Washington state adopts preventive ergonomics rule
Hospitals must identify, correct hazards
While hospitals across the nation await the final version of an ergonomics standard, Washington state hospitals are already preparing for a more comprehensive new rule. They must identify work-related musculoskeletal disorders (MSDs) and reduce the hazards "to the extent technologically and economically feasible."
After deciding that voluntary measures were inadequate, the Washington state Department of Labor and Industries adopted a rule in May that phases in ergonomics requirements. Hospitals fall in the second tier of hazardous industries, which means they must begin identifying hazards and educating employees by July 2003 and must be in full compliance by July 2004.
"The problem is huge. The cost is staggering," says Michael Silverstein, MD, assistant director for industrial safety and health. "There’s a strong body of scientific understanding about what causes these problems and how they can be prevented. We’ve been using all kinds of approaches to try to reduce the impact of the problems in the last 10 or 15 years. We finally decided that we had everything but a rule that required [compliance]."
The Washington rule came as the U.S. Occupational Safety and Health Administration (OSHA) held hearings on a national standard. The primary difference between the two involves the "trigger" for ergonomic management. OSHA’s standard requires employers to respond to MSD injuries; Washington’s regulation targets potential hazards.
"This rule is based on the belief that it is important to identify and fix hazards before people get hurt," says Silverstein. "It is a prevention-based rule. It is the only rule designed in this way that we’re aware of."
California has a law covering ergonomics that is triggered by more than one work-related MSD related to the same job activity.
OSHA mired in political controversy
So far, the Washington rule has withstood opposition that was less intense than that faced by the proposed OSHA standard.
Although several bills were introduced in the past session of the Washington state legislature to restrict or derail the ergonomics rule, they failed to pass.
The Washington State Hospital Association expressed concern about medical and scientific questions surrounding MSDs and ergonomics. "We don’t know how many repetitions is too many [for repetitive stress disorders]," says Beverly Simmons, director of workers’ compensation programs for the association. "Everybody’s different. One body type is different from another body type. If the science and medical community can’t agree, how are employees and employers and regulators going to agree? It’s going to be very difficult."
Hospitals are also concerned about the differences between the OSHA and state regulations. Washington is required to adopt regulations at least as effective as federal ones. "We are not aware of anything that says that OSHA has approved the state regulation as being as effective as its proposed regulation is," she says.
Representatives of health care workers spoke out strongly in favor of the rule. "They’ve exercised some real leadership," says Bill Borwegen, MPH, occupational health and safety director of the Service Employees International Union in Washington, DC. "All the studies show if you put in these programs, and you reduce your workers’ compensation costs dramatically."
Meanwhile, just two days before Washington state adopted its rule, the Appropriations Committee of the U.S. House of Representatives approved an amendment that would prevent OSHA from spending funds to "promulgate, issue, implement, administer, or enforce any proposed, temporary, or final standards on ergonomic protection." The Senate also has voted to bar OSHA from spending funds to implement the standard. Similar language prevented OSHA from issuing an ergonomics rule before Sept. 30, 1998. A draft proposal was first released in 1995. (See Hospital Employee Health, November 1999, p. 121.)
While political jockeying continued in Congress, OSHA proceeded with plans for its final hearing in July and stood by its prediction that a final rule would be out by the end of the year. The National Coalition on Ergonomics, an industry group that includes manufacturers, trucking companies, grocers, and major business organizations, has vowed to sue to prevent the ergonomics rule from being enforced. The American Hospital Association has joined the coalition in strong opposition to OSHA’s proposed standard.
State hopes to cut workers’ comp costs
The Washington rule stemmed from a desire to cut workers’ compensation costs, says Silverstein. One-third of the state’s workers’ compensation claims involve musculoskeletal injuries, he says.
"The total direct cost to the state, in medical costs and wage replacement, is well over $400 million a year," says Silverstein, noting that employers must either be state-insured or pay premiums to a state workers’ compensation fund. "If you add in the impacts on productivity and absenteeism, the total cost over a year is $1 billion."
The Department of Labor and Industries promised to create a "blue-ribbon" panel of independent experts to review the rule requirements and determine if they are understandable and fair.
The state also is providing technical assistance to employers and demonstration projects that include workers’ compensation premium discounts.
"We think we have a very good rule that’s going to be fair, flexible, feasible," Silverstein maintains. "We think it’s going to effectively reduce injuries."
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content