The American Nurses Association has advocated for federal protections from disabling back and musculoskeletal disorders for nearly two decades. The issue is high on ANA's priority list for legislative initiatives. According to the latest governmental statistics released in April 2002 (Bureau of Labor Statistics), nursing personnel ranked in the top 6 of all United States occupations for the number of musculoskeletal disorders that required days away from work. Health care workers who care for patients experienced twice the proportion of injuries due to overexertion than did construction laborers in the year 2000.

In the 1990's ANA leaders and injured nurses testified at multiple Congressional and agency hearings in support of the Occupations Health and Safety Administration's (OSHA) ergonomics standard. Although a standard was issued in 2000, it was rescinded by Congress in March 2001 in an unprecedented legislative event. OSHA is currently barred from working on a substantially similar standard without another act of Congress. Although OSHA recently committed to a "comprehensive plan" to address ergonomic hazards, all elements are voluntary and the enforcement mechanisms unclear. In 2002, bipartisan efforts by members of Congress were not successful in readdressing this issue.

State efforts to reduce the occurrence of disabling musculoskeletal disorders among workers range from successful passage of legislation requiring employers to implement comprehensive ergonomics programs (Washington State) to the introduction of industry sector specific legislation addressing specific needs in regard to control measures (Oregon's "No-Lift" legislation for health care). The most critical component of effective ergonomics legislation is that it mandate the prevention of injuries by eliminating workplace hazards rather than waiting for injuries to occur to trigger action.

Legislation was introduced in eight states during 2002 to address ergonomic standards designed to reduce repetitive injuries in the workplace. Only RI enacted legislation. The new law establishes a special commission on ergonomics, consisting of 15 members to consider the need for ergonomic guidelines to protect and secure workers and to define ergonomics, best practices, and educate employees on injury reduction. CA legislation that called for the revision of the state's ergonomics standards suffered a veto. Legislation that was introduced but not enacted includes: FL legislation which specified levels of proof required in cases involving occupational disease or repetitive exposure for workers compensation purposes. KY legislation would have created a taskforce to study repetitive stress disorders while MA and MN legislation would have required the adoption of the occupational safety and health standards. PA wanted to urge Congress to revisit the issue of musculoskeletal disorders and to support meaningful legislation that addressed injuries caused by repetitive motion. A series of bills in WA attempted to call for the repeal or postponement of the state ergonomic rules as well as tax credits for employers who comply with the rules.