A new game plan for ergonomics — or a sham?

Chao promises course of action’ by September

The fate of future ergonomics regulation may be settled just six months after Congress rescinded a broad-reaching standard that was designed to reduce musculoskeletal disorders (MSDs), the most common disabling injury in health care and other industries.

Labor Secretary Elaine Chao announced three "national forums" to be held in July and said she plans to "identify a course of action" on ergo-nomics in September. The forums will take place in Washington, DC, Chicago, and California. Exact locations had not yet been announced. "We are bringing everyone to the table to get this important issue moving forward and resolved," Chao said in a statement. "Defining the best approach for ergonomic injuries is not a simple process, and we need everyone’s voice heard in the process."

The forums will be led by an administrative law judge but will be more informal than the extensive hearings held by the U.S. Occupational Safety and Health Administration (OSHA). They are charged with addressing three questions:

1. What is an ergonomics injury? The Department of Labor is interested in establishing an accepted definition that (OSHA), employers, and their employees can understand and apply.

2. How can (OSHA), employers, and employees determine whether an ergonomics injury was caused by work-related activities or nonwork-related activities; and, if the ergonomics injury was caused by a combination of the two, what is the appropriate response?

3. What are the most useful and cost-effective types of government involvement to address workplace ergonomics injuries (e.g., rulemaking, guidelines, "best practices," publications/conferences, technical assistance, consultations, partnerships, or combinations of such approaches)? The agency particularly invites comments on the advantages and disadvantages of each approach or combination of approaches.

Five principles to guide future ergo action
According to Labor Secretary Elaine Chao, a "new and comprehensive approach to ergonomics" will encompass the following principles:
Prevention: The approach should emphasize the prevention of injuries before they occur.
Sound science: The approach should be based on the best available science and research.
Incentive-driven: The approach should focus on cooperation between OSHA and employers.
Flexibility: Future actions must recognize the costs of compliance to small businesses.
Clarity: Any approach must include short, simple, common-sense instructions.

Can we learn anything new?

Worker advocates immediately decried the forums as a "sham" and questioned why Chao needed more information when OSHA collected some 18,000 pages of testimony at public hearings last year.

In January, a National Academy of Sciences panel issued a report that was prepared at the request of Congress and concluded that "The weight of the evidence justifies the introduction of appropriate and selected interventions to reduce the risk of MSDs of the low back and upper extremities." (See Hospital Employee Health, March 2001, p. 30.)

"I can’t believe we’re going to learn anything new," says Bill Borwegen, MPH, occupational health and safety director of the Service Employees International Union in Washington, DC. "All I can think is this is window dressing, some type of political cover for Elaine Chao."

AFL-CIO officials charged that the questions amounted to an attack on the science of ergonomics and the definition. By changing the definition of a work-related MSD, the administration could make the problem diminish, they asserted. "The only question that needs to be answered now, but was not even asked by Chao is "What should OSHA do now to protect workers?" said an AFL-CIO statement.

Employee health professionals took a more hopeful approach. "A lot of people thought this was going to be shelved for a long time," says Guy Fragala, PhD, PE, CSP, director of environmental health and safety at the University of Massachusetts Medical Center in Worcester. "We want to be cautiously optimistic right now. Most people are agreeing that there’s a problem that needs to be addressed," he says. "The disagreement comes about how we need to approach the solution."

The continued OSHA focus on ergonomics gives hospital-based employee health professionals additional justification for continuing with programs to reduce MSD injuries, notes MaryAnn Gruden, MSN, CRNP, NP-C, COHN-S/CM, executive president of the Association of Occupational Health Professionals (AOHP) and employee health nurse practitioner at Sewickley (PA) Valley Hospital. AOHP will seek to have some type of input into the forums, Gruden says.

RNs had 13,000 MSDs in 1999

According to the Bureau of Labor Statistics, more than 44,000 nurses’ aides, orderlies, and attendants suffered from work-related MSDs in 1999, the highest number of any occupation. Registered nurses had some 13,000 MSDs. Together, they accounted for one-tenth of the nation’s MSDs that led to lost workdays.

An OSHA spokesman says Chao is following through on her promise to continue to seek a way to reduce those injuries. "No one should have ever interpreted the repeal of this rule to mean that the ergonomics issue is over and done with," he says. "The secretary of labor has been very adamant about what her approach is going to be, and she’s fulfilling that."