Manual handling in child care work: components of back injury risk during the task of nappy changing

[Truncated abstract] Manual handling is a duty inherent to child care. Whether it is domestic or occupational, the manual handling work involved in caring for young children doesn’t differ. The lifting and handling of young children and interaction with infant nursery equipment and children's furniture is relentless. General manual handling (MH) work is associated with higher than normal levels of musculoskeletal disorder (MSD). Occupational health and work safety (OHS) practices have been created to identify, assess and minimise injury risk to workers. The key variables taken into account are the characteristics of the loads, equipment, job design and the anthropometry and ability of those doing the work. Although there is no apparent lack of OHS regulations applied to child care work, unusually high rates of MSD continue to be reported (Owen, 1992; Bright & Colabro, 1999; King et al., 2006) with lower back injury (LBI) being the main contributor (Brown & Gerbrick, 1993). The exceptionally high rates of injury for workers employed in child care, the majority of whom are female, exposes an implication of injury risk to women caring for young children in the domestic environment. Many of these women in domestic child care will be pregnant or postpartum and as such likely to already have some LBI or transient physical disability (Pheasant, 1986). Past studies of MH in child care have observed likely implications for LBI from lifting children and interaction with equipment, but to date there has been no biomechanical analysis or objective measurement of the tasks or the components. That being said, lifting children is not a standardised activity and therefore difficult to measure. Nappy changing however, is one MH child care task that is performed frequently and includes variables that are quantifiable. The aim of this research was to establish an understanding of the complexities involved in nappy changing and to explore the biomechanical risk hazards for LBI. Due to the significant number of women involved in domestic child care and occupational MH work, this study has implications for the child care environment as well as the broader workplace...