Thursday, March 27, 2008


BOHICA is not a new Japanese word used in lean manufacturing and it is not a cynical Dilbert-ism although it could be. For those with a military background, you may recognize it and may have even used it on occasion. BOHICA is a crude expression that stands for “Bend Over Here It Comes Again” to convey the notion, please pardon the expression, of getting …. (let’s just say treated badly) by someone else (usually someone in authority). If you will please look beyond its original rude meaning, I would like to use the same expression in a completely different context.

BOHICA still represents “Bend Over Here It Comes Again” only with “IT” being another recordable injury as a result of bending or lifting. This is a very serious, very costly and very preventable injury! No joke.

How many of us see this reoccurring injury involving bending and lifting year-in and year-out on our safety dashboards? What are the usual countermeasures we put in place if any? Is it working? How do we know?

Did you know that after colds, back injuries are the No. 1 cause of missed work? It is estimated to cost more than $90 billion a year in medical bills which is certainly a waste. According to the Bureau of Labor Statistics, back injuries account for 1 in every 5 workplace injuries or illnesses with more than one million workers suffering back injuries each year. One million workers….suffering…each year!

And it is not just a manufacturing problem. Two other occupational fields where back injuries occur most are in construction and health care. Yes, in the health care workplace. The six of the top 10 professions at greatest risk for back injuries are nurse’s aids, licensed practical nurses, registered nurses, health aids, radiology technicians and physical therapists, according to national statistics. Greater than one third of these back injuries are attributed to patient handing. For our friends in lean healthcare, this is a worthy problem to eliminate and for reference please see “A Back Injury Prevention Guide for Healthcare Workers” as a starting point.

The motion of lifting, placing, carrying, holding and lowering are all involved in manual material handling however data shows that the act of lifting accounts for four out of five incidents of back injuries. The first thing that may come to mind is providing training to lift properly which is a common countermeasure to address the problem, “Trained or Re-trained associate in proper lifting methods.” But does that really prevent the injuries from occurring? Maybe not. According to one report, body mechanics training in proper lifting techniques has been discredited by 35 years of research.

Even Henry Ford way back in 1922, as quoted from his book, My Life and Work, said, “The first step forward in assembly came when we began taking the work to the man instead of the man to the work. We now have two general principles in operations-that a man shall never to take more than one step, if possibly it can be avoided, and that no man need ever stoop over.” Although he was certainly focusing on motion economy, I am sure back injuries were a problem for manufacturing in those days too.

It is commonly thought that no approach has been found for totally eliminating back injuries caused by lifting however this should not discourage us from finding a proper and permanent countermeasure. Perhaps Mr. Ford points us in the right direction. Prevent the action of bending and lifting to eliminate back injuries.

Potential suggestions include adjusting the heights of pallets and shelves above the knee and installing mechanical assists to 100% eliminate human effort to lift or bend. Focus on prevention by better job design with detailed study and proper countermeasures. Spend the time and effort to grasp the situation, ask the 5 whys, and check to make sure the countermeasures are effective.

A quick fix of training or re-training may help only as a temporary countermeasure but this problem demands long-lasting improvements.

As a little added bonus, here is my first haiku on this topic.

Bending over to
lift another piece again;
Snap goes my poor back.

Thanks to Jon Miller at Gemba Research for the inspiration.

1 comment:

Anonymous said...

Mike - This topic is worth much consideration – thanks for bringing it forward. The injury is not the only outcome of poorly designed manual handling tasks, it just happens to be the most tangible – funny how pain manages to bring work design issues to light and the one that requires action.

Another unspoken concept is that repetitive bending to pick up items requires more effort (placing unnecessary burden on worker), creates less engagement (I have yet to see someone rush to complete tasks which cause them discomfort or pain) and, here’s the big one; bending takes more time!! A good rule of thumb is that every 6” a human moves requires about 0.2 seconds. Doesn’t seem like a lot, but it adds up.