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Developing Work Related Musculoskeletal Disorder (WMSD) Prevention Tools for High Risk Industries

Safety & Health Assessment & Research for Prevention (SHARP) — Research for Safe Work

Work-Related Musculoskeletal Disorders (WMSDs)

What are Work Related Musculoskeletal Disorders and Why Are They Important?

Sprains and strains of muscles, tendons, or ligaments are an all too common type of injury that most of us experience at some point in our lives. They are not always easy to foresee, they can take a long time to heal, and they can seriously impact our quality of life. Certain kinds of sprains and strains, often referred to as work-related musculoskeletal disorders (WMSDs), such as tendonitis, bursitis, epicondylitis, carpal tunnel syndrome, sciatica, and rotator cuff syndrome are often caused by forceful exertions, repetitive motions, and awkward postures used in the workplace. These conditions often develop over time in areas of the back, shoulder, hand/wrist, and knee, and together account for 43% of all compensable lost-time workers' compensation claims costs in Washington State and 44% of all accepted claims costs (see Figure 1).

Figure 1 State Fund WMSDs of the Neck, Back and Upper Extremity, 2000-2010

SHARP examines workers' comp claims yearly to assess the industries at highest risk for WMSDs as well as the body areas most closely associated with compensable claims. In 2010, SHARP initiated a 5-year research project to develop and disseminate WMSD hazard assessment resources for use by employers, workers' groups, and health and safety practitioners to assist them in focusing their injury prevention efforts.

What Can We Do About the Problem?

Through both management/labor interviews and musculoskeletal risk assessments of jobs during company site visits, as well as semi-structured case follow-up interviews with injured workers themselves, we hope to develop effective prevention strategies for reducing industry-wide injury rates. We can't witness these kinds of injuries as they happen, but we can try to learn about the jobs in certain industries both before and after injuries occur. To that end, we are conducting extensive fieldwork to observe workers doing their jobs while also talking to injured workers from these same industries after they've filed compensable claims.

Industries with a wide variance in claims rates were given preference so that each contained companies with both high and low claims rates for each body region. We want to explain this variance and determine which factors differentiate the claims rates for companies of similar size and industry from one other? If different companies take different approaches to solving these kinds of issues, are there best practices we could document that might help reduce claims rates for entire industries? First hand access to comparable companies with either high or low injury rates will give us the ability to evaluate observed risk factors and potential prevention strategies.

How Do We Proceed?

Using claims data from 2000-2008, we identified 23 industries across seven NORA sectors (excluding mining, oil refining, and public safety) to include in this study (see Table 1). Companies within each of these 23 industries were stratified along three broad categories of sizesmall (20-50 full-time equivalents (FTE) per year), medium (50-100), and large (100+)and then ranked on WMSD incidence rate for each of four body regions: back, shoulder, hand/wrist, and knee.

In order to quantify the observed risk factors associated with individual jobs in these industries, our team developed a quick assessment checklist tool to use in the field which is based on several validated instruments currently available. The resulting tool was programmed to be accessed using a small handheld digital tablet (see Figure 2), and will serve as a potential model for use by employers and health and safety committees in the future as they make their workplace safer for employees.

Figure 2 - Job analysis using digital handheld tablet

Each participating company we visit receives a summary evaluation report (707 KB PDF / 2 min) of each observed job identifying key risk factors and recommended control measures to help reduce their workers' risk for developing WMSDs. We use data collected from injured worker interviews to both guide our analysis of and support our findings from company site visits as well as to construct informational case studies for educational and outreach purposes. Over the next 3 years, our objective is to complete:

  • No less than 112 site visits to collect job assessment and interview data from 56 pairs of companies matched on size, industry sector, and body area;
  • An additional 448 interviews from 224 companies regarding potentially explanatory organizational work factors; and
  • 280 case follow-up interviews with injured workers.

Here's an example (855 KB PDF / 2 min) of some of the work we've done in the past. You can learn more about WMSDs from our website.

This project is funded, in part, by a grant from the National Institute for Occupational Safety and Health (NIOSH). To learn more about this project call the SHARP program at 1‑888‑667‑4277 or email us at

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