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Work-related musculoskeletal disorders of the neck, back, and upper extremity in Washington State, 1997-2005.

Silverstein B; Adams D
Olympia, WA: Washington State Department of Labor and Industries, 40-11-2007, 2007 Dec; :1-98
INTRODUCTION: Someone once said that "every statistic is a dried tear." That sounds pretty dramatic but with every work-related musculoskeletal disorder claim statistic is a worker in pain. Take for example, HN, a 54-year-old terminal worker who developed sciatica during her six years on the dock. She missed 370 days of work over the 18 months of medical treatment costing $29,780. Incurred cost of her claim was $54,400. She eventually returned to work with her employer of injury. This study uses workers' compensation claims data from Washington State to examine the frequency, incidence, cost, and industry distribution of new neck, back and upper extremity (hand/wrist, elbow, and shoulder) disorders, and respectively sciatica, carpal tunnel syndrome (CTS), hand/wrist tendonitis, epicondylitis and rotator cuff syndrome (RCS) as examples of more specific diagnoses within these body region categories. Sciatic pain is manifested as radiating low back pain that goes below the knee. This very sensitive (95%) indicator of lumbar disc herniation (Deyo, 1992) has been associated with manually handling heavy loads. Carpal tunnel syndrome (CTS) is the compression of the median nerve at the wrist, due to ischemia or inflammation. CTS is characterized by numbness, tingling, or pain in the median nerve distribution of the hand (first 3 ½ fingers), frequently worse symptoms at night. Work-related CTS has been associated with high repetition, force, awkward wrist postures and segmental vibration (Bernard, 1997; Viikari-Juntura and Silverstein, 1999). A recent study by Ettema (2006) suggested that shear forces related to rapid or forceful finger motions cause tendon scarring in the carpal tunnel. Melchior (2006) reported increased risk with wrist flexion of more than two hours per day in women. Epicondylitis is an inflammation of the tendon at the elbow (lateral epicondylitis or tennis elbow is most common). Epicondylitis is characterized by pain during resisted maneuvers that load the tendons and by tenderness on tendon palpation. Repetitive forceful postures such as twisting or pronation of the forearm combined with extension of the wrist while gripping have been associated with epicondylitis. Rotator cuff syndrome involves inflammation, degeneration and tear of the tendons around the shoulder (with the supraspinatus tendon most frequently involved). Pain with certain motions is common, particularly against resistance. Tearing usually results in weakness. Work-related shoulder disorders have generally been attributed to high static or repetitive loads on the shoulder girdle, particularly in combination with abduction, rotation or flexion (Bernard, 1997; Melchior et al, 2006). Each of these specific conditions has also been associated with an acute traumatic onset (e.g., falls). The objectives in this study were to estimate the overall and yearly trends in claim incidence rates, lost workdays and costs over the period 1997-2005, for general and specific work-related musculoskeletal disorders. We also wanted to identify industries where there are the highest rates and numbers of claims to focus prevention efforts.
Injuries; Injury-prevention; Musculoskeletal-system-disorders; Back-injuries; Neck-injuries; Extremities; Information-retrieval-systems; Information-processing; Surveillance-programs; Statistical-analysis; Health-hazards; Health-care; Industrial-environment; Occupations; Work-environment; Worker-health; Carpal-tunnel-syndrome; Hand-injuries; Arm-injuries; Body-regions; Lost-work-days; Disabled-workers; Muscle-physiology; Immune-reaction; Neuromotor-function; Neuromuscular-function; Repetitive-work; Manual-lifting; Manual-materials-handling; Pain-tolerance; Cumulative-trauma; Posture; Vibration-effects; Vibration-exposure; Force
Barbara Silverstein, PhD, MPH, Safety and Health Assessment and Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, PO Box 44330, Olympia, WA 98504-4330
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Funding Type
Cooperative Agreement
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Identifying No.
Priority Area
Agriculture, Forestry and Fishing
Source Name
Work-related Musculoskeletal Disorders of the Neck, Back, and Upper Extremity in Washington State, 1997-2005
Performing Organization
Washington State Department of Labor and Industries
Page last reviewed: September 24, 2021
Content source: National Institute for Occupational Safety and Health Education and Information Division