OSHA Inspection: UNIVERSITY OF IOWA HOSPITALS & CLINICS

Issued

Mar 15, 1999

Abate by

Jul 26, 1999

Penalty

Initial $5,000 · Current $4,000 Reduced

Hazardous substances 8300

General-duty citation text

Iowa Code (1999) - Chapter 875
88.4: The employer did not furnish employment and a place of employment
which were free
from recognized hazards that were causing or likely to cause permanent
disability or serious
physical harm to employees in that employees were exposed to stressors
such as, but not
limited to, repetitive motion, high forces, and awkward postures:
(a)University of Iowa Hospitals and Clinics, Dietary Department -
Employees were required to perform tasks involving identified
ergonomic risk factors including, but not limited to, repetitive motions,
high force, awkward postures, lifting heavy and bulky material, and
excessive reaching for items, which resulted in stressors that had
caused, were causing, or were likely to cause work-related
musculoskeletal disorders (WMSD).  WMSD's such as carpal tunnel,
bilateral carpal tunnel, trigger finger, tendinitis, pain with loss of
range
of motion, sprains, and strains resulted in lost work time or restricted
work activity for employees in the dietary department. Areas where
WMSD's occurred include, but are not limited to, ingredient assembly,
vegetable preparation, meat slicing and the bakery. The 200 logs for
1996, 1997, and part of 1998 show that at least 52 employees in the
department experienced work-related musculoskeletal disorders.
(b)University of Iowa Hospitals and Clinics, Dietary Department -
Employees, including supervisors, were not provided information and
training necessary to: 1) recognize WMSD signs and symptoms, and
the importance of early detection and reporting, 2) report WMSD
signs, symptoms, and hazards, and make recommendations, 3) follow
general WMSD administrative control measures, 4) utilize job-specific
enginering controls and work practices that have been implemented in
their jobs, 5) understand and participate in a comprehensive ergonomic
plan, and 6) (in the event of the occurrence of a WMSD) follow
medical management protocol and perform job tasks in a manner that
meets the employee's medical/work restriction.
(c)University of Iowa Hospitals and Clinics, Dietary Department -
Job tasks that exposed employees to recognized ergonomic stressors
were not changed, or otherwise engineered, to reduce or eliminate
those stressors. Job tasks observed as having easily corrected risk
factors include, but are not limited to, the following:
1) ingreient assembly, where the job task required repeated reaching
into containers placed at floor level and bending over and reaching to
scoop and weigh material. These stressors could have been reduced or
eliminated by changing the elevation of containers and scales, and by
using different bulk containers;
2) vegatable preparation area, where, among other stressors, work
practices involved repeated high reaches into boxes with repeated
grasping of vegetables. High reaches could have been eliminated byplacing
vegetable boxes on their side, or by emptying the contents of
the boxes prior to performing the job task;
3) meat slicing, where slicing operations were performed by the
automatic slicer in the "manual" mode causing repetitious and forcefull
arm extention. This stressor could be eliminated by using the
"automatic" mode of the slicer;
4) bakery, where repeated reaching and bending over was required to
scoop product from mixing bells. This stressor could have been
eliminated by elevating the bell, or by placing the product at the proper
height to maintain neutral postures.
In all areas, job rotation was a feasible method of reducing exposure
which was not utilized by the employer.
Among other methods, one feasible and acceptable abatement method to
correct these
hazards is to implement an effective program following  Ergonomics Program
Management
Guidelines For Meatpacking Plants.
Another method of acceptable abatement is to correct deficiencies in the
existing
ergonomic plan. To the extent not already implemented, the following
elements of an
ergonomic plan should be implemented in the dietary department.
A.Worksite Analysis
1.Have a professional perform a comprehensive work site
analysis.
2.Identify high risk jobs and specific risk factors in all
departments.
3.Identify light duty jobs and specific risk factors and
restrictions for each job.
4.Review safety and health records to identify problem
areas and develope a trend analysis.
5.Conduct periodic symptom surveys and employee
interviews.
B.Hazard Prevention and Control
1.Ensure that knives are sharpened appropriately for each
task.
2.Ensure that new hire and return to work conditioning
procedures are adequate and within any medical
restrictions.
3.Encourage job rotation or other administrative controls.
4.Implement a rest/exercise program to provide relief for
fatigued muscle tendon groups.
5.Provide a variety of grips and designs for knives and
other equipment.
6.Implement engineering controls where feasible.7.Provide personal
protective equipment as a temporary
control.
C.Medical Management
1.Encourage early reporting of symptoms and evaluation of
symptoms.
2.Provide case management including identifying the
person in charge, monitoring, and follow up.
3.Provide effective conservative treatment including earlier
intervention and prevention to reduce the number of
surgeries.
4.Provide conservative return to work program and follow
up.
5.Provide specific job hardening instructions for return to
work.
6.Ensure that adequate relief personnel are available to
provide employees, with restrictions, access to timely
medical treatment.
7.Provide specific written return to work protocols to all
personnel.
8.Implement an effective communication system, at all
levels, to ensure employees returning to work are
following restrictions.
D.Training and Education
1.Physicians should show evidence of having attended a
course or seminar dealing with CTD's.  Physicians
should also be aware of specific hazards and conditions
related to the facility.
2.Employees need training to be able to identify ergonomic
hazards, the basics of body mechanics, and work
practices to minimize the ergonomic hazards of their
jobs.
3.Supervisors and lead people need additional training in
identifying early signs and symptoms of CTD's and
responding, through appropriate intervention, to prevent
these injuries.
4.Management need to be able to identify light duty work
assignments and limitations involved in employees' work
restrictions.  They also need to be aware of plant
resources which will prevent CTD's and make these
resources available to employees, their representatives
and supervisors.
5.Health care providers need training in specific guidelines
for preventing and eliminating CTD's.
6.All personnel need thorough training in the purpose andfunction of the
program.
E.      Management Leadership and Employee Participation
1.Assign and communicate responsibilities for setting up
and managing the ergonomics program so managers,
supervisors, employees, and their representatives know
what is expected of them and how you will hold them
accountable for meeting those responsibilities.
2.Provide those persons with the authority, resources,
information, and training necessary to meet their
responsibilities.
3.Examine your existing policies and practices to ensure
they encourage reporting and do not discourage
reporting.
4.Identify at least one person to:
(i) Receive and respond promptly to reports about signs
and symptoms of WMSDs,WMSD hazards and
recommendations.
(ii) Take action, where required, to correct identified
problems.
5.Communicate regularly with employees and employee
representatives about the ergonomic program and their
concerns about WMSD's.
F.Recordkeeping
1.Maintain an accurate injury and illness log.
2.Maintain accurate first reports of injury and illness.
3Develope an ergonomic trend analysis based on the
reported injury and illness entries.

Issued

Mar 15, 1999

Abate by

Apr 29, 1999

Penalty

Initial $7,000 · Current $2,125 Reduced

Hazardous substances 8870

Issued

Mar 15, 1999

Abate by

Apr 29, 1999

Issued

Mar 15, 1999

Abate by

Apr 29, 1999

Penalty

Initial $5,000 · Current $2,125 Reduced

Hazardous substances 8870

Issued

Mar 15, 1999

Abate by

Apr 29, 1999

Penalty

Initial $2,000 · Current $2,125

Issued

Mar 15, 1999

Abate by

Apr 29, 1999

Penalty

Initial $5,000 · Current $2,125 Reduced

Hazardous substances 8870

Issued

Mar 15, 1999

Abate by

Apr 29, 1999

Penalty

Initial $7,000 · Current $1,000 Reduced

Issued

Mar 15, 1999

Abate by

Apr 29, 1999

Penalty

Initial $2,000 · Current $1,000 Reduced

Issued

Mar 15, 1999

Abate by

Apr 29, 1999

Penalty

Initial $3,000 · Current $1,167 Reduced

Issued

Mar 15, 1999

Abate by

Apr 29, 1999

Penalty

Initial $3,000 · Current $1,167 Reduced

Issued

Mar 15, 1999

Abate by

Apr 29, 1999

Penalty

Initial $3,000 · Current $1,166 Reduced