What is HSG60?
HSG60, "Upper Limb Disorders in the Workplace," is the Health and Safety Executive's authoritative guidance on preventing and managing work-related upper limb disorders (WRULDs). These conditions affect the hands, wrists, arms, elbows, shoulders, and neck, causing pain, weakness, and disability that can end careers and significantly impact quality of life.
Upper limb disorders encompass a range of conditions including carpal tunnel syndrome, tenosynovitis, epicondylitis (tennis elbow), rotator cuff injuries, and non-specific arm pain. While sometimes called repetitive strain injuries (RSI), the causes extend beyond simple repetition to include force, awkward postures, vibration, and psychological factors.
HSG60 provides a comprehensive framework for identifying work activities that may cause upper limb problems, assessing the associated risks, and implementing effective control measures. The guidance emphasises early intervention, recognising that these conditions respond best to prompt action before they become chronic and disabling.
The document applies across all sectors where work activities place demands on the upper limbs. This includes obvious candidates like assembly line work and keyboard use, but also extends to construction, healthcare, catering, retail, and any occupation involving sustained or repetitive arm movements.
Who Needs This Document?
HSG60 is essential reading for those managing upper limb disorder risks:
Primary Audiences:
- Production and operations managers in manufacturing
- Health and safety professionals across all sectors
- Occupational health practitioners and nurses
- Ergonomists and workplace design consultants
- HR managers dealing with absence and disability
- Line managers supervising repetitive work activities
Secondary Audiences:
- Office managers responsible for DSE workstations
- Construction supervisors overseeing hand tool use
- Healthcare managers concerned with patient handling
- Retail managers with checkout and stocking activities
- Food processing and packing managers
- Workers at risk of developing upper limb conditions
Any organisation where workers perform repetitive, forceful, or sustained upper limb activities should understand and apply HSG60 guidance.
Key Topics Covered
HSG60 provides comprehensive coverage of upper limb disorder prevention and management:
Understanding Upper Limb Disorders
The guidance explains the nature and causes of these conditions:
- Types of upper limb disorders and their characteristics
- Specific conditions (carpal tunnel, tenosynovitis, etc.)
- Non-specific upper limb pain
- Risk factors that contribute to development
- How work activities cause tissue damage
- Individual factors affecting susceptibility
Risk Factors
HSG60 identifies key factors that increase upper limb disorder risk:
- Repetition of movements
- Force requirements
- Awkward or static postures
- Duration and frequency of exposure
- Inadequate recovery time
- Cold temperatures
- Vibration exposure
- Psychosocial factors (stress, work pace, control)
High-Risk Activities
The guidance identifies work activities commonly associated with problems:
- Assembly line and production work
- Keyboard and mouse use
- Food preparation and packing
- Sewing and textile work
- Construction and hand tool use
- Healthcare and patient handling
- Checkout and scanning operations
- Musical instrument playing
Risk Assessment
Systematic approach to identifying and assessing risks:
- Observing work tasks and methods
- Consulting workers about problems
- Using assessment tools and checklists
- Recording and documenting findings
- Prioritising actions based on risk
- Reviewing assessments regularly
Control Measures
Hierarchy of controls for reducing risks:
- Eliminating hazardous tasks where possible
- Automating high-risk operations
- Redesigning tools and equipment
- Modifying workstation layouts
- Changing work methods
- Reducing pace and providing breaks
- Job rotation and task variety
- Training and awareness
Workstation and Tool Design
Guidance on ergonomic design principles:
- Work surface heights and positions
- Reaching distances and clearances
- Tool handle design and grip requirements
- Weight and balance of equipment
- Powered versus manual tools
- Anti-vibration considerations
Work Organisation
Managing how work is organised to reduce risks:
- Work pace and production targets
- Rest breaks and recovery time
- Job rotation schemes
- Task variety and balance
- Work scheduling
- Autonomy and control for workers
Health Surveillance
Monitoring worker health to detect early problems:
- When health surveillance is appropriate
- What surveillance should include
- Symptom questionnaires and reporting
- Clinical assessments
- Record keeping requirements
- Acting on surveillance findings
Early Intervention
The importance of prompt action when problems emerge:
- Encouraging early symptom reporting
- Investigating reported symptoms
- Temporary work modifications
- Medical referral and treatment
- Return to work planning
- Preventing progression to chronic conditions
Managing Cases
Handling workers who develop upper limb disorders:
- Supporting affected workers
- Workplace adjustments
- Reasonable adjustments under equality law
- Phased return to work
- Alternative duties
- Preventing recurrence
Training and Information
Educating the workforce about upper limb disorders:
- Awareness of risks and symptoms
- Correct work techniques
- Using equipment properly
- Reporting problems early
- Exercises and self-care
- Supervisor training
Using This Guidance
Implementing HSG60 effectively requires a systematic approach:
Step 1: Identify At-Risk Activities Review all work activities across your organisation. Identify tasks involving repetitive movements, forceful exertions, awkward postures, or sustained upper limb activity. Consult workers about tasks they find demanding.
Step 2: Assess the Risks For identified activities, conduct detailed risk assessments. Consider repetition rates, force levels, postures, duration, and other risk factors. Use HSG60 assessment guidance or established tools like ART (Assessment of Repetitive Tasks).
Step 3: Consult Workers Talk to workers performing at-risk tasks. They understand the demands better than anyone and often have ideas for improvements. Ask about symptoms already being experienced.
Step 4: Implement Controls Based on your assessments, implement appropriate control measures. Follow the hierarchy: eliminate, substitute, engineer, then administratively control. Involve workers in developing solutions.
Step 5: Redesign Where Needed Consider whether tasks, tools, or workstations need fundamental redesign. Sometimes incremental changes are insufficient, and more significant ergonomic intervention is required.
Step 6: Manage Work Organisation Address how work is scheduled and paced. Ensure adequate recovery time, implement job rotation where appropriate, and give workers some control over their work patterns.
Step 7: Establish Health Surveillance Where risks remain despite controls, implement health surveillance to detect early symptoms. Train workers to recognise and report problems. Act promptly on any findings.
Step 8: Create Supportive Culture Build a culture where workers feel comfortable reporting symptoms early. Avoid blame when problems arise. Focus on solutions and support rather than criticism.
Step 9: Monitor and Review Track absence and health data related to upper limb problems. Regularly review risk assessments and control measures. Improve arrangements based on experience and feedback.
Why It Matters
Preventing upper limb disorders is essential for multiple compelling reasons:
Protecting Worker Health: Upper limb disorders cause significant pain, disability, and reduction in quality of life. Some conditions become permanent, preventing workers from performing their jobs or even daily activities. Prevention protects workers from these outcomes.
Legal Compliance: Employers have duties under the Health and Safety at Work Act and Management of Health and Safety at Work Regulations to assess and control risks that may cause work-related ill health. Upper limb disorders are foreseeable outcomes of many work activities.
Reducing Absence Costs: Musculoskeletal disorders including upper limb conditions are leading causes of sickness absence. The direct costs of absence, plus replacement staff and lost productivity, represent significant business impact.
Avoiding Compensation Claims: Employees who develop work-related upper limb disorders may claim compensation. Successful claims for conditions like carpal tunnel syndrome routinely reach substantial sums. Prevention is far more cost-effective.
Maintaining Productivity: Workers experiencing upper limb pain work more slowly and less accurately, even before taking absence. Early intervention maintains workforce productivity and quality.
Retaining Skills: Experienced workers who develop chronic conditions may be unable to continue in their roles. The loss of skills and knowledge, plus recruitment and training costs, affects business capability.
Regulatory Expectations: HSE expects employers to take systematic approaches to preventing work-related ill health. Following HSG60 demonstrates commitment to this expectation.
Equality Duties: Workers who develop lasting upper limb conditions may be disabled for equality law purposes. Employers must make reasonable adjustments, but prevention is preferable to managing established conditions.
Worker Wellbeing: Beyond legal compliance, caring employers want to prevent workers suffering from painful, disabling conditions. Healthy workers are also more engaged and productive workers.
Industry Standards: HSG60 represents accepted good practice across industries. Customers, contractors, and partners expect organisations to manage these risks appropriately.
By following HSG60 guidance, employers can identify upper limb disorder risks, implement effective controls, support affected workers, and build workplaces where these preventable conditions no longer harm workers or burden businesses.