In 2001, backed by the National Academy of Sciences research report, Occupational Safety and Health Administration (OSHA) Assistant Secretary Charles Jeffress stated to Congress that implementation of the recently passed Ergonomics Standard would prevent over 460,000 serious workplace injures and save the nation’s employers $9 billion each year. And yet the opposition party aligned against this standard, including powerful lobbies for the insurance industry. Employer trade groups filed a suit against OSHA in the U.S. Circuit Court in Washington to block the standard from becoming law. The suit was successful because, according to its detractors, the ergonomic standard “does not give employers the right to examine workers’ activities outside of the workplace to determine whether a injury really is work related.”
This same suit also argued that the proposed standard would interfere with the states’ rights regarding implementation of the workers’ compensation laws by setting higher compensation rates (90 percent of weekly wages) for ergonomic injuries than other claim averages (now 66 percent of weekly wages). These arguments continue in the hallowed halls today as the number of soft tissue work-related injures steadily climbs to historic levels. Some would call musculoskeletal disorders a silent epidemic unworthy of national concern, compared to wars and pandemic flu viruses. I would tend to agree if it weren’t for the relatively low-cost methods we could use to prevent on-the-job injuries and change our attitudes toward workplace ergonomics.
According to the National Safety Council’s 2006 Injury Facts, on-the-job injuries due to “cumulative trauma” ranked No. 5 among the nation’s root causes for lost-time work accidents at 600,000 man-hours per year. The body part most frequently injured, according to CalOSHA’s Consultation Service, is the lower back; 22 percent of injuries involved the nerves and musculature of the lower spinal column. In 1983 the number of musculoskeletal injury claims was only 47,000 (5 per 10,000 workers). According to the National Council on Compensation Insurance, in the year 2000 we reached 2.1 million claims (200 per 10,000 workers). These accounted for more than one-third of the total workers’ comp paid claims, which averaged $24,000. Unfortunately for employers and employees in this country, these statistics are steadily rising year after year. As musculoskeletal disorders comprise the predominant uncontrolled loss for most contractors, the time for debunking the science of ergonomics and debating the political and economic ramifications of ergonomic standards should be quickly coming to an end.
There are two important terms that we should define if we are going to understand how we may reduce the No. 1 cause of workers’ compensation claims for roofers: ergonomics and musculoskeletal disorder (MSD).
The term “ergonomic” (“erg” is from the Greek word for “work”) was first coined in Europe during its industrial revolution as workers began succumbing to the effects of repetitive motion while positioned at severe workstations for 14- to 16-hour shifts. In a 1999 hazard alert, OSHA defined ergonomics as “the science of fitting the job to the worker.” The alert states, “When there is a mismatch between the physical requirements of the job and the physical capacity of the workers, work-related musculoskeletal disorders (MSDs) can result. Ergonomics is the practice of designing equipment and work tasks to conform to the capability of the workers; it provides a means for adjusting the work environment and work practices to prevent injuries before they occur.”
In roofing, an added difficulty comes when we attempt to arrange the constantly changing construction site to suit the physical needs of the average construction worker. Not only does the fluid nature of the contracted work constantly change, but so do the personnel, materials and equipment. During construction or demolition, structures, walking/working surfaces and obstacles once obvious are suddenly obliterated while methods, means, tools, equipment and materials are never constant. Most multi-employer sites have crews from different companies working in either consort or conflict with other tradesmen. Under such site conditions, any significant effort by one contractor to adjust his workspace to fit his employees’ needs would be immediately countermanded by another crew. The area beneath, beyond and above any construction worker is trespassed hourly by unregulated personnel working on their own contract objectives. The means and methods of ergonomic adaptation found in the manufacturing and warehousing industries would offer little long-lasting relief of strains realistically foreseen on most construction/demolition sites.
Musculoskeletal disorder is a term that is relatively new to occupational medicine and covers a lot of anatomy. The exact nature of these dysfunctional conditions vary greatly and include repetitive stress disorder, repetitive strain disorder, repetitive motion disorder, overuse syndrome, and cumulative trauma disorder.
MSD may refer to broad range of physical injures which occur in the flexible joints and attachment points of muscle to bone. They are caused by putting demands on the body to work harder, stretch farther or receive impacts greater than the body’s preparation or condition allows. In every case there is a mechanical failure of parts in motion, substantially impinging sensory nerves and causing intense localized or referred pain signals to be sent to the brain. These injures can be major due to a gross trauma (overuse syndrome) or accumulated effects over time (cumulative or repetitive trauma disorder).
The junction of our muscular system with our skeletal framework is the key to the body’s function and mobility. A common example of MSD would include shin splints. This condition may exhibit either acute or chronic symptoms due to overpronation (flattening) of the feet when impact force is applied repetitively. This flat foot impact causes accumulated forces measured in hundreds of pounds per square inch to be transferred regularly through ligaments and tendons between these two systems. Also called medial tibial stress syndrome, acute shin splints can result in painfully swollen, damaged ligaments where the muscles to the surface of the tibia. Chronic minute stress fractures of the tibia cause over-layering of bone tissues, placing an intense strain on these ligaments. Like most MSDs, once the victim becomes symptomatic, there is little efficacious treatment other than rest and avoidance to alleviate the pain and discomfort. Continuing the occupational operations will inevitably aggravate the condition, promoting further injury.
Be aware of the typical MSD symptoms. A basic knowledge of what these disorders may feel like in their initial stages will prepare your workers to avoid the long-range effects of the disorder. These symptoms may include:
• Continual deep fatigue.
• Poor sleep habits.
• Deteriorating normal endurance levels for age.
• Frequently cold fingers/hands in mild temperatures.
• Changes in skin color over joints (inflamed or pale).
• Prolonged swelling of soft tissues.
• Slight numbness to total loss of tactile sensation.
• Transient tingling sensations.
• Sudden, peculiar weakness in a limb.
• Diminished response in time or strength to a demand.
• Aching, throbbing, burning or shooting pains.
While manufacturers of construction equipment are constantly looking for ergonomic designs which could mitigate impact and absorb vibrations for many hand and power tools, it may only be seen as the first step in a journey of a thousand miles. If the No. 1 reason for workers’ compensation claims for construction workers is damage to the lumbar vertebrae during lifting operations, then this is where the construction industry should first look to make a difference.
The Roofer’s Ergonomic Protection Plan
If more than 20 percent of the MSDs diagnosed in this country affect the lumbar spinal region, then reducing these injuries and the resulting workers compensation claims should be the contractor’s first order of the day. There are a number of proactive hazard controls that a roofing contractor may consider to reduce these lumbar injuries. While most of these controls are low cost/high impact procedures, business owners should expect some initial resistance to change in workers’ behaviors. Even the simplistic nature of their participation in an ergonomic protection plan (EPP) can prove challenging to a construction worker used to performing tasks his own way at his own pace.
A successful EPP urges companies and employees to:
• Develop, write, read, understand, apply and participate in the company’s ergonomic protection plan on a daily basis.
• Regularly audit the workers’ compensation insurance policy for injury trends so you know where the problems lie and what effect your changes are having.
• Perform ergonomic jobsite analyses (JSAs) with the competent person in order to identify the practices at the root cause of the problems on the site.
• Provide opportunities to perform safe work practices to avoid musculoskeletal injuries whenever it would be feasible to do so.
• Maintain a reasonable and preventive conditioning regimen among workers by offering group gym memberships.
• Make an effort to keep employees’ weight in check by encouraging proper diet and aerobic exercise.
• Before beginning any work shift, utilize a brief 3- to 5-minute warm-up period to promote oxygenated blood flow to muscles before they are loaded.
• Discourage employees from self-inflicted damage by reducing the size and weight of personal loads you require them to carry.
• Test lift loads to determine first if the weight is safe to handle alone.
• Lift heavy, awkward or repetitive loads only when necessary.
• Determine the proper grip, body position and route of travel before your lift.
• Plan ahead and ensure the load can be lowered carefully.
• Avoid unnecessarily handing off or accepting a heavy load.
• Never use your back like a crane to lift a load.
• Practice the skills of lifting early and often to develop proper techniques.
• Never use excessive force to perform a task or use a tool.
• Avoid continuous pressure from a hard surface, sharp edge or posture on any part of the body.
• Try to keep the straining parts of the body warm during cold temperatures.
• When standing or sitting for prolonged periods, shift your weight and flex your leg muscles regularly.
• Take frequent rest breaks and wear anti-vibration gloves when using vibratory equipment.
• Remain aware of changes in your work tasks and their associated hazards.
• Be aware of those body positions most prone to strain and sprains.
• Whenever you’re in doubt of your capacity to bear a load, cease all operations.
• Report any and all suspected MSD injuries to your foreman or supervisor immediately.
In my next article, I’ll explore more ways to minimize musculoskeletal injuries, including a revolutionary lifting aid called Handi-Straps (www.handi-straps.com).