Workers cope with strain injuries

Identification card nestled between thumb and fingers, Terrie Little makes a dent in the line of students waiting for leftover turkey burgers in the Branford College dining hall. Card, swipe, beep, button, once per student — same faces, same time, same place and same motion.

But Little’s swipes are accompanied by a wince these days, and she sports a black wrap around one elbow. After hours upon hours spent moving her hands in the same way and applying pressure in the same places, the dining hall worker has developed a repetitive strain injury.

While the pain comes and goes, Little said she is not sure if it will ever leave her for good.

“It’s a sharp pain in my elbow I feel every time I swipe,” she said. “But I just have to deal with it for now.”

Of the approximately 350 work-related injuries reported annually at Yale, dining hall workers rank alongside maintenance staff and police officers with the highest number of injury claims, Risk Manager Marjorie Lemmon said. This number has ballooned since Yale switched to an electronic ID system a half decade ago, she said, adding dining hall swipers to the ranks of the vegetable slicers, ice cream scoopers and dish movers already at risk for RSIs.

RSIs often come with the territory for service employees. The advent of e-mail and the Blackberry drew attention to the threat of carpal tunnel syndrome, the wrist RSI that has infiltrated the ranks of cubicle dwellers. But at Yale, according to several dining hall workers, arms numbed by hundreds of hours of performing the same task yield injuries, time off and for the University’s worker’s compensation bills.

Dining Services Executive Director Don McQuarrie said Yale does its best to purchase labor-saving equipment whenever possible, citing the use of electric cutters and choppers. But he said RSIs are almost inevitable in an environment like a dining hall.

“In any environment when people have to repeat the same movement time and time again, as cooks or entry workers do, you run the risk of repetitive strain,” McQuarrie said.

Almost any repeated motion can result in an RSI, according to the National Institutes of Health. Shirley Lawrence, a dining hall worker in Morse College, said she has developed three separate RSIs as a result of her Yale work. The first flare-up occurred while she was painting, the second while cleaning and the third while swiping. Several surgeries and a job transfer later, Lawrence still faces recurring injuries.

The pain of an RSI is excruciating, dining hall worker Phyllis Arpino said. Arpino’s RSI — a pinched nerve in the forearm — was diagnosed in the early 1990s. Characterized by burning pain from her palm to her elbow, Arpino’s RSI would keep her awake nights, as lowered blood flow made her whole arm throb. After years of slicing cakes in Commons, Arpino lost so much control of her hands that she had one of her veins “tied open” through a surgery funded by Yale’s worker’s compensation program. But she was eventually able to switch away from the more labor-intensive positions, she currently sorts nutrition cards in the Ezra Stiles College dining hall with complete mobility in her hands.

Lemmon said that after filing the required forms and getting a Yale-approved doctor to diagnose the injury as work-related, the University’s workers are eligible for worker’s compensation benefits. These benefits range from accommodating short term medical restrictions through reduced hours and temporary transfers to longer term position transfers.

“It’s in the best interest of everyone involved to have the workers come back to Yale as soon as possible,” Lemmon said. “They need to know that the University values them.”

But because most of Yale’s rules about worker’s compensation are governed by state labor statutes, Lemmon said the University has limited flexibility when implementing benefits packages.

Card, swipe, beep, button. By the end of lunch, Little has let more than 200 students through. After a few weeks working at Branford, Little’s pain led her to seek out a doctor. Her physician gave her an arm brace; the pain disappeared for a few months, but has started to return this month.

By Connecticut law, worker’s compensation is only activated after four days of absence, but Little was never absent from work long enough to claim it. Her Yale Health Plan coverage allowed her to see a doctor, but her supervisor told her that her current job as swiper was the lightest job available, so even a temporary transfer was not an option. State statutes say that if a doctor decides patients can work, they cannot claim compensation if they choose not to work; Little’s doctor told her to go back to work, but swipe with her left hand.

Because of union regulations that govern bidding on new job postings, Arpino said that even in cases where a permanent transfer is an option, it often does not come soon enough. After her surgery, she had to spend several more years scooping cream cheese and slicing pastries at Commons before she earned the seniority to bid for a different position.

Lemmon said worker’s compensation is a no-fault insurance, meaning as long as the injury is work-related — sustained while doing the lifting, cutting, swiping or mopping involved in most dining hall positions — Yale will issue worker’s compensation whether or not the University is at fault. But documents from the Office of Risk Management exhort supervisors to get their employees back to work as soon as possible, explaining that Yale pays out-of-pocket for the first $1 million of each claim.

As part of the latest contract between Yale and Local 35, the union to which most dining hall and maintenance workers belong, a committee has convened to establish new guidelines for worker’s compensation and prevent work-related injuries by means of additional training and equipment, Lemmon said. Currently, union members can reclaim their jobs after up to a year of absence due to a work-related injury, and will be compensated for any work hours missed at 60 percent of their total salary.

One dining hall worker, who wished to remain anonymous, said RSIs are underreported and underdiagnosed within the Yale labor community. While hauling pots and pans across a residential college kitchen, her hands just went numb, and the sound of the pans clattering to the floor warned her that something serious was wrong, she said. She went to one doctor affiliated with Yale’s worker’s compensation managed care network, who almost refused to X-ray her. He insisted she must have some old injury that had flared up again.

But the determined and concerned dining hall worker solicited a second opinion. Her doctor, who was not a part of Yale’s network, barely glanced at her X-ray before telling her what was wrong.

“Does it hurt here?” he asked, pressing the bump on the underside of her wrist, which flares into a walnut-sized pain center on bad days. The doctor’s diagnosis of carpal tunnel syndrome was not enough for her to get worker’s compensation, as workers must have documentation from one of the physicians on Yale’s list to be eligible for reduced hours or other benefits.

As she slices the stems off bunches of bananas, the worker fingers the lump on her left wrist. Her right hand, too, is starting to throb with the telltale burn of carpal tunnel.

“I know it’s coming in my other hand, too,” she said. “But what can you do?

The dinner rush starts in Branford’s dining hall. Little will swipe between 200 and 300 people into dinner tonight. Card, swipe, beep, button, 200 to 300 more times — same students, same time and same place with hand curled in exactly the same way. Little knows that her injury, which had largely settled down for a few months last year, depends on the weather. A week of rain early last month sent streaks of pain up her elbow, forcing her to stay home from work.

It is, she says, going to be a long winter.

Dining-hall workers are at risk for repetitive-strain injuries. In addition to swiping cards, workers perform many other repetitive activities.
jeff white
Dining-hall workers are at risk for repetitive-strain injuries. In addition to swiping cards, workers perform many other repetitive activities.

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