This primer describes the basic elements of a workplace program aimed at preventing work-related musculoskeletal disorders (WMSDs). Management commitment, worker participation, and training are addressed along with procedures for identifying evaluating, and controlling risk factors for WMSDs. The text cites NIOSH ergonomics investigations to illustrate practical ways for meeting program needs. The primer includes a "toolbox," which is a collection of techniques, methods, reference materials, and sources for other information that can help in program development.

Table of Contents

Foreward

The National Institute for Occupational Safety and Health (NIOSH) operates an 800-number to provide workers, employers, and organizations information about various workplace safety and health concerns. Over the past several years, the volume of NIOSH 800-number calls concerning work-related musculoskeletal disorders (WMSDs) has grown. They are now second only to questions about chemical hazards. WMSD inquiries, exceeding 3,700 in 1996, have come largely from callers associated with small- and medium-sized businesses, which often have limited resources to deal with occupational safety and health issues. This document has been prepared to respond to the needs of this audience.

This primer describes the basic elements of a workplace ergonomics program. The text is largely built around NIOSH experiences in evaluating risks of WMSDs in a variety of workplaces. Descriptions of these NIOSH experiences provide practical illustrations of ways to identify and evaluate ergonomic hazards and to begin problem-solving efforts.

In response to the widespread concern about WMSDs, and with the knowledge that many workplaces have begun successful programs to control them, a wide variety of organizations have published ergonomics program manuals and primers. We hope that this NIOSH primer will be a useful addition to the existing information.

Linda Rosenstock, M.D., M.P.H.
Director, National Institute for Occupational Safety and Health
Centers for Disease Control and Prevention

Overview

This primer provides basic information that will be useful for employers, workers, and others in designing effective programs to prevent work-related musculoskeletal disorders (WMSDs), one of the most prevalent and costly safety and health problems in the modern workplace. It defines the key elements of an effective program in a format that allows the user to tailor the information to a particular work setting or situation. It also provides a "toolbox" of useful materials for putting a program into place, including reference materials, sources for further information, and generic forms and questionnaires.

The primer is based on the extensive practical experience accumulated by the National Institute for Occupational Safety and Health (NIOSH) in conducting investigations in actual workplace settings, providing technical assistance to employers and workers, and evaluating the latest technical literature.

The seven elements of an effective program comprise a seven-step "pathway" for evaluating and addressing musculoskeletal concerns in an individual workplace. Each step is addressed in more detail in the primer, with examples drawn from actual NIOSH workplace evaluations. The seven steps are as follows:

One: Looking for signs of a potential musculoskeletal problem in the workplace, such as frequent worker reports of aches and pains, or job tasks that require repetitive, forceful exertions.

Two: Showing management commitment in addressing possible problems and encouraging worker involvement in problem-solving activities.

Three: Offering training to expand management and worker ability to evaluate potential musculoskeletal problems.

Four: Gathering data to identify jobs or work conditions that are most problematic, using sources such as injury and illness logs, medical records, and job analyses.

Five: Identifying effective controls for tasks that pose a risk of musculoskeletal injury and evaluating these approaches once they have been instituted to see if they have reduced or eliminated the problem.

Six: Establishing health care management to emphasize the importance of early detection and treatment of musculoskeletal disorders for preventing impairment and disability.

Seven: Minimizing risk factors for musculoskeletal disorders when planning new work processes and operations it is less costly to build good design into the workplace than to redesign or retrofit later.

Acknowledgements

Authors
Alexander L. Cohen, Christopher C. Gjessing, Lawrence J. Fine, Bruce P. Bernard, James D. McGlothlin

The authors of this document thank the numerous staff members of the National Institute for Occupational Safety and Health (NIOSH) and others for their assistance and advice in preparing this primer.

We are grateful to the following NIOSH personnel who supplied and critiqued materials for the document and made valuable recommendations after reviewing earlier drafts: Vernon Anderson, Susan Burt, Michael Colligan, Cheryl Estill, Lytt Gardner, Katharyn Grant, Daniel Habes, Thomas Hales, Hongwei Hsiao, Leslie MacDonald, Brian Moyer, Christopher Pan, Shiro Tanaka, Thomas Waters, and Joann Wess. We also thank the many NIOSH researchers who provided examples of NIOSH research and authored Health Hazard Evaluation Reports and other studies cited in the text.

Vanessa Becks, Susan Feldmann, Anne Hamilton, Susan Kaelin, Patricia Morris, and Jane Weber prepared the final camera copy for the printed version. Richard Carlson developed the artwork. Matthew Miller helped develop the HTML version of this primer.

We thank the following reviewers for their thoughtful comments on earlier drafts of this document:

Deborah Berkowitz United Food & Commercial Workers Union	Gary Orr, P.E., C.P.E. U.S. Department of Labor
Patricia Bertsche, M.P.H., R.N., C.O.H.N.-S. The Ohio State University	Lida Orta-Anes, Ph.D. United Auto Workers
Robert Biersner, J.D., Ph.D. U.S. Department of Labor	David Ridyard, C.P.E., C.I.H., C.S.P. Applied Ergonomics Technology
Donald Bloswick, Ph.D., P.E., C.P.E. The University of Utah	Suzanne Rodgers, Ph.D. Consultant in Ergonomics
Michael Gauf CTD News	Scott Schneider, C.I.H. Center to Protect Workers Rights
Bradley Joseph, Ph.D., C.P.E. Ford Motor Company	Barbara Silverstein, Ph.D., M.P.H. Washington State Department of Labor and Industries

Disclaimer

Mention of any company name or product does not constitute endorsement by the National Institute for Occupational Safety and Health.

This document is in the public domain and may be freely copied or reprinted.

To receive documents or other information about occupational safety and health topics, contact NIOSH at

NIOSH—Publications Dissemination
4676 Columbia Parkway
Cincinnati, OH 45226–1998

Telephone: 1–800–35–NIOSH (1–800–356–4674)
Fax: 513–533–8573
E-mail: pubstaft@cdc.gov

or visit the NIOSH Web site at www.cdc.gov/niosh/

This publication is also available from the National Technical Information Service (NTIS) by calling1-800-553-6847 or (703) 605-6000. Please ask for PB97-144901.

DHHS (NIOSH) Publication No. 97-117

March 1997