Repetitive Strain CIVIL 5430/6430

Injury VAIBHAV CHAVAN

 Purpose:

• To focus on the Repetitive Strain Injuries

(RSIs), one of the fastest growing occupational
injuries in construction as well as other
industries.

Presentation Topics of discussion:

Overview • What is Repetitive Strain Injury (RSI)?

• Why is it necessary to study?
• What are common RSIs being observed in
construction industry?
• Factors
• Preventive measures
• OSHA involvement
 Repetitive Strain Injury

• Repetitive strain injury or RSI is a term used to

describe the painful, awkward, or
uncomfortable conditions of the muscles,
tendons, nerves and other soft tissues.
• It may be caused by repetitive tasks, forceful
exertions, vibrations, mechanical compression,
or sustained or awkward positions.
• They can result from overexertion, which is
exceptionally ordinary in the construction work
environment

Illustration Source: Occupational Health and Safety Council of Ontario

RSIs are also known
as:
• Repetitive Motion Injury (RMI)
• Musculoskeletal Disorder (MSD)
• Cumulative Trauma Disorder (CTD)
• Occupational Overuse Syndrome (OOS)
• Work-Related Upper Limb Disorder (WRULD)
• Upper Extremity Musculoskeletal Disorder (UEMSD)
 • Construction: One of the largest industries in
the United States, prone to many work-related
severe injuries, disability, lost work hours, and
Why do we fatalities.
• According to the Occupational Safety and
need to give Health Hazard, 3.8 out of every 100 workers will
become injured within their career.
attention to • Thanks to continual prevention and intervention
RSIs? efforts, a decline in overall construction injuries
has been observed,
• But there are still some severe hazards which
haven’t got the attention they deserve.
 • When we think of construction-related injuries,
what do we think of?
• Injuries caused by
Why do we • falls,
• equipment accidents,
need to give • vehicles, and more
attention to • But there are injuries which are caused over a
period due to other factors than falls,
RSIs? equipment accidents, vehicles, etc., which we
fail to give importance to.
• Among them is the Repetitive Strain Injuries.
 • According to (Occupational Health and Safety
Administration (OSHA)), RSIs are one of the most
frequently reported causes of restricted or lost work
hours.
• In 2010, 25% of construction injuries were from RSIs
(U.S. Bureau of Labor Statistics (BLS)).
• (U.S. Bureau of Labor Statistics (BLS)) in 2013 stated
that RSI cases comprised for 33% of all the worker
Background illness and injury cases.
• Incident rate for RSI was 3.0 per 10,000 workers in
year 2012.
• Musculoskeletal disease, a type of RSI, had a rate of
incident of about 37.8 per 10,000 workers, and
accounted overexertion for 12.5/10,000 workers.
 • Repetitive strain injuries take an average of 23 days
to recover fully. which is 14 days more than the
average for all other injuries (most take only 9 days).
• Repetitive strain injuries cost employers an
estimated $80 billion a year.
• Carpal tunnel syndrome (CTS) is the most common
Background RSI, affecting more than 8 million Americans.
• Nearly half of all CTS cases cause workers to miss 31
days or more of work time.
• An estimated 260,000 carpal tunnel syndrome (a
type of RSI) release surgeries are performed
annually; 47% of these cases are work-related.
 RSIs: The
Leading
Construction
Injury

Source: Bureau of Labor Statistics (BLS).

 Rate per 10,000 FTEs
25.2
Transportation 53.3
16.1
Retail 21.8
14.7
Wholesale 25.2
11.9
Rate of Health care 32.9

overexertion Agriculture
11.2
31.0
injuries resulting Construction
10.6
26.4
in days away from 9.7
Manufacturing
work, 25.2
5.3
selected Mining 9.1
industries, 2016 Utilities
5.1
24.0
0.7 Overexertion in
Finance 3.7
lifting
9.8
All industries 21.5 Other overexertion

Source: Bureau of Labor Statistics (BLS).

 Back Shoulder
60% Abdomen Legs
Arms Multiple body parts

50%

Work-related 40%
musculoskeletal
disorders in 30%

construction, by
body part, 20%

2012-2016
10%

0%
2012 2013 2014 2015 2016

Year

Source: Bureau of Labor Statistics (BLS).

 Rate per 10,000
Finish carpentry 56.1
Tile and terrazzo 56.1
Residential building* 47.1
Plumbing & heat A/C 46.5
Drywall & insulation 45.1
Rate of Roofing 39.2
overexertion Framing 34.1
injuries resulting Structural steel 33.5
in days away from Masonry 33.4
work, Other heavy construction* 30.7
selected Land subdivision* 29.8
construction Highway, street, & bridge* 26.7
subsectors, 2016 Flooring 24.9
Electrical 24.2
Utility system* 16.8
Nonresidential building* 15.4
All construction 37.0

Source: Bureau of Labor Statistics (BLS).

Cost of
Injuries

Source: Liberty Mutual Workplace Safety Index Findings

 • Drilling overhead
What • Installing carpet
construction • Lifting heavy sheetrock
Job Tasks • Hammering
• Lifting mason bricks
Cause Pain? • Roofing, etc.
 Carpal Tunnel Syndrome
What are
some
examples of
RSIs Tendinosis
observed in
Construction
Industries? Bursitis
 Tenosynovitis: Tenosynovitis involves an inflammation
of tendon sheath.
Other injuries
that are Epicondylitis: Epicondylitis involves inflammation of a
tendons at the place where they attach to the bones
repetitive at an elbow.

stress injuries Thoracic Outlet Syndrome: Thoracic outlet syndrome

involves a condition affecting a blood vessels & nerves
(RSI's) in their shoulder and neck.

include: Cubital Tunnel Syndrome: Is a condition which

involves compression of an ulnar nerve at the place
where it passes their elbow near to their, 'funny bone.'
Risk Factors that can
cause RSIs:
• Awkward postures
• Repetition
• Excessive Force
• Static posture
• Vibration
• Poorly Designed Tools
• Extreme temperature
• Poor work organization
Awkward Postures

• What awkward postures do workers work

in?

• Bending
• Working overhead
• Kneeling
• Twisting
• Reaching far in front of you to pick up
something
• Working with a bent wrist.
 Repetition
Repeating the same motion over and over places stress on your
muscles and joints. The amount of stress depends on these
factors:
• How quickly the job is done
• How long the job is done
• How much force the job requires, and
• How much recovery time there is between motions.

What jobs require repetition?

Excessive Force
What jobs require excessive force?

common jobs that require a lot of force include:

• Lifting something heavy and carrying it
• Pushing or pulling heavy objects
• Using a tool handle that is too small. This may result in
pinching, squeezing or griping the handle, which can tire the
hand
• Using a glove that is too large and doesn’t fit properly. This
will require more force to hold onto a tool. This can affect
women and other workers who may have smaller hands
• Using a heavy tool that is not balanced may require a lot of
force to control.
Vibration

• The two main types of vibration that can

lead to RSIs are:
1) hand/arm vibration: and,
2) whole body vibration.
Poorly
Designed
Tools
What’s the problem with
these tools?
Poor Work Organization
This refers to the way jobs are structured, carried out, and
supervised, for example:
• Production schedule demands
• Infrequent rest breaks
• Not enough workers
• Poor planning
• Poor supervision
Identifying Risk
Factors
What are some other ways to
identify risk factors on job site?

1. Employer records (OSHA 300 logs,

workers’ comp info., etc.)
2. Worker surveys or interviews
3. Walk around inspections
4. Job evaluations
Problem Solving
What are some ways to prevent strains, sprains,
and Repetitive Strain Injuries (RSIs)?

• Better materials
• Better tools
• Improved work methods
• Better work organization
• Training
• Stretch and flex, and
• Personal protective equipment (PPE)
Solution: Better
Materials
How can building materials be improved?

Better materials should be:

• Lighter weight
• Packaged in smaller units
• Redesigned – like the blocks in this photo.
Solution: Better Hand
Tools
What should you look for in a hand tool?

The best tool is one that:

• Fits the job you are doing
• Fits the work space available
• Reduces the force you need to apply
• Fits your hand
• Can be used in a comfortable work position
Power Tools
• How should you select a power tool?
• It should have a long trigger.
• It should have low vibration and noise levels.
• It should be heavy enough to do the job, but not
add strain.
• Use a power tool instead of a hand tool when you
can.
 Power vacuum lifter avoids manual lifting

Solution: Improved
Work Methods
How can the work be done differently to reduce risk factors at
your job?
• Use platforms, lifts and forklifts
• Use hoists or chain falls
• Use carts and dollies
• Make smaller loads
• Use power tool instead of hand tools
Solution: Better Planning
and Organization
• Plan the work ahead of time
• Deliver materials close to where they will be used
• Have proper equipment at the job site
• Minimize bending, reaching or twisting – work at
waist level whenever possible
• Use the buddy system – get help
Solution: Training
What should training include?
• Risk factors
• Symptoms of MSDs
• Impact of MSDs on workers’ lives
• Solutions
Solution: Personal
Protective Equipment
(PPE)
The National Institute for Occupational
Safety and Health (NIOSH) recommends
that employers not rely on back belts to
protect workers.

What are some examples of PPEs that

can help reduce MSDs?
• Shoulder pads
• Knee pads
• Vibration reducing gloves
Implementing
Solutions
What are some challenges implementing
solutions?
• Costs too much
• Slows down production
• Equipment not available
• Change isn’t easy

• Preventing MSD hazards is less expensive

and more effective than trying to control
them later.
Screeding
Manual Screed Roller screed Walk-behind screed

Screed Solutions
Handling Drywall
Using a stand to lift and position the Using a cart to carry drywall Using a strap or handles to carry
drywall in place drywall

Drywall Solutions
Rebar Tying
Rebar Tying Solution
Overhead
Drilling
Overhead
Drilling
Solution
Caulking
Power Caulking Gun Solution
 What Can You • What changes can the worker do on his/her
Do To Get own?
• What changes can a contractor make?
Solutions • What can the union do?
Implemented?
 • Management commitment and worker
What should be involvement
• Hazard Information and Reporting
included in
• Job Hazard Analysis and Control
Safety program • Training
to reduce RSIs? • RSI Medical Management
• Program Evaluation
Workers Are The Experts

Participatory Ergonomic Programs emphasize worker participation and include five

steps:
1) identification of RSIs and workplace hazards that may cause these problems,
2) analysis of workplace hazards,
3) development of solutions to reduce or eliminate hazards,
4) implementation of solutions, and
5) evaluation of the solution's effectiveness.
 1. Repetitive Strain Injuries (RSIs) are injuries affecting the
muscles, bones, tendons, ligaments, nerves, and soft
body tissues.
2. RSIs are one of the costliest workplace injuries.
3. RSI risk factors include: awkward postures, repetition,
Key points: excessive force, static posture, vibration, poorly designed
tools, extreme temperature, poor work organization.
4. Solutions include: better materials, better tools,
improved work methods, better work organization,
training, stretching, and personal protective equipment
(PPE).
5. OSHA has an ergonomics standard, but it is very limited.
6. A comprehensive ergonomics program involves workers.
Conclusion:
• Repetitive Strain Injuries are not just a local, but also a global issue.
• Construction, being the fast-paced and evolving industry, tends to expose workers to vivid health and safety
risks that may lead to work related RSIs.
• It is encouraged to integrate ergonomic assessment as a policy to analyze jobs and identify risk and degree of
risk at the early stages.
• Based on findings of the study there is a need to incorporate measures to be utilized for reduction of RSIs in
the planning and execution of construction tasks to improve occupational safety and in order to reduce the
leading financial, personnel, and productivity costs is evident.
• There is a crucial need to focus on this topic and make appropriate strict policies regarding it.
• Further this paper can be utilized to mark the base factors associated with RSIs and respective design
implementation can be done.
• This study would be helpful to produce wider and regular dissemination of the practical solutions which could
help reduce the risk of injury to many more workers in the different sections.
Thank-you.