Musculoskeletal Pain the Primary Health Risk to American Workers

Several studies exploring workplace injuries, chronic conditions, and American health has identified musculoskeletal pain as the primary risk to employees. Musculoskeletal pain can be caused by a variety of different factors, but poses risks to almost every industry in blue collar America. Scientists, and employers are working diligently to identify the root causes of the chronic illness and help industries prevent further distress. 

Statistics suggest that every 1 in 2 American employees experience some form of chronic musculoskeletal complications, supported by surveys sampling more than 252 million citizens.The industries with the highest risk of complications include software businesses, utility management, retail, transportation, hospitality, construction, manufacturing, healthcare, education, and more. These industries require employees to be sitting or standing for long periods of time, and sometimes also require heavy lifting that can pose risk to their musculoskeletal stability. Leading experts relate the hard manual labor and sedentary position of the body over long periods of time as some of the main causes of this specific injury. 

What is the Musculoskeletal System

The musculoskeletal system includes the bones, muscles, ligaments, joints, connective tissues, cartilage, and tendons. This system gives our human bodies structure and supports movement of the limbs. The MSK system is vital to a person’s mobility and can change with them over time. The overall endocrine system is stimulated by exercise and interacted with via biochemical signaling passed through other organs in the body. 

5 Main Functions of the MSK System

• Movement: The skeletal system pulls on bones causing movement at the joints. Facial skeletal muscles pull on soft tissues resulting in facial expressions. All the movement is caused by the respiratory system introducing oxygen into the blood supporting the systems, enabling the muscles to breathe.

• Support: Muscles in the system support the internal organs, but are prone to weaknesses with age or injury. Prolonged weakness to the system's muscles can result in organ displacement.

• Protection: Skeletal muscles protect vital organs and cushion exterior physical impacts taken by the body. 

• Heat Generation: Heat is a waste product of body metabolism which is maintained by keeping an internal body temperature of 98.6 degrees Fahrenheit. Shivering is a major control of the MSK system to regulate the body temperature and generate heat when the internal body temperatures fall below optimal levels. 

• Blood Circulation: Cardiac muscles pump the heart and control the body’s blood circulation to vital organs and other areas of the body. 

“Ergonomic injuries” are those that affect the MKS system. These injuries are the result of overuse, improper use, or exterior inflictions to the muscles, tendons, ligaments, or hard structures. Symptoms of MKS injuries include but are not limited to the inability to effectively use limbs or muscles to complete tasks, soreness, bruising, muscle tears, and bone fractures. These symptoms often accompany the hazards associated with sitting and working at a desk, impacting the employee over long periods. The study also analyzed the resulting economic expenditure associated with MSK-related injuries and discovered its national costs have more than doubled over the last decade. 

Associated Costs of Musculoskeletal Injuries

The cost to treat MSK is one of the third largest industries in the United States healthcare system, totaling more than $600 billion annually.Associated costs to treat MSK injuries include medical appointments, expert referrals, and leave from work. The injuries also have to be treated with various medications, physical therapy, and work limitations after being diagnosed. These costs fall predominantly on the employee who ends up having to take the excess leave from employment and source the kind of treatments that best fit their situation. Employers also take the brunt of any MSK injury costs by involving their insurances and liability officials. 

The Hinge study also acknowledged that the driving factor behind increasing costs is the undeniable connection between MSK and mental health treatments, as affected employees often use double the average worker’s sick days.  The average worker misses more than 8 days of work, while employees experiencing symptoms of MSK complications often miss upwards of 13 average days annually to deal with their treatment and mental health. The sheer absence of millions of workers for extended durations of time throughout the annual work year alone costs businesses and the greater US economy millions of dollars.

Impacts of New MSK Understanding 

The impacts of MSK are affecting many aspects of employee health and welfare in the United States, as medical costs and health inequities continue to increase. Access to MSK-associated healthcare, medicines, and affordable treatments have continued to drive up prices, far surpassing the economic costs shared by employers to treat other ailments like heart disease ($309 billion), cancer ($243 billion), and diabetes ($188 billion). It is no surprise that medical costs, insurance, and access to treatments have all become a much larger burden on the lower and middle working class of America.

The nuances of MSK and its lack of study have also prevented many employer insurance companies from effectively covering their employee’s risk of MSK exposure and rehabilitation. The lack of understanding has only recently resulted in studies highlighting the close relation to employee mental health welfare. Chronic pain can often intensify mental challenges resulting in increased anxiety and depression, worsening the MSK symptoms. Many health insurances fail to fill the gap in social and behavioral support needed to recuperate from mental health symptoms associated with the effects of chronic MSK in the workplace. 

Solutions recommended by the Hinge report and other health professionals suggest filling the gaps in coverage by addressing issues with physical recovery, behavioral support, and medical services. Remote care and support are ultimately important in treating the patient’s physical self-care and mental health. With digital accessibility at an all-time high, connecting patients to health professionals is easier than ever, and acquiring the kind of frequent care needed to recover from MSK complications entirely. 

Testing Workers Safety Gear

Many industries across the United States require workers to abide by certain safety standards set by the Occupational Health and Safety Administration (OSHA), often including basic safety gear. There are multiple different sets of safety gear that are differentiated based on the line of work employees are undertaking. These standards were developed to prevent serious injury and reduce the risk of any incidents while on an active job site. 

The kind of gear and duration of use is constantly modified to better fit the needs of employees and their environment. OSHA and other committees set out to test the gear to understand how they respond to real world situations, and if they comply with the American National Standards Institute (ANSI).

Types of Protective Gear

There are many different types of protective safety gear utilized by the general workforce in the United States. The purpose of utilizing safety gear while at work is to minimize workplace injuries, protect employee health, and promote healthy work environments. The most common gear observed in the field include, but are not limited to:

• Gloves

• Respirator

• Helmet

• Hearing protection

• Hard hat

• Goggles

• Eye protection

• Face shield

• Ear plugs

These types of protective wear otherwise known as PPE (personal protective equipment) were continuously developed in response to dangerous work environments where employees are interacting with chemical, radiological, physical, electrical, mechanical, and other unique hazards. The different types of PPE is completely dependent on the type of work being conducted and the risk to the employee. 

All PPE used in a work environment should also be maintained and clean in a reliable fashion to ensure its performance will be effective. All workplaces should have a system in place to source safely designed and constructed equipment that fits the employees comfortably and to encourage their use in the workplace. If the PPE does not fit properly workers are less likely to consistently choose to utilize them, increasing the risk of engaging in dangerous or exposed activities. Like all workplace duties, the use of specific PPE must be trained and there are a multitude of different online and in person resources available. Specific criteria included in the worker training programs requires users to understand wearing PPE:

• When it is necessary to source PPE.

• The type of PPE necessary.

• How to properly wear, remove, and adjust equipment.

• The limitations and effectiveness of certain PPE.

• The proper care, maintenance, lifespan, and disposal procedures for the PPE.

Testing PPE Effectiveness

Many different committees surrounding PPE have developed their own unique tests applicable to types of equipment to assess their usefulness and construction when used in the workplace. All PPE advertised by OSHA pass the ANSI standards, however there are additional tests done to ensure their application is necessary and effective in real world simulations. 

Many of the tests completed by committees are to study the way PPE responds when in motion. These tests are vital because they simulate real world situations when workers are climbing, walking on a site, or in motion in the event of an accident. Plenty of tests are run during the construction process of PPE to ensure their stability and durability in the face of exposure or collision. 

The most important tests that PPE is run through include their effectiveness when under different kinds of stresses. Most employers have working conditions that deal with at least one of these conditions, if not all of them. Some employees undergo working conditions that replicate all five tests on the same job. 

5 General Tests:

1. Ascent

2. Descent

3. Load bearing

4. Load bearing under stress

5. Friction

When ascending PPE needs to protect the worker from overhead dangers like spills, falls, and miscellaneous contusions. On the descent tests, PPE is analyzed in scenarios that replicate falls and rapid downward altitude changes. The descent test is incredibly vital in types of constructive work that involves large amounts of climbing and transporting materials from different levels. The load bearing test seeks to establish the stability of different PPE when a worker or equipment is suspended in place. Labs simulate load bearing under stress by adding swinging or momentum into the PPE test trial. The final test for PPE before deciding its credibility among employers is a friction test, establishing the durability of the equipment when moved between levels at high speeds. The friction test replicates the event of a fall or dropped item on a work site and can be applied to many different forms of PPE. 

Applications for PPE Tests

Many of the tests can be applied to the various PPE used by the industry, and having more than one test is an effective way at determining its durability in a real world environment. These tests not only put workers at ease knowing the equipment they use is in fact safe and effective, but also the employers. Industry leaders want the assurance that the kind of PPE they invest in for their companies is safe, effective, and actually prevents workplace injuries. The other caveat that comes from these tests is changes in the standardizations published by overhead administrations like OSHA and ANSI. If a certain PPE is found to be more or less effective than previously assumed, the standards advertised to employers may have to be entirely modified. These tests also provide clarity into the specific uses individual PPE should be used for, creating more uniform standards and expectations of certain industries. 

Blazing Temperatures Boil Florida

Relentless high temperatures across the southern United States have sent several coastal regions of Florida to boiling temperatures. Major ocean areas around the peninsula recently reached shockingly high temperatures of 96 degrees Fahrenheit. The extraordinarily high temperatures are completely atypical preceding many negative consequences for the nearshore wildlife, resource sustainability, and habitat stability of the region. 

Global warming is a major component of high temperature contributions, in addition to the settling of a warm weather dome across much of the United States this past month. The bath-like coastal waters are setting record breaking temperatures and may be foreshadowing of many similar events in the future, expected to impact the region. 

Florida Reaches Record Temperatures

The high 90 degree recorded water temperatures are more than 15 degrees above the average conditions for the coastal region. Water is an incredibly stable fluid element, only changing temperatures under extreme fluctuation pressures. The heat dome that settled around Florida caused the immense heat conditions that forced the nearshore water temperature to near 100 degrees. While the high water temperatures are only a temporary effect of the peculiar weather phenomena, the lasting effects could be devastating. 

Florida hosts an incredible array of nearshore wildlife, habitats, and resources that may all suffer from the high temperatures. The coral reefs in Florida are already incredibly fragile after many past bleaching events have left them exposed to continued damages. Loss of coral species is sometimes irreversible as they are slow growing organisms that rely on specific water temperature and salinity conditions. Coral reefs support all of the other ecosystems in the ocean by providing stable strata, habitats, and resources for reef fish and microorganisms. With the current temperature conditions and future projections, it is likely to result in significant loss of the already sparse reef. 

When temperatures increase past the threshold tolerable by corals, they succumb to the environment in what is known as a bleaching event. These events leave the bleached, white remains of the coral skeletons devoid of life. Fish and other previous inhabitants are forced away from the reef, bringing all of the upper ecosystems with them. Resulting habitat loss greatly deteriorated many of the fisheries relied upon by Floridians and the rest of the country. Only time will tell what the complete scope of loss will entail from this severe temperature event. 

The high temperature trends are expected to continue into late August and unfortunately coincide with the area’s hurricane season. This is another factor many meteorologists are keeping an eye on as warmer sea surface temperatures can exacerbate and accelerate cyclonic storms. The Gulf of Mexico and bordering states are prone to severe weather events that pass through the area, and these past month’s conditions are expected to continue that trend.  

Human Fueled Climate Change

Severe events like the localized warming observed in Florida have become more common over the last 75 years as human induced climate changes are beginning to affect major weather stability. With the onset of rapid industrialization of most of the world there have been significant increases in greenhouse gas emissions. These greenhouse gasses pollute the atmosphere and increase the carbon dioxide concentration in the upper atmosphere. Carbon dioxide traps heat which is reflected and reabsorbed by the surface of the Earth and especially the oceans. 

With increased heat trapping greenhouse gasses in the atmosphere, human activities are further accelerating global warming and events similar to this past month in Florida. Other effects caused by the localized global warming events may include more intense tropical storms driven by the high temperatures of the surface seawater in the Caribbean. These environmental fluctuations are likely to continue in frequency and intensity as global warming trends have not been abated and surface temperatures continue to rise.

Other regions of the United States are also experiencing the effects in the form of flooding, heat waves, wildfires, and other associated high temperatures. Global warming does not only affect the coastlines, beaches, and nearshore waters as it has implications for the entire topography of the world. 

Solutions to the Temperature Rise

As events like the extraordinary temperature conditions of the southeastern United States continue to happen, scientists and environmentalists continue to search for solutions. Most of the ideas being studied are for better understanding at the remedy of such events, as the cause is most often associated with the unfortunate byproducts of modern human activities. 

Remedies for heat events like that observed in Florida are focusing on coral retainment and recovery efforts, although concerns suggest there could be a mass fatality event of more than 90% of the living species in southern Florida. There is already an ongoing coral recovery program in southern Florida experimenting with coral plantation, genetic modification, and reef restoration projects. Many of these projects have been underway for more than 5 years and had seen phenomenal successes up until this event. Most coral restoration projects were focused on developing artificial reefs for corals to attach to, which would establish corals in barren areas and provide better natural barriers to incoming storm surge. 

All of these solutions are futile in environmental heat stress, because of the fragility of the coral species and their environmental relationship. It does not matter how many corals are planted, or reefs restored, if the ocean temperatures do not return to normal levels. The other striking outcome from continued events like this are naturally selecting out most of the nearshore coral species that are more sensitive to changes, and leaving those that dwell in deeper waters. 

Canada’s Raging Wildfires Spreading Toxic Smoke Across USA

Hundreds of uncontrolled fires have been setting massive areas of forests in Canada ablaze threatening critical infrastructure, millions of acres, and dozens of U.S. states. These forest fires began rapidly spreading this month and quickly spread across millions of acres after several instances of lightning strikes and failure to control small fires greatly exacerbated the magnitude of this natural disaster. 

Canadian officials are continuing to expel resources to fight the ongoing fires in the Quebec province. The country has enlisted aid from the United States in an effort to abate the ongoing disaster, although most of the damage has already exacerbated many of those additional resources. The resulting effects from the extreme fires have expelled enormous volumes of toxic gasses and smoke that has since traveled thousands of miles enshrouding many American states in the northeast. 

Canada Fires Wreaking Havoc

Multiple fires began in the Canadian Quebec province earlier this month, and they quickly grew into each other creating massive wildfires that began to rapidly scorch millions of acres of forest. The typical fire season for Canada lasts between May and October, but earlier summer temperatures have made many of the wild grasses and forest lands particularly dry this season creating many areas more prone to fire hazards. 

Many large areas of remote wilderness exist in large provinces like Quebec and that increases the difficulty of fire fighting resources from accessing the fires. More than 400 fires are currently burning across the country and more than 200 are described as being out of control, with the most severe residing in Quebec. 

The rapid growth of the wildfires severely crippled many areas of infrastructure throughout the province including road closures, rural evacuations, telecommunication interruptions, and continued risks to high voltage power lines. This critical infrastructure is experiencing massive shutdowns throughout the country and directly affecting tens-of-thousands of people. More than 100 of those fires are currently under urgent watch as they have grown past their original boundaries and are now posing risk to residents and commercial properties. 

The accumulation of massive forest fires across the country has interrupted people's daily lives, safety, and overall air quality. Canada has reached out to its neighbors in the United States for help and additional resources as the fires must be contained to prevent further damage. U.S. President Biden pledged to help and send aid in any way he can after speaking with Prime Minister Justin Trudeau. President Biden also repeated a resounding warning to many of the northeastern United States as they are currently facing their own challenges in response to the toxic fumes flooding the atmosphere and circulating south from the fires. 

Toxic Fumes Impact Northeast

The scale and duration of the massive forest fires affecting the Canadian wilderness has resulted in an enormous amount of toxic gasses entering the atmosphere. These gasses have continued to spread thousands of miles away from their origins at the fires and now pose significant risks to residents living in the northeastern United States. 

Videos and photos from downtown New York city this past weekend showed the towering skyscrapers in a scene that resembles something like the sunset over the Sahara Desert. Smoke, ash, and toxic chemicals filled the sky over many large cities in New England and the midwest as storm cell systems moved the gasses across the region. 

Health advisories were posted for millions of people residing in these heavily populated metropolitan areas as the thick smoke rapidly took over the sky. Many claimed the smoke burned their eyes, lungs, and left them with lingering chest inflammation. Health officials recommended remaining indoors and limiting time spent outside in direct exposure. Many residents also took up masks and air filtration devices eerily reminiscent of the covid-19 pandemic still lingering in many parts of the world. 

Individuals most likely to be affected by smoke inhalation symptoms include people working outdoors, namely in construction and development industries. Employers are encouraged to provide adequate protections in the form of respiratory protection for their employees as they will be facing increased risks. Other individuals with respiratory disabilities like asthma, emphysema, and autoimmune diseases are also at an increased risk. 

Future Events Imminent 

As climate change continues to impact many regions of the world, extreme forest fire events similar to this one are likely to become more common every year. The effects of climate change are gradual, but incredibly damaging to areas prone to fire hazards. Increased global temperatures can reduce annual moisture reaching the ground creating dry underbrush and vegetation that can easily catch fire and create a situation for rapid expansion of even small forest fires. 

Other effects climate change poses for increased wildfires is the modification of historical weather trends. Many areas in the north are experiencing earlier summer conditions and later falls. The changing seasons affects many of the critical industries previously mentioned and makes accessing necessary firefighting resources more difficult as they are not as readily available outside of the regular fire season.

Industries that respond to environmental emergencies are slowly adapting the the changing climate as they need resources much earlier than previously and they must maintain that level of aid for longer annual periods. Current firefighting efforts are still lacking effectiveness to the ongoing emergencies, even with help from the United States, and officials are working extremely hard to gain control. 

What is New With OSHA in 2023?

Each year occupational safety administrators seek to make changes that effectively keep employees safe while working. The Occupational Safety and Health Administration is a government agency working to ensure safety by setting and enforcing standards applicable to the United States Department of Labor.

Last year there were more than 2.5 million workplace injuries reported to administrators across the United States. These injuries more-or-less fit into categories involving overexertion, falls, object impacts, and bodily reactions to awkward postures. OSHA constantly makes reforms to their rules as needed in various industries. Their mission includes evolving with current events and addressing potential areas where any safety risks could occur. The changes with the new rules OSHA is proposing for 2023 will seek to better prevent these injuries and many others in the workforce. 

Who is OSHA?

OSHA began regulating workplace safety after the Occupational Safety and Health Act was passed in 1970. The origins of the administration arose after massive public outcries against rising injuries and death rates at work. Congress created the Occupational Safety and Health Administration to ensure safe and healthful workplace conditions existed for workers in all industries. The administration works to create and enforce specific safety standards by providing training, outreach, education, and assistance. 

Each year the administration receives a budget to effectively provide the resources needed to regulate workplace safety around the country. Originally this budget was utilized to develop the enforcement strategies best fit for businesses, but has gradually evolved into targeting more of those high-hazard industries that have continued ongoing workplace injuries. The current enforcement strategy aids in identifying the specific sites where high injury rates occur, and offers critical resources directly to the highest problem areas within labor departments. One of the most important proponents of OSHA’s enforcement plans is their education and outreach protocols that play vital roles dealing with health and safety. 

OSHA has invested heavily into its websites, educational materials, and resource distribution across the United States. More than 23 million users are present on the OSHA website each year, with more than 300,000 annual downloads of its advisor software systems. The administration has continued to branch out creating various web pages for individual employees, businesses, industry partners, and foraging counterparts in Europe and beyond. 

New Rules for 2023

This year OSHA has made some big changes in reforming many previously existing regulations to better fit the evolving industries in the United States. Here are 5 important changes that you should know about including record keeping, Lockout-Tagout changes, silica exposure, updated HazCom classifications, and shipping requirements. 

1. Recordkeeping Proposed Rule

OSHA published a new rule which would revise electronic injury and illness reporting requirements in US workplaces. Key impacts will include:

• Expanding reporting requirements to ensure companies with more than 100 employees are able to electronically submit all of their OSHA information, whereas previously they were only required to submit a single form’s data. 

• OSHA plans to publish the data collected from the electronic submissions on a public database after removing individual identifiers. Immediately this portion of the proposed ruling has garnered concerns about the likelihood and effectiveness of completely removing personal information from the data prior to being released to the public. 

• The new ruling will also provide exclusions for establishments with 250 or more employees from having to electronically submit their Form 300A information annually to OSHA. 

2. Lockout-Tagout (LOCO) Updates

LOCO is OSHA’s control of hazardous energy standards, initially established in 1989. This regulation has largely remained unchanged since its establishment although OSHA is finally modernizing it to match industry standards utilizing computer based safety softwares. 

• Most hazard controls in national industries recognize and incorporate many different computer based safety softwares. 

• A request for information (RFI) assessed the strengths and limitations of such software when controlling hazardous energy. 

• The RFI determined the current regulations in LOTO, which specifies control current devices are unsuitable for energy isolating devices, must be changed in response to recent technological advancements. Modern technologies may have improved the safety and control of such circuit type devices, and OSHA has responded by preparing to update the LOTO standard and compliance implications for employers. 

3. Silica Exposure Considerations

Silica dust particles are incredibly small and can become trapped in the lung tissue of a person who is exposed, leading to inflammation and scarring that can affect their respiratory tracts. The minute particles can reduce the lung’s capacity to take in oxygen causing a condition classified as silicosis. Silicosis can result in permanent lung damage as it is a progressive, debilitating, and sometimes fatal disease. 

OSHA developed two standards for respiratory silica, one for general industries like construction and one for maritime. Those 2016 standards established exposure action levels reducing the acceptable amount of total daily exposure, installing exposure control measures, and implementing medical surveillance programs to monitor employee health. The established regulations also required businesses and recordkeepers to maintain written documentation of the ongoing exposure control plans and maintain the OSHA standards. 

Other chemical exposure regulations like those that deal with lead, cadmium, and formaldehyde also yield an additional medical removal provision that the former silica regulations lacked. The medical provision required employers to monitor certain airborne exposure indicators or those found in blood concentrations, removing the employee from the contact area once exposure levels are reached. The United States Court of Appeals concluded that OSHA failed to explain its decision to remove the medical provisions from the 2016 silica regulations and remanded the rule for additional consideration of the implications. 

• OSHA is planning to revisit the silica rules and to implement a medical provision installing surveillance programs and removal procedures. 

• Employers that are subjected to the silica rules must ensure they have effective workplace inspection and hygiene standards, efficient incident management strategies, and the ability to promptly record medical removal cases. 

4. Regulatory Activities in Regards to Heat Exposure

The United States Department of Labor reported that hazardous heat exposure resulted in an average of 35 fatalities and 2,700 annual cases in industries across the nation. These injuries also resulted in multiple days away from work during the length of injury. 

• Heat exposure injuries may be incorrectly diagnosed or underreported due to failures when documenting at what point the heat exposure caused or contributed to the official cause of death and injury. This is especially true when the victim ultimately succumbs to some other life threatening condition such as a heart attack or stroke, which may have direct correlations with the onset of heat exposure injuries. 

• OSHA will initiate work on a heat exposure index standard. 

• New emphasis on indoor and outdoor heat related hazards.

5. HazCom Proposed Rule

Proposed updates to existing HazCom standards to align with the United Nations Globally Harmonized System of Classification and Chemical Labeling. 

• Classifications for flammable gasses, aerosols, and desensitized explosives.

• Additional requirements for various sized shipping containers. 

• Specific requirements for bulk shipments. 

• Required classifications of hazards under normal use including those that result in chemical reactions and other physical changes. 

More Plans For OSHA

As OSHA continues to evolve to better fit modern industries there are likely to be many more reforms down the road. The administration will continue to focus on reducing injuries, illnesses, and fatalities in all traditional industries while also looking ahead toward future challenges. Future safety violations may surround new chemicals or other workplace hazards in the growing service sector industries. OSHA regulations must also adapt to many more hybrid workplaces utilizing virtual assistance and AI technologies to either replace or assist the bulk of their employees.