"This document was published prior to the publication of OSHA's final rule on Ergonomics Program (29 CFR 1910.900, November 14, 2000), and therefore does not necessarily address or reflect the provisions set forth in the final standard."
ASSISTANT SECRETARY FOR OCCUPATIONAL SAFETY AND HEALTH
U.S. DEPARTMENT OF LABOR
THE SUBCOMMITTEE ON REGULATORY REFORM
AND PAPERWORK REDUCTION
HOUSE SMALL BUSINESS COMMITTEE
April 13, 2000
Madam Chairperson, members of the Subcommittee, thank you for inviting me to testify about the Occupational Safety and Health Administration's proposed ergonomics standard. I welcome this opportunity to discuss the severe problem of work-related musculoskeletal disorders, also known as MSDs. OSHA has spent 10 years studying this issue, analyzing evidence, reviewing data, talking to stakeholders, and discussing ideas and options. It is now time to act.
Work-related musculoskeletal disorders are the most widespread occupational health hazard facing our Nation today. Nearly two million workers suffer work-related musculoskeletal disorders every year, and more than 600,000 lose time from work as a result. Although the median number of lost workdays associated with these incidents is seven days, the most severe injuries can put people out of work for months and even permanently impact their ability to perform their job. In addition, $1 of every $3 spent on workers' compensation stems from insufficient ergonomic protection. The direct costs attributable to MSDs are $15 to $20 billion per year, with total annual costs reaching $45 to $54 billion. Yet today, fewer than 30 percent of general industry employers have ergonomics programs.
The human dimension of this problem is striking. This debate is about real people confronting real risks to their livelihood, health and well-being. Ursula Stafford is a 24-year-old paraprofessional for the New York City school district. Ms. Stafford was assigned to assist a paralyzed student who used a wheelchair. The student weighed 250 pounds and Ursula weighed 122. She received no training on how to lift the student (which was required, for example, to help the student go to the bathroom), nor did her employer provide any lifting equipment. Ursula worked only two days before seriously injuring her back on the third day. She had a herniated disc and spasms in her neck. Today she wears a back brace, endures constant pain and has been told that she may never be able to have children because her back may not be able to support the weight. Compounding this tragedy is the fact that Ursula's predecessor was similarly injured and became permanently disabled. Under the requirements of OSHA's proposal, Ursula's employer would have been required to fix the job after the first injury occurred. Ursula might never have been hurt.
Then there is Walter Frazier, a 41-year-old poultry worker, who has undergone four surgeries on his hands and wrists. For nearly nine years, Walter worked as a "live-hanger" in a chicken processing plant. An admittedly nasty job, live-hanging is simple in concept. Ten to twelve people stand beside a processing line, stretch over a barrier bar designed to contain the often-flapping chickens, grab the chickens by the legs, and then stretch upward while twisting to hang the chickens on fast-moving overhead shackles. Walter repeated this process about once every three seconds-that's about 10,000 times a day, 50,000 times a week, 2.5 million times a year.
Walter felt the initial pains in his hands shortly after beginning to work at the plant. Through the years his pain intensified while his health has diminished. Finally, in 1998, barely able to lift 20 pounds and unable to perform many daily household chores, he agreed with his doctor's recommendations and had the first of four surgeries in an attempt to repair his damaged hands. In addition to severe hand problems, Walter has lower back pain and severe and chronic arthritis in his hands and shoulders. "My doctor told me I can't do this job anymore. My body's overworked, and I can't do this any further."
Many other workers have written us to express support for ergonomics regulation. One put it like this: "I'm an ultrasonographer who has recently been fired from my job because I had to be out with MSD. I probably would have never had this problem if there were an ergonomics standard present in my workplace."
Another worker who lost her job was Mary, a nurse in Oregon, who sustained a back injury and had to work on light duty for a year. Then her hospital told her to find another job because they did not have anything for her to do. Today she works at different part-time jobs in different locations and can no longer provide patient care. And there's Debra Teske, a customer service representative, diagnosed with bilateral carpal tunnel syndrome that required surgery on her right hand. Today, she has difficulty cooking, cleaning and picking up small objects. She can no longer kayak or bike, hobbies that she once enjoyed. And Carmen Willis, a nurse's aide, is on disability and must use a speaker phone because she cannot hold the telephone.
Beth Piknick is a registered nurse and also knows firsthand the importance of OSHA's proposed ergonomics program standard. While working as an ICU nurse, she suffered a career-ending back injury that was devastating, both personally and professionally. Throughout her career, Ms. Piknick helped patients move from their beds to chairs and back. Twisting, bending, pulling and pushing were all part of the job. She never had any back problems. But on February 17, 1992, while helping move a patient, Beth severely injured her back. Physicians, surgeons, and physical therapists were not able to relieve the constant pain. Finally, two years after the injury Beth had spinal fusion surgery coupled with a major rehabilitation program. She was willing to endure whatever pain it took to return to the job she loved. Despite the surgery and the physical therapy, however, she cannot return to her job. Before her injury, Ms. Piknick was an active person who enjoyed bicycling, racquetball, waterskiing and yearly white water rafting trips with her family. Now, she cannot participate in any of those activities.
Women disproportionately suffer some of the most debilitating types of MSDs, such as carpal tunnel syndrome. This is not because women are more vulnerable to MSDs-but because a large number of women work in jobs associated with heavy lifting, awkward postures or repetitive motions. They hold a disproportionate number of jobs as nurses, cashiers, packagers, maids and house staff, assemblers and office workers. Consequently, women suffer 70 percent of the carpal tunnel syndrome cases and 62 percent of the tendinitis cases that are serious enough to warrant time off work.
Workers should not have to suffer like this. Often solutions to mismatches between workers and their tasks are right at hand-simple, easy and inexpensive. But too many employers have yet to realize the benefits of ergonomics and put protective programs in place. Fewer than 30 percent of employers with 20 or fewer employees have addressed ergonomics although more than 325,000 musculoskeletal disorders occur each year in smaller workplaces. In contrast, more than three-quarters of the companies with 250 or more employees have analyzed hazards and installed some engineering controls to decrease the risk of musculoskeletal disorders.
Ergonomics has an impact beyond workers. This discipline has its roots in improving efficiency and productivity. For years, many employers have known that good ergonomics is often good economics. And those employers have not only saved their workers from injury and potential misery, but they have saved millions of dollars in the process. The proposed rule draws on the experience of companies that have implemented successful programs.
Many businesses-both large and small-have already demonstrated the value of ergonomics programs. Enid Memorial Hospital, a small nursing care facility in Oklahoma, instituted an ergonomics program focused on back-injury prevention. Enid Memorial presented its program to staff through lectures, videos, handouts and demonstrations. The facility purchased mechanical lifts and made them available throughout the establishment. In 1997 and 1998, this practical ergonomics program cut the rate of work-related injuries by almost 75% from their 1996 level, and reduced the number of associated lost workdays by over 85 percent.
A 25-person Ohio lumberyard, the Weyerhaeuser Customer Service Center, invited an ergonomist from the State of Ohio's Workers' Compensation program to survey their site. Based on the recommendations they received, the lumberyard developed checklists for use by each of their employees in evaluating the ergonomic appropriateness of the facility's personal protective equipment, mechanical equipment and overall workplace. The lumberyard completely redesigned their office workstations in 1994. As of July of last year, they had not had any lost-time injuries since strengthening their program.
Two Maine New Balance shoe manufacturing facilities cut their workers' compensation costs from $1.2 million to $89,000 per year and reduced their lost and restricted workdays from 11,000 to 549 during a three-year period. New Balance achieved this by adding engineering controls, eliminating piecework, forming manufacturing teams, and rotating work activities.
Ultra Tool and Plastics, a small New York plastics products manufacturer, implemented an ergonomics program that cut back injuries by 70 percent and reduced associated lost workdays by 80 percent. Some solutions included: purchasing ergonomic chairs for production employees; providing back safety training; installing robot presses to eliminate the need for production employees to reach for parts; and making pallet jacks available for metal bins to allow height adjustments.
CR/PL Limited Partnership, a small Texas ceramic fixture manufacturer, had a fairly high incidence of lost workday injuries occurring in this facility due to moving products ranging from 25 to 52 pounds. The firm added mechanical-lift assists and changed the heights of some work stations to reduce lost workdays associated with MSDs by 60 percent in 2 years.
In 1996, Sysco Food Services of Houston, a food service distributor, had 201 injuries with 3,638 lost workdays. Sysco's back injuries accounted for almost 40 percent of the injuries and more than half the company's total workers' compensation costs. Most of the back injuries occurred in the warehouse and on delivery routes. Sysco formalized its ergonomics program under the leadership of its occupational health nurse. They instituted an early return to work policy. Workers were encouraged to report any symptoms. The company re-racked its warehouse and put brakes on the hand trucks. Sysco assessed its customers' locations for hazards during delivery and worked with its customers on improvements. Sysco also worked with its suppliers to get smaller bags, handles on packages, sturdier cardboard and lighter boxes. One year after implementing an ergonomics program, injuries dropped 25 percent, and the cost of workers' compensation cases was down by more than 45 percent.
Many solutions to ergonomic problems are common sense and inexpensive. OSHA has identified many solutions that cost less than $100. For example, workers at a packaging plant complained of leg and back fatigue. Their management installed footrests for standing posture workstations at a cost of $50 each. At a manual assembly plant, a worker's job involved installing a small part with needle-nosed pliers that put stress on the wrist. The supervisor suggested another tool-available in the tool crib-that would make the task easier and safer without costing an extra dime. Another company recognized the need to make changes to their packaging line workstations because workers developed musculoskeletal disorders. They simply added a belt conveyor to move packaged boxes away from the workstation-at a cost of $90.50 per worker. Employees in a poultry processing plant complained that ill-fitting protective gloves did not provide adequate protection. The company bought protective gloves from several manufacturers to provide a wide range of sizes for better fit. The cost was negligible. In many mechanical assembly companies, the use of hand tools injures small parts of workers' hands. Some companies have used padded tools with inexpensive materials to reduce injury, at minimal cost. These are only a few examples among many.
On November 23, 1999, OSHA published its 11-page proposed ergonomics standard in the Federal Register. As explained in the lengthy Preamble, the proposal was based on sound scientific evidence-including findings by the National Academy of Sciences-that strongly supports two basic conclusions: (1) there is a positive relationship between work-related musculoskeletal disorders and the workplace; and (2) ergonomics programs and specific ergonomic interventions can reduce these injuries.
OSHA is providing ample opportunity for the public to provide input on its ergonomics proposal. We have already heard from more than 7,000 stakeholders during the 100-day pre-hearing comment period, and we are now in the midst of 9 weeks of public hearing on the proposal. During the hearings, we expect to hear from more than a thousand witnesses, including representatives of large and small businesses, small business owners, employee representatives and individual workers, as well as physicians, ergonomists, occupational health nurses, and others.
OSHA rulemaking hearings are legislative-type proceedings in which parties with information and views relevant to the proposed standard may provide testimony and be questioned by the agency. Our hearings go even farther, as OSHA also allows participants to question each other. OSHA believes it has provided sufficient time for this questioning, not all of which has been used. For example, after a National Institute for Occupational Safety and Health (NIOSH) panel testified about the scientific evidence on the causes and management of MSDs, participants did not even use all of the three hours that had been reserved for questioning the panel.
Participants who have filed a notice of intent to appear will also have an additional 90 days after the close of the hearing to submit further comments, including comments on the hearing testimony and other evidence already in the record. In total, the combined period - including the pre-hearing comment period, the public hearing, and the post-hearing comment period - which interested members of the public will have to comment on OSHA's proposal exceeds eight months. This period is in addition to the small business review panel process conducted under SBREFA, the opportunity for comment after that process concluded, and the eight years of dialogue that have occurred since OSHA issued its Advance Notice of Proposed Rulemaking in 1992. Throughout this process, we have continually increased our understanding of the concerns of workers and businesses, and have considered carefully all of the views we have heard on how best to provide protection.
We very much appreciate efforts of everyone who has filed written comments and those who are participating in the public hearing process. As with all OSHA rules, we will base our final standard on the complete rulemaking record, including pre- and post-hearing comments, as well as the hearing testimony.
OSHA's proposed ergonomics program standard relies on a practical, flexible approach that reflects industry best practices and focuses on jobs where work-related MSDs occur, problems are severe, and solutions are generally understood. It would require general industry employers to address ergonomics-the fit between the worker and work-for manual handling and manufacturing production jobs, where we know the problems are most severe. And it requires other general industry employers to act when their employees experience work-related musculoskeletal disorders.
Under the proposal, about 1.6 million employers-those with manufacturing and manual handling jobs-would initially need to implement a basic ergonomics program. This means assigning someone to be responsible for ergonomics; providing information to employees on the risk of injuries, signs and symptoms to watch for, and the importance of reporting problems early; and setting up a way for employees to report signs and symptoms. Full programs for these and other general industry employers would be required only if one or more work-related MSDs actually occurred. But even if a worker is hurt, the employer need not implement a full program if a "Quick Fix" can take care of the problem. If the employer corrects a hazard within 90 days, verifies that the fix has eliminated the hazard, and has no additional MSDs in that job, no further action is necessary. In addition, a "grandfather" clause gives credit to firms that already have implemented ergonomics programs that satisfy the core elements of the standard.
Under OSHA's proposal, only 25 percent of general industry companies with fewer than 20 workers will be required to adopt basic ergonomics programs for one or more of their jobs involving manual handling or manufacturing production work. Over a 10-year period, about 900 thousand small employers will need full programs because one or more of their workers will have experienced an MSD.
The OSHA proposal identifies six elements for a full ergonomics program: management leadership and employee participation; hazard information and reporting; job hazard analysis and control; training; MSD management; and program evaluation. OSHA intends that ergonomics programs be job-based, covering only the job where the risk of developing an MSD exists and any other jobs in the workplace that have the same work activities and conditions. Ergonomics programs need not cover all the jobs at the workplace. Nor are all MSDs covered. Rather, only MSDs caused by a work activity that is a core element of an employee's job or a significant part of her work day will trigger coverage.
The proposal would require that workers who experience covered MSDs receive a prompt response from their employer, including an evaluation of their injury and access to follow-up by a health care professional, if necessary. It also provides work restriction protection for workers when a health care professional has determined restricted work is indicated due to a work-related MSD. Because the proposed standard is only triggered when an MSD is reported, its protectiveness depends heavily on workers' willingness to raise problems when they occur. Evidence shows that employees are reluctant to report symptoms if doing so might cause them to miss work and lose pay. Therefore, OSHA has proposed that workers whose injuries prevent them from working would receive 90 percent of their after-tax pay and 100 percent of benefits to limit economic loss as a result of their injuries. Workers capable of performing only light duty receive full after-tax pay and benefits. This is roughly equivalent to the 2/3 of pre-tax pay that workers already receive under most State workers' compensation programs. But this provision is not about worker pay, it's about injury prevention. It is designed to encourage early reporting and intervention, which is to the worker's benefit and the employer's benefit. OSHA has included similar provisions in several other standards, including those on asbestos, cotton dust, formaldehyde, lead, methylene chloride, benzene and cadmium.
OSHA estimates the proposed standard would prevent about 3 million work-related MSDs over the next 10 years and save an estimated $9.1 billion annually in lost production, administrative, and other direct costs alone. The total benefit far outweighs the estimated $4.2 billion annual cost of the proposal to employers. Although some private organizations have published estimates that differ from OSHA's, many of these estimates contain either fundamental misunderstanding of OSHA's economic analysis, or of how OSHA's proposed rule would be applied. For example, some of these estimates compare their estimates of initial costs to OSHA's estimates of annualized costs (American Meat Institute and the Center for Office Technology). Other estimates compare the costs for a 150-person plant to an OSHA estimate provided for a 17-person plant (American Meat Institute). Some estimates assume that firms would have to make vastly greater efforts than anything required by OSHA's proposed standard, actually used by existing programs, or adopted as part of OSHA's corporate settlement agreements. For example, one appraisal estimated that complying with part of OSHA's employee participation requirement would require 10 employees in a 150-employee facility to meet 2 days a week every week for 6 months. Nothing in OSHA's standard requires such an effort. This same study assumed that the only way to control problem jobs would be to decrease productivity by 25 percent. Evidence we have received to date indicates that ergonomics programs often lead to productivity increases. Other studies use data based on speculative projections rather than real-world examples. Despite such flaws, where cost estimates submitted for the record demonstrate any mistake or lack of clarity in OSHA's economic analysis, we will revise the analysis accordingly.
Small Business Assistance
OSHA has paid close attention to the unique needs of small businesses as we have developed the proposal. We drafted the 11-page proposal in a question-and-answer format that is written in plain language. The proposal exempts businesses with 10 or fewer employees from recordkeeping requirements. It extends the phase-in requirements for job hazard analysis for two years and the phase-in for implementing permanent controls for three years.
In accordance with the Small Business Regulatory Enforcement Fairness Act (SBREFA), OSHA, the Office of Management and Budget, and the Small Business Administration convened a Panel to review and comment on a working draft of the ergonomics program. The Panel sought advice and recommendations from potentially affected small business representatives. Twenty-one small business representatives from a variety of industries participated in the effort. The Panel raised a number of questions and suggested several potential improvements to OSHA's draft, many of which were addressed in the proposal we published in November.
OSHA made changes to both the economic analysis and its proposed standard after the SBREFA Panel's review. Those changes included: refining the work restriction protection provision; increasing the original cost estimates to $4.2 billion; clarifying that repeat training is not necessary if employees have already received ergonomics training; and providing examples of covered manufacturing and manual handling jobs. Another significant addition based on the SBREFA process was the "Quick Fix" option. The draft we provided the SBREFA Panel required employers to implement full ergonomics programs in the event an employee contracted an MSD. Small entity representatives asked why a full program was necessary if a condition could be easily remedied and workers protected. Those comments led to the "Quick Fix."
In addition to drafting a standard that places a minimal burden on small businesses, OSHA plans to provide extensive assistance to small businesses to assist with compliance-through publications, checklists, training grants, information sheets that help employers provide required information to their workers, Internet-based materials, outreach sessions and its free consultation program. Every small employer that needs help will be able to contact one of OSHA's state consultation programs for free assistance in deciding what they need to do or whether they need a program at all.
We are also undertaking extensive efforts to train OSHA's own compliance staff. The OSHA Training Institute already trains the agency's compliance officers about ergonomics. Consistent with our standard practice whenever OSHA promulgates new standards, we will revise those courses based on the final rule and ensure that all compliance officers who will perform ergonomics inspections receive updated training. In addition, we will continue to send compliance officers to conferences and programs on applied ergonomics, where best practices are discussed, in order to hone their skills even further.
MSDs have a very measurable impact on the lives and careers of American workers. Companies that have worked to prevent these injuries with sound ergonomics programs have often improved productivity, drastically reduced workers' compensation costs, and improved job satisfaction. OSHA believes that the same opportunity for a safer workplace must be extended to other workers whose livelihoods and careers remain at risk. Preventable hazards too often mean the difference between a happy, healthy productive worker and one whose life and career may be forever changed by the misery of chronic pain from a senseless injury.
Thank you for the opportunity to testify about this very important issue. I will be pleased to answer any questions the Subcommittee may have.