What gives you the confidence to believe that OSHA can publish a proposed ergonomics standard this fall and the final version next year, given the controversy surrounding this standard?

Ergonomics will be a poster child for the internal reinvention of our standards process. We've had the solicitor, the policy people, the economists in early to shape this proposal. Enormous amounts of stakeholder involvement have been done already. Once the proposal makes it through the clearance process (reviews by a small business panel and the Office of Management and Budget), we'll publish it this fall, September will be my goal. From there to the hearings is a matter simply of soliciting and receiving comments. After the hearings, it will be a matter of considering the comments, considering whether we ought to make modifications, responding to the comments, and making a final determination to go ahead.

How can employers without safety resources on staff handle requirements such as identifying ergonomic risk factors, conducting job assessments, and designing solutions?

I don't think safety and health in a small business is any different than another part of the business. How do small businesses do quality control? Or how do they analyze the efficiency of their production? I think small businesses have a more difficult time, they don't have the resources or the sophistication. But they still have to do it.

When it comes to ergonomics, I hope small businesses will look at the support materials that we have available through the Internet and on printed material. We are developing now and will have lists of hundreds of employers by industry that will suggest if you have a problem in the printing industry, for example, call one of these printers; in this industry, here are things you should look for; in this industry, here are some successful solutions.

Then we have free consultation services through our state consultation programs. If small businesses want, they can have a consultant come on site and work with them on identifying what the problem is and fixing it.

Of course, some will choose to contract with someone else to get assistance. Some of the insurance companies have services available to their clients to look at problems and recommend solutions.

Are you concerned by some reports that there are not enough ergonomics experts to provide assistance when the standard hits?

I think there are a lot of ergonomists and people who have ergonomics training out there available to assist. But I would also caution people that ergonomics is not a mystery science. The critics would have you believe that only a highly sophisticated person with great training is able to figure out ergonomic problems. I don't feel that's true.

When you can see that the problems come from lifting things that are too heavy, getting a hand truck to move things around or getting a forklift is not something that requires a high level of sophistication. When you have workers who are constantly having to reach too high and are developing shoulder problems from that, getting them a ladder or a platform or a box to stand on, again, does not require sophisticated ergonomic programs.

The challenge before us is to make ergonomics understandable to everybody and have folks realize that there are some simple solutions, commonsense solutions.

The draft requirements encourage early reporting of signs and symptoms, ailments common to the workplace such as pain, tingling and numbness. When do these everyday ailments become a problem covered by the standard?

First, the employer has to satisfy himself or herself that the condition people are complaining about is job-related. The second step, before any obligation is created, is to determine that it is something caused by a recurring part of the employee's job.

My former boss stepped off the curb one time, for example, caught his back up, and was out of work for two weeks with a back injury. Stepping off a curb going from one meeting to another is a work-related injury. But it was not something that would trigger the coverage of this standard. It was a back injury, but we're not going to redesign that curb because it is not (a recurring) risk factor that must be controlled.

Any time someone is hurt on the job the employer has got to make the determination, "Is this work-related and am I covered under workers' compensation?" The ergonomics standard does not change one iota that determination. There is nothing new about what they have to decide after the standard is in place. They are already making those decisions.

What is changing is the expectation of what is the normal cost of doing business, the normal cost of growing older. If we had been sitting here 50 years ago, asking this question, and someone who sewed for a living was complaining about the tendons drawing up in their hands, we would've said, "Well, that's to be expected from the job you're in and that's not considered a job-related injury."

Today we do consider that a job-related injury because we know some things that can keep it from happening. So over 50 years, expectations have changed. We expect our workplaces to protect us and to take advantage of the most recent technology and information available to keep us from having any more aches and pains than you get normally.

These job-related determinations can be hard calls. What can employers do?

They are hard calls. And very few employers that I've talked to, if there's a question, will draw conclusions on their own without some medical assistance. We don't expect people to be physicians, don't expect them to be ergonomists. When you get a close call - if you're not sure a problem is because of a calcium deficiency in the body or a strain put on by the workplace - you're going to have to get the same kind of assistance from the medical practitioner that we get today.

How can readers educate employees about ergonomics-related signs and symptoms without opening a Pandora's Box of complaints and perhaps overreaction?

When a company first says, "We want to know all the pains and symptoms you have so we can do something to keep it from getting worse," experience shows almost without exception that your reports increase. So I think that's to be expected. And that's not a bad sign.

If you wait until aches and pain become something that causes employees to lose time away from the job or undergo surgery, you're still going to have to fix the problem. Plus then you're going to have the cost of medical problems, workers' comp, absenteeism, or whatever. Getting the early report of pain and responding early is a significant advantage in cost-savings. You save yourself an enormous amount of trouble.

I would say gird yourself for more complaints initially, it's going to happen. Sift through them. Know that even if you've got to sift some out that are not work-related, it's going to help you in the long run by avoiding more costly problems later. And experience indicates after that first wave, the numbers decline below where they had been originally. That's because the employers have intervened in the situations that are causing the reports of injuries or the reports of aches and signs and symptoms.

Are back belts and wrist supports types of PPE that can be used to control ergonomic problems?

We have seen the same evidence on back belts that everyone else has. Some people say that they help a lot, other people say that they don't help at all and sometimes make the situation worse. We've not seen anything to convince us at OSHA that back belts are protective. So I would not classify back belts as PPE. I'm not going to criticize someone for using them, but I don't believe they would be accepted as a preventive measure or a protective measure for back injuries.

The braces clearly continue to be recommended by medical practitioners for people with wrist problems. But they are not preventive, not protective. They come in after you've had a problem, so they are a medical treatment, really, not protective equipment. So I don't recommend them as protective equipment. I don't see them as protective equipment in the proposal.

Some readers are concerned that the draft gives too much authority to medical providers. There is a fear that some medical practitioners will simply prescribe rest for ergonomic-related problems, take the employee out of work, and cause productivity problems. Your comments?

I think we do need to talk this out - the provision of having to accept the medical provider's recommendation. But in the proposal as it exists now, the medical provider is one chosen by the employer - not one of the employee's choosing. So the employer has some obligation to educate the medical professionals about the requirements of a particular job, and the reasonable expectations from doing that job. I'd encourage people to allow the doctors to visit before they have a problem and get a sense of what the workplace requires.

That's much harder for a small business than a large business that has a company doctor. I think that is a difficult area and one we will talk about at some length.

There are certainly different directions we could go. But I think it is important in ergonomics to realize that it's more important here than in other areas to encourage people to report their signs and symptoms.

If you're talking about something that's cumulative, that starts low and gets worse, the way to catch it is by this early reporting. And if people fear that if they file a report they're going to lose some kind of wages or benefits, I think we must do something to ensure they file it.

Next month: Jeffress discusses the other big standard in OSHA's pipeline, the safety and health program rule.

Can you handle it?

This is the second part of Industrial Safety & Hygiene News' exclusive interview with agency Chief Charles Jeffress. Part one appeared in our May issue. Both parts are available on the Internet at www.ishn.com.

How realistic is it to expect OSHA to issue an ergonomics proposal and a safety and health program proposal, two very big standards, within possibly months of each other?

Neither of these standards is new. Jeffress didn't start these after he got here. Both have been in various stages of discussion and development for ten years now. So what you're really seeing is both [standards] coming to fruition at the same time. We are at the right point with each of them in terms of having a pretty good consensus developed by the stakeholders about best practices. It's time to go forward. In some ways it's fortuitous that they're coming at the same time.

How's that?

Both are program standards. [Ergonomics programs and safety and health programs] require some similar elements in terms of management leadership, employee involvement, and finding and fixing hazards. For businesses that haven't begun yet or are in the early stages of program development, it's going to enable those businesses to deal with both at one time and not have to do one thing one year, and a few years later come back and start something else.

Some people question the need for both standards. If you just issued a safety and health program rule, and companies followed that rule, wouldn't they be identifying and fixing their ergonomic problems, and training employees about ergonomics?

I understand conceptually that line of reasoning, because if you have a safety and health program in place that truly works, you'll address all the hazards. You could say that the safety and health program standard is all you need, you don't need process safety management, hazard communication, electrical safety, fall protection, or ergonomics.

But I think we all welcome specific guidance when we can get it. With respect to ergonomics, we can give more precise information on what kinds of factors to assess that might be causing problems. We can give more specific guidance on when to act. So, we have an obligation to have an ergonomics standard just like we do all these other standards.

What about the strain of potentially complying with both of these standards at the same time? One of our readers says he has hundreds if not thousands of work stations to assess for the ergonomics standard alone. He says it took years to do assessments for lockout-tagout.

I guess I would ask that reader, "What is it about his safety and health program currently that he's going to have to fix? Does he not have management leadership? Does he not have employee involvement? Is he not finding hazards and fixing hazards?"

My guess is if he has the kind of program in place that he says he has, where he is looking at all these work stations for lockout-tagout issues, then he really is not going to have much to do on the safety and health program standard. He might not have anything to do at all. The ergonomics standard is going to require some additional assessments, I'm sure.

How about smaller companies that may have to do both?

There are a couple of things to remember regarding the ergonomics standard: The requirement of management commitment is not something that takes a major expenditure of funds. And, in a small business where you've got 25 to 50 employees, you're talking about a relatively short orientation time for initial training about potential job hazards. You're talking about a day or two to have people become aware of what the potential hazards are.

Beyond that, there's no obligation unless somebody gets hurt. Severty-five percent of American businesses report no injuries in the course of a year. So, for most people the ergonomics standard is not going to trigger immediate action. It's only when somebody gets hurt that they have to respond.

Will there be some additional requirements on business? Yes. But I believe that the investment pays off. Small businesses that have put in ergonomics programs have found that they increase productivity and reduce workers' compensation and medical costs. You have to believe that the up-front investment is going to pay a dividend.

There are always people who are reluctant to make investments when they can't see an immediate payoff. It's going to be hard for them to have the faith that they have avoided some injury and know that it has paid off. If they will talk to other businesses of their same size in their industry, I think they'll find out that it's a good investment. They don't have to hear it from me.

You've said in the past that only 30 percent of businesses have safety and health programs. And you've said 75 percent of businesses have no injuries each year. So what do you need safety and health programs for, anyway?

Most of these businesses that don't have safety and health programs are small businesses. The statistic that is very troubling to me is this: If you work in a small business with fewer than ten employees, you're more than twice as likely to be killed on the job than if you work for a large business. So if we're going to make a difference in the workplace, it's important that we reach small businesses in ways we haven't reached small businesses before.

Some small business people will see safety and health rules as a burden. But the people who put programs in place, even in small businesses, report to us that they are a success. They are a productive investment, not a burden.

How are our readers with existing ergonomics programs going to know if their programs qualify to be "grandfathered" into the ergonomics standard?

They should have confidence that they are in compliance if they have a program in place and it's clear that the program is authorized and supported by the leadership of the company; that employees feel free to report problems; that employees have been trained in what kind of symptoms to look for; and the employer is responding to those concerns and instituting solutions where possible.

We have found people in violation of the general duty clause where they had written [ergonomics] programs in place, but for months people had been complaining about an issue, and the company hadn't done anything about it.

We haven't found problems with people who have programs in place and are working on issues and injuries are still occurring. Whether injuries are still occurring is not the measure of success. Are you keeping workers informed of what the concerns are out there, and are you responding proactively when you hear the concerns - that's the measure of success.

We know in ergonomics no one solution will be good for everybody. It will take tests of different ideas to determine what works. We're looking at the effort being made to solve problems.

It is a judgment call. Whether you can trust an OSHA inspector to have good judgment is really the question people are asking when you say, "How do you know when you're in compliance?" I can tell people we're going to ensure compliance officers use good judgment, we're going to make sure they're well trained, but for most people the proof is going to be when they see that compliance officer in the plant, making an assessment.