Advice for teachers on voice care, including spotting problems, simple preventative measures and information on how and when to seek appropriate specialist help
Musculo-skeletal disorders at work
HSE statistics show that in 2016-17, 8.9 million working days were lost as a result of work-related musculo-skeletal disorders, with each affected person taking an average of 17.6 days off work in that 12-month period.
Although official statistics suggest that teachers are at a relatively low risk of developing MSDs, research undertaken on behalf of the Health and Safety Executive (HSE) by ergonomists at Loughborough University in 2005, found that teachers not only considered aches and pains as ‘part of the job’, but one quarter of those surveyed said that they would not report these types of problems to their employer. This is despite the fact that, according to the Loughborough findings, more than 75 per cent of primary school teachers suffer ongoing discomfort and pain due to back, shoulder and neck problems.
Government statistics on teacher ill health retirement show that more than ten per cent of ill health retirements between 2007 and 2012 arose due to musculo-skeletal disorders. These figures represent the successful cases – each year there are a similar number of unsuccessful claims.
Furthermore, a survey of primary and early years members of the NEU and the Voice union carried out in 2011 by the Jolly Back consultancy found that:
- 88 per cent of respondents had experienced back pain
- 73 per cent had experienced neck and shoulder pain
- 53 per cent had suffered from problems with their knees
- 33 per cent had suffered from hip problems.
The survey also found that 82 per cent suffered from musculo-skeletal disorders once a week or more, and 38 per cent had taken time off work as a result of MSDs.
The top three work activities which respondents felt caused or contributed to MSDs were:
- 91 per cent – bending over low tables
- 85 per cent – sitting on children’s chairs
- 71 per cent – kneeling at low tables/on the floor.
Like the Loughborough research, the Jolly Back survey found that that work-related musculo-skeletal discomfort in the education profession was under-reported. Reasons suggested for this included:
- that MSDs were accepted as ‘part of the job’
- that teachers were unaware of reporting systems in place
- that in some cases teachers feared jeopardising their career by making a complaint.
It is thought that this type of problem has increased with modern teaching practices. Teachers, and other staff, now spend comparatively little time sitting behind their desks: they are instead encouraged to interact more closely with pupils, especially in infant or nursery classes. This results in staff feeling that they must stoop over children at low tables or perch on tiny chairs.
Especially in early years settings, classroom chairs and tables are very much designed with the requirements – in particular, the average size – of pupils in mind, rather than adults. Staff moving around the classroom providing help and support to pupils will often sit on such chairs. This will frequently result in staff experiencing discomfort and cramped posture – not to mention the very real risk of developing MSDs in the longer term.
Ofsted, however, has confirmed that such interaction should not be made in a way which could constitute a threat to staff health, and that being ‘on a level’ with students does not have to be taken in the literal sense.
The research carried out by Loughborough University found that where ‘tailored’ interventions had been made in order to improve matters, the results were very successful.
Staff spending most of each day on their feet are also at greater risk of health problems including:
- varicose veins
- poor circulation
- painful swelling in the feet and legs
- foot problems
- joint damage
- low back pain
- heart and circulatory problems
- specific problems in the case of pregnant women, including pre-term birth, spontaneous abortions and slower foetal growth rates. Dutch researchers, publishing their findings in the journal Occupational and Environmental Medicine in 2012, found that women who spent long periods on their feet during their pregnancy, in jobs such as sales, childcare, and teaching, had babies whose heads were an average of 1cm (three per cent) smaller than average at birth.
Consequently, neither constant sitting nor constant standing constitutes the preferred solution to classroom ergonomics. The ideal option is for provision to be made in order that teachers might vary their work so they can sit – on appropriate chairs – or stand, walk around and so on as they see fit.
Health and safety law
Employers have a general duty under section 2 of the Health and Safety at Work etc Act 1974 to do all that is reasonably practicable to protect their workers’ health and safety. That should mean avoiding prolonged standing where alternative means of doing the job are possible, particularly if these methods are used successfully by other employers.
Regulation 11 (paragraph 3) of the Workplace (Health Safety and Welfare) Regulations 1992 says: “A suitable seat shall be provided for each person at work in the workplace whose work includes operations of kind that the work (or a substantial part of it) can or must be done sitting.” The law says the seat must be suitable for the person using it. It should have a footrest where necessary.
Furthermore, the Equality Act 2010 can apply in occupational health and safety settings, where employers fail to take adequate measures to accommodate workers.
NEU safety representatives should make it clear that it is neither an acceptable nor an inevitable working practice for staff to sit, for however long, on inappropriate chairs – or indeed to subject themselves to periods of prolonged standing, bending or kneeling.
What else can safety representatives do?
There are a number of positive steps that safety representatives can take to raise awareness and improve ergonomic practices in the workplace. Safety representatives need to check that their employers are fulfilling duties under the Workplace (Health Safety and Welfare) Regulations 1992 and the Management of Health and Safety at Work Regulations 1999, by identifying and assessing risks to employees, and – where necessary – ensuring that appropriate measures are put in place to remove such risks or reduce them to acceptable levels.
In order to facilitate this, safety representatives will need to take steps to identify and monitor potential risks to the health and safety of employees. The following strategies are suggested for such purposes:
- conducting an audit of staff experiences to find out both the extent of any problem together with full details of the particular hazards being encountered – body mapping and risk mapping techniques might be helpful in this regard
- doing a special inspection that concentrates on ergonomics in the classroom, using the checklist below
- where applicable, calling for risk assessments to be undertaken as outlined below.
Safety representatives should ask for copies of the risk assessments that the employer has done to ensure that they are preventing and controlling hazards using the best ergonomic practices identified in the Management of Health and Safety at Work Regulations. Employers should consult safety representatives in the risk assessment process. Where prevention and control measures are in place then safety representatives should check that they are being adhered to and maintained and also they are effective in preventing injuries and ill health. Management should take prompt action in cases where risk assessments are inadequate or non-existent.
Safety representatives can also monitor the employer’s safety policy and systems of work regarding best ergonomic practices. Expert advice may need to be sought, from the local authority, the NEU or the HSE.
Seating should allow the body to be comfortable and not restricted. The seat design is critical for this.
- The seat should not be too high – if a person’s legs cannot reach the ground, pressure will be suffered on the soft tissues under the thighs, which hinders the return of blood from the lower limbs, causing tingling and numbness in the thighs.
- The seat depth should allow clearance at the back of the knees in order to prevent pressure on the network of blood vessels and nerves.
- The seat back and angle should support the natural curves of the spine (in particular the lower back).
- The main weight-bearing should be taken by the ischial tuberosities (the bony parts of the bottom) and the top half of the thighs.
- In addition, a chair should enable teachers to change posture at intervals, ensuring that different groups of muscles can be used for support, and that no particular group of muscles gets tired.