Occupational injuries for service members are common in every branch of the military and in practically every job, from wrenching one's back while lifting a missile to wiping out on a freshly mopped office corridor.
"One ankle fracture can take somebody out of their job for six months, just as stress or strain can take somebody out on limited duty for 90 days," said Catherine Hall, chief of occupational safety for the Defense Health Agency in San Antonio, Texas.
"They're a cost to the mission any time you take somebody out of the fight."
All jobs are unique. While a mechanic is going to have more hand injuries than an office worker, all occupations have an "injury trend," Hall said. Repetitive stress injuries, for instance, Hall described as "cumulative traumas." A dentist does very different work than a wrench-turning mechanic but is just as likely, if not more so, to develop repetitive motion wrist and hand injuries. For a mechanic, working in cold weather makes things even worse, she said, because blood flows away from hands, resulting in more force being applied.
But for mechanics, medical professionals, or many other jobs, "working in a small, finite area and doing it all day long" is going to result in stress to the fingers, hands, and arms, said Hall, who is a retired Air Force jet mechanic turned safety specialist.
"With the term 'ergonomics,' people automatically think [of a desk and] computer work station setting, but there's so much more work-related musculoskeletal risk in a lot of other settings," said Kelsey McCoskey, an ergonomist from the U.S. Army Public Health Center (APHC) at the Aberdeen Proving Ground in Maryland.
And even with corrective surgery, very often one's injured back or knee might not ever be the same, said John Pentikis, a colleague of McCoskey and the manager of the ergonomics and engineering branch at APHC. With carpal tunnel surgery, for example, surgery usually "only brings back about 70% of [one's] original capability to exert force, even without symptoms," he said.
Engineering controls
Hand injuries that result from doing difficult-to-reach repairs are never going to go away. But there are many tools to ease a workload, under the rubric of "engineering controls." These are the best way to minimize and eliminate exposure to work-related musculoskeletal disorder risk factors, but often they come down to simply using basic tools - dollies, carts, lifts, power tools, and other task-appropriate equipment.
"That's our gold standard," said McCoskey. "There are also administrative controls like training, or adding more people, or rotating more people through positions. But really, it's engineering controls that are what we try to do as much as possible - reduce the work related musculoskeletal risk that someone is exposed to. There are some things we simply can't design out. But if we can minimize overall risk by having controls where we can, that's going to reduce the risk."
Pentikis spoke of the "hierarchy of controls," or how to mitigate the workplace hazards by eliminating or substituting those hazards. They are, in order of effectiveness: