Work-Related Musculoskeletal Disorders: A Review of the EvidenceIn May 1998 the National Institutes of Health asked the National Academy of Sciences/National Research Council to assemble a group of experts to examine the scientific literature relevant to work-related musculoskeletal disorders of the lower back, neck, and upper extremities. A steering committee was convened to design a workshop, to identify leading researchers on the topic to participate, and to prepare a report based on the workshop discussions and their own expertise. In addition, the steering committee was asked to address, to the extent possible, a set of seven questions posed by Congressman Robert Livingston on the topic of work-related musculoskeletal disorders. The steering committee includes experts in orthopedic surgery, occupational medicine, epidemiology, ergonomics, human factors, statistics, and risk analysis. This document is based on the evidence presented and discussed at the two-day Workshop on Work-Related Musculoskeletal Injuries: Examining the Research Base, which was held on August 21 and 22, 1998, and on follow-up deliberations of the steering committee, reflecting its own expertise. |
Contents
| 1 | |
2 State of the Evidence | 6 |
3 Seven Questions Posed by Congressman Robert Livingston | 19 |
4 Conclusions | 23 |
References | 25 |
Examining The Research Base | 28 |
Examining the Research Base | 32 |
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actions activities areas assess associated biomechanical body causal cause Center claims clinical considered contribution criteria David Department discussion effect epidemiological Ergonomics evidence examine example exertion exposure external factors Figure force framework Health Human identified important incidence individual Industrial influence Institute internal loads intervention Invited involve Labor levels limits literature loads Massachusetts measured mechanical Medical Medicine methods Michigan models muscle musculoskeletal disorders nerve observed Occupational Occupational Safety occur organizational pain Paper prepared Participants Performance physical plausible population possible presented problem procedures produce psychological Public Question range reduced relationships relative Research Base responses risk Robert Safety and Health School scientific shows social specific Steering Committee Steven stress stressors studies symptoms task tendon tissue topic University variables variety Washington Work-Related Musculoskeletal Injuries workers workplace Workshop on Work-Related
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Page 20 - What is the state of scientific knowledge, characterized by the degree of certainty or lack thereof, with regard to occupational and non-occupational activities causing such conditions? 4. What is the relative contribution of any causal factors identified in the literature to the development of such conditions in (a) the general population; (b) specific industries; and (c) specific occupational groups? 5. What is the incidence of such conditions in (a) the general population; (b) specific industries;...
Page 16 - ... al., 1998; Lahad et al., 1994) have not examined all of the studies (experiments and quasi-experiments) that have appeared in the literature to date. As such, it is not possible to characterize the quality of the evidence for the full collection of studies. However, there are a number of high-quality studies that can be used to determine whether interventions can reduce the risk of musculoskeletal disorders. The literature provides evidence that interventions, of various types and complexity,...
Page 20 - What are the conditions affecting humans that are considered to be work-related musculoskeletal disorders? 2. What is the status of medical science with respect to the diagnosis and classification of such conditions? 3. What is the state of scientific knowledge, characterized by the degree of certainty or lack thereof, with regard to occupational and non-occupational activities causing such conditions? 4. What is the relative contribution of any causal factors identified in the literature to the...
Page 21 - These case studies were reported in 6. Does the literature reveal any specific guidance to prevent the development of such conditions In (a) the general population; (b) specific industries; and (c) specific occupational groups? 7. What scientific questions remain unanswered, and may require further research, to determine which occupational activities in which specific industries cause or contribute to work-related musculoskeletal disorders?
Page 10 - It can also be shown that the frequency and duration of exertions are related to work standards and quotas. Production rates are based on estimates of the time required to perform a given task.
Page 11 - These studies, although numerous, have used diverse methods for measuring both exposure to mechanical factors and the health outcomes of interest. As results have not converged in every regard, some individuals have discounted some or all of the collective evidence. In an effort to clarify this situation, the National Institute of Occupational Safety and Health (NIOSH) undertook a review of the epidemiological literature (Bernard, 1997), with the intent of examining critically the strengths and weaknesses...
Page v - Research, University of Massachusetts Medical School; Frederick Mosteller, Department of Statistics (emeritus), Harvard University; Dorothy P. Rice, School of Nursing (emeritus), University of California, San Francisco; Stover H. Snook, Harvard School of Public Health; and Laura W. Welch, Department of Occupational and Environmental Medicine, Washington Hospital Center, Washington, DC Although the individuals listed above have provided many constructive comments and suggestions, responsibility for...
Page 26 - Marras, WS and Granata, KP (1997). The development of an EMG-assisted model to assess spine loading during whole-body free-dynamic lifting. International Journal of Electromyography and Kinesiology, 7, 259-268.
Page 16 - The available reviews of the literature (Smith et al., 1998; Lahad et al., 1994) have not examined all of the studies (experiments and quasi-experiments) that have appeared in the literature to date. As such, it is not possible to characterize the quality of the evidence for the full collection of studies. However, there are a number of high-quality studies that can be used to determine whether interventions can reduce the risk of musculoskeletal disorders. The literature provides evidence that interventions,...