Qec Reference Guide
Qec Reference Guide
Qec Reference Guide
Reference Guide
Contents
Introduction 2
Establishing priorities 5
Appendix 14
QEC Forms 16
Introduction
Work related musculoskeletal disorders (WMSDs) are a The ergonomics approach to reducing musculoskeletal
common health problem throughout the industrialised disorders requires the holistic assessment of all elements
world and a major cause of disability. WMSDs are of the work system so that optimal solutions can be
conditions of the nerves, tendons, muscles, and achieved (see diagram below). This requires the full range
supporting structures of the musculoskeletal system that of generic issues to be considered, such as task design,
can result in fatigue, discomfort, pain, local swelling, or worker/equipment interface, individual variation (including
numbness and tingling. WMSDs usually develop from motivation) and organisational culture, training needs, work
cumulative damage resulting from months or years of organisation and legal requirements. This approach ensures
exposure to excessive levels of physical and psychosocial that the needs of all relevant user groups within the
stressors at work. organisation are addressed.
Scientific evidence has shown that physical and The Quick Exposure Check fits within this approach at the
psychosocial factors are critical in the development level of the individual(s) in the work system and enables
of WMSDs. their exposure to a range of risk factors for WMSD to be
assessed. It is important that the issues depicted in the
The major risk factors for WMSDs in the workplace outer levels of the diagram are also addressed using
include: appropriate ergonomic techniques and that interventions
heavy manual handling should be considered at all levels.
repetitive and forceful actions
vibration
awkward static postures that arise from badly designed
Societal and cultural pressures
workstations, tools, equipment, working methods
poor work organisation. Legal and regulatory rules
Exposure to such factors produces effects within the Organisational and management behaviour
workers body (e.g. decreased blood flow or local muscle
Team and group behaviour
fatigue). If adequate recovery does not take place, it can
lead to the development of WMSDs.
Individual behaviour
Physical ergonomics
Physical
Devices
QEC assesses the exposure of the four body areas The QEC assessment encourages consideration
at greatest risk to the most important risk factors of changes to workstations, tools, equipment and
for WMSDs. QEC has been developed for use by working methods to eliminate, or at least minimise,
Occupational Safety and Health practitioners, safety levels of exposure. This should be done in discussion
representatives or those responsible for health and safety with the worker(s). Those who have regular involvement
in Small and Medium Enterprises (SMEs) to: in performing the task may have good suggestions for
assess the change in exposure to musculoskeletal risk improvement. Consultation at this stage will assist with
factors before and after an ergonomic intervention the introduction of change in the workplace.
involve both the practitioner (observer) and the workers
(who have direct experience of performing the job) in When a change has been made, exposure should be
conducting the assessment and identifying possibilities re-assessed to confirm the efficacy of the intervention in
for change reducing the risk factors for WMSDs. This can be done
encourage improvement of workplaces and allow immediately following the change rather than waiting for
consideration of the comparative impact and potential changes in the prevalence of reported WMSDs to become
cost benefits of a number of alternative interventions evident which may take many months.
increase awareness among managers, engineers,
designers, health and safety practitioners and workers
about musculoskeletal risk factors in the workplace
compare exposures between two or more people
performing the same task, or between people
performing different tasks.
Getting started and using QEC effectively
Initially, it is necessary to set priorities for assessment. (b) Organise a representative group of workers to review
You may be asked by a worker, a supervisor or a manager the work performed and identify five tasks with the
to carry out an assessment because of the problems highest priority.
reported by or to them about pain, sickness absence or
low productivity for one specific operation. Alternatively, (c) Alternatively, if time permits, begin your survey by
you may be required to carry out assessments as part of talking with workers individually and asking them to
your responsibilities to survey a range of jobs and tasks describe what they do.
conducted by workers at different locations within your
organisation. Ask the worker to describe the organisation of their day
by hours with breaks.
If you are directed to a specific task, then begin there and Ask them to list the tasks performed and map them onto
carry out assessments of additional tasks within that job if a plan. Record the task duration.
time allows. If a more general survey has been requested Define repetitive and non-repetitive activities within each
then it may be difficult to decide where and how to start. It task.
is important to set priorities and use resources effectively Identify actions performed in each task.
and the following approaches are suggested: Define cycles and the frequency of repetitive tasks.
Confirm the information with more than one worker and
(a) It may be possible to conduct a workplace survey ask about:
about pain and discomfort, and focus on those - a typical day and variations from the norm
situations where the prevalence of problems is highest - downtime and stoppages
(you could use checklists and body maps for this, - non scheduled breaks
for example go to the following websites: - any additional/unusual tasks performed at different
times in the month/year.
http://ergo.human.cornell.edu/ or Carry out assessments for tasks identified.
http://www.hazards.org/tools/index.htm
See over for example >
Example of tasks performed daily by a laboratory technician
For each job ask them to describe the organisation of their day by hours with breaks:
Time duration Hour 1 Hour 2 Hour 3 Hour 4 Hour 5 Hour 6 Hour 7 Hour 8
Task admin. pipetting pipetting rest Sample pipetting pipetting Lunch pipetting admin Rest Clean Media prep and
delivery equipment administration
as delivery
delay
Tasks Repetitive (R) Equipment Actions Cycle length Frequency of Total duration Other
or not (NR)? performed cycle (seconds) throughout
in task day (mins)
Pipetting R Pipette - Place tip in fluid 3 20 per min 240 Delay in sample delivery
- Depress plunger caused interruption to
- Withdraw sample pipetting task and
- Transfer/expel sample equipment cleaning
to well task substituted
In order to conduct an exposure assessment, it is 6. If you do not have a clear view of the worker, change
necessary to decide what task or part of task you will your position or ask the worker to demonstrate the
assess (see page 5). If you observe one repetitive task, posture. If the person is crouching or kneeling this may
it is suggested that you observe the task for 20/30 cycles pose additional risks and may need to be investigated
before completing the form. It should take approximately in a supplementary assessment.
10 minutes to make the assessment. Where daily patterns
of work and job demands vary, observe workers more 7. For the Workers Assessment, ask the worker to
than once. For group work, ensure a sufficiently answer the questions and then place a tick in the
representative number of individual workers are assessed. appropriate box. The graduation in shading for each
Re-observation may be necessary to confirm judgements question indicates an increase of exposure to risk.
made.
8. The workers answer may differ from the actual answer
1. Introduce yourself and explain the aims of the exposure and the observer may want to carry out some
assessment. measures to inform any intervention that may be
introduced e.g. by measuring the weight of the load.
2. Enter the details on the front sheet: workers name, job However, this measure should be used to supplement
title, task, assessors name, date and time of the exposure assessment and not to replace the
assessment in the space provided. Leave Action workers assessment of the load, as workers opinions
required blank until you have completed the exposure are very important.
assessment.
9. In three questions on the Workers Assessment
3. Answer each question with respect to the task you (L, P, Q), you should ask the worker for more detail
have selected to assess. if appropriate as a basis for identifying the nature of the
problem and opening a dialogue to seek solutions. This
4. For each question in the Observers Assessment information can be recorded in the box at the bottom
place a tick in the most appropriate shaded box for of the page. This area can also be used to record other
questions A-G based on your observation of posture observations made during the assessment.
and movement of the back, shoulder/arm, wrist/hand
and neck. The graduation in shading for each question 10. Providing immediate feedback to workers after you
indicates an increase of exposure to risk. have assessed the task can be useful in terms of
credibility and also to encourage suggestions for
5. Assess the worst case for each body area. For example: improvements. These could be incorporated into the
the assessment for back posture should be made at Action Required section on the front of QEC. The
the moment when the back is most heavily loaded, graduation in shading for each question indicates an
i.e. when the person leans or reaches forward to increase of possible risk and this can helpful in telling
pick up the load. the worker where particular problems lie.
the assessment of frequency of motion should be
recorded when a production line is at full speed. 11. Score assessment (Page 11).
Observers assessment
If in doubt when conducting the assessment, opt for the
higher exposure category.
The workers responses are an integral part of the Visual demand (L1-L2)
assessment and it is important that they answer each
question based on their experience of doing the work. Ask the worker to specify if the level of visual demand of
Explain the meaning of the questions and list the the task is low (almost no need to view fine details) or
response categories. If the worker is in doubt, opt high (need to view some fine details). If the requirement
for the higher exposure category. is high, ask for more information about this aspect of the
task. Record this in the space at the bottom of the page.
Maximum weight handled (H1-H4)
Driving (M1-M3)
This question refers to the weight borne by the worker,
and not the maximum weight handled in the task or the This question investigates whole-body vibration that may
load handled with the use of equipment. result from driving a vehicle at work. The worker is asked
to estimate total time spent driving a vehicle during the
The workers perception of the load weight may differ from working day. If the worker does not drive, do not leave the
the actual weight category, e.g. a light load may seem answer blank, place a tick in M1 Less than one hour per
heavy if held at full reach. The actual weight of the load day or Never. This question only refers to driving at work,
can be measured by the observer if required, to inform any do not include driving to and from work.
intervention that may be introduced. However, this
measure should be used to supplement the exposure
assessment and not to replace the workers assessment of Vibration (N1-N3)
the load.
This question enquires about the hand-arm vibration that
may arise from using vibrating tools at work. The worker is
Time spent on task (J1-J3) asked to estimate the total time spent using vibrating tools
during the working day. If the worker does not use
This question examines the amount of time per day the vibrating tools, do not leave the answer blank, place a tick
worker spends conducting the task being assessed. in N1 Less than one hour per day or Never.
This question refers to the maximum force level exerted by This question asks about the difficulties that workers may
one hand when performing the task. Even if the task is have keeping up with their work. If the answer is often,
performed with two hands, ask the worker about the force ask for more information about this aspect of the work.
for one hand only. Record this in the space at the bottom of the page.
The QEC Exposure Scores are based on combinations To score the exposure assessment
of risk factors identified by the observer for each body 1. Use the Exposure Scores sheet to determine the scores
area and by the workers subjective responses. These for each body area. For example, at the top left hand
scores represent a hypothetical relationship between the corner of the sheet for the Back:
increased level of exposure and potential health outcomes. The first table shows the scores for combinations
Current epidemiological evidence is not sufficient to define Posture (A1-3) and Weight (H1-4). Identify the
the actual relationship for different working situations. corresponding exposure combination, e.g. the
Nevertheless the existing scoring system provides a basis combination A2 and H2 would score 6, for A3 and
for comparing the level of exposure before and after an H3 score 10. Enter this in the Score 1 box at the
intervention. In addition, increasing levels of exposure are bottom right-hand corner.
signified by darker shading in the boxes on both the Do this for the correct combination of factors for
assessment and the scoring sheets. the back, i.e. by calculating either scores 1 to 5 OR
scores 1 to 3 plus score 6.
The assessment scores should be used to: Then sum the total scores for the back.
determine the comparative levels of exposure for each
body area 2. Repeat this procedure for each body area and other
identify where exposures are highest, and consequently, factors (i.e. driving, vibration etc).
prioritise the issues that interventions should address.
3. Do this following both the initial assessment and any
The aim of an intervention is to reduce exposure scores. intervention.
When changes to a task are planned, an assessment
should be done based upon the improvements proposed.
This will indicate the potential benefits of the intervention
and reveal if the exposure to risk factors for any other
body area is increased inadvertently. Re-assessment
should always be done following the implementation of
any intervention.
Interpreting the scores
Exposure scores for body areas Even if the exposure score is Low, it is important to note
The total score for each body area is determined from the that one or two interactions may be contributing
interactions between the exposure levels for the relevant disproportionately to the score (i.e. a score of 8 or more).
risk factors (see table below), and their subsequent
addition. For Moderate, High and Very High scores, there are likely
to be several interactions that should be identified and
reduced. It is also possible that one or two interactions are
Important risk factors at the highest levels (i.e. 10 or 12) of exposure. These
Back Wrist/hand should be addressed urgently to reduce the level of
load weight force exposure for these factors.
duration duration
frequency of movement frequency of movement These interactions should be monitored and reviewed as
posture posture injury to the body could occur if exposure continues.
Shoulder/arm Neck
load weight duration Exposure scores for other factors
duration posture The exposure scores for driving, vibration and work pace
task height visual demand have been categorised into three exposure categories:
frequency of movement Low, Moderate, High. Stress has a fourth category: Very
High. Where scores are Moderate or High, or Very High,
the level of exposure should be reduced.
It is important to take note of which interactions contribute
most to the overall score for each body area. Exposure level
Score Low Moderate High Very High
The exposure scores for the back, shoulder/arm, Driving 1 4 9 -
wrist/hand and neck have been categorised into 4 Vibration 1 4 9 -
exposure categories: Low, Moderate, High or Very High. Work pace 1 4 9 -
Stress 1 4 9 16
Exposure level
Score Low Moderate High Very High
Back (static) 8-15 16-22 23-29 29-40
Back (moving) 10-20 21-30 31-40 41-56
Shoulder/arm 10-20 21-30 31-40 41-56
Wrist/hand 10-20 21-30 31-40 41-46
Neck 4-6 8-10 12-14 16-18
Interventions & re-assessment
Interventions
When seeking to make changes to reduce the exposure of The information for the QEC assessment is provided
workers to known risk factors for WMSDs, it is essential to by both the practitioner (observer) and the worker who
consider all aspects of the work system so that optimal has direct experience of performing the task. Workers
solutions can be achieved (see diagram below). may have good suggestions for improvement and their
participation will assist with the introduction of change.
This initial co-operation should be encouraged and should
Societal and cultural pressures
be continued during the design and implementation of
Legal and regulatory rules any changes that are made to the task, equipment and
workplace.
Organisational and management behaviour
Interventions that focus solely on the worker (e.g. training,
Team and group behaviour
selection) have been found of limited value in reducing or
preventing WMSDs. The ergonomics redesign approach
Individual behaviour
is therefore preferable.
Physical ergonomics
Physical
Devices
Re-assessment of exposure
The Quick Exposure Check [QEC] was designed at the An approach to determine cost benefits of health and
Robens Centre for Health Ergonomics to meet safety interventions has been developed by European
practitioners requirements for a practical method of Safety and Health. Details of these can be found at:
assessing exposure to WMSD risk factors in the http://europe.osha.eu.int/good_practice/risks/msd/.
workplace.
Legal requirements to prevent musculoskeletal
It was developed using a participatory ergonomics disorders
approach, with 200 practitioners involved throughout the The European Directives that provide protection for
process. It was developed, tested, modified and validated workers against developing Musculoskeletal Disorders are:
based upon both simulated and real work tasks. The tasks
covered a wide range of work activities, such as manual Directive 89/391 - a general framework for risk
handling, repetitive tasks, static or dynamic tasks, seated identification and prevention.
or standing tasks, and tasks with low or high visual Directive 90/269 - identification and prevention of
demands. manual handling risks.
Directive 90/270 - identification and prevention of risks
Studies have shown that QEC has good sensitivity and from work with display screen equipment, including
usability, acceptable or moderate levels of agreement for minimum requirements for equipment, work environment
its inter-observer reliability, and a good intra-observer and computer interface.
reliability. Field studies have indicated that it is reliable in a Directive 89/654 - minimum standards for workplaces,
practical context and suitable for a wide range of jobs. including seating, lighting, temperature and work station
layout.
Directive 89/655 - suitability of work equipment.
Directive 89/656 - suitability of personal protective
equipment.
Directive 98/37 - machinery (replaced Directive 89/392).
Directive 93/104 - organisation of working time.
- Robens Centre for Health Ergonomics - Power tools: How to Reduce Vibration Health Risks.
http://www.eihms.surrey.ac.uk/robens/erg/ INDG338. HSE Books, 2001.
- Upper Limb Disorders in the Workplace. HSG60. HSE - Tackling Work-Related Stress: A Managers Guide to
Books, 2002. ISBN 0717619788 Improving and Maintaining Employee Health and Well-
being. HSG 218. HSE Books, 2001. ISBN 0717620506.
- Europe Under Strain: A Report on Trade Union
Initiatives to Combat Workplace Musculoskeletal
Disorders. Brussels: TUTB, 1999. ISBN 2-930003-29-4
http://www.etuc.org/tutb/uk/
Quick Exposure Check (QEC)
assess the changes in exposure to musculoskeletal risk factors of the back, shoulders
and arms, hands and wrists, and neck before and after an ergonomic intervention
involve the practitioner (i.e. the observer) who conducts the assessment,
and the worker who has direct experience of the task
indicate change in exposure scores following an intervention
The QEC Guide gives more detailed information about each question and the background to QEC.
Workers name:
Task:
Date: Time:
Action(s) required:
18
Workers name Date
Observers Assessment Workers Assessment
Back Workers
A When performing the task, is the back H Is the maximum weight handled
(select worse case situation)
MANUALLY BY YOU in this task?
A1 Almost neutral?
H1 Light (5 kg or less)
A2 Moderately flexed or twisted or side bent?
H2 Moderate (6 to 10 kg)
A3 Excessively flexed or twisted or side bent?
H3 Heavy (11 to 20kg)
B Select ONLY ONE of the two following task options: H4 Very heavy (more than 20 kg)
EITHER
For seated or standing stationary tasks. Does the J On average, how much time do you spend
back remain in a static position most of the time? per day on this task?
B1 No J1 Less than 2 hours
B2 Yes J2 2 to 4 hours
F3 More than 20 times per minute? * If Often, please give details in the box below
*P
*Q 19
Exposure Scores Workers name Date
Back Shoulder/Arm Wrist/Hand Neck
Back Posture (A) & Weight (H) Height (C) & Weight (H) Repeated Motion (F) & Force (K) Neck Posture (G) & Duration (J)
A1 A2 A3 C1 C2 C3 F1 F2 F3 G1 G2 G3
H1 2 4 6 H1 2 4 6 K1 2 4 6 J1 2 4 6
H2 4 6 8 H2 4 6 8 K2 4 6 8 J2 4 6 8
H3 6 8 10 H3 6 8 10 K3 6 8 10 J3 6 8 10
H4 8 10 12 H4 8 10 12 Score 1 Score 1
Score 1 Score 1
Back Posture (A) & Duration (J) Height (C) & Duration (J) Repeated Motion (F) & Duration (J) Visual Demand (L) & Duration (J)
A1 A2 A3 C1 C2 C3 F1 F2 F3 L1 L2
J1 2 4 6 J1 2 4 6 J1 2 4 6 J1 2 4
J2 4 6 8 J2 4 6 8 J2 4 6 8 J2 4 6
J3 6 8 10 J3 6 8 10 J3 6 8 10 J3 6 8
Static Posture (B) & Duration (J) Frequency (D) & Weight (H) Wrist Posture (E) & Force (K) Total for Driving
B1 B2 D1 D2 D3 E1 E2
J1 2 4 H1 2 4 6 K1 2 4 Vibration
J2 4 6 H2 4 6 8 K2 4 6
J3 6 8 H3 6 8 10 K3 6 8
N1 N2 N3
Score 4 H4 8 10 12 Score 4
1 4 9
Score 4
Frequency (B) & Weight (H)
B3 B4 B5 Total for Vibration
H1 2 4 6 Frequency (D) & Duration (J) Wrist Posture (E) & Duration (J)
D1 D2 D3 E1 E2 Work pace
H2 4 6 8
J1 2 4 6 J1 2 4
H3 6 8 10
J2 4 6 8 J2 4 6
P1 P2 P3
H4 8 10 12
J3 6 8 10 J3 6 8 1 4 9
Score 5
Score 5 Score 5
Frequency (B) & Duration (J)
B3 B4 B5 Total for Work pace
J1 2 4 6
J2 4 6 8
Stress
J3 6 8 10
Score 6 Q1 Q2 Q3 Q4
1 4 9 16
Total score for Back Total score for Shoulder/Arm Total score for Wrist/Hand 20
Sum of scores 1 to 4 OR Sum of Scores 1 to 5 Sum of Scores 1 to 5
Scores 1 to 3 plus 5 and 6
20 Total for Stress
NOTES