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A conceptual model for work-related neck and upper-limb musculoskeletal disorders.

Authors
Armstrong-TJ; Buckle-P; Fine-LJ; Hagberg-M; Jonsson-B; Kilbom-A; Kuorinka-IA; Silverstein-BA; Sjogaard-G; Viikari-Juntura-ER
Source
Scand J Work, Environ & Health 1993 Apr; 19(2):73-84
NIOSHTIC No.
00215398
Abstract
A conceptual model was developed for work related musculoskeletal disorders (MSD) of the neck region and upper limbs. The model was developed to highlight the multifactorial nature of these problems, and to be used as a research tool. Twenty two epidemiological studies were used to support the work relatedness of these problems. Various characteristics of the work environment that led to these disorders were taken into account. The development of fatigue due to muscle energy deficiencies, and mechanical as well as physiological responses were addressed. Local changes conveyed to the central nervous system by sensory afferent nerves produced perceived fatigue. Repeated fatigue resulted in muscle disorders. The underlying metabolic events such as the accumulation of calcium ions was discussed. The special role of motor control of the working muscle and the recruitment patterns of motoneurons were addressed. The ultimate reporting of fatigue and pain depended on their effect on work capacity relative to work demands as well as socioeconomic factors. Tendon disorders were related to contact and shearing forces from adjacent anatomic surfaces, as well as tensile forces from muscle contractions. Common tendinitis sites were the wrist, forearm, elbow, and shoulder. Degenerative processes were detailed. How exertion of the body led to tendon responses was summarized. The pathogenesis of nerve disorders was discussed and included median nerve compression, the effect of pressure in vibration, and materials handling, and dose responses. The authors consider the proposed model to be useful in the design of studies on the etiology and pathomechanisms of work related MSD, as well as in the planning and evaluation of preventive programs.
Keywords
NIOSH-Author; Cumulative-trauma-disorders; Ergonomics; Epidemiology; Dose-response; Injury-prevention; Mathematical-models; Muscle-stress; Musculoskeletal-system-disorders; Neuropathy
CODEN
SWEHDO
Publication Date
19930401
Document Type
Journal Article
Fiscal Year
1993
NTIS Accession No.
NTIS Price
Issue of Publication
2
ISSN
0355-3140
NIOSH Division
DSHEFS
Priority Area
Musculoskeletal-system-disorders
Source Name
Scandinavian Journal of Work, Environment and Health
State
MI; OH; WA
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