Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-4 (of 4 Records) |
Query Trace: Crombie K[original query] |
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Work-Related Risk Factors for Rotator Cuff Syndrome in a Prospective Study of Manufacturing and Healthcare Workers
Meyers AR , Wurzelbacher SJ , Krieg EF , Ramsey JG , Crombie K , Christianson AL , Luo L , Burt S . Hum Factors 2021 187208211022122 OBJECTIVE: This prospective study assessed the risk of developing rotator cuff syndrome (RCS) with separate or specific combinations of biomechanical exposures measures, controlling for individual confounders. BACKGROUND: Compared with other musculoskeletal disorders, rates of work-related shoulder musculoskeletal disorders have been declining more slowly. METHOD: We conducted up to 2 years of individual, annual assessments of covariates, exposures, and health outcomes for 393 U.S. manufacturing and healthcare workers without RCS at baseline. Task-level biomechanical exposures assessed exposure to forceful exertions (level, exertion rates, duty cycles), vibration, and upper arm postures (flexion, abduction). Hazard ratios (HRs) were calculated with Cox proportional hazard models. RESULTS: We observed 39 incident RCS cases in 694 person-years (incidence rate = 5.62 per 100 person-years). Adjusting for confounders, we found increased risk of incident RCS associated with forceful hand exertions per minute for three upper arm posture tertiles: flexion ≥45° (≥28.2% time, HR = 1.11, CI [1.01, 1.22]), abduction ≥30° (11.9-21.2%-time, HR = 1.18, CI [1.04, 1.34]), and abduction >60° (≥4.8% time, HR = 1.16, CI [1.04, 1.29]). We failed to observe statistically significant effects for other interactions or any separate measures of biomechanical exposure. CONCLUSION: This study highlights the importance of assessing combinations of exposure to forceful repetition and upper arm elevation when developing interventions for preventing RCS. APPLICATION: Based on these results, interventions that reduce exposure to forceful repetition (i.e., lower force levels and/or slower exertion rates) may reduce the risk of RCS, especially when upper arm elevation cannot be avoided. |
A prospective study of carpal tunnel syndrome: workplace and individual risk factors
Burt S , Deddens JA , Crombie K , Jin Y , Wurzelbacher S , Ramsey J . Occup Environ Med 2013 70 (8) 568-74 OBJECTIVES: To quantify the risk for carpal tunnel syndrome (CTS) from workplace physical factors, particularly hand activity level and forceful exertion, while taking into account individual factors including age, gender, body mass index (BMI), and pre-existing medical conditions. METHODS: Three healthcare and manufacturing workplaces were selected for inclusion on the basis of range of exposure to hand activity level and forceful exertion represented by their jobs. Each study participant's job tasks were observed and evaluated onsite and videotaped for further analysis, including frequency and duration of exertion and postural deviation. Individual health assessment entailed electrodiagnostic testing of median and ulnar nerves, physical examination and questionnaires at baseline with annual follow-up for 2 years. RESULTS: The incidence of dominant hand CTS during the study was 5.11 per 100 person-years (29 cases). Adjusted HRs for dominant hand CTS were as follows: working with forceful exertion ≥20% but <60% of the time: 2.83 (1.18, 6.79) and ≥60% of the time vs <20%: 19.57 (5.96, 64.24), BMI ≥30 kg/m2 (obesity): 3.19 (1.28, 7.98). The American Conference for Governmental Industrial Hygienists (ACGIH) Threshold Limit Value (TLV) for hand activity level also predicted CTS, HR=1.40 (1.11, 1.78) for each unit increase in the TLV ratio, controlling for obesity and job strain. CONCLUSIONS: Workplace and individual risk factors both contribute to the risk for CTS. Time spent in forceful exertion can be a greater risk for CTS than obesity if the job exposure is high. Preventive workplace efforts should target forceful exertions. |
Workplace and individual risk factors for carpal tunnel syndrome
Burt S , Crombie K , Jin Y , Wurzelbacher S , Ramsey J , Deddens J . Occup Environ Med 2011 68 (12) 928-33 OBJECTIVES: To quantify the relationship between workplace physical factors, particularly hand activity level (HAL) and forceful exertion and carpal tunnel syndrome (CTS), while taking into account individual factors. To compare quantitative exposure assessment measures with more practical ratings-based measures. METHODS: In a group of healthcare and manufacturing workers, each study participant's job tasks were evaluated for HAL, forceful exertion and other physical stressors and videotaped for further analysis, including frequency and duration of exertion and postural deviation. Electrodiagnostic testing of median and ulnar nerves and questionnaires were administered to all participants. A CTS case required median mononeuropathy and symptoms on hand diagrams in fingers 1-3. Multiple logistic regression models were used to analyse associations between job and individual factors and CTS. RESULTS: Of 477 workers studied, 57 (11.9%) were dominant hand CTS cases. Peak force ≥70% maximum voluntary contraction versus <20% maximum voluntary contraction resulted in an OR of 2.74 (1.32-5.68) for CTS. Among those with a body mass index ≥30, the OR for ≥15 exertions per minute was 3.35 (1.14-9.87). Peak worker ratings of perceived exertion increased the odds for CTS by 1.14 (1.01-1.29) for each unit increase on the 10-point scale. The odds for CTS increased by 1.38 (1.05-1.81) for each unit increase on the HAL 10-point scale among men, but not women. Combined force and HAL values above the ACGIH TLV for HAL resulted in an OR of 2.96 (1.51-5.80) for CTS. DISCUSSION/CONCLUSIONS: Quantitative and ratings-based job exposure measures were each associated with CTS. Obesity increased the association between frequency of exertion and CTS. |
A comparison of assessment methods of hand activity and force for use in calculating the ACGIH(R) hand activity level (HAL) TLV(R)
Wurzelbacher S , Burt S , Crombie K , Ramsey J , Luo L , Allee S , Jin Y . J Occup Environ Hyg 2010 7 (7) 407-16 This article compares several methods that were used for determining hand activity level and force in a large prospective ergonomics study. The first goal of this analysis was to determine the degree of correlation between hand activity/ force ratings using different assessment methods. The second goal was to determine if the hand activity/force methods were functionally equivalent for the purpose of calculating the ACGIH(R) hand activity level (HAL) threshold limit value (TLV(R)). A final goal was to investigate reasons for potential differences between methods. More than 700 task analyses were conducted on 484 workers at three study locations. Hand activity was assessed by two methods, including a trained observer on site using a 10-point visual analog scale for hand activity level and by offsite video analysis of the same task to calculate the frequency of exertions and the work/recovery ratio. Hand force was assessed by two on-site methods: ratings of perceived exertion (RPE) using a modified Borg CR-10 scale by a trained observer and RPE by the worker performing the task. The two methods for assessing hand activity level were correlated (Spearman rank = 0.49) and produced main TLV result categories (below Action Limit, Action Limit, TLV) with percent of exact agreement ranging from 71 to 91% and weighted Kappa ranging from 0.61 to 0.75. The two RPE methods for assessing hand force were correlated (Spearman rank ranging from 0.47 to 0.69) and produced TLVs with percent of exact agreement ranging from 64 to 83% and weighted Kappa ranging from 0.52 to 0.62. Differences between methods may be explained by a number of task and subject variables that were significantly associated with higher levels of hand activity and force. In summary, this study found substantial agreement between two methods for assessing hand activity level and moderate agreement between two methods for assessing hand force. |
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