In recent years, strides have been made to enhance workplace safety through regulations, innovative technologies and hazard assessments. Despite these efforts, research highlights a troubling disparity: Workers of color are more likely to be employed in high-risk occupations compared to their white counterparts. Recognizing this issue and the prevalence of musculoskeletal disorders (MSDs) as the most common workplace injury, the National Safety Council released a new report titled, The Intersection of DEI and MSDs: Ensuring Equitable Outcomes.

Why Employers Should Care

MSDs are the largest category of workplace injury resulting from risk factors including forceful exertions, awkward or static postures, and repetitive movements. MSDs are injuries or disorders of the muscles, nerves, tendons, joints, cartilage and spinal discs. Common MSDs are sprains, strains, muscle ruptures, tendonitis, tennis elbow, carpal tunnel syndrome and back pain. Specifically, work-related MSDs are conditions in which the work environment or performance of work contributes significantly to the condition, the condition is made worse by the work performed or the condition persists longer due to work-related factors. 

Affecting nearly one-quarter of the global population, MSDs impact business efficiency. MSDs are the leading cause of worker disability, involuntary retirement and limitations to gainful employment. They cost employers nearly $18 billion each year in lost productivity, workers’ compensation, absenteeism and presenteeism, turnover and the ability to attract new talent. Injuries caused by overexertion cost $12.49 billion alone in 2021 according to the 2024 Liberty Mutual Safety Index.

Investing in MSD prevention is also good for employee wellbeing. Suffering from work-related injuries such as MSDs can keep employees from living their fullest lives on and off the clock. Employees experiencing MSD discomfort may miss out on activities they enjoy doing such as walking their dog, playing with their kids or dancing with a loved one. 

Organizations that care about and take steps to mitigate MSDs are showcasing their commitment to worker health and safety, which can be impactful for organizational culture. And while it may seem like a big investment to combat MSDs, MSD risk reduction is a smart investment. Every dollar spent on prevention generates twice the return or more. Employers need to be aware of and invested in this most pressing workplace issue to ensure the safety, health and happiness of their workers, and to protect the bottom line.

Understanding the Disparity

The report, which was published through the MSD Solutions Lab — a groundbreaking initiative launched by the NSC in 2021 with funding from Amazon — delves into the factors contributing to inequitable outcomes in workplace safety. It is based on data compiled by the Bureau of Labor Statistics and the U.S. Census Bureau, and references over 100 academic publications and sources.

Key Findings

Work Organization:

• Shift Work and Long Hours: Workers of color often hold positions requiring shift work, men are more likely to work long hours and women are more likely to participate in part-time work, all of which elevate the risk of MSDs. These demanding schedules reduce time for adequate rest and recovery, prolong exposure to workplace hazards and limit time for personal responsibilities.
• Job Type and Pace: Certain job types and fast-paced work environments, which are more likely to employ workers of color, further contribute to the prevalence of MSDs. More labor-intensive work with high demands and fast paces can also be difficult for older workers.

Workplace and Equipment Design:

• Accessibility Issues: Employees using wheelchairs or those smaller than the fifth percentile female may struggle to access their workstations fully. Additionally, personal protective equipment (PPE) has traditionally been designed for the average white male, leaving women and non-binary or transgender workers with improperly fitting gear.
• PPE Fit: A survey highlighted that only 19% of women, non-binary and transgender construction workers receive appropriately sized safety gear.

Safety Culture:

• Inclusive Policies: A strong safety culture, characterized by clear and accessible policies and benefits, such as paid sick leave and long-term disability, is crucial for protecting all workers. Workplaces lacking these benefits may foster an unsafe culture where employees feel insecure about taking necessary time off for injuries.

Psychological Safety:

• Sense of Belonging: Employee wellbeing is closely tied to a sense of belonging and feeling valued within the organization. Voice suppression is particularly harmful to employees of color, who may already feel marginalized. Black and Hispanic workers report higher levels of discomfort in reporting unsafe conditions.

Psychosocial Risk Factors:

• Job Stress and Lack of Control: Psychosocial risk factors, including job stress, lack of control, job dissatisfaction, and poor support from supervisors or coworkers, are more prevalent in jobs held by workers of color. These factors increase the risk of MSDs, particularly in high-stress roles.

Proposed Solutions

The NSC report outlines a comprehensive approach to addressing these inequities through the hierarchy of controls:

1. Elimination: Remove jobs requiring high exertion, awkward postures or fast-paced work when possible

2. Substitution: Adapt workplace design to accommodate various sizes and abilities, and provide ergonomic support for employees with medical conditions or disabilities

3. Engineering Controls: Introduce adjustable assistive devices and technologies like lifts, ramps and ergonomic tools to reduce strain and repetitive motions

4. Administrative Controls: Implement policies ensuring accessibility, anonymous reporting systems and diverse representation in safety leadership; collect feedback from a diverse group of employees to identify effective solutions

5. PPE: Regularly assess and meet the PPE needs of all employees, considering different body types, abilities and cultures

Commitment to Equitable Safety

At NSC, we’re committed to helping employers create that culture of safety by providing tools, resources, research, education, training and consulting services that are useful to them – and their workforce.

Through this white paper, we dove into the intersection of DEI and MSDs. The U.S. workforce is highly diverse, and with MSDs being the most common workplace injury in the U.S., we wanted to uncover possible connections between DEI and MSDs. Importantly, the diversity of workers is not a risk factor for MSDs. MSD risk factors are due to the workplace not accommodating or providing for all people. 

The facets of DEI and ergonomics more broadly share similar goals. The goal of ergonomics is to fit the work to the worker, and this really means all workers of all demographic characteristics. Therefore, we wanted to explore how organizations can be best equipped to fit their work to their entire workforces and the challenges they may run into when trying to do so. Ergonomics and MSD prevention are human-centered practices focused on modifying work environments and job tasks to meet the needs of the workforce and empower healthier, safer and more efficient work. 

Lastly, the connection between societal determinants of health and occupational health inequities deserved further exploration, so we set out to uncover these connections more through the paper. Considering DEI factors in relation to MSD risk and prevention addresses many issues pertaining to health disparities of diverse working populations and helps to fill a gap in MSD prevention research.

Pioneering research like this is part of ongoing NSC initiatives through the MSD Solutions Lab. These efforts aim to prevent MSDs and ensure that workplace safety measures are inclusive and effective for all employees.