painting with a brush, is particularly hazardous.  Different hand positions will require different amounts of force – in general pinching and pressing require more effort. In addition, the weight and shape of tools or objects will add to the amount of force needed. Tools that do not allow the most neutral position of the wrist, elbow and shoulder also substantially increase the force required.

Prevention

Prevention and control measures established with the participation of both employees and employers are more likely to be effective. These can include providing a well-designed and comfortable workstation, adequate job design, training in proper lifting procedures, well-suited adjustable chairs, and scheduled breaks.

Eliminate hazards at the source. Employers should focus on avoiding repetitive patterns of work through job design changes such as mechanizing tasks, where possible. Additionally, structure jobs so that workers can rotate between various tasks where they do something completely different, using different muscle groups.

When it isn’t practical to eliminate the repetitive patterns of work, a well-designed workstation that is adjusted to fit the worker’s body size and shape can help. Workers should be provided with appropriate, carefully maintained tools and equipment to reduce the force needed to complete tasks and prevent muscle strain.

Because repetitive strain injuries develop slowly, workers should be trained to understand what causes these injuries, how best to prevent them, and how to recognize the early signs and symptoms of repetitive stress injuries. Workers need to know how to adjust workstations to fit their tasks and individual needs. Besides providing training, employers should encourage employees to take short, frequent rest breaks to allow their muscles to relax, and to consciously control muscle tension throughout the work shift.

Repetitive strain injuries can improve once the source is eliminated.  However, if nothing is done to address the injury or remove its cause, the damage could become permanent.

RSI awareness resources from CCOHS:

• International RSI Awareness Day
• MSDs, key topic page
• Work-related Musculoskeletal Disorders (WMSDs), fact sheet
• Musculoskeletal Disorders (MSD) Prevention Manual 
• Office Ergonomics Safety Guide  
• Musculoskeletal Disorders (MSDs): Awareness, e-Course
• Musculoskeletal Disorders (MSDs): Prevention, e-Course
• Musculoskeletal Disorders, infographic
• Sitting at Work, infographic

It's silent but deadly - the poisonous gas that you can't see, smell, taste or touch. However, what carbon monoxide (CO) lacks in personality, it makes up for in potency. Carbon monoxide poisoning is responsible for hundreds of deaths, and thousands of hospital visits every year in North America. The Ontario Association of Fire Chiefs reports that more than 50 people die each year from carbon monoxide poisoning in Canada, including 11 on average in Ontario.

A common and deadly hazard, carbon monoxide results from the incomplete burning of natural gas and any other material containing carbon such as gasoline, kerosene, oil, propane, coal, or wood. Cigarette smoke and motor vehicle exhaust are also sources of carbon monoxide.

Health effects of carbon monoxide

When we breathe in carbon monoxide, it interferes with the ability of red blood cells to carry oxygen to the heart, brain, and other vital organs. Exposure to very high concentrations can overcome a person in minutes with few or no warning signs and result in loss of consciousness or even death; hence the extreme danger of this gas.

The initial symptoms of poisoning are similar to the flu (but without the fever). They include headache, tightness across the chest, shortness of breath, fatigue, dizziness, drowsiness, or nausea. As symptoms worsen the victim may experience muscle weakness, vomiting, confusion, and even collapse, losing consciousness. The sense of confusion, caused by this gas, can interfere with the victim's ability to realize that their life is in danger.

Workplaces at risk

Internal combustion engines are the most common source of carbon monoxide in the workplace. There is also a risk of exposure in boiler rooms, warehouses, petroleum refineries, blast furnaces, steel production and pulp and paper production. Farmers have been poisoned by carbon monoxide while using motorized equipment such as gasoline pressure washers inside barns. While workers in confined spaces such as mines are at risk, harmful levels of carbon monoxide can also be present in large buildings or outdoor areas. Other occupations with risk of carbon monoxide exposure are taxi drivers, welders and garage mechanics. Emergency workers entering uncontrolled environments without wearing a carbon monoxide detector have also been subject to serious injury and even death.

What employers can do

1. Install an effective ventilation system that will remove carbon monoxide from work areas.
2. Maintain water heaters, space heaters, cooking ranges, and other potential carbon monoxide-­producing equipment in good working order.
3. As an alternative to gasoline­-powered equipment, use equipment powered by electricity, batteries, or compressed air.
4. Use personal and/or area carbon monoxide detectors that are reliable and set to alarm well below the exposure limit. Area alarms should give both visual and audible warnings immediately.
5. Don't allow the use of gasoline-­powered engines or tools in poorly ventilated areas.
6. Test air quality regularly, and prior to entry, in areas where carbon monoxide may be present, including confined spaces.
7. Ensure employees wear appropriate and approved respirators, such as full­-facepiece pressure­-demand self-contained breathing apparatus (SCBA), in areas with high carbon monoxide concentrations.
8. Educate workers who may be exposed to carbon monoxide. They must know the sources and symptoms, how to protect themselves, how to recognize symptoms in co­workers, and how to respond in case of an emergency.

Employees have a part to play

Employees, too, can help prevent carbon monoxide poisoning by reporting any potential carbon monoxide hazards to their employer, and looking out for ventilation problems, ­ especially in enclosed areas where gases of burning fuels may be released. Don't use gas-powered engines in an enclosed space. Report complaints of headache, dizziness, drowsiness, or nausea if you suspect carbon monoxide poisoning, and leave the contaminated area immediately. If you get sick, tell your doctor that you may have been exposed to carbon monoxide at work.

Protect yourself from carbon monoxide exposure at home

This winter the news continues to regularly report deaths and illnesses from carbon monoxide poisonings. In the cold weather months many deaths occur as the result of defective or poorly operated home heating devices. Follow these life­saving tips to protect you and your family:

• Install carbon monoxide detectors in your home that have both audible and visual alarms. If battery-operated, replace the battery when you change the time on your clocks each spring and fall.
• Never burn anything in a stove or fireplace that isn't vented. Don't use an oven as a heat source.
• When indoors, do not use portable flameless chemical heaters, gas camping stoves or generators and never burn charcoal.
• Never run a car or truck in the garage with the garage door shut or in a garage that is attached to a house. Even idling a vehicle outdoors for a long period of time can expose the occupants to carbon monoxide because of the potential for carbon monoxide to be pulled into the vehicle’s heating system.

Further information about carbon monoxide

• OSHA Carbon Monoxide Poisoning Fact Sheet, Occupational Safety and Health Administration (OSHA)
• Carbon Monoxide fact sheet, CCOHS
• Carbon Monoxide at the Work Site PDF, Work Safe Alberta
• Carbon Monoxide, Canada Safety Council
• Prevent Carbon Monoxide Poisoning, Health Canada

Workplace stress is a health and safety hazard that can take a significant toll on worker health. Addressing this hazard just got a little easier. The Occupational Health Clinics for Ontario Workers (OHCOW) and the Canadian Centre for Occupational Health and Safety (CCOHS) have collaborated to create StressAssess, a free online survey tool to assist workplaces in identifying and addressing psychosocial hazards that can lead to stress and mental injury.

“Workplace stress is particularly challenging to address because it does not fit into traditional hazard categories such as chemical, musculoskeletal, or slips and falls,” says Valerie Wolfe, Executive Director, South Central Region, at the Occupational Health Clinics for Ontario Workers (OHCOW). “This tool is a good starting point to begin the conversation, helping workplace parties take action on recognizing, assessing and preventing stress in their organization.”

StressAssess provides workplaces with an internationally recognized survey tool to anonymously, collectively, and confidentially gather information about current work conditions and psychosocial hazards. Administrators deploying the survey in their workplace are guided through a five step process. Upon completion of the survey, a summary report is provided.  Along with comparisons against validated national averages, it includes practical ideas to help workplaces address identified concerns.

While the survey tool is meant to diagnose the workplace (not the worker), the website also includes a personal edition for individuals interested in measuring their own personal level and sources of stress.

StressAssess is available at www.stressassess.ca and a mobile app version is currently in development.

This month’s featured podcast provides tips for keeping your feet safe and happy this winter.

Feature Podcast: Staying a Step Ahead of Cold Feet Trouble

With all the walking, standing, and working we do on our feet, we expose them to potential injury. In winter, there are cold weather afflictions that can have painful and sometimes serious consequences. Learn more about the harm that working in cold weather can cause your feet.

The podcast runs 6:24 minutes. Listen to the podcast now.

Encore Podcast: How psychological factors affect musculoskeletal symptoms and disorders

Dr. Birgitte Blatter, Business Line Manager of Healthy, Vital and Safe Work at TNO in the Netherlands explores the role workplace psychosocial factors play in the development of musculoskeletal symptoms and disorders.

The podcast runs 12:05 minutes. Listen to the podcast now.

CCOHS produces free monthly podcasts on a wide variety of topics designed to keep you current with information, tips, and insights into the health, safety, and well-being of working Canadians. You can download the audio segment to your computer or MP3 player and listen to it at your own convenience... or on the go!

See the complete list of podcast topics. Better yet, subscribe to the series on iTunes and don't miss a single episode

When workers are impaired on the job, whether by fatigue, use of drugs, or consumption of alcohol, it can have serious consequences. To help workplaces take steps to address the issue of impairment, CCOHS has developed an online course, Impairment and Cannabis in the Workplace.

The use of cannabis as a therapeutic treatment has been legal in Canada as of 2001 and the sale and use of recreational cannabis will become legal in Canada with a target date of on or before July 1, 2018.

Using cannabis as an example, Impairment and Cannabis in the Workplace  provides managers and supervisors, health and safety committee members, human resources specialists, and health and safety advisors with an understanding of impairment, its impacts and causes, and the importance of having a workplace policy and corresponding procedures.

When impairment affects workplace safety or one’s health, it becomes a workplace hazard that should be managed. It’s important that we understand what impairment looks like and how to address impairment related issues when they arise in the workplace.

You can access the Impairment and Cannabis in the Workplace online course from the CCOHS website: www.ccohs.ca/products/courses/impairment/.

Related Resources from CCOHS

• Workplace Strategies: Risk of Impairment from Cannabis – White Paper
• Impairment at Work, fact sheet
• Substance Use in the Workplace, fact sheet

Make sure this message sticks: bullying does not belong in the workplace.

Threats, constant or unjust criticism, intimidation, belittling, heckling, gossip, physical abuse - bullying behaviors are increasingly being recognized as a serious workplace problem that can cause undue stress, anxiety, and low morale among workers.

Hand out these stickers to reinforce the message that bullying is not part of the job. Bullying behaviors should be reported to a designed authority in your workplace, supervisor, union representative, or someone who can help.

These stickers are ideal for Pink Shirt Day on February 28th, and for use all year round as a simple but clear reminder that bullying is not to be tolerated.