Upper Limb Musculosketal Disorders: Quantifying Risk

产品说明：这项多中心前瞻性队列研究将：（i）确定3年期间特定远端上肢疾病和症状的基线患病率和随后的发病率，用于3个级别的工作身体暴露（低，中，高），（ii）量化工作和个人风险因素（例如，力、姿势、重复等），(iii)验证现有的工作分析方法（特别是美国政府卫生学家会议（ACGIH）的手活动阈值（TLV）（HAL），应变指数（SI）和华盛顿州检查表），（iv）开发一个最终的模型来确定MSD风险。 来自两个不同州的5个非常不同的行业的600名工人（研究辍学者被替换）将参加这项研究，以帮助确保研究结果的普遍性。 为了最大限度地提高客观性和准确性，工作物理暴露将主要依靠测量来量化暴露。 为了最大限度地提高临床和流行病学的有效性和可靠性，所有参与者都将接受认证手部治疗师和合格医生的健康结果评估。 这些措施将包括：基线调查表、结构化面谈和标准化体检。 将每月监测工作物理暴露的变化。 将每月使用症状问卷对所有患者进行特定疾病和症状评估，并对有症状的患者进行结构化访谈/体格检查。 在评估工人人群方面经验丰富的资深医生将为有CTS样症状的工人提供电诊断测试（在基线时，如果出现新症状，则在每月随访期间）。 在整个现场观察阶段，工作身体暴露和健康结果评估小组将彼此保持盲态。 将利用多变量逻辑回归（MLR）模型和生存分析来探讨工作身体危险因素与特定疾病、聚集性疾病和症状之间的关系。 除了量化人体工程学风险因素，各种工作，心理和个人风险因素之间的相互作用将被探讨。 该项目预计将导致改善现有的人体工程学工作评估模型的能力，这些模型对广泛的行业具有强大的预测能力。

DESCRIPTION: This multi-center prospective cohort study will: (i) Determine baseline prevalence rates and subsequent incidence rates over a 3 year period for specific distal upper extremity disorders and symptoms for 3 levels of job physical exposures (low, medium, high), (ii) Quantify job and individual risk factors (e.g., force, posture, repetition, etc.), (iii) Validate existing job analysis methods (especially American Conference of Governmental Hygienists (ACGIH) Threshold Limit Value (TLV) for Hand Activity (HAL), Strain Index (SI) and Washington State Checklist), and (iv) develop a final model for determining MSD risks. A cohort of 600 workers (study drop-outs replaced) from 5 very different industries with a total worker population of over 10,000 in two diverse states will participate in the study to help ensure generalizability of the study results. To maximize objectivity and accuracy, job physical exposures will rely primarily on measurements to quantify exposures. To maximize clinical and epidemiological validity and reliability, all participants will have health outcomes assessments by Certified Hand Therapists and qualified physicians. These will include: baseline questionnaires, structured interviews and standardized physical examinations. Changes in job physical exposures will be monitored monthly. Specific disorders and symptoms will be assessed monthly using a symptom questionnaire on all, and structured interviews/physical examinations on those with symptoms. Senior physicians experienced in evaluating worker populations will provide electrodiagnostic testing (at baseline, and during monthly follow-up if new symptoms develop) to those workers with CTS-like symptoms. Job physical exposure and health outcomes assessment teams will be blinded to each other throughout the field observation phase. Multivariate logistic regression (MLR) models and survival analyses will be utilized to explore relationships between job physical risk factors and specific disorders, aggregate disorders and symptoms. In addition to quantifying ergonomic risk factors, interactions between various job, psychosocial and individual risk factors will be explored. This project is expected to result in the ability to improve the existing ergonomic job evaluation models that have robust predictive capabilities for a broad range of industries.