"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."

Thank you, Tom [Armstrong] and Alfred [Franzblau] for your introduction and opening remarks for this important conference. As all of you know, Tom has played a key role in disseminating ergonomic principles to industry during the last two decades.

I'd also like to thank the University of Michigan's Center for Occupational Health and Safety Engineering, one of the top Educational Resource Centers training tomorrow's safety and health professionals. It's a pleasure to address some of the world's top scholars and practitioners dealing with disorders of the upper extremities.

When it comes to occupational safety and health, I don't need to tell you that upper limb musculoskeletal disorders are one of the hottest topics on the screen these days. Politically, they've been so hot during this last Congress that you mention the word ergonomics in Washington, and you're likely to ignite a firestorm.

It's not surprising, given that cumulative trauma disorders are a huge problem. In 1994, they accounted for about 64 percent of America's half million annual workplace illnesses. This excludes disorders due to over-exertion, such as lifting. All told, this is America's fastest-growing workplace hazard. Reported cases are up nearly 1000 percent in a decade, and they're still rising.

The Bureau of Labor Statistics estimates that there are about 700,000 new cases a year, while workers' comp has tallied 2.7 million claims per year. These cost business $20 billion -- one-third the total for all workers' comp claims. The indirect costs are estimated at more than $100 billion a year. These disorders cause more lost workdays -- 18, on average -- than most other injuries. And they were the Number 1 cause of losses incurred by 60 percent of 100 corporations surveyed by the Liberty Mutual Group. Because of these facts, Secretary Reich is anxious to move on ergonomics.

OSHA has the authority and a duty to deal with this problem. And, I'd like to make it clear that we will move forward with a program that includes all of OSHA's tools.

This is hardly a hot-button issue only in Washington. When I go out in the field, over and over, I hear tragic stories from workers, but also promising solutions by businesses. When I visited an Anheuser-Busch brewery in New Hampshire recently, the joint health and safety committee members insisted that I see what they had done on ergonomics.

I wish policy making in Washington could be so sensible and simple.

After my first year in the capital, I was asked what frustrated me the most. I said: "How hard it is to get anything done." The simplest things become so complicated. After the last year, I've come to realize that one of the best things about Washington is how hard it is to get anything done.

On a recent trip, I saw a hand-scrawled sign taped to one of those hand-dryers you find in airport restrooms. It said: Press here for a message from Washington.

Since that certainly describes much of the 104th Congress on the subject of ergonomics, I'd like to talk with you this morning about our political battles and where we currently stand on developing better ways to protect the millions of American workers afflicted and threatened by musculoskeletal disorders. I'd also like to give you a little context: First, how OSHA has been reinventing itself to better shield workers from all hazards. And second, OSHA's history of addressing musculoskeletal disorders -- in terms of research, public education, compliance assistance, enforcement, and development of a standard.

A year and a half ago, when a new Congress came storming into Washington, one Republican Congressman offered the stunning pearl of wisdom that "ergonomics never killed anyone." Then, the House voted to cut OSHA's budget by $3.5 million -- precisely the amount they calculated that we had spent doing research and outreach on musculoskeletal disorders. In June 1995, the Congress approved a budget rider that specifically prohibited OSHA from promulgating a proposed or final rule, or even from issuing voluntary guidelines.

So, first the Congress effectively shut down our work on an ergonomics standard. Then they cut our budget. And, finally, they shut down the government.

Despite our difficulties during the last year, I'm pleased to say that our fiscal 1997 budget, approved just three weeks ago, represents an unexpectedly happy ending. We wound up with $326 million, a 7 percent increase over our 1996 level. Given the fact that we came perilously close to a meltdown, it is gratifying that, in the end, Congress supported us. And we could not have achieved it without broad-based support, including the very timely letter to Congress sent by 160 scientists -- which probably included some of you -- under the aegis of the American Public Health Association. I can't thank you enough.

I think everyone learned a thing or two from the 104th Congress. We learned that we can't move forward without working with all segments of the public. And, I'd venture to say, Congressional leaders learned that extreme tactics like shutting down the government just don't work, and that there is widespread support for safety and health, when employers and workers are involved in the process -- which is exactly the modus operandi of the new, reinvented OSHA.

Even during our darkest days, the Clinton Administration had begun to successfully build a new OSHA that improves the well-being of all American workers, boosts the fortunes of business, and makes OSHA less bureaucratic and more results-oriented.

Since 1970, when Congress created the agency and fatality rates began dropping, America's overall workplace death rate has been cut in half. That's more than 100,000 workers who didn't die because of improved safety and health. Today, fewer workers are injured or die thanks to OSHA standards, enforcement, and cooperative efforts with employers. Yet, every year, more than 6,000 workers still die from workplace accidents, another 50,000 die from work-related conditions, and nearly seven million are injured or become ill. So, the challenge remains: How do we find the most effective ways to close the gap between our mission -- of helping more than 100 million American workers in six and a half million workplaces, and their employers -- and our resources? That's why President Clinton, Vice President Gore and Secretary Reich last year unveiled a three-pronged strategy for the new OSHA. What are these three foundations?

1. Give employers a choice -- between partnership with OSHA and workers to provide better safety and health, or traditional enforcement: If businesses choose the high road of trying to ensure that job sites are safe and healthy, the adversarial relationship will end, and the red tape will be history. If not, we get tough with enforcement.

2. Use common sense regulations and enforcement: Identify clear priorities; focus on key rules; eliminate or reform out-of-date and confusing standards, and work with businesses and employees to develop new and revised rules. And, 3. Focus on results -- not red tape.

We embarked on this new course not because OSHA's destination -- of safer, healthier workplaces -- has changed, but because we believe we can get there in better ways.

The basic premise is: We clearly distinguish, and treat differently, employers who are responsible and those who neglect their workers' well-being. When employers flagrantly disregard safety and health, OSHA is tougher than ever with enforcement. But, in other cases, we believe in partnership, and shared responsibility, for safe, healthy workplaces. We want to work with -- not against -- employers and workers. We want to gather information, and hear complaints and ideas.

Our Cooperative Compliance Programs offer employers with high numbers of injuries a chance to work with OSHA to develop safety and health programs. We're going to be in 29 states, and we're eliminating many more hazards, more cost effectively, than we ever could have done on our own. If the national results are anything like Wisconsin, for example, we have a big success on our hands. Eighty percent of the 200 original manufacturing firms cut their injury and illness rates by an average of 30 percent in one year, and 100 improved so much that they fell off the list entirely.

Partnership works, but only in tandem with common-sense, credible enforcement. As I've said, we're giving employers the choice of partnership or enforcement, but companies that willfully neglect their workers have already made their choice. In the 1995 fiscal year, we had 125 significant cases with penalties over $100,000, an 85 percent increase over the prior year. And we once again increased the number of significant cases during the 1996 fiscal year, to 165.

In July, for example, OSHA announced an egregious case in Maine that gained particular notoriety because the company's behavior was so outrageous. We cited one of the country's largest egg producers, DeCoster Egg Farms, with more than 40 violations and $3.6 million in penalties. The conditions were deplorable: Seven hundred employees, working up to 15 hours a day, were denied overtime, forced to handle dead chickens and manure potentially infected with Salmonella, and exposed to live electrical parts, unguarded machines and overflowing septic tanks. As Secretary Reich said when he announced the penalties: DeCoster treated its workers like animals.

We hit serious violators hard, but we've also reduced penalties for firms with superior records and ones that rapidly correct problems. With our new poster policy, instead of fining a firm for not posting our posters, as OSHA used to do, generally inspectors just hand out a poster.

OSHA is also working with stakeholders and focusing on results with our:

* Voluntary Protection Programs, which recognize companies that reduce hazards by integrating comprehensive safety and health program into their total management system;

* negotiated rulemaking, which allows those affected by a regulation to help write it;

* consultation programs, which offer assistance to employers; plain-language rules, and elimination of outdated, duplicative and conflicting standards;

* recordkeeping proposals that incorporate many ideas gathered from stakeholders;

* redesign of field offices to identify, analyze, and solve problems, instead of reacting to them;

* and our revamped complaint-handling, cutting the response time and unneeded inspections.

When partnership doesn't work, enforcement does. But, another incentive for businesses to improve health and safety is to look at the bottom line. Growing numbers of companies realize that better health and safety increases productivity, reduces the number of person-hours lost to injuries and illnesses, and cuts workers' comp costs, which tripled in the U.S. during the 1980's. A study of employers in Oregon -- one of 32 states that require some or all businesses to establish safety and health programs -- found that for every dollar spent on such programs, most employers save between $4 and $6. To managers, dollars -- and decency -- speak louder than incidence or frequency statistics.

Which brings me back to musculoskeletal disorders. The proportion of the workforce at risk is enormous, and the costs are mind-boggling, but the numbers are tricky. It's not so easy to measure exposures and cases of musculoskeletal illness, as, say, falls in construction. The onset usually requires multiple risk factors -- repetitive motion, awkward or fixed posture, forceful exertions, the use of vibrating or high-impact tools, cold temperatures, among others.

Numbness, burning and aching in fingers, hands, wrists and arms, together with neck and back pain, are some of the symptoms felt by office workers, whose computers allow them to type fast and continuously, and whose employers' productivity demands can turn offices into electronic sweatshops. Similar symptoms afflict meatpackers who must rapidly and repeatedly slice poultry or slabs of meat and hoist them onto conveyor belts. Nursing home workers frequently develop back injuries from lifting patients. Likewise, garment workers doing fast-paced piecework, and cashiers continuously using price scanners, are at risk. At first, the symptoms may just seem like everyday aches and pains . . . but they are not.

At OSHA's 25th anniversary this spring, Shirley Smith, a former poultry cutter described how she tried to hang on to her job despite severe pain from splitting chicken breasts. She couldn't drive, cook or hold her grandchildren. Finally, her injury was so incapacitating, she was fired.

A New York secretary wrote to us after 13 years of physical therapy and a string of operations on her hands and fingers. She had been a typist for a politician, spending 12-to-14 hours a day at her keyboard, trying to meet endless tight deadlines. Suffering chronic pain in her forearms, elbows, shoulders and neck; numbness in her hands, and an intolerance to cold, she was diagnosed by a series of doctors as having carpal tunnel nerve compression, a neuroma, keloids, and tenosynovitis.

A garment worker who stitched shoulder pads told us how she had to stitch as many as possible because she was paid on a piecework basis. She reached the point where she could hardly move by the end of the day. Eventually, her entire life was affected: She couldn't work. She couldn't comb her hair. She couldn't even brush her teeth.

Such stories are legion.

So, what has OSHA done? What has OSHA tried to do? And what have we been able to do?

The agency has issued citations for work-related musculoskeletal disorders under OSHA's general duty clause, or 5(a)(1), for more than a decade. About 500 citations have been issued, and in virtually all cases employers have willingly worked to abate the hazards. These include 13 major settlements in which corporations agreed to fix problems in all of their workplaces -- not only where the citation was issued.

A few weeks ago, Thomas Smith -- an executive with the Sara Lee Corporation, the world's largest packaged meat company -- said that Sara Lee entered into an ergonomics agreement because -- and I quote -- "OSHA was breathing down our necks." Management was initially lackluster in its commitment, but we issued several large citations, and OSHA's director of enforcement threatened two Sara Lee managers with jail. "There is no faster way to get management commitment," Mr. Smith added. The company got the message, jumped on the bandwagon, and now proudly reports that they cut the number of lost workdays due to cumulative trauma disorders by 86 percent.

Getting back to OSHA's long history with ergonomics, in 1990, OSHA announced that we would work on one, and also put out meatpacking guidelines, which remain relevant. And OSHA published two booklets -- "Ergonomics: The Study of Work" and "Working with VDTs."

In 1991, 30 unions petitioned us to develop an emergency temporary standard. OSHA said no, because the situation did not seem to meet the legal conditions to uphold an emergency standard. However, OSHA agreed that there was enough information to go forward to develop a standard.

Permit me to digress again to give you a quick primer on OSHA's rulemaking process. The agency's authority to promulgate standards comes from the 1970 Occupational Safety and Health Act. Health standards are specifically governed by the law's requirements that OSHA -- and I quote "shall set the standard which most adequately assures, to the extent feasible, that no employee will suffer material impairment of health or functional capacity even if such employee has regular exposure to the hazard dealt with by such standard for the period of his working life."

The Act goes on to say that these standards shall be "based upon research, demonstrations, experiments, and such other information as may be appropriate. In addition to the attainment of the highest degree of health and safety protection for the employee, other considerations shall be the latest available scientific data in the field, the feasibility of the standards, and experience gained under this and other health and safety laws."

Court decisions have established legal tests that OSHA must meet to promulgate a rule. We must make a threshold finding that employees are at significant risk of developing an adverse health effect due to exposure to an identified workplace hazard. In addition, we must identify economically and technologically feasible methods to substantially reduce that risk before we can proceed.

The rulemaking process has three major components. The first is a data collection and analysis phase. This is followed by public participation, in the form of written comments and public hearings. The last phase involves synthesizing the record developed during the first two phases, and deciding on the best approach to follow. OSHA's rulemakings are deliberative, participatory, and transparent. All information used becomes part of the rulemaking record.

As for ergonomics, we are still in the first phase of data collection and analysis. OSHA published an advance notice of proposed rulemaking in 1992 -- during the prior Republican Administration -- and received about 300 public comments, including information about the problem, and existing industry programs. We also surveyed 3,000 establishments of all sizes and in all types of industries. This gave us a data base of current industry practices, which was helpful in drafting a regulatory impact analysis. In addition, OSHA made more than 30 site visits to gather first-hand information about implementation of ergonomic principles in facilities with programs.

OSHA and NIOSH assembled more than 3,000 articles from the scientific literature, and culled relevant information to define the problem's health effects. The body of scientific knowledge available is extensive, and, unlike most OSHA health standards, is based on human evidence rather than extrapolations from animal evidence. The agency also obtained workers' compensation data documenting the risk to employees.

OSHA uses all of these data sources to develop a rulemaking approach. The draft rule is accompanied by extensive analyses of the health effects, the risks to exposed employees, what the exposed population is, and economic and technological feasibility. The formal public participation phase of a rulemaking begins when OSHA publishes the proposed standard in the Federal Register, along with supporting documents, and solicits written comments and information. This is followed by public hearings, where interested parties can present oral testimony, and OSHA and others can question them. A post-hearing comment period allows rulemaking participants a final opportunity to add to the record, or to submit briefs. When the record is finally closed, OSHA begins the difficult task of summarizing and analyzing all of this information, and determining what provisions should be included in the final standard. The final rule must be based on this record, taken as a whole.

On top of this legal process, OSHA also must meet several administrative requirements and obtain approvals to proceed to a final rule. The Office of Management and Budget has two review processes: One is a policy review under a Presidential Executive Order, and the other is to review information-collection provisions under the Paperwork Reduction Act. Two recent Congressional requirements also will impact rulemaking for ergonomics. Agencies have long been required to assess their rules' impact on small businesses, but these have been modified to establish more formal consultation with small business panels. In addition, Congress can now review and veto final rules.

So, when OSHA promulgates a final rule for ergonomic protection, it will have been reviewed, discussed, analyzed, commented upon, disseminated, and considered in every way, shape, and form available in the legal, administrative and political process of rulemaking.

Now, back to the story. This process continued after I became Assistant Secretary in 1993, when I also brought in one of your next speakers this morning -- Barbara Silverstein -- to head our ergonomics team. In March of 1995, we circulated a draft standard to stakeholders for comments. It identified risk factors of concern, and defined what would be considered problem jobs that would need to be controlled. It provided a non-mandatory checklist that could be used by employers to assess jobs and determine when they were covered by the requirements. It was performance-oriented, based on finding and fixing problem jobs, rather than specifying what control measures to use. And it included provisions for medical management, worker training, and other components of existing, effective ergonomic programs. At that time, OSHA also released 600 pages of supporting information that we had gathered.

But, as you recall, this was just the time that the 104th Congress descended on Washington.

As you know, a coalition of firms and trade associations have been skeptical of how real work-related musculoskeletal disorders are, and doubtful that -- even if musculoskeletal disorders are a problem -- that OSHA could fashion a workable standard. They opposed any standard, and have opposed efforts to reduce them through ergonomic redesign of workplaces. Well, their hired guns came out shooting.

The opponents argue that addressing ergonomics would cost American businesses billions of dollars, and destroy jobs. Some trade associations have said that they would be willing to see an ergonomics standard, but argue that there isn't any conclusive scientific proof of a relationship between risk factors and injuries and illnesses. They trotted out a model of what they called a perfectly designed epidemiological study and, by comparison, they naturally found that existing studies of musculoskeletal disorders came up short. One off-base analysis described ergonomics as "theories characterized by uncertainty, speculation and occasional plain foolishness."

This is a logic that would have us still debating whether there is sufficient evidence to classify tobacco as a hazard of enough concern to justify governmental action.

I believe that OSHA can meet the test of showing, on the basis of the best available evidence, that workers do face a significant risk of harm when a combination of risks factors is present.

But those in Congress opposed to a standard had the upper hand in 1995 and early 1996. They tagged on a budget rider banning a proposed standard and publication of voluntary guidelines to help employers make their workplaces less hazardous. So, we were forced to suspend our work. The rider that the House passed in OSHA's fiscal 1997 budget also prohibited the agency from collecting data. I think this was too much of a reach.

Thanks to the leadership of Rep. Nancy Pelosi of California, the forces of reason prevailed this summer, when the House narrowly defeated the ergonomics budget rider, 216-205. The Senate also resisted the rider, and when OSHA's 1997 budget was signed by President Clinton, this arbitrary restriction on OSHA's ability to do its job was gone. I cannot over-emphasize the importance of the American Public Health Association's letter that many of you signed. It was well-timed and influential. Nor can I over-estimate my gratitude for this invaluable assistance. The Congress has just approved a budget that gives us the resources to rev up our engines on ergonomics.

Despite our improved fortunes, we do not have a mandate or the desire to rush out with an ergonomics standard. During the budget debate this fall, a few Congressional Cassandras warned that we would sneak a 600-page rule into the Federal Register the moment we had a chance. The only thing that was 600 pages were our 1995 supporting documents. OSHA doesn't disgorge 600-page rules, or operate by stealth.

The truth of the matter is: We are moving ahead responsibly and deliberately, but with determination. Indeed, with OSHA's new ways of doing business, we want to carefully reach out to all stakeholders to get ideas and suggestions. We will proceed with a sensible plan of action.

We are getting our ergonomics team going again to shepherd the process of developing a standard. A joint OSHA-NIOSH conference on effective ergonomic practices and programs will be held on January 8 and 9 in Chicago. This will be a forum for hundreds of leaders in business, labor, academia and government to discuss what works, with breakout sessions on different industries. NIOSH is completing its literature review of research that has been done. We've formed a task force to review new potential cases for enforcement, focusing on high-risk industries. We will step up our public education, and will publish a technical assistance manual for employers within the next year.

But, whatever we do, we know that we'll be carefully watched by those who deny that millions of working Americans suffer from work-related musculoskeletal disorders.

Given the politics of ergonomics and the politicization of science around this issue, all of you have a crucial role to play. You can help clarify the debate, correcting the many mischaracterizations of the nature and scope of the problem. You can continue to add to the body of scientific research. Your research and clinical experience are invaluable in buttressing the case for an ergonomics standard; we would welcome any studies or information that you have. And, you can keep speaking out about the need to address this hazard, and the good research that you and others are doing.

But, let me tell you a secret I discovered since coming to Washington: Occupational safety and health issues tend to be more contentious in the capital than in the country. Sure, there are greedy employers who don't care about their workers' well-being, but the vast, vast majority of American businessmen and -women believe that their offices, factories and shops should be safe and healthy.

Despite the alleged burden, many businesses -- small businesses in particular -- have long been asking for assistance and guidelines on how to deal with cumulative trauma disorders. At the same time, bigger companies, which are self-insured and face soaring workers' comp costs, have a powerful impetus to correct hazards. As I mentioned, more than 99 percent of the companies OSHA has cited under the general-duty clause have implemented ergonomics programs and abated hazards.

Countless businesses -- from General Motors and the Iowa Beef Processors to nursing homes and newspapers -- have redesigned workplaces and work practices to better fit employees, and boost their profitability. They have recognized that, because people come in all shapes and sizes, so work environments must be flexible, and early intervention is key. If not, our bodies may break down before our machines do. Designing flexibility can be as simple as rotating employees among jobs or putting workers on a platform so they don't have to lift something so high. It can mean using a computer keyboard holder that adjusts up and down so that typists can reduce strain. Or selecting a knife with a slanted blade rather than a straight one so that a poultry processor exerts less pressure.

These are hardly just matters of personal comfort. They can make the difference between a full-functioning worker or a former worker confined to home due to disability. These little, generally low-cost changes can have a critical impact on a worker's health and an employer's bottom line.

Like the labor-management team that escorted me around the New Hampshire brewery, there are workplaces all over the country where workers and employers have applied ergonomic principles, prevented injuries, saved money, and developed an exceptional sense of pride in accomplishment.

But, for all the companies that are doing things right, many more have yet to adequately address musculoskeletal disorders and make ergonomic improvements. That's where the power of the bully pulpit, useful guidelines, and a common sense standard come in.

Cutting corners on protection is not what the American people -- including American businesspeople -- want. Poll after poll shows overwhelming public support for increasing efforts to improve health and safety. Doing otherwise would represent the failure of a decent, just society, and an economic failure to protect the tremendous productive resources of our nation's people.

Some may ask: Do we really need regulations and guidelines for ergonomics? I am convinced we do. This is a huge, painful, costly public-health problem. OSHA must address it. So, stay tuned, because we will be moving soon. But, with the new OSHA, we intend to do it in ways that are beneficial to workers and management.

Regulations are the foundation for effective safety and health programs. They level the playing field for businesses that are already serious about safety and health. And they put the uncaring or negligent employer on notice that this is the way the job must be done to be safe.

It's in all our interests to improve safety and health, and reduce the number of musculoskeletal disorders that are inflicting so much pain on so many American workers, keeping them from doing their jobs and living normal lives. At OSHA, we're here for the long haul. We're working for the day when every man and woman who goes to work comes home to their families as with their bodies unharmed.

This is essential work, and it's an honor to share it with you. Thank you for your attention and support -- in the past, and in the days to come.