Biomedical subjects

Judith E Gold

Publications and source records attributed to Judith E Gold.

5 recordsLinked to original sources

PubMed2006

Medium- and long-term reproducibility of self-reported exposure to physical ergonomics factors at work.

INTRODUCTION: The literature is sparse on reproducibility of self-reported exposure to physical ergonomics risk factors for musculoskeletal disorders (MSDs). Aims of this study were to evaluate, in a cohort of workers interviewed up to three times: 1-year test-retest reliability; and 5- and 6-year recall of physical exposures. We also examined whether reproducibility was influenced by the presence of UE MSD or by technological changes introduced between the last two surveys. METHODS: A cohort of automobile manufacturing employees was interviewed at baseline, one and six years later about work history, physical and psychosocial exposures at work, upper limb symptoms, injury and medical history, and demographics. Agreement between interviews was evaluated by intraclass correlation and Spearman coefficients. Differences in exposure between 1- and 6-year follow-up were analyzed by Wilcoxon matched-pairs signed-ranks test. RESULTS: Large and significant decreases in work pace and physical effort were observed from baseline, although an upper extremity composite index was quite stable in the total population. One-year test-retest reliability was fair to good for the composite exposure index (ICC=0.58), whole-body vibration, handling parts, and tool use, but poor for the other variables considered. Long-term reproducibility, from baseline or 1-year follow-up to 6-year follow-up, was poor for the composite index and almost all single items. UE MSD case status influenced 1-year test-retest reliability, with subjects who changed case status from baseline displaying higher reliability, but not reproducibility of recalled exposures. A strong regression to the mean effect was observed on exposures reported at follow-up surveys. CONCLUSIONS: Recalled ergonomics exposures could be employed in retrospective cohort studies as a somewhat reliable and unbiased estimate of the self-reported exposures that would have been obtained up to one year earlier, but not over a longer period (5-6 years). These longer-term results may have been limited by difficulty in matching jobs between interviews; also the regression to the mean effect likely contributed to reduce agreement. Changes in production technology and work organization produced a decrease in physical workload intensity and job pace, but did not have a substantial impact on an exposure index for the upper limb.

Automobiles↗

PubMed2006

Work routinization and implications for ergonomic exposure assessment.

Jobs in many modern settings, including manufacturing, service, agriculture and construction, are variable in their content and timing. This prompts the need for exposure assessment methods that do not assume regular work cycles. A scheme is presented for classifying levels of routinization to inform development of an appropriate exposure assessment strategy for a given occupational setting. Five levels of routinization have been defined based on the tasks of which the job is composed: 1) a single scheduled task with a regular work cycle; 2) multiple cyclical tasks; 3) a mix of cyclical and non-cyclical tasks; 4) one non-cyclical task; 5) multiple non-cyclical tasks. This classification, based primarily on job observation, is illustrated through data from a study of automobile manufacturing workers (n = 1200), from which self-assessed exposures to physical and psychosocial stressors were also obtained. In this cohort, decision latitude was greater with higher routinization level (p < 0.0001), and the least routinized jobs showed the lowest self-reported exposure to physical ergonomic stressors. The job analysis checklist developed for non-routinized jobs is presented, and limitations of the task analysis method utilized in the study are discussed. A work sampling approach to job analysis is recommended as the most efficient way to obtain a comparable unbiased exposure estimate across all routinization levels.

Arm↗

PubMed2006

Recall of prior musculoskeletal pain.

OBJECTIVES: Patients, as well as healthy people, often fail to remember prior symptoms, illnesses, or treatments. The authors investigated how well people in a workplace recalled their prior musculoskeletal pain and which factors influenced recall accuracy. METHODS: In this prospective study (1992-1998), among a cohort of automobile manufacturing workers (N=464), musculoskeletal pain reported at baseline was compared with recalled pain at follow-up. Two outcomes (ie, forgetting and over-recalling) were examined in relation to several personal and occupational characteristics. RESULTS: Of those who had experienced pain or discomfort in the upper extremities at baseline, 72% did not recall it 6 years later. Symptoms at the time of recall strongly influenced pain recall; forgetting approached 100% among those with no current or recent symptoms. However, forgetting was considerable even among those with current symptoms (45%). Prior pain status was over-recalled by 37% of those with upper-extremity pain at the time of recall, but only by 3% of those without symptoms. Women, those with history of an upper-extremity disorder or systemic disease, who were clinical cases or had more anatomical areas in pain at baseline forgot less often. Over-recalling was related to age, having current symptoms, or being a clinical case. The results were similar for low-back and knee pain. CONCLUSIONS: Prior musculoskeletal symptoms are poorly remembered after some years, and the recall is strongly influenced by current symptoms. Recalled information should not be relied upon when an epidemiologic case definition is being constructed or when an attempt is being made to describe the natural history of a disorder.

Adult↗

PubMed2005

Pressure pain thresholds and musculoskeletal morbidity in automobile manufacturing workers.

OBJECTIVES: Reduced pressure pain thresholds (PPTs) have been reported in occupational groups with symptoms of upper extremity musculoskeletal disorders (UEMSDs). The purpose of this study was to determine whether automobile manufacturing workers (n=460) with signs and symptoms of UEMSDs had reduced PPTs (greater sensitivity to pain through pressure applied to the skin) when compared with unaffected members of the cohort, which served as the reference group. The association of PPTs with symptom severity and localization of PE findings was investigated, as was the hypothesis that reduced thresholds would be found on the affected side in those with unilateral physical examination (PE) findings. METHODS: PPTs were measured during the workday at 12 upper extremity sites. A PE for signs of UEMSDs and symptom questionnaire was administered. After comparison of potential covariates using t tests, linear regression multivariable models were constructed with the average of 12 sites (avgPPT) as the outcome. RESULTS: Subjects with PE findings and/or symptoms had a statistically significant lower avgPPT than non-cases. AvgPPT was reduced in those with more widespread PE findings and in those with greater symptom severity (test for trend, P</=0.05). No difference between side-specific avgPPT was found in those with unilateral PE findings. Reduced PPTs were associated with female gender, increasing age, and grip strength below the gender-adjusted mean. After adjusting for the above confounders, avgPPT was associated with muscle/tendon PE findings and symptom severity in multivariable models. CONCLUSIONS: PPTs were associated with signs and symptoms of UEMSDs, after adjusting for gender, age and grip strength. The utility of this noninvasive testing modality should be assessed on the basis of prospective large cohort studies to determine if low PPTs are predictive of UEMSDs in asymptomatic individuals or of progression and spread of UEMSDs from localized to more diffuse disorders.

Adult↗

PubMed2004

Infrared thermography for examination of skin temperature in the dorsal hand of office workers.

Reduced blood flow may contribute to the pathophysiology of upper extremity musculoskeletal disorders (UEMSD), such as tendinitis and carpal tunnel syndrome. The study objective was to characterize potential differences in cutaneous temperature, among three groups of office workers assessed by dynamic thermography following a 9-min typing challenge: those with UEMSD, with ( n=6) or without ( n=10) cold hands exacerbated by keyboard use, and control subjects ( n=12). Temperature images of the metacarpal region of the dorsal hand were obtained 1 min before typing, and during three 2-min sample periods [0-2 min (early), 3-5 min (middle), and 8-10 min (late)] after typing. Mean temperature increased from baseline levels immediately after typing by a similar magnitude, 0.7 (0.3) degrees C in controls and 0.6 (0.2) degrees C in UEMSD cases without cold hands, but only by 0.1 (0.3) degrees C in those with cold hands. Using paired t-tests for within group comparisons of mean dorsal temperature between successive imaging periods, three patterns of temperature change were apparent during 10 min following typing. Controls further increased mean temperature by 0.1 degrees C ( t-test, P=0.001) at 3-5 min post-typing before a late temperature decline of -0.3 degrees C ( t-test, P=0.04), while cases without cold hands showed no change from initial post-typing mean temperature rise during middle or late periods. In contrast, subjects with keyboard-induced cold hands had no change from initial post-typing temperature until a decrease at the late period of -0.3 degrees C ( t-test, P=0.06). Infrared thermography appears to distinguish between the three groups of subjects, with keyboard-induced cold hand symptoms presumably due, at least partially, to reduced blood flow.

Adult↗