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Results for “Cumulative Trauma Disorders”

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PubMed1992

Industrial rehabilitation medicine. 2. Assessment of the problem, pathology, and risk factors for disability.

This self-directed learning module highlights new advances in this topic area. It is part of the chapter on industrial rehabilitation medicine in the Self-Directed Medical Knowledge Program for practitioners and trainees in physical medicine and rehabilitation. This article covers ergonomic assessment of upper limb and low back injury, medical diagnostics for upper extremity cumulative trauma disorder (UE-CTD) and low back pain, and an evaluation of delayed recovery following work injury. Advances that are covered in this article involve factors contributing to UE-CTD, lumbar spine-imaging techniques, and the high-risk variables that contribute to prolonged disability.

Back Pain↗

PubMed1995

Work-related musculoskeletal symptoms among sheet metal workers.

We report results of two pilot studies of the relationship between musculoskeletal disorders and work tasks in sheet metal workers. These two studies were undertaken as pilot investigations to determine if symptoms of carpal tunnel syndrome or other work-related musculoskeletal symptoms are present in sheet metal workers, and to determine if we could begin to identify the factors in sheet metal work that cause them. In the first study, telephone interviews were conducted with 18 disabled sheet metal workers; the second survey entailed self-administered questionnaires completed by 47 active and retired sheet metal workers. Among the disabled workers, rotator cuff cases reported the greatest percent of time spent hanging duct, an overhead task commonly carried out during field work. Carpal tunnel cases reported more hand tool use than the rotator cuff cases. The questionnaire survey of active and retired workers found the proportion of time spent in a sheet metal shop (contrasted with field work) to be positively associated with hand symptoms; sheet metal workers who spent at least 65% of their time in the shop had an odds ratio of 3.4 for symptomatic hand cumulative trauma disorder (CTD) (p = 0.12). The proportion of time spent hanging duct was positively associated with both neck and shoulder symptoms, with odds ratios of 7.9 (p = 0.08) and 2.7 (p = 0.16), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

[Evolution of work duties in manufacturing activities].

The present work deals with duties' evolution according to the aspect of the investment's increase in facilities and equipment for employ, of industry-wide agreement, of cost accounting, of added value, of plant lay-out, of job competence and of production technologies. The mutual relation between duties and risk of cumulative trauma disorders is studied in qualitative and quantitative way making use of active and waiting labour time allotment during the labour cycle, rest and fatigue factor, labour losses, collective and individual breaks, high repeated work and worked items' variability. In conclusion the paper presents elements and examples about investments in automation and organisation with relay-out.

Arm Injuries↗

PubMed1997

The Union Health Center: a working model of clinical care linked to preventive occupational health services.

As health care provision in the United States shifts to primary care settings, it is vital that new models of occupational health services be developed that link clinical care to prevention. The model program described in this paper was developed at the Union Health Center (UHC), a comprehensive health care center supported by the International Ladies Garment Workers Union (now the Union of Needletrades, Industrial and Textile Employees) serving a population of approximately 50,000 primarily minority, female garment workers in New York City. The objective of this paper is to describe a model occupational medicine program in a union-based comprehensive health center linking accessible clinical care with primary and secondary disease prevention efforts. To assess the presence of symptoms suggestive of occupational disease, a health status questionnaire was administered to female workers attending the UHC for routine health maintenance. Based on the results of this survey, an occupational medicine clinic was developed that integrated direct clinical care with worker and employer education and workplace hazard abatement. To assess the success of this new approach, selected cases of sentinel health events were tracked and a chart review was conducted after 3 years of clinic operation. Prior to initiation of the occupational medicine clinic, 64% (648) of the workers surveyed reported symptoms indicative of occupational illnesses. However, only 42 (4%) reported having been told by a physician that they had an occupational illness and only 4 (.4%) reported having field a workers' compensation claim for an occupational disease. In the occupational medicine clinic established at the UHC, a health and safety specialist acts as a case manager, coordinating worker and employer education as well as workplace hazard abatement focused on disease prevention, ensuring that every case of occupational disease is treated as a potential sentinel health event. As examples of the success of this approach, index cases of rotator cuff tendonitis, lead poisoning, and formaldehyde overexposure in three patients and their preventative workplace follow-up, affecting approximately 150 workers at three worksites, are described. Work-related conditions diagnosed during the first 3 years of clinic operation included cumulative trauma disorders (141 cases), carpal tunnel syndrome (47 cases), low back disorders (33 cases), lead poisoning (20 cases), and respiratory disease (9 cases). This pilot project represents a new model for effective integration of clinical care and occupational disease prevention efforts within a primary care center. It could serve as a prototype for development of such services in other managed and primary care settings.

Ambulatory Care Facilities↗

PubMed1995

Ergonomics in the electronic library.

New technologies are changing the face of information services and how those services are delivered. Libraries spend a great deal of time planning the hardware and software implementations of electronic information services, but the human factors are often overlooked. Computers and electronic tools have changed the nature of many librarians' daily work, creating new problems, including stress, fatigue, and cumulative trauma disorders. Ergonomic issues need to be considered when designing or redesigning facilities for electronic resources and services. Libraries can prevent some of the common problems that appear in the digital workplace by paying attention to basic ergonomic issues when designing workstations and work areas. Proper monitor placement, lighting, workstation setup, and seating prevent many of the common occupational problems associated with computers. Staff training will further reduce the likelihood of ergonomic problems in the electronic workplace.

Computer Terminals↗

PubMed1999

[Compressive ischemic neuropathies of the upper extremities and work].

The objective of the presented study was to motile that cumulative trauma disorders of the upper extremities in recent years leads to arising morbidity and applications for compensation for occupational diseases. This rise is probably not associated with an increase of this disorder but a different awareness of workers and doctors as regards the possible adverse effect of forceful and frequently repeated movements of the upper extremities on their function, extended diagnostics and notification. It is important to master the diagnosis of these diseases and interpretation of auxiliary examinations to prevent inadequate payment of damages to the affected subjects and on the other hand to prevent breakdown or in adequate function of the financial provisions in this area. A number of syndromes of the mentioned conditions has very few objective symptoms and abnormal results of auxiliary examinations. The diagnosis of stenotic syndromes has a compared with other disorders great support in electrophysiological techniques, their high sensitivity and specificity (1, 15). The authors discuss therefore their problems and suggest electrophysiological criteria of medium grade affections in the carpal tunnel syndrome which is the condition for compensation for occupational disease and which so far was defined only roughly in this country.

Cumulative Trauma Disorders↗

PubMed2000

Ergonomics: CTD management evaluation tool.

Cumulative trauma disorder (CTD) occurrences peaked in number in 1994 and although decreasing in 1995, still accounted for 62% of all illness cases reported. A CTD Management Evaluation Tool was developed to assist Occupational Safety and Health Compliance Officers (CSHOs) in program evaluation and documentation of the occupational health management component and the need for an ergonomics program. Occupational and environmental health nurses may use the tool not only to reduce and prevent CTD occurrences, but also as a benchmark for program evaluation.

Cold Temperature↗

PubMedDate not supplied

[D.L.vo n. 626/94 - Musculoskeletal diseases caused by use of micropipette in laboratory].

The use of manual pipettes has been associated with a high prevalence of upper extremity and neck cumulative trauma disorders (CTD's) and work-related musculoskeletal disorders (WMSD's) among laboratory workers. The primary risk factor for these disorders are poor ergonomics in three specific areas: posture, repetition and force. Federal agencies have issued guidelines for pipetting practices to reduce the risk of injury and WMSD's. Pipette manufacturing have responded to the problem by improving the ergonomics and buttons and plungers that require less forces during operations. Another problem was still open with the traditional axial-design pipette: deviation of body or extremity from an ergonomically favourable neutral position. The new generation of micropipettes solves this problem.

Carpal Tunnel Syndrome↗

PubMed1993

Work-related chronic injuries of the forearm and hand: their specific diagnosis and management.

Work-related chronic injuries occur in muscles, tendons, and nerves. Epidemiological, histological, and physiological data confirm their often disputed physical basis. Terms such as repetitive strain injury and cumulative trauma disorder, when used as a diagnosis, have obscured the issue for they are really statements of causation. Definitive diagnosis is required both to treat and prevent such injuries. Precise terminology that identifies the tissue and its pathology is required. A detailed assessment methodology is described that allows a precise diagnosis. A clear relationship to work stress is necessary both to establish the cause and formulate prevention strategies. Treatment must begin early and be appropriate to the tissue and the nature of the injury. Examples are presented and discussed. Early treatment begins before too much damage has been done and yields better results.

Cumulative Trauma Disorders↗

PubMed2000

Quantitative analysis of cumulative trauma risk factors and risk factor interactions.

This study identifies the strongest occupational risk factors and risk factor interactions in the development of indicators associated with cumulative trauma disorders (CTD). Suggestions for minimizing the occurrence of indicators associated with onset of CTD are presented. Five Occupational risk factors and six risk factor interactions were evaluated to determine their contribution to accepted indicators of the onset of CTD, including exertion, discomfort, difficulty, and fatigue. Taguchi's level-analysis procedure was used to design a 16-trial hammering experiment and to analyze the results. From the hypothesized occupational risk factors, repetition was found to have the strongest effect on the values of the physiological and subjective indicators of the onset of CTD.

Adult↗

PubMed1997

Kienböck's disease. I. Anatomy and Etiology.

Cumulative trauma disorders (CTD) pose a major industrial problem in terms of increased medical costs, lost productivity and degraded worker health and safety. From an anatomical view, CTD's are classified into three major categories: tendon disorders, neurovascular disorders and nerve disorders. Up until recently these categories seemed to cover CTD of the upper extremity, however, Kienböck's disease, a typically less common disease and one that does not fit into the established CTD categories, has been observed to exhibit CTD characteristics and does appear in the manufacturing environment. The most common types of employment observed to exhibit individuals with this disease are carpentry, jobs involving the use of pneumatic tools (wrench), spot welders, sheet metal work, farmers and factory workers. The present article makes a critical examination of the relevant anatomy and etiologic aspects of this disease.

Cumulative Trauma Disorders↗

PubMed1999

Work-related musculoskeletal complaints in sonologists.

The prevalence of musculoskeletal complaints of the hand and wrist, and the neck and back, in physicians who operate sonography equipment was evaluated, and associations between these complaints and various work-related and personal variables were studied. A questionnaire survey was distributed among physician sonographers (sonologists) in Italy. The relationship between work habits and musculoskeletal complaints was analyzed by logistic regression models adjusted for gender, age, and duration of work with ultrasound. A total of 2041 physician sonographers completed the questionnaire. It was found that a large proportion of the subjects regularly had work-related complaints, such as neck and back pain (NBP) (18.5%) or hand and wrist cumulative trauma disorder (HWD) (5.3%). Roughly 80% of the sonographers were currently affected, or had been affected in the past, by one or more work-related symptoms. Various work-related factors appeared to be related to musculoskeletal syndromes. The average time spent for each examination was related both to NBP and HWD. Discomfort for transducer design was the best predictor of HWD, whereas a comfortable chair and correct position of the body protected from the onset of NBP. These results support the role of ergonomic factors in the pathogenesis of both NBP and HWD in sonographers.

Adult↗

PubMed2002

Ergonomics: muscle fatigue, posture, magnification, and illumination.

Chronic low-level trauma very often goes unnoticed until symptoms prompt sufferers to seek medical help. Many combined risk factors, rather than a single event or practice, lead to cumulative trauma disorders. Muscle fatigue leads to muscle trauma as well as a cascade of other injuries. With preemptive ergonomic strategies, such as the use of magnification and illumination, many of the common disabilities associated with dental careers can be avoided or reduced. The information in this article is of particular interest to not only the practicing dentist, but the entire dental team.

Age Factors↗

PubMed1990

Peripheral nerve dysfunction in practicing dental hygienists.

Hand-intensive repetitive procedures such as those performed by dental hygienists can lead to cumulative trauma disorders of the upper extremity. One such disorder is median nerve dysfunction leading to carpal tunnel syndrome (CTS). Vibrometry has been used in industrial settings as a method of early detection of sensory nerve impairment. This technique uses vibratory stimuli to assess the level of sensory perception in the fingertips. Using programmed frequency stimuli, 58 practicing dental hygienists were evaluated bilaterally for median nerve dysfunction. Results indicated that 15 (25.9%) of the dental hygienists reported the presence of CTS symptoms, while 7 (12.0%) tested positive for mild median nerve dysfunction. The findings suggest that vibrometry testing could aid in the early detection of CTS, thereby reducing its effects on clinical practice and facilitating early treatment.

Carpal Tunnel Syndrome↗

PubMedDate not supplied

Neuromuscular and psychological characteristics in subjects with work-related forearm pain.

There are scant data available on the neuromuscular and psychological characteristics of patients with cumulative trauma disorders. We compared 16 subjects with work-related forearm and hand pain in the dominant upper limb with 9 age-matched control subjects. Pain subjects were divided into two groups based on nerve conduction studies: eight subjects were in the study group for median neuropathy at the wrist (MN, median transcarpal latency >2.3 ms), and eight were in the study group for electrodiagnostically negative pain (EN). Average pain, forearm muscle tenderness, grip strength, pinch strength, and wrist flexor and extensor strength were measured. The Health Status Questionnaire and the Beck Depression Inventory were used to measure health perception and depressive symptoms, respectively. Work satisfaction was determined by a newly devised scale. Statistical analysis was by analysis of variance and planned comparison analysis. The MN and EN groups did not significantly differ on any of the measures except median transcarpal latency. Both pain groups had significantly (P < 0.05) greater average pain, greater extensor muscle tenderness, higher Beck Depression Inventory scores, higher pain rating, and poorer physical functioning on the Health Status Questionnaire than did the normal control group. Grip strength and wrist extension force were diminished in both cumulative trauma groups compared with control subjects; however, only grip strength in the MN group and wrist extension force in the EN group differed significantly (P < 0.05) from control subjects. Only the EN group had significantly less work satisfaction than did the control group. Overall, both pain groups differed from control subjects and shared similar characteristics, with the exception of median neuropathy.

Adult↗

PubMed2001

Chronic occupational repetitive strain injury.

OBJECTIVE: To review common repetitive strain injuries (RSIs) that occur in the workplace, emphasizing diagnosis, treatment, and etiology of these conditions. QUALITY OF EVIDENCE: A MEDLINE search from January 1966 to June 1999 focused on articles published since 1990 because RSIs are relatively new diagnoses. MeSH headings that were explored using the thesaurus included "cumulative trauma disorder," "overuse injury," and "repetitive strain injury." The search was limited to English articles only, and preference was given to randomized controlled trials. MAIN MESSAGE: Repetitive strain injuries result from repeated stress to the body's soft tissue structures including muscles, tendons, and nerves. They often occur in patients who perform repetitive movements either in their jobs or in extracurricular activities. Common RSIs include tendon-related disorders, such as rotator cuff tendonitis, and peripheral nerve entrapment disorders, such as carpal tunnel syndrome. A careful history and physical examination often lead to the diagnosis, but newer imaging techniques, such as magnetic resonance imaging and ultrasound, can help in refractory cases. Conservative management with medication, physiotherapy, or bracing is the mainstay of treatment. Surgery is reserved for cases that do not respond to treatment. CONCLUSION: Repetitive strain injury is common; primary care physicians must establish a diagnosis and, more importantly, its relationship to occupation. Treatment can be offered by family physicians who refer to specialists for cases refractory to conservative management.

Chronic Disease↗

PubMed1997

Potential problems associated with use of speech recognition products.

Commercial speech recognition products are being used increasingly as alternate input devices for computers, particularly by persons with physical disabilities. These discrete speech dictation systems require the user to insert brief but distinct pauses after each spoken word. Anecdotal evidence suggests that some persons using these products experience moderate to severe problems with their voices, such as hoarseness, sore throats, and even complete loss of voice. This preliminary study, which includes data gathered from survey dissemination and clinical studies, indicates that persons with cumulative trauma disorder may be the most susceptible to these voice problems. Also, we hypothesized that in using these discrete speech recognition systems, there may be a tendency to maintain constant pitch, volume, and inflection, keeping the vocal tract musculature in a fixed position. Maintaining this fixed position for extended periods may result in muscle fatigue and, eventually, injury to the laryngeal musculature. Further studies are needed, however, to investigate the effects suggested here. In the meantime, we recommend that users become informed about the unnatural speech patterns used with discrete speech recognition systems; learn to use good vocal hygiene, such as performing warm-up and cool-down voice exercises; and use alternate methods of input along with the speech recognition product.

Aphonia↗

PubMed1990

The effects of education on hand use with industrial workers in repetitive jobs.

Eighteen subjects participated in a preliminary study to determine the effects of two types of educational programs on the hand-use patterns of industrial workers at risk for developing cumulative trauma disorder (CTD). The subjects were divided into three groups: Two groups received different educational programs and the third group served as the control. One program used a handout as the only educational tool; the other used the handout as well as a hands-on demonstration of the concepts in the handout. Pretests and posttests of the frequency of movements identified with CTD of the hand and wrist during work were administered to all subjects. Both educational programs were significantly effective in reducing the number of at-risk movements performed by workers tested 1 week after receiving the education. No significant difference was found between the two educational programs. The results of this study show that education can affect hand-use patterns, and a similar study on a larger sample is recommended.

Adult↗