These guidelines provide recommendations for nursing home employers to help reduce the number and severity of work-related musculoskeletal disorders (MSDs) in their facilities. MSDs include conditions such as low back pain, sciatica, rotator cuff injuries, epicondylitis, and carpal tunnel syndrome. The recommendations in these guidelines are based on a review of existing practices and programs, State OSHA programs, as well as available scientific information, and reflect comments received from representatives of trade and professional associations, labor organizations, the medical community, individual firms, and other interested parties. OSHA thanks the many organizations and individuals involved for their thoughtful comments, suggestions, and assistance.