Work-Related Upper Extremity Musculoskeletal Disorders (original) (raw)
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Work-related musculoskeletal disorders (WMSDs): risk factors, diagnosis and prevention
Scripta Scientifica Salutis Publicae, 2018
INTRODUCTION: Impairments like musculoskeletal disorders (MSDs) that involve many days away from work affect negatively the productivity of businesses. Depending on the severity of the impairment, losses to businesses can be significantly high. Research to improve the understanding of the relationship between MSDs, carpal tunnel syndrome (CTS), related economic costs, lost productivity in businesses is essential given workplace injuries not only affect productivity but deteriorate the situation destabilizing the economic state of businesses. Millions of working days are lost due to work-related diseases all over the world. AIM: The aim of this article is to analyze the main MSDs in regard to the diagnosis and the risk factors that lead to such conditions, and to outline some of the measures concerning the prevention of MSDs. MATERIALS AND METHODS: Diagnosis, prevention and main risk factors of MSDs are analyzed based on literature search and vital statistics. RESULTS: Among the major risk factors for MSDs are biomechanical, biobehavioral, psychosocial and organizational risk factors. The most common diseases of the musculoskeletal system are: myositis, tendonitis, paratenonitis, tendovaginitis, tendomyositis, stenotic tendo-ligamentitis, periarthritis, styloiditis, epicondylitis, spondylosis, spondyloarthritis and others. Isolated damages are less frequent. More frequent are the combined musculoskeletal and soft tissue disorders, such as myotendinitis, myotendinosis, myoinsertionitis, tendosinovitis, as well as interstitial lesions with vascular and neurological disorders: myositis, carpal tunnel syndrome with n. medianus lesion, scalenus syndrome-with nervous and vascular damages of the arm, etc. As work-related MSDs arise from multiple risk factors, a holistic preventive approach is needed. Preventive strategies need to be taken at three levels: primary prevention with a combined focus on the risk assessment process and implementation of technical, organizational and person-oriented measures; secondary prevention consists of targeting, early identification and intervention; and tertiary prevention aims to stimulate and facilitate the (multidisciplinary) returnto-work process of workers being absent from work due to an MSDs problem. CONCLUSION: Early recognition of occupational MSDs by preliminary examination and regular checkups is very important because medical treatment is unlikely to be effective once these impairments become long-standing. Cost effectiveness will be achieved by proper diagnosis, occupational MSD identification, and early onset of adequate rehabilitation followed by a short-term rehabilitation of the worker.
Journal of Occupational Rehabilitation, 2005
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 followup 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.
Work-related musculoskeletal disorders of the upper limb
Joint Bone Spine, 2002
Work-related musculoskeletal disorders of the upper limb (WRMSDs-UL) account for over two-thirds of all occupational disorders recognized in France. This broad term encompasses a vast array of disorders whose development is facilitated by environmental factors present at the workplace. Numerous epidemiological studies have established the key role of occupational activities in the genesis of WRMSDs-UL. This role is mediated by biomechanical factors (repetitive motion, strenuous effort, extreme joint postures) and/or psychosocial factors. Biological plausibility supports the epidemiological data. The high incidence of WRMSDs-UL indicates a need for greater emphasis on prevention. Joint Bone Spine 2002 ; 69 : 546-55. © 2002 Éditions scientifiques et médicales Elsevier SAS biomechanics / epidemiology / occupational / psychosocial / upper limb / work-related musculoskeletal disorders * Corresponding and reprints. E-mail address: aptel@inrs.fr (M. Aptel).
The nature of work-related neck and upper limb musculoskeletal disorders
Applied Ergonomics, 2002
The nature of work-related musculoskeletal disorders of the neck and upper limbs is reviewed using both scientific data and the consensus view of experts, union bodies and government agencies across the European Union. Work-related musculoskeletal disorders describe a wide range of inflammatory and degenerative diseases and disorders. These conditions result in pain and functional impairment and may affect, besides others, the neck, shoulders, elbows, forearms, wrists and hands. They are workrelated when the work activities and work conditions significantly contribute to their development or exacerbation but are not necessarily the sole determinant of causation. The classification and the need for standardised diagnostic methods for assessment of neck and upper limb musculoskeletal disorders are reviewed. These disorders are a significant problem within the European Union with respect to ill health, productivity and associated costs. The pathomechanisms of musculoskeletal disorders affecting tendons, ligaments, nerves, muscle, circulation and pain perception are reviewed and conceptual models for the pathogenesis of musculoskeletal disorders affecting the neck and upper limbs are presented. The epidemiological evidence on the work-relatedness of these disorders is discussed. A relationship between the performance of work and the occurrence of neck and upper limb musculoskeletal disorders is evident. Intervention strategies in the workplace for the reduction of both exposure and effect should focus upon factors within the work organisation as well as actively involving the individual worker. The current knowledge is sufficient to enable informed decisions to be made on future research needs and prevention strategies at the societal, organisational and individual level.
Work-Related Musculoskeletal Disorders
Journal of Occupational & Environmental Medicine, 1997
! 32% (705,800) of work-related injuries arise from overexertion or repetitive motion: # 367,424 injuries due to overexertion in lifting (65% back injuries) # 93,325 due to overexertion in pushing/pulling (52% back injuries) # 68,992 due to overexertion in holding, carrying or turning objects (58% back injuries) # 47,861 shoulder injuries # 83,483 unspecified overexertion injuries # 92,576 repetitive motion injuries (including typing, key entry, repetitive hand tool use, repetitive grasping etc.) 55% affect the wrist, 7% affect the shoulder and 6% affect the back
A Longitudinal Study of Industrial and Clerical Workers: Predictors of Upper Extremity Tendonitis
Journal of Occupational Rehabilitation, 2005
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 followup 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.
Epidemiologic surveillance of upper-extremity musculoskeletal disorders in the working population
Arthritis & Rheumatism, 2006
Objective. Since 2002, an epidemiologic surveillance system of work-related, upper-limb musculoskeletal disorders (MSDs) has been implemented in France's Pays de la Loire region to assess the prevalence of MSDs and their risk factors in the working population. Methods. The surveillance was based on a network of occupational physicians (OPs) and used the recommendations of a group of European experts (criteria document consensus). In 2002-2003, 80 of 400 OPs volunteered to participate. All underwent a training program to standardize the physical examination. Health status was assessed by self-administered questionnaire and physical examination. Occupational risk factors were assessed by self-administered questionnaire. Exposure scores were computed for each anatomic zone by summing the risk factors taken into account by the criteria document. Results. More than 50% of the 2,685 men and women randomly included in 2002-2003 experienced nonspecific musculoskeletal symptoms during the preceeding 12 months and ϳ30% experienced them in the preceeding week. The prevalence of clinically diagnosed MSDs was high: ϳ13% of workers experienced at least 1 of the MSDs. The most frequent disorder was rotator cuff syndrome followed by carpal tunnel syndrome and lateral epicondylitis. The prevalence of MSDs increased with age and varied widely across economic sectors and occupations. More than half of the workers were exposed to at least 2 risk factors of MSDs. Exposure varied according to industrial activity and occupation. According to the criteria document, a high percentage of MSD cases could be classified as probably work related (95% in men and 89% in women age <50, and 87% in men and 69% in women age >50).
Upper extremity disorders: A literature review to determine work-relatedness
The Journal of Hand Surgery, 1995
Administration (OSHA) assessed a $3.44 million dollar fine against a meat packing plant for egregious violation of the general duty clause secondary to a high prevalence of cumulative trauma disorder(s) (CTD). Currently, OSHA is creating ergonomic standards to address work-related musculoskeletal disorders. These standards would require all employers to make efforts at reducing work place exposures that are implied to cause CTD. Inaccurate identification of causal relationships may misdirect medical care and lead to inappropriate use of funds and unnecessary government interventions. Literature Review An extensive amount of literature has been written about various aspects of chronic upper extremity musculoskeletal disorders, often referred to as CTD. 3-6 The written works regarding use-related complaints in the upper extremities date back centuries. 7 Etiology, related factors, risk factors, causal relationships, abatement programs, treatment plans, and medical interventions are just some of the topics addressed in this literature)-78