The Price of Progress?

As technology continues to proliferate in government, so do problems with worker health.

by / December 20, 2002
An operator working in the Rochester, N.Y., Office of Emergency Communications had such acute pain in her fingers, she was forced to leave her job. And she wasn't alone; at one point, more than one-third of Rochester 911's work force was diagnosed with musculo-skeletal disorders that included numbness in the hands, wrists and elbows.

The culprit is ergonomics, or lack thereof. Staff members handling emergency calls in the office were using new technology without ergonomically designed furniture or equipment. The situation was resolved when the workers' union and city management collaborated to design an entirely new facility that accommodated workers' physical needs, including workstations with adjustable keyboards and screens.

Not every computer-related health problem becomes so extreme, nor do all situations require a top-to-bottom overhaul of everything from workstations to lighting. But illness and injury from computers is an all-too-real problem that's costing workers their health, while government loses productivity and tax dollars.

"Poor ergonomics is a significant issue in the workplace," said Hank Austin, senior vice president for ErgoTeam, a consulting firm specializing in ergonomics. "People working with computers can develop a wide range of problems that affect every part of the body."

It's not just happening in high-stress work situations, but in any government agency with computers. For example, nearly 96 percent of public employees who are members of the American Federation of Teachers (AFT) use computers or technology equipment at work. Of those, 26 percent have developed health problems using computer-related equipment.

The Bureau of Labor Statistics (BLS) reported that more than 600,000 workers suffered serious workplace injuries caused by ergonomic hazards in 1999, the most recent year for statistics. The National Academy of Sciences puts the injuries from repetitive stress at 1 million annually.

Neither government agency breaks down the number of injuries due directly to computer use, but in 1999 the BLS reported about 28,000 cases of carpal tunnel syndrome, which is often related to computers. The debilitating condition, which can occur over years, is also one of the most costly. Because so many people with carpal tunnel receive surgery, it is the leading cause of lost workdays, and the average cost is more than $13,000 per case. But ergonomic experts say the true cost is triple that amount.

Workplace Design
Austin has nearly 20 years of experience in the field of ergonomics and worker safety. To spot ergonomic troubles in any office, he suggests taking a look at the workers. "See how many are rubbing their wrists, how many have small pillows behind their backs while they sit. That will begin to give you an idea of the ergonomic conditions," he said.

Wrists and backs aren't all that hurt when workers use computers -- vision blurs, and hips, thighs and even ankles throb with pain. Less obvious problems with poor computer ergonomics include what Austin calls "psycho-social issues," which arise when workers are in constant discomfort or pain. The psychological effect of poor ergonomics can be especially acute for workers in customer service, or those who feel they have little control over their situation.

"The impact can start with lost workdays as workers stay home to recuperate mentally and physically," Austin said. The problems can grow into morale issues and eventually lead to valued employees quitting their jobs. Unfortunately, managers are often the last to realize what's going on because workers are reluctant to complain about a sore wrist or fatigue from using a computer. Meanwhile, public-sector employees report more stress and stress-related illnesses today than they did 25 years ago, according to the AFT.

Most people think poorly designed keyboards or computer monitors that are too high, too low or too close to the workers are causes. Nonadjustable chairs and desks also are reasons workers suffer while using computers. Other factors that contribute include poor lighting and ventilation.

Another significant concern centers on bad software design. For example, Austin cites mainframe database programs that require workers to use "F" keys to execute commands. Software that forces users to move their fingers all over the keyboard can be just as damaging physically as a nonadjustable chair. Poorly designed Web-based software programs, which may call for extensive use of both the keyboard and the mouse, can also lead to repetitive stress injuries.

Growing Concern
With the proliferation of IT throughout government, public-sector workers have grown concerned about health risks from overuse of computers. In response, some organizations are taking a variety of measures to combat the problem. First, they are evaluating working situations individually and in groups to resolve immediate ergonomic issues. These steps include teaching workers better ways to sit and use their computers, and providing more worker-friendly equipment, such as adjustable chairs and monitors.

Second, organizations are hiring ergonomic experts to evaluate office workflow processes and alleviate a wide range of potential health risks. Austin calls this approach industrial engineering. "We try to remove any unnecessary steps in the workflow and look at the best way for them to perform their job ergonomically."

Other solutions include the use of technology tools. Voice recognition software, which is mentioned repeatedly, converts human speech into text that can be edited and stored on the computer. While the software reduces the need for a keyboard, its accuracy can vary depending on how it's used.

Other software tools attempt to prevent injuries before they occur. For example, Magnitude Information Systems produces ergonomic management software that uses an algorithm to measure and monitor workers' computer use, and alerts them when it's time to take a rest, especially after they engaged in repetitive motions that may lead to injury. Mark Fuller, Magnitude's senior vice president, said the software is designed to address the repetitive stress issue before it becomes a problem and causes injuries. "The software gives the worker microbreaks after so many keystrokes," he explained.

The firm recently announced the sale of an enterprise license to Lockheed Martin, which has 140,000 workers. Other customers include Exxon Mobil Corp. and an agency within the Department of Defense.

These approaches -- especially re-engineering workflow -- don't come cheap, and introducing new techniques for getting the job done can take time and temporarily reduce productivity as workers learn new ways of doing familiar tasks. During the dot-com boom, when good workers were hard to find, many firms spent the extra dollar to make employees more comfortable. But in today's sluggish economy, with unemployment rising, more workers are willing to labor under stressful conditions. It also leaves organizations with less money to spend on what they deem as low-priority needs, such as ergonomics.

Different Standards
Rather than wait for government agencies to introduce ergonomic solutions, public-sector workers, through their unions, are trying to fix things on the legal and regulatory front. The American Federation of State, County and Municipal Employees (AFSCME), and the American Federation of Government Employees -- which represents workers in the federal sector -- have been lobbying for years to get new ergonomic standards passed by the Occupational Safety and Health Administration (OSHA).

Since 1990, the U.S. Labor Department has been considering rules on ergonomics. The issue got a boost in 1998 when the National Academy of Science linked workplace injuries to awkward and repetitive motions, and estimated that businesses lose $50 billion a year from sick leave, decreased productivity and medical costs from repetitive motion injuries, such as carpal tunnel syndrome.

In 2000, the Clinton administration issued rules that would have covered more than 100 million workers and required employers to redesign jobs that involved a variety of repetitive motions, including typing. The same year, Washington became the first state to adopt its own ergonomic rules, which take effect July 1, 2004. In Washington state, 50,000 employees suffer from work-related musculo-skeletal injuries, costing the state more than $411 million a year in medical and worker's compensation claims, according to the Department of Labor and Industries.

But Congress repealed Clinton's national ergonomic standards in March 2001, and the Bush administration promised to set a new policy for workplace safety based on stepped-up enforcement, training, research and voluntary guidelines. But unions, including AFSCME, called the new measures, "too little, too late" and "a sham." Their chief concern is that the guidelines rely too much on voluntary efforts and not enough on government oversight.

Jim August, AFSCME's assistant director of research and collective bargaining, said workers in 27 states aren't covered by federal OSHA laws, though several have their own laws that apply to worker health and safety. August called the newly issued ergonomic standards in Washington state a "model" AFSCME would like to see other states follow. "What we want to see is one standard emerge, not 50 different ones," he said.

But that fragmentation may be what's happening. When the White House repealed OSHA's regulations, many states withdrew state-level regulatory proposals that were based on the federal standards set in 2000. Now, according to Ergoweb Inc., a news service for the ergonomics industry, at least two states -- Alaska and Minnesota -- are contemplating new laws of their own. Washington, and to a lesser degree California, also have established standards.

People like August are pushing for a national, proactive approach to ergonomic standards. "If you compare the costs of doing nothing with the cost of buying better equipment and for training, the benefits will always outweigh the expense," he said, stressing that state and local governments should push ahead despite the fiscal crisis in the public sector.

Others agree. An ounce of prevention is worth a pound of cure, according to Austin. "Preventive maintenance on workers is the same as preventive maintenance on equipment," he said. "Why have a maintenance program for machines and not one for humans?"
Tod Newcombe Features Editor