Prospective Cohort Study of Upper Eztremity MSDs Among 17 Diverse Employers
The goal of this multi-center study is to perform a large, prospective cohort study to quantify the risks for Distal Upper Extremity Musculoskeletal Disorders (MSDs) and to develop dose-response relationships for individual and aggregate disorders. Specific disorders targeted include carpal tunnel syndrome, lateral epicondylitis, medial epicondylitis, deQuervains stenosing tenosynovitis, extensor tenosynovitides, wrist compartment flexor tenosynovitides, trigger digit, and numerous other types of specific muscle-tendon unit disorders in the distal upper extremity. The research project was additionally renewed in 2007 and expanded to include shoulder disorders including shoulder tendinitides. The study includes subjects drawn from 17 plants primarily drawn from two U.S. states (Wisconsin and Utah). Job positions were selected after preliminary walk-through surveys to attempt to stratify subject enrollments into approximately one third each of high, medium, and low job exposures using a simplified Strain Index while blinded to health outcomes data/information. Enrollments were accomplished mostly from 2003-2004. Participants are employees of a variety of manufacturing plants including gas motor manufacturing, electric light assembly, apparel manufacturing, airbag manufacturing, assembly, generator manufacturing and meat processing. All subjects were consented and completed baseline data collection that included questionnaires (e.g., demographics, handedness, habits, hobbies, exercise, psychosocial factors), structured interviews (e.g., recent and prior neck, shoulder and distal upper extremity symptoms), hand symptoms diagrams, two standardized physical examinations (including measured height and weight), and nerve conduction studies. All workers jobs were measured. Job exposure measures included measurements, videotaping and reported elements of jobs to capture components required to compute Strain Index scores, ACGIH TLV for HAL and ratings of perceived exertion. Work organizational factors were additionally captured. Subjects were followed monthly for the development of new symptoms with an approximately 85％ success rate in directly contacting individual subjects each month. Subjects were also followed for treatments they received or self-administered, and resolution of symptoms. Jobs with material changes in exposures were re-measured. A priori case definitions were developed. Data are being analyzed with SAS 9.1.3 (Cary, North Carolina) and includes descriptive statistics, univariate and multivariate hazard ratios. This study enrolled 920 subjects. The mean age is 41.5+/-11.2 years. Most (67.3％) are female, reflecting the convenience sampling strategy and the self-selection into repetitive jobs. The mean body mass index is 29.5+/-6.92 kg/sq. meter. A minority are current smokers (28.4％), have diabetes mellitus (5.2％), hypertension (16.1％), hypercholesterolemia (15.3％) or thyroid disease (6.7％). The one-month period prevalence of tingling or numbness in at least 2 median nerve served digits (1-4) at baseline was 36.2％ on the right and 31.8％ on the left. The one-month period prevalence of a combination of tingling/numbness and nerve conduction studies interpreted as consistent with CTS in the right hand at baseline was 29.5％ with 10.9％ of the study population categorized as moderate or severe. Job physical factors are being analyzed with preliminary Strain Index scores suggesting a relationship between increasing job physical factors and risk of CTS.
Kurt T. Hegmann Matthew S. Thiese Ulrike Ott Steve Oostema Arun Garg Jay Kapellusch Gwen Deckow-Schaefer James Foster
University of Utah University of Wisconsin-Milwaukee
国际会议
17th World Congress on Ergonomics(第十七届国际人类工效学大会)
北京
英文
1-6
2009-08-09（万方平台首次上网日期，不代表论文的发表时间）