One in three workers have carpal tunnel syndrome at Maryland poultry plant

Imagine a workplace in your town where one of every three employees had the same work-related illness. Better yet, imagine that it was one in three employees in your own workplace. That'd be pretty shocking, right?

Well, that's what the CDC’s National Institute for Occupational Safety and Health (NIOSH) found among 191 workers at Amick Farms’ poultry processing plant in Hurlock, MD. Thirty-four percent had carpal tunnel syndrome (CTS). Equally striking, a whopping 76 percent of the workers in the study had evidence of nerve damage in their hands and wrists. The findings of this NIOSH “Health Hazard Evaluation” were released today.

The Amick Farms plant processes about 177,000 chickens per day with a workforce of 877 employees in production jobs. The workers, who are represented by the United Food and Commercial Workers Union (UFCW) Local 27, typically work 8-hour shifts and are given a 36-minute lunch break and another 12-minute break. The incessant line speed and repetitive motion of the cutting tasks have workers in not just this plant, but throughout the poultry industry, calling their workplaces "houses of pain."

In a blog post about the Amick Farms' HHE, the NIOSH researchers note:

“The high prevalence of carpal tunnel syndrome at this plant is not surprising given the literature on the topic as well as past NIOSH HHEs in poultry processing showing a link between carpal tunnel syndrome and levels of exposure to hand repetition and force above recommended limits.”

No, I guess we shouldn’t be surprised by the results. It was around this time last year when NIOSH released another HHE from a different poultry processing plant. This one, from a Pilgrim’s Pride facility in South Carolina, found 42 percent prevalence of CTS among 375 workers on the daytime production shift. 42%, 34%, it's all bad news for poultry processing workers.

Both of these HHE’s were requested by the firms in order to fulfill a requirement by the USDA’s Food Safety Inspection Service (FSIS). Poultry companies that wanted to convert to an alternative inspection system called the “Hazard Analysis and Critical Control Point (HACCP) Inspection Models Project (HIMP)” had to invite NIOSH to conduct an HHE. The alternative system reduces the number of FSIS inspectors and allows the plants to increase production line speeds.

NIOSH’s evaluation at the Amick Farms’ plant involved multiple visits to the facility during 2014. Ninety-six percent of the 199 eligible employees participated. Their average age was 40 years (range: 20–70), with 46% of the workers identifying as Hispanic, 30% identifying as African-American, and 20% identifying as Creole. The workers answered a questionnaire about their work and medical history. Each of them also underwent nerve conduction test (which I hear is downright painful.)

What did NIOSH find?

The agency identified 64 workers (34%) who met its case definition for CTS:

Pain, numbness, burning, tingling in the hands or wrists, occurring more than 3 times or lasting 7 days or longer in the past 12 months; AND marked or shaded the location of their symptoms in the median nerve distribution area on a hand symptom diagram; AND an abnormal median nerve conduction in the affected hand or wrist.

Worse yet, 42% had carpal tunnel in both hands.

The nerve conduction test results were also alarming. Of the 64 workers with CTS, 92% had moderate or severe median mononeuropathy in at least one hand. Among all 191 workers who had nerve conduction tests, the presence of median mononeuropathy was rated as moderate in 49% of the workers and severe in 13%. Even without the sophisticated nerve conduction tests, 110 of the 191 workers reported having symptoms of musculoskeletal injuries. Fifty-eight percent, for example, reported being awakened from sleep in the last 7 days by the symptoms.  (At the South Carolina Pilgrim's Pride plant, 67 percent of workers reported this same problem.)

The NIOSH HHE also included videotaping of numerous job tasks in the plant. The researchers observed workers having to reach above their shoulders to use knife sharpeners (many times per shift) and did not have the ability to adjust platforms to fit their height and the type of work.  These sort of work-design failures are key contributors to musculoskeletal injuries. The researchers noted that 59% of the tasks exceeded the recommended limits established by ACGIH for hand activity and force.

Like NIOSH, I'm not surprised by these terrible findings, and I know that poultry workers at these and other plants across the country won't be surprised either. The poultry industry has been allowed to take a pass and not be held accountable for the injuries sustained by its workers. The companies are not required to fix the conditions that cause these injuries because there are no meaningful federal regulations that require them to do so.

I appreciate the thoughtful time and effort invested by NIOSH in conducting the HHEs in these poultry plants. At some point, however, more studies finding the same result just become an interesting academic exercise. There's already plenty in the scientific literature about the types and causes of injuries in poultry processing plants. How many more HHEs and studies do policy makers need before they tell the poultry industry enough is enough?


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It sounds like malpractice to me. That’s what I’ve been thinking ever since learning how poultry workers are treated (and not treated) for work-related injuries. The latest example comes from Pilgrim’s Pride, the largest US poultry processing company. Last week OSHA issued the first-ever citation…

I understand that the poultry demand around the world is very great but does this excuse overworking workers to the point where there are numerous cases of injuries in poultry industries? In my opinion enough is enough and these industries should take it upon themselves to better the working conditions if they won't take responsibility for the injuries that may follow, it's just the humane thing to do.

By Sandisiwe Mkhi… (not verified) on 10 Apr 2015 #permalink

Hello: I was told I need carpal tunnel surgery. I'm researching alternatives and found 2 on the web - "my carpal solution" and "carpal rx". They seem promising to me, but I would appreciate any INDEPENDENT information you might have about either of these products. Thank you so much. Irene

Thanks for blogging about this. A shocking summary of the life-long adverse health effects suffered by some of the poorest and most disadvantaged workers.
I am surprised that the NIOSH report didn't recommend that employers gave their workers information about the health risks from the job, or instruction and training to adjust their workstations properly, or supervision to ensure that people were actually working safely.

By Patrick Mackie (not verified) on 11 Apr 2015 #permalink

There is no excuse for the pain that the workers experience.I get that the employers want to see results but this is not how to do it.The first thing that needs to be taken care of is the well-being of the workers.Employers need to understand that to get good results workers need to work at their optimum levels.I do not think workers can work at their best when they are hurt.

By Makuwa VM (not verified) on 11 Apr 2015 #permalink

If so much information is available, why is nothing done about this problem? What can be done in order to improve working conditions at these plants?

By Natascha Rotha… (not verified) on 12 Apr 2015 #permalink

It is shocking to think that employers still exploit workers in modern times. We have to question the morals and humaneness of these employers. But also, why are trade unions not standing up for their workers and demanding that improved policies be implemented?

By Jenna Rheeders… (not verified) on 12 Apr 2015 #permalink

With the advancements in technology and engineering, it is shocking to hear of the ordeals poultry employees go through in order to fulfill their employers's expectations. In my opinion, it is inhumane that the employers do not feel it necessary to better the working conditions. Through family experience, I am aware of the immense pain of a carpal tunnel patient. I feel that it is necessary for labour unions to intervene on this issue as the health and well-being of humans are at stake.

With the advancements in technology and engineering, it is shocking to hear of the ordeals poultry employees go through in order to earn a living.In my opinion, it is inhumane that the employers do not feel it necessary to better the working conditions. Through family experience, I am aware of the immense pain of a carpal tunnel patient. I feel that it is necessary for labour unions to intervene on this issue as the health and well-being of humans are at stake.

Consumer boycotts and public PR campaigns have been effective in recent years. Unions can play a role but comsumers have to step up. Give the political nature of the regulatory process in the US, we can't wait for OSHA to regulate line speed in these plants. All of us can advocate to have worker sustainability be one of the criteria used for food choice, adding that to a desire for pesticide free food with a low carbon or water footprint. A campaign to get Whole Foods, Costco, even Walmart to integrate that metric into their overall measures of sustainability is within reach. Think about the changes in working condtions in garment manufacturing after public protests and boycotts (I know, not even close to perfect, but amazing at the same time).

By Laurie Welch (not verified) on 13 Apr 2015 #permalink

What are the legal options of these workers? They should use the media to help them in their plight, show video's on You Tube and social media . In South Africa we have a program called Carte Blanche, they are like a horn blower and gets the attention of the public to help bring about change. If you can get the public's attention and sympathy the battle for better working conditions will be halfway won. Lawyers should also get involved in a mass action against these companies, for medical expenses, and be prepared to receiving payment only if the lawsuits are successful. It is a pity that health and safety is not more important than making a profit.

By Rens 15026486 (not verified) on 14 Apr 2015 #permalink

The fact that more employees are affected by the same disease should indicate that something is wrong about the workplace.I understand that workers have families to feed but if it affects your health then it's not worth it,why don't they do something about it since the employers are so inconsiderate.When you look for a job,a safe working environment should be part of the package.

By Faith Makondo(… (not verified) on 15 Apr 2015 #permalink

As you said there are no regulations against these conditions but maybe it would be more productive to try and get new regulations introduced so that this does not continue so that these greedy poultry plant owners have no say in the matter because at the moment they are legally sound and i doubt that any lawyers will help.

By Damean Billson (not verified) on 15 Apr 2015 #permalink

I agree, can nothing be done to change the regulations of the workplace? Also, it's excellent that this research has been done and that the workers are aware of their condition, however what will be done about it? Will the employers provide the correct health care that they deserve or will they be treated at all?

By Rebecca Marshall (not verified) on 16 Apr 2015 #permalink

Employees are being exploited by employers.The question that needs to be asked is what are trade unions doing about this?shouldn't they be protecting employees?(u14146542)

By Hleliwe Frans (not verified) on 17 Apr 2015 #permalink

Are there any alternative treatments to surgery for this disease? I would be interested to know as maybe this would be more cost effective.

Employers should take care of their employees. They should take extra precautions

By Muradzikwa SC (not verified) on 18 Apr 2015 #permalink

The injustice that exists at work places is a disgrace to humanity. Upon finding out about their employee's condition, isn't the company under some form of obligation to make sure their employees receives appropriate medical care ?

By Khanya Matoman… (not verified) on 18 Apr 2015 #permalink