Repetitive Stress Injuries in the Workplace
Employers should use workplace ergonomics to help reduce repetitive stress injuries on the job.
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The number of workers suffering from a repetitive stress injury or disorder (RSD) is on the rise -- mostly because of the increased use of computers in the workplace.
RSDs (also called cumulative trauma disorders) now account for about 60% of all job-related injuries, and one in eight American workers has been diagnosed with an RSD at one time or another. If you own a small business, you probably know that workplace injuries fall under your workers' compensation insurance coverage, so its important to understand RSDs and how to prevent them.
What Kinds of Work Can Lead to RSDs?
Computer and keyboard use by office workers. The most common job-related RSDs involve injury to the upper extremities (wrists, elbows, and hands) due to repetitive keyboard activities. This is no surprise, considering the growing reliance on computers in the workplace. Office employees often spend hours at a time inputting or manipulating computer data, and if this is done without regard to proper ergonomics -- or for too many hours without sufficient breaks -- a nerve entrapment syndrome such as carpal tunnel syndrome may develop.
Bar code scanning by grocery checkers. Another occupation that has a higher-than-normal incidence of RSDs is that of the grocery checker. With the advent of scanners that read bar codes on grocery products, grocery checkers are required to pull or slide products across a scanner -- hundreds or even thousands of times a shift. This repetitive activity often leads to the development of cumulative trauma injury to the upper extremities. The repetitive turning of the neck from side to side may also cause a RSD to the neck or shoulders. In addition, constant lifting activities may cause injury to the back.
Fixed-position activities. Occupations that require workers to stay in a fixed position for a long stretch of time (called static posturing) can also lead to RSDs. Some examples of static posturing include prolonged sitting or standing, prolonged gripping or grasping, and holding a particular position for long periods. For example, an operator or front desk clerk who holds a telephone receiver between the head and shoulder or an airline mechanic who has to crawl and work in a twisted position may develop cumulative trauma disorders.
Other work-related activities that lend themselves to repetitive stress injuries include:
- assembly line work
- polishing, sanding, and painting
- pipe setting
- any overhead work
- butchering or meat packing
- sawing and cutting
- stocking shelves and packing
- massaging clients
- playing musical instruments, and
- working as a mechanic.
Carpal Tunnel Syndrome and Other Forms of RSD
A familiar form of RSD is carpal tunnel syndrome, which causes swelling inside the tunnel thats created by bone and ligament in the wrist. This swelling can put pressure on nerves passing through the tunnel -- leading to pain, tingling, and numbness.
Other types of RSDs include:
- tendinitis - tears in tissue connecting bones to muscles
- myofascial damage - tenderness and swelling from overworking muscles
- tenosynovitis - irritation of the boundary between the tendon and surrounding sheath, and
- cervical radiculopathy - compression of disks in the neck (common in workers who hold a phone on their shoulders while using computers)
Prevent RSDs with Proper Ergonomics
Improper ergonomics is the primary cause of RSDs across many kinds of jobs. Ergonomics is the study of how people interact with their physical environment. It uses scientific knowledge about objects, systems, and environments (like work stations) to maximize productivity and minimize injuries. So ergonomics plays an important role in the cause and prevention of work-related cumulative trauma injuries.
As an employer, what can you do? Take steps to protect employees from carpal tunnel syndrome and other repetitive stress disorders. You may, for example, upgrade the equipment that employees use, train employees in improving work techniques, and modify the layout of work stations.
Train employees to avoid RSDs. The proper ergonomic model for the prevention of carpal tunnel syndrome (an RSD injury to the wrist) would include keeping the wrists in a neutral position (straight), elbows down by the sides, and the shoulders back, while sitting up straight. Employees can be shown how to follow this model and can be encouraged to reduce the frequency of repetitive activity where possible. Larger employers might consider hiring an ergonomics consultant to help them figure out what changes to make.
OSHA guidelines and enforcement. OSHA provides voluntary ergonomic guidelines for specific industries such as grocery stores, nursing homes, and poultry processing plants. In addition, the agency occasionally issues ergonomics-related citations. These citations are issued under general provisions of the OSHA law requiring employers to maintain safe workplaces.
Warning Signs of RSD
There are no clear ways to alert a worker that theyre headed for an RSD. Often, by the time an employee realizes that something is wrong, damage has already been done. For this reason, mindful employers should encourage workers to pay attention to the following warning signs:
- Pain. Workers may feel a sharp or dull and aching pain in their limbs, which may increase in intensity over time. Some employees feel this pain after working on the computer or cash register for a few hours, while others start to notice it only when they make certain movements outside of work -- such as twisting a doorknob to open a door or raising their arms to wash their hair.
- Tingling or numbness. Sometimes a worker's hand or arm may have a tingling sensation, or the employee may experience numbness or tingling in certain fingers. This is a sign that nerve damage may have already occurred, so these symptoms should be taken seriously.
- Fatigue. A worker who is experiencing pain may tire easily or may be unable to perform the same amount of work they have gotten done in the past.
- Weakness or clumsiness. A loss of strength, dropping items, or having difficulty picking things up can be a sign of a possible RSD.
What the Future May Bring
To combat the growing number of workplace RSDs, several states are considering regulations for businesses that use video display terminals -- better known as computer workstations. Rules adopted in New Mexico for state employees who use computers can serve as a model for your business:
- Maintain room lighting at a level that reduces eyestrain and glare.
- Control glare by indirect lighting and nonreflecting furnishings.
- Use acoustic pads to control noise levels.
- Locate workstations at a reasonable distance from heating and cooling vents.
- Provide chairs that are flexible and easily adjusted.
- Allow frequent work breaks.
Want to Learn More?
For additional information on workers' compensation benefits, see Nolos article Workers' Compensation Basics for Employers. For more information about employee health and safety in general, including tips on preventing workplace injuries, see The Employer's Legal Handbook, by Fred Steingold (Nolo).