Ergonomics In the News

 

e-Office Safety ergonomist Emil Reisser-Weston appears as part of an ergonomics awareness campaign - Monitor Victims in conjunction with ViewSonic. Workstation ergonomic assessment is demonstrated.

 

Everything about RSI

RSI symptoms include pain, clumsiness and pins and needles. Moving the affected joint or lightly brushing the overlying skin causes pain. RSI sufferers may have a lower threshold for vibration along the median nerve so are more sensitive to repeated movements such as using a keyboard, playing a musical instrument or operating a checkout till. RSI pain is more diffuse than carpal tunnel syndrome and injections won't help. To prevent further pain, you should check your posture at work, take regular breaks (you're legally entitled to 20 minutes every six hours) and do hand exercises recommended by the RSI Association. Treatment remains tricky; specific pain-relieving drugs are being developed but general painkillers like paracetamol don't help. Most people improve once they stop the repetitive task. Help and information from the RSI Association: 0800 018 5012.

Dear Doctor. The Guardian 

How injuries occur

To function properly, the body needs a steady supply of blood. Cutting off or slowing the blood supply harms the tissues of the body. Tense muscles squeeze off their own flow of energy and fuel.

Muscles can get energy without oxygen, but not without pain. The process produces lactic acid, a potent pain-causing chemical. As pain develops, muscles tighten further to "guard" the surrounding area. Nerves deprived of blood and squeezed by muscles begin to tingle or go numb.

The rise in computer use has caused the number of RSI cases to skyrocket in recent years. A number of books have been written on the subject and many people have started Internet campaigns to make workers more aware of the dangers.

Ms Gregory said: "RSI will be the industrial disease of the 21st century if employers ignore the well-being of staff. Employers need to start taking RSI seriously."

Bank workers win test case action on RSI

An appeal court ruling on repetitive strain injury yesterday landed HSBC, the former Midland Bank, with a bill for damages and costs of around £750,000 and was hailed by campaigners as a breakthrough for sufferers from the industrial injury.

The bank lost its appeal to overturn a £60,000 compensation award made last year to five former keyboard operators at the bank's Frimley processing centre in Surrey, who had all developed disabling pain in their arms, necks and shoulders after their work rate was increased.

Lord Justice Stuart-Smith dismissed HSBC's claims that the symptoms suffered by the "Frimley five", all part-time women workers, were psychosomatic.

The five - Angela Osler, Jane Alexander, Margaret Rolfe, Beverly Mulholland and Rachel Lancaster, aged between 33 and 50 - were awarded £7,000 compensation each, plus up to £5,800 for loss of individual earnings.

Healther Tilston of the finance union Unifi, which backed the test case action, said the outcome was "great news for all RSI sufferers." The judgment will boost the campaign by Unifi and the Chartered Society of Physiotherapy for "diffuse RSI" to be recognised as an industrial injury.

Last year, a high court judge insisted there was no medical evidence that RSI existed after throwing out a claim for damages by four journalists against the Financial Times. Four years earlier, another high court judge claimed the term was "meaningless".

To mark last week's RSI awareness day, the TUC called on the Court of Appeal to raise compensation levels for sufferers of the debilitating "typist's injury". Last year the Law Commission proposed that current payouts of between £2,000 and £7,000 for people who have suffered repetitive strain injury as a result of their jobs should be increased by 50-100%. "Our main objective will always be prevention," said TUC general secretary John Monks. "But if the worst happens, the courts should give sufferers more realistic compensation."

Seumas Milne, Labour Editor,

Can I claim for RSI pain?

My sister believes she may be suffering from repetitive strain injury (RSI) caused by her work inputting computer information from application forms. Could she bring a claim against her employers and win compensation? Many employers neglect the duty of all businesses to provide a safe working environment for their employees by breaking Health & Safety guidelines on assessing the risks staff face and making modifications as a result. So an employee who feels she is suffering from RSI could well have the starting point of a claim, arguing that she has suffered ill health as a consequence of her employer's negligence. But the damages awards are not very high, and it can be a lengthy process.
Some unions are taking the RSI issue very seriously and winning damages for members. Your sister would be best off going through a union. Any case involving medical evidence can be very costly.
According to the Trades Union Congress, the typical compensation payment ordered by the courts is between £2,000 and £7,000 for the pain and suffering of the victim. In the recent case of the Midland Bank's Frimley cheque processing centre in Surrey, several RSI sufferers won claims averaging £7,000.
The TUC is urging a doubling in financial value for this kind of compensation payment. It estimates that 200,000 people a year suffer symptoms of RSI.

Neasa MacErlean,

RSI test case starts

A major test case in which part-time bank workers are claiming compensation for Repetitive Strain Injury has begun in Britain.
The Banking Insurance and Finance Union is taking the case on behalf of five former part-time employees of Midland Bank's processing centre in Frimley, Surrey.

The five were employed inputting cheques and other information onto computers and worked to strict deadlines.

Outside court, Bifu negotiating officer Linda Gregory said: "The women have suffered RSI as a result of thousands and thousands of very small repetitive movements encoding information from cheques.

"The symptoms show themselves as pain in the hands, wrists, all up the arms, shoulders, elbows and across the back of the neck."

Repetitive Strain Injury, or RSI, refers to a spectrum of diseases, from tendonitis of the hand or wrist to carpal tunnel syndrome.

The injuries come from repeated physical movements, such as typing or using a computer mouse, that cause damage to tendons, nerves, muscles and other soft body tissues.

The US government yesterday ordered businesses to protect their employees from repetitive strain injury (RSI), in a move which could have wide implications for workplaces across the world.

Many employers have long denied that the use of computers and other modern workplace tools could cause musculo-skeletal disorders (MSD), despite the fact that the incidence of such injuries has skyrocketed in the last few decades.

But the Clinton administration's introduction of strict new standards to deal with the RSI and back injuries associated with modern offices is certain to encourage trade unions and lobby groups around the world to press the issue.

The US government initiative - one of the first of its kind in the world - has been fiercely opposed by business groups and the Republican party.

Under the new code proposed by the government's occupational safety and health administration (OSHA), all US companies whose workers do production line jobs or whose work involves manual lifting will be automatically required to provide ergonomic programmes to protect their workers.

Injuries covered also include back strains caused by bad posture or repetitive lifting, hernias, muscle injuries of the kind caused by incessant typing, and other ailments caused by work demands.

The code's real impact comes in the requirement that any business in which a single employee can be shown to have suffered a documented work-related musculo-skeletal disorder must also introduce ergonomic protection for all of its workforce.

Officials said yesterday that this means that virtually every US company - except those engaged in construction, agriculture and maritime work, which are specifically excluded - will be affected.

"Work-related musculo-skeletal disorders such as back injuries and carpal tunnel syndrome are the most prevalent, most expensive and most preventable workplace injuries in the country," the US labour secretary, Alexis Herman, said at the announcement of the new standards in Washington. "Real people are suffering real injuries that can disable their bodies and destroy their lives. The good news is that real solutions are available."

"We are compelled to act. Employees are getting hurt. Workers are being sent home. People are suffering," the OSHA administrator Charles Jeffress told a news conference.

"Our bottom line is this. When more than 600,000 American workers have to take time off to recover from MSDs, and over a million more experience less serious MSD problems at work, we know we have a national problem."

American employers gave notice that they will fight the new code, which they say is unnecessary and expensive.

"We'll use the force of our membership to hold OSHA's feet to the fire to have the science before they regulate," the employment policy director of the National Association of Manufacturers, Jennifer Krese, said.

Mr Jeffress countered that the code was flexible and simple and that employers who had already addressed the issue of musculo-skeletal disorders would be "in good shape to meet their requirements".

A key item in the new code is a protection to encourage workers to report their stress injuries early enough.

"All too often we have found that employees are reluctant to report their injuries because they fear they will lose their jobs or be put in lower paying positions," Mr Jeffress said.

To help prevent the problem, workers transferred to lighter work will retain full pay and benefits, while workers who have to leave their jobs to recover from such injuries will have rights to retain 90% of their pay and 100% of their benefits while they do so.

Scientists trace RSI nerve centre, Tim Radford Science Editor
 

London scientists believe they have discovered what goes wrong in that mysterious but growing affliction called repetitive strain injury (RSI).

They report in the Lancet today that they used scanning devices to map the way a key nerve moves when healthy people flex their fingers and found that it moves a great deal less for those musicians, keyboard operators and assembly line workers who complain of chronic pain in the hand, wrist or forearm.

"It would be very helpful for your nerve if it could move out of the way when you are moving your fingers, and your wrist, and that doesn't seem to happen in these patients with RSI," said Jane Greening, a physiotherapist at University College London. "The nerve appears to be stuck, which means that when people do those sorts of movements, the nerve could be compressed and irritated."

The median nerve runs down the forearm to the fingers though an arch of bone called the carpal tunnel: so do the tendons needed to grip and flex the fingers. The nerve is sheathed in a slippery substance which helps it move out of the way as the tendons move. When it does not move, the research implies, the trouble begins.

The next step will be to compare the "non-specific" RSI sufferers with patients with carpal tunnel syndrome, a more easily diagnosed condition involving measurable damage to the median nerve. But the report will anyway be a relief to thousands who have been told that RSI does not exist, or is an imaginary affliction, and to thousands more who have not yet complained on sore wrists or pins and needles in the fingers. Bruce Lynn of UCL thinks the condition is increasingly common.

"We have done small surveys in which maybe as many as half the people regularly get pain. Then it goes away. For a small proportion of those people, the pain becomes a permanent feature of their life, and in about 1% it is so serious they end up seeking medical help and or having to stop work," he said.

"People are not paying attention to the advice they are getting from health and safety people about taking breaks, about taking care to arrange their work station and sit properly," he added.

Fifteen hundred small business managers are about to find themselves at the head of a campaign to drag British staff-care into line with the rest of the world. This month, they will be the first of 100,000 companies to be questioned about their ability to bring long-term sick or injured staff back into work. And it is generally expected that they will have no imaginative answers. People in the UK who struggle with long-term sickness are often as good as discarded, because the mechanisms for helping them back to work are patchy. Three thousand workers every week move from long-term sick leave to incapacity benefit (effectively saying they are unfit to work), and 90% will not return to their jobs.

It's a huge drain on the country's working population - 750,000 experienced workers are already excluded from the job market. The great irony about long-term sick leave is that the three major causes of early retirement - RSI, back pain and stress - are the ones most likely to respond to well-planned rehabilitation programmes. It's just a matter of showing the will to get them back to work.

Now the government is finally recognising that with a little effort the skills and experience of sick workers can continue to be used. Government minister Margaret Hodge will shortly introduce four pilot projects that she hopes will bring 21,000 long-term sick back to the workforce. Their absence from work, she acknowledges, is "a needless waste of skills and experience".

But the TUC believes this does not go far enough. It plans to use its millennium congress in September to call on the government to introduce a statutory duty on employers to help long-term sick staff back to work.

Many of those who leave every year because of long-term illness are women: 10m of them suffer from back pain, 80% of whom have struggled with the condition for more than a year. For too many workers, long-term pain can prompt them to take early retirement, with little support from their bosses. But these staff would be protected, the TUC believes, if employers had a rehabilitation policy, backed by support workers in every NHS region, which would allow them to spot an employee's sickness turning long-term, and put early plans in place for support and recovery.

"Rehabilitation", in the TUC's view, means any method by which people disabled by sickness or injury can be returned to work - through medical treatment, retraining, or by adapting the work environment or working patterns.

Britain has been demonstrably behind the rest of the world in understanding this. In Sweden, a worker disabled by sickness or injury has a 50-50 chance of getting back to work - here, it's 10 to one against.

"In some countries, occupational rehabilitation is work-directed from a very early stage," says Trish Thornton, senior research fellow in social policy at the University of York. Many European employers are obliged to put rehab plans into effect as soon as an employee's illness looks like being long-term - the Swedish have to do it after eight weeks, the Dutch after 12. And once that plan is in place, the worker is protected: a Swedish employee cannot be dismissed while receiving national insurance sickness benefit, and in Germany a disabled worker returning under rehabilitation cannot be dismissed without permission from the authorities. The Americans with Disabilities Act gives similar protection in the US; in Australia, a case-manager "buddy" is appointed, whose first loyalty is to the returning worker, not the employer.

Although it costs an employer to keep a disabled employee's job open, Thornton has discovered several imaginative solutions. The French have devised a subsidy which reimburses supportive employers using money collected from levies on firms that have not met their quota of disabled staff. In New Zealand, the accident compensation corporation supports the wages of the returning person. The disability services in Bavaria are thinking of paying the wages of the "buddies".

By contrast, British rehabilitation schemes can founder because it is not possible to claim sickness benefit and work at the same time. But armed with evidence from around the world, the TUC expects to lay into the subject in September on the theme of "get your rehabilitation in first".

"We believe employers ought to have an action plan ready, should the worst happen," says a spokesperson. "All the evidence suggests that early support maximises the chances of a successful return to work." For employers, who are continually hunting for skilled, experienced staff, this can only be a good thing.

Links

British Safety Council:   www.britishsafetycouncil.co.uk
British Occupational Health Research Foundation:   www.bohrf.org.uk/
The Ergonomic Society:   www.ergonomics.org.uk
National Safety Council:   www.nsc.org
The Institution of Occupational Safety and Health:   www.iosh.co.uk/home.html
Health and Safety Executive:   www.hse.gov.uk/hsehome.htm