Magazine article Risk Management

Post-Employment Screening for MSDs

Magazine article Risk Management

Post-Employment Screening for MSDs

Article excerpt

Musculoskeletal disorders (MSDs)--such as carpal tunnel syndrome, hand tendonitis and shoulder inflammation--cost the U.S. economy between $13 and $15 billion annually. As a result, many executives who promote MSD prevention need to look carefully at better testing for predicting who is at risk during hiring and before putting people in new jobs. Such screening should be carried out after an applicant is given a conditional job offer, in accordance with the Americans with Disabilities Act (ADA). In theory, screening employees minimizes hand disorders in jobs having upper extremity MSD risks. Screening is also thought to benefit employees by achieving proper diagnoses and foregoing unnecessary surgery.

In comparison, federal and state OSHA regulators expect inherently hazardous jobs to be evaluated, and the risks designed out of them, to the extent possible. Companies having taken initial risk reduction steps and refinements are most likely to benefit in the long term. On the other hand, regulatory compliance officers put little stock in what they consider to be administrative efforts, such as employee screening to control potential injuries. Therefore, the use of post-offer screening is not likely to ward off potential OSHA enforcement concerns.

Other governmental agencies mandate close adherence to their regulations, like the Equal Employment Opportunity Commission (EEOC) and the ADA. In accord with ADA requirements particularly, job-related screening is a significant issue, particularly for identifying problems with workers' upper extremities. Whether by choice or by mandate, employers would be well-advised to establish some kind of post-employment screening process to determine employees' susceptibility to MSDs as a matter of prevention. Testing may include fitness-for-duty, electronic screening, written exams, nonwork-related physicals, strength capability, clinical exams (e.g., Tinel's sign or Phalen's maneuver) and others.

The current "gold standard" for MSD diagnosis is the NCV test, which measures the speed of impulses through a nerve, using an electrical stimulus to the nerve. NCV testing costs around $550 per limb, however, not counting attending physician evaluation charges. It also regularly produces false negatives for symptomatic people and false positives for asymptomatic people. …

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