Addressing musculoskeletal disorders in the UK rail industry
Dr Kirsten Huysamen
Lead Human Factors Specialist
Introduction
What are Musculoskeletal Disorders?
Musculoskeletal disorders (MSDs) are a broad term used to describe injuries and conditions that affect the musculoskeletal system.
Bones | Joints | Ligaments | Tendons | Muscles | Soft Tissues
Aches, pains, discomfort, stiffness, reduced mobility or swelling in the affected area etc.
Back pain | Carpal tunnel syndrome | Muscle strains |Tendonitis
Osteoarthritis | Sciatica | Neck pain | Bursitis | Tennis elbow
Ligament sprains | Repetitive strain injury |Plantar fasciitis
Hand-arm vibration syndrome | Rotator cuff injury
• Onset: Appears suddenly or develop gradually over time.
• Frequency: Can occur once or multiple times.
• Severity: Can progress from mild to severe if not managed correctly.
MSD risk factors
What factors contribute to the development of an MSD?
Individual
Job & workplace
Characteristics of an individual that can influence their susceptibility to developing an MSD
Psychosocial
Physical demands and conditions of the job and workplace that contribute to the development of an MSD.
Cultural, social and psychological aspects of the job or working environment that are linked to MSD development
MSD risk factors
What factors contribute to the development of an MSD?
Individual
Job & workplace
• Age, gender, weight, genetics
• Physical fitness, health conditions, previous injuries
• Lifestyle factors (e.g. smoking, diet, hydration)
• Experience (e.g. past work and level of experience)
Job
• Handling heavy load
• Bending or twisting (frequently / sustained)
• Repetitive movements; exerting great force
→arms, hand, fingers; legs feet
• Awkward and static postures or movements (frequently / sustained)
→stooping, sitting, kneeling, hand above shoulder level, squatting etc.
• Repeating same movement for long periods
• Working at a fast pace
Psychosocial
Workplace
• Uneven, slippery or irregular working surfaces
• Temperature
• Outdoors
• Tools, equipment, PPE
• Unsuitable workstation
• Cramped working conditions
• Vibration
• Job control, job demand, job autonomy
• Repetitive monotonous tasks
• Utilising skills
• Reward, recognition, breaks
Do not often stem from a single cause but rather from a combination of multiple risk factors
MSDs in UK rail
How many rail workers are affected?
Musculoskeletal disorders (MSDs) are one of the leading causes of absence in the UK rail industry
• Contributes to 1 in 4 days of sickness absence
• Costs the industry approximately £89 million per year
Likely an underestimate due to underreporting
RSSB Mental Wellbeing Survey (2021)
• Nearly half of responders reported experiencing (in past 12 months):
o Backache (48%)
o Upper body pain (54%)
o Lower limb pain (43%)
The data required to address this problem
is currently unavailable
To better understand this issue RSSB launched the first industry-wide MSD survey
Identifying and assessing MSD risk
How can we identify MSD risks in the workplace?
Review MSD data: Use company reports, MSD survey data and/or RMT insights to identify trends and potential MSD issues.
Identify risks in the workplace: Recognise MSD risk factors in the workplace, and then report them.
• e.g., job & workplace, psychosocial
Consult workers: Engage with employees or RMT members to understand their MSD concerns.
Assess potential risk: A qualified human factors professional conducts ergonomic evaluations and MSD risk assessments to pinpoint hazards.
Rapid Entire Body Assessment (REBA) tool
What is the REBA tool and when should it be used?
The REBA tool is an ergonomic assessment method used to evaluate the risk of MSDs associated with various job tasks.
• It measures the MSD risk of the task, rating it from 1 to 11+
• Assessment is performed by a qualified Human Factors professional
• It should be used when investigating multiple complaints of MSD’s
Job level assessment
Tool helps pinpoint the tasks which pose the highest risk and identify which elements of the task would most benefit from improvement.
Task specific analysis
If a task is identified as having a high MSD risk, the tool can help assess the risk level and prioritise the most critical elements for improvement.
Effectiveness evaluation
Tool can evaluate the effectiveness of implemented mitigations and confirm the risk will likely be reduced
REBA Tool Worksheet
How the tool works:
• The tool is used while observing someone carrying out the task.
- Take video and photos
• A REBA worksheet is used to evaluate each body part.
• The worksheet is divided into two sections: Sections A and B.
• Each body part is given a score depending on its position.
• The tool also considers the load being handled, quality of grip, nature of the task
• These scores are inputted into the table to produce the final REBA score.
REBA Tool Example
Video Link: Railwayman At Work Railway Worker Stands Stock Footage SBV-319392905 - Storyblocks
REBA Tool Example
Step 1: Neck Position
Neck is bent backwards by 27° = +2 27°
REBA Tool Example
Step 2: Trunk Position
Trunk is bent forwards by 38° = +3
REBA Tool Example
Step
3: Legs
55°
We assume that weight is evenly distributed through both legs = +1
The angle of the left leg is 55 ° = +1
REBA Tool Example
Step 4: Table A Score
Neck Score = 2 | Trunk Score = 3 | Leg Score = 2
Table A Score = 5
Step 5: Add Force/Load Score
If the load <5kg : +0
If the load 5kg to 10kg : +1
If the load >10kg : +2
Adjust if shock or rapid build up force: add +1
Table A Score = 5
Assume force is 5kg to 10kg = 1 +
Score A = 6
REBA Tool Example
Step 7: Upper Arm Position
The upper arm is bent up by 110 ° = +4
The shoulder is raised = +1
The upper arm is abducted = +1
110°
REBA Tool Example
Step
8: Lower Arm Position
The lower arm is bent by 35 ° = +2
REBA Tool Example
Step 9: Wrist Position
32°
The wrist is bent by 32° = +2
The wrist is bent from the midline = +1
REBA Tool Example
Step 10: Table B Score
Upper Arm Score = 6 | Lower Arm Score = 2 |
Wrist Score = 3
Table B Score = 9
Step 11: Add Coupling Score
Good – Well fitting handle and mid range power grip: +0
Fair – Acceptable but not ideal hand hold or coupling acceptable with another body part: +1
Poor – Hand hold not acceptable but possible: +2
Unacceptable – No handles, awkward, unsafe with any body part: +3
Table B Score = 9
Coupling Score = 1 +
Score B = 10
REBA Tool Example
Step 12: Table C Score
Table A Score = 6 | Table B Score = 10
Step 13: Add Activity Score
1 or more body parts are held for longer than 1 min (Static): +1
Repeated small range actions (more than 4x a min): +1
Action causes rapid large range changes in postures or unstable base: +1
Table C Score = 10
Activity Score = 1 +
REBA Score = 11
Very high risk, implement change
2 3 2 5 1 6
6 2 3 9 1 10 1 10 11
Additional resources
Where can I find more information?
RSSB’s MSD hub
https://www.rssb.co.uk/about-rssb/key-industry-topics/healthand-wellbeing/managing-musculoskeletal-health-in-the-railindustry
Rail Wellbeing Live: Presentations-related to MSDs
https://www.railwellbeinglive.co.uk/
Right Track 47: ‘Handle with Care’ article
https://publications.rssb.co.uk/story/right-track-issue-47-spring2024/page/9
HSE Musculoskeletal Disorders Webpages: Guidance and tools
https://www.hse.gov.uk/msd/
Dr Kirsten Huysamen
Lead Human Factors Specialist
Kirsten.Huysamen@RSSB.CO.UK