Hooked on Ergonomics

John knows a bit about citations, as an industrial hygienist with the D.C. branch of the Occupational Safety and Health Administration. A veritable haven for safety-obsessive meter maids, OSHA houses the most prolific citation-writers of any federal agency, and their popularity reflects it. Last December, in a customer-satisfaction survey conducted by all federal agencies, OSHA tied for last place — with the IRS.

But John has not come to write citations. He is here at my invitation, as part of OSHA’s voluntary consultation service, which affords businesses a chance to escape regulatory wrath by making sure they comply with OSHA’s innumerable safety standards. In light of the agency’s recent concern that workplaces be ergonomically outfitted (ergonomics is the study of the body’s interaction with the work space), I’m interested in finding out whether mine is sound. My office has always resembled an archaeological dig — a paper graveyard of stories past. But while the average eye might consider it unkempt, John sees a potential deathtrap.

He takes a seat in my chair and says it’s not up to specifications (indeed, when I later read OSHA’s “Working Safely With Video Display Terminals,” I see that my seatpan should be 45.72 centimeters wide and “slightly concave with a softly padded ‘waterfall’ edge”). Other hazards abound. The lighting casts a glare on my computer screen that could cause “eye strain.” The cups of water on my desk are a “hygiene violation.” The papers on the floor are impeding my escape route and could result in “ignition from spontaneous combustion.” As for my computer set-up, don’t get John started. My keyboard is too high, as is my chair, which could imperil the circulation behind my knees. John says my mouse, which sits three inches from my keyboard, is not close enough — unless I fancy being a ticking carpal-tunnel time bomb. John says I need a foot rest to alleviate back strain. (I tell John I don’t have back strain. He doesn’t seem to care.)

John is also concerned about my behavioral practices. For instance, when I lift anything, “even a paper clip,” I should visualize the lift, tuck the pelvis, bend the knees, and “hug the load.” (John supplies a handout.) When keystroking, I must be sure to take frequent stretch breaks. In fact, John sets his own alarm to go off every half hour, just as a reminder. I mean to ask John if OSHA requires that somebody feed me grapes as I work, but his watch alarm goes off. I wait for him to stretch, but there’s no time.

John has to go, and as I show him to the restroom, he’s still thinking safety first. THE WEEKLY STANDARD restroom passes muster on soap, towels, and toilet seat covers. But as John unzips at the urinal, his head rolls back and he inspects the ceiling. “Proper ventilation is very important,” he scolds. John is gone now. But he has left me with much to think about, including a 19-point checklist on ergonomic stress at workstations, an 82-point OSHA safety checklist, a 44-point Army ergonomics checklist, and another 24-point ergonomics worksheet followed by a 145-point corrective action checklist.

Ludicrous though it may seem, this episode will be repeated, though not so amicably, in millions of workplaces across America if OSHA has its way. Late last year, OSHA quietly published its proposed ergonomics rule — a set of regulations for curtailing musculoskeletal disorders that takes up 311 pages in the Federal Register. If implemented as is, the ergonomics standard would apply to nearly every occupation, imposing a multi-billion-dollar burden on American industry and effectively permitting OSHA micromanagerial oversight of historically unregulated preferences — such as the height of your chair.

OSHA defines a musculoskeletal disorder (MSD) as an illness or injury to soft tissues of the upper and lower extremities, as well as the back, “primarily caused or exacerbated by workplace risk factors” such as “repeated exertion” or “awkward postures.” Its manifestations include everything from carpal tunnel syndrome to Raynaud’s phenomenon to DeQuervain’s disease to carpet-layer’s knee — all falling under the umbrella of what one industry source calls “Jeffress’s Pain In The Ass.”

That would be Charles Jeffress, head of OSHA since 1997, who accuses Republicans of playing politics with ergonomics. Sure enough, Republicans in Congress have been staving off the ergonomics rule for years. But last November, Senate Democrats threatened a filibuster to overcome a GOP blocking maneuver. The day after Congress adjourned, Jeffress, playing a little politics of his own, unveiled his rule, starting the clock on a 60-day period for public comment. A man with a mission, Jeffress likens his task to that of St. George, who slew a dragon to win Britain’s freedom. He has vowed to enact the ergonomics rule this year — before a 12-month National Academy of Sciences study can cast doubt on the underlying “science” or a potential Republican administration can finally derail it.

This has industry groups panicked. Even by OSHA’s own miserly estimates (which have doubled since February 1999), the rule would cost industry $ 4.2 billion — making it the costliest regulation the agency has ever imposed. This number, however, is in fierce dispute. The Small Business Administration puts the cost at $ 18 billion, while Food Distributors International, which conducted a six-figure analysis of its own, says it will cost the food-distribution industry alone $ 26 billion, with $ 6 billion in annual follow-up costs.

So far-reaching is OSHA’s rule that even some administration officials are balking. According to an internal memo obtained by THE WEEKLY STANDARD, one OSHA official informed Jeffress, “We have a serious political problem at Commerce. Secretary Daley . . . is deeply opposed to our rule as currently drafted” and “could well start lobbying the Secretary/Office of Management and Budget/White House.” According to the memo, commerce secretary William Daley’s policy director, Jon Orszag, formerly among OSHA’s strongest allies, “feels convinced our rule is too broad, the grandfather clause is inadequate, etc.”

And lately, OSHA has had public relations troubles. In January, the Washington Post surfaced an advisory letter sent to a Houston credit services employer, T. Trahan, who wished to know what his safety obligations were to his employees working at home. OSHA informed him that an employer was responsible for eliminating safety hazards from home offices, noting that if an employee works in his basement and “the stairs leading to the space are unsafe, the employer could be liable.”

Politically, this was the equivalent of OSHA’s soaking itself in benzene and toasting up a cigarette (an act prohibited by OSHA standard 1910.1028, App. A, SubPart 2, Paragraph VIII). The unanimous editorial denunciations and general ridicule that ensued were reminiscent of the mid ’90s, when newly elected Republicans related OSHA horror stories about dentists afraid to return children’s baby teeth for tooth-fairy recompense lest they violate disposal procedures (OSHA said the fear was groundless) and employers fined for failing to warn employees not to eat the toner from the copier machine.

Labor secretary Alexis Herman withdrew the advisory letter the next day to prevent “widespread confusion,” and eventually assured employers they wouldn’t be subject to home inspections. To achieve clarity, Herman called for the Clinton administration’s favorite all-purpose salve, “a national dialogue.” Promised House majority leader Dick Armey, “This will be a short, one-sided conversation.”

Though the ergonomics proposal has yet to generate as much public outrage as the letter on home offices, it should. The word “ergonomics” derives from the Greek words ergos (work) and nomos (laws). While it is difficult to settle on a generally agreed definition (books by ergonomists spend entire chapters hashing out what exactly ergonomics is), OSHA defines it as “the science of fitting the worker to the job,” in employment where repetitive motions can result in musculoskeletal disorders. Such elusive notions — and the general scarcity of quantitative analysis in epidemiological studies — can cause even fellow soft scientists to mention ergonomics with a smirk. Many hard scientists consider ergonomics on a par with, say, phrenology.

The “emerging science” of ergonomics began around the turn of the century, as studies were conducted to determine how to streamline tasks for productivity. It got a boost during World War II, when pilots in cramped cockpits confused their flap controls with their landing gear, causing hundreds of accidents and making clear the need for better-designed fighter planes.

In the last two decades, ergonomics has forsaken its emphasis on ease-of-use to become a quasi-religion of preventive medicine. And it’s not just the horny-handed sons of toil on auto assembly lines and slaughterhouse floors who need protection. Seventy percent of the work force now sits for a living, often in front of computers. It’s a group that consists primarily of aging white-collar baby boomers, a demographic never renowned for its stoicism. They are largely untouched by old industrial-revolution hazards, such as fractures and severed limbs, but suffer instead from often undiagnosable symptoms, such as wrist pain and tingling fingers.

Though journalists had been typing away on clunky, poorly designed typewriters for decades prior to the ’80s, the increased use of computers saw them discovering new discomforts like carpal tunnel syndrome (resulting from pressure on the median nerve within the wrist’s carpal tunnel). Though no scientific study has ever proved that keyboarding alone causes carpal tunnel syndrome, that hasn’t kept stories from proliferating over the last 15 years. Ergo, ergo-nuttiness knows no bounds. A phone-sex employee in Florida, for instance, recently won a worker’s compensation settlement claiming she contracted carpal tunnel syndrome from masturbating up to seven times a day while talking to clients.

With new maladies comes new consumer demand, which is why “ergonomic” is not so much a scientific term as a marketing one. Today, it is possible to purchase all things “ergonomic,” from violas to vibrators. A tortilla chip company has boasted of its chips’ “unique ergonomic shape” — indented for “easy thumb and forefinger grip.” A Notre Dame student designed an ergonomic electric chair, sparing convicts the distress of facing electrocution without proper lumbar support. With no regulatory oversight, manufacturers are on their honor when claiming their products are “ergonomically correct” — even if the science has not yet determined, for example, how much or even whether typing in a certain position causes injuries. Even a self-proclaimed ergonomically correct product like Microsoft’s wave-shaped keyboard may bear a warning that continuous use can cause repetitive stress injuries.

Ergo-hysteria, naturally, is great for ergonomists, who for decades have been relegated to science’s children’s table. Uncertified, they are largely drawn from the ranks of industrial hygienists, engineers, and psychologists. Even the Human Factors and Ergonomics Society, an association of more rigorous ergonomists, has a relatively low threshold for entry: five years experience and a bachelor’s degree in anything (only 6.5 percent of its members have a medical background). Nothing promises to be better for ergonomists than OSHA’s proposed regulations. Within days of its announcement, press releases were flying from altruistic ergonomists offering wares from the “Ergercise Video” to the “BioErgonomics and Stretch Station. TM”

Even without the proposed rule, OSHA has for years fined companies for ergonomics violations under the 1970 OSH Act’s general-duty clause, which obligates employers to provide hazard-free workplaces. Historically, OSHA has interpreted this seemingly benign clause as license to pounce on anyone for anything, often to comic effect. In 1992, OSHA tagged the American Brush Co. for permitting employees to operate a “heavy 1.8 lb. tape dispenser which places a great amount of torque on the hand and wrist.” Shaw’s Supermarket subjected its employees to “sustained shoulder adduction” and dangerous “static wrist extensions with the power grip.” Sounds pretty dangerous, until you learn the above activity involved squeezing icing from a bag to decorate a cake.

Sometimes OSHA safety inspectors double as feng shui consultants. They instructed an Ohio Kroger grocery store to “locate the cash drawer to the side of the cashier (opposite the bag stand) at a height of 32-36 inches from the floor.” And when Anamet Inc. of Illinois was ordered to provide wide “adjustable-height foot rests,” OSHA specified that employees’ feet were to perch “at an angle of twenty-five degrees from the horizontal.”

Most of the time, companies hold their nose and swallow their medicine, electing not to challenge OSHA in costly litigation (OSHA fines range up to $ 7,000 per small violation, $ 70,000 per serious violation). But as employment lawyer Eugene Scalia details in a forthcoming Cato Institute study, OSHA has suffered devastating losses in the only three ergonomics cases litigated to judgment. In the first two cases, OSHA couldn’t prove the injuries were caused by work. In the third, the judge had the testimony of the agency’s experts stricken as falling afoul of the Supreme Court’s junk-science test.

Such setbacks have only steeled OSHA’s nerve, while prompting industry critics, like National Coalition on Ergonomics counsel David Sarvadi, to call such agency enforcement measures “ramrod jobs.”

While OSHA is required to provide a comment period, allowing critics to register their objections, it has done so on an exceedingly fast track. Only in the face of protests from Congress and industry did it extend the 60-day period to 90 days, ending March 1. Even so, Sarvadi says it has been impossible to obtain in time from OSHA’s docket office all of the over 50,000 pages of exhibits needed to mount an adequate rebuttal.

The regulations and explanatory preamble are a hulking monstrosity. OSHA claims it’s an easy read, proudly asserting that in compliance with Al Gore’s Reinventing Government initiative, it’s all written in “plain language.” Fans of Gore’s “Global Information Infrastructure: Agenda for Cooperation” will recognize the accessible, crackling prose style.

OSHA never uses more than once a term it can turn into an acronym. Even such a plain-language-ism as “personal protective equipment” becomes “PPE.” Already on the second reference, “flexor pollicus longus” — whatever that is — is “FPL.” Between the acronyms unfolds an elaborate string of regulations that is not just daunting and burdensome but asinine.

Getting OSHA’s ergonomists to defend the particulars in a sustained Q&A is no easy feat. When I called one, he said, “I have to send you to the media gestapo. There’s always paranoia here, [but in light of OSHA’s recent PR fiasco over home offices] there’s even more now.” After I waited several days to be cleared for an in-person visit, which they initially indicated would be no problem, a flack finally responded: “I’ve been told we have to defer your request to another time.” Translation in plain-language format: “No.”

OSHA’s reticence is understandable. The only lines of work that draw exemptions under the sweeping rule are construction, maritime industries, and agriculture — and only because OSHA intends to impose individual ergonomics regulations on each at a later date. But the rule doesn’t actually come right out and say this. Instead, it claims just three groups are covered: manual handling jobs (grocery baggers, garbage collectors, etc.), manufacturing jobs, and “other jobs with MSDs” — that is, whose workers are susceptible to musculoskeletal disorders, a category that encompasses the whole of American industry.

In another ploy, OSHA leavens its intricate requirements with glimpses of how much worse they could’ve been. For instance, OSHA was considering requiring every employer to assess his operation to determine where “MSD hazards” were present. But in its beneficence, the agency will not require this assessment and will simply assume that hazards are lurking everywhere.

The proof that dire measures are needed, OSHA claims, is the recent proliferation of work-related MSDs — but this misleads on several counts. First, repeated-trauma injuries have actually declined 24 percent since 1994 and make up just 4 percent of workplace injuries and illnesses. The high-profile threat of carpal tunnel syndrome, which OSHA usually assumes is caused by typing, has been grossly inflated. The Bureau of Labor Statistics says a mere 0.6 percent of all reported injuries that required time away from work were due to use of keyboards. But OSHA lays it on thick, claiming the percentage of carpal tunnel cases that required more than 30 days away from work exceeded that of fractures and even amputations.

Second, as all parties admit (though OSHA does so only in passing in its sprawling document), science has not so far been able to isolate single predictors of musculoskeletal pain, which is subjectively experienced but not always observable. Pinning down causation is hard, and OSHA has selectively pulled findings to buttress its position. One of the studies OSHA touts loudest is a review of the literature conducted by the National Institute of Occupational Science and Health (NIOSH). But even some of the NIOSH study’s own peer reviewers noted it failed to take account of contradictory findings or back up with evidence its judgment that work caused the pain.

OSHA concedes that MSDs have multiple causes: everything from pre-existing medical conditions like diabetes to “psychosocial factors” (several studies show job dissatisfaction is often characteristic of people citing pain). But this doesn’t stop OSHA from using the term “work-related MSDs” as if it meant something more than pain an employee complains of while at work. Dr. Howard Sandler is an occupational medical expert associated with the industry-backed National Coalition on Ergonomics. But over the years, he did more than $ 1 million in contract work for OSHA.

Sandler, who regularly consults on MSD cases, says a sweeping regulation triggered by employee complaints is a recipe for disaster: “Maybe what the employee wants is a new desk. Maybe they just want attention. And maybe, if the carpal tunnel syndrome is from obesity, and you have a 280 lb, 5′ 1″ typist, until she loses 100 pounds, guess what ain’t going away — her carpal tunnel syndrome.” Sandler himself has bilateral carpal tunnel syndrome. “But I have mine from gout,” he says. “As long as I don’t drink, I don’t have problems. So every Friday and Saturday night, I have a little wrist pain.”

OSHA has no time for such considerations. It is too busy fashioning lists. For instance, when an employee complains of an MSD, his employer, instead of implementing a full ergonomics program, can opt for a “Quick Fix.” Here is the Quick Fix list:

a. Make available to the employee OSHA’s MSD management standard.

b. Work with the employee to eliminate the hazard within 90 days (e.g., if the employee is experiencing a typing-related MSD, try a voice-activated computer).

c. Put these Quick Fix measures in place within 90 days of identifying the problem, then check in 30 days to make sure they’re working. (OSHA says the best way to do this is to “ask the employee,” but notes that employers will have “materially reduced” hazards if they implement controls that a “reasonable person” would assume reduce the likelihood of injury. Lacking expertise, OSHA does not define a “reasonable person.”)

d. Keep a record of the Quick Fix measures.

e. Implement a full ergonomics program if the Quick Fix fails or another MSD of the same type occurs in the same job within three years.

Naturally, each of the five points has subpoints, and those often have offspring. For example, making available OSHA’s management standard sounds simple. It’s not. It involves: providing a prompt response to an injured employee, providing him a free health-care professional (HCP) for diagnosis and treatment, providing the HCP information about the job, the perceived MSD hazards, and the ergonomics standard, and obtaining a written opinion from the HCP on how to manage the employee’s recovery. While calling in an HCP is generally considered optional, following his advice is not: Once an HCP has recommended putting an employee on work restriction protection (WRP), the employer has only to obey.

On the other hand, if the HCP concludes the employee likely injured his back playing 36 holes of golf last Saturday, the HCP is not allowed to tell the employer. In fact, to keep things simple for employers, OSHA helpfully assumes that all injuries are work-related. If the HCP suggests WRP, the employee is put on light duty at full pay. If, however, the employee must cease work altogether, the employee is entitled to a six-month vacation at 90 percent of pay and 100 percent of benefits, unless he’s ready to return before then and the hazard has been fixed.

OSHA concedes much of this might be unnecessary if an employer already has an effective ergonomics program in place. OSHA merely insists that the program meet all the agency’s basic obligations and record-keeping requirements, as well as eliminate or “materially reduce” all MSD hazards. This is another bit of regulatory sleight-of-hand — call it the Do Exactly What We Say And You’re Okay Grandfather Clause (DEWWSAYOGC).

If, God help you, your Quick Fix program doesn’t work, you will of course be required to implement the full ergonomics program, the one that takes hundreds of pages to explain. To get just a taste of the complexities, pick one of its provisions at random — say, the training section. You might think training would be easy: Call a staff meeting, slap on a video, break for lunch. You would be wrong. Not only does OSHA suggest that training include a Q&A, but non-English speakers must be trained in their mother tongues, and English speakers must be trained at their various levels of comprehension.

If an employee can’t read, the employer is obligated to “provide information orally or through visual displays or graphics,” OSHA says. And those graphics, says OSHA, sounding like a schoolmarm instructing her class on a craft project, should not be “stale” or “invisible.” They must be “visually appealing,” and the employer must convey them in “plain language” — as OSHA itself is so fond of doing.

Near the end of the ergonomics rule, readers who haven’t dozed off or quit in frustration will find a table setting forth OSHA’s cost estimates. It shows, industry-by-industry, what percentage of profits affected firms will lose to compliance costs. Assuming a “worst-case scenario” (when companies can’t pass the cost on to consumers), makers of bakery products can say goodbye to 19.08 percent of their annual profits. Grocery stores will lose 35.7 percent of their annual profits. Department stores will hemorrhage 41.53 percent of their annual profits. And, under this worst-case scenario, according to OSHA’s own numbers, makers of mens’ and boys’ clothing can kiss off 161.69 percent of their profits — meaning they will need to find second jobs to pay for compliance at their first ones.

OSHA concludes “that the proposed standard is economically feasible” because, well, it doesn’t really say — you’ll have to trust the agency here. Of course, if OSHA’s ergonomics proposal stands, the agency will likely have to set up its own Quick Fix program for all its lawyers, at risk of carpal tunnel syndrome from banging out trial briefs in the avalanche of litigation that will inevitably ensue. By contrast, private industry will have an attractive alternative: Ignore OSHA altogether and continue doing business as usual — from Mexico.

Matt Labash is a staff writer at THE WEEKLY STANDARD.