The saying, "Hard work has never killed anyone", was never used by an OSHA inspector.

Introduction

The National Institute for Occupational Safety and Health (NIOSH) recognized that musculoskeletal injuries was the leading cause of disability of people in their working years and ranked first among health problems in the frequency with which they affected the quality of life. In response to this crisis, a National Symposium In The Prevention Of Leading Work-Related Diseases and Injuries was co-sponsored by NIOSH and the Association of Public Health in 1985. As a result of this symposium, proper worker selection method was identified as one of the key elements to developing an effective proactive program for injury prevention.

Determination of work capacity is an essential requirement in safely matching a new hire to job demands and/or returning the injured worker back to the job. The Americans With Disabilities Act (ADA) has caused employers to focus on determining valid requirements for determining whether or not a person, despite any real or perceived disability, can safely work. The increasing need to reduce musculoskeletal injuries (e.g., costly back injuries) and at the same time comply with the ADA has resulted in the growing use of ADA-compliant preplacement functional evaluations (PFE). In the context of this presentation, a PFE is defined as a job-specific physical capabilities evaluation performed by a qualified professional.

The authors have had extensive experience in the utilization of pre-placement functional evaluations (PFE) as a key element in an effective on-the-job injury prevention program.

The authors, a safety/risk management specialist and a clinician/ergonomist professional offer their views respectively on this process by discussing case examples and method of delivery of this Service.

Pre-placement Functional Evaluations - Case Examples
Case Presentation No. 1:

In 1988 the secondary author was employed as a manager of safety and health for a large independent exploration and production company and charged with the task of developing a program to reduce back injuries among the offshore and onshore field work force. Circumstances triggering the need to develop such a program included a four year injury history in which 95% of lost time injuries were back injuries. This included an annual average of nine reportable back injuries, four of which were disabling, and two which were permanent and total. Annual average workers compensation costs for back injuries during this four year period were $708,000, or roughly $3,000,00 for the four year period.

Employees sustaining back injuries during this period averaged 8 years with the company, and ranged in age from 21 to 57. An extensive injury prevention program that had been in place appeared to be working well for everything except back injuries. Program elements added to focus on back injury prevention included back school training, fitness awareness, and ergonomics. No changes were made in pre-placement medical screening, which was limited to the typical occupational physician evaluation without back x-rays or any special physical agility assessment.

The reduction effect on back injuries was immediate. Eighteen months after the program implementation reportable back injury frequency had declined by 67%. There were no disabling back injuries, and workers compensation costs were down by over $1,000,000. Twenty-four months into the program the first disabling back injury occurred resulting in one day of lost time. However, thirty months into the program two permanent and total back injuries occurred. Both injuries involved new hires, both employees were offshore mechanics, and both had degenerative disc disease. Another disabling back injury occurred around the same time, a back strain to a long tenured lease operator, resulting in three days lost time.

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