Possible associations were sought between cumulative trauma disorders and jobs which require highly repetitive or highly forceful hand and wrist motions, irrespective of other factors. Efforts were made to develop field instruments to identify occupationally related upper extremity cumulative trauma disorders (CTDs) in active workers; to estimate the prevalence of upper extremity CTDs among workers in jobs needing force and repetitiveness; to estimate individual and multiplicative contributions of occupational and nonoccupational factors which may be associated with these disorders; and to test the null hypothesis of no association between the prevalence of CTDs among workers with different force and repetitive work requirements. The overall prevalence of upper extremity CTDs estimated in this study was high, 31 percent on interview and 18 percent on physical examination and interview. The prevalence of hand wrist disorders was 20 percent on interview and 10 percent on physical exam and interview. Hand wrist CTD prevalence was not uniform across all exposure categories. Hand wrist CTDs were strongly associated with high force/high repetitive work and to a lesser extent with high repetitiveness or high force alone. According to the authors, irrespective of the type of industry or product, jobs with similar force and repetitiveness attributes would have similar risks for CTD. The findings suggest that primary prevention can be accomplished through job modification and reductions in force, and repetitive and postural stresses.
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