A 1996 Connecticut population based, randomized telephone interview survey of self reported, chronic work related musculoskeletal disorders (WRMSD) of the neck and upper extremities was performed to replicate and extend the 1988 National Health Interview Survey Occupational Health Supplement (NHIS-OHS). Nested in this survey were discrete case control studies to examine special areas of interest. Self reported WRMSD were widely prevalent in the Connecticut working population, and far exceed injury claims entered into the state's workers' compensation system. WRMSD appear to receive medical treatment largely within the private sector, rather than under workers' compensation insurance. Elevated WRMSD risks are seen in female gender, among Financial Services/Insurance Industry workers, and manual laborers. The population based estimated etiologic fraction of all chronic, subacute onset WRMSD attributed solely to work was 32% by medical providers. Seriousness of the WRMSD injury is an important factor influencing filing of workers' compensation injury claims. Industry sectors associated with increased injury reporting were Manufacturing, Transportation, and General Trades; with decreased reporting in the Agriculture, Construction and Mining and the Financial, Insurance and Real Estate Sectors. Demographically, workers with greater educational and personal economic resources and family support, reported injuries less often. Familiarity with the workers' compensation system did not prove a significant factor in multivariate analyses. Working in more tightly controlled settings where perceived management interest in workers is low was associated with higher injury reporting. In terms of individual social and economic impact, WRMSD cases had an average of $489 in annual out-of pocket expenses. Only 57.3% of RSI injuries sought medical treatment. WRMSD cases were treated mostly in the private sector, and only 21 % of individuals who had medical visits or procedures reported having them paid by workers' compensation insurance. WRMSD cases reported high levels of impairment in Activities of Daily Living scales, were significantly more likely to have had to change residence for financial reasons, to have lost a car due to finances, to have been divorced, and less likely to have been promoted. Medical care was provided primarily by personal physicians with surgeons, Orthopedists and medical specialists seeing lesser numbers of RSI patients. RSI injury treatment outcomes were examined by type of health insurance plan. A general finding was a lack of significant difference in outcomes between managed care and private insurance plan care. RSI cases were more likely that controls to have worksite ergonomic evaluations and intervention, however, RSI injuries triggered ergonomic interventions in only about 25% of instances. Job safety evaluations, workstation layout and equipment changes, worker training programs and health and safety committee evaluations were utilized in preference to administrative changes in work schedules as preferred ergonomic intervention strategies.
The Ergonomics Technology Center, Division of Occupational and Environmental Health, University of Connecticut Health Center, Farmington, CT 06030-6210
Ergonomics Technology Center, University Connecticut Health Center, Farmington, Connecticut