Preventing Work-Related Musculoskeletal Disorders

Why are WMSDs a Problem?

In 1996, more than 647,000 American workers experienced serious injuries due to overexertion or repetitive motion on the job. These work-related musculoskeletal disorders (WMSDs) account for 34 percent of lost workday injuries. WMSDs cost employers an estimated $15 to $20 billion in workers' compensation costs in 1995 and $45 to $60 billion more in indirect costs.

WMSDs are not a comfort issue; they may result in crippling disability. Severely injured workers may never be able to return to their jobs or be able to handle simple, everyday tasks like combing their hair, picking up a baby or reaching for a book on a high shelf.

Work-related musculoskeletal disorders occur when there is a mismatch between the physical requirements of the job and the physical capacity of the human body. More than 100 different injuries can result from repetitive motions that produce wear and tear on the body. Back pain, wrist tendinitis and carpal tunnel syndrome may all stem from work-related overuse. Specific risk factors associated with WMSDs include repetitive motion, heavy lifting, forceful exertion, contact stress, vibration, awkward posture and rapid hand and wrist movement.

What Can Be Done About WMSDs?

The good news is that for almost every job, there are different ways to do the work that can reduce the risk of injury. Simple, inexpensive solutions often can prevent these painful disorders.

The science of fitting the job to the worker is called ergonomics. Designing the work and the work environment properly can prevent WMSDs. Employers that have implemented ergonomics programs have had great success in avoiding WMSDs, keeping workers on the job and boosting productivity and workplace morale.

Are MSDs Clearly Linked to Work?

Yes, often they are. Last year, the National Institute for Occupational Safety and Health (NIOSH) reviewed more than 2,000 studies of work-related musculoskeletal disorders. The agency's in-depth analysis of 600 epidemiologic studies from this group of studies was further evaluated by a panel of 27 scientists and ergonomists from academia, government and private practice. NIOSH concluded that "compelling scientific evidence shows a consistent relationship between musculoskeletal disorders and certain work-related physical factors, especially at higher exposure levels." NIOSH's effort produced the most comprehensive compilation to date of credible epidemiological research, and the research pinpointed, in many cases, a strong link between risk factors on the job and WMSDs.

What is OSHA Doing About WMSDs?

Standard setting The Occupational Safety and Health Administration (OSHA) is developing a program-based ergonomics standard to help employers reduce the risk of work-related musculoskeletal disorders in their workplaces. For the first phase of its efforts, OSHA is focusing on manufacturing operations and manual handling and sites that experience one or more WMSDs.

OSHA met with various stakeholders in Washington in February 1998 to discuss its plan to require an ergonomics program rather than adherence to a specific list of requirements. A second series of meetings was held in July and September 1998 to seek individual stakeholder input on steps employers who would be covered under an ergonomics standard should take to protect their workers, what action levels should be used to trigger further action, how to determine when controls are adequate for a problem job, and what employers should be covered by the standard. Currently the agency is considering the following major elements for an ergonomics program: management leadership and employee participation, hazard awareness and employee training, medical management, job hazard analysis, hazard prevention and control, program evaluation and documentation. OSHA has begun the review process, consulting with small businesses, under the Small Business Regulatory Enforcement and Fairness Act (SBREFA). The agency plans to publish a formal proposal in the Federal Register in the summer.

Outreach NIOSH and OSHA held a joint effective practices conference in Chicago in January 1997 and are holding a second national meeting in Houston in March 1999. In 1997 and 1998 OSHA held eleven regional conferences to enable employers and employees to share effective solutions to ergonomic problems. The agency also has developed a video profiling how four firms instituted ergonomics programs that worked to prevent injury and save money. "Ergonomics Programs that Work" can be purchased from the National AudioVisual Center (telephone 703-605-6186) for $55. An ergonomics page on OSHA's web site at http://www.osha.gov/ under "Outreach" provides additional information on the issue.

Do Ergonomics Programs Really Work?

Yes! Thousands of employers have already instituted ergonomics programs that include elements OSHA is considering for its proposal. For example:

• Red Wing Shoes in Minnesota modified work stations and gave its employees adjustable chairs. Even though the company added two new plants, workers' comp costs dropped 75 percent over four years.
• Fieldcrest-Cannon in Columbus, Georgia, cut MSDs from 121 in 1993 to 21 in 1996. They credit their success to worker involvement in designing systems to limit the need for workers to bend and reach.
• In North Carolina, Perdue Farms started an ergonomics program in 1991. It was so effective, the company expanded it to all its plants. Although the average lost workday injury and illness rate for poultry processing is about 12 per 100 full-time workers, six Perdue plants had no lost time injuries in 1996.
• Lunt Silversmiths in Massachusetts bought lifts so workers would no longer need to carry dies for silver casting by hand. The result? No more back injuries in the machine room.
• Woodpro Cabinetry in Cabool, Missouri, saved $42,000 in workers' compensation costs by bringing its injury rates down when it added conveyors to limit lifting. This is a significant amount for a company with about 100 workers.

What Can I Do To Prevent WMSDs?

Employers and employees can work together effectively to reduce WMSDs. Here are some ways:

• Look at injury and illness records to find jobs where problems have occurred.
• Talk with workers to identify specific tasks that contribute to pain and lost workdays.
• Ask workers what changes they think will make a difference.
• Encourage workers to report WMSD symptoms and establish a medical management system to detect problems early.
• Find ways to reduce repeated motions, forceful hand exertions, prolonged bending or working above shoulder height.
• Reduce or eliminate vibration and sharp edges or handles that dig into the skin.
• Rely on equipment-not backs-for heavy or repetitive lifting.

Simple solutions often work best. Workplace changes to reduce pain and cut the risk of disability need not cost a fortune. For example:

• Change the height or orientation of the product or give poultry processors knives with curved handles so they won't have to bend their wrists unnaturally to cut the birds apart.
• Provide lifting equipment so nursing home workers won't strain their backs lifting patients by themselves.
• Offer workers involved in intensive keyboarding more frequent short breaks to rest muscles.
• Vary tasks of assembly line workers to avoid repeated stress for the same muscles.