KEEPING EMPLOYEES, AND THE JOB, HEALTHY Cumulative disorders are a rising occupational hazard


In the old days, the term "occupational hazard" conjured up images of a helmeted construction worker balanced at the peak of an unfinished building as a menacing swinging steel girder was lowered into place.

In today's workplace, the obstacles to a healthy office environment may not be as obvious or dangerous as a falling brick or a collapsing mine shaft, but they are certainly more commonplace and, in some cases, just as debilitating.

Everywhere you look in the modern office or workshop lies the potential for an illness or accident -- from desks and chairs that are too high or too low to poorly arranged computer keyboards and inferior tools. Statistics show that

poorly designed workstations or desks often result in problems with an employee's musculoskeletal system, particularly in women and elderly workers.

In November, a Bureau of Labor Statistics survey found that employers reported 6.6 million occupational injuries and illnesses in 1989, about 136,000 more than were reported the previous year.

But perhaps most alarmingly, the survey shows that in the Automated Age, where more and more tasks are broken down into repetitive, assembly-line jobs, there has been an explosion in the number of repetitive trauma cases. In 1981, the BLS reported that 18 percent of reported occupational illnesses were disorders associated with repetitive trauma. Last year,

the figure was 52 percent.

And repetitive trauma -- instances of occupational illnesses caused by repeated motion, pressure or vibration -- shows no signs of abating any time soon, according to doctors, ergonomists and labor experts.

"This is a growing problem with no end in sight," said Louis Slesin, the editor of VDT News, a New York City-based compute

newsletter. "Better equipment and training is the solution, along with changing work habits, but industry isn't going to like it one bit."

Several experts on ergonomics -- the study of the worker in the workplace -- stress that there is no "magic bullet" to cure all office ailments resulting from cumulative trauma disorder or repetitive

stress; there are, however, several precautions and treatments that employers should consider to eliminate or minimize these problems:

Better equipment: The advice here is basic -- chairs, desks, computers, printers, facsimile machines, etc. should be user-friendly instead of forcing the worker into contortions just to operate them.

Adjustable chairs are a must in the modern office. A person who regularly uses a keyboard or typewriter should be positioned so that their elbows are roughly even with the typing panel. Shorter workers should have access to a footrest that can be placed under their desk and prevent their feet from dangling for long periods of time.

Just as a good schoolteacher admonishes a student for poor posture, a conscientious employer who has provided his or her employees with quality work equipment should make sure workers are using it properly.

Employees can become very comfortable sitting or typing in awkward positions, doctors and physical therapists say -- that is, until they suddenly find themselves with a painful backache, bursitis or tendinitis. Employers may not want to be as upfront as the schoolteacher about poor posture, but some tactful reminders about sitting up straight pinned to the office bulletin board may help.

Doctors and physical therapists say they are always seeing patients whose telephone-handling skills have left them with sore necks and shoulders. The telephone should not be squeezed between the head and your shoulder; a telephone headset should be provided for workers who need to use their hands and the telephone simultaneously. Also, computer terminals that are placed to either side of the desk, instead of directly in front of the user, can cause neck strain.

The glare from video display terminals should be reduced according to each person's preference. Some ergonomists recommend that employers have new employees' eyes checked before hiring to determine any potential problems. The tilt of a VDT can also cause neck and eye strain.

Employers in workshops might reduce the size or weight of a load in a repetitive job task or provide armrests to better absorb the weight. To keep word processors' wrists from resting too low on the keyboard, padded edges can provide a comfortable lift.

Monitoring: Just as any good business manager or owner watches his production output, so must they oversee working conditions and those areas of the business where illnesses and physical complaints occur more often.

"Treat every single case as if it were real," says Bob Bettendorf of the Institute for Office Ergonomics in Stamford, Conn. "The possibility that the problem occurred elsewhere or isn't there at all exists, but don't dwell on it because drawing attention to it probably won't help you or the employee."

Monitoring can also accurately assess the incidence of the disorder, the employees most likely at risk, and the preventive measures best suited for a problem.

Yet experts say it is also important that employers don't give the impression that they are monitoring worker productivity. This will only increase stress levels in the workplace, and statistics show the resulting higher tension levels often result in even more work-related ailments.

"One of the first things enlightened management will do is to encourage people to come forward with their problems and then treat them medically," Mr. Bettendorf said. "There will be a significant cost upfront but studies have

shown that the payoff later can be tremendous."

A little-known service that can be of help to the business owner who strives for a healthier workplace is the Maryland Occupational Safety and Health agency's consultation service.

At no cost, MOSH's consultation engineers will visit a work site and conduct an inspection for potential health problems. Although some employers may be reluctant to invite the same agency that can issue compliance violations, Ronald D. LeClair, the chief of MOSH's consultation service, says his unit is only there to make recommendations.

"Our unit may be a logical place to start if [an employer] had some initial questions," Mr. LeClair said. "We may not be able to give you the specific advice that a consultant can give but we can tell you if it looks like you need help and we are a free service, too."

Intervention: Once an employer has discovered a problem with repetitive stress on site, there are a number of different ways to intervene while the employee recovers.

The simplest answer is rest. If data processors complain that their arms or wrists feel tired or tingle, reduce their workload and see if the aches persist. Although it might be a small inconvenience for a manager, it's preferable to losing that employee for a few hours or days because of the need for medical treatment.

Labor statistics show that almost half the people who complain of some form of occupational illness don't lose any time from work and a large portion of the remaining 50 percent are treated through one medical visit.

Employers should also consider modifying an employee's work site to correct the problem. Some companies have rotated workers between jobs during the day, thus preventing many cases of repetitive stress while also reducing the tedium involved in some jobs.

Retraining an employee for a new job should be the last course an employer considers, since it involves more time and money than any other option, said Frances L. Salback of the Rehabilitation Division of the Maryland Workers Compensation Commission.

Although employers may fear that surveillance and training and intervention will cost them a great deal of money in consultation fees, ergonomists say the literature on how to operate and maintain a healthy office site is readily available at local libraries, or from government health agencies or private informational clearinghouses.

The National Institute for Occupational Safety and Health will provide employers and employees alike with a wide variety of information on safety and health topics, from indoor air quality to carpal tunnel syndrome.

The agency also offers a Health Hazard Evaluation Program, under which employers, workers and unions who suspect a health problem in the office or workplace can ask NIOSH to assess the problem. For information, call 1-800-35-NIOSH.


"Sitting on the Job: How to Survive the Stresses of Getting Down to Work --A Practical Handbook," by Scott W. Donkin and Joseph J. Sweere, Houghton-Mifflin, Boston, 1989

"Potential Office Hazards and Controls," prepared by Robert Arndt and Larry Chapman for the Congressional Office of Technology Assessment, University of Wisconsin, Madison, Wis. 1984

"A Manager's Guide to Ergonomics in the Electronic Office," by Marvin J. Dainoff and Marilyn Hecht Dainoff, John Wiley & Sons, New York, 1986

"Computers, Work and Health: A Sociotechnical Approach," by Trevor A. Williams, Taylor & Francis, New York, 1988

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