Musculoskeletal System

Monotonous workload is characterized by working on one task or a few simple tasks where the same movements are repeated over and over for most of the working time. What characterizes these jobs is that the work process is short and often done quickly. The length of the work process is the time that elapses from the start of the task until the next similar task begins.

The work is also considered monotonous if the work process is repeated often at the same hour and other risk factors are prominent, such as limited possibility of changing posture or movements when working on the task.

Jobs are considered very monotonous if the work process takes less than 30 seconds or if the same movement is repeated for more than half the working time. There is a greater risk of stress symptoms if repetitive stress work is performed for more than three to four hours a day, and this should be taken into account and the work of employees should be organized accordingly.

• Few, monotonous, short and repetitive work movement
• Restricted freedom of movement
• Difficult to change posture or movement
• Constant tension in certain muscle groups
• Mental stress, for example due to lack of change, lack of time, speed and demands for attention
• Physical exertion

There is a greater risk of stress symptoms due to monotonous work if more than one negative factor, mentioned above, characterizes the work.

It is common for employees to work in locked work positions. Then it is difficult to change posture and in addition work is often done in unsuitable working postures. In addition to the monotony of the work it is necessary to examine in which work positions the employee works and whether the equipment and facilities are suitable for the people and the project.

Employees’ freedom of movement is often limited when work is monotonous. They then have little or limited chance of influencing work organization, work speed and pace. The same applies to the nature of the project, the rest period or when the project is to be completed. Monotonous repetitive movements cause constant tension and fatigue in the muscles and this often leads to stress symptoms in the muscles and joints.

Monotonous work can also be stressful. Such work often involves working in a performance-based system or a so-called bonus system. Studies show that there is a greater risk of stress symptoms with such a work arrangement. These jobs are often accompanied by social isolation, as more often than not there is a lack of human communication and support.

Mental stress increases muscle tension and fatigue and can reduce concentration and impair reactions. Prolonged mental strain prevents muscle relaxation when taking a break from work and thus keeps certain muscle fibers constantly in tension for a long time.

When mental stress and monotonous work go hand in hand, stress symptoms are much more likely.

It is important to avoid monotonous work as much as possible. It is best to organize different movements so that different muscle groups are activated through work rotation. The work organization must offer diversity in both working postures and movements, that is, a division between standing and movement, hard work and light work. If it is not possible to ensure diversity through work rotation, it should be ensured that employees get regular rest from their tasks throughout the day.

In order to increase staff independence and job satisfaction, it can be good for a small group of employees to work together on certain projects and for them to have the opportunity to manage the organization within those projects. It is also important that employees who work in specific, monotonous jobs can switch between different work stations in the overall production process so that they get a holistic overview of it and feel responsible in the process.

It takes a long time to recover strength due to the muscle tension created by monotonous workloads. In light of this, more emphasis should be placed on work rotation than rest breaks in order for different muscle groups to be active during the work shift.

If this is not possible when doing monotonous work, short breaks should be taken for, for example, two minutes every twenty minutes or ten minutes per hour. If there are no lunch or coffee breaks or change of tasks, they should be taken separately but not cumulatively. These breaks can be used for physical exercises. You can install apps or computer programs on a computer or smart device that publishes exercises regularly.

Tight and small workspaces can make it difficult for employees to use correct postures and movements when working. In tight spaces, it can be difficult to take advantage of the equipment that is available because there is simply no room to exert oneself properly when using it, for example bending correctly.

Good work facilities, diverse tasks, proper exertion, knowledge of body functions and exercise increase the chances of being able to reduce various ailments such as muscle pain, carpal tunnel syndrome, joint pain and back pain. It is important to organize the work so that it includes diversity and train employees to perform different tasks that exert different body parts.

Employees can, in most cases, move to some extent at each workstation and should be instructed about the importance of moving while working. Instead of standing still, you can use weight transfer or move the weight of your body from one leg to the other.

The most common strain symptoms associated with work are in the back, neck and shoulders. It largely depends on the nature of the work, the working conditions and the physical activity of the employees, whether the work involves undesirable working postures or movements. Movements that people do without difficulty are rarely harmful.

Duration is very important. How often and for how long certain working postures or movements are applied is important.

When working standing up, make sure that the working height is correct. It is best to be able to stand evenly on both feet with arms close to the body, a straight back and relaxed shoulders. The working height should be 5 to 10 centimeters below the elbow when doing light work, such as with computers, chopping vegetables and in assembly work.

When working standing up, it is very important to be able to adjust the working height to each individual to avoid MSDs in the back, shoulders and neck. Diverse tasks and height-adjustable desks encourage good working postures.

When work requires the use of force or when working with large objects, it is necessary to have the working height lower.

More energy goes into working standing up than sitting down because then there is more strain on the cardiovascular system. It also involves a lot of strain on the back, hips, knees, ankles and vascular system in the legs. Prolonged positions can cause edema and swelling in the legs and fatigue pain.

It is important to organize the work so that employees can change postures and have the opportunity to sit and stand alternately while working. Active chairs are often a good solution to relieve the strain on the back and legs if the tasks are organized for standing while working. Active chairs are designed so that they are easier to get up from than traditional chairs. Employees are therefore very mobile even though they are sitting at work.

A diagram of the Nordic assessment system for estimating the total load on the motor and musculoskeletal system can be found below.

The main advantage of working sitting down is that the strain on the legs, back and torso muscles is less than when standing. The person sitting is more stable and can perform more precise movements than if they are standing. A good sitting posture is when sitting the person is sitting with a straight back and there is good support for the lower back, the upper arms are relaxed, there is good support under the feet and there is no pressure from the chair under the thigh. Furthermore, the feet need good space.

Prolonged sitting, however, is undesirable in the long run. It has been shown that there is more strain on the lower back when people are sitting than when they are standing.

During prolonged sitting there is also a risk of:

• Stiffness in the hips and lower back that can lead to back problems
• Slower blood flow from calves and thighs due to being sedentary
• Pressure from the chair on the blood vessels in the thighs and backs of the knees
• Adverse effects on the cardiovascular system

It is important that all equipment, desk, chair, monitor and other, are adjustable so that individuals can easily change the settings and adapt the equipment to themselves.

If the job involves spending the most of the time sitting down, it is important to ensure that you can get up regularly from the task. It is best if it is possible to include work rotation in the work organization so that the whole shift is not worked sitting down. This way it is possible to ensure the diversity of movements and work postures.

Work postures or movements that require employees to stretch and turn at the same time are likely to cause MSDs. A suitable operating range for the arms is the area that the forearms cover without having to stretch them, with the elbows close to the body.

Maximum reach is when the arm is straight and the work posture is simultaneously good. If the operating range is more than 32-37 centimeters away from the edge of the table, employees are at risk of developing strain injuries to the neck, arms or shoulders, unless it lasts only for a short time and is rarely performed. Therefore, avoid placing objects or devices that are often worked with far from the employee.

If the operating range is between 20-25 centimeters to 32-37 centimeters measured from the edge of a table or machine, there is considered to be a probability of damage to health and it is therefore necessary to assess how long such work lasts. If this is done often or for a long periods, there is a need to better adapt the work facilities to the employee and bring the tasks closer.

A diagram of the Nordic assessment system for estimating the total load on the motor and musculoskeletal system can be found below.

Precision work requires a higher working height to avoid a stooping posture. When doing precision work, it is important to have support under your forearms. A good working height for precision work is to have the project approximately 30-50 centimeters from the eyes and it should be on a sloping surface. A suitable working height when doing precision work is 10-20 centimeters above the elbow.

When working with the hands at shoulder height or above the shoulders, it puts a lot of strain on the muscles in the neck, shoulders, arms and back as well as increasing the strain on the cardiovascular system. Even if you only hold light objects, there is strain on your arms and shoulders when holding your arms up. Often, such work also involves tilting one’s head backwards.

Such postures and movements are common among painters and carpenters but can often be solved with ladders and scaffolding. Some postures are inherently difficult to avoid, such as when painting ceilings. However, they can sometimes be improved by using other tools or using aids such as inflatable neck collars that make the work easier, although they do not completely prevent a bad neck position during the work. If such work postures cannot be avoided, efforts should be made to organize the work so that time spent doing the tasks is significantly limited.

Working below knee height places great demands on employees to have good working postures. When squatting, lying on your knees or crouching, you put a lot of strain on the knees, either because of how bent they are or because of the weight of the body resting on them. There is a high risk of knee injuries when working in this way.

It is recommended that when working on the knees for a long time, you use knee pads or padding under the knee. Heavy objects are often used in these positions, for example in construction or flooring. There is also a risk of strain on the back, shoulders and arms while working in these positions. If it is not possible to avoid such work postures, efforts should be made to organize the work so that time spent on such tasks is significantly limited.

Lying working postures are rare. Such working postures are most often necessary in a confined space and then the arms usually need to be lifted up, which reduces blood flow to them. The conditions for the movement of the arms is poor in a supine position as the weight of the body rests on the shoulders and shoulder muscles. Therefore, it is not possible to work for long in such a position and such work should be limited.

It is important that it is easy to adjust the work desk, both for sitting and standing work heights. Too high a working height results in an undesirable steady muscle tension in the shoulders and neck. Too low a working height results in an awkward position for the neck and back, which puts strain on the joints, ligaments and muscles of the spine and shoulders.

The chair is an important piece of equipment for work. It must be chosen for each and every employee based on the tasks they are working on. The chair must be stable and easily adjustable, both height, seat depth and backrest. Legs should be able to rest on the floor without the front edge of the chair pressing under the thighs or knees.

Properly shaped back of the chair should provide good support for the lower back. There are differences in whether it is suitable to use chairs with arms, so it is a good idea to choose chairs that have arms that are easy to remove or push back. Every employee needs to learn to adjust their work chair and make the most of its adjustment options.

When choosing a work chair, take into account the physique of the person that will be using it and the type of work to be done. A good work chair is best utilized if the user adjusts the chair several times a day. Diversity increases and fatigue decreases. It must be easy to change the chair’s settings while sitting in it.

The following points must be taken into account when choosing a work chair:

• The seat should support 2/3 of the thighs. It needs to be reasonably spacious and comfortably padded so that the user can move freely and be in a comfortable posture. The height of the seat must be adjustable and the inclination of the seat back and forth should be adjustable.
• The back of the chair needs to provide good support, especially to the lower back. It needs to be easily adjustable up and down.
• The arms need to be adjustable if they are to be used as support under the forearms. Care must be taken that the arms are not too long so that they collide with the edge of the table and prevent a good sitting posture.
• Chair legs should be five-sided. If the chair is on wheels, make sure that the wheels fit the flooring. A slippery surface causes unnecessary muscle tension.

There are chairs with an unconventional shape available, for example balance chairs and standing chairs and active chairs. It’s nice to have these chairs in the office for variety.

It is the user’s responsibility to take advantage of the chair’s possibilities and to ensure that the chair is always adjusted in accordance with the tasks performed.

If employees sit on a chair and do not reach the floor with their whole foot, a footstool must be used. This will prevent unwanted pressure from the edge of the chair under the knees. There are several types of footstools, they need to be height-adjustable, large and sturdy enough so that they do not slip.

Many professions work with hand-held tools. They are used in everything from fine precision work to rough works that require a lot of power. When evaluating tools from an occupational health and safety perspective, many factors and their synergistic effects need to be taken into account. A good hand-held tool has a handle that allows employees to move the joints of the hand as close to rest as possible. The handle must fit both small and large hands.

It is also necessary to consider whether the tool causes vibration in the hands and/or body, so it is good to familiarize yourself with the regulation on protection against stress due to mechanical vibration in the workplace, as vibration can cause both discomfort and permanent damage. The effects and consequences of vibration depend on the amplitude, frequency and time. That is, if the displacement is great, if the movement is rapid and if the vibration lasts for a long time, the effects and consequences will be greater.

Vibration is divided into hand and arm vibration and body vibration. Causes and consequences vary depending on the case.

Various things can be done to respond to vibrations. These include:

• Changed working methods where employees are less exposed to mechanical vibration
• Appropriate choice of ergonomically designed work equipment that produces the least possible vibration with respect to the work to be performed
• Accessories that reduce the risk. For example, seats that significantly reduce vibration throughout the body and handles that reduce the transfer of vibration to the hands and arms.
• Information and training to teach staff to use work equipment correctly and safely and to keep mechanical vibration to a minimum. Like looking at the sitting posture and body posture and the settings of seats and even controls.
• Suitable working hours with appropriate rest periods. Limit staff exposure time and reduce vibration.

The work desk should be easily adjustable so that its height can be quickly adapted to the employee. The working height should be based on the possibility of working with a straight back and relaxed shoulders. Improper working height can put unnecessary strain on the shoulders, arms and wrists.

There must be enough desk space to accommodate a keyboard, mouse and worksheets as well as space in front of the keyboard for the user to rest their hands on the table. It must also be possible to install a lamp if necessary. There must be enough space for the legs under the work desk to be able to sit in a comfortable position, so the thickness of the table should not exceed three centimeters.

The keyboard should have a matte finish so it does not cast a glare. Research suggests that a negative keyboard tilt, which is approximately 10-15° away from the individual, causes less strain on the wrist than a keyboard that tilts towards the user. Therefore, the keyboard should lie flat on the table surface and not tilt towards the employee.

Monitors and keyboards should be separate so that they can be adapted to each individual’s needs. The monitor’s height, rotation and tilt should be easy to adjust according to the needs of the user. The goal is for employees to have to bow their heads as little as possible to look at the monitor.

The monitor must have sharp and clear symbols and be free of flickering. The position of the monitor should be such that brightness from a window comes from the side and light does not shine directly into the eyes or is reflected from the screen.

Good lighting is an important part of the work environment and reduces the risk of muscle tension and eye fatigue. Proper lighting is a prerequisite for working in a comfortable position. With age, vision changes and the need for lighting increases. When planning a workplace, it is necessary to assess how much lighting is necessary and what kind of light sources are most suitable.

The location of the light source should be decided after the work environment has been planned. If the description at the outset has not been sufficiently elaborate or circumstances change, the lighting and other aspects mentioned here need to be reviewed.

Lighting for computer work takes into account whether the monitor has a light or dark background. Lux is a unit of measurement for the amount of light that falls on a certain surface. If the brightness is too high, it will be harder to read the screen. For a computer monitor with a dark background, it is advisable to limit the aerial lighting to 200-300 lux and use special lighting on the scripts and keyboard.

The recommended overhead lighting for monitors with a light background is 500-750 lux, which is also suitable for normal office work. The need for special lighting for text on paper and keyboard must be assessed each time. A lighter monitor therefore fits much better with the brightness requirements for traditional office work. The distracting effect of rebound or reflection is much less noticeable than with dark monitors. Always keep in mind the position of the computer monitor so that the brightness from the windows comes from the side and the lighting is not reflected in the screen.

If there is too much brightness, it will be harder to read the screen. For a computer monitor with a dark background, it is advisable to limit the overhead lighting to 200-300 lux and use special lighting on the scripts and keyboard.

The mouse should be placed next to the keyboard so that the arms are as close as possible to the torso when working. It is desirable to use the left and right hands alternately on the mouse. Due to the structure of the keyboard, it is often more convenient to have the mouse to the left of the keyboard. It is good to have a special pad for the mouse.

It is not desirable to work a full day only on a laptop as the screen and keyboard are not separate and there is little possibility of adapting the facilities to the individual. The screen is low which can put strain on the shoulders and neck. It is therefore recommended to connect a laptop to another monitor and/or keyboard and computer mouse if possible.

When using tablets at work, care must be taken to ensure that adequate facilities are available so that employees can have good posture while working. It is not advisable to work on a tablet for long at a time. Care must be taken that tablets are not too heavy or large if they need to be held while working on them. Larger tablets are more convenient for the eyesight, but are also heavier and more bulky.

Holding a tablet for a long time can put strain on the fingers, hands and shoulders, so it is good to see whether it is possible to place the tablet on a table or on a flat surface. There are also various types of adjustable holsters for tablets, some with a keyboard so that the work is easier and puts less strain on the body.

The consequences of heavy use of tablets and smartphones are becoming apparent in people’s posture. The symptoms are often the so-called “text neck” which is caused by people hunching when using the tablet and other devices. Having the neck at an angle of 15-45 ° puts a great strain on the neck and down the back.

• Keep the neck in a central position – upright position
• Keep tablet/phone at eye-level
• Have the tablet on a table
• Don’t work on a tablet for long periods at a time
• Take regular breaks

The rules on safety and wellbeing when handling loads include a provision that the employer must take organizational measures or use appropriate aids, in particular hardware, to prevent employees from having to handle loads. In preventive work against physical strain symptoms, it is important to implement technical equipment for lifting and transporting heavy loads so that it becomes a normal part of the work process.

The most common reasons for not using technical equipment or lifting equipment in the workplace:

• The appropriate technical equipment is not available
• Technical equipment or lifting equipment are too few compared to the need
• There is a lack of education on the use of appropriate lifting equipment or technical equipment
• There is a lack of training in the use of appropriate lifting equipment or technical equipment
• Lack of room
• Lack of time
• Negative attitude towards lifting equipment and technical equipment.

The workplace should be organized so that loads do not have to be handled. If this can not be avoided, use appropriate equipment. Examples of equipment are forklifts, trolleys on wheels, patient lifts, good handles and more. The workplace risk assessment shall assess whether there is a need for more employees to work together to prevent strain injuries, for example in the care of patients.

The main factors of physical stress in lifting and moving loads are:

• Weight of load
• Frequency
• How often the load is lifted
• Location of load
• From what height is the load lifted and at what height is it lowered

It has been shown that most people are at risk of straining their back when lifting more than 25 kilograms.

As the weight of the load or its distance from the body increases, the pressure in the muscles and joints of the lower back increases. Always try to keep the load close to the body, because the strain on the back will increase when the load is kept away from the body.

There are various risk assessment tool available for assessing the strain of lifting loads. In the Nordic risk assessment tool, the strain on the back when lifting and carrying loads is measured by the weight of the load and the distance between the lower back and the center of gravity of the load. It is important to keep in mind that when assessing strain, time is of the essence, i.e. how often the work or movements take place and for how long each time.

According to the Nordic assessment tool, employees should not lift more than 25 kilograms in the best conditions, and the distance between the lower back and center of gravity of the load may be at most 30 centimeters away from the lower back. Employees should not lift more than 15 kilograms if the distance of between the lower back and the center of gravity of the load is 45 centimeters.

If the load is between 7 and 25 kilograms, all other risk factors at work must be assessed in addition to the weight. If there are other negative factors, for example that there is frequent lifting during the shift, work postures are inconvenient, work has to be done under the pressure of time or in cold environments or where conditions are slippery, there is a risk of damage to health and therefore it is important to find a solution that reduces strain and thereby avoid MSDs.

An insignificant risk of damage to health is considered to be when lifting loads up to 7 kg if the load is kept close to the body. However, one must always keep time in mind and evaluate how often the work or movement is repeated during the shift/working hours.

If the employee has to handle heavy loads or do repetitive work, it is crucial to limit that work as much as possible. Equipment should also be used when appropriate, but it is the employer’s duty to provide employees with appropriate equipment and instruction in its use.

A diagram showing the assessment of the weight of loads in the Nordic risk assessment tool for estimating the total load on the musculoskeletal system can be found below.

Keep in mind that equipment should always be used if possible.

If this is not possible, here are some tips when it comes to lifting heavy loads at work:

• Get training on how to lift, carry, push and pull in the safest way
• Keep the load close to the body
• Ensure good balance when lifting
• Lift with your back straight, bend your knees and hips
• Avoid lifting and twisting at the same time
• Get help from others when lifting heavy loads
• Don’t lift loads above shoulder height

When discussing the dangers of lifting, carrying, pushing or pulling, be careful not to focus too much on the weight of the load.

The overall picture of the work process must be viewed:

• How many times a day the employee lifts and whether they get enough rest between lifting is important
• It is no less important to examine the work technique used when lifting, what working postures are used, where the load is located, where it should be transported and how to handle the load.
• It is necessary to assess whether the work space is sufficient to be able to carry out the work with good working postures and lifting technique.
• The physique and endurance of the employees are also very important and this needs to be taken into account
• Paths must be accessible and the surface safe; surfaces, for example, must not be slippery or obstructed, such as by power cords.

Lifting heavy loads is both detrimental to health and financially inefficient. In most cases, technical equipment can be used to facilitate the work.

It is important to keep in mind that prevention is effective. Prevention can reduce work-related strain disorders and this results in better employee health and improved company operations. The solution can be, for example, work rotation so that the employee gets a break from lifting while doing other lighter jobs.

To avoid strain disorders, you need to:

• Reduce physical strain
• Improve work organization
• Use appropriate technical and lifting equipment
• Provide guidance on physical exertion and the use of technical and lifting equipment

The position of the load when it is picked up and put down, is of great importance for the strain that it puts on the body. If the load is located at or above shoulder height or below knee height, it is a major risk factor. When lifting from the floor or placing the load on the floor, the risk of overloading the back, knees and hips increases.

If it is not possible to avoid placing a load on the floor, use suitable lifting equipment when lifting, for example a forklift so that you do not have to lift a heavy load by hand. In such situations, it is important to have knowledge and training in good work technique and physical exertion.

When carrying loads, constant muscle tension forms and muscles get tired quicker than during movement work. When holding a load in one hand, uneven strain on the body is created and the risk of stress injuries increases. It is best to hold the load in both hands in front or on your back. The longer you hold the load, the greater the tension in the muscles and the higher the strain. When walking with a load, the strain on the back increases. For these reasons it is important to consider the distance that the load must be carried.

Carrying maximum weights farther than 20 meters at a time should be avoided. When carrying on stairs, even more strain is created than when carrying on level ground. Keep in mind for comparison that one step corresponds to 1 meter. It is important to organize the work process with a logical arrangement of machines and workstations in order to avoid as much carrying as possible.

These are issues that need to be looked at in particular in various industrial jobs where the entire processing process is composed of different workstation. It is also important to ensure that floors are not slippery and that there are no obstacles such as barriers, pipes, cables and power cords on the walkway.

To assess whether the work of pushing or pulling involves the risk of damage to the health of the employee, these items must be considered:

• The weight of loads
• How far the load is to be pushed or pulled
• Condition of the surface and type of wheels
• Whether it is easy to get a grip on the load
• At what height you can get a grip
• Physical condition of employees

Where it is difficult to estimate the strain of pushing and pulling loads, it is not advisable to push or pull loads heavier than 20 kilos (200 N).

In order to reduce strain while pushing or pulling loads, these items must be considered:

• Getting a good grip on the load
• The grip on the load is at a comfortable height and that it is possible to lean forward when pushing
• When pulling, lean back and use the weight of the body
• It is good to use straps on the load when pulling

Pregnant women and women who are breastfeeding are advised not to lift more than 10-12 kilograms from the fourth month of pregnancy and for three months after giving birth. Do not lift more than 5-6 kilograms after the seventh month of pregnancy.

As the abdomen expands during pregnancy, the load, which previously could be lifted in the best conditions by keeping the load close to the center of the body, becomes heavier because the load has to be kept further from the center of the body and the strain on the back becomes greater. Due to the changes in the woman’s body during pregnancy and the first months after birth, it is considered dangerous for the health of the mother and fetus to lift heavy loads.

The risk depends on the weight of the load, how it is lifted, how often it is lifted and how far the load is from the center of the body. It is recommended that from the fourth month and for three months after birth that you lift as little as possible at one time.

The change in posture due to a larger abdomen makes it more difficult to stand or sit in the same position for long periods. It is more difficult to bend or twist the torso, as well as to kneel or work squatting down. Blood flow to the uterus may decrease with prolonged standing or heavy walking.

From the beginning of the fourth month of pregnancy, it is important to plan your work so that you can sit and stand alternately. It is important to spread rest breaks evenly over the shift, as the need for division between work and rest increases as the pregnancy progresses.

Here are guidelines for risk assessment in the work environment of pregnant women and women who have recently given birth or are breastfeeding:

According to the regulation on the work of children and adolescents, having children lift a weight heavier than 8-10 kilograms should be avoided. In the regulation child refers to a person under the age of 15, or who is still in compulsory education. In the regulation, adolescent refers to a person who has reached the age of 15 but is under the age of 18 and is no longer in compulsory education.

The regulation also stipulates that young people should not be allowed to lift a weight heavier than 12 kilograms. Young people in the regulation refers to a person under the age of 18.

Studies of pressure in the lower back have shown that the pressure increases greatly when bending forward and there is a particularly high risk when lifting loads with the body twisted. This often happens, for example, when digging or taking care of bedridden or disabled people.

If there is limited space for good posture, people tend to twist their torso. When lifting in unsuitable conditions, for example with the load far away from the body, with a lateral bend in the back or with a twist, the load can cause up to 200% higher pressure in the cartilage pads of the lower back than when lifting in the best conditions.

The risk of strain symptoms in the upper back, shoulders, neck and arms increases if the load is lifted often or so that the arms are at or above shoulder height or far from the body for a long period of time. Although the load is not too heavy for the back, it can be too heavy for the arms and shoulders.

Excessive strain can lead to muscle inflammation around the shoulders and neck, tendon attachments in the shoulders and elbows and premature wear and tear on the joints. When lifting above shoulder height, it is difficult to balance the load and this further increases the risk of back strain.

Working conditions, such as the height of tables, and other fixtures and devices need to be inspected, for example when stacking or clearing tables, forklifts and platforms. Efforts shall be made to have work facilities and equipment adjustable so that the working height can be adapted to each individual or other solutions should be found to ensure a good working height for each individual.

Excessive strain is placed on the back, neck, shoulders and arms when lifting loads and moving them. It is estimated that between 60-90% of people in Europe suffer from back pain at some point in their lives and that 15-42% usually suffer from MSDs. There is no difference in the incidence of back problems in women and men. Back problems are more common in some professions, for example in the construction industry, with flooring, transport, horticulture, care and domestic cleaning.

Back pain is the most common work-related disorder in Europe, with 60% of sick leave due to musculoskeletal disorders. Although most people who experience back pain recover well, the rate of absence from work is high and it is important to keep in mind that there is a tendency for back pain to recur. Back pain can cause great damage to health and financial loss to individuals, but it also has a financial impact on business activities and society in general.

MSDs in the neck, arms and shoulders are known in most professions, but they are most common in the fishing industry, in factory, construction, office, hotel and restaurant work. Strain in the neck, shoulders and arms has been shown to be more common in women than in men. Despite the increasing supply of technical and lifting equipment, many jobs still involve a lot of physical strain in lifting loads and moving them.

Most common causes of physical strain disorders when lifting, carrying and moving:

• Loads that are too heavy or large
• Loads are lifted continuously during working hours
• Too short a rest between lifting loads and moving them
• Unsuitable work postures
• Lack of technical or lifting equipment
• Unsuitable organization of work environment
• Unexpected movements of the load
• The load is unmanageable or difficult to grasp
• Vibration from the load or technical equipment
• Cold or draft in the workplace
• Direct injuries, for example from sharp edges or handles or when the load moves unexpectedly during transport, for example when lifting a patient who moves unexpectedly
• Dissatisfaction at work, little flexibility or opportunity for decision-making
• Inadequate training on physical exertion and the use of technical or lifting equipment
• Poor physical condition, low endurance and weakness or illness

Tight and small work spaces can make it difficult for employees to use correct postures and it can, for example, be difficult to bend over properly. The space required for employees to bend over at work must be at least 60-80 centimeters. It should be  ensured that it is possible to access a bed on both sides when an individual needs to be assisted there.

The rule is that the workplace should be organized so that there is no need to handle loads. This can be difficult when working in someone’s home. Therefore, the circumstances must always be assessed before starting work and loads should not be lifted unnecessarily.

Always use the appropriate equipment. Examples of equipment are helping aids for forklifts, wheelbarrows, patient lifts, sails, turntables, conveyor belts and turntables, good handles and more. Equipment should be selected to suit the job and fit into the work space.

A written plan for safety and health at work should assess whether more staff need to work together to prevent strain injuries, for example in the care of patients.

Employers have a duty to ensure that employees have a safe and healthy working environment.

Municipalities and companies that provide home nursing, home care and other services in the home need to carry out a risk assessment for the work of home staff and a prevention plan based on the results of the assessment.

The working conditions of employees must be assessed before agreements are made with individuals who use such services, and the assessment must be reviewed if circumstances change.

Employees shall promote the adequacy of working conditions within their work area in terms of facilities, hygiene and safety.

Employees who notice defects or deficiencies which could lead to reduced safety or poorer conditions or hygiene which they cannot repair themselves must immediately notify the security guard, safety representative, foreman or employer.

It must be ensured that the risk assessment carried out at the outset covers all aspects and creates an overall picture of the working conditions.

When assessing risk for the musculoskeletal system, one must consider, among other things; workspace, accessibility and whether the necessary equipment and equipment are available for proper physical exertion. The work organization and scope of projects must also be assessed, with the aim that there is a reasonable time to complete projects without being under pressure.

It is necessary to ensure that staff receive the necessary instruction and training in the use of equipment and give employees the time to exercise, especially new recruits but also staff who have worked longer.

It is important for employees who work alone to be able to get help if they or a client has an accident or falls ill during the service. It is stressful working in conditions that raise fears of not being able to cope alone with complex and unexpected events that may arise.

Working alone, especially at night, can be overwhelming for many, as well as more stressful. It is important that such situations are discussed in the workplace and that employees enjoy support so that the work environment is as good as possible.

Musculoskeletal disorders in working people are a widespread problem worldwide. The good news is that we have a lot to say about how we use our bodies and how we design our work environment.

In Europe, 60% of sick leave is due to musculoskeletal pain. This number will increase if nothing is done. Prevention is the strongest weapon to prevent more people from joining this group.

Most people can improve their work environment to some degree. By adjusting the chair better, adjusting the table height, having support under your feet, considering lighting, air quality, noise or the arrangement of the work desk.

Remember that we have a lot of control over our physical exertion. It is good to stand and sit alternately at work, take short breaks and get the blood moving.

Here on the AOSH website, you can find various aids in the preparation of risk assessments that are intended to promote the safety and health of employees and prevent health damage due to work or the work environment.

Indoor air is one of the things that is often forgotten when talking about the work environment – but there is nothing better than being able to open the window and breathe in oxygen.

How is the access to windows in your work area?

Are you able to open a window?

The temperature in a normal work area during sedentary work should be 18-22 °C It is best to keep it 20-21 ° C.

The humidity of the room also needs to be considered. It is said that the humidity percentage depends on the temperature and people often experience hot air as dry. It is most convenient to have a humidity percentage around 30-50%. It is worth mentioning that Icelanders are known for keeping their houses dry and hot.

Bear in mind that light can have a significant effect on physical exertion at work.

It is important to have good lighting for all work.

Using daylight is best, but there is often need to add to that light here in Iceland. It is best for lighting to fall on the work from the side, not from the front and not at all from the back, since that means we are working in the shadows of our own bodies.

Good lighting helps us maintain good physical exertion during our work. Incorrect lighting encourages us to pore over the projects or squint, lean over the projects or have an inconvenient posture in order to see better what we are doing.

In the appendix to the rules on screen work, there is a clause about lighting that is good to keep in mind when working on a computer monitor.

Flooring is important.

It is not good for the body to stand on a hard floor surface for long. If this is the case and it is not possible to improve it, the footwear must be examined carefully. It is good to wear shoes with soft soles. It is also advisable to change shoes during the day to rest your feet.

The best flooring material and the softest to stand on is cork. Then parquet, but it is most difficult for us humans to stand on hard surfaces such as tiles or stone floors.

Article 16 of the rules of workplace housing is precisely concerned with flooring.

All unwanted sounds and sounds we do not like is noise.

In order for us to be able to perform our work with full concentration, other sounds in the environment should not normally exceed 50 dB (A).

We experience stress if we are disturbed by external noise and that stress affects concentration, performance, mood and attitude.

To limit noise in the environment, everyone needs to be alert to reasons and solutions.

The noise can be due to bustle in the environment, conversations, phone calls, music and so on. The noise can also be amplified due to poor sound quality, such as loud echoes.

Be considerate to others, hold meetings where they do not interfere with other work, walk around quietly and restrain yourself in conversations and phone calls.

Hurrying when working can sometimes have serious consequences – many accidents at work have taught us that.

But it’s also bad not to give yourself space to consider before setting off on a project or not to take the time to use task-easing equipment for the work when appropriate.

Why do we prioritize time over physical well-being?

It is often the case that in order to be faster at work, physical exertion and one’s own well-being is ignored. It is bad for the body in the long run. Is the time worth it?

Those who have had to leave work due to musculoskeletal problems would probably answer this question in the negative.

You don’t know what you have got until it is gone.

An important part of ergonomics is to consider the work environment. An organized work environment means that there is “a place for each object and each object in its place.” It is said that one minute spent on planning pays off at least five-fold. So this should be an easy calculation. But an organized work environment is also thought to affect mental well-being. The overview is greater and the individual feels better.

The layout of the work environment should be in accordance with the red, yellow, green rule (see red, yellow, green). What we are working on should be as close to the body as possible (either on a table or arranged around us). Care should be taken not to align objects on top of each other if they are heavy. The look is not more important than the functionality of the workstation …

Try taking 5-10 minutes to organize your desk today and you will see; work will be much more fun tomorrow

All work should be done as close to the body as possible, directly in front of it and be careful not to twist the body too much.

It does not matter what you are working on, keep it directly in front of you! Some good man said that it is best to have the nose and toes always pointing in the same direction and we think it is actually a very good way to remind ourselves of this!

Here are some tips to help you improve your sitting position.

Straighten your back properly and try to keep it fairly straight when you work.

In a sitting position, it is best to sit in a so-called 90° position. Then you sit with your hips at a 90° angle and knees at a 90° angle.

Admittedly, it has been debated whether the hips should be at 90° and it has been argued that it is even better for the hips to be about two centimeters higher than the knees, which means that we open up the hip angle to get a better position on the lower back.

The height adjustment of the work chairs is usually on the right side and then usually the front button (but it depends on the type of chair).

If the chair becomes too low compared to the desk with this setting, you need to raise it so that your working height is at elbow height and then maybe use a footstool under your feet – or lower the desk.

Please note: If the chair becomes too low compared to the desk with this setting, you will need to raise it and then perhaps use a footstool under your feet – or lower the desk so that your working height is at elbow height.

In a sitting position, it is the working height that makes the most difference.

The work height is the height that you are working at. It is often added on top of the desk height.

For example: The keyboard is your work height if you are working on a computer.

Now adjust yourself to the height that suits you: Working height in elbow height. The sitting position is 90° (see sitting position – start).

If your feet do not reach the floor now, you need to put something under them – preferably a footstool (see footstools).

If there is no footstool, you need to use your imagination: an old phone book (if it is still available), a thick folder (all documents are on the computer anyway) or books that no one is reading.

Sitting positions are different and there is no single sitting position that is absolutely correct.

To take a break from the 90° sitting position (see sitting position – start) it is a good idea to switch to another sitting position. Humans were NEVER meant to sit in the same sitting position for many hours a day.

It is sometimes said that the next sitting position is the correct sitting position – which actually means that movement (even if sitting) is the best for the body.

Another good sitting position is, for example, a 110° angled position. It is sometimes called the jockey position, but then the seat of chair seat has to be forward-leaning. See if you can tilt your chair. This sitting position is good because then the curves of the spine remain the same as when standing …

What needs to be considered when adjusting a chair??

• Is it easy to adjust? is it easy to reach the adjustment buttons?
• Can it be raised and lowered?
• Can the seat be tilted?
• Can the seat be moved backwards and forwards?
• Can the back of the chair be moved up and down?
• Can the back of the chair be moved forwards and backwards?
• Does the chair have arms? – If so, are they adjustable ??

If these questions are answered in the affirmative, the chair should be easy for everyone to use.

Do not be afraid to use the settings – the more you “tinker” with your chair, the more likely you are to find a setting that suits you. It is good to switch from one mode to another during the working day. The more diverse the postures – the better for the body.

Many chairs have the possibility of movement that it is possible to keep the seat in a “loose” position and by adjusting it in this way, there is increased movement of the body even when sitting. It is not suitable for everyone to sit still.

If the chairs you have access to at the moment are not very adjustable, you need to use your imagination.

Your sitting position is your responsibility – not the chair’s!

The chair is an aid. There are more aids available to improve your posture. If the seat does not fit well, there are loose seats that can be placed in the chair, for example sloping seats, or tempur seats that mold according to your weight and shape. Also air-filled seats that facilitate movement on the seat and seats to elevate yourself.

If the back of the chair does not fit well, you can use a backrest to support the back. There are molded backrest available, both made of sponge, air-filled and tempur.

It can also be a good idea to switch between chairs if possible. Changing the type of support when sitting will provide some rest.

When sitting at a table, most people use their eyesight for the tasks that are being done. Then it is common to sit in what we sometimes call “a shrimp position”, or like the letter C. To avoid that posture, the task must be moved closer to the eyes and then it is necessary to use all available aids – such as a tilted writing desk, reading podium or some elevation . Such aids prevent you from leaning over the table, going into a “shrimp position” and hunching over your work.

Remember that all work should be done as close to the body as possible. Never work on anything to the side, always have the project directly in front of you.

It takes more than a good chair for us to feel comfortable when sitting down. The use of footstools can help improve posture. There are many types of footstools. For example, some stools have a kind of gusset (like stairs) and others have a larger base on which the whole foot rests.

Footstools with a larger base area are preferred, as the foot rests better on such a foundation. The gusset can (in the long run) push uncomfortably much against the sole of the foot and create tension in the instep and sole.

However, it is still best to rest both feet on the floor, which is possible when the desks are height-adjustable, then there should be enough space for the feet. The rule is to adjust the chair first and then the desk.

Many people work on electrically adjustable desks. They need to remember that the recommended desk height for sedentary work is that the task is at elbow height (see – working height – sitting position). That is to say, what we are working on is at elbow height.

You can then start adjusting the chair, remember the 90° position on the knees (see starting position), then place the task on the desk and finally adjust the desk height.

When using a tilted writing desk (see shoulders and neck) it is usually assumed that the center of the writing desk is at elbow height.

Remember to use the technology and raise the desk so that you can stand at it. Working on a computer while standing up is a nice change. To remind yourself to at the desk while standing up , you can get into the habit of always raising the desk before going to lunch and or for a coffee break and before going home. When you find the raised desk, try to work that way for at least 10-15 minutes. This partially increases the chances that for part of the day you will be standing while working.

The height of the table depends on the nature of the task. The nature of the tasks is usually divided into three categories – light work, precision work and hard work.

For precision work, which is work that requires the application of eyesight, it is best to adjust the table height 5-10 centimeters above the elbow height.

For lighter work, which could be buttering bread, chopping vegetables, painting a picture, tailoring materials and working on a keyboard, the table height should be 5-10 centimeters below the elbow height. This is the table height that desks should be at.

For hard work, which can be, for example, sawing, sanding and kneading dough, the table height should be 15-20 centimeters below  elbow height.

Didn’t you definitely try standing at the desk yesterday?

It is a good idea to keep the following in mind when standing at work.

Stand:

• with a slight space between the legs.
• with knees relaxed. Many people have a tendency to overextend their knees, which leads to a forward-leaning position that is not good.
• with hips in center. Make sure that the lower back is not too arched. Also, don’t “hang on the hips.”
• with your back straight – but not tensed.
• with the neck straight.
• with the chin pulled in – do not push it forward.

Many people push their shoulders forward and thus become hunched over in the upper back. The best way to prevent this is to look up from your work on a regular basis.

It is important that the working height suits our height, but of course we are not all the same height. Even though we were all equally tall, it also matters how we are built, that is, the proportions of our bodies. Some have long legs and others have longer torsos. Therefore, it is very important to adjust all work facilities based on the individual.

There are very remarkable measurements (anthropometry) that have been made for many years on the proportions of man, because they and their size affect so many things. For example, the design of furniture, clothing and items.

But according to the Nordic assessment system; yellow, red, green (see NEW – red, yellow, green) – instructions, the recommended work areas for standing work are based on:

• Green area: which is considered to be from the hips to the middle of the abdomen.
• Yellow area: which is from the hips and down to the knees – and from the middle of the abdomen and up to the shoulders.
• Red area: which is from the knees and down to the floor – and from the shoulders and up to the head!

You should never work in a red area for long

One of the things that often happens when standing at work is that due to fatigue in the legs, one involuntarily starts to stand more on one leg and then switching to the other instead of standing evenly on both feet.

Standing on one leg more than the other means that the distribution of body weight is uneven and there is a distortion in the spine which then causes discomfort in the back and hips. It is therefore important to always stand evenly on both feet, with space between the legs and to avoid overextending your knees.

If you experience fatigue, it is better to perch on a standing chair or sit down for a short while to gather your strength.

Use today to notice your physical exertion while standing.

It is important to remember that with standing work it is best to make the work dynamic, that is to say not to stand the same way, completely still. Just taking a few steps, or using heavy loads, helps to turn static work into dynamic work.

It is called static work when a person’s muscles are tensed, which hinders circulation. Constantly tensed muscles lead to the accumulation of lactic acid (which is a precursor to myosotis…) where the blood flow around the muscles is restricted.

Dynamic work, on the other hand, is likely to stimulate blood circulation. It (mostly) prevents varicose veins and promotes better nutrition to the muscles. We induce dynamic work with small movements, such as taking small steps back and forth or to the sides.

No one should ever stand completely still while working. We are made for movement.

Here is a fun short video about movement at work.

People may think that it is not always possible to do all work as dynamic work (see – static work and dynamic work) – but maybe there it is just habit that gives us that idea?

Most work can be done as dynamic work.

It is important that employees receive instruction on physical exertion at work as soon as they are introduced to the job, as we quickly for habits when doing our jobs. Common habits are not standing on both feet, sitting hunched over, with shoulders tensed and having the tasks too far away from the body. In many cases, this can be prevented if we decide to change the habit. For example, you can let your phone beep regularly and then adjust your position, do light exercises before lunch and coffee breaks and last but not least mobilize your co-workers to remind each other to use better postures.

By linking good physical exertion immediately to the task, the chances of the employee lasting in the job increase.

Many of us work with computers and although they are a wonderful invention, there are many things that can be improved in the physical exertion when using a computer.

The center of the screen should be at shoulder height or about 15 inches below the direct line of sight.

This is called a “relaxed sight line”. Það mætti hugsanlega þýða sem „afslöppuð sjónlína“ en það hugtak er ekki notað.

Most computer monitors are adjustable (usually with a single movement – no struggle!) But if not, just use your imagination: For example, is it possible to put a book that is not used often under the monitor?

Those with bifocal or varifocal glasses need to keep this in mind when adjusting the height of the computer monitor. Each and everyone needs to find where their focus point is. Sometimes it also helps to tilt the monitor. Remember, however, that the neck must not be in a bad position due to the height of the monitor.

It is important to remember to let go of the computer mouse as often as possible. It’s not going anywhere! It is also important not to always rest your arm on the desk, holding the mouse and with your index finger in the trigger position!!

Just relax and rest the hand that normally holds the mouse, either in your lap or at least at the center of the body. All work should be done directly in front of the body and as close to it as possible. So, let go of the mouse and rest your shoulder and arm.

Many computer users feel a pain in the hand that holds the mouse. Usually around the elbow. The reason, in many cases, is a pressure injury on the wrist after overuse of gel pads in a mouse pad!!). Therefore, mouse pads with gel pads should be turned once a week to diversify and prevent pressure injuries.

So, on Mondays the pad is turned (although not upside down) so the gel pad is supports the wrist one week and the other week the arm is freer and the shoulder is used more.

The keyboard should not be tilted (do not elevate it in the back!). Keep the keyboard straight on the desk and make sure to use the shortcut keys as much as possible to minimize the time the mouse hand has to use the mouse.

Good tip: Many computer users feel a pain in the mouse hand. Usually around the elbow. The reason, in many cases, is a pressure injury on the wrist after overuse of gel pads in a mouse pad!!). (Yes, even if the pain is in the elbow). Therefore, mouse pads with gel pads should be turned once a week to diversify and prevent pressure injuries.

So, on Mondays the pad is turned (although not upside down) so the gel pad is supports the wrist one week and the other week the arm is freer and the shoulder is used more.

The computer monitor should always be positioned so that daylight shines on it from the side. This means that the computer monitor must not be positioned in front of a window so that daylight shines in the eyes, nor in such a way that the computer monitor faces the window (the sun shines on the screen, which means a reflection from the screen).

Try moving your computer monitor so that daylight comes from the side if it is not already positioned that way.

It is best to do it right away.

There are rules about working with screens. Be sure to check them out.

Lifting loads puts a lot of strain on the whole body. Mostly on the legs, back and shoulders.

When you need to lift things:

• Estimate the weight of the item.
• Keep a good distance between your legs.
• Face the object directly and stand as close to it as possible.
• Bend your knees and hips.
• Keep your back straight.
• Achieve a firm grip with straight elbows and relaxed shoulders.
• Lift by moving the body weight from the toes back to the heels.
• Slowly straighten your knees and hips at the same time.
• Keep the object as close to your body as possible at all times.

Putting down a load requires exactly the same – except in reverse order!

You can read more about lifting loads further up on the page.

It is not advisable to lift everything and in whatever way!

The recommended weight of a load is a maximum of 25 kilos. That said, be careful not to overdo it with carrying heavy loads. Then it is better to use aids or task-easing equipment to avoid putting too much strain on the body.

You should avoid lifting above shoulder height. It is not good for the body to lift a load up above the shoulders often and repeatedly, or to work for a long periods of time with the arms at or above shoulder height. Although the load is not considered too heavy for the back, it can be too heavy for the arms and shoulders!

Excessive strain can lead to muscle inflammation around the shoulders, upper back and neck.

It is also more difficult to balance when carrying a load that is lifted above shoulder height.

Below you will find rules on safety and hygiene when handling loads.

You can also read more about lifting and carrying loads further up on the page.

How are you supposed to remember to take a break? It is too common for people to sit for long periods of time without getting up.

Let technology help you.

You can install the break exercises on the computer. This automatically gives you a reminder to move, stretch and adjust your body position!

The website of the Directorate of Health also has exercises for children and adolescents that are suitable for all ages.

We couldn’t resist putting up this photo.

… and reminding you that sometimes postures at work are “inherited”. It is remarkable how contagious bad physical exertion is. Unfortunately, teaching good physical exertion is often forgotten when working methods are taught. Good physical exertion while should be interwoven with the work.

Remember that children are quick to behave as we do – even though young children exert themselves almost perfectly in the first few years. They also sit straight and upright and use diaphragmatic breathing at rest.

In fact, this should be reversed. Adults should adopt the physical exertion of their children – not the other way around.

Did you receive instructions on how best to exert yourself in the work you do?

If not – now might be the chance to change that. Here on the AOSH website, we have some educational points that might help you. But then it’s a good idea to start this discussion in the workplace and see if there is any need for guidance on work postures in your workplace.

Resting in between or switching between tasks promotes better well-being – whether you are working sitting or standing.

Rest does not have to be a long and intense break. Sometimes it’s enough to get up from the work and stretch, get a glass of water or just look out the window. This increases the chances that you will be in a good starting position when you sit down again.

For those who stand, rest often consists of perching on a chair for a moment. Stretching your back and moving your neck and shoulders. However, make sure that the resting position is good for the body.

In some workplaces, relaxation is done once a day and those who know mindfulness are encouraged to practice it every day.

Remember to enjoy, not rush!

To flourish basically means that the individual is given the opportunity to become the best version of themselves and to live a good life.

The Icelandic word for flourish is “blómstra” which means to bloom and is very apt.

In order for the seed to become a flower, you must consider the soil and nutrients. The sun, the water, the shelter and that other plants do not suffocate the flower.

Therefore, it may be a good idea to consider the following: What is your work environment like? Are you flourishing in it? What nourishes you in your work environment? What does it take for you to flourish?

It is important for mental and physical health that the working environment is good, because as stated in Article 37 of the Act on Environment, Hygiene and Safety at Work, work must be carried out in such a way as to ensure the fullest safety and good environment and hygiene.