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PubMed2002

The gap between exposure and implementation of computer workstation ergonomics in the workplace.

The population of people using computers is increasing in home, school and work environments [20,21]. Research suggests that more computer usage may lead to increased incidence of upper extremity cumulative trauma disorder (UECTD) and other work related musculoskeletal injuries [8]. Yet, proper computer workstation ergonomics training is not readily available. This pilot study attempts to better understand the gap between ergonomic interventions and the initiation of work-practice change. The pilot study used self-report through an anonymous Internet survey to explore university faculty and staff training in computer workstation ergonomics, assess UECTD and other computer-use related symptoms, and learn about the respondents' success implementing their knowledge of computer workstation ergonomics. The 55 respondents ranged in age from 21 to 65, and spent an average of 5.3 hours at the computer during a typical workday. Over 70% of respondents experienced symptoms associated with excessive computer use. Although 60% of respondents had exposure to computer workstation ergonomics information, less than 10% reported implementing their knowledge of computer workstation ergonomics in their tasks. This paper looks at organizational and individual issues preventing the implementation of computer workstation ergonomics in the workplace. The Transtheoretical Model for Health Behavior Change [25,27] is used to further evaluate effectiveness of ergonomic interventions. Recommendations for interventions and future evaluations are presented.

Adult↗
PubMedDate not supplied

[Health surveillance in construction].

In the Italian and international literature there are very few studies about work diseases and their prevention in the construction's compartment. The analysis of the most recent articles about this theme, however, suggests the presence of an high professional risk in the compartment and indicates as the most relevant risk factors noise, dusts, fibres, manual lifting, prolonged fixed postures, cumulative trauma disorders, vibrations, chemical substances and climatic conditions. The role that extra-lavorative risk factors can play on health is also relevant; those risks are due to the workers' peculiar life-style: hyper caloric diet, smoke and use of alcohol. Interventions of medical hygienic prevention, formation and information are therefore necessary. Lombardy Region, which from many years is careful to the problems about the prevention in building yards, has created a Working party who has elaborated the "Guide Lines for the sanitary surveillance in the building industry". The indications reported in the Guide Lines could represent, even for the occupational-doctors of the building contractors of the New Hospital, a good base for the working out of the workers' health care activity, in the respect of the dues of the law in force.

Facility Design and Construction↗
PubMedDate not supplied

Comparison of motor unit action potential characteristics and hand dominance using monopolar needle electrodes in the abductor pollicis brevis and abductor digiti minimi muscles.

This study examined specific electrical characteristics of voluntary single motor unit action potentials (SMUAPs): amplitude, duration, phase change, and rate of rise. These characteristics, which were detected from two intrinsic muscles of the hand--the abductor pollicis brevis and the abductor digiti minimi--were compared to hand dominance. Forty subjects participated in the study. Five characteristics were detected from each muscle using the quadrant technique while the subject produced a minimal isometric contraction. Based on results of an ANOVA [two-factor with replication] test, our study revealed no significant difference between muscles in the dominant and non-dominant hands. Descriptive statistics for each muscle characteristic are presented. This study has identified parameters for SMUAP characteristics detected in non-impaired individuals ranging in age from 20 to 43 years. The normative parameters serve as a valuable base from which one may examine potential neuronal damage from cumulative trauma disorders.

Action Potentials↗
PubMed1992

An analysis of 2846 industrial illnesses and injuries seen in a family practice.

We analyzed 2846 industrial illnesses and injuries in 2430 patients seen in a family practice with a large occupational medicine component over a three-and-a-half-year period. Of the 268 medical diagnoses made, back injuries and cumulative trauma disorders to the upper extremities comprised the majority. A large number of pesticide and chemical exposures were also seen. Consultations were obtained in 16.7% of the cases and 61.7% of the cases were closed as resolved. There were 17 patients hospitalized and no deaths. We recommend that family practice residents be trained in the procedures and laws of the workers' compensation system as well as in treating specific occupational health problems.

Adolescent↗
PubMed1992

Use of medical insurance claims for surveillance of occupational disease. An analysis of cumulative trauma in the auto industry.

Medical insurance claims, linked with work histories for a large automotive manufacturer over a 3-year period, identified large numbers of cases of potentially work-related diseases, including 30,600 episodes of probable cumulative trauma disorders (CTD). CTD incidence rates were calculated within five plants, and high-risk areas identified, however, unknown differences in medical insurance coverage by exposure group limited interpretation. Case-control analyses, with controls also identified by insurance claims, addressed coverage and produced age-adjusted and sex-adjusted estimates of risks. All five plants had departments with statistically significant, elevated risks for one or more of the diagnoses carpal tunnel syndrome, CTD of other upper extremities, rotator cuff syndrome, CTD of the neck and of the lower back. Medical insurance claim data linked with work history provide the basis for practical and comprehensive surveillance for CTD and potentially a variety of other occupational diseases.

Accidents, Occupational↗
PubMedDate not supplied

[Biomechanical risk for the upper limbs: experience at a factory of feeding electric cables].

Cumulative trauma disorders are found more and more frequently in working environments. Our examination concerns a factory of feeding electric cables, whose workers were subjected to a sanitary checking in 2001, 2002, 2003. The valuation of the risk due to a biomechanical overload of the upper limbs, carried out according to the OCRA method, pointed out, with reference to the specific task of pressing, a middle-high grade of exposure, while the clinical-instrumental results showed symptoms and objective signs of suffering on the median nerve of the wrist with regard to a significant percentage of workers. The following interventions on the production cycle and on the exposure times obtained a reduction of the risk with a subsequent decrease of the noticed troubles.

Arm↗
PubMed1992

Implementing ergonomic strategies in the workplace--an occupational health nursing perspective.

1. Failure to recognize the work relatedness of cumulative trauma disorders has contributed to an insufficient emphasis on appropriate ergonomic strategies in many industries. 2. Occupational health nurses have a responsibility to make clear their roles, skills, and contributions as integral members of the ergonomic team. 3. When implementing a comprehensive ergonomic program, the "wins" are most often seen in the gradual steps of continuous improvement. 4. To meet the challenges of the year 2000 and beyond, education is a critical element. This means education of management and employees, community health care providers, nurses in other specialty areas, allied health professionals, regulatory agencies, and others about the broad and diversified roles and contributions of occupational health nurses in ergonomics and other occupational health arenas as well.

Ergonomics↗
PubMed2004

Rates of carpal tunnel syndrome, epicondylitis, and rotator cuff claims in Ontario workers during 1997.

The primary objective of this research was the calculation of crude and specific rates of first-allowed, lost-time carpal tunnel syndrome (CTS), epicondylitis, and rotator cuff syndrome/tear (RCS/RCT) claims in Ontario workers during 1997. A secondary objective was to determine if results related to these diagnoses were consistent with findings for all cumulative trauma disorders affecting the specific part of upper extremity region. Rates were calculated by combining claim counts and population "at-risk" estimates derived from the Ontario Workplace Safety and Insurance Board databases and Canadian Labour Force Survey, respectively. The prevention index was used to prioritize occupations for intervention. Gender-specific rates declined as one moved proximally along the upper extremity. Similarly, female to male claim rate ratios declined from 1.61 for CTS to 0.47 for RCS/RCT. Frequently occurring highest rate and prevention index occupational categories across gender and diagnoses included "textiles, furs & leathergoods" and "other machining occupations". Diagnosis-specific findings were consistent with previously reported part of upper extremity findings.

Adolescent↗
PubMedDate not supplied

[Carpal tunnel syndrome among supermarket cashiers].

We studied Carpal Tunnel Syndrome prevalence in part time and full time female supermarket cashiers and in a control group (female primary school teachers). Subjects underwent a clinical examination in which information about personal, physiological, pathological and occupational factors were collected by a physician with a questionnaire and a self-administered Katz's hand diagram. The study protocol included median nerve conduction studies (NCS) for each worker, performed bilaterally according to the palmar technique described by J. Kimura. Case definition of Carpal Tunnel Syndrome was based on the combination of typical symptoms (classic/probable or possible) and electrodiagnostic findings according to the Consensus Criteria for the Classification of Carpal Tunnel Syndrome published by Rempel et al. in 1998. Biomechanical risk for upper limb was assessed by a group of trained observer using videotape and scales of hand activity level (HAL) and normalized peak of force (PF) proposed by the American Conference of Governmental Industrial Hygienists (ACGIH): supermarket cashier job tasks resulted on the threshold limit value line, confirming high biomechanical risk factors for CTS. Both symptoms and case prevalence resulted higher in supermarket cashiers than in control group and in full time cashiers if compared with part time ones. This difference between groups of part-/full-time cashiers could be due to total hours of exposure during the week and/or to the amount of recovery time between work sessions. Further longitudinal study could give more information about the role of different biomechanical risk factors in the onset of cumulative trauma disorders of the upper limb.

Adult↗
PubMed1991

Business analysis in occupational health and safety consultations.

We present a method for incorporating business analysis into comprehensive health and safety consultations using as an example a plant with an elevated incidence of cumulative trauma disorders. Business information, including product and management history, short- and long-term corporate goals, functional analysis, profit history, organizational structure with respect to health and safety, and personnel and labor-management relationships are evaluated simultaneously with traditional ergonomic factors. The additional business data allow consultants to identify the full scope of etiologies and make practical, credible recommendations that are more likely to be adopted by management and labor. We propose that techniques of "business analysis" be routinely incorporated into occupational health and safety consultations. However, because collection and interpretation of these data require business skills outside the occupational safety and health expert's usual repertoire, the consulting team must include participants with business expertise. We have found that occupational health medical personnel with an understanding of business analysis concepts can be very effective advocates for changes in health and safety practices. We strongly recommend incorporating methods of business analysis into the occupational health and safety curriculum.

Accidents, Occupational↗
PubMed1989

Quantitative muscle strength testing: a comparison of job strength requirements and actual worker strength among military technicians.

In this study the authors investigate the percentage of mismatch between job demands and worker physical capacity in Utah National Guard mechanics. This population had demonstrated a higher incidence of low back trouble than other job descriptions reviewed. The authors utilized onsite still and videotape photography and a computerized biomechanical strength prediction model to assess loads on the lumbosacral spine due to various job tasks. Job demands were then compared to the actual physical capacity of the individual workers based on static strength testing in job-related positions. A load cell on the testing apparatus entered the force generated into a computer which averaged the force of the last three seconds of a five-second lift. It was determined that as much as a 38% mismatch existed within this population for some job tasks which these workers were exposed to. Suggestions for preventing job-related low back cumulative trauma disorders are presented, including: engineering redesign, worker selection programs, work hardening, and others.

Back Pain↗
PubMed1987

Electrodiagnostic characteristics of acute carpal tunnel syndrome.

Carpal tunnel syndrome (CTS) exemplifies a cumulative trauma disorder which may occur in industrial settings. Occasionally, industrial workers develop CTS acutely over the course of a few days to a few weeks. We recently performed electrodiagnostic studies on 22 workers at a midwestern automobile manufacturing plant who developed symptoms compatible with CTS. All tests were within eight weeks of symptom onset; 70% were within four weeks. The acute syndrome was manifested by a conduction block of sensory, motor, or both fiber types beneath the carpal ligament. All patients received sensory studies; nine had motor studies as well. Sensory nerve latencies were not prolonged in proportion to the symptoms, which were short in comparison to the low amplitude sensory nerve action potential evoked proximal to the carpal ligament. Sensory nerve action potential amplitude at midpalm averaged 200% of the value obtained proximally. Because of short distance and residual latency, comparison of motor latencies proximal and distal to the carpal ligament was less helpful than the difference in amplitude of the evoked potentials. Amplitude of the distal response increased an average of 32%. Prompt identification of acute CTS was followed by a recommendation for job change which, along with conservative therapy, led to resolution of symptoms in 77% of patients. The diagnosis of acute CTS leading to avoidance of inciting activities is beneficial in the industrial setting.

Action Potentials↗
PubMed1995

Evaluating and treating common upper extremity nerve compression and tendonitis syndromes ... without becoming cumulatively traumatized.

Cumulative trauma disorder, repetitive motion injury, and overuse syndrome are all umbrella descriptions of many specific injuries that require careful evaluation, diagnosis, and treatment to restore function, decrease pain, and minimize time spent in a patient role. This article describes anatomic sites of common nerve compressions and tendonitis in the upper extremity (UE). Evaluation techniques are described with emphasis on clinical, environmental, and psychological mitigating factors essential in identifying microtrauma of nerves and tendons to achieve the correct differential diagnosis. Conservative treatment recommendations, including splinting, ergonomics, corticosteroid injection, and hand surgery, are outlined to assist the practitioner in discerning the most appropriate course of action. Surgical intervention and postoperative care and follow-up for median, ulnar, radial, and thoracic outlet nerve compression syndromes are briefly described.

Arm↗
PubMed1994

Psychophysically acceptable weights for a combination lifting task using bags with handles.

This paper presents a study on a combination lift and lower manual handling task and was designed to simulate the loading of grocery bags into a car trunk. Twelve male subjects performed an externally paced task of lifting grocery bags loaded with weights from 15 cm above the floor and over a wooden sill. There were two different sill heights of 70 cm and 90 cm, and for each of these heights there were two frequencies of 3 and 6 lifts per cycle. The dependent variables were maximum acceptable weight of lift (MAWOL). A unique lifting sequence and a modified version of the psychophysical methodology were used to determine MAWOL. There was a significant difference in the MAWOL across the two sill heights as well as the MAWOL at the two different frequencies. Plastic bags were determined to increase the average load lifted by 27% as compared to paper bags. At normal grocery bag weights, the increased load carrying capacity represents an increase in the safety factor. Not only can the risk of lower back injuries be decreased by using plastic bags with handles but the risk of developing a cumulative trauma disorder could also be decreased.

Adult↗
PubMedDate not supplied

Injuries in the mining industry.

This chapter reviews the history, statistics, and epidemiology of mining injuries in the United States. Although injuries in mining have been drastically reduced since the start of this century, their rates have not changed substantially in the past decade, and mining injury rates remain among the highest of all US industries. The injuries are often severe, as indicated by both high fatality rates and the high average number of days lost from work for nonfatal injury. Cumulative trauma disorders and acute traumatic injuries are common.

Accidents, Occupational↗
PubMed1993

Review of system designs employs ergonomics prior to work injuries. CTDs do not need to be the result of trial-and-error processes with new or simpler equipment.

The six stages of complex man/machine systems design can and should be applied to simpler systems as well. This process ensures that operator performance requirements are carefully considered and that operators will not be overloaded. When ergonomic considerations are ignored, cumulative trauma disorders among operators often occur after weeks, months or years of system use. Many problems can be avoided with little or no additional cost if ergonomics is considered during the design or equipment selection phase of new systems. For existing systems, an ergonomics review can determine the necessary interface enhancements or function re-allocations that will resolve problems, and reduce the likelihood of injury.

Accidents, Occupational↗
PubMed2006

Multiple cognitive capabilities/deficits in children with an autism spectrum disorder: "weak" central coherence and its relationship to theory of mind and executive control.

This study examined the validity of "weak" central coherence (CC) in the context of multiple cognitive capabilities/deficits in autism. Children with an autism spectrum disorder (ASD) and matched typically developing children were administered tasks tapping visuospatial coherence, false-belief understanding and aspects of executive control. Significant group differences were found in all three cognitive domains. Evidence of local processing on coherence tasks was widespread in the ASD group, but difficulties in attributing false beliefs and in components of executive functioning were present in fewer of the children with ASD. This cognitive profile was generally similar for younger and older children with ASD. Furthermore, weak CC was unrelated to false-belief understanding, but aspects of coherence (related to integration) were associated with aspects of executive control. Few associations were found between cognitive variables and indices of autistic symptomatology. Implications for CC theory are discussed.

Autistic Disorder↗