Risk factors for hand-wrist disorders in repetitive work

Abstract

Objectives: To identify the risk of hand-wrist disorders related to repetitive movements, use of hand force and wrist position in repetitive monotonous work. Methods: Using questionnaires and physical examinations, the prevalence and incidence of hand-wrist pain and possible extensor tendonitis (wrist pain and palpation tenderness) were determined in 3123 employees in 19 industrial settings. With the use of questionnaires and video recordings of homogenous work tasks number of wrist movements, hand force requirements and wrist position were analysed as risk factors for hand-wrist disorders, controlling for potential personal and psychosocial confounders. All participants were re-examined three times during a follow-up period of three years. Results: Force but not repetition and position was related to hand-wrist pain and possible tendonitis in the baseline analyses showing an exposure-response pattern. Odds ratios for the risk of hand pain was 1.7 (95% CI 1.3 to 2.2) and for possible tendonitis 1.9 (95% CI 1.1 to 3.3). There was no significant interaction between the ergonomic factors. In the follow-up analyses force remained a risk factor for hand pain (OR 1.4, 95% CI 1.1 to 1.8) and for possible tendonitis (OR 2.9, 95% CI 1.3 to 6.8). Repetition was also a risk factor for the onset of hand-wrist pain (OR 1.6, 95% CI 1.2 to 2.3). Conclusions: Increasing levels of force were associated with prevalent and incident hand-wrist pain and possible extensor tendonitis. The results for repetition were less consistent. Working with the hand in a nonneutral position could not be identified as a risk factor. P ain in the hand-wrist region may be a sign of an inflammatory or degenerative process involving the tendons and occasionally the tendon sheaths too. Depending on the structures involved the condition is diagnosed as tendonitis, peritendonitis or tenosynovitis. Hand complaints are common among manual workers with self-reported prevalence around 30-45%. Symptoms are not always accompanied by clinical findings. Several studies found very low prevalence of clinical tenosynovitis with swelling and/or crepitation but with a considerable variation-from no cases of clinical tenosynovitis at all, up to more than 18%, apparently with more or less the same case definition. [1][2][3][4][5] Some studies support the hypothesis that mechanical load put on the wrist could be a factor in the development of wrist tendonitis. According to newer biomechanical models mechanical load is the product of a combination of the intensity of hand use, expressed as the percentage of rest periods, and ergonomic factors (number of wrist movements), force involved in the movements and the position of the wrist. It is, however, quite difficult to get a precise picture of the actual hand load put on a person's hand during the working day because the same person often performs different work tasks with different combinations of possible risk factors. At the same time, personal factors (for example, gender, medical conditions, previous trauma, and leisu...

Risk factors for de Quervain’s disease in a French working population

“…Exposure to workpace dependent on the technical organization, which could represent a measure of the repetitiveness of the task, increased the risk of DQD. This agrees with previous studies on hand-wrist tendonitis (12,13,16,31,34,35). The multifactorial nature of disorders involving several biomechanical and organizational factors is coherent with the literature reporting higher risk of hand-wrist tendinitis for combined exposure to work-related risk factors (13,32).…”

“…The multifactorial nature of disorders involving several biomechanical and organizational factors is coherent with the literature reporting higher risk of hand-wrist tendinitis for combined exposure to work-related risk factors (13,32). Contrary to some studies, no association was found for the physical demands of the task, forceful exertion (12,13,31,34,35) or exposure to hand-wrist vibrations (31). DQD was not associated with computer use in our study, although a high incidence of DQD has been reported in a large cohort of computer users (36).…”

The Mediating Role of Work-related Musculoskeletal Disorders on the Relationship between Psychosocial Factors and Presenteeism among Administrative Workers

“…The findings of the current study are constant with other studies that found low social support were related to increased risk of neck, shoulder, and upper-back pain [39]. Furthermore, previous studies proved that workers with elbow and shoulder disorders worked reduced hours of their working time [40].…”

Social support modifies association between forward bending of the trunk and low-back pain: Cross-sectional field study of blue-collar workers

“…Using objective measurements, our studies constitute an important contribution to the investigation of the association between work-related forward bending and LBPi because previous studies have mainly relied on self-reported measures (11). Furthermore, this study is -to our knowledge -among the first using long-term objective measurements of forward bending during longer time periods, circumventing drawbacks due to selected time windows and short recording periods (18)(19)(20)(21).…”

“…One reason for the conflicting results can be differences in methodology used to measure forward bending of the trunk (15). The majority of studies investigating the association between forward bending of the trunk and LBP (11) have been criticized for using self-reported measures (16,17) or the short window of observations (18)(19)(20)(21). Therefore, valid objective measurements using accelerometers are preferable due to higher precision (22) and possibility for longer measurement periods (23).…”