Multifactor association of job,individual and psychosocial factors in prevalence of distal upper extremity disorders and quantification of job physical exposure

The objective of this study was to develop a multifactor model of job, individual and psychosocial factors in prevalence of distal upper extremity musculoskeletal disorders (DUE MSDs); and quantify job physical exposure to establish safe exposure limits. The study sample comprised of 525 workers who were part of a large prospective cohort study and represented a broad array of industrial practices and a wide range of job physical exposure. Only baseline data was considered for the analysis in the study. Workers underwent laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current DUE MSDs. All workers' jobs were individually measured for job physical exposure factors and videotaped. Binomial logistic regression was used to develop and test the multifactor association and quantification of job physical exposure for safe exposure limits. Results indicated that work-related DUE MSDs are multifactor in nature and are significantly affected by specific factors of (1) job physical exposure - percentage duration of exertion (PDOE), workers' subjective ratings of perceived effort or intensity of exertion (IOE) (using Borg CR-10), hand activity level measured by the American conference of Governmental Industrial Hygienists (ACGIH) threshold limit value for hand activity level (TLV for HAL), and presence of 2-point pinch grasps; (2) individual factors - female gender, diabetes, higher body mass index (BMI), and past and current smokers; (3) psychosocial factors - neither likely/unlikely or very unlikely to take up the current job again, divorced/separated, and presence of family problems. Quantification of job physical exposure indicated that prevalence of work-related DUE MSDs significantly increases with efforts per minute (Eff/min) >8 (OR = 1.69, p = 0.006) and woker's perceived effort based on Borg rating for IOE at the end of the shift >3 (OR = 2.46, p < 0.001). Further studies should be conducted to validate these safe exposure limit criteria.     

Assessment of physical demands and comparison of multiple exposure definitions in a repetitive sawmill job: board edger operator

The primary objectives of the study were to 1) describe the physical exposures in a sawmill job with a high incidence of upper extremity musculoskeletal injuries in terms of multiple measures of posture, exertion and frequency (with varying definitions) and 2) to examine the comparability of those definitions. Surface electromyography and electrogoniometry were used to quantify the muscle demands and joint motions. Fourteen board edger operators from two sawmill facilities participated. All exposure assessments, with the exception of surface EMG measurements, were performed on the production lines. EMG measurements were performed within the facility in a location removed from the production line. The measurements showed that, on average, ranges of motions of 59, 102 and 84 degrees respectively in the planes of wrist radial/ulnar deviation, flexion/extension and pronation/supination were required to perform the job. Significant differences (p < .001) were observed between ranges of motion defined by peak postures and those due to peak postures required to perform the primary task only. Performance of the primary task required an average of 32% of maximum voluntary contraction from the forearm muscles assessed. Repetitions per day ranged, on average, from 2,015 to 9,365. Incidence of reported upper extremity musculoskeletal injuries in the two facilities assessed was found to be higher with the greater total exposure. However, examination of the trend with a standardized measure of injury incidence was not possible.