The Wrist Watch:
                   How a Plant Handles
                   Occupational Hazard
                   With Common Sense
                   Many Small Changes Enable
                   Sara Lee Bakery to Ease
                   Carpal Tunnel Syndrome
                   Special Stools, Custom Tools
                   By Joan E. Rigdon

                   The Wall Street Journal
                   PAGE A1
                   (Copyright (c) 1992, Dow Jones & Co., Inc.)

                 NEW HAMPTON, Iowa -- The problem began with some special
                   orders at the bakery. Customers wanted croissants whose tips curled
                   forward and touched.

                   When Sara Lee Corp.'s bakery in this rural town started making them,
                   and also filling orders for hand-decorated cakes, its workers had to twist
                   their wrists more than before. At first no one noticed. Employees,
                   standing on concrete floors with their arms extended over conveyor belts,
                   even raced one another at times, with winners handling almost 100 pieces
                   a minute. "They wanted so many and we went so fast, faster and faster,"
                   recalls one worker, Carol Panoch.

                   Their prize: carpal tunnel syndrome, a debilitating wrist disorder caused
                   by repeated hand motions. It and other so-called cumulative trauma
                   disorders caused by repetitive motion today make up the fastest growing,
                   most widespread U.S. occupational hazard, according to the Bureau of
                   Labor Statistics. Cumulative trauma disorders, or CTDs, afflicted
                   185,400 American workers in 1990, almost nine times the number
                   reported for 1982.

                   Symptoms suffered by the bakery workers here were typical: shooting
                   pains in the arms, numb and tingling fingers and aching wrists. Some
                   workers wore splints to work or bed. Some had surgery. The town's
                   small hospital leased a deluxe physical therapy machine to help handle the
                   case load.

                   But today, five years after that machine was purchased, it is more or less
                   foreign to Sara Lee workers. While hundreds of U.S. businesses, from
                   manufacturing plants to data-processing centers, continue to grapple with
                   complaints of CTDs, the bakery here has nearly eliminated them. It did so
                   -- after an initial balky start -- by using a homespun approach that
                   stresses prevention and relies on close observation of work procedures
                   and small modifications in them.

                   The bakery hired a hand surgeon to come in and evaluate its procedures.
                   It brought its labor union into the game. Instead of buying new equipment
                   off the shelf -- ergonomically designed chairs and keyboards for offices
                   can cost $100 to $1,000 a pop -- it used its own maintenance
                   department whenever possible to make dozens of small changes. In some
                   cases, workers themselves invented devices they thought would alleviate
                   problematic physical motions. For instance, one engineer devised a new
                   icing gun that weighed less and took less strength to squeeze.

                   The result is that employees missed only eight days of work because of
                   carpal tunnel syndrome in the first seven months of this year, after being
                   out 181 days during all of last year. The local union is generally pleased
                   with the bakery's response. "They've made great progress," says Bob
                   Schilling, the local business agent for the Bakery, Confectionary &
                   Tobacco Workers.

                   This is not to say the Sara Lee bakery has been a paragon of
                   enlightenment. Like many businesses, it was initially quite skeptical of
                   workers' seemingly vague complaints in the early-1980s -- even though
                   another, non-food unit of Sara Lee Corp. had been cited by the
                   Occupational Safety and Health Administration as long ago as 1979 for
                   conditions conducive to carpal tunnel syndrome. Bakery workers' early
                   suggestion to slow down the production line was dismissed out of hand.

                   Nor is the Sara Lee bakery here the only business at the forefront in
                   combating the problem. Facing lawsuits and huge government fines, many
                   other plants have also changed procedures. In the past decade, unions
                  have prodded meatpackers and auto makers to finance studies and
                   redesign work stations.

                   What distinguishes this Sara Lee bakery is that it tackled the problem
                   before it became epidemic. The majority of companies either do nothing
                   about complaints of repetitive motion injuries or offer limited treatment,
                   such as mandatory stretching exercises. This is so even though carpal
                   tunnel and other CTDs are a costly and growing problem. They made up
                   nearly 56% of work-related illnesses in 1990, according to the Bureau of
                   Labor Statistics, compared with 21% in 1982. And the CTD cases cost
                   an average of $29,000 in lost wages and medical treatment, says the
                   National Council on Compensation Insurance. That doesn't include legal
                   damages, which have been averaging $50,000 per plaintiff, or fines levied
                   by OSHA, which have been as high as $3 million.

                   "When people are off work for four, six and eight weeks and have
                   surgery and perhaps end up with a small amount of permanent disability .
                   . ., it doesn't take long to demonstrate that you can be cost-effective by
                   investing to keep claims down," says Ray Wright, former personnel
                   director of the Sara Lee bakery in New Hampton. The 630-employee
                   bakery estimates that its preventive approach to carpal tunnel syndrome
                   now saves it up to $750,000 a year in costs of worker's compensation
                   and lost labor.

                   The first complaints of wrist pain here arose in the early 1980s, and they
                   drew little attention from management. Local doctors couldn't diagnose a
                   problem, and workers felt they were written off as complainers. Tony
                   Gotto, the bakery's personnel director and then the safety manager, says,
                   "We had supervisors and co-workers who did not buy in because there
                   was no sign of injury." Marlene Lindell, who was the bakery's safety
                   nurse until 1990, agrees that the hardest part about fighting carpal tunnel
                   was "persuading management to look and see what the cause was."

                   When employee Carol Brockway first complained of shooting pains in
                   her arms in the early 1980s, she feared her bosses thought, "What's she
                   trying to pull? Is she trying to get off work or trying to get paid off?" For
                   four years, she complained to Ms. Lindell and local doctors, but all she
                   got was conflicting diagnoses of muscle disorders and a cortisone

                   But in 1986 the bakery recruited a hand surgeon from Cedar Rapids,
                   some 100 miles to the south, who talked about preventing the symptoms
                   instead of just treating them. William Eversmann operated on the bakery's
                   early cases, including Ms. Brockway. He also visited the bakery, where
                   he timed the number of worker wrist actions per minute and the weight of
                   various doughs and tools. He measured table heights and photographed
                   workers stooping, stretching or flicking their wrists to do their work. He
                   showed the photos to the managers and asked them to suggest ways
                   employees could do the work without using awkward postures.

                   Based on the doctor's recommendations, the bakery made a few
                   changes, including slowing down fast workers while asking others to
                   speed up to 60 pieces a minute. It also added one worker to a
                   production line that had a lot of problems. Workers were already rotating
                   jobs, but on Dr. Eversmann's advice, they made a point of alternating
                   harder jobs with easier ones. Also, Dr. Eversmann presented a slide
                   show using photographs of the workers themselves, to explain the

                   But the program was a flop with workers. Confused by the technical
                   terms in the slide show and dubious about "the company doctor,"
                   workers watched in fear as colleagues who reported symptoms headed
                   into surgery and then disappeared for weeks or months to recuperate.
                   Fearful that all cases would result in surgery, some avoided reporting their
                   symptoms, thereby increasing their own eventual need for surgery.

                   Many workers objected to Dr. Eversmann because he wasn't a specialist
                   in ergonomics -- the study of how people physically adapt to their
                   working environment -- with experience in a wide variety of fields. But he
                   was the closest thing to an expert in the region, bakery officials say, and
                   had done ergonomics work at a meat plant (not owned by Sara Lee).
                   "You've got to work with the resources that are available," says Mr.
                   Gotto, the former safety manager.

                   Workers also objected to having to make the unpaid, four-hour round
                   trip to Dr. Eversmann's office, sometimes through ice and snow and
                   sometimes before or after a full day's work. They asked for permission to
                   see other doctors who worked closer by, but the bakery didn't know of
                   any then, Mr. Gotto says.

                   The ill-feelings, along with union objections on other issues including a
                   two-tier pay system, boiled over into a two-week strike in March of
                   1990. "People wanted the dignity of being able to choose their own
                   doctor," says Jan Laue, then a union official involved in carpal tunnel
                   issues at the plant.

                   Under a new contract, the company agreed to use two additional
                   doctors, in towns only 40 miles away, and to pay workers for up to four
                   hours of driving time per round trip to the Cedar Rapids doctor. The
                   bakery also put its carpal tunnel policy in writing.

                   But the big change was the formation of a cumulative trauma disorder
                   committee of four managers and four union-selected employees. "If we
                   made any errors in setting up our program, it was not involving our union
                   early on," says Mr. Gotto.

                   With the committee and a choice of doctors, workers say changes moved
                   forward quickly. Tapping its own maintenance department, the bakery
                   raised and lowered tables and conveyor belts and made stools for
                   workers who used to stoop. Mats made it easier to stand on concrete
                   floors for entire shifts. Foot rails allowed them to shift their weight instead
                   of standing in the same position all day.

                   Workers pitched in by ordering or inventing new tools that were easier to
                   work with. Razor-edged plastic scrapers, used to get batter out of mixing
                   vats, were replaced with scrapers with handles. Acrylic putty on tool
                   handles, which workers formed in their hands and let harden, gave each
                   worker a custom fit. And workers punched handles into plastic buckets
                   that they previously picked up by jamming their fingertips against narrow

                   Also, the committee changed the way employees worked. Conveyor
                   belts were moved closer to workers who previously leaned forward.
                   Pallets were stacked close to conveyor belts so it wasn't necessary to
                   carry items between the two. Workers learned to carry large pans on
                   their forearms instead of grasping the pans by their edges, which puts the
                   entire weight on the wrists.

                   Through a buddy system, veteran workers now show rookies the most
                   comfortable way to work, although that's sometimes difficult to do
                   without seeming nosy.

                   Because it's difficult to remember all the correct postures while working
                   on the assembly line, the CTD committee sometimes prowls the plant,
                   photographing workers to point out harmful postures. The bakery also
                   checks all workers annually for signs of carpal tunnel syndrome; it uses a
                   machine called a vibrometer to see whether any loss of sensitivity is
                   developing in the fingertips.

                   The results have been significant: Last year just 13 suspected carpal
                   tunnel cases were referred to outside physicians at the bakery, compared
                   with 34 in 1987. And absenteeism related to the disorder has plunged;
                   the eight work days lost through Aug. 1 of this year present a stark
                   contrast with 1987, when, for the full year, 731 work days were lost.

                   Still, union officials fault the bakery for scrimping on the services of a
                   bona fide ergonomist and for not buying expensive automated equipment
                   for one production line to load heavy pans. (Mr. Gotto says the bakery
                   sees to it that workers don't have to lift the pans for more than half an
                   hour at a time.)

                   Moreover, they hardly view the parent Sara Lee Corp. as devoted to a
                   safe workplace. OSHA cited its Hanes underwear plant in Galax, Va.,
                   13 years ago for conditions leading to tendinitis, carpal tunnel syndrome
                   and other CTDs. In 1990, OSHA cited Sara Lee's bakery in Traverse
                   City, Mich., for essentially the same thing. And just last May, the federal
                   agency cited Sara Lee's Seitz Foods meat-processing plant near Kansas
                   City for not adopting an ergonomics program it had agreed to institute
                   years earlier, in exchange for a temporary reprieve from OSHA
                   inspections. Asked about this and why Sara Lee didn't develop a
                   corporatewide CTD program after the Hanes case, company officials at
                   headquarters in Chicago decline to comment.

                   Says Ms. Laue, the former union official: "The solution isn't to go through
                   one worker after another. If the job is injuring the worker, the job needs
                   to be changed."


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