Dr. Butch de Castro

(WOMENSENEWS)–Forty-six-year-old Maggie Flanagan used to love her work with newborns. When monitors beeped hundreds of times during a 12-hour shift in the hospital nursery, she responded swiftly, so as not to let the noise damage the ears of her tiny patients.

But every time Flanagan stretched to quickly hit a shoulder-height button to quiet the machine, she unwittingly inched closer to a crippling injury. Combined with a series ofother repetitive motions, Flanagan soon beganfeeling pain in her back, neck and shoulders that wouldn’t go away.

“We’re always responding to monitors in health care,” the Tacoma, Wash., nurse told Women’s eNews in a telephone interview. “I knew I was having back strain, but wasn’t aware of the subtle signs of repetitive motion injury.”

When she was moving a monitor with another nurse, she developed back spasms. She was diagnosed with a cornucopia of back-neck-and-shoulder injuries that put her out of work for eight months in 1999.

Ergonomic injuries like hers, also known as musculoskeletal disorders, occur more often in the heavily female health-care sector than any other industry, according to the most recent statistics from the Occupational Safety and Health Administration.

Disproportionate Affect on Women

It’s a situation that advocates say affects a disproportionate number of women. “One of every nine ergonomic-related injuries occurs in the health care sector, and the health care sector is predominantly women,” said Bill Borwegen, occupational health and safety director for the 1.6 million members of Service Employees International Union.

Borwegen added that state-funded insurance payments often expire before an employee is able to resume work, compelling the injured to apply for government-funded disability payments. “You and I as taxpayers end up paying for their injuries.”

Borwegen argues that many of the injuries would have been prevented by Clinton-era workplace ergonomics laws that the Bush administration, upon taking office in January 2001, downgraded to voluntary guidelines for employers.

“People are being crippled, they end up losing their jobs,” he said in an interview from the union’s Washington, D.C., offices. “Injuries could be dramatically reduced by putting in place good ergonomic programs that require the use of mechanical lifting and transfer devices.” Such devices, according to Borwegan, would also benefit patients, making them less likely to be dropped and “less prone to skin tears,” which he described as a serious medical hazard.

Depending on Goodwill

Flanagan also believes that voluntary guidelines are inadequate. “Until we get legislation that mandates employers to identify and eliminate hazards then we’ll always be dependent on the goodwill of others for our health and safety,” the nurse said.

Following her injury in 1999, Flanagan was not only out of work for those difficult eight months. “When I was injured, I wasn’t injured for the duration of my shift alone,” Flanagan said. “I was injured 24-7 and my husband basically became a single parent. I couldn’t do any of the dressing, bathing or feeding of my two sons–I couldn’t do anything.”

Now, she is back at her job, but putting up with relentless pain. “I love my job,” she said. “I still do it. I just never thought helping people take such good care of their children would affect how I’d be able to take care of mine. I’ve grieved for that.”

Difficult Data Comparison

After changing the way it gathers and classifies data, the Bureau of Labor Statistics has said that the most current statistics on workplace injuries can’t be compared to data from before 2001, making it difficult to gauge how U.S. workplace might have been affected by the lack of ergonomics standards.

Gary Visscher, deputy assistant secretary at OSHA, said the agency is doing what it can to encourage employers to adhere to its safety recommendations.

“In the absence of a standard, we have a very aggressive program and we’re working with a lot of different people on addressing ergonomic issues in their own particular workplace.” Visscher said that many health care facilities have self-imposed ergonomics standards that conform to official guidelines.

Visscher said that between 1992 and 2001, musculoskeletal injuries, as a percentage of overall injuries, ranged between 34 and around 35 percent. Currently, he said, the figure stood at 34 percent. “It’s certainly not gone up and I think that’s an important indicator. We are doing better in total injuries and we’re doing better in musculoskeletal disorders.”

No Improvement Since 2001

Workers’ advocates, however, say that voluntary standards do not appear to be reducing injuries.

“Since 2001 nurses have continued to become injured,” said Dr. Butch de Castro, senior staff specialist for occupational health and safety at the Washington, D.C.-based American Nurses Association. He added that many nurses are leaving the profession “because of exposure to ergonomic hazards in healthcare settings and that is primarily due to patient lifting or patient handling, which is done manually.”

A survey conducted by the American Nurses Association’s Web site in 2001 found that of 4,286 respondents, 2,166 nurses said they “often” continue working despite experiencing back pain, while 1,750 said they “sometimes” worked through pain. The survey also found that a disabling back injury was the second-leading health concern among nurses, ranking higher than AIDS or hepatitis exposure from needle sticks.

And the Bureau of Labor Statistics annual report on injuries in the workplace for 2002, the most recent year for which statistics are available, indicated that 79,007 nursing aides, orderlies and attendants reported injuries that required days to be taken off from work in 2002. Of those, about 91 percent were women. These workers, according to the findings, were second only to truck drivers in the number of injuries reported by vocation. They “predominantly suffered sprains and strains to their trunk (typically their back), due to overexertion related to lifting or moving patients.”

While not all accidents on the job are considered preventable, workers’ advocates say musculoskeletal disorders can be prevented by proper ergonomic standards. Such injuries accounted for 44,400 of 79,007 total injuries in health care, in 2002. Clinton-era workplace-safety regulations aimed at preventing such injuries went into effect on Jan. 16, 2001, after 10 years of research and drafting. They required 6 million workplaces to educate 102 million workers about the musculoskeletal risks of certain job-related tasks, while mandating businesses to invest in new equipment, furniture and practices in instances where injuries were reported.

Compliance costs were estimated by OSHA to reach $4.5 billion a year while business lobbyists estimated it would cost more than 10 times that much, $67 billion. Days before leaving office, Clinton signed the new regulations into law. With Bush’s pledge of support, the Republican-led Congress in 2001 revoked the regulations.

Shaya Mohajer is a graduate of the New York University Graduate School of Journalism and has written for Newsday, The Orange County Register, Women’s eNews and other publications.

For more information:

Penney Kome–
“New Repetitive Strain Rules May Be Challenged”
Women’s eNews, Jan. 29, 2001:

American Nurses Association–
Workplace Issues: Occupational Safety and Health: