The Cruelest Cuts

OSHA is pushing for federal rules that would require companies to count job-related musculoskeletal disorders - a step that could make it easier for safety officials to prevent such injuries.

But the emerging plan may also provoke a battle with business groups. Industry leaders fear it could pave the way for regulation to prevent MSDs, the most common injuries in American factories.

Often caused by repetitive tasks and heavy lifting, MSDs afflict the muscles and nerves in wrists, arms, necks and backs. They include sprains and strains, along with common on-the-job injuries such as carpal tunnel syndrome and tendinitis.

Hundreds of thousands of workers suffer MSDs on the job each year, federal statistics show.

The U.S. Chamber of Commerce views the proposed reporting requirement as a "first salvo in what we see as a very deliberate push" for federal action to curb such injuries, says Marc Freedman, the chamber's director of labor policy. Industry representatives contend any future ergonomics rules would probably prove unwarranted and burdensome to businesses.

But others call OSHA's plan an inexpensive way to improve workplace safety.

AFL-CIO safety director Peg Seminario said it would help regulators and company officials understand what is causing MSDs.

"In individual workplaces, there is no easy way to make an assessment of the extent of MSD injuries," she said. "By having this information, it will make it readily apparent."

Under the plan, employers would be required to record MSDs in a new column on workplace injury logs - documents that regulators examine to look for trends.

Until seven years ago, companies were required to do just that. But faced with a legal challenge from manufacturers, OSHA removed the column in 2003. Employers still had to report these ailments but could include them with other injuries. That made it harder for regulators to detect patterns - and easier for businesses to hide such disorders.

A 2008 Observer investigation into the poultry industry revealed that was part of a trend: Weak government oversight and enforcement often allowed companies to escape serious consequences when they ignored workplace hazards.

Poultry workers routinely make 20,000 cutting motions a shift, and the jobs often leave them with nerve and muscle damage. But it has been more than a decade since OSHA fined a poultry processor for ergonomic hazards likely to cause MSDs, the Observer found.

OSHA is expected to release a detailed regulatory proposal soon. The agency would then field public comments about the plan before taking action.

The feedback from industry groups will likely be extensive, as business leaders prepare for a new ergonomics war.

OSHA has already lost one fight over ergonomics.

In 1990, then-U.S. Labor Secretary Elizabeth Dole announced "a major initiative" to prevent MSDs in the workplace. After a decade of research and debate, OSHA in 2001 issued a collection of rules - known as the "ergonomics standard" - that required employers to address hazards likely to cause those injuries.

But under lobbying from businesses, the Republican-led Congress and President Bush repealed the regulations two months after they took effect.

OSHA deputy administrator Jordan Barab said last month that the agency's current reporting proposal "is not a prelude for a broader ergonomics standard."

But Barab has said that MSDs are a "huge health and safety problem" - and that addressing them remains one of the agency's highest priorities.

Under the Bush Administration, OSHA made it a priority to establish voluntary safety programs and partnerships with companies. Now, under President Obama, the agency has signaled that it will take a tougher approach, with stepped-up enforcement efforts and new rules to improve workplace safety.

Hilda Solis, a former congresswoman viewed as a friend to labor unions, now heads the U.S. Department of Labor. And David Michaels, an epidemiologist who has pushed to protect workers suffering from radiation exposure and other hazards, leads federal OSHA. Both replaced leaders who were seen as more friendly to business.

Many company doctors face pressure to conceal workplace injuries - even if it means providing inadequate medical treatment, according to a new study by Congress' watchdog agency.

The report by the U.S. Government Accountability Office - spurred by the Observer's stories on hidden injuries in the poultry industry - concludes that safety regulators haven't done enough to ensure the accuracy of worksite injury numbers.

Federal OSHA, which oversees safety in about half the states, said it would follow all of the GAO's recommendations. It's unclear whether the remaining states, including the Carolinas, will adopt them.

"Many of the problems identified in the report are quite alarming, and OSHA will be taking strong enforcement action where we find underreporting," U.S. Labor Secretary Hilda Solis said Monday.

In a survey of 504 occupational health practitioners - including company doctors and nurses - the GAO found:

More than a third said they were asked to provide insufficient treatment to workers so that job-related injuries did not show up on company injury logs.

More than half said they were pressured by company officials to downplay injuries or illnesses.

More than two-thirds said they knew of employees who feared disciplinary action if they reported injuries.

The GAO pointed to another factor that discourages reporting: programs that reward employees with prizes or bonuses if their plants go long periods without recordable injuries.

"The widespread underreporting so clearly documented in this (GAO) report is undermining the health and safety of American workers," said Sen. Tom Harkin, D- Iowa, chairman of the Senate Health, Education, Labor and Pensions Committee. "If we don't know the full extent of the workplace hazards workers face, we cannot fully address these risks."

Skimping on care

Companies are required to record all workplace injuries that result in time off work or medical attention beyond first aid. It's an honor system, and the injury logs are used by regulators and others to gauge plant safety. Low injury rates allow companies to avoid scrutiny from safety regulators and may help them win contracts and reduce workers' compensation costs.

Workplace injury and illness rates - a key factor in determining whether regulators inspect a company - have declined nationally in recent years. But some experts suspect that's partly because employers aren't reporting all on-the-job injuries.

At a conference in New York City last year, occupational doctors said their employers had encouraged them to treat some injuries in a way that would keep them off the official logs. A cut, for instance, must be recorded if the worker gets stitches - but not if the doctor simply covers it with a bandage.

"One practitioner said that an injured worker's manager took the worker to multiple providers until the manager found one who would certify that treatment of the injury required only first aid, which is not a recordable injury," the GAO report stated.

In its investigation of the poultry industry, the Observer found that some in-house medical attendants prevented injured workers from getting treatment that would cost their companies money.

OSHA is supposed to conduct audits to ensure that companies accurately report injuries. But the GAO found that the agency doesn't routinely interview workers when it tries to verify injury reports, so it may miss chances to find underreporting.

Some workplace safety inspectors also told the GAO that they rarely learn about injuries from workers. That's because their audits are typically conducted about two years after injuries occur - and by that time, many injured workers have moved to other jobs.

The GAO urged the government to conduct audits sooner and to interview workers. OSHA said it would take those steps.

'Broken system'

Last month, federal OSHA said it would launch a program aimed at catching companies that hide workplace injuries. N.C. Labor Commissioner Cherie Berry said she has instructed the state's OSHA office to join that effort.

"I believe the majority of North Carolina businesses are honest in their reporting requirements, yet I do realize there may be some who are less than truthful and those are the ones we will go after," Berry said in a statement Monday.

Still, Berry said, N.C. workplace deaths and injuries are on the decline.

Tom O'Connor, executive director of the National Council for Occupational Safety and Health, called the GAO's findings "dramatic," adding: "If healthcare professionals are being asked to not record injuries properly, then we have a pretty broken system."