Ergo controversy: Experts shun OSHA symposium

Rehash of research a waste of time, they say

Even something as benign as a research symposium can cause a ruckus when the topic is ergonomics.

Eleven leading researchers declined an invitation to present their findings to a recent symposium of the National Advisory Committee on Ergonomics (NACE), a panel set up by the U.S. Occupational Safety and Health Administration (OSHA) to guide the research element of the agency’s comprehensive approach to ergonomics.

They said the panel’s mission to study the work link of musculoskeletal disorders (MSDs) was just another way to stall action on ergonomics. Mean-while, the National Committee on Ergonomics complained to OSHA that the panel was biased toward creating more ergonomics regulation.

In fact, the controversy highlights the contentious atmosphere surrounding ergonomics, one that dogs any efforts by OSHA to reduce work-related MSDs.

John Henshaw, OSHA administrator, contended that the symposium "demonstrates how much NACE members value getting a full picture of the research being conducted and looking at ways the science is being reduced to practice in the workplace.

"Our challenge is to continue to move the dialogue forward and work toward a common end — reducing injuries and illnesses in the workplace," he said in a statement.

Any reduction in injuries is occurring despite OSHA, not because of it, contends Bill Borwegen, MPH, health and safety director of the Service Employees International Union. "We’ve seen literally a handful of ergonomics citations issued [in general industry] since this program was announced," he adds.

The research portion of the ergonomics program has also been ineffective, Borwegen notes. "People are arguing over things we’ve known for years, if not decades," he says.

Last fall, NACE sent invitations to leading ergonomics researchers to submit papers for the symposium connected with the panel’s January meeting. The topic: Musculoskeletal and Neuro-vascular Disorders — The State of Research Regarding Workplace Etiology and Prevention.

To many of the researchers, that was like asking for evidence that smoking causes cancer.

"It became clear to me that the symposium was not going to be looking at how to build upon the results of past research," says Bradley Evanoff, MD, associate professor of medicine at the Washington University School of Medicine and medical director of the BJC ergonomics program at BJC Health Care Inc. in St. Louis. "It looked like it was going to rehash a lot of what was done before. We should quit arguing about whether physical exposures are related to musculoskeletal disorders and start talking about how to decrease musculoskeletal disorders."

In the letter to OSHA, the 11 researchers cited three previous, in-depth reviews of evidence that linked workplace factors to MSDs and cited ergonomic interventions as preventive tools. Most recently, in 2001, a National Academy of Sciences (NAS)/Institute of Medicine (IOM) panel issued a report that documented a relationship between occupational risk factors and MSDs.

"The weight of the evidence justifies the introduction of appropriate and selected interventions to reduce the risk of musculoskeletal disorders of the low back and upper extremities," the panel concluded.

Evanoff and other researchers told OSHA they would participate in the symposium "if the NACE decided to take the next logical step and directed the symposium instead toward evaluating the progress made in addressing the recommendations of the NAS/IOM panel, especially the evaluation of effectiveness of company-based ergonomic programs."

Ergonomics advocates also have criticized the makeup of NACE, noting that it includes a labor lawyer who has represented the U.S. Chamber of Commerce on ergonomics issues and a hand surgeon who has testified for employers in workers’ compensation cases, arguing that injuries were not work-related.

One well-respected member of NACE is Audrey Nelson, PhD, RN, FAAN, director of the Patient Safety Research Center at the James A. Haley Veterans Hospital in Tampa, FL. Nelson has conducted research that has influenced patient-handling interventions nationwide.

She notes that the symposium was arranged to share ergonomics information from specific fields of work.

"One of the goals of that presentation was to make sure that all of the NACE members had a solid foundation. We all bring unique experience and expertise to the table. Everyone is not broad-based." NACE members already had been briefed on the IOM report, Nelson explains. Meanwhile, workgroups have discussed which areas should be the focus of OSHA guidelines and how to create incentives for employers to follow the guidelines, she says. "I think maybe we’re not moving as fast as some people would like, but we’re moving in the right direction."

Nelson also defends the panel against criticism that it is biased, noting concerns have come from both sides of the ergonomics debate. But she also expresses some empathy for the researchers who failed to attend the symposium.

"I think that they mirror some of the frustration that many people have in the field, that the ergonomics [standard] did not go through and several other major initiatives did not go forward," she adds.

"My philosophy is that you can’t give up. You have to keep pushing, and you have to have a voice. And any opportunity to share that information is important so things don’t stop and slow down," Nelson stresses.