Nine ways to reduce the #1 cause of workplace injuries

As the leading cause of workplace injury and illness, musculoskeletal disorders (MSD) are a common problem in many workplaces. In high incident jobs such as laborers, freight, stock and material handlers, nurses' aides, orderlies and truck drivers the median days away from work for each MSD injury is a troublesome 10 days, but all industries are affected with MSDs representing 28% of all workplace injuries (Bureau of Labor Statistics, 2009). The cost of lost productivity and Workers' Compensation is staggering.

MSDs can take many forms but typically involve the back, wrist, elbow or shoulder and are often caused or aggravated by working in awkward positions, using repetitive motions, and making forceful exertions. Examples of MSDs include low back pain, carpal tunnel syndrome and tendonitis.

Here are nine ways employers can identify and address the problem:

1. Analyze your Workers' Comp Loss Run

The risk exposure to MSD injuries increases with poorly designed workstations, tasks and hand tools. Your loss run report will help identify trends related to departments and workstations and so on. Also, by looking at the dates of hire, you can identify if there are groups such as newly hired employees who need more training.

2. Make hands-on demonstrations part of training

Workers must understand the nature of MSD risk factors and how to avoid injury. Oftentimes, videos or graphic presentations are used as training tools. Supplementing such information with hands on demonstrations can result in a greater understanding of the risks and ways to avoid them. The National Institute on Occupational Safety and Health (NIOSH) has a new training publication, Practical Demonstrations of Ergonomic Principles (.pdf) that includes a series of demonstrations organized by type of ergonomic principle, step-by-step methodology and a description of the materials needed.

3. Hear your employees

Nobody understands the discomfort, fatigue or aches associated with performing a task better than the employee who performs it. Simple solutions such as the location of supplies, height of work benches, storage restricting leg room, types of handles on bins, adjustable fixtures, job rotation etc., could make tasks easier and reduce the risk of injury. Moreover, greater involvement of employees means higher morale and commitment to proper procedures and early detection.

4. Consider ergonomic principles before purchasing tools

Those involved in the selection and purchase of new or replacement tools can benefit from the results of the three factors listed above. Considering ergonomic factors prior to purchase can go a long way in avoiding issues.

5. Recognize that health of employees play a role

As in many workplace injuries, an employee's health can affect the ability to avoid MSDs. Factors that have been shown to increase an individual's risk include:

• Inflammatory disease, such as arthritis
• Diabetes
• Excessive weight
• Hypertension
• Stress
• Smoking
• Conditions affecting hormone levels, such as pregnancy or menopause
• Advancing age
• General poor physical condition

6. Understand Carpal Tunnel Syndrome

Several years ago there was great concern that the rise in computer use would mean an explosion in carpal tunnel syndrome (CTP) Workers' Compensation cases. Today many experts agree that there is insufficient evidence to link CTP and computer keyboard use.

Studies suggest that age (more common among older individuals), gender (women are 3 times more likely to be diagnosed with CTS), heredity (narrow carpal tunnel in wrist) and medical conditions (diabetes, rheumatoid arthritis or thyroid imbalance) may contribute to the development of CTS, but in many cases it's idiopathic. Surgery is often the most effective treatment.

According to an article in October 2011, Safety + Health, "Workplace Myth? Carpal Tunnel," some work activities can contribute to the development of CTS. Repetitive manual work tasks requiring a forceful grip and use of vibrating tools can damage the median nerve in the arm. Loggers and meatpackers are subject to such injuries.

7. Manage upper extremity disorders related to computer use

While computer use is not linked to CTS, upper extremity disorders related to the use of keyboards are the second most common reason for work-related disability after back pain, according to Barry Simmons, MD, chief of the hand and upper extremity service in the department of orthopedic surgery at Boston's Brigham and Women's Hospital. Although surgery is often the most effective treatment for CTS, many upper extremity disorders can be addressed by modifying workstations and hand movements.

To reduce the risk of some upper-extremity disorders related to computer use, Harvard Medical School recommends:

• When working on a keyboard or with a mouse, keep your wrists in a neutral position, rather than flexed downward or extended upward.
• Take a break from computer work and stretch every hour. Between these breaks, take shorter breaks to rest your hands, either palms up on your lap or on a wrist rest.
• Keep all items you may need access to - documents, telephone, keyboard, mouse and supplies - no more than 16-18 inches away to avoid awkward postures or reaching.
• Place the computer monitor directly in front of you, at arm's length.
• Consider setting your keyboard on an adjustable tray that allows your forearms to remain parallel to the floor, with elbows bent at a 90-degree angle. Wrists should form a straight line with your forearms.
• Keep your mouse close to the keyboard and at the same height. A padded wrist rest may help reduce strain.

8. Match employees to the physical demands of the job

Written job descriptions with the essential job functions and post-office pre-employment functional capacity evaluations can avert a bad hire and costly claims.

9. Use existing resources

Insurance companies and medical clinics often have free or low-cost services to perform a workplace evaluation. Ergonomic solutions can be simple and straightforward to make - even small changes such as altering the height of a chair can make a considerable difference.