Washington state takes aim at ergo hazards
Rule moves forward despite opposition
Even as the U.S. Occupational Safety and Health Administration (OSHA) backs away from ergonomics regulation, Washington state is moving forward as a model for tougher action. A new rule that becomes effective this month will require employers to identify "caution zone jobs" and to reduce the hazards of musculoskeletal disorder injuries.
Lifting 75 pounds or more once a day qualifies as a caution zone job. That means hospitals must analyze and reduce the hazards of jobs that involve patient transfer. (To see the WMSD Hazard Sample Worksheet, click Table 1 and Table 2.)
"The standard requires that employers reduce exposure to the hazard below the hazardous level or to the degree that it’s economically or physically feasible to do that," explains Michael Silverstein, MD, assistant director for industrial safety and health at the Washington State Department of Labor and Industries in Olympia.
Business coalition opposes rule
So far, the Washington rule has stood up to political pressure to quash it. After a review by a Blue Ribbon Panel on Ergonomics, Washington Gov. Gary Locke directed the state Department of Labor and Industries to stay on course with implementation but to delay enforcement for two years. A business coalition that includes the Washington State Hospital Association has filed suit, seeking to overturn the rule.
As of July 1, employers in the state’s highest risk industries, including nursing homes, must begin identifying hazards and providing education to employees about ergonomics. Hospitals must meet those requirements beginning July 1, 2003. By July 2004, they must reduce the hazards. However, fines and citations for failure to comply won’t be issued until two years later.
"Even the largest hospitals have several more years before there would be a possibility for a citation or a fine. There is plenty of time for those programs to be fine-tuned," says Silverstein.
Yet hospitals that are struggling financially may not be able to afford to buy all the lifting devices on the time line expected by the Department of Labor and Industries, contends Beverly Simmons, executive director of the hospital association’s workers’ compensation program in Seattle.
"We believe in those [ergonomic] principles and we’re acting upon them," says Simmons. "[But] we feel that until hospitals are appropriately compensated [in reimbursement], it’s going to be very difficult for any sort of compliance to happen unless it’s voluntary."
However, Silverstein counters that voluntary programs are ineffective.
"I think employers are going to find it pretty confusing under the program the federal government has announced," he says. "The agency is saying no one is required to meet those [voluntary] guidelines. On the other hand, they will be issuing citations under the general duty clause.
"If I’m not responsible for following these specific guidelines, what does it mean to be responsible for maintaining a workplace that is free of recognized hazards?" he says. "It’s kind of a guessing game. The agency is not telling them ahead of time what they could be cited for."
MSDs cost more than $410 million
The Washington Department of Labor and Industries began work on an ergonomics rule in 1998, in response to the grim statistics of musculoskeletal disorder (MSD) injuries. More than 52,000 workers’ compensation claims each year involve MSDs, making it the largest category of injuries and illnesses affecting Washington workers. The department estimated that the total annual direct cost of MSDs exceeds $410 million.
Yet in a department-sponsored survey, 60% of employers reported they had taken no efforts to reduce workplace MSD hazards (WMSD). The department adopted the rule in May 2000.
"L&I estimates that the ergonomics rule will prevent 40% of work-related MSD injuries and 50% of work-related MSD costs once all the elements of the rule are fully effective," the department reported, though adding the caveat, "These are average figures and actual reductions will vary by workplace and by industry."
The department identified the top 12 industries with the highest work-related MSD injuries. Nursing homes made the list; hospitals fell in the second-highest category. The implementation of the rule requires the top 12 industries to comply a year earlier than other employers, and it gives small employers — those with fewer than 50 employees — extra time.
The department also developed demonstration projects and assistance programs. But employers can decide how to set up their ergonomics programs and reduce hazards.
"We’ve tried to strike a balance between being specific enough so that employers know when they have to do something and when they’re finished, and being flexible, so employers don’t face one-size-fits-all obligations," says Silverstein.
The rule passed muster with the Blue Ribbon Panel of experts, which concluded that the rule, its enforcement directive, and its procedures "provide a foundation for fair and consistent enforcement." The panel also stated that "the rule itself is clearly written, and together with the educational materials, enforcement policies and procedures, is understandable."
That is a vastly more positive outlook than the reaction to the failed OSHA standard, which was rescinded by an act of Congress. A National Academy of Sciences panel reviewed the scientific literature and concluded that ergonomic interventions would reduce the risk of work-related MSDs. But several provisions of the OSHA standard, including pay and benefit guarantees, sparked controversy, even from those who otherwise supported ergonomics regulation.
The Washington Department of Labor & Industries also hopes to smooth the transition to enforcement by supporting demonstration projects, providing educational assistance, and conducting test inspections.
"By the time we actually do real inspections, we’re going to have a very well-trained group of inspectors," says Silverstein. "Both the business and labor communities are going to have a very good idea of what to expect. I’m very concerned that we conduct ourselves in a fair and consistent manner."
Cost/benefit flawed, opponents say
Those efforts will not be enough to make the ergonomics regulation a fair one, a business coalition asserts. More than 230 business organizations, companies, and individuals joined together to form Washington Employers Concerned About Regulating Ergonomics (WE CARE).
The coalition asserts that the regulation is not based on sound science and that the department’s cost-benefit analysis is flawed.
The Washington State Hospital Association, which sponsors a Zero Lift program, doesn’t question the benefit of ergonomic intervention. But following the standard will require more resources than the labor department acknowledges, says Simmons. Many hospitals can’t afford to hire consultants to help with implementation and don’t have available staff to dedicate to the project, she notes.
"We believe industries should be taking a hard look at this and implementing what they can in ergonomics," Simmons says. "[Hospitals] can do it bit by bit, but they can’t do it all at once."
(Editor’s note: For more information, see the Washington Department of Labor & Industries ergonomics web site at www.lni.wa.gov/wisha/ergo/default.htm.)
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