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Washington Court Hotel – Atrium Ballroom
525 New Jersey Avenue, NW
Washington, DC

The meeting of the National Advisory Committee on Ergonomics (NACE) was opened by MaryAnn Garrahan, the committee’s Designated Federal Official, at approximately 9:04 am on Wednesday, January 22, 2003. About 55 members of the public were present for the opening of the meeting.

The following NACE members were present:

 
  • Edward Bernacki, M.D., M.P.H.,
Associate Professor and Director, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • Lisa M. Brooks, C.I.E.,
Health and Safety Program Manager for International Paper, Memphis, Tennessee
  • Paul A. Fontana, President/CEO,
Work Rehabilitation, Inc., Lafayette, Louisiana
  • Willis J. Goldsmith, Esq.,
Jones, Day, Reavis & Pogue, Washington, DC
  • Morton L. Kasdan, M.D.,
Clinical Professor of Surgery, University of Louisville, Louisville, Kentucky
  • Carter J. Kerk, Ph.D.,
Associate Professor in Industrial Engineering, South Dakota School of Mines & Technology, Rapid City, South Dakota
  • James L. Koskan, MS, CSP,
Corporate Director of Risk Control, SUPERVALU INC., Minneapolis, Minnesota
  • George P. LaPorte, Ergonomics Manager,
NATLSCO Loss Control Services, Division of Kemper Insurance Companies, Lake Zurich, Illinois
  • Barbara McCabe, Program Manager,
Operating Engineers National Hazmat Program, Operating Engineers, Beaver, West Virginia
  • J. Dan McCausland, Consultant and Director,
Worker Safety and Human Resources, American Meat Institute, Madison, Wisconsin
  • Audrey Nelson, Ph.D., PN, Center Director,
VHA Patient Safety Center of Inquiry, Suncoast Development Research Evaluation Research Center of Safe Patient Transitions, Tampa, Florida
  • Lida Orta-Anes, Ph.D., Associate Professor,
Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
  • Roxanne Rivera, President and CEO,
PMR Construction Services, Inc., Albuquerque, New Mexico
  • W. Corey Thompson, National Safety and Health Specialist,
American Postal Workers Union, Washington, DC
  • Richard Wyatt, Ph.D., Associate Director,
Aon Ergonomic Services, Huntsville, Alabama

In her opening statement, MaryAnn Garrahan, the Designated Federal Official, introduced the NACE legal counsel, Susan Sherman, and provided an overview of the meeting’s purpose. The Designated Federal Official also welcomed OSHA Assistant Secretary John Henshaw.

OSHA Assistant Secretary John Henshaw thanked the committee members for their willingness to serve and noted that the work the committee was about to undertake was of paramount importance to OSHA and to the nation’s workers. He stated that the committee’s charter calls for them to discuss topics such as guidelines, outreach and assistance, and continuing research. Mr. Henshaw indicated that neither a regulatory approach to addressing ergonomics nor enforcement activities would be a part of the committee’s deliberations since they are outside the scope of the committee’s charter. He mentioned that OSHA has four overall objectives with respect to ergonomics:
  • Decrease ergonomic hazards
  • Reduce ergo-related injuries and illnesses
  • Help employers prevent musculoskeletal disorders (MSDs)
  • Ensure flexibility and encourage innovation
Mr. Henshaw stated the OSHA was not expecting the advisory committee to conduct research or develop guidelines but rather the broad goal for the committee is to identify how or what it might take to reduce the science to practice and to identify ways to sell the value of these strategies to workers and employers. Mr. Henshaw introduced NACE Chair, Dr. Carter Kerk and briefly summarized Dr. Kerk’s expertise in the field of ergonomics.

Chair Carter Kerk asked the committee members to introduce themselves. The Chair outlined the five goals of the committee:
  • Advise the Secretary on various industry specific and/or task specific guidelines
  • Identify gaps in research
  • Identify research needs
  • Look at methods of outreach
  • Find ways to increase communication among shareholders
The Chair indicated since this is the first time the committee has met, the rest of the meeting would focus on background information to help the committee accomplish its goals.

Mr. Steve Witt, Director of the Directorate of Standards and Guidance (DSG), provided an overview of the new Standards and Guidance directorate. Mr. Witt made a distinction between guideline development and standards development. Guideline development differs from standards development in that the selection criteria are not totally objective. It is not statutory or judicially based but instead looks at injury rates. When developing guidelines, it is not the Agency’s intention to do initial, original work. The Directorate of Standards and Guidance will draw upon work that already exists and has been determined to be acceptable and productive. Five key considerations will be looked at during the guideline development process:
  1. Does the program reflect specific conditions prevalent in a particular industry or task?
  2. Does the program contain specific control methods and methodology?
  3. Does the program include a mechanism for reporting and responding to injuries, symptoms, and hazards?
  4. Does the program present a process for identifying hazards?
  5. Does a process exist for identifying, implementing, and evaluating corrective actions to reduce injuries?
OSHA believes that employers who adopt ergonomic guidelines will reduce injury levels, reduce costs, and retain employees. Three industries have been targeted to date for ergonomic guidelines: nursing homes, retail grocery, and poultry processing. Mr. Witt explained in detail the control graphics developed for the nursing home draft guidelines. The final nursing home guidelines are tentatively planned for release in the next four to six weeks. The format used for the nursing home guidelines will be used for future guidelines for other industries. Mr. Witt stated OSHA has a mid-April goal for issuing guidelines for Retail Grocers and Poultry Workers.

Discussion: Paul Fontana stated he has concerns that the guidelines focus only on new equipment rather than existing equipment. Mr. Fontana added that there is a need to educate workers that what they do at home, at play, and at work has the potential to contribute to ergonomic injuries.

Roxanne Rivera asked Mr. Witt if any studies had been done on guidelines leading to improved retention of employees. Mr. Witt responded that no studies had been done to date, but OSHA hopes that studies will be done after the guidelines are implemented.

Richard Wyatt asked about the redundancy of methods and how they will be captured by guidelines for other industries. Mr. Witt stated that OSHA will look at success stories and identify similar processes or activities among industries. While OSHA intends to make each of the Agency’s guidelines industry or task specific, there is no reason that a guideline cannot be used elsewhere.

Barbara McCabe asked if Mr. Witt could expand on what occurred during the site visits OSHA made when developing the initial set of nursing home guidelines. Michael Seymour, Director of Physical Hazards of OSHA, responded on behalf of Mr. Witt by saying that the site visits were conducted by OSHA and consultants. Mr. Seymour stated that the site visits included interviews with employees, managers, and employers.

Willis Goldsmith indicated that companies are concerned that guidelines may become standards for enforcement purposes. Mr. Witt reiterated Mr. Henshaw’s remarks that the voluntary guidelines will not be used for enforcement. Mr. Witt stated that Mr. Fairfax would comment on enforcement during his afternoon presentation.

Audrey Nelson inquired as to what the timeframe is for rolling out guidelines. Mr. Witt indicated that Bonnie Friedman of OSHA’s Office of Public Affairs will address this question in a press release and copies of the guidelines would be available on OSHA’s public website as well as at local OSHA offices. Ms. Friedman stated that general press releases are issued when a new guideline is available. Ms. Friedman also stated that her office works with the trade press to reach specific industries. She also noted that a video for nursing homes will soon be available on the website.

Lida Orta-Anes asked what the process for developing future guidelines is. Mr. Witt responded that OSHA developed guideline development protocols during the development of the nursing home guidelines. The guideline development protocols will be used to develop all future guidelines. A short slide show of the protocol process was presented to the committee. Dr. Orta-Anes inquired as to how NACE would fit into the process. Mr. Witt indicated that OSHA would look to the committee for input on what industries or tasks to target for the next group of guidelines.

Dan McCausland expressed a concern about the pending poultry guidelines. Mr. McCausland stated that many tasks in the meat packing industry are very similar to the poultry industry. He stressed that care should be taken so that the new poultry guidelines do not conflict with the meat packing guidelines.

James Koskan expressed a concern over the volume of material that is provided in the guidelines. He felt that “fluff” in the guidelines should be eliminated whenever possible and stressed that a short one-page style guideline like that used for the nursing homes was the best approach.

Corey Thompson asked what supporting resources OSHA would offer, specifically, what support would OSHA provide to employers to help them implement the guidelines. Mr. Witt stated that OSHA will continue to fund the Consultation Services Program and encourage employers to take advantage of the program; also, there are compliance assistance specialists in each regional office that can serve as speakers to industry groups.

Barbara McCabe stated that most guidelines appear to be targeted toward general industry. She cautioned that construction applications should not be forgotten.

Lisa Brooks asked how the first three industries were chosen. Mr. Witt stated it was a combination of being approached by industry groups that had concerns about their own industries and by evaluating existing injury/illness data.

Willis Goldsmith inquired as to whether OSHA would look at who has implemented the guidelines and what the effectiveness of the guidelines was. Mr. Witt stated that this was something of interest to OSHA and the Agency would look into this in the future.

Dan McCausland asked why the nursing home guidelines were not being expanded to cover hospitals. Mr. Witt again acknowledged that there are similar activities in nursing homes, hospitals, and long-term health care. However, the Agency feels that by keeping guidelines focused on a specific industry, the guidelines will be more manageable and will be better supported by the targeted industry.

Audrey Nelson cautioned that making guidelines too broad can cause them to lose some of their benefits. She pointed out that high risk tasks in an acute care facility are very different from high risk tasks in a general hospital setting.

George LaPorte asked if the committee would be involved in the review of future guidelines. Mr. Witt responded that the review of the guidelines is a public process and OSHA will place a notice in the Federal Register when a new guideline is ready. Because this is a public process, the committee cannot be given the guidelines prior to the Federal Register notice.

Miriam Miller, Co-Counsel for Administrative Law in the Division of Legislative and Legal Counsel, Office of the Solicitor, Department of Labor, provided an overview of the legal basis for creating national advisory committees. She reviewed the procedures for conducting meetings, discussed under what circumstances meetings could be closed to the public, and in what format meetings can be held. Ms. Miller also showed a short film on advisory committees.

Discussion: Roxanne Rivera asked if sub-committees could be created. Ms. Miller responded in the affirmative. Ms. Sherman also stressed that the working groups cannot do all the work and simply have the committee rubber stamp the end product, as this would negate the public process that is required of all national advisory committees.

James Koskan asked if individual committee members could get together to discuss issues. Ms. Miller responded in the negative and reiterated that all committee business is to be discussed in a public forum. Morton Kasdan asked if members can discuss what has happened at NACE meetings with their co-workers. Ms. Miller stated that because of the members’ constitutional right to freedom of speech, committee members are not prohibited from talking about the meetings.

Veneta Chatmon, Program Specialist, Office of Public Affairs, addressed the committee and provided procedural details for submitting travel reimbursement requests. She also reviewed the handout on travel and reimbursement procedures provided to each committee member.

Richard Fairfax, Director, Enforcement Programs, provided, for information purposes only, an overview of how the Agency would enforce ergonomics issues. The Agency’s primary enforcement tool is the site-specific targeting, or SST. Nursing homes were part of the SST inspection program; however, in September 2002, a national emphasis program (NEP) was starting on nursing homes. Four other industries have been identified for the development of local emphasis programs. These four industries are warehousing, hospitals, meat packing, and automotive parts manufacturing. Under the local emphasis programs, OSHA will be targeting individual establishments based on high injury rates and looking at ergonomic-type problems such as repetitive motion and back injuries. Mr. Fairfax stated that the Agency will focus its efforts on using legal strategies designed for successful prosecutions. To successfully cite under the General Duty Clause, or Section 5(a)(1) of the OSH Act, one has to prove that there is a hazard present and not just that a violation has occurred. Four specific criteria need to be met when citing under the General Duty Clause. OSHA’s compliance officers have received training in conducting ergonomic inspections. Mr. Fairfax is the head of the National Ergonomics Coordination Team. This team reviews ergonomic cases and assists the field compliance officers in determining what additional steps are required for specific cases.

Discussion: James Koskan stated that many people in his industry are frustrated with the time lag between an inspection and the closing conference. Mr. Fairfax acknowledged that some inspections have extensive lag times but that the majority of inspections are closed in a reasonable time frame.

Morton Kasdan stated he had concerns over the terminology that was issued when discussing ergonomic hazards.

Richard Wyatt asked for clarification on the target rates that were used when identifying high risk industries. Mr. Fairfax responded that that target rate of 14 was based on total injury cases, both lost work day and restricted work activity.

Roxanne Rivera asked if the General Duty Clause was developed specifically for enforcement of ergonomic hazards. Mr. Fairfax responded that it was not written for ergonomics, it was written as across the board for hazards that OSHA did not have standards or regulations to apply.

Lida Orta-Anes expressed concern about conducting inspections without providing recommendations on how to correct or improve the work situation.

Lisa Brooks expressed concern about the discussion on enforcement when Mr. Witt specifically stated in his presentation that the guidelines would not be used as an enforcement tool. Mr. Fairfax stated that the guidelines would not be used as enforcement and that the Agency’s field compliance officers had been informed of this during their ergonomics training.

Paula White, Director of Cooperative and State Programs, discussed the Compliance Assistance Plan her directorate developed for the compliance assistance prong of the Secretary’s four-pronged approach to ergonomics. For ergonomics, Ms. White’s directorate will be developing both general compliance assistance programs as well as industry specific programs.

Ms. White provided information on how her directorate would make use of their existing cooperative programs to focus on ergonomics. The Voluntary Protection Program (VPP) is OSHA’s longest-standing and most prestigious recognition program. To participate in VPP, an employer has to go beyond OSHA standards and address all workplace hazards. Many of OSHA’s VPP sites have very effective ergonomic programs. The Agency is working with these current VPP sites to identify sites that are willing to share best practices and programs with the intent to develop a kind of program where employers help other employers. Ms. White would like to have this type of ergonomic recognition program developed by the end of this fiscal year and to launch it next year.

The Strategic Partnership Program is a very active program and is a program that has multiple employers working with OSHA area and regional offices. Similar to the VPP, the participants in Strategic Partnership Program share information with other employers, so that it is not OSHA telling employers what works, but peers helping each other.

The Agency’s newest program is the OSHA Alliance Program. Alliances are designed to offer an opportunity for groups to work with OSHA on a broader scale. Alliances are not site-based programs, but rather a method to involved trade associations and professional groups in OSHA’s training, education, outreach efforts and to promote the national dialogue on safety and health. Ms. White highlighted some of the companies that are participating in these various programs and provided general information on their success stories. Ms. White discussed the Consultation Service Program that OSHA sponsors in each state. OSHA provides training to the consultants who in turn provide assistance to employers who request it. Services can be provided through on-site visits, speeches, training, or publications.

Ms. White provided an overview of the ergonomics material that is available on OSHA’s website. The material posted includes success stories, new releases, etools, and links to state plan states that have their own ergonomics standards.

Ms. White concluded her presentation by providing an overview of OSHA’s education centers. These education centers offer a week long course on the principles of ergonomics. It is the intent of Ms. White’s directorate to develop a one-day course as each ergonomic guideline is issued. These one-day courses will be handed off to the education centers to use.

Discussion: Lida Orta-Anes expressed concern that the information provided by Ms. White is more anecdotal and does not appear to be backed by scientific studies that support claims of reduced injuries and lost time.

Willis Goldsmith asked Ms.White to provide a summary of how the Education Center course curricula are developed. Ms. White indicated that the courses offered by the Education Centers are based on existing OSHA courses the Agency developed for its staff, minus the module on OSHA policy.

Barbara McCabe asked if the materials were available in languages other than English. Ms. White replied that English as a second language is a significant issue for OSHA. However, translating OSHA material to Spanish is not an easy task due to the many dialects and forms of Spanish.

Richard Wyatt asked if the newspaper industry was included in the printing industry alliance. Ms. White stated that no newspapers are part of the printing industry alliance and that few newspapers expressed an interest in having a dialog with OSHA on this program.

James Koskan inquired as to how long the alliance Program had been in place. Ms. White indicated this program was initiated in the summer of 2002.

John Howard, Director of NIOSH, and Dr. Tom Waters, Chief of Human Factors and Ergonomic Research Section for NIOSH, presented a basic model for work-related musculoskeletal disorders (WMSDs). Dr. Waters stated that the basic model suggests that a loading factor in the workplace leads to some kind of tissue response, which then leads to some kind of outcome. The outcome can be both positive (the person gets stronger/fitter) and negative (the person suffers a musculoskeletal disorder, impairment, or disability). The specific response is influenced by many factors. The basic model is a complicated system and the problem is how to design studies to capture all the factors. Most researchers agree that the risk of MSDs increases as the magnitude of the physical factors increase. Engineering controls can be highly effective in reducing the risk of WMSDs. This opinion is supported by a number of studies. Dr. Waters provided supporting details from a General Accounting Office study involving five companies in varying industries (TR 175). Many researchers, businesses, and the Federal government believe ergonomics is good economics. It can increase product quality and worker productivity as well as increase worker safety, health, and morale (TR 176). Intervention effectiveness depends on a number of factors. Most researchers agree that the higher the stress, the more likely it is that effective intervention methods can be found. While the basic principles of ergonomics are applicable across most all industries, it is recognized that those interventions need to be customized in specific instances. For example, lifting in a health care setting as compared to lifting in a manufacturing environment; while both involve the basic concept of lifting, the interventions are different.

Dr. Waters’ review of several ergonomic studies has led him to a number of conclusions. First, there is a need for national studies of WMSDs. These studies need to be both prospective and cross-sectional epidemiological studies of dose/response. Second, improved tools are needed for exposure assessment. The tools need to be user friendly (do not need to have a college education or special ergonomic training to use effectively). The tools need to increase sensitivity and specificity and they need to consider both the physical and work organization factors. The tools should also be multi-purposed. Third, there is a need to develop and validate standardized case definitions of WMSDs. Fourth, there is a need to clarify the interaction of risk factors. For example, what roles do individual factors such as genetics, obesity, age, and gender play? Fifth, there is a need to demonstrate the relative effectiveness of interventions. Some of the research reviewed by Dr. Waters has been applied to the real world environment. Dr. Waters recommend the NACE members review several documents for further information. These documents included California OSHA’s “Easy Ergonomics”, NIOSH’s “Simple Solution” document for agriculture, and various Hazard Evaluation Technical Assistance documents (TR 188).

Discussion: Willis Goldsmith asked for clarification on Dr. Waters’s statement that the basic model was understood, yet more research was needed to further develop the model. Dr. Waters stated that more research is needed on the psychosocial context of the model.

James Koskan asked Dr. Waters to expand on the research efforts related to the dose/response relationship. Dr. Waters replied the NIOSH has a major study underway. However, it is not looking at a broad number of industries and therefore, additional research will still be needed.

Morton Kasdan expressed concerns that existing data for WMSDs could be flawed due to economic incentives for physicians to diagnose injuries as work-related. Paul Fontana also expressed a similar concern, as it has been his experience that most companies do not use doctors with specific occupational medicine training to treat their injured workers. Dr. Waters agreed that this was a concern and NIOSH has made a commitment to develop a group of researchers to address this concern.

Roxanne Rivera asked if the claims of reduced worker’s compensation costs were based on looking at just WMSD injuries or overall injuries. Dr. Waters replied that this was based on overall injuries.

George LaPorte related that it has been his experience that when ergonomic programs are introduced into the workplace, the workplace initially experiences an increase in incident rates for the first six to twelve months of the program. This is typically followed by a significant decline. Many other members stated that they also experienced a similar rise/decline as well as resistance to instilling behavioral changes in the workplace, reluctance of workers to modify personal behavior, and reluctance of doctors to participate in studies because of patient confidentiality/privacy rules.

Ms. Susan Sherman informed the committee members that copies of the various slides and materials used during today’s meeting would be made available to all NACE members.

The committee members participated in a round table discussion to outline the individual members opinions on what direction the committee should take, what areas of interest each member may have, and how best to handle communications between the members.

The public was provided the opportunity to speak. Two organizations gave short presentations. Mr. Bill Kojola, representing the AFL-CIO, stated the AFL-CIO strongly believes that a comprehensive, mandatory OSHA ergonomic standard is needed to prevent workers from suffering musculoskeletal disorders and that voluntary efforts are not sufficient to provide workers needed protection. Mr. Kojola indicated that the NACE needs to focus its efforts on providing advice and recommendations to OSHA on workplace measures that protect as many workers as possible, as quickly as possible. Mr. Barauch Fellner, representing the National Coalition of Ergonomics, stated his organization has concerns over the lack of a definitive definition of a musculoskeletal disorder. The National Coalition of Ergonomics also believes that the NACE needs to assist OSHA in identify the gaps in ergonomic research. Mr. Fellner stated that ergonomics research needs to be based on sound scientific data rather than anecdotal success stories.

In concluding the meeting, the Chair thanked the members for their willingness to serve and thanked the public for their interest in ergonomics. The meeting was adjourned at 4:05 on Wednesday, January 22, 2003.