Each occupation has various risk factors that can affect an individual’s health. Obviously, different types of careers have varying risks because of the wide variety of activities performed in those industries. The commercial and residential cleaning industry can expose workers to various harmful substances. These include:

• Biological hazards such as bacteria, mold, fungi, and various types of infectious pathogens.
• Chemical hazards used in cleaning that may be toxic and can be transmitted through contact with skin or inhalation into the respiratory system.
• Environmental hazards such as noisy cleaning equipment or poor air quality in which the worker may be exposed.

The focus of this article is to discuss various risk factors of musculoskeletal injury and to identify intervention strategies to minimize those risks. Common injuries include muscle strains, ligament sprains, tendonitis, herniated intervertebral discs, nerve compression injuries, compartmental swelling issues, and skin trauma. It is important to understand that many if not most of the musculoskeletal injuries sustained by janitors and other cleaning industry workers is the result of:

• Repetitive movements that occur over a long period of time.
• Improper mechanics of how cleaning tasks are performed.
• Forceful exertions to move heavier objects.
• Exposure to certain surfaces for a long period of time.
• Exposure to continuous vibrational forces.

Repetitive Movements Overtime

Cleaning by nature requires repetitive movements such as vacuuming, scrubbing, wiping, sweeping, mopping, pushing-pulling, etc. The impact of these activities can be compounded if the worker is performing them in environments that are very cold or very hot. The nature of these activities by themselves performed for short duration are generally not damaging to the soft tissues of the body. However, performed for long periods of time they can fatigue the tissues and lead to musculoskeletal breakdown.

Intervention strategies include:

• Simply building in “pause” period where the repetitive activity is disrupted. Taking a properly timed break from activity eliminates the repetitive forces for a period of time giving the body tissues time to relax and rejuvenate before resuming activity.
• Requiring a “change” in activity after a determined period of time. This alters the activity so that the same repetitive movements are halted for a specific movement while the new activity engages other body area, again allowing the previously worked body tissues time to relax and rejuvenate.

Improper Body Mechanics

While repetitive movements can themselves be stressful to the musculoskeletal system over time, if those movements are performed with improper body mechanics (activities such as bending over, reaching upward, twisting, standing being off balance or at an angle, etc.) the repetitive stress to the body is magnified. Making proper adjustments to either the movement itself, or possibly altering the work environment so that the interaction between the worker and “objects” is performed more efficiently and safely.

Intervention strategies include:

• If a cleaning task requires having to reach overhead, incorporate the use of a small step ladder so that overhead reaching is minimized or eliminated. Reaching overhead, especially if performed while carrying added weight like a duster, increases the risk for shoulder injuries.
• A task that requires the worker to bend or twist, especially if while carrying an object, subjects the muscles and fascia of their back to high-load forces increasing the risk of back strain. These types of activities also place potentially damaging shear forces on the intervertebral discs of the spine. Over time this can lead to degradation and increase the risk of disc herniation. Educating the worker to turn by taking small steps their feet, instead of twisting at the trunk, can work to eliminate these stresses. When lifting, train workers to keep the object they are lifting near their body to reduce the length of the resistance arm (distance form the trunk to the center of mass of the object being lifted) which will reduce the stress placed on the joint between their pelvis and low back.

Forceful Exertions

In the cleaning industry it can be required to move heavy objects such as furniture, desks, or to clean behind various pieces of equipment. This can entail a forceful pushing, pulling, or lifting component. When an object is needed to be moved to access cleaning, it should be determined if the weight of the object can be effectively and safely moved by an individual using proper technique, or if equipment is needed to move the object and thus spare the stress to the body.

Intervention strategies include:

• An important strategy in lifting is to engage the involved musculature and then move the object slowly and under control, as compared to rapidly and possibly in an unbalanced fashion.
• If it is determined that moving the object poses excessive risk to an individual, the purchase or design of appropriate equipment to manage the load will be necessary. There are a variety of devices that are available to help manage the movement or transfer of loads deemed to great for a person to move safely.

Prolonged Surface Exposure

Standing on a hard, ungiving floor for excessive periods of time can lead to various joint and back injury. Having to lean against an object that is firm, or irregular can lead to pressure on areas and potentially lead to skin breakdown.

Intervention strategies include:

• The wearing of appropriate cushioning footware can reduce the loading forces to the weight bearing joints of the body.
• Placing a cushioning mat where a worker may be required to stand or kneel for any length of time can also help reduce the stress to body tissues and lessen the risk of soft tissue breakdown or vascular compression.
• If an activity requires a person to lean a body part against a firm, or irregular surface, ensure that the body part is covered so there is no exposure of bare skin.

Exposure to Continuous Vibrational Forces

Certain cleaning equipment may have vibrational forces that are used to clean. If the total time of use of this type of equipment is excessive, a person may develop a condition or symptoms collectively known as Hand-Arm Vibration Syndrome (HAVS). If the repetitive vibrational forces continue overtime, the condition can progress and lead to the damage of nerves and blood vessels, and the resultant pain and diminished manual dexterity that can make fine hand motor tasks difficult.

Intervention strategies include:

• Incorporate the use of new low-vibration tools, selecting effective anti-vibration gloves (sometimes called jackhammer gloves), and developing alternative techniques with lower vibration values.
• Limit exposure time in using vibrating equipment including mandatory break times.

In Conclusion

The development of more ergonomically designed equipment, the practice of proper body mechanics when cleaning or moving objects, and other appropriate intervention strategies toward reducing worker exposure to musculoskeletal stresses have proven effective in reducing injuries to soft tissues and bone. However, all these strategies combined do not address perhaps the most important factor in preventing or reducing musculoskeletal injuries. That factor is to condition the workers body (muscles, joints, fascia, bone) to effectively withstand the required forces of the work of cleaning.

If workers want to more effectively protect their bodies from the stresses and potential trauma and damage from the required activities of the cleaning industry, they will need to condition their bodies as an athlete works to condition his/her body for the rigors of their sport. And, by so doing they will enjoy the fringe benefits of a more healthy, robust, and capable body that will allow them to go and do the things they enjoy.