The Occupational Safety and Health Administration (OSHA) continues to ignore back support belts in all the guidelines it has published, such as:
-- “Ergonomics Guidelines for Nursing Homes”;
-- “Ergonomics for the Prevention of Musculoskeletal Disorders: Guidelines for Poultry Processing”; and
-- “Ergonomics for the Prevention of Musculoskeletal Disorders: Draft Guidelines for Retail Grocery Stores.”
Those three industries — nursing homes, poultry processing and retail grocery stores — are prime examples of where ergonomics is needed. And back support belts likewise.
Back support belts are not even mentioned in the guidelines. When OSHA issued its ergonomics standard in November 2000 (which was summarily overturned by the Congressional Review Act), it stated in the preamble that “the Agency is persuaded that the evidence of the effectiveness of back belts, although limited, exceeds that available for other types of equipment that workers wear that is classified as personal protection equipment (PPE). OSHA has therefore decided not to prohibit the classification of back belts as PPE for the purposes of this standard.”
So you’d think that back belts would be mentioned, at least as an option. OSHA’s published guidelines for poultry processing contain a list of personal protection equipment, such as gloves and footwear. But not back belts.
OSHA also lists studies that support the effectiveness of ergonomics in nursing homes, poultry processing and retail grocery stores. But you won’t find a word about any study that advocates the use of back support belts — for example, the extensive study of Home Depot employees from 1989 to 1994 (MHM, January 1997). The results apply to any retail activity that involves lifting.
Back support belts in nursing homes were addressed in a 1998 study. Researchers at Loma Linda University studied a large nursing home chain and found a 33% reduction in low back injuries after back belts were applied. These are just two of the eight studies of back support use from 1995 to 1998.
You’d think that the reconstituted OSHA would at least give all the folks in the nursing home industry, the poultry industry and the retail grocery industry the option to use back support belts, especially since there are major studies that show their effectiveness.
Why the omission? Well, the National Institute for Occupational Safety and Health (NIOSH) has always disapproved of back support belts and would like to recommend against their use. In 1994, the Back Belt Working Group of NIOSH published the “Workplace Use of Back Belts,” a 24-page booklet which stated that the Working Group “does not recommend the use of back belts to prevent injuries among uninjured workers, and does not consider back belts to be personal protective equipment” (bold-faced “does not” courtesy of NIOSH).
You might get the impression that NIOSH was fixated on back support belts, especially since that agency published “Back Belts — Do They Prevent Injury?” right on the heels of “Workplace.”
Likewise, you might conclude that NIOSH has an ax to grind in selecting the studies that are included with OSHA’s various guidelines.
“It’s not important,” you argue. “Nobody has to pay attention to the guidelines — it’s not like they’re standards.” Each guideline contains a disclaimer like: “Furthermore, the fact that OSHA has developed this document is not evidence and may not be used as evidence of an employer’s obligations under the general duty clause; the fact that a measure is recommended in this document but not adopted by an employer is not evidence, and not be used as evidence, of a violation of the general duty clause.” You’ll never find that language in any standard.
Whatever the arguments for or against the guidelines, back support belts should be offered as an optional ergonomics strategy. Nurses, grocery clerks and poultry workers deserve as much.
Bernie Knill, contributing editor