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This page describes the research projects that have been conducted by SHARP since its inception in 1990. Reports describing the findings of these studies are listed on SHARP's Publications page.

Project descriptions

Developing strategies for injury and illness prevention

Evaluation of Washington State's ergonomics rule implementation

The Centers for Disease Control and Prevention (CDC) funded SHARP to evaluate the implementation process of Washington State's ergonomics rule. The study was completed in 2004. The rule was repealed by voter initiative in 2003. The overall goal of that project was to evaluate whether the implementation of the Washington State ergonomics rule increased employer and employee awareness of work-related musculoskeletal disorders (WMSDs) and their workplace risk factors. The expectation was that increased hazard identification and control activities in establishments covered by the rule would ultimately reduce the burden of WMSDs in Washington State well before enforcement began. To accomplish these goals SHARP surveyed Washington businesses in 2001 and 2003 on the extent of WMSD hazards in their workplaces and on any steps they were taking to address these conditions. These surveys were followed by site visits conducted by University of Washington researchers. Trade association and union newsletters and journals were monitored by University of Washington Department of Communications researchers, for increases in articles on ergonomics awareness. Washington's WMSD workers compensation claims were also monitored over the study period. The results of this ergonomics study are available from SHARP. Completed.

Healthy Workplaces project

In 1999, the State legislature provided funding that enables SHARP to determine the relationship between financial health, organizational health and worker health in Washington businesses. SHARP's "Healthy Workplaces" project will examine patterns of best practices in a given industry by conducting an industry-wide telephone survey and workplace site visits. Also, by analyzing several statewide administrative databases, we are able to evaluate employment and revenue growth, workers' compensation claims, and the potential for worker exposure to hazardous chemicals. This information will assist in the development of strategies that both enhance economic performance and improve worker health. Ongoing.

Participatory ergonomics in bareroot tree nurseries

Agricultural workers are exposed to the same risk factors associated with work-related musculoskeletal disorders as workers in other industries such as meat packing and construction. SHARP is conducting an ergonomics intervention study, partially funded by NIOSH, in bareroot tree nurseries in Washington State. The primary objective of this research project is to assess the effectiveness of a participatory ergonomics program at identifying and eliminating or reducing exposure to risk factors associated with work-related musculoskeletal disorders. Participatory ergonomics involves the active support and involvement by management and support in the identification of ergonomics problems and in the development of economically and technically feasible solutions. Completed.

Seattle-King County ALERT (Adult Lead Exposure Reduction Testing) project

Information from the lead users survey helped identify businesses for this educational intervention project which is funded by a grant from the National Institute for Occupational Safety and Health (NIOSH). With the ultimate goal of reducing the number of lead-overexposed workers, SHARP provided information and assistance to King County lead-using industries, such as auto radiator repair shops, glass manufacturers, and firing ranges, in order to facilitate increased blood lead testing, exposure monitoring, and the use of exposure controls. Linked with the Adult Blood Lead Registry, this project integrated case-based surveillance activities and hazard surveillance to help prevent occupational lead poisoning. Completed.

Heat stress determination and management

Industrial Hygiene and Ergonomic team members assisted an aluminum reduction facility in a joint labor/management heat stress evaluation. SHARP personnel provided technical assistance by applying technologically innovative approaches to the problem of working in a hot environment. Completed.

Drywall project

At the request of drywall industry labor and management, SHARP investigated the use of several different devices for manually handling drywall boards. A one-person handle and two person handles were compared to using no assistive device. Measurements included muscle activity (electromyography), heart rate and perceived exertion. Although awkward postures were reduced with the one-person handle, the weight of the handle was a problem. The small two person handles reduced the physical load compared to using no handles. Please contact SHARP for a copy of the report. Completed.

Exploring specific risk factors and health problems

Prospective study of upper extremity musculoskeletal disorders

The objective of this study is to evaluate the relationship between work-related factors and the development of non-traumatic soft tissue musculoskeletal disorders of the upper extremities, such as carpal tunnel syndrome and tendonitis. Approximately 1,000 workers will be followed prospectively for 3 years to determine the interactions between different work-related and individual risk factors on both incidence and persistence of musculoskeletal disorder symptoms, clinical findings, and compensated injury claims. Manufacturing sites and hospitals are participating in this NIOSH-funded study. Ongoing.

Indoor air quality issues in Washington State workplaces

SHARP is actively involved in investigations of workplaces contaminated with toxigenic molds and other microbiological contaminants. SHARP staff have recommended qualified private industrial hygiene companies to perform sampling of contaminated workplaces; participated in site visits with L&I’s industrial hygiene consultants and compliance staff; collected preliminary samples for analysis; provided oversight on more extensive sampling conducted by a private industrial hygiene company; reviewed previous industrial hygiene investigations; coordinated a workplace’s application for a NIOSH Health Hazard Evaluation; worked with L&I's Chemically-related Illness (CRI) unit to ensure that IAQ-related claims are handled by the appropriate claims managers; conducted a Health Symptoms Survey and provided the results to treating physicians and the CRI unit; and addressed IAQ questions posed by employees, building managers, and employers. SHARP also provided WISHA with technical support for its regional directive on indoor air quality (356 KB PDF). Ongoing.

Nursing homes

Nursing home workers are at high risk for musculoskeletal disorders, particularly back and shoulder disorders. The majority of these disorders are related to resident handling activities. SHARP began working with a local nursing home to develop a prospective study of those combinations of resident handling loads that may predict back and shoulder disorders. SHARP received a NIOSH NORA (National Occupational Research Agenda) grant to evaluate the effectiveness of several different kinds of interventions to reduce back and shoulder disorders due to resident handling activities. Using industry wide surveys and selected site visits at baseline and follow-up, SHARP will be able to assess whether implementing a "zero-lift" environment reduces these resident handling related disorders. This study will continue until 2001 in order to evaluate short-term and long-term effects. Completed.

Exposures to metalworking fluids in Washington machine shops.

Metalworking fluids, including cutting oils, coolants, and machine oils, are composed of numerous potentially toxic substances, and can be contaminated with bacteria, fungi, and microbial toxins. Overexposure to these substances has been associated with cancer, skin conditions (such as dermatitis), and lung diseases (including asthma and pneumonitis). SHARP is performing a comprehensive evaluation of the potential exposures posed to Washington state workers and is working with federal, state and local agencies concerned with hazardous waste reduction to evaluate the potential for health problems associated with recycling metalworking fluids and extending their working life. A fact sheet for workers and a resource for employers and health & safety personnel are available that describe the hazards associated with using metalworking fluids and provide suggestions for controlling toxicity and exposure. Ongoing.

Work-related disorders of the knee in Washington State, 1990-98

There were 7,822 claims due to knee disorders per year in the Washington State Fund workers compensation database. 5,432 of these were due to soft-tissue disorders, such as strains and sprains, or inflammation or irritation of joints or bursae (fluid-containing sacs around the kneecap). Among the soft-tissue disorders, there were 218 claims, consistently diagnosed as patellar bursitis (bursitis of the knee) or tendinitis. Except for patellar bursitis and tendinitis, knee disorders had, in most cases, a sudden onset and were associated with falls, slipping or tripping. A gradual onset was seen only in 5 percent of the cases. Bursitis or tendinitis of the knee had a gradual onset in more than half (52%) of the claims, typically as a consequence of abrasion against a hard surface. These latter disorders were seen in occupations such as carpenters and floor workers, masons, stone workers, and tile setters. They were also seen in plumbing, heating, and air-conditioning work and among employees of general building contractors. Completed.

Falls in the construction industry

The construction industry is at high risk of injury in general, and is at particular risk of fall-related injuries. A study of workers' compensation claims was undertaken to examine this problem. The study describes fall injuries in this industry and trends over time and examines injury rates in Washington construction companies before and after they were inspected by WISHA and cited for violating the fall protection standard. We found that those companies that were inspected and cited had a greater decrease in fall-related compensable claims after the WISHA inspection than those companies (of the same size and industry type) who had no inspection. Please contact SHARP for a copy of the report. Completed.

Health and satisfaction in the office work environment

Working with the Environmental Protection Agency, SHARP took a comprehensive look at what makes a healthy office work environment by studying their own Labor & Industries coworkers. Reductions in hand/arm and shoulder/back symptoms were observed that were mostly associated with employees' perceptions of improvements to the physical work environment. Completed.

Violence in Washington workplaces

Two 1995 projects examined violence in Washington workplaces. The first was a review of existing data sources, including the U.S. Department of Labor Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries, the BLS annual Survey of Occupational Injuries and Illnesses, and Washington State workers' compensation claims. High-risk industries and occupations were described. The second study was a mail survey of high-risk retail businesses to determine their safety practices and their experiences with robberies and related injuries. Completed.

Potential illness outbreak in a county police department

When a potential illness outbreak involving chronic fatigue and Epstein Barr virus infection occurred in a county police department, SHARP collaborated with the Department of Health in an investigation. Medical records for possible cases were reviewed and a report summarizing findings was distributed to the police department and the local health district. Completed.

Staff assaults in psychiatric hospitals

High rates of accepted workers' compensation claims reflect the severity of the assault problem faced by state employees at Western and Eastern State Hospitals (approximately 18 to 23 injuries per 100 working nursing staff per year). At the request of the legislature, SHARP staff surveyed local hospital employees, interviewed patient groups, and reviewed workers' compensation and incident report files. This effort identified several steps that could be taken to reduce the number of assaults. Completed.

Occupational injuries among adolescents

Between 1988 and 1991, approximately 17,800 workers' compensation claims were filed for work-related injuries and illnesses among workers aged 11 to 17 years. These claims were analyzed and a summary report is available. Completed.

Tracking health conditions related to work

Work-related asthma (WRA) surveillance and prevention

During the Summer of 2000, the State Board of Health adopted a revised Reportable Conditions Rule for the State of Washington. In accordance with this rule, all health care providers and health care facilities in the state are mandated to report any known or suspected case of WRA to the SHARP program. SHARP collects cases of WRA from workers' compensation data and provider reports to describe the incidence and distribution of WRA in Washington State and to target resources for appropriate prevention activities. Results of baseline surveillance were published in the report, Workers' Compensation Based Surveillance of Asthma, Hospitalized Burns, and Adult Blood Lead Levels, 1994-1998. Information concerning SHARP's WRA surveillance system is available from our Occupational Health Surveillance Library. Ongoing.

Work-related burns surveillance and prevention

During the Summer of 2000, the State Board of Health adopted a revised Reportable Conditions Rule for the State of Washington. In accordance with this rule, SHARP is authorized to develop voluntary reporting agreements with health care facilities to collect case reports of work-related burn injuries requiring hospitalization. SHARP collects case reports from workers' compensation data and provider reports to describe the incidence and distribution of these serious injuries and to target resources for appropriate prevention activities. Results of baseline surveillance were published in the report, Workers' Compensation Based Surveillance of Asthma, Hospitalized Burns, and Adult Blood Lead Levels, 1994-1998. Information concerning SHARP's work-related burns surveillance system is available from our Occupational Health Surveillance Library. Ongoing.

Adult Blood Lead Registry

Exposure to lead can cause damage to several organ systems including the nervous, renal, blood-forming, and reproductive systems. Blood lead levels for Washington State adults are reported to the State Department of Health and tracked by SHARP. From May 1993 to December 2000, the registry received test results for over 29,000 workers. Approximately 4% of the tested individuals had blood lead results greater than or equal to 25 micrograms per deciliter, the level of concern for occupational lead overexposure. SHARP sends educational materials on workplace lead exposure to all workers with elevated blood levels. Information concerning SHARP's adult blood lead level surveillance system is available from our Occupational Health Surveillance Library. Ongoing.

Fatality Assessment and Control Evaluation (FACE)

This NIOSH-funded project tracks, investigates, and distributes information about work-related fatal injuries with the goal of preventing work-related fatal injuries. Ongoing.

Work-related musculoskeletal disorders in Washington State

SHARP has been tracking back and upper extremity claims incidence using State Fund data. Several reports have been issued describing the magnitude and cost of these problems, as well as the industries where workers are at highest risk. In the 1998 report, SHARP reported the use of a "Prevention Index" that combines the ranks of the number of claims and the rate of claims by industry to better focus prevention activities. SHARP expects to issue an updated report at the beginning of each year. Information concerning SHARP's WMSD surveillance system is available from our Occupational Health Surveillance Library. Ongoing.

Occupational Skin Disorders project

Funded by the National Institute for Occupational Safety and Health (NIOSH), the aim of the Occupational Skin Disorders project was to design and test an experimental epidemiological surveillance system for occupational skin disorders. On average, there are about 900 approved dermatitis-related workers' compensation claims filed each year. With the help of a medical provider network, we found the number of claims was an under-representation of the true number of cases in the state. Data collected from the workers' compensation system and network of medical providers indicated that the majority of cases were being caused by "chemicals", soap and water, vegetation, latex gloves, and unknown sources. The data demonstrated high rates of skin disorders in the advanced composite-using industry, health care industry and agriculture. We conducted several site visits and developed educational materials. The most recently developed materials were on the hazards and control of poison oak and poison ivy in agriculture and the prevention of hand dermatitis in the health care setting. Completed.

Lead users survey

This project was undertaken to identify the number of Washington workers who are at risk of developing lead poisoning and to learn more about the workplaces where they are employed. SHARP conducted a mail survey of approximately 1,800 non-construction Washington businesses that were potential lead users. Survey responses indicated that only a fraction of lead-using businesses conduct workplace air-lead sampling and employee blood-lead testing. Completed.

Nail guns: an emerging hazard

Injuries due to pneumatic nailers ("nail guns") have increased from 298 accepted claims in 1991 to 490 accepted claims in 1998. The rate increased from 2.6 claims/10,000 full time equivalent workers per year to 3.5 Claims/10,000 full time equivalent workers per year. Most of these injuries were among wood frame builders. The proportion of claims due to "nail gun" injuries among wood frame builders more than doubled from 2.5% in 1991 to 5.7% in 1998. As with many health and safety hazards, using safety controls and periodic training can reduce the number of injuries. SHARP distributed a surveillance report with our findings in December 1999. Completed.

Testing methods for identifying risks

Identifying and ranking the most hazardous workplace chemicals

The SHARP HazChem project is aimed at identifying the most hazardous chemicals in Washington workplaces and the workers who are using them. SHARP distributed a survey to over 1500 safety and health professionals and labor groups across Washington State. Identifying these chemicals will help SHARP target the most hazardous industries for research, education and outreach. Ongoing.

Biomechanical Assessment System for Ergonomics (BASE)

To establish cause-effect relationships between workplace risk factors and musculoskeletal injuries, reliable quantitative measurement data are needed. Before simple and economic tools for ergonomic task evaluations can be used in field inspections, they must be validated by more sophisticated and reliable quantification methods. SHARP’s application of technology for objective measurement of ergonomic risk factors in the field is an Ongoing process. Current work includes: physical exposure quantification tool selection, sampling strategy, data acquisition procedures, data processing techniques, data reduction method, and data interpretation. Ongoing.

Assessing physical stress in old and new poultry processing plants

Over the years, poultry processing plants have had high incidence rates for upper extremity musculoskeletal disorders. The present study is designed to quantify physical exposures on the upper extremities when performing different poultry processing tasks, and muscle fatigue during a work shift. This study includes two parts: one for physical exposures at jobs of an old poultry processing plant, and another at jobs of a new plant where new technology is used and many risk factors seem have been reduced. Completed.

Pinch gripping and forearm load

High force on the hand and wrist is associated with carpal tunnel syndrome and hand tendinitis. Handling heavy objects and/or grasping objects improperly can generate high force on the hand-arm muscular system. Using the technique of surface electromyography (EMG), muscle activity can be measured while performing task activities. SHARP’s studies in a poultry processing plant and a sawmill showed that using the fingers to separate slippery chicken meat involves significantly more pinch gripping than handling heavy lumber. We found hat the poultry job required significantly more forearm muscle effort than the sawmill job, and that pinch gripping requires substantially more forearm muscle effort than power gripping. Consequently, the draft ergonomics regulation recently proposed by L&I has identified the 2 lb. pinch grip as potentially hazardous depending on the frequency and duration of exposure. Completed.

A field kit for monitoring pesticide exposure

During the 1995 growing season, SHARP collaborated with the University of Washington's Occupational Medicine Program and Department of Environmental Health, to carry out a field study to validate a new field kit for measuring blood cholinesterase levels in pesticide-exposed workers against the results from a reference lab. Pesticide handlers (mixers, loaders, and applicators), field workers, and referents from six ranches in Eastern Washington were recruited for the study. Completed.

Ergonomics evaluation on sawmill trimmer operator’s job

Due to the health concerns of musculoskeletal injury incidence at a trimmer operator’s job, a case study was conducted to identify and quantify risk factors in the job so that proper ergonomic intervention measures could be developed. Various physical exposure quantification methods were used to quantify workload experienced by the operators during work shift when processing different products. Major risk factors (e.g. repetitive hand movement, forceful hand exertion, and awkward wrist/forearm postures) were identified. Causes of these risk factors were discussed and ergonomic intervention measures were suggested. Completed.

The Painters Project

SHARP contracted with the National Institute for Occupational Safety and Health (NIOSH) to conduct a pilot project aimed at evaluating residential painters' potential lead exposure. The project was Completed in May of 1995. The study concentrated on surface preparation work in homes built before 1950 (i.e., homes most likely to have lead paint present). The study found that painters may be exposed to air concentrations many times the current legal limit. The study also attempted to quantify the number and location of painters at risk for high lead exposures. Completed.

Ergonomics and safety training integrated into carpenters' apprenticeship programs

SHARP continued working with the United Brotherhood of Carpenters (UBC) Health and Safety Fund, contractors, and NIOSH to develop integrated ergonomics training in apprenticeship programs. A large number of apprentices in western Washington received training, as did a number of contractors. Training materials are being used nationwide by the UBC. SHARP is evaluating the effectiveness of the training by examining severe, acute and cumulative trauma injury rates before and after implementation. Completed.

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