NIOSH issues first report on ergonomics in pharmacies

NIOSH welcomes pharmacists to make needed health hazard evaluation requests

A new report from CDC’s National Institute for Occupational Safety and Health (NIOSH) might be what pharmacists need to get the conversation going about ergonomics—otherwise known as the science of making an environment safe, healthy, and comfortable.

The report is based on an employer representative’s request to have NIOSH’s Health Hazard Evaluation Program (HHE) examine why pharmacy employees at an Indian Health Service pharmacy were having musculoskeletal disorders. HHE representatives visited the health service clinic in April 2016 and summarized their findings and recommendations in the report, which was published in March of this year.

“This is the first NIOSH health hazard evaluation that we’ve done on ergonomics in pharmacies,” said Jessica Ramsey, MS, CPE, NIOSH musculoskeletal health program coordinator and one of the authors of the report. “When we went back into the literature, we were not able to find a lot of studies looking at ergonomics and musculoskeletal disorders [in pharmacies].”

The workplace environment has been on pharmacists’ radars lately and was even a topic presented to the APhA House of Delegates at this year’s Annual Meeting & Exposition in Nashville. According to Chelsea Anderson, PharmD, MBA, BCPS, from Purdue University College of Pharmacy, there is a need to increase awareness of how the pharmacy workforce interacts with the work environment and how that might affect the care of patients.

“Ergonomics is an important factor of any work environment and should be carefully considered when planning and designing the pharmacy work space,” said Anderson.

Ramsey said the recommendations in the NIOSH report can apply to pharmacists and technicians performing similar tasks in any setting. In particular, the recommendations about workstation features and adjustments are universal (many were obtained from the Handbook of Ergonomic Design Guidelines).

The primary concern at the health service clinic was that up to 200 undistributed prescriptions were returned to stock each week because patients did not pick them up in the designated time frame. Most returns required employees to open the prescription bottle and pour the contents back into the robotic prescription dispensing system. NIOSH investigators found that pharmacy employees at the health service clinic used repetition, forceful movements, and awkward postures during their work. Many employees reported symptoms consistent with work-related musculoskeletal disorders, and repetitive motion injuries were the most common recordable injury among pharmacy employees.

Recommendations in the report include evaluating a way to reduce the number of return-to-stock bottles that need to be opened, removing child-resistant caps from larger quantity medication bottles, and educating employees on musculoskeletal disorders and ergonomics.

As Ramsey noted, many of the recommendations in the report are relatively easy to make because they are small changes: purchasing appropriate quantities of medicine, adjusting workstations for each individual employee, and alternating tasks to help reduce exposures.

Employees also have a responsibility. “We usually recommend that an employee tell their supervisor about any symptoms they believe are work related and, of course, consult a health care provider if the symptoms persist,” said NIOSH’s Kristin Musolin, DO, MS, coauthor of the report.

Musolin and Ramsey encourage pharmacy staff to reach out to NIOSH with concerns.

“We do welcome additional requests and would be happy to go into other facilities and do similar HHEs, and then that would increase the amount of data and the body of knowledge,” said Ramsey.

To request an HHE, visit

For the full article, please visit for the July 2018 issue of Pharmacy Today.