General Motors reached agreement yesterday with the Labor Department and the United Auto Workers to institute the most extensive program in U.S. industry to combat repetitive motion injuries.

The new agreement, which covers more than 300,000 workers at 138 GM plants, is similar to one the department's Occupational Safety and Health Administration reached with Chrysler and Ford during the past year, but affects more people. All three companies agreed to the new safety programs to settle OSHA charges against them.

OSHA officials said the agreements with the Big Three U.S. automakers could serve as an industry-wide standard that could apply to the U.S. assembly plants of Honda, Toyota and Nissan.

In announcing the agreement, outgoing Labor Secretary Elizabeth Hanford Dole called repetitive motion injuries "one of the nation's greatest worker health and safety concern in the decade of the 1990s." The department's Bureau of Labor Statistics reported last week that repetitive motion injuries accounted for more than half the occupational illnesses reported in 1989.

Repetitive motion injuries, also commonly called cumulative trauma disorders, are disorders to the musculoskeletal and nervous systems caused by repeated motions over extended periods of time. The most common such injury is carpal tunnel syndrome, which accounted for 48 percent of all reported workplace injuries, the Labor Department said.

These injuries are being diagnosed in near epidemic proportions in almost every industry from meat packing and auto manufacturing to data processing and retailing. The science of fitting the job to the needs of the worker is called ergonomics.

OSHA has stepped up its enforcement efforts since the start of the Bush administration despite the strong support for deregulation by many of the president's supporters. Unlike most other federal agencies, it has the power to issue prescriptive regulations that not only tell a corporation what to do, but also prescribe precisely how it should be done.

With the rise in repetitive motion injuries in recent years, OSHA has targeted ergonomic problems in the workplace as part of a special enforcement program. Earlier this year, OSHA issued general guidelines for dealing with the problem in the meatpacking industry.

Gerard F. Scannell, the assistant secretary in charge of OSHA, said the agreement "assures that the Big Three of the U.S. auto industry now are all committed to implementing effective programs to reduce or eliminate the root causes of repetitive motion trauma."

Federal officials said GM will work with the UAW to make work stations more comfortable, redesign tools and introduce mechanical devices to prevent excessive lifting.

Stephen P. Yokich, director of the UAW's General Motors Department, called the settlement an "important agreement" that recognizes the role of the worker in helping to identify dangerous jobs and participating in job redesign.

"The transformation of the workplace required by this agreement won't be possible overnight," Yokich said, "but if we are to make progress, there must be an immediate recognition by the management at each individual plant of the full extent of the problem."

Company spokesman Thomas J. Pyden said General Motors reached the agreement because it "is committed to a safe work environment for all of its employees."

Although the OSHA agreement covers GM plants nationwide, the agency will not be able to enforce it in states such as Maryland which have federally approved state safety plans. The 3,100 workers at the GM assembly plant in Baltimore, for example, will have to seek enforcement of the program either through the state or through their labor contract. The same would apply to the 273 GM workers in Fredericksburg, Va.

Other states with their own health and safety plans are Michigan, Indiana, Iowa, Kentucky, Minnesota, Oregon, Tennessee and California.

OSHA said that under the agreement the states are being "encouraged" to either honor or agree to the terms of the settlement. The agency said GM is expected to notify each state agency to "reach an understanding regarding the application of this agreement."

Yokich said that many of the details of the settlement were incorporated as part of the new contract negotiated with GM in September and can be enforced by the union.