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New record-keeping rules will go into effect in January as planned, but most likely without adding new information on the incidence of musculoskeletal disorders (MSDs).
Controversy over ergonomics spilled into the record-keeping area, as Labor Secretary Elaine Chao said the department needs another year to decide on a definition of work-related MSDs. The record-keeping rule, which was issued in the final days of the Clinton administration, had been under review by the Bush administration for about six months. Industry groups filed suit to halt its enforcement, objecting to the MSD category and other reporting changes.
In fact, when Chao convened ergonomics forums in July, she declared that the definition of a work-related ergonomics injury was a central question. "Until a definition is agreed upon, the data collected [on the new Occupational Safety and Health Administration (OSHA) 300] will not help us target the injuries that need to be eliminated," Chao said in a statement.
Chao has promised to announce an action plan on ergonomics in September. (See "Ergo faces new forums, recurring questions," in this issue.) OSHA also has asked for public comment on how to record hearing loss and in regard to the proposal to postpone the separate MSD column and changes in hearing-loss record keeping. (For more information, see editor’s note at the end of this article.)
While industry groups asserted that the definition and category contained on the OSHA 300 logs would encourage overreporting of MSDs — perhaps, including nonwork-related injuries — unions accused Chao and OSHA of trying to sidestep the problem by literally erasing it.
"Keep in mind, this is the nation’s leading workplace hazard," says Bill Borwegen, MPH, occupational health and safety director of the Service Employees International Union in Washington, DC. "Why wouldn’t you want to give it its own category? This is clearly a way to minimize this huge hazard."
Chao also held back provisions on hearing-loss conservation, saying more time is needed to decide on the criteria for recording occupational hearing loss. "OSHA believes that the record should be reopened to permit consideration of additional medical and other relevant evidence, and to explore alternative approaches," the agency announced in the Federal Register.1
Even without those two controversial items, the record-keeping rule brings many changes in the way employers record injuries and illnesses. Hospitals can expect to see their injury and illness statistics soar as all needlesticks become reportable. The record-keeping rule was designed to work in conjunction with the revised bloodborne pathogen standard, which requires a needlestick log. (For details on the new rule, see "OSHA record keeping at a glance," in this issue.) Days away from work due to injury will rise as employers count calendar days that employees were unable to work, even if they weren’t scheduled to do so. That includes weekends, vacations, and days off.
Yet in other ways, the rule makes record keeping less painful. The new forms are easier to use, and OSHA provided a list of circumstances in which injuries or illnesses would not be work-related. OSHA defined the tasks that are first aid only (and therefore make an injury not recordable), and stated that pre-existing conditions must be "significantly aggravated" by a work event to become work-related injuries.
"I think people are anxiously awaiting a new form," says Kae Livsey, RN, MPH, public policy and advocacy manager at the American Association of Occupational Health Nurses in Atlanta. "It’s been challenging for [employers] to know what to record. This is written in a way that’s clearer to understand." The rule includes a new privacy provision that allows an employee’s name to be kept off the OSHA 300 log in certain cases, including needlesticks and sharps exposures. "We’re thrilled to see any policy that addresses the issue of privacy in an appropriate way," says Livsey.
Meanwhile, debate over how to record MSDs is likely to remain vigorous. OSHA emphasized in its Federal Register notice that work-related "soft-tissue disorders" must still be recorded according to requirements that apply to all injuries and illnesses. There simply will not be a separate column to check for MSD data collection. That change may not be enough to halt the lawsuit, filed by the National Association of Manufacturers, against the record-keeping rule. "We were pleased that they took that action, but that is not everything we were seeking from our lawsuit," says Washington, DC, attorney Baruch Fellner.
Others insist that collecting separate data on MSDs is critical as employers assess their need for ergonomics programs and the success of their efforts. "I think it’s going to be important for employers to record musculoskeletal disorders," says Livsey. "What they’re going to see is that there’s a problem that needs to be dealt with."
[Editor’s note: The American Association of Occupational Health Nurses in Atlanta will be holding workshops on the record-keeping rule in various cities. For information, call (770) 455-7757 or see the web site, www.aaohn.org. A copy of the rule and the most recent Federal Register notice is available from the OSHA web site, www.osha.gov.
Comments can be sent to Docket Officer, Docket No. R-02A, Occupational Safety and Health Administration, Room N-2625, U.S. Department of Labor, 200 Constitution Ave. N.W., Washington, DC 20210. Telephone: (202) 693-2350. Fax: (202) 693-1648.]
1. Occupational Safety and Health Administration. Occupational injury and illness recording and reporting requirements. 66 Fed Reg 35,113 (2001).