Manual handling training: investigation of current practices and development of guidelines

This report presents findings of a systematic literature review, telephone survey and expert panels undertaken to determine what constitutes effective manual handling training. The results of the systematic review indicate there is very little evidence supporting the effectiveness of both technique and educational based manual handling training. There was evidence that principles learnt during training are not applied in the workplace. Strength and flexibility training appears potentially beneficial, however further research is needed to determine whether it has long term benefits in terms of injury reduction. There was no evidence for the effectiveness of back schools in preventing low back pain. Ergonomics interventions that include risk assessment, observation of workers, tailored training and task/equipment redesign have been shown to be beneficial in the literature. The telephone survey indicated that induction of new staff and statutory requirements are the main drivers for manual handling training. More than 75% of companies surveyed conduct inhouse manual handling training rather than out sourcing training to consultants. Most organisations and consultancies record participant feedback on training courses and sickness absence is regarded as the main outcome measure of effectiveness. Survey respondents felt that manual handling training is mor effective if it is tailored to specific industry and task demands. Practical elements in training were believed to reinforce learning, particularly if tailored to individual job demands. To be effective, manual handling training needs to be embedded as an ongoing process in organisations and reinforced with regular refresher courses. Training should encourage the workforce to assess risk and there needs to be careful monitoring of working practices. The expert panels reviewed the findings and the discussions were used to generate and refine a set of guiding principles for ef fective manual handling training.

[1]  S Brooke,et al.  Manual handling in the operating theatre. , 1999, Professional nurse.

[2]  M Gagnon,et al.  The efficacy of training for three manual handling strategies based on the observation of expert and novice workers. , 2003, Clinical biomechanics.

[3]  Venning Pj.  Back injury prevention among nursing personnel. The role of education. , 1988 .

[4]  S S Asfour,et al.  Effects of frequency and load to lift on endurance time. , 1989, Ergonomics.

[5]  P Harber,et al.  Occupational back pain of nurses: Special problems and prevention. , 1988, Applied ergonomics.

[6]  J Girvin,et al.  Education and training , 2016, Elderly care.

[7]  S Pheasant,et al.  Back pain in nurses: epidemiology and risk assessment. , 1992, Applied ergonomics.

[8]  J. B. Luntley,et al.  Lifting and handling of patients by anaesthetists , 1995, Anaesthesia.

[9]  K M Bafna,et al.  A muscular endurance training program for symmetrical and asymmetrical manual lifting tasks. , 1990, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[10]  J D Troup,et al.  Patient-Handling Skill, Back Injuries, and Back Pain: An Intervention Study in Nursing , 1989, Spine.

[11]  R Ortengren,et al.  The influence of a preventive educational programme on trunk flexion in janitors. , 1984, Applied ergonomics.

[12]  Sue Hignett,et al.  Competency-based training for patient handling. , 2007, Applied ergonomics.

[13]  L. Kaplan,et al.  Secondary Prevention of Low‐Back Pain: A Clinical Trial , 1990, Spine.

[14]  R. Norman,et al.  Biomechanical analysis of peak and cumulative spinal loads during simulated patient-handling activities: a substudy of a randomized controlled trial to prevent lift and transfer injury of health care workers. , 2001, Applied ergonomics.

[15]  D A Stubbs,et al.  Back pain in the nursing profession. I. Epidemiology and pilot methodology. , 1983, Ergonomics.

[16]  Gary N. McLean,et al.  Theories Supporting Transfer of Training. , 2001 .

[17]  A. Garg,et al.  An ergonomic evaluation of nursing assistants' job in a nursing home. , 1992, Ergonomics.

[18]  J. Wachs,et al.  Predictors of Registered Nurses' Lifting Behavior , 1989, AAOHN journal : official journal of the American Association of Occupational Health Nurses.

[19]  Richard F Edlich,et al.  Prevention of disabling back injuries in nurses by the use of mechanical patient lift systems. , 2004, Journal of long-term effects of medical implants.

[20]  R A Graveling.  The prevention of back pain from manual handling. , 1991, The Annals of occupational hygiene.

[21]  R Kneafsey.  The effect of occupational socialization on nurses' patient handling practices. , 2000, Journal of clinical nursing.

[22]  J J Knapik,et al.  The influence of physical fitness training on the manual material handling capability of women. , 1997, Applied ergonomics.

[23]  Z Whysall,et al.  A stage of change approach to reducing occupational ill health. , 2006, Preventive medicine.

[24]  Lex M. Bouter,et al.  The efficacy of the back school: a randomized trial , 1990 .

[25]  G. Burgess,et al.  Compliance with the manual handling regulations amongst a random selection of small businesses in England. , 2002, The Annals of occupational hygiene.

[26]  Jane Swain,et al.  Do they practise what we teach? A survey of manual handling practice amongst student nurses. , 2003, Journal of clinical nursing.

[27]  W Karwowski,et al.  Effects of job-simulated flexibility and strength-flexibility training protocols on maintenance employees engaged in manual handling operations. , 1992, Ergonomics.

[28]  C D Burt,et al.  Prompting correct lifting posture using signs. , 1999, Applied ergonomics.

[29]  D. Gardner,et al.  Manual Handling Injuries in Health Care Workers , 2000, International journal of occupational safety and ergonomics : JOSE.

[30]  J Hidalgo,et al.  Physical training: a tool for increasing work tolerance limits of employees engaged in manual handling tasks. , 1992, Ergonomics.

[31]  A Mital,et al.  Effects of an endurance and strength training programme on lifting capability of males. , 1984, Ergonomics.

[32]  P J Venning.  Back injury prevention among nursing personnel. The role of education. , 1988, AAOHN journal : official journal of the American Association of Occupational Health Nurses.

[33]  Steven A. Lavender.  A Test of the LiftTrainer: An Aggressive Approach for Preventing Back Injuries Through Training , 2000 .

[34]  K. Yau,et al.  Consultative team to assess manual handling and reduce the risk of occupational injury , 2001, Occupational and environmental medicine.

[35]  A Genaidy,et al.  Effects of a job-simulated exercise programme on employees performing manual handling operations. , 1994, Ergonomics.

[36]  S Lings,et al.  Intensive education combined with low tech ergonomic intervention does not prevent low back pain in nurses , 2004, Occupational and Environmental Medicine.

[37]  J. Cromie,et al.  Occupational health and safety in physiotherapy: guidelines for practice. , 2001, The Australian journal of physiotherapy.

[38]  Margaret O Best.  An evaluation of Manutention training in preventing back strain and resultant injuries in nurses , 1997 .

[39]  A Garg,et al.  Prevention strategies and the low back in industry. , 1992, Occupational medicine.

[40]  B Spencer,et al.  Doctors' training in manual handling. , 2000, Age and ageing.

[41]  A M Genaidy,et al.  Improving human capabilities for combined manual handling tasks through a short and intensive physical training program. , 1990, American Industrial Hygiene Association journal.

[42]  Christopher R Hayne.  The Training Process in a Health and Safety Programme , 1995 .

[43]  D. J. Wood,et al.  Design and Evaluation of a Back Injury Prevention Program Within a Geriatric Hospital , 1987, Spine.

[44]  A M Genaidy.  A training programme to improve human physical capability for manual handling jobs. , 1991, Ergonomics.

[45]  P.J. Venning.  Back Injury Prevention among Nursing Personnel , 1988 .

[46]  D A Stubbs,et al.  Back pain in the nursing profession. II. The effectiveness of training. , 1983, Ergonomics.

[47]  Roger Haslam,et al.  Developing the Stage of Change Approach for the Reduction of Work-related Musculoskeletal Disorders , 2007, Journal of health psychology.

[48]  Don B. Chaffin,et al.  An evaluation of the effect of a training program on worker lifting postures , 1986 .

[49]  R. Edlich,et al.  Devastating injuries in healthcare workers: description of the crisis and legislative solution to the epidemic of back injury from patient lifting. , 2005, Journal of long-term effects of medical implants.

[50]  Snook Sh,et al.  Approaches to the control of back pain in industry: job design, job placement and education/training. , 1988 .

[51]  S J Linton,et al.  Ergonomic education for nursing students. , 1993, International journal of nursing studies.

[52]  J D Troup,et al.  Ergonomics and training. , 1987, International journal of nursing studies.

[53]  Gustav Wickström,et al.  A five-year intervention study to reduce low back disorders in the metal industry , 1993 .

[54]  Maury A. Nussbaum,et al.  Empirical evaluation of training and a work analysis tool for participatory ergonomics , 2003 .

[55]  Judith K Sluiter,et al.  Effectiveness of measures and implementation strategies in reducing physical work demands due to manual handling at work. , 2005, Scandinavian journal of work, environment & health.

[56]  M Lortie,et al.  Manual handling in warehouses: the illusion of correct working postures. , 1994, Ergonomics.

[57]  Matthew Massy-Westropp,et al.  The impact of manual handling training on work place injuries: a 14 year audit. , 2004, Australian health review : a publication of the Australian Hospital Association.

[58]  J A Jones,et al.  The ability of non-ergonomists in the health care setting to make manual handling risk assessments and implement changes. , 1999, Applied ergonomics.

[59]  E. Salas,et al.  The science of training: a decade of progress. , 2001, Annual review of psychology.

[60]  T J Stobbe,et al.  Occupational ergonomics and injury prevention. , 1996, Occupational medicine.

[61]  Karl H.E. Kroemer,et al.  Personnel training for safer material handling , 1992 .

[62]  M Kane,et al.  Lifting: why nurses follow bad practice. , 1994, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[63]  A Yassi,et al.  A Randomized Controlled Trial to Prevent Patient Lift and Transfer Injuries of Health Care Workers , 2001, Spine.

[64]  C. Maher,et al.  A systematic review of workplace interventions to prevent low back pain. , 2000, The Australian journal of physiotherapy.

[65]  Heather Gray,et al.  Factors influencing the effectiveness of manual handling education , 2004 .

[66]  R. Deyo,et al.  The effectiveness of four interventions for the prevention of low back pain. , 1994, JAMA.

[67]  A Mital,et al.  An endurance training programme for frequent manual carrying tasks. , 1989, Ergonomics.

[68]  S. Mathiassen,et al.  On the evolution of task-based analysis of manual materials handling, and its applicability in contemporary ergonomics. , 2006, Applied ergonomics.

[69]  L Straker,et al.  A randomized and controlled trial of a participative ergonomics intervention to reduce injuries associated with manual tasks: physical risk and legislative compliance , 2004, Ergonomics.

[70]  S J Legg,et al.  Effects of psychophysical lifting training on maximal repetitive lifting capacity. , 1988, American Industrial Hygiene Association journal.

[71]  T. Hansson,et al.  Primary Prevention of Back Symptoms and Absence from Work: A Prospective Randomized Study Among Hospital Employees , 1993, Spine.

[72]  F. Fathallah,et al.  The effect of feedback training on lumbosacral compression during simulated occupational lifting , 2004, Ergonomics.

[73]  Mark R Stevenson,et al.  Evaluating the effectiveness of a participatory ergonomics approach in reducing the risk and severity of injuries from manual handling , 2005, Ergonomics.

[74]  M. Scholey,et al.  Back stress; the effects of training nurses to lift patients in a clinical situation. , 1983, International journal of nursing studies.

[75]  W. Vollmer,et al.  The Back Injury Prevention Project pilot study. Assessing the effectiveness of back attack, an injury prevention program among nurses, aides, and orderlies. , 1993, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[76]  A Scott.  Improving patient moving and handling skills. , 1995, Professional nurse.

[77]  A M Genaidy.  Truncal flexibility exercise effects on musculoskeletal capability for manual handling operations. , 1991, Applied ergonomics.

[78]  T. Ore,et al.  Evaluation of safety training for manual handling of people with disabilities in specialised group homes in Australia , 2003, Australian and New Zealand journal of public health.

[79]  J. Knibbe,et al.  Prevalence of back pain and characteristics of the physical workload of community nurses. , 1996, Ergonomics.

[80]  Tuula Merisalo,et al.  Effects of work changes and training in lifting technique on physical strain: A pilot study among female workers of different ages , 1998 .

[81]  Health and Safety Statistics , 1979 .

[82]  M. Liang,et al.  A controlled trial of an educational program to prevent low back injuries. , 1997, The New England journal of medicine.

[83]  S Hignett,et al.  Work-related back pain in nurses. , 1996, Journal of advanced nursing.

[84]  I. Dey.  Qualitative Data Analysis: A User Friendly Guide for Social Scientists , 1993 .

[85]  Leon Straker,et al.  Reducing Work-associated Back Problems in the Health Service: The role of the physiotherapist/ergonomist , 1989 .

[86]  R Hollingdale,et al.  Back pain in nursing and associated factors: a study. , 1997, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[87]  S H Snook.  Approaches to the control of back pain in industry: job design, job placement and education/training. , 1988, Occupational medicine.

[88]  Graham Blamire.  An Educational Framework for Training in Manual Handling , 1995 .

[89]  Audrey Nelson,et al.  Prioritizing Safe Patient Handling: The American Nurses Association's Handle With Care Campaign , 2006, The Journal of nursing administration.

[90]  M Z Forssell,et al.  The Back School , 1981, Spine.

[91]  M Lortie,et al.  Training in handling: an evaluative study. , 1989, Ergonomics.

[92]  R. H. Westgaard,et al.  Ergonomic intervention research for improved musculoskeletal health: A critical review , 1997 .

[93]  R S Carlton,et al.  The effects of body mechanics instruction on work performance. , 1987, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[94]  Sam Salem,et al.  Effectiveness of controlled workplace interventions in reducing lower back disorders , 2006 .

[95]  S. Hignett.  Intervention strategies to reduce musculoskeletal injuries associated with handling patients: a systematic review , 2003, Occupational and environmental medicine.

[96]  N. Black,et al.  The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. , 1998, Journal of epidemiology and community health.

[97]  C. Solomon,et al.  Accidental injuries in agriculture in the UK. , 2002, Occupational medicine.

[98]  R A Haslam,et al.  Manual handling risks and controls in a soft drinks distribution centre. , 1999, Applied ergonomics.

[99]  B. Owen,et al.  An ergonomic approach to reducing back/shoulder stress in hospital nursing personnel: a five year follow up. , 2002, International journal of nursing studies.

[100]  S. Snook,et al.  A study of three preventive approaches to low back injury. , 1978, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[101]  M. Frings-Dresen,et al.  Pushing and pulling in relation to musculoskeletal disorders: a review of risk factors. , 1998, Ergonomics.

[102]  W. Fungladda,et al.  Reduction of low back muscular discomfort through an applied ergonomics intervention program. , 2005, The Southeast Asian journal of tropical medicine and public health.

[103]  Jocelyn Cornish,et al.  Evaluation of moving and handling training for pre-registration nurses and its application to practice. , 2007, Nurse education in practice.

[104]  S J Linton,et al.  Low back schools. A critical review. , 1987, Physical therapy.

[105]  M. Quiñones.  Pretraining context effects: Training assignment as feedback. , 1995 .

[106]  Robert S. Bridger,et al.  Lifting technique and abdominal belt usage: a biomechanical, physiological and subjective investigation , 1998 .

[107]  T K Tang.  Manual materials handling: a survey of risks, and the selection and training of workers in Singapore. , 1987, Ergonomics.

[108]  Beverley E Ellis.  Moving and Handling Patients: An evaluation of current training for physiotherapy students , 1993 .

[109]  M P Rayson,et al.  Resistance training and the enhancement of the gains in material-handling ability and physical fitness of British Army recruits during basic training , 2002, Ergonomics.