June 21, 2000

U.S. Department of Labor
Occupational Safety and Health Administration
Attn: Mr. Charles Jeffress, Assistant Secretary of Labor
200 Constitution Avenue, NW (S.2315)
Washington, DC 20210

Assistant Secretary Jeffress:

The American Society of Safety Engineers (ASSE), on behalf of its nearly 33,000 members, submits the following post-hearing comments concerning OSHA's proposed Ergonomic Program Rule, (64 Federal Register, 65768 11/23/99).

Reference to Previous Statements
ASSE requests that the following documents, already submitted to OSHA by the Society, be made part of the final record:

• Testimony of American Society of Safety Engineers (ASSE) on the Matter of: Department of Labor, U.S. Occupational Safety and Health Administration Proposed Ergonomics Standards (Chicago, Illinois, 4/21/2000).
• ASSE Formal Ergonomics Testimony to the House of Representatives Subcommittee on Regulatory Reform House Small Business Committee (Washington, DC, 4/13/2000).
• ASSE Formal Comment on the OSHA Ergonomics Proposed Standard (2/28/2000).
• ASSE Request for Comment Period Extension - OSHA Ergonomic Draft Standard (12/17/1999).
• ASSE Statement on the OSHA "Working Draft" Ergonomic Program Standard (6/4/1999). This document also contains the Society's official counter proposal draft standard to OSHA.
• ASSE Ergonomic Position Statement, (5/9/1997).

Recognition of Health Care Professionals (HCP)
During the hearings, it became more evident than ever that the Agency needs to significantly revise its positioning of HCPs in the proposed standard. We remain concerned that OSHA has included HCPs virtually "en-masse" in the standard regardless of their overall background, training, education, and experience in ergonomics. On several occasions we observed HCPs testifying about engineering controls even though it was apparent from the testimony that he/she had absolutely no idea of what they were testifying to. The list could go on-and-on, however, here are just some examples of issues addressed by HCP testimony:

• HCP statements addressing workstation design and analysis.
• Engineering aspects of Job Hazard Analysis.
• HCPs as the "hub" of effective ergonomic intervention management programs.
• Bending/lifting techniques are preferable to engineering controls which would run the opposite of the draft standard's intent.
• Licensing as a HCP is fundamentally equivalent to that of professional safety or ergonmics certification.

One of our primary concerns with the draft standard is that the verbiage explaining the proposed standard generally leaves the impression that health care professionals are the preferred long-term choice for ergonomic consultations and evaluations. The language in the preamble specifically refers to safety professionals and engineers as "personnel" while health care is recognized as a "profession". While the language in the rule itself does not leave this impression, the preamble and supporting text does. These documents explain how the standard will be implemented and enforced in the workplace. The Society has taken the position that this approach is poor public policy and we will actively oppose its final promulgation. Finally, ASSE maintains that the testimony delivered in the hearings appears to support our concern, that the general public perceives HCPs as the primary professional responsible for the identification and mitigation of WMSDs in the workplace. Such a perception is wrong and will be harmful to workers.

ASSE points out that we see little formal education and training for HCPs in regard to recommending engineering and workstation design. Safety professionals who practice ergonomics use this type of education and experience to conduct systematic analyses of workstations and work methods and provide recommendations to mitigate these hazards. We request that OSHA iterate for us the specific engineering and safety qualifications of HCPs. Safety is multi-disciplinary. As a result, safety professionals know where their expertise begins and ends. There are certain functions that safety professionals cannot perform because of education, background and experience. It is imperative that OSHA also specifically recognize similar limitations for HCPs in the standard.

We do not question that health care professionals, specifically, Occupational and Physical Therapists are highly trained in musculoskeletal disorders. Some of these persons belong to ASSE, and we are aware that these professionals spend at least four to six years in college. We are also aware that they must pass a registration examination and be licensed to practice in each state. However, it must be noted that most, if not all of this curriculum includes analysis of activity and motion with specific understanding of musculoskeltal anatomy and kinesiology. We see the emphasis of this background to be in anatomy, joint protection and body mechanics. We generally see no analysis, design or engineering in such curriculum. OSHA as a general rule requires engineering controls before considering lifting motions and other anatomical approaches to mitigate hazards.

We note that several witnesses claimed that before the prominence of ergonomics, HCPs would travel to worksites to perform worksite ergonomic evaluations and determine prevention and intervention strategies. The experience of our 33,000 members would indicate there have been few instances of a HCP providing an overall evaluation of a work station from the ergonomics perspective including engineering and management controls. The concern of ASSE is that under the current OSHA proposal HCPs, traditionally remediation providers, are positioned as the primary providers to recommend workplace preventive measures. At the same time the proposal, through its explanatory text, would appear to exclude safety professionals competent and trained to provide such services. While ASSE acknowledges that some HCPs are qualified to provide such consultation, many others lack the overall background, experience, or technical education to understand the complexity of the workplace based upon physical injury diagnosis alone. After hearing the testimony presented at the hearings, we reaffirm our belief that the following questions and issues need to be resolved by OSHA before allowing the proposal to move forward:

• Why are safety professionals not directly cited in the draft standard, under proposed Section 1910.945 Key Terms and Definitions, when these professionals will be responsible to implement the standard if or when it is promulgated?
• Why does OSHA consider those persons performing engineering or safety functions to be personnel, while those who provide health care related functions are considered to be professionals? This questions refers specifically to the 11/23/1999 Federal Register announcement on Page 65823, left column, bottom of the page "Identify Controls".
• Does the standard provide health care professionals with unfettered access to the workspace since our interpretation is that it does?
• Does the standard really clarify the role of the health care professional in regard to MSD management, or does it provide the health care professional with abatement responsibilities far beyond his or her background?
• Is the opinion of a health care professional unquestionable if they offer hazard abatement strategies to safety professionals regardless of his or her overall occupational safety and health background? This questions refers specifically to the 11/23/1999 Federal Register announcement on Page 65844, right column, bottom of the page and on Page 65485, right column, top of the page.
• The proposal also appears to specifically recognize that health care professionals have the opportunity to suggest workplace changes. How will OSHA ensure that these health care professionals are qualified to provide such consultation?
• Does OSHA have any data or studies indicating that health care professionals have the experience, technical education, and overall background to provide ergonomic consultation?
• Does OSHA not see an urgent need to look at the overall issue of credentials for those professionals qualified to perform ergonomic evaluations?

We agree with most of the witnesses that ergonomics is a part of the entire safety issue. We also agree that safety professionals and safety engineers are the coordinators of safety programs, and that healthcare providers are an important component of a program. We do not question that injury management and rehabilitation require the expertise of an HCP. But, we would strongly disagree with some of the claims that analysis and engineering of workstations are part of the health care discipline. We agree that safety professionals and HCPs should work together when the disciplines meet. There is no question that these people are important pieces of the whole safety picture. But, we believe it is a professional responsibility for both professions to understand their limitations and stay within them.

ASSE truly believes that OSHA's poor treatment of safety professionals is due to a simple oversight, and the entire situation could be quickly remedied with a clarification of the explanatory text in the standard if/when it is published. We are convinced that more inclusion of safety professionals in the standard makes sense from an economic, professional, public and worker protection point of view. ASSE looks forward to working with OSHA on this issue, and our hope is that we can resolve this concern in a manner helpful to safety professionals and the employees and employers they are responsible to safeguard. We feel that a clarification will benefit safety professionals, and most importantly the American workforce they are dedicated to protect.

Sincerely,

Frank H. Perry, CSP, P.E.
Society President, 1999-2000

Copy to:

ASSE Board of Directors ASSE Council on Professional Affairs ASSE Council on Practices and Standards ASSE Governmental Affairs Committee

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