Participating core and specialty programs: Center for Direct Reading and Sensor Technologies, National Center for Productive Aging and Work, Occupational Health Equity, Safe●Skilled●Ready Workforce, Small Business Assistance, and Surveillance.

Employers, workers, insurance companies, labor unions, and non-governmental organizations adopt interventions to reduce back injuries among services workers.

NOTE: Goals in bold in the table below are priorities for extramural research.

  Health Outcome Research Focus Worker Population* Research Type
A Musculoskeletal disorders (esp. back injuries) Risk factors like manual labor, awkward posture, lifting, age Building and dwelling, temporary employment services, auto repair and maintenance, lessors of real state, waste collectors, travel accommodations subsectors; vulnerable workers; small businesses Intervention Translation

* See definitions of worker populations

Activity Goal 4.5.1 (Intervention Research): Conduct studies to develop and assess the effectiveness of interventions to prevent musculoskeletal disorders in the services sector.

Activity Goal 4.5.2 (Translation Research): Conduct translation research to understand barriers and aids to implementing effective interventions to prevent musculoskeletal disorders in the services sector.


Many services sector workers are required to complete repetitive tasks and often exert considerable force in sometimes awkward postures, which have been associated with musculoskeletal disorders (MSDs). The incidence rate for musculoskeletal injuries resulting in days-away-from-work for the services sector is 28.9 per 10,000 equivalent full-time workers compared to an incidence rate of 29.8 for all private establishments [BLS 2015]. Data from both the Ohio Bureau of Worker’s Compensation and BLS indicated that building maintenance and repair, janitorial, cleaning, garbage collection, automotive repair workers, and hotels all have elevated rates of MSDs. [BLS 2015; Meyers et al 2017].

Smaller businesses, such as many found in services subsectors, are recognized as having fewer human and capital resources available to devote to the prevention of workplace illnesses, injuries, and fatalities. Managers in smaller businesses often work in isolation without sufficient access to peer opinion and industry best practices. These factors not only reduce prevention activities, but may also reduce the reporting of illnesses and injuries to government agencies, insurance companies, and other organizations.

Many of services industries employ workers that are vulnerable due to age, ethnic background, language, gender, education level or lack of long-term job stability. These workers may not report injuries or suggest job aids because of their vulnerabilities. They may be more likely to be required to do some of the most physically challenging jobs which could lead to back injuries.


In the services sector, 89% of the 3 million firms have less than 20 employees, and these small businesses typically have limited access to health and safety specialists [U.S. Census Bureau 2011]. Therefore, these small businesses do not provide the same outreach, interventions, and proactive committees to reduce these exposures as, for example, manufacturing environments. Interventions that are targeted to specific populations within the services sector are needed to reduce the prevalence of MSDs in these subsectors. Intermediary organizations may be used for outreach and could include trade associations, worker groups, insurance companies, chambers of commerce, small business development centers, professional organizations, small-business-focused media, and public health and other government agencies. Some interventions for reducing back injuries are well known and utilized in other industries that could be adopted by Service sector industries. Intervention effectiveness studies using traditional and sensor related methods are needed. Translation work is needed to inform Service sector industries of these interventions and show how they could be adopted by these industries.

BLS (2014). Nonfatal occupational injuries and illnesses requiring days away from work, 2013, USDL-14-2246, Table 5. Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics.

BLS (2016). Nonfatal occupational injuries and illnesses requiring days away from work, 2015, Table 9. Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics.

Meyers AR, Al-Tarawneh IS, Wurzelbacher SJ, Bushnell PT, Lampl MP, Bell J, Bertke SJ, Robins DR, Tseng C, Wei C, Raudabaugh JA, Schnorr TM [2017]. Applying machine learning to workers’ compensation data to identify industry-specific ergonomic and safety prevention priorities — Ohio, 2001–2011. Manuscript submitted for publication.

U.S. Census Bureau [2011]. Statistics for all U.S. firms with paid employees by geographic area, industry, gender, and employment size of firm: 2007 Washington, DC: U.S. Department of Commerce, U.S. Census Bureau, icon

Page last reviewed: April 24, 2018