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.