Is it the peak that matters or is it the cumulative exposure?
Wells R; Sjøgaard G
Arbete och Halsa 2001 Jun; 2001(10):481-483
Introduction: Musculoskeletal disorders (MSDs), including low back pain, carpal tunnel syndrome, tenosynovitis and certain myalgias are considered to have strong work-related components. Many measures of "ergonomic exposure" in the workplace have been used in determining their work-relatedness. There are many possible injury mechanisms that could be responsible for the development of these disorders at work. Some are clearly due to a high peak load, rupture of the interspinous ligament (due perhaps to a fall) or end plate failure in a lumbar motion unit while some are the result of longer term processes such as the development of myalgia in the trapezius. Inspection of some recent reviews shows that exposure measures used in epidemiological studies of musculoskeletal disorders fall into groups such as force, posture, repetition, static load, and vibration (1, 2). It should be noted that this discussion of the importance of peak and average exposures is also present in environmental and occupational health sciences where the most common metric of exposure is the Time-Weighted Average (TWA). This paper addresses the findings from physiological and epidemiological sources as to the importance of peak and cumulative exposure on the development of musculoskeletal disorders and makes some suggestions on exposures to include in the study of MSDs.
Ergonomics; Epidemiology; Exposure-assessment; Employee-exposure; Musculoskeletal-system; Musculoskeletal-system-disorders; Back-injuries; Cumulative-trauma; Cumulative-trauma-disorders; Carpal-tunnel-syndrome; Injuries; Force; Posture; Repetitive-work; Vibration; Time-weighted-average-exposure; Physiological-factors; Kinesiology
Richard Wells, Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Canada
Hagsberg M; Knave B; Lillienberg L; Westberg H
Arbete och Halsa (X2001 - exposure assessment in epidemiology and practice, June 10-13, 2001, Göteborg, Sweden)
The Institute for Work and Health, Toronto, Ontario, Canada