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Workplace factors such as heavy lifting, twisting, and repetition lead to musculoskeletal disorders (MSDs), and ergonomic modifications can reduce the risk, a National Academy of Sciences panel concluded. Opponents of the U.S. Occupational Safety and Health Administration’s (OSHA) ergonomics standard have asserted that there is insufficient science to link specific workplace risk factors with injuries and that not enough is known about the effectiveness of ergonomic interventions. In fact, critics had sought to delay the release of OSHA’s standard until the National Academy of Sciences completed its work.
Yet the panel stated, "The weight of the evidence justifies the introduction of appropriate and selected interventions to reduce the risk or [MSDs] of the lower back and upper extremities."
Jeremiah A. Barondess, MD, president of the New York Academy of Medicine and chair of the panel, noted that the 19 expert members spent two years in a "rigorous" literature review. "In general, the literature related to the lower back is more robust than the literature relating to the upper extremities," Barondess told Hospital Employee Health. "However, both are adequate."
Charles Jeffress, OSHA administrator, greeted the report as confirmation of the agency’s efforts. He noted the panel’s conclusion: "To be effective, intervention programs should include employee involvement, employee commitment, and the development of integrated programs that address equipment design, work procedures, and organizational characteristics."
"OSHA’s ergonomics program standard meets these requirements," Jeffress said in a statement. "Our standard provides the framework to enable employers to effectively respond to the concerns identified by the NAS panel."
However, opponents of the standard asserted that the report substantiated their concerns. "Despite the study’s implied support of OSHA’s ergonomics regulation, it actually reinforces the business view that there is a lack of sound scientific evidence on the causes of [MSDs] by acknowledging the wide array of complicated, unquantifiable and subjective factors that contribute to these disorders," Ed Gilroy, chairman of the National Coalition on Ergonomics, said in a statement. The study also calls for more research and better statistics on MSDs, something the business community has been urging for years.
Barondess notes that every scientific field contains room for further research. He also notes that the panel wasn’t trying to either bolster or debunk OSHA’s standard. "The report is a straightforward objective review of the quality of the underlying science," he says. "The report is about science; it is not about policy. There will be people who like the science base and people who don’t like the science base, but it is what it is."
Nonetheless, not even the expert panel could avoid the sort of controversy that has dogged the field of ergonomics. One member, a hand surgeon, wrote a dissent, citing "significant interpretations of the scientific literature that I consider inaccurate and misrepresentations." The dissent by Robert M. Szabo, MD, at the department of orthopedic surgery at the School of Medicine of the University of California, Davis, focused on carpal tunnel syndrome, expressing a concern about the lack of scientific evidence linking the syndrome with keyboard use.
"The report acknowledges that the keyboard literature is weak," counters Barondess. But he adds that all other members signed off on the full report "enthusiastically," including another hand surgeon. "It’s not possible to agree with the dissent," he says. "The argument is too narrowly drawn [on carpal tunnel syndrome] and is based to a great degree [on weaker scientific studies]."
[Editor’s note: A copy of the full report, Musculoskeletal Disorders and the Workplace ($54.95) is available from the National Academy Press, 2101 Constitution Ave. N.W., Washington DC 20418. Telephone: (800) 624-6242 or (202) 334-3313. The report can also be accessed on-line at www.nas.edu.]