Can ANSI succeed where OSHA failed?
Voluntary effort relies on consensus building
Another ergonomics standard may be on the horizon. Just months after the resounding political defeat of the U.S. Occupational Safety and Health Administration’s (OSHA) ergonomics rule, a voluntary standard moved forward under the auspices of the American National Standards Institute (ANSI) in Washington, DC.
Labor Secretary Elaine Chao urged caution and asked for time to compile more data on ergonomics when she testified before Congress in April about the continued need for an ergonomics standard. Yet at that moment, the National Safety Council, accredited by ANSI to coordinate the development of national standards, was compiling comments to a second draft standard on controlling musculoskeletal disorders (MSDs). The ANSI standard focuses on work-related MSDs of the upper extremities and neck and outlines the basic elements of MSD management, reporting, employee involvement, training, and job analysis and intervention.
Voluntary, yet influential
While ANSI standards are voluntary, the organization is recognized as the standard-setting body for the United States in a myriad of areas, and its standards often form the basis for federal regulations. The standards are developed through a process guided by strict procedures and consensus building. The 55-member ergonomics committee includes representatives from industry, labor unions, insurers, and ergonomics experts. Both the American College of Occupational and Environmental Medicine and the American Association of Occupational Health Nurses are represented.
Like OSHA, ANSI has been working on an ergonomics standard for about 10 years. The first draft generated numerous comments and led to significant changes, says Terry Miller, former secretary of the Accredited Standards Committee on Control of Cumulative Trauma Disorders at the National Safety Council, based in Itasca, IL.
"This issue is a very controversial one, whether it’s with OSHA or a voluntary standard," says Miller. "You’re going to get people with very strong opinions on both sides. A consensus standard doesn’t mean everyone agrees and it’s unanimous. ANSI is trying to see if there’s enough agreement that they can propose the standard through the ANSI process."
ANSI standard shorter, more focused
Although its provisions could apply more broadly to MSDs, the ANSI standard addresses only work-related disorders of the upper extremities and neck. It targets the most controversial aspect of MSD prevention and ergonomics: cumulative stress or repetitive motion disorders that could lead to carpal tunnel syndrome, tendinitis, or bursitis, among other diagnoses.
At a relatively short 20 pages, the standard is not nearly as detailed or prescriptive as OSHA’s 600-page standard. For example, the draft ANSI standard calls for employers to use records of work-related MSDs, employee reports of MSD symptoms and job surveys to determine which jobs need further analysis and intervention. Job surveys are defined as a "cursory" review of jobs using questionnaires, checklists, or other methods. "Each organization may want to establish criteria for when a job survey result or health surveillance data indicate the need for a job analysis," the standard states.
The OSHA standard required employers to use a "basic screening tool" to determine if a reported MSD was work-related. Work-related MSDs triggered other provisions that required employers to provide medical management, job hazard analysis and control, and training.
In its most controversial provision, the OSHA standard required employers to provide "work restriction protection," or 90% of pay and 100% of benefits for employees who are out of work due to their MSD injury. The ANSI standard does not address that issue or any other matter related to workers’ compensation.
Finding strength in consensus
In the public arena, the views of those who oppose the OSHA ergonomics standard seem irreconcilable with those who support a standard. But in the ANSI process, those conflicting perspectives are represented on the panel drafting the document. "We feel that makes for a stronger document," says Stacy Leistner, an ANSI spokesman. "It has been through multiple levels of review by diverse audiences."
Leistner stresses that the consensus process assures only consideration of all points of view. "The group may decide that not all comments would be incorporated," he says, adding, "There has to be a justification of why a comment would not be incorporated."
The background section of the draft standard reveals this give and take, offering various conclusions about MSDs. For example, the draft standard says, "It is often possible to develop and implement control measures for suspected or established work-related risk factors for MSDs, although quantitative exposure disorder relationships may not be available in the technical or scientific literature for all work-related risk factors."
While employee health professionals welcome voluntary standards or guidelines that support ergonomics, they stress that the ANSI effort can’t replace a new standard from OSHA. "It could help move the standards-making process forward by presenting an approach to standards development," says Guy Fragala, PhD, PE, CSP, director of environmental health and safety at the University of Massachusetts Medical Center in Worcester, and a leading ergonomics expert. "Because of the high number of injuries that are occurring in this area, OSHA has to address this in some way," he adds.
The ANSI standard will be very useful for some employers, says Bill Borwegen, MPH, occupational health and safety director of the Service Employees International Union (SEIU). "It gives a blueprint to employers who want to do the right thing," he points out. "For all the other employers, that’s why we need an OSHA standard."
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