Columbus, Ohio in response to a confidential request for a health hazard evaluation (HHE). The request was prompted by employee concerns about the potential hazards of repetitive lifting, excessive work pace, and heat stress associated with the job of "order selector." There were three objectives of this investigation: 1) Determine the prevalence and incidence of work-related musculoskeletal disorders (WMDs), particularly low back pain, associated with manual lifting activities of the order selectors in the grocery warehouse.2) Document the presence of potential occupational hazards in the warehouse including repetitive lifting and heat stress.3) Develop recommendations for preventing or reducing the physical stresses associated with repetitive lifting and heat stress.During three separate visits over a six month interval, the NIOSH team collected information at the Big Bear work site to assess the extent and magnitude of the reported health hazards. During this and subsequent visits, we administered a questionnaires to the workers that included items designed to assess the workers' perceptions of physical workload and symptoms of musculoskeletal disorders. Occupational Safety and Health Administration (OSHA) logs and medical records were reviewed to determine the extent of the recorded injuries and lost time. Ergonomic analyses were conducted on the following dates:1) On May 14, 1992, we conducted a preliminary analysis to determine variations in load weights and the types of stressful lifting postures that pose a risk to the worker.2) On July 14, 1992, we returned and conducted a second-level of analysis on over 200 individual lifts. In addition to measuring load weights and postures, we used a lumbar motion monitor to measure trunk rotations. Measurements for assessing heat stress were also conducted on July 14.3) On November 5, 1992, we examined the effects of lifting frequency and work duration as they affected oxygen use and heart rate.The results of our medical evaluation confirmed that back injuries among selectors was the most important cause of lost workdays in the warehouse. Workers' compensation data provided by Big Bear for 1991 showed 22 cases of back sprain/strain among all the workers in the grocery warehouse (about 16 cases per 100 workers). On average, during the five years, back injuries among the selectors accounted for about 60% of all lost workdays in the grocerywarehouse.This Health Hazard Evaluation (HHE) report and any recommendations made herein are for the specific facility evaluated and may not be universally applicable. Any recommendations made are not to be considered as final statements of NIOSH policy or of any agency or individual involved. A questionnaire was completed by more than 80% of current grocery selectors and showed that the work force was all male, who on average were younger, taller, and heavier than the majority of workers in the U.S. work force. More than 70% of the full time selectors reported significant physical discomfort in the region of the low back and 18% re...