ELIZABETH BRACKETT: Neurologist Michael Monika is making an office call, one which he hopes will cut down on his future patient load. Dr. Monika is an ergonomic consultant and neurologist.
DR. MICHAEL MINIEKA, Ergonomics Consultant: Is there a problem?
WORKER: I'm sitting at a different desk.
ELIZABETH BRACKETT: He started his consulting business in ergonomics, the science of fitting the worker to the job, after seeing hundreds of patients come to him with work related repetitive stress injuries.
DR. MICHAEL MINIEKA: Why don't we start with the chair, okay, because it doesn't look like, does it? You're not getting the support you need in the small of your back.
ELIZABETH BRACKETT: Dr. Monika was hired by the American Library Association after several employees developed the most common repetitive stress disorder, carpal tunnel syndrome, a painful inflammation of the joints in elbow and wrist.
DR. MICHAEL MINIEKA: Some companies are doing a very good job thinking about their employees, they want them to be safe and comfortable at work. So some employees, some companies are doing a great job, those are the companies I know. The companies that aren't doing a great job are the ones whose employees come into my office.
ELIZABETH BRACKETT: More and more workers are coming into doctors' offices suffering from work related injuries linked to over exertion and repetitive motion. According to the U.S. Department of Labor's Occupational Safety & Health Administration, or OSHA, nearly two million workers a year experience what the agency calls musculoskeletal disorders, or MSD's.. Sue Rosenthal Matthews experienced a debilitating MSD, carpal tunnel syndrome. Her joints were so inflamed and swollen after repetitive computer use, she was out of work for a year.
SUE ROSENTHAL MATTHEWS: I would wake up and have pain starting first in my wrist, my fingers would swell up, and then would it go up my elbow, coming up my neck and down the back of any neck and back.
ELIZABETH BRACKETT: Rosenthal Matthews' employer, Northwestern Memorial Hospital, agreed to make ergonomic changes for their employees. Ergonomic chairs, computer desks with proper support, key boards that pulled out.
SUE ROSENTHAL MATTHEWS: I was very fortunate that my job listened. But I'm concerned about people who, their jobs don't listen.
ELIZABETH BRACKETT: OSHA is now proposing ergonomic standards which would affect all workers, except those who are self employed or in the agricultural maritime and construction industries. OSHA administrator, Charles Jeffress, toured this fly wheel manufacturing plant near Chicago to promote the new standards.
CHARLES JEFFRESS: I think the solutions to the types of material handling issues that have caused ergonomic problems are becoming increasingly known and better known. We've been looking at issues of ergonomics for 20 years. It's time, I believe, to take these good solutions that are available and have everyone put them in place.
ELIZABETH BRACKETT: 27 million workers would be covered under the proposed standards. 1.9 million employers would be required to set up an ergonomics program, which would include assigning someone to be responsible for ergonomics, providing employees with information about ergonomic hazards, and setting up a system to report ergonomic injuries. Once an ergonomic problem is identified, employers are subject to fines of up to $70,000 if they don't make the necessary changes in equipment or personnel. Jeffress chose to visit the DACO Company because of steps the company has already taken to prevent ergonomic injuries.
CHARLES JEFFRESS: How heavy is this?
SPOKESMAN: That's about 85 pounds or so. So, you could pick it up by hand, but you wouldn't want to all day long.
ELIZABETH BRACKETT: Company President Ken Lindgren says the ergonomic changes were made for several reasons.
KEN LINDGREN: It's really two steps. One is we want to guarantee our employees, as much as we can, that they will arrive home at night in the same condition that they left in the morning. Two, we want to guarantee our customer an uninterrupted supply of material.
ELIZABETH BRACKETT: But not all employers are pleased with the proposed standards. Managers at this bottle cap manufacturing plant are very proud of their safety record. To be required to do more, they say, would be both expensive and redundant. Company President Albert Miller also represents other employers as vice chairman of the Illinois Manufacturers Association.
ALBERT MILLER: I think we're already being legislated enough. I think this issue has been covered under Workmen's Compensation, and I think American industry's track record in the last ten years of creating a safer work environment is outstanding.
ELIZABETH BRACKETT: What riles many employers is the provision in the standard that would require them to pay 90% of the salaries of employees who are given time off for ergonomic injuries.
ALBERT MILLER: Paying employees at the 90% level to be on leave under this OSHA act versus 60% of Workman's Comp, really gives no incentive for an employee to get back to work.
ELIZABETH BRACKETT: But Jeffress says employees need an incentive to report their injuries.
CHARLES JEFRESS: We believe it's important to reassure employees if you get hurt, report it, you won't be penalized, and moreover, that report will stimulate a fix to your job.
ELIZABETH BRACKETT: OSHA projects the cost to industry of the proposed guideline at $4 billion. The return, they say, would be 9 billion dollars in benefits, largely as a result of increased productivity from healthy workers. But industry disputes the numbers, labeling the proposed guidelines the costliest regulations in OSHA history.
ALBERT MILLER: The Employment Policy Foundation of Washington estimates that the cost for industries could be between 60 and $99 billion and the benefits somewhere more in the neighborhood of 6 billion.
ELIZABETH BRACKETT: OSHA has been talking about ergonomics for 20 years. Two previous attempts to develop rules were scuttled by Congress. This time there have been 190 days for public comment and nine weeks of public hearings, like this one in Chicago.
SPOKESMAN: Reasons for ergonomic program, it reduces injuries, reduces costs...
ELIZABETH BRACKETT: Those for and against the regulations agreed that the unusually lengthy hearings were necessary given the impact the proposals would have. Industry lawyer Baruch Fellner challenged University of Michigan Professor Dr. Donald Chaffin, known as the father of ergonomics, as to whether there was enough scientific evidence defining musculoskeletal disorders - or MSD's -- to warrant the costly regulations.
BARUCH FELLNER: Do you believe the science is sufficiently clear to allow enforcement personnel of OSHA to issue penalties for a failure to comply with this standard as drafted?
DONALD CHAFFI: It would appear to me that a person who would be enforcing such a standard will have to have sufficient ergonomics knowledge. They are going to have to be trained on how to interpret the science and use the science as it is today.
ELIZABETH BRACKETT: But Fellner insists that employers can't know whether their employees' strained wrist or back pain occurred on the job or a weekend football game. MSD's, he claims, do not exist as medical injuries.
BARUCH FELLNER: They do not exist as injuries and illnesses, because they do not present as x ray findings, they do not presently as MRI findings, they do not present as CAT scan findings. They are not your tumor, they are not your fracture. They are the indeterminate ache and pain that one has that you cannot find the source of, whether it's low back pain or otherwise. And under those circumstances, my definition of injury and illness is or ought to be the doctor's definition of injury or illness, and that is - to borrow a phrase from an old movie -- show me the money. Show me the x ray, show me the CAT scan, show me the MRI. And you can't when it comes to the vast array of MSD disorders.
ELIZABETH BRACKETT: Jeffress says employers' fears are understandable but overstated.
CHARLES JEFFRESS: The biggest resistance is a fear of change, it's not unlike resistance to other things. When people have never done a fix before, they're afraid it's going to cost too much, they're afraid they're not smart enough to do it; they're afraid people are going to take advantage of them. Once people start putting fixes in place and realize the savings to themselves as well as what is better for employees, people say, well, we should have been doing this all along.
ELIZABETH BRACKETT: It could be several years before employers are faced with the need to comply. The final rules are on track to be finished this year -- but will be phased in over the next three years. And expected court challenges could delay the implementation even further.
JIM LEHRER: And last week the House of Representatives voted to block OSHA from implementing its ergonomic rules.