Ergonomic and Safety 

Climate Evaluation at 

a Brewery – Colorado

Jessica G. Ramsey, MS, CPE

Loren Tapp, MD, MS

Douglas Wiegand, PhD

Health Hazard Evaluation Report

HETA 2010-0008-3148

December 2011 

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

Workplace

Safety and Health

 National Institute for Occupational 

Safety and Health
The employer shall post a copy of this report 

for a period of 30 calendar days at or near 

the workplace(s) of affected employees. The 

employer shall take steps to insure that the 

posted determinations are not altered, defaced, 

or covered by other material during such 

period. [37 FR 23640, November 7, 1972, as 

amended at 45 FR 2653, January 14, 1980].
Health Hazard Evaluation Report 2010-0008-3148 Page i

Report Abbreviations................................................................................................ii

Highlights of the NIOSH Health Hazard Evaluation........................iii

Summary .........................................................................................................v

Introduction ...................................................................................................1

Assessment.....................................................................................................3

Results and Discussion...............................................................................4

Conclusions................................................................................................. 15

Recommendations.................................................................................... 15

References.................................................................................................... 18

Contents

Acknowledgments Acknowledgments and Availability of Report................................ 20

Appendix Ergonomic Evaluation Criteria.............................................................. 19
Page ii Health Hazard Evaluation Report 2010-0008-3148

Abbreviations

HHE Health hazard evaluation

MSD Musculoskeletal disorder

NAICS North American Industry Classification System

NIOSH National Institute for Occupational Safety and Health

OSHA Occupational Safety and Health Administration

WMSD Work-related musculoskeletal disorder
Health Hazard Evaluation Report 2010-0008-3148 Page iii

The National Institute 

for Occupational Safety 

and Health (NIOSH) 

received a request 

for a health hazard 

evaluation at a brewery 

in Colorado. The union 

submitted the request 

because of concerns 

about musculoskeletal 

disorders. Tasks requiring 

repetitive motions on the 

can line and in the bottle 

depalletization (depal) 

areas were thought to 

be the cause of these 

disorders.

Highlights of the

NIOSH Health

Hazard Evaluation

What NIOSH Did

● We visited the plant in January 2010.

● We observed and videotaped employees during routine work. 

This allowed us to document risk factors for work-related 

musculoskeletal disorders (WMSDs).

● We measured the heights of workstations and distances that 

employees reached to do a job task. These measurements 

determine the risk of injury.

● We talked with employees about their work, history of 

WMSDs, and their medical history.

● We reviewed occupational safety and health injury and illness 

logs. We also looked at employees’ medical records.

● We asked employees about injury reporting behavior and 

perceptions of safety at the plant (i.e., safety climate).

What NIOSH Found

● Employees are at an increased risk for upper extremity 

WMSDs. This risk is due to awkward postures, forceful 

exertions, and repetitive motions.

● The rates of injuries and illnesses are similar to or below that 

of other plants in the brewery industry.

● Job rotation patterns were not consistent.

● The most common musculoskeletal injuries among can 

line and bottle depal employees were shoulder and wrist 

disorders.

● Employees indicated that safety training, policies, and 

procedures needed to be improved at the facility.

● Some employees felt uncomfortable reporting safety 

incidents or expressing their safety concerns. Employees felt 

the issues would either not be addressed by the employer or 

that reporting would result in a negative outcome, such as 

disciplinary action.
Page iv Health Hazard Evaluation Report 2010-0008-3148

What Managers Can Do

● Design work areas to have a working height between 27”–62”. 

Most lift tables should be redesigned so that the top rows are 

within this range.

● Add rotating platforms to the height-adjustable lifts.

● Rotate employees to different job tasks every break, instead 

of every 4 hours. All employees should use the same rotation 

pattern.

● Train employees on ergonomics and WMSDs. This will 

help them recognize and avoid risk factors that can lead to 

musculoskeletal problems.

● Encourage employees to report work-related musculoskeletal 

discomfort. These complaints should be logged to identify 

jobs that need to be modified.

● Keep employees informed about what is being done to 

respond to their health and safety concerns.

● Determine why some employees are not interested in efforts 

to improve safety in the workplace. Hiring a consultant with 

experience in this area may be useful.

What Employees Can Do

● Work safely and lift properly.

● Use the adjustable features on lift tables, platforms, chutes, 

and forklift trucks. This will allow you to be closer to 

equipment controls and the materials you are handling. 

● Take part in safety and ergonomic committees.

● Report injuries and unsafe work conditions to your 

supervisor. You should also report them to the union.

● Seek care from a healthcare provider if you are injured at 

work. The provider should be experienced in occupational 

health.

Highlights of the

NIOSH Health

Hazard Evaluation

 (continued)
NIOSH evaluated 

ergonomic hazards, 

WMSDs, and safety 

climate among employees 

in the can line and bottle 

depal. We found that 

employees are exposed 

to risk factors for WMSDs 

to the upper extremities. 

Recommendations for 

reducing the risk of 

WMSDs include designing 

all work surfaces to be 

within a height range of 

27”–62” and providing 

rotating platforms. We also 

recommended improving 

communication between 

employer and employees 

regarding employee safety 

and health concerns and 

encouraging employees 

to report work-related 

musculoskeletal 

discomfort. 

Summary

Health Hazard Evaluation Report 2010-0008-3148 Page v

On October 16, 2009, NIOSH received an HHE request from 

a union representative at a brewery in Colorado. The request 

concerned MSDs possibly caused by repetitive motions including 

lifting, pulling, pushing, and reaching in the can line and bottle 

depalletization (depal) areas.

During January 20–21, 2010, we visited the brewery. We observed 

workplace conditions and work processes and practices. We 

videotaped tasks on the can line and bottle depal. We also 

measured workstation heights and reach distances. We talked with 

employees privately to discuss their health and workplace concerns. 

We reviewed medical records of work injuries, and surveyed 

employees about their health and safety reporting behavior and 

perceptions of health and safety within the organization (i.e., safety 

climate).

We found that employees were exposed to a combination of 

risk factors for developing upper extremity WMSDs, including 

awkward postures, forceful exertions, and repetitive motions. 

Personal factors such as age, sex, smoking, physical activity, and 

strength can also influence the occurrence of MSDs. The employee 

interviews and review of OSHA Form 300 Logs of Work-Related 

Injuries and Illnesses confirmed that the most common WMSDs 

were to the upper extremity (shoulder and wrist). Twelve employees 

indicated they were injured on the job in the past 12 months; only 

half reported their injury(ies) to the employer. 

Recommendations for reducing the risk of WMSDs include 

designing all work surfaces to be within a height range of 27”–62”

and providing rotating platforms. The safety survey indicated that 

half of the employees feel that the safety training they receive is not 

adequate, and that the safety procedures and practices in place do 

not work. Recommendations for improving safety communication 

and involvement are also included in this report.

Keywords: NAICS 312120 (Breweries), brewery, ergonomics, can 

line, bottle depalletizer, shoulder, wrist, work-related musculoskeletal 

disorders, WMSDs, safety climate, safety reporting
Page 1 Health Hazard Evaluation Report 2010-0008-3148

Introduction

On October 16, 2009, NIOSH received an HHE request from a 

union representative at a brewery in Colorado to evaluate potential 

ergonomic hazards among employees. The request concerned 

MSDs possibly caused by repetitive motions during can line and 

bottle depalletizer (depal) job tasks.

During January 20–21, 2010, we visited the brewery. On 

January 20, 2010, we held an opening meeting with employer 

representatives, employee representatives, and union officials. We 

observed work processes, practices, and workplace conditions. We 

collected video of can line and bottle depal tasks and measured 

workstation design parameters. We also privately interviewed 

employees to discuss their health and workplace concerns, 

requested medical records related to WMSDs possibly caused 

or aggravated by repetitive work tasks, and surveyed employees 

with regard to health and safety reporting behavior and safety 

climate. On January 21, 2010, we held a closing meeting and 

provided preliminary recommendations to management and 

union officials. We sent a letter with our preliminary findings and 

recommendations on February 8, 2010.

Plant Description

The brewery was built in 1988 and included a 100-acre plant 

sitting on 1,200 acres of land. This brewery produced 8.7 million 

barrels of beer in 2009. Three can lines each produced 2,200 

cans/minute, and three bottle lines each produced 1,200 bottles/

minute. The plant employed 700 people including 83 employees 

in the bottle depal and can line areas. The plant ran 24 hours a 

day, 7 days a week, with 3 shifts. The plant had plant safety and 

departmental safety committees. Departmental communication 

meetings were held every 2 weeks, and a meeting with the 

general manager was held quarterly. The plant offered an annual 

ergonomic “Safety in Motion” training as well as peer-on-peer 

observations that varied in frequency by department. The company 

had two incentive programs, “Safety Beer,” which provided a case 

of beer per person for every month without an OSHA recordable 

injury, and an optional wellness program that provided flexible 

spending account monies for nonsmokers who completed an 

annual physical and health risk assessment.

The brewery had an unstaffed medical clinic on site that was used 

for first aid treatment. If an employee sustained a non-emergency 
Health Hazard Evaluation Report 2010-0008-3148 Page 2

Introduction

 (continued) injury, the group manager was notified, and the employee was seen 

by the health and safety manager to determine if she/he needed 

medical care at one of the two local occupational medicine clinics 

contracted by the brewery. All employees were required to undergo 

baseline and annual hearing evaluations; emergency responders 

were also required to complete an annual respiratory questionnaire, 

respirator fit testing, and pulmonary function testing. The 

employer maintained OSHA Logs, injury/illness logs, incident 

reports, and workers’ compensation records onsite.

Can Line

This plant had three can lines (61, 62, and 63). Following brewing 

and quality assurance, beer was placed into cans and packaged for 

distribution. All three can lines could run 2,000 cans per minute; 

the difference between the lines was how the cans were packaged. 

Line 61 handled only 12-ounce cans and packaged them in a 12 

pack, a 6-pack Hi-Cone (cans held together with plastic rings), an 

18 multipack, or a 24 multipack. Line 62 handled 12-ounce and 

16-ounce cans and then packaged them in an 18 multipack, a 4 

Hi-Cone, or a 6 Hi-Cone. Line 63 packaged 24 and 30 packs and a 

24-pack suitcase.

We focused our observations on two tasks on the can line: filler 

and packer. The filler job on all three lines consisted of moving 

sleeves of can lids from an adjustable height pallet to an adjustable 

chute, removing the lids from the sleeves, and throwing the empty 

sleeves into a cart. While working on the filler job, employees 

also pulled cans from the line for quality control checks. We 

observed various packer jobs on the different lines; each consisted 

of manually placing cardboard trays and cartons of boxes onto 

the packaging line and disposing of empty pallets. While working 

on a packer, employees also performed quality control checks and 

were required to manually lift packs of beer. Employees rotated 

between filler, packer, and utility jobs in this department. Because 

of the variability of the tasks involved in the utility job, we did 

not observe this task. The rotation pattern in use during our 

visit required that an employee stay on the filler job for 4 hours. 

This was the only rotation that was mandatory; other rotations 

depended on the workgroup.
Page 3 Health Hazard Evaluation Report 2010-0008-3148

Bottle Depal

We were asked to focus our observations in bottle depal on forklift 

truck drivers. Skids of empty beer bottles were received in trucks in 

the shipping/receiving department. Forklift truck drivers removed 

the skids from the delivery trucks and placed them on the depal 

line. A depal machine removed the bottles from the containers and 

sent them down the line to be filled. The drivers were required to 

keep two conveyor lines stocked, meaning they made multiple trips 

back and forth between trucks and the two lines. Additional tasks 

included cutting wrap from around skids of bottles and clearing 

jams in the machines. Approximately 4 months before our visit 

the company had implemented a rotation pattern where employees 

could only work on the bottle depal line for 4 hours. The other 

jobs in the rotation pattern were additional forklift truck tasks.

Assessment

We walked through the plant to observe the process of can line 

and bottle depal. We took videos to assess the tasks performed by 

the employees and measured workstation heights. While analyzing 

the videos of the work tasks after our site visit, we noticed that 

employees used visual display monitors at various workstations. 

The heights of the monitors were not recorded during our visit; 

however, recommendations are provided for heights that should 

eliminate neck flexion and extension. An optimal distance and 

position to eliminate reaching and elevated shoulder postures 

while using touch screen visual display monitors are provided.

We considered WMSDs as those MSDs to which the work 

environment and the performance of the work contribute 

significantly, or MSDs that are made worse or longer lasting by 

work conditions. A full description of the ergonomic evaluation 

criteria we used to determine risk factors for WMSDs is provided 

in the Appendix.

We held confidential interviews with employees working in the 

bottle depal and can line departments. The interviews focused on 

medical, occupational, family, and social histories. This included, 

but was not limited to, work type and duration, work-related 

injuries or illnesses, past or current health conditions, medications, 

and possible workplace exposures. We also reviewed medical 

records of employees who had WMSD symptoms, OSHA Logs 

for years 2007–2009, and company incident reports filed between 

December 2008 and March 2010. The incident reports were mailed 

to us after the site visit.

Introduction

 (continued)
Health Hazard Evaluation Report 2010-0008-3148 Page 4

Assessment

 (continued) The employees who participated in the confidential medical 

interviews also met individually with a NIOSH project officer to 

complete a survey that explored work-related injuries and safety. 

Questions in the survey included injury reporting behavior; 

perceived consequences of reporting safety incidents and 

concerns; reasons for not reporting safety incidents and concerns; 

perceptions of safety climate; and safety knowledge, motivation, 

compliance, and participation.

Results and Discussion

Ergonomics

Can Line

Filler

We observed employees working the filler job on Lines 61 and 

63. Depending on the number of lids in the chute, employees 

performed four to eight lifts per minute. Each sleeve of lids 

weighed approximately 2 pounds. The heights and angles of the 

chutes were adjustable; however, it was unclear whether employees 

were adjusting the chutes. If the employees allowed the chute to 

become empty, they had to reach with their left shoulder abducted, 

sometimes leaning off the platform, to align the lids on the chute 

while removing them from the sleeve. If they tried to completely 

fill the chute, they had to either remove the lids from the sleeve 

with elevated shoulder postures or hold the sleeve with their 

elbow flexed for extended periods of time. The best option was to 

maintain the lids toward the middle of the chute. The height of 

the pallet of lid sleeves was adjustable but we did not see employees 

adjusting it.

Packer

Line 62 Multipacker

Employees used a vacuum lift to pick up two cartons of boxes at a 

time from a pallet located on a lift table. The cartons were stacked 

four high, four wide, and two deep. While the cartons of boxes 

were still on the vacuum lift, employees rotated them onto their 

sides and then placed them onto the machine conveyor. The lift 

table could not be rotated and employees had no room to move 

around the pallet, so they had to reach with their shoulder flexed 

to reach cartons on the back row. Once the cartons were on the 

conveyor, employees manually flipped the cartons over and allowed 

the boxes to slide out onto the machine conveyor. This required 

an awkward wrist posture during the flipping motion. The empty 
Page 5 Health Hazard Evaluation Report 2010-0008-3148

Results and Discussion 

(continued)

cartons were placed on top of the boxes until two or three were 

accumulated and were then thrown into a compactor. The height 

of the side of the compactor caused employees to have shoulder 

flexion during the throwing motion. When the pallet was empty, 

the employee lowered the lift table and slid the pallet off the table. 

A new pallet was then moved down a conveyor line onto the lift 

table. The lowest position of the lift table placed the top row of 

cartons at the higher end of the safe reach zone. Once every 10 

minutes, the employee checked for defects by removing the cans 

from the case, inspecting them, placing them back in the case, and 

resealing the case. This required the employee to carry cases of beer 

as well as use a touch screen visual display monitor while reaching 

with elevated shoulder postures.

Hi-Cone Tray and 2-12 Packers

Employees removed cardboard trays from a pallet located on a lift 

table and placed them on the machine conveyor line. The height of 

the lift table could be somewhat adjusted but could not be rotated. 

Because the height could not be lowered enough, the reach to 

the top trays required elevated shoulder postures. Because the lift 

could not be rotated, the employee had to reach with his shoulder 

flexed for the trays at the back of the pallet. The video showed that 

the employee may have had room to step around to the side of the 

pallet to reduce the reach, but this action was not observed.

Line 63 Packer

Employees used a vacuum lift to pick up two cartons of boxes at a 

time from a pallet on a lift table. The cartons were stacked three 

high, two wide, and four deep. While the cartons of boxes were 

still on the vacuum lift, employees rotated them onto their sides 

and moved them to the machine conveyor. The position of the lift 

table required the employees to reach with their shoulder flexed 

for the boxes at the back of the pallet. The height of the lift table 

could be adjusted but not low enough for the highest carton to be 

in the middle of the safe reach zone. The lift could not be rotated; 

however, there was space to move around the lift, and employees 

were observed doing this to reduce the reach distance. Employees 

then flipped the cartons over and allowed the boxes to slide out 

onto the machine conveyor line. This required an awkward wrist 

posture during the flipping motion. The particular employee 

observed then broke down the cardboard cartons using the corner 

of the stair rail and threw them into a dumpster. The position of 

the dumpster and the fact that the cartons were broken down did 
Health Hazard Evaluation Report 2010-0008-3148 Page 6

Results and Discussion 

(continued) not require as much shoulder flexion as the Line 62 multipacker. It 

was noted that vacuum lifts were available; however, they were not 

always used.

Bottle Depal

We observed one employee unloading pallets of empty beer 

bottles from multiple delivery trucks to two depal lines using a 

forklift truck. The forklift truck could move two pallets at a time. 

Occasionally, if a line was full, the employee removed the pallets 

from the truck and placed them next to the line because there 

was not room to place them on the conveyor. This resulted in 

double handling the pallets. The forklift truck was not equipped 

with rearview mirrors and did not have many adjustments. The 

placement of the computer caused awkward shoulder and elbow 

postures. Employees explained that they were responsible for 

unloading 8–10 trucks during their 4-hour rotation at this task. 

Each truck had approximately 38 pallets, meaning 304–380 moves 

per shift during this task. Employees explained that the other jobs 

in their rotation were more self-paced. Forklift operators were at 

an increased risk of MSDs due to prolonged sitting, trunk twisting 

and bending during reverse operations, awkward neck postures 

during reverse operations, and exposure to whole-body vibration 

[Waters et al. 2005].

Medical Assessment

Employee Interviews

We interviewed 36 employees during three shifts; 30 of 30 available 

can line employees, four of five bottle depal forklift operators, and 

two previous bottle depal or can line employees who had been 

transferred to different jobs for medical reasons. The 36 employees 

included 14 women, the average age of the employees was 48 years 

(range: 26 to 66 years), the average years working at the plant was 

15 (range: 3 to 22 years), and the average time in their current work 

area was 9 years (range: 1 month to 22 years).

The interviewed employees were asked about current 

musculoskeletal symptoms potentially related to work tasks; 

nine (25%) reported having these symptoms. Eight of the nine 

employees’ symptoms involved pain in the upper extremity, 
Page 7 Health Hazard Evaluation Report 2010-0008-3148

Results and Discussion 

(continued) including four with pain in the shoulder, three in the wrist, and 

one in the thumb. Four reported that they had a prior shoulder 

disorder. Five reported seeing a physician within the past year for 

MSDs, and one had seen a physician 5 years before our visit. Two 

employees were on modified duty at the time of our visit; one 

had been on modified duty 4 months earlier. Four of the nine 

employees with symptoms stated they did not report their current 

MSD to their supervisor/employer. Seven worked primarily as 

fillers, packers, a combined filler/packer job, or as utility operators 

in can lines 61, 62, and 63; two worked in bottle depal. Six of 

the nine felt their symptoms were due to the packer job. The 

other three employees each named a different job they felt was 

responsible for their symptoms: the filler job, the utility operator 

job, and the bottle depal job.

Medical Record and Incident Report Review

Medical records of six employees were reviewed. Five employees 

had been diagnosed with a WMSD on the basis of their workers’ 

compensation medical records; the sixth employee’s records were 

from a personal medical provider whose notes did not discuss the 

relationship of the MSD to work. Four of six employee records 

involved shoulder pain; two employees were diagnosed with rotator 

cuff tears, one was diagnosed with pectoralis strain, and one was 

diagnosed with intermittent right shoulder pain subsequent to a 

prior shoulder injury requiring surgery. The other two employee 

records involved thumb, hand, and/or wrist pain; one employee 

was diagnosed with DeQuervain stenosing tenosynovitis, the other 

was diagnosed with bilateral thumb pain and mild deQuervain 

tenosynovitis. Two employees were waiting for approval to have 

surgery (one wrist and one shoulder) at the time of this review.

Eleven incident reports dated between December 2008 and March 

2010 were reviewed. Three were initial incidents that led to medical 

evaluations included in the medical record review discussed above. 

The remaining eight incidents did not require a medical evaluation 

and involved five employees. Of these eight remaining reports, 

five concerned shoulder pain, two concerned wrist pain, and one 

concerned elbow pain.
Health Hazard Evaluation Report 2010-0008-3148 Page 8

Results and Discussion 

(continued) OSHA Form 300 Logs of Work-Related Injuries 

and Illnesses

The results of the brewery’s OSHA Logs for years 2007, 2008, 

and 2009 are described in Table 1. Sprain, strain, soreness, or 

inflammation entries were the most common and accounted for about 

50% of all injuries in 2007 and 2008 but increased to 71% in 2009.

Figure 1 describes these entries by joint type and shows that 

the shoulder was the most commonly involved part of the body 

and accounted for about 40% of sprain, strain, soreness, or 

inflammation entries in 2007 and 2008, but increased to nearly 

60% in 2009. Job titles were entered for each of these shoulder 

injuries and included one administrator and one bottle line 

employee in 2007; one brewing, one can line, and one bottle line 

employee in 2008; and four can line, two fork truck, and one bottle 

line employee in 2009.

Figure 1. OSHA Form 300 Log of 

Work-Related Injuries 

and Illnesses entries for 

sprain, strain, soreness, or 

inflammation by joint type for 

years 2007–2009.

Table 1. OSHA Form 300 Log of Work-Related Injuries and Illnesses entries by type for years 2007–2009

2007 2008 2009

Strain, sprain, soreness, inflammation 5 7 12

Laceration 1 5 1

Contusion/abrasion 1 0 2

Fracture 0 2 1

Amputation 1 0 0

Burn 0 1 0

Foreign body 1 0 0

Hearing loss 0 1 1

Total entries 9 16 17
Page 9 Health Hazard Evaluation Report 2010-0008-3148

Results and Discussion 

(continued) We used data from the Colorado plant’s OSHA Logs to calculate 

and compare incidence rates of nonfatal injury and illness between 

the Colorado plant and the U.S. brewery industry as a whole 

[http://data.bls.gov/iirc/]. The incidence rates are for nonfatal 

injuries and illnesses per 100 full-time employees for each year 

(Table 2). These rates can be useful for determining problem areas 

and progress in preventing work-related injuries and illnesses 

and show comparisons across similar industries. These rates are 

calculated using the following formula:

Number of injuries and illnesses × 200,000 / employee 

hours worked = incidence rate

The 200,000 hours in the formula represents the equivalent of 100 

employees working 40 hours a week, 50 weeks a year. From 2007 

through 2009, employees at the Colorado plant averaged 41 work 

hours per week. Incidence rates in all categories would be slightly 

increased if the formula was modified to reflect this (using 205,000 

hours in the numerator); however, we used the standard formula 

number of 200,000 hours to allow comparison to other plants with 

the same NAICS code throughout the United States.

Table 2. Comparison of nonfatal injury and illness incidence rates for years 2007–2009; Colorado plant (CO) 

and U.S. private industry plants with NAICS Code 312120 (U.S.)

Year 2007 2008 2009

Case Type U.S. CO U.S. CO U.S. CO

Total* 4.3 1.4 3.9 2.6 3.6 3.3

Days away† 0.9 0.5 0.8 0.6 1.0 0.5

Job transfer‡ 1.5 0.8 0.9 0.6 1.1 1.5

DART§ 2.4 1.3 1.8 1.3 2.0 2.0

*total recordable nonfatal injury and illness cases

†cases involving days away from work

‡cases involving job transfer or restricted work activity only

§total cases involving days away from work (including days of restricted work activity and/or job transfer)

Incidence rates for nearly all categories at the Colorado plant 

are below the U.S. NAICS rates. However, from years 2007 to 

2009, the Colorado plant shows an increase in the total injury 

and illness incidence rates, while the U.S. rates for this industry 

show a decrease. This increasing trend in injuries and illnesses 

during this time period may be due to an increase in reporting 

and documenting, or could indicate a real increase in injuries and 

illnesses.
Health Hazard Evaluation Report 2010-0008-3148 Page 10

The results of the medical interviews and reviews of medical 

records, incident reports, and OSHA Logs confirmed that WMSDs 

had occurred among bottle depal and can line employees, and 

that the most commonly reported injuries were to the shoulder 

and wrist. Review of the 3 years of OSHA Log data also revealed 

that the brewing department and bottle lines each had five 

musculoskeletal disorder entries during this time period. The 

OSHA Logs showed an increase in recordable WMSDs from 2007 

through 2009, particularly shoulder disorders. Working at or above 

shoulder level, flipping material, prying, and pushing have strong 

associations with shoulder WMSDs. The combinations of work 

factors leading to neck/shoulder MSDs have been documented in 

previous studies [Holmstrom et al. 1992; NIOSH 1997; Miranda 

et al. 2001]. Personal factors such as age, sex, smoking, physical 

activity, and strength can also influence the occurrence of MSDs 

[NIOSH 1997]. In addition, rapid, repetitive hand motions have 

been associated with musculoskeletal disorders of the wrist and 

shoulder.

Safety Survey

Employees (n = 36) also met with us individually to complete a 

survey that explored safety reporting behavior and perceptions of 

safety within the organization (i.e., safety climate).

Work-related Injuries in the Past Year

Employees were asked whether they experienced injuries to their 

neck, shoulder, arm, hand, or back in the 2009 calendar year. 

Twelve employees (33.3%) indicated they experienced at least one 

of these injuries in the past year, for a total of 18 injuries overall. 

Hand injuries were the most common (n = 6; 33.3%), followed 

by injuries to the shoulder (n = 5; 27.8%), back (n = 3; 16.7%), 

“other body part” (n = 2; 11.1%), neck (n = 1; 5.6%), and arm 

(n = 1; 5.6%). Note that the results here do not necessarily match 

the responses in the medical interviews because of a difference in 

current symptoms of MSD (medical interview) versus acute injuries 

in the past 12 months (safety survey).

Of the 18 injuries reported in our survey, employees reported 

that 12 (66.7%) required first aid, six (33.3%) required a doctor’s 

attention, five (27.8%) resulted in a job reassignment, and one 

(5.6%) was considered a lost time accident. Nine (50%) of these 

Results and Discussion 

(continued)
Page 11 Health Hazard Evaluation Report 2010-0008-3148

injuries were reported to the employer by six individuals.

Injury Reporting Behavior

As noted above, 12 employees indicated they had experienced 

at least one work-related injury in the 2009 calendar year. Six 

individuals did not report their injury(ies), five of these individuals 

reported their injury(ies), and one individual reported some but 

not all of his/her injuries.

Exploring Barriers to Reporting Safety 

Incidents or Concerns

Perceived Outcomes of Reporting a Safety Incident 

or Concern

Employees were asked if they reported a safety incident or 

concern (described as any injury, near miss, or safety hazard) they 

experienced or witnessed at work in the 2009 calendar year. Those 

who indicated that they had reported a safety incident or concern 

(n = 15) were presented with a list of possible perceived negative 

consequences they may have experienced as a result of reporting 

the incident/concern and were asked to check all that occurred. 

Ten of the 15 individuals (66.6%) selected one or more of the 

listed perceived outcomes.

The most frequently reported outcome (n = 4) was “the issue was 

not addressed by management.” A small number of employees 

(ranging from 1 to 3) indicated they experienced either adverse 

job performance outcomes (e.g., disciplinary action) or poor 

interpersonal treatment (e.g., being ignored by others at work).

Reasons for Not Reporting a Safety Incident or 

Concern

Employees were also asked if they experienced a safety incident 

or concern (again, described as experiencing or witnessing an 

injury, near-miss, or hazard) in the 2009 calendar year but chose 

not to report it. Eleven participants (30.6%) indicated they had 

experienced a safety incident or concern, but chose not to report it. 

These individuals were presented with a list of possible reasons why 

they chose not to report the incident/concern, and were asked to 

check all that occurred. 

Results and Discussion 

(continued)
Health Hazard Evaluation Report 2010-0008-3148 Page 12

The most common reasons were “I took care of the issue myself” 

(n = 6), “I felt uncomfortable about making a report” (n = 5), and 

“I thought I’d be labeled a ‘troublemaker’” (n = 5). The other 

most frequently endorsed reasons (ranging from 1 to 3) included 

thinking it would make work unpleasant, not wanting to be 

questioned by the employer, believing nothing would be done to 

fix the problem, thinking the issue was not important enough 

to report, and concern over potential negative impact on one’s 

performance evaluation.

Safety Climate

Safety climate refers to employees’ perceptions of the safety-related 

aspects of their organization. One conceptualization of safety 

climate [Neal et al. 2000] focuses on individual perceptions of the 

value of safety within an organization, comprised of the following 

dimensions: management values (the extent to which the employer 

places a high priority on safety), safety communication (the extent to 

which an open exchange of information regarding safety exists), 

safety training (the extent to which training is accessible, relevant, 

and comprehensive), and safety systems (the extent to which safety 

policies and procedures are perceived to be effective in preventing 

safety incidents).

Employees’ responses to the safety climate survey items were 

measured with a scale ranging from 1 (“strongly disagree”) to 5 

(“strongly agree”), with higher scores indicating a more positive 

perception of safety climate. Table 3 includes each safety climate 

survey item along with the proportion of employees who indicated 

agreement with the statement by scoring the question as either a 4 

or 5 on the scale.

Overall, perceptions of safety climate were favorable among the 

employees. When summing the survey items into a comprehensive 

safety climate score, the average was 35 with a range of 10–50. 

Neutrality would be represented by a total of 30, indicating a 

neutral response of “3” for each of the 10 survey items, so an 

average of greater than 30 indicates that overall employees tended 

to view the safety climate favorably. However, examination of the 

percent agreement with individual survey items indicates that some 

areas need improvement.

Results and Discussion 

(continued)
Page 13 Health Hazard Evaluation Report 2010-0008-3148

Results and Discussion 

(continued) The safety climate dimensions with the relatively lowest scores 

were safety training and safety systems. Approximately half 

of the surveyed employees felt that the workplace safety and 

health training they received was inadequate and that they were 

not confident that the safety procedures and practices in the 

organization were effective. Another area of concern was safety 

communication, in which nearly half of surveyed employees 

believed they had insufficient opportunity to discuss and deal with 

safety issues in meetings.

Table 3. Proportion of 36 employees agreeing with safety climate items

Survey Item Agreement

n (%)

Management Values

Management places a strong emphasis on workplace health and safety 26 (72.3)

Safety is given a high priority by management 21 (58.3)

Management considers safety to be important* 23 (65.7)

Safety Communication

There is sufficient opportunity to discuss and deal with safety issues in meetings 19 (52.7)

There is open communication about safety issues within this workplace 24 (66.7)

Employees are regularly consulted about workplace health and safety issues 23 (63.9)

Safety Training

Employees receive comprehensive training in workplace health and safety issues 18 (50)

Employees have sufficient access to workplace health and safety training programs 18 (50)

Safety Systems

There are systematic procedures in place for preventing breakdowns in workplace safety 17 (47.3)

The safety procedures and practices in this organization are useful and effective 19 (52.7)

*Proportion of 35 employees agreeing with this safety climate item.

Safety Knowledge, Motivation, Compliance, and 

Participation

Participants were also asked individual-level questions to 

evaluate their safety knowledge, motivation to engage in safe 

behaviors and avoid at-risk behaviors, compliance with safety 

rules and procedures, and safety participation (i.e., supporting 

and promoting safety in the workplace). These survey items were 

measured with a scale ranging from 1 (“strongly disagree”) to 5 

(“strongly agree”), with higher scores indicating a more positive 

personal inclination towards safety. Table 4 includes each of these 

survey items along with the proportion of employees who indicated 

agreement with the statement by scoring the question as either a 4 

or 5 on the scale.
Health Hazard Evaluation Report 2010-0008-3148 Page 14

Of the individual-level safety dimensions, safety participation 

is the area that had relatively low scores, indicating that some 

employees did not voluntarily promote the safety program within 

the company.

Results and Discussion 

(continued)

Table 4. Proportion of 36 employees agreeing with individual-level safety items

Survey Item Agreement

n (%)

Safety Knowledge

I know how to use safety equipment and standard work procedures 34 (94.5)

I know how to maintain or improve workplace health and safety 33 (91.7)

I know how to reduce the risk of accidents and incidents in the workplace 34 (94.5)

Safety Motivation

I feel that it is worthwhile to put in effort to maintain or improve my personal safety 36 (100)

I feel that it is important to maintain safety at all times 36 (100)

I believe that it is important to reduce the risk of accidents and incidents in the workplace 36 (100)

Safety Compliance

I use all the necessary safety equipment to do my job* 35 (100)

I use the correct safety procedures for carrying out my job 36 (100)

I ensure the highest levels of safety when I carry out my job 35 (97.2)

Safety Participation

I promote the safety program within the organization 28 (77.8)

I put in extra effort to improve the safety of the workplace 31 (86.1)

I voluntarily carry out tasks or activities that help to improve workplace safety 23 (63.9)

*Proportion of 35 employees agreeing with this individual-level safety item.
Page 15 Health Hazard Evaluation Report 2010-0008-3148

Conclusions

Employees were exposed to a combination of risk factors for 

upper extremity WMSDs, including awkward postures (elevated 

shoulders and extended reaches), forceful exertions (lifting 

heavy weights), and repetitive motions (twisting and reaching). 

The overall rates of OSHA-reportable injuries and illnesses are 

below those of other plants in the brewery industry. However, we 

confirmed that WMSDs had occurred among bottle depal and can 

line employees, with shoulder and wrist injuries most commonly 

reported. The safety climate survey indicated that safety training 

and safety systems are areas that should be improved. Half of the 

employees surveyed felt the safety training and the safety practices 

and policies endorsed by the company were inadequate. This may 

also be reflected in the relatively low scores in safety participation, 

which may indicate that employees do not see potential benefits in 

promoting the company’s safety program.

Recommendations On the basis of our findings, we recommend the actions listed 

below to reduce the risk of WMSDs and create a more healthful 

workplace. We encourage the brewery to use the safety committees 

to discuss the recommendations in this report and develop an 

action plan. Those involved in the work can best set priorities 

and assess the feasibility of our recommendations for the specific 

situation at the plant.

Our recommendations are based on the hierarchy of controls 

approach. This approach groups actions by their likely effectiveness 

in reducing or removing hazards. In most cases, the preferred 

approach is to eliminate hazardous materials or processes and 

install engineering controls to reduce exposure or shield employees. 

Until such controls are in place, or if they are not effective or 

feasible, administrative measures and/or personal protective 

equipment may be needed.

Engineering Controls

Engineering controls reduce exposures to employees by removing 

the hazard from the process or placing a barrier between the 

hazard and the employee. Engineering controls are very effective 

at protecting employees without placing primary responsibility 

of implementation on the employee. Many of the height 

recommendations listed below were obtained from The Handbook of 

Ergonomic Design Guidelines [Humantech 2009].
Health Hazard Evaluation Report 2010-0008-3148 Page 16

● Design all work surfaces to be within a height range of 27”–

62”. Moving the working height toward the middle of the 

range should reduce the risk for back and shoulder WMSDs.

● Provide lift tables with 36” of height adjustability.

● Redesign most lifts so that the top rows of lids, cartons, or 

trays are in the working range listed above.

● Use height-adjustable lifts with platforms that also rotate. 

This places the materials closer to the employee and reduces 

reach distances.

● Balance overhead tools (e.g., vacuum assists) at less than 74”

above the standing surface.

● Place the top of adjustable visual display screens at a height 

of 58”–71” (adjustable height) or at 66” (fixed height). Place 

screens at a viewing distance of 18”–30” (adjustable distance) 

or 23” (fixed distance).

● Place touchscreen displays used while standing at a height 

of 47”–71” (adjustable height) or 59” (fixed height). Place 

the displays within a reach of 22”. Tilt the screen slightly 

downward to avoid glare.

● Use rearview mirrors on forklifts to reduce neck strain.

● Provide industrial mats for employees who stand for 90% or 

more of their working hours. Mats should be ≥ 0.5” thick, 

have an optimal compressibility of 3%–4%, have beveled 

edges to minimize trip hazards, and be placed at least 8”

under a workstation to prevent uneven standing surfaces. 

Mats can be ordered to meet specific electrical/static 

requirements.

● Implement a replacement schedule for mats. Mats should be 

replaced if they appear worn out or are damaged.

Administrative Controls

Administrative controls are management-dictated work practices 

and policies to reduce or prevent exposures to workplace hazards. 

The effectiveness of administrative changes in work practices 

for controlling workplace hazards is dependent on management 

commitment and employee acceptance. Regular monitoring and 

reinforcement are necessary to ensure that control policies and 

procedures are not circumvented in the name of convenience or 

production.

Recommendations

 (continued)
Page 17 Health Hazard Evaluation Report 2010-0008-3148

Recommendations

 (continued) ● Rotate employees through several jobs with different physical 

demands to reduce the stress on limbs and body regions. 

Rotate every break, rather than every 4 hours, to increase job 

variability. Use the same rotation pattern for all employees.

● Provide space around height adjustable platforms so 

employees can move closer to materials and reduce reach 

distances before lifting.

● Use a flat paddle or box grabber to move materials closer to 

employees and reduce reach distances before lifting.

● Investigate a way to remove boxes from cartons on the 

multipacker lines rather than flipping with the wrists; it may 

be possible to use the vacuum lift to tilt the cartons until the 

boxes come out.

● Evaluate the effectiveness of the implemented engineering 

and administrative controls.

● Schedule more breaks to allow for rest and recovery. Taking 

short breaks for 3–5 minutes every hour can give the body a 

rest and reduce discomfort.

● Train employees on adjustability features of their equipment 

and workspace and ensure that they are using them.

● Train employees on MSDs and ergonomics covering specific 

operations that have been identified by NIOSH or the 

company as causing or likely to cause MSDs.

● Perform surveillance with OSHA Logs and company injury/

illness logs to identify jobs that need intervention to reduce 

or eliminate ergonomic hazards. Our review of records 

indicates that evaluating the brewing department and bottle 

lines may be beneficial.

● Encourage employees to report symptoms of discomfort 

or pain associated with work tasks. Early reporting allows 

intervention measures to be implemented before the effects 

of a job problem worsen.

● Seek care from a medical provider with experience in 

occupational medicine if injured.

● Improve communication between the employer and 

employees regarding responses to employee safety and health 

concerns. A member of the safety management team should 

communicate directly with employees who report health and 

safety concerns to ensure the concern is understood and if 

applicable, what steps are being taken to address the issue.
Health Hazard Evaluation Report 2010-0008-3148 Page 18

Recommendations

 (continued) ● Consider hiring a consultant to help improve employee 

participation in the company’s safety program. One area of 

focus should be to develop methods for encouraging safety 

reporting behavior as opposed to implementing disciplinary 

or otherwise negative consequences when such reports are 

received. The consultant may also be able to determine what 

the perceived weaknesses are in the workplace safety and 

health training so that improvements can be made to boost 

employees’ confidence in the safety policies and procedures 

within the organization.

References

Holmstrom EB, Lindell J, Moritz U [1992]. Low back and neck/

shoulder pain in construction employees: occupational workload 

and psychosocial risk factors. Part 2: Relationship to neck and 

shoulder pain. Spine 17(6):672–677.

Humantech [2009]. The handbook of ergonomic design guidelines 

– Version 2.0. Ann Arbor, MI: Humantech, Inc.

Miranda H, Viikari-Juntura E, Martikainen R, Takala EP, 

Riihimäki H [2001]. A prospective study of work related factors and 

physical exercise as predictors of shoulder pain. Occup Environ 

Med 58(8):528–534.

Neal A, Griffin MA, Hart PM [2000]. The impact of organizational 

climate on safety climate and individual behavior. Safety Sci 34(1–

3):99–109.

NIOSH [1997]. Musculoskeletal disorders and workplace factors: 

a critical review of epidemiologic evidence for work-related 

musculoskeletal disorders of the neck, upper extremity, and low 

back. Cincinnati, OH: U.S. Department of Health and Human 

Services, Centers for Disease Control and Prevention, National 

Institute for Occupational Safety and Health, (DHHS) Publication 

No. 97–141. [http://www.cdc.gov/niosh/docs/97-141/]. Date 

accessed: October 2011.

Waters T, Genaidy A, Deddens J, Barriera-Viruet H [2005]. Lower 

back disorders among forklift operators: an emerging occupational 

health problem? Am J Ind Med 47(4):333–340.
Page 19 Health Hazard Evaluation Report 2010-0008-3148

Appendix: Ergonomic Evaluation Criteria

Musculoskeletal disorders are those conditions that involve the nerves, tendons, muscles, and supporting 

structures of the body. They can be characterized by chronic pain and limited mobility. WMSD refers to 

(1) musculoskeletal disorders to which the work environment and the performance of work contribute 

significantly, or (2) MSDs that are made worse or longer lasting by work conditions. A substantial body 

of data provides strong evidence of an association between MSDs and certain work-related factors 

(physical, work organizational, psychosocial, individual, and sociocultural). The multifactorial nature 

of MSDs requires a discussion of individual factors and how they are associated with WMSDs. Strong 

evidence shows that working groups with high levels of static contraction, prolonged static loads, or 

extreme working postures involving the neck/shoulder muscles are at increased risk for neck/shoulder 

MSDs [NIOSH 1997]. Further strong evidence shows job tasks that require a combination of risk factors 

(highly repetitious, forceful hand/wrist exertions) increase risk for hand/wrist tendonitis [NIOSH 1997]. 

Finally, strong evidence shows that low-back disorders are associated with work-related lifting and forceful 

movements [NIOSH 1997]. A number of personal factors can also influence the response to risk factors 

for MSDs: age, sex, smoking, physical activity, strength, and anthropometry. Although personal factors 

may affect an individual’s susceptibility to overexertion injuries/disorders, studies conducted in high-risk 

industries show that the risk associated with personal factors is small compared to that associated with 

occupational exposures [NIOSH 1997].

In all cases, the preferred method for preventing and controlling WMSDs is to design jobs, workstations, 

tools, and other equipment to match the physiological, anatomical, and psychological characteristics and 

capabilities of the employee. Under these conditions, exposures to risk factors considered potentially 

hazardous are reduced or eliminated.

Workstation design should directly relate to the anatomical characteristics of the employee. Because a 

variety of employees may use a specific workstation, a range of work heights should be considered. On the 

basis of functional anthropometry, working heights should be within a range of 27” to no higher than 62”

[Humantech 2009]. These heights correspond to hand height dimensions for the 5th percentile female 

and shoulder dimensions for the 95th percentile male.

References

Humantech [2009]. The handbook of ergonomic design guidelines – Version 2.0. Ann Arbor, MI: 

Humantech, Inc.

NIOSH [1997]. Musculoskeletal disorders and workplace factors: a critical review of epidemiologic 

evidence for work-related musculoskeletal disorders of the neck, upper extremity, and low back. 

Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and 

Prevention, National Institute for Occupational Safety and Health, (DHHS) Publication No. 97–141. 

[http://www.cdc.gov/niosh/docs/97-141/]. Date accessed: October 2011.
Health Hazard Evaluation Report 2010-0008-3148 Page 20

Acknowledgments and

Availability of Report

The Hazard Evaluations and Technical Assistance Branch 

(HETAB) of the National Institute for Occupational Safety and 

Health (NIOSH) conducts field investigations of possible health 

hazards in the workplace. These investigations are conducted 

under the authority of Section 20(a)(6) of the Occupational Safety 

and Health Act of 1970, 29 U.S.C. 669(a)(6) which authorizes 

the Secretary of Health and Human Services, following a written 

request from any employer or authorized representative of 

employees, to determine whether any substance normally found 

in the place of employment has potentially toxic effects in such 

concentrations as used or found. HETAB also provides, upon 

request, technical and consultative assistance to federal, state, and 

local agencies; labor; industry; and other groups or individuals to 

control occupational health hazards and to prevent related trauma 

and disease.

Mention of any company or product does not constitute 

endorsement by NIOSH. In addition, citations to websites 

external to NIOSH do not constitute NIOSH endorsement of 

the sponsoring organizations or their programs or products. 

Furthermore, NIOSH is not responsible for the content of these 

websites. All Web addresses referenced in this document were 

accessible as of the publication date.

This report was prepared by Jessica G. Ramsey, Loren Tapp, and 

Douglas Wiegand of HETAB, Division of Surveillance, Hazard 

Evaluations and Field Studies. Industrial hygiene equipment 

and logistical support was provided by Donald Booher and Karl 

Feldmann. Health communication assistance was provided 

by Stefanie Evans. Editorial assistance was provided by Ellen 

Galloway. Desktop publishing was performed by Greg Hartle.

Copies of this report have been sent to employee and management 

representatives at the brewery, the state health department, and the 

Occupational Safety and Health Administration Regional Office. This 

report is not copyrighted and may be freely reproduced. The report 

may be viewed and printed at http://www.cdc.gov/niosh/hhe/. 

Copies may be purchased from the National Technical Information 

Service at 5825 Port Royal Road, Springfield, Virginia 22161.
Below is a recommended citation for this report:

NIOSH [2011]. Health hazard evaluation report: ergonomic and safety climate 

evaluation at a brewery – Colorado. By Ramsey J, Tapp L, Wiegand D. Cincinnati, 

OH: U.S. Department of Health and Human Services, Centers for Disease Control 

and Prevention, National Institute for Occupational Safety and Health, NIOSH 

HETA No. 2010-0008-3148.

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