Push and pull check (DUTCH)

What is the purpose of the DUTCH assessment?

The pushing (‘duw’) or pulling (‘trek’) of objects can require a great deal of physical force. This can sometimes lead to shoulder complaints. Therefore, it is important to make sure that loads are not too heavy and that pushing and pulling activities are not performed too frequently. It is also important to ensure that the surfaces on which objects move are in good condition and that the objects being handled are of an appropriate design, e.g. wheels are made of the right material so they run smoothly and handles are at an appropriate height. How a task is performed is also important – if a trolley is set in motion suddenly the forces can be much greater than if a force is applied gradually.

Under the Dutch Working Conditions Act (July 2017), employers must identify risks associated with the pushing and pulling of objects as part of their Risk Inventory and Evaluation (RI&E). If the RI&E is insufficient for highlighting the level of risk associated with these tasks, then the Duw & Trek Check (DUTCH) risk assesment may offer an additional approach.

What is the DUTCH risk assessment?

DUTCH is a simple risk assessment method for determining the likelihood of injury when performing pushing and pulling tasks, without the need to measure forces.

When using DUTCH, you can check:

  • whether work tasks involving pushing and pulling are likely to lead to musculoskeletal complaints;
  • which risk factors of a pushing or pulling task contribute to a risk of musculoskeletal complaints. This information is important for identifying where steps can be taken to reduce the risk of injury and the potential benefits from modifiying the work task (plan-of-action).

The method should not be used to assess the physical risk to an individual, but should be applied to the group of workers who perform the task over the day.

Important: if there are jobs in your organization that involve multiple physically demanding tasks during a day, then the DUTCH will not provide a complete picture of the physical work load for those jobs. In such cases, you should consult an expert.

The method is based on scientific evidence from the literature on the most important risk factors associated with pushing and pulling (shoulder complaints), supplemented with experts judgments. Based on a validation study the method has been improved in September 2019.

Read this article:
DUTCH: A New Tool for Practioners for Risk Assessment of Push and Pull Activities

When should DUTCH be used?

The method has been developed for the purpose of assessing tasks that involve the pushing and pulling of wheeled objects (trolleys). It is intended for assessing whole body force exertions – i.e. forces involving the use of the hands, arms, torso and legs.

The method is suitable for assessing adult workers aged between 18 and 67 yeras, across all types of industries and service sectors.

Examples of the various wheeled objects and industries in which the DUTCH risk assessment can be used include:

  • wheeled containers (transport sector, retail industry, or distribution centres);
  • hand pallet trucks (warehouses);
  • maintenance trolleys (mechanics, cleaners);
  • liquid containers (chemicals, food industry);
  • beds, wheelchairs, and hoists (healthcare sector);
  • mobile scaffolds (construction industry).

Who can use the DUTCH risk assessment?

Users of the tool are those who are responsible for the health and safety of workers, such as health and safety coordinators, HR managers, or – in smaller companies – the managing director himself. No specific prior knowledge is needed to use the method. The method can also be used by health and safety experts, ergonomists, occupational hygienists, and safety experts.

How to carry out the DUTCH risk assessment.

You first need to read and answer some simple questions. To answer the questions, you need information about the tasks being performed and the workplace in which the tasks are undertaken:

  • observe one or more workers performing the push/pull tasks
  • determine the average and maximum weights being pushed or pulled (kg, trolley and load)
  • determine the height of the hands when pushing or pulling (the height of the hands relative to the body)
  • determine the average distance covered during each push or pull (in metres)
  • determine the average number of times the pushing and pulling task is performed
  • note the characteristics of the wheels on the trolley being pushed or pulled (wheel diameter, wheel material, quality of the bearings)
  • note the features of the floor surface over which the push or pull task is performed (floor surface, humps, slopes, inclines, and the difference in the height and length of these)
  • observe the workers and note the features of the task that lead to awkward arm postures or repeated manoeuvring of the object.

Some comments and tips before you start:

  • Record average values: if the task varies considerably from one worker to the next, then use average values for different workers. This means you should gather data from several workers who perform the task. The same applies to variations between days.
  • Consider having two people carry out the assessment – especially the first time.
  • Involve workers in the assessment and ask them questions about the task. This is likely to improve the outcomes of the assessment.

The DUTCH risk assessment has been developed by TNO on behalf of the Dutch Ministry of Social Affairs and Employment in collaboration with a group of experts: Mark Boocock (Auckland University of Technology, New Zealand), Marco Hoozemans (Faculty of Behavioural and Movement Sciences, VU Amsterdam), Paul Kuijer (Netherlands Center for Occupational Diseases, Coronel Institute of Occupational Health, Academic Medical Center Amsterdam), Bert Moss (Inspectorate SZW), and Hetty Vermeulen (vhp human performance). We thank Mark Boocock for his valuable work on the validation and English translation of DUTCH.