Last December, a federal jury in Brooklyn, N.Y., caused a sensation when it found the Digital Equipment Corp. liable for crippling hand, wrist and arm injuries suffered by three working women who used computer keyboards made by the company. The award of nearly $6 million, the first of its kind in the nation, dramatized the increasing incidence and serious nature of cumulative trauma disorders (CTDs) -- also known as repetitive-strain injuries -- and underscored the urgent need for preventive regulation. CTDs include a number of musculoskeletal ailments such as carpal tunnel syndrome, epicondylitis, ganglion, tendinitis and tenosynovitis. Symptoms include numbness, tingling, weakness and shooting pain in the hands, wrists, forearms and fingers. In extreme cases, victims are unable to perform simple tasks, such as lifting young children or opening bureau drawers. Carpal tunnel syndrome, common among computer users, is so debilitating that it results in more lost workdays (a median of 30 days per case) than any other occupational illness. One of the plaintiffs in the Digital case suffered from carpal tunnel syndrome and underwent four unsuccessful operations to restore the use of her arms. Word processing and data-entry workers are not the only ones who suffer. CTDs also plague auto assemblers, poultry cutters, meatpackers and workers whose jobs require heavy lifting. According to the Bureau of Labor Statistics, CTDs have been the fastest-growing class of occupational illness in the United States for more than a decade. Workers reported 23,000 CTD cases in 1981, accounting for 18 percent of all reported occupational illnesses. By 1994, the number of CTD cases had jumped to 332,000, or two-thirds of occupational illnesses reported that year. Even these figures -- which are drawn from employer reports and exclude federal, state and local government workers, as well as the self-employed -- understate the problem. The American Public Health Association estimates that more than 775,000 workers suffered CTDs and related injuries in 1995. The Occupational Safety and Health Administration considers CTDs to be the nation's most important occupational health problem, costing the U.S. economy an estimated $100 billion a year in workers compensation claims and lost work time. In OSHA's view, CTDs are largely preventable through the application of ergonomics, the science of redesigning the workplace to meet the safety and health needs of the worker. In 1990, OSHA began working on an ergonomics standard that would address the causes of repetitive-strain injuries. The next year, it issued nonbinding ergonomic guidelines for the meatpacking industry. By September 1994, OSHA's ergonomics standard was ready for implementation. It would have required employers to revamp the work process to limit the amount of time workers could spend at five tasks considered CTD risk factors: performance of the same motion or motion pattern; use of vibrating or impact tools; use of forceful hand exertions; unassisted frequent or heavy lifting; and fixed or awkward postures. The limits were two to four hours in the case of the first four risk factors, and one to two hours in the case of the fifth. OSHA would enforce the standard to insure that employers met its requirements. However, the Clinton administration decided not to implement the standard, fearing that Republicans would exploit the issue during the fall 1994 election campaign. Once the Republicans captured control of Congress, it was too late. The GOP quickly targeted OSHA for budget-cutting, singling out the ergonomics standard for particular scrutiny. In March 1995, House Republicans cut $16 million from OSHA's budget and ordered it to stop work on the ergonomics standard. In the face of this attack, OSHA narrowed the scope of the standard to apply only to workplaces where two workers have been diagnosed with similar CTDs within the same year. Whereas the original version emphasized prevention (it would have applied to most workplaces under OSHA's jurisdiction), the weakened standard would not apply to a given workplace until people there were injured. In addition, OSHA would no longer require employers to analyze their safety logs and workers compensation records in order to identify jobs that might be high CTD risks. Nor would employers have to evaluate their safety programs to find better ways to prevent CTDs. But even this eviscerated version did not appease House Republicans; later that month, they ordered another $3.5 million cut. This measure, House Majority Whip Tom DeLay argued, was necessary to punish OSHA for "flouting the will of this Congress." That same year, North Carolina Republican Rep. Cass Ballenger sponsored an OSHA reform bill that, had it passed, would have eliminated OSHA's power to use the general duty clause of the Occupational Safety and Health Act to penalize employers for hazardous working conditions not already covered by a regulation. With no ergonomics standard in place, the general duty clause was the only enforcement tool available to OSHA to combat the growing CTD problem. He dismissed the need for regulation of ergonomics-related disorders, saying, "No one ever died from ergonomics." It's hardly surprising that the ergonomics standard has met such stiff opposition in Congress. The National Association of Manufacturers, one of Washington's most influential lobbying groups, set up the National Coalition on Ergonomics, an alliance of 300 corporations and trade associations, expressly to fight the standard. Corporate-financed think tanks such as the Heritage Foundation and the Cato Institute have played an important role in promoting the view that the CTD crisis is little more than an employee "comfort" problem best dealt with by employers on a voluntary basis. Some of the most vocal opponents of the standard in Congress have strong ties to companies with long histories of health and safety problems. DeLay, who is known in conservative circles as "Mr. Dereg," has nursed a grudge against regulatory agencies ever since OSHA fined his pest control company for safety violations when he was a private businessman. Poultry workers suffer from one of the highest rates of CTDs, and OSHA's ergonomics standard would have had a direct impact on chicken-processing companies such as Tyson, which has a plant in Ballenger's congressional district. According to the Washington Post, UPS lobbyist and former OSHA Director Dorothy "Dottie" Strunk was so closely involved in writing Ballenger's bill that an early version was dubbed "Dottie's draft." Not surprisingly, UPS has actively opposed the ergonomics standard. Many of its delivery and warehouse workers incur repetitive-strain injuries while lifting boxes and making deliveries. The company holds the record for the most safety and health complaints and fines in OSHA's 26-year history. It also gave House Republicans close to $750,000 during the 1995-96 election cycle. Last July, Republican Rep. Henry Bonilla of Texas tried again to attach a rider to OSHA's appropriation denying it the right to work on the ergonomics standard or even to gather scientific data on repetitive-motion illness. In response, the American Public Health Association's Occupational Health and Safety Section sent an urgent letter to Congress criticizing the Republican plan. "Within the scientific community, there is a strong consensus, based on an extensive body of solid evidence, on the role of ergonomic factors in the incidence of workplace injuries," the letter stated. "If no more data are collected, workplace injuries will erroneously appear to be eliminated. Prevention programs will be endangered and important research terminated. Crippling injuries throughout American workplaces will be the inevitable result." In a surprise victory, House Democrats narrowly mustered enough support to defeat the rider. Thanks largely to pressure from organized labor and the shift of public opinion against Gingrich, 34 moderate Republicans voted with the Democrats. This victory notwithstanding, OSHA's ergonomics standard faces an uncertain future. The agency is now permitted to work on the standard again, but the Republicans have come close to forcing OSHA to gut the proposed standard for the past two years and will probably try again during budget negotiations this summer. The fate of the standard now depends largely on President Clinton's willingness to support it. So far, he's given mixed signals. Clinton acquiesced in 1995 when congressional Republicans used the appropriations process to forbid OSHA from promulgating the standard. Last spring, on the other hand, Clinton promised the Service Employees International Union -- many of whose members suffer from CTDs -- that he would veto any legislation undermining "the safety and the solidarity of the workplace." In the same speech, Clinton asserted that "our government is now the smallest it's been since 1965, but it's still strong enough to protect workplace safety." Despite such promises, his rhetoric about "reinventing" government spells trouble for the ergonomics standard and a strong OSHA. The Clinton administration would put companies on the honor system by allowing them to self-report illnesses and injuries. OSHA would then focus its inspection efforts on the companies that reported the worst safety records, while exempting the others. This program is based on the administration's controversial "Maine 200" pilot study, which focused on inspecting the 200 companies with the worst self-reported safety records. Clinton's plan follows in the footsteps of similar business-friendly initiatives by the Reagan and Bush administrations, giving companies an incentive to under-report the number of injuries and illnesses. Likewise, some companies may follow the honor system in the absence of an ergonomics standard, but if experience is any guide, most will ignore OSHA's nonbinding recommendations. CTD rates have stabilized in some high-risk industries, such as meatpacking, not because of a voluntary honor system but because companies were anticipating the promulgation of OSHA's ergonomics standard. Even the industry-funded Insurance Information Institute admits that this stabilization "stems in part" from the fact that OSHA's ergonomics standard was in the works. On the bright side, in November, California became the first state in the nation to adopt its own ergonomics standard. While corporate opponents managed to weaken it considerably, California OSHA's standard serves as a precedent for further action at the federal level. While the handful of cases adjudicated prior to the Digital decision resulted in victories for the computer industry or in out-of-court settlements, this landmark decision has focused public attention on ergonomics. Furthermore, with more than 2,000 cases in the judicial pipeline, the CTD problem will not disappear. Suits against the asbestos industry followed a similar pattern -- early losses for workers followed by victories as more information on corporate liability was uncovered. Still, the best policy is prevention, and until an effective OSHA ergonomics standard is on the books, increasing numbers of workers will suffer.