Text For Citation: 01 Item/Group: 001 Hazard: ERGONOMIC

Section 5(a)(1) of the Occupational Safety and Health Act of 1970: The employer did not furnish employment and a place of employment which were free from recognized hazards that were causing or likely to cause death or serious physical harm to employees in that: a) Nursing department employees engaged in the manual pulling, lifting and moving of patients were exposed to an increased risk of musculoskeletal injuries. The hospital's injury and illness records (OSHA-200 Logs) for 1987 and 1988 documented that there was a pattern of back injuries among this group of employees that were caused or aggravated by the exertions involved in the performance of these tasks, on or about June 21, 1988. A feasible and acceptable abatement method to correct this hazard is the implementation of a comprehensive back injury prevention program. This program should include at a minimum, the following elements: 1) A formal written policy endorsed by the Hospital Administrator or President which outlines the authority and specific responsibilities of the staff in the implementation, compliance and enforcement of the various provisions of the hospital's back injury prevention program. 2) Investigation and analysis of back injury cases as a means of identifying specific, activities and patient care areas where greatest number of incidents are occurring. 3) Detailed ergonomic evaluations of those tasks which are associated with the highest frequencies of employee back injuries, including the identification of specific elements in those tasks which are capable of being modified through the use of mechanical lifting devices and aids or changes in lifting methods, including where necessary, the use of multiple personnel during specified lifting tasks. 4) Official procedures and guidelines describing specific step-by-step techniques for the various routine lifting and patient transfer tasks performed by nursing department personnel. 5) Preplacement assessments of the lifting skills and abilities of all new hires prior to assignment to specific patient care areas. (NOTE: To minimize abuse of such placement procedures it is necessary to identify the high-risk jobs and quantify the required job-demands. Workers should be matched to jobs as a function of the specific job demands and work capacities.) 6) Mandatory inservice back injury prevention training for all nursing department employees who may be involved in lifting and patient transfer tasks. Training sessions should include, at a minimum: a) A review of the hospital's back injury prevention policy. b) A discussion of the general rules of body mechanics, along with those musculoskeletal disorders which may result from overexertions encountered during lifting and patient transfer tasks. c) Hands-on demonstrations of the specific lifting and patient transfer techniques described in the hospital's procedures and guidelines with specific emphasis on the use of mechanical lifting devices and aids. d) A discussion of the benefits of exercise in reducing the incidence of work induced back injuries, including the identification of sources of information on specific exercises and available exercise programs. e) A review of the procedures to be followed by employees subsequent to the occurrence of a back injury, along with a description of the medical rehabilitation services and return-to-work programs which are available to these employees. 7) Internal monitoring of staff compliance with the policy and procedures of the back injury prevention program. ABATEMENT NOTE: STEP 1 - Effective administrative protection, including the establishment of a formal back injury prevention policy, mandatory inservice training and preplacement assessments of new hires, shall be provided as an interim protection measure until feasible engineering and permanent administrative controls can be implemented which will reduce employee exposure to nominal risk. STEP 2 - Submit to the Area Director a written, detailed plan of abatement outlining a schedule for the implementation of engineering and administrative measures to control employee injury due to manual lifting and employee transfer tasks. Engineering controls to reduce musculoskeletal stresses include, but are not limited to, task redesign, reduction of lifting frequency or weight and use of mechanical lifting devices and aids. The plan shall include at a minimum, target dates for the following actions which must be consistent with the dates required by this citation: 1) Investigation and analysis of back injury cases to identify where the greatest number of of incidents are occurring. 2) Ergonomic evaluations of the those tasks associated with the highest frequencies of back injuries. 3) Development of procedures and guidelines for routing lifting and patient transfer tasks. 4) Evaluation of mechanical lifting devices and aids. 5) Procurement, installation and implementation of selected procedures and lifting devices. 6) Monitoring to assure effective utilization of the control measure(s). Ninety (90) day progress reports are required during the abatement period. STEP 3 - Abatement shall have been completed by the implementation of the back injury prevention program and upon verification of the programs' effectiveness in reducing the occurrence of musculoskeletal injuries among nursing department personnel.