Risk Assessments Using the Strain Index and the TLV for HAL, Part II: Multi-Task Jobs and Prevalence of CTS

Details

• Personal Author:
  Bao SS ; Garg, Arun ; Hegmann KT ; Kapellusch JM ; Merryweather AS ; Silverstein BA ; Thiese MS
• Description:
  The Strain Index (SI) and the American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit value for hand activity level (TLV forHAL) have been shown to be associated with prevalence of distal upper-limb musculoskeletal disorders such as carpal tunnel syndrome (CTS). The SI and TLV for HAL disagree on more than half of task exposure classifications. Similarly, time-weighted average (TWA), peak, and typical exposure techniques used to quantity physical exposure frommulti-task jobs have shown between-technique agreement ranging from 61% to 93%, depending upon whether the SI or TLV for HAL model was used. This study compared exposure-response relationships between each model-technique combination and prevalence of CTS. Physical exposure data from 1,834 workers (710 with multi-task jobs) were analyzed using the SI and TLV for HAL and the TWA, typical, and peak multi-task job exposure techniques. Additionally, exposure classifications from the SI and TLV for HALwere combined into a singlemeasure and evaluated. Prevalent CTS cases were identified using symptoms and nerve-conduction studies. Mixed effects logistic regression was used to quantify exposure-response relationships between categorized (i.e., low, medium, and high) physical exposure and CTS prevalence for all model-technique combinations, and for multi-task workers, mono-task workers, and all workers combined. Except for TWA TLV for HAL, all model-technique combinations showed monotonic increases in risk of CTS with increased physical exposure. The combined-models approach showed stronger association than the SI or TLV for HAL for multi-task workers. Despite differences in exposure classifications, nearly all model-technique combinations showed exposure-response relationships with prevalence of CTS for the combined sample of mono-task and multi-task workers. Both the TLV for HAL and the SI, with the TWA or typical techniques, appear useful for epidemiological studies and surveillance. However, the utility of TWA, typical, and peak techniques for job design and intervention is dubious. [Description provided by NIOSH]
• Subjects:
  Biomechanical Phenomena Ergonomics Health Care Facilities Workforce And Services Musculoskeletal Diseases Musculoskeletal System Occupational Exposure Occupational Health Risk Assessment Risk Factors Safety
• Keywords:
  Activity Levels Analytical Instruments Analytical Models Author Keywords: Job Rotation Biomechanics Carpal Tunnel Syndrome Employee Exposure Exposure-response Force Hand Injuries Injury Prevention Job Analysis Job Design Job Rotation Medical Monitoring MSDs Musculoskeletal System Disorders Nerve Function Physiological Measurements Repetitive Work Risk Analysis Risk Assessment Risk Classifications Risk Factors Strain Index Stress Threshold Limit Values TLV TLV For HAL

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• ISSN:
  1545-9624
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 10 ; OSHA Region 5 ; OSHA Region 8 ; Utah ; Washington ; Wisconsin
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  157-166
• Volume:
  15
• Issue:
  2
• NIOSHTIC Number:
  nn:20050924
• Citation:
  J Occup Environ Hyg 2018 Feb; 15(2):157-166
• Contact Point Address:
  Jay M. Kapellusch, Department of Occupational Science & Technology, College of Health Sciences, University of Wisconsin-Milwaukee, P.O. Box 413, Milwaukee, WI 53201
• Email:
  kap@uwm.edu
• Federal Fiscal Year:
  2018
• Performing Organization:
  University of Wisconsin, Milwaukee
• Peer Reviewed:
  True
• Start Date:
  20130901
• Source Full Name:
  Journal of Occupational and Environmental Hygiene
• End Date:
  20170831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:d96b94346fc85d455b1f094f4e43f83dc712312e843325c398c773b76025350a65714ace0ae3fd9341b4287482816825843fc346b9005c43cf5dc0476558b256
• Download URL:
  https://stacks.cdc.gov/view/cdc/211104/cdc_211104_DS1.pdf
• File Type:
  [PDF - 1.08 MB ]