From The Ergoweb® Learning Center

Readers Respond: Statistics, Health Care, Worker’s Comp and Workplace Control

Government Counts More Accurate Than Reported

Dear Editor:

I must disagree with the March 10, 2004 article [“Government Statistics Not Giving Accurate Injury Counts” Ergonomics Today. March 10, 2004] that employees in federal, state and local government agencies are being omitted.

The article states or at least implies that federal, state and local government employees are not counted in the Bureau of Labor Statistics (BLS) Annual Survey of Occupational Illnesses and Injuries. It also states that the survey “fails to even include police and firefighters.”

The County of Solano County, California was included in this survey that I completed both in 2003 and 2002. As part of this survey, injuries for local police (deputy sheriffs and correctional officers) were requested and submitted.

Doug Donnahoo
Risk Analyst


Government Statistics Particularly Skewed Against Health Care

Dear Editor:

Thank you for Jeanie Croasmun’s article of 3-10-04 [“Government Statistics Not Giving Accurate Injury Counts” Ergonomics Today. March 10, 2004]. Some related comments specific to healthcare workers…

In addition to healthcare worker injury being under-reported at an estimated 50 percent, the manner in which data on reported injuries is presented obscures the incidence and severity of injuries to U.S. healthcare workers.

For example, in April 2002, the U.S. Bureau of Labor Statistics provided the “Number and Median Days of Nonfatal Occupational Injuries and Illnesses with Days away from Work Involving Musculoskeletal Disorders by Selected Occupations, 2000.” Of 129 occupations, truck drivers were ranked first with 45,327 MSDs; categories of healthcare workers were ranked individually, listing CNAs second with 44,660 MSDs, RNs sixth with 12,074 MSDs, and LPNs eighteenth with 5,598 MSDs. However, all types of healthcare workers who provide direct patient care generally suffer the same types of injuries from performing the same activities – primarily low back injuries from lifting patients. The total combined number of MSDs to healthcare workers is 62,332 MSDs, placing healthcare workers 138% above “first place”! Ranking categories of healthcare workers individually greatly minimizes the incidence of injuries related to manual patient lifting.

Additionally, the footnote states that the table reflects sprains, strains, tears, etc. (soft tissue injuries) and that “herniated spinal discs are not included.” Research shows that 70% of nurse back injuries are to the lumbar spine with 57% to intervertebral discs. [Langford, Elizabeth, RN “Buried But Not Dead: A survey of occupational illness and injury incurred by nurses in the Victorian health service industry” Injured Nurses’ Support Group, Australian Nursing Federation Victorian Branch. 1997.] While soft tissue injury may be expected to heal within days or weeks, the impact of spinal injury often extends for many months, years, or a lifetime, often leading to surgery, disability, and loss of nursing career. Thus, the extremely serious spinal injuries, which may account for the majority of nurse injuries, are not reflected by available data.

Another difficulty is that time loss data may not capture the extended time periods away from work required by spinal injuries. Healthcare workers may be off for months or years or may never return either due to the severity of their injuries or to employers who terminate injured nursing staff if unable to lift patients. The number of nurses “leaving” (often forced out) due to work-related MSDs is not easily discerned from available data.

Since research has shown since 1991 that use of safe mechanical lift equipment, by either nursing staff or trained lift teams, could prevent most back injury to nurses, it seems that losing thousands of nurses to preventable injuries would be intently scrutinized. Yet, the unnecessary disabling of nurses by requiring hazardous manual lifting goes largely ignored and unchallenged.

With nursing being 95 percent female, it is my opinion that disabling and discarding nurses is gender-related exploitation which no male-dominated profession would tolerate. Where is the outrage? Why doesn’t the data show what is actually happening to nurses? With only the “tip of the iceberg” visible, perhaps exposing the true extent of the problem would be an embarrassment or might dissuade young people from entering nursing.

Anne Hudson, RN, BSN


Over-simplifying Worker’s Compensation?

Dear Editor:

Please be careful in that you do not “OVER SIMPLIFY” the issues surrounding proposed Workers Compensation Reform in California. Your two paragraphs in the February issue [of The Ergonomics Report] (which decidedly seem pro non-reform) serves no benefit to resolving the problem and smells of being written by, or at the least excerpted from, California Plaintiffs Attorneys Association, Chiropractors Association, Physical Therapists Association, Workers Compensation Physician Mills, and Labor Associations.

The Workers Compensation system within California is seriously flawed and the only two parties suffering from it are the injured employee and employers, while all of the above are PROFITING!

You entitled your article “California Workers Compensation Proposal Scrutinized” — where did you scrutinize it? All you have done is inflame the issue with one-sided rhetoric of the critics only!

Do not turn a good thing, your newsletter, into a political soapbox without giving fair and reasonable coverage to all sides of the issues, or I for one will go elsewhere. A fact, I am certain, that will have no impact upon your financial success, or your sleep at night, but at least I will have peace of mind knowing that I have not given up my soul to those who reap unacceptable profits while those whom are injured suffer.

Thank you for taking the time to at least read this.

Rod Gonzalez
Safety Manager


Editor’s note: Ergoweb’s goal is to always provide unbiased and thorough reporting on ergonomics, and the California worker’s compensation situation is no exception. However, due to the complexity of not only the California debate but also worker’s compensation debates taking place throughout the country, summarizing the information in a few short paragraphs doesn’t always equate to sufficient coverage. Therefore, Ergoweb will feature an in-depth look at proposed worker’s compensation legislation and system changes that could affect both employees and employers throughout the U.S. in the April, 2004 issue of The Ergonomics Report.


Defining Control Through Job Completion

Dear Editor:

Valerie Rice [“Who Defines Control?” Ergonomics Today. Sept 15, 2003] makes important qualifications to my comments about control [“A Workable Definition of Control For the Workplace.” Ergonomics Today. July 2, 2003].

I said finishing is good for you; she gave an example of people who finish but are still stressed.

I explain it more fully in the reference [“Ergonomics In a Subjective World.” Ergonomics Australia. Sept 2002], but here’s a summary.

Relaxation is the natural reward for finishing — I think it’s wired into the brain. So if we don’t finish, it’s hard to relax. But finishing alone doesn’t get us across the line, as Valerie’s example shows; whether due to our own inclination, or imposed by the structure or timing of the job, we can be robbed of the prize by rushing from one task to the next.

It’s a very similar problem to that which we find with micropauses; some people relax their muscles during a micropause, others don’t, and this seems to predict the development of pain some years down the track. And some jobs just don’t provide the possibility of micropauses.

So perhaps it’s management’s job to provide jobs that can be finished, the individual’s job to take advantage of the opportunities provided, and the counselor’s or ergonomist’s job to help the two come together if it’s just not working out?

David Brown