Jeff Bezos is obsessed with a common Amazon warehouse injury

In his final letter to shareholders, Amazon CEO Jeff Bezos urged a deep dive into musculoskeletal disorders, which account for about 40% of work-related injuries across the company and affect millions of workers globally across sectors. It is often synonymous with jobs in manufacturing and places like warehouses.

Of course, Amazon's treatment of its employees has become a high-profile issue, from the recent union battle in an Alabama warehouse to conditions for its essential workers during the pandemic. And it has been cited for a high incidence of workplace injuries in recent years, though the company has said in the past that it also reports more workplace incidents than peers due to a more proactive safety culture.

"If you read some of the news reports, you might think we have no care for employees," Bezos wrote in his letter, released earlier this month. "In those reports, our employees are sometimes accused of being desperate souls and treated as robots. That's not accurate. They're sophisticated and thoughtful people who have options for where to work."

But they also do suffer from MSDs that occur on jobs that include what can be described as robot-like repetition. The extended remarks by Bezos about this workplace injury amounted to one of the first announcements by a large corporation to draw broader attention to the issue, according to several experts consulted by CNBC. Estimates suggest that MSDs cost U.S. companies over $50 billion each year and resulted in between 21 and 32 days away from work on average between 1997 to 2010, and in addition to Amazon warehouse work, MSD issues in meat processing and poultry plants have drawn recent attention.

MSDs, often called "ergonomics injuries," are typically strains and sprains caused by repetitive motions, overexertion, or task performance in awkward positions and include issues like carpal tunnel syndrome and tendonitis. According to the Bureau of Labor Statistics, retail trade, manufacturing, and social assistance jobs accounted for 50% of all MSD cases in the private sector. While common in factory-line workplaces and among first-time workers, they can also occur through sports, desk-work and everyday use.

"MSDs are common in the type of work that we do and are more likely to occur during an employee's first six months," Bezos wrote, adding that the company launched a program to coach small groups of employees on body mechanics and safety which contributed to a 32% decrease in injuries between 2019 and 2020, while the time away as a result of the injuries "decreased by more than half," Bezos said in the recent letter.  "We need to invent solutions to reduce MSDs for new employees, many of whom might be working in a physical role for the first time."

Amazon declined to provide additional information on its ongoing MSD efforts to CNBC.

While MSD cases in the U.S. workplace have declined over the last decade, approximately 1.71 billion people suffer from musculoskeletal conditions globally with lower back pain being the most common occurrence, the World Health Organization reported. That number is expected to increase as the population ages and grows.

"Many of these injuries are actually preventable, they're not accidents, they're things we can work to avoid and make a huge difference to patients," says Anna Miller, vice chair for the department of orthopedic surgery and chief of the orthopedic trauma division at Washington University School of Medicine.

While common among manufacturing employees working along the repetitive assembly line, they can also occur from sitting in a home office, conducting remote work.

One of the biggest issues with MSDs is that there's no concrete reason why they occur and they can happen spontaneously from a seemingly menial task like walking up a flight of stairs, says John Dony, senior director of the National Safety Council. There's little research about how they happen, why they occur and who is the most susceptible. While older workers often suffer wear and tear MSDs, younger workers often try to "tough it out" or fail to understand the risks, Dony said. 

Some studies suggest obesity, genetics or smoking can increase the risk of MSDs but the data is not very clear on causal relationships, says Andrew N. Pollak, senior vice president for clinical transformation and chief of orthopedics at the University of Maryland Medical System.

Very limited federal funding is devoted to this research, but large corporations like Amazon, which now employs over a million workers, can better collect information they can share with other companies. 

"That kind of research has been difficult to accomplish in smaller companies because you simply don't have the same number of people doing the same jobs as you do at a big behemoth like Amazon," Pollak says. 

MSDs can also lead to mental health issues for many frontline workers, and many people continue working even after suffering a strain because they need the money, says Miller.

In many service-oriented jobs, workers feel pressure to continue working to make the customer happy and work through injuries to meet objectives, says Jaimo Ahn, a professor and associate chair for education in the department of orthopedic surgery at the University of Michigan Health System. 

"If you're not reaching your objective or you feel like you aren't where you need to be then you keep going," Ahn said.

In addition to the WorkingWell coaching program included in Amazon's workplace safety efforts, which launched for 859,000 employees across 250 sites last year, Amazon is also developing automated staff schedules that use "sophisticated algorithms to rotate employees" across several jobs to prevent overusing certain muscle groups and injury, and that began rolling out this year.

Rotational schedules are one of the simplest precautionary solutions that prevent sustained use of one specific muscle, as is teaching workers how to lift from the legs instead of the arms or back. Engineering out a task that involves excessive bending, requiring anti-slip shoes, or requiring workers to lift heavy objects with a partner, also help. Some companies already have these policies in place, but they are sometimes ignored or not well-communicated, Dony said.

Other alternatives include automation and implementing robots or machines that minimize hand use and can help when lifting, or wearable devices that show surroundings and detect in detail the span and range of motion. Robots have been a source of contention when it comes to workplace injuries in the past, in some cases cited for increasing risks to human workers, including forcing workers to move too fast to keep up in an ergonomically safe manner. But the company's top officers have rejected that argument.

Solving MSDs beyond Amazon, throughout the world of work and across many smaller, less deep-pocketed employers, begins with assessing the risk and walking through the workspaces. 

"If you never even go into assess what risk or exposure you're putting someone at, you're already behind the game," Dony says.