Musculoskeletal disorders and workplace factors. A critical review of epidemiologic evidence for work-related musculoskeletal disorders of the neck, upper extremity, and low back.

Abstract

Review of Epidemiologic Evidence for Work-Related Musculoskeletal Disorders of the Neck, Upper Extremity, and Low Back incorporates a number of editorial changes, including grammar, formatting, and consistency issues that were identified in the first printing.In addition, the notation of Dr. Lawrence Fine as co-editor was inadvertently omitted in the first printing and has been re-inserted.The conclusions of the document in terms of decisions regarding the weight of the existing epidemiologic evidence for the relationship between workplace factors and musculoskeletal disorders remain unchanged.The following technical inconsistencies or errors were corrected: Page 2-14: Text was corrected to reflect that five studies (as opposed to three) examined the relationship between force and musculoskeletal disorders of the neck.Page 2-28: For Viikari-Juntura [1994], the "NR" entry in the Risk Indicator column was replaced with the value 3.0.Page 2-34: Bergqvist [1995a] was changed to Bergqvist [1994].The Risk Indicator entry for this study was changed from 4.4 to 3.7 (both noted as statistically significant), the entry for Physical Examination was changed from "Yes" to "No," and the entry for Basis for Assessing Exposure was changed from "job titles or self-reports" to "observation or measurements."Page 3-3: Text was corrected to reflect that four studies (as opposed to three) met all four evaluation criteria.A description of Kilbom and Persson [1987] was moved forward in the chapter to this section and includes a clarification that health outcome in their study was based on symptoms and physical findings.Page 3-32: The confidence interval depicted for Ohlsson [1994] was corrected to show a range from 3.5 to 5.9.Page 3-69: Schibye et al. [1995] was added to Table 345.Table 1-1.Private sector industries with the highest incidence rates of injuries and illnesses from overexertion resulting in days away from work, 1994 Industry * SIC code † 1994 annual average employment ‡ (in thousands) Incidence rate (per 10,000 workers) 95% confidence interval (rate per 10,000) Number of cases Source: Bureau of Labor Statistics, U.S. Department of Labor, Annual Survey of Occupational Injuries and Illnesses, 1994 Case and Demographic Resource Tables (ftp://stats.bls.gov/pub/special.requests/ocwc/osh/c_d_data).* High rate industries were those having an incidence rate greater than three times the rate for all private industry, at the most detailed or lowest SIC level at which rates are published.Generally, manufacturing industries are published at the 4-digit code level and the remaining industries at the 3-digit level.† Standard Industrial Classification Manual, 1987 edition.‡ Annual average employment from the BLS Covered Employment and Wages (ES-202) Survey.§ Excludes farms with fewer than 11 employees.1-4 Table 1-2.Private sector industries with the highest incidence rates of injuries and illnesses from repetitive motion resulting in days away from work, 1994 Industry * SIC code † 1994 annual average employment ‡ (in thousands) Incidence rate (per 10,000 workers) 95% confidence interval (rate per 10,000) Number of cases Knit underwear mills (manufacturing) 2254 25 165.6 (145, 187) 370 House slippers (manufacturing) 3142 3 146.3(92, 201) 48 Men's and boy's work clothes (manufacturing) 2326 42 117.2Source: Bureau of Labor Statistics, U.S. Department of Labor, Annual Survey of Occupational Injuries and Illnesses, 1994 Case and Demographic Resource Tables (ftp://stats.bls.gov/pub/special.requests/ocwc/osh/c_d_data).* High rate industries were those having an incidence rate greater than three times the rate for all manufacturing workers at the most detailed or lowest SIC level at which rates are published.Generally, manufacturing industries are published at the 4-digit code level and the remaining industries at the 3-digit level.† Standard Industrial Classification Manual, 1987 edition.‡ Annual average employment from the BLS Covered Employment and Wages (ES-202) Survey.§ Excludes farms with fewer than 11 employees. INFORMATION RETRIEVALThis document examines scientific peerreviewed epidemiologic journal articles, including recent publications addressing MSD risk factors, conference proceedings, and abstracts dealing with upper-extremity or back MSDs, recent textbooks, internally reviewed government reports or studies conducted by NIOSH, and other documents.Reports of epidemiologic studies were acquired using both CD-ROM and online commercial and governmental databases.Searches were carried out on computer-based bibliographic databases: Grateful Med ® (which includes Medline ® and Toxline ® ), NIOSHTIC ® (a NIOSH database), and CIS (the International Labour Organization occupational health database).The search strategy included the following key terms: occupation, repetition, force, posture, vibration, cold, psychosocial, psychological, physiological, repetition strain injury, repetitive strain injury, epidemiology, etiology, cumulative