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Stop the Pain (1999)

Following 8 years of intense resistance by some employer groups and their allies in Congress, OSHA finally issued a draft proposed ergonomics standard on Feb. 19, 1999. This working document is the first step toward developing a final standard which the Occupational Safety and Health Administration (OSHA) seeks to accomplish in the year 2000. The draft standard contains six basic elements of an ergonomics program: Management Leadership and Employee Participation; Hazard Identification and Information; Job Hazard Analysis and Control; Training; Medical Management; and Program Evaluation.

OSHA’s draft is a positive step forward, but it needs to be strengthened. It would cover workers in manufacturing jobs and where workers perform lifting operations, including moving patients in health care facilities. However, in other workplaces, action to prevent injuries would not be required unless a worker reported experiencing problems, such as a keyboard operator who complained about pain in the hands and/or wrists. Workers need a standard that requires action to prevent injuries rather than one that is triggered after an injury occurs.

At the present time, only California (CalOSHA) has passed an ergonomics standard.

WORK-RELATED MUSCULOSKELETAL DISORDERS

Injuries to the back, shoulders, elbows, wrists, hands and neck, which are called musculoskeletal disorders, comprise the biggest safety and health problem in the workplace today. These types of injuries now account for over one-third of all reported serious workplace injuries, affecting more than 600,000 workers each year. (The number of injuries is actually much higher as many workers do not report these injuries.) OSHA estimates that these disorders cost employers $15-20 billion annually in direct workers’ compensation costs.

Work-related musculoskeletal disorders (WMSDs) are also commonly referred to as repetitive strain injuries (RSIs) or cumulative trauma disorders. They result from the overuse, or misuse, of muscles, tendons and nerves. These injuries are caused by risk factors: working conditions such as repetitive motion, awkward and uncomfortable body positions, and heavy lifting. Workers who operate computers and health care workers who must lift and move patients are examples of AFSCME members who suffer these injuries. However, any worker who is exposed to such conditions is at risk of suffering a WMSD.

Carpal tunnel syndrome (CTS) is a common WMSD that affects keyboard operators and other workers who perform repetitive or forceful motions with their hands or wrists. In addition to pain, the symptoms of CTS include numbness, tingling and weakness in the hands. These symptoms are usually felt in the first three fingers and the base of the thumb. Often the pain is worse at night and, in advanced cases, CTS can make common activities such as holding a frying pan, folding laundry or lifting an infant impossible.

As with other occupational illnesses and injuries, WMSDs are preventable. Ergonomics is the practice of fitting the job to the worker, rather than the other way around. Redesigning jobs with the right equipment and reorganizing the way work is performed reduces workers’ exposure to ergonomic risk factors.

Help Us Win a Strong OSHA Ergonomics Standard
AFSCME will actively participate in the upcoming rulemaking to urge OSHA to issue a standard that will protect all of our members who are at risk of a WMSD. Examples of AFSCME members who have been injured at work because of ergonomics hazards, and examples of successful ergonomics programs that have been implemented and have reduced the number of injuries will help make our case. If you have information that can help or if you would like more information or assistance on ergonomics issues, contact the Department of Research and Collective Bargaining Services at (202) 429-1215 or e-mail.

AN ERGONOMICS PROGRAM PREVENTS WMSDs

An ergonomics team made up of representatives from labor and management, and including individuals who know about ergonomics and the medical treatment of ergonomic injuries, can serve as the vehicle for developing an ergonomics program. A comprehensive ergonomics program includes:

  • training to increase ergonomic awareness and build in-house expertise;
  • collecting information on workers’ injuries and discomfort;
  • identifying risk factors in the workplace that are causing injury and discomfort;
  • giving workers input into how they do their jobs;
  • developing ways to control ergonomic hazards by modifying equipment and the organization of work;
  • implementing a medical management program to identify WMSDs early and ensure appropriate medical treatment;
  • identifying or creating light-duty positions and making other job accommodations; and
  • evaluating the effectiveness of the program.

Training

Awareness about ergonomics should be raised by training workers and supervisors about the causes and prevention of WMSDs. The training should cover:

  • signs and symptoms of WMSDs;
  • use and adjustment of equipment;
  • breaks and other ways to reduce the amount of time workers are exposed to ergonomic risks;
  • activities such as stretching, and lifestyle changes that reduce the risk of WMSDs;
  • reporting symptoms to the employer’s designated person; and
  • procedures to request an ergonomic evaluation of job tasks, equipment used or to get medical help.

Collecting Information

Information on which workers have been injured or are having pain can be obtained by:

  • looking for repetitive strain injuries in the OSHA 200 log;
  • checking workers’ compensation records; and
  • conducting a survey to identify workers who have symptoms.

Identifying Risk Factors

A job analysis means taking a close look at a job to see what conditions are causing problems. It is important to look at all the tasks that are part of a job. The main risk factors to look for are:

  • repetitive motion
  • awkward posture
  • long periods of repetitive activity (duration)
  • lack of recovery time
  • forceful movement
  • vibration
  • uncomfortable environmental conditions
  • stressful work organization

Controlling Ergonomic Hazards

As with any other danger, management should eliminate ergonomic hazards with equipment that gets rid of the risk. Other control measures include work organization and training.

1. Equipment can control ergonomic risks.

The following are examples of equipment that can eliminate or reduce ergonomic risks:
  • patient lifting devices
  • transfer board to move a patient from a bed
  • a truck with a hydraulic tailgate
  • adjustable computer equipment and furniture
  • tools with bent handles that allow the worker to keep wrists straight

2. Work organization changes.

The way work is done can be changed without different equipment. Here are some examples:

  • buying supplies in smaller containers to reduce the weight of materials that must be lifted;
  • having a lifting team move patients;
  • taking frequent rests from using the keyboard and mouse;
  • and/or rotating jobs.

3. Use safe lifting techniques to prevent back injuries.

The use of safe lifting techniques is often not practical, especially when lifting patients, because the total weight lifted is usually the greatest cause of back injuries. When people are lifting too much, even using proper techniques may not prevent a back injury.

Back Belts Are Not the Answer to Preventing Back Injuries

The National Institute of Occupational Safety and Health (NIOSH) concluded that there is a lack of scientific evidence that back belts work. In fact, relying on back belts to prevent back injuries might even make the problem worse. The risk of a back injury increases if workers wearing belts try to lift more weight than they would have if they were not wearing a belt.

Implementing a Medical Management Program

The proper medical management of WMSDs requires: identifying and evaluating the signs of WMSDs early on; making a correct diagnosis; providing appropriate medical treatment according to standardized protocols; and controlling the risk factors responsible for injuries.

A medical management program includes the following components:

  • access to trained health care providers experienced in the detection and treatment of WMSDs;
  • periodic inspections of the workplace to identify risk factors and ensure that hazards have been corrected;
  • symptoms surveys that are conducted on an annual basis, or more often where indicated;
  • a list of light-duty jobs to reduce exposure to WMSDs risk factors;
  • medical surveillance that includes baseline and any subsequent evaluations;
  • a system to report early signs and symptoms of WMSDs;
  • standardized procedures for health care providers; and
  • evaluation, treatment and follow-up for individuals after treatment and/or return to duty.

Making Job Accommodations

Workers who have a WMSD, who are returning to work after an injury, or who are experiencing symptoms may need accommodations to reduce exposure to ergonomic risk factors. Light-duty positions or switching to another job temporarily or permanently are methods to help injured workers.

Evaluating the Effectiveness of the Program

The ergonomics program should be evaluated to determine if it is working. Records should be reviewed to find out if there are fewer injuries, or less lost and/or restricted work time, sick leave, or medical and other costs. Symptoms surveys should be conducted periodically to see if health complaints are decreasing.

NEGOTIATING TO PREVENT WMSDs

There are different ways to secure ergonomically correct working conditions through negotiations. One approach is to simply establish an ergonomics committee that has sufficient scope and authority to address these problems:

The employer and union agree to establish a joint committee on ergonomics. The committee shall consist of an equal number of representatives from both parties. The committee’s purpose is to develop, implement and monitor the effectiveness of the ergonomics program. The ergonomics program includes but is not limited to the following elements: training on the causes and prevention of WMSDs; collecting information on injuries and symptoms; identifying ergonomic risk factors; changing equipment and work organization; ensuring appropriate medical management for affected employees; identifying light-duty positions and making other job accommodations; and evaluating the effectiveness of the ergonomics program.

Contract language can also address particular working conditions. For example, language prohibiting single person lifts would dramatically reduce back injuries among health care workers. In office settings, AFSCME locals have negotiated detailed language about the type of computer equipment and furniture that is provided.

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