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Modeling the Effect of the 2018 Revised ACGIH® Hand Activity Threshold Limit Value® (TLV) at Reducing Risk for Carpal Tunnel Syndrome
Recent studies have shown the 2001 American Conference of Governmental Industrial Hygienists (ACGIH®) Threshold Limit Value (TLV®) for Hand Activity was not sufficiently protective for workers at risk of carpal tunnel syndrome (CTS). These studies led to a revision of the TLV and Action Limit. This study compares the effect of applying the 2018 TLV vs. the 2001 TLV to predict incident CTS within a large occupational pooled cohort study (n = 4,321 workers). Time from study enrollment to first occurrence of CTS was modeled using Cox proportional hazard regression. Adjusted and unadjusted...
Workplace Interventions can Reduce Sickness Absence for Persons With Work-Related Neck and Upper Extremity Disorders
A One-Year Prospective Cohort Study Objective: The objective of this study was to investigate whether workplace interventions are effective in reducing sickness absence in persons with work-related neck and upper extremity disorders and whether disorder improvement after intervention reduces sickness absence. Methods: This study was a prospective cohort study of workers with work-related neck pain or upper extremity disorders. Data were obtained from the Swedish “Work-related disorders” and “Work environment” surveys. Register data on sickness-absence 1 year after the surveys...
Sex Differences in Glenohumeral Muscle Activation and Coactivation During a Box Lifting Task
Manual material handling is associated with shoulder musculoskeletal disorders, especially for women. Sex differences in glenohumeral muscle activity may contribute to women's higher injury risk by affecting shoulder load and stability. We assessed the effects of sex (25 women vs 26 men) and lifting load (6 kg vs 12 kg) on muscle activation during box lifting from hip to eye level. Surface and intramuscular electromyography were recorded from 10 glenohumeral muscles. Most muscles were more activated for the heavier box and for women. These effects were larger for “prime...
Risk factors of hospitalization for carpal tunnel syndrome among the general working population
Objectives: Carpal tunnel syndrome (CTS) causes a considerable amount of sick leave and healthcare costs. The etiology of CTS is multifactorial, involving both personal and occupational risk factors. To date, few prospective cohort studies on occupational risk factors of CTS have examined the general working population. Methods: The study population consisted of participants from the Northern Finland Birth Cohort of 1966 who attended the 31-year follow-up in 1997 and were working ≥3 days a week in a paid job (N=6326). Information on socio-economic status, weight and height, smoking, exposure...
Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers
Work-related upper limb and neck musculoskeletal disorders (MSDs) are one of the most common occupational disorders worldwide. Studies have shown that the percentage of office workers that suffer from MSDs ranges from 20 to 60 per cent. The direct and indirect costs of work-related upper limb MSDs have been reported to be high in Europe, Australia, and the United States. Although ergonomic interventions are likely to reduce the risk of office workers developing work-related upper limb and neck MSDs, the evidence is unclear. This is an update of a Cochrane Review which was last published in 2012...
Bi-directional relation between effort-reward imbalance and risk of neck-shoulder pain
Assessment of mediation through depressive symptoms using occupational longitudinal data Objectives: Bi-directional associations between perceived effort?reward imbalance (ERI) at work and neckshoulder pain have been reported. There is also evidence of associations between ERI and depressive symptoms, and between depressive symptoms and pain while the links between ERI, depressive symptoms and pain have not been tested. We aimed to assess whether depressive symptoms mediate the association between ERI and neck-shoulder pain, as well as the association between neck-shoulder pain and ERI. Methods...
An ergonomic field study to evaluate the effects of a rotatable handle piece on muscular stress and fatigue as well as subjective ratings of usability, wrist posture and precision during laparoscopic surgery
An explorative pilot study Purpose: The interface between surgeon and the laparoscopic instrument is an important factor in biomechanical stress that may increase the risk of musculoskeletal complaints in surgeons. This article investigates the effect of a laparoscopic instrument with a rotatable handle piece (rot-HP) on muscular stress and fatigue during routine laparoscopic procedures (LP) as well as usability, wrist posture and working precision. Methods: 40 LP (subtotal hysterectomies) performed by 11 surgeons were investigated. 20 LP were carried out with the rot-HP and 20 with a fixed (standard...
Occupational biomechanical risk factors for surgically treated ulnar nerve entrapment in a prospective study of male construction workers
Evidence was provided for forceful hand-grip work, with and without vibration, as a risk factor for ulnar nerve entrapment (UNE) surgery in a large cohort of Swedish construction workers. Several individual biomechanical factors comprising such work were associated with increased risk of UNE, including: increased grip force, upper extremity load, frequency of hand-held tool use, and hand arm vibration. Source: Jackson, J. A., Olsson, D., Punnett, L., Burdorf, A., Järvholm, B. et Wahlström, J. (2018). Scandinavian journal of work, environment & health . http://dx.doi.org/10.5271/sjweh...
Hand forces exerted by long-term care staff when pushing wheelchairs on compliant and non-compliant flooring
Purpose-designed compliant flooring and carpeting have been promoted as a means for reducing fall-related injuries in high-risk environments, such as long-term care. However, it is not known whether these surfaces influence the forces that long-term care staff exert when pushing residents in wheelchairs. We studied 14 direct-care staff who pushed a loaded wheelchair instrumented with a triaxial load cell to test the effects on hand force of flooring overlay (vinyl versus carpet) and flooring subfloor (concrete versus compliant rubber [brand: SmartCells]). During straight-line pushing, carpet overlay...
The influence of job rotation and task order on muscle responses in females
Job rotation aims to reduce muscle fatigue by switching between functionally different tasks to theoretically lessen the risk of site-specific fatigue and work-related musculoskeletal disorders (WMSDs). The effectiveness of job rotation in mitigating the onset of muscle fatigue is partially known, but there is limited ergonomic data on female populations despite comparatively lower upper body strength and increased risk of WMSDs. Rotating between two functionally different tasks, continuing a single task, and varying task order were assessed in the present study for influence on muscle fatigue...
Effects of standing on typing task performance and upper limb discomfort, vascular and muscular indicators
Standing is a popular alternative to traditionally seated computer work. However, no studies have described how standing impacts both upper body muscular and vascular outcomes during a computer typing task. Twenty healthy adults completed two 90-min simulated work sessions, seated or standing. Upper limb discomfort, electromyography (EMG) from eight upper body muscles, typing performance and neck/shoulder and forearm blood flow were collected. Results showed significantly less upper body discomfort and higher typing speed during standing. Lower Trapezius EMG amplitude was higher during standing...
Visual and psychological stress during computer work in healthy, young females - physiological responses
Purpose: Among computer workers, visual complaints, and neck pain are highly prevalent. This study explores how occupational simulated stressors during computer work, like glare and psychosocial stress, affect physiological responses in young females with normal vision. Methods: The study was a within-subject laboratory experiment with a counterbalanced, repeated design. Forty-three females performed four 10-min computer-work sessions with different stress exposures: (1) minimal stress; (2) visual stress (direct glare); (3) psychological stress; and (4) combined visual and psychological stress...
Risk factors for episodic neck pain in workers
A 5-year prospective study of a general working population Purpose: Development of neck pain (NP) in workers has a multifactorial etiology and depends on both individual and workplace factors. The aim of this study was to investigate risk factors for episodic NP in a large diverse sample of active workers. Methods: A prospective study based on the surveillance program implemented by the French Public Health Agency in the Loire Valley region. Between 2002 and 2005, 3710 workers were included. Between 2007 and 2010, 2332 workers responded to a follow-up questionnaire which assessed: (1) musculoskeletal...
Ergonomic study on wrist posture when using laparoscopic tools in four different techniques regarding minimally invasive surgery
Purpose: With reference to four different minimally invasive surgery (MIS) cholecystectomy the aims were: to recognize the factors influencing dominant wrist postures manifested by the surgeon; to detect risk factors involved in maintaining deviated wrist postures; to compare the wrist postures of surgeons while using laparoscopic tools. Materials and methods: Video films were recorded during live surgeries. The films were synchronized with wrist joint angles obtained from wireless electrogoniometers placed on the surgeon's hand. The analysis was conducted for five different laparoscopic tools...
Effects of work surface and task difficulty on neck-shoulder posture and trapezius activity during a simulated mouse task
Objectives. The purpose of this study is to evaluate the influence of the work surface and task difficulty on the head, upper back and upper arm postures and activity of the descending trapezius during a simulated mouse task. Methods. Healthy female university students (N = 15) were evaluated. The work surface was positioned at elbow height (EH) and above elbow height (AEH) and the task difficulty was set at low (LD) and high (HD) levels. The postures were recorded by inclinometers. Trapezius activity was normalized by the maximum voluntary isometric contraction (MVIC). Results. Significantly...
Predicting Forearm Physical Exposures During Computer Work Using Self-Reports, Software-Recorded Computer Usage Patterns, and Anthropometric and Workstation Measurements
Objectives: Alternative techniques to assess physical exposures, such as prediction models, could facilitate more efficient epidemiological assessments in future large cohort studies examining physical exposures in relation to work-related musculoskeletal symptoms. The aim of this study was to evaluate two types of models that predict arm-wrist-hand physical exposures (i.e. muscle activity, wrist postures and kinematics, and keyboard and mouse forces) during computer use, which only differed with respect to the candidate predicting variables; (i) a full set of predicting variables, including self...
Relations between work and upper extremity musculoskeletal problems (UEMSP) and the moderating role of psychosocial work factors on the relation between computer work and UEMSP
Purpose: Computer work has been identified as a risk factor for upper extremity musculoskeletal problems (UEMSP). But few studies have investigated how psychosocial and organizational work factors affect this relation. Nor have gender differences in the relation between UEMSP and these work factors been studied. We sought to estimate: (1) the association between UEMSP and a range of physical, psychosocial and organizational work exposures, including the duration of computer work, and (2) the moderating effect of psychosocial work exposures on the relation between computer work and UEMSP. Methods...
Integration of active pauses and pattern of muscular activity during computer work
Submaximal isometric muscle contractions have been reported to increase variability of muscle activation during computer work; however, other types of active contractions may be more beneficial. Our objective was to determine which type of active pause vs. rest is more efficient in changing muscle activity pattern during a computer task. Asymptomatic regular computer users performed a standardised 20-min computer task four times, integrating a different type of pause: sub-maximal isometric contraction, dynamic contraction, postural exercise and rest. Surface electromyographic (SEMG) activity was...
Electromyographic analysis of relevant muscle groups during completion of computer tasks using different computer mouse positions
Background: We analyzed muscular activity for different computer mouse positions during the completion of a timed computer task and determined whether the different mouse positions could affect muscular activity, productivity and perceived fatigue. Methods: The subjects were nine healthy young men. Two mouse positions were studied: the distal position (DP), with the forearm rested on the desk; the proximal position (PP), with only the wrist rested on the desk. The subjects performed a 16-min task in each position. Surface electromyography data were recorded for the upper back and shoulder muscles...
Reversible median nerve impairment after three weeks of repetitive work
Little is known about the time relation between entry into a job with high mechanical exposures and median nerve affection. We found that 22 days of seasonal repetitive work led to impaired sensory and motor nerve conduction with recovery within 3-6 weeks post-season. If related to newly increased exposures, median nerve affection is most likely reversible if exposures are reduced. Source: Tabatabaeifar, S., Svendsen, S. W., Johnsen, B., Hansson, G. Å., Fuglsang-Frederiksen, A., & Frost, P. (2017). Scandinavian Journal of Work, Environment & Health . http://dx.doi.org/10.5271/sjweh...
What workplace programs help prevent upper extremity musculoskeletal disorders?
Upper extremity musculoskeletal disorders (MSDs) include painful conditions and injuries of the muscles, tendons, joints and nerves that affect the neck, shoulders, elbows, wrists and hands. In Canada, upper extremity MSDs and low-back pain are the leading causes of disabling work-related injuries. While there is general agreement that work hazards (such as repetitive, awkward and static postures, heavy loads, vibration, low job control and poor social support) can contribute to the development of upper extremity MSDs, there is less agreement on the most appropriate ways to reduce or eliminate...
Musculoskeletal injury as "part of the job"
Health and safety in hand-intensive healthcare occupations Preventing work-related upper limb disorders The main focus of previous research on musculoskeletal injuries in healthcare workers has been on back injuries, in particular to nurses. Less attention has been given to work-related upper limb disorders (WRULDs) specifically for those who are performing hand-intensive tasks as part of their work; that include precision hand and wrist movements, repetitive hand motions and sustained awkward postures. Professional healthcare workers such as physiotherapists, physical therapists, sports therapists...
Psychosocial Factors Related to Lateral and Medial Epicondylitis
Results From Pooled Study Analyses Objective: The goal is to assess the relationships between psychosocial factors and both medial and lateral epicondylitis after adjustment for personal and job physical exposures. Methods: One thousand eight hundred twenty-four participants were included in pooled analyses. Ten psychosocial factors were assessed. Results: One hundred twenty-one (6.6%) and 34 (1.9%) participants have lateral and medial epicondylitis, respectively. Nine psychosocial factors assessed had significant trends or associations with lateral epicondylitis, the largest of which was between...
Carpal tunnel syndrome and manual work
The OCTOPUS cohort, results of a ten-year longitudinal study This large longitudinal cohort study provides a prospective validation of the ACGIH TLV® method for the assessment of biomechanical exposures at work. It confirmed that “forceful hand exertions” more than “any exertion” significantly increase the risk of CTS. This study suggests that the current limits (AL and TLV) might not be sufficiently protective for some workers. Source: Violante FS, Farioli A, Graziosi F, Marinelli F, Curti S, Armstrong TJ, Mattioli S, Bonfiglioli R. Scand J Work Environ Health , 2016...
Effects of participatory ergonomic intervention on the development of upper extremity musculoskeletal disorders and disability in office employees using a computer
Objective: To evaluate the participatory ergonomic method on the development of upper extremity musculoskeletal disorders and disability in office employees. Methods: This study is a randomized controlled intervention study. It comprised 116 office workers using computers. Those in the intervention group were taught office ergonomics and the risk assessment method. Cox proportional hazards model and generalized estimating equations (GEEs) were used. Results: In the 10-month postintervention follow-up, the possibility of developing symptoms was 50.9%. According to multivariate analysis results,...
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