OSHA may track MSDs, warns of inspections

Is ergonomics reg on the horizon?

Keeping track of work-related musculoskeletal disorders (MSDs) would be a new priority under a proposed record-keeping rule, evidence of a new direction for the U.S. Occupational Safety and Health Administration.

OSHA moved swiftly to reinstate a requirement to record MSDs on the OSHA 300 log in a proposal that was published in the Federal Register on Jan. 29. In an expedited timeline, the agency requested comments by March 15 and scheduled a public hearing for March 9. OSHA said it wants the revised OSHA 300 log to be in place by Jan 1, 2011.

"It's clear that they want to get this in effect as soon as possible," says Brad Hammock, Esq., workplace safety compliance practice group leader at Jackson Lewis LLP in the Washington, DC, region office.

Meanwhile, OSHA also has shifted some positions from voluntary compliance efforts to enforcement. The agency added 100 inspectors in the fiscal year 2010 budget and would have another 60 inspectors in the proposed 2011 budget.

In a live, online "chat" on the proposed budget, OSHA administrator David Michaels, PhD, MPH, said the additional inspectors would enable the agency to conduct more targeted inspections and National and Local Emphasis Programs, which involve inspections that are focused on specific standards or concerns, such as bloodborne pathogens.

U.S. Labor Secretary Hilda Solis said the budget showed "this administration's strong commitment to vigorous enforcement. . . . [W]e are sending a strong message throughout industry that we will not tolerate the endangerment of workers. We will continue those efforts with a number of new and innovative enforcement initiatives in the coming year."

OSHA defines work-related MSDs

As OSHA notes in its record-keeping proposal, the new reporting requirement doesn't call for employers to respond to the new data they will collect. In fact, it predicts that the proposed rule would create little burden on employers.

"OSHA stresses that the purpose of this rulemaking is solely to improve data gathering regarding work-related MSDs. The proposed rule does not require employers to take any action other than to check the MSD column on the OSHA 300 log if a work-related MSD case occurs that meets the general recording requirements of the record-keeping regulation," the agency said in the Federal Register notice.

Yet even the act of recording MSDs brings up past controversies. A far-reaching ergonomics rule was rescinded by Congress in 2001. "A number of people in the employer community will believe this is the very first step towards re-regulating ergonomics," says Hammock.

Under the Bush administration in 2003, OSHA eliminated the MSD record-keeping provision, asserting that it was too difficult to define work-related MSDs — an argument that echoed the controversy over the ergonomics rule. "OSHA found that no single definition of 'ergonomic injury' was appropriate for all contexts," the agency said when it suspended the MSD reporting requirement.

Yet OSHA now notes that MSD definitions are being used by the Bureau of Labor Statistics, the National Institute for Occupational Safety and Health, the U.S. Navy, and the American National Standards Institute. The proposed OSHA definition would provide both examples and exclusions: "MSDs are disorders of the muscles, nerves, tendons, ligaments, joints, cartilage, and spinal discs. MSDs DO NOT include disorders caused by slips, trips, falls, motor vehicle accidents, or other similar accidents. Examples of MSDs include: carpal tunnel syndrome, rotator cuff syndrome, De Quervain's disease, trigger finger, tarsal tunnel syndrome, sciatica, epicondylitis, tendinitis, Raynaud's phenomenon, carpet layers knee, herniated spinal disc, and low back pain."

MSDs would be treated no differently than other occupational illnesses and injuries in terms of the criteria for reporting, OSHA says. An employer would record the MSD on the OSHA 300 log only if all of four criteria are met: "The employee experiences 'pain, tingling, burning, numbness or any other subjective symptom of an MSD'; the symptoms are work-related; new; and meet the general recording criteria in the recordkeeping regulation" (that is, they involve restricted work, job transfer, days away from work, or medical treatment beyond first aid).

Underreporting remains a problem

The proposed rule was welcome news to safe patient handling experts, who said it would shed more light on the problem. Critics also have asserted that occupational injuries and illnesses are greatly undercounted. While the proposed rule does not address the fundamental reason for undercounting — that is, a system based solely on employer reports — it would provide important new information, says Kenneth D. Rosenman, MD, chief of the Division of Occupational and Environmental Medicine at Michigan State University in East Lansing and an expert on occupational injury and illness reporting.

"I think it's important because it's the only way we can get a [handle on] the number of musculoskeletal injuries," he says. Hospitals could use the MSD information to measure the effectiveness of injury prevention efforts, although comparisons to the national rate or to other hospitals would be problematic because of differences in reporting, he says.

For its part, OSHA says the new MSD information would help with policy setting: "Having the total number of MSDs would provide BLS with more complete data for analyzing the magnitude of the MSD problem and trends over time in the country as a whole, as well as in specific industries. Having more complete MSD data would assist OSHA and other safety and health policymakers in understanding MSDs and making informed decisions on policies concerning workplace MSDs."