We recently examined uncommon workplace injuries, referred to as “serious injuries and fatalities” (SIFs). Professional safety groups like the American Society of Safety Professionals (ASSP) and the National Safety Council (NSC) have researched SIFs for years and offer employers resources to prevent SIFs.
But what about common workplace injuries like musculoskeletal disorders (MSDs) and slips, trips, and falls? Injuries that raise your recordable injury rate may garner increased attention from the Occupational Safety and Health Administration (OSHA) or your state’s workplace safety and health agency, increased workers’ compensation insurance premiums, or even disqualification during a bidding process.
Some of the top causes of employers’ workers’ compensation costs include MSDs caused by overexertion and repetitive motions, falls on the same level, and slips and trips without a fall, according to insurer Liberty Mutual’s Workplace Safety Index.
MSDs, sometimes called “ergonomic injuries,” include back strains and sprains, carpal tunnel syndrome, rotator cuff tears, and tendonitis. These injuries are usually caused by awkward or static postures, forceful exertions, or repetitive movements.
MSD risks are present across industries. Healthcare workers, including those in home healthcare and nursing homes, are at great risk. The National Institute for Occupational Safety and Health (NIOSH) looked at 117,000 home care workers (both home healthcare and personal care workers) treated in emergency departments for work-related injuries over a five-year period. More than half of the injuries (52%) were caused by overexertion and repetitive motion. Slips, trips, and falls accounted for 15% of injuries.
Other affected industries include meatpacking and poultry processing, public safety occupations such as corrections, firefighting, and law enforcement, shipyards, and wholesale trade.
MSDs are some of the most common workplace injuries and are a significant challenge for employers, according to the NSC. Some 30% of days away from work are due to MSDs, resulting in annual costs of approximately $20 billion for U.S. employers, according to the NSC.
Ergonomics at Work
Hazards are specific to the task, tool, and workstation design within an industry, so the guidelines for controlling MSD hazards tend to be specific to that industry as well.
Some ergonomic interventions rely on recommended motions or postures, while others involve engineering controls like assistive equipment or tools.
The National Institute for Occupational Safety and Health (NIOSH) has developed guidelines, such as its Ergonomic Guidelines for Manual Material Handling, that cover ergonomic interventions to reduce the physical demands of manual materials-handling tasks.
Engineering controls recommended in NIOSH’s ergonomic interventions for soft drink beverage delivery include external handles and pull-out steps on beverage delivery trucks, two-wheeled hand trucks with counterbalancing devices, improved carton design to ease product handling, and substituting plastic containers for glass to reduce product weight.
Worker risk factors can be identified through biomechanical monitoring of manual materials handling, psychophysical discomfort assessment surveys, and videotaping.
Ergonomic interventions recommended for the prevention of repetitive motion injuries include cutouts in worktables that reduce reaching distances; devices that enable workers to easily turn parts in multiple directions during production, reducing awkward postures or reaching; and the use of “ergonomic” handles on tools to reduce the need for forceful pinch grips.
Other interventions include floor mats in areas where workers stand for long periods to reduce discomfort and fatigue; sit-stand stools to reduce extended reaches and fatigue; height-appropriate work surfaces or work-height modifications to reduce reaching motions; and permanently raised standing surfaces to reduce awkward body postures.
Recommended engineering controls in meatpacking and poultry processing involve tool handle and workstation designs. Hand tools such as knives, pliers, and scissors have been designed to minimize bending of the wrist, either side to side or up and down, and minimize the finger force and contact stress to fingers and the palm. Some tool handles can help prevent the transmission of cold or vibration to the tool user. Handles should not be so big that they prevent users with small hands from maintaining a “C”-shape of a grip between the fingers and thumb.
A wraparound handle or strap can allow a user to maintain control of the tool while relaxing the fingers on the handle. Some powered hand tools can reduce the finger force necessary to operate tools.
Some spray nozzles are designed to minimize the hand force needed and allow users to maintain proper posture and positioning. Cutout workstations can reduce the need for workers to lean and reach.
Workstation tilters or dumpers can reduce bending and reaching to remove products (meat or poultry) from containers. Work stands may be necessary to fit the worker to the assigned task, reducing awkward postures and reaching, and proper workstation height minimizes excessive forward trunk bending and arm lifting during production.
The backrests and seats of chairs or stools can reduce worker fatigue if workstations do not require extended forward or elevated reaching, bending, or trunk twisting.
Wheeled devices such as carts, hand trucks, lift tables, and pallet jacks can assist with manual materials handling when transporting containers between work areas. Belts, overhead conveyors, and roller tables can eliminate the need to carry meat and poultry products through a facility.
Safety Council’s Ongoing Research
The NSC continues to research MSD prevention through its MSD Solutions Lab, an NSC initiative established in 2021 with funding from Amazon to address work-related MSDs. The MSD Solutions Lab released a guide last year on workplace MSD surveillance.
The safety group suggested that a surveillance program should have:
- Standardized recordkeeping that includes guidelines for consistent injury classification and data collection, helping managers and supervisors better identify risks and target prevention efforts.
- System implementation—Best practices for designing and maintaining effective injury surveillance frameworks that adapt to an employer’s size and capabilities.
- Technology integration—Leveraging Internet of Things (IoT) devices, artificial intelligence (AI) analytics, and automated systems to enhance workplace monitoring and early intervention, with practical considerations for implementation.
- Real-world application with use cases and interactive exercises to help train staff to effectively implement strategies in the workplace.
The MSD Solutions Lab recommended that employers focus on developing systems that work for them. Some employers may choose spreadsheets to record injuries, while others may prefer to use sophisticated software or automated systems. The group’s guide includes an appendix with sample data dashboards and injury recordkeeping forms for your reference when developing or refining your injury surveillance methods.
The MSD Solutions Lab has also explored new technologies. It published a white paper, Emerging Technologies for the Prevention of Musculoskeletal Disorders, acknowledging that employers may not have access to new tools or the knowledge to evaluate and implement risk-reducing technologies effectively.
Emerging technologies that may help some employers prevent MSDs include:
- “Computer vision,” a potentially helpful tool for larger organizations seeking to aggregate data and analyze ergonomic risks. The NSC’s “Work to Zero” initiative released an earlier white paper on applications of computer vision to mitigate fatal workplace injury risks.
- Wearable sensors as a supplement to engineering controls, which may help control the costs of ergonomic solutions.
- Passive exoskeletons for manual material handling. Studies have shown that exoskeletons can reduce muscle activity by up to 40%.
The MSD Solutions Lab also looked at robotics in the workplace. Co-bots and “follow-me” robots, also called autonomous mobile robots (AMRs), can move loads around a facility, following an operator and performing material-handling tasks such as carrying, pulling, or pushing loads. The group examined the potential for co-bots to reduce workplace MSD risks. Autonomous and semi-autonomous material-handling equipment can be used to reduce overexertion from carrying, lifting, lowering, pulling, or pushing loads; eliminate repetitive activities like performing the same hand motion repeatedly in high-precision, monotonous, or pick-and-place work that poses MSD risks; and reduce worker exposures to an environment with varied temperatures or hazards that are uncomfortable and unsafe for material handling.
Slips, Trips, and Falls
Falls on the same level are a leading cause of days away from work, job restriction, or transfer (DART) cases, according to the NSC. Eighty percent of cases occurred in service industries, according to the NSC, including healthcare and social services, retail trade, transportation and warehousing, and accommodations and food services. Twenty percent occurred in goods-producing industries, with 13% in manufacturing alone.
Young, inexperienced workers may lack knowledge of workplace injury risks. NIOSH encourages employers to provide young workers with information on staying safe at work, pointing to slips, trips, and falls as common causes of workplace injuries. The causes of slips, trips, and falls in the workplace include greasy floors, ice, loose mats or rugs, rain and snow, and spills.
NIOSH suggests that employers remind young workers to:
- Clean up spills and anything slippery, and check with supervisors on how to use cleaning products and avoid cleaners that could make floors slippery.
- Clean off any slippery material on the rungs, steps, or feet of a ladder before use, and avoid exceeding the load limit noted on the ladder.
- Clear lobbies, stairs, and walkways of any tripping hazards, such as clutter, cords, empty boxes, and wires.
- Make sure that floor mats lie flat and aren’t wrinkled or bunched.
NIOSH also provided guidance on slip, trip, and fall prevention for healthcare employers. According to NIOSH, the top slip, trip, and fall hazards in healthcare include:
- Contaminants (fluids, food, grease, oil, and water) on the floor;
- Improper use of floor mats and runners;
- Inadequate lighting;
- Poor drainage of drains and pipes;
- Stairs and handrails;
- Step stools and ladders;
- Tripping hazards like clutter, hoses, loose cords, medical tubing, and wires;
- Walking surface irregularities both indoors and outdoors, like uneven flooring or ground, holes, protrusions, and rocks; and
- Weather conditions like ice and snow.
NIOSH’s guidance provides employers with an extensive checklist of slip, trip, and fall hazards to address in healthcare facilities.
NIOSH also offers a fact sheet for wholesale and retail employers. Like the institute’s advice for healthcare employers and those that employ young workers, it points to risk factors in the wholesale and retail trades, including boxes and containers; ice, rain, and snow; loose mats and rugs; poor lighting; spills on walking surfaces; and walking surfaces in disrepair. NIOSH has detailed recommendations for employers on footwear, planning and workplace design, and training, as well as advice for wholesale and retail workers concerning housekeeping and material handling.
A focus on preventing common workplace injuries, such as MSDs and slips, trips, and falls, may help contain your safety-related costs and your exposure to OSHA inspections and enforcement.