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Thiese M.S.,University of Utah | Gerr F.,University of Iowa | Hegmann K.T.,University of Utah | Harris-Adamson C.,Samuel Merritt University | And 8 more authors.
Archives of Physical Medicine and Rehabilitation | Year: 2014

Objective: To analyze differences in carpal tunnel syndrome (CTS) prevalence using a combination of electrodiagnostic studies (EDSs) and symptoms using EDS criteria varied across a range of cutpoints and compared with symptoms in both ≥1 and ≥2 median nerveeserved digits. Design: Pooled data from 5 prospective cohorts. Setting: Hand-intensive industrial settings, including manufacturing, assembly, production, service, construction, and health care. Participants: Employed, working-age participants who are able to provide consent and undergo EDS testing (N=3130). Interventions: None. Main Outcome Measures: CTS prevalence was estimated while varying the thresholds for median sensory latency, median motor latency, and transcarpal delta latency difference. EDS criteria examined included the following: median sensory latency of 3.3 to 4.1 milliseconds, median motor latency of 4.1 to 4.9 milliseconds, and median-ulnar sensory difference of 0.4 to 1.2 milliseconds. EDS criteria were combined with symptoms in ≥1 or ≥2 median nerve-served digits. EDS criteria from other published studies were applied to allow for comparison. Results: CTS prevalence ranged from 6.3% to 11.7%. CTS prevalence estimates changed most per millisecond of sensory latency compared with motor latency or transcarpal delta. CTS prevalence decreased by 0.9% to 2.0% if the criteria required symptoms in 2 digits instead of 1. Conclusions: There are meaningful differences in CTS prevalence when different EDS criteria are applied. The digital sensory latency criteria result in the largest variance in prevalence. © 2014 by the American Congress of Rehabilitation Medicine.


PubMed | University of Iowa, University of California at San Francisco, Safety and Health Assessment and Research for Prevention Program, University of Wisconsin - Milwaukee and 4 more.
Type: Journal Article | Journal: Archives of physical medicine and rehabilitation | Year: 2014

To analyze differences in carpal tunnel syndrome (CTS) prevalence using a combination of electrodiagnostic studies (EDSs) and symptoms using EDS criteria varied across a range of cutpoints and compared with symptoms in both 1 and 2 median nerve-served digits.Pooled data from 5 prospective cohorts.Hand-intensive industrial settings, including manufacturing, assembly, production, service, construction, and health care.Employed, working-age participants who are able to provide consent and undergo EDS testing (N=3130).None.CTS prevalence was estimated while varying the thresholds for median sensory latency, median motor latency, and transcarpal delta latency difference. EDS criteria examined included the following: median sensory latency of 3.3 to 4.1 milliseconds, median motor latency of 4.1 to 4.9 milliseconds, and median-ulnar sensory difference of 0.4 to 1.2 milliseconds. EDS criteria were combined with symptoms in 1 or 2 median nerve-served digits. EDS criteria from other published studies were applied to allow for comparison.CTS prevalence ranged from 6.3% to 11.7%. CTS prevalence estimates changed most per millisecond of sensory latency compared with motor latency or transcarpal delta. CTS prevalence decreased by 0.9% to 2.0% if the criteria required symptoms in 2 digits instead of1.There are meaningful differences in CTS prevalence when different EDS criteria are applied. The digital sensory latency criteria result in the largest variance in prevalence.


Rempel D.,University of California at San Francisco | Gerr F.,University of Iowa | Harris-Adamson C.,University of California at San Francisco | Hegmann K.T.,University of Utah | And 9 more authors.
Journal of Occupational and Environmental Medicine | Year: 2015

OBJECTIVE:: Evaluate associations between personal and workplace factors and median nerve conduction latency at the wrist. METHODS:: Baseline data on workplace psychosocial and physical exposures were pooled from four prospective studies of production and service workers (N = 2396). During the follow-up period, electrophysiologic measures of median nerve function were collected at regular intervals. RESULTS:: Significant adjusted associations were observed between age, body mass index, sex, peak hand force, duration of forceful hand exertions, Threshold Limit Value for Hand Activity Limit, forceful repetition rate, wrist extension, and decision latitude on median nerve latencies. CONCLUSIONS:: Occupational and nonoccupational factors have adverse effects on median nerve function. Measuring median nerve function eliminates possible reporting bias that may affect symptom-based carpal tunnel syndrome case definitions. These results suggest that previously observed associations between carpal tunnel syndrome and occupational factors are not the result of such reporting bias. Copyright © 2015 by American College of Occupational and Environmental.


Kim K.H.,Safety and Health Assessment and Research for Prevention Program | Martin B.J.,University of Michigan
International Journal of Industrial Ergonomics | Year: 2013

Spinal cord injury (SCI) and low back pain (LBP) significantly limit personal and occupational activities. Since upper body movements are crucial to extend hand reach envelopes and maintain postural balance, coordinated control of torso and hand movements is essential. In this study, adapted patterns of coordination were investigated in SCI, LBP and control participants performing seated manual material handling tasks, in which a load was transferred with both hands from a home location to one of 4 targets in the mid-sagittal plane.Torso peak velocities are larger and delayed for the SCI when compared to the control group, while hand peak velocities are comparable. However, hand peak velocities are smaller in the LBP than control group. Hand movements generally precede torso movements for all groups, but more prominently for the SCI than the other groups. Furthermore, for SCIs torso movements were suppressed until the hands were aligned with target elevation.These results indicate that SCI individuals have developed a unique coordination pattern to compensate for their limited balance control, although this strategy may reduce their effective workspace and overload the upper extremities. In contrast, LBPs seem to have reduced movement speed while their coordination patterns are generally similar to those in the control group. Relevance to industry: This study analyzed movements of persons with spinal cord injury or low back pain in manual material handling tasks. Assessing their adapted movement strategies would help to improve workspace design to accommodate workers with limited capacities and to provide quantifiable evidence and guidelines on the effectiveness of occupational rehabilitation programs. © 2012 Elsevier B.V.


Kim K.H.,Safety and Health Assessment and Research for Prevention Program | Gillespie R.B.,University of Michigan | Martin B.J.,University of Michigan
Journal of NeuroEngineering and Rehabilitation | Year: 2014

Background: Control of reaching movements for manual work, vehicle operation, or interactions with manual interfaces requires concurrent gaze control for visual guidance of the hand. We hypothesize that reaching movements are based on negotiated strategies to resolve possible conflicting demands placed on body segments shared by the visual (gaze) and manual (hand) control systems. Further, we hypothesize that a multiplicity of possible spatial configurations (redundancy) in a movement system enables a resolution of conflicting demands that does not require sacrificing the goals of the two systems. Methods. The simultaneous control of manual reach and gaze during seated reaching movements was simulated by solving an inverse kinematics model wherein joint trajectories were estimated from a set of recorded hand and head movements. A secondary objective function, termed negotiation function, was introduced to describe a means for the manual reach and gaze directing systems to balance independent goals against (possibly competing) demands for shared resources, namely the torso movement. For both systems, the trade-off may be resolved without sacrificing goal achievement by taking advantage of redundant degrees of freedom. Estimated joint trajectories were then compared to joint movement recordings from ten participants. Joint angles were predicted with and without the negotiation function in place, and model accuracy was determined using the root-mean-square errors (RMSEs) and differences between estimated and recorded joint angles. Results: The prediction accuracy was generally improved when negotiation was included: the negotiated control reduced RMSE by 16% and 30% on average when compared to the systems with only manual or visual control, respectively. Furthermore, the RMSE in the negotiated control system tended to improve with torso movement amplitude. Conclusions: The proposed model describes how multiple systems cooperate to perform goal-directed human movements when those movements draw upon shared resources. Allocation of shared resources can be undertaken by a negotiation process that is aware of redundancies and the existence of multiple solutions within the individual systems. © 2014 Kim et al.; licensee BioMed Central Ltd.


Kim K.H.,Safety and Health Assessment and Research for Prevention Program | Choe S.B.,University of Michigan | Haig A.J.,University of Michigan | Martin B.J.,University of Michigan
Spine | Year: 2010

Study Design.: Controlled laboratory study. Statistical regression and between-group comparisons. Objective.: To characterize functional limitation and adaptive strategies in seated manual transport tasks for spinal cord injury (SCI), low back pain (LBP), and control participants. Summary of Background Data.: People with SCI are known to have adapted electromyographic activities and slow hand movement velocity, while those with LBP have reduced range of motion and lumbar joint contribution. However, their resultant outcome in torso movements has not been systematically quantified. Methods.: Seated participants performed either 2- or 1-handed loaded transports to 1 of 6 targets 49 cm above the hip-point, at 0°, 45°, and 90° azimuths, at close and far distance. Three-dimensional torso movements were modeled by combinations of B-spline base functions. Results.: The SCI and LBP participants exhibit smaller torso flexion and axial rotation than control participants. The SCI participants tend to move the torso away from the target to maintain upper body balance. These differences among groups are significantly reduced in the 1-handed transport condition and/or transports to the frontal target. Conclusion.: The movement patterns suggest that SCI participants may have adapted torso movement strategies to compensate for the limited control of upper body balance, while LBP participants may limit torso motion to avoid pain. © 2010, Lippincott Williams & Wilkins.


Reeb-Whitaker C.K.,Safety and Health Assessment and Research for Prevention Program | Bonauto D.K.,Safety and Health Assessment and Research for Prevention Program
Annals of Allergy, Asthma and Immunology | Year: 2014

Background There is little published evidence for occupational respiratory disease caused by hop dust inhalation. In the United States, hops are commercially produced in the Pacific Northwest region.Objective To describe occupational respiratory disease in hop workers.Methods Washington State workers' compensation claims filed by hop workers for respiratory disease were systematically identified and reviewed. Incidence rates of respiratory disease in hop workers were compared with rates in field vegetable crop farm workers.Results Fifty-seven cases of respiratory disease associated with hop dust inhalation were reported from 1995 to 2011. Most cases (61%) were diagnosed by the attending health care practitioner as having work-related asthma. Seven percent of cases were diagnosed as chronic obstructive pulmonary disease, and the remaining cases were diagnosed as allergic respiratory disorders (eg, allergic rhinitis) or asthma-associated symptoms (eg, dyspnea). Cases were associated with hop harvesting, secondary hop processing, and indirect exposure. The incidence rate of respiratory disease in hop workers was 15 cases per 10,000 full-time workers, which was 30 times greater than the incidence rate for field vegetable crop workers. A strong temporal association between hop dust exposure and respiratory symptoms and a clear association between an increase in hop dust concentrations and the clinical onset of symptoms were apparent in 3 cases.Conclusion Occupational exposure to hop dust is associated with respiratory disease. Respiratory disease rates were higher in hop workers than in a comparison group of agricultural workers. Additional research is needed before hop dust can be confirmed as a causative agent for occupational asthma. © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.


Bonauto D.K.,Safety and Health Assessment and Research for Prevention Program | Lu D.,Safety and Health Assessment and Research for Prevention Program | Fan Z.J.,Safety and Health Assessment and Research for Prevention Program
Preventing chronic disease | Year: 2014

INTRODUCTION: Data that estimate the prevalence of and risk factors for worker obesity by occupation are generally unavailable and could inform the prioritization of workplace wellness programs. The aims of this study were to estimate the prevalence of obesity by occupation, examine the association of occupational physical activity and a range of health behaviors with obesity, and identify occupations in which workers are at high risk of obesity in Washington State.METHODS: We conducted descriptive and multivariable analyses among 37,626 employed Washington State respondents using the Behavioral Risk Factor Surveillance System in odd numbered years, from 2003 through 2009. We estimated prevalence and prevalence ratios (PRs) by occupational groups adjusting for demographics, occupational physical activity level, smoking, fruit and vegetable consumption, and leisure-time physical activity (LPTA).RESULTS: Overall obesity prevalence was 24.6% (95% confidence interval [CI], 24.0-25.1). Workers in protective services were 2.46 (95% CI, 1.72-3.50) times as likely to be obese as workers in health diagnosing occupations. Compared with their counterparts, workers who consumed adequate amounts of fruits and vegetables and had adequate LTPA were significantly less likely to be obese (PR = 0.91; 95% CI, 0.86-0.97 and PR = 0.63; 95% CI, 0.60-0.67, respectively). Workers with physically demanding occupational physical activity had a lower PR of obesity (PR = 0.83; 95% CI, 0.78-0.88) than those with nonphysically demanding occupational physical activity.CONCLUSION: Obesity prevalence and health risk behaviors vary substantially by occupation. Employers, policy makers, and health promotion practitioners can use our results to target and prioritize workplace obesity prevention and health behavior promotion programs.


PubMed | Safety and Health Assessment and Research for Prevention Program
Type: | Journal: Work (Reading, Mass.) | Year: 2012

Work-related musculoskeletal disorders (WMSDs) are debilitating for workers and costly for employers. Existing exposure assessment tools were modified for rapid job physical exposure and company organizational exposure assessment. These were augmented with injured worker interviews to put the meet on the bones in characterizing risk. These risk assessments are conducted in all industry sectors.


PubMed | Safety and Health Assessment and Research for Prevention Program
Type: Journal Article | Journal: Work (Reading, Mass.) | Year: 2012

This study reports trends in the pattern of injuries related to workplace violence over the period 1997-2007. It tracks occupations and industries at elevated risk of workplace violence with a special focus on the persistently high claims rates among healthcare and social assistance workers.Industry and occupational incidence rates were calculated using workers compensation and employment security data from Washington State.Violence-related claims rates among certain Healthcare and Social Assistance industries remained particularly high. Incidents where workers were injured by clients or patients predominated. By contrast, claims rates in retail trade have fallen substantially.Progress to reduce violence has been made in most of the highest hazard industries within the Healthcare and Social Assistance sector with the notable exception of psychiatric hospitals and facilities caring for the developmentally disabled. State legislation requiring healthcare workplaces to address hazards for workplace violence has had mixed results. Insufficient staffing, inadequate violence prevention training and sporadic management attention are seen as the key barriers to violence prevention in healthcare/social assistance workplaces.

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