Predictors of Upper Extremity Discomfort: A Longitudinal Study of Industrial and Clerical Workers

Upper extremity discomfort associated with work activity is common with a prevalence of over 50% in many settings. This study followed a cohort of 501 active workers for an average of 5.4 years. Cases were defined as workers who were asymptomatic or had a low discomfort score of 1 or 2 at baseline testing and went on to report a discomfort score of 4 or above on a 10-point visual analog scale. This change is considered clinically significant. Controls had a low baseline discomfort score and continued to have a low discomfort rating throughout the study. The risk factors found to have the highest predictive value for identifying a person who is likely to develop a significant upper extremity discomfort rating included age over 40, a BMI over 28, a complaint of baseline discomfort, the severity of the baseline discomfort rating and a job that had a high hand activity level (based upon hand repetition and force). The risk profile identified both ergonomic and personal health factors as risks and both factors may be amenable to prevention strategies.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45012/1/10926_2005_Article_871.pd

A method to design job rotation schedules to prevent work-related musculoskeletal disorders in repetitive work

This is an Accepted Manuscript of an article published by Taylor & Francis Group in International Journal of Production Research in 2012, available online: http://www.tandfonline.com/10.1080/00207543.2011.653452.Job rotation is an organisational strategy widely used in human-based production lines with the aim of preventing work-related musculoskeletal disorders (WMSDs). These work environments are characterised by the presence of a high repetition of movements, which is a major risk factor associated with WMSDs. This article presents a genetic algorithm to obtain rotation schedules aimed at preventing WMSDs in such environments. To do this, it combines the effectiveness of genetic algorithms optimisation with the ability to evaluate the presence of risk by repeated movements by following the OCRA ergonomic assessment method. The proposed algorithm can design solutions in which workers will switch jobs with high repeatability of movements with other less demanding jobs that support their recovery. In addition, these solutions are able to diversify the tasks performed by workers during the day, consider their disabilities and comply with restrictions arising from the work organisation.The authors wish to thank the Universitat Politecnica de Valencia which supported this research through its Program for the Support of Research and Development 2009 and its financing through the project PAID-06-09/2902.Asensio Cuesta, S.; Diego-Mas, JA.; Cremades Oliver, L.; González-Cruz, M. (2012). A method to design job rotation schedules to prevent work-related musculoskeletal disorders in repetitive work. International Journal of Production Research. 50(24):7467-7478. https://doi.org/10.1080/00207543.2011.653452S74677478502

A Longitudinal Study of Industrial and Clerical Workers: Predictors of Upper Extremity Tendonitis

Upper extremity tendonitis (UET) associated with work activity is common but the true incidence and risk factors can best be determined by a prospective cohort study. This study followed a cohort of 501 active workers for an average of 5.4 years. Incident cases were defined as workers who were asymptomatic at baseline testing and had no prior history of UET and went on to be diagnosed with an UET during the follow-up period or at the follow-up evaluation. The incident cases were compared to the subset of the cohort who also had no history of an UET and did not develop tendonitis during the study. The cumulative incidence in this cohort was 24.3% or 4.5% annually. The factors found to have the highest predictive value for identifying a person who is likely to develop an UET in the near future included age over 40, a BMI over 30, a complaint at baseline of a shoulder or neck discomfort, a history of CTS and a job with a higher shoulder posture rating. The risk profile identifies both ergonomic and personal health factors as risks and both categories of factors may be amenable to prevention strategies.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45013/1/10926_2005_Article_872.pd

Predictors of Persistent Elbow Tendonitis Among Auto Assembly Workers

Introduction : Lateral and medial epicondylitis associated with work activity is a common upper extremity musculoskeletal disorder with a prevalence of 4–30% depending upon the work setting and diagnostic criteria. The influence of treatment, ergonomic factors, medical history, psychosocial variables, and aging on the improvement of symptoms has not been well defined. Methods : This was a prospective cohort study of a cohort of 45 workers with active elbow tendonitis for an average of 13 months. Complete resolution of symptoms was the defined outcome measure. Results : The predictive factors for persistent elbow tendonitis included older age (OR = 1.1, 95% CI: 0.99, 1.33), higher hand repetition level for their job(s) (OR = 2.5, 95% CI: 1.00, 6.25), more deviation from a neutral wrist position during the work activity (OR = 2.0, 95% CI: 0.80, 5.56), and lower perceived decision authority on the job (OR = 0.9, 95% CI: 0.79, 0.98). Other ergonomic, psychosocial, and electrophysiologic measures were not predictive. The models had relatively high sensitivity and specificity. Treatment effects could not be evaluated due to incomplete data available. Conclusions : Older workers with jobs requiring more repetition and awkward wrist postures, and less decision authority were less likely to have resolution of their elbow tendonitis. Implications : Workers at highest risk for persistent elbow tendonitis should be placed at jobs with lower repetition levels and that use more neutral wrist postures. Effective interventions must address both the ergonomic and psychosocial risk factors in a multifaceted approach to this problem.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45018/1/10926_2005_Article_5945.pd

Diagnosing soft tissue rheumatic disorders of the upper limb in epidemiological studies of vibration-exposed populations

Objectives To investigate approaches adopted to diagnose soft tissue rheumatic disorders of the upper limb (ULDs) in vibration-exposed populations and in other settings, and to compare their methodological qualities. Methods Systematic searches were made of the Medline, Embase, and CINAHL electronic bibliographic databases, and of various supplementary sources (textbooks, reviews, conference and workshop proceedings, personal files). For vibration-exposed populations, qualifying papers were scored in terms of the provenance of their measuring instruments (adequacy of documentation, standardisation, reliability, criterion-related and content validity). Similar criteria were applied to general proposals for whole diagnostic schemes, and evidence was collated on the test-retest reliability of symptom histories and clinical signs. Results In total, 23 relevant reports were identified concerning vibration-exposed populations-21 involving symptoms and 9 involving examination/diagnosis. Most of the instruments employed scored poorly in terms of methodological quality. The search also identified, from the wider literature, more than a dozen schemes directed at classifying ULDs, and 18 studies of test-retest reliability of symptoms and physical signs in the upper limb. Findings support the use of the standardised Nordic questionnaire for symptom inquiry and suggest that a range of physical signs can be elicited with reasonable between-observer agreement. Four classification schemes rated well in terms of content validity. One of these had excellent documentation, and one had been tested for repeatability, agreement with an external reference standard, and utility in distinguishing groups that differed in disability, prognosis and associated risk factors. Conclusions Hitherto, most studies of ULDs in vibration-exposed populations have used custom-specified diagnostic methods, poorly documented, and non-stringent in terms of standardisation and supporting evidence of reliability and/or validity. The broader literature contains several question sets and procedures that improve upon this, and offer scope in vibration-exposed populations to diagnose ULDs more systematically ISSN/ISBN: 0340-0131 WEB/URL: ISI:000253349400008