Report Links Job Activities to Stress Injuries

Providing a boost to proponents of new job safety rules, a federal agency issued a report Tuesday citing persuasive scientific evidence that many repetitive stress injuries are work-related.

The report, from the National Institute for Occupational Safety and Health, generally rebuts the arguments of business lobbyists opposing the Clinton administration’s plans to draft workplace ergonomic regulations.

Business forces have thwarted previous federal efforts to combat such repetitive stress injuries as lower back disorders and carpal tunnel syndrome, contending that too little is known about their causes and cures to justify costly regulations.

Relying on the same arguments, employer groups also succeeded in watering down a California ergonomics standard--the first of its kind in the nation--taking effect Thursday.

But NIOSH Director Linda Rosenstock said her agency’s new report, based mainly on an analysis of more than 600 previous epidemiologic studies, provides “compelling evidence” of the link between work and repetitive stress injuries. “This new report will help focus ongoing studies and public dialogue critical for reducing these burdens on health and productivity,” she said in a prepared statement.

The report found that the highest rates of work-related ailments from repetitive motion or overexertion come in such industries as meatpacking, auto and garment manufacturing, nursing and airlines.

Not surprisingly, the report found that the strongest evidence of a connection between job activities and musculoskeletal injuries comes when a worker is exposed to a variety of stresses throughout the day. For instance, it cited a worker who repeatedly lifts heavy objects while standing in an awkward position.

In the case of such ailments as carpal tunnel syndrome and tendinitis, however, strong evidence that job activities caused the problem emerged only when a combination of factors was involved. For instance, there was no significant link shown between carpal tunnel injuries and working in a job that required “extreme postures.”

However, a strong link emerged when a job required extreme posture and the use of high force, or both high force and frequent repetition.

NIOSH has estimated the economic cost of musculoskeletal disorders--one of the many terms used to describe repetitive stress injuries and related ailments--at $13 billion annually.

The Occupational Safety and Health Administration, the federal agency hoping to draft ergonomics regulations, welcomed the NIOSH report.

Gregory R. Watchman, the acting administrator of OSHA, said the report confirms that repetitive stress injuries represent “the biggest workplace health problem in America today.”

Still, business groups opposed to ergonomics regulation said the case for such rules remains weak. “The study’s authors call their own work a ‘first step.’ We second their call for more research,” said Laurie Baulig, co-chair of an employer group called the National Coalition on Ergonomics.

“NIOSH is unable to answer two simple, yet critical questions--if repetitive motion at work causes injuries, how many repetitions does it take? And what, if any, specific proven measures can employers take to actually prevent these ailments?”

The NIOSH report follows the recent release of figures showing that these injuries, which emerged as the fastest-spreading occupational ailment in the 1980s and ‘90s, finally have begun to decline. In 1995, the latest year for which statistics are available, 308,200 of these disorders were reported in the U.S. private sector, down 7% from 1994.

Baulig said the numbers showed there is no “epidemic” of repetitive stress injuries. But regulatory advocates have characterized the decline as evidence that employers can take measures to curb the ailments.

The NIOSH report highlighted the fact that ergonomic research is scarce on many issues. For instance, even though many computer users complain of wrist pain, the available research does not prove that a clear connection exists between such work and “chronic” health problems, said Mark R. Cullen, a professor at Yale University’s medical school, the medical director for Aluminum Co. of America and a NIOSH advisor.

Cullen said additional study is needed on that and many other areas. Still, he said, within the community of experts studying repetitive stress injuries in the workplace, “there is no fundamental dispute” that repetitive stress injuries are a serious problem.