"This document was published prior to the publication of OSHA's final rule on Ergonomics Program (29 CFR 1910.900, November 14, 2000), and therefore does not necessarily address or reflect the provisions set forth in the final standard."

What Are RSIs?

Occupational RSIs, or repetitive stress injuries, comprise more than one hundred different types of job-induced injuries and illnesses resulting from wear and tear on the body. RSIs are one of the fastest growing workplace injuries, and can result any time there is a mismatch between the physical requirements of the job and the physical capacity of the human body. Specific risk factors that can cause RSIs include repetitive motion, force, awkward posture, heavy lifting, or a combination of these factors.

RSIs can be so severe that they inhibit the ability to accomplish many simple activities, or destroy a worker's ability to continue to perform the job. Among the most common causes of RSIs are:

Speeding Up the Line: The poultry processing workforce has almost doubled in size since 1980, in part to meet Americans' desire for lean and easy-to-cook meat. But the increase in demand for chicken has had a corresponding rise in RSIs in poultry workers. Over the past 15 years, line speeds in poultry plants have risen for a number of reasons to a maximum allowable rate of 91 chickens per minute, up from the high 50s. Automation, which generally has improved working conditions around the world, has also created in some cases work that is faster than ever, subject to electronic surveillance, and reduced to limited tasks that are numbingly repetitive and often resulting in crippling injuries, debilitating pain, and severe impairment of bodily capacity. At one poultry plant in Mississippi, workers' bathroom breaks are monitored and limited to three per week.

Intensive Keying: Leslie S., 26, spent her days clicking details onto computer drawings of historic ruins for a part of the Federal government's American building survey. After 10 months on the job, Leslie could no longer hold the mouse, write with a pen or brush her teeth without experiencing a burning pain. She tried many solutions: physical therapy, wrist braces, and anti-inflammatory drugs, but nothing provided the relief she needed. Her doctor recommended Leslie leave her job, and, distraught, she did. After consulting with five doctors and undergoing a six-month program of physical and occupational therapy, Leslie has finally regained the use of her left hand, but must follow a regimen prescribed by her doctor of applying ice, heat and self-massage to her arm and upper body every evening.

Repetitive and Heavy Lifting: For more than 11 years Henry G. has been a driver for a large delivery service. In 1994, the company more than doubled the weight limit on boxes, raising it from 70 pounds to 150 pounds. After all of those years of picking up and delivering hundreds of packages a day under heavy time pressures, Henry's back finally snapped -- and on the day the new weight limit went into effect. It was his first on-the-job injury. He needed surgery to correct the damage and today keeps the two-and-one-half inch screws and steel clamps from his back in a small plastic container to remind him of the hazards of his job.

RSIs account for one in four lost-time injuries and illnesses reported by employers to the Bureau of Labor Statistics -- 615,000 in 1993. Of that number, 65 percent involved backs and 32 percent involved upper extremities.

The Cost of RSIs

One in every three workers' compensation dollars pays for RSIs. In all, insurers awarded an estimated 2.73 million workers' compensation claims for RSIs in 1993, costing employers more than $20 billion. Indirect costs to employers are estimated to be five times that amount -- $100 billion. One major insurance company estimated the individual cost per claim to be $8,000, or double the average claim for other injuries or illnesses.

So What Can Be Done About RSIs?

Ergonomics, the science of adjusting the job to fit the body's needs, can prevent RSIs. Ergonomic solutions need not be expensive; in fact, the solutions are often simple. While in some cases redesigning the workplace is the best way to prevent RSIs, often many simple and inexpensive remedies will eliminate a significant portion of the problem. For instance, providing knives with curved handles to poultry workers, so they won't have to unnaturally bend their wrists; taking more frequent short breaks to rest muscles; providing lifting equipment so nursing home workers won't strain their backs lifting patients by themselves; or varying tasks to break up the routine of activities.

One large airline's flight reservation facility, with 650 employees, had 250 cases of RSIs over a two year period. An alarming 30 percent of these cases resulted in surgery. The company took some simple steps to reduce the number of RSIs including hiring an ergonomist to redesign the workstations, developing work/rest regimens, and eliminating electronic monitoring that included disciplinary action based on productivity, among other actions. Since then, incidence of RSIs has dropped, underscoring the lesson that ergonomics can prevent RSIs.

A nationally-known poultry producer instituted an ergonomics program in 1991. Since then, workers' compensation claims have been reduced from $4 million to $1 million. In one facility, days missed due to cumulative trauma disorders have declined from 552 to 24 per year; days of restricted work have gone from 1,717 per year to 48; and the incident rate is one-third of what it was in 1991. The workers' compensation costs in that plant alone have decreased by 68 percent since 1991. When the state's Labor Department visited one plant in 1993, they surveyed employees about the ergonomics program; about 60 percent reported that their jobs, tools and workplace had improved.

OSHA's Role

The Occupational Safety and Health Administration (OSHA) has developed a four-point approach, consisting of education, research, enforcement, and rulemaking, to combat RSIs.

1. Educational activities include co-sponsoring a major conference on ergonomics on January 8 and 9, 1997 for hundreds of leaders in business, labor, academia and government, and developing a technical assistance manual that discusses feasible solutions to ergonomic problems drawn from the best practices in the private sector, among other activities.

2. Research activities include updating and expanding OSHA's database to better track the implementation of ergonomic programs in corporate settings, review the scientific literature on RSIs and providing targeted training grants to prevent RSIs and assessing the effectiveness.

3. Enforcement activities include identifying and pursuing ergonomic infractions through traditional inspection activity and pursuing ergonomic cases throughout the legal process.

4. Further, OSHA will resume the rulemaking process that was interrupted by Congress to deal with this major workplace health and safety hazard. Employers and workers both need to learn more about RSIs and the ways they can be prevented. Employers especially need to know that there are cost-effective solutions they can implement to combat RSIs.

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