Feature Archive

On-the-Job

Are workers paying a high price for productivity?

WebMD Feature

Feb. 21, 2000 (Washington) -- For most of his nearly nine years as a worker in a chicken slaughterhouse in Harbeson, Del., Walter Frazier outperformed everyone around him. About 10,000 times a day he would take a live, often reluctant chicken off the conveyor belt in front of him and hang it by its feet on a line over his head; from there it would be carried to the kill room.

His co-workers saw it as a thankless job, one they did everything to avoid. But Frazier talks with pride of hanging as many as 26 birds in a minute -- "I was a leader in there" -- and showing younger workers what a hard day's labor involved.

But Frazier has paid a high price for his productivity. Three times in the past two years he has had surgery to repair cysts and other injuries in his wrists and hands -- damaged, his doctors say, by the repetitive motion his job required. He also has severe arthritis in his shoulders and hands, along with lower back pain.

Frazier's case is well known to officials of the Occupational Safety and Health Administration (OSHA) -- so much so that this past November, when the agency proposed new regulations aimed at preventing such injuries, they invited him to speak at the Washington, D.C., press conference. After eight years of political battles, OSHA unveiled a standard that would require many employers to institute workplace ergonomics programs, which, depending on circumstances, will range from performing employee education to modifying job tasks to providing different workstations or equipment. The goal is to stem the rising tide of work-related musculoskeletal disorders (MSDs), including those known as repetitive stress or repetitive strain injuries, that account for one third of all occupational injuries reported to the Bureau of Labor Statistics each year.

Such injuries go beyond the computer-related carpal tunnel syndrome plaguing office workers to include a variety of soft tissue and joint problems. These can affect cashiers, baggage handlers, meat packers, bakers -- anyone whose job regularly requires heavy lifting, overhead reaching, or other repetitive tasks. And while the financial costs of these injuries are significant -- in 1997, MSDs accounted for $1 of every $3 spent on workers' compensation, and OSHA estimates the bill for employers is more than $15 billion each year -- there's also a highly personal toll: MSDs can permanently disable workers, leaving them unable to do their jobs or perform everyday tasks. "It's important for us to remember there are real people out there getting hurt," OSHA Administrator Charles Jeffress says.

But many business groups and lawmakers say the measures in OSHA's proposal will themselves require unwarranted expense. Citing insufficient scientific evidence, they argue the government should not regulate this issue until there's conclusive proof that workplace ergonomics actually cause (or can remedy) MSDs. "There is a lack of consensus in the scientific and medical communities on the causes of MSDs," says Jennifer Krese, director of employment policy for the National Association of Manufacturers. "Certainly not enough to justify a rule of this magnitude."

Numerous studies, including research reviewed in 1998 by the National Academy of Sciences (NAS) involving 66 leading specialists in orthopedic surgery and occupational medicine, suggest ergonomics can be at least partly responsible for MSDs. "Physical work factors [such as lifting heavy boxes or equipment] can affect the loading [strain] that is experienced by a worker's tissues and structures," the NAS report said, adding, "Research clearly demonstrates that specific interventions can reduce the reported rate of musculoskeletal disorders for workers who perform high-risk tasks." A new NAS study on the subject, which will reexamine current medical findings and look closely at how these disorders can be prevented, is slated for completion in early 2001.

But most experts agree that these injuries rarely stem from ergonomics alone; a combination of contributing factors are often involved, including work schedules, pacing of activities, and time pressures on the job. And anyone looking to quantify how much any specific factor is to blame could find it a tough issue to study. "It's difficult to apply critical, scientific methods to determine that a particular action done repetitively over a number of hours will result in injury,'' says Russell E. Windsor, M.D., an orthopedic surgeon and expert in joint replacement surgery from the Hospital for Special Surgery in New York. Unlike a workplace accident, the origins of repetitive injuries are "subtle," he adds. "So many different things can come into play. It's not like having a steel pipe hit you on the head. ''