OSHA posted the guidelines today at www.osha.gov/ergonomics (select "guidelines").
"These guidelines are the result of an extensive and cooperative process involving a wide-ranging, inclusive review of both scientific information and existing ergonomic practices and programs in the nursing home," said OSHA Administrator John Henshaw. "We also conducted one-on-one meetings with major stakeholder groups to gather information on best practices that have been successfully used in the nursing home industry to ensure we are recommending practical solutions that will work in the real world."
The agency notes that despite the efforts of nursing home employers and employees in recent years, "workers in nursing homes are more than twice as likely as other workers to be injured on the job." According to the Bureau of Labor Statistics, employees in nursing and personal care facilities suffer over 200,000 work-related injuries and illnesses a year. "Many of these are serious injuries - more than half require time away from work," notes OSHA. "Workers''compensation costs for the industry now amount to nearly $1 billion per year."
OSHA notes the ergonomic stressors that workers in nursing homes face include:
- Force - the amount of physical effort required to perform a task (such as heavy lifting) or to maintain control of equipment or tools;
- Repetition - performing the same motion or series of motions continually or frequently;
- Awkward postures - assuming positions that place stress on the body, such as reaching above shoulder height, kneeling, squatting, leaning over a bed, or twisting the torso while lifting;
- Vibration - rapid oscillation of the body or part of the body, often caused by use of powered hand tools or equipment; and
- Contact stress - pressing the body or part of the body against a hard or sharp edge, such as using the hand as a hammer.
The guidelines are in three parts, with a reference list at the end:
- Management Practices - Discusses the importance of management commitment and employee participation in ergonomics training, occupational health management of musculoskeletal disorders and ergonomics program evaluation.
- Worksite Analysis - Discusses assessment of resident handling tasks and activities other than resident handling.
- Control Methods - Contains illustrations that demonstrate various methods to control common ergonomic stressors.
The guidelines are intended to provide practical solutions for reducing ergonomic-related injuries and illnesses in nursing homes. They will not be used for enforcement purposes. Draft guidelines are being developed for other industries and will be made available for comment when they are completed.
The guidelines include information about nursing homes that instituted successful ergonomics programs, such as Wyandot County Nursing Home in Upper Sandusky, Ohio. The facility reported staff members suffered back injuries, including a single injury that resulted in workers' compensation costs of $240,000. To combat the problem, the facility acquired 18 ceiling lifts, as well as portable total lifts, sit-to-stand lifts, a lift walker and 58 electrically adjustable beds at a cost of approximately $150,000.
Since Wyandot implemented a policy of performing all assisted resident transfers with mechanical lifts or gait belts, back injuries from resident lifting have been eliminated. Increased efficiency has allowed staff members to spend more time with residents, and caregivers' attitudes and energy levels have reportedly improved. In addition, residents no longer complain of shoulder pain and bruises that had previously been associated with manual resident handling.
Anyone interested in commenting on the guidelines must submit written comments by Sept. 30. Individuals are required to submit their intent to participate in a one-day stakeholder meeting by Sept. 19.
The meeting will be held in the Washington, D.C. area; location and date will be announced following the comment period. Written comments (10 pages or fewer) and intent to participate can be faxed to OSHA's Docket Office at (202) 693-1648 or sent electronically to ecomments.osha.gov. Three copies of written comments and attachments, or one copy of intent to participate, must be submitted to the OSHA Docket Office, Docket No. GE2002-1, Room N-2625, U.S. Department of Labor, 200 Constitution Ave. NW, Washington, D.C. 20210. Individuals who wish to comment who do not have Internet access can request a printed copy of the guidelines by calling OSHA toll-free at 1-800-321-OSHA.