Occupational Physicians Withdraw Support for OSHA Final Ergonomics Standard

Occupational Physicians Withdraw Support for OSHA Final Ergonomics Standard

CHICAGO, November 14, 2000 — The American College of Occupational and Environmental Medicine (ACOEM) today announced its opposition to the final ergonomics program standard issued by the Occupational Safety and Health Administration (OSHA), citing the standard’s lack of a sound medical foundation. While maintaining the need for a medically based standard to protect the nation’s workers, ACOEM becomes the only major medical association previously supporting the standard to withdraw its support. The highly publicized rule is intended to reduce the number of musculoskeletal disorders in the nation’s workforce.

"We cannot support the final regulation as it is currently written," said ACOEM President Robert L. Goldberg, MD, FACOEM, director of ErgoUC with the Ergonomics Program and assistant clinical professor at the University of California, San Francisco. He expressed the College’s fear that in its haste to publish the rule, OSHA has put the standard in legal jeopardy by the its failure to address the shortcomings debated during hearings held earlier this year. During those hearings, ACOEM submitted several recommendations which would have established a firm medical basis for the diagnosis and treatment of musculoskeletal disorders.

Fundamental to an effective standard is a process to verify the diagnosis of a musculoskeletal disorder and to determine that the injury or disorder is directly related to workplace duties. Throughout the past two years of the rulemaking process, ACOEM has consistently urged OSHA to limit implementation of the standard only to work-related disorders for which credible scientific evidence exists. Yet, the final standard appears to require neither a medical diagnosis nor a causal assessment.

"This standard is certain to be held up by legal battles for the next several years," said Dr. Goldberg. "Unfortunately, OSHA’s failure to base the standard on a firm medical foundation lends credence to the arguments that will be made in court by those who will try to block this standard from going into effect. It is distressing that our nation’s workers will be left without preventive measures to protect them from unnecessary musculoskeletal injuries."

"One of the keys to ensuring effective implementation of an ergonomics standard is a medical diagnosis," said Dr. Goldberg. "A proper diagnosis protects ill or injured workers by ensuring that their signs and symptoms are directly related to a musculoskeletal disorder rather than another type of injury or illness. It also helps ensure that the patient receives proper treatment and workplace modifications."

The final measure put forth by OSHA would provide that the standard be triggered without a clear determination that a worker’s reported symptoms or signs are related to a musculoskeletal disorder that is attributable to the worker’s job.

While ACOEM is pleased that OSHA included an appeals process for temporary work restrictions and work removal, the College is disappointed that the standard’s multiple review requirement fails to provide for health care providers who have the ability to make a diagnosis or causal assessment — or who have any knowledge of the prevention and treatment of musculoskeletal disorders. Other programs, such as the Department of Labor’s Federal Employees’ Compensation Program; OSHA’s lead, arsenic, and asbestos standards; and most workers’ compensation programs, base their work restrictions and removal requirements on a medical diagnosis.

ACOEM also points out shortcomings in some of the terminology used in the standard. The standard simply lists several specific disorders but fails to specify the criteria for a determination of a musculoskeletal disorder. Absent a physician or other health care provider qualified to make a diagnosis, OSHA fails to define the signs, symptoms, and diagnostic testing data that would lead a health care provider to support the diagnosis of a musculoskeletal disorder. "The failure to include a medically accurate definition of musculoskeletal disorder will contribute to confusion and additional cause for litigation," said Dr. Goldberg.

In light of the anticipated lawsuits from both labor organizations and private industry, ACOEM is hopeful that the courts will resolve these issues, resulting in a stronger and more enforceable ergonomics program standard.

"We would support any action that will correct the errors and omissions present in this standard, said Dr. Goldberg. "Throughout the rulemaking process, ACOEM has supported the development of an ergonomics standard but in the end, this final standard does not address the concerns we raised. ACOEM has no choice but to oppose the final standard. Our physician members, who represent a range of backgrounds, from private practice and academia to public health and corporate practice, treat thousands of workers each year who are affected by musculoskeletal conditions and who need the protection of a medically sound standard."

ACOEM, an international society of more than 7,000 occupational and environmental medicine physicians, provides leadership to promote optimal health and safety of workers, workplaces, and the environment by the education of health professionals and the public; stimulating research; enhancing quality of practice; guiding public policy; and advancing the field of occupational and environmental medicine.


Note to Editors: ACOEM President Robert L. Goldberg, MD, FACOEM, and First Vice President Edward J. Bernacki, MD, MPH, FACOEM, are available for media questions by calling Debra Bethard-Caplick at 847/818-1800, ext. 383, or voice page 773/963-6178.

Contact: Debra Bethard-Caplick 847/818-1800, x 383; email: dcaplick@acoem.org
Greg Barranco, 202/785-5553; email mailto:gbarranco@acoem.org%20%20%20%20%20%20%20%20g


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This Page Last Updated November 15 2000