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Systematic review of the role of occupational health and safety interventions in the prevention of upper extremity musculoskeletal symptoms, signs, disorders, injuries, claims and lost time.

Authors
Kennedy-CA; Amick-BC III; Dennerlein-JT; Brewer-S; Catli-S; Williams-R; Serra-C; Gerr-F; Irvin-E; Mahood-Q; Franzblau-A; Van Eerd-D; Evanoff-B; Rempel-D
Source
J Occup Rehabil 2010 Jun; 20(2):127-162
NIOSHTIC No.
20037703
Abstract
BACKGROUND: Little is known about the most effective occupational health and safety (OHS) interventions to reduce upper extremity musculoskeletal disorders (MSDs) and injuries. METHODS: A systematic review used a best evidence synthesis approach to address the question: "do occupational health and safety interventions have an effect on upper extremity musculoskeletal symptoms, signs, disorders, injuries, claims and lost time?" RESULTS: The search identified 36 studies of sufficient methodological quality to be included in data extraction and evidence synthesis. Overall, a mixed level of evidence was found for OHS interventions. Levels of evidence for interventions associated with positive effects were: Moderate evidence for arm supports; and Limited evidence for ergonomics training plus workstation adjustments, new chair and rest breaks. Levels of evidence for interventions associated with "no effect" were: Strong evidence for workstation adjustment alone; Moderate evidence for biofeedback training and job stress management training; and Limited evidence for cognitive behavioral training. No interventions were associated with "negative effects". CONCLUSION: It is difficult to make strong evidenced-based recommendations about what practitioners should do to prevent or manage upper extremity MSDs. There is a paucity of high quality OHS interventions evaluating upper extremity MSDs and none focused on traumatic injury outcomes or workplace mandated pre-placement screening exams. We recommend that worksites not engage in OHS activities that include only workstation adjustments. However, when combined with ergonomics training, there is limited evidence that workstation adjustments are beneficial. A practice to consider is using arm supports to reduce upper extremity MSDs
Keywords
Musculoskeletal-system-disorders; Injury-prevention; Control-methods; Occupational-health; Extremities; Injuries; Ergonomics; Human-factors-engineering; Medical-research; Workplace-studies; Office-equipment; Medical-equipment; Job-stress; Biomechanics; Training; Author Keywords: Upper extremity musculoskeletal disorders; Occupational health and safety interventions; Systematic review
Contact
C. A. Kennedy, The Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, Ontario, M5G 2E9, Canada
CODEN
JOCTEW
Publication Date
20100601
Document Type
Journal Article
Email Address
ckennedy@iwh.on.ca
Funding Type
Grant
Fiscal Year
2010
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-T42-OH-008421
Issue of Publication
2
ISSN
1053-0487
Source Name
Journal of Occupational Rehabilitation
State
TX; MA; FL; IA; MI; MO; CA
Performing Organization
University of Texas, Health Science Center, Houston, Texas
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