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How to use ergonomics as a loss control tool.

As the fastest growing category of workplace illnesses, cumulative trauma disorders is one of the nation's most debilitating worker safety and health issues of the 1990s, according to the Occupational Safety and Health Administration. In 1988 the Department of Labor reported more than 115,000 such cases, compared to approximately 23,000 cases in 1980. These statistics translate into billions of dollars a year in higher medical costs and lost worker productivity.

Cumulative trauma disorders affect the musculoskeletal and nervous systems and result in injury to tendons, tendon sheaths and related bones, hands, muscles and nerves, wrists, elbows, arms, back or legs. The two most prevalent forms are lower back/disc compression-related injuries and carpal tunnel syndrome, which affects the median nerve that runs through the carpal channel in the wrists. The conditions are contracted through repeated exposure within the work environment rather than a single traumatic event.

Workers' compensation payments due to lower back injuries increased from $14 billion in 1979 to $30 billion in 1985, reports OSHA, which estimates that two-thirds of lower back injuries occurring in the workplace are considered cumulative trauma disorders. The National Institute for Occupational Safety and Health estimates that carpal tunnel syndrome affects 23,000 workers a year, with each case costing an average of $3,500 in benefits and rehabilitation. If the condition requires surgery, that figure could reach $30,000 per patient.

While cumulative trauma disorders have hit the automotive assembly and meat-packing industries the hardest, no industry remains unscathed. For instance, long-haul truck drivers are particularly susceptible to lower back injuries. Government regulators note that some 40 million computer users, including secretaries, telephone operators and newspaper reporters and editors, face the risk of cumulative trauma injuries. In effect, any employee who works in a poorly designed work area, whether they be airline baggage handlers or cashiers at grocery stores, is at risk.

Ways to Help

Education is key. Training workers how to lift heavy materials, for instance, has proven effective in reducing lower back injuries. Aerobic exercise, including walking, swimming or jogging, can also help reduce the risk of injury by strengthening back muscles. In addition, stretching exercises increase circulation and the range of motion and reduce muscle tension. Medication such as anti-inflammatory drugs may reduce pain from injuries but is viewed as a secondary treatment. Even surgery is not a cure-all because, as doctors note, the likelihood for reoccurrence exists.

A more permanent solution for avoiding or reducing workplace injuries involves tailoring the job to fit the employee rather than vice versa. Therefore, injury prevention should focus on reducing the levels of physical stress through job redesign. In other words, no matter how much training a worker receives, he or she will still be vulnerable to injury if required to lift a 40-pound object from an awkward position five or six times per minute.

The importance of a healthy ergonomic environment in the workplace has gradually become recognized. Initially, the meat-packing industry was targeted because its rates for ergonomic illnesses are greater than those of other industries. Last year the Labor Department issued meat-packing plants ergonomic guidelines that focus on identifying existing and potential ergonomic hazards, eliminating the hazards and monitoring illness and injury trends so symptoms can be treated before becoming worse. OSHA intends to inspect red meat slaughterhouses and processors this year to gauge the effectiveness of the guidelines.

Detection: ASAP

Early detection and proper treatment of cumulative trauma disorders can save thousands of dollars in surgery costs. Most therapists agree that treatment should involve the employer, employee and physician. Although it may be tough to sell the philosophy of rest, therapy, job rotation and modification to employers concerned with their place in a competitive market, the savings from avoiding surgery and reducing lost hours due to lengthy postoperative rehabilitation can be significant. For example, carpal tunnel surgery, combined with lost work time, disability payments and rehabilitation, can cost employers up to $20,000. And surgical costs for cumulative trauma-related lower back injuries can be as high as $10,000.

While management support for programs to reduce cumulative trauma injuries is growing, many managers nevertheless consider the cost of prevention more expensive than the problem. Like any major investment, however, the financial gain must be viewed in the long term. Revamping the work environment is expensive, and companies wanting a quick return often choose the less expensive option of retraining employees. Retraining is a "soft" cost that some feel more readily passes through the approval process. Retooling equipment or installing new conveyor lines is a "hard" cost that shows up more easily on the bottom line and therefore requires more approval.

Take, for example, back problems. The Bureau of Labor Statistics states that back problems are the second leading cause of employee absenteeism after the common cold. As much as 75 percent of the U.S. work force conducts business in seated positions for extended periods of time, and prolonged poor seating is a chief culprit of lower back pain.

Applying Ergonomics

An ergonomically designed chair can cost as much as $800. If 50 chairs are needed for 50 different workstations, that translates into an outlay of $40,000. While the cost may sound prohibitive, lower back surgery alone costs close to $10,000, and a week of postoperative hospitalization averages $700 per day. If four lower back injuries are eliminated over the 10 years the chairs are in use, the expense is more than justified. Furthermore, a well-designed workplace not only reduces injuries but increases productivity. Because workers are less fatigued and taxed when performing their jobs, their ability to think clearly and produce effectively increases.

However, no article on ergonomics would be complete without including a buyer beware warning in the purchase of ergonomic furniture. A chair labeled "ergonomic" is useless if it is not fully adjustable and does not prevent fatigue. The rationale behind having an adjustable chair is that people sit in different positions while performing different tasks. A chair that forces people to sit in a rigid position will injure some of them. Yet keep in mind that even a well-made ergonomic chair will not help an employee who has not been taught to use it properly.

Ergonomic Surveys

A thorough ergonomic survey that analyzes the entire work process is necessary to prevent cumulative trauma disorders. One survey method many employers, insurers and ergonomic consultants use is video to record workers' actions. By running the tape in slow motion or stop-action, workers' movements can be scrutinized, then modifications can be made to the equipment, the workers' positions and work flow. In addition to uncovering areas for potential injury, using video, light, vibration, force and weight measuring devices in these surveys can help risk managers develop practical solutions to worksite problems.

Injury trends develop over a period of years. Likewise, the results of ergonomic. approaches in the work environment must be studied in greater detail in the future. However, the results of just a single ergonomic survey by one insurer led the company to install ergonomically designed keyboard shelves-at a cost of only $175 each. Today the firm orders only ergonomically sound office equipment, including copy holders, footrests and chairs.

OSHA is in the process of convening an advisory committee on ergonomic regulations for general industry. Up until now, the lack of across-the-board guidelines has resulted in divergent views in how states diagnose problems and deal with them. Subsequently, until general ergonomic guidelines can be established industrywide, employers would do well to maintain open-door communications with their employees by listening to their comments and seeking their input in any planned changes to equipment or work flow. The first step to redesigning the workplace could be as easy as adjusting the height of a secretary's chair. Robert W. Eby Jr., CSP, is vice president of loss control and David Mahone is an ergonomics loss control specialist with Continental Insurance in Cranbury, NJ.
COPYRIGHT 1991 Risk Management Society Publishing, Inc.
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1991 Gale, Cengage Learning. All rights reserved.

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Author:Eby, Robert W., Jr.; Mahone, David
Publication:Risk Management
Date:Mar 1, 1991
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