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NSC White Paper Studies Intersection of Common Work Injuries and DEI

A new white paper from the U.S. National Safety Council (NSC) looked at the connections between musculoskeletal disorders (MSDs) and diversity, equity, and inclusion (DEI) in the workplace.

The report, The Intersection of DEI and MSDs: Ensuring Equitable Outcomes, was announced on 10 June, and it was based on data compiled by the U.S. Bureau of Labor Statistics and the Census Bureau, along with findings from more than 100 academic publications and sources.

“Research shows workers of color face more work-related injuries and illnesses,” the paper said. “…Collectively, these data demonstrate the disproportionate rate of non-fatal injuries, inclusive of MSDs, between groups in a variety of industry sectors.”

MSDs are injuries or illnesses involving the cartilage, joints, muscles, nerves, spinal discs, and tendons. A work-related MSD is either caused by the work environment and the actions an employee must take at work, or these aspects worsen an MSD, according to the U.S. Centers for Disease Control and Prevention (CDC).

Not to be confused with injuries sustained from falls, slips, or similar incidents, MSDs include back pain, carpal tunnel syndrome, hernias, tendonitis, tennis elbow, and other muscle ruptures, sprains, strains, and tears. These can occur from the body overexerting itself through or by repeatedly bending, climbing, crawling, reaching, or twisting. MSDs are also the most common type of workplace injury, according to Paige DeBaylo, research manager of the MSD Solutions Lab at the NSC.

“Importantly, the diversity of workers is not a risk factor for MSDs—MSD risk factors are due to the workplace not accommodating or providing for all people,” DeBaylo tells Security Management.

It is estimated that nearly one-quarter of the global population suffers from a work-related MSD, which in turn impacts business efficiency, DeBaylo notes.

“MSDs are the leading cause of worker disability, involuntary retirement, and limitations to gainful employment. They cost employers nearly $18 billion each year in lost productivity, workers’ compensation, absenteeism and presenteeism, turnover, and the ability to attract new talent,” DeBaylo says.

While 16 percent of all private-sector workers in the United States find themselves in high-risk occupations, there are certain demographic groups with a significantly higher representation in these dangerous roles. The breakdown is: 26 percent of workers with up to a high school education are in these roles, as well as 24 percent of working Hispanics, 22 percent of foreign-born workers, 21 percent of non-Hispanic Black workers, 21 percent of working males, and 20 percent of working American Indians or Alaska Natives. In contrast, only 13 percent of white workers and 9 percent of workers with more than a high school level of education are found in these same occupations, according to the white paper.

What Puts Workers at Risk for MSDs?

Beyond the higher prevalence of marginalized groups in higher-risk jobs, other aspects can contribute to more incidents of MSDs among the overall workforce.

Shift work, long hours, and part-time employment. These factors can impact the likelihood of MSDs. The NSC report referenced a 2014 study conducted among nurses that “revealed night workers had a significantly higher prevalence of MSD symptoms in their lower back and ankle compared to day workers.”

While men tend to work longer hours compared to women, women participate more in part-time work, which also carries an increased risk of developing an MSD—exacerbated by a lack of health benefits, which is usually reserved for full-time employees.

Environment and equipment. This factor includes a workspace’s layout, the design of equipment, and the design or availability of well-fitted personal protective equipment (PPE). The workplace and its equipment are often not designed for workers with physical limitations, and some equipment is not designed to accommodate women.

International standards require that workspaces accommodate 90 percent of the population, but those remaining 10 percent could find it difficult to access or utilize the entire space, especially if the space or station cannot be adjusted. In this setting, an MSD could easily arise from an employee having difficulty reaching a common and often-used item.

“In addition to workstation and work environment design, diversity in PPE selection is inadequate and may pose an additional risk to workers,” the report said. “PPE has traditionally been designed to fit the average white male, and as a result, females in the workforce are often not provided with properly fitting gear.”

Culture. A strong safety culture is crucial to ensuring that workplaces are inclusive and safe from MSD risks. This type of culture includes offering paid sick leave and long-term disability. The report noted that workplaces that lack these benefits “may enable an unsafe culture in which employees feel insecure about their employment and unsafe taking necessary time off when they’ve suffered a workplace injury, such as an MSD.”

Psychological safety. This factor is also important in creating and maintaining an inclusive work environment. This usually presents through employees who feel that they can safely speak up when work hazards or challenges arise without fear of negative consequences—such as retaliation, job loss, or intimidation.

“Voice suppression can prove particularly harmful to employees of color, as they may already perceive their voices and opinions as less valued than the majority group,” the report said. “As a result of this disparity, Black and Hispanic workers report the most unease about reporting unsafe work conditions when compared to other racial and ethnic groups.”

Stress and psycosocial risk factors. Certain psychosocial risk factors can also influence the prevalence of MSDs, such as job stress, job dissatisfaction, time pressure, and poor organizational, supervisor, or coworker support.

“Occupational stress has direct associations with MSDs, in that people with higher occupational stress are more likely to experience work-related MSDs,” the report added. These factors can also impact the recovery from an MSD.

“Due to workplace and societal factors, such as pay inequity or a lack of representation in higher levels of an organization, female workers are more frequently exposed to psychosocial risks, such as workplace violence or harassment, compared to male workers,” the report said. “…Black workers reported a 60 percent higher rate of discrimination than white workers, while women reported a 53 percent higher prevalence of discrimination than men. This study emphasizes the need for focused interventions to reduce workplace discrimination among at-risk segments of the U.S. labor market.”

These risk factors can contribute to anxiety, burnout, depression, and emotional turmoil. The report noted that other studies had found an association between those mental health stressors and wrist, hand, and back issues.

Potential Solutions to MSD Risks

The report also outlined potential solutions to inequities that contribute to MSDs.

“Investing in MSD prevention is also good for employee wellbeing,” DeBaylo says. “Suffering from work-related injuries such as MSDs can keep employees from living their fullest lives on and off the clock.”

Elimination. Take stock of the physical demands of roles and identify ones that demand a high level of physical exertion, maintaining awkward or prolonged poses, and a fast work pace. When possible, eliminate these demands.

Substitution. Invest in adapting the design or the workspace and work stations to accommodate employees with physical abilities that fall outside of the majority range.

Also provide ergonomic accommodations for staff with a disability or medical condition. “Ergonomics and MSD prevention are human-centered practices, focused on modifying work environments and job tasks to meet the needs of the workforce and empower healthier, safer, and more efficient work,” DeBaylo adds. 

Engineering. Adjustable devices and technology—such as carts, conveyors, hoists, lifts, ramps, and turntables—can help decrease strenuous or repetitive activities.

Administrative. Develop and implement policies and procedures that ensure accessibility for all workers, as well as ones that result in an open and anonymous reporting program and promote representation in safety materials. Also, “it is essential to seek and include feedback on job tasks and risk factors from a diverse group of employees to source solutions suitable for all,” the report noted.

PPE. Conduct regular checks with staff to confirm PPE needs are being met and appropriately fit and protect the user.

“While it may seem like a big investment to combat MSDs, MSD risk reduction is a smart investment,” DeBaylo says. “Every dollar spent on prevention generates twice the return or more. Employers need to be aware of and invested in this most pressing workplace issue to ensure the safety, health, and happiness of their workers, and to protect the bottom line.”