Prospective Study of Upper Extremity Musculoskeletal Disorders.

摘要

This epidemiologic study of upper extremity musculoskeletal disorders in manufacturing and health care industries collected individual demographic, health, psychosocial, work organizational and physical load exposure information among 733 permanent full-time workers in 12 different workplaces in Western Washington. As participants were diagnosed with a clinical outcome or leave the workplace, they were removed from the cohort. These participants were replaced with newly hired workers quarterly (resulting in approximately 1000 total participants) for determination of disease incidence in the workplace. All participants entering the cohort were given a clinical exam (physical examination and nerve conduction testing) and complete all study. The participants were also questioned briefly to determine current job and health status, with symptomatic workers examined for clinical morbidity outcomes. All workers were initially classified by job into one of six different exposure levels based on hand force and repetition rate determined from observational assessment and force measurement. Detailed task analysis and exposure assessment using task-based video analysis and force estimation was conducted on all participants representing each of the exposure levels in the two work environments. Worker health and exposure was assessed every four months for up to three years. Individuals doing the same job often had different exposures, indicating the value of individual exposure assessment in these types of studies. Prevalent, persistent and incident cases of tension neck syndrome, rotator cuff tendinitis, lateral and medial epicondylitis and carpal tunnel syndrome were identified. Multivariate analysis identified slightly different factors associated with each of these clinical conditions at baseline and for incident cases over the course of three years.