A Tribute to a Physician and Friend Who Understood The Connection Between Work and Health

Last Friday my good friend David Rempel died. This is not only a huge loss for his family and friends but also for healthcare. I wanted to post this in memory of David.

In Memoriam: David M. Rempel, MD, MPH, CPE

The occupational health and safety community has lost an extraordinary scientist, educator, mentor, colleague, and advocate with the passing of David M. Rempel, MD, MPH, CPE, Professor Emeritus of Medicine at the University of California, San Francisco, and Professor Emeritus of Bioengineering at the University of California, Berkeley. He was a unicorn, as they say, unique in his expertise across engineering, medicine, research, teaching, and advocacy.

David devoted his career to a simple but profoundly important idea: work should be designed so that people can do their jobs without sacrificing their health. He believed that work-related injuries could and should be prevented through better design of tools, tasks, workplaces, technologies, and systems. That conviction shaped more than three decades of research and teaching and influenced human factors and ergonomics (HFE) practice throughout the United States and around the world.

David founded the University of California Ergonomics Program in 1991, bringing together medicine, engineering, public health, epidemiology, biomechanics, and human factors in a way that was unusual at the time and that ultimately became a model for interdisciplinary HFE research and education. His scientific work sought both to understand the mechanisms by which work contributes to injury and to translate that understanding into practical solutions. His research ranged from the biomechanics and physiology of tendons, muscles, and peripheral nerves of the upper extremity to the design and evaluation of hand tools, computer input devices, workstations, manufacturing tasks, and workplace interventions. His basic science work showed how forceful repetitive exertions led to tendon tears and how forceful hand exertions and non-neutral wrist postures increased pressure in the carpal tunnel and compression on the median nerve. This provided important evidence on the mechanism of work-related tendon and nerve injuries of the upper extremity.

A visit to his lab shows the immense impact he had on the items we use every day and how he translated findings from his basic research into design. For example, the shape, spacing, and tactile feedback that we enjoy on computer keyboards are largely derived from his research. The same can be said for many of the computer input devices that we still use today. There was a time when these devices caused pain and injury among workers, but through research, David helped to make them safer for all of us. His expertise in engineering and design was applied to some of the most challenging problems. He was an avid “research to practice” scientist across many industry sectors, including dentistry, gastroenterology, agriculture, and construction. If you look closely, you will still see workers using tools that he helped design.

David was a leader and collaborator in the large NIOSH Upper Extremity Musculoskeletal Disorder Consortium studies, which brought investigators from institutions across the country together to improve understanding of exposures and risk factors for carpal tunnel syndrome, tendinopathies, epicondylitis, and other work-related upper-extremity disorders. This was one of the most ambitious ergonomics studies undertaken in the United States. He was the Principal Investigator of the initiative to combine datasets across institutions, and even with colleagues in Italy who had undertaken a similar study. He was masterful at facilitating collaborative initiatives with many colleagues and fostered lifelong friendships with those with whom he worked. The project also served as a foundation for a new generation of researchers to learn, collaborate, and develop lifelong friendships. Importantly, the work established stronger scientific foundations for the exposure assessment methods and prevention guidelines used by researchers and practitioners today when designing safe work.

David was an excellent physician who treated patients with upper-extremity injuries until he retired in 2016. His expertise was highly sought after, and he cared for people with severe work-related injuries and mentored medical residents throughout his career. Yet, his commitment to protecting workers continued throughout his retirement, never missing an opportunity to contribute to science and mentor his younger colleagues and students. He contributed to research examining ergonomics and injury risks among warehouse workers, where technology, productivity demands, work organization, and physical workload intersect in complex ways. He also contributed his expertise to the Poultry and Swine Line Speed Evaluation, or PULSE, studies, bringing rigorous ergonomics methods to the national discussion about production speed, workload, and the health of workers in meat and poultry processing.

David’s influence extended far beyond his own laboratory. He served the field nationally and internationally through the National Academies of Sciences, Engineering, and Medicine; the American Conference of Governmental Industrial Hygienists Physical Agents Committee; the Human Factors and Ergonomics Society; and the International Ergonomics Association, among many other scientific and professional organizations. He contributed to the development of scientific guidance and standards and helped translate research evidence into approaches that employers, practitioners, researchers, policymakers, and workers continue to use. He was a Fellow of the Human Factors and Ergonomics Society and remained actively engaged in international ergonomics initiatives throughout his career.

Just as important to David was building a community around the field. In 1987, he co-founded the Bay Area Ergonomics Roundtable, creating a forum in which researchers and practicing ergonomists could learn from one another and share solutions to real workplace problems. That instinct, to bring people together rather than work within disciplinary or institutional boundaries, characterized his entire career. He was also the first Technical Director of the Office Ergonomics Research Committee, a consortium of companies that have supported office-based research and design for the past 30 years. His collaborators spanned UCSF, UC Berkeley, the Center for Occupational and Environmental Health, universities throughout the United States, government agencies, labor organizations, employers, and research institutions worldwide.

Perhaps David’s greatest legacy, however, is found in the people he taught. His laboratory was deliberately interdisciplinary. His students and trainees included bioengineers, mechanical engineers, environmental health scientists, ergonomists, epidemiologists, physicians, and occupational medicine trainees. He taught them not simply how to conduct research, but how to think: to begin with an important problem, measure carefully, question assumptions, respect the evidence, and never lose sight of the worker whose health the research was intended to protect. His thriving lab continues today, and his scientific rigor, focus on the worker, and collaborative spirit are embedded in all of its activities.

Today, David’s influence can be seen throughout academia and industry. People he trained and mentored have gone on to lead ergonomics programs at major organizations, including Genentech and Pixar, and to conduct and lead human factors and ergonomics research within companies such as Apple, Amazon, and Oculus. Others have become faculty members, researchers, and educators at institutions including the University of Washington, Harvard, Northeastern, Purdue University, San Jose State University, UCSF, and UC Berkeley. Still others work in occupational health practice, government, consulting, and industry, applying the principles David taught them every day.

In this way, the reach of David’s career cannot be captured simply by counting his hundreds of publications, grants, committees, awards, or scientific discoveries. His true impact is multiplied through the people he trained. For those fortunate enough to have been his students, colleagues, and collaborators, David was far more than an accomplished scientist. He was a mentor whose ideas changed careers, a colleague who connected people and disciplines, and a teacher whose lessons will continue to shape the field long after his own research has ended.

David Rempel’s guidance, intellectual rigor, generosity as a mentor, and unyielding commitment to improving work so that all workers can be healthy and free from preventable injury will be deeply missed. Still, his impact will continue to inspire generations to come.

David had a wonderful family and a sense of adventure. He is survived by Gail, Paul, and Jenna; his parents; his brothers—Marc, Tim, and Nick—and their families; and 25 first cousins. For donations in his name, please consider the West Marin Climate Action, ALS Network, or UC Berkeley Foundation - David Rempel Endowed Fellowship Fund (FW9194000).