Corporate Training Magazine

Stopping the Psychosocial Risks of RSIs
Vol 1 Issue 1 - Sept 2005

By Dennis Merrill

Workplace injuries are taking on a new direction in Canada and across North America, with repetitive strain injuries (RSIs) now accounting for one-third of all workplace injuries. RSIs also account for a growing number of lost-time claims and treatment costs.

"Some people are referring to RSI as the workplace injury of the new millennium," reported Millard Health psychologist Andre Masson.

The statistics back up Masson's claim. The Workers' Compensation Board reported that in 2004, 60% of claims were for injured workers between the ages of 35 and 50 years, the average lost time claim cost was $5,628, and the total cost per year was $1.7 million.

The cost for treating repetitive strain injuries has also consistently been significantly above non-RSIs. In 2000 the average repetitive strain injury cost was $4,874. In 2003, it was $6,682. For all non-repetitive strain injuries, the average cost in 2000 was $2,923. In 2003 it rose to $3,463. WCB also reported that 28% of all RSI claims resulted in time off work and the average time lost was 38.58 days added proof of the need for companies to take a proactive approach.

While an increasing number of companies are recognizing the physical factors in their workplace (such as ergonomics), there are also a number of psychosocial risk factors surrounding RSI.

These factors include:
1. Lack of information
People who do not know the preventative measures to take (ergonomics, pacing, stress management) are at risk.
2. Stigma
A workplace in which RSIs are perceived as a sign of weakness or laziness will discourage preventative measures and care during early stages of injuries.
3. Excessive workload demands
Employees who are expected to work through breaks or lunch (by management, by co-workers or by job demands) are not able to effectively use ergonomics and pacing skills. Consistently working through breaks or lunch will increase risk.
4. Consistent overtime
While occasional overtime poses little or no increased risk, a regular routine of working overtime is accompanied by fatigue and stress, both of which increase the risk of RSIs.
5. Prolonged rushed working conditions
The added workload, increased time demands and tight deadlines inherent in today's workplace all encourage less well-considered work habits and can increase muscle tension.
6. Uncertainty
In the workplace, a long period of employee uncertainty on issues such as job security, promotions, transfers and performance appraisals can increase muscle tension and the risk of injury.
7. Workplace conflict
Long-term conflict can lead to a tense, frustrating workplace and chronically tight muscles, both of which can increase the risk of RSIs.

"The nature of psychosocial risk factors is such that they contribute to all repetitive strain injuries in more or less the same way heightening muscle tension, increasing carelessness and force in motor movements, decreasing self-care, and decreasing general health. The most common RSIs are tendon problems. Tendonitis is often the first injury. It can then develop into tendonosis (the fraying or deterioration of that tendon) or Carpel Tunnel Syndrome can also develop," stated Masson.

He explained that as with any type of injury, early diagnosis and treatment of RSIs is very effective in preventing their development into a more serious injury. "Mild tendonitis will cause no permanent damage if treated soon enough. But if it develops into significant tendonosis, it will likely cause permanent damage. Further, early diagnosis and treatment can actually prevent injuries from occurring in the first place."

Open discussion plays an important preventative role. For example, when one employee is diagnosed with an early RSI in a socially healthy workplace where injuries are treated as normal and treatable occurrences, that employee may talk to other employees about the injury. The discussion may include the risk factors that lead to the injury, how to avoid those risk factors and the sort of treatment appropriate at an early stage of the RSI. The other employees can then take appropriate precautions to prevent similar injuries to themselves.

Masson informed that RSIs can be minimized and treated if caught in the early stages. The risk and subsequent cost of RSIs dramatically rise if left unattended until the later stages of development. In these later stages, lack of information about and appreciation of RSIs becomes much more important. "When the employee is wondering what is happening to his or her arm, a work environment that demands the employee be tough and ignore any pain may result in the injury going untreated and getting worse, to the point of work time being lost later on."

Unfortunately, many employees suffering from these injuries do not seek treatment in the early stages because of the psychosocial factors surrounding RSI in the workplace. One of the main factors preventing this early diagnosis and treatment is the stigma surrounding RSIs.

Masson explained, "An RSI that is often not immediately obvious to co-workers and employers is occasionally treated as a form of laziness. This results in employees hiding their incipient symptoms, failing to get simple information about preventing or treating the minor injuries as they start, and allowing the more serious injuries to develop."

One promising indicator for companies and employees is that the stigma surrounding RSI appears to be diminishing. Recent studies show that the growing number of cases of RSI is serving to increase awareness and understanding, which in turn decreases the stigma.

"As more people develop RSIs, the stigma is decreasing. Especially as employers and others involved in the management of injured employees themselves develop RSIs, or as they watch family members develop injuries, the recognition of the need for appropriate attitudes towards this injury is developing. The ongoing decrease in the stigma associated with this injury may be an important factor in maintaining or increasing workplace productivity in this new millennium," reported Masson.

Knowledge of proper ergonomics, pacing and RSIs is the best way to prevent these injuries. A corporate culture accepting of these injuries and willing to put some resources into preventing them is also very helpful. Some steps that companies can take to address and prevent the psychosocial factors include:

making employee and family assistance programs available and accessible
decreasing workplace stress by allowing employee input into decisions that affect they way they do their jobs … addressing the social and other sources of workplace stress early
for workplaces that involve shift work, providing information on how to get regular and good sleep.

Masson concluded, "Knowledge is an important tool in preventing and treating RSIs. The more the employer knows about this type of injury, the more the work environment will be arranged to decrease risk factors. The more the employee knows about RSIs and ergonomics, the less behavioural risk factors will contribute to the development of RSIs, and the sooner minor injuries will be detected and treated. The more the workplace as a whole knows about RSIs, their prevention and treatment, the more productive an attitude will prevail in the workplace."