Training in manual material handling: what’s going on ?

Introduction
Several research studies reveal ineffective proof of courses in manual material handling (MMH) as a prevention measure for low back disorders. Some positive results are found when changing behaviour towards low back load, promoting an active lifestyle, or changing stress is included. Since the details of MMH courses are insufficient known, this project analysed the content of today’s trainings and consequences for the future.

Methods
A web-based questionnaire was developed for MMH trainers (n=35), contacted via the Belgian Ergonomics Society (BES). The questionnaire was based on literature reviews and included 5 parts: general characteristics regarding MMH (frequency, duration, location etc), content of the training (anatomy, biomechanics, exercices, changing behaviour etc), work and organisational characteristics (preceding company visit, management involvement etc), follow-up and subjective remarks.

Results
The duration of a course was 3 to 4 hours (58%). Only half of the trainers included practical exercises in the courses. Regarding changing behaviour, most trainers (58%) focussed on only one aspect such as attitude (74%), social pressure (68%) or risk calculation (61%). Only 42% of the trainers included several aspects of behavioural change.

Discussion
Legislation (Royal Decree of manual handling (12/08/1993, based on the European guidelines of 1989), obliges employers to inform and instruct MMH workers on working techniques. It is impossible to include all of the necessary topics mentioned in literature in a short period of time (e.g. 4 hours). Furthermore, the course itself should not stand alone as a prevention measure but should be part of a global ergonomic policy including an ergonomic risk analysis. This analysis should be followed by technical and work organisational solutions to improve the work place. Finally, MMH training should be organised, taking into account improvement of physical fitness and changing behaviour.