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Barbara Silverstein : WMSDs : Knowledge, practice, policy


Barbara Silverstein

SHARP, Washington State Dept of Labor & Industries

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SHARP, Washington State Dept of Labor & Industries, USA

Aims :

To provide SHARP examples of how research influences workplace practices and public policies. Examples include
1) Washington State (WA)(TIRES) project,
2) WA Ergonomics Regulation,
3) WA SPH legislation,
4) impact of WA OSHA on WC claims rates.
5) Precarious employment requires more attention.

Methods :
We use state WC and OSHA data to prioritize prevention efforts.Seven types of injuries represent 90% of all WC state fund claims, lost workdays and costs (Figure 1).


Figure 1. Washington State Fund Upper Extremity WMSDs Compensable WC Claims Rates by Industry Sector

We use a prevention index (PI) to prioritize activities, averaging incidence rate and count rank order. WMSDs are more than 50% of all claims, costs and time loss days. General and Specialty Freight trucking were in the top 5 industries by PI in all but falls from elevation.

Results :
1) SHARP TIRES project (http://www.keeptruckingsafe.org) works with trucking companies to develop prevention strategies.
2) Ergonomics regulation. SHARP reports (1998) on
-* 1) magnitude and distribution of WMSDs by industry,
-* 2) results of a 5,000+ employers survey on workplace WMSD risk factors and ergonomics activities, were key for ergonomics rulemaking, enacted in 2002 and repealed in 2003. Subsequent decline in ergonomics activities cost $180 million per year.
3) Safe Patient Handling (SPH). SHARP is evaluating implementation of Safe Patient Handling legislation [2006ESH1672] for acute care hospitals by comparing hospitals in Washington (legislation) and Idaho (no legislation) at 3 points in tiime (2007, 2009, and after full implementation (2011) of the SPH legislation. The 2009 assessment indicates Washington hospital staff have increased awareness of WMSD hazards and preventive measures, implemented SPH committees, equipment and training to a significantly greater degree than Idaho hospitals.
4) Consultation and Enforcement. SHARP assesses the impact of State OSHA enforcement and consultation activities on workers compensation claims injury rates by employer size and industry. In five of the last 8 years, statistically significant reductions in WC claims rates were seen with enforcement but not consultation in fixed worksites. Closer examination of targeting strategies is underway. The fact that there are no WMSD regulations to enforce may have some impact on these findings and future strategies.
5) Precarious Employment. The conmtingent workforce is growing. These workers tend to be the most vulnerable with the least protection. We need to better understand the magnitude of the risk of WMSDs and ways to address them in this population. This will require research, practice, regulation, and evaluation.

Keywords : Surveillance, Public policy

References :
IFoley M, Silverstein B, Pollisar NL, Neradilek, B (2008). Impact of implementing the Washington state ergonomics rule on employer reported risk factors and hazard reduction activity. AJIM 52(1):1-16.
Washington State Legislation 2006-ESH1672
Smith C, Silverstein B, Bonauto D, Fan J (2009). Temporary workers in Washington State 2009 AJIM 2009 Jul 17. [Epub ahead of print.


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