The following elements are important for organisations to have to be successful at addressing musculoskeletal disorders at the primary prevention level (before injuries occur):

• Management commitment and perseverance to tackle sprains and strains; 
• Consultation and participation; 
• Education, awareness and training;
• An ergonomics programme and programme coordinator;
• Risk Management System:
  • Identify hazardous manual tasks or jobs with many manual tasks, assess, control, review;
• Ergonomic assessments before problems present -
  • Workstation, work environment (eg space & layout), job design, equipment, systems and/or nature of items (eg equipment and loads);
• Multifaceted intervention:
  • Equipment - design, procurement, supply, storage, maintenance, modification;
  • Load- design, procurement, supply, storage, modification;
  • Environmental-design, construction, maintenance;
  • Jobs-workable systems that are balanced and sustainable;
• Application of hierarchy of controls;
• Healthy workplace promotion- culture, leadership, systems, jobs, environment, tools, worker knowledge and capacity;

The following elements are important for organisations to have to be successful at addressing musculoskeletal disorders at the secondary prevention level (soon after signs/symptoms are reported or injury presents):

• Early reporting;
• Clear diagnosis;
• Early and appropriate health intervention;
• Communication between the health provider, worker, employer and insurer;
• Case management;
• Education and awareness;
• Incident investigation and risk management ;
• Job analysis and modification;
• Manual task risk management;
• Ergonomic Assessments soon after problems present -
  • Workstation, work environment (eg space & layout), job design, equipment, systems and/or nature of items (eg equipment and loads).
• Control-Eliminate or minimise causation or aggravating factors;
• Early and appropriate return to work;
• Job restriction; and
• Register the injury or hazard so that it feeds into a database that can be used for risk management.

The following elements are important for organisations to have to be successful at addressing musculoskeletal disorders at the tertiary prevention level (preventing aggravation or further injury):

• Appropriate health intervention;
• Education and awareness;
• Consultation and case management;
• Job capacity evaluation;
• Job analysis and modification;
• Manual task risk management;
• Ergonomic assessments when known problems exist -
  • Workstation, work environment (eg space & layout), job design, equipment, systems and/or nature of items (eg equipment and loads);
• Select and modify appropriate job;
• Gradual return to work and conditioning;
• Maintaining independence;
• Redeployment if indicated; and
• Register the existing injury so that it feeds into a database that can be used for risk management.

A risk management system is the foundation for systematically identifying, assessing, controlling and reviewing risks. This system applies to hazards that arise from performing manual tasks and should take place:

• regularly, as part of operations;
• when a hazard, injury/disorder, incident or near miss has been reported in relation to a manual task;
• when new manual tasks are being introduced; and
• when there are changes that influence the way manual tasks are performed (eg change in environment, equipment, systems of work).

The manual task risk management process ensures that the demands of the task do not exceed the physical capabilities of workers performing the job. This process may be applied before or after an injury and it may be used for individuals with and without physical limitations.

The first step in managing risks from performing manual tasks is to identify manual tasks that have the potential to cause injury or harm (ie identify hazardous manual tasks) so that they may be targeted for closer examination and the risks controlled. 

Hazardous manual tasks can be identified by:

• reviewing hazard/injury reports; 
• consulting with employees and safety and health representatives; and 
• by observing tasks being performed.

There are a number of factors that may make a manual task hazardous, particularly for the development of musculoskeletal disorders. Some of these are known to have direct effects on the body, while others contribute to the risk by making the task more difficult to perform. These factors have been classified as direct and indirect risk factors.

Direct risk factors

Risk factors that have a direct effect on the body include:

• actions and postures (including awkward postures, sustained postures and repetitive movement);  
• forces and loads (including forceful exertion); and 
• exposure to vibration (including whole-body and hand-arm vibration).

Indirect risk factors

Risk factors that can make the task more difficult to perform include:

• the working environment (eg poor lighting and cool temperatures); 
• systems of work, work organisation and work practices (eg inadequate rest breaks and unfamiliarity of the task); and 
• worker characteristics (eg physical limitations).

The above risk factors may interact and increase the overall risk. The overall risk of developing a musculoskeletal disorder will increase if:

• a direct risk factor level is high (eg high forces are required to lift an object);  
• the task involves being exposed to more than one direct risk factor (eg lifting heavy loads in awkward postures);  
• indirect risk factors are present and interact within a task (eg lifting loads in awkward postures in a cool environment); or  
• if there are several hazardous manual tasks that an individual is exposed to during their work shift or as part of their job.

Sources of risks

Hazardous manual task risk factors may stem from various sources in the workplace. Addressing the sources of risks is the most effective way of controlling the risks.

The sources of risks may be varied and can include:

• work area design and lay-out (eg inadequate space for task type);  
• the nature of the item, equipment or tool (eg poorly designed chairs);   
• the nature of the load (eg heavy load); 
• the working environment (eg cool temperatures); and 
• systems of work, work organisation and work practices (eg low job control).

As with all hazards, applying the preferred order (hierarchy) of control measures is important when determining how the risk can be controlled.

There are three main types of control measures that can be applied to hazardous manual tasks. The preferred order of application is as follows:

1. Eliminate the hazard or hazardous manual task e.g., automate manual tasks that require handling of heavy loads
2. Redesign, modify, alter or substitute:

• ​Work area and layout (eg height of stored items)  
• Nature of items, equipment and tools (eg use appropriate trolleys to transport the load, apply mechanical material handling equipment to lift the load); 
• Systems of work, work organisation and work practices (eg allocation of stored items, reduce double handling)
• Nature of the load (eg divide the load)
• Work environment (eg provide adequate space for handling)

3. Apply administrative controls:

• by providing information (eg labelling heavy loads), training (risk management approach and task specific) and supervision; and/or
• developing and enforcing policies and procedures.    

​Follow up is an important consideration to support the risk management plan. It involves finding out whether the changes made have eliminated or reduced the assessed risks, whether control strategies are continuing to be effective and ensuring that new risks have not been introduced into the workplace as a result of implementing a control. ​​