The drive to reduce back injuries in construction is an opportunity for OH
to lend its skills and knowledge to a sector badly in need of risk management. By Lorraine Shepherd
Construction workers suffer more from occupational ill-health than from
accidents in the workplace. And the sector’s record on managing health risks is
at least as bad as it is on managing safety risks.
Every year more than one-quarter of all construction accidents reported to
Health and Safety Executive1 involve manual handling. It also accounts for
about three-quarters of all ill-health in construction, according to the recent
HSE survey of self-reported, work-related illness2.
By its very nature construction work involves lots of manual handling, such
as laying heavy building blocks, erecting scaffolds, moving sheet materials,
placing kerbstones and installation work. And as such the industry cannot
afford to ignore the potential for injury. Not only is it unacceptable for
health and safety reasons, but managing it properly also makes good business
In response to this problem the HSE has published practical guidelines on
the construction sector called Backs for the Future – Safe Manual Handling in
Construction3. Launched by HSE chief inspector of construction Kevin Myers in
February, it is supported by the Construction Confederation, the GMB union and
Using a series of case studies, the guidance looks at ways in which real
manual handling risks on construction sites have been reduced in practice. Many
of the solutions to the manual handling problems identified in the booklet are
simple, cost-effective measures that have been developed by designers, contractors
What is evident is that manual handling problems are not intractable. By
taking an innovative approach, most problems can be solved. And the earlier in
the procurement process these problems are addressed, the more cost-effective
Everyone involved with construction projects can introduce manual handling
risks and must play their part in controlling those risks. Under the
Construction Design and Management (CDM) regulations, 1994, which apply to most
construction work, everyone involved in the construction process must have
adequate regard to health and safety. Backs for the Future sets out the basic
principles for dealing with manual handling risks and provides a flexible
framework for action.
The guide describes common manual handling risks and looks at how they can
be tackled through better planning, control and management. For this approach
to work everyone in the sector, from clients to employees, must play their
Key players, such as clients, can use the guidance to help them decide what
information they need to provide about the site and any constraints it could
place upon manual handling during the construction phase. Designers will find
the resource useful in its advice on how to avoid risk through specification.
For example, specifying lighter weight building blocks will avoid common
problems. Lighter blocks can still meet the building regulation requirements on
noise transmission, which is the reason usually given to justify the need for
Planning supervisors can use the guidance to help them meet their duties
under the CDM regulations, such as making sure that the site is planned so that
handling equipment can be easily used.
Contractors will find advice on identifying and tackling manual handling
risks by improving poor practices and ensuring workers are instructed in safe
The guidance can give employees an understanding of how they can co-operate
with their employer in following the safe systems of work laid down for dealing
with handling tasks. And, we must not forget the manufacturers and suppliers
who have an important role to play in ensuring loads are properly packaged and
secured and appropriately marked.
Backs for the Future provides a starting point to get people thinking about
manual handling problems. Unfortunately, the construction industry cannot boast
a good record on providing OH support to its workforce, but where there are OH
professionals working in the industry, the guidance presents them with an
opportunity to apply their knowledge and skills to an industry where help is
badly needed to solve manual handling problems.
OH nurses should be able to help all the key players in construction understand
their own and others’ roles and responsibilities in tackling the risks through
better planning, control and management and to illustrate the benefits that
this will bring.
Employers are likely to need help and encouragement from OH professionals to
make progress on this issue. The challenge to the industry is to increase its
take up of OH support to ensure health risks are properly identified and
addressed. OH professionals can and should make a valuable contribution to
reducing the unacceptable toll of manual handling injuries.
Lorraine Shepherd is an occupational health inspector with the Health and
Safety Executive and holds the health and welfare portfolio for the
1 Health and Safety Statistics (1998/99) HSE Books ISBN 0 7176 1716 5
2 Jones JR, Hodgson JT, Clegg TA Self-reported Work-related Illness in 1995
HSE Books (1998) ISBN 0 7176 1509 X
3 Backs for the Future – Safe Manual Handling in Construction HSG149 HSE
Books (2000) ISBN 0 7176 1122 1
Back pain: legislative background
Manual handling has been a high-profile issue for the Government and the HSE
for many years. Repeated efforts to secure agreement on a regulatory framework
led to the adoption of the Manual Handling of Loads directive, and in turn led
on to the introduction of the manual handling regulations in January 1993.
The Government’s new public health priorities recognise the importance of
the workplace as a target for improving the nation’s health. A first theme for
the Workplace Initiative is workplace-based action on back pain, encouraging
"joined-up working" between stakeholders. The Back in Work programme
launched in May 1999 is designed to raise awareness of the costs of back pain
and the need to tackle the problem in a holistic and integrated way. It aims to
do this by funding a number of pilot projects to identify good practice in
relation to one or more of the four main elements in the development of chronic
back pain: prevention; access to assessment and treatment; rehabilitation; and
managed return to work. Back in Work will provide construction with important
lessons on how to join with others locally to integrate approaches on back pain
into effective occupational health management systems.
Phase IV of the HSE’s Good Health is Good Business campaign was launched in
October 1999. Manual handling figures highly in the campaign’s efforts to
ensure compliance with the law with the use of enforcement where appropriate.
The construction industry’s Working Well Together campaign, which was
launched in May last year, aims to raise health and safety standards by gaining
commitment to improved communication, co-operation and competence. Some of the
Working Well Together action plans developed by those signed up to the campaign
have addressed the need to complement risk control measure by better manual
Tips on tackling manual handling
– Forming ceilings with sheet materials can involve two workers working on
tower scaffolds trying to support the sheet material in place – usually with
the head – while fixing it into position. Use of a panel lifter allows a single
worker to lift, position and support the sheet and then fix it. Manual handling
is virtually eliminated.
– Use of vacuum or hydraulic systems to place kerbstones, slabs or blocks
removes nearly all manual handling from the task. These systems can be supplied
as adapters connecting to existing plant, such as earth-moving machinery, which
may already be on site. Use of paving slab lifting devices also reduces risks
from bending and lifting.
– Sheet materials can be transported using panel trolleys. For manual
handling of other large items, a variety of devices are available including
magnetic grips, suction grips, plate carriers and handling slings.
– Ladder hoists are available to hire or buy. A wide variety of materials
can be transported on a ladder hoist.
– Building blocks with hollows into which the hand or thumb can be inserted
allow the block to be gripped more easily. This can help to reduce strain on
the lower back.
Backs for the Future – Safe manual handling in construction3