Repetitive Motion
Repetitive motion injuries occur as a result of performing the same motion over and over again, day after day and year after year. In fact, repetitive motion injuries caused more days of missed work than any other occupational injury or illness in 2001 (median of 18 days away from work). [source].
Repetitive motion injuries are common in the pork industry. Workers in large sow complexes may wind up processing several hundred pigs in one day. As a result of repeating the same physical motion, workers are at risk of developing repetitive motion injuries. How a worker uses his or her body to perform a certain task can increase or decrease the likelihood of a repetitive motion injury.
Work-Related Musculoskeletal Disorders (MSDs) are musculoskeletal disorders caused or made worse by the work environment. Work MSDs can cause severe and debilitating symptoms such as pain, numbness, and tingling; reduced worker productivity; lost time from work; temporary or permanent disability; inability to perform job tasks; and an increase in workers compensation costs.
An epidemic of repetitive motion disorders is occurring in general industry. Possible causes include increased demands for production, out-of-shape workers, inadequate education on prevention of injuries, as well as poor tool design. Workers in swine industries frequently report similar problems. (Occupational Hazards on Swine Farms, Accessed 7/2007)
Sources of injury in swine workers include lifting or moving swine, handling feed, and vaccinating or bleeding swine. Improper lifting, bending or stooping frequently strains the muscles in the back. Occasionally, back pain may be so severe that the worker experiences lost work time. The workers should be adequately educated on proper lifting techniques, i.e., lifting at the knees without twisting while keeping the load close to the body. The use of back belts is controversial. Job rotation may be another option that allows muscles time to recover from overuse. (Occupational Hazards on Swine Farms, Accessed 7/2007)
Frequent injections or bleeding of swine is associated with complaints of wrist or arm pain. If recovery time between these activities is insufficient and forceful or awkward postures are involved, the risk for developing a repetitive motion disorder is high. Conditions such as tendonitis, tenosynovitis, and carpal tunnel syndrome may occur. To prevent these injuries from occurring, the worker should try to alternate hands and maintain their wrist in neutral positions. Knee pads will help decrease pressure on the knees. Hand stretching exercises may also be useful. There is a need for a multiple injection needle which can be re-used and requires little force to work the equipment effectively. (Occupational Hazards on Swine Farms, Accessed 7/2007)
The Occupational Safety and Health Act (OSH Act) requires employers to comply with hazard-specific safety and health standards. In addition, pursuant to Section 5(a)(1) of the OSH Act, often referred to as the General Duty Clause, employers must provide their employees with a workplace free from recognized hazards likely to cause death or serious physical harm, including ergonomic hazards. OSHA will cite for ergonomic hazards under the General Duty Clause or issue ergonomic hazard letters where appropriate as part of its overall enforcement program.
Hazard
Many activities can contribute to work-related musculoskeletal problems including: repetitive, forceful, or prolonged exertions of the hands; frequent or heavy lifting, pushing, pulling, or carrying of heavy objects; prolonged awkward postures; and vibration. Working conditions that combine risk factors will increase the risk for musculoskeletal problems. The level of risk depends on how long a worker is exposed to these conditions, how often they are exposed, and the level of exposure. Repetitive motion injuries are most commonly caused by work done during the processing stage of pork production. These tasks include clipping teeth, giving shots or cutting tails. A repetitive motion injury exposure is determined by the way you use your body when completing these tasks. The most common repetitive motion injury is carpel tunnel syndrome, a disorder that occurs when a nerve that runs from the forearm into the hand becomes pressed or squeezed at the wrist. Carpal tunnel is characterized by discomfort and weakness in the hand. A person may have symptoms in one or both hands. Among the symptoms a worker may first notice in the dominant hand are:
- Numbness or tingling in the hand and fingers (thumb, index and middle finger)
- Pain in the wrist, palm or forearm
- More numbness or pain at night than during the day
- More pain as the hand or wrist is used
- Trouble gripping objects
- Weakness in the thumb
If an employee has symptoms of carpal tunnel syndrome they should see a doctor to receive treatment for the illness.
Prevention & Control
Musculoskeletal disorders are often confused with ergonomics. Ergonomics is the science of fitting workplace conditions and job demands to the capabilities of workers. In other words, musculoskeletal disorders are the problem and ergonomics is a solution [source].
Training
Advise your employees on avoiding improper ways to use their body:
- Twisting their body when carrying animals or other heavy objects
- Continuously bending or twisting their wrists
- Working from an awkward position
- Reaching above shoulder level again and again
- Using hands to push, pound or in some manner exert strong force
- Gripping tools that dig into their palm
Administrative
Encourage your employees to follow these guidelines to decrease their chances of suffering a repetitive motion injury:
- Allow short “stretch” breaks when employees are repeatedly performing the same task.
- Rotate assigned tasks performed during the day.
- Cross-train employees to multiple tasks and encourage or schedule job/task switching
Engineering
· Redesign the job/task
· Consider using tools designed with ergonomics in mind.
· If possible, adjust working heights or surfaces to help employees maintain proper posture
Reduce the Risk of Developing Carpal Tunnel Syndrome
- Physically alter how the repetitive activity is performed (such as by changing hands).
- Keeping the wrist in a neutral position, if possible.
- Gently stretching hands and fingers during short breaks can also help.
Key Points:
- Work in a comfortable position.
- Take short “stretch” breaks when performing repetitive motion tasks.
- Change your position following a break.
- Know how to recognize the symptoms of repetitive motion injuries.
DO:
- Work in a comfortable position.
- Take short “stretch” breaks when repeatedly performing the same tasks. Gently stretch the parts of the body you have been using.
- If possible, rotate the tasks you perform during the day.
- Always maintain good posture.
DON’T:
- Continuously bend or twist your wrists.
- Work from an awkward position.
- Reach above shoulder level again and again.
- Use your hands to push, pound, or in some manner exert strong force.
- Grip tools that dig into your palm.
- Ignore the symptoms of repetitive motion injuries.
Q: What is an "ergonomic injury"?
A: Input from the recent ergonomics forums demonstrated to OSHA that there are a wide variety of opinions on how the Agency should define an ergonomic injury and that the definition adopted by OSHA depends on the context. Ergonomic injuries are often described by the term "musculoskeletal disorders (MSD)." This is the term of art in scientific literature that refers collectively to a group of injuries and illnesses that affect the musculoskeletal system; there is no single diagnosis for MSDs. As OSHA develops guidance material for specific industries, the agency may narrow the definition as appropriate to address the specific workplace hazards covered. OSHA will work closely with stakeholders to develop definitions for MSDs as part of its overall effort to develop guidance materials.
Q: Are all MSDs work-related?
A: No. MSDs can and do develop outside the workplace.
Q: How do you determine whether MSDs are work-related?
A: The determination of whether any particular MSD is work-related may require the use of different approaches tailored to specific workplace conditions and exposures. Broadly speaking, establishing the work-relatedness of a specific case may include:
-- taking a careful history of the patient and the illness;
-- conducting a thorough medical examination; and
-- characterizing factors on and off the job that may have caused or contributed to the MSD.
Q: Why are there only OSHA ergonomic guidelines and not a rule?
A: Congress passed, and the President signed, Senate Joint Resolution 6, which rescinded the original ergonomics rule, and under the Congressional Review Act, prohibits the agency from issuing a rule that is substantially the same as the former one.There are a number of reasons why guidelines are preferable to doing a rule. OSHA must follow certain criteria in doing a rule - any rule. In terms of ergonomics, there are factors that make doing a rule very difficult:
• There are a variety of different hazards and combinations of different hazards to be addressed;
• Exposure to the hazards is not readily measured in some cases;
• The exposure-response relationship is not well understood;
• Cost and feasibility of abatement measures may be uncertain and may be very high in some cases; and
• It is very difficult, except in the most general terms, to prescribe remedies for abating such hazards in a single rule.
These considerations make it very difficult to develop simple criteria for compliance that can apply to a broad range of industries.
On the other hand, industry and task specific guidelines can be developed more quickly and are more flexible, and can provide specific and helpful guidance for abatement to assist employees and employers in minimizing injuries. Guidelines are the most effective method available for reducing injuries quickly.
Q: How do you expect OSHA's guidelines to reduce injuries and illnesses related to MSDs?
A: Injuries and illnesses related to MSDs have consistently declined over the last 10 years, even though there has not been a standard addressing them. Guidelines, such as OSHA's Meatpacking Guidelines, and voluntary industry efforts have been successful in reducing the injury and illness rates for these disorders. For example, on a national basis, rates for carpal tunnel injuries with days away from work have gone down by 39 percent from 1992 to 1999. For the same time period, rates for strains and sprains with days away from work have also gone down by 39 percent, and rates for back injuries with days away from work have gone down by 45 percent. In the meatpacking industry, with industry-specific guidelines and focused OSHA enforcement, rates of carpal tunnel injuries with days away from work have gone down 47 percent from 1992 to 1999. Over the same time period, rates of strains and sprains with days away from work have gone down by 61 percent, and rates for back injuries with days away from work have gone down by 64 percent. OSHA expects that industry-or-task-specific guidelines will further reduce injuries and illnesses as they are completed and implemented. OSHA's VPP (Voluntary Protection Program) participants, who have implemented safety and health programs, have injury and illness rates 53 percent below the average for their respective SIC codes.
Q: What is a guideline and how does it differ from a standard?
A: A guideline is a tool to assist employers in recognizing and controlling hazards. It is voluntary. Failure to implement a guideline is not itself a violation of the General Duty Clause of the OSH Act. Guidelines that OSHA develops will provide information to help employers identify ergonomic hazards in their workplaces and implement feasible measures to control those hazards.
Guidelines are more flexible than standards. They can be developed quickly and can be changed easily as new information becomes available with scientific advances. Guidelines make it easier for employers to adopt innovative programs to suit their workplaces, rather than inflexible, one-size-fits-all solutions to issues that may be unique to the industry or facility.
Q: What industries will these guidelines cover?
A: OSHA will develop industry-or-task-specific guidelines for a select number of industries, taking into account injury and illness incidence rates as well as available information on what is known to work. These guidelines will be developed with input from others. As industry-or-task-specific guidelines are drafted, we will make public announcements and share the information as broadly as possible.
Q: Will the guidelines cover agriculture?
A: Guidelines offer the flexibility to go beyond general industry. The previous administration's ergonomics standard was limited in scope to general industry. In addition to the industry-specific guidelines that OSHA plans to develop, the agency will encourage other industries to develop their own guidelines to reduce MSDs.
Q: Will OSHA use the new guidelines as a basis for enforcement?
A: No. An employer's failure to implement the new guidelines will not be a violation of the General Duty Clause of the OSH Act. Rather, OSHA intends that the guidelines will provide information to help employers identify ergonomic hazards in their workplaces and implement feasible measures to control such hazards. For this reason, OSHA anticipates that there would likely be no basis for a Section 5(a)(1) citation for employers with ergonomic hazards who effectively implement the ergonomics guidelines or other appropriate measures. OSHA will not be focusing its enforcement efforts on employers who have implemented effective ergonomic programs or who are making good-faith efforts to reduce ergonomic hazards.
Q: Does this mean OSHA will not use the General Duty Clause to cite for ergonomic hazards?
A: OSHA will use the General Duty Clause to cite employers for ergonomic hazards. Under the OSH Act's General Duty Clause, employers must keep their workplaces free from recognized serious hazards, including ergonomic hazards. This requirement exists whether or not there are voluntary guidelines.
Q: What if I am an employer in an industry for which OSHA does not develop industry-specific guidelines?
A: Even if there are no guidelines specific to your industry, as an employer you still have an obligation under the General Duty Clause, Section 5(a)(1) to keep your workplace free from recognized serious hazards, including ergonomic hazards. OSHA will cite for ergonomic hazards under the General Duty Clause or issue ergonomic hazard letters where appropriate as part of its overall enforcement program. OSHA encourages employers where necessary to implement effective programs or other measures to reduce ergonomic hazards and associated MSDs. A great deal of information is currently available from OSHA, NIOSH, and various industry and labor organizations on how to establish an effective ergonomics program, and OSHA urges employers to avail themselves of these resources.
Q: What will the OSHA enforcement program entail?
A: OSHA has been assessing MSD-related issues in complaints, referrals, and targeted inspections. OSHA will continue to evaluate the findings of its inspections and issue General Duty Clause citations or hazard alert letters for ergonomics hazards where appropriate. OSHA will do the same when responding to worker complaints.
OSHA will conduct inspections for ergonomic hazards and issue citations under the General Duty Clause and issue ergonomic hazard alert letters where appropriate. OSHA will conduct follow-up inspections or investigations within 12 months of certain employers who receive ergonomic hazard alert letters.
OSHA will initiate a National Emphasis Program in the nursing home industry to guide inspections of nursing homes, and to focus significant effort on addressing ergonomic hazards related to patient lifting.
OSHA will conduct specialized training of appropriate staff on ergonomic hazards and abatement methods and designate 10 regional ergonomic coordinators and involve them in enforcement and outreach.
Q: Will OSHA notify employers who have high rates of MSDs?
A: Yes. As an adjunct to the Site Specific Targeting (SST), OSHA annually notifies employers in the OSHA Data Initiative who report high Lost Workday Injury and Illness rates at their establishment(s), and recommends that they seek assistance in addressing these workplace hazards. If employers report high rates of injuries which in some cases may be related to ergonomic issues, they will also be urged to seek assistance to address those hazards.
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