OSHA’s new ergo plan generates good vibes

This time around AAOHN, ACOEM have input

The Occupational Safety and Health Administration (OSHA) has retaken center stage in the ongoing debate over the best way to address the nation’s ergonomic challenges. Following a long and rancorous debate over its ergonomics rule, culminating in its rescission by Congress, OSHA unveiled a four-point ergonomic plan. The plan was announced in early April and further fleshed out in a presentation before the American Occupational Health Conference (AOHC) in Chicago on April 17 by Assistant Secretary of Labor John Henshaw.

At the conclusion of Henshaw’s remarks, the presidents of the organizations jointly sponsoring the conference, Deborah V. DiBenedetto, MBA, RN, COHN-S/CM, ABDA, of the American Association of Occupational Health Nurses (AAOHN) and Dean Grove, MD, of the American College of Occupational and Environmental Medicine (ACOEM), pledged to work together with OSHA to achieve its goals. Their move was a metaphor for the general response of the occupational health profession, which has been overwhelmingly positive. (Editor’s note: There was one notable exception — the American Nursing Association.)

OSHA’s four-point plan addresses the following areas:

• Guidelines: OSHA will develop industry- or task-specific guidelines based on current incidence rates and available information about effective and feasible solutions.

• Enforcement: Employers must keep their workplaces free from recognized serious hazards under the Occupations Safety and Health Act’s General Duty Clause. Under this clause, inspections for ergonomic hazards will be conducted and citations issued.

• Outreach and assistance: OSHA will provide assistance to businesses, particularly small businesses, and help them proactively address ergonomic issues in the workplace.

• Research: OSHA will serve as a catalyst to encourage researchers to design studies in areas where additional information would be helpful.

Henshaw further explained these key points in his remarks. "Our intention is to build on guidelines and best practices already developed," he said. "We will move forward rapidly so we can put guidelines in place this year." While pursuing enforcement, "OSHA will focus on [those who are noncompliant] and develop a strategy to ensure that General Duty Clause citations will stand up," Henshaw added. "We’ll design a successful plan to target ergonomic violations."

OSHA plans to offer advice and training on industry-specific and task-specific guidelines and assistance on how to develop an effective ergonomics program as part of its outreach and assistance initiative, Henshaw explained. "We’ll provide a wealth of materials on our web site, support development of ergonomic training materials and training sessions, and make ergonomics training available through the 12 Education Centers around the country." The new plan also includes specialized focus to help Hispanic and other immigrant workers, he added.

In an effort to spur additional research, OSHA is establishing a national advisory committee to advise OSHA in part on gaps in ergonomics and prevention techniques. "In concert with the National Institute for Occupational Safety and Health [NIOSH], the committee, representing a broad range of experts, will help OSHA serve as a catalyst to expand current research on the subject," Henshaw explained.

The right direction

Even before Henshaw’s speech, DiBenedetto had called OSHA’s plan "a step in the right direction." Of course, the previous rule left much to be desired. "We could not tolerate the last standard — it was out of the scope of OSHA," DiBenedetto told Occupational Health Management when contacted at the AOHC confab. "The big problem was that it was so enveloping there was no clear demarcation between on-the- job and off-the-job injuries."

DiBenedetto offers the example of an avid needleworker who develops acute tendonitis. "If I’m also a secretary and type reports all day, that could also contribute but the underlying cause is non-occupational. What OSHA tried to do was deal with people fairly. But anything that could casually be related to work became a burden of the employer — and businesses will not tolerate that kind of regulation," she explains.

Under the guidelines suggested by OSHA, the General Duty Clause can still be effective, notes DiBenedetto. "Employers must provide a workplace free from hazards known to cause injury," she observes. "If they try to follow the guidelines but OSHA finds some violations, they’ll probably be OK. But if they say, The heck with you’ and OSHA comes in and finds bad conditions, they will come down on them. There is up to a $70,000 fine for egregious and wanton disregard of the General Duty Clause."

"If you try to exercise a good-faith effort, that’s what’s important," adds Katie Hundley, MSN, COHN-S, and a member of AAOHN from Richmond, VA, who was also attending the conference. "From what I see, the intent is not to try to nail those who do make the effort but to target the 5% who take the attitude that they won’t do anything unless they absolutely have to."

Hundley is well aware of AAOHN’s support of the new plan. "This is something that is long-awaited, and people are looking at it as an opportunity to try to provide solutions to this significant problem. We, as the largest group of providers, have the best understanding of losses due to ergonomics in terms of productivity, absenteeism and medical costs. We want to see anything and everything done to address this problem."

DiBenedetto was impressed not only with OSHA’s approach, but also with the way Henshaw reached out to AAOHN and ACOEM in his speech. "He was very good and very personal about it," she notes. "He said he would like to meet with our audience every year because we are on the forefront right there with the workers."

"What I heard them say is that they are very interested in partnering with OSHA and ACOEM and having us provide whatever input we can to him to bring guidelines and best practices into the workplace," adds Hundley. "We take the perspective that if something has a preventive health component to it and it helps employers buy into existing health and safety efforts, it’s a plus."

What form will this new partnership take? "For one thing, we’ll come up with general white papers — what it means to have an ergonomic program, what it means to have ergonomic responses to repetitive motion injuries, and so on," says DiBenedetto. "Our message might be something like, This is a turnkey guideline for you, Mr. Employer, for dealing with work-related injuries.’ Or, for safe bending and safe lifting. They could also talk about the role of the occupational health nurse and physician. In other words, a blueprint to help businesses."

"We have a lot in our bag of tricks," says DiBenedetto. "For example, a representative of a copier company came up to me and told me they had a resource they’d like to share. They said they’d like to be on the task force. With this approach, OSHA won’t necessarily have to develop the guidelines — it will be the professional societies."

This takes the pressure off OSHA, notes DiBenedetto. Hundley agrees, and sees it as a big plus. "If that’s the way to go, OK. They’ve been pummeled [for the ergonomics rule]. We look to them to be a resource for business."

This alliance also enables the professional societies to be proactive for their members and for their publics, says DiBenedetto. It absolutely gives us a higher profile," she concedes. "It helps the members, and it gives us greater [visibility]." AAOHN already has a head start, she notes. "We already have a number of ergonomic programs and associated cost savings on our site at www.Bizhealthcheck.com," she says.

"We already have an office of occupational health nursing and occupational medicine right within OSHA," adds Hundley, "so they have in-house talent on which to draw. For example, we helped write guidelines for nursing homes and such."

DiBenedetto also sees benefit in the teaming of AAOHN and ACOEM. "We have not come together since the issues of confidentiality," she observes.

Hundley sees the new OSHA approach having a significant impact. "It will create a lot of opportunities," she says. "If we can bring this to fruition, we can help identify high-risk areas and determine what the next steps should be. We can make significant advances in appropriate medical assessment, ergonomic changes in the workplace, teaching employees how to manage daily tasks to avoid injury, continuous follow up on costs savings, and overall analysis of the changes that have been instituted."

Above all, Hundley welcomes OSHA’s abandonment of what she calls the "whip & chain" approach to change. "It’s a softer, friendly, gentler OSHA that wants to work from a partnership point of view," she asserts. "Henshaw is a practitioner, not a politician. The whole perspective is different: just try to do the right thing."

[For more information, contact: Deborah V. DiBenedetto, MBA, RN, COHN-S/CM, ABDA, President, American Association of Occupational Health Nurses Inc., 2920 Brandywine Road, Suite 100, Atlanta, GA 30341. Telephone: (770) 455-7757. Fax: (770) 455-7271. Web: www.aaohn.org.]