11.1 The Manual Handling Operations Regulations 1992 came into operation on 1 January 1993 as part of the so-called ‘six pack’ of new Regulations. Although the Regulations implemented European Directive 90/269/EEC, the HSE had previously attempted to introduce Regulations on manual handling in an attempt to reduce the huge toll of accidents from this source. At the time of the introduction of the Regulations more than a quarter of the accidents reported each year to the enforcing authorities (the HSE and local authorities) were associated with manual handling. In 1990/91, 65% of handling accidents resulted in sprains and strains, whilst 5% were fractures. Many manual handling injuries have cumulative effects eventually resulting in physical impairment or even permanent disability.