Manual weight lifting

Primary prevention of postural risks at work must be carried out during the planning of the plants and fittings of the workplace, taking into account in the first place the physical and psychological characteristics of the workers rather than the economic and productive ones. For example, appropriate clear spaces should be available to easily transfer patients. The employment of adjustable beds is recommended and, generally, the employment of low beds (less than 50 cm high) should be avoided, because it forces the personnel to bend awkwardly. Specific hoists should be made available to perform the different operations on patients. Health personnel should be appropriately trained on the correct way to perform the different manoeuvres of lifting and moving patients and on the employment of hoists. Furthermore, personnel should be adequately informed about the possible risks that such manoeuvres entail for the musculoskeletal system.
A useful indication is that of performing all lifting operations with one's legs wide apart in order to make the support base as wide as possible to improve the equilibrium of the position. When rearranging the bed, the best custom would be to lean one knee on the bed in order to avoid awkward stress to the vertebral column.
When turning a non-cooperating patient in bed, the operator should keep one foot forward and the other backward with bent knees and grasp the patient at the pelvis or scapula level. Should a patient be moved (for example onto a wheel-chair), the operator needs to make the support base as wide as possible and bend the knees, then the operator should make his/her arm pass underneath the patient's and firmly grasp the patient's folded arms. This manoeuvre is best performed by two operators, one on each side.
Should the patient be able to cooperate even to a small extent, it is useful to train him/her to perform adequate matching endeavours. If the patient is not able to second the stress, it is useful to make a strong length of material pass underneath the patient's body and lift him/her up together with other operators to divide the stress. Alternatively, a first operator could grasp the patient underneath the shoulder, a second operator at the pelvis and a third one at the knees.
A stretcher can be employed to make the transfer easier. It should be positioned crosswise with respect to the bed in order to allow freedom of movement to the operators. Alternatively, a board could be employed. It should be positioned in parallel to the patient's body which is then dragged onto it.
The general principles that can be taught to workers in order to prevent harm and injuries during the moving and lifting stress include:
-it is necessary to make sure that the route is clear of obstacles and, if the ground is not flat, it is necessary to make sure to be able to brake;
-it is necessary to employ footwear with a firm grip on the ground;
-when moving heavy objects, it is better to push them than to pull them. Furthermore, to start the movement it is better to face backwards, pushing one foot firmly to the ground, and begin the movement applying the strength with the back.
Preventive measures consist in the assessment of the musculoskeletal strain during the working activity. This is done by employing both systems to analyse posture and biomechanical models to measure the exposure to the load of physical work, giving an indirect analysis of the stress borne by the vertebral column and the main joints.
Furthermore, during health surveillance an accurate clinical-functional examination of the vertebral column must be performed and, if necessary, radiological examinations can be required to establish whether the health operator is fit to perform tasks that involve moving and lifting patients or other loads. Furthemore, the personnel must be periodically examined both to allow the early diagnosis of alterations linked to the job and to prevent further deterioration of the worker's condition, as well as to allow an appropriate motory recovery.

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Manual weight lifting