Rani Lueder (1998) The Hidden Injuries. Published in CTD News
Bureau of Labor Statistics
Hidden Injuries
What’s going on? For each of the last three years, BLS concluded CTD rates continue to decline.
Their new data holds that private employers reported approximately 276,000 CTDs in 1997, compared with 281,000 in 1996, 308,000 in 1995 and 332,000 in 1994. Corporate America heralds this drop as a result of heightened ergonomic awareness.
Am I the only ergonomist that believes the BLS findings are pointed in the wrong direction? The longer that we delude ourselves that CTDs are dropping, the longer it will take to get our house in order.
Before we pat ourselves on the back, let’s evaluate where we are.
Are things really getting better?
My experience with organizations suggests that chronic symptoms among computer users are at an all time high. Almost half of employees at most computer-based workplaces I visit experience chronic symptoms often involving multiple body parts. Remember, only the best companies are willing to hire an ergonomics consultant to help them with their ergonomics program.
What of the others?
CTD News summarized findings of a national survey I conducted for the Social Security Administration in 1996 and 1997, based on information originally published in the Federal Register. In that survey, based on widely used research protocols, 54% reported neck/shoulder and 40% had hand/wrist discomfort or pain on that particular workday. Such rates were once unthinkable for large organizations.
Of course, ergonomic problems are particularly protracted with smaller companies that typically can lack the infrastructure and resources to monitor or accommodate employees. Just stop by a travel agency, freight shipment franchise, car rental place, grocer, bank, or other small enterprise and really look at the way that the work.
However, let’s not fool ourselves into thinking that even large organizations are able to keep up with the injuries in their camps… How can a safety director respond to thousands of employees in pain? Most don’t. Ergonomic quality control continues to be a major problem within organizations. Many try to buy decent products, but more often than not, these are the wrong products or installed and used in the wrong way... and installation problems are rarely rectified.
Few corporations actively monitor the extent of their ergonomic problems in-house. Once Pandora’s box is opened, how would they be able to shut the doors again?
Some safety representatives tell me that a central component of their safety efforts consists of shuffling their people around to different low-end jobs, so that they don’t show up in injury statistics as lost time.
The workplace is changing…
Why should we expect CTD rates to improve? An insidious aspect of today’s work is that people’s work doesn’t look all that different from a few years ago. Yet, each year the work on the computer becomes more intense. My research suggests that when you increase time at the computer from two hours to four hours a workday, you approximately double the pain rate. When you increase time yet again from four hours to six hours a day at the computer, you once more almost double the collective pain rate.
Another factor is the dramatic increase in overtime work. Corporate downsizing is often profitable over the short-term because the remaining employees have to make up for the shortage in the labor pool by working longer hours… And many of these users have existing symptoms.
And then, the employees…
We often hear about "Workers comp cheats" that defraud the Workers Comp system. What of the majority of workers that are not reporting their symptoms?
Many employees now require interventions to stop the downward spiral of pain. Although more than half the employees I interview describe protracted symptoms, enormous numbers of them do not report their symptoms. Sometimes employees who filed claims subsequently tell others not to report symptoms under any circumstances because "the system is set up against them".
If employees do report symptoms, their supervisors do not believe that they have time to evaluate next steps, or they do not know how to respond. There is an increasing sense that there is little that they can do to prevent these injuries.
What about the BLS rate decrease?
In 1993, Oleinick et al analyzed the OSHA log200 database for the state of Michigan in 1986.
They analyzed officially recorded rates of occupational injuries and illnesses in that state and concluded actual BLS recorded data was understated by a factor of 4, due to the vagaries of interpreting the data.
Further, when accounting for the fact that BLS (OSHA Log200) and Workers’ compensation data are not integrated, they found an 8.58-fold increase over the BLS data. They further concluded that for that year, BLS data failed to account for 373 million of 421 million missed workdays resulting from occupational injuries.
Fine, you say, but 1986 was over a decade ago. What does that have to do with the current situation?
Their primary conclusions addressed the way that injury data, once trapped, is massaged and interpreted. That issue has not changed. Underreporting of the recorded data is as big a problem now as it was then.
Given the high rates of non-reporting of injuries by employers and employees, the nature of the bureaucratic loopholes that allow companies to avoid reporting injuries, the limitations of the process used to analyze recorded BLS data, the separation between BLS (OSHA Log200), Workers’ Comp, and Health Insurance databases, and numerous related factors, I don’t find the new BLS findings credible. I hope that this discussion can start others.
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