Occupational ergonomics: theory and applications, second edition. Bhattacharya A, McGlothlin JD, eds. Boca Raton, FL: CRC Press, 2012 Mar; :845-885
Upper extremity cumulative trauma disorders (CTDs) are regional musculoskeletal impairments that are associated with repetitive mechanical trauma occurring in the workplace. CTDs of the upper extremities encompass a multitude of physical symptoms, pathology, and disability related to muscle tissue, ligaments, tendons, tendon sheaths, joints, and nerves. In various literature, CTDs have also been referred to as repeated trauma illness, repetitive motion injury, regional pain syndrome, repetitive strain injury (Australia), and occupational cervicobrachial disorder (Japan, Germany, and Scandinavia). They were once named according to the occupation or body part affected, for example, trigger finger, bricklayer's shoulder, pricer's palsy, mouse elbow, writer's cramp, stitcher's wrist, and carpenter's elbow. These terms were descriptive but tended to minimize, even romanticize, the afflictions suffered by workers because of their jobs. The medical terms that are now more commonly used to describe CTDs (even among non-physicians) tend to add legitimacy to the symptoms that workers experience, and have likely increased workers' awareness regarding the work relatedness of overuse disorders. Some authors have advised against the use of inconsistent and imprecise terminology such as cumulative trauma, repetitive strain injury, and overuse syndrome in referring to musculoskeletal disorders (MSDs) of occupational origin. As such, the term work-related musculoskeletal disorders (WMSDs) may be more currently favored in the occupational health community; however, the term "cumulative trauma disorders" has been used interchangeably in this chapter. CTD is consistent with the terminology originally used in the first edition of this chapter, and the term distinguishes these conditions as a result of chronic overuse injury to the affected soft tissues. This contrasts with acute traumatic injuries, following the near instantaneous transfer of high energy, resulting in sprains, broken bones, cuts, lacerations, or amputations-which can also be viewed as "disorders" of the musculoskeletal system. This chapter will address upper extremity CTDs (UECTDs) from an occupational ergonomics perspective, with emphasis on the approaches to identifying risk factors and characterizing a worker's exposure to them. The chapter will emphasize more recent work including job analysis and exposure assessment methods developed since the first edition of this text. The chapter will provide an update on MSD prevention programs (relevant to UECTDs) at Occupational Safety and Health Administration (OSHA) and NIOSH (National Institute for Occupational Safety and Health), the U.S. federal agencies charged with protecting worker safety and health.