What are MSDs?
Any injury, damage or disorder of the joints and tissues in the upper and lower limbs of the body, back and neck. Back and other MSD pain caused by work-related activities (for example, awkwardly lifting children, sitting on children’s chairs, getting on/off the carpet) can develop quickly or build slowly over time.
However, once developed, MSDs can adversely affect many aspects of life, including work and leisure activities, ability to take care of our mental and physical health, ability to drive and can lead to absence from work.
Symptoms can include back ache, sciatica, knee pain and shoulder discomfort, hip stiffness, painful toe joints and others.
Effective awareness and management of MSDs helps reduce risk and improve wellbeing, no matter what size your organisation is.
Potential benefits may include:
- Fewer injuries to educators
- Reduced risk of work-related ill health and sickness absence
- Reduced stress and improved morale
- Improved staffing levels/attendance
- Improved professional care to children.
The good news is, the majority of MSDs can be prevented, symptoms eased and fully recovered from with early intervention, suitable treatment and musculoskeletal health management.
What kind of working practices can increase the risk of MSDs?
Examples of working practices which can increase MSD risk in early years settings include:
- Repetitive bending and twisting (e.g. over low tables and child-height sinks)
- Uncomfortable working position, including unsuitable furniture (e.g. sitting on children’s chairs, kneeling at child-height desks)
- Repetitive or awkward lifting of children and heavy equipment (e.g. when using nappy changing units, at mealtimes, moving sand/water trays and outdoor equipment)
- Not receiving and acting upon notification of symptoms quickly enough (e.g. niggling pain leading to longer term injury. Prevention of injury is most effective)
- Psychosocial factors (e.g. high job demands leading to increased anxiety and associated MSD risk)
- Working too long without a break (e.g. not allowing body to rest and recover)
- Time pressures (e.g. inadequate time to move and change postures, or to correctly set up and to use equipment appropriately).
What are my legal duties as an employer?
As an employer, you have legal duties to assess, control and manage the risks associated with work-related MSDs. This includes managing the risks to children, visitors and volunteers. The self-employed have similar responsibilities to third parties.
The Health and Safety at Work etc Act 1974 states you must ensure, so far as reasonably practicable, the health and safety of all employees while at work. You must also ensure that others are not put at risk by work activities. This includes safety of visitors and volunteers. The self-employed have similar responsibilities.
‘So far as reasonably practicable’ means balancing the level of risk against the measures needed to control the real risk in terms of money, time or trouble.
The Management of Health and Safety at Work Regulations 1999 require you to manage health and safety effectively. You must carry out an assessment of the risks to the health and safety of your employees, while they are at work, and to other people who may be affected by your organisation’s work activities.
You must consult with your employees and, where applicable, their health and safety representatives, on health and safety issues, including:
- Risks arising from their work
- Proposals to manage and/or control these risks
- The best ways of providing information and training
Manual Handling Operations Regulations 1992 seek to reduce the health and safety risks to employees from handling and lifting loads. They give advice on how to handle and move loads to prevent poor posture or injury.
Health and Safety Display Screen Regulations 1992 apply to workers who use DSE daily, for an hour or more at a time. These set out minimum requirements for workstations.
Workplace (Health, Safety & Welfare) Regulations 1992 give information on toilet breaks, staff room access, adult height desks and chair access.
The Provision and Use of Work Equipment Regulations 1998 covers information relating to work equipment, pushchairs, trollies and staff bringing in own seating/work equipment.
The Equalities Act 2010 covers information factoring pre-existing conditions and MSDs, age of workers, pregnancy, reasonable adjustments.
Seating at Work Guidance 1997 – Very specific guidance on how to ensure workplace seating is safe and suitable for all – including for those with additional needs.
How can I manage the risk of MSDs in my early years setting?
Working in the early years is physically demanding.
Risk assessment is about identifying and taking sensible measures to control the risks in your workplace, not about creating huge amounts of paperwork.
You may already be taking steps to protect your employees, but your risk assessment will help you decide whether you should be doing more.
The aim is to make the risk of someone being injured (employee, visitor or child) as low as possible. See the HSE website for more information.
A hazard is something in your setting that can cause harm. A risk is the chance, however large or small, that a hazard could cause harm.
You can delegate the task of risk assessment, but you will need to make sure it is carried out by someone who:
- is competent to do so (has the right skills, knowledge and experience)
- involves your staff and any representatives in the process
- understands when specialist help/advice may be needed
Identify the hazards
Look for hazards that may result in harm when working with children aged under five. Remember to ask your employees, or their representatives, for their views as they will have first-hand experience of what happens in practice.
You should also seek the views of those who only work with children occasionally. The main areas to think about are the working environment and the educator.
Who might be harmed?
Decide who might be harmed and how. This will usually be the educator, but it might also include children or visitors. You should also consider whether there are any groups who may be particularly at risk, such as: new starters, pregnant workers, employees returning to work, those with pre-existing medical conditions or those working long hours.
Evaluate the risks
Having identified the hazards, decide how likely it is that harm will occur. You are not expected to eliminate all risks, but you must make sure you know about the main risks and how to manage them responsibly. You need to do everything reasonably practicable to protect people from harm.
You must carry out an assessment of the risks to the health and safety of your employees, while they are at work, and to other people who may be affected by your organisation’s work activities. The risk assessment should include any specific risks to females of childbearing age who could become pregnant, and any risks to new and expectant mothers.
Record your findings
Record your significant findings – make it simple and focus on controls.
If you have five or more employees, you are required by law to write it down. If you have fewer than five employees you do not have to write anything down, but it is good practice to keep a record.
An easy way to record your findings is to use HSE’s risk assessment template. This also includes a section for your health and safety policy.
Any record produced should be simple and focused on controls.
Use the findings of risk assessments, accident investigations and consultation with workers to identify what changes to working practice, control measures and changes to the built environment can be made to mitigate the risk of MSDs amongst employees, e.g. trolleys, ergonomically assessed workstations etc.
Regularly review your risk assessment
You should review your MSD risk assessment on a regular basis.
There is no set frequency for carrying out a review, but you need to ensure that the risks to those who work with under-fives, and others, are suitably controlled.
For this to be effective you need to know about any MSD cumulative strain and incidents, your practitioners and their working environments.
Changing circumstances may also prompt a review, e.g. increasing number of children on role, changing ratios or reduced number of employees, children with specific moving and handling needs, acquiring new equipment, buildings expansion or redesign. If anything significant changes, check your risk assessment and update it.
Practical suggestions
Seating, furniture and equipment
- Offer a range of safe, appropriate seating that meets the needs of an early years workforce
- Consider staff health and safety (ergonomics) when choosing new seating, furniture and equipment.
- Ensure seating, furniture and equipment is in good working order and meets health and safety requirements
- Ensure seating, furniture and equipment is inspected and maintained at regular intervals, in line with manufacturer’s recommendations.
- Ensure manual handling equipment is provided and used appropriately by our employees>
- Remove any unsafe equipment from service immediately and report this to a named contact.
Storage
- Ensure furniture and equipment is safely stored to minimise practitioner lifting, carrying and awkward postures
- Consider, and where possible use, mobile storage solutions.
Workplace design considerations
- Ensure employees have access to adult-height sinks (or can use a washing up bowl in standing), plus access to an adult height desk and chair for written/computer work.
- Consider educators’ working postures with equipment provided to support ‘child height’ working
- Ensure nappy changing units have unrestricted access to at least two sides, and are set at correct standing height or have steps so children can position themselves with assistance and less lifting.
- Ensure floors are even, unobstructed, well-lit and doorways (including of storage areas) are accessible.
- Ensure learning resources, artwork and decorations are hung to ensure clear, unobstructed walkways for workers to move freely, without the need to stoop.
- Encourage children’s independence to access their own resources and equipment, at mealtimes and sleep times to reduce lifting.
- Encourage movement, rest breaks and hydration throughout the day.
- Ensure timetabling allows as much time as possible for children to be independent and for staff to safely assist children.
- Ask employees about their seating requirements and workstation/classroom set up.
- Ensure new design and build consultations include workplace health and safety needs of staff.
Training
- The early years workforce should have regular, setting-specific manual handling training (which includes lifting and moving children in a range of situations and postural awareness for employees)
- Employees and volunteers working regularly on a computer/mobile device (more than an hour a day, most weekdays) should complete Display Screen Equipment (DSE) training and assessment.
Knowledge
- Educators should be aware of MSD risks in the setting and how to reduce their risks (in the classroom, outdoor learning and at a computer).
- Staff should know how to carry out routine safely checks on mobile and safely equipment and report any faults.
- Staff should be competent and capable of doing their work in a way that is safe for them and other people.
- Staff should know how to recognise and report early symptoms of MSD ill health, with clear reporting structure for doing so.
