A review of international countermeasures for the prevention of musculoskeletal disorders: the mountain to Mohammed syndrome.

My research reviewing various nations’ handling of their musculoskeletal disorders (MSDs) problem originated with the objective of presenting a paper on the subject to an international audience at the recent 18th Annual World Safety Organization’s Environmental, Safety and Health Conference in Denver, CO. This review of the MSD problem from industrial nations was mostly concentrated in comparing regulations and activities between the US and the European Union member states. The investigation’s target was to evaluate how progressive the international community has been in complimenting ergonomic interventions with employment physical ability testing as a holistic approach toward the reduction of MSDs. Following a rather exhaustive investigation, the results were startling. Matching prospective workers to their physical job demands does not even appear on the radar screen in well over 20 nations. MSDs, injuries or disorders of the muscles, nerves, tendons, joints, cartilage, and spinal column, are the overall leading nature of occupational injuries around the world. They are a serious problem requiring scientific, non-partisan, action to design and implement a lasting solution. From my perspective as an active risk professional of over 30 years, the present ergonomic approach as a solution, in and of itself, has been and will remain inadequate. While there is a consensus of opinion in the world ergonomic and risk control communities that strain and sprain injures are caused by a mismatch between the physical abilities of the worker and the physical demands of the job, for the most part, the international risk community appears to understand the problem and proposed countermeasures from rather narrow parameters. In the United States, when OSHA focused its attention on the issue of MSDs, it concentrated on ergonomic solutions. OSHA’s proposed tiered rule encompassed five specific areas of countermeasure from hazard analysis and engineering controls to medical management of those injuries that do occur. I have had no argument with OSHA’s technical direction to counteract MSD-related injuries. My only problem with the agency to date has been its limited approach to correct a complex problem. For example, in the development of the proposed ergonomic rule, there was only one paragraph in the commentary addressing physical employment screening. Even the scientific documentation in support of the 1991 Revised NIOSH Lifting Equation devoted only 1.5 pages out of 270 to pre-employment strength testing where it stated: “It is clear. . . that the inability to demonstrate a lifting strength equal to that required on the job is a significant risk factor”. OSHA’s